Stem cell transplantation into mouse cochlea may impact future hearing loss therapies

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Public release date: 26-Jun-2012 [ | E-mail | Share ]

Contact: David Eve celltransplantation@gmail.com Cell Transplantation Center of Excellence for Aging and Brain Repair

Putnam Valley, NY. (June 26 , 2012) Researchers in Japan who evaluated the risks and efficacy of transplanting two varieties of stem cells into mouse cochlea have concluded that both adult-derived induced pluripotent stem (iPS) cells and mouse embryonic stem (ES) cells demonstrate similar survival and neural differentiation capabilities. However, there is a risk of tumor growth associated with transplanting iPS cells into mouse cochleae. Given the potential for tumorigenesis, they concluded that the source of iPS cells is a critical issue for iPS cell-based therapy.

Their study is published in a recent issue of Cell Transplantation (21:4), now freely available on-line at http://www.ingentaconnect.com/content/cog/ct/,

"Hearing loss affects millions of people worldwide," said Dr. Takayuki Nakagawa of the Department of Otolaryngology, Graduate School of Medicine, Kyoto University, Japan. "Recent studies have indicated the potential of stem-cell based approaches for the regeneration of hair cells and associated auditory primary neurons. These structures are essential for hearing and defects result in profound hearing loss and deafness."

The authors noted that embryonic stem cells have previously been identified as promising candidates for transplantation, however they have also been associated with immune rejection and ethics issues. Consequently, this study compared the survival and neural differentiation capabilities of ES and three clones of mouse iPS cells.

"Our study examined using induced pluripotent stem cells generated from the patient source to determine if they offer a promising alternative to ES cells," explained Dr. Nakagawa. "In addition, the potential for tumor risk from iPS cells needed clarification."

Four weeks after transplantation, the researchers found that the majority of cochleae that had been transplanted exhibited the settlement of iPS or ES-derived neurons. However, there was a difference in the number of cells present based on cell lines. They noted that the number of cells able to be transplanted into cochleae is limited because of the cochleae's tiny size. Thus, the number of settled cells is low.

They also noted the formation of a teratoma (encapsulated tumor) in some cochlea after transplantation with one group of iPS cells.

"To our knowledge, this is the first documentation of teratoma formation in cochleae after cell transplantation," said Dr. Nakagawa.

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Stem cell transplantation into mouse cochlea may impact future hearing loss therapies

Global Collaboration Enables Stem Cell Therapy to Rehabilitate Tragically Burned 3-Year-Old

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Johannesburg, South Africa (PRWEB) June 27, 2012

After three-year-old Isabella Pippie Kruger was burned on over 80% of her body in a tragic accident, her mother was left searching for a viable option to repair her extremely damaged skin and save her life.

The solution came from across the globe in the form of a company called Genzyme in Boston, MA. Genzyme has developed a protocol for cultivating autologous epidural stem cells in order to generate new skin for patients who have suffered extreme skin trauma.

Genzyme was able to graft 41 sheets of new skin that was made of Pippies own genetic material. This was then flown across the world to South Africa, where the procedure of grafting her new skin took place. It was the first time this type of procedure was administered in South Africa.

Global collaboration in the administration of stem cell therapies to treat previously untreatable conditions is accelerating the paradigm shift in the medical community for the treatment of disease, trauma and injury; a shift that is spearheaded by the utilization of autologous stem cells. The use of the patients own stem cells in emerging regenerative therapies eliminates the chance of rejection of the transplanted tissue and the need for immuno-suppression drugs leading to more favorable outcomes.

To learn more about how families can bank their own, valuable stem cells to ensure access to a variety of emerging regenerative treatments and therapies, visit http://www.stemsave.com or call 877-783-6728 (877-StemSave) today.

The future of Regenerative Medicine is now.

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Global Collaboration Enables Stem Cell Therapy to Rehabilitate Tragically Burned 3-Year-Old

FDA report faults Houston stem-cell company

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The Sugar Land company involved in Gov. Rick Perry's unlicensed adult stem-cell procedure is rife with basic manufacturing problems, according to the U.S. Food and Drug Administration.

