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Can Knee Cartilage Be Regrown?

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Stanford Magazine

 

STANFORD WILL SHINE ANOTHER SPOTLIGHT on the curative potential of stem-cell technology this year with an innovative approach to treating damaged cartilage and osteoarthritis. Already enthused by results from the lead-up work, Jason Dragoo, associate professor of orthopaedic surgery, is preparing to launch a human trial for restoring articular cartilage at the knee joint.

The trial, involving 40 patients, uses cells taken from the fat pad under the knee and concentrates them in the lab to produce therapeutically friendly progenitor cells—also called adipose-derived stem cells. For 20 of the patients, these cells will be used to surgically target distinctly identified defects in the articular cartilage, the movement-aiding tissue at the end of joints. This approach, says Dragoo, is like trying to fix holes in a tire, as opposed to methods for resurfacing “treadwear” all along the cartilage.

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ABSTRACT

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Importance  Women with early-stage breast cancers are expected to have excellent survival rates. It is important to identify factors that predict diagnosis of early-stage breast cancers.

Objective  To determine the proportion of breast cancers that were identified at an early stage (stage I) in different racial/ethnic groups and whether ethnic differences may be better explained by early detection or by intrinsic biological differences in tumor aggressiveness.

Design, Setting, and Participants  Observational study of women diagnosed with invasive breast cancer from 2004 to 2011 who were identified in the Surveillance, Epidemiology, and End Results (SEER) 18 registries database (N = 452 215). For each of 8 racial/ethnic groups, biological aggressiveness (triple-negative cancers, lymph node metastases, and distant metastases) of small-sized tumors of 2.0 cm or less was estimated. The odds ratio (OR) for being diagnosed at stage I compared with a later stage and the hazard ratio (HR) for death from stage I breast cancer by racial/ethnic group were determined. The date of final follow-up was December 31, 2011.

Main Outcomes and Measures  Breast cancer stage at diagnosis and 7-year breast cancer–specific survival, adjusted for age at diagnosis, income, and estrogen receptor status.

Results  Of 373 563 women with invasive breast cancer, 268 675 (71.9%) were non-Hispanic white; 34 928 (9.4%), Hispanic white; 38 751 (10.4%), black; 25 211 (6.7%), Asian; and 5998 (1.6%), other ethnicities. Mean follow-up time was 40.6 months (median, 38 months). Compared with non-Hispanic white women diagnosed with stage I breast cancer (50.8%), Japanese women (56.1%) were more likely to be diagnosed (OR, 1.23 [95% CI, 1.15-1.31], P < .001) and black women (37.0%) were less likely to be diagnosed (OR, 0.65 [95% CI, 0.64-0.67], P < .001). Actuarial risk of death from stage I breast cancer at 7 years was higher among black women (6.2%) than non-Hispanic white women (3.0%) (HR, 1.57 [95% CI, 1.40-1.75]; P < .001), and lower among South Asian women (1.7%) (HR, 0.48 [95% CI, 0.20-1.15]; P = .10). Black women were more likely to die of breast cancer with small-sized tumors (9.0%) than non-Hispanic white women (4.6%) (HR, 1.96 [95% CI, 1.82-2.12]; P < .001); the difference remained after adjustment for income and estrogen receptor status (HR, 1.56 [95% CI, 1.45-1.69]; P < .001).

Conclusions and Relevance  Among US women diagnosed with invasive breast cancer, the likelihood of diagnosis at an early stage, and survival after stage I diagnosis, varied by race and ethnicity. Much of the difference could be statistically accounted for by intrinsic biological differences such as lymph node metastasis, distant metastasis, and triple-negative behavior of tumors.

 

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  • Scientists say cooking the rice this way can cut the calories by up to 60%
  • The method increases the amount of resistant starch (RS) in the rice
  • RS is indigestible to the human body and so is not turned into sugar or fat
  • However, doctors have warned reheating rice can cause food poisoning 

Do you love rice but are worried about your weight?

The good news is scientists have now discovered a way to reduce the calorie content by 60 per cent – simply by the way it is cooked.

Cooking the rice with coconut oil, and then cooling it for 12 hours in the fridge, more than halved the number of calories in the rice when it was eaten.

However, doctors have previously warned that eating reheated rice can cause food poisoning, and so advise making sure the rice is steaming hot all the way through before eating it.

