Today’s focus: EDTA (ethyline diamine tetra acetate) for the treatment of cardiac, peripheral and cerebral atherosclerosis.

Reports:

• Basics of EDTA pharmacology
• History of EDTA as a treatment for atherosclerosis
• Trial to Assess Chelation Therapy (TACT)
• Controversies of EDTA chelation for treating atherosclerosis. E.g. U.S. vs. Evers.

Resources for learning more:

• www.drcranton.com/chelation.htm
• www.acam.org
• Saunders textbook: Cardiovascular Drug Therapy - with chapter and many references on EDTA chelation therapy.

Who are the ‘Quackbusters‘? We didn’t have time to cover this question during the show, but this group remains a mystery. It publishes opinions against so-called ‘integrative medicine’ (previously called ‘alternative medicine’), including attacks against the use of EDTA chelation for atherosclerosis. We on the STAT editorial team would appreciate learning who funds this organization. It is not clear from their website.
Next week’s show: We’ll address testosterone for stroke care and the controversial area of bio-identical hormone therapy (versus the use of synthetic/derivatized hormones).

Flow Productions will be producing additional lines of podcasts based on cutting medical news and information. Click for demos: Audio magazine format and video (’enhanced podcast’). If you are interested in sponsoring one of the shows please contact info@flowproductions.org.

Part 1 of 4. This 4-part series focuses on controversies in the area of strokes and TIAs. Future Rife with Strife series will focus on controversies in other areas of neurology.

Hear these reports:

The Role Of Controversies In The Advancement Of Medicine: medical controversies, with criticism and debates, are the way that optimal medical therapies crystallize.

TIA and Stroke Admissions: a study on primary care physicians last year in the journal Stroke showed that even when strokes and TIAs were well recognized as medical emergencies by the PCPs, essentially 30% of them would not admit the TIA patients as a medical emergency.

Immediate Treatment of TIAs: the PROFESS trial is underway comparing clopidogrel (Plavix) with ASA/dipyridamole (Aggrenox) for secondary stroke prevention. Until those results are available, which drug is best to use for the prevention of stroke in TIA patients? Or is Aspirin alone adequate ?

Carotid Stenting Versus Carotid Endarterectomy: Which do you recommend for your patients and why?

Intra-Arterial Thrombolytics for the Treatment of Acute Stroke: You may recall the “Lazarus phenomenon” from STAT episode #61. Dramatic improvement after intra-arterial thrombolytic occurred in twenty-five percent of the patients. Might this ‘emerging therapy’ someday take the place of IV infusions of thrombolytics?

Percutaneous Closure of Patent Foramen Ovales for Stroke Prevention: The relative risk of any thromboembolic event is 4-fold in patients with a PFO. A study in the New England Journal of Medicine 4 months ago support that PFOs and resulting paradoxical emboli are a cause of stroke in both older patients and younger patients. How about this proposition: the large-scale procedural intervention - percutaneous PFO closure - for the prevention of strokes (and migraines)? Now there’s a controversy that society is probably not quite ready to grapple with.

Next week’s show: Controversies about neuroprotection before or after acute ischemic stroke, and EDTA chelation therapy as a preventive and treatment for cerebrovascular and cardiovascular disease.

Flow Productions will be producing additional lines of podcasts based on cutting medical news and information. Click for demos: Audio magazine format and video (’enhanced podcast’). If you are interested in sponsoring one of the shows please contact info@flowproductions.org.

Special title for this installment: Information power forming the future of neurology and medicine.

Hear these reports:

Elsevier’s WiserWiki Allows Physicians To Update Evidence-Based Medical Information With Experience-Based Practice Insights: WiserWiki potentially creates a virtual, living, continually updated medical manual – possibly much more useful and ‘in the now’ – than a periodically updated, edition-based textbook (which only a handful of ‘experts’ edit)!

Illumin8 research tool to help researchers answer complex R&D questions faster and more accurately: The first web-based research tool that integrates ‘natural language search technology’ with the large amounts of content from Elsevier’s scientific articles and web sources.

Education in the third dimension: Enactive learning - ‘learning by doing’ - may be poised for a big comeback because now, thanks to the large, active European Union-funded research network called Enactive.

Med Schools Adjusting to Millennial Students: Medical educators are looking into a variety of different ideas on how to best teach this new tech-savvy, team-oriented generation. We predict that collaborative approaches - including wiki technology - and audio and video podcasting, and the use of iTunes U - will be important parts of their modern teaching approaches!

Thoughts on the ‘Global Brain’: Medical ideas here on Earth (thanks to information technology) are now well interconnected by a web of ‘synapses’ - the billions of nodes of the world wide web. It’s like a ‘global brain.’ Stored information on blogs and wikis - like WiserWiki – are analogous to stored memory in the brain’s synapses. And podcasting (‘audioblogging’) is like the ‘voice’ for the global brain!

Next week’s show will be the first of a new series of STAT special-topic installments: Rife with Strife – uncertainties and controversies in neurology and medicine. The focus will be on the cerebral vascular disorders and stroke.

Flow Productions will be producing additional lines of podcasts based on cutting medical news and information. Click for demos: Audio magazine format and video (’enhanced podcast’). If you are interested in sponsoring one of the shows please contact info@flowproductions.org.

This week’s show: The I.T. Sword has Two Edges: benefits and Risks of I.T. for neurology

Hear these reports:

Double-edged Sword of I.T.: It’s reaching into physician practices whether they’re ready for it or not. The government’s seeing to that. Is it a ‘brave new world’ for neurology and medicine? One possibly with significant risks and benefits: clinical practice guidelines and electronic medical records. Ninety (90)% of authors of clinical practice guidelines had financial relationships with the pharmaceutical industry (according to JAMA back in 2002). See the Association of American Physicians and Surgeons (AAPS) website.

Will you recommend that your patients put their health records in the hands of Google, Microsoft or Wal-Mart? You may soon be getting requests to do so. See this Newsweek story.

The National ePrescribing Patient Safety Initiative (NEPSI): This software is available to equip every physician in the US with electronic prescribing software. Created by a coalition of health insurers and software companies, it’s compatible with the software in 99% of the nation’s pharmacies. It’s easy to learn and free of charge. Could there be future privacy and control-related risks with this technology as well?

