Thursday, July 30, 2009

Diabetes Type 1 and 2 Adult Stemcell Trials Underway



By Amy Price PhD

The Journal of the American Medical Association, reported on a study of young adults with newly diagnosed diabetes. These young people were treated with their own stem cells. 20 out of 23 reduced or ended dependence on insulin as their bodies took over production of insulin. Twelve patients stayed off insulin for extended periods, while eight relapsed and returned to low-dose shots. Three didn’t respond. The average time individuals avoided insulin shots was 31 months

The concept driving the research is as follows. In type I diabetes, the patient’s immune system turns on the beta cells that produce insulin, the hormone that breaks down the glucose we eat in food. Eventually, the immune cells will virtually eliminate all of the body's beta cells, and glucose levels will start to climb. Researchers considered if they wiped out the original immune system and replaced it with stem cells it could reset the person’s immune system with disease free cells.
Patients are fist treated with chemotherapy to reduce overactive immune system. Stem cells extracted from the patient’s own blood are grown out and later returned through intravenous injection. This procedure is carried out within six weeks of initial diagnosis for best chance of recovery.

The procedure is certainly not risk free as complications of the stem-cell treatment included pneumonia in two patients, low sperm counts in nine of the 17 men in the study, and endocrine dysfunction in three patients.

Levels of C Peptide were measured as this substance shows up when cells are making insulin. 20 out of 23 participants showed improved insulin production.

Julio Voltarelli, and colleagues at the University of Sao Paulo, Brazil, with colleagues in the U.S. worked on this project. Voltarelli's team has managed to show that the stem cells can give long-lasting beta cells a chance to grow — at least ones that can produce insulin for about three years. Other researchers are pursuing intriguing new stem cell options, including stem cells that can be grown from a patient's own skin, which would eliminate the need for extracting immune stem cells from bone marrow.

No one considers this a cure yet but it is a step in the right direction “A cure is needed, but it will probably not come from a single breakthrough,” wrote Christopher D. Saudek of Johns Hopkins University in Baltimore, in an accompanying editorial. "I wouldn't use the word cure," says Dr. Richard Burt, one of the co-authors from Northwestern University. "But it appears we changed the natural history of the disease. It's the first therapy for patients that leaves them treatment-free — no insulin, no immune suppression for almost five years."
"Every door that we open leads to another door," says Burt. "All research is built by sitting on the shoulders of other studies. This trial is something that will contribute to and move the field of stem cell therapy forward." It is, as Burt says, a start. For a Julio Voltarelli and colleague webcast click here

A study using donor adult bone marrow stem cells has garnered FDA approval with a company called Osiris Approximately 60 patients will be enrolled in this trial. Male and female patients are eligible and must be between the ages of 18 and 30 years old. Patients must have been diagnosed with T1DM based on the ADA criteria and must be screened for clinical trial eligibility between 2 and 16 weeks from initial T1DM diagnosis.

If you or someone you know has recently been diagnosed with T1DM and you would like more information, please contact us at Diabetes@Osiris.com.

There is also a study underway as of March for type 2 Diabetes. The university of Miami in conjunction with other sites are starting clinical trials combining adult stem cell therapy with hyperbaric oxygen as this combination was quite promising in an initial pilot study. As of January 2009 Researchers were planning to recruit patients between the ages of 45 and 65 who have been diagnosed with type 2 diabetes after age 40 and have had the disease for more than five but less than 15 years. The media contact for this research is below. You can read more at http://www.diabetesresearch.org/Newsroom/NewsReleases/DRI/oxygenstemcells.htm
Media Contact:
Jeanne Krull
University of Miami Miller School of Medicine
305-243-4853 / 305-812-6668
jkrull@med.miami.edu

The image is borrowed from a blog with a really concise nicely done diabetes information site http://kirstyne.wordpress.com/2007/09/03/another-reason-to-keep-your-weight-in-check-diabetes/
More information can be found at http://www.diabetes.org/

Sunday, July 26, 2009

Inflammation, Alzheimers, NSAIDS and Balance


Image from Harvard.edu

By Amy Price PhD

There is some information on the internet declaring Alzheimers is more common in people who take NSAIDS. I have watched people do things like take vicodin instead of an antiinflammatory or discontinue baby aspirin therapy suggested by a cardiologist to deal with sticky platelets. Some will not take an antiinflammatory because bone fractures don't heal as well if one is simultaneously taking this class of medication.

