A New Noninvasive Method May Detect Alzheimer's Early

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No methods currently exist for the early detection of Alzheimer’s disease, which affects one out of nine people over the age of 65. Now, an interdisciplinary team of Northwestern University scientists and engineers has developed a noninvasive MRI approach that can detect the disease in a living animal. And it can do so at the earliest stages of the disease, well before typical Alzheimer’s symptoms appear.

Led by neuroscientist William L. Klein and materials scientist Vinayak P. Dravid, the research team developed an MRI (magnetic resonance imaging) probe that pairs a magnetic nanostructure (MNS) with an antibody that seeks out the amyloid beta brain toxins responsible for onset of the disease. The accumulated toxins, because of the associated magnetic nanostructures, show up as dark areas in MRI scans of the brain.

This ability to detect the molecular toxins may one day enable scientists to both spot trouble early and better design drugs or therapies to combat and monitor the disease. And, while not the focus of the study, early evidence suggests the MRI probe improves memory, too, by binding to the toxins to render them “handcuffed” to do further damage.

“Using MRI, we can see the toxins attached to neurons in the brain,” Klein said. “We expect to use this tool to detect this disease early and to help identify drugs that can effectively eliminate the toxin and improve health.”

With the successful demonstration of the MRI probe, Northwestern researchers now have established the molecular basis for the cause, detection by non-invasive MR imaging and treatment of Alzheimer’s disease. Dravid introduced this magnetic nanostructure MRI contrast enhancement approach for Alzheimer’s following his earlier work utilizing MNS as smart nanotechnology carriers for targeted cancer diagnostics and therapy. (A MNS is typically 10 to 15 nanometers in diameter; one nanometer is one billionth of a meter.)

Details of the new Alzheimer’s disease diagnostic were published December 22 by the journal Nature Nanotechnology. Klein and Dravid are co-corresponding authors.

The emotional and economic impacts of Alzheimer’s disease are devastating. This year, the direct cost of the disease in the United States is more than $200 billion, according to the Alzheimer’s Association’s “2014 Alzheimer’s Disease Facts and Figures.” By the year 2050, that cost is expected to be $1.1 trillion as baby boomers age. And these figures do not account for the lost time of caregivers.

This new MRI probe technology is detecting something different from conventional technology: toxic amyloid beta oligomers instead of plaques, which occur at a stage of Alzheimer’s when therapeutic intervention would be very late. Amyloid beta oligomers now are widely believed to be the culprit in the onset of Alzheimer’s disease and subsequent memory loss.

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A New Noninvasive Method May Detect Alzheimer's Early

[[{"fid":"3246","view_mode":"media_original","fields":{"format":"media_original","field_file_image_alt_text[und][0][value]":"","field_file_image_title_text[und][0][value]":""},"type":"media","attributes":{"height":400,"width":400,"class":"media-element file-media-original"},"link_text":null}]]No methods currently exist for the early detection of Alzheimer’s disease, which affects one out of nine people over the age of 65. Now, an interdisciplinary team of Northwestern University scientists and engineers has developed a noninvasive MRI approach that can detect the disease in a living animal. And it can do so at the earliest stages of the disease, well before typical Alzheimer’s symptoms appear.Led by neuroscientist William L. Klein and materials scientist Vinayak P. Dravid, the research team developed an MRI (magnetic resonance imaging) probe that pairs a magnetic nanostructure (MNS) with an antibody that seeks out the amyloid beta brain toxins responsible for onset of the disease. The accumulated toxins, because of the associated magnetic nanostructures, show up as dark areas in MRI scans of the brain.This ability to detect the molecular toxins may one day enable scientists to both spot trouble early and better design drugs or therapies to combat and monitor the disease. And, while not the focus of the study, early evidence suggests the MRI probe improves memory, too, by binding to the toxins to render them “handcuffed” to do further damage.“Using MRI, we can see the toxins attached to neurons in the brain,” Klein said. “We expect to use this tool to detect this disease early and to help identify drugs that can effectively eliminate the toxin and improve health.”With the successful demonstration of the MRI probe, Northwestern researchers now have established the molecular basis for the cause, detection by non-invasive MR imaging and treatment of Alzheimer’s disease. Dravid introduced this magnetic nanostructure MRI contrast enhancement approach for Alzheimer’s following his earlier work utilizing MNS as smart nanotechnology carriers for targeted cancer diagnostics and therapy. (A MNS is typically 10 to 15 nanometers in diameter; one nanometer is one billionth of a meter.)Details of the new Alzheimer’s disease diagnostic were published December 22 by the journal Nature Nanotechnology. Klein and Dravid are co-corresponding authors.The emotional and economic impacts of Alzheimer’s disease are devastating. This year, the direct cost of the disease in the United States is more than $200 billion, according to the Alzheimer’s Association’s “2014 Alzheimer’s Disease Facts and Figures.” By the year 2050, that cost is expected to be $1.1 trillion as baby boomers age. And these figures do not account for the lost time of caregivers.This new MRI probe technology is detecting something different from conventional technology: toxic amyloid beta oligomers instead of plaques, which occur at a stage of Alzheimer’s when therapeutic intervention would be very late. Amyloid beta oligomers now are widely believed to be the culprit in the onset of Alzheimer’s disease and subsequent memory loss.Read more