They also advise leaving the rice in the fridge no more than a day before reheating. 

Scientists have discovered that adding coconut oil to rice and cooling it in the fridge for 12 hours cuts the calorie content in half Read more: http://www.dailymail.co.uk/health/article-3009374/Want-rice-HALF-calories-Just-cook-coconut-oil-refrigerate-overnight-eating.html#ixzz3e6HgYt9c Follow us: @MailOnline on Twitter | DailyMail on Facebook

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Gut Bacteria Combined With Poor Diet May Promote Childhood Malnutrition

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JAMA

April 21, 2015, Vol 313, No. 15

M. J. Friedrich

A recent study reported that bacteria in the gastrointestinal (GI) tract of undernourished infants from Malawi promote development of kwashiorkor, shedding light on how gut microbes interact with diet and the immune system to contribute to severe childhood malnutrition (Kau AL et al. Sci Transl Med. 2015;7[276]:1-15).

Researchers purified immune-targeted gut microbes from 2 cohorts of human identical twins in which one twin was healthy and the other had kwashiorkor, isolating several types of pathogenic bacteria from gut microbiota of malnurished children.

Investigators also transplanted fecal microbiota samples from healthy and malnourished twins into germ-free mice who were fed either a standard nutritionally sufficient mouse chow diet or a low-nutrient diet typical in Malawi.

Mice fed a low-nutrient “Malawian” diet that received microbiota from a malnourished twin had a high number of immune-targeted gut bacteria from the Enterobacteriaceae family. These mice also lost more weight than animals fed the same diet but who were colonized with microbiota from the healthy co-twins. Mice fed standard nutrient-balanced mouse chow lost less weight and were healthier, regardless of the microbiota they received. Two strains of gut bacteria from the healthy twin ameliorated undernutrition and lethality in mice colonized by microbiota from the malnourished twin.

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JAMA

Rodney Willoughby, MD, a pediatric infectious disease specialist at the Medical College of Wisconsin, can’t help thinking about the future—a future in which thousands of men and women develop precancerous or cancerous lesions that could have been prevented had they been vaccinated against the human papillomavirus (HPV) as 11- or 12-year-olds.

“The family practitioners and pediatricians do a really bad job in promoting HPV vaccination for a variety of reasons,” said Willoughby, a member of the Advisory Committee on Immunization Practices’ (ACIP) working group on the HPV vaccine and the American Academy of Pediatrics’ Committee on Infectious Diseases. “We recognize that we are falling down on the job. This is actually a real emergency.”

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JAMA

Targeted Trial Trumps the Rest

Editorial | April 7, 2015

The effect of folate supplementation on cardiovascular disease has been studied in many observational studies and randomized trials and has been a topic of debate for a number of years. In this issue of JAMA, Huo and colleagues1 provide results from their important clinical trial of folic acid therapy for primary prevention of stroke. In a carefully designed and executed randomized trial, 20 702 adults with hypertension were randomized to receive enalapril alone (n = 10 354) or enalapril combined with 0.8 mg folic acid (n = 10 348). As recommended by the data and safety monitoring board, the trial was terminated early, after 4.5 years, with emergence of a significant reduction in the incidence of first stroke, the primary end point, of 2.7% (282 events) in the enalapril–folic acid group vs 3.4% (355 events) in the enalapril alone group (hazard ratio, 0.79; 95% CI, 0.68-0.93). In further support of the finding, the benefit was more pronounced in the prespecified subgroup of study participants with the lowest baseline levels of plasma folate (ie, <5.6 ng/mL) with rates of first stroke of 2.8% (73 events among 2600 participants) in the enalapril–folic acid group vs 4.6% (116 events among 2548 participants) in the enalapril alone group (hazard ratio, 0.61; 95% CI, 0.45-0.82). There was a smaller effect among those in higher baseline folate categories.

These remarkable findings may represent an underestimate of the potential true effect of folic acid supplementation in this setting for several reasons. First, adherence was imperfect, although high. Approximately 69% of participants took at least 70% of their assigned pills overall. Second, mean folate levels in the control group increased substantially—by 60% during the course of the trial, with an especially marked increase among those with the lowest levels at baseline. The cause of this increase is unclear—whether due to improvements in diet or use of supplements in the control group. Either way, this change and the incomplete adherence diminished the contrast between the groups and likely attenuated the apparent benefit. Third, for ethical reasons the trial was stopped early, and the full effects may take longer to be seen; indeed, there was a suggestion of increasing benefit in the treatment group vs the control group over time.

