Author Archives: ev1

Seldom wrong, never in doubt

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MclogoThe need, impact, importance and disagreement rate for second opinion pathology referrals has been a constant topic of discussion for many years.  These second opinions generally come in two flavors.  The first is a consultation of a particularly challenging case by a pathologist or clinician.  Patients can also initiate these consults if they are uncomfortable with a diagnosis.  The second flavor is the review of pathology diagnoses of patients now seeking treatment at a new institution who were originally diagnosed by an outside pathologist from the referring institution.  The popular press contains many stories about misdiagnoses in patients and mismanagement until second opinion/expert review identified a problem with the original pathology review.  The pathology literature contains dozens of studies and meta-analyses looking at disagreement rates from referral centers looking at "us versus them", working off the notion that the second opinion/referral/expert diagnosis is "the right one", "the gold standard" or represents "the absolute truth" for treatment, management, outcomes measurements and classification for subsequent tissue/molecular studies.  In a similar, but distinctly different scenario, pathologists, clinicians and patients can each seek a "second opinion" or consultation on challenging cases or diagnoses they are uncomfortable with.

Here is the typical scenario and how this works:

SecondOpinion2"Most people never consider the possibility of getting a second opinion on the pathology report from which the diagnosis was made, but the entire plan of treatment depends on what kind of cancer you have and how far it has spread, both of which usually depend in part or whole on the pathologists interpretation of the biopsy or surgical specimen. Changes in the interpretation of the pathology can dramatically change both the treatment and the prognosis.

At the same time, most patients probably do not need a second pathology opinion. There are some common sense cues that can let you know if it might make sense. I think that if you have a really rare cancer, it is always advisable to get a second pathology opinion.

If your pathology report doesn't give a definite diagnosis, a second opinion is probably in order.

Your hospital/group name here Pathology Department has the expertise to diagnose and classify all types of cancer, which helps oncologists choose the most effective treatment method for their patients. We provide second opinion evaluation of tissue samples submitted by physicians and pathologists for patients outside Your health care system name here.

We have experts in a wide range of cancer subspecialties, including:

  • Breast
  • Dermatopathology
  • Gastrointestinal
  • Genitourinary
  • Gynecological
  • Head and neck
  • Neuropathology
  • Bone and soft tissue
  • Thoracic

SecondopinionFees must be paid at time of the review. Many insurance carriers will reimburse the costs of second opinion consultations. If payment is a problem, we can work with you. Follow-up reviews are payable separately. Please remember that our service is for pathology second opinions only. We cannot discuss or recommend treatment options."

Consultations in pathology are an integral and routine part of daily practice.  Except for the pathologist or the group that claims "I/we don't send anything out".  That person/group may not but informed patients/clinicians will.  As a resident I was warned if you don't show cases to others or get consults from external sources you are doing your patients and yourself a disservice.  

Institutions/individuals who provide second opinion reads as part of or exclusively as their practice of pathology have from time to time, in many subspecialties made claims about disagreement rates that justify the practice for risk management and appropriate patient management with published disagreement rates from 2-5%, depending on the specimen tissue source or part type.  There is also the issue of defining what constitutes a "disagreement", although most studies cite a difference that would alter prognosis or treatment.

Teleconsultations using whole slide imaging, as frequent readers know, I think are one of the many use cases/applications for digital pathology.  Mitigating slide handling issues, improving turn around time, retaining original glass slides onsite, reviewing cases with your consultant in real-time and education/training from external review at another site.

A recent paper shows that, in general, there is a very high level of agreement among pathologists for secondary review of pathology for referral patients, in this study, a rate of 99.4% agreeement.  While small (0.6%), the diagnostic differences may be highly clinically significant, arguing that secondary review of pathology materials should be standard of care.  This high agreement rate should allay concerns of patients and clinicians (and perhaps some pathologists) alike regarding the value and consistency of diagnoses rendered by the pathology community at large.

With such high agreement, why not digital pathology for second opinions/specimen review for patient referrals/slide review prior to additional surgery/treatment?

And in some cases, with follow up case sharing, even outsmart the consultant?

Ryan Swapp, M.D., Marie Christine Aubry, M.D., Diva Salomao, M.D., and John Cheville, M.D., all of Mayo Clinic’s Division of Anatomic Pathology, recently released a study, “Outside Case Review of Surgical Pathology for Referred Patients: The Impact on Patient Care,” that can now be found as an early online release in CAP Archives of Pathology & Laboratory Medicine.

ChickenThe Division of Anatomic Pathology reviewed the pathology of nearly all patients that were referredto Mayo Clinic for treatment from 2005-2010. The objective was to identify the rate of major disagreements with diagnoses from external institutions and to characterize the nature and impact of discordant diagnoses on patient care.

Interestingly, they also concede that that their review diagnosis was not always the correct one.

Summary:  Major disagreements occurred only 0.6% of the time (457 of 71,811 cases) from 2005-2010.  The most frequent areas of disagreement were gastrointestinal (80 cases; 17.5%), lymph node (73;16.0%), bone/soft tissue (47; 10.3%), and genitourinary(43; 9.4%).  The disagreeing diagnosis was not always the correct one.  In a subset of these cases for which additional tissue was taken (n=86 disagreements from July 2009 – Dec 2010), this subsequent tissue showed that the original diagnosis was correct 15.1% of the time (13 of 86 cases).

View Full Study

 

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Detection and Segmentation of Cell Nuclei in Virtual Microscopy Images: A Minimum-Model Approach

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Automated image analysis of cells and tissues has been an active research field in medical informatics for decades but has recently attracted increased attention due to developments in computer and microscopy hardware and the awareness that scientific and diagnostic pathology require novel approaches to perform objective quantitative analyses of cellular and tissue specimens. Model-based approaches use a priori information on cell shape features to obtain the segmentation, which may introduce a bias favouring the detection of cell nuclei only with certain properties. In this study we present a novel contour-based “minimum-model” cell detection and segmentation approach that uses minimal a priori information and detects contours independent of their shape. This approach avoids a segmentation bias with respect to shape features and allows for an accurate segmentation (precision = 0.908; recall = 0.859; validation based on ?8000 manually-labeled cells) of a broad spectrum of normal and disease-related morphological features without the requirement of prior training.

Full article


 

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Digital Pathology Association Regulatory Committee Offerings

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The Digital Pathology Association has established a regulatory committee; the committee goal is to create a sense of urgency within regulatory agencies and to bring clarity to the digital pathology clearance and approval process. 

