Medical update 1

Medical update 1

Opening the Window of Time in Stroke Therapy: New Evidence for the Emergency Department CMEßsee pdf

Finding Perspective: Influenza in the Shadow of Ebola CME/CE

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 ‘Chinese Elephant Man’ undergoes fourth surgery to remove the world’s largest facial tumourßsee

New Perspectives on Secondary Prevention of Atherothrombotic Events: Addressing Unmet Needs CME ßsee ppt From Medscape Education Cardiology

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PCI Master Class: Painting the Picture of Complex PCI: Opportunities & Challenges CMEßsee

power point   From Medscape Education Cardiology

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The Role of the Weekly GLP-1 Receptor Agonists in Treating T2DM: Breaking News CMEßsee  PowerPoint

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Hypoglycemia in Type 2 Diabetes CME From Medscape Education   PowerPoint

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Ebola  What US Clinicians Need to Know   page1  2  3

Metformin-Associated Lactic Acidosis Presenting as an Ischemic Gut in a Patient Who Then Survived a Cardiac Arrest

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သြားထဲမွာ ပါတဲ့ lead ပါ၀င္ မွ ုကို ၾကည့္ျပီး ဒီလူ ဘယ္မွာေနလဲ ဆို တာ အနည္းဆံုးေတာ စံုစမ္း လိုရတယ္တဲ့

ဒါေၾကာင့္အမွူ လိုက္ လို မရေအာင္မွ ု ခင္း ျဖစ္ရင္ သြား ဆြဲနွုတ္ ခံရဖို ့ အလားအလာရွိတယ္.........

အေၾကာင္း အရင္ း သိၿခင္ရင္ ကိုယ္ ဘာသာအေသးစိတ္ ဖတ္ရွုရန္

Lead in teeth can tell a body's tale, study finds

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ဆူညံသံမ်ားတဲ့ ရက္ ကြက္မွာ ေနရင္ နာထိုင္းမယ္ တဲ့

ဆူညံသံမွ ျဖစ္ေပၚလာေသာ အသံ db မ်ားက နား ထဲမွာရွိတဲ့ hair cell ေတြ ကို လံုး၀ဖ်က္ဆီးလိုက္လို ့ပါဘဲ

ဖ်က္ဆီး ျပီးသြားရင္ ျပန္မျဖစ္ေတာ့ဘူးတဲ့ ဒါကို noise-induced hearing loss လို ့ အမည္တပ္လိုက္ပါတယ္

အေၾကာင္း အရင္ း သိၿခင္ရင္ ကိုယ္ ဘာသာအေသးစိတ္ ဖတ္ရွုရန္

Effect of loud noises on brain revealed in study

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Monoamine oxidase A ဆို တဲ့ neurotransmitter ကို ေျပာင္း ေပးတဲ့ enzyme ကေလးေမြး ျပီးသြားရင္ မ်ားလာတဲ့အတြက္

စိတ္က်ၿခင္းကို ခံစားရတယ္

ေနာက္ျပီး ဒီ enzyme ကို တိုင္းတာရတာခက္တယ္ တဲ့   saliva or blood မွ ယူျပီး peripheral marker မွ တိုင္းယူမွရသတဲ့

ရတဲ့ အေျဖေပၚမူတည္ျပီး Monoamine oxidase A inhibitor ေပးရင္ ေကာင္းတယ္ တဲ့ဗ်ာ

အေၾကာင္း အရင္ း သိၿခင္ရင္ ကိုယ္ ဘာသာအေသးစိတ္ ဖတ္ရွုရန္

Monoamine oxidase A: Biomarker for postpartum depression

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အသက္ၾကီးလာရင္ stem cell ေတြ ေကာင္း ေကာင္း မပြားနိုင္ အလုပ္မလုပ္နိုင္ေတာ့လို့ immune က်လြယ္မယ္ တၿခားေရာပါေတြ ၀င္ လြယ္မယ္တဲ့   အေၾကာင္း အရင္ း သိၿခင္ရင္ ကိုယ္ ဘာသာအေသးစိတ္ ဖတ္ရွုရန္