Getting drug addicted,setting up the CNS for chronic pain sensitivity by not treating inflammation,or letting excess platelet aggregation continue doesn't help cognition either and in may ultimately set you up for the very condition you are trying to avoid.

There is research reporting specific use of antiinflammatory agents may reduce Alzheimers. It could be chronic pain and inflammation that aggravate loss of cognition rather than the NSAIDS taken to alleviate the symptoms.

There are many cardiac patients who took part in a Canadian study 25 years ago. They were encouraged to take a baby aspirin, vitamin C, and calcium buffered with vitamins K and D rather than be placed on beta blockers and more heavy duty cardiac meds. For many of these individuals this regimen solved the problem.

Drug addiction doesn't always come from illegal street drugs. There are multitudes who became addicted just trying to stop the long term pain. These drugs work by altering nerve and brain messengers and overtime this leads to imbalance in the way the brain works.
As for the bones? Studies show that in eostrogen deficient or aged persons aspirin use may protect bone density. Research also shows fracture healing can be slowed by antiinflammatory use but this effect is temporary and if you stop taking them the fracture will heal at a normal rate.

In conclusion it is all about balance...

Monday, July 13, 2009

Save This Brain


By Amy Price PhD

There have been multiple articles featuring brain and serious neck injury stating how people have overcome cognitive obstacles despite adversity. I celebrate these articles as I know from personal experience the tolls that this road takes and the cost to family members and supporters. One mother was explaining how one minute her brain injured son could do complex algebra and the next he could not tell a red diamond from a black spade in a deck of cards. I too remember those days.

The cognitive inconsistencies are joined by emotional areas. Sometimes the brain will forget what we want it to remember and play over and over like a broken tape those areas we only want to put behind us. The other day I found some practical help in the way of videos and research on how to navigate the initial trauma. These outline what to expect in the emergency room, how to protect yourself in the event of a crash and ways you can help yourself get the best medical care. I thought I would share them here. If you go to the web site you can download the material as MP3 or as PDF files. This is a brilliant solution as watching a video makes it tough to pick up the references which are the key to deeper study...Enjoy!

In the next few posts there will be strategies for overcoming brain fog and getting the sharp mental edge back

Sunday, July 12, 2009

Immediate Post Surgery Wound Care Hints


By Amy Price PhD

After surgery wound care could be better addressed. The advice is usually to ice the area for twenty minutes at a time and don't get it wet for 48 hours to 21 days depending on the procedure because of infection risks. Who are they kidding...After bleeding, being washed down with iodine and being touched,probed,cut and stitched by hands I have no personal relationship with all that I want is a bath or a shower!

The risk of infection is serious as it can travel to your bones or become systemic and cause more damage than the original problem. It can travel through open places in the wound or through the stitching which acts as a wick. Until the area has healed over it is best not to swim or use a hot tub because of bacterial risks. It is important to follow your doctor's advice for changing dressings etc. If the area becomes hot to the touch, swells rapidly,starts pulsing or you start to run a fever get your doctor's advice.

To shower after spine and cervical surgery I purchased a silicon swim cap as this is completely waterproof and less irritating than latex. I cut generous pieces which I placed over the wound and taped it in place with duct tape. For arms and legs I used umbrella bags, big ones for leg and smaller for arm areas. I placed them over top of the dressing and bandage and taped this in place. You will still need to exercise care and try not to get the area wet...a bath could be a bad idea! If it gets a little damp in spite of all precautions gently dry the area, put on topical antibiotic and replace the dressing.

If this was an emergency room visit remember emergency rooms will only stabilize you, they have no obligation to provide treatment beyond this. An emergency room visit needs follow up with a doctor. At emergency if you have tendons exposed insist on being seen by a specialist on call. I had three fingers all with tendon avulsions stitched up with no repairs. It took a year of occupational and physical therapy to get the function back. A word to the wise...if you have broken something and they have splinted, cast or wrapped it and it starts to smell bad or the exposed areas turn dark and lumpy go back to the hospital. They don't mean literally black, if it darkens substantially, swells and get worse rather than better have this checked out. With a temporary cast the swelling can cut off the circulation and the tissue starts to die. I almost lost a hand this way as I was told if it turns black come back, since it cost me 10,000 dollars for the emergency room appearance and 273 dollars for a bandage available at the dollar store.I really wasn't up for a repeat visit!

