Posts tagged with "patient"

Endothelial progenitor cells for treating stroke patients

A new study recently published in STEM CELLS Translational Medicine demonstrates the long-term safety of laboratory-expanded endothelial progenitor cells for treating ischemic stroke. This could be good news for the 15 million people who, according to to the World Stroke Organization, suffer from this dangerous condition each year.

Ischemic stroke is the most common type of stroke, affecting nearly 90 percent of all cases. It is caused by a blocked blood vessel in the brain. In the normal central nervous system, endothelial progenitor cells (EPCs) play an active role in building blood vessels. This has led researchers to wonder whether EPCs circulating in the blood could be recruited after a stroke to assist in repairing damaged vessels in the brain. However, there is one major problem with this idea: The number of circulating EPCs is too low to provide much regenerative capacity – a number that further decreases in the aging or in those with heart problems.

This makes ex vivo (lab) expanded EPCs an attractive alternative.

“Transplantation of EPCs was already determined in animal experiments to be a safe and effective method for treating ischemic stroke. However, their safety and efficacy had yet to be determined in humans,” said Zhenzhou Chen, M.D., Ph.D., Southern Medical University, Guangzhou, China, and a corresponding author on the study. “In our trial, we tested the safety and feasibility of transplanting an acute ischemic stroke patient with his or her own (autologous) ex vivo expanded EPCs.”

Eighteen patients were recruited for the randomized, single-blinded study. Each received conventional treatment after their stroke then, seven days after symptom onset, underwent a bone marrow aspiration to collect EPCs and bone marrow stromal cells (BMSCs) for expansion in the lab. The patients were divided into three groups and, beginning at week four after the aspiration, one group was intravenously infused with their own EPCs, while the other two groups received either their own BMSCs or a saline placebo as the controls.

Each patient was then monitored for 48 months. Study co-author Xiaodan Jiang, M.D., Ph.D., also from Southern Medical University, explained, “We watched for mortality of any cause, adverse events and any new-onset diseases or conditions. Changes in neurological deficits were also assessed at different time points.”

In the end the researchers found no toxicity events nor did they see any infusional or allergic reactions in any of the patients. “The EPC group had less serious adverse events compared to the placebo-controlled group, although there were no statistical differences in mortality among the three groups,” Dr. Chen reported. “Ex vivoexpansion always raises concerns that it may cause instability in the chromosomes or maybe lead to tumors. However, in our long-term study we observed no increased tumorigenicity. This safety indicator was also confirmed by many animal studies and other trials using expanded bone marrow-derived stem cells for treatment of ischemic stroke.”

The researchers did note limitations in their study, including lack of patient-centered quality of life outcomes. “Moreover, because of the small size of the cohorts involved, we could neither identify the neurological or functional benefits of EPCs on ischemic stroke, nor determine the pros and cons between EPCs and BMSCs for stroke treatment,” Dr. Jiang said. “Thus, we believe a larger phase 2 trial is warranted.”

“This is a promising line of cell therapy research using a novel treatment method that is simple and non-invasive,” said Anthony Atala, M.D., Editor-in-Chief of STEM CELLS Translational Medicine and director of the Wake Forest Institute for Regenerative Medicine. “We look forward to larger phase 2 trial results.”

The full article, “Autologous endothelial progenitor cells transplantation for acute ischemic stroke: A four-year follow-up study,” can be accessed at http://www.stemcellstm.com.

About STEM CELLS Translational Medicine: STEM CELLS Translational Medicine (SCTM), published by AlphaMed Press, is a monthly peer-reviewed publication dedicated to significantly advancing the clinical utilization of stem cell molecular and cellular biology. By bridging stem cell research and clinical trials, SCTM will help move applications of these critical investigations closer to accepted best practices. SCTM is the official journal partner of Regenerative Medicine Foundation.

About AlphaMed Press: Established in 1983, AlphaMed Press with offices in Durham, NC, San Francisco, CA, and Belfast, Northern Ireland, publishes two other internationally renowned peer-reviewed journals: STEM CELLS® (www.StemCells.com), celebrating its 36th year, is the world’s first journal devoted to this fast paced field of research. The Oncologist® (www.TheOncologist.com), also a monthly peer-reviewed publication, entering its 23rd year, is devoted to community and hospital-based oncologists and physicians entrusted with cancer patient care. All three journals are premier periodicals with globally recognized editorial boards dedicated to advancing knowledge and education in their focused disciplines.

About Wiley: Wiley, a global company, helps people and organizations develop the skills and knowledge they need to succeed. Our online scientific, technical, medical and scholarly journals, combined with our digital learning, assessment and certification solutions, help universities, learned societies, businesses, governments and individuals increase the academic and professional impact of their work. For more than 200 years, we have delivered consistent performance to our stakeholders. The company’s website can be accessed at www.wiley.com.