Key to aging immune system: Discovery of DNA replication problem

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Mechanism promoting multiple DNA mutations described by scientists

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diverticulitis ျဖစ္ျပီးသူဟာ စိတ္ေရာ ကိုယ္ ပါ မက်န္းမာတာကို နွစ္ရွည္စြာ ခံစားေနရတယ္

 အသက္ၾကီးလာရင္ diverticulosis ဆို တာ ျဖစ္လာၾကတယ္

အသက္ 60 ေက်ာ္ over 50% ေလာက္က ဒါမ်ိဳးေတြ ျဖစ္ေနၾကဘဲ  ,,(အသက္ ၆၀ ေက်ာ္မ်ား သတိထားဖို ့)

diverticulosis ဆို တာ  colon ရဲ ့နံရံ မွာ အေပါက္ကေလးေတြ ျဖစ္တာ ပါ

ဒါကကိစၥမရွိဘူး ဒါေပမဲ့ ေပါက္သြားရင္ ေတာ့ diverticulitis လို့ ေခၚတယ္

အဲေတာ့ ဗိုက္ထဲကို အူလမ္းေၾကာင္းမွာရွိတဲ့ပိုး၀င္မယ္ ဗိုက္နာမယ္

ပိုးသတ္ေဆးေပးမယ္ သိပ္ဆိုးရင္ခြဲရမယ္

 diverticulitis ျဖစ္တဲ့လူဖ်ားနာျပီး IBS ျဖစ္ ဖို့ ၄ ဆ ရွိပါတယ္

ဒါကိုpost-diverticulitis irritable bowel syndrome လို ့ ေခၚပါတယ္

အေၾကာင္း အရင္ း သိၿခင္ရင္ ကိုယ္ ဘာသာအေသးစိတ္ ဖတ္ရွုရန္

Diverticulitis patients reveal psychological, physical symptoms long after acute attacks

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AF ကို ျဖစ္ေစေသာ short circuit ကို Catheter ablation ျဖတ္ေတာက္ ၿခင္ ျဖင့္ လူအမ်ားစု ရဲ့ အသက္ရွင္ဖို့ အခြင့္ အလမ္းမ်ားလာတယ္ တဲ့

အေၾကာင္း အရင္ း သိၿခင္ရင္ ကိုယ္ ဘာသာအေသးစိတ္ ဖတ္ရွုရန္

Ablation increases survival for adults with atrial fibrillation

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Clever Chemistry Improves New Class of Antibiotics

Fetal Exposure to Nicotine Increases Long-Term Risk of Obesity

Study Associates Pro-Inflammatory Molecules With Early Death in HIV Patients

Potential Treatment for Drug-Resistant H7N9 Influenza Virus

Preventing Cell Death from Infection: Scientists Demonstrate Powerful Method to Find New Therapies

New Drug Combo Cures Toughest Cases of Hepatitis C, Hints to Future Injection-Free Therapies

Minimally Invasive Surgery Rates Triple in U.S. for Pancreatic Disease

New Avenues for Influenza Control Suggested by Identification of an Enzyme That Plays a Crucial Role in Resistance to the Infection

Gold Nanoparticles Help to Develop a New Method for Tracking Viruses

Fish Derived Serum Omega-3 Fatty Acids Help Reduce Risk of Type 2 Diabetes

New Breast Cancer Stem Cell Findings Explain How Cancer Spreads

Scientists Show How Insulin-Producing Cells May Fail in Diabetes, Might Someday Be Restored

Breast Cancer Cells Disguise Themselves as Neurons to Cause Brain Tumors

New MRI Technique Illuminates Wrist in Motion

Solution Found to Problem Limiting Development of Human Stem Cell Therapies

Higher Vitamin D Levels in Pregnancy Could Help Babies Become Stronger

High Blood Pressure Potentially More Dangerous for Women Than Men

Turning Off 'Aging Genes'

New Technique Enables Patient With 'Word Blindness' to Read Again

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NSE and S-100B ေတြ အိပ္ေရးပ်က္တဲ့အခါ ေသြး ထဲမွာမ်ားလာတယ္

ဒါေတြဦးေနွာက္ပ်က္စီးတဲ့အခါ မ်ားေလ့မ်ားထရိွတဲ့အရာပါ

အဲေတာ့ အိပ္ေရးပ်က္တဲ့လူဟာ အိပ္ေရး၀သူမ်ားနွင့္ယွဥ္ လွ်င္ မွတ္ဥာဏ္သိပ္မေကာင္း ေမ့လြယ္တာေတြ ့ရွိလာနိုင္ပါတယ္

ဒါေၾကာင့္ အိပ္ေရး ၀ေအာင္ အိပ္ပါ လို့ ............

