StemCell Therapy

Embryonic stem cells, as their name suggests, are derived from embryos. Most embryonic stem cells are derived from embryos that develop from eggs that have been fertilized in vitroin an in vitro fertilization clinicand then donated for research purposes with informed consent of the donors. They are not derived from eggs fertilized in a woman's body.

Growing cells in the laboratory is known as cell culture. Human embryonic stem cells (hESCs) aregenerated by transferringcells from a preimplantation-stage embryointo a plastic laboratory culture dish that contains a nutrient broth known as culture medium. The cells divide and spread over the surface of the dish. In the original protocol, the inner surface of the culture dish was coated with mouse embryonic skin cellsspecially treated so they will not divide. This coating layer of cells is called a feeder layer. The mouse cells in the bottom of the culture dish provide the cells a sticky surface to which they can attach. Also, the feeder cells release nutrients into the culture medium. Researchers have nowdevised ways to grow embryonic stem cells without mouse feeder cells. This is a significant scientific advance because of the risk that viruses or other macromolecules in the mouse cells may be transmitted to the human cells.

The process of generating an embryonic stem cell line is somewhat inefficient, so lines are not produced each time cells from the preimplantation-stage embryo are placed into a culture dish. However, if the plated cells survive, divide and multiply enough to crowd the dish, they are removed gently and plated into several fresh culture dishes. The process of re-plating or subculturing the cells is repeated many times and for many months. Each cycle of subculturing the cells is referred to as a passage. Once the cell line is established, the original cells yield millions of embryonic stem cells. Embryonic stem cells that have proliferated in cell culture for for a prolonged period of time without differentiating, and are pluripotentare referred to as an embryonic stem cell line. At any stage in the process, batches of cells can be frozen and shipped to other laboratories for further culture and experimentation.

At various points during the process of generating embryonic stem cell lines, scientists test the cells to see whether they exhibit the fundamental properties that make them embryonic stem cells. This process is called characterization.

Scientists who study human embryonic stem cells have not yet agreed on a standard battery of tests that measure the cells' fundamental properties. However, laboratories that grow human embryonic stem cell lines use several kinds of tests, including:

As long as the embryonic stem cells in culture are grown under appropriate conditions, they can remain undifferentiated (unspecialized). But if cells are allowed to clump together to form embryoid bodies, they begin to differentiate spontaneously. They can form muscle cells, nerve cells, and many other cell types. Although spontaneous differentiation is a good indication that a culture of embryonic stem cells is healthy, it is not an efficient way to produce cultures of specific cell types.

So, to generate cultures of specific types of differentiated cellsheart muscle cells, blood cells, or nerve cells, for examplescientists try to control the differentiation of embryonic stem cells. They change the chemical composition of the culture medium, alter the surface of the culture dish, or modify the cells by inserting specific genes. Through years of experimentation, scientists have established some basic protocols or "recipes" for the directed differentiation of embryonic stem cells into some specific cell types (Figure 1). (For additional examples of directed differentiation of embryonic stem cells, refer to the NIH stem cell report available at http://stemcells.nih.gov/info/scireport/pages/2006report.aspx.)

Figure 1. Directed differentiation of mouse embryonic stem cells. Click here for larger image. ( 2008 Terese Winslow)

If scientists can reliably direct the differentiation of embryonic stem cells into specific cell types, they may be able to use the resulting, differentiated cells to treat certain diseases in the future. Diseases that might be treated by transplanting cells generated from human embryonic stem cells include diabetes, traumatic spinal cord injury, Duchenne's muscular dystrophy, heart disease, and vision and hearing loss.

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What are embryonic stem cells? [Stem Cell Information]

July 20, 2015 Researchers have used models to identify a potential link between excess production of inflammatory proteins that cause rheumatoid arthritis and the development of heart valve disease. The research ... read more July 20, 2015 Researchers have successfully treated patients with moderate to severe eczema using a rheumatoid arthritis drug recently shown to reverse two other disfiguring skin conditions, vitiligo and alopecia ... read more Antibiotic Exposure Could Increase the Risk of Juvenile Arthritis July 20, 2015 Taking antibiotics may increase the risk that a child will develop juvenile arthritis, according to a study. Researchers found that children who were prescribed antibiotics had twice the risk of ... read more Common Mental Health Drug Could Be Used to Treat Arthritis July 16, 2015 Lithium chloride which is used as a mood stabiliser in the treatment of mental health problems, mainly bipolar disorder, could be used to treat arthritis according to a new ... read more Rheumatoid Arthritis: Novel Approach Identifies Unique DNA Signature July 14, 2015 Researchers have for the first time identified disease-associated changes to the DNA epigenome in joint fluid cells from patients with rheumatoid ... read more Arthritis Drug Could Be Used to Treat Blood Cancer Sufferers July 5, 2015 Scientists have discovered that a common drug given to arthritis sufferers could also help to treat patients with blood cancers, and is one thousandth of the cost of another drug that works in the ... read more New Test Could Predict Arthritis Drug Failure in Patients July 3, 2015 It may be possible to predict early which rheumatoid arthritis patients will fail to respond to the biologic drugs given to treat them, a study of 311 patients has found.These findings could help ... read more Vitamin B12 Supplement Linked to Pimply Skin June 24, 2015 Vitamin B12 tweaks how genes behave in the facial bacteria of some people who normally enjoy clear skin, leading to pimples, new research ... read more Patients With Primary Hand Osteoarthritis Should Not Be Prescribed Hydroxychloroquine, Study Suggests June 13, 2015 The results of an interventional trial showed that use of the disease-modifying anti-rheumatic drug hydroxychloroquine for 24 weeks did not diminish mild-moderate pain from primary hand ... read more Biologics Improve Productivity and Reduce Missed Workdays in Rheumatic Disease June 12, 2015 The results of a systematic review of published studies showed that biologics improve both absenteeism (not showing up for work) and presenteeism (being at work but not functioning fully) in patients ... read more Low Birth Weight and Childhood Infections Predict Ankylosing Spondylitis June 11, 2015 The results of a new study showed that a diagnosis of ankylosing spondylitis can be predicted by low birth weight, having older siblings and hospitalization for infection between the ages of 5-16 ... read more Physical Trauma Associated With Onset of Psoriatic Arthritis Among Psoriasis Patients June 11, 2015 The results of a large population study showed an increased risk of developing Psoriatic Arthritis among psoriasis patients exposed to physical trauma, particularly when the trauma involved bone ... read more Ultrasound-Defined Tenosynovitis Identified as Strong Predictor of Early Rheumatoid Arthritis June 10, 2015 A new study showed that ultrasound diagnosis of tenosynovitis (inflammation of the tendon sheath) was superior to clinical symptoms and signs in the prediction of early Rheumatoid ... read more Intensive Initial Therapy With Triple DMARDs Improves Functional Ability in Early Rheumatoid Arthritis June 10, 2015 New research showed that initial therapy with combination DMARDs significantly improves measures of disease activity and functional ability in patients with early rheumatoid ... read more Stem Cell Discovery Paves Way for Targeted Treatment for Osteoarthritis June 9, 2015 Scientists have made a significant advance that could make cell-based treatments for arthritis less of a lottery. Researchers have identified individual stem cells that can regenerate tissue, ... read more June 3, 2015 A world-first vaccine-style therapeutic approach to treat rheumatoid arthritis has been developed by researchers. Rheumatoid arthritis is a disease in which the immune system attacks healthy tissues, ... read more New UK Research 'Challenges the Assumption That Arthritis Patients Take Their Medication Regularly' May 26, 2015 40% of UK arthritis patients scored low on an adherence questionnaire at least once during their time in a recent study, indicating that they might not be taking their expensive biological therapies ... read more Compound Has Potential for Treating Rheumatoid Arthritis May 21, 2015 A new study outlines a chemical compound with potential for treating rheumatoid arthritis. Rheumatoid arthritis is a chronic autoimmune disorder that affects an estimated 1.3 million people in the ... read more Scientists Reveal Potential New Drug Target for the Treatment of Rheumatoid Arthritis May 20, 2015 A novel drug target for the treatment of rheumatoid arthritis has been identified, which focuses on the cells that are directly responsible for the cartilage damage in affected joints. Rheumatoid ... read more May 12, 2015 An important discovery has been made about an immune cell that is already being used in immunotherapy to treat diseases such as type I diabetes. The work details how regulatory T cells can cure ... read more

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Arthritis News -- ScienceDaily

This article is about a type of pregnancy. For other uses of the word "surrogacy", see Surrogate. Legal regulation of surrogacy in the world:

Both gainful and altruistic forms are legal

No legal regulation but is done

Legal only altruistically

Allowed between relatives up to second degree of consanguinity

Banned

Unregulated / uncertain situation

A surrogacy arrangement or surrogacy agreement is the carrying of a pregnancy for intended parents. There are two main types of surrogacy, gestational surrogacy (also known as host or full surrogacy[1]) and traditional surrogacy (also known as partial, genetic, or straight surrogacy[1]). In gestational surrogacy, the pregnancy results from the transfer of an embryo created by in vitro fertilization (IVF), in a manner so the resulting child is genetically unrelated to the surrogate. Gestational surrogates are also referred to as gestational carriers. In traditional surrogacy, the surrogate is impregnated naturally or artificially, but the resulting child is genetically related to the surrogate. In the United States, gestational surrogacy is more common than traditional surrogacy and is considered less legally complex.[2]

Intended parents may seek a surrogacy arrangement when either pregnancy is medically impossible, pregnancy risks present an unacceptable danger to the mother's health or is a same sex couples preferred method of procreation. Monetary compensation may or may not be involved in these arrangements. If the surrogate receives compensation beyond reimbursement of medical and other reasonable expenses, the arrangement is considered commercial surrogacy; otherwise, it is referred to as altruistic. The legality and costs of surrogacy vary widely between jurisdictions, sometimes resulting in interstate or international surrogacy arrangements.

Having another woman bear a child for a couple to raise, usually with the male half of the couple as the genetic father, is referred to in antiquity. Babylonian law and custom allowed this practice, and infertile woman could use the practice to avoid a divorce, which would otherwise be inevitable.[3]

Many developments in medicine, social customs, and legal proceedings worldwide paved the way for modern commercial surrogacy:[4]

Surrogacy has the potential for various kinds of clash between surrogate mothers and intended parents. For instance, the intended parents of the fetus may ask for an abortion when complications arise and the surrogate mother may oppose the abortion.[6][7]

A surrogate is implanted with an embryo created by IVF. The resulting child is genetically unrelated to the surrogate. There are several sub-types of gestational surrogacy as noted below.

A surrogate is implanted with an embryo created by IVF, using intended father's sperm and intended mother's eggs.

A surrogate is implanted with an embryo created by IVF, using intended father's sperm and a donor egg where the donor is not the surrogate. The resulting child is genetically related to intended father and genetically unrelated to the surrogate.

A surrogate is implanted with an embryo created by IVF, using intended mother's egg and donor sperm. The resulting child is genetically related to intended mother and genetically unrelated to the surrogate.

A donor embryo is implanted in a surrogate; such embryos may be available when others undergoing IVF have embryos left over, which they opt to donate to others. The resulting child is genetically unrelated to the intended parent(s) and genetically unrelated to the surrogate.

This involves naturally[8] or artificially inseminating a surrogate with intended father's sperm via IUI, IVF or home insemination. With this method, the resulting child is genetically related to intended father and genetically related to the surrogate.

A surrogate is artificially inseminated with donor sperm via IUI, IVF or home insemination. The resulting child is genetically unrelated to the intended parent(s) and genetically related to the surrogate.

As of 2013, locations where a woman could legally be paid to carry another's child through IVF and embryo transfer included India, Georgia, Russia, Thailand, Ukraine and a few U.S. states.[9]

The legal aspects of surrogacy in any particular jurisdiction tend to hinge on a few central questions:

Although laws differ widely from one jurisdiction to another, some generalizations are possible:

The historical legal assumption has been that the woman giving birth to a child is that child's legal mother, and the only way for another woman to be recognized as the mother is through adoption (usually requiring the birth mother's formal abandonment of parental rights).

Even in jurisdictions that do not recognize surrogacy arrangements, if the genetic parents and the birth mother proceed without any intervention from the government and have no changes of heart along the way, they will likely be able to achieve the effects of surrogacy by having the surrogate mother give birth and then give the child up for private adoption to the intended parents.