At Pathology Visions 2011 a Regulatory Panel of experts convened with representatives from the U.S. Food and Drug Administration (FDA), the Centers for Medicaid and Medicare Services (CMS), and the College of American Pathologists (CAP).  The DPA regulatory committee presented a series of questions for the panel to address.  DPA members can view the panel experts presentations and the panel recording “Navigating Digital Pathology’s Path to Patients” within the Member Community.

Choose one of categories below:

FDA

CMS/CLIA

CAP

FDA

In the United States, technology manufactured for digital pathology (i.e. scanners, software) are considered medical devices and are regulated by the U.S. Food and Drug Administration (FDA). Manufacturers may market their digital pathology technology for Research Use Only (RUO) unless the FDA has issued a clearance or approval to a specific manufacturer and for an intended use of the digital pathology hardware and software.  Several manufacturers have received one or more FDA 510(k) clearances, however no manufacturer has yet received an FDA approval of their technology for primary diagnosis.
 
The FDA remains focused on the safety and the effectiveness of digital pathology.  Safety is defined in 21 CFR 860.7(d)(1) as the “Reasonable assurance, based on valid scientific evidence, that the probable benefits to health from use of the device for its intended uses and conditions of use, when accompanied by adequate directions and warnings against unsafe use, outweigh any probable risks.”   Effectiveness is defined in 21 CFR 860.7(e)(1) as “Reasonable assurance, based on valid scientific evidence, that in a significant portion of the target population, the use of the device for its intended use and conditions of use, when accompanied by adequate directions for use and warning against unsafe use, will provide clinically significant results.”

In October 2009 the FDA Hematology and Pathology Devices Panel held a meeting to gain expert opinion and industry feedback on the replacement of H&E glass slides and conventional microscopy by whole slide images (WSI), specifically for rendering a routine surgical pathology diagnosis of a disease or condition.  No formal guidance document has been issued by the FDA for digital pathology, however one is expected soon.  In the meantime the FDA has provided two guidance documents, IVD 
Diagnostic products Labeled for Research Use Only and Mobile Medical Applications, that are relevant to digital pathology. 

- Pathology Visions 2011 Presentations (Members Only)
- Regulatory Panel | Navigating Digital Pathology’s Path to Patients (Members Only)
- Digital Pathology 510(k) Clearances
- FDA October 2009 meeting materials and transcriptions
- FDA issued guidance documents relevant to digital pathology
    1. IVD Diagnostic Products Labeled for RUO/IUO
    2. Mobile Medical Applications

CMS/CLIA

Centers for Medicare and Medicaid Services (CMS) oversees the Clinical Laboratory Improvement Amendments (CLIA) which regulate all non research, laboratory tests preformed on humans in the U.S. The goal of CLIA is to insure quality laboratory testing, and therefore quality control (QC) portions of CLIA will apply to digital pathology;  including the analytic phase of testing which requires monitoring the testing personnel, the test system, and the laboratory environment. Other requirements that apply to all testing include calibrations, establishing or verifying performance specifications, test system or equipment maintenance, test results comparisons, corrective actions, having a back-up plan for instrument failure, and a procedure manual.  Validation of a digital pathology system is also necessary, and labs should follow CLIA requirements for test reports. 

In February 2012 Clinical Laboratory Improvement Advisory Committee (CLIAC) held a meeting which discussed emerging issues in digital pathology. CLIAC provides scientific and technical advice and guidance to the Secretary of Department of Health and Human Services (HHS); the Assistant Secretary for Health; the Director of Centers for Disease Control and Prevention (CDC); the Commissioner of the Food and Drug Administration (FDA); and the Administrator of the Centers for Medicare and Medicaid Services (CMS). The advice and guidance pertain to general issues related to improvement in clinical laboratory quality and laboratory medicine.  CLIAC may also provide advice and guidance on specific questions related to a possible revision of CLIA standards. 

- Validation of Digital Pathology in a Healthcare Environment
- Pathology Visions 2011 Presentations (Members Only)
- Regulatory Panel | Navigating Digital Pathology’s Path to Patients (Members Only)
- Current CLIA Regulations
- Summary of CLIAC February 2012 Meeting

CAP

The College of American Pathologists (CAP) is a CLIA accredited organization composed of board-certified pathologists with a mission to serve patients, pathologists, and the public through the advocation of excellence in pathology and laboratory medicine worldwide. 

CAP issues laboratory accreditation checklists which support the accreditation process.  The checklists align with the CLIA mandate of high quality laboratory testing by providing a solid foundation for excellence in patient safety, and compliance with policies, procedures, and laboratory processes.  The Anatomic Pathology, Laboratory General, and Cytopathology checklists have items that can apply to digital pathology systems.  

In 2011 a CAP Center working group was formed to create guidelines for digital pathology.  Thirteen guidelines were developed to assist the pathology community with validating WSI for clinical diagnostic use.  The thirteen guidelines, which are still under development, were presented at Pathology Visions 2011.  The final version of the guidelines has not been issued but is expected soon.  

Download the DPA white paper, Validation of Digital Pathology in a Healthcare Environment, for more specific information about the CAP checklist items and the draft guidelines. 

- Validation of Digital Pathology in a Healthcare Environment
- Pathology Visions 2011 Presentations (Members Only)
- Regulatory Panel | Navigating Digital Pathology’s Path to Patients (Members Only)
- The College of American Pathologists' Laboratory Accreditation Program (CAP-LAP) Practical World View on Digital Pathology from a CLIA Accreditation Provider (Members Only)
- Recommendations for Validating Whole Slide Imaging in Pathology: College of American Pathologists (CAP) Pathology and Laboratory Quality Center (Members Only)
- CAP Checklists

 

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"Dissection as Studio Practice with Real Anatomical Specimens," Class with Laura Splan, Observatory, Next Monday, July 23

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I am very excited about "Dissection as Studio Practice," a class taking place next Monday, July 23, at Observatory. Taught by artist Laura Splan, the class will begin with an illustrated survey of the use of notions of "dissection" in contemporary art practice; these principles will then be applied to in-class projects which include the dissection of your very own anatomical specimens (i.e. frog, sheep brain, cow eye). This class is open to all expernience levels, and participants are invited to bring additional materials, objects and artifacts that will inspire their “dissective” inclinations.

