StemCell Therapy

Genetics Practice Problems

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Monohybrid Cross:

In humans, brown eyes (B) are dominant over blue (b)*. A brown-eyed man marries a blue-eyed woman and they have three children, two of whom are brown-eyed and one of whom is blue-eyed. Draw the Punnett square that illustrates this marriage. What is the mans genotype? What are the genotypes of the children?

(* Actually, the situation is complicated by the fact that there is more than one gene involved in eye color, but for this example, well consider only this one gene.)

Testcross:

In dogs, there is an hereditary deafness caused by a recessive gene, d. A kennel owner has a male dog that she wants to use for breeding purposes if possible. The dog can hear, so the owner knows his genotype is either DD or Dd. If the dogs genotype is Dd, the owner does not wish to use him for breeding so that the deafness gene will not be passed on. This can be tested by breeding the dog to a deaf female (dd). Draw the Punnett squares to illustrate these two possible crosses. In each case, what percentage/how many of the offspring would be expected to be hearing? deaf? How could you tell the genotype of this male dog? Also, using Punnett square(s), show how two hearing dogs could produce deaf offspring.

Incomplete Dominance:

Note: at least one textbook Ive seen also uses this as an example of pleiotropy (one gene multiple effects), though to my mind, the malaria part of this is not a direct effect of the gene.

(For many genes, such as the two mentioned above, the dominant allele codes for the presence of some characteristic (like, B codes for make brown pigment in someones eyes), and the recessive allele codes for something along the lines of, I dont know how to make that, (like b codes for the absence of brown pigment in someones eyes, so by default, the eyes turn out blue). If someone is a heterozygote (Bb), that person has one set of instructions for make brown and one set of instructions for, I dont know how to make brown, with the result that the person ends up with brown eyes. There are, however, some genes where both alleles code for something. One classic example is that in many flowering plants such as roses, snapdragons, and hibiscus, there is a gene for flower color with two alleles: red and white. However, in that case, white is not merely the absence of red, but that allele actually codes for, make white pigment. Thus the flowers on a plant that is heterozygous have two sets of instructions: make red, and make white, with the result that the flowers turn out mid-way in between; theyre pink.)

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Genetics Practice Problems - Biology

Welcome to the Nicholas Institute of Sports Medicine and Athletic Trauma (NISMAT), a world-renowned research, teaching, and treatment center. Established at Lenox Hill Hospital in 1973, NISMAT was the worlds first hospital-based facility committed solely to the study of sports medicine, and has since played a key role in advancing the field, as well as redefining its focus. Once perceived as a discipline concerned only with repairing athletes' traumatic injuries, sports medicine is now recognized as a science that expands the understanding of the relationship between exercise and fitness at all levels, across every age group. Whether youre a medical practitioner or a patient, a professional athlete--or a weekend one, an occasional jogger or a marathon runner, woman or man,...

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Welcome to the Nicholas Institute of Sports Medicine and Athletic Trauma (NISMAT), a world-renowned research, teaching, and treatment center. Established at Lenox Hill Hospital in 1973, NISMAT was the worlds first hospital-based facility committed solely to the study of sports medicine, and has since played a key role in advancing the field, as well as redefining its focus. Once perceived as a discipline concerned only with repairing athletes' traumatic injuries, sports medicine is now recognized as a science that expands the understanding of the relationship between exercise and fitness at all levels, across every age group. Whether youre a medical practitioner or a patient, a professional athlete--or a weekend one, an occasional jogger or a marathon runner, woman or man, adolescent or octogenarian, NISMAT brings you the most comprehensive and current medical information and references available. Here, youll learn about injury treatment and prevention. Training tips and exercise programs. Physical therapy, sports physiology, nutrition, and so much more. Welcome to NISMAT.

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Alefacept Preserves Beta Cell Function in Some New-Onset Type 1 Diabetes Patients out to Two Years July 20, 2015 Individuals with new-onset type 1 diabetes who took two courses of alefacept (Amevive, Astellas Pharma Inc.) soon after diagnosis show preserved beta cell function after two years compared to those ... 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 Cholesterol Metabolism in Immune Cells Linked to HIV Progression July 17, 2015 Lower levels of cholesterol in certain immune cells -- a result of enhanced cholesterol metabolism within those cells -- may help explain why some HIV-infected people are able to naturally control ... read more July 17, 2015 A study in mice may identify new ways to treat immune thrombocytopenia. Immune thrombocytopenia, or ITP, is an autoimmune disease whereby the immune system sends antibodies to attack and destroy the ... read more July 16, 2015 In response to an infection, the immune system refines its defensive proteins, called antibodies, to better target an invader. New research has revealed two mechanisms that favor the selection of B ... read more July 16, 2015 Iron regulatory proteins play an important role in the body's immune system. Proteins responsible for controlling levels of iron in the body also play an important role in combating infection, ... read more HIV Uses Immune System's Own Tools to Suppress It July 15, 2015 A research team has made a significant discovery on how HIV escapes the body's antiviral responses. The team uncovered how an HIV viral protein known as Vpu tricks the immune system by using its ... read more Host Genetics Played a Role in Vaccine Efficacy in the RV144 HIV Vaccine Trial July 15, 2015 Host genetics played a role in protection against HIV infection in the landmark RV144 vaccine trial conducted in Thailand, research ... read more July 15, 2015 Immunologists have identified a distinct set of long-lived antibody-producing cells in the human bone marrow that function as an immune ... read more Magnetic Nanoparticles Could Be Key to Effective Immunotherapy July 15, 2015 In recent years, researchers have hotly pursued immunotherapy, a promising form of treatment that relies on harnessing and training the body's own immune system to better fight cancer and ... read more Why Does PTSD Increase the Risk of Cardiovascular Disease? July 15, 2015 A new review article finds that post-traumatic stress disorder (PTSD) leads to overactive nerve activity, dysfunctional immune response and activation of the hormone system that controls blood ... read more Scientific Curiosity and Preparedness for Emerging Pathogen Outbreaks July 14, 2015 An essay reflects on a career path that started with the study of a somewhat obscure mouse virus mice and ended up at the frontline of the SARS and MERS coronavirus ... read more Anti-Stress Hormone May Provide Indication of Breast Cancer Risk July 14, 2015 A new study shows that women with low levels of an anti-stress hormone have an increased risk of getting breast cancer. The study is the first of its kind on humans and confirms previous similar ... read more Aerosolized Vaccine Protects Primates Against Ebola July 13, 2015 Scientists have developed an inhalable vaccine that protects primates against ... read more Cancer Discovery Links Experimental Vaccine and Biological Treatment July 13, 2015 A new study has linked two seemingly unrelated cancer treatments that are both now being tested in clinical trials. One treatment is a vaccine that targets a structure on the outside of cancer cells, ... read more Skin Cancer Marker Plays Critical Role in Tumor Growth July 13, 2015 The protein keratin 17 -- the presence of which is used in the lab to detect and stage various types of cancers -- is not just a biomarker for the disease, but may play a critical role in tumor ... read more July 13, 2015 Immune cells that creep across blood vessels trigger potentially fatal bleeding in platelet-deficient mice, according to a new report. If the same is true in humans, blocking the passage of these ... read more Scientists Find Molecular Switch That Creates Long-Term Immunity July 13, 2015 Researchers have identified a protein responsible for preserving the antibody-producing cells that lead to long-term immunity after infection or ... read more July 10, 2015 The microbiota is involved in many mechanisms, including digestion, vitamin synthesis and host defense. It is well established that a loss of bacterial symbionts promotes the development of ... read more Multiple Myeloma Hides in Bones Like a Wolf in Sheep's Clothing July 9, 2015 Multiple myeloma uses a trick akin to a wolf in sheeps clothing to grow in and spread to new bone sites. By overexpressing Runx2, a gene that normally is a master regulator of bone formation, the ... read more