If the jurisdiction specifically prohibits surrogacy, however, and finds out about the arrangement, there may be financial and legal consequences for the parties involved. One jurisdiction (Quebec) prevented the genetic mother's adoption of the child even though that left the child with no legal mother.[10]

Some jurisdictions specifically prohibit only commercial and not altruistic surrogacy. Even jurisdictions that do not prohibit surrogacy may rule that surrogacy contracts (commercial, altruistic, or both) are void. If the contract is either prohibited or void, then there is no recourse if one party to the agreement has a change of heart: If a surrogate changes her mind and decides to keep the child, the intended mother has no claim to the child even if it is her genetic offspring, and the couple cannot get back any money they may have paid or reimbursed to the surrogate; if the intended parents change their mind and do not want the child after all, the surrogate cannot get any reimbursement for expenses, or any promised payment, and she will be left with legal custody of the child.

Jurisdictions that permit surrogacy sometimes offer a way for the intended mother, especially if she is also the genetic mother, to be recognized as the legal mother without going through the process of abandonment and adoption.

Often this is via a birth order[11] in which a court rules on the legal parentage of a child. These orders usually require the consent of all parties involved, sometimes including even the husband of a married gestational surrogate. Most jurisdictions provide for only a post-birth order, often out of an unwillingness to force the surrogate mother to give up parental rights if she changes her mind after the birth.

A few jurisdictions do provide for pre-birth orders, generally in only those cases when the surrogate mother is not genetically related to the expected child. Some jurisdictions impose other requirements in order to issue birth orders, for example, that the intended parents be heterosexual and married to one another. Jurisdictions that provide for pre-birth orders are also more likely to provide for some kind of enforcement of surrogacy contracts.

Ethical issues that have been raised with regards to surrogacy include:[12]

Different religions take different approaches to surrogacy, often related to their stances on assisted reproductive technology in general.

Paragraph 2376 of the Catechism of the Catholic Church states that: "Techniques that entail the dissociation of husband and wife, by the intrusion of a person other than the couple (donation of sperm or ovum, surrogate uterus), are gravely immoral."[13]

Jewish law states that the parents of the child are the man who gives sperm and the woman who gives the egg cell. More recently, Jewish religious establishments have accepted surrogacy only if it is full gestational surrogacy with both intended parents' gametes included and fertilization done via IVF.[14]

A study by the Family and Child Psychology Research Centre at City University London in 2002 concluded that surrogate mothers rarely had difficulty relinquishing rights to a surrogate child and that the intended mothers showed greater warmth to the child than mothers conceiving naturally.[15][16][17]

Anthropological studies of surrogates have shown that surrogates engage in various distancing techniques throughout the surrogate pregnancy so as to ensure that they do not become emotionally attached to the baby.[18][19] Many surrogates intentionally try to foster the development of emotional attachment between the intended mother and the surrogate child.[20]

Surrogates are generally encouraged by the agency they go through to become emotionally detached from the fetus prior to giving birth.[21]

Instead of the popular expectation that surrogates feel traumatized after relinquishment, an overwhelming majority describe feeling empowered by their surrogacy experience.[19][22]

Although surrogate mothers generally report being satisfied with their experience as surrogates there are cases in which they are not. Unmet expectations are associated with dissatisfaction. Some women did not feel a certain level of closeness with the couple and others did not feel respected by the couple.[23]

Some women experience emotional distress when participating as a surrogate mother. This could be due to a lack of therapy and emotional support through the surrogate process.[23]

Some women have psychological reactions when being surrogate mothers. These include depression when surrendering the child, grief, and even refusal to release the child.[24]

A 2011 study from the Centre for Family Research at the University of Cambridge found that surrogacy does not have a negative impact on the surrogate's own children.[25]

A recent study (involving 32 surrogacy, 32 egg donation, and 54 natural conception families) examined the impact of surrogacy on motherchild relationships and children's psychological adjustment at age seven. Researchers found no differences in negativity, maternal positivity, or child adjustment.[26]

Fertility tourism for surrogacy is driven by legal regulations in the home country, or lower price abroad.

India is a main destination for surrogacy. Indian surrogates have been increasingly popular with intended parents in industrialized nations because of the relatively low cost. Indian clinics are at the same time becoming more competitive, not just in the pricing, but in the hiring and retention of Indian females as surrogates. Clinics charge patients between $10,000 and $28,000 for the complete package, including fertilization, the surrogate's fee, and delivery of the baby at a hospital. Including the costs of flight tickets, medical procedures and hotels, it comes to roughly a third of the price compared with going through the procedure in the UK.[27]

Surrogacy in India is of low cost and the laws are flexible. In 2008, the Supreme Court of India in the Manji's case (Japanese Baby) has held that commercial surrogacy is permitted in India. That has again increased the international confidence in going in for surrogacy in India. But as of 2014, a surrogacy ban was placed on homosexual couples and single parents.

There is an upcoming Assisted Reproductive Technology Bill, aiming to regulate the surrogacy business. However, it is expected to increase the confidence in clinics by sorting out dubious practitioners, and in this way stimulate the practice.[27]

Liberal legislation makes Russia attractive for "reproductive tourists" looking for techniques not available in their countries. Intended parents come there for oocyte donation, because of advanced age or marital status (single women and single men) and when surrogacy is considered. Gestational surrogacy, even commercial is absolutely legal in Russia, being available for practically all adults willing to be parents.[28] Foreigners have the same rights as for assisted reproduction as Russian citizens. Within three days after the birth the commissioning parents obtain a Russian birth certificate with both their names on it. Genetic relation to the child (in case of donation) does not matter.[29] On August 4, 2010, a Moscow court ruled that a single man who applied for gestational surrogacy (using donor eggs) could be registered as the only parent of his son, becoming the first man in Russia to defend his right to become a father through a court procedure.[30] The surrogate mother's name was not listed on the birth certificate; the father was listed as the only parent.

Surrogacy is completely legal in Ukraine. However, only healthy mothers who have had children before can become surrogates. Surrogates in Ukraine have zero parental rights over the child, as stated on Article 123 of the Family Code of Ukraine. Thus, a surrogate cannot refuse to hand the baby over in case she changes her mind after birth. Only married couples can legally go through gestational surrogacy in Ukraine.

The United States is sought as a location for surrogate mothers by some couples seeking a green card in the U.S., since the resulting child can get birthright citizenship in the United States, and can thereby apply for green cards for the parents when the child turns 21 years of age.[31] However, this is not the main reason. People come to the US for surrogacy procedures, including to enjoy a better quality of medical technology and care, as well as the high level of legal protections afforded through some US state courts to surrogacy contracts as compared to other countries. Increasingly, homosexual couples who face restrictions using IVF and surrogacy procedures in their home countries travel to US states where it is legal.

Read more:
Surrogacy - Wikipedia, the free encyclopedia

Often when a reader is confronted with a legal issue or concern, it is a time of confusion and emotional distress. Between possible physical injuries, medical bills and emotional stress, the legal processand just finding legal information or legal helpcan be overwhelming. We understand that. As a matter of fact, while everyone at LawyersAndSettlements.com is well-versed in legal matters, no one on the editorial staff is a lawyer or in any way a part of a law firm. Not only does that ensure our journalistic integrity, but it also allows us to see legal issues from the most important perspectiveyours. We understand the legal questions you have. From questions about personal injury settlements to what's involved in addressing medical legal issues or how to find a lawyer to help with employment law cases, LawyersAndSettlements.com provides the answers and legal information you need to help you make informed decisions and find legal help.

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Lawsuits, Legal News & Issues, Lawsuit Settlements, Class ...

When Hypothyroid Mom launched on October 1st, 2012, I hoped my blog would reach a few readers outside of my family and friends, but never did I imagine the number of people that it would reach in such a short time. I was blown away when thyroid expert Dr. Kent Holtorf, medical director of the non-profit National Academy of Hypothyroidism and medical director of the Holtorf Medical Group, included @HypothyroidMom in his recommended list of people to follow on Twitter on a Friday in early November (#FF FollowFriday).

Dr. Kent Holtorf @HoltorfMed

#FF @HypothyroidMom @BHthyroid @crzythyroidlady @ThyroidMary @ThyroidChange @OutsmartDisease #hypothyroid #thyroid #hashimotos disease

When the Holtorf Medical Group contacted me recently about including this guest blog post at Hypothyroid Mom, I was so honored. Its pretty obvious by how I responded to his team.

Dr. Holtorf has been a great supporter of Hypothyroid Mom since I launched in October 2012. He shared my blog with his followers on Twitter in the very early days when no one but my family and friends had any idea I existed. Absolutely yes I would gladly include this guest blog post about Hashimotos disease.

Dr. Holtorf ROCKS! You let him know that.

What is Hashimotos thyroiditis or Hashimotos disease? It is a genetically inherited disorder of the immune system in which there is chronic inflammation of the thyroid gland. Its as though the bodys immune system is confused and turns against the thyroid gland, making antibodies that interfere with the thyroid hormones ability to function.

How common is it? It might be more common than you think. According to current published data, there are approximately 14 million Americans who have Hashimotos and women are seven times as likely to have it as men. The number one symptom of hypothyroidism, or sluggish thyroid functioning, is fatigue. This stands to reason, since the thyroid hormones help our cells absorb and utilize energy from sources such as food and other hormones.

People who have Hashimotos can find themselves feeling like theyve been short-changed, but so often, they dont know why. They think, Why am I so tired all the time? Even if I sleep all night long, I still feel like I could sleep all day, too. They push themselves just to make it through the day. Their routine might include caffeine in the morning in order to make it to lunch. Instead of eating, they drink a shake and take a nap until lunch is over. The short nap gives them just enough energy to get through the afternoon. They cant wait to get home so they can crawl into bed as soon as possible. If its been a rough day, they may not even have enough energy to put on pajamas before going to bed. Does this sound at all familiar to you or is there someone you know that this describes? You dont have to feel this way, and you dont have to live this way.

The thyroid antibodies the immune system makes with Hashimotos are proteins that attach themselves to thyroid hormone, decreasing the amount of hormone that is available in the bloodstream. This is the primary reason it is so important to find a physician who will work with you to determine the appropriate treatment for you. The first course of treatment is determining the best thyroid replacement for you.

Once you find a Hashimotos disease doctor they will begin by treating you with thyroid hormone replacement therapy, but there are other medical and nutritional additions that can help.

Individuals with Hashimotos disease often have low levels of DHEA and testosterone. When these are supplemented, it can decrease levels of antibodies and decrease the ongoing destruction of the thyroid gland. It has also been shown that selenium deficiency can play a role in Hashimotos disease. Taking Selenium supplementation can often reduce antibody levels, though selenium is not a replacement for thyroid medication.

Low Dose Naltrexone has also shown to be very effective for autoimmune diseases such as Hashimotos disease and it can lower anti-thyroid antibodies.

Identifying and treating any chronic viral or bacterial infection that may be the underlying cause of the immune dysfunction can reverse the disease.

It might seem strange, but immune boosters can help Hashimotos disease. But they must boost the TH1 portion of the immune system and not the TH2 immunity. Treating with TH1 immune boosters can cause a reduction of the hyperactive TH2 immune response that is present in Hashimotos disease and help reverse the underlying cause. This may be especially helpful when a chronic infection is present, which is often the case (especially in chronic fatigue syndrome and fibromyalgia). The immune-modulatory properties of gamma globulin, either given intramuscularly or intravenously, can be very beneficial.

As you now know, there are a variety of treatments for Hashimotos and finding a hashimotos doctor that can assess you correctly and understand the treatment options can make all the difference in your quality of life.

Continued here:
Hashimoto's Thyroiditis - It's a Genetics Thing by Holtorf ...

