MOM, Metal Ions And Lymphopenia

Metal-on-metal hip replacement and resurfacing have become the most commonly used type of procedure in the United Kingdom for patients who are < 60 years of age with osteoarthritis. Therefore, this research consisted of a cross-sectional study with analysis of demographic, clinical and laboratory characteristics of patients who had undergone metal-on-metal hip resurfacing, ceramic-on-ceramic and metal-on-polyethylene hip replacement to assess whether there was a relationship between MOM replacements and circulating metal ions in the blood, and absolute numbers of circulating lymphocytes.


There were 164 patients in the study, of which 106 had MOM hips, all were aged < 65 years and had pre-operative diagnosis of osteoarthritis and no pre-existing immunological disorders. Patients were excluded if their replacement had taken place less than six months previously, thereby avoiding the high-wearing, bedding-in phase. Blood samples were taken using a plastic needle cannula to avoid metal contamination.


The results showed that 'there were significant differences in the levels of metal ions in the whole blood and in the absolute lymphocyte counts'. A group of 10 patients of the 106 from the MOM group had circulating levels of chromium greater than 5 parts per billion. Therefore, the authors conclude that 'patients with MOM hips had reduced peripheral blood counts of T-lymphocytes in particular and B-lymphocytes when compared with control subjects with hip replacements which did not produce metal wear debris'. Although the effect of reduced lymphocytes is unknown, there has been a link between high levels of cobalt and chromium and DNA damage of lymphocytes and the authors recommend that long-term studies need to be conducted to determine whether the moderate lymphopenia associated with MOM hip replacements is detrimental or even beneficial to longevity of the replacement.


Read the full text article.


Source

The Journal of Bone and Joint Surgery

New Vascular Channel On

is pleased to announce the launch of a new Vascular channel. The section will include news on arterial diseases (aortic abdominal aneurysms, thoracic aortic aneurysms, aortic arch, dissections and ischemia, as well as peripheral arterial disease) and venous diseases (varicose veins and deep vein thrombosis).



asks that any subscribers to the tailored Newsletter or Newsalert, who would like to receive the news from this new section in their e-mails, amend their preferences using the link provided in their last/next e-mail from (or use our feedback form if you would like assistance).



Other channels that have been added recently and will also need to be updated in the e-mail subscriptions include:
Asbestos / Mesothelioma
Back Pain
COPD
Eczema / Psoriasis
Fibromyalgia
Lymphology/Lymphedema
Medical Practice Management
Melanoma / Skin Cancer
Menopause
Ovarian Cancer
Palliative Care / Hospice Care
Tuberculosis
Veterans / Ex-Servicemen
If you have a suggestion for another new channel you would like to see on our site please fill in the form at the bottom of our Contact Us page.


To sign up for one of our free e-mails please fill in the form on the relevant page:
Weekly Newsletter
Daily Newsalert

Every e-mail provides you with a link to unsubscribe or change your preferences if you wish to do so.

2010 Merit Award Winners Announced By ASH

The American Society of Hematology (ASH) recognizes the following abstract presenters at the 52nd ASH Annual Meeting in Orlando, FL, with the highest scoring abstracts in the categories of undergraduate student, medical student, graduate student, resident physician, and post-doctoral fellow. Merit Award winners receive a $500 honorarium plus annual meeting travel reimbursement.



The 2010 Merit Award recipients are:



Undergraduate Student

Maria Virgilio

Treatment of Zebrafish Models of Ribosomopathies (Diamond Blackfan Anemia (DBA) and 5q- Syndrome) With L-Leucine Results in an Improvement of Anemia and Developmental Defects: Evidence for a Common Pathway?

Abstract #195



Medical Student

Karrune Woan

Identification of a Discrete Subpopulation of T-Cells Over-Expressing HDAC11 With a TH17 Phenotype

Abstract #588



Graduate Student

Wulan Deng

Manipulating Higher Order Chromatin Structure of the ОІ-Globin Locus by Targeted Tethering of a "Looping" Factor

Abstract #647



Post-Doctoral Fellow

Jian Xu, PhD

Reactivation of Silenced Human HbF in Adult Mice by Inactivation of BCL11A

Abstract #643



Mary Rodes Gibson Memorial Award in Hemostasis and Thrombosis



This award was established to recognize the trainee (undergraduate student, medical student, graduate student, resident physician, or post-doctoral fellow) who is the first author and presenter of the highest scoring abstract submitted in the field of hemostasis and thrombosis. This annual award is made possible by the Mary Rodes Gibson Hemostasis-Thrombosis Foundation to continue the legacy of Mary Rodes Gibson, who suffered from severe, type 3 von Willebrand disease.