CaringBridge.org: Patients or their families easily create - for free - their own private website so that family and friends can provide the patients and caregivers with support through guest book messages and photos.

I.T. for Autism: This is a must-see video produced by Amanda Baggs who has autism. We became aware of the video thanks to Wired Magazine. Ms. Baggs might otherwise be considered mute and retarted, if not for technology. She shares amazing insights with us from her valuable and intelligent perspective using her computer and synthetic voice technology from Dynavox. Dr. Mike Merzenich, neuroscientist at UC San Francisco is quoted: the idea that 75 percent of autistic people are mentally retarded is “incredibly wrong and destructive.” Let’s see if many more autistics start ’speaking out’ through information technology.

Next week’s show: It’s the second part of this two-part series on Information Technology for Neurology: new learning enhancements available through I-T, the use of ‘Wikis’ for the establishment of independently developed clinical practice guidelines, and more.

On this show: You’ll hear insights from sleep apnea patient Mr. Sam Frank for whom proper diagnosis and treatment of his obstructive sleep apnea (OSA) - especially the use of continuous positive airway pressure (CPAP) during sleep - has dramatically changed his life for the better. There’s a good chance that Mr. Frank (prior to his treatment) typifies numerous OSA sufferers in your practice for whom sleep apnea remains undiagnosed and untreated.

Next week: The installment topic will be a surprise. We’re sure you’ll find that it’s interesting, timely and important neurology and medical news information. Hint: information technology (IT) for neurology reigns supreme.

Thanks for staying subscribed to STAT! — The Podcast of Neurology News and Medicine.

Flow Productions will be producing additional lines of podcasts based on cutting medical news and information. Click for demos: Audio magazine format and video (’enhanced podcast’). If you are interested in sponsoring one of the shows please contact info@flowproductions.org.

On this show: We conclude the 3 interviews with Sleep Medicine experts Dr. Michael Littner and Dr. Jay Puangco. How important is sleep medicine in the practice of neurology? Might we expect significant increases - or decreases - in the use of sleep labs, what with Medicare’s likely reimbursement for home sleep apnea studies? And finally: Dr. Littner and Dr. Puangco provide us with take-to-the-office clinical pearls we may be able to use to help our patients.

Next week: Part 4 of the 4-part series. Hear insights from sleep apnea patient Mr. Sam Frank for whom proper diagnosis and treatment of his OSA - especially the use of continuous positive airway pressure (CPAP) during his sleep - has dramatically changed life for the better. PS: There’s a good chance that Mr. Frank (prior to his diagnosis and treatment) exemplifies numerous people in your practice who’s OSA remains undiagnosed and untreated.

Thanks for staying subscribed to STAT! — The Podcast of Neurology News and Medicine.

Sponsor: Flow Productions. Flow will be producing additional lines of podcasts based on cutting medical news and information. If you are interested in sponsoring one of the shows please contact info@flowproductions.org. Click here to see and hear an example of our next-generation video podcasts.

On this show: We continue our interviews with Sleep Medicine experts Dr. Michael Littner and Dr. Jay Puangco. Cardiologists regularly use home testing for arrhythmia detection on a relatively large scale. Is it time for neurologists and other physicians to do likewise for testing sleep apnea? If Medicare completes the final approval of payment for home testing for sleep apnea, this may provide access (to this extremely important testing) to a huge number of patients. But do you think you can become a sleep apnea expert - employing home apnea testing for your patients - after just a weekend certification course? Think again!

Upcoming 2 shows: On Part 3 and 4 (next two weeks) we’ll complete our 3 interviews with Dr. Littner and Dr. Puangco, and hear insights from sleep apnea patient Mr. Sam Frank for whom proper diagnosis and treatment of his OSA - especially the use of continuous positive airway pressure (CPAP) during sleep - has dramatically changed his life for the better.

On this show: Interview with Sleep Medicine experts Dr. Michael Littner and Dr. Jay Puangco. We’ll have an overview of Sleep Medicine, and highlight the importance Sleep Medicine as a medical specialty. Also: what percent of the population is estimated to have sleep apnea? And what fraction of those may remain undiagnosed? Is ’snoring’ and ‘excessive daytime sleepiness” (EDS) on your history intake form? If not, maybe it should be! Would you be eligible for a sleep medicine fellowship? And finally: insights into formal training in Sleep Medicine, from neurologist Dr. Puangco who’s in the Sleep Medicine fellowship at UCLA.

Upcoming 3 shows: On Part 2 and 3 (next two weeks) we continue our interviews with Dr. Littner and Dr. Puangco discussing the new and revolutionary home testing technologies for sleep apnea. And we’ll address what’s probably the current hottest topic in Sleep Medicine. Hint: the topic is ‘hot’ because of potential for significant reimbursement for efficient diagnostics coming soon.

On Part 4 we’ll hear insights from sleep apnea patient Mr. Sam Frank for whom proper diagnosis and treatment of OSA has changed his life for the better.

Today’s show: Second part of the interview with Dr. Daniel Amen, MD and Dr. Douglass. They discuss the accuracy of SPECT images for ‘imaging human behavior,’ and the accuracy of SPECT scans for diagnosing preclinical and clinical Alzheimer’s disease. They’ll also touch upon the potential quagmire of neuroethical issues related to the health insurance industry, particularly when insurance companies may discriminate against patients who test positive for Alzheimer’s based on SPECT neuroimaging, or based on positive tests for the APO E-4 allele (the Alzheimer’s ‘risk gene’).

For more information about SPECT scanning and the Amen Clinics: www.AmenClinics.com.

Next week’s show: It will be the first of a four-part Reap the Sleep series on Sleep Medicine - with focus on sleep apnea. We’ll interview sleep medicine experts Drs. Michael Littner and Jay Puangco.

Today’s show: Interview with Dr. Daniel Amen, MD. SPECT scanning has dramatically changed the way Dr. Amen looks at and sees (and treats) his patients.

Psychiatrists remain the only doctors who never look at the ‘organ’ they treat (the human brain). We make psychiatric diagnoses today essentially like our predecessors did back in 1840. Might SPECT scanning change that?

‘Imaging human behavior’ with SPECT is considered a new frontier for the entire field of neuropsychiatry since we can now literally see functional imbalances in the brain, and then do what we can to try to correct those imbalances.