High School Programs to Introduce Students to Northwestern Medicine

Northwestern University has a long history of opening its doors to young high school scholars interested in programs towards careers in science and medicine. Recently, more than 30 young men from Westinghouse College Prep spent time on Northwestern's medical campus during their Northwestern Medicine Scholars Program, which introduces young men to all types of medical careers.

The Women's Health Research Institute at Northwestern University offers a comparable program for young women in Chicago Public Schools. This program, The Women's Health Science Program (WHSP) offers specialized week-long academies during the summer where students are mentored by current graduate and medical students, clinicians, and researchers. These young women learn clinical skills (such as suturing, vitals, and phlebotomy ) as well as basic science, laboratory skills revolving around oncofertility.

While the target populations of these two programs differ, their goals of investing in future science and medical leaders remains the same.

High School Programs to Introduce Students to Northwestern Medicine

Northwestern University has a long history of opening its doors to young high school scholars interested in programs towards careers in science and medicine. Recently, more than 30 young men from Westinghouse College Prep spent time on Northwestern's medical campus during their Northwestern Medicine Scholars Program, which introduces young men to all types of medical careers. The Women's Health Research Institute at Northwestern University offers a comparable program for young women in Chicago Public Schools. This program, The Women's Health Science Program (WHSP) offers specialized week-long academies during the summer where students are mentored by current graduate and medical students, clinicians, and researchers. These young women learn clinical skills (such as suturing, vitals, and phlebotomy ) as well as basic science, laboratory skills revolving around oncofertility. While the target populations of these two programs differ, their goals of investing in future science and medical leaders remains the same.

High School Programs to Introduce Students to Northwestern Medicine

Northwestern University has a long history of opening its doors to young high school scholars interested in programs towards careers in science and medicine. Recently, more than 30 young men from Westinghouse College Prep spent time on Northwestern’s medical campus during their Northwestern Medicine Scholars Program, which introduces young men to all types of medical careers.

The Women’s Health Research Institute at Northwestern University offers a comparable program for young women in Chicago Public Schools. This program, The Women’s Health Science Program (WHSP) offers specialized week-long academies during the summer where students are mentored by current graduate and medical students, clinicians, and researchers. These young women learn clinical skills (such as suturing, vitals, and phlebotomy ) as well as basic science, laboratory skills revolving around oncofertility.

While the target populations of these two programs differ, their goals of investing in future science and medical leaders remains the same.

Women Receiving Longer Radiation Therapy than Necessary

A recent study published in the Journal of the American Medical Association (JAMA) has concluded that about two-thirds of women who undergo a lumpectomy to treat breast cancer receive radiation therapy for longer than necessary. Radiation is used after a lumpectomy to reduce the likelihood of cancer returning and to increase survival rates. Traditional radiation treatment following lumpectomies typically lasts five to seven weeks. However, the JAMA study, along with various other tests and studies indicate that a shorter, more intense three to four week treatment of radiation is just as effective.

Studies have also found that women prefer to receive shorter courses of radiation treatment, and that shorter treatment is less expensive. Considering that about 60% to 75% of women with breast cancer receive lumpectomies, there is significant potential for increased patient satisfaction and reduced costs by offering shorter radiation therapy. Unfortunately, years of ingrained practice and hesitancy to change a course of treatment used for years may slow the rate in which shorter radiation therapy is used on lumpectomy patients. However, due to this study and others like it, this course of treatment will likely become more common over time.

Source: Kolata, Gina. “Long Radiation Treatments Called Unnecessary in Many Breast Cancer Cases.”  The New York Times. 10 December 2014.