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Immune System News -- ScienceDaily

Fat transfer breast augmentation can give women fuller, more attractive breasts without the need for breast implants.

Many women are now choosing fat transfer breast augmentation as a natural alternative to enhance their breasts without getting breast implants. Fat transfer breast augmentation is considered a more natural approach to breast augmentation since it uses the patients own fat cells instead of unnatural materials. As an added benefit, liposuction is used to remove the fat that will be used in the fat transfer breast augmentation. The fat is removed from the thighs, abdomen, buttocks or another area with excess fat, offering the added benefit ofslimming and toning.

Fat cell transfers were first performed around 1896. The first fat transfers for facial rejuvenation as early as 1912. This is not anovel or new procedure, but has been perfected over the years.

In the last 20 years, surgeons have been documenting some long-term benefits found fromfat cell transfers, including the ability to maintain volume as well as regenerative evidence.

The BRAVA is an external bra which gently expands a womans breast tissue making this breakthrough procedure possible for natural breast augmentation and reconstruction.

It is the Brava that makes the Brava + Fat Cell transfer breast augmentation technique possible. For women who want cosmetic breast augmentation the options are no longer limited to the traditional methods of implants.

I have always wanted to have natural looking breast augmentation without implants because I just felt that I did not want a foreign object in my body

I did tons of research on fat transfer the breast and decided that that was the best option for me. In addition to that I was able to harvest the fat from my stomach and inner thighs which have always been my problem areas. The result has been beyond my wildest dream. Not only do my breasts look like Im back in High school I have gone down two dress sizes after surgery. I cannot be happier. Dr Bednar is an amazing doctor!

I cannot wait to show off my new body when I go on my anniversary cruise in April . My husband also cannot believe my transformation. Hes even thinking about Botox now!

Kindest regards to all the staff for taking such good care of me. I will send you tons of patients, trust me, Leslie

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Breast Augmentation using Fat Stem Cell Transfer in ...

Although the word "arthritis" means joint inflammation, the term is used to describe around 200 rheumatic diseases and conditions that affect joints, the tissues that surround the joint, and other connective tissue.5

The most common form of arthritis is osteoarthritis. Other common rheumatic conditions include gout, fibromyalgia and rheumatoid arthritis.4

You will also see introductions at the end of some sections to any recent developments that have been covered by MNT's news stories. Also look out for links to information about related conditions.

Fast facts on arthritis

Here are some key points about arthritis. More detail and supporting information is in the main article.

Typically, pain, aching, stiffness and swelling in and around one or more joints characterize rheumatic conditions. The symptoms can develop gradually or suddenly. Certain rheumatic conditions can also involve the immune system and various internal organs of the body.6

Some forms of arthritis, such as rheumatoid arthritis and lupus, can affect multiple organs and cause widespread symptoms.

Arthritis is more common among adults aged 65 years or older, but people of all ages (including children) can be affected.

There are 52.5 million adults in the US, equating to 22.7% of the population, reported to have a form of arthritis, rheumatoid arthritis, gout, lupus or fibromyalgia.1

With people living longer in the US, the prevalence of doctor-diagnosed arthritis is expected to increase. It has been estimated that by the year 2030, 67 million, 25% of the projected total adult population aged 18 years and older, will have doctor-diagnosed arthritis.

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Arthritis: Causes, Symptoms and Treatments

Arthritis Arthritis Overview

Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where two bones meet. A joint functions to allow movement of the body parts it connects. Arthritis literally means inflammation of one or more joints. Arthritis is frequently accompanied by joint pain. Joint pain is referred to as arthralgia.

Arthritis is classified as one of the rheumatic diseases. These are conditions that are different individual illnesses, with differing features, treatments, complications, and prognosis. They are similar in that they have a tendency to affect the joints, muscles, ligaments, cartilage, and tendons, and many have the potential to affect internal body areas as well.

There are many forms of arthritis (over 100 have been described so far, and the number is growing). The forms range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation as a result of an overactive immune system (such as rheumatoid arthritis). Together, the many forms of arthritis make up the most common chronic illness in the United States.

Arthritis sufferers include men and women, children and adults. More than half of those with arthritis are under 65 years of age. A majority of Americans with arthritis are women.

Medically Reviewed by a Doctor on 5/23/2014

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Arthritis: Get the Facts About Symptoms and Diet

Hair follicle lineage and niche signals regulate hair follicle stem cells. (a) HFSCs can exist in two states. Quiescent bulge stem cells (Bu-SCs) are located in the outer layer of this niche and contribute to the generation of the outer root sheath. Primed stem cells reside in the hair germ, sandwiched between the bulge and a specialized dermal cluster known as the dermal papilla. They are responsible for generating the transit amplifying cell (TAC) matrix, which then gives rise to the hair shaft and its inner root sheath (IRS) channel. Although matrix and IRS are destroyed during catagen, many of the outer root sheath (ORS) cells are spared and generate a new bulge right next to the original one at the end of catagen. The upper ORS contributes to the outer layer of the new bulge, and the middle ORS contributes to the hair germ. Some of the lower ORS cells become the differentiated inner keratin 6+ (K6+) bulge cells, which provide inhibitory signals to Bu-SCs, raising their activation threshold for the next hair cycle. (b) During telogen, K6+ bulge cells produce BMP6 and FGF-18, dermal fibroblasts (DFs) produce BMP4 and subcutaneous adipocytes express BMP2. Together, these factors maintain Bu-SCs and hair germ in quiescence. At the transition to anagen, BMP2 and BMP4 are downregulated, whereas the expression of activation factors including noggin (NOG), FGF-7, FGF-10 and TGF-2 from dermal papillae and PDGF- from adipocyte precursor cells (APCs) is elevated. This, in turn, stimulates hair germ proliferation, and a new hair cycle is launched. Bu-SCs maintain their quiescent state until TAC matrix is generated and starts producing SHH.