In a report one expert called a blow to the entire adult stem-cell industry, the FDA found that Celltex Therapeutics Corp. cannot guarantee the sterility, uniformity and integrity of stem cells it takes from people and then stores and grows for eventual therapeutic reinjection.

"You have not performed a validation of your banking and thawing process to assure viability" of the stem cells, reads the April 27 report, meaning that the company cannot verify the cells are alive.

The FDA report, which followed an April 16-27 inspection of Celltex, was released under the Freedom of Information Act Monday to the Houston Chronicle and a University of Minnesota bioethicist who complained in February that Celltex is a potential danger to patients and not in compliance with federal law.

The report, partially redacted, was not accompanied by a warning letter.

A former FDA official who asked not to be identified, however, said the deficiencies - 79 in all, from incorrectly labeled products to failed sterility tests - are so serious that Celltex risks being shut down if it does not remedy the problems quickly.

Adult stem cells are cells in the body that multiply to replenish dying cells. Long used to treat leukemia and other cancers, they have shown promise for tissue repair in many other diseases in the last decade, although most scientists in the field consider them not ready for mainstream use.

Rules take effect July 8

Celltex has been in the public eye since it was revealed that Perry's Houston doctor treated him with his own stem cells during back surgery last July and in follow-up appointments. His stem cells were stored and grown at Celltex.

Perry subsequently called for Texas to become the nation's leader of adult stem cell medicine, which he touts as an ethical alternative to embryonic stem cells. Perry worked with his Houston doctor and a state representative to write legislation intended to commercialize the therapy in Texas.

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Magnet helps target transplanted iron-loaded cells to key areas of heart

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Optimal stem cell therapy delivery to damaged areas of the heart after myocardial infarction has been hampered by inefficient homing of cells to the damaged site. However, using rat models, researchers in France have used a magnet to guide cells loaded with iron oxide nanoparticles to key sites, enhancing the myocardial retention of intravascularly delivered endothelial progenitor cells.

The study is published in a recent issue of Cell Transplantation (21:4), now freely available online.

"Cell therapy is a promising approach to myocardial regeneration and neovascularization, but currently suffers from the inefficient homing of cells after intracavitary infusion," said Dr. Philippe Menasche of the INSERM U633 Laboratory of Surgical Research in Paris. "Our study was aimed at improving and controlling homing by loading human cord-blood-derived endothelial progenitor cells (EPCs) for transplant with iron oxide nanoparticles in order to better position and retain them in the hearts of myocardial-injured test rats by using a subcutaneously implanted magnet."

The researchers found that the cells were sufficiently magnetic to be able to be remotely manipulated by a magnet subsequent to implantation.

According to the researchers, an objective assessment of the technique to enhance the homing of circulating stem cells is the ability to track their fate in vivo. This was accomplished by visualization with MRI.

"We found a good correlation between MRI non-invasive follow-up of the injected cells and immunofluoresence or quantitative PCR data," said Dr. Menasche. The researchers concluded that further studies were needed to follow cell homing at later time points. They noted that the magnitude of homing they experienced may have been reduced by the relatively small number of cells used, owing to their large size and the subsequent risk of coronary thrombosis.

"In a rat model of myocardial infarction, this pilot study suggested homing of circulating stem cells can be improved by magnetic targeting and warrants additional benchwork to confirm the validity of concept," said Dr. Menasche. "There is also a need to optimize the parameters of targeting and assess the relevance of this approach in a clinically relevant large animal model."

"This study highlights the use of magnets to target transplanted cells to specific sites which could increase their regenerative impact. Factors to still be extensively tested include confirming the safety of the cells containing the magnetic particles and whether this process alters the cell's abilities" said Dr. Amit N. Patel, director of cardiovascular regenerative medicine at the University of Utah and section editor for Cell Transplantation.

