As elective transfer of a single embryo (eSET) becomes increasingly accepted, the need to improve implantation rates becomes crucial. Selecting the most competent embryo therefore constitutes a major challenge in assisted reproductive technology. Embryo morphology and developmental stage at given time points are closely correlated with developmental competence and assessment of morphological parameters at discrete inspection points thus remains the preferred way of evaluating embryonic potential. Lately, more attention has been given to the assessment of dynamic embryo development as a tool for evaluating embryonic potential. The introduction of time-lapse equipment approved for use on human embryos offers novel clinical opportunities for continuous monitoring of embryos, enabling flexible evaluation of known morphological parameters and potentially introducing new dynamic markers of viability. Due to lack of larger, randomized clinical studies it remains to be elucidated whether embryo selection using dynamic parameters improves clinical outcome and which parameters are of significance. Before such randomized controlled studies are organized, the most promising parameters to evaluate must be identified. This mini-review summarizes the current knowledge about dynamic markers of viability and discusses the potential clinical role of time-lapse analysis in embryo assessment and selection.
Monthly Archives: April 2012
Ethics of intergenerational (father-to-son) sperm donation
In the ever changing field of reproductive medicine, clinics are regularly confronted with requests for novel variants of medically assisted reproduction. Particularly third-party (assisted) reproduction, which requires the involvement of an oocyte or sperm donor, is ethically and psychologically complex due to the parties involved, but nevertheless widely accepted. A particular type of third party reproduction concerns intrafamilial medically assisted reproduction (IMAR), where the donor is a family member of the recipients. In IMAR, some of the ethical and psychological issues associated with third party reproduction are intensified. The precise impact and consequences, however, remain speculative due to the lack of information regarding IMAR. Both the ESHRE Task Force on Ethics and Law and the Human Fertilization and Embryology Authority have recently highlighted the lack of information and the need for debate. In order to contribute to the discussion and knowledge on IMAR, we present a couple that recently visited our academic clinic with a request for a very particular variant of IMAR: first degree, intergenerational father-to-son sperm donation. As our academic hospital did not have experience with this variant of IMAR, our interdisciplinary Ethics Committee for Reproductive Medicine extensively discussed the request, resulting in an advisory report on the ethics of IMAR in general and father-to-son sperm donation in particular. Here, we will first present the andrological and social background of the couple and subsequently discuss the ethical considerations that led to the approval of their request. We will conclude the paper with recommendations for a morally sound practice of IMAR.
Oocyte cryopreservation for age-related fertility loss
The recent introduction of oocyte vitrification has significantly advanced the outcome of oocyte cryopreservation, leading to clinical results comparable to those achieved in IVF using fresh oocytes, as reported by experienced centres. This has lead to new debate, both in the professional community and in society at large, about the acceptability of offering this technology to reproductively healthy women who want to cryopreserve their oocytes against the threat of time. Given the many demands calling for simultaneous realization in a relatively short period of their lives, many women who want to have children feel to be under considerable pressure. The option of oocyte cryopreservation may in fact give them more breathing space. In this document, it is concluded that the arguments against allowing this application of the technology are not convincing. The recommendations include the need for adequate information of women interested in oocyte cryopreservation, also in order to avoid raising false hopes. The message must remain that women's best chances of having a healthy child are through natural reproduction at a relative early age. Centres offering this service must have the necessary expertise to employ oocyte cryopreservation efficiently with the so far non-standardized protocols. As data about long-term safety is still lacking, centres also have a responsibility to contribute to the collection of these data.
The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres
BACKGROUND
This study aimed to calculate costs and health-related quality of life of women with endometriosis-associated symptoms treated in referral centres.
METHODS
A prospective, multi-centre, questionnaire-based survey measured costs and quality of life in ambulatory care and in 12 tertiary care centres in 10 countries. The study enrolled women with a diagnosis of endometriosis and with at least one centre-specific contact related to endometriosis-associated symptoms in 2008. The main outcome measures were health care costs, costs of productivity loss, total costs and quality-adjusted life years. Predictors of costs were identified using regression analysis.