We had a wonderful time in the last iteration of this class, as you can see from the photos above. Full description of the class follows. Class size is limited; if interested, be sure to RSVP via email to morbidanatomy[at]gmail.com. You can see more of Laura Splan's work by clicking here. Hope very much to see you there!

Lecture and Studio Art and Dissection Class with artist Laura Splan
Date: Monday, July 23
Time: 7-10 PM
Fee: $75
*** Class size is limited to 16; please RSVP to morbidanatomy[at]gmail.com
This class is part of the Morbid Anatomy Art Academy

This class will survey the use of dissection in contemporary art practice through an illustrated lecture, specimen dissections, and studio time for individual and collaborative projects. We will examine the conceptual and cultural significance of cutting, excavating, disassembling, labeling, observing and displaying “bodies.” The lecture will present a brief history of dissection as well as work by contemporary artists exploring imagery, tropes and methods of dissection. The collaborative and individual art projects will be fun and lively hands on explorations of the meaning of dissection in a work of art. Each student will receive a complete specimen dissection kit (i.e. frog, sheep brain, cow eye) to create a self-directed dissection project with. Participants should bring additional materials, objects and artifacts that will inspire their “dissective” inclinations. Additional supplies will be provided by the instructor to stimulate your creativity. No prior art training is required. Everyone is welcome.

Laura Splanis a Brooklyn based visual artist. Her mixed media work explores historical and cultural ambivalence towards the human body. She was a Visiting Lecturer at Stanford University where she taught “Art and Biology”. She has been a Visiting Artist at the New York Academy of Sciences, California College of Art, San Francisco Art Institute, Maryland Institute College of Art, and Cal Arts. Her artwork was recently commissioned by the CDC Foundation. She curates the visual portal DomesticatedViscera.com. Images of her artwork can be found on her website: LauraSplan.com. You can find out more here. Feel free to contact Laura through her website with any questions about the class by clicking here. You can see photos from the last class by clicking here.

You can find out more here, and RSVP with an email to morbidanatomy[at]gmail.com.

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"Dissection on Display: Cadavers, Anatomists and Public Spectacle" by Christine Quigley, Book Review by Bess Lovejoy

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I am very excited to read the new and wonderful looking book Dissection on Display: Cadavers, Anatomists and Public Spectacle by Christine Quigley, who many of you might best know as editor of the wide-ranging blog Quigley's Cabinet. I have not yet had a chance to read the book, but we are all in luck, as friend of Morbid Anatomy Bess Lovejoy--author of the forthcoming Rest in Pieces: The Curious Fates of Famous Corpses--has kindly offered up a very detailed and thoughful review of the book special for the Morbid Anatomy blog.

Lovejoy's review follows; you can also find out more about the book--or purchase a copy of your very own--by clicking here.

Dissection on Display: Cadavers, Anatomists and Public Spectacle
By Christine Quigley
Mcfarland, February 24, 2012

Most of us have never seen a dead body, let alone witnessed the dissection of a cadaver. But for centuries in Europe, Britain, and America, public dissections were highly social occasions. In the candlelit, damask-draped anatomy theatre of 18th century Bologna, townspeople jostled medical students and high-ranking officials during a two-week-long dissection that took place as part of the annual carnival. In 16th century Britain, hundreds crowded around to watch the dissections of executed criminals. And in early 19th century America, the most fashionable strata of society (men and women alike) attended public dissections for a chance to “see and be seen.”

In her new book, Dissection on Display: Cadavers, Anatomists and Public Spectacle, scholar, author, and blogger Christine Quigley traces the hidden history of anatomists who perform for the public. Not all of the men she profiles are known just for their dissections: some, like 17th and 18th century Europeans Frederik Ruysch and Honoré Fragonard, did the dirty work in private, then displayed the exquisitely-crafted results to the public in the form of art and illustration. Many of the names Quigley profiles will be familiar to Morbid Anatomy readers, though others -- like Thomas “Mummy” Pettigrew, the 19th century London antiquarian who unrolled mummies to entertain his guests – may be fresh discoveries.

Using a series of thematically-grouped vignettes, Quigley explores anatomists as demonstrators, educators, collectors, showmen, and more. Some of the book’s most intriguing passages deal with the lessons that public dissections were supposed to impart: not just about the workings of the body, but the workings of God, and of justice. Even more than a chance to gain medical wisdom, public dissections were often promoted as an opportunity to witness the glory of God in the functioning of a corpse’s entrails. Sometimes they were also seen as a chance to exult in the final stage of  punishment meted out to a criminal. The mutilation of the corpse was thought to deny the deceased a chance at Resurrection -- thus condemning him or her both in life and afterlife.

Quigley also touches on the racial and sexual undertones that have long troubled the study of anatomy. One of the book’s most disturbing sections profiles French naturalist and zoologist Georges Cuvier and his quest to uncover (literally) the mysteries that lay between the legs of Saartjie Bjartmaan, also known as the “Hottentot Venus.” Bjartmaan – a young Khoisan woman from South Africa -- entertained audiences in early 19th century London and Paris with the enormous size of her buttocks. Some whispered that Bjartmaan was also blessed with a similarly enormous labia minora, and like other scientists of the time, Cuvier was fascinated by such rumors. After Bjartmaan’s death, he detailed her dissection in a medical journal and preserved both her brain and genitals in greenish glass bottles outside his office. Thus the last shred of modesty that Bjartmaan had protected in life was unceremoniously stripped from her in death, in a way that calls to mind the brutally frank autopsy reports of modern dead celebrities.

Today, human dissection is usually hidden from the public. This cloaking began in the 19th century, when, as Quigley writes, “The anatomists withdrew behind the doors of educational institutions, and the townspeople were not invited to join them.” These days dissections occur exclusively in a medical or forensic context, and the only corpses we see are on television. No longer is the public treated to theatrical displays of their own inner-workings, as they were in the days when Andreas Vesalius kept Renaissance audiences glued to their seats.

But there have been exceptions. In 2002, the controversial Gunter von Hagens – he of the plastinated corpses and Body Worlds exhibits – staged a ticketed dissection of the body of a 72-year-old man in London. The event drew considerable attention, and Hagens faced the threat of arrest even while wielding the scalpel. Yet the room was packed, proving that our appetites for dissection haven’t waned. Quigley includes an excellent photograph of the event, notable not for the pale cadaver about to be sliced apart, but for the front row of the audience, their faces horrified, bemused, and fascinated in turn. One woman crosses her hands over her chest in protection, clutching her check and beginning to grimace. Next to her, an older gentleman folds his wrists behind his elbows and leans back as if to say “show me what you got.” Von Hagens himself is at the forefront of the image, clad in a black fedora -- his nod to Rembrandt’s “The Anatomy Lesson of Dr. Nicolaes Tulp,” which hangs on the wall above him.