အေၾကာင္း အရင္ း သိၿခင္ရင္ ကိုယ္ ဘာသာအေသးစိတ္ ဖတ္ရွုရန္

Sleep to Protect Your Brain

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Vitamin E May Delay Decline in Mild-To-Moderate Alzheimer’s Disease

Building a Better Malaria Vaccine: Mixing the Right Cocktail

Advances in Nanotechnology's Fight Against Cancer

Scientists Discover How Immune Cells Die During HIV Infection; Identify Potential Drug to Block AIDS

How Cells Remodel After UV Radiation

New Role for Milk: Delivering Polyphenols With Anti-Cancer Activity

New Compound Could Reverse Loss of Muscle Mass in Cancer, Other Diseases

New Method to Detect Genetic Defects in Egg Cells Could Double Success Rate of IVF

Researchers Find Potential New Treatment Approach for Pancreatic Cancer

Essential Factor for Lyme Disease Transmission Identified

Two-Drug Combo Helps Adolescents With ADHD, Aggression

Malaria Drug Target Raises Hopes for New Treatments

Where Alzheimer's Starts and How It Spreads

Cancer-A stop sign for cancer

Cancer-A stop sign for cancer

A Stop Sign for Cancer

Dec. 13, 2013 — A particularly aggressive form of leukemia is the acute lymphoblastic leukemia (ALL). It is especially common among children and very difficult to treat. Researchers from the University of Veterinary Medicine, Vienna have now discovered completely new targets for the treatment of blood cancers. Studying the cancer protein STAT5, the scientists found new opportunities for the development of effective anti-cancer drugs. The research team published the scientific work, which could also become relevant for other types of cancer, in the Journal Leukemia.

Proteins in cells communicate like relay runners in a competition. The sticks that are transferred between the runners are the "signals." These signals are passed within the cell from one protein to another and ensure cell growth and survival. In cancer cells it is interesting approach to block this information cascade and thereby block the proliferation of cancer cells.

Essential for the signalling in cancer cells is the protein STAT5. It is known that STAT5 is overstimulated in many cancers. It forwards signals in an uncontrolled manner and is ultimately responsible for the excessive cell division of cancer cells. In mice that suffer from leukemia, it has already been shown, that the elimination of STAT5 makes the animals gain health again. Therefore, the importance of the protein in cancer is obvious. The researchers now want to apply this information on cancer therapy in humans.

Slowing down STAT5

The research team led by Veronika Sexl from the Institute of Pharmacology and Toxicology at the Vetmeduni Vienna took a closer look at STAT5. Using leukemia as a model disease, the team looked for therapeutically exploitable attack points on the protein and they actually identified such. The shutdown of two distinct signals of STAT5 led to a significantly later progression of leukemia in mice compared to animals that harbored the unmodified STAT5. One of these two therapeutically relevant sites is of particular importance: "The shutdown of the site Serin779 on STAT5 makes it impossible for STAT5 to fulfil its role as a relay runner and migrate into the nucleus. Thus, the effect of STAT5 is inhibited," says Hölbl-Kovacic, one of the lead authors of the pioneering publication.

Interrupting the relay race at several points

In a large-scale screening, the co-lead author Angelika Berger identified those relay runners that act before Serin779, the so-called PAK (p21 activated kinase). This means that PAK has control over STAT5 and activates it. By inhibiting PAK, STAT5 is turned off and disconnected from the relay race. The cancer researchers also found that PAK is still active, when cancer cells have already been treated with the current standard therapeutic agent Imatinib. This means that a potential new drug that acts on PAK could be well used in combination with Imatinib. Such a strategy would be of great importance in patients that no longer respond to Imatinib and are "therapy-resistant." PAK kinases thus represent a new therapeutic target, which is independent of previous treatment methods.