RESULTS
Data analysis of 909 women demonstrated that the average annual total cost per woman was 9579 (95% confidence interval 8559–10 599). Costs of productivity loss of 6298 per woman were double the health care costs of 3113 per woman. Health care costs were mainly due to surgery (29%), monitoring tests (19%) and hospitalization (18%) and physician visits (16%). Endometriosis-associated symptoms generated 0.809 quality-adjusted life years per woman. Decreased quality of life was the most important predictor of direct health care and total costs. Costs were greater with increasing severity of endometriosis, presence of pelvic pain, presence of infertility and a higher number of years since diagnosis.
CONCLUSIONS
Our study invited women to report resource use based on endometriosis-associated symptoms only, rather than drawing on a control population of women without endometriosis. Our study showed that the economic burden associated with endometriosis treated in referral centres is high and is similar to other chronic diseases (diabetes, Crohn's disease, rheumatoid arthritis). It arises predominantly from productivity loss, and is predicted by decreased quality of life.
Therapeutic potential of andrographolide for treating endometriosis
BACKGROUND
Mounting evidence shows that nuclear factor-B (NF-B) plays an important role in endometriosis. We therefore evaluated the therapeutic potential of andrographolide, an NF-B inhibitor.
METHODS
Primary cell cultures were performed using ectopic endometrial tissue specimens and their homologous eutopic endometrial specimens from 16 women with endometriosis, as well as control samples from 4 women without endometriosis. Andrographolide was evaluated for an effect on cell proliferation and cell cycle, DNA-binding activity of NF-B and expression of cyclooxygenase-2 (COX-2) and tissue factor (TF). In a rat model of endometriosis, andrographolide treatment was evaluated for an effect on lesion size, hotplate response latency and expression of phosphorylated p50 and p65, COX-2 and nerve growth factor (NGF) in ectopic endometrium.
RESULTS
Andrographolide dose dependently suppressed proliferation and cell cycle progression, attenuated DNA-binding activity of NF-B in endometriotic stromal cells and inhibited COX-2 and TF expression. In the rat experiment, induced endometriosis resulted in reduced response latency. Andrographolide treatment significantly reduced lesion size in a dose-dependent manner and significantly increased response latency. Andrographolide treatment also significantly reduced immunoreactivity of COX-2, phosphorylated p50 and p65, and NGF in ectopic endometrium.
CONCLUSIONS
Treatment with andrographolide significantly suppresses the growth of ectopic endometrium in vitro and in vivo, and results in a significant improvement in generalized hyperalgesia in rats with induced endometriosis. Therefore, andrographolide may be cytoreductive and may relieve pain symptoms in women with endometriosis. With excellent safety and cost profiles, andrographolide could be a promising therapeutic agent for endometriosis.
Segmental bowel resection for colorectal endometriosis: is there a correlation between histological pattern and clinical outcomes?
BACKGROUND
Laparoscopic segmental resection as a treatment for intestinal endometriosis can be supported by favorable clinical outcomes, but carries a high risk of major complications. The purpose of this study is to evaluate histopathological patterns of colorectal endometriosis and investigate potential relationships between histological findings and clinical data.
METHODS
We consecutively included 47 patients treated with laparoscopic segmental resection because of symptomatic colorectal endometriosis. All patients underwent follow-up for a median of 18 months (range: 6–35). We examined the histological patterns of colorectal endometriosis and evaluated the relationships between histological findings (satellite lesions, positive margins and vertical infiltration) and clinical outcomes (incidence of recurrence, quality of life and symptom improvement). Moreover, we observed if satellite lesions could influence preoperative scores of the short form-36 health survey (SF-36) questionnaire and visual analogue score (VAS) for pain symptoms.
RESULTS
There were no statistically significant differences in terms of anatomical and pain recurrences, pain symptoms and quality of life improvement among patients with or without positive margins, satellite lesions and different degrees of vertical infiltration (P > 0.05). Furthermore, women with or without satellite lesions were no different in terms of preoperative VAS of pain symptoms and SF-36 scores (P > 0.05).
CONCLUSIONS
The presence of satellite lesions or positive resection margins does not seem to influence clinical outcomes of segmental colorectal resection. Similarly, satellite lesions do not appear to have a major role in determining preoperative clinical presentation. These results may be useful to reconsider the surgical strategy for bowel endometriosis.
Evaluating the association between endometrial cancer and polycystic ovary syndrome
BACKGROUND
Given the current lack of clarity in the published literature, we performed a systematic review of the literature to determine the exact strength of the association between polycystic ovary syndrome (PCOS) and endometrial cancer (EC).
