New Surgery May Reverse Hand Paralysis

Newswise — Justin M. Brown, MD, reconstructive neurosurgeon at UC San Diego Health System, is one of only a few specialists in the world who have pioneered a novel technique to restore hand function in patients with spinal cord injury. In a delicate four-hour procedure, Brown splices together tiny nerve endings, only one millimeter in width, to help restore hand mobility. Most patients return home 24 hours after surgery. “Even if a patient appears to have lost total hand function, as long as there is some nerve in the arm or shoulder under the patient’s control, some mobility may be regained,” said Brown, director of the Neurosurgery Peripheral Nerve Program and co-director of the Center for Neurophysiology and Restorative Neurology at UC San Diego Health System. “With a nerve transfer, the goal is to reverse paralysis. This means achieving functional grasp and release so that patients can eat independently, operate a computer or hold a loved one’s hand.”

Brown and his team treat hand impairments at cervical level 5 and below. Operating under a microscope, Brown disconnects the damaged nerve and reconnects it to a healthy one. The healthy nerve is taken from underneath the muscles of the upper arm and then connected to a nerve branch that provides finger function. In contrast to muscle transfers, nerve transfers allow whole muscle groups to be restored in the arm without visibly changing the body’s anatomy. “The nerves grow at a rate of 1 millimeter per day,” said Brown, who is also founding member and first president of the International Society for Restorative Neurology. “Over a period of six to 12 months, patients can essentially wake up their arms and hands and return to a satisfying level of functionality and improved quality of life.” Brown said that patients occasionally experience temporary weakness where the original healthy nerve is taken. These muscles, however, can recover their original strength. Casting and immobilization is seldom needed after the surgery. He added that the overall result is that multiple hand functions can be restored with a single transplant. “The recovery of hand function is consistently rated as the highest priority for persons with quadriplegia,” said Brown. “While nerve transfers take longer to heal so that axons can regenerate, patients often experience better long-term biomechanical outcomes.” In the United States there are approximately 300,000 people living with spinal cord injuries with 12,000 new injuries occurring each year. More than half of these injuries result in neck-level injures that lead to loss of hand and arm function. Brown said this technique may also be offered in select cases to patients with paralysis as a result of trauma, stroke, or brain injury. Brown earned his medical degree from the Eastern Virginia Medical School in Norfolk. He completed a surgical internship and neurosurgical residency at Baylor College of Medicine in Houston and a peripheral nerve fellowship in the Division of Plastic and Reconstructive Surgery at Washington University School of Medicine. He was formerly co-director of the Peripheral Nerve Center at Washington University in St. Louis.

Pregnant Women Should Avoid Alcohol During Pregnancy

UC San Diego doctors refute studies condoning moderate alcohol consumption during pregnancy Newswise — Experts at the University of California, San Diego School of Medicine disagree with a series of new studies from Denmark that suggest consumption of up to 8 alcoholic drinks a week or occasional binge drinking during pregnancy is generally safe for the developing baby. Kenneth Lyons Jones, MD, professor in the UCSD Department of Pediatrics and a renowned expert in birth defects, and Christina Chambers, MPH, PhD, director of the California Teratogen Information Service (CTIS) Pregnancy Health Information Line, say these studies are misleading to pregnant women, citing more than 30 years of research to the contrary.

“This series of studies collected data on alcohol exposure during an interview conducted sometime between 7 and 39 weeks of pregnancy. The quantity and frequency of alcohol consumed was based on mother’s recall which may not be accurate,” said Jones who was one of the first doctors to identify Fetal Alcohol Syndrome (FAS) in 1973. Published in BJOG: An International Journal of Obstetrics and Gynecology, the series of studies analyzed data from more than 1,600 women in the Danish National Birth Cohort. The amount of alcohol consumed by the women during their pregnancy was classified as either none, low, moderate, or high. In addition, binge drinking was defined as having 5 or more drinks on a single occasion. When the child reached the age of 5, the children underwent various development tests. Researchers found no significant association between prenatal alcohol consumption at low and moderate levels and general intelligence, attention, executive function or IQ. However, only half of the women invited in the follow-up studies agreed to participate. It is possible that those women who drank during pregnancy and who agreed to participate were more likely to have higher functioning children. Chambers, a UCSD School of Medicine professor, pointed out the overwhelming evidence of more than 30 years of research supporting the conclusion that alcohol, especially alcohol consumed in a binge pattern, can be harmful to the developing baby. “Individual women metabolize alcohol differently, and vary in terms of how susceptible they may be to having an affected child,” Chambers said. “Although we do not want to alarm women who find out they are pregnant and realize that they have consumed low levels of alcohol before they knew they were pregnant, we emphasize that a ‘safe’ amount of alcohol that any individual woman can drink while pregnant is impossible to establish. The best advice continues to be that women should avoid alcohol entirely during the nine months that she is carrying the baby.” Jones and Chambers recently launched the first clinic in Southern California to care for patients affected by Fetal Alcohol Spectrum Disorders (FASD.) The new FASD clinic provides a one-stop multidisciplinary team approach to diagnosing and caring for children with prenatal alcohol exposure-related developmental problems. The new FASD clinic, located on the campus of Rady Children’s Hospital-San Diego will offer multidisciplinary specialty care to children struggling with the disorder.