According to Dr. Amen, SPECT neuroimaging opens the minds of doctors who employ it, and it opens many doors for possible therapeutic options for neurobehavioral disorders (not just medications). SPECT can apparently document brain changes (improvements) from treatments like acupuncture/acupressure, hyperbaric oxygen, dietary supplements and even transcranial magnetic stimulation.

For more information about SPECT scanning and the Amen Clinics: www.AmenClinics.com.

Next week’s show: Part 2 of the interview with Dr. Daniel Amen (and Dr. William Campbell Douglass). The doctors will discuss the accuracy of SPECT images of the brain, and their accuracy for diagnosing pre-clinical Alzheimer’s disease. They’ll also discuss the potential quagmire of issues related to likely discrimination by health insurance companies after people test positive for Alzheimer’s based on SPECT neuroimaging (or based on positive tests for APO E4, the Alzheimer’s risk gene).

Hear these reports:

A New Method Has Been Developed to Efficiently Identify the Apo E4 Genetic Determinants of Alzheimer’s Disease: You may soon have a way to rapidly, accurately and inexpensively determine if your patients have the APO E4 genotype.

Politics of Genetic Testing and Genetic Discrimination: If the new method (above) becomes highly available and affordable, what might be some of the consequences of using the assay on a wide-scale basis? Might a ‘perfect storm’ for a huge wave of medical-political problems be brewing?

Affiris Has Been Granted European Patent for Alzheimer’s Vaccine: Learn why this vaccine has significant potential for safety and efficacy in humans. Hint: less autoimmune attack on the brain.

How A Stressful Life Can Contribute to Development of Alzheimer’s Disease: Acute stress increases corticotropin-releasing factor (CRF) from the brain, which results in increases in amyloid plaque.

Alzheimer’s Disease and Memantine: On STAT episode #80 we mentioned that this newer Alzheimer’s drug acts primarily on glutamatergic neurotransmission. We may have been wrong. According to this story Memantine actually works similarly to the drugs that boost acetylcholine-related signaling. So even though Memantine is known to block glutamatergic NMDA receptors, Memantine actually has stronger effects on acetylcholine receptors and weak effects as a glutamate antagonist. And unless Memantine is used in narrow concentration ranges, it has adverse effects on the brain’s neuronal communications. Bottom line: It may be unlikely that glutamate receptor blocker drugs will ever be used successfully on a wide scale in neurology, since perhaps major side-effects should be expected.

Hebrew University Ph.D. Student Named Winner of Kaye Award for ‘Natural Protection’ to Reduce Spread of Alzheimer’s Disease: Who’s this winner? Erez Podoly. And what’s the remarkable source of the ‘natural protection’? Hint: the substance is a protein normal to the body, and the mammalian genus Capra (as in ‘Capricorn’) has come to the rescue to produce it for us.

Rapid-Fire Review Quiz: As icing on the cake we’ll stimulate your synapses with a quiz, covering some of the key points we’ve made during the last 4 weeks.

Next week’s show: Our 2nd installment of Imagery for Neurology - Imaging and images for neurology professionals. It’s the 1st part of a 2-part series during which we interview SPECT neuroimaging expert Dr. Daniel Amen. We think you’re in for a treat. Before the interviews we encourage you to go back and listen to STAT episode #45 when we covered Dr. Amen’s work, and also visit www.AmenClinics.com to see his remarkable SPECT ‘Images of Human Behavior.’ You may also want to listen to episode #54 on the neuroethics of neuroimaging before next week’s show!

Hear these reports:

Lipids in the brain: an important factor for Alzheimer’s disease? Researchers at VIB Switch Laboratory in Switzerland recently discovered that a certain brain fat promotes formation of Alzheimer’s peptide, the neurotoxic protofibril. Key concept: concentrations of various lipids in the brain strongly affect biological equilibriums between senile plaques of Alzheimer’s disease and toxic protofibrils.

Omega-3 supplements in mild to moderate Alzheimer’s disease: effects on neuropsychiatric symptoms. The omega-3 fats used in this study helped combat depression and agitation in Alzheimer’s patients who received the supplements.

A diet enriched with the omega-3 fatty acid docosahexaenoic acid reduces amyloid burden in an aged Alzheimer mouse model: Mouse study. From Journal of Neuroscience (2005). Researchers employed the omega-3 fatty acid DHA (docosahexaenoic acid) and demonstrated that DHA-enriched diets reduce total amyloid-beta by more than 70%. Overall plaque burden was reduced by 40%, compared to mice on a low-DHA or control diet.

NIH study on DHA in Slowing Progression of Alzheimer’s Disease: Four hundred (400) Alzheimer’s patients are being studied, based on evidence that omega-3 fatty acids appear to have anti-amyloid, anti-oxidant and neuroprotective properties. This study has huge implications and may provide hope for delaying onset of Alzheimer’s, and for fending off the impending Alzheimer’s crisis, saving billions of health care dollars.

Plight of natural product therapies in US medicine: we discuss some of the underlying politics and possibilities.

Alzheimer and trans fatty acids from hydrogenation of vegetable oils: There’s a possible link. We discuss some of the evidence and current efforts by many of the States to ban trans fats, and require warnings about their damaging health effects. University of Maryland researcher Dr. Mary Enig has done extensive research in this area.

Next week’s show: It will be our 11th installment of Defeating Dementia. During the 3rd of this 3-part mini series we’ll discuss Alzheimer’s-related genetics news and some research discoveries related to diagnosis and treatment of Alzheimer’s. We’ll also have more news and information on prevention of Alzheimer’s.

Promising news and approaches for progressive brain disorders - Part 1 of a 4-part mini series.

Hear these reports:

• Multifaceted Aspects of Alzheimer’s Disease: From Social to Molecular Problems. We touch upon the many insights presented in this report from a special issue of the Journal of Alzheimer’s Disease.
• ‘Young-Onset’ Alzheimer’s Is Increasing: Increased awareness of young-onset Alzheimer’s - in 55 to 65-year old patients with memory problems - is important because these people are experiencing delays in correct diagnosis of their dementia, and therefore treatment and support for these relatively young patients is delayed.
• Brain-Injured War Veterans Show A Faster Decline In Cognitive Functioning As They Age. What was especially interesting about the findings from this research was that the rate of cognitive decline could be predicted – at least in part - by how intelligent the veterans were, and their level of education, before they sustained their brain injuries. The research results may stress the importance of the concept of ‘brain reserve’ and maximizing that reserve with intellectual stimulation, for prevention of dementia.
• Borrelia Bug Revisited: We review the evidence and resources to further understand the paradigm of Borrelia Burdorferi as a cause of Alzheimer’s disease. STAT listeners will recall Dr. Alan MacDonald’s comment that “Round things happen in neurodegeneration.” For an overly packed, but useful view into this paradigm go to www.MolecularAlzheimer.org.