Women Receiving Longer Radiation Therapy than Necessary

A recent study published in the Journal of the American Medical Association (JAMA) has concluded that about two-thirds of women who undergo a lumpectomy to treat breast cancer receive radiation therapy for longer than necessary. Radiation is used after a lumpectomy to reduce the likelihood of cancer returning and to increase survival rates. Traditional radiation treatment following lumpectomies typically lasts five to seven weeks. However, the JAMA study, along with various other tests and studies indicate that a shorter, more intense three to four week treatment of radiation is just as effective. Studies have also found that women prefer to receive shorter courses of radiation treatment, and that shorter treatment is less expensive. Considering that about 60% to 75% of women with breast cancer receive lumpectomies, there is significant potential for increased patient satisfaction and reduced costs by offering shorter radiation therapy. Unfortunately, years of ingrained practice and hesitancy to change a course of treatment used for years may slow the rate in which shorter radiation therapy is used on lumpectomy patients. However, due to this study and others like it, this course of treatment will likely become more common over time. Source: Kolata, Gina. “Long Radiation Treatments Called Unnecessary in Many Breast Cancer Cases.”  The New York Times. 10 December 2014.

Women Receiving Longer Radiation Therapy than Necessary

A recent study published in the Journal of the American Medical Association (JAMA) has concluded that about two-thirds of women who undergo a lumpectomy to treat breast cancer receive radiation therapy for longer than necessary. Radiation is used after a lumpectomy to reduce the likelihood of cancer returning and to increase survival rates. Traditional radiation treatment following lumpectomies typically lasts five to seven weeks. However, the JAMA study, along with various other tests and studies indicate that a shorter, more intense three to four week treatment of radiation is just as effective.

Studies have also found that women prefer to receive shorter courses of radiation treatment, and that shorter treatment is less expensive. Considering that about 60% to 75% of women with breast cancer receive lumpectomies, there is significant potential for increased patient satisfaction and reduced costs by offering shorter radiation therapy. Unfortunately, years of ingrained practice and hesitancy to change a course of treatment used for years may slow the rate in which shorter radiation therapy is used on lumpectomy patients. However, due to this study and others like it, this course of treatment will likely become more common over time.

Source: Kolata, Gina. “Long Radiation Treatments Called Unnecessary in Many Breast Cancer Cases.”  The New York Times. 10 December 2014.

Science literacy helps answer life's questions

Understanding science isn't just important to scientists and health care professionals, a basic understanding of science is critical for all people to participate fully in the national and international conversation.   A recent issue of The Conversation, discusses the importance of science literacy in today's world whether we are trying to learn the facts about Ebola or wanting to learn what stem cell research is.   Many of our public policies and regulations need to be based on facts and not politics and biased headline reporting.

Science literacy helps answer life's questions

Understanding science isn't just important to scientists and health care professionals, a basic understanding of science is critical for all people to participate fully in the national and international conversation.   A recent issue of The Conversation, discusses the importance of science literacy in today's world whether we are trying to learn the facts about Ebola or wanting to learn what stem cell research is.   Many of our public policies and regulations need to be based on facts and not politics and biased headline reporting.

Science literacy helps answer life’s questions

Understanding science isn’t just important to scientists and health care professionals, a basic understanding of science is critical for all people to participate fully in the national and international conversation.   A recent issue of The Conversation, discusses the importance of science literacy in today’s world whether we are trying to learn the facts about Ebola or wanting to learn what stem cell research is.   Many of our public policies and regulations need to be based on facts and not politics and biased headline reporting.

Sex differences may be found in COPD

Chronic Obstructive Pulmonary Disease, the third leading cause of death in the U.S., was thought to primarily affect men.   But in recent years, the number of women with COPD has significantly increased and today more women than men die of COPD.  This increase was originally thought to be a latent effect due to the  increase in smoking in women in the 1060's but new research suggests that some other sex effects may be in play. One of the challenges of uncovering sex differences is sometimes technology.  Today, a new technical, computerized method ---integrative network inference analysis--- is providing new insight into potential mechanisms for sex differences in COPD.  Scientists are able to chart different genetic patterns within likely networks for each sex using sputum and blood.   Using this technique, researchers at Harvard have identified functionally related sets of genes that are different in women and men with COPD.   These methods are beyond the scoop of this writer but the lesson here is that every day researchers are using more and more complex applications to better understand the impact of  biological sex on disease. Sex difference exist in all body systems and the need to support sex inclusive research is critical. Source:  http://www.biomedcentral.com/1752-0509/8/118

Sex differences may be found in COPD

Chronic Obstructive Pulmonary Disease, the third leading cause of death in the U.S., was thought to primarily affect men.   But in recent years, the number of women with COPD has significantly increased and today more women than men die of COPD.  This increase was originally thought to be a latent effect due to the  increase in smoking in women in the 1060′s but new research suggests that some other sex effects may be in play.