Stem Cell Death caused by Common Medications used by Physicians

In yet another study, researchers have again determined that steroid medication and local anesthetics are really bad for cells.Steroid is a strong anti-inflammatory that iscommonlyused by physicians to treat swelling. The most common steroid medications are Cortisone, Hydrocortisone, Depomedrol, and Betamethasone. Local anesthetics are medications injected by physicians that help numb an area. The most common are Lidocaine, Novacaine, and Marcaine (bupivicane). Several years ago we tested local anesthetics with stem cells in our stem cell culture lab and thisexperiencechanged the way we harvest cells.However, we still see fat based stem cell clinics using common liposuction methods to collect stem cells. The problem with the most common aspiration method for fat liposuction is the use of large amounts of stem cell killing local anesthetic infiltrated into the adipose tissues. While this helps with patient comfort and the technique is easy and straightforward for the doctor, since the doctor has no idea about the viability of the cells being harvested, he has no way of knowing if he is killing the cells with the anesthetic. As discussed, several years ago we investigated the effects of these anesthetics with stem cells after we began to notice that certain harvest techniques used by certain clinic doctors would lead to much lower stem cell yields in culture. In addition, we began to see stem cell culture failures in certain patients on steroid medications. To determine why this was happening, we began to isolate the slight variables in technique used by different physicians and patient medications and ultimately this lead us to test various anesthetics with stem cells. We were blown away by how toxic these anaesthetics like lidocaine and bupivicane (the two most common used by doctors) were to cells. In fact, even at doses about 100 to 1,000 times less that what physicians normally use, some of these anesthetics are still effective at killing stem cells. So if youre planning an adipose or bone marrow stem cell procedure and your doctor wants to use generous amounts of local anesthetics that will come in contact with your cells, the stem cells the doctor is harvesting are likely DOA. While there are ways to keep patients comfortable with local anesthetics and keep cells safe, these procedures have to be carefully developed over time with viability being periodically checked in an advanced culture facility. Since our first 4 years of stem cell experience involved a check for cell viability every time (live cells grow in culture, dead cells dont), we developed our harvest techniques to keep cells alive. In addition, if youre on steroid medications, you may want to speak with your doctor about getting off these medications for your stem cellprocedure, as our experience (and this recent study) show that these medications are also hard on cells.

Disclaimer: Like all medical procedures, Regenexx Procedures have a success & failure rate. Not all patients will experience the same results.

If you liked this post, you may really enjoy this book by the same author - Dr. Chris Centeno

Written by Regenexx Founder, Dr. Chris Centeno, this 150 page book explains the Regenexx approach to patients and orthopedic conditions. Whether youre are an existing patient or simply interested in the human body and how everything in the body ties together, you will enjoy exploring this book in-depth. With hyperlinks to more detailed information, related studies and commentary, this book condenses a huge amount of data and resources into an enjoyable and entertaining read.

Chris Centeno, M.D. is a specialist in regenerative medicine and the new field of Interventional Orthopedics.

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Stem Cell Death caused by Common Medications used by ...

What is it?

Vischeck is a way of showing you what things look like to someone who is color blind. You can try Vischeck online- either run Vischeck on your own image files or run Vischeck on a web page. You can also download programs to let you run it on your own computer.

Roughly 1 in 20 people have some sort of color vision deficiency. The world looks different to these people: they often find it hard to tell red and green things apart. This often means that they sometimes can't see things that 'color normal' people can see (examples).

Many pictures, documents and web pages are hard for color blind people to read because the people who designed them didn't think about the problem. Vischeck lets them check their work for color blind visibility. It is also interesting to anyone who is just plain curious about what the world looks like if you're color blind.

Vischeck is a computer simulation of the entire process of human vision. The model can be divided into three parts.

The first stage includes the physical properties of the display devices (including various CRT and LCD monitors, and standard CYMK print on paper), the ambient lighting and the effects of physiological factors such as corneal haze, lens opacities and short or long-sightedness which might degrade the optical image.

The second stage of the model describes the transformation of optical image on the retina into a neural representation of that image in the optic nerve. At this point, visual disabilities and anomalies such as color-blindness or retinal degeneration can be included in the model.

The final stage in Vischeck is a model of human cortical vision. At this stage, we include information about the way in which color, spatial patterns and motion are combined and processed in the visual cortex, to form the observer's perception of the image

View original post here:
Vischeck: About Vischeck

Last year, Patricia Beals was told she'd need a double knee replacement to repair her severely arthritic knees or she'd probably spend the rest of her life in a wheelchair.

Hoping to avoid surgery, Beals, 72, opted instead for an experimental treatment that involved harvesting bone marrow stem cells from her hip, concentrating the cells in a centrifuge and injecting them back into her damaged joints.

"Almost from the moment I got up from the table, I was able to throw away my cane," Beals says. "Now I'm biking and hiking like a 30-year-old."

A handful of doctors around the country are administering treatments like the one Beals received to stop or even reverse the ravages of osteoarthritis. Stem cells are the only cells in the body able to morph into other types of specialized cells. When the patient's own stem cells are injected into a damaged joint, they appear to transform into chondrocytes, the cells that go on to produce fresh cartilage. They also seem to amplify the body's own natural repair efforts by accelerating healing, reducing inflammation, and preventing scarring and loss of function.

Christopher J. Centeno, M.D., the rehab medicine specialist who performed Beals' procedure, says the results he sees from stem cell therapy are remarkable. Of the more-than-200 patients his Bloomfield, Colo., clinic treated over a two-year period, he says, "two thirds of them reported greater than 50 percent relief and about 40 percent reported more than 75 percent relief one to two years afterward."

According to Centeno, knees respond better to the treatment than hips. Only eight percent of his knee patients opted for a total knee replacement two years after receiving a stem cell injection. The complete results from his clinical observations will be published in a major orthopedic journal later this year.

The Pros and Cons

The biggest advantage stem cell injections seem to offer over more invasive arthritis remedies is a quicker, easier recovery. The procedure is done on an outpatient basis and the majority of patients are up and moving within 24 hours. Most wear a brace for several weeks but still can get around. Many are even able to do some gentle stationary cycling by the end of the first week.

There are also fewer complications. A friend who had knee replacement surgery the same day Beals had her treatment developed life-threatening blood clots and couldn't walk for weeks afterwards. Six months out, she still hasn't made a full recovery.

Most surgeries don't go so awry, but still: Beals just returned from a week-long cycling trip where she covered 20 to 40 miles per day without so much as a tweak of pain.

As for risks, Centeno maintains they are virtually nonexistent.

"Because the stem cells come from your own body, there's little chance of infection or rejection," he says.

Not all medical experts are quite so enthusiastic, however. Dr. Tom Einhorn, chairman of the department of orthopedic surgery at Boston University, conducts research with stem cells but does not use them to treat arthritic patients. He thinks the idea is interesting but the science is not there yet.

"We need to have animal studies and analyze what's really happening under the microscope. Then, and only then, can you start doing this with patients," he says.

The few studies completed to date have examined how stem cells heal traumatic injuries rather than degenerative conditions such as arthritis. Results have been promising but, as Einhorn points out, the required repair mechanisms in each circumstance are very different.

Another downside is cost: The injections aren't approved by the FDA, which means they aren't covered by insurance. At $4,000 a pop -- all out of pocket -- they certainly aren't cheap, and many patients require more than one shot.

Ironically, one thing driving up the price is FDA involvement. Two years ago, the agency stepped in and stopped physicians from intensifying stem cells in the lab for several days before putting them back into the patient. This means all procedures must be done on the same day, no stem cells may be preserved and many of the more expensive aspects of the treatment must be repeated each time.

Centeno says same day treatments often aren't as effective, either.

But despite the sky-high price tag and lack of evidence, patients like Beals believe the treatment is nothing short of a miracle. She advises anyone who is a candidate for joint replacement to consider stem cells first.

"Open your mind up and step into it," she says. "Do it. It's so effective. It's the future and it works."

Read the original here:
Stem Cell Treatment May Help Ease Osteoarthritis Pain ...

Nanorobots in Medicine

Future applications of nanomedicine will be based on the ability to build nanorobots. In the future these nanorobots could actually be programmed to repair specific diseased cells, functioning in a similar way to antibodies in our natural healing processes.

Developing Nanorobots for Medicine

Design analysis for a cell repair nanorobot: The Ideal Gene Delivery Vector: Chromallocytes, Cell Repair Nanorobots for Chromosome Repair Therapy

Design analysis for an antimicrobial nanorobot: Microbivores: Artifical Mechanical Phagocytes using Digest and Discharge Protocol

A Mechanical Artificial Red Cell: Exploratory Design in Medical Nanotechnology

Nanorobots in Medicine: Future Applications

The elimination of bacterial infections in a patient within minutes, instead of using treatment with antibiotics over a period of weeks.

The ability to perform surgery at the cellular level, removing individual diseased cells and even repairing defective portions of individual cells.

Significant lengthening of the human lifespan by repairing cellular level conditions that cause the body to age.

Nanomedicine Reference Material

An online copy of volume one of the bookNanomedicine by Robert Freitas.

Chapter 7: "Engines of Healing" from the book Engines of Creation, The Coming Era of Nanotechnology by Eric Drexler

For a fun, fictionalized account of miniaturized medicine rent the 1966 movie Fantastic Voyage, or read the novelization of the movie by Isaac Asimov.

Institute of Robotics and Intelligent Systems

Nanomedicine Center for Nucleoprotein Machines

Related Pages

In about 20 years researchers plan to have the capability to build an object atom by atom or molecule by molecule. Molecular manufacturing, also called molecular nanotechnology will provide the ability to build the nanorobots needed for future applications of nanomedicine.

Read this article:
Nanorobots in Medicine - Nanomedicine

Cloning/Embryonic Stem Cells

The term cloning is used by scientists to describe many different processes that involve making duplicates of biological material. In most cases, isolated genes or cells are duplicated for scientific study, and no new animal results. The experiment that led to the cloning of Dolly the sheep in 1997 was different: It used a cloning technique called somatic cell nuclear transfer and resulted in an animal that was a genetic twin -- although delayed in time -- of an adult sheep. This technique can also be used to produce an embryo from which cells called embryonic stem (ES) cells could be extracted to use in research into potential therapies for a wide variety of diseases.

Thus, in the past five years, much of the scientific and ethical debate about somatic cell nuclear transfer has focused on its two potential applications: 1) for reproductive purposes, i.e., to produce a child, or 2) for producing a source of ES cells for research.

The technique of transferring a nucleus from a somatic cell into an egg that produced Dolly was an extension of experiments that had been ongoing for over 40 years. In the simplest terms, the technique used to produce Dolly the sheep - somatic cell nuclear transplantation cloning - involves removing the nucleus of an egg and replacing it with the diploid nucleus of a somatic cell. Unlike sexual reproduction, during which a new organism is formed when the genetic material of the egg and sperm fuse, in nuclear transplantation cloning there is a single genetic "parent." This technique also differs from previous cloning techniques because it does not involve an existing embryo. Dolly is different because she is not genetically unique; when born she was genetically identical to an existing six-year-old ewe. Although the birth of Dolly was lauded as a success, in fact, the procedure has not been perfected and it is not yet clear whether Dolly will remain healthy or whether she is already experiencing subtle problems that might lead to serious diseases. Thus, the prospect of applying this technique in humans is troubling for scientific and safety reasons in addition to a variety of ethical reasons related to our ideas about the natural ordering of family and successive generations.

Several important concerns remain about the science and safety of nuclear transfer cloning using adult cells as the source of nuclei. To date, five mammalian species -- sheep, cattle, pigs, goats, and mice -- have been used extensively in reproductive cloning studies. Data from these experiments illustrate the problems involved. Typically, very few cloning attempts are successful. Many cloned animals die in utero, even at late stages or soon after birth, and those that survive frequently exhibit severe birth defects. In addition, female animals carrying cloned fetuses may face serious risks, including death from cloning-related complications.

An additional concern focuses on whether cellular aging will affect the ability of somatic cell nuclei to program normal development. As somatic cells divide they progressively age, and there is normally a defined number of cell divisions that can occur before senescence. Thus, the health effects for the resulting liveborn, having been created with an "aged" nucleus, are unknown. Recently it was reported that Dolly has arthritis, although it is not yet clear whether the five-and-a-half-year-old sheep is suffering from the condition as a result of the cloning process. And, scientists in Tokyo have shown that cloned mice die significantly earlier than those that are naturally conceived, raising an additional concern that the mutations that accumulate in somatic cells might affect nuclear transfer efficiency and lead to cancer and other diseases in offspring. Researchers working with clones of a Holstein cow say genetic programming errors may explain why so many cloned animals die, either as fetuses or newborns.