Asthma, preterm birth and preeclampsia

An extensive review of pregnancies over the course of more than three decades shows that women with poorly managed asthma are at an increased risk of having a low-birth weight baby, a premature baby and other pregnancy complications, such as preeclampsia. The new study was recently published in the British Journal of Obstetrics and Gynecology. Christina Chambers, a professor of pediatrics at the University of California, San Diego was part of the team of seven researchers who reviewed data involving more than 1 million women between 1975 and 2009.

“The findings are significant and call for women with asthma to be more closely monitored during pregnancy,” Chambers said. “It would be advisable for women on regular medications for asthma or having frequent symptoms to be monitored at least monthly during the course of their pregnancies,” she said. The study found that the infants of women with asthma were likely to weigh an average of 0.2 lbs. less at birth compared to babies of mothers without asthma. Mothers with poorly controlled asthma were also at a 25% increased risk of preterm birth and 50% increased risk of developing preeclampsia, a condition in which high blood pressure develops during pregnancy. Click here to read more about the study.

Baby born with six separate heart defects whose parents were told he would not survive stuns doctors with recovery

A toddler who is thought to be the only child in the world born with SIX separate heart defects has stunned doctors by making an incredible recovery - after they warned his parents he would not survive. Medics told Michelle and Darryl Lewis that their baby had an unheard of number of heart defects - and suggested they terminate the pregnancy at a 21-week scan. But the devastated couple refused - despite doctors’ fears that the baby would not survive the birth. However, despite a difficult birth and surgery at just eight-hours old, followed by four more operations, young Riley recovered. He made such good progress that he was even well enough to be a pageboy at his parents’ wedding just seven months later. Michelle, 32, from Tunbridge Wells, Kent, said: 'The surgeons told us that it is nothing short of a miracle that Riley is here at all. 'Doctors told us having one heart defect was unlucky, but six was unheard of. They said he probably wouldn’t make it through the pregnancy, and even if he did, wouldn’t survive long after birth. 'We were devastated - but Darryl and I just turned to each other and we knew straight away there was no way either of us was going to give up on our baby. 'The rest of my pregnancy was terrifying - I lived in fear of something going wrong. 'When I went into labour, Riley’s heart stopped every time I had a contraction - we nearly lost him so many times. But he’s a tough little boy and he’s amazed all of us - he’s so strong, and we are so proud of him.' The couple had no idea there were any complications with Michelle’s pregnancy until their 21 week scan - when nurses struggled to hear the heartbeat clearly. Michelle was booked in for a specialist scan a week later at the Evelina Children’s Hospital, London, where the stunned couple were told the extent of Riley’s condition. They were warned their unborn child was suffering from a back-to-front valves, a large hole in the heart, as well as various conditions that made his arteries thick and made it difficult for blood to pump around the body. Michelle said: 'The nurse’s face just dropped, and she went out of the room to get a doctor. 'I knew something was wrong and I just burst into tears before they had even told us what was wrong. It was the worst feeling I’ve ever experienced in my life.The doctors said our baby’s heart was struggling to pump blood around his body, and he had so many complications he wouldn’t live. 'They said they’d never seen anything like it - having so many conditions was totally unheard of. 'They took us into a little room and advised us to terminate the pregnancy - but there was no way we would even consider it. 'They agreed to monitor me closely throughout the rest of the pregnancy, but it was terrifying. I was always thinking the worst was going to happen, but Darryl kept me positive and was my rock. 'I was induced and went into labour on Christmas eve, and it lasted 15 terrifying hours before doctors decided to perform an emergency caesarean on Christmas day 2010. 'I heard this little scream and the nurses held him up for me to see before he was whisked away. I remember seeing his big beautiful eyes and just pleading that he would keep fighting.'