The 2010 recipient is:



Louisa M. Dowal, PhD

A Chemical Genetic Analysis of Platelet Activation Identifies an Antithrombotic Allosteric Modulator That Acts Through Helix 8 of Par1

Abstract #483



Source:

Lindsey Love

American Society of Hematology

Racial Differences In Risk Factors For Venous Thromboembolism And Pulmonary Embolism

A new study of 1,960 White-Americans and 368 Black-Americans with objectively diagnosed venous thromboembolism (VTE) showed that, compared to Whites, Blacks had a significantly higher proportion with pulmonary embolism (PE), including idiopathic PE among Black women, and a significantly higher proportion of Blacks with VTE were women (71% vs 61% for Whites) The study is published in the American Journal of Hematology.



VTE is blood clots in veins and consists of deep vein thrombosis (DVT), a blood clot in the "inner" or "deep" vein, typically of the leg or pelvis, and its complication, PE, a dislodged DVT that has traveled with the returning blood to the heart and become lodged in the lungs. Most epidemiologic studies of VTE risk factors have been conducted within White-American and -European populations. However, compared to Whites, Black-Americans appear to have a higher risk and incidence of VTE. Two single nucleotide polymorphisms (DNA sequence variations), factor V Leiden (G1691A) and prothrombin (G20210A), have been identified as risk factors for DVT and PE in Europeans and White-Americans, but not Black- Americans.



"VTE appears to be more common in Blacks than Whites, but while we have identified many inherited causes for VTE in Whites, no such inherited causes in Blacks have been identified," said lead researcher Prof. John Heit, of the Mayo Clinic College of Medicine, Minnesota, USA. "We wondered whether Blacks were more likely to have VTE related to common exposures that can cause VTE, such as major surgery, hospitalization for acute medical illness, trauma, fracture, or birth control pills, to account for VTE being more common in Blacks, but this does not appear to be the case. Thus, we now question whether Blacks may have some as yet unidentified inherited cause for VTE."



The researchers found that, compared to Whites with VTE, Blacks with VTE have a higher proportion of PE events, a lower proportion of VTE related to transient risk factors and a higher proportion with idiopathic VTE, i.e. from a seemingly unknown or unrelated cause.



Blacks had a significantly higher mean BMI, and a significantly lower proportion with recent surgery, trauma or infection, family history of VTE and documented thrombophilia. Conversely, Blacks had a significantly higher proportion with hypertension, diabetes mellitus, chronic renal disease and dialysis, HIV and sickle cell disease. Compared to White women, Black women had a significantly lower proportion with recent oral contraceptive use or hormone therapy



"Given the poor survival after PE, our finding of an increased prevalence of PE among Blacks (particularly idiopathic PE) is disturbing, especially when coupled with previous reports of increased complications after VTE and higher PE case-fatality among Blacks," added Heit.



The study is accompanied by an editorial by Dr. Samuel Goldhaber of Brigham and Women's Hospital and Harvard Medical School, Boston, USA.



Full citation:
JA Heit et al; Comparison of Characteristics from White- and Black-Americans with Venous Thromboembolism: A Cross Sectional Study; American Journal of Hematology, 2010; DOI: 10.1002/ajh.21735



About the author:
John A. Heit, M.D., FACP, FACC, is Director of Coagulation Laboratories and Professor of Medicine at the Mayo Clinic College of Medicine, MN, USA.



Source:

Amy Molnar

Wiley-Blackwell

New Clinical Study Shows RyMed InVision-Plus&reg; IV Connector Dramatically Reduced Catheter-Related Bloodstream Infections By Over 92%

Georgia Health Sciences University, Augusta, GA exhibited a poster at the recent 11th National Conference on Cancer Nursing Research in Los Angeles, in which their clinical study showed RyMed Technologies' zero displacement InVision-Plus® IV Connector significantly decreased the incidence of catheter-related bloodstream infections (CR-BSIs) by 92.6% on average when compared to a simple split septum with negative displacement IV connector (Becton-Dickinson Q-Syte®) and a reversed split-septum device with negative displacement IV connector (ICU Medical Clave®). No clinical studies have been published comparing different types of connectors in oncology patients on CR-BSIs. CR-BSIs can cause treatment delays, add time to nursing care, increase costs, increase mortality and decrease quality of life for the patient and family.


The purpose of the study was to determine infection rates for a split septum valve, a negative reversed split-septum valve and an intraluminal protection device (IPD) with zero displacement in both critical care and medical in-patient oncology patients.


Detailed results:



-- CR-BSI incidences decreased 96.3%, from 2.9 to 0.1 infections per 1,000 catheter days, when the RyMed InVision-Plus® needleless IV connector was used compared to the Becton-Dickinson's Q-Syte® product.



-- CR-BSI incidences decreased 88.9%, from 3.7 to 0.4 infections per 1,000 catheter days, when the RyMed InVision-Plus® needleless IV connector was used compared to the ICU Medical Clave® product.



-- Overall, 92.6% decrease in infection rate was found when using the RyMed InVision-Plus® with Neutral Advantage™ technology.


Leading the study was Dr. Cynthia C. Chernecky PhD, RN, AOCN, FAAN, Jennifer Waller, PhD both from Georgia Health Sciences University; and Denise Macklin, BSN, RNC.