STAT5 has a role in many cancers

Angelika Berger explains: "So far, the PAK kinases have received relatively little attention in cancer therapy. However, they could be beneficial for a wide range of applications. All types of cancers, in which STAT5 plays a role, could be treated by this system in a new way. Those are the leukemias but also a number of other diseases such as breast cancer or prostate cancer."

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http://www.sciencedaily.com/releases/2013/12/131213093306.htm  

Diabetes-New Treatment for Skin-Corneal Wound Healing in Diabetic Patients

Diabetes-New Treatment for Skin-Corneal Wound Healing in Diabetic Patients

New Treatment for Skin, Corneal Wound Healing in Diabetic Patients

Dec. 12, 2013 — Diabetes Mellitus (DM), a metabolic disorder that affects nearly 170 million people worldwide, is characterized by chronic hyperglycemia that disrupts carbohydrate fat and protein metabolism resulting from defects in insulin secretion, insulin action or both. DM can cause long-term damage, dysfunction and even failure of various organs.

Patients with DM may develop corneal complications and delayed wound healing. This slow wound healing contributes to increased infections and the formation of bed sores and ulcers. Corneal complications include diabetic neuropathies and ocular complications that often lead to reduced vision or blindness.

A team of Wayne State University researchers recently developed several diabetic models to study impaired wound healing in diabetic corneas. Using a genome-wide cDNA array analysis, the group identified genes, their associated pathways and the networks affected by DM in corneal epithelial cells and their roles in wound closure. Their findings may bring scientists one step closer to developing new treatments that may slow down or thwart the impact on vision.

The team, led by Fu-Shin Yu, Ph.D., professor of ophthalmology and director of research at the Kresge Eye Institute, has discovered transforming growth factor β (TGFβ) signaling as a major pathway affected by hyperglycemia in DM corneal epithelial cells. In addition, Yu and his team identified for the first time that wound-induced upregulation of TGFβ3 is dampened by hyperglycemia and that by adding TGFβ3 to the wound, epithelial wound closure was accelerated.

This discovery, published online in the scientific journal, Diabetes, may provide new treatment options for diabetic wound healing in tissues such as the cornea and skin.

"Delayed wound healing are major complications of diabetes, often leading to severe end results such as diabetic ulcers, losing a limb or going blind," said Joan Dunbar, Ph.D., associate vice president for technology commercialization at Wayne State University. "Dr. Yu's discovery of the genome-wide transcriptional analysis has allowed the development of composition and methods to treat negative effects of diabetes, which may ultimately promote healing of wounds, reduce the negative effects of diabetic neuropathies, and promote the health of the eye and maintenance of eye sight in diabetics. The findings in the cornea have a strong implication in the skin as they both have neuropathy and delayed wound healing."

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http://www.sciencedaily.com/releases/2013/12/131212160143.htm

Diabetes Drugs Affect Hearts of Men, Women Differently

Diabetes Drugs Affect Hearts of Men, Women Differently

Diabetes Drugs Affect Hearts of Men, Women Differently

Dec. 12, 2013 — Widely used treatments for type 2 diabetes have different effects on the hearts of men and women, even as the drugs control blood sugar equally well in both sexes, according to researchers at Washington University School of Medicine in St. Louis.

In particular, the commonly prescribed diabetes drug metformin had positive effects on heart function in women but not in men, who experienced a shift in metabolism thought to increase the risk of heart failure.

"We saw dramatic sex differences in how the heart responds to the different therapies," said senior author Robert J. Gropler, MD, professor of radiology. "Our study suggests that we need to better define which therapies are optimal for women with diabetes and which ones are optimal for men."

The study appears in the December issue of the American Journal of Physiology -- Heart and Circulatory Physiology.

To the researchers' knowledge, this is the first study to investigate sex differences in the heart's response to diabetes treatments. In type 2 diabetes, the pancreas continues to make insulin, but the body can't use it effectively to move glucose out of the blood and into the tissues. And for reasons that are not entirely clear, patients with diabetes are at higher risk for heart failure.