Next week’s show: It will be our 10th installment of Defeating Dementia - Promising news and approaches for progressive brain disorders. During the second of the 2-part mini series we’ll discuss the importance of good and bad lipids in the brain (as factors in Alzheimer’s), and we’ll report on research linking genetic mutations to frontotemporal dementia. We’ll also discuss and review important comorbidities with Alzheimer’s – like diabetes and sleep apnea. And we’ll cover more research news related to Alzheimer’s diagnosis, treatment and prevention.

Hear these reports:

• Fibrates and Statins Cut Peripheral Neuropathy Risk: in a subgroup of 530 people, fibrates reduced the risk of neuropathy by essentially 50%, and statins reduced the risk by 35%.
• Monofilaments for Peripheral Neuropathy Testing Often Inaccurate: current monofilaments are rarely accurate – with up to 100% false positives (for some monofilaments). A new, more reliable monofilament device was described and endorsed in the story.
• Fibromyalgia Pain May Be Caused by Neuron Mismatch: unexplained pain experienced by patients with fibromyalgia is the result of a mismatch between sensory and motor systems.
• Opiod System Controls Pain, Reward and Addictive Behaviors: The report supports the idea that any further research on - and development of - morphine-related drugs may necessarily result in more addictive analgesics; also that blocking the mu-receptor may hold promise for the treatment of drug abuse and addiction. Another key point was made regarding the delta opiate receptor: that delta-agonists may be useful to alleviate affective disorders, to improve emotional states.
• Morphine: should it be a comfort measure for the dying or pain control for the living? Between 40-70% of cancer patients may not have sufficient pain control, and misconceptions about morphine may be a contributing factor.
• Postpartum Headache Requires Stepwise Approach: We present the breakdown of the diagnoses in 95 cases of post-partum headaches. The original story provides a detailed algorithm for the workup.

Next week’s show: It will be our 9th installment of Defeating Dementia - Promising news and approaches for progressive brain disorders. During the first of another 2-part mini series we’ll cover important dementia-related news on Alzheimer’s disease markers, genetic discoveries around dementia, how stress may contribute to developing Alzheimer’s and a lot more.

Hear these reports:

• Migraine patients are at high risk for Serotonin Syndrome: consider the syndrome in any migraine patient with flu-like signs and symptoms, who is also taking combination of triptan plus an SSRI (or plus another serotonin agonist drug). Also: Seratonin Syndrome, and Libby Zion are what let to the changes in US residency training (from the Libby Law).

• One-third of migraineurs can expect complete pain relief. This is promising news. Also in this study, over a12-year follow-up period only 1.6% of migraineurs developed chronic migraines.

• Role of the Stem Cell Factor (SCF) gene (for the factor and it’s receptor) in our sensitivity to pain: the discovery may lead to new approaches for treating pain, the drug Gleevac for example, which blocks the SCF receptor.

• Evidence is lacking that shoe insoles prevent general back pain: better methodologies and studies needed to study whether insoles useful in treating existing backpain or in secondary prevention.

Next week’s show: Our 8th installment of Reign Over Pain - Commanding news you can use to benefit your hurting patients. This will be Part 2 of the 2-part mini series on pain medicine. A few of the news topics we’ll cover: Fibrates and statins appear to cut the risk of neuropathy; fibromyalgia may be caused by a sensory-motor neuron mismatch; insights into the opiod pain control system; morphine as a comfort measure for the dying - or should it be for pain control for the living? And finally, the stepwise approach to managing postpartum headache.

After we give you a quick recap on Part 1 from last week…

Hear these reports:

1. Neurons Can be Generated From Glial Cells. Glia cells are stem cells in the brain, and using specific transcription factors they can be induced to differentiate into functional nerve cells. With this remarkable discovery, we have yet another means of potentially replacing – regenerating - damaged brain cells after injury or disease, by transforming the endogenous glia cells into neurons.
2. Getting closer to being able to transplant stem cells into the human brain. Stem cells implanted into the hippocampi of mice increased new nerve cells by 65% and new astrocytes rose by essentially 125%.
3. Implanted cardiac stem cells prevented life-threatening arrhythmias. Essentially 100% of the control mice developed V-tach (the mice that had myocardial infarctions, but were not given the stem cells). But the mice that were given the stem cells (after having an MI) had the same risk of developing V-tach as healthy mice which did not have MIs. Explained by stem cell gene’s ability to synthesize cellular protein Connexin 43.
4. Human embryonic heart stem cells condition – bring health to - mice hearts after MIs. The stem cells - epicardium derived stem cells - had what was described as “an almost instant stimulating effect on the surrounding heart tissue.”
5. Elsevier Launches New Journal: “Stem Cell Research.” The new journal will focus on “high-quality research in all aspects of stem cell science. Report describes stem cell therapy (regenerative medicine) as “a field growing faster than any other in the life sciences.”
6. Stem cell therapy rescues motor neurons in ALS model. The researchers saw almost 100 percent protection of the motor neurons. However, the motor neurons apparently could not maintain their synaptic connections with the muscles they control. More research needed to explain why.
7. Nanomedicine Opens The Way For Nerve Cell Regeneration. Researchers at the university of Miami demonstrated that magnetic nanoparticles result in ‘mechanical tension’ that stimulates the growth of axons. And researchers at University of California, Berkeley use nanofibers containing growth factors to provide what is described as a ‘bioactive matrix’ on which neurons can regrow.

Next week’s show: Our 7th installment of Reign Over Pain - Commanding news you can use to benefit your hurting patients. Here are a few topics on which we’ll be presenting news: Migraine and Serotonin Syndrome, Postpartum Headache, fibromyalgia and peripheral neuropathy.

