Novel Urine Test IDs Prostate Cancer | Renegade Neurologist

From MedPage Today.com:

An experimental urine test may pick up prostate cancers before biopsy in high-risk men, researchers found.

The Prostate Cancer Gene 3 (PCA3) test score at the time of a negative first biopsy predicted a positive rebiopsy two years later with 79.1% specificity and 36.4% sensitivity, according to retrospective analysis of a clinical trial to be reported here at the Genitourinary Cancers Symposium.

“PCA3 may be detecting cancers that were missed by biopsy,” said Jack Groskopf, PhD, of Gen-Probe San Diego, at a press conference in advance of the presentation.

The test also was a good overall predictor of the outcome of repeat biopsy, said Groskopf, whose company makes a commercial PCA3 assay approved for use in Europe, but not in the U.S outside of certified laboratories.

Serum prostate specific antigen (PSA) and percent free PSA — markers usually used to follow men on watchful waiting — don’t correlate with future biopsy outcomes, he noted.

The urine test may be useful in refining rebiopsy decisions for the increasing number of men put on observation for prostate cancer, according to press conference moderator Nicholas J. Vogelzang, MD, medical director of the Developmental Therapeutics Committee of US Oncology.

The PCA3 urine test would likely complement PSA in this regard, not replace it, Groskopf said.

“Urologists are using the test if, for example, there is a negative biopsy and a high PSA score,” he told reporters. “Low scores would argue perhaps hold off on additional or possibly extend the time period until the next biopsy.”

PCA3 is a prostate-specific mRNA overexpressed in more than 90% of prostate cancers with “very high” tumor cell specificity, while PSA is related to prostate size and can be elevated by benign prostate disorders.

Given positive results in prior small studies, the researchers aimed to validate a urine test to detect PCA3 for predicting repeat biopsy outcome.

They analyzed results from 1,072 men in the placebo arm of REDUCE, a trial of prostate cancer prevention with the drug dutasteride (Avodart), who had elevated serum PSA (2.5 to 10 ng/mL) but a negative prior biopsy.

Since these men had planned biopsies at two and four years into the study, the researchers retrospectively measured PCA3 levels in prospectively collected urine samples.

Overall, incrementally higher PCA3 scores were associated with greater likelihood of prostate cancer on biopsy, rising from 6% at a score under 5 to 22% at the usual threshold of 35 to 57% in those with a score over 100.

At the PCA3 cutoff of 35, the urine test had 48.4% sensitivity and 78.6% specificity for positive biopsy, with accuracy significantly better than serum PSA (P=0.0077) and a trend compared with percent free PSA (P=0.0645).

PCA3 also improved the accuracy of a multivariate predictive model and was associated with higher Gleason scores (7 or greater) on biopsy, which may suggest that it could help in screening for aggressive cancers, Groskopf said.

This could be particularly useful since there is still no good way to identify these more aggressive cancers from the typically slow-growing prostate cancers, Vogelzang said.

A clinical trial of the PCA3 urine test is now under way as a step toward a submission to the FDA.

Indian Spice May Prevent Liver Damage | Renegade Neurologist

From MedPageToday.com:

Explain to interested patients that this study shows that curcumin appears to delay liver damage in mice. It has not been evaluated for this purpose in humans.

Note that investigators believe curcumin might be pursued as a treatment for chronic cholangiopathies in humans.

A major component of the Indian spice turmeric was found to decrease inflammation and fibrosis in vitro and in an animal model of chronic cholangiopathy, a new study found.

Mdr2-/- mice fed curcumin, the compound that gives turmeric its bright yellow color, had reduced liver damage, cholestasis, and fibrosis compared with mice fed a normal diet (P

“We demonstrate that curcumin is beneficial in a genetic mouse model of cholangiopathy and biliary fibrosis, and propose potential molecular and cellular targets of curcumin in this model,” Michael Trauner, MD, of Medical University Graz in Austria, and colleagues wrote.

“Collectively, our findings have important implications for understanding the pathophysiology of cholangiopathies and suggest that combined targeting of cholangiocyte and portal myofibroblasts activation could represent a central strategy to treat or delay the progression of chronic cholangiopathies and liver fibrosis.”

Progressive inflammatory conditions of the liver include primary sclerosing cholangitis and primary biliary cirrhosis, which are characterized by inflammation, scarring, and destruction of the bile ducts inside and outside of the liver.

Chronic cholangiopathies, which are usually genetic or autoimmune in origin, cause inflammation and fibrosis and can lead to the need for liver transplantation.

Previous research in rodents with chemically induced liver damage and fibrosis found that curcumin has anti-inflammatory, antioxidative, and antifibrotic properties, the investigators noted.

