April 2012 Archives

Some antidepressants may alleviate insomnia and improve sleep quality in menopausal women suffering hot flashes

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antidepressants.JPGWomen going through menopause don't have many options for relieving hot flashes, and many women report difficulty sleeping and sleep disturbance as a result.

Hormone therapy - estrogen with or without progestin - is the most common and only FDA-approved treatment of menopausal hot flashes, but its use declined after studies showed a delicate balance of risks and benefits of hormone therapy.

But could some antidepressants reduce insomnia symptoms and improve self-reported sleep quality while reducing the frequency and severity of hot flashes in menopausal women?

School of Public Health and Medical School professor Kristine Ensrud, M.D., M.P.H. recently published research that found the selective serotonin reuptake inhibitor (SSRI) escitalopram reduced insomnia symptoms for menopausal women and lessened the severity of hot flashes. The results of her research suggest that the medication could provide a non-hormonal, off-label option for women looking for effective management of menopause-related hot flashes and sleep disturbances.

"Hormone therapy is the current 'gold standard' in treatment for menopausal hot flashes, but there are concerns about long-term use and whether the risks outweigh the benefits," Ensrud said. "Because hormone therapy is only recommended in low doses for short periods of time to relieve menopausal symptoms, we wanted to see what alternatives there might be, by determining the effect of the antidepressant escitalopram on hot flashes and sleep complaints."

According to Ensrud, her study's findings can reassure providers and patients that SSRIs, the most commonly prescribed antidepressants, are options for women going through the transition of menopause."

U of M, regional hospitals stress the impact of declining medical education funding

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In May, 219 students will graduate from the University of Minnesota Medical School. Medical residencies will allow these students to continue their training but unfortunately, a limited number of residency slots in Minnesota means more than half of our graduating students will land outside our state's borders.

Statistics show that once we lose these students, it's difficult to bring them back.

Worse, the cost to hospitals forced to recruit providers from out of state is twice what it costs to train them in-state.

So why can't we simply add more residency slots? There are a few reasons but one of the primary reasons is funding.

In 2011, the Minnesota State Legislature severely reduced funding that supports graduate medical education. The funding, known as Medical Education and Research Costs (MERC), was slashed from $63 million to $31 million.

Last week, Minnesota Public Radio's Elizabeth Dunbar put the spotlight on the challenges associated with cutting medical education funding. Read the story and listen to the feature here.

Kidney transplant chain saves lives

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Image: AHC LogoA recent and rare transplant chain provided new kidneys for three new patients. Ty Dunn, Medical School and University of Minnesota Physicians, explains that the chain folds in on itself and you have three pairs and everybody donates and everybody gets a transplant.

Watch on KARE 11 and KSTP

How do mammals sense and respond to infection?

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It's a good question, and one that puzzled many health experts for decades.

But starting in the mid 1980's, a doctor named Dr. Bruce Beutler helped increase modern medicine's understanding of how our body's sense and respond to infection. In doing so, he helped shift the treatment approach for inflammatory conditions impacting millions of patients worldwide.

Beutler discovered an important family of receptors that allow mammals to sense infections when they occur, triggering a powerful inflammatory response. For this work he received the 2011 Nobel Prize in Physiology or Medicine. Subsequently, his research led to new treatments that have dramatically improved modern medicine's approach to rheumatoid arthritis, Crohn's disease, psoriasis and other inflammatory conditions.

On Friday, April 20, 2012, Beutler will speak at the 50th Annual J.S. and H.R. Blumethal Memorial Lecture in the Mayo Auditorium, located at 420 Delaware Street Southeast. The event, which is sponsored by the University of Minnesota Medical School's Center for Immunology, is free and open to the public.

About Dr. Bruce Beutler

Beutler is currently a Regental Professor and Director of the Center for Genetics of Host Defense at the University of Texas Southwestern Medical Center at Dallas. He has authored or co-authored more than 300 papers, which have been cited more than 46,000 times.

Could cutting 64 calories a day reverse the childhood obesity epidemic?

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Sixty-four calories. That's the number a new study published in the American Journal of Preventive Medicine found children in the U.S. must eliminate to help slash childhood obesity by 2020.

If children don't either decrease their calorie intake or increase physical activity - or both - more than 20% will be obese by 2020 and the average U.S. child will be nearly four pounds heavier than a child of the same age in 2007-2008.

But could 64 calories really be the magic number to preventing such scenarios?

To find out we asked University of Minnesota School of Public Health epidemiologist Jamie Stang, Ph.D. Her answer: 64 calories is a start, but there probably is no magic bullet.

"Childhood obesity isn't a problem with a quick-fix solution," Stang said. "It will take the cooperation of parents, educators, health care providers, schools, communities, the food industry, policymakers and the teens themselves, all working together to create more opportunities for healthful eating. Some children may also need to achieve a higher calorie reduction or exercise output than others, and for families with sedentary kids, 64 calories they may be disappointed in the lack of weight loss.