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Emerging interactions between skin stem cells and their ...

IMAGE:Amir Toor, M.D., hematologist-oncologist and member of the Developmental Therapeutics research program at VCU Massey Cancer Center is pictured. view more

Credit: VCU Massey Cancer Center

Researchers at VCU Massey Cancer Center's Bone Marrow Transplant Program have recently published findings from a phase 2 clinical trial that demonstrate lymphocyte recovery in related and unrelated stem cell transplant recipients generally falls into three patterns that are significantly associated with survival. This first-of-its-kind research continues the efforts of principal investigator Amir Toor, M.D., to understand the immune system as a dynamical system that can be modeled to improve stem cell transplantation.

"We began considering lymphocyte reconstitution following stem cell transplantation as similar to population growth models. So, we graphed the lymphocyte counts of our patients at various times following their transplant as a logistic function and observed distinct patterns that correlated with clinical outcomes," says Toor, the lead investigator of the study and hematologist-oncologist and member of the Developmental Therapeutics research program at VCU Massey Cancer Center. "Our goal is to use this data to develop models that can predict complications from stem cell transplantation. Then, we may be able to intervene at key points in times with appropriate clinical treatments that will make the most positive impact on patients' outcomes."

The study, recently published in the journal Biology of Blood & Marrow Transplantation, retrospectively examined lymphocyte recovery and clinical outcome data from a recent phase 2 clinical trial (Clinical trials.gov identifier - NCT00709592) in which 41 patients received a stem cell transplant from related or unrelated donors. As part of the clinical trial protocol, the patients underwent low-dose radiation therapy and received one of two different doses of anti-thymocyte globulin (ATG), an immune-modulating drug given to guard against graft-versus-host-disease (GVHD) before transplantation. GVHD is a condition where the donor's immune system attacks the recipient's body. Following transplantation, the researchers observed that the patients' lymphocytes recovered in one of three general patterns that correlated significantly with survival, relapse, GVHD and the need for further donor immune cell infusions to treat the cancer.

Group A experienced fast, early lymphoid expansion, culminating in a high absolute lymphoid count (ALC) within two months of transplantation. Group B experienced a slower, but steady lymphoid expansion that peaked much later than group A with a lower ALC. Group C experienced very poor lymphocyte recovery that demonstrated an early, but brief lymphoid expansion with a very low ALC. Group B had the best clinical outcomes with a survival rate of 86 percent, followed by group A with a survival rate of 67 percent and group C with 30 percent survival. Relapse rates between groups A and B were similar at 33 and 29 percent, respectively, while group C experienced a 90 percent relapse rate. GVHD was observed in 67 percent of patients in group A, 43 percent of patients in group B and 10 percent of patients in group C. Finally, adoptive immunotherapy with donor cell infusions was required for 13 percent of patients in group A, 21 percent in group B and 70 percent in group C.

The discovery of these patterns in lymphocyte recovery build on prior research by Toor and his team that supports the concept of the immune system working as a dynamical system. In 2013, the Massey Bone Marrow Transplant Program's research team and Massey researcher Masoud Manjili*, D.V.M., Ph.D., sequenced DNA from the T cells of 10 stem cell transplant recipients and their donors and found a fractal, self-repeating pattern in the participants' T cell repertoires. This discovery suggested that physicians could potentially sequence the DNA of patients after they undergo stem cell transplantation and predict potential GVHD complications based on the pattern in which their T cell repertoire is developing. Another study of the same participants in 2014 also used whole exome sequencing and found significant variation in minor histocompatability antigens (mHA, which are receptors on the cellular surface of donated organs that are known to give an immunological response in some organ transplants) between the donor-recipient pairs. This variation represents a large and previously unmeasured potential for developing GVHD for which conventional human leucocyte antigen (HLA) testing, the test that matches stem cell transplants with donors, does not measure. This large library of immune targets, in turn, can serve to drive immune complications of transplantation such as GVHD or graft rejection.

Currently, physicians use stochastic models to determine the probability of a patient developing GVHD based on HLA test results. Stochastic models are not precise because they estimate probability by allowing for random variation in one or more variables. Dynamical system modeling, on the other hand, would account for the key variables influencing transplant outcomes and their evolution over time, allowing physicians to personalize therapy based on the extent of a patient's immune recovery following transplantation.

"We've uncovered order in the structure of the immune system, we've found new variables influencing GVHD and we've now shown patterns in lymphocyte reconstitution that identify at-risk patients," says Toor. "Now, we are working to put it all together and develop a model of immune system reconstruction following stem cell transplantation that will allow physicians to make more informed treatment decisions."

###

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Massey researchers identify patients at risk for stem cell ...

Adult stem cells are undifferentiated cells, found throughout the body after development, that multiply by cell division to replenish dying cells and regenerate damaged tissues. Also known as somatic stem cells (from Greek , meaning of the body), they can be found in juvenile as well as adult animals and human bodies.

Scientific interest in adult stem cells is centered on their ability to divide or self-renew indefinitely, and generate all the cell types of the organ from which they originate, potentially regenerating the entire organ from a few cells. Unlike embryonic stem cells, the use of human adult stem cells in research and therapy is not considered to be controversial, as they are derived from adult tissue samples rather than human 5 day old embryos generated by IVF (in vitro fertility) clinics designated for scientific research. They have mainly been studied in humans and model organisms such as mice and rats.

A stem cell possesses two properties:

To ensure the safety of others, stem cells undergo two types of cell division (see Stem cell division and differentiation diagram). Symmetric division gives rise to two identical daughter cells, both endowed with stem cell properties, whereas asymmetric division produces only one of those stem cells and a progenitor cell with limited self-renewal potential. Progenitors can go through several rounds of cell division before finally differentiating into a mature cell. It is believed that the molecular distinction between symmetric and asymmetric divisions lies in differential segregation of cell membrane proteins (such as receptors) between the daughter cells.

Adult stem cells express transporters of the ATP-binding cassette family that actively pump a diversity of organic molecules out of the cell.[2] Many pharmaceuticals are exported by these transporters conferring multidrug resistance onto the cell. This complicates the design of drugs, for instance neural stem cell targeted therapies for the treatment of clinical depression.

Adult stem cell research has been focused on uncovering the general molecular mechanisms that control their self-renewal and differentiation.