The announcement of Dolly sparked widespread speculation about a human child being created using somatic cell nuclear transfer. Much of the perceived fear that greeted this announcement centered on the misperception that a child or many children could be produced who would be identical to an already existing person. This fear is based on the idea of "genetic determinism" -- that genes alone determine all aspects of an individual -- and reflects the belief that a person's genes bear a simple relationship to the physical and psychological traits that compose that individual. Although genes play an essential role in the formation of physical and behavioral characteristics, each individual is, in fact, the result of a complex interaction between his or her genes and the environment within which he or she develops. Nonetheless, many of the concerns about cloning have focused on issues related to "playing God," interfering with the natural order of life, and somehow robbing a future individual of the right to a unique identity.

Several groups have concluded that reproductive cloning of human beings creates ethical and scientific risks that society should not tolerate. In 1997, the National Bioethics Advisory Commission recommended that it was morally unacceptable to attempt to create a child using somatic cell nuclear transfer cloning and suggested that a moratorium be imposed until safety of this technique could be assessed. The commission also cautioned against preempting the use of cloning technology for purposes unrelated to producing a liveborn child.

Similarly, in 2001 the National Academy of Sciences issued a report stating that the United States should ban human reproductive cloning aimed at creating a child because experience with reproductive cloning in animals suggests that the process would be dangerous for the woman, the fetus, and the newborn, and would likely fail. The report recommended that the proposed ban on human cloning should be reviewed within five years, but that it should be reconsidered "only if a new scientific review indicates that the procedures are likely to be safe and effective, and if a broad national dialogue on societal, religious and ethical issues suggests that reconsideration is warranted." The panel concluded that the scientific and medical considerations that justify a ban on human reproductive cloning at this time do not apply to nuclear transplantation to produce stem cells. Several other scientific and medical groups also have stated their opposition to the use of cloning for the purpose of producing a child.

The cloning debate was reopened with a new twist late in 1998, when two scientific reports were published regarding the successful isolation of human stem cells. Stem cells are unique and essential cells found in animals that are capable of continually reproducing themselves and renewing tissue throughout an individual organism's life. ES cells are the most versatile of all stem cells because they are less differentiated, or committed, to a particular function than adult stem cells. These cells have offered hope of new cures to debilitating and even fatal illness. Recent studies in mice and other animals have shown that ES cells can reduce symptoms of Parkinson's disease in mouse models, and work in other animal models and disease areas seems promising.

In the 1998 reports, ES cells were derived from in vitro embryos six to seven days old destined to be discarded by couples undergoing infertility treatments, and embryonic germ (EG) cells were obtained from cadaveric fetal tissue following elective abortion. A third report, appearing in the New York Times, claimed that a Massachusetts biotechnology company had fused a human cell with an enucleated cow egg, creating a hybrid clone that failed to progress beyond an early stage of development. This announcement served as a reminder that ES cells also could be derived from embryos created through somatic cell nuclear transfer, or cloning. In fact, several scientists believed that deriving ES cells in this manner is the most promising approach to developing treatments because the condition of in vitro fertilization (IVF) embryos stored over time is questionable and this type of cloning could overcome graft-host responses if resulting therapies were developed from the recipient's own DNA.

For those who believe that the embryo has the moral status of a person from the moment of conception, research or any other activity that would destroy it is wrong. For those who believe the human embryo deserves some measure of respect, but disagree that the respect due should equal that given to a fully formed human, it could be considered immoral not to use embryos that would otherwise be destroyed to develop potential cures for disease affecting millions of people. An additional concern related to public policy is whether federal funds should be used for research that some Americans find unethical.

Since 1996, Congress has prohibited researchers from using federal funds for human embryo research. In 1999, DHHS announced that it intended to fund research on human ES cells derived from embryos remaining after infertility treatments. This decision was based on an interpretation "that human embryonic stem cells are not a human embryo within the statutory definition" because "the cells do not have the capacity to develop into a human being even if transferred to the uterus, thus their destruction in the course of research would not constitute the destruction of an embryo." DHHS did not intend to fund research using stem cells derived from embryos created through cloning, although such efforts would be legal in the private sector.

In July 2001, the House of Representatives voted 265 to 162 to make any human cloning a criminal offense, including cloning to create an embryo for derivation of stem cells rather than to produce a child. In August 2002, President Bush, contending with a DHHS decision made during the Clinton administration, stated in a prime-time television address that federal support would be provided for research using a limited number of stem cell colonies already in existence (derived from leftover IVF embryos). Current bills before Congress would ban all forms of cloning outright, prohibit cloning for reproductive purposes, and impose a moratorium on cloning to derive stem cells for research, or prohibit cloning for reproductive purposes while allowing cloning for therapeutic purposes to go forward. As of late June, the Senate has taken no action. President Bush's Bioethics Council is expected to recommend the prohibition of reproductive cloning and a moratorium on therapeutic cloning later this summer.

Prepared by Kathi E. Hanna, M.S., Ph.D., Science and Health Policy Consultant

Last Reviewed: April 2006

The rest is here:
Cloning/Embryonic Stem Cells - Genome.gov

The recent sequencing of the human genome has accelerated scientific discoveries in genetics related to medicine and animal and plant science. Research universities in Georgia, supported by government funding and collaborations with private industry, conduct leading-edge research that contributes to improved prevention, diagnosis, and treatment of genetically caused diseases. The Georgia Research Alliance, a university, business, and government partnership, has been a key supporter of genetics research through eminent scholars, research laboratories and equipment, and technology incubators. Newborn Genetics Screening The state of Georgia has paid for newborn genetics screening since 1978. The program, developed in collaboration with the Emory University School of Medicine's Department of Human Genetics and Genetics Laboratory, tests all Georgia newborns for thirteen inherited diseases, including metabolic diseases. Emory, located in Atlanta, is one of the nation's leading research and treatment centers for inherited diseases, including lysosomal enzyme diseases, fragile X syndrome, and Down syndrome. Emory scientists are leaders in developing new enzyme replacement therapies for children born with Gaucher disease and Fabry disease, screening and treatment for maple syrup urine disease, and FISH technology (fluorescence in situ hybridization, which allows physicians to look for chromosomal abnormalities under a microscope). Emory's large staff of genetics counselors works with parents and prospective parents at centers throughout the state. In addition, genetics counseling and screening to predict adult cancers has developed rapidly since scientists discovered altered genes that increase the risk of breast, ovarian, and colon cancers. University Genetics Research Several of Georgia's research universities have extensive research centers focused on genetics. The Department of Human Genetics at the Emory University School of Medicine includes both laboratory research and clinical treatment programs in one of the largest academic genetics departments in the nation. Emory has the world's largest research program on fragile X syndrome to be funded by the National Institutes of Health (NIH). The gene responsible for fragile X syndrome, the most common cause of inherited mental retardation, was discovered by Emory professor Steven T. Warren, who led an international team of scientists. Warren and his team also have developed screening techniques and are working on potential new therapies for fragile X syndrome, which affects 3,500 individuals in Georgia either directly or as carriers. Emory geneticist Stephanie Sherman's discovery of what is known as the "Sherman Paradox," in which genetic diseases caused by the triplet repeat of amino acids are not passed on to offspring with the usual probabilities common among most genetic disorders, has been invaluable in helping physicians predict risk for these genetic diseases. Through support from the NIH, scientists at Emory and the Centers for Disease Control and Prevention have conducted sixteen years of research on the causes and clinical consequences of Down syndrome through the Atlanta Down Syndrome Project. All Atlanta-area newborns with Down syndrome and their parents are eligible to participate in the project. In 2000 the NIH expanded the Atlanta project into the National Down Syndrome Project by adding five other research centers (in Arkansas, California, Iowa, New Jersey, and New York). The Department of Genetics at the University of Georgia (UGA) in Athens includes many faculty who teach genetics to undergraduate and graduate students. Graduate research and training includes molecular genetics, evolutionary biology, and genomics. Four genetics faculty members are also members of the prestigious National Academy of Sciences.

The UGA Center for Applied Genetic Technologies (CAGT) brings together diverse expertise in plant and animal genomics, DNA markers, and transformation (a process of genetic alteration) and provides state-of-the-art facilities and instrumentation. Within CAGT are research labs and the Georgia BioBusiness Center incubator, which supports start-up companies in the biosciences by providing them access to management expertise and sophisticated instrumentation.

Link:
Genetics in Georgia | New Georgia Encyclopedia

Author Message

James L McLeod

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Paul McChesney (Admin)

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Anonymous

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Paul McChesney (Admin)

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If you have significant vision problems in both eyes, that make it more difficult to work, that is a more complex question.

If you have an impairment in one eye only, you are probably going to have to find something else, such as severe headaches that interfere with concentration, to establish disability.

A local social security lawyer can better answer the question as to whether your situation justifies an SSI or social security disability claim.

D.Fowler

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Reply by Paul: See the preceeding answer for the best I can give as to proving disability by blindness.

The "grid" hardly applies to blindness. It is a set of rules that directs a finding of disabled or not disabled based on age, education, work experience, and degree of exertional limitations. The cases involving people with nonexertional limitations will not be controlled by the grids. Vision impairments are nonexertional.

KIM MELTON

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Reply by Paul Yes, if it is serious enough, and if you have worked enough. To win an SSI case you need not show you have worked, but need to show that your family has no income. But to win it needs to affect your ability to function in a work setting. In order to judge, you need to provide me with the limitations it causes in your case. Also your city and state.

(Message edited by admin on July 26, 2005)

heather@inorbit.com

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I quit in April of 2000 because I was pregnant and my vision got significently worse, I was tripping over everything and was scared I would fall and harm the baby. I was also getting severe strains from the computer glare and was advised to avoid computers at that time to "save" my vision. I have not worked since.

Is the above enough to qualify? I have 55 days left to appeal. Can you suggest an attorney in the Miami area? Thank You so much for your help.

Reply by Paul You have a very serious problem, and should definitely pursue a disability claim in addition to other avenues that might, if you are lucky, lead to employment. It seems to me that you are virtually legally blind, and have other problems, too.

If you get on disability, there are might be special programs that make it easier for you to experiment with working while you are drawing disability.

I would certainly get an attorney at this point; you have tried once on your own and been unsuccessful. If you have trouble getting an attorney right away, be sure to appeal on your own by going down to the Social Security office. GET A RECEIPT! That will give you a little extra time.

I will suggest an attorney by email.

anonnymous

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mary alston

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Paul McChesney (Admin)

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Ted Fogg

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Paul McChesney (Admin)

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misty traweek

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Paul McChesney (Admin)

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The crucial question in cases involving vision is how well you can see with best correction. You don't tell me what your corrected vision is, so I can't say.

The Snellen number, 20/20 or 20/400, tells how well you can see at a distance in the center of your field of vision. You also can be disabled because of narrowing of field of vision and difficulty with close vision, which is more relevant for work puroposes.

All eye doctors know what "legally blind" means, and if your doctor will say you are that, you can probably get benefits without an attorney.

Headaches can be disabling, but that sort of case is difficult to prove. If that is your main basis for your claim, get a lawyer before you file, even, and develop your case carefully.

Take care and good luck.

mbjbajjc

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Paul McChesney (Admin)

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Of course, as you probably know, legally blind people are not allowed to drive.

While you still have a job, you must be positive that you have all possible long and short term disability benefits that might be available to you.

I would talk to a good Social Security lawyer before I went out of work, in order to try to minimize any possible time without income.

You might look into a less demanding job that would enable you to earn your full state retirement.

Take care and good luck.

murlesl

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Paul McChesney (Admin)

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Mickey Unregistered guest

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Paul McChesney (Admin) Board Administrator Username: Admin

Post Number: 800 Registered: 5-2004

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Marie Unregistered guest

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Paul McChesney (Admin) Board Administrator Username: Admin

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deana verner Unregistered guest

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Paul McChesney (Admin) Board Administrator Username: Admin

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That's the long answer. The short answer is get your medical records and sit down with a good disability lawyer, preferably before you stop working, and take your next steps very carefully.

Dan Williams Unregistered guest

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Paul McChesney (Admin) Board Administrator Username: Admin

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If you are not legally blind, the test for disability based on vision alone is complex; it is based on both your "visual field," meaning how far to the side, up and down you can see when you fix your eyes on a spot in front of you, and your "central visual acuity," meaning how well you can see at a spot in front of you with the glasses that help you most.

If you are not legally blind, and your vision is stable, disability based on eyesight is based on the product of your visual field and your central visual acuity, so that the better your central vision, the worse your visual field must be in order to establish disability.

I know that's confusing; the bottom line is that it is too complicated for me to answer.