METHODS
All published studies on the association between PCOS and EC identified through MEDLINE (1966–April 2011), EMBASE (1980–April 2011) and Cochrane (1998–April 2011). Original data were abstracted where available and summarized on a separate Microsoft Excel (2007) database for analysis. A total of 14 studies comparative and non-comparative were identified and included.
RESULTS
The non-comparative and comparative data suggested that women with PCOS were more likely to develop EC. A meta-analyses of five comparative studies showed an increased risk of EC in women with an odds ratio of 2.89 with a 95% confidence interval of 1.52–5.48.
CONCLUSIONS
Women with PCOS are about three times more likely to develop EC compared with women without it. This translates into a 9% lifetime risk of EC in Caucasian women with PCOS compared with 3% in women without it. Although most women (91%) with PCOS will not develop endometrial cancer, our study has shown that they are more likely at increased risk. More studies are required to clarify the exact molecular mechanisms, determine the best way of screening and preventing disease progression.
Periodontal disease: a potential modifiable risk factor limiting conception
BACKGROUND
Periodontal disease (PD) is a common chronic infectious and inflammatory disease of the gums and its supporting tissues, associated with several adverse health outcomes including significant obstetric consequences. PD is treatable with good oral hygiene and dental care, and consequently is a modifiable variable that may lead to improvements in adult health. To date, there are no published studies describing the influence of PD on a woman's time to conceive (TTC).
METHODS
This study formed part of the Smile study, which was a multi-centre randomized controlled trial of treatment for PD in mid-pregnancy. PD was defined as the presence of pockets ≥4-mm deep at ≥12 probing sites in fully erupted teeth. At the time of recruitment, women were asked about their TTC and whether they had required fertility treatment.
RESULTS
Of 3737 pregnant women recruited to the study, information was available from 3416 spontaneous conceptions, including 1014 cases with PD (29.7%). Planned pregnancies accounted for 1956 of the 3416 pregnancies available for study. For 146 women, the TTC was >12 months and PD was more prevalent in this group (34.9% versus 25.7%, P = 0.015). The mean TTC in women with PD was 7.1 months [confidence interval (CI): 5.7–8.6] compared with 5.0 months (CI: 4.4–5.5, P = 0.019) in those without PD. PD was present in 23.8% of Caucasian women and 41.4% of non-Caucasian women. Compared with Caucasian women without PD, non-Caucasian women with PD had an increased likelihood of TTC >12 months [13.9% versus 6.2%, odds ratio (OR): 2.88 (CI: 1.62–5.12), P < 0.001], but there was no difference for Caucasians with PD (8.6% versus 6.2%, OR: 1.15, CI: 0.74–1.79, P = 0.534). Other simultaneous predictors of TTC >1 year included age, BMI >25 and smoking.
CONCLUSIONS
In the non-Caucasian population, PD was associated with an increased TTC, but whether this is related to PD, or some other factor also present within this population, should be further investigated.
Obstetric outcome in singletons after in vitro fertilization with cryopreserved/thawed embryos
BACKGROUND
There is increasing use of cryopreservation in IVF. This study compared singletons born after cryopreservation with singletons born after fresh IVF cycles and singletons born to women in the general population.
METHODS
Data were collected for Swedish IVF treatments during the years 2002–2006. All singletons from single embryo transfer (SET) and double embryo transfer (DET) after cryopreserved (n = 2348) and fresh cycles (n = 8944) were included and cross-linked with the Swedish Medical Birth Registry and compared with all singletons born after spontaneous conception (n = 571 914). Main outcomes were preterm and very preterm birth and low and very low birthweight (VLBW). Other outcomes were small for gestational age, large for gestational age (LGA), perinatal mortality and maternal outcomes.
RESULTS
Singletons from cryopreserved SET/DET or cryopreserved SET had increased rates of extreme preterm birth compared with singletons from the general population. A lower rate of LBW was found for cryopreserved SET/DET singletons compared with singletons from fresh cycles; however, a higher rate of perinatal mortality was detected. The rates of LGA and macrosomia were increased for cryopreserved SET/DET singletons when compared with those from fresh cycles and the general population. For maternal outcomes, a higher rate of pre-eclampsia was noted for pregnancies from cryopreserved cycles compared with those from fresh cycles or the general population, but the rate of placenta praevia was lower in pregnancies from cryopreserved cycles compared with those from fresh cycles.