So how can children eliminate these calories from their diets? According to Stang:

• Consume a variety of nutrient-dense foods and beverages among the basic food groups.
• Choose foods with limited saturated and trans fats, cholesterol, added sugars and salt.
• Meet recommended intakes within energy needs by adopting a balanced eating pattern.
• Engage in regular physical activity and reduce sitting for extended periods of time.
• Have approximately 60 minutes of moderate- to vigorous-intensity activities daily.

U of M Expert Perspective: Patients shouldn't fear dental X-rays

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Chances are, if you've been to the dentist recently you've undergone an X-ray.dental-x-ray_B.jpg

The tool helps dentists diagnose current problems and plan treatment for existing ones.

But could dental X-rays increase your risk of developing brain tumors? New research suggests that they could...but many dental experts and the American Dental Association (ADA) aren't so sure.

In a new study published in the latest issue of Cancer, researchers report patients exposed to yearly bitewing examinations (a common form of dental X-ray) may be at a greater risk of developing an intracranial meningioma, a common form of brain tumor.

But while the news can be scary at face value, even the researchers caution that their research isn't condemning dental X-rays. Instead, they're advocating for more moderate X-ray exposure.

According to Mansur Ahmad, Ph.D., associate professor of oral medicine and diagnosis within the University of Minnesota's School of Dentistry, the question isn't whether or not radiation causes cancer - we know that it does. The question is which type of cancer radiation can cause.

"Patients shouldn't be scared of dental X-rays, but patients and their doctor can work to cut down on radiation exposure," said Ahmad. "Doctors can also use lead aprons and have strict rules for which patients need X-rays and which do not."

Ahmad recommends dentists look at benefit versus risk when it comes to radiation. X-rays can be useful for some clinical examinations or to help with treatment.

"As dentists we need to ensure we're working with our patients to determine when and why an X-ray may be needed," he said. "We should never be issuing X-rays just because a patient comes in for a visit."

Focus on Community Health for School of Nursing

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villarruel2010-av.jpgThe University of Minnesota's School of Nursing is hosting its annual Nursing Research Day on April 27, 2012.

This year's theme is Transforming Health through Community Engaged Research and Practice, which closely aligns with the school's nationally-recognized Community Health program.

This year's keynote speaker will be Antonia M. Villarruel, Ph.D., FAAN, Associate Dean for Research and Global Affairs at the University of Michigan School of Nursing. Dr. Villarruel will discuss her efforts in health promotion and health disparities research, particularly with the Latino community. Other session presentations will cover a range of topics from gerontological nursing to kangaroo pediatric care to a talk on community-based health literacy.

Projects involved in this year's Nursing Research Day will be of particular interest to researchers in nursing and related health fields, practicing nurses and educators. Special attention will be paid to sharing ways innovations presented at the event can optimize clinical practice, health policy and research.

Nursing Research Day is Friday, April 27, beginning at 8:00 am in McNamara Alumni Center. It is free to attend, but preregistration is required. Boxed lunches are also available for $11.

U of M Expert Perspective: FDA approval process puts patient safety first

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The U.S. Food and Drug Administration (FDA) has extended its review of the obesity drug Qnexa for three more months. The new target date provides the FDA additional time to review a new drug safety plan submitted by the company who manufactures Qnexa.

But according to the Associated Press, the drug may face an uphill battle for approval:

"The FDA has rejected three experimental drugs for obesity in the last three years, including Qnexa, raising questions about whether any new weight loss drugs can win approval. The agency has not approved a new prescription diet pill since 1999."

So what exactly does it take for a drug to receive the FDA's approval?

According to Stephen W. Schondelmeyer, professor of pharmaceutical care within the U of M's College of Pharmacy, the process can be complex.

"Once a drug is created by a company, there is still a long process before it is sent to the FDA," said Schondelmeyer. "It must go through three phases of rigorous trials and testing, often lasting five to ten years total."

After three phases of clinical trials are complete and confirm the drug's safety and success, the drug is submitted to the FDA Expert Advisory panel, which makes a recommendation to the FDA.

If recommended by the panel, the drug is then reviewed by internal divisions of the FDA, each reviewing for their area of expertise. Finally, the drug is brought to the FDA Commissioner's Office for the final approval.

"The FDA approval process is designed to ensure patients and consumers have access to the safest drugs available," said Schondelmeyer. "It's a process designed with safety in mind."

US researchers continue their attack on cystic fibrosis

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According to the Boston Globe, scientists at Massachusetts General Hospital and the Boston University School of Medicine may have cleared a major hurdle in the fight against cystic fibrosis: coaxing stem cells into different types of lung tissue.

The results of both teams were published in the latest edition of Cell Stem Cell.

The new developments arrive on the heels of approval for Kalydeco, a drug that targets the underlying cause of cystic fibrosis.

The University of Minnesota's Cystic Fibrosis Center is directly involved in trials for Kalydeco. While the drug is currently approved for patients over age six, the U of M is helping determine if more people could also be helped by this new treatment.

In addition, U of M researchers are currently conducting cystic fibrosis and lung disease research in both infants and children to help identify the disease at the earliest ages possible.