Discoveries in recent years have suggested that adult stem cells might have the ability to differentiate into cell types from different germ layers. For instance, neural stem cells from the brain, which are derived from ectoderm, can differentiate into ectoderm, mesoderm, and endoderm.[5] Stem cells from the bone marrow, which is derived from mesoderm, can differentiate into liver, lung, GI tract and skin, which are derived from endoderm and mesoderm.[6] This phenomenon is referred to as stem cell transdifferentiation or plasticity. It can be induced by modifying the growth medium when stem cells are cultured in vitro or transplanting them to an organ of the body different from the one they were originally isolated from. There is yet no consensus among biologists on the prevalence and physiological and therapeutic relevance of stem cell plasticity. More recent findings suggest that pluripotent stem cells may reside in blood and adult tissues in a dormant state.[7] These cells are referred to as "Blastomere Like Stem Cells" (Am Surg. 2007 Nov;73:1106-10) and "very small embryonic like" - "VSEL" stem cells, and display pluripotency in vitro.[7] As BLSC's and VSEL cells are present in virtually all adult tissues, including lung, brain, kidneys, muscles, and pancreas[8] Co-purification of BLSC's and VSEL cells with other populations of adult stem cells may explain the apparent pluripotency of adult stem cell populations. However, recent studies have shown that both human and murine VSEL cells lack stem cell characteristics and are not pluripotent.[9][10][11][12]

Stem cell function becomes impaired with age, and this contributes to progressive deterioration of tissue maintenance and repair.[13] A likely important cause of increasing stem cell dysfunction is age-dependent accumulation of DNA damage in both stem cells and the cells that comprise the stem cell environment.[13] (See also DNA damage theory of aging.)

Hematopoietic stem cells are found in the bone marrow and give rise to all the blood cell types.

Mammary stem cells provide the source of cells for growth of the mammary gland during puberty and gestation and play an important role in carcinogenesis of the breast.[14] Mammary stem cells have been isolated from human and mouse tissue as well as from cell lines derived from the mammary gland. Single such cells can give rise to both the luminal and myoepithelial cell types of the gland, and have been shown to have the ability to regenerate the entire organ in mice.[14]

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Adult stem cell - Wikipedia, the free encyclopedia

This article is about the ageing of living things. For ageing specifically in humans, see ageing. For the study of ageing in humans, see gerontology. For the science of the care of the elderly, see geriatrics. For experimental gerontology, see life extension. For premature ageing disorders, see Progeroid syndromes.

Senescence () (from Latin: senescere, meaning "to grow old", from senex) or biological aging (also spelled biological ageing) is the gradual deterioration of function characteristic of most complex lifeforms, arguably found in all biological kingdoms, that on the level of the organism increases mortality after maturation. The word "senescence" can refer either to cellular senescence or to senescence of the whole organism. It is commonly believed that cellular senescence underlies organismal senescence. The science of biological aging is biogerontology.

Senescence is not the inevitable fate of all organisms. Organisms of some taxonomic groups (taxa), including some animals, even experience chronological decrease in mortality, for all or part of their life cycle.[1] On the other extreme are accelerated aging diseases, rare in humans. There is also the extremely rare and poorly understood "Syndrome X", whereby a person remains physically and mentally an infant or child throughout one's life.[2][3]

Even if environmental factors do not cause aging, they may affect it; in such a way, for example, overexposure to ultraviolet radiation accelerates skin aging. Different parts of the body may age at different rates. Two organisms of the same species can also age at different rates, so that biological aging and chronological aging are quite distinct concepts.

Albeit indirectly, senescence is by far the leading cause of death (other than in the trivially accurate sense that cerebral hypoxia, i.e., lack of oxygen to the brain, is the immediate cause of all human death). Of the roughly 150,000 people who die each day across the globe, about two thirds100,000 per daydie of age-related causes; in industrialized nations, moreover, the proportion is much higher, reaching 90%.[4]

There are a number of hypotheses as to why senescence occurs; for example, some posit it is programmed by gene expression changes, others that it is the cumulative damage caused by biological processes. Whether senescence as a biological process itself can be slowed down, halted or even reversed, is a subject of current scientific speculation and research.[5]

Cellular senescence is the phenomenon by which normal diploid cells cease to divide. In cell culture, fibroblasts can reach a maximum of 50 cell divisions before becoming senescent. This phenomenon is known as "replicative senescence", or the Hayflick limit in honour of Dr.Leonard Hayflick, co-author with Paul Moorhead, of the first paper describing it in 1961.[6] Replicative senescence is the result of telomere shortening that ultimately triggers a DNA damage response. Cells can also be induced to senesce via DNA damage in response to elevated reactive oxygen species (ROS), activation of oncogenes and cell-cell fusion, independent of telomere length. As such, cellular senescence represents a change in "cell state" rather than a cell becoming "aged" as the name confusingly suggests. Although senescent cells can no longer replicate, they remain metabolically active and commonly adopt an immunogenic phenotype consisting of a pro-inflammatory secretome, the up-regulation of immune ligands, a pro-survival response, promiscuous gene expression (pGE) and stain positive for senescence-associated -galactosidase activity.[7] The nucleus of senescent cells is characterized by senescence-associated heterochromatin foci (SAHF) and DNA segments with chromatin alterations reinforcing senescence (DNA-SCARS).[8] Senescent cells are known to play important physiological functions in tumour suppression, wound healing and possibly embryonic/placental development and paradoxically play a pathological role in age-related diseases.[9] The elimination of senescent cells using a transgenic mouse model led to greater resistance against aging-associated diseases,[10] suggesting that cellular senescence is a major driving force of ageing and its associated diseases.

Organismal senescence is the aging of whole organisms. In general, aging is characterized by the declining ability to respond to stress, increased homeostatic imbalance, and increased risk of aging-associated diseases. Death is the ultimate consequence of aging, though "old age" is not a scientifically recognized cause of death because there is always a specific proximal cause, such as cancer, heart disease, or liver failure. Aging of whole organisms is therefore a complex process that can be defined as "a progressive deterioration of physiological function, an intrinsic age-related process of loss of viability and increase in vulnerability".[11]

Differences in maximum life span among species correspond to different "rates of aging". For example, inherited differences in the rate of aging make a mouse elderly at 3 years and a human elderly at 80 years.[12] These genetic differences affect a variety of physiological processes, including the efficiency of DNA repair, antioxidant enzymes, and rates of free radical production.

Senescence of the organism gives rise to the GompertzMakeham law of mortality, which says that mortality rate accelerates rapidly with age.