In fact, Quigley takes pains to show us how conscious Von Hagens – the most famous modern anatomist -- is of his historical lineage. (Many of his most famous pieces, such as his flayed horse and rider, quote directly from the work of earlier anatomists such as Fragonard.) This is where the book shines: Quigley has stitched together a family tree of public anatomists who contributed to our understanding of the body, but whose work often remains hidden like the organs beneath our skin. Dissection on Display is recommended reading for anyone with a healthy sense of curiosity, morbid or otherwise, about what used to happen when we were allowed to watch.

The writer of this post, Bess Lovejoy, is a writer, editor, and researcher based in Seattle. Her book Rest in Pieces: The Curious Fates of Famous Corpsesis coming out March 2013. You can find out more about her at her website besslovejoy.com." To find out more--or to purchase a copy of this book--click here.

Image: The Anatomy lesson of Dr Nicolaes Tulp, Remrandt van Rijn, 1632; found on Wikipedia. According to Quigley, the dissection was performed in Leiden’s anatomical theatre, and included an audience of townspeople that were left out of the painting. Instead, Rembrandt was paid to include surgeons who may or may not have actually been there.

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Research and Markets: Nutrition and Vitamin Partnering 2007-2012

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DUBLIN--(BUSINESS WIRE)--

Research and Markets (http://www.researchandmarkets.com/research/fnttfk/nutrition_and_vita) has announced the addition of the "Nutrition and Vitamin Partnering 2007-2012" company profile to their offering.

Nutrition & Vitamins Partnering 2007-2012 provides understanding and access to the nutrition & vitamins partnering deals and agreements entered into by the worlds leading healthcare companies.

The report provides an analysis of nutrition & vitamins partnering deals. The majority of deals are discovery or development stage whereby the licensee obtains a right or an option right to license the licensors nutrition & vitamins technology. These deals tend to be multicomponent, starting with collaborative R&D, and commercialization of outcomes.

Understanding the flexibility of a prospective partners negotiated deals terms provides critical insight into the negotiation process in terms of what you can expect to achieve during the negotiation of terms. Whilst many smaller companies will be seeking details of the payments clauses, the devil is in the detail in terms of how payments are triggered contract documents provide this insight where press releases do not.

This data driven report contains over 220 links to online copies of actual liver disease deals and contract documents as submitted to the Securities Exchange Commission by companies and their partners, where available. Contract documents provide the answers to numerous questions about a prospective partners flexibility on a wide range of important issues, many of which will have a significant impact on each party's ability to derive value from the deal.

In conclusion, this report provides everything a prospective dealmaker needs to know about partnering in the

research, development and commercialization of nutrition & vitamins technologies and products.

Report scope

Nutrition & Vitamins Partnering 2007-2012 is intended to provide the reader with an in-depth understanding and access to nutrition & vitamins trends and structure of deals entered into by leading companies worldwide.

The rest is here:
Research and Markets: Nutrition and Vitamin Partnering 2007-2012

Finding MRSA

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In the Journal of Clinical Microbiology, researchers at University Hospital Heidelberg in Germany evaluate how well the new BD Max MRSA assay can detect low-prevalence methicillin-resistant Staphylococcus aureus as compared to BD's GeneOhm MRSA achromopeptidase assay. The Max MRSA assay had a 93.9 percent sensitivity and a 99.2 percent specificity while the GeneOhm MRSA ACP assay 93.8 percent sensitivity and 98.3 specificity, though the researchers note that the differences were not statistically significant. Upon retesting, the Max MRSA test could resolve all samples while the GeneOhm MRSA ACP tests could not. In addition, the researchers point out that GeneOhm MRSA ACP assay took less time to deliver results, though it needed more hands-on time than the Max MRSA test did.

"This study shows that within a routine clinical setting in a population with low MRSA prevalence the fully automated BD Max MRSA assay and the established BD GeneOhm MRSA ACP assay have similar sensitivity and specificity characteristics," the researchers conclude. "The BD Max MRSA assay produced less unresolved results, had fewer false positive results and showed reduced handling requirements thereby facilitating use of this molecular assay."

Link:
Finding MRSA

Longevity Global Inc. Comes Up With Brand New Line Of Multi Utility WeldAll Series of Welders

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(PRWEB) July 20, 2012

Longevity Global Inc. is the leading equipment brand of the nation, deals in welders, cutters and power generators. They work with high success ratio and complete customer satisfaction. Longevity Global Inc. has announced multi utility welders for sale with improved and innovative technology. Their welding equipment and other products are best in efficiency and comes with assured long service for various industrial clients. Longevity Global Inc. provides extensive collection of welders such as tig welders, mig welders and stick welders.

Mr. Simon Katz, president of Longevity Global Inc. took the dice to make an announcement. He stated, We feel great to introduce our WeldAll series combo welders in all the types of welders. These Multi-Purpose Welder machines are available with MOSFET and IGBT Inverter Technology. These welding equipment are portable and simple in use for all your welding jobs such as aluminum welding and cutting. Our innovative R&D department offers these machines with TIG, STICK, plasma cutter combinations from small sized machines ranging in weight from 40-70lbs and no bigger than the size of a standard microwave.

Longevity Global Inc. supply and manufactures economy welders such as aluminum welders, stick welders, and others. Their WeldAll Series combo welder can generally weld and cut all types of metals including aluminum, steel, bronze, copper, stainless steel, mild steel, etc. Their offered welders for sale are cost competitive in comparison to most of the leading market players and are very affordable for retail as well as industrial clients.

Longevity Global Inc. is providing its dedicated service since 2001. It is growing at a phenomenal pace with high customer satisfaction, innovative products and efficient industrial production. It works in different parts of world with distributors in Canada, Mexico, Brazil, Australia, United Kingdom, and multiple other countries. Longevity Welding serve globally with manufacturing facilities with its logistic companies to effectively distribute products in a punctual and effective manner. To know more visit http://www.longevity-inc.com

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Longevity Global Inc. Comes Up With Brand New Line Of Multi Utility WeldAll Series of Welders

Biology Leaves Gay Men Highly Vulnerable to HIV: Study

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By Randy Dotinga HealthDay Reporter

FRIDAY, July 20 (HealthDay News) -- New research pinpoints a major reason why gay and bisexual men remain so vulnerable to the AIDS epidemic: When it comes to the transmission of HIV, a man who has unprotected anal intercourse is at especially high risk.

