Thursday, May 31, 2012

New Drugs for Autism

New drugs, fresh hope for autism patients

By Julie Steenhuysen
Reuters


CHICAGO — Lynn and Neil Balter always dreaded stage productions at their son Jack's elementary school.
When Jack was up there with the other performers, the noise, the lights, the crowd almost always got to him, and he would "start spinning," wandering around the stage or turning in circles, Lynn says. "It usually turned into an embarrassing situation," she adds.
But at a dance performance at Jack's Scottsdale, Arizona, school last December, something was different. "He was half a beat behind in the dance, but he did the whole thing," Neil says. "He participated and took the bow with his class."
Afterward, Jack's teacher greeted the Balters in tears. "I don't know what is going on with this kid, but there is this miracle happening and I have a different kid at school," she told the Balters.
Jack, 9 years old, has autism. What his teacher didn't know is that Jack was taking part in a clinical trial for a drug aimed at overcoming some of the social impairment associated with autism, a spectrum of disorders that range from the social awkwardness and narrow interests seen in Asperger syndrome to severe communication and intellectual disabilities.
For years the best that doctors have been able to offer patients with autism is intensive therapy and anti-psychotic drugs such as Johnson & Johnson's Risperdal to blunt some of the extreme behaviors associated with their disorder - tantrums, aggression and self-harm. Anti-psychotics quiet the patients. But they do nothing to address the core social and communication problems that make it impossible for many autistic children to develop deep relationships with their families and peers and grow into independently functioning adults.
As Jack's experience suggests, that may be about to change. Researchers are conducting advanced trials of the first drugs expressly designed to correct the genetically induced signaling problems in the brain that result in autism. The early indications are positive enough to offer new hope for families and spark interest from drug companies.

For patients, this research "may not solve their autism, but it may solve aggression, it may solve sensory overload, which leads to a lot of behavioral issues," says Isaac Pessah, an autism researcher at the University of California at Davis, who has not been involved in any of the drug trials.
Swiss drugmakers Novartis International AG and Roche Holding AG, as well as privately held Seaside Therapeutics in Cambridge, Massachusetts, all have drugs in late-stage tests targeting Fragile X syndrome, the most common form of inherited intellectual disability and the most common known genetic cause of autism. And though Fragile X accounts for only a small percentage of autism patients, early studies suggest the drugs may work in other forms of autism, too.
If the current trials show enough benefit to satisfy U.S. regulators, the first drugs could be available in a few years. And if that happens, they will serve a growing population. The latest figures from the Centers for Disease Control and Prevention estimate that as many as 1 in 88 children in the United States has autism, a near-doubling of the rate reported in 2002.
Even so, the number of studies of the drugs remains small, and the trials themselves have been relatively small. Of those that have been completed, the effect has been dramatic in some patients but negligible in others.
"This is a new day, and that's exciting," says Dr. Thomas Insel, director of the National Institute of Mental Health in Bethesda, Maryland, one of the National Institutes of Health. "But we also have to temper that with the reality that there may be many failures along the way before we come up with a treatment that is both effective and safe."

Nine-year-old Jack Balter plays tug-of-war with his sister Brianna at their home in Scottsdale, Arizona, on May 17.
Mad scientist
As a toddler, Jack Balter was hyperactive. He would be mesmerized by the wheels on toy trucks or anything else that spins, stand on his tiptoes, cover his ears - all classic signs of autism. "We didn't even know what autism really was, so we didn't know it was something out of the ordinary," says Lynn, 52.

Jack was diagnosed with autism just before his third birthday. Since then he has had about 60 hours of intensive therapy a week, including speech and physical therapy and social interaction therapy. About 10 percent of autistic children who receive intensive therapy "bloom," enjoying rapid improvement as they grow older, according to a recent study published in the journal Pediatrics.