CONCLUSIONS
The obstetric outcome of singletons after cryopreservation was slightly poorer when compared with the general population. In comparison with fresh cycles, the outcome varied. The finding of an increased rate of LGA after cryopreservation requires further study.
Circulating luteinizing hormone level after triggering oocyte maturation with GnRH agonist may predict oocyte yield in flexible GnRH antagonist protocol
BACKGROUND
The use of gonadotrophin-releasing hormone (GnRH) agonist for triggering final oocyte maturation and ovulation can reduce ovarian hyperstimulation syndrome (OHSS) in high-risk patients. LH levels post-trigger with GnRH agonist might be correlated with oocyte yield and maturity. Our aim was to evaluate the relationship between serum LH level at 12-h post-trigger and oocyte yield, maturity and fertilization rate in patients at high risk of OHSS and therefore who were treated with a flexible GnRH antagonist protocol in which final oocyte maturation was triggered with GnRH agonist.
METHODS
In a prospective cohort study, 91 patients at high risk of OHSS were treated with a flexible GnRH antagonist protocol and divided into six groups according to their serum LH levels at 12-h after GnRH agonist administration: ≤15.0, 15.1–30.0, 30.1–45.0, 45.1–60.0, 60.1–75.0 and >75.0 IU/l. The oocyte yield, maturity, fertilization rate and clinical outcomes for each LH interval were analyzed.
RESULTS
There was a statistically significant reduction in oocyte yield with a concentration of serum LH ≤15.0 IU/l (P < 0.05), whereas no statistically significant differences in the oocyte maturity and fertilization rate among the six groups (P > 0.05) were seen. Only 5 out of 91 patients (5.5%) had a serum LH ≤15.0 IU/l at 12-h post-trigger with GnRH agonist. In addition, no statistically significant difference was seen regarding high-quality embryos, implantation rate, clinical pregnancy rate and early miscarriage between patients with LH ≤15.0 IU/l and >15.0 IU/l (P > 0.05).
CONCLUSIONS
Serum LH level at 12-h post-trigger with GnRHa <15.0 IU/l is associated with a dramatically lower oocyte yield but not with the oocyte maturity and fertilization rate. Serum LH levels post-trigger with GnRH agonist do not affect clinical outcomes.
Fertility awareness and parenting attitudes among American male and female undergraduate university students
BACKGROUND
In the USA, the postponement of childbearing reflects contemporary social norms of delaying marriage, pursing educational goals and securing economic stability prior to attempting conception. Although university students are more likely to delay childbearing, it is unclear to what extent they are aware of age-related fertility decline. The current study is the first of its kind to assess fertility awareness and parenting attitudes of American undergraduate university students.
METHODS
Two-hundred forty-six randomly selected undergraduate university students (138 females and 108 males) completed an online self-report survey adapted from the Swedish Fertility Awareness Questionnaire. Students were evenly distributed between the freshman, sophomore, junior and senior classes with a mean age of 20.4 years.
RESULTS
Participants wanted to have their first and last child within the window of a woman's fertility. However, participants demonstrated a lack of fertility awareness by vastly overestimating the age at which women experience declines in fertility, the likelihood of pregnancy following unprotected intercourse and the chances that IVF treatments would be successful in the case of infertility. Nearly 9 in 10 participants want to have children in the future and viewed parenthood as a highly important aspect of their future lives.
CONCLUSIONS
Delaying childbearing based on incorrect perceptions of female fertility could lead to involuntary childlessness. Education regarding fertility issues is necessary to help men and women make informed reproductive decisions that are based on accurate information rather than incorrect perceptions.
‘Zero is not good for me’: implications of infertility in Ghana
BACKGROUND
Given the high value placed on children in sub-Saharan Africa, previous research suggests that infertility increases the risk of psychological distress and marital conflict, encourages risky sexual behavior and deprives infertile individuals and couples of an important source of economic and social capital. This paper explores the implications of infertility for women in Ghana, West Africa.
METHODS
Semi-structured interview data collected from 107 women (aged 21–48 years, mean 33 years) seeking treatment in gynecological and obstetric clinics in Accra, Ghana, are analyzed. Based on iterative open coding of the interviews, the focus of the analysis is on mental health, marital instability, social interaction and gendered experiences.