In fact, if that kind of intercourse was only as risky as vaginal intercourse, researchers report, HIV cases among gay and bisexual men would shrink dramatically. It would go down even more, they added, if their rates of casual sex declined.

The reality, however, is much different. "Everywhere we looked, HIV is expanding both in high- and low-income countries among men who have sex with men," said study author Dr. Chris Beyrer, director of the Johns Hopkins Fogarty AIDS International Training and Research Program.

The experts were quick to note that, worldwide, it is heterosexual men and women who are by far the majority of those who are infected with HIV. Still, more than 30 years into the AIDS epidemic, gay and bisexual men remain especially vulnerable to infection despite a heavy emphasis on condoms and HIV testing; these men make up the bulk of HIV cases in the United States and other Western countries.

According to UNAIDS, HIV is more common among gay and bisexual men than adults in general in all areas of the world, even Africa. In North America, an estimated 15 percent of gay and bisexual men are infected with HIV; the rate is the highest, 25 percent, in the Caribbean.

Previous research has shown that being on the receiving end of anal intercourse is equally risky whether you're a man or a woman. The risk was estimated at 1.4 percent per sex act with an infected person -- about 18 times more risky than male-to-female vaginal intercourse.

The study authors estimate that if receptive anal intercourse were only as risky as vaginal intercourse, HIV cases would fall by 80 percent to 98 percent among gay and bisexual men over five years. They also estimate that cases would fall by 29 percent to 51 percent if more gay and bisexual men had sex in long-term relationships instead of casual encounters.

The findings appear in the July 20 issue of The Lancet, along with several other studies that examine the prevalence of HIV -- the virus that causes AIDS -- in gay and bisexual men and offer suggestions about prevention.

Two studies examined the higher risk of HIV infection among black men.

Originally posted here:
Biology Leaves Gay Men Highly Vulnerable to HIV: Study

Happy Feet: Plastic Surgery for Best Foot Forward

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Foot Plastic Surgery Is All the Rage, but Is It Safe?

July 20, 2012 (New York City) -- Are toes really the new nose?

Media reports of an uptick in toe and foot plastic surgery suggest that there is nothing that we won't do to put our best feet forward (and of course, sport sexy, strappy, and often pricey shoes). This includes getting our toes shortened, liposuctioned, or removed altogether.

Liposuction may help slim toes so they fit in pointy stiletto toe boxes, and some women opt to shorten a toe or remove one altogether so that they are less snug in the toe box.

Others still are signing up for laser treatments to zap away foot fungus and/or permanently remove hair on their toes and feet. There is also a surge in what are being called "Loub jobs," a plastic surgery procedure that allows women to wear their pricey Christian Louboutin shoes without pain.

"Foot beautification is definitely a trend," says Wendy Lewis. She is a New York City-based beauty consultant and author of several books, including Plastic Makes Perfect. "Many of these foot concerns are directly related to the shoes we wear."

Not everyone is on board. The American Orthopaedic Foot and Ankle Society is against cosmetic foot surgery of any kind. According to the group, foot complications, including permanent nerve damage, infection, bleeding, scarring, and chronic pain when walking, may occur. According to this group, "Cosmetic foot surgery should not be considered in any circumstances."

Cheryl Burgess, MD, is an assistant clinical professor of dermatology at Georgetown University and George Washington University in Washington, D.C. Her foray into the world of foot plastic surgery involved treating people with HIV. These individuals tend to lose fat in their faces and other parts of their body due to the cocktail of medications they must take.

Word got out, and soon Burgess was injecting fat or other fillers such as Sculptra into the feet of women who wanted to wear Christian Louboutin shoes.This treatment has been dubbed a "Loub job."

According to Burgess, another popular foot fix is Botox injections to treat hammer toes. With hammertoes, there is a bend in the middle joint. She also uses Botox to curb excessive and often smelly sweating of the feet. It is already approved to treat excessive underarm sweating.

Originally posted here:
Happy Feet: Plastic Surgery for Best Foot Forward

"Phantom Creep Theatre: Lon Chaney Shall Not Die," Tonight at The Coney Island Museum

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At the Coney Island Museum in Brooklyn, the Phantom Creep Theater pays tribute to classic horror with its version of the spook show, a macabre entertainment popular in the early 20th century that weds Grand Guignol tradition with modern sideshow showmanship. Hosted by M.C.’s in the vein of late-night television horror hosts like Ghoulardi and Dr. Creep, the shows feature B movies, live music, old-hat magic and a total blackout in which a monster or phantom tears through the theater.
--"No Rest for the Wicked, Undead or Ghoulish," New York Times. July 12, 2012

Tonight, at the Coney Island Museum, I hope to see you for "Phantom Creep Theatre: Lon Chaney Shall Not Die!",  an ode to the 1950s spook show organized in part by friend and Midnight Archive creator Ronni Thomas. The night's series of performances, screenings and hijinx will be dedicated to the memory and work of Lon Chaney Sr., patron saint of classic horror, and will feature a live theatrical recreation of the lost 1929 film "Thunder,"which included "insidious carnies, murderous dwarves, [and] ravenous gorillas on the loose" and reputedly killed "the man of a 1,000 faces." In fine spook show tradition, there will also be an attempt to make contact with the ghost of Mr. Chaney, a chance to meet the "Hypno Corpse," varied film screenings, live music, and many thrills and screams, all for only 10 dollars.

Full details follow; hope very much to see you there!

PHANTOM CREEP THEATRE: Lon Chaney Shall Not Die!
Location: The Coney Island Museum
Date: TONIGHT Saturday, July 21
Time: Doors 8:00, Event 8:30 PM
Admission: $10
Free Popcorn!

Set your faces to stun for THE UNHOLY THREE (1930), screened from a 16mm film print! This film includes insidious carnies, murderous dwarves, ravenous gorillas on the loose, Lon Chaney, Sr.'s only speaking role, and much, much more!