"We've been lucky. He's responded," says Lynn. Jack is now in a mainstream classroom with a full-time aide.
In a family video posted to YouTube, Jack lays out his ambitions: "On the outside, I'm just a regular old kid. On the inside, I'm a mad scientist." He says that when he grows up, he wants to be an oceanographer, a meteorologist, a climatologist, a volcanologist and a seismologist.
But even with therapy, Jack has struggled to interact with the world around him, talking in numbing detail about his favorite subjects, never playing sports or watching cartoons, standing too close to people. To other children, he seems odd.

"He's always been in his own tunnel," Lynn says.
Last November, Jack was enrolled in a trial of Seaside's compound STX209, or arbaclofen. Arbaclofen contains one of the active ingredients in an older drug, baclofen, that has been used since the 1960s to treat cerebral palsy.

Jack was part of a randomized study of 150 children with autism. Neither his parents nor his doctors knew whether he received the drug or a placebo.
Jack's parents are convinced he got the drug. Neil, 51, who founded custom storage maker California Closets at age 17 and now runs another custom closet and home organization business, graphed Jack's progress during the trial. "You can see when he got to the 10-milligram dose, 18 days in a row" he came home with a positive report from his teacher, Neil says.

Teachers didn't know about the trial, but they knew something was suddenly different. Carrie Cunningham, Jack's third-grade teacher, says Jack was more focused and could express himself better, and his emotions were mostly in check. "His aide and I both noticed a change almost immediately," she says.

They also noticed when the study ended. "It was a nightmare," Cunningham says. "All of a sudden, everything brought tears to his eyes. Everything was a battle."

Two weeks later, Jack started on a follow-up study in which his parents know he is getting the drug, and Jack has once again improved.
Neil says that on a scale of 1 to 10, with 1 being severe disability and 10 being normal, he used to think of Jack as a 5. Since Jack has been taking arbaclofen, Neil sees him at 7.5.

"It's not a cure," he says, "but it definitely moved the needle."
Seaside is running two late-stage trials in adults and children with Fragile X, and a study in children with different types of autism, including autism with no identifiable cause, like Jack's. Results of the study in which Jack participated are expected later this year.


- Posted from my iPad HD

Location:Georgetown, TX

Monday, May 28, 2012

Technology creates a Tsunami like change in Healthcare's leadership environment

For the last decade and a half I have been researching the future of healthcare and the effect of that future on the leadership environment and more importantly on the interconnectivity that these changes will bring to the patient.
As a speaker, I started each seminar with a question to help me gauge the familiarity of my audience with this subject. The question was, “During the development or revision of your strategic plan, how many of you took into consideration the Walgreens, Amazon.com, the pharmaceutical industry, or Dole Food Company's strategies?" What I was unprepared for was that as many times as I asked this same question, I never had an indication in the affirmative.
As good as that may have been for future speaking engagements, it concerned me that even though there were some seismic changes occurring in healthcare, they were apparently going on unnoticed. The truth is that we should be looking and preparing for the tsunami like change in the diagnostic, administrative, and therapeutic milieu.
This wave like transformation started quietly with the onset of NASA's need for biological testing, physiological monitoring, rapid computing as well as superior communications under less than optimal conditions. This was one of the first if not the seismic event that started the tsunami’s construct.
This is what I typed in 2002. Less than a decade later I am dictating this on an iPad tablet. The tsunami I noted has in many cases overcome healthcare organization and providers.
This primer was written in 2002 to offer providers options to get through these changes. Like the earth quake based tsunami there is another more subtle wave like changes on the horizon, specifically that of the Tech Savvy Patient.
The provider's primer will be published in June of this year and the second in this series, The Savvy Patient, will be published in the fall of 2012.
Webster Russell
- Posted from my iPad HD

Location:Georgetown TX,United States

Saturday, May 12, 2012

15 Current Technologies A Child Born Today Will Never Use

15 Current Technologies A Child Born Today Will Never Use
Avram Piltch, Laptopmag.com Date: 12 May 2012

From the moment that I found out my wife was pregnant with our first child, a son, I’ve thought of his development in terms of tech. When pregnancy sites described our six-week-old fetus as the size of a “lentil,” I referred to him as the length of an RFID chip. When the doctor said he had reached 1.3 pounds, I told all my friends that my son was the size of an iPad. When he was born this week, he was about the size of an HP Envy 15, though unfortunately his cries did not use Beats Audio.