On top of that, if you have a disease like sarcioidosis that causes ever varying impairment, it becomes more difficult to correct vision with glasses; the prescription that worked yesterday might not work tomorrow.

Maybe it would be wise to get your medical records and sit down with an attorney that handles a lot of these cases.

Take care and good luck.

joseph mantia Unregistered guest

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Paul McChesney (Admin) Board Administrator Username: Admin

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You have a good shot at continuing benefits, but you need to be ready to appeal quickly if they try to cut you off.

The fact that your primary problem has improved makes it more likely for them to cut you off.

But your condition has also worsend; you need to be sure that appears in the record. Be sure they get good records of each of your new problems.

If you get a termination notice, be sure to appeal, in person, within 10 days, and get a receipt proving you did so. If so, you can get benefits continued while you appeal. This will protect you from immediate catastrophe.

If they try to terminate you, you should immediately get legal aid involved, or else hire an attorney.

Brian (Unregistered Guest) Unregistered guest

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In the statement they sent me .it has alot of limitations on it......I can't lift anything over 50 pds....25 pds occasionally...I can't be up on ladders...I can walk or stand for 6 hours in an 8 hour work day..I can't handle small objects...and so forth.

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Social-Security-Disability-Forum: Blindness and Vision ...

Preventive Medicine Residency Program, Program Director University of Texas Rio Grande Valley (UTRGV) McAllen, TX

Opportunity

Preventive Medicine Residency Program, Edinburg, Texas

Program Director

The University of Texas Rio Grande Valley is recruiting a Program Director for a new Preventive Medicine Residency Program at Doctors Hospital at Renaissance in Edinburg, Texas. The University of Texas Rio Grande Valley is a multisite, academic, community-based program located in the Lower Rio Grande Valley of South Texas. We offer university-based training at a regional academic campus, which sits minutes away from the Gulf Coast.

The South Texas area is a unique multicultural coastal region filled with rich history, wild life and plant life, and beautiful weather. This region is a birders paradise in a Gulf Coast area with beautiful and unspoiled wetlands and beaches, crowded only with birds, fish and dolphins. The program is located in a lush semi-tropical region that is at the threshold where Latin American and U.S. cultures meet. Though it is one of the dynamic, least expensive and fastest growing areas in the country the South Texas population has a number of economic, health and educational disparities. This is a place where you can enjoy the best life has to offer and make a difference.

The ideal candidate for this position must possess the following: (a) 3-5 years of experience as a faculty member in an ACGME accredited Preventive Medicine residency program, with 3 or more years GME administrative experience; (b) exemplary clinical skills; (c) an interest in research (clinical and/or basic); and (d) experience in teaching resident physicians and medical students in an ambulatory or inpatient setting. Applicants must be board-certified in Preventive Medicine and eligible to obtain a Texas medical license.

The individual in this position will:

Background:

The 75th Texas Legislature made a major commitment to improve education and health professional opportunities in the South Texas/Border Region by mandating the creation of a Regional Academic Health Center to serve the Cameron, Starr, Hidalgo, and Willacy counties of Rio Grande Valley of Texas. The Regional Academic Health Center (RAHC) is a research and medical education endeavor in which programs are directed at distinctive regional needs and conducted in affiliation with health professionals and educational entities of the region.

Over the past decade, the Texas Legislature and the UT System have collectively invested over $79 million in infrastructure and other resources to support medical education and research in Cameron, Hidalgo, Starr and Willacy counties. The facilities include three buildings currently organized and operated under The University of Texas Health Science Center San Antonio Regional Academic Health Center (RAHC) a medical education building and an academic and clinical research building in Harlingen and a medical research building in Edinburg along with a building in Brownsville for the school of public health under the University of Texas Health Science Center Houston.

Approvals from the University of Texas System Board of Regents (May 3) authorizing UT System Chancellor Francisco G. Cigarroa, M.D. [2], to move forward with plans to establish a medical school in South Texas (in Austin as well) represents the beginning of the transition of the UT Health Science Center-San Antonio Regional Academic Health Center into an independent, free-standing, comprehensive and research-intensive regional medical school, with its own president and structure for South Texas. The schools will train a health care workforce in rapidly growing areas of the state with substantial physician and health professional shortages, increase biomedical research, and improve health care for Central Texas, South Texas, and the Rio Grande Valley. The medical schools will also lead to the commercialization of discoveries made by their researchers and significantly strengthen the economic vibrancy of their local communities and regions, while more importantly bringing these life-saving discoveries to the patients bedside.

Plans for a full-fledged medical school for the Rio Grande Valley have been in the works since the early 1990s, when legislators began documenting how the Valleys fast-growing and historically underserved region needed to better recruit physicians likely to commit to the area.

The Board of Regents publicly and explicitly acknowledged its commitment to the development of a medical school in South Texas, contingent upon the following factors:

Actions to date to support this initiative include:

The UT System is joining together with a regional coalition of community leaders to successfully transition the Regional Academic Health Center into the free-standing, comprehensive, research intensive medical school the Rio Grande Valley deserves.

It is hoped that by 2018, the freestanding medical school will:

Nationally, more than 70 percent of physicians typically end up practicing medicine in the same region where they graduated. By providing excellent medical education opportunities to students in South Texas, we anticipate that graduates will remain to improve the delivery and quality of health care.

The Organization:

The University of Texas System

Educating students, providing care for patients, conducting groundbreaking research and serving the needs of Texans and the nation for more than 130 years, The University of Texas System is one of the largest public university systems in the United States, with nine academic universities and six health science centers. Student enrollment exceeded 215,000 in the 2011 academic year. The UT System confers more than one-third of the states undergraduate degrees and educates nearly three-fourths of the states health care professionals annually. The UT System has an annual operating budget of $13.1 billion (FY 2012) including $2.3 billion in sponsored programs funded by federal, state, local and private sources. With roughly 87,000 employees, the UT System is one of the largest employers in the state.

The UT System has been utilizing the strength and assets of UT Health Science-San Antonio (UTHSCSA) in much the same way that in 1959 UTHSCSA used the strength of UT Southwestern in Dallas and the University of Texas Medical Branch at Galveston to get its medical school off the ground. In addition, the establishment of the medical school in South Texas will be part of a paradigm shift from the current model of separate universities and health science centers spread across the state. The new medical school will be established within the new institution, University of Texas Rio Grande Valley, which was recently formed with the closure of the two Rio Grande Valley universities (UT Pan American and Brownsville). The vast majority of the top medical schools in the U.S. are associated with a large university, and research expenditures generated from universities with medical schools are significantly higher than those of universities without medical schools.

The school of medicine will be developed initially through the use of facilities at the UTHSCSA, including four buildings that are part of UTHSCSAs Regional Academic Health Center in Harlingen, Edinburg and Brownsville. Today roughly 100 medical students receive part of their medical education at the RAHC and between 30 and 35 graduate medical residents study and work at hospitals across the Valley each year. With the new school of medicine, UT plans to increase graduate medical residents to 150 per year and place them in hospitals throughout the Valley.

The University of Texas Rio Grande Valley (UTRGV)

A New University with a Long History

The University of Texas Rio Grande Valley was created by the Texas Legislature in 2013 in a historic move that brings together the resources and assets of UT Brownsville and UT Pan American and, for the first time, makes it possible for residents of the Rio Grande Valley to benefit from the Permanent University Funda public endowment contributing support to the University of Texas System and the Texas A&M University System.

The new university will also be home to a School of Medicine and will transform Texas and the nation by becoming a leader in student success, teaching, research, and health care. UTRGV will enroll its first class in the fall of 2015, and the School of Medicine will open in 2016.

UT Brownsville and UT Pan American

The shared history of The University of Texas Pan American and The University of Texas at Brownsville goes back to 1927, when Edinburg College was founded. In 1973, Pan American opened a second campus in Brownsville, which later became an independent institution of The University of Texas System in 1991. Over the years, the missions and the identities of these great institutions have continually evolved to serve the communities of the Rio Grande Valley.

Now, the evolution and connection between these two institutions is coming full circle as UT Brownsville and UT Pan American are being established as a single, new university and medical school, with a single, new identityThe University of Texas Rio Grande Valley.

UTRGV will combine the talent, assets, and resources of UT Brownsville, UT Pan American, and the Regional Academic Health Center, along with other resources, to create a new model of excellence in education.

Eleven colleges and schools will form the academic foundation for UTRGV, including:

When the UTRGV School of Medicine is fully accredited, a College of Medicine and Health Affairs will be formed that will include Nursing, Social Work, and Allied Health.

The Position:

Reports to: The position will initially report to the Chairman, Department of Preventative Medicine at UTRGV and the DIO.

Position Summary:

UTRGV School of Medicine is seeking a full time Program Director for a community based, medical school affiliated Preventive Medicine Residency Program located at the Regional Academic Health Center (RAHC) in the Lower Rio Grande Valley of South Texas. The incumbent will have protected time for administrative Residency Program Director duties and development of the program, will maintain a clinical practice, supervise residents and teach medical students. Academic rank will be commensurate with the candidates level of experience.

Key Responsibilities

This is accomplished by:

Location

The Rio Grande Valley

The Rio Grande Valley (RGV) or the Lower Rio Grande Valley, informally called The Valley, is an area located in the southernmost tip of South Texas. It lies along the northern bank of the Rio Grande, which separates Mexico from the United States. The Rio Grande Valley is not a valley, but a delta or floodplain containing many oxbow lakes or resacas formed from pinched-off meanders in earlier courses of the Rio Grande.

The region is made up of four counties: Starr County, Hidalgo County, Willacy County, and Cameron County. As of January 1, 2012, the U.S. Census Bureau estimated the population of the Rio Grande Valley at 1,305,782. According to the U.S. Census Bureau in 2008, 86 percent of Cameron County, 90 percent of Hidalgo County, 97 percent of Starr County, and 86 percent of Willacy County are Hispanic. The largest city is Brownsville (Cameron County), followed by McAllen (Hidalgo County). Other major cities include Edinburg, Mission, Harlingen, Rio Grande City and Pharr.

The Valley encompasses several landmarks that attract tourists, and is primarily known for South Padre Island. Popular destinations include Port Isabel Lighthouse, Laguna Atascosa National Wildlife Refuge, Santa Ana National Wildlife Refuge, and Bentsen-Rio Grande Valley State Park. The Valley is a popular waypoint for tourists seeking to visit Mexico.

Quality of Life

The Rio South Texas region (McAllen-Edinburg-Mission MSA) is one of the most exciting places to work, and play. From semi-pro sports teams to a thriving arts and music scene, there is much to see and do here. Rio South Texas boasts beautiful beaches, plus more than a dozen museums, a nationally-renowned zoo and even a waterpark, making this region a family-friendly destination. Many outdoor adventures await you kayaking, canoeing, biking, birding, running, hiking, golfing, or exploring our many wildlife sanctuaries and heritage tourism attracts those who want to take a stroll down memory lane. Combined with a low cost-of-living, some of the best public and private primary and secondary schools in the state and nation, moderate weather and affordable housing, the Rio South Texas region shines brightly.

Texas is the third largest producer of citrus fruit in United States, the majority of which is grown in the Rio Grande Valley. Grapefruit make up over 70% of the Valley citrus crop, which also includes orange, watermelon, tangerine, tangelo and Meyer lemon production each winter.

Community Statistics

Safe and Secure Communities

Rio South Texas is safe, and among the fastest growing regions in the nation.

Rankings

2013

2012

2011

Cost of Living Comparisons

The cost of living in McAllen ranks consistently below the national average primarily because of low housing prices. The following table provides comparisons between McAllen and other U.S. cities: McAllen ranked as 3rd most affordable city in the nation to live in (Kiplinger, 2012)

South Texas Independent School District (STISD)

South Texas Independent School District (STISD) serves junior high and high school students who live along the southernmost tip of Texas, the region known as the Rio Grande Valley. The district stretches over three counties, Cameron, Hidalgo and Willacy, and overlaps 28 other school districts. When it comes to educating the next generation, the Rio South Texas region is prepared.

The district contains four schools that received gold, silver or bronze medals in U.S. It is the only all-magnet school district in the state. All schools are accredited by the Texas Education Agency and Southern Association of Colleges and Schools. Over 95 percent of STISD graduates continue their education at major universities or technical colleges.