Dr. Chernecky stated, "Decreasing infections is essential to quality nursing care in oncology. The use of best product when added to other nursing interventions is essential as it can enable best outcomes for treatments and ultimately quality of life and a decrease in mortality".


"This new clinical data continues to demonstrate the superior design features of RyMed's InVision-Plus® needleless IV connector technology and how they have a significant positive patient safety impact among the cancer patient population," said Dana Wm. Ryan, President & CEO, RyMed Technologies, Inc.


This poster presentation by Dr. Chernecky was preceded by another in which she highlighted similar success by the RyMed product in decreasing intraluminal thrombotic occlusions compared to a negative displacement mechanical valve. Additionally, Chernecky also delivered a podium presentation discussing new data on the apparent ineffectiveness of other silver coated needleless IV connectors.


Catheter-related bloodstream infection (CR-BSI) continues to be one of the most frequent hospital acquired infections (HAIs) reported by hospitals nationwide. It has been reported that a patient that develops a CR-BSI could die up to 25% of the time, and the industry is discovering that RyMed's InVision-Plus® technology with zero fluid displacement is going to save many lives.


Source: RyMed Technologies, Inc

New Study Reveals Genetic Link To Blood Cancers

The study, published in the journal Nature Genetics, has shown that susceptibility to a series of blood cancers, known as myeloproliferative disorders (MPDs), is linked to a particular area of the patient's DNA, which is prone to developing mutations.


Myeloproliferative disorders are characterised by the overproduction of red and white blood cells, which increases the risk of strokes and heart attacks. Many cases of MPDs are caused by a mutation in a gene called JAK2. When the JAK2 gene has mutated, it sends abnormal messages to the blood stem cells to produce more and more blood cells.


Scientists, funded by Leukaemia Research, have found that a particular region of chromosome 9 that carries the JAK2 gene is predisposed to acquiring mutations, but only in individuals with a particular genetic makeup. It is likely that this finding will lead to a much better understanding of how the JAK2 gene mutations happen and why they lead to an increased risk of someone developing an MPD.


The study, carried out at the Wessex Regional Genetics Laboratory in Salisbury and the University of Southampton, has proved that people carrying this mutation-prone region of DNA on chromosome 9 that includes the JAK2 gene have triple the risk of developing an MPD.


The chromosome 9 variant is present in 40 per cent of the UK population but only 1 in 20,000 people develop an MPD each year. Nonetheless, the new research has confirmed that the inheritance of this genetic variant can contribute to inherited susceptibility to develop an MPD.


The study found that the link was especially strong in polycythaemia vera (PV), one of the main three MPDs. Professor Nick Cross, from the University of Southampton who led the research team, says: "This research provides strong evidence that at least half of the cases of PV diagnosed each year are linked to an inherited genetic variant on chromosome 9. Whilst this risk is still very small it nonetheless confirms that individual susceptibility to acquiring cancer-causing mutations is linked to genetic inheritance. Now that we have this evidence we can carry out studies to determine exactly how the variant contributes to this risk."


Dr Shabih Syed, Scientific Director at Leukaemia Research, adds: "This is a very important step forward in our knowledge of the causes of myeloproliferative disorders. It helps us to understand why some people might be predisposed to acquiring genetic mutations that lead to cancers."


The report is published online from 15 March 2009 in the journal Nature Genetics under the title 'JAK2 haplotype is a major risk factor for the development of myeloproliferative neoplasms'. The corresponding author is Professor Nicholas Cross of the Human Genetics Division, University of Southampton and the Wessex Regional Genetics Laboratory, Salisbury. The study was funded by the cancer charity Leukaemia Research.


Southampton University

soton.ac.uk

Thrombolysis: An Enlarged Treatment Window And Stent Support Open Possibilities For More Patients

Professor Ferro sees better chances for stroke victims in the newest scientific findings on thrombolytic treatment. This intravenously applied medication to break up blood clots has significantly improved survival chances for stroke victims. Guidelines and regulatory approvals have hitherto recommended a time window of three hours between the onset of stroke and the beginning of therapy.


The recently published ECASS III study showed that treatment between 3 and 4.5 hours after the onset of a stroke with the thrombolytic agent alteplase can also improve clinical outcome. Data from the trial show that thrombolysis, when used in the 3 to 4.5 hour time window, is consistent with the safety profile reported for the approved time window of 0 to 3 hours. "These new insights open treatment possibilities for a variety of patients who hitherto were not able to profit from thrombolysis. Many patients today still are not able to reach a clinic within three hours," Professor Ferro says. "I assume that this will soon be reflected in the treatment guidelines and regulatory approvals."


Yet another new approach should likewise expand the possibilities of thrombolysis. Professor Ferro notes that "endovascular stent-assisted thrombolysis is a promising treatment for patients with a specific type of artery occlusions arising from internal carotid artery (ICA) dissection." Spontaneous ICA dissection is a common cause of stroke in young people. The condition mainly has thromboembolic consequences which are often resistant to intravenous thrombolysis.



Source
European Neurological Society