Hear these reports:

1. Simple Cocktail Turns Human Skin Cells (Fibroblasts) into Embryonic Stem Cell-Like Cells: the ‘right to life’ issues may now be out of the equation.
2. Rapid decision (as result of #1): California Stem Cell Agency heavily funds research on the non-embryonic stem cells: the ‘skin-cell-to-stem-cell discovery’ is already influencing the plans at the California Institute of Regenerative Medicine - just one week after the Japanese scientists announced their dramatic breakthroughs in Cell.
3. Remote-Presence Robots Help Extend Reach of Neurologists: Thirty (30) robots deployed throughout some Michigan hospitals maximize the coverage by stroke neurologists and endovascular specialists. Their remote robotic presence cuts the time needed to respond to stroke patients from 2 hours (or more), down to just 10 minutes or less.
4. Software Helps Build Perfect Robotic Hand: Scientists in Shanghai and Portsmouth are working on intelligent software that will take us one step closer to building the perfect robotic hand. Along with stem cell therapies, this technology also has the potential to revolutionize medicine. Development of robotic hands, which can perform tasks with the dexterity of a human hand, is described as “one of the holy grails of science.”

Other Web Links:

• Wisconsin Alumni Research Foundation’s patent claim on all human embryonic stem cells.
• Patent on process using stem cells to generate nerve cells.
• CellCyte Genetics Corporation’s approval of its patent for methods to direct and deliver stem cells to target organs in the body.

Citation: Yamanaka, et al.: “Induction of Pluripotent Stem Cells from Adult Human Fibroblasts by Defined Factors.” Publishing in Cell 131, 5, November 30, 2007. www.cell.com

Next week’s show: Part 2 of Quest for the Best in Neurology (installment #6). We’ll report on how nanomedicine is opening new paths in our quest for nerve cell regeneration; also milestones in the regeneration of brain cells; and how stem cell therapy rescues motor neurons in an ALS model. We’ll also touch upon research related to the heart stem cell therapy we mentioned in todays show (Part 1): how stem cells train the heart following a heart attack. And we’ll cover a number of other stem-cell-related headlines too.

Hear these reports:

• Nursing Mothers’ Codeine Use May Be Risky for Infants: The CYP2D6 enzyme is involved in breaking down about 75 percent of all psychotropic medications, codeine being one of them. This is part of the early concept and specialty of ‘psychiatric pharmaco-genomics.’
• Noise Helps Memory Performance in ADHD Children: White noise appears to selectively improve the performance of kids with attention deficit-hyperactivity disorder (ADHD). Possible reason: stochastic resonance can be beneficial to dopamine deprived neural systems, with ADHD being one example. External auditory noise can restore low dopamine levels - and thus improve cognitive performance in these scholastically ‘low achiever’ children,
• In Utero Exposure to Smoking by Mother Can Increase Risk of ADHD: Maybe it’s time that this information be used to alert practitioners and families that at least some cases of ADHD may be preventable in utero!
• Computerized Training of Working Memory as a Therapeutic Strategy in ADHD: Working memory can be improved by computer-based training exercises in children with ADHD, and such training may be of clinical use for ameliorating the symptoms in ADHD.
• CDC Urges Meningitis Vaccine For All Adolescents: Tetravalent meningococcal conjugate vaccine is recommended for all 11- to 18-year-olds. This is the result of a vote by the CDC back in June (2007). Actual long-term risk-benefit ratio: unknown.
• Simple Approach to Reduce Part of World’s Pediatric Mortality Rates By Essentially 45%: Insecticide-Treated Bed Nets (‘mosquito nets’). You can donate any amount of money you wish - to provide nets for children in Africa – at www.nothingbutnets.net. According to the site: no portion of your donation will be diverted for ‘administrative’ costs.

OTHER REPORTS:

• Early Results Of Aricept Study Hint At Autism Improvement
• New Autism Research Funded
• Is Autism Prevalence Truly On The Rise?
• Majority Of Traumatic Brain Injuries Are Pediatric

Next week’s show: Installment #5 of Quest For The Best In Neurology: robots are extending the reach of Neurologists; nanomedicine has opened the way for nerve cell regeneration; and much more.

On this episode hear these reports:

• Neuroimaging Advances in Cerebral Palsy: Thanks to recent advances in neuroimaging CP is no longer considered a static disease for which little can be done. Neuroimaging is taking the clinical management, diagnosis and classification of CP to ‘quantum levels’ higher than we’ve ever seen in the past.
• Pedophiles Have Deficits in Brain Activation: With functional MRI scanning we now have images which demonstrate pedophiles’ altered sexual interest. So now, for the first time in the history of Medicine we can study this ‘psychiatric’ condition as a neurobiological disease. These new discoveries may ultimately contribute to the development of new and effective means of therapies for the disorder. However, societal/ethical questions and implications abound around such things as using the neuroimaging technology for criminal investigations and forensics.

Next week’s show: Installment #6 of Podcast for Peds (Part 2). Here are some of the questions we’ll be answering (based on the news):

• Which pain medication generally accepted as safe in pregnancy and while nursing may - in significant numbers of cases - be resulting in the fetus and the nursing infant getting a whopping dose of morphine?
• What available test may enable you to make more informed drug-prescribing decisions, before prescribing that ‘mystery’ pain medication (and before prescribing numerous other psychotropic drugs as well)?
• And what about the CDC’s recent vote and urgent call for the mass immunization of all US adolescents with Menactra (one of the meningococcal meningitis vaccines)? Is the urgent call based on actual evidence that a risk/benefit ratio supports their decision?

We’ll also present fascinating news on ADHD: The noise, which helps performance in ADHD children; a simple preventive measure mothers can take, which may lower their risk of bearing a child with ADHD; and news on how computers are helping ADHD sufferers.

Hear these reports:

• Federal lawmakers recently formed first-ever Congressional Multiple Sclerosis caucus.
• Scientists find that the newly discovered cellular markers for multiple sclerosis – the CD39 regulatory T cells – are deficient in MS patients.
• Gene mutations/variations for the interleukin 2 and 7 receptors raise MS risk by 30%: This represents the first genetic risk factor to be discovered in almost 30 years. Key questions are: Might the ‘downstream’ effects of such gene mutations (on the IL receptors) be linked to the newly discovered decrease in CD39 regulatory T cells? What’s causing the gene mutations? Could the mutations be arising from viral or bacterial infections, and/or other environmental toxins?
• Brain lesions on MRI scans may predict MS in optic neuritis: this data may help us stratify optic neuritis patients’ risk of developing MS.