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Senescence - Wikipedia, the free encyclopedia

Chronic kidney disease (CKD), also known as chronic renal disease, is a progressive loss in renal function over a period of months or years. The symptoms of worsening kidney function are not specific, and might include feeling generally unwell and experiencing a reduced appetite. Often, chronic kidney disease is diagnosed as a result of screening of people known to be at risk of kidney problems, such as those with high blood pressure or diabetes and those with a blood relative with CKD. This disease may also be identified when it leads to one of its recognized complications, such as cardiovascular disease, anemia, or pericarditis.[1] It is differentiated from acute kidney disease in that the reduction in kidney function must be present for over 3 months.

Chronic kidney disease is identified by a blood test for creatinine, which is a breakdown product of muscle metabolism. Higher levels of creatinine indicate a lower glomerular filtration rate and as a result a decreased capability of the kidneys to excrete waste products. Creatinine levels may be normal in the early stages of CKD, and the condition is discovered if urinalysis (testing of a urine sample) shows the kidney is allowing the loss of protein or red blood cells into the urine. To fully investigate the underlying cause of kidney damage, various forms of medical imaging, blood tests, and sometimes a renal biopsy (removing a small sample of kidney tissue) are employed to find out if a reversible cause for the kidney malfunction is present.[1]

Recent professional guidelines classify the severity of CKD in five stages, with stage 1 being the mildest and usually causing few symptoms and stage 5 being a severe illness with poor life expectancy if untreated. Stage 5 CKD is often called end-stage kidney disease, end-stage renal disease, or end-stage kidney failure, and is largely synonymous with the now outdated terms chronic renal failure or chronic kidney failure; and usually means the patient requires renal replacement therapy, which may involve a form of dialysis, but ideally constitutes a kidney transplant.

No specific treatment has been unequivocally shown to slow the worsening of CKD. If an underlying cause of CKD, such as vasculitis, or obstructive nephropathy (blockage to the drainage system of the kidneys) is found, it may be treated directly to slow the damage. In more advanced stages, treatments may be required for anemia and renal bone disease (also called renal osteodystrophy, secondary hyperparathyroidism or chronic kidney disease - mineral bone disorder (CKD-MBD)). Chronic kidney disease resulted in 956,000 deaths in 2013 up from 409,000 deaths in 1990.[2]

CKD is initially without specific symptoms and is generally only detected as an increase in serum creatinine or protein in the urine. As the kidney function decreases:

People with CKD suffer from accelerated atherosclerosis and are more likely to develop cardiovascular disease than the general population. Patients afflicted with CKD and cardiovascular disease tend to have significantly worse prognoses than those suffering only from the latter.[citation needed]

Sexual dysfunction is very common in both men and women with CKD. A majority of men have a reduced sex drive, difficulty obtaining an erection, and reaching orgasm, and the problems get worse with age. A majority of women have trouble with sexual arousal, and painful menstruation and problems with performing and enjoying sex are common.[8]

The most common recognised cause of CKD is diabetes mellitus. Others include idiopathic (ie unknown cause, often associated with small kidneys on renal ultrasound), hypertension, and glomerulonephritis.[9] Together, these cause about 75% of all adult cases.

Historically, kidney disease has been classified according to the part of the renal anatomy involved.[citation needed]

Diagnosis of CKD is largely based on the clinical picture combined with the measurement of the serum creatinine level (see above). In many CKD patients, previous renal disease or other underlying diseases are already known. A significant number present with CKD of unknown cause. In these patients, a cause is occasionally identified retrospectively.[citation needed]

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Chronic kidney disease - Wikipedia, the free encyclopedia

In biology, a mutation is a permanent change of the nucleotide sequence of the genome of an organism, virus, or extrachromosomal DNA or other genetic elements. Mutations result from damage to DNA which is not repaired or to RNA genomes (typically caused by radiation or chemical mutagens), errors in the process of replication, or from the insertion or deletion of segments of DNA by mobile genetic elements.[1][2][3] Mutations may or may not produce discernible changes in the observable characteristics (phenotype) of an organism. Mutations play a part in both normal and abnormal biological processes including: evolution, cancer, and the development of the immune system, including junctional diversity.

Mutation can result in several different types of change in sequences. Mutations in genes can either have no effect, alter the product of a gene, or prevent the gene from functioning properly or completely. Mutations can also occur in nongenic regions. One study on genetic variations between different species of Drosophila suggests that, if a mutation changes a protein produced by a gene, the result is likely to be harmful, with an estimated 70 percent of amino acid polymorphisms that have damaging effects, and the remainder being either neutral or weakly beneficial.[4] Due to the damaging effects that mutations can have on genes, organisms have mechanisms such as DNA repair to prevent or correct (revert the mutated sequence back to its original state) mutations.[1]

Mutations can involve the duplication of large sections of DNA, usually through genetic recombination.[5] These duplications are a major source of raw material for evolving new genes, with tens to hundreds of genes duplicated in animal genomes every million years.[6] Most genes belong to larger families of genes of shared ancestry.[7] Novel genes are produced by several methods, commonly through the duplication and mutation of an ancestral gene, or by recombining parts of different genes to form new combinations with new functions.[8][9]

Here, domains act as modules, each with a particular and independent function, that can be mixed together to produce genes encoding new proteins with novel properties.[10] For example, the human eye uses four genes to make structures that sense light: three for color vision and one for night vision; all four arose from a single ancestral gene.[11] Another advantage of duplicating a gene (or even an entire genome) is that this increases redundancy; this allows one gene in the pair to acquire a new function while the other copy performs the original function.[12][13] Other types of mutation occasionally create new genes from previously noncoding DNA.[14][15]

Changes in chromosome number may involve even larger mutations, where segments of the DNA within chromosomes break and then rearrange. For example, in the Homininae, two chromosomes fused to produce human chromosome 2; this fusion did not occur in the lineage of the other apes, and they retain these separate chromosomes.[16] In evolution, the most important role of such chromosomal rearrangements may be to accelerate the divergence of a population into new species by making populations less likely to interbreed, thereby preserving genetic differences between these populations.[17]

Sequences of DNA that can move about the genome, such as transposons, make up a major fraction of the genetic material of plants and animals, and may have been important in the evolution of genomes.[18] For example, more than a million copies of the Alu sequence are present in the human genome, and these sequences have now been recruited to perform functions such as regulating gene expression.[19] Another effect of these mobile DNA sequences is that when they move within a genome, they can mutate or delete existing genes and thereby produce genetic diversity.[2]

Nonlethal mutations accumulate within the gene pool and increase the amount of genetic variation.[20] The abundance of some genetic changes within the gene pool can be reduced by natural selection, while other "more favorable" mutations may accumulate and result in adaptive changes.

For example, a butterfly may produce offspring with new mutations. The majority of these mutations will have no effect; but one might change the color of one of the butterfly's offspring, making it harder (or easier) for predators to see. If this color change is advantageous, the chance of this butterfly's surviving and producing its own offspring are a little better, and over time the number of butterflies with this mutation may form a larger percentage of the population.