Riley was just eight hours old when he had his first heart surgery - an operation inserting a small balloon into enable his heart to pump blood through his arteries. His parents kept a vigil by his bedside, and when he was just five days old, he underwent further operation to insert a shunt into his arteries. And his terrified parents almost lost him again following an MRI scan when he was four months old - where the tot reacted violently to anaesthesis used to put him to sleep, causing his heart rate to shoot up to 260. Michelle added: 'After his first operation, the surgeon came out and said to us he had no idea how Riley was still here - he said it was a real miracle. 'We just spent every minute by his side. He was recovering from his second operation on New Year’s Eve, and all the fireworks were going off outside the London Eye, just across the river from the hospital. 'The nurses kept asking if we wanted to go outside and watch, but we just wanted to stay with our little boy. It was the best New Year I’ve ever had, the three of us together.' After five months in hospital, Riley was finally able to go home - and was even well enough to be pageboy at his parents’ wedding in July 2011. And despite needing a further three operations in the last twelve months, doctors are amazed by Riley’s progress - and say he is doing much better than expected. Although he will need to have further operations in the future to replace shunts as he grows, medics are confident that Riley will be able to lead a normal life. Darryl said: 'I just can’t thank all the doctors and nurses at St Evelina’s hospital enough. If it wasn’t for their hard work and dedication, we probably wouldn’t have our little boy - we’ll always be in their debt. 'We are just two normal people - we don’t drink a lot, we don’t do drugs, we’re quiet living - we couldn’t understand why this had happened to us or how to deal with it. 'But the doctors and nurses were amazing looking after Riley, and looking after us too. 'Riley is our little superstar. I look at him and Michelle every day and just think how lucky I am to have them both.'

Diabetes breakthrough as experts learn how to completely reverse the condition in mice

Scientists have successfully reversed diabetes in mice using stem cells, paving the way for a breakthrough treatment for the illness. The research is the first to show that human stem cell transplants can successfully restore insulin production and reverse diabetes in mice. Crucially, the team re-created the 'feedback loop' that enables insulin levels to automatically rise or fall based on blood glucose levels. Diabetes affects more than two million people in Britain. After the stem cell transplant, the diabetic mice were weaned off insulin, a procedure designed to mimic human clinical conditions. Three to four months later, the mice were able to maintain healthy blood sugar levels even when being fed large quantities of sugar. Transplanted cells removed from the mice after several months had all the markings of normal insulin-producing pancreatic cells.

The research was led by Timothy Kieffer, a professor in the Department of Cellular and Physiological Sciences at the University of British Columbia (UBC) in Canada, and scientists from the New Jersey-based BetaLogics, a division of Janssen Research & Development. Prof Kieffer said: 'We are very excited by these findings, but additional research is needed before this approach can be tested clinically in humans. 'The studies were performed in diabetic mice that lacked a properly functioning immune system that would otherwise have rejected the cells. 'We now need to identify a suitable way of protecting the cells from immune attack so that the transplant can ultimately be performed in the absence of any immunosuppression.' Type 2 diabetes results from insufficient production of insulin by the pancreas, while those with Type 1 don't produce any at all. Insulin enables glucose to be stored by the body’s muscle, fat and liver and used as fuel; a shortage of insulin leads to high blood sugar that raises the risk of blindness, heart attack, stroke, nerve damage and kidney failure. Regular injections of insulin are the most common treatment for the type 1 form of this disease, which often strikes young children. Although experimental transplants of healthy pancreatic cells from human donors have shown to be effective, that treatment is severely limited by the availability of donors. The study was published online in the journal Diabetes.

Two cups of coffee a day can reduce the risk of heart failure (but five are bad for you)

Two mugs of coffee a day could help keep the heart healthy. A study has linked the drink with a lower risk of heart failure. With up to 40 per cent of those affected dying within a year of diagnosis, heart failure has a worse survival rate than many cancers. The latest research suggests that regularly drinking moderate amounts of coffee can cut the odds of cardiac trouble – though too much could be counter-productive. Crunching together the results of five previous studies, involving almost 150,000 men and women, showed that those who enjoyed one or two mugs of coffee a day were 11 per cent less likely to develop heart failure than those who had none. Heart attack survivors gained as much benefit as those with healthy hearts.