RESULTS
Infertile women report facing severe social stigma, marital strain and a range of mental health difficulties. Many women feel that they shoulder a disproportionate share of the blame for infertility and, by extension, face greater social consequences than male partners for difficulties conceiving. Women who do not self-identify as infertile corroborate these findings, asserting that the social consequences of infertility are severe, particularly for women.
CONCLUSIONS
Infertility in Ghana has important consequences for social interactions, marital stability and mental health. These consequences are not perceived to be shared equally by Ghanaian men.
Endothelial dysfunction but not increased carotid intima-media thickness in young European women with endometriosis
BACKGROUND
Atherosclerosis is a chronic and degenerative disease developing typically in the elderly; nonetheless, a condition of accelerated atherosclerosis can be observed precociously in the presence of some diseases. Endometriosis, a chronic benign gynecological disorder, shows some characteristics, such as oxidative stress, systemic inflammation and a pro-atherogenic lipid profile, which could increase the risk of developing accelerated atherosclerosis. The aim of our study was to evaluate markers of subclinical atherosclerosis in young European women with endometriosis.
METHODS
This cross-sectional study included 37 women with endometriosis and 31 control subjects. The presence of subclinical atherosclerosis was investigated by ultrasound evaluation of common carotid intima-media thickness (ccIMT) and flow-mediated dilation (FMD); in addition, serum levels of lipids, inflammatory and coagulation parameters, as well as markers of endothelial inflammation and activation, were determined.
RESULTS
Women with endometriosis showed significantly lower values of FMD compared with controls [mean difference: –4.62, 95% confidence interval (CI): –6.52, –2.73; P < 0.001], whereas no significant differences in ccIMT values were found between the two groups. As regards markers of endothelial inflammation and activation, women with endometriosis had significantly higher values of inter-cellular adhesion molecule 1 (P < 0.001), vascular cell adhesion molecule 1 (P < 0.001), E-selectin (P < 0.001), von Willebrand factor (P = 0.004) and ristocetin cofactor (P = 0.001) compared with controls.
CONCLUSIONS
Our study suggests that women with endometriosis have more subclinical atherosclerosis, resulting in a higher risk of developing cardiovascular disorders. Moreover, our findings demonstrate that endothelial dysfunction can occur in the absence of structural atherosclerotic changes; its evaluation might be helpful in young women with endometriosis.
Favorable infertility outcomes following anti-tubercular treatment prescribed on the sole basis of a positive polymerase chain reaction test for endometrial tuberculosis
BACKGROUND
The endometrial tuberculosis (TB) PCR test is now commonly employed for the diagnosis of female genital TB, a common cause of infertility in India. Although treatment in the absence of demonstrable tubal damage may be of doubtful benefit to fertility, the presence of mycobacterial DNA demonstrated by a positive PCR indicates infection by tubercle bacilli causing sub-clinical or latent disease potentially responsible for future clinical manifestations. This study was undertaken to assess the outcome of infertility management following early anti-tubercular treatment (ATT) based only on a positive endometrial TB-PCR test.
METHODS
This was an intervention study conducted at an IVF center in northern India in 443 infertile women of whom 169 (38.15%) were found to have positive TB-PCR (Group I), while 274 (61.85%) had negative Mycobacterium tuberculosis (MTB)-PCR (Group II). Infertile women of <40 years of age, without any evidence of tubo-peritoneal or endometrial involvement, who underwent endometrial biopsy for the detection of MTB by PCR, were included. All the TB-PCR positive women were administered standard 6-month anti-tubercular chemotherapy. Additional treatment with assisted reproduction techniques was offered in the case of failure of spontaneous pregnancy after completion of ATT.
RESULTS
There were no statistical differences in the two groups in the overall pregnancy rate, 101 (59.8%) versus 167 (60.9%). In Group I, 48 (92.3%) spontaneous conceptions occurred within the first 12 months, i.e. during the period of ATT administration or within 6 months of treatment completion; in Group II, the occurrence of spontaneous conceptions was distributed more evenly in relation to time, i.e. 36 (53.7%) in <12 months as compared with 31 (46.3%) after first year (P< 0.001).