Neutral mutations are defined as mutations whose effects do not influence the fitness of an individual. These can accumulate over time due to genetic drift. It is believed that the overwhelming majority of mutations have no significant effect on an organism's fitness.[citation needed] Also, DNA repair mechanisms are able to mend most changes before they become permanent mutations, and many organisms have mechanisms for eliminating otherwise-permanently mutated somatic cells.

Beneficial mutations can improve reproductive success.

Continue reading here:
Mutation - Wikipedia, the free encyclopedia

Type 2 diabetes is a chronic disease in which people have problems regulating their blood sugar. People with diabetes have high blood sugar because their bodies:

Type 2 diabetes is extremely common. The Centers for Disease Control and Prevention (CDC) estimates that over 29 million children and adults in the United States have some form of diabetes. That is about 9 percent of the population. The vast majority of these people have type 2 diabetes.

When you eat food, the body digests the carbohydrates in into a type of sugar called glucose. Glucose is the main source of energy for cells. Cells rely on the hormone insulin to absorb and use glucose as a form of energy. Insulin is produced by the pancreas.

People usually develop type 2 diabetes because their cells have become resistant to insulin. Then, over time, their body may stop making sufficient insulin as well. These problems lead to blood sugar, or glucose, building up in the blood

There are several different types of diabetes:

Type 1 diabetes used to be known as juvenile onset diabetes because it is usually first diagnosed in childhood, though it can be diagnosed later in life as well.. People with type 1 diabetes cannot make insulin and are insulin dependent. They must use insulin injections to control their blood sugar.

According to the CDC, only about five percent of people with diabetes have type 1 diabetes (CDC).

There is no known way to prevent type 1 diabetes.

Type 2 diabetes is the most common type of diabetes, and was once known as adult onset diabetes. However, in recent years, the rate of type 2 diagnoses in children has been growing.

Type 2 diabetes usually starts as insulin resistance. Cells stop responding properly to insulin and sugar is unable to get from the blood into the cells. Over time, the pancreas cannot make enough insulin to keep blood sugars in the normal range and the body becomes progressively less able to regulate blood sugar.

The rest is here:
Type 2 Diabetes: Everything You Need to Know

The stem cell controversy is the consideration of the ethics of research involving the development, usage, and destruction of human embryos. Most commonly, this controversy focuses on embryonic stem cells. Not all stem cell research involves the creation, usage and destruction of human embryos. For example, adult stem cells, amniotic stem cells and induced pluripotent stem cells do not involve creating, using or destroying human embryos and thus are minimally, if at all, controversial.

The use of stem cells has been happening for decades. In 1998, scientists discovered how to extract stem cells from human embryos. This discovery led to moral ethics questions concerning research involving embryo cells, such as what restrictions should be made on studies using these types of cells? At what point does one consider life to begin? Is it just to destroy an embryo cell if it has the potential to cure countless numbers of patients? Political leaders are debating how to regulate and fund research studies that involve the techniques used to remove the embryo cells. No clear consensus has emerged. Other recent discoveries may extinguish the need for embryonic stem cells.[1]

Since stem cells have the ability to differentiate into any type of cell, they offer something in the development of medical treatments for a wide range of conditions. Treatments that have been proposed include treatment for physical trauma, degenerative conditions, and genetic diseases (in combination with gene therapy). Yet further treatments using stem cells could potentially be developed thanks to their ability to repair extensive tissue damage.[2]

Great levels of success and potential have been shown from research using adult stem cells. In early 2009, the FDA approved the first human clinical trials using embryonic stem cells. Embryonic stem cells can become all cell types of the body which is called totipotent. Adult stem cells are generally limited to differentiating into different cell types of their tissue of origin. However, some evidence suggests that adult stem cell plasticity may exist, increasing the number of cell types a given adult stem cell can become. In addition, embryonic stem cells are considered more useful for nervous system therapies, because researchers have struggled to identify and isolate neural progenitors from adult tissues[citation needed]. Embryonic stem cells, however, might be rejected by the immune system - a problem which wouldn't occur if the patient received his or her own stem cells.

Some stem cell researchers are working to develop techniques of isolating stem cells that are as potent as embryonic stem cells, but do not require a human embryo.

Some believe that human skin cells can be coaxed to "de-differentiate" and revert to an embryonic state. Researchers at Harvard University, led by Kevin Eggan, have attempted to transfer the nucleus of a somatic cell into an existing embryonic stem cell, thus creating a new stem cell line.[3] Another study published in August 2006 also indicates that differentiated cells can be reprogrammed to an embryonic-like state by introducing four specific factors, resulting in induced pluripotent stem cells.[4]

Researchers at Advanced Cell Technology, led by Robert Lanza, reported the successful derivation of a stem cell line using a process similar to preimplantation genetic diagnosis, in which a single blastomere is extracted from a blastocyst.[5] At the 2007 meeting of the International Society for Stem Cell Research (ISSCR),[6] Lanza announced that his team had succeeded in producing three new stem cell lines without destroying the parent embryos. "These are the first human embryonic cell lines in existence that didn't result from the destruction of an embryo." Lanza is currently in discussions with the National Institutes of Health (NIH) to determine whether the new technique sidesteps U.S. restrictions on federal funding for ES cell research.[7]

Anthony Atala of Wake Forest University says that the fluid surrounding the fetus has been found to contain stem cells that, when utilized correctly, "can be differentiated towards cell types such as fat, bone, muscle, blood vessel, nerve and liver cells". The extraction of this fluid is not thought to harm the fetus in any way. He hopes "that these cells will provide a valuable resource for tissue repair and for engineered organs as well".[8]

The status of the human embryo and human embryonic stem cell research is a controversial issue as, with the present state of technology, the creation of a human embryonic stem cell line requires the destruction of a human embryo. Stem cell debates have motivated and reinvigorated the pro-life movement, whose members are concerned with the rights and status of the embryo as an early-aged human life. They believe that embryonic stem cell research instrumentalizes and violates the sanctity of life and is tantamount to murder.[9] The fundamental assertion of those who oppose embryonic stem cell research is the belief that human life is inviolable, combined with the belief that human life begins when a sperm cell fertilizes an egg cell to form a single cell.

A portion of stem cell researchers use embryos that were created but not used in in vitro fertility treatments to derive new stem cell lines. Most of these embryos are to be destroyed, or stored for long periods of time, long past their viable storage life. In the United States alone, there have been estimates of at least 400,000 such embryos.[10] This has led some opponents of abortion, such as Senator Orrin Hatch, to support human embryonic stem cell research.[11] See Also Embryo donation.