Experience a one time live theatrical recreation of the (lost) film that killed Lon Chaney, Sr.... THUNDER! No one has seen this gut wrenching, edge of your seat, golden era rail road drama, in over 80 years!! You can't see it anywhere, but the Phantom Creep Theatre stage!

These presentations and more are part of an entire evening celebrating the man of a 1,000 faces, the man who ceased to exist between pictures, the broken hearted clown who was born on April Fool's Day - Lon Chaney, Sr.!

Will you bear witness to COUNT MOLOCH and EK, as they attempt to make contact with the ghost of Lon Chaney, Sr., live on the Coney Island Museum stage?!?!

Entities known, and unknown, may leave the stage and roam the room in the dark. Will you be ripped from your seat, or frozen with fear to it?

"That's all there is to life: A little laugh, a little tear." - Lon Chaney, Sr.

Plus, the HYPNO CORPSE will shock and amaze you!

LIVE performances, FILM (not digital!) projections, LIVE music! ...ONLY ten bones?! YES! 

The team that ran the original Silver Scream Spook Show at Coney Island, reunite for the first time ever on the stage that started it all! NYC's 8mm Movie Matinee, along with Atlanta GA's Silver Scream Spook Show, and the internet's own Midnight Archive web series, are throwing a gala summer-long series!

A spook show collaboration of colossal proportions in Coney Island! Ghosts materialize before your eyes! Monsters summoned from beyond! Strange creatures reach out at you through the darkness!

Including, but not limited to:

Golden era monster movies presented from 16mm film prints!

Live morbid magicians conjuring spirits that may run out into the audience to shake and shock you to your very core!

Each month is a DIFFERENT theme with NEW films, NEW gags, and NEW live hijinks! Collect ALL the memories and experiences!

You can find out more, and get tickets, by clicking here; tickets can also be purchased at the door. You can read the entire New York Times article about the event by clicking here.

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Howard Murad, M.D. to Share Inclusive Health Insights in Institute for Integrative Nutrition Webinar

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EL SEGUNDO, Calif.--(BUSINESS WIRE)--

The Institute for Integrative Nutrition has announced a free educational webinar to feature Howard Murad, M.D., whose scientifically-proven methodologies and Inclusive Health approach to overall well-being have helped millions enjoy healthier, more beautiful lives. During the special exclusive webinar taking place on Monday, July 23 at 2 p.m. EDT, Dr. Murad will share easy ways to look and feel younger.

In this exclusive live discussion, moderated by the Institute for Integrative Nutrition, Dr. Murad will share his philosophies on Inclusive Health, youth building and how to improve total well-being from the inside out. Hell also address audience questions about looking and feeling younger and healthier!

Dr. Murad will also be explaining his scientific discovery of The Science of Cellular Water, which identifies the common denominator of aging and illness as cellular water loss, is now recognized as a comprehensive approach to understanding health and aging, looking at the ability of cell membranes to hold water as the fundamental marker of youthful good health.

When: Monday, July 23 at 2pm Eastern Time

Where: Your computer or telephone

What: A live interview and Q&A session with the founder of Inclusive Health -- Dr. Howard Murad!

Register at http://bit.ly/OzRL5b to receive a confirmation.

Since 1992, Integrative Nutrition has been the cutting-edge leader in holistic nutrition education. As the worlds largest nutrition school, it trains students around the world to become certified Health Coaches. These Health Coaches work one-on-one with clients to help them create a balanced life, reach wellness goals and achieve optimum health.

Howard Murad, M.D., FAAD, is changing the way people think about health and wellness with scientifically-proven methodologies and an Inclusive Health approach to overall well being that has helped millions enjoy healthier, more beautiful lives. A board-certified dermatologist, trained pharmacist, founder of the University of Inclusive Health, Associate Clinical Professor of Medicine at UCLA, Director of Murad Research Labs, and best-selling author of The Water Secret, Dr. Murad has treated over 50,000 patients and continues to practice medicine at the Murad Inclusive Health Medical Group in El Segundo, California.

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Howard Murad, M.D. to Share Inclusive Health Insights in Institute for Integrative Nutrition Webinar

Research and Markets: Israel In Vitro Diagnostics Market Outlook to 2017 – Clinical Chemistry Genetic Testing …

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DUBLIN--(BUSINESS WIRE)--

Research and Markets (http://www.researchandmarkets.com/research/wsdqpt/israel_in_vitro_di) has announced the addition of GlobalData's new report "Israel In Vitro Diagnostics Market Outlook to 2017 - Clinical Chemistry Genetic Testing, Haematology, Histology and Cytology, Immuno Chemistry, Infectious Immunology and Microbiology Culture" to their offering.

This new report provides key market data on the Israel In Vitro Diagnostics market. The report provides value (USD million) data for each segment and sub-segment within seven market categories - Clinical Chemistry, Genetic Testing, Haematology, Histology And Cytology, Immuno Chemistry, Infectious Immunology and Microbiology Culture. The report also provides company shares and distribution shares data for each of the aforementioned market categories. The report is supplemented with global corporate-level profiles of the key market participants with information on company financials and pipeline products, wherever available.

This report is built using data and information sourced from proprietary databases, primary and secondary research and in-house analysis by GlobalData's team of industry experts.

Scope

- Market size and company share data for In Vitro Diagnostics market categories - Clinical Chemistry, Genetic Testing, Haematology, Histology And Cytology, Immuno Chemistry, Infectious Immunology and Microbiology Culture.

- Annualized market revenues (USD million) data for each of the segments and sub-segments within seven market categories. Data from 2003 to 2010, forecast forward for 7 years to 2017.

- 2010 company shares and distribution shares data for each of the seven market categories.

- Global corporate-level profiles of key companies operating within the Israel In Vitro Diagnosticsmarket.

- Key players covered include Siemens Healthcare, F. Hoffmann-La Roche Ltd., Abbott Laboratories, Beckman Coulter, Inc., bioMerieux S.A., Becton, Dickinson and Company and others.

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Research and Markets: Israel In Vitro Diagnostics Market Outlook to 2017 - Clinical Chemistry Genetic Testing ...

DNA From Boxer's Bloody Swab Leads to Arrest

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Jul 19, 2012 6:05pm

A boxer could be facing jail time following his most recent boxing match, thanks to a bloody nose and a resourceful FBI agent.

Martin Tucker, a light welterweight, won his last boxing match, but a bloody cotton swab discarded at the ring was picked up by undercover FBI agent Robert Schmitz, who was investigating a bank robbery.