About Regenerative Medicine Foundation (RMF): The non-profit Regenerative Medicine Foundation fosters strategic collaborations to accelerate the development of regenerative medicine to improve health and deliver cures. RMF pursues its mission by producing its flagship World Stem Cell Summit, honouring leaders through the Stem Cell and Regenerative Medicine Action Awards, and promoting educational initiatives.

Cosmetic Surgery

In 2009, then Governor of California Arnold Schwarzenegger signed the Donda West Plastic Surgery Law, requiring health checks be conducted prior to all major plastic surgery procedures in the state. This was following the death of rapper Kanye West’s mother. It was later determined that her heart attack was spawned by a combination of numerous postoperative complications and pre-existing coronary artery disease. Today, women especially peruse Instagram and covet a perfect pout, perky derriere and firm breasts seen on Insta models. Just because you may desire cosmetic surgery does not mean you are physically or mentally fit for it NOW. Dr. Stanley Poulos is a board certified San Francisco area plastic surgeon who takes steps to ensure the health and safety of his patients during surgery and post- operatively. Here are some indicators Dr. Poulos looks for to assess patients for surgery.

Dr. Poulos stresses that it is essential for a surgeon to take a good medical history and exam of the patient. Current and past illnesses, especially cardiac or pulmonary problems, surgeries, and medications should all be discussed. Lab tests may be required on a case by case basis depending on patient history and planned procedures.

Urinalysis

When it comes to preparation for a plastic or cosmetic surgery procedure, a urinalysis can inform the doctor if you have certain types of infections, like a urinary tract (UTI), bladder, or kidney infection. Urine tests are also effective in detecting high blood pressure and diabetes.

Blood Count Test

Also known as a complete blood count (CBC), this blood test literally counts your blood. It takes note of the number of red blood cells, white blood cells, and platelets. This tells physicians if you’re anemic (red blood cell deficiency) or have a blood clotting disorder like hemophilia. CBC tests also detect infectious bloodborne diseases like HIV or hepatitis.

Heart function

Electrocardiogram (ECG or EKG)

Essentially, the ECG is a medical test that tells if your heart is in good condition through detecting any heart abnormalities by measuring the electrical activity of the heart when it contracts. Cosmetic surgery basically causes tremendous stress on the body, with the heart being one of the most important organs when it comes to stress response. That is why it is crucial for the doctor to assess whether your heart can endure the trauma during the operation.

Chest X-Ray

The Chest X-Ray is also one of the tests that may be required for your procedure. This is usually carried out to check the condition of your lungs and see whether you have breathing difficulties when you are put in anesthesia. This test is especially requested if you are a smoker or have a history of smoking. Signs of pneumonia or any breathing disorder may result to the postponement or cancellation of your surgery.

Smoking Use and History

Mixing nicotine with plastic surgery can result in problems:

Loss of cheek skin, nipples or tummy skin after a facelift, breast lift, breast reduction, or tummy tuck surgery

  • Infections
  • Death of fat cells (fat necrosis), causing hard lumps
  • Delayed wound healing
  • Thick, wide scars
  • Blood clots, which can be fatal
  • Increased pain
  • Permanent small vessel damage adding risk even if you quit
  • Loss of breast implants
  • Life-threatening complications like stroke, heart attack, blood clots, and pneumonia.

Mammogram

The mammogram is typically required for women who want to get breast augmentation or breast lift done. This is to help detect signs of breast cancer.

Psychological Screening

Although there is no formal psych test to assess a patient’s readiness and motives for cosmetic surgery, Dr. Poulos takes time with his patients to learn their reasons for desiring cosmetic change. Immediate red flags include, having surgery to try to keep a wayward spouse, an exaggerated concern over a minor problem, someone who seems addicted to cosmetic surgery, or a patient with body dysmorphic disorder. This syndrome is most appropriately treated by psychological treatment not surgical intervention.

Alcohol Habits

It is important not to drink alcohol before undergoing plastic surgery – or any type of surgery for that matter – as it can cause unforeseen complications and seriously impact final results and the way you heal. Alcohol, especially when consumed to excess, can dry out your skin, which can then result in cracks appearing. If you’re having a plastic surgery procedure where skin is stretched (facelift, breast augmentation or abdominoplasty for example) then dry, cracked skin will make it harder for the surgeon to staple or stich the skin together, resulting in a less than optimum result and possibly scar.