Best High Schools rankings:

Higher Education

With well over 70,000 students, and enrollment growing with each semester, the Rio South Texas region is rapidly emerging as the center for higher education along the U.S.-Mexico border. Several higher educational institutions serve the regions growing workforce.

University of Texas-Pan American: Part of the University of Texas system, UTPA in Edinburg serves more than 18,500 students. This four-year university offers undergraduate degrees in numerous subject areas. The university also has two Ph.D. programs, as well as several graduate programs.

For more information on one of the best ranked public universities, visit http://www.utpa.edu/about/overview/

University of Brownsville-Texas Southmost College: Situated right along the shared border with Mexico, UTB-TSC is one of the most historic campuses in Texas. However, UTB-TSC offers students in the Rio South Texas region access to some of the most modern technologies and programs. Here, students can receive two or four-year degrees, as well as Masters and doctoral programs.

To learn more, visit http://www.utb.edu/Pages/default.aspx

South Texas College: This growing college campus offers two-year and four-year degrees to more than 20,000 students in the Rio South Texas region. STC offers technical programs and partners with local industry to ensure the regional workforce meets the needs of businesses today, and tomorrow. STC has campuses in McAllen, Rio Grande City and Weslaco.

For more information on one of the fastest growing college centers along the border, visit http://www.southtexascollege.edu

Texas State Technical College: TSTC provides students in the Rio South Texas with a variety of options for Associates degrees. TSTC makes it easy for students to either pursue a career after two years through a variety of campus services, but also courses are readily transferable to most universities in Texas.

Visit http://harlingen.tstc.edu/ to learn more.

UTRGV has retained the services of Kaye Bassman Intl to assist with the recruitment for this position.

For more information or to refer a qualified candidate please contact:

Eric Dickerson, Managing Director, Kaye/Bassman International Corp.

(972) 265-5245

Ericd@kbic.com

Here is the original post:
Preventive Medicine Residency Program, Program Director ...

by Yoel Jakobovits

With one spectacular development tumbling over the next in ever more rapid succession, our generation is witnessing the compression of history in the scientific and medical realm just as much as in the geopolitical realm. Indeed, it may well be that in the long term, the direction of humanity and its history ultimately will be affected more profoundly by these scientific and medical developments than even by the current unprecedented global political upheavals.

Medical ethics concentrates largely on the opposite ends of life. For example, the beginning of life questions relate principally to abortion, contraception and conception issues even before birth. At the other end of life, inquiries relate to the management of dying, the moment of death, autopsies and organ harvesting even before death...

This article outlines the essential medical facts pertaining to stem cell Research and therapy, and summarizes the principal approaches in Jewish law which have been proposed thus far. Clearly, given the novelty of these innovations, both the medical and scientific questions as well as Jewish legal answers are in flux, and must be tentative at this point in time.

WHAT ARE STEM CELLS?

Every discussion of medical ethics must be governed by the axiom: good ethics -- and good Jewish law -- require good facts.

All the various parts of a plant or tree -- the trunk, branches, leaves and fruits -- develop from the stem. Similarly, all the cells of a living organism develops from precursor cells, known as stem cells.

Mammalian development begins with the union of a male's sperm cell with a female's egg. The resultant cell has the inherent potential to develop into the entire gamut of cells forming the organism. This prime cell divides, within several hours of fertilization, into two identical duplicate cells, each of which retains this broad potential. After several more divisions, by about the fourth day, these cells began to specialize, forming a hollow sphere called a blastocyte, which is composed of an outer and inner layer of cells. Cells of the outer layer are destined to form the placenta and other supporting tissues of pregnancy. The inner layer cells go on to develop into all of the organs and tissues of the developing fetus.

These cells are now somewhat more limited in their potential -- they can give rise to many but not all the types of cells necessary for fetal development. As stem cells "mature" their potential to develop into any kind of human tissue decreases. Soon after, these stem cells undergo further specialization (called differentiation), becoming cells committed to developing into a given line of cells.

Ultimately stem cells develop into "master cells," designed to multiply into specific tissue types. For example, blood stem cells will develop into the various types of blood cells; skin stem cells into the various types of skin cells. Once they reach this level of specialization, they're committed to developing specific tissues.

The cells related to developing the blood are the best understood stem cells. They reside in the bone marrow of all children and adults, and are, in fact, usually present in very small numbers in the circulating blood stream as well. Because red and white cells in the peripheral blood have limited life spans, the stem cells are crucial to maintaining an adequate blood supply in the healthy person...

WHERE ARE STEM CELLS?

At present there several sources of stem cells:

- Early human embryos. In general these embryos are developed as a result of couples using in vitro fertilization to conceive a child. The union of sperm and eggs in a petri dish produces many embryos. Implementing them all into the mother's uterus would freeze and a grave danger to her because of the multiple fetuses she would have to carry. Therefore, only a few are implanted; the remaining are leftover or spare. These pre-implanted embryos are a widely used source of stem cells.

- Tissue obtained from aborted fetuses.

- Cells obtained from the umbilical cord.

- Using somatic cell nuclear transfer (SCNT), an adult cell's gene-containing nucleus can be combined with an egg from which the nucleus has been removed. Using special techniques, the resultant cell can be induced to divide and develop as an early stem cell to form a blastocyte from which very potent cells can be obtained. This is the basis of cloning.

IMPLICATIONS FOR THE FUTURE

Why isolate and develop pluripotent stem cells, that is, stem cells that have the ability to become any human tissue? At the most fundamental level, stem cell research will help enormously in understanding the complex events of early mammalian development. Secondly, such research could dramatically change the way in which drugs are developed and tested. Specific healthy and diseased cell lines could be exposed to specific drugs, largely obviating the need for much more dangerous and expensive human testing.

The most far-reaching applications would come in the area of cell therapies. Thousands of people are on waiting lists for organ transplants. Because the supply of donors is much smaller than the number of waiting patients, many patients will die of their illnesses before suitable donors can be found... Ultimately it is hoped that stem cells could be stimulated to develop into a source of replacement cells to create banks of transplantable human tissue. There is already reason to believe that this will be possible in replenishing the diseased or absent brain cells caused by Parkinson's or Alzheimer's diseases, strokes, spinal cord injuries, various heart diseases, diabetes, and arthritis.

JEWISH LEGAL CONSIDERATIONS

We begin the outline of the Jewish legal approach to stem cell research by stressing some general overarching principles. In contrast with other religions, Judaism has no problem with "playing God," provided we do so according to His rules as expressed by authentic Jewish legal mandate. Far from being shunned, "playing God" in the Jewish tradition is, in fact, a religious imperative: the concept of emulating God is implicit in the mandate to heal and provide effective medical relief wherever possible. Of note, the only two "professions" ascribed to God Himself are those of teaching and healing. By teaching and/or healing, we fulfill the obligation to "play God." There's no reason that microscopic manipulation of a faulty genetic blueprint should be any different than surgical manipulation of a defective macroscope -- that is, visible to the unaided eye -- tissue or organ. Normative Jewish law sanctions -- nay, encourages -- medical intervention to correct both congenital and acquired defects, and makes no distinction between stem and somatic (body) cell tissues.

The crucial distinction here is between the permissible act of correcting a defect and the forbidden act of attempting to improve on God's creations (generally proscribed by the laws of cross-breeding). For example, it would be permitted, were it possible, to correct the genetic defect which leads to Down's syndrome, but manipulating genes to produce a "perfect-bodied" six-footer with blue eyes would be prohibited.

There would, therefore, be no Jewish legal problem with using stem cells derived from adult tissue. Similarly, it would appear that using cells from umbilical cord tissue would be permissible. A rather minor concern here might be the following: May one have umbilical tissue collected and frozen so that the cells will be available in case one requires stem cell therapy sometime in the future? Is this degree of effort, in trying to ensure one's health, appropriate or excessive?

While there are few Jewish legal objections to deriving the stem cells from adult or umbilical cord tissue, the problems arise, however, with deriving stem cells from the embryonic tissue.

Post-implantation embryonic tissue (that is an embryo already implanted into the uterine wall) is after all, an early fetus; clearly no sanction would be given to aborting a fetus in order to obtain stem cell tissue. Even were fetal tissue necessary to provide life-sustaining therapy for a patient, no sanction would be given to sacrifice an innocent fetus even in the interest of saving another life. The only exception to this rule is the obligation to forfeit the life of the "non-innocent" fetus when its continued existence constitutes a danger to its mother by virtue of the fetus's pursuer ("rodef") status.

Even fetal life before the 40th day of gestation -- which is considered "mere water" -- could not be aborted in order to obtain stem cell tissue. Prior to 40 days, a miscarried fetus does not trigger birth-related purity issues, and therefore is of lesser status than a more mature fetus. (There is a large body of rabbinical writings regarding the 40-day status of a fetus.)...

TOWARD THE FUTURE

The prime source of embryonic stem cell tissue is embryos that have not been implanted into the uterine wall. As discussed above, they are usually the "by-products," spare embryos left aside during in vitro fertilization in order not to dangerously overload the mother's uterus. The Jewish legal status of these spare, non-implanted embryos is somewhat unclear. Some rabbinical opinions suggest that in addition to the 40-day milestone, an embryo doesn't reach fetal status until it is implanted into the uterus. Prior to that, while still in a petri dish, or other artificial medium, it cannot develop into a viable fetus. Therefore such early embryos have no real life potential at all and they're not considered alive. Consequently, there would be no Jewish legal opposition to disposing of them, researching on them, or deriving stem cell tissue from them.

The status of pre-implantation embryos has another potentially important Jewish legal consequence. Pre-implantation genetic diagnosis (PGD) offers a promising approach to prevent the birth of genetically defective children. By studying embryos before implantation into the uterus, it is possible to identify those defective genes. By selecting only genetically intact embryos for implantation, the development of genetically defective fetuses would be avoided. Assuming the pre-implanted embryo has not reached the level of a fetus, Jewish legal sanction may be possible.

The ethical issues raised by stem cell research and therapy are, of course, not only of interest to Jews. In an unprecedented national broadcast, President Bush defined some fairly restrictive regulations. Just recently the administration argued strongly in favor of banning all research into human cloning. Evidently the crossroads of medical science and the generation of life itself raises fears and genuine concern in the minds of many thinking people.

It appears that Jewish legal concerns may be more permissive than is generally understood. Clearly, it behooves us, as Jews, to avail ourselves of whatever Torah and scientific knowledge we can -- not only as we try to find the Jewish legal guidance for ourselves, but perhaps equally importantly -- as we strive to fulfill our national mandate to be a Light Unto the Nations -- to help shed light on these vexing issues for society at large.

The author is on the staff of Johns Hopkins University School of Medicine in Baltimore, MD.

Article reprinted with permission from Jewish Action magazine (Summer 2002), published by the Orthodox Union http://www.ou.org.

Presented in cooperation with Heritage House, Jerusalem. Visit http://www.innernet.org.il.

Continued here:
Judaism and Stem Cell Research - Torah.org

ELSI Research Program The Ethical, Legal and Social Implications (ELSI) Research Program ELSI Research Program Overview

The National Human Genome Research Institute's (NHGRI) Ethical, Legal and Social Implications (ELSI) Research Program was established in 1990 as an integral part of the Human Genome Project (HGP) to foster basic and applied research on the ethical, legal and social implications of genetic and genomic research for individuals, families and communities. The ELSI Research Program funds and manages studies, and supports workshops, research consortia and policy conferences related to these topics.

An article describing the ELSI Research Program in greater detail can be found here: The Ethical, Legal and Social Implications Program of the National Human Genome Research Institute: Reflections on an Ongoing Experiment

On February 10, 2011, Nature magazine published NHGRI's strategic plan for the future of human genome research, called Charting a course for genomic medicine from base pairs to bedside . This plan includes a section on Genomics and Society that outlines four areas that will need to be addressed as genomic science and medicine move forward. Based on these areas, the NHGRI has developed the following broad research priorities.

A more detailed discussion of each of these areas and a list of examples of possible research topics is available at ELSI Research Priorities and Possible Research Topics.

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The NHGRI, along with several other National Institutes of Health (NIH) institutes, has released revised general program announcements to solicit research projects that anticipate, analyze, and address the ethical, legal, and social implications of the discovery of new genetic technologies and the availability and use of genetic information resulting from human genetics and genomic research.

The NHGRI participates in the NIH-wide program announcments on human subjects research issues.