One of the challenges of uncovering sex differences is sometimes technology.  Today, a new technical, computerized method —integrative network inference analysis— is providing new insight into potential mechanisms for sex differences in COPD.  Scientists are able to chart different genetic patterns within likely networks for each sex using sputum and blood.   Using this technique, researchers at Harvard have identified functionally related sets of genes that are different in women and men with COPD.   These methods are beyond the scoop of this writer but the lesson here is that every day researchers are using more and more complex applications to better understand the impact of  biological sex on disease.

Sex difference exist in all body systems and the need to support sex inclusive research is critical.

Source:  http://www.biomedcentral.com/1752-0509/8/118

Compounded Bioidentical Hormone Therapy under scrutiny

 Unsubstantiated claims, lack of scientific safety and efficacy data, and lack of quality control continue to surround custom-compounded bioidentical hormone products and yet, many women seem to believe that they are somehow "safer" than lab synthesized hormones.   FDA-approved hormone therapy provides tested and regulated therapy without the risks of unregulated and untested custom preparations that often include custom compounded therapies. Bioidentical hormones, a marketing term not recognized by the US Food and Drug Administration (FDA), refers to exogenous hormones biochemically similar to those produced within the body and includes 17A-estradiol (predominant estrogen before menopause), estrone (predominant estrogen after menopause), estriol (from placenta), progesterone (ovaries, placenta, and adrenal glands), testosterone (ovaries and adrenal glands), and their conjugates.[1] These are derived from soy and yam precursors and must be chemically processed to make them able to be absorbed by the human body. Hormones that meet the definition of bioidentical are available as FDA-approved prescription therapies and include estradiol (oral, patch, gel, lotion, mist, and vaginal ring, cream, or tablet) and micronized progesterone (oral or vaginal). The FDA has not approved estriol. Custom-compounded bioidentical hormone products are prepared, assembled, and packaged according to a provider's prescription into gels, creams, lotions, sublingual tablets, subdermal implants, suppositories, or troches.[2] Transdermal therapies avoid the first-pass effect through the liver, and there is evidence that they have a lower clotting risk.[3] Progesterone may have fewer negative effects than synthetic progestins on lipids, sleep and mood, and breast (density, tenderness, and cancer risk) when combined with estrogen. No FDA-approved testosterone therapy (bioidentical or otherwise) is available for women. Lack of Testing for Efficacy, Safety, and Quality Control The major difference between FDA-approved hormone products meeting the definition of bioidentical versus custom-compounded products is that the former are regulated by FDA, tested for purity, potency, and efficacy, and sold with FDA-approved product information that includes boxed warnings. Efficacy and safety data, required for obtaining particular product indications, have been demonstrated in randomized, clinical trials with peer-reviewed published reports for FDA-approved bioidenticals but not for custom-compounded products.[4,5] No large, long-term studies have been done to determine the effectiveness, safety, or adverse effects of custom-compounded bioidentical hormones. In 2008, because of lack of scientific data on estriol, FDA stated that pharmacies should not compound drugs containing estriol unless the prescriber has a valid investigational new drug application.[4] To read the entire article, visit  Menopause.  To learn more about your options during menopause visit MenopauseNU.org developed by the Women's Health Research Institute at Northwestern University.      

Compounded Bioidentical Hormone Therapy under scrutiny

 Unsubstantiated claims, lack of scientific safety and efficacy data, and lack of quality control continue to surround custom-compounded bioidentical hormone products and yet, many women seem to believe that they are somehow “safer” than lab synthesized hormones.   FDA-approved hormone therapy provides tested and regulated therapy without the risks of unregulated and untested custom preparations that often include custom compounded therapies.

Bioidentical hormones, a marketing term not recognized by the US Food and Drug Administration (FDA), refers to exogenous hormones biochemically similar to those produced within the body and includes 17A-estradiol (predominant estrogen before menopause), estrone (predominant estrogen after menopause), estriol (from placenta), progesterone (ovaries, placenta, and adrenal glands), testosterone (ovaries and adrenal glands), and their conjugates.[1] These are derived from soy and yam precursors and must be chemically processed to make them able to be absorbed by the human body.

Hormones that meet the definition of bioidentical are available as FDA-approved prescription therapies and include estradiol (oral, patch, gel, lotion, mist, and vaginal ring, cream, or tablet) and micronized progesterone (oral or vaginal). The FDA has not approved estriol. Custom-compounded bioidentical hormone products are prepared, assembled, and packaged according to a provider’s prescription into gels, creams, lotions, sublingual tablets, subdermal implants, suppositories, or troches.[2] Transdermal therapies avoid the first-pass effect through the liver, and there is evidence that they have a lower clotting risk.[3] Progesterone may have fewer negative effects than synthetic progestins on lipids, sleep and mood, and breast (density, tenderness, and cancer risk) when combined with estrogen. No FDA-approved testosterone therapy (bioidentical or otherwise) is available for women.