More here:
Stem cell controversy - Wikipedia, the free encyclopedia

Regenerative medicine is a branch of translational research[1] in tissue engineering and molecular biology which deals with the "process of replacing, engineering or regenerating human cells, tissues or organs to restore or establish normal function".[2] This field holds the promise of engineering damaged tissues and organs via stimulating the body's own repair mechanisms to functionally heal previously irreparable tissues or organs.[3]

Regenerative medicine also includes the possibility of growing tissues and organs in the laboratory and safely implanting them when the body cannot heal itself. If a regenerated organ's cells would be derived from the patient's own tissue or cells, this would potentially solve the problem of the shortage of organs available for donation, and the problem of organ transplant rejection.[4][5][6]

Attributed to William Haseltine (founder of Human Genome Sciences),[7] the term "regenerative medicine" was first found in a 1992 article on hospital administration by Leland Kaiser. Kaisers paper closes with a series of short paragraphs on future technologies that will impact hospitals. One paragraph had Regenerative Medicine as a bold print title and stated, A new branch of medicine will develop that attempts to change the course of chronic disease and in many instances will regenerate tired and failing organ systems.[8][9]

Regenerative medicine refers to a group of biomedical approaches to clinical therapies that may involve the use of stem cells.[10] Examples include the injection of stem cells or progenitor cells obtained through Directed differentiation (cell therapies); the induction of regeneration by biologically active molecules administered alone or as a secretion by infused cells (immunomodulation therapy); and transplantation of in vitro grown organs and tissues (tissue engineering).[11][12]

From 1995 to 1998 Michael D. West, PhD, organized and managed the research between Geron Corporation and its academic collaborators James Thomson at the University of Wisconsin-Madison and John Gearhart of Johns Hopkins University that led to the first isolation of human embryonic stem and human embryonic germ cells.[13]

Dr. Stephen Badylak, a Research Professor in the Department of Surgery and director of Tissue Engineering at the McGowan Institute for Regenerative Medicine at the University of Pittsburgh, developed a process for scraping cells from the lining of a pig's bladder, decellularizing (removing cells to leave a clean extracellular structure) the tissue and then drying it to become a sheet or a powder. This extracellular matrix powder was used to regrow the finger of Lee Spievak, who had severed half an inch of his finger after getting it caught in a propeller of a model plane.[14][15][16][dubious discuss] As of 2011, this new technology is being employed by the military on U.S. war veterans in Texas, as well as for some civilian patients. Nicknamed "pixie-dust," the powdered extracellular matrix is being used to successfully regenerate tissue lost and damaged due to traumatic injuries.[17]

In June 2008, at the Hospital Clnic de Barcelona, Professor Paolo Macchiarini and his team, of the University of Barcelona, performed the first tissue engineered trachea (wind pipe) transplantation. Adult stem cells were extracted from the patient's bone marrow, grown into a large population, and matured into cartilage cells, or chondrocytes, using an adaptive method originally devised for treating osteoarthritis. The team then seeded the newly grown chondrocytes, as well as epithileal cells, into a decellularised (free of donor cells) tracheal segment that was donated from a 51 year old transplant donor who had died of cerebral hemorrhage. After four days of seeding, the graft was used to replace the patient's left main bronchus. After one month, a biopsy elicited local bleeding, indicating that the blood vessels had already grown back successfully.[18][19]

In 2009 the SENS Foundation was launched, with its stated aim as "the application of regenerative medicine defined to include the repair of living cells and extracellular material in situ to the diseases and disabilities of ageing." [20]

In 2012, Professor Paolo Macchiarini and his team improved upon the 2008 implant by transplanting a laboratory-made trachea seeded with the patient's own cells.[21]

On Sep 12, 2014, surgeons at the Institute of Biomedical Research and Innovation Hospital in Kobe, Japan, transplanted a 1.3 by 3.0 millimeter sheet of retinal pigment epithelium cells, which were differentiated from iPS cells through Directed differentiation, into an eye of an elderly woman, who suffers from age-related macular degeneration.[22]

More here:
Regenerative medicine - Wikipedia, the free encyclopedia

Genetics includes the study of heredity, or how traits are passed from parents to offspring. The topics of genetics vary and are constantly changing as we learn more about the genome and how we are influenced by our genes.

Mendel & Inheritance powerpoint presentation covering basics of genetics

Heredity Simulation use popsicle sticks to show how alleles are inherited Penny Genetics flip a coin to compare actual outcomes versus predicted outcomes from a punnett square Heredity Wordsearch fill in the blank, find words

Simple Genetics Practice using mendelian genetics and punnett squares

Genetic Crosses with two traits basic crosses, uses Punnet squares Genetic Crosses with two traits II basic crossses, uses Punnett squares Dihybrid Crosses in Guinea Pigs(pdf) step through on how to do a 44 punnett square

Codominance & Incomplete Dominance basic crosses involving codominance

Genetics Practice Problems includes codominance, multiple allele traits, polygenic traits, for AP Biology Genetics Practice Problems II for advanced biology students, includes both single allele and dihybrid crosses, intended for practice after students have learned multiplicative properties of statistics and mathematical analysis of genetic crosses

X-Linked Traits practice crosses that involve sex-linkage, mainly in fruitflies

X Linked Genetics in Calico Cats more practice with sex-linked traits Multiple Allele Traits practice with blood type crosses and other ABO type alleles Multiple Allele Traits in Chickens shows how combs are inherited (rrpp x RRpp) Inheritance and Eye Color uses a simulation to show how multiple alleles can influence a single trait (eye color)

The Genetics of Blood Disorders a worksheet with genetics problems that relate to specific disorders: sickle cell anemia, hemophilia, and Von Willebrand disease.

See more here:
Genetics | The Biology Corner

Description of Services

The Division of Pediatric Endocrinology, Diabetes and Metabolism Consultation provides diagnostic and therapeutic services for children with diabetes mellitus, hypoglycemia and disorders of physical growth, sexual maturation, thyroid function, pituitary function, and calcium and phosphorous metabolism.

The Pediatric Endocrine Testing Center provides diagnostic endocrine tests for patients (both children and adults) in areas of endocrinology and carbohydrate, amino acid, and mineral and lipid metabolism. The center addresses growth abnormalities and the range of conditions that can cause them.

The Nutrition Consultation Service provides consultative and follow-up service by a physician and dietitian for children up to 18 years of age with obesity problems and associated disorders.

Referrals are required from primary care physicians or other Childrens Hospital specialty services. These should be accompanied by a written reason for the referral together with related patient records and growth charts. Referrals for patients enrolled in managed care insurance plans also require authorization from the primary care physician and sometimes from the insurance provider. All necessary referral and authorization forms must be received before the patients visit and include separate authorization for each physician, diabetes nurse educator, dietitian, laboratory and X-ray services. For accurate provider numbers or more information, please call the office number listed.