But drinking five or more mugs a day appeared to be bad for the heart, the journal Circulation Heart Failure reports. Researcher Dr Murray Mittleman, of the Beth Israel Deaconess Medical Center in Boston, said: ‘As with so many things, moderation appears to be the key here too.’ The researchers aren’t sure why coffee seems to cut the odds of heart failure, in which the organ, weakened by a heart attack or disease, struggles to pump blood around the body. They say it may be because the drink reduces the likelihood of high blood pressure and of diabetes – both of which boost the odds of heart failure. Dr Mittleman said: ‘It stands to reason that reducing one’s odds of developing either one of them, in turn, reduces one’s chance of heart failure.’ Colleague Elizabeth Mostofsky added: 'This is good news for coffee drinkers.' Other recent research to hearten coffee drinkers includes a study that credited the drink with helping people live longer. The US government-funded researchers found the more coffee you drink, the less likely you are to die from a number of different ailments. These include heart disease, respiratory disease, stroke, injuries, accidents, diabetes and infections, but not cancer. It is also known that some people inherit genes that make them more reliant on caffeine than others. Those with the 'caffeine addict' genes, need to drink more coffee to get the same buzz.

World's first GM babies born

The world's first geneticallymodified humans have been created, it was revealed last night. The disclosure that 30 healthy babies were born after a series of experiments in the United States provoked another furious debate about ethics. So far, two of the babies have been tested and have been found to contain genes from three 'parents'. Fifteen of the children were born in the past three years as a result of one experimental programme at the Institute for Reproductive Medicine and Science of St Barnabas in New Jersey. The babies were born to women who had problems conceiving. Extra genes from a female donor were inserted into their eggs before they were fertilised in an attempt to enable them to conceive. Genetic fingerprint tests on two one-year- old children confirm that they have inherited DNA from three adults --two women and one man. The fact that the children have inherited the extra genes and incorporated them into their 'germline' means that they will, in turn, be able to pass them on to their own offspring. Altering the human germline - in effect tinkering with the very make-up of our species - is a technique shunned by the vast majority of the world's scientists. Geneticists fear that one day this method could be used to create new races of humans with extra, desired characteristics such as strength or high intelligence. Writing in the journal Human Reproduction, the researchers, led by fertility pioneer Professor Jacques Cohen, say that this 'is the first case of human germline genetic modification resulting in normal healthy children'. Some experts severely criticised the experiments. Lord Winston, of the Hammersmith Hospital in West London, told the BBC yesterday: 'Regarding the treat-ment of the infertile, there is no evidence that this technique is worth doing . . . I am very surprised that it was even carried out at this stage. It would certainly not be allowed in Britain.'

John Smeaton, national director of the Society for the Protection of Unborn Children, said: 'One has tremendous sympathy for couples who suffer infertility problems. But this seems to be a further illustration of the fact that the whole process of in vitro fertilisation as a means of conceiving babies leads to babies being regarded as objects on a production line. 'It is a further and very worrying step down the wrong road for humanity.' Professor Cohen and his colleagues diagnosed that the women were infertile because they had defects in tiny structures in their egg cells, called mitochondria. They took eggs from donors and, using a fine needle, sucked some of the internal material - containing 'healthy' mitochondria - and injected it into eggs from the women wanting to conceive. Because mitochondria contain genes, the babies resulting from the treatment have inherited DNA from both women. These genes can now be passed down the germline along the maternal line. A spokesman for the Human Fertilisation and Embryology Authority (HFEA), which regulates 'assisted reproduction' technology in Britain, said that it would not license the technique here because it involved altering the germline. Jacques Cohen is regarded as a brilliant but controversial scientist who has pushed the boundaries of assisted reproduction technologies. He developed a technique which allows infertile men to have their own children, by injecting sperm DNA straight into the egg in the lab. Prior to this, only infertile women were able to conceive using IVF. Last year, Professor Cohen said that his expertise would allow him to clone children --a prospect treated with horror by the mainstream scientific community. 'It would be an afternoon's work for one of my students,' he said, adding that he had been approached by 'at least three' individuals wishing to create a cloned child, but had turned down their requests. Read more: http://www.dailymail.co.uk/news/article-43767/Worlds-GM-babies-born.html#ixzz1z3kodj58