Weblinks:

• IL-2 Receptor Gene Mutation Impairs Regulatory T Cell Function and Causes Autoimmunity
• MS Link to Epstein-Barr Virus, Spirochetal Infections and Chlaymdia pneumonia infections.
• Seventy-five percent (75%) of female patients - initially presenting with optic neuritis – will eventually develop MS.
• Optic neuritis can occur during systemic viral infections, and can be caused by infections in the paranasal sinuses, and in the orbits.

Next week’s show: Seventh installment of Infection-Inflammation: Calor, Dolor, Rubor, Tumor for the 21st century Neurologist. Well report important news on influenza, and we’ll discuss news about how modeling sepsis (and other infections) is helping in our understanding of infectious disease. We’ll also present compelling information on fighting the ‘super bugs’ in hospitals, and much more.

• Glial cells are ‘teammates’ to the neurons and can apparently be ‘exercised’ to grow stronger.
• Einstein’s brain has over 70% more glial cells per neuron (in the association area) than the average brain.
• Gliomas from mobile phones: the jury’s still out, but evidence supporting a link is mounting, and be cognizant of the possibility of circumlocutions about the issue.
• Silver nanocomposite-labeled cancer cells can be targeted and destroyed using laser light.
• Platinum plus alkaloid from the Chinese ‘Happy Tree’ aids pediatric glioma: the cisplatin-irinotecan combination.
• Preoperative glioma grading system helps assess prognosis.
• Dendritic cell vaccine shows promise in glioblastoma multiforme.
• Molecule from Northern Leopard frog described as ‘Mother Nature’s magic bullet for recognizing and destroying cancer cells.’

Hear this report: Placebo Response Receiving New Attention and the Respect it Deserves.

Weblinks:

• Original story at Clinical Neurology News
• Stimulate the nucleus accumbens in the midbrain and stimulate the immune system.

Citation (other): Harnessing the Power of the Placebo Effect and Renaming It “Remembered Wellness.” Herbert Benson, M.D, Richard Friedman, Ph.D Annual Review of Medicine, February 1996, Vol. 47, Pages 193-199

Next week’s show: It’s our second installment of Neoplasia News– Oncology For Neurology. We’ll report on a number of important ‘neoplasia news’ items related to gliomas, and we’ll even ‘hop on’ some recent research findings from a frog molecule which may be a treatment for brain tumors.

Focus: restless leg syndrome (RLS)

Hear these RLS-related reports:

• Frequency and Pain of Restless Legs Should Guide Therapy

• Dopamine Agonists Aid Sleep in Restless Legs

Other reports:

• Vigilance is Impaired in Drivers with Obstructive Sleep Apnea

• Screen Arnold-Chiari Patients for Sleep-Related Breathing Problems

• Ramelteon Effective for Subset of Insomnia Patients

Weblinks: Sleep Research Model Based on Sleeping Drosophila Flies

Restless Leg Syndrome links:

• RLS is a Genetic Disorder According to New Research

• News May Have Exaggerated Prevalence Of RLS

• Prevalence of Clinically Significant RLS 3% in U.S. Population, according to Archives of Internal Medicine

• RLS Linked To Low Serum Iron and Poor Iron Uptake In Brain

Sleep Deprivation Links:

• Co-Morbidities:

• Doubles Risk Of Death From All Causes

• Linked To Hypertension, Especially In Women

• Linked To CVD, Stroke, Diabetes, Cancer

• Physiological Stress from Sleep Deprivation:
  • Activates The HPA Axis
  • May Increase Adrenergic Receptor Function
  • Linked To Increased C-reactive Protein (CRP)

Next week’s show: Theatre Of The Mind – Psychoneuroimmunology: Dynamics Between Psyche, Nerves, The Endocrine System And The Immune System (our second installment). Focus will be the science behind, and importance of…the placebo response. And we’ll touch upon questions like, ‘Homeopathy: The system of therapy based on highly dilute substances. Are they active substances or just placebos?’ And: ‘Are there substantive benefits from Aromatherapy?’

Hear these reports and discussions:

• Gene Variants May Confer Sporadic ALS Susceptibility
• Sago Palm As A Cause Of ALS (likely involves glutamate neurotoxicity). Might other toxins be involved in causing ALS too (depending on genetic susceptibility)?
• Military Veterans Have Almost 60% Greater Chance Of Getting ALS Than The General Population.
• Hereditary ALS Linked To Low Electrical Charges In The Cells - resulting in clumping of SOD enzyme.
  
• Genetic Cause Discovered For Systemic Lupus Erythematosus.
• Schizophrenia Risk Genes Affect Even Healthy Individuals
• Einstein Researchers Used Novel Approach to Uncover Genetic Components of Aging
• A New Brake On Cellular Energy Production Has Been Discovered
• PINK1 Gene Protects from Parkinson Disease
• Parkinson’s Protein’ – ‘Parkin’ - Protects Neurons From Oxidative Stress-Induced Cell Death By Activating Specific Survival Mechanisms
• Nobel Prize In Physiology And Medicine For 2007 Awarded To Doctors Mario Capecchi, Martin Evans And Oliver Smithies For Their Work On Gene Modification (In Mice).

Next week’s show: Reap The Sleep - Insights into sleep, and sleep disorders.

Hear these reports:

• Gene Therapy Showed Promise for Parkinson Disease
• NIH Examines Creatine for Parkinson’s Therapy
• Tips for Calming Motor Fluctuations
• Parkinson’s Drug Permax Withdrawn from Market
• Parkinson’s Rotigotine Patch Treatment Approved
• Safinamide Enhances Control of Parkinson’s: Combining the drug with dopamine enhanced the latter’s efficacy, which can lessen over time
• Simvastatin Found to Reduce Parkinson’s, Alzheimer’s Risk
  

We also reviewed these reports from previous STAT! episodes:

• sNNOO31 neural stem cell differentiator protein for Parkinson’s (from episode #7)
• Stereotactic implantation of human cadaveric dopamine-producing retinal pigment epithelial cells into the striatum of Parkinson’s patients shows promise. Randomized, double-blind, placebo-controlled study underway (from episode #7)
• Parkinson’s may improve when H. pylori infections eradicated (from episode #73)

Weblinks to:

• Genomic Pathway Approach to a Complex Disease
• Coenzyme Q10 supplementation may slow disease progression in early-stage Parkinson’s disease.