As my newborn son grows to match the size of a mid-tower desktop, a large-screen TV and eventually a server rack, I can’t help but think about all the gadgets he won’t even remember using that were so important to his dad. I’m not talking about long dead-and-buried technologies such as the VHS recorder or the 35mm camera. Rather, I’m thinking about devices and concepts most of us use today that will fall out of mainstream use so soon that he either won’t remember them, or will only have very hazy memories of having lived with them.

Wired Home Internet

I was surprised when a 23-year-old co-worker told me she didn't remember a time before broadband Internet. At some point, her parents must have had dial-up, but she was so young that she doesn't even remember back that far. Wireless broadband won't dominate the home market until he's 8 to 10, but my son won't remember a world where consumers pay for wired Internet connections.

Even today, 4G LTE provides comparable download speeds and better upload speeds than cable Internet, but the cost of using mobile broadband all the time is prohibitive. At some point in the next few years, broadband providers are going to realize that giving everyone home antennas is more scalable than wiring and maintaining each street's network of fiber-optic cables. At that point, the paradigm will shift and it will be cheaper to purchase wireless than wired Internet. Clear already offers a 4G WiMax home Internet hub with unlimited service, though it's not fast enough to compete with cable Internet.

Dedicated Cameras and Camcorders

Smartphone cameras are already killing the consumer point-and-shoot and the family camcorder. Unlike cameras, which most of us carry only when we think we might need to take pictures, smartphones are always with us. They offer all kinds of apps and filters for adjusting pictures on the fly and they allow us to share our photos and videos online as soon as we take them. DSLRs and micro four-thirds cameras will remain with us, but within a few years, the average consumer won't own a dedicated camera at all.

Landline Phones

As of 2010, the Centers for Disease Control and Prevention reports that 26 percent of U.S. homes had wireless phones only. By the time my son turns 5 in 2017, only a handful of old people and Luddites will continue to own house phones while everyone will likely use cellphones exclusively. By the time my son is 10, most businesses will have done away with their desk phones and saved a lot of money and hassle in the process.

Slow-Booting Computers

Waiting for one's computer to boot is one of the great tech frustrations of the PC era, but my son will never know that pain. With the move toward always-on computing, future users will almost never turn their computers off, instead waking them from sleep in a second or less. New operating systems will be able to install updates and patches without requiring a reboot. However, if for some reason, you do need to restart the computer, boots will take only a couple of seconds because of SSDs and fast-starting operating systems like Windows 8. "When I was your age, we had to wait up to two minutes for a computer to power on, and we liked it," I'll tell him.

Windowed Operating Systems

When my son is ready for his own computer, the windows will be gone from Windows. Microsoft 's PC operating system will still exist, as will Mac OS X. But, in the next few years, we'll say good bye to the window metaphor where each application you run is displayed in a draggable box that has a title bar and widgets.

Microsoft has already signaled its intent to kill the window metaphor by making the tile-based Metro UI the default screen for Windows 8. How long before Mac OS and even Ubuntu also default to touch-friendly UIs that don't have tiny widgets?

Hard Drives

My first computer, a TI 99, used cassette tapes to store data. My second computer used 5.25-inch floppy disks, and the third system had a combination of a 3.5-inch floppy drive and a small IDE hard drive. The next PC had a zip drive and a tape backup unit. However, as different as these disks were, they all used the same magnetic platter technology that's been popular since reel-to-reel tapes ruled the earth.

Today, solid state drives finally allow us to end the ancient practice of storing our data on spinning magnetic platters. Because they have no moving parts, SSDs are infinitely faster than hard drives and more durable, too. Today, the cost of solid-state storage is significantly higher than magnetic media, but expect that delta to shrink significantly over the years while users come to expect SSD speeds from even low-end computers. By the time my son gets his first new laptop, you won't be able to buy one without an SSD. Hard drives and their cheap storage will only remain useful for servers, where space is more important than speed.