More information: Chaudeurge, A.; Wilhelm, C.; Chen-Tournoux, A.; Farahmand, P.; Bellamy, V.; Autret, G.; Mnager, C.; Hagge, A.; Larghro, J.; Gazeau, F.; Clment, O.; Menasch, P. Can Magnetic Targeting of Magnetically Labeled Circulating Cells Optimize Intramyocardial Cell Retention? Cell Transplant. 21 (4):679-691; 2012.

Journal reference: Cell Transplantation

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Magnet helps target transplanted iron-loaded cells to key areas of heart

Philadelphia-area youngsters explore wonders of space with astronauts

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For 250 of Philadelphia's young people, 20 questions wasn't a guessing game but the number of chances to hear firsthand from astronauts on the International Space Station.

NASA astronauts Joe Acaba and Don Pettit and European Space Agency astronaut Andre Kuipers spoke via a satellite video to 250 Philadelphia Destination Imagination participants visiting the Philadelphia University campus Tuesday morning. The questions may have sounded mundane to many on Earth, but the answers from space elicited laughs and cheers from the audience.

"How do you do laundry in space?" You don't.

"Do you get to keep pets?" Only if you count lab specimens.

"What do you sleep on?" In a sleeping bag, and sometimes you wake up floating on the ceiling.

Destination Imagination, a Cherry Hill-based nonprofit educational program, received one of six invitations to communicate with astronauts on the space station about eight months ago, said Chuck Cadle, the group's chief executive. Twenty of the Destination Imagination participants, a group made up of local residents, area Boys and Girls Club members, and day campers, were given questions to read collected from Destination Imagination students in Knoxville, Tenn., that had been screened by NASA. The students from Tennessee also listened to the astronauts.

Cadle, who wanted to join NASA's mission control as a child, said it was a once-in-a-lifetime opportunity. Before the group heard from the astronauts, Cadle asked how many wanted to join NASA. About five raised their hands. After the 20-minute session, he asked again and saw about 40 hands shoot up.

"Events like this introduce students to science," Cadle said. "We want to teach them about the mystery behind it."

The one-day event also featured an appearance by U.S. Rep. Chaka Fattah, senior member of the House Appropriations subcommittee that funds NASA. Throughout the day there were hands-on challenges for the students, such as working in a team to create from household materials a container that would keep an egg safe when dropped.

"No matter how much you find out, there's always going to be more," said Tracey Riley, 16, who attended the event with the Wissahickon Boys and Girls Club. She asked the astronauts if they experienced the same thoughts and feelings in space as on Earth. Riley was told astronauts have the same feelings, but have to think differently about performing basic actions, such as setting a glass down and its not staying there.

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Philadelphia-area youngsters explore wonders of space with astronauts

Area students quiz Space Station astronauts via video

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"What do you sleep on?" In a sleeping bag, and sometimes you wake up floating on the ceiling.

Destination Imagination, a Cherry Hill-based nonprofit educational program, received one of six invitations to communicate with astronauts on the space station about eight months ago, said Chuck Cadle, the group's chief executive. Twenty of the Destination Imagination participants, a group made up of local residents, area Boys and Girls Club members, and day campers, were given questions to read collected from Destination Imagination students in Knoxville, Tenn., that had been screened by NASA. The students from Tennessee also listened to the astronauts.

Cadle, who wanted to join NASA's mission control as a child, said it was a once-in-a-lifetime opportunity. Before the group heard from the astronauts, Cadle asked how many wanted to join NASA. About five raised their hands. After the 20-minute session, he asked again and saw about 40 hands shoot up.

"Events like this introduce students to science," Cadle said. "We want to teach them about the mystery behind it."

The one-day event also featured an appearance by U.S. Rep. Chaka Fattah, senior member of the House Appropriations subcommittee that funds NASA. Throughout the day there were hands-on challenges for the students, such as working in a team to create from household materials a container that would keep an egg safe when dropped.

"No matter how much you find out, there's always going to be more," said Tracey Riley, 16, who attended the event with the Wissahickon Boys and Girls Club. She asked the astronauts if they experienced the same thoughts and feelings in space as on Earth. Riley was told astronauts have the same feelings, but have to think differently about performing basic actions, such as setting a glass down and its not staying there.