The compound comes from the rhizomes of the perennial herb Curcuma longa and has been used for centuries in Ayurvedic medicine to treat a wide range of gastrointestinal disorders. But recent research suggests the chemical might have other medical applications, including possible effects on plaque in Alzheimer’s disease.

In the current liver study, investigators noted, it was unknown if curcumin could prevent bile duct inflammation and liver damage due to cholangiopathies.

“Since the effectiveness of currently available medical therapies to slow the progression of cholangiopathies is limited, there is an urgent need for novel and effective medical treatment strategies,” Trauner and colleagues wrote.

In their experiment, the researchers fed mice a diet enriched with 4% curcumin by weight for four and eight weeks. The mice were Mdr2-/-, a genetically altered strain that spontaneously develops progressive inflammatory conditions of the liver, including primary sclerosing cholangitis and primary biliary cirrhosis.

These conditions can cause the liver bile ducts to become inflamed, scarred, and blocked, which leads to extensive tissue damage and fatal liver cirrhosis. A control group of Mdr2-/- mice was fed a typical diet containing no curcumin.

The researchers analyzed tissue and blood samples from the mice before and after adding curcumin to their diet.

They found that curcumin reduced bile duct blockage and liver cell damage at both four and eight weeks by blocking portal myofibrocyte proliferation and decreasing expression of vascular cell adhesion molecule-1, thus reducing inflammation and fibrosis. No such delay in liver fibrosis was seen in the control group.

“These results show that curcumin may have multiple targets in liver, including activation of PPARgamma in cholangiocytes and inhibition of ERK1/2 signaling in portal myofibroblasts, thereby modulating several central cellular events in a mouse model of cholangiopathy,” they wrote. “Targeting these pathways may be a promising therapeutic approach to cholangiopathies.”

They pointed out that curcumin might represent an alternative to ursodeoxycholic acid, the only current drug treatment for inflammatory liver disease, or liver transplant.

The long-term effects of ursodeoxycholic acid remain unclear, they wrote, and curcumin might present a natural, well-tolerated option.

Sports Concussions & The Immature Brain - Dana Foundation

Check out this website I found at dana.org

One of the tell tale signs of a concussion is a decrease in cognitive ability. All athletes should have a base line cognitive test done before any season begins. The other signs I look for are balance disorders. Most physicians will miss this if they are not trained to look for it. Patients will rock side to side mainly when their eyes are closed. They tend to have central titibation of the head and spine. Past pointing is off and one leg balancing is off. Some times these findings are not very pronounced but if you are looking for them you can pick them up.

Abstract | Temporo-insular enhancement of EEG low and high frequencies in patients with chronic tinnitus

BMC Neuroscience
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Temporo-insular enhancement of EEG low and high frequencies in patients with chronic tinnitus Moazami-Goudarzi, Morteza Michels, Lars Weisz, Nathan Jeanmonod, Daniel info:doi/10.1186/1471-2202-11-40 BMC Neuroscience 2010, 11:40 2010-03-24 BMC Neuroscience 2010-03-24 11 1 Research article 40 -->Research article

Temporo-insular enhancement of EEG low and high frequencies in patients with chronic tinnitus

Morteza Moazami-Goudarzi email

, Lars Michels email

, Nathan Weisz email

and Daniel Jeanmonod email

BMC Neuroscience 2010, 11:40doi:10.1186/1471-2202-11-40

Published: 24 March 2010

Abstract (provisional)

Background

The physiopathological mechanism underlying the tinnitus phenomenon is still the subject of an ongoing debate. Since oscillatory EEG activity is increasingly recognized as a fundamental hallmark of cortical integrative functions, this study investigates deviations from the norm of different resting EEG parameters in patients suffering from chronic tinnitus.

Results

Spectral parameters of resting EEG of male tinnitus patients (n=8, mean age 54 years) were compared to those of age-matched healthy males (n=15, mean age 58.8 years). On average, the patient group exhibited higher spectral power over the frequency range of 2-100 Hz. Using LORETA source analysis, the generators of delta, theta, alpha and beta power increases were localized dominantly to left auditory (Brodmann Areas (BA) 41,42, 22), temporo-parietal, insular posterior, cingulate anterior and parahippocampal cortical areas.

Conclusions

Tinnitus patients show a deviation from the norm of different resting EEG parameters, characterized by an overproduction of resting state delta, theta and beta brain activities, providing further support for the microphysiological and magnetoencephalographic evidence pointing to a thalamocortical dysrhythmic process at the source of tinnitus. These results also provide further confirmation that reciprocal involvements of both auditory and associative/paralimbic areas are essential in the generation of tinnitus.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

I know many people who suffer from Tinnitus and most of them were told it comes from the ear. It may start in the ear but chronic Tinnitus is due to malfunction of the brain.