CONCLUSION
Infertile women without tubal or endometrial damage given early anti-tuberculosis treatment based on a positive endometrial TB-PCR test had an excellent chance of early spontaneous conception.
Diet-induced paternal obesity in the absence of diabetes diminishes the reproductive health of two subsequent generations of mice
BACKGROUND
Obesity and related conditions, notably subfertility, are increasingly prevalent. Paternal influences are known to influence offspring health outcome, but the impact of paternal obesity and subfertility on the reproductive health of subsequent generations has been overlooked.
METHODS
A high-fat diet (HFD) was used to induce obesity but not diabetes in male C57Bl6 mice, which were subsequently mated to normal-weight females. First-generation offspring were raised on a control diet and their gametes were investigated for signs of subfertility. Second-generation offspring were generated from both first generation sexes and their gametes were similarly assessed.
RESULTS
We demonstrate a HFD-induced paternal initiation of subfertility in both male and female offspring of two generations of mice. Furthermore, we have shown that diminished reproductive and gamete functions are transmitted through the first generation paternal line to both sexes of the second generation and via the first generation maternal line to second-generation males. Our previous findings that founder male obesity alters the epigenome of sperm, could provide a basis for the developmental programming of subfertility in subsequent generations.
CONCLUSIONS
This is the first observation of paternal transmission of diminished reproductive health to future generations and could have significant implications for the transgenerational amplification of subfertility observed worldwide in humans.
Want to learn more about Parkinson’s Disease?
Readmore: Local, News, Parkinson’s Disease, Want to Learn more about Parkinson’s Disease?, Parkinsons Conference, Crown Reef Resort, Parkinson’s Conference at Crown Reef Resort
Parkinson’s Disease affects nearly one million people in the United States.
A man who has the disorder and his mother put on a conference at the Crown Reef Resort Thursday to teach people about the disease.
Parkinson’s involves the malfunction or death of nerve cells in the brain that produce a chemical that sends messages to part of the brain that controls movement.
The cause of Parkinson’s in unknown and there is no cure. But there are treatment options like medication and surgery to manage symptoms.
“There is a lot of hope out there. There’s a lot of new medications coming through the pipeline that will be helpful. We also encourage people to live their lives to the fullest everyday,” says Karlin Schroeder with the Parkinsons Disease Foundation.
Clickhereto read more about Parkinson’s Disease.
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Sanofi and Michael J. Fox Foundation Collaborate on Potential New Treatment for Parkinson’s Disease
– Fox Foundation to sponsor a clinical trial to study Sanofi compound –
PARIS , France , April 19, 2012 /CNW Telbec/ – Sanofi (EURONEXT: BSAC – News) (NYSE: SNY – News) announced today that it has entered into a collaboration with the Michael J. Fox Foundation (MJFF) to conduct a clinical trial to assess the safety and tolerability of AVE 8112, a Sanofi PDE4 inhibitor – phosphodiesterase type 4 inhibitor – in patients with Parkinson’s disease (PD).
“AVE8112 has shown promising pro-cognitive activity in preclinical models that could be of interest to the under-addressed cognitive aspects of Parkinson’s disease, an area of unmet need where a new treatment could make a tangible difference in patients’ lives,” said Todd Sherer , Ph.D., Chief Executive Officer of MJFF. “Groundbreaking collaborations with like-minded partners such as Sanofi are a hallmark of the Fox Foundation’s approach and help us speed scientific advances with potential to improve the treatment of Parkinson’s for patients today and in the future.”
Under the terms of the collaboration, MJFF will sponsor a phase I b clinical trial to assess the safety and tolerability of AVE8112 in patients with Parkinson’s disease. All data and results generated by the clinical trial will be owned by MJFF and shared with Sanofi. Further development plans will be based upon the results of the study.
“The Michael J. Fox Foundation has been a driving force in discovering and developing improved therapies for those living with Parkinson’s disease. Through this research collaboration, together we will be able to study Sanofi’s pharmaceutical compound for a possible new treatment for PD patients around the world,” said Dr. Elias Zerhouni , President, Global R&D, Sanofi. “We hope to continue to develop relationships with private foundations like the Michael J. Fox Foundation to pool our resources and maximize the potential of our drug portfolio to address unmet medical needs.”
The clinical trial will be conducted at clinical sites in the United States in Baltimore , MD, and Los Angeles , CA. Patient enrollment in the study is expected to begin later this year.