Citations (other): Depletion of CoQ10 by Statin Drugs:

• Langsjoen PH, Langsjoen AM. The clinical use of HMG CoA-reductase inhibitors and the associated depletion of coenzyme Q10. A review of animal and human publications. Biofactors 2003;18:101-11.
• Jula A, Marniemi J, Huupponen R, Virtanen A, Rastas M, Ronnemaa T. Effects of diet and simvastatin on serum lipids, insulin, and antioxidants in hypercholesterolemic men: a randomized controlled trial. JAMA 2002;287:598-605.

Next week’s show: Our 4th installment of Nerve University – Education, Research And Scholarship In Neurology. We’ll continue our discussion on genetics and gene therapies - their potential for diagnosing and treating a number of neurological disorders.

Hear these reports:

• Rapid Test For Viral Meningitis Is First To Win Agency Approval: Xpert EV test detects viral meningitis in CSF in < 3 hours (instead of the usual 3-7 day wait).
• Serogroup 22 Emerging as Common Meningitis Cause (in > 60% cases): Is it time that the pneumococcal conjugate vaccine include this serotype?
• Infections Land Parkinson’s In Ed: Worsening motor changes in your patient? Consider infections.
• Premorbid Brain Changes Found in Familial Creutzfeldt-Jakob Disease: Magnetic resonance diffusion weighted imaging can measure brain changes from CJD a decade or more before the onset of symptoms.

Weblinks:

• Prions + Retroviruses as Cause of Songiform Encephalopathies
• Blood pheresis procedure for cancer: remove TNF blocker cytokines and let the ‘inflammation against cancer’ begin.
• Inflammation, auto-immunity and types I and II diabetes.
• International researchers discuss evidence associating chronic inflammation with long list of diseases.
• Staph. Aureus and Borellia burgdorferi go intracellular, and possibly a number of other bacteria too.

Next week’s show: Our second installment of Movement Disorder Quarter – steadying guidance on motor disturbances. We’ll focus on latest neurology news related to Parkinson’s disease, including gene therapies showing promise.

Hear these reports:

• Bush Issues Second Stem Cell Veto
• AARP To Offer Health Insurance
• ALS Registry Legislation Introduced
• MD’s Call For More Funding For Disaster Planning
• More Medical Schools, Slots Needed To Fill Md Shortage
• Small Practices Decline
• AMA: Investigate Store Clinics
• Pay For Reporting Programmed Launched In July
• Federal Team Arrests 38 For Medicare Billing Fraud
• CMS Projects Medicare Fee Cut Of 9.9% In 2008

Weblinks:

• ABC survey shows essentially 70% of Americans support stem cell research.
• Military service linked to ALS.
• ALS caused by toxic brain levels of the excitatory neurotransmitter glutamate.

Next week’s show: Infection-Inflammation: Calor, Dolor, Rubor, Tumor for the 21st century Neurologist (7th installment).

Hear these reports:

• Failure To Admit Patients With Tia Ups Stroke Risk
• Reversing Trend - Hospitalizations For Stroke Decline In U.S Poststroke Costs Hit Young The Hardest
• Hispanic Stroke Awareness:
• Immune Response Genes Found Linked To Intracranial Aneurysm
• Reducing Post-Stroke Infections [And] Mortality From A Novel Caspase Inhibitor Drug.
• Ending Poststroke Therapy With Statins Too Soon May Raise Mortality Risk
• Hyperglycemia After Stroke Is Linked To Poor Outcomes
• Imaging, History Predict Early Post-Tia Stroke
• Intravenous Immunoglobulin For Acute Ischemic Stroke:
• Antidepressants May Improve Multiple Outcomes After Stroke

Weblinks:

• Activated Immune System Attacks The Brain After Stroke
• Glycosylated Proteins Have Increased BBB Penetration
• Increased Body Iron Stores Are Associated With Poor Outcome After Thrombolytic Treatment In Acute Stroke: Chelation Therapy May Hold Promise

Next week’s show: Our 6th installment of Policy for Neurology - Plans and strategies impacting your patients and your practice.

• Cell Phone and Risk For Brain Tumors: According to meta-analysis, short-term use of cell phones may increase risk of gliomas only, but long-term use (10 years or more) may increase risk of all brain tumors. Older analog signals (higher energy than newer digital signals) may be a factor.
• Other news:
  • Transcranial Stimulation May Short-Circuit Migraines.
  • Role of Electrical Stimulation in Dysphagia Treatment Under Debate
  • Adverse Events Occur In Over 30% of Vagal Nerve Stimulation Device Patients

Web links:

• Neuralive device (Transcranial magnetic stimulation for migraine).
• Vagal Nerve Stimulation for Depression (references).

• Refractory Migraine Diagnostic Criteria Proposed
• Meta-Analysis Suggests Link Between PFO, Migraine
• Peripartum Migraines Linked To Increased Risk For All Vascular Events
• Combination Treatment Reduced Migraine Activity
• Refractory Migraine Diagnostic Criteria Proposed
• Venous Stenting Leads To Long-Term Reprieve From Exertional Headache
• Pregabalin Is First Drug To Get Fibromyalgia Approval
• Providers Unaware Of Shifts In Opioid Rx Rules
• Pain Treatment Centers Recognized

• Endarterectomy Outcomes Beat Stenting: In a total of more than 17,000 patients.
• Statins and Cycloserine Lessen Tramautic Brain Injury Deficits
• Biomarker Enzyme May Help Predict Severity of Brain Trauma
• DTI Sheds Light on Diffuse Trauma
• Chitin (chitosan) shows great healing and biostimulant properties

Next week’s show: Reign Over Pain - Commanding news you can use to benefit your hurting patients (6th episode).

Focus: The Interactive Autism Network: Interview with ‘IAN’s’ founders Drs. Paul and Kiely Law.

The two pediatricians will discuss their personal family experience with the autism spectrum disorders (ASDs) and how it led to their founding of IAN. We’ll also discuss how this rapidly growing online community of families and researchers may help us understand the incidence, etiology and pathogenesis of ASDs, and help in our ability to diagnose and treat this troubling and apparently rapidly growing spectrum of disorders. Please get involved with the Interactive Autism Network and tell your families affected by autism about IAN: www.iancommunity.org.