Movie Theaters

Pundits have been predicting the death of the movie theater since the first televisions hit the market, but this time, it's really going to happen for a number of reasons. First, with large HD televisions going mainstream and 3D sets becoming more affordable, the average home theater is almost as good as the average multiplex theater. Second, studios and their cable partners have begun releasing some movies for on-demand viewing on the same day they debut in theaters, a trend which is likely to continue.

Finally, the cost of going to a movie theater is so out of control — movie tickets in New York cost around $13 each — that nobody is going to keep paying it. In a world where an on-demand film that's still in theaters costs $7 to rent and one that just left the theater streams for $2.99 from Amazon, who will spend more than $50 for a family of four to go see the same movie surrounded by annoying patrons, dirty seats and overpriced popcorn? Art house theaters that offer specialized films and a sense of community may remain, but the average multiplex will be gone before my son notices it was ever there.

The Mouse

Within five years, the cost of adding capacitive touch capability to screens will be so small that every display, from large-screen TVs to laptops, will have it. More precise pointing devices such as the mouse and touchpad won't disappear overnight, but they'll likely fade away or become secondary input methods within the next several years. Already with Windows 8, the user interface will support touch even if you don't necessarily need to use it all the time.

3D Glasses

Ever since the first 3D films hit theaters in the 1950s, viewers have been forced to wear some kind of glasses in order to experience three-dimensional effects. However, in the past year or so, we've started seeing a number of glasses-free solutions hit the market.

In 2011, Toshiba released the Qosmio F755 notebook, which uses its webcam to track your eye movements and serve up really compelling 3D images, though these are only optimized for a single viewer. Last year, phone vendors HTC and LG both launched handsets with glasses-free, stereoscopic 3D screens that weren't home theater quality, but were good enough for some three-dimensional fun. By the time my son is 10, large-screened devices like TVs will be able to offer a compelling glasses-free 3D experience to many viewers at the same time.

Remote Controls

When I was a child, the family TV didn't even have a remote control. We had to actually get up and walk across the room to change the channel. By the time my son enters grade school, most of us will have moved on to either using our smartphones or a combination of gestures and voice commands to change channels.

Desktops

By the time my son is in elementary school, PC vendors will have stopped producing most desktop computers, though all-in-ones with large screens, high-end workstations for people who do industrial-strength computations, and servers (probably in blade form) will remain. As someone who loves to build desktops from parts, I hope the market for PC components remains intact so my son and I will still be able to custom build a computer together, but I fear that option may disappear too.

Phone Numbers

I still remember my parents' phone number, which hasn't changed in more than 30 years, but how many of us dial numbers rather than just tapping a name in our contacts menu? With the advent of VoIP chat services like Skype, Google Talk and even Facebook audio chat, you can just dial someone by username. When my son is in high school, he'll be asking the pretty girl on the bus for her user ID, not her phone number.

Prime-time Television

In ancient times, people had to gather around their TVs at a set time each week to watch "Starsky and Hutch." Then VCRs arrived and you could find out whether the Duke boys outsmarted Boss Hogg any time you wanted. DVRs now let us tape shows without using tapes, but because most TV networks make their shows available for free either via Web streaming or cable on-demand, we don't even have to record shows.

Fax Machines

In the age of email, instant messaging and 4G connections, there's only one lame excuse for the continued existence of the fax machine, a gadget that had its heyday in the 1970s, and that excuse has to do with signatures. Some companies and their lawyers will only accept a scribbled signature as valid on contracts and forms, so if you want to file that loan application or send in your insurance claim form with your signature on it, fax may still be your best option.

However, three things will finally slay the fax. First, more companies will start accepting online forms with electronic signatures as valid, so someone's illegible signature on a hard copy isn't needed. Second, for those who just can't let go of the signature requirement, touch devices will allow people to scribble their John Hancocks into digital forms. Finally, the death of landlines will also mean death for fax machines.