***
About Parkinson’s Disease Over one million people in the US and an estimated 5 million people globally suffer from Parkinson’s disease, a neurodegenerative disorder caused by the diminished production of dopamine, a key neurotransmitter, resulting in progressive impairment of motor function including tremors, rigidity and difficulty in moving. Another symptom of PD is cognitive dysfunction, such as difficulty planning, sequencing, initiating and sustaining behavior toward a goal. Estimates vary but some studies suggest a cognitive deficit may occur in up to 80% of people with Parkinson’s. While there is a drug approved for the treatment of dementia in PD, there are currently no treatments available for patients who experience less severe cognitive impairments.
About Sanofi Sanofi, a global and diversified healthcare leader, discovers, develops and distributes therapeutic solutions focused on patients’ needs. Sanofi has core strengths in the field of healthcare with seven growth platforms: diabetes solutions, human vaccines, innovative drugs, consumer healthcare, emerging markets, animal health and the new Genzyme. Sanofi is listed in Paris (EURONEXT: BSAC – News) and in New York (NYSE: SNY – News).
About The Michael J. Fox Foundation for Parkinson’s Research As the world’s largest private funder of Parkinson’s research, The Michael J. Fox Foundation is dedicated to accelerating a cure for Parkinson’s disease and improved therapies for those living with the condition today. The Foundation pursues its goals through an aggressively funded, highly targeted research program coupled with active global engagement of scientists, Parkinson’s patients, business leaders, clinical trial participants, donors and volunteers. In addition to funding more than $285 million in research to date, the Foundation has fundamentally altered the trajectory of progress toward a cure. Operating at the hub of worldwide Parkinson’s research, the Foundation forges groundbreaking collaborations with industry leaders, academic scientists and government research funders; increases the flow of participants into Parkinson’s disease clinical trials with its online tool, Fox Trial Finder; promotes Parkinson’s awareness through high-profile advocacy, events and outreach; and coordinates the grassroots involvement of thousands of Team Fox members around the world. Now through December 31, 2012 , all new and increased giving to The Michael J. Fox Foundation, as well as gifts from donors who have not given since 2009 or earlier, will be matched on a dollar-for-dollar basis with the $50-million Brin Wojcicki Challenge, launched by Sergey Brin and Anne Wojcicki .
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Sanofi and Michael J. Fox Foundation Collaborate on Potential New Treatment for Parkinson's Disease
19th century therapy for Parkinson’s disease may help patients today
Public release date: 19-Apr-2012 [ | E-mail | Share ]
Contact: Deb Song deb_song@rush.edu 312-942-0588 Rush University Medical Center
(CHICAGO) In the 19th century, Jean-Martin Charcot, the celebrated neurologist, developed a “vibration chair,” to relieve symptoms of Parkinson’s disease. Charcot reported improvements in his patients, but he died shortly thereafter and a more complete evaluation of the therapy was never conducted. Now, a group of neurological researchers at Rush University Medical Center have replicated his work in a study to see if Charcot’s observation holds true against modern scientific testing.
Results from the study indicate that while vibration therapy does significantly improve some symptoms of Parkinson’s disease, the effect is due to placebo or other nonspecific factors, and not the vibration. The findings are published in the April issue of Journal of Parkinson’s Disease.
“We attempted to mimic Charcot’s protocol with modern equipment in order to confirm or refute an historical observation,” explains lead investigator Christopher G. Goetz, MD, director of the Parkinson’s disease and Movement Disorders Center at Rush. “Both the treated group and the control group improved similarly, suggesting other factors had an effect on Parkinson’s disease motor function.”
Charcot’s patients told him that during long carriage rides or train journeys, uncomfortable or painful symptoms of Parkinson’s disease seemed to disappear, and the relief lasted quite some time after the journey. He developed a chair that mimicked the continuous jerking of a carriage or train.
Goetz and his colleagues randomly assigned 23 patients to either a vibrating chair or the same chair without vibration. During the treatment sessions, both groups of study participants listened to a relaxation CD of nature sounds. Study participants underwent daily treatment for a month.
The patients in the vibration treatment group showed significant improvement in motor function after daily 30-minute treatments for four weeks. Although not as high, motor function scores for the no vibration group also improved significantly. Both groups showed similar and significant improvement in depression, anxiety, fatigue, and nighttime sleep and both groups reported similar high satisfaction with their treatment.