The young participants were not the only ones whose interest in space was piqued by the experience. Britt Dyer, the Destination Imagination special projects and events director who ran the question session, admitted that on a whim, she had looked up the application form to become a NASA astronaut while preparing for the event. She said that speaking with the astronauts was "surreal," and that she hoped the young participants would be inspired to think about the space frontier.

"Kids think about being basketball players or football players. They don't know that there are all these opportunities," Dyer said.

Ka'alea Rennie, 10, who asked how astronauts sleep in space, said she did not want to become an astronaut, but after talking to those aboard the International Space Station would consider a brief excursion into space.

"Maybe once in my life," Ka'alea said, "but not for a very long time

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Area students quiz Space Station astronauts via video

Life seen to survive in space conditions

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Expose allows long exposures to space conditions and solar UV-radiation on the International Space Station. Several trays filled with organisms were installed on the outside of the laboratory. Credits: ESA

PARIS, June 26 (UPI) -- Research on the International Space Station is giving credibility to theories that life came from outer space, the European Space Agency says.

In 2008, a suitcase-sized experiment dubbed Expose-E subjected organic compounds and living organisms such as lichen, seeds and algae to the hostile environment of outer space.

The result? You can freeze it, thaw it, vacuum-dry it and expose it to radiation, but life survives, scientists said.

Life on Earth is protected by our atmosphere from harmful ultraviolet rays, but the space samples endured the full power of the sun's rays.

The samples were returned to Earth in 2009 and the results of the study have been published in the journal Astrobiology.

Lichen have proven to be especially tough, researchers said, and, some species have continued to grow normally since their return to Earth.

"We are exploring the limits of life," ESA's Rene Demets said in a release from the agency's Paris headquarters.

Living organisms persevering in open space supports the idea of "panspermia" -- that life can spread from one planet to another or even between solar systems, researchers said.

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NASA satellites see wildfires across Colorado

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Public release date: 26-Jun-2012 [ | E-mail | Share ]

Contact: Rob Gutro Robert.j.gutro@nasa.gov 443-858-1779 NASA/Goddard Space Flight Center

Nearly half of the United States' airborne fire suppression equipment was operating over Colorado on June 25, 2012, CNN reported, as tens of thousands of acres burned. Fires raged in southwestern Colorado, northeastern Colorado, and multiple locations in between.

The Moderate Resolution Imaging Spectroradiometer (MODIS) on NASA's Aqua satellite captured this natural-color image on June 23, 2012. Red outlines approximate the locations of actively burning fires. The High Park and Weber Fires produced the largest plumes of smoke.

The High Park Fire continued to burn west of Fort Collins. Started by lightning on June 9, 2012, this blaze had consumed 83,205 acres (33,672 hectares), making it the second-largest fire in Colorado history, after the Hayman Fire that burned in 2002. As of June 25, more than 2,000 people were fighting the High Park Fire, and firefighters had it 45 percent contained, according to InciWeb. Nevertheless, The Denver Post reported that the fire had destroyed 248 homes, making it the most destructive in Colorado history, even if it was not the largest.

In the opposite corner of the state, the Weber Fire started around 4:15 p.m. on June 22. As of June 25, the fire had burned approximately 8,300 acres (3,400 hectares) and was being fought by 164 personnel. The cause was under investigation. The fire had high growth potential because of possible wind gusts from thunderstorms, InciWeb reported. On the other side of Durango, the Little Sand Fire had been burning for weeks after being started by a lightning strike on May 13. As of June 25, that fire had burned 21,616 acres (8,748 hectares), was being fought by nearly 200 people, and was 31 percent contained.

West of Colorado Springs, the Waldo Canyon Fire forced 11,000 people from their homes, many of them compelled to evacuate in the middle of the night on June 23. The fire started around noon on June 23, and by June 25 it had grown to 3,446 acres (1,395 hectares). InciWeb stated that 450 firefighters were battling the blaze, which retained the potential for rapid growth.