Schmitz suspected Tucker was involved in a 2009 armed robbery of a credit union in Temperance, Mich. Subsequent tests of the DNA collected from the bloody swab proved his hunch correct, according to court filings.

Tucker, a roofer and part-time boxer, was arrested this week, and ordered held withoutbail Wednesday. Hes accused of using a semi-automatic weapon in the theft of nearly $5,400.

One other man involved in the robbery, Quentin Sherer, was arrested in November 2011.

During his investigation of the robbery, Schmitz began looking through Sherers social networking profiles and found a picture of Sherer and Tucker together, according to court documents filed by Schmitz. Tucker matched the physical description of the unknown suspect in the 2009 robbery. Schmitz began looking into Tucker.

In a Myspace Internet search, [Schmitz] learned that Tucker was featured in a boxing match in Toledo, Ohio, the affidavit reads. During the match, Tucker sustained a bloody nose, and [Schmitz] was able to obtain a discarded Q-tip that contained Tuckers blood.

That Q-tip was submitted to an FBI lab, where it was found that Tuckers DNA matched the DNA found on a mask worn by one of the alleged bank robbers, as well as the steering wheel of the getaway vehicle.

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DNA From Boxer's Bloody Swab Leads to Arrest

Posted in DNA

DNA could reveal ID of Sydney bodies

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DNA tests could reveal the identities of bodies found in an underworld graveyard in Sydney.

The tests could verify the bodies of Melbourne hitman Christopher Dale Flannery and missing heiress Juanita Neilsen, presumed victims of Sydney gangsters in the 1970s and '80s, News Ltd reports.

The pair's DNA will be be tested against samples from bones found in sand dunes at Kurnell, near Botany Bay, by workers building a desalination plant in 2005.

Soon after police contacted relatives of Flannery, known as Mr Rent-a-Kill, to obtain a DNA sample, the report says.

NSW homicide commander Detective Superintendent Michael Willing says the remains belong to two males and there is the possibility of a third person.

Police will match samples against their missing persons database.

There is speculation the dunes could have been a dumping ground for killers such as Neddy Smith, the report says.

'Because of that, some people are suggesting they (the bones) could be Flannery's or a missing prostitute called Lyn Woodward,' Det Willing told News Ltd.

'To be honest, we do not have any idea whose remains they are.'

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DNA could reveal ID of Sydney bodies

Posted in DNA

Keystone Symposia announces new 3-year grant to tackle major global health challenges

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Public release date: 19-Jul-2012 [ | E-mail | Share ]

Contact: Yvonne Psaila yvonnep@keystonesymposia.org 970-262-2676 Keystone Symposia on Molecular & Cellular Biology

SILVERTHORNE, CO July 19, 2012 Keystone Symposia on Molecular and Cellular Biology is pleased to announce that it has received a fourth grant from the Bill & Melinda Gates Foundation to promote discoveries that will solve urgent global health problems via support of infectious disease conferences in the "Keystone Symposia Global Health Series." The grant also funds Global Health Travel Awards for investigators from developing countries, a pre-meeting workshop for Travel Awardees, and registration costs for local participants at the conferences that are based in developing countries.

A Colorado, USA-based nonprofit organization, Keystone Symposia received three previous grants from the Foundation, beginning in 2004 and ending with the December 2012 conference on "Immunological Mechanisms of Vaccination" in Ottawa, Ontario, Canada, which will be held following the conclusion of the Grand Challenges meeting for that program's grantees. Keystone Symposia typically holds one Global Health Series conference each year in conjunction with the Grand Challenges meeting.

The new grant will provide support for conferences in 2013, 2014 and 2015. It consists of $2.25 million in funding over three years or $750,000 per year.

The five 2012-2013 season Keystone Symposia conferences funded by the new grant are: "Malaria" in New Orleans, Louisiana, USA in January 2013; "HIV Vaccines" in Keystone, Colorado, USA in February 2013; "Tuberculosis: Understanding the Enemy" in Whistler, British Columbia, Canada in March 2013; "Immune Activation in HIV Infection: Basic Mechanisms and Clinical Implications" in Breckenridge, Colorado, USA in April 2013 and "The Innate Immune Response in the Pathogenesis of Infectious Disease" in Ouro Preto, Brazil in May 2013. The latter will be the first conference for Keystone Symposia in Latin America.

More than half of the grant is used to fund Global Health Travel Awards for investigators, clinicians, graduate students and postdoctoral fellows from developing countries where the health issues of the meeting topic are endemic. Without these awards, these individuals would not be able to attend the conferences and participate in the valuable knowledge-sharing and collaboration-building that result. To date, more than 1,100 individuals from at least 50 countries have participated in Keystone Symposia conferences as a result of Global Health Travel Awards.

A unique component of the Global Health Series meetings that the funding also supports is a pre-meeting workshop for Travel Awardees in which three to four speakers provide an overview of the field, its current status and primary challenges. This has proved enormously valuable to participants who may be more involved in field work and therefore not as close to the latest research.

The grant will also help fund some registration costs for local scientists, postdoctoral associates and students when the conferences are held in developing countries. This promotes sharing of the latest research advances with those on the frontlines of battling global health challenges. It also stimulates growth of the research enterprise in developing countries.

James Aiken, Chief Executive Officer of Keystone Symposia, expressed his deep appreciation for the grant: "The support from the Foundation is an essential base that we build upon to expand our global science educational activities and to enhance science capability worldwide."

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Keystone Symposia announces new 3-year grant to tackle major global health challenges

Hartemink Named New Director for Duke's Computational Biology and Bioinformatics Program

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igsp headline news Published by KENDALL MORGANTuesday, July 10, 2012

Alex Hartemink, the Alexander F. Hehmeyer Associate Professor of Computer Science, Statistical Science, and Biology, has been appointed as the new Director of the Computational Biology and Bioinformatics (CBB) Program, effective July 2012. Based in the Duke Institute for Genomes Sciences& Policy, the CBB Program is an integrative, multi-disciplinary doctoral program encompassing the study of biology using computational and quantitative methods.

"I'm really excited to be doing this because of the many people who have contributed their time and energy to build the program to its present level of excellence," Hartemink said. "It's exciting to be involved with a program that inspires that kind of commitment, and I look forward to working with colleagues and students to make the program even better going forward."