“Our results confirm Charcot’s observation of improvement in Parkinson’s disease symptomology with chronic vibration treatment, but we did not find the effect specific to vibration,” said Goetz. “Instead, our data suggest that auditory sensory stimulation with relaxation in a lounge chair or simply the participation in a research protocol has equivalent benefit as vibration on motor function.”
“While we can agree that our results may not change scientific thinking on treatment mechanisms, our results will allow clinicians to guide patients to at least one apparatus that is safe and associated with objective changes in parkinsonian impairment scores,” said Goetz. “Charcot’s advice to colleagues resonates as one places vibration therapy in the context of potential options for patients. ‘It is no small gain to be able to relieve the sufferers of paralysis agitans.’”
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19th century therapy for Parkinson's disease may help patients today
NI in Parkinson’s research world first
Published Friday, 20 April 2012
Researchers from around the world are coming together to study Parkinson’s (Getty)
The announcement was made at a special event at Queen’s University, as part of Parkinson’s Awareness Week.
Parkinson’s UK says the research study will boost the chances of finding a cure to stop the devastating symptoms, including tremors, mood changes, movement difficulties, loss of smell and speech problems.
The charity is looking to recruit up to 3,000 sufferers throughout the UK, who are at an early stage of the condition, for the study called ‘Tracking Parkinson’s’.
The aim of the 1.6m study is to identify elusive biomarkers and develop simple tests, like blood tests, to diagnose the disease.
We could identify some of the problems and, moving forward, we could actually treat Parkinson’s rather than the symptoms, and that would be a cure.
Kieran Breen, Director of Research and Innovation at Parkinson’s UK
As part of the study, the responses to treatments for tremors, movement problems, anxiety, memory lapses and digestion problems will be closely monitored for up to five years.
“Studies like ‘Tracking Parkinson’s’ could make a huge difference and help us to ultimately find a cure,” said Dr Kieran Breen.
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Clinical Trial at Evergreen Healthcare Shows Intestinal Gel Reduces Symptoms of Advanced Parkinson’s Disease
KIRKLAND, Wash., April 20, 2012 /PRNewswire/ — A recent clinical trial conducted at Evergreen Healthcare shows that a new form of a common drug used to treat Parkinson’s Disease greatly improves the quality of life for patients and reduces the affects of symptoms such as tremors, slowness, stiffness and difficulty walking.
Evergreen was the only site in the Pacific Northwest to hold the trial, which was led by Dr. C. Warren Olanow, a Fellow of the American Academy of Neurology and Professor of Neurology and Neuroscience at the Mount Sinai School of Medicine in New York.
The trial tested standard oral dosages of a Parkinson’s drug against the newer levodopa-carbidopa intestinal gel (LCIG) and found that the intestinal treatments gave patients an average of two extra hours per day of reduced symptoms and improved movement.
“We have been involved in the trials since 2008,” said Dr. Alida Griffith, principal investigator for the trial at Evergreen’s Booth Gardner Parkinson’s Care Center. “Levodopa is the ‘gold standard’ treatment for Parkinson’s disease.”
The intestinal gel contains levodopa and carbidopa, two drugs commonly prescribed for Parkinson’s, and is infused through a portable pump connected to a tube implanted in the intestine.
In the three-month, double-blind trial, 71 participants were randomized to receive either the continuous infusion of LCIG and dummy pills or a dummy intestinal gel and pills that contained levodopa and carbidopa. At the start of the study, the average person had Parkinson’s disease for about 11 years and experienced 6.6 hours of symptomatic behavior per day. A total of 93 percent of participants completed the study.
The results of the study are set to be presented as part of the Emerging Science program (formerly known as Late-Breaking Science) at the American Academy of Neurology’s 64th Annual Meeting in New Orleans from April 21 to April 28, 2012.
The study was supported by Abbott.
Learn more about Parkinson’s disease at http://www.aan.com/patients.
To learn more about the Evergreen Neuroscience Institute, visit http://www.evergreenhealthcare.org/parkinsons or call the Evergreen Healthline 425.899.3000.
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Clinical Trial at Evergreen Healthcare Shows Intestinal Gel Reduces Symptoms of Advanced Parkinson's Disease