The Woodland Heights Fire just west of Estes Park was small but very destructive, consuming 27 acres (11 hectares) and destroying 22 homes, Denver's Channel 7 News reported. That fire was completely contained by the evening of June 24.

As fires burned, Colorado also coped with extreme heat. The Denver Post reported that Denver endured triple-digit temperatures June 22 through 24, and the National Weather Service forecast temperatures of at least 100 degrees Fahrenheit (38 degrees Celsius) for June 25 and 26, with temperatures in the upper 90s through June 29.

Colorado's fires have followed a dry spring. Although the state experienced unusually heavy snow in February, little snow followed in March and April, part of a larger pattern of low snowfall. By June 19, 2012, conditions throughout the state ranged from unusually dry to extreme drought, according to the U.S. Drought Monitor.

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NASA satellites see wildfires across Colorado

China’s race to space

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On Sunday, three Chinese astronauts manually docked their craft with the Tiangong 1 space module, which is due to be replaced by a permanent space station around 2020.

Yes, China is just repeating achievements weve already pulled off but the United States cant even launch its own astronauts these days. So the news confirms what analysts have warned about for years: America is steadily losing the race for space.

The implications are huge, especially for our national security.

Chinas equivalent of NASA isnt about scientific research or space rides; its an arm of the Peoples Liberation Army. So, while the Obama administration has largely ceded leadership in space flight to Russia and private firms like Space X, China is gearing for something that will give the phrase Star Wars a whole new meaning.

AP

Another advance: Chinas first woman in space, Lin Yang, 34, was one of the astronauts on the docking mission.

Lt. Gen. Ronald Burgess of the Pentagons Defense Intelligence Agency, warns that Chinas real goal is to find ways to deny or degrade the space assets of potential adversaries like the United States, while building up their own military capabilities, including beyond the Earths atmosphere.

In that sense, the space-docking exercise is just one more landmark in an anti-satellite warfare program thats been aimed at us since 2007, when China successfully tested its first satellite-killing ballistic missile.

Then, in January 2011, it sent up a highly sophisticated out-of-the-atmosphere kinetic kill vehicle (or KKV). The Chinese said it was for anti-missile defense. Others, including in the Pentagon, noted that it would work well for shooting down satellites, too. Ian Easton, researcher at a Washington think tank that tracks Chinese military trends, said then, The implications of this test are potentially huge in expanding Chinas ability to render our satellite-based Global Positioning System useless.

GPS works by transmitting signals from satellites to receivers on earth, which then automatically coordinate signals from several satellites to give the user information on his location, speed, bearing and more. The more satellites, the more exact the data.

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China’s race to space

Nasa plan likely to be cancelled

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General news

With the deadline for approval now passed, it looks like Nasas request to use U-tapao naval airbase for atmospheric studies is going nowhere. The matter now goes to parliament which will not met until August.

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Nasa already has prepared an official logo for the the Southeast Asia Composition, Cloud, Climate Coupling Regional Study (SEAC4RS). The exercise aims to address key questions regarding the influence of Asian emissions on clouds, climate, and air quality. (Nasa handout)

Cancellation likely, Yingluck concedes Thanida Tansubhapol

The cabinet yesterday voted to forward Nasa's request to use U-tapao naval airbase in Rayong for atmospheric studies to parliament for debate in August, which will likely result in the project being cancelled.

The request will be debated at the next session of a joint sitting of parliament, under Section 179 of the constitution, which does not require a vote. The parliament is now in recess and will not convene until August.

Speaking after the cabinet meeting yesterday, Prime Minister Yingluck Shinawatra admitted the decision might cause Nasa to scrap the project.

It would be a pity if Nasa withdrew the request as Thailand would lose an opportunity to develop its weather forecasting capabilities, she said.

"The cabinet agrees that we should use parliamentary mechanisms to scrutinise the request in the interests of the country," she said.