In his new role, Hartemink will be responsible for the overall leadership, management, and maintenance of the PhD and certificate training activities of the program. Hartemink says that in addition to focusing on the existing doctoral program, he will also consider the potential for other innovative opportunities in computational biology and bioinformatics at Duke, including at the undergraduate and post-doctoral levels.

"This is an important time for the field because several strands are coming together at the same time," Hartemink says. "As one example, next-generation sequencing technology and the plummeting cost of sequencing has really changed the amount of data people regularly collect, and we need to be able to understand those data in a computationally efficient and statistically principled way. Quantitative expertise has become increasingly valuable in this big data world."

Learn more about the Computational Biology and Bioinformatics Program.

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Hartemink Named New Director for Duke's Computational Biology and Bioinformatics Program

DSM completes acquisition of Ocean Nutrition Canada and expands its Nutritional Lipids growth platform

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Royal DSM, the global Life Sciences and Materials Sciences company, announced today that it has successfully completed the acquisition of Ocean Nutrition Canada, the leading global provider of fish-oil derived nutritional products to the dietary supplement and food and beverage markets. The acquisition, announced on 18 May 2012, strengthens and complements DSM`s newly established, global Nutritional Lipids growth platform. The acquisition, for a total enterprise value of CAD 540 million, is expected to be EPS accretive from 2013 onwards.

Feike Sijbesma, CEO and Chairman of the DSM Managing Board, said: "With the completion of this transaction we have now completed 1.7 billion worth of growth enhancing acquisitions since we embarked on our current strategic plan less than two years ago, including nearly 1.3 billion in the Nutrition cluster, as we continue to further improve our attractive portfolio in health, nutrition and materials to deliver shareholder value with stronger, more stable growth and profitability. After our successful acquisition of Martek in 2011, the acquisition of Ocean Nutrition Canada is the logical next step in developing our Nutritional Lipids into a major growth platform for our Nutrition cluster."

Leendert Staal, President and CEO of DSM Nutritional Products, commented: "Having completed the acquisition in a timeframe of only two months, we are very pleased to welcome all employees of Ocean Nutrition Canada to DSM today and I look forward to developing this exciting opportunity together. Our attention is now fully focused on ensuring a smooth integration of the business in a timely and efficient manner. Business continuity and customer satisfaction will remain key priorities for us as we focus on future synergy generation between both businesses."

Strategic rationale With the acquisition of Ocean Nutrition Canada, DSM strengthens and complements its Nutritional Lipids growth platform, which was established after the acquisition of Martek in 2011. DSM can now uniquely offer a full range of products in the rapidly growing nutritional lipids category, offering both fish oil derived omega-3 fatty acids and microbially derived nutritional lipids.

The nutritional lipids category is at an early stage yet well established and is based on strong science, offering significant growth opportunities across a broad range of market segments and applications. Healthy nutritional lipids have been shown in a growing body of scientific evidence to provide significant health benefits and support brain, eye, and cardiovascular health throughout life, yet many consumers do not include enough in their daily diets because dietary sources are limited. In particular, leading experts have noted the important health benefits of omega-3 fatty acids, a specific class of nutritional lipids.

DHA (docosahexaenoic acid), is an omega-3 fatty acid abundant in the brain and retina and important to supporting brain health throughout life. EPA (eicosapentaenoic acid) is also an omega-3 fatty acid important for human health. Together, EPA and DHA have been identified as important to supporting cardiovascular health throughout life.

Ocean Nutrition Canada is the leading provider of fish-derived DHA and EPA omega-3 with its MEG-3 product line. DSM is the leading provider of microbial DHA from algae with its life`sDHA(TM) product line. Also part of the DSM portfolio is life`sARA(TM), a microbially derived nutritional lipid called ARA (arachidonic acid). ARA is an omega-6 fatty acid and the principal omega-6 in the brain. Like DHA, ARA is important for proper brain development in infants.

Given the very different value proposition and pricing of fish oil derived omega-3s compared to microbial derived nutritional lipids, these products do not compete. In fact, Ocean Nutrition Canada`s fish derived omega-3 products are highly complementary to DSM`s existing microbially derived nutritional lipid products as they address different customer needs and reach different market segments.

The acquisition allows DSM to strengthen and complement its newly established, global Nutritional Lipids growth platform. It strengthens DSM`s position in the North American dietary supplement market by adding fish-oil derived omega-3 fatty acids to its portfolio and it allows DSM to further leverage its global infrastructure to expand Ocean Nutrition Canada`s sales in dietary supplement markets outside North America and in the food and beverage markets worldwide. In addition, by leveraging forms, encapsulation and emulsification technologies, the range of applications and products can be expanded.

DSM expects the transaction to be EPS accretive from 2013 onwards. The acquisition is expected to accelerate revenue growth through material revenue synergies with expanded distribution, marketing and product development. Customary operational efficiencies will also be realized in the integration process.

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DSM completes acquisition of Ocean Nutrition Canada and expands its Nutritional Lipids growth platform

DNA analysis of ancient remains to uncover origin mysteries

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Public release date: 17-Jul-2012 [ | E-mail | Share ]

Contact: Deborah Marshall d.mashall@griffith.edu.au 61-040-872-7734 Griffith University

Griffith University researchers will analyse DNA sequences from ancient human remains, some dating back 45,000 years, to determine the origins of the peoples of South-east Asia and Australia.

In collaboration with the Universities of Auckland, Copenhagen and New South Wales, the researchers will analyse human remains from continental and oceanic Asia and Australia using more powerful newly developed ancient DNA sequencing methods.

Chief Investigator Professor David Lambert from the School of Environment says understanding where the earliest people of Asia and continental Australia came from is critical to understanding modern human evolution.

"The recent sequencing of the Australian Aboriginal genome has identified two waves of human migration through Asia,'' he said.

"Aboriginal Australians descended from an early human dispersal into eastern Asia, possibly 62,000 to 75,000 years ago.

"This dispersal is separate from the one that gave rise to modern Asians 25,000 to 38,000 years ago, although there is evidence for hybridisation between them."

The researchers aim to identify descendent individuals from both lineages and detect historic patterns of interbreeding among these early people.

Professor Paul Tacon from Griffith University's Place, Evolution & Rock Art Heritage Unit said the research was a world-first study to attempt to recover human DNA sequences from more than 80 ancient human remains collected from a range of time points.

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DNA analysis of ancient remains to uncover origin mysteries

Posted in DNA