This research - alongside breakthroughs such as those out of Boston - may help prevent or ease the progression of the disease in the future.

U reproductive center launches fertility assessment program

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Image: AHC LogoThe University of Minnesota Physicians' Reproductive Medicine Center is heading a service that analyzes a woman's fertility. Theodore Nagel, Medical School and University of Minnesota Physicians, explains that the goal of the assessments is to increase women's education and awareness of their reproductive chances at an older age.

Watch on UM News and KARE 11

Read on MN Daily

New screening determines chances of pregnancy

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Image: KARE 11 LogoThere is now a way for women to check their biological clock. Theodore Nagel, Medical School and University of Minnesota, discusses who is a great fit for the biological clock test and some reasons why women are choosing to take the test.

Watch on KARE 11

Director of Masonic Cancer Center: New study is no cause to abandon mammography

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Researchers in Norway recently published new research demonstrating that women today undergo unneeded treatment as a result of additional mammograms and an increase in cancer diagnoses.

The new study estimates 15 to 25 percent of breast cancers found by mammograms wouldn't cause problems during a woman's lifetime, but the tumors were treated anyway.

But do the numbers tell the whole story? University of Minnesota Physician Doug Yee, M.D., director of the University of Minnesota's Masonic Cancer Center isn't so sure. In an interview with Fox 9, Yee said studies like this shouldn't be cause to abandon mammography.

"The bottom line is that mammograms were useful for most women who received the test," he said, "and it was very clear that they had fewer breast cancer deaths because women were participating in mammogram screening programs."

Watch the entire Fox 9 story.

NIH awards $20M to train next generation of global health researchers; U of M among award recipients

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To help foster the next generation of global health scientists, Fogarty International Center and its partners at the National Institutes of Health (NIH) are building a network of U.S. academic institutions to provide early-career physicians, veterinarians, dentists and scientists with a significant mentored research experience in a developing country.

To support the effort, the NIH will award $20.3 million over the next five years. The money will send 400 early-career health scientists on nearly year-long research fellowships in 27 low- and middle-income countries. The Fogarty Global Health Program for Fellows and Scholars will provide five consortia of academic institutions with about $4 million each, to support the training activities of a total of 20 partner institutions.

The University of Minnesota Medical School's Division of Global Pediatrics was one of one of only two universities in the Midwest to receive a Fogarty award. The award builds on the University's strong global health research programs in Uganda and Kenya.

"This award will allow the University of Minnesota to foster the next generation of global health researchers and confirms the U of M's role as a leader in global health research and education," said Dr. Chandy John, U of M's principal investigator on the award and Director of the Division of Global Pediatrics.

Learn more about the Medical School's Division of Global Pediatrics.

New skin cancer study highlights U of M tanning bed research

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Researchers at the Mayo Clinic have found melanoma rates among young women are eight-times higher than they were 40 years ago. Though the study didn't look at what caused the melanoma, researchers suggested indoor tanning as the main factor.

Citing a University of Minnesota study that found a strong correlation between tanning-device use and melanoma, the Mayo Clinic researchers said they are sure that ultra-violet radiation is linked to cancer in a big way, especially tanning bed exposure.

In 2010, researchers at the U of M's School of Public Health and Masonic Cancer Center found that people who use any type of tanning bed for any amount of time are 74 percent more likely to develop melanoma.

"We found that it didn't matter the type of tanning device used; there was no safe tanning device," said DeAnn Lazovich, Ph.D., at the time of her study's release. "We also found - and this is new data - that the risk of getting melanoma is associated more with how much a person tans and not the age at which a person starts using tanning devices. Risk rises with frequency of use, regardless of age, gender, or device,"

Click here to see an interview with Dr. Lazovich.

Now revised, controversial bird-flu research gets publication go-ahead from U.S. govt. panel

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The National Science Advisory Board for Biosecurity (NSABB) has reversed course and now supports publication of controversial research studies showing how scientists in the Netherlands and Wisconsin created new, easy-to-spread forms of bird flu in the lab.

The move comes as researchers partially revise their research to exclude details that could be used by bioterrorists to potentially create a pandemic. The NSABB had originally said publishing full details of the research would be too risky.

University of Minnesota professor Michael Osterholm, Ph.D., serves on the NSABB and had been directly involved with the original recommendation for redaction.

According to Osterholm, the H5N1 strains that were created in the lab could lead to research that improves pandemic preparedness, but he and others were concerned that releasing details of the research created a very real risk of a human pandemic -- by accident or intentional release of the virus.

"These papers really represent a seminal moment in life sciences," Osterholm said before a Feb. 2 New York Academy of Sciences debate about the issue. Osterholm is director of the Center for Infectious Disease Research and Policy and at the University of Minnesota School of Public Health. "We now have really been confronted with examples of where the science itself -- which is very important in moving forward for the public's health -- also poses potential risk for nefarious actions or even situations where this virus might escape from the laboratory."

Read the full story from the U of M's Center for Infectious Disease Research & Policy.