Body Weight

Sometimes patients will enter a plastic surgeon’s office excited about a decision to finally move forward with breast or body contouring surgery, but then afterwards emerge having found out they are not currently a candidate because of excess body fat. This scenario is not only disappointing, but it can be an emotionally deflating and potentially embarrassing experience for patients. Dr. Poulos sympathizes with the emotional pain that such patients feel, and he wants to help them realize their goals. However, there are several specific reasons that your plastic surgeon might recommend weight loss prior to undergoing a procedure. In addition, the results that you can achieve are likely to be much better if your weight is in a better range. Consider an overweight woman who wants breast reduction surgery. Even when the breasts become smaller and more uplifted, it is extremely difficult for us to deal with the fullness lateral to the breasts (the “bra roll”), which significantly compromises the aesthetic result. In addition, it is much harder to get a beautiful transition between the breast and the abdomen due to the excess weight. On the other hand, let’s consider the patient that is overweight and wants a tummy tuck or liposuction. In this instance, the surgeon will not be able to remove all the excess fat in these areas, as it is technically challenging and can look odd as it is out of proportion to the surrounding fatty deposits. Even large volume liposuction cannot fully solve this problem. Body contouring surgery is great for shaping your body, but it is not a method or substitute for weight loss or weight control. At Dr. Poulos’ clinic there is a full-time wellness/weight loss coordinator who helps patients achieve a healthy body composition ( body fat percentage and lean muscle mass balance) prior to undergoing body contour procedures.

What is an option for those who need to lose weight to be a better candidate for cosmetic surgery?

There is an FDA approved “Gastric Balloon” procedure that Dr. Poulos performs. It is appropriate for patients with a BMI of 30 to 40 that have not had previous weight loss surgery. Patients diagnosed with bulimia, binge eating, compulsive overeating, high liquid calorie intake habits or similar eating related psychological disorders are not good candidates. Dr. Poulos has now treated numerous patients who have successfully lost up to 20% of their body weight with the balloon procedures and have gone on to aesthetic body contouring with much improved results.

How does the balloon method work?

This non-surgical outpatient procedure begins with a diagnostic endoscopy to ensure that there are no contraindications and that it is safe to perform. Once the patient is mildly sedated and comfortable, the procedure can begin. The deflated gastric balloon is inserted through the esophagus and into the stomach. A syringe is then used to fill the balloon with a sterile saline solution. Once the weight loss balloon has been filled with saline, it expands to approximately the size of a grapefruit. The entire procedure takes about 20 minutes. Patients can usually return home after the placement or removal procedures within 30 minutes. Over the last 20 years this procedure has helped over 277,000 people. The gastric balloon encourages portion control while patients make healthy changes to diet and lifestyle.

How long does the balloon stay in place?

The balloon remains in the stomach for the first six months after the procedure. With the stomach balloon and Dr. Poulos’ support team, patients usually see the most drastic results in the first six months. It is very important to use this time to develop healthy habits that will continue for not only the 12-month weight loss program, but for the rest of one’s life.

What to expect after the balloon placement

Over the first 14 days after placement, patients may experience nausea or vomiting. Dr. Poulos recommends a liquid diet for his patients during the first week to help manage these symptoms. Also prescribed are effective anti-nausea drugs to help the patient through the initial stage.

How is the balloon removed?

Once the stomach balloon has been in place for six months the balloon is removed. The simple and non-surgical procedure is very similar to the placement process. Once the gastric balloon has been removed, it is very important to continue working closely with Dr. Poulos’ team and coaches to follow the personal diet and exercise plan provided. This will help to keep you in a positive and healthy mindset while achieving your weight loss goals.

About Dr. Stanley Poulos

Dr. Poulos specializes in cosmetic breast surgery and body contouring procedures. He helped pioneer the quick lift facial rejuvenation surgery in California and is recognized as one of the leading plastic surgeons in Marin County and the entire San Francisco Bay area. Dr. Poulos and Plastic Surgery Specialists have extensive experience in body contour procedures. A graduate of the University of Texas Medical School, Dr. Poulos completed his internship and residency at UC San Francisco. He completed a plastic surgery fellowship at St. Francis Hospital in San Francisco and is certified by the American Board of Plastic Surgery. www.psspecialists.com

Why Some Women are Delaying Pregnancy

New Survey Shows Women Lacking Information for Informed Healthcare Decisions

New findings from a recent survey show that women living with chronic inflammatory or autoimmune disease feel they don’t have enough information to make informed decisions about how to balance pregnancy with disease management. Some women feel they have no choice but to stop treatment or delay their plans for pregnancy. These women are living with a variety of autoimmune conditions including rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis and Crohn’s disease.