The ELSI program also participates in a number of related research grant opportunities, and time limited requests for applications.

The NHGRI ELSI Program accepts Conference Grant (R13) applications. For specific instructions for preparing a conference grant application, see:

The ELSI program participates in a number of training and career development funding opportunities.

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In the Fall of 2003, the NHGRI in collaboration with U.S. Department of Energy (DOE) and the National Institute of Child Health and Human Development (NICHD) launched a new initiative to create interdisciplinary Centers of Excellence in ELSI Research (CEER). The CEERs are designed to bring investigators from multiple disciplines together to work in innovative ways to address important new, or particularly persistent, ethical, legal, and social issues related to advances in genetics and genomics. In addition, the centers will support the growth of the next generation of researchers on the ethical, legal and social implications of genomic research. Special efforts will be made to recruit potential researchers from under-represented groups.

The National Human Genome Research Institute (NHGRI) is soliciting grant applications for the support of Centers of Excellence in ELSI Research (CEERs).

For more information about the CEER's program, see: Centers of Excellence in ELSI Research (CEER).

To view the PDFs on this page you will need Adobe Acrobat Reader.

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Joy Boyer, B.A. E-mail: boyerj@exhange.nih.gov

Dave Kaufman, Ph.D. E-mail: dave.kaufman@nih.gov

Nicole Lockhart, Ph.D. E-mail: lockhani@mail.nih.gov

Jean McEwen, J.D., Ph.D. E-mail: mcewenj@mail.nih.gov

Alexander Lee E-mail: alexander.lee@nih.gov

Annie Niehaus E-mail: annie.niehaus@nih.gov

Tasha Stewart E-mail: Tasha.stewart@nih.gov

Address The Ethical, Legal and Social Implications Research Program National Human Genome Research Institute National Institutes of Health 5635 Fishers Lane Suite 4076, MSC 9305 Bethesda, MD 20892-9305

Phone: (301) 402-4997 Fax: (301) 402-1950 E-mail: elsi@nhgri.nih.gov

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Last Updated: May 20, 2015

See original here:
The ELSI Research Program - Genome.gov

Chronic Kidney Disease: The Basics

You've been told that you have chronic kidney disease (CKD). What does that mean? And what does it mean for your health and your life? This booklet will help answer some of the questions you might have.

You have two kidneys, each about the size of your fist. Their main job is to filter wastes and excess water out of your blood to make urine. They also keep the body's chemical balance, help control blood pressure, and make hormones.

CKD means that your kidneys are damaged and can't filter blood like they should. This damage can cause wastes to build up in your body. It can also cause other problems that can harm your health.

CKD is often a "progressive" disease, which means it can get worse over time. CKD may lead to kidney failure. If your kidneys fail, you will need dialysis or a kidney transplant to maintain health.

You can take steps to keep your kidneys healthier longer:

Chances are, you feel normal and were surprised to hear that you have CKD. It is called a "silent" disease, because many people don't have any symptoms until their kidneys are about to fail. The only way to know is to get your kidneys checked with blood and urine tests.

1. A blood test checks your GFR, which tells how well your kidneys are filtering. GFR stands for glomerular filtration rate.

2. A urine test checks for albumin. Albumin is a protein that can pass into the urine when the kidneys are damaged. See picture below.

These two tests are used to monitor CKD and make sure that treatment is working. See CKD: Tracking My Test Results.

Diabetes and high blood pressure are the most common causes of CKD.

Your provider will look at your health history and may do other tests. You need to know why you have CKD, so your treatment can address the cause of the CKD.

People with CKD often take medicines to lower blood pressure, control blood glucose, and lower blood cholesterol. Two types of blood pressure medicinesACE inhibitors and ARBsmay slow CKD and delay kidney failure, even in people who don't have high blood pressure. Many people need to take two or more medicines for their blood pressure. They also may need to take a diuretic (water pill). The goal is to keep your blood pressure at the level set by your health care provider.

Some medicines are not safe for people with CKD. Other medicines need to be taken in smaller doses. Tell your provider about all the medicines you take, including over-the-counter medicines (those you get without a prescription), vitamins, and supplements.

People with CKD often have high blood pressure. They can also develop anemia (low number of red blood cells), bone disease, malnutrition, and heart and blood vessel diseases.

The blood and urine tests used to check for CKD are also used to monitor CKD. You need to keep track of your test results to see how you're doing.

Track your blood pressure.

If you have diabetes, monitor your blood glucose and keep it in your target range. Like high blood pressure, high blood glucose can be harmful to your kidneys. See CKD: Tracking My Test Results.

Some people live with CKD for years without going on dialysis. Others progress quickly to kidney failure. You may delay dialysis if you follow your provider's advice on medicine, diet, and lifestyle changes.

If your kidneys fail, you will need dialysis or a kidney transplant to maintain health. Most people with kidney failure are treated with dialysis.

Some people with kidney failure may be able to receive a kidney transplant. The donated kidney can come from someone you don't know who has recently died, or from a living persona relative, spouse, or friend. A kidney transplant isn't for everyone. You may have a condition that makes the transplant surgery dangerous or not likely to succeed.

People with CKD can and should continue to live their lives in a normal way: working, enjoying friends and family, and staying active. They also need to make some changes as explained here.

What you eat may help to slow down CKD and keep your body healthier. Some points to keep in mind:

Your provider may refer you to a dietitian. Your dietitian will teach you how to choose foods that are easier on your kidneys. You will also learn about the nutrients that matter for CKD.

Cigarette smoking can make kidney damage worse.Take steps to quit smoking as soon as you can.

You are the most important person on your health care team. Know your test results and track them over time to see how your kidneys are doing. Bring this table to your health care visits and ask your provider to complete it.

GFR The GFR tells you how well your kidneys are filtering blood. You can't raise your GFR. The goal is to keep your GFR from going down to prevent or delay kidney failure. See the dial picture below.

Urine albumin Albumin is a protein in your blood that can pass into the urine when kidneys are damaged. You can't undo kidney damage, but you may be able to lower the amount of albumin in your urine with treatment. Lowering your urine albumin is good for your kidneys.

Blood pressure The most important thing you can do to slow down CKD is keep your blood pressure at the level set by your health care provider. This can delay or prevent kidney failure.

A1C A1C test is a lab test that shows your average blood glucose level over the last 3 months. Lowering your A1C can help you to stay healthy. (For people with diabetes only.)

Read more:
Chronic Kidney Disease: What Does it Mean for Me ...

Chronic Kidney Disease (cont.) More Chronic Kidney Disease Overview

Chronic kidney disease

Chronic kidney disease occurs when one suffers from gradual and usually permanent loss of kidney function over time. This happens gradually, usually over months to years. Chronic kidney disease is divided into five stages of increasing severity (see Table 1 below). The term "renal" refers to the kidney, so another name for kidney failure is "renal failure." Mild kidney disease is often called renal insufficiency.

With loss of kidney function, there is an accumulation of water, waste, and toxic substances in the body that are normally excreted by the kidney. Loss of kidney function also causes other problems such as anemia, high blood pressure, acidosis (excessive acidity of body fluids), disorders of cholesterol and fatty acids, and bone disease.

Stage 5 chronic kidney disease is also referred to as kidney failure, end-stage kidney disease, or end-stage renal disease, wherein there is total or near-total loss of kidney function. There is dangerous accumulation of water, waste, and toxic substances, and most individuals in this stage of kidney disease need dialysis or transplantation to stay alive.

Unlike chronic kidney disease, acute kidney failure develops rapidly, over days or weeks.

Medically Reviewed by a Doctor on 11/11/2014

Medical Author:

Pranay Kathuria, MD, FACP, FASN, FNKF

Read the original post:
Kidney Disease Causes, Symptoms, Treatment - More Chronic ...

Your cats kidneys do many important things. They help manage blood pressure, make hormones and red blood cells, and remove waste from her blood.

Cats kidneys begin to fail with age. Untreated, kidney disease can lead to a series of health problems. When its chronic, theres no cure. But with early diagnosis and good care, you can help boost both the quality and length of your pets life.

Older cats arent the only ones at risk. Kittens can be born with kidney diseases. Trauma and infection are also causes.

There are two types of kidney failure in cats. Each has different causes, treatments, and outlooks.

Acute renal failure develops suddenly, over a matter of days or weeks. It happens in cats of all ages and is usually the result of:

If diagnosed in time, acute renal failure can often be reversed. But chronic kidney problems can be harder to treat. Found mostly in middle-aged and older cats, they develop over months and even years. If your cat is 7 years or older, pay special attention to her health.

While the exact causes of chronic kidney disease arent always clear, even to vets, they include:

See the article here:
Cat Kidney (Renal) Failure Symptoms and Causes - WebMD

April 2012, Volume 8, Issue 4 Published by AEGIS Communications

By Peter E. Murray, BSc(Hons), PhD | Pamela C. Yelick, PhD | Thomas G.H. Diekwisch, DMD, PhD, PhD

Dentists are enthusiastic about using stem cell therapies and are willing to get training to deliver stem cells to give patients replacement teeth and gums. The Regenerative Endodontic Procedures presentation I made at the American Dental Association conference in Las Vegas was sold out. Every day I am getting letters, e-mails, and telephone calls from people asking me to grow teeth for themselves or their child. A high demand exists for dentists to give their patients dental stem cell therapies. Dentists appear optimistic that stem cells will allow them to deliver more miraculous therapies that will benefit their patients and improve their quality of life.

Some dentists are collecting baby teeth to be used as a source of stem cells, through stem cell banking companies such as BioEden, StemSave, and Store-A-Tooth. The hope is that these dental stem cells could be used to heal the patients when they need it in the future. These services were unthinkable only a few years ago. The next stem cell advance I expect is the availability of regenerative dental kits, which will give dentists the ability to deliver stem cell therapies in their own office. The delivery of stem cell therapies by the dentist is complicated, and these kits will simplify the process and make the treatment more affordable.

Dental researchers have learned how to revitalize tissue in necrotic teeth and regenerate teeth and also grow teeth in mice; it is just a matter of time and money before these therapies replace implants and dentures. The recent face transplants and jaw replacements have taught us how to successfully reconnect tissues to nerves and the blood supply. These advances have allowed surgeons to make someone who was a victim of facial trauma or cancer whole and healthy again. X-ray imaging technologies such as cone beam and micro-CT will add a new dimension to tooth and tissue replacement by allowing the dentist to design replacement body parts to be regenerated by dental stem cells. The goal of the dental stem cell researcher is to give the dentist the power to make every patient whole and healthy. When dental stem cell therapies become routine it will be historic, and the most fantastic time to practice as a dentist.

Dental stem cells are adult stem cells present in both baby (deciduous) teeth, and adult teeth. The stem cells consist of dental mesenchymal stem cells and dental epithelial cells. Dental epithelial cells give rise to enamel, while dental mesenchymal stem cells give rise to all of the other tissues of the tooth, including pulp, dentin, cementum, periodontal ligament, and surrounding alveolar bone. Mesenchymal cells are derived from ectomesenchymal neural crest cells, which provide teeth with their unique characteristics as compared to mesodermal cell-derived bone-forming stem cells. Dental stem cells have been characterized from a variety of tooth tissues, including the pulp, periodontal ligament tissues, specialized immature tooth-rootderived stem cells of the papilla (SCAP), and the surrounding alveolar bone. Although erupted teeth no longer have enamel-progenitor stem cells present, very immature unerupted teeth have soft enamel organ tissues that are rich in enamel-forming epithelial progenitor cells and blood vessels.

Harvested dental stem cell populations are quite heterogeneous, which can be both an asset and a liability. There is no reliable way to efficiently generate large numbers of pure dental stem cell populations in culture at the present time, and in fact, these populations change over time in culture, indicating that they prefer not to exist as homogeneous stem cell populations.

Dental stem cells are a valuable autologous adult stem cell source, meaning that they can be used in the same individual without the danger of an immune rejection response, with potential use for regenerative medicine approaches. They are multipotent, meaning that they can give rise to a limited number of tissue types, including cartilage, bone, adipose tissue, neural, and tooth tissues. The ability to harvest cells from extracted wisdom teeth and supernumerary teeth that would otherwise be discarded as waste makes these tissues unique and valuable stem cell sources. The successful demonstration that harvested dental stem cells can be cryopreserved for extended periods of time and subsequently thawed and differentiated into a variety of tissues, including bone, dentin, nerve, and adipose tissues, has fueled the tooth-banking industry for eventual use of cryopreserved dental stem cells in regenerative medicine applications.