"It is imperative that we gain understanding of diabetes medications and their impact on the heart in order to design optimal treatment regimens for patients," said Janet B. McGill, MD, professor of medicine and a study co-author who sees patients at Barnes-Jewish Hospital. "This study is a step in that direction."

The investigators evaluated commonly prescribed diabetes drugs in 78 patients, who were assigned to one of three groups. Under McGill's supervision, the first group received metformin alone; the second received metformin plus rosiglitazone (Avandia); and the third received metformin plus Lovaza, which is a kind of fish oil.

Metformin reduces glucose production by the liver and helps the body become more sensitive to insulin. Rosiglitazone also improves insulin sensitivity and is known to move free fatty acids out of the blood. Lovaza is prescribed to lower blood levels of triglycerides, another type of fat.

Importantly, Gropler noted that when they compared the three groups without separating men and women, no differences in heart metabolism were seen. But when the patients were separated by sex, the drugs had very different and sometimes opposite effects on heart metabolism, even as blood sugar remained well-controlled in all patients.

"The most dramatic difference between men and women is with metformin alone," said Gropler, who also sees patients at Barnes-Jewish Hospital. "Our data show it to have a favorable effect on cardiac metabolism in women and an unfavorable one in men."

The research suggests that these divergent responses in men and women may provide at least a partial explanation for the conflicting data surrounding some diabetes drugs. Specifically, the proportion of men and women participating in a clinical trial may play an unappreciated role in whether drugs are found to be safe and effective.

There is particular controversy surrounding rosiglitazone. In 2010, the U.S. Food and Drug Administration (FDA) restricted rosiglitazone's use because of questions about cardiovascular safety. Based on a recent review of data, the FDA reversed its 2010 decision last month, lifting the restrictions.

In the current study, metformin caused the heart metabolism of men to move in an undesirable direction -- burning less sugar and more fats. Chronic burning of fat by the heart, according to Gropler, leads to detrimental changes in the heart muscle, which can lead to heart failure.

"Instead of making heart metabolism more normal in men, metformin alone made it worse, looking even more like a diabetic heart," Gropler said. "But in women, metformin had the desired effect -- lowering fat metabolism and increasing glucose uptake by the heart."

Taking either rosiglitazone or Lovaza with metformin seemed to mitigate some of the negative heart effects of metformin alone in men. But women, already benefiting from metformin, improved heart metabolism further by adding rosiglitazone, with the desired effect of reducing the heart's dependence on fat metabolism. Adding Lovaza did not have a strong effect in either direction for men or women.

Gropler pointed out that he and his colleagues have shown in previous work that even healthy men and women show differences in how their hearts burn fuel. Healthy male hearts tend to burn more glucose, while in women, healthy hearts tend to burn more fats. This difference may help explain why women with diabetes tend to get more aggressive heart failure than men: Women already burn more fats.

"We now know there are sex differences at baseline, both in the metabolism of healthy hearts and in the hearts of patients with diabetes," Gropler said. "We are adding the message that these sex differences persist in how patients respond to drugs. For patients with diabetes, we are going to have to be more attentive to sex differences when we design therapies."

Further complicating matters, the researchers also noted that the differences they observed in heart metabolism can't be measured with conventional blood tests.

Unlike many heart studies that rely on blood sugar and cholesterol tests that anyone might get at a doctor visit, the Washington University researchers used positron emission tomography (PET) scans to image the heart and measure blood flow, oxygen consumption and fatty acid and glucose uptake by the heart, among other measures. They also took echocardiograms in conjunction with the PET scans and used stable isotopes to monitor whole-body metabolism and how this influences the heart.

Although the trial was relatively small in terms of the number of patients, it was unusually rigorous in the methods used to analyze heart metabolism, according to Gropler. He noted that only a handful of medical centers worldwide have the resources to perform such a study.

"If you use standard measurements, you're going to miss the sex differences we observed," Gropler said. "This may mean we have to do more complex imaging of the heart to better understand which therapies are best for which patients."

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http://www.sciencedaily.com/releases/2013/12/131212123321.htm