Optical Discs

I still remember the first DVD I bought, because it was a copy of "Hard Boiled" that I ordered from a now-defunct website called Urban Fetch. It may take until my son turns 10 for the major entertainment companies to stop publishing in DVD and Blu-ray format, but make no mistake, discs aren’t long for this world.

Optical discs will last another decade or so because consumers aren't eager to repurchase films they already own on disc and because there are still a number of old or rare titles you can't find on cloud services like iTunes or Amazon. Yet with the growth in downloadable and streaming video services, all physical media is on the fast track to extinction.


- Posted from my iPad HD

Location:Georgetown TX,United States

Wednesday, May 9, 2012

Nano Tech hits the Dentist's office


Medical Daily: Nanotech Dental Fillers Kill Bacteria and Regenerate Decayed Teeth
medicaldaily.com


Nanotech Dental Fillers Kill Bacteria and Regenerate Decayed Teeth

A team of bioengineers have created the first cavity-filling composite that destroys harmful bacteria and restores tooth enamel lost by decay.

A team of bioengineers have created the first cavity-filling composite that destroys harmful bacteria and restores tooth enamel lost by decay.

Instead of just limiting tooth decay with conventional fillings, the new material, made with nanotechnology, controls destructive bacteria that co-exist in the natural colony of microbes in the mouth and to rebuild the tooth’s minerals, according to lead researcher Professor Huakun Xu from Maryland University School of Dentistry.

“Tooth decay means that the mineral content in the tooth has been dissolved by the organic acids secreted by bacteria residing in biofilms or plaques on the tooth surface,” Xu said in a news release. “These organisms convert carbohydrates to acids that decrease the minerals in the tooth structure.”

After drilling out a decayed tooth, the cavity will still contain residual bacteria, which is impossible to remove, but the primer like the adhesive, which is made up of antibacterial elements that contain nano-size silver particles, can be used to prepare a drilled-out cavities to control the harmful bacteria and then the antibacterial adhesive will be spread into the cavity to stick tight into the tissue of the tooth.

“The reason we want to get the antibacterial agents also into primers and adhesives is that these are the first things that cover the internal surfaces of the tooth cavity and flow into tiny dental tubules inside the tooth,” Xu said.

The primary reason for post-filling tooth failure is secondary caries or decay at the restoration margins, but the new primer and adhesive that will kill the residual bacteria that remain after the dentist drilled away the decayed tooth. Additionally, the antibacterial agent, with a base of quaternary ammonium and silver nanoparticles, has a high pH that can limit acid production by tooth bacteria.

Xu said that the prepared tooth would be filled with a composite that contains calcium phosphate nanoparticles that can regenerate tooth minerals.

Scientists are say that fillings made from the new nano-composite, with antibacterial primer and antibacterial adhesive should last longer than the usual five to 10 years, but additional research needs to confirm its longevity.

“The bottom line is we are continuing to improve these materials and making them stronger in their antibacterial and remineralizing capacities as well as increasing their longevity,” Xu said.

Researchers have tested the new products by using biofilms from saliva from volunteers, and they are planning to test their products on animal and human teeth.


Copyright ⓒ 2012 MedicalDaily.com All rights reserved.
http://www.medicaldaily.com/news/20120504/9771/nanotechnology-teeth-filler-cavity-bacteria-tooth-enamel.htm

Location:Georgetown,United States

That little spider on the wall or silkworm could help rebuild your bones

Silk scaffolding could help rebuild your bones
io9.com

We’ve already learned recently that spider silk could help your computers stay cool — but now it looks like it could help you heal from broken bones as well.

Newly published research explores the idea of using silk proteins as a nanoscaffold, to help bones knit and repair. They created a biodegradable silk scaffold that was strong and flexible enough to hold bone pieces in place, while they reform and grow.