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April 21, 2015, Vol 313, No. 15

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JAMA

April 21, 2015, Vol 313, No. 15 >

The incidence of type 1 diabetes has been progressively increasing during the past several decades, particularly among children younger than 5 years.1 At the same time, there has been substantial progress in understanding the pathogenesis of the disease and identifying those at risk of progressing to type 1 diabetes.2 In children at genetic risk, diabetes-related autoantibodies appear, followed by the evolution of metabolic abnormalities and the eventual clinical appearance of the disease.2 If individuals identified by genetic markers subsequently undergo seroconversion and develop 2 or more diabetes-related autoantibodies, their risk of progression to type 1 diabetes is 75% over 10 years and appears to be almost inevitable over 20 years.3 However, attempts at both primary prevention, ie, before seroconversion, and secondary prevention, ie, in those with diabetes-related autoantibodies, have not been successful.4 The interventions evaluated to date have been limited to those deemed extremely safe, because such interventions would be used in at-risk individuals who may or may not actually progress to type 1 diabetes.

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Figure

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JAMA

SCIENTIFIC DISCOVERY AND THE FUTURE OF MEDICINE

The human body is soft, curvilinear, and continuously evolving; modern electronic devices are rigid, planar, and physically static. Recent research has yielded a complete set of advanced materials, manufacturing approaches, and design layouts that eliminates this profound mismatch in properties. The resulting devices can intimately integrate onto or into the human body for diagnostic, therapeutic, or surgical function with important unique capabilities in biomedical research and clinical medicine. These emerging technologies have strong potential to improve human health and to enhance the understanding of living systems. They fall into 3 categories—soft, injectable, and bioreabsorbable electronics—each demonstrated in extensive animal studies and several in initial human trials. The Figure presents images of bioelectronic devices.

Figure. Images of Biocompatible Electronic Devices A, Inflated balloon catheter equipped with arrays of sensors for pressure, flow, and contact along with actuators for ablation therapy and light-emitting diodes for optical characterization. B, Three-dimensional membrane wrapped around the entire surface of the heart for cardiac electrotherapy. C, Actively multiplexed sheet of electronics laminated onto the surface of the brain for high-resolution electrocorticography. D, Wireless electronics mounted on the skin for continuous, multimodal monitoring of physiological status. E, Injectable optoelectronic system threaded through the eye of a sewing needle and wrapped around its shaft to highlight the small dimensions and flexible mechanics. F, Bioresorbable electronic circuit, partially dissolving in a drop of water. All of the constituent materials dissolve at controlled rates into harmless end products when exposed to biofluids.

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malaria vaccine

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For over two decades, the quest to develop a working malaria vaccine has proven largely fruitless. According to the World Health Organisation (WHO), about 3.2 billion people worldwide are at risk of being diagnosed with malaria. Every year, nearly 198 million cases are identified. WHO says a significant number of the almost 200 million cases are from Africa. However in recent times not only is there a potential malaria vaccine in the pipeline, a new device which is capable of diagnosing Malaria in minutes has emerged.

John Lewandowski, co-founder and CEO of Disease Diagnostics Group, has invented a new way of diagnosing the deadly disease using two magnets and a laser pointer. He believes that this will eradicate malaria by strengthening the offensive against it, while curbing issues regarding delay in detection.

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ABSTRACT

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JAMA

JAMA Clinical Evidence Synopsis | February 10, 2015

Clinical Question  Are Echinacea products associated with a reduced incidence and a shorter duration of common colds compared with placebo?

Bottom Line  Individual prophylaxis trials show no association with prevention of the common cold, but exploratory meta-analysis suggests that Echinacea products may be associated with a small reduction in cold incidence. In treatment trials, there was no association of Echinacea products with a shorter duration of colds.

Preparations of the plant Echinacea are widely used in North America and Europe for prevention and treatment of the common cold.1 This JAMA Clinical Evidence Synopsis summarizes the results of a Cochrane review2 regarding the association ofEchinacea products with prevention and treatment of colds.

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