The ice is easy in principle but not so easy for the drugged and injured to apply. Some people travel for surgery and it is a considerable time before they are at home to ice. Do yourself a favor and buy some instant ice at a pharmacy before your procedure or get the surgery to supply you with a couple of extra packs for the trip home. The ice takes down swelling and eases pain while helping your body heal. At home consider the wound site. An awkward area like the elbow,knees or shoulders may be best with a bag of frozen peas which will bend to the shape. A posterior neck surgery may benefit from an emptied and refilled with water large soda bottle (don't freeze the soda it explodes). Ask a family member or friend to do ice duty day and night. If you are like me and don't want to ask anyone for anything consider that you can buy them a gift, take them to dinner or return the favor. It is an investment in your healing. Be nice to those who care enough to be available, they do not benefit from you getting an attitude because you feel bad that you need the help and being thankful can go along ways towards preserving relationships

There will be a follow up post on scar care soon. This information is for educational purposes only and does not constitute medical advice. That is your doctor's assignment.

Saturday, July 4, 2009

Two Hearts, The FDA and Stem cells


By Amy Price PhD
My email informs me people are hungry for real help on finding medical providers who can offer stem cells. They want to know are stem cells a viable alternative, Can you find me quality information instead of hype, and what is your view on the FDA in this regard?

This field is moving very rapidly and what was not possible only a year ago is happeneing today.I have sen great and not so great results for orthopedic, heart, blood and some wound healing applications but it is important to realize that this therapy is still in experimental stages and there are no guarantees.

A few pioneers have moved through the opposition and fear of new therapies to pave the way for university hospitals who are now offering up stem cells in the way of research. One good example is new heart tissue grown out in Los Angeles "We seek to actually reverse the injury that has been caused by the heart attack, by re-growing new heart muscle to at least partially replace the scar that's formed," says Dr. Eduardo Marban of Cedars-Sinai Heart Institute

Watch CBS Videos Online
A tale of two hearts summarizes this nicely. Both hearts were damaged. The first heart was in a young man whose parents are dedicated medical professionals. They waited eagerly for FDA clearance so they could take their son for a legal stem cell repair. The wait was too long and emergency surgery ensued. The young man lived but sustained brain damage and paralysis. This heart could have been repaired with adult stem cells. A company that developed the stem cell technology was less than one hour from them. The cultural mindset opinion that procedures performed outside of North America because of FDA restrictions were too risky cost them deeply.

On the other spectrum was a banker friend well known in the diplomatic community? His heart was damaged and he was urged to change his lifestyle and lose weight. He picked up over the counter diet pills later banned by the FDA and marched to the treadmill like a soldier in boot camp to the acclaim of family and treating professionals. Noticing his lips and finger tips had an ominous bluish tinge, I asked to see the pills. They contained amphetamines in the form of herbs. We urged him to see his cardiologist and to stop the pills but he chose to soldier on until a month later he collapsed on the treadmill and was taken to hospital where his chest was sawed open and major heart surgery took place as it was the only way to save his life.
The FDA found a niche because when humans are physically vulnerable they will pay or do almost anything for survival. They keep us safe from predators in the marketplace. They help us with food labels and medical warnings. Dieters have been known to ingest tapeworms, destroy their stomachs, livers, kidneys, hearts and intestines to lose a few pounds. Doctors who see patients on whom they conduct treatment for a fee will say I have to be honest with you the chances aren’t great but if it is your choice we can proceed. They are applauded for their ‘honesty’ whether the treatment succeeds or not. We say go ahead because even false hope is better than none at all. Likely none of us would hire a roofer who said I will work on your roof but because of pre-existing structural damage it likely won’t work out! The FDA has a tough job and emotional stakes run high.

On the other hand the FDA is a bureaucracy with allegiances and political agendas, not because they are necessarily evil but because this is a given for group behavior. They are shaped by society and moved by mass public opinion. They also make mistakes and if some of the lifesaving drugs we have today would have needed FDA approval masses would be dying while wars were fought that have little to do with how well something works.

Do I think most people or their doctors have enough medical training to make an informed choice about stem cells? No…but I am not sure the FDA is in a position to make this choice for the best interests of the people and I would welcome some of the transparency they have promised.

Would I consider not having FDA approval for a therapy before using it on myself or family? I would not consider a banned or illegal substance but I would have non FDA sanctioned treatment or off label use of pharmaceuticals. It has in the past improved my quality and likely my length of life. I would not consider a choice like this lightly. The risks need to be weighed against the benefits and I would have to know and trust the doctor involved whether in this country or somewhere else on the globe.