The team extracted silk protein microfibers by using alkaline hydrolysis to rapidly break down the raw stuff into microfibers ranging from 10 to 20 um in just minutes. These were used to reinforce a silk protein scaffold and create a a fully biodegradable composite with high-compressive strength and improved cell growth. This new biomaterial mimics the bone’s own stiffness and roughness well enough that cells differentiated better in its presence.

These silken scaffolds not only could help heal broken bones and aid regeneration, but the researchers also think it could be used to engineer new bones. Which means it’s only a matter of time before we all have Wolverine claws.


- Posted from my iPad HD

Location:Georgetown TX,United States

Electronic implant restore some vision


BBC
By Fergus Walsh Medical correspondent

Two British men who have been totally blind for many years have had part of their vision restored after surgery to fit pioneering eye implants.

They are able to perceive light and even some shapes from the devices which were fitted behind the retina.

The men are part of a clinical trial carried out at the Oxford Eye Hospital and King’s College Hospital in London.

Professor Robert MacLaren and Mr Tim Jackson are leading the trial.

The two patients, Chris James and Robin Millar, lost their vision due to a condition known as retinitis pigmentosa, where the photoreceptor cells at the back of the eye gradually cease to function.

The wafer-thin, 3mm square microelectronic chip has 1,500 light-sensitive pixels which take over the function of the photoreceptor rods and cones.

The surgery involves placing it behind the retina from where a fine cable runs to a control unit under the skin behind the ear.

‘Magic moment’
When light enters the eye and reaches the chip it stimulates the pixels which sends electronic signals to the optic nerve and from there to the brain.

The chip can have its sensitivity altered via an external power unit which connects to the chip via a magnetic disc on the scalp.

Chris James from Wroughton in Wiltshire said there was a “magic moment” when the implant was switched on for the first time and he saw flashing lights - showing that the device was functional.

“I am able to make out a curve or a straight line close-up but I find things at distance more difficult. It is still early days as I have to learn to interpret the signals being sent to my brain from the chip.”

Mr James, a motor-racing enthusiast, says his ambition is to be able to make out the silhouettes of different cars on the race-track.

Prof MacLaren, who fitted the first implant in the UK at the Oxford Eye Hospital, said:

“It’s the first time that British patients who were completely blind have been able to see something.

“In previous studies of restorative vision involving stem cells and other treatments, patients always had some residual sight.

“Here the patients had no light perception at all but the implant reactivated their retina after more than a decade.”

The chip results in the brain receiving flashes of light rather than conventional vision - and it is in black and white rather than colour.

But in an unexpected development, the other British man to have the implant says he is now able to dream in colour for the first time in 25 years. Robin Millar says he is also able to stand in a room and detect light coming through windows.

Prof MacLaren said the results might not seem extraordinary to the sighted, but for a totally blind person to be able to orientate themselves in a room, and perhaps know where the doors and windows are, would be “extremely useful” and of practical help.

In 2010 a Finnish man who received the experimental chip was able to identify letters, but his implant worked only in a laboratory setting, whereas the British men’s devices are portable. The implant was developed by a German company, Retina Implant AG.

Mr Tim Jackson, eye surgeon at King’s College Hospital who has also fitted one of the devices, said:

“This pioneering treatment is at an early stage of development, but it is an important and exciting step forward, and may ultimately lead to a much improved quality of life for people who have lost their sight from retinitis pigmentosa.

“Most of the people who receive this treatment have lost their vision for many years, if not decades. The impact of them seeing again, even if it is not normal vision, can be profound, and at times quite moving.”

Both surgeons stress that the chip is not a treatment but part of a clinical trial. Up to a dozen British patients will be fitted with the implants.

Although it could ultimately benefit patients with the most common form of progressive blindness, age-related macular degeneration, they are not eligible for the study at present.

Nor are patients with glaucoma or optic nerve disease.

Nick Astbury, Chair of VISION 2020 UK, a global initiative for the elimination of avoidable blindness said: “This trial will bring hope to two million blind and partially-sighted people living in the UK. It is the first step on a long journey to help people with sight loss to see again and live independently”.


- Posted from my iPad HD

Location:Georgetown TX,United States