What are the potential clinically relevant applications for dental stem cells? These cells are now being tested for their potential use in a variety of clinical applications, ranging from use as immuno-modulatory agents and as regenerative stem cells that can facilitate regeneration of cardiac tissues, bone, and even neuronal tissues. Human mesenchymal stem cells, including dental stem cells, have been tested for spinal cord regeneration in animal models. While a few dental stem cell therapies have been conducted in humans, the vast majority of these studies have been performed in animal models, making their utility in humans uncertain at the present time. One approach that holds great promise is to generate induced stem cells (iSCs) from harvested human dental stem cells. This approach, which reprograms dental stem cells into an embryonic state, thereby expanding their potential to differentiate into a much wider range of tissue types, has tremendous appeal for autologous tissue engineering applications. Barriers to this approach include the fact that iSC reprogramming efficiency is extremely low at the present time, and largely relies on the use of retroviruses, which have carcinogenic potential. Another useful application is to study dental stem cells harvested from individuals exhibiting a variety of craniofacial skeletal and dental syndromes in order to increase our understanding of the molecular nature of diseases ranging from cleidocranial dysplasia syndrome (CCD), Sensenbrenner syndrome, and Treacher-Collins syndrome. In this way, targeted therapies may eventually be devised to treat and/or prevent some of these diseases.

One of the most promising uses for harvested dental stem cells is for applications in regenerative dentistry. Dental tissue-engineering approaches combining dental stem cells, biodegradable and biocompatible scaffolds, cell sheet technologies, and exogenous growth factors are being used to devise methods to reliably regenerate dental tissues including pulp, periodontal tissues, alveolar bone, dentin, enamel, and salivary glands. Although not currently available, these approaches may one day be used as biological alternatives to the synthetic materials currently used.

Teeth are unique in that they provide readily accessible sources of adult stem cells for tissue regeneration and repair. Similar to other organs in the human body, adult teeth and their surrounding tissues contain mixed populations of cells, including differentiated cells as well as a number of adult stem cells (progenitor cells). While other organs in the body are essential throughout life, teeth are replaced at least once when the deciduous dentition is lost in favor of the permanent dentition. These deciduous teeth provide an easily accessible source of stem cells. Wisdom teeth form a second readily available source of stem cells in adolescent jaws. Stem cells from teeth may not only be useful for the regeneration of dental tissues but also contribute to the regeneration of non-dental organs, such as the liver or heart.

Studies in our laboratory have demonstrated that periodontal stem cells are capable of completely renewing a periodontal ligament. Studies in humans using stem cells to aid periodontal therapy are currently underway, outside of the United States. Alveolar bone regeneration is an area that could still significantly benefit from innovative stem cell and tissue regeneration approaches.

Much progress has been made indicating that pulp stem cells are capable of forming pulp-like tissues and some of these approaches are useful to rescue pulp tissue. Clinically, replacement of an entire pulp is still challenging because of limited access of regenerated tissues to blood vessels and nutrients at the root apex.

Stem cells in conjunction with growth factors have resulted in successful new bone formation and regeneration in small defects. Future advances in stem cell research will thus focus on the regeneration of larger defects and the regeneration of functional bone.

Scientifically, the regeneration of whole teeth de novo remains the most attractive challenge in dental tissue regeneration. Coaxing dental stem cells into initiating developmental cascades to form complex tooth organs with enamel, dentin, and roots would be both scientifically and clinically attractive. So far, progress has been based on the ability of tooth germ-derived tissues to self-organize and reassemble into a developing tooth organ. Another group of scientists has advanced the field by identifying factors responsible for supernumerary teeth, prompting the hope that these factors might reveal the inductive code required to trigger new tooth formation.

Peter E. Murray, BSc(Hons), PhD | Dr. Murray is a postgraduate research administrator and professor in the Department of Endodontics, College of Dental Medicine, Nova Southeastern University.

Pamela C. Yelick, PhD | Dr. Yelick is a professor in the Department of Oral and Maxillofacial Pathology, in the Sackler Genetics and Cell Molecular and Developmental Biology programs, and the Department of Biomedical Engineering at Tufts University.

Thomas G.H. Diekwisch, DMD, PhD, PhD | Dr. Diekwisch is the Allan G. Brodie Endowed Chair for Orthodontic Research, head of the Department of Oral Biology, and director of the Brodie Laboratory for Craniofacial Genetics as well as a professor of Anatomy/Cell Biology, Bioengineering, Orthodontics, Periodontics at the University of Illinois at Chicago College of Dentistry.

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ARTHRITIS OVERVIEW

Arthritis refers to inflammation of a joint. The inflammation can affect any of the important structures inside a joint, including the joint lining (synovium), bones, cartilage, or supporting tissues. Common symptoms of arthritis include pain, stiffness, and swelling of the joint. The condition may affect one or several joints throughout the body.

There are many possible causes of arthritis, although some are much more common than others. Some types of arthritis respond well to treatment and resolve without any lingering effects, whereas other types of arthritis are more difficult to control and can be disabling.

This topic provides an overview of arthritis; more detailed information about the various types of arthritis is also available. (See 'Where to get more information' below.)

ARTHRITIS CAUSES

There are many possible causes of arthritis, including age-related wear and tear, infections, autoimmune conditions, injuries, and others. Topic reviews that discuss specific types of arthritis are available separately. (See 'Where to get more information' below.)

ARTHRITIS SYMPTOMS

Joint symptomsThe most common symptoms of arthritis include joint pain and stiffness. There may also be joint tenderness, swelling, and limited movement of one or more joints. The skin over the joint is sometimes red and warm.

There are two main types of arthritis: inflammatory and noninflammatory. Examples of inflammatory arthritis include infectious arthritis, rheumatoid arthritis, and gout. An example of noninflammatory arthritis is osteoarthritis, the most common type of arthritis. The location, timing, and pattern of joint pain, as well as the presence of swelling and symptoms outside the joint (such as rash), can help to distinguish between inflammatory and noninflammatory arthritis.

Inflammatory arthritisInflammatory arthritis usually causes joint stiffness with rest, especially morning stiffness. Certain types of inflammatory arthritis, such as rheumatoid arthritis and the arthritis of systemic lupus erythematosus (SLE), affect joints symmetrically (ie, affect the same joints on both sides of the body).

Noninflammatory arthritisNoninflammatory arthritis usually causes pain that is aggravated by movement and weightbearing and is relieved by rest. Joints on one or both sides of the body may be affected.

ARTHRITIS DIAGNOSIS

The process of diagnosing arthritis involves several steps. A medical history and physical examination usually provide the most helpful information; laboratory tests, imaging tests (such as x-rays), and other tests are sometimes needed.

Laboratory and imaging testsLaboratory and imaging tests are sometimes, but not always, needed to determine the cause of arthritis.

Blood tests may be recommended. For example, if rheumatoid arthritis or systemic lupus erythematosus (SLE) is suspected, it can be helpful to test the blood for antibodies that are commonly present in these diseases. Examples include the rheumatoid factor (RF) for rheumatoid arthritis and the antinuclear antibody (ANA) for SLE.

Testing of the fluid inside a joint, called the synovial fluid, is often helpful in determining the cause of a persons arthritis. After making the skin numb, the fluid is removed by inserting a needle inside the joint and withdrawing a sample of fluid. This procedure is sometimes called a joint tap. Analysis of the joint fluid is particularly helpful in confirming that the arthritis is inflammatory and in establishing a diagnosis of septic arthritis (due to bacterial infection), gout, or pseudogout.

X-rays provide detailed pictures of bones. Other imaging tests, such as ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT scan), provide images of the tissues inside and surrounding the joints. One or more of these imaging tests may be recommended to detect erosions (bone damage due to arthritis), fractures, calcium deposits, or changes in the shape of a joint.

For many types of arthritis, changes in the joint are not visible on x-ray for months or even years. However, x-rays are often useful to monitor over time.

WHEN TO SEEK HELP

Some signs and symptoms of arthritis require urgent medical care. If you have one or more swollen joints and any of the following, you should seek medical care as soon as possible.

Fever

Weight loss

An inability to function due to joint pain

An overall sense of feeling ill

Sudden weakness of specific muscle groups

ARTHRITIS TREATMENT

The treatment of arthritis depends upon the specific cause (see "Patient information: Osteoarthritis treatment (Beyond the Basics)" and "Patient information: Rheumatoid arthritis treatment (Beyond the Basics)"). Common treatments include physical and occupational therapy, pain relievers (such as acetaminophen), antiinflammatory medications (such as ibuprofen), and medications that suppress the immune system (such as prednisone or methotrexate).

WHERE TO GET MORE INFORMATION

Your healthcare provider is the best source of information for questions and concerns related to your medical problem.

This article will be updated as needed on our web site (www.uptodate.com/patients). Related topics for patients, as well as selected articles written for healthcare professionals, are also available. Some of the most relevant are listed below.

Patient level informationUpToDate offers two types of patient education materials.

The BasicsThe Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient information: Bursitis (The Basics) Patient information: Ganglion cyst (The Basics) Patient information: Osteoarthritis (The Basics) Patient information: Arthritis and exercise (The Basics) Patient information: Knee replacement (The Basics) Patient information: Hip replacement (The Basics) Patient information: Knee pain (The Basics) Patient information: Hand pain (The Basics) Patient information: Hip pain in older people (The Basics) Patient information: Rheumatoid arthritis (The Basics) Patient information: Rheumatoid arthritis and pregnancy (Beyond the Basics) Patient information: Juvenile rheumatoid arthritis (The Basics) Patient information: Gout (The Basics) Patient information: Calcium pyrophosphate deposition disease (pseudogout) (The Basics) Patient information: Psoriatic arthritis in adults (The Basics) Patient information: Psoriatic arthritis in children (The Basics) Patient information: Reactive arthritis (The Basics) Patient information: Septic arthritis (The Basics)

Beyond the BasicsBeyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

Patient information: Osteoarthritis symptoms and diagnosis (Beyond the Basics) Patient information: Rheumatoid arthritis symptoms and diagnosis (Beyond the Basics) Patient information: Gout (Beyond the Basics) Patient information: Pseudogout (Beyond the Basics) Patient information: Systemic lupus erythematosus (SLE) (Beyond the Basics) Patient information: Ankylosing spondylitis and other spondyloarthritis (Beyond the Basics) Patient information: Psoriatic arthritis (Beyond the Basics) Patient information: Reactive arthritis (Beyond the Basics) Patient information: Osteoarthritis treatment (Beyond the Basics) Patient information: Rheumatoid arthritis treatment (Beyond the Basics) Patient information: Joint infection (Beyond the Basics)

Professional level informationProfessional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.

Arthritis associated with gastrointestinal disease Clinical manifestations of rheumatoid arthritis Clinical manifestations and diagnosis of psoriatic arthritis Diagnosis and differential diagnosis of rheumatoid arthritis Imaging techniques for evaluation of the painful joint Evaluation of the adult with monoarthritis Evaluation of the adult with polyarticular pain General principles of management of rheumatoid arthritis in adults Overview of the systemic and nonarticular manifestations of rheumatoid arthritis Septic arthritis in adults Specific viruses that cause arthritis Treatment of psoriatic arthritis Non-radiographic axial spondyloarthritis, undifferentiated spondyloarthritis, and peripheral spondyloarthritis

The following organizations also provide reliable health information.

National Library of Medicine (www.nlm.nih.gov/medlineplus/arthritis.html, available in Spanish)

National Institute of Arthritis and Musculoskeletal and Skin Diseases (301) 496-8188 (www.niams.nih.gov/Health_Info/Arthritis/default.asp)

National Institute on Aging (www.nia.nih.gov/health/publication/arthritis-advice, available in Spanish)

American College of Rheumatology (404) 633-3777 (http://http://www.rheumatology.org/Practice/Clinical/Patients/Information_for_Patients/)

The Arthritis Foundation (800) 283-7800 (www.arthritis.org)

Patient SupportThere are a number of online forums where patients can find information and support from other people with similar conditions.

About.com Arthritis Forum (http://arthritis.about.com/forum)

Literature review current through: Aug 2015. | This topic last updated: Mon Jun 09 00:00:00 GMT 2014.

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Arthritis - UpToDate