Now, a new initiative called the AIM (Autoimmune Motherhood) Movement is being launched to rally these women and provide support, information and a place for them to share stories about motherhood with chronic inflammatory disease. The education campaign and online community aims to help women learn the facts about their conditions and appropriate disease management options, while allowing them to share experiences to empower one another.

AIM Survey Shows:
• Almost half (44%) of U.S. women surveyed had concerns serious enough that they delayed their plans to become pregnant
• 61% believed they could not combine treatment and breastfeeding
• Only 41% consulted a healthcare professional before becoming pregnant, suggesting the need for women to become more engaged in treatment and pregnancy planning earlier

Dr. Grace Wright, rheumatologist at New York University Langone Medical Center is interviewed about the topic along with patient Rosanna, who shares her compelling story of living 30 years with rheumatoid arthritis and the physical and emotional challenges she endures while dealing with her disease. Both guests will help bring awareness to the issues surrounding ways to manage chronic inflammatory disease throughout the family planning journey. They’ll also reveal the results of the AIM Patient Survey to help others in similar situations make the best decisions for themselves and their families. See the recent interview down below:

Why Some Women are Delaying Pregnancy

New findings from a recent survey show that women living with chronic inflammatory or autoimmune disease feel they don’t have enough information to make informed decisions about how to balance pregnancy with disease management. Some women feel they have no choice but to stop treatment or delay their plans for pregnancy. These women are living with a variety of autoimmune conditions including rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis and Crohn’s disease.

Now, a new initiative called the AIM (Autoimmune Motherhood) Movement is being launched to rally these women and provide support, information and a place for them to share stories about motherhood with chronic inflammatory disease. The education campaign and online community aims to help women learn the facts about their conditions and appropriate disease management options, while allowing them to share experiences to empower one another.

AIM Survey Shows:

  • Almost half (44%) of U.S. women surveyed had concerns serious enough that they delayed their plans to become pregnant
  • 61% believed they could not combine treatment and breastfeeding
  • Only 41% consulted a healthcare professional before becoming pregnant, suggesting the need for women to become more engaged in treatment and pregnancy planning earlier

On Wednesday, July 11th, join Dr. Grace Wright, rheumatologist at New York University Langone Medical Center and patient Rosanna, who shares her compelling story of living 30 years with rheumatoid arthritis and the physical and emotional challenges she endures while dealing with her disease. Both guests will help bring awareness to the issues surrounding ways to manage chronic inflammatory disease throughout the family planning journey. They’ll also reveal the results of the AIM Patient Survey to help others in similar situations make the best decisions for themselves and their families.

The Remarkable Life of David Hysong

Meet David Hysong — 30 year old adenoid cystic carcinoma patient and CEO of SHEPHERD Therapeutics. Here’s his remarkable story is below for consideration to pass along or speak with him about his journey:

Hysong finished his master’s degree in intellectual history in 2011 and found himself with a year’s lag time before he planned to enter the U.S. Navy. He was young, good looking, and smart. Most people in his position would probably have kicked back, gotten a job to pay the bills, and had some fun. However, David Hysong is not “most people.”

His story continues, and on a dare, he applied to Harvard Divinity School in 2012 for enrollment in the Fall. A series of educational and life adventures soon followed — good and bad, including his cancer diagnosis — and after graduation in May 2015, Hysong considered medical school. He took preparatory courses while working 80-hour weeks at two jobs to pay off medical and student debts. The schedule, in the wake of cancer treatment and graduate school, began to burn him out. Hysong then took a break for a few weeks. The clouds cleared and he was inspired to undertake what he calls “an impossible task”: a biotech start up that searched for cures to rare cancers like his.

Now, welcome SHEPHERD Therapeutics. His Genzyme and Harvard connections enabled him to assemble a world-class team of scientists. The firm’s goal is to find cures for the more than 250 rare cancers that make up 42 percent of cancer diagnoses in the United States. Hysong says that Shepherd is well on its way.

“We’ve raised close to $6.5M and we’re only just now finalizing our product portfolio,” he says. “The cool thing is, a lot of the times, therapeutics are approved when they represent a 30 percent survival rate or 40 percent survival rate. For the diseases we’re looking at, our preliminary data show about an 80 percent survival rate. We really think we’re going to be very successful and save a lot of lives.”

You can read David’s full story on Harvard Divinity School’s website, here: https://hds.harvard.edu/news/2017/12/07/Hysong-idealism-in-action#

Hysong was on the 2016 Forbes 30 Under 30 Healthcare list, and he was named as part of a class of 2017’s Future Biotech Giants. Not to mention he’s been covered by Southern Living, and he has spoken at the Forbes Under 30 Summit. SHEPHERD Therapeutics has offices in Boston and Nashville.