205 Millers Run Road

Contact Information: 412-692-7337

4055 Monroeville Blvd., Building One

Contact Information: 412-692-7337

2599 Wexford Bayne Rd.

Original post:
Endocrinology, Diabetes and Metabolism - CHP

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Cleveland Clinic's Center for Integrative & Lifestyle Medicine is dedicated to addressing the increasing demand for integrative healthcare by researching and providing access to practices that address the physical as well as lifestyle, emotional, and spiritual needs of patients.

As the body of evidence for alternative medicine grows, we remain at the forefront providing the most updated education and practices to patients. Cleveland Clinic's Center for Integrative & Lifestyle Medicine sees more than 5,000 patients per year for a variety of services.

Learn about our wide range of services and treatments including acupuncture, massage and lifestyle management programs.

Meet the Integrative & Lifestyle Medicine team of physicians and specialists.

Womens Wellness Week is a complete program that gives you physical, nutritional and informational tools you need to live healthier.

Disclaimer: Cleveland Clinic does not endorse Young Living Essential Oils Products and has not authorized the use of its name in association with Young Living Essential Oils Products.

Treat someone you love to a gift certificate good for any Cleveland Clinic Center for Integrative & Lifestyle Medicine service even physician consults and holistic psychotherapy.

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Integrative & Lifestyle Medicine - Cleveland Clinic

Fine-Tuning Your Longevity Genes

By Bryant Villeponteau, Ph.D.

Introduction

The nearly universal human desire to preserve youth can often motivate people to make major lifestyle changes or try the latest wonder supplement. But is it really possible to slow the rate of aging with current knowledge and technology? I argue herein that aging can be significantly slowed by fine tuning your longevity genes. Indeed, scientific research carried out in the last 20 years has shown that lifespan can be readily modulated by a variety of genetic or dietary strategies. In this article, I describe our efforts at Genescient LLC in Irvine, CA, to develop strategies to delay aging and age-related disease. Genescients primary business focus is on the development of pharmaceuticals for age-related diseases, but in conjunction with its spinoff firm Life Code LLC, it has provided testing services for the development of nutraceuticals based on its unique genomics platform. Our findings can be summarized as follows:

What Are the Main Effects of Aging?

Fig. 1: Aging causes an exponential increase in the annual mortality rate.

The actual declines in function with age occur at the cell, organ, and systemic levels, but the impacts of this decline can differ with the individuals genes and environment. The net result of aging is a progressive increase in all-cause mortality and morbidity. In the case of humans, all-cause mortality is known to double every eight years after sexual maturity until it reaches an annual mortality rate plateau of about 50% over 105 years of age.

All grafted data under 110 years are from the Social Security Administration Death Master File, while data on 110 to 119 year olds are from validated human super-centenarians from the website http://www.grg.org.

Read more from the original source:
Fine-Tuning Your Longevity Genes | Life Code

Rapid developments in the medical field in the last century have revolutionized the field of medical practice. It is now possible to diagnose diseases faster and more accurately using advanced diagnostic techniques. Medical management has become more effective with refined medications having more specific actions and fewer side effects. Surgical treatment has moved towards less invasive modes of management with lesser morbidity and faster recovery. Among all these developments, the medical profession in India is at crossroads facing many ethical and legal challenges in the practice of the profession. The medical fraternity is becoming more and more dependent on technology and market forces tend to influence decision making by the doctors. The fundamental values of medicine insist that the doctor's obligation is to keep the patients interest above everything else. The important issues of autonomy, confidentiality, justice, beneficence, and non malefecience are key factors that should guide the daily decision making by the doctor. These decisions may be involving a simple choice of antibiotics for an infection or the best medication for hypertension or hypercholestrolemia. It becomes more complex involving major ethical concerns in organ transplantation, clinical trials, genetic manipulations, end of life issues, or assisted reproductive techniques. However, the principles of ethics remain the same for all the above situations. The ethical guidelines of medical practice provided by The Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002 is aimed at strengthening the ethical standards among registered medical practitioners in India.

The health sector in India has seen a major transformation with health care becoming a profitable sector attracting investors from diverse and varied backgrounds with profitable motives. There is also an allegation that the practice of modern medicine is becoming more impersonal, and with the increasing dependence on technology, the cost of treatment also rises. It is a fact that cannot be ignored that there is increasing dissatisfaction on the part of the patients who are expecting more and more from the doctors, leading to increasing incidence of litigation. The Medical Council of India has a redressal mechanism that can give punishment to the erring doctor after proper investigative procedures. The unnecessary harassment of doctors who are falsely implicated in criminal negligence issues has been curtailed by the Supreme Court, which has issued guidelines for the criminal charging of a doctor for negligence.

The medical profession that was once considered noble is now considered along with other professions in the liability of paying for damages. The patients who wanted monetary compensation for the alleged medical negligence used to resort to the civil courts. This was the only avenue earlier that used to be a lengthy process with its detailed procedural formalities. The confusion about the inclusion of doctors under the Consumer Protection Act, 1986 has been laid to rest by the landmark decision of the Supreme Court in 1996 that puts the services of doctors for consideration under the purview of the Consumer Protection Act. This resulted in an increasing incidence of consumer cases where doctors were implicated for all types of allegations by patients. The recent Supreme Court guidelines that call for stricter evaluation by the Consumer Courts before proceeding with alleged medical negligence cases by the patients will be a boon to the doctors who will not be pulled into unnecessary litigation. However it has to be noted that the judicial bodies favour the patient who has suffered due to the negligent action of the doctors as reiterated by another Supreme Court decision recently confirming the decision of the State Commisison and giving a much higher compensation.

It is imperative that the present day medical doctors have continuing medico-legal education. Doctors have a legal duty to comply with the applicable ethical and legal regulations in their daily practice. Ignorance of law and its implications will be detrimental to the doctor even though he treats the patient in good faith for the alleviation of the patient's suffering. All actions that are done in good faith may not stand legal testing. With the increasing number of cases filed by aggrieved patients seeking legal remedy from doctors and medical establishments, it is no longer a matter of choice, but a context-driven legal mandate and necessity for the doctors to be conversant with basic legal issues involved in medical practice. This symposium aims at giving a basic insight into two main areas of medical practice:

The ethical issues in medical practice including changing doctor-patient relationships, the need for introducing ethical training in the undergraduate and postgraduate medical training, the modern challenges in urological practice, and the ethical and legal issues in kidney transplantation covered from an Indian perspective.

The legal issues covered include the basics of medical negligence, changing concepts of informed consent, and the practical issues of medical negligence cases with representative case decisions from the Indian Courts.

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Ethical and legal issues in medical practice