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NASA tweaks flight path of Mars mission

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This artist's concept features NASA's Mars Science Laboratory Curiosity rover, a mobile robot for investigating Mars' past or present ability to sustain microbial life. Credit: NASA/JPL-Caltech

PASADENA, Calif., June 26 (UPI) -- NASA says a maneuver Tuesday adjusted the flight path of its Mars Science Laboratory spacecraft for delivering the rover Curiosity to a landing target on Mars.

The car-size, 1-ton rover is set to arrive at Mars Aug. 6 to begin a two-year mission to investigate whether Mars ever offered an environment favorable for microbial life.

The latest trajectory correction maneuver -- the third and smallest since the spacecraft's Nov. 26, 2011, launch -- used four thruster firings totaling 40 seconds in duration, engineers at NASA's Jet Propulsion Laboratory in Pasadena, Calif., reported.

The maneuver served both to correct errors in the flight path and to carry out a decision to shift the landing target about 4 miles closer to the martian mountain next to Curiosity's intended landing site.

Shifting the landing target closer to the mountain may shave months off the time needed for driving from the touchdown location to selected destinations at exposures of water-related minerals on the slope of the mountain, scientists said.

"This puts us closer to our entry target, so if any further maneuvers are needed, I expect them to be small," JPL's Tomas Martin-Mur, the mission's navigation team chief, said.

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NASA tweaks flight path of Mars mission

Research and Markets: MEMS, NANO and Smart Systems – Selected papers from the 2011 7th International Conference on …

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DUBLIN--(BUSINESS WIRE)--

Research and Markets (http://www.researchandmarkets.com/research/9lpbg8/mems_nano_and_sma) has announced the addition of the "MEMS, NANO and Smart Systems" report to their offering.

Series: Advanced Materials Research, Volumes 403 - 408

Selected, peer reviewed papers from the 2011 7th International Conference on MEMS, NANO and Smart Systems (ICMENS 2011), November 4-6, 2011, Kuala Lumpur, Malaysia

The object of this collection of peer-reviewed papers is to provide a forum for the discussion of new developments, recent progress and innovations in the design and implementation of MEMS, NANO and Smart Systems-on-Chip. It addresses all aspects of the design methodology of such systems, with the emphasis on current and future challenges in research and development in both academia and industry.

The 983 papers are grouped into 22 chapters: Materials Behavior, Casting and Solidification, Surface, Subsurface and Interface Phenomena, Coatings and Surface Engineering, Composite Materials, Materials Forming, Machining, Nanomaterials and Nanomanufacturing, Biomedical Manufacturing, Environmentally Sustainable Manufacturing Processes and Systems, Manufacturing Process Planning and Scheduling, Meso/Micro-Manufacturing Equipment and Processes, Modeling, Analysis and Simulation of Manufacturing Processes, Computer-Aided Design, Manufacturing and Engineering, Semiconductor Materials Manufacturing, Laser-Based Manufacturing, Precision Molding Processes, Rapid Manufacturing Technologies, Nontraditional Manufacturing, Nanofabrication, Nanometrology and Applications, Metrology and Measurement, and Mechanical and Electronic Engineering Control. The huge volume of information makes this a veritable encyclopedia of the subject matter.

For more information visit http://www.researchandmarkets.com/research/9lpbg8/mems_nano_and_sma

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Loma Linda University Center for Health Disparities and Molecular Medicine Receives $5.9 Million Grant Award

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The Loma Linda University Center for Health Disparities and Molecular Medicine learns that funding by the National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health (NIH), has been renewed with a grant of more than $5.9 million over the next five years. ...

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Loma Linda University Center for Health Disparities and Molecular Medicine Receives $5.9 Million Grant Award

FunnyJunk lawyer's wife wades into fray, calls critics "nazi scumbags"

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FunnyJunk v. The Oatmeal

Charles Carreon, the Tucson lawyer currently suing Oatmeal creator Matt Inman, the National Wildlife Foundation, the American Cancer Society, and anyone impersonating him on Twitter, is something of a poet. (And, when we spoke to him last week, we learned that he loves The Ramones.)