Lack of Testing for Efficacy, Safety, and Quality Control

The major difference between FDA-approved hormone products meeting the definition of bioidentical versus custom-compounded products is that the former are regulated by FDA, tested for purity, potency, and efficacy, and sold with FDA-approved product information that includes boxed warnings. Efficacy and safety data, required for obtaining particular product indications, have been demonstrated in randomized, clinical trials with peer-reviewed published reports for FDA-approved bioidenticals but not for custom-compounded products.[4,5]

No large, long-term studies have been done to determine the effectiveness, safety, or adverse effects of custom-compounded bioidentical hormones. In 2008, because of lack of scientific data on estriol, FDA stated that pharmacies should not compound drugs containing estriol unless the prescriber has a valid investigational new drug application.[4]

To read the entire article, visit  Menopause.  To learn more about your options during menopause visit MenopauseNU.org developed by the Women’s Health Research Institute at Northwestern University.

 

 

 

Improving Health for LGBT Patients

Feinberg School of Medicine faculty helped create the Association of American Medical Colleges’ (AAMC) first guidelines for medical schools on improving health care for people who are lesbian, gay, bisexual, transgender (LGBT), gendering nonconforming or born with differences of sex development (DSD). “This resource guide is important because these populations have been historically disproportionately harmed or neglected in the medical system,” said Alice Dreger, PhD, professor of Clinical Medical Humanities and Bioethics at Northwestern University and member of the AAMC Advisory Committee on Sexual Orientation, Gender Identity, and Sex Development. “By being a part of this committee I hope I am helping to seed a new generation of doctors who will know how to really help patients in these populations.” The guide, “Implementing Curricular and Institutional Climate Changes to Improve Health Care for Individuals Who Are LGBT, Gender Nonconforming, or Born with DSD,” provides information about the health needs of individuals from those populations, and about the role of academic medicine and the health care system in supporting them. Click HERE to read the full release.  

Improving Health for LGBT Patients

Feinberg School of Medicine faculty helped create the Association of American Medical Colleges’ (AAMC) first guidelines for medical schools on improving health care for people who are lesbian, gay, bisexual, transgender (LGBT), gendering nonconforming or born with differences of sex development (DSD).

“This resource guide is important because these populations have been historically disproportionately harmed or neglected in the medical system,” said Alice Dreger, PhD, professor of Clinical Medical Humanities and Bioethics at Northwestern University and member of the AAMC Advisory Committee on Sexual Orientation, Gender Identity, and Sex Development. “By being a part of this committee I hope I am helping to seed a new generation of doctors who will know how to really help patients in these populations.”

The guide, “Implementing Curricular and Institutional Climate Changes to Improve Health Care for Individuals Who Are LGBT, Gender Nonconforming, or Born with DSD,” provides information about the health needs of individuals from those populations, and about the role of academic medicine and the health care system in supporting them.

Click HERE to read the full release.

 

Fireworks fly when sperm fertilizes egg!

Sparks literally fly when a sperm and an egg hit it off. The fertilized mammalian egg releases from its surface billions of zinc atoms in "zinc sparks," one wave after another, a Northwestern University-led interdisciplinary research team has found. Researchers at Northwestern developed technology that captured images of these fireworks.  According to Dr. Teresa Woodruff, PhD part of the team studying this phenomenon and director of the Women's Health Research Institute at NU, "The amount of zinc released by an egg could be a great marker for  identifying a high-quality fertilized egg, something we haven't been able to do.  Once we can, fewer embryos would need to be transferred during fertility treatments." View a WGN-TV segment on the new discovery HERE. The study is publishing in the Dec. 15 by the journal Nature Chemistry. Read more and view pictures HERE.

Fireworks fly when sperm fertilizes egg!

Sparks literally fly when a sperm and an egg hit it off. The fertilized mammalian egg releases from its surface billions of zinc atoms in “zinc sparks,” one wave after another, a Northwestern University-led interdisciplinary research team has found. Researchers at Northwestern developed technology that captured images of these fireworks.  According to Dr. Teresa Woodruff, PhD part of the team studying this phenomenon and director of the Women’s Health Research Institute at NU, “The amount of zinc released by an egg could be a great marker for  identifying a high-quality fertilized egg, something we haven’t been able to do.  Once we can, fewer embryos would need to be transferred during fertility treatments.” View a WGN-TV segment on the new discovery HERE. The study is publishing in the Dec. 15 by the journal Nature Chemistry. Read more and view pictures HERE.

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