So when Inman cranked out his infamous drawing of a mom seducing a Kodiak bear, Carreon took his displeasure to the blank page and churned out "Don't Mess With My Mom."

In case the subtext here wasn't clear, Carreon dedicated the verses to "Matthew Inman of the Oatmeal." Here's a small hors d'oeuvrejust imagine the lines set to a pumping, palm-muted set of power chords.

Your allies are the fools Who cut and paste all day. They think they're important, But their anger is impotent. They say nasty things, But they don't get paid. Their ignorance is deep, So ya' get 'em on the cheap.

Your humor's scatological, Your mind is pathological. Did someone drop you on your head, When you were in your baby-bed? Did they take away your rattle, And teach you how to tattle?

Whatever the reason, You have committed treason Against decency and sanity, You're offensive to humanity.

Carreon and his wife, Tara, are furious about Inman's online campaign, which was designed to mock Carreon and his initial demand that Inman pay $20,000 for allegedly defaming a client. And they're even angrier about the behavior of Inman's followers and supporters, who have been peppering the Carreons with e-mails that say things like:

You are the biggest fucking asshole I have ever seen. I hope you do the world a favor and die soon.

Others have taken Carreon's pretty-easy-to-find e-mail address and signed him up for all sorts of things, including Club Nintendo, the Olive Garden newsletter, and porn sites like Tube8. The prospect of having a Tube8 user account linked to his e-mail address terrifies Carreon. As he put it in his amended legal complaint this week:

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FunnyJunk lawyer's wife wades into fray, calls critics "nazi scumbags"

Clot-busting medicine safe for use in warfarin-treated patients following stroke

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Public release date: 26-Jun-2012 [ | E-mail | Share ]

Contact: Debbe Geiger Debbe.Geiger@duke.edu 919-660-9461 Duke University Medical Center

DURHAM, N.C. The clot-busting medicine, tPA (tissue plasminogen activator), is safe to use in acute stroke patients already on the home blood thinner warfarin, according to researchers from Duke Clinical Research Institute (DCRI). This study helps allay previous concerns that tPA was too dangerous to use in patients on home anticoagulation and would lead to high risk for potentially fatal intracranial bleeding.

"To date, we have no randomized trials or large cohort studies to guide us," says Ying Xian, M.D., Ph.D., assistant professor of medicine at Duke, and first author of the study published today in JAMA. "Our large national study found no statistically significant increase in risk, which supports using intravenous tPA in warfarin-treated patients following stoke if their INR is less than or equal to 1.7."

The International Normalized Ratio (INR) measures the rate at which blood clots while taking anti-clotting medications like warfarin.

The Duke researchers also found almost half of warfarin-treated patients who might have qualified for tPA following stroke did not receive treatment, according to DCRI Director Eric Peterson, M.D., the paper's senior author. "We noted a substantial under-treatment of patients on warfarin who were eligible, but did not receive tPA following their stroke."

Warfarin is an anticoagulant proven to reduce the rate of stroke in patients with atrial fibrillation irregular heart beats. If warfarin treatment fails and the patient suffers a stroke, tPA is the only effective treatment. However, it also carries an increased risk of symptomatic intracranial hemorrhage (sICH).

American Heart Association guidelines say IV tPA in warfarin-treated patients may be used if the INR is less than or equal to 1.7, but few small studies supported the guidelines.

The Duke observational trial included 23,437 stroke patients on warfarin treated at 1,203 hospitals, making it the largest to look at IV tPA use in warfarin-treated patients following stroke. While warfarin-treated patients had slightly higher crude rates of intracranial bleeding (5.7% vs. 4.6%) than non-warfarin patients, they were also older. After adjusting for age, stroke severity and other factors, warfarin and non warfarin users had similar intracranial hemorrhage risk.

"This study provides support for the current treatment guidelines," says Xian, and indicates that a portion of the population is being under-treated.

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Clot-busting medicine safe for use in warfarin-treated patients following stroke