Listener feedback: Two STAT! doctor subscribers provide feedback. One regarding the importance of Neurolgists’ continued use of medications off-label. The other doctor provides his comments regarding the quality level of STAT! productions, and his wish for additional lines of Medical News Podcasts productions.

Next week’s show: Our 6th installment of Ideology for neurology- working toward neurological perfection: Would you choose neurology again today, if you were considering specialties to pursue? And here’s another question: accumulation of which metal in the gray matter is tied to multiple sclerosis? Listen and learn.

Weblinks:

• Interactive Autism Network

• Internet System for Assessing Autistic Children (Dr. Law’s letter describing the ‘ISAAC’ system).

Focus: Current and emerging applications for Botox: the diluted natural protein from a highly toxic bacterium has many potential uses — maybe even for tension headaches.

And other medicines with merit:

• Ramelteon, a melatonin receptor agonist drug, is approximately 10 times more potent than natural melatonin.
• Pramipexole okayed for restless legs.
• Aspirin may reduce ischemic events in giant cell arteritis: appears to be a safe and effective adjunct in patients whose giant cell arteritis puts them at increased risk for ischemic vision loss and cerebrovascular accidents.
• Rituximab resolved severe vasculitis of the carotid and other vessels.

And last but not least: Granny…. The taser didn’t faze her. Isn’t the use of electricity to stun the body a lot more “holistic” — as a self-defense weapon with merit — than stunning it with piercing lead?

Next week’s show: Our 4th installment of Podcast for Peds - issues related to problems of the developing nervous system, and the young folks who have them. We?re pleased to have as guests Drs. Paul and Kiely Law to tell us more about the Interactive Autism Network!

Weblinks:

• Dr. Alan Scott, botox pioneer of 1980.
• Mechanism of action for botox
• Intrathecal baclofen for cerebral spasticity
• Cannabis sativa for spasticity in MS (Vanderbilt University)
• First-ever finding of genetic risk factors for restless leg syndrome
• Information on hormesis
• Botox ‘Emerging’ Applications:
  • Chronic Low Back Pain
  • Migraine and tension headache
  • BPH
  • Chronic prostatitis (= Chronic Pelvic Pain Syndrome, CPPS)

Reference (other): Free radical-mediated molecular damage. Mechanisms for the protective actions of melatonin in the central nervous system. Reiter R, Acunastroviejo D, Tan D, Burkhardt S (2001). Ann N Y Acad Sci 939: 200-15. PMID 11462772.

Focus: Doctor Shortage - More than 60% of CEOs surveyed identified physician shortages as a serious problem that must be addressed.

Other vulnerability issues:

• Medical debt on credit cards: According to research, increasing numbers of families are turning to credit cards to pay for medical care.
• Oxycontin maker and three current and former executives pleaded guilty last month in federal court to criminal charges of misbranding. Agree to pay over $600 million in fines.
• Kidneys vulnerable to fibrosis risk with use of gadolinium contrast agents. Click here for case registry.
• You as a practitioner probably have some sort of ‘ties’ to a Pharma or medical device company (that’s based on the odds, based on the data).
• Sterility concerns prompt recall of all Endura Dural substitute dural grafting products.
• Are retail prices for Medicare Part D drugs growing disproportionately, compared to wholesale prices?

And last but not least: If you were mom in this amazing story, would you want to slap the doctor after your baby was born?

Next week’s show: Our 4th installment of Medicines with Merit - Pharmaceuticals showing promise for the patient with neurological disease. Learn fascinating information on the current and potential therapeutic uses of botulinum toxin, Botox, and on many other medicines with merit too!

Weblink (other): Critical Care journal information on how nursing shortage likely increases ventilator associated pneumonia.

Citations regarding modafinil (Provigil):

• Antiparkinsonian and neuroprotective effects of modafinil in the mptp-treated common marmoset. Jenner, P (July 2000). Experimental Brain Research 133 (2): 178-188.
• Efficacy and safety of modafinil (Provigil) for the treatment of fatigue in multiple sclerosis: a two centre phase 2 study. Rammohan, K W (2002). Journal of Neurology Neurosurgery and Psychiatry 72 (2): 179-183.
• Modafinil attenuates disruptions in cognitive performance during simulated night-shift work. Neuropsychopharmacology. 31 (7): 1526-1536. 2006.
• Cognitive enhancing effects of modafinil in healthy volunteers. Turner, Danielle (January 2003). Psychopharmacology 165 (3): 260-269.

Treat Alzheimer’s Early With Cholinesterase Inhibitors, Treat Long Term?

• At 1 year, patients on donepezil were significantly less likely to convert to Alzheimer’s disease. Over a year and a half, they did better on thinking, memory, and daily functioning measures, but by 3 years, there was no difference in the rate of conversion to Alzheimer?s signs and symptoms.
• Listeners are reminded of the potential importance of the likely neuroborreliosis etiology of Alzheimer’s; also the free CSF testing for evidence of the bug, being offered by Dr. Alan MacDonald in his research. Contact Dr. MacDonald via his website www.molecularalzheimer.org
• We also reflect briefly on research focusing on the use of vitamin E to reduce Alzheimers. The National Guideline Clearinghouse says vitamin E should be considered - at 1000 I.U. PO BID - in an attempt to slow progression of Alzheimer’s disease. Not a cure, but maybe Alzheimer’s patients can live longer and have better health if they take vitamin E.

Rivastigmine Patch Gets Approval for Dementia: It?s the second patch approved for Parkinson’s disease. One of the researchers (a consultant for the manufacturer, Novartis) said the patch appears better tolerated than the pill.

Alzheimer’s Disease Affects 5 Million: The prevalence is projected to skyrocket in the next 40 years.

Money and Leadership Sought As Alzheimer’s Crisis Looms: The Center for Health Transformation is a health policy think tank founded by former Speaker of the House Newt Gingrich. The Center has a national financial-plus-leadership strategic plan intended to tackle the impending Alzheimer’s epidemic.

Race and Ethnicity Play Role in Alzheimer’s Treatment Delays: The survey found that essentially 70% of both African American and Hispanic caregivers were likely to dismiss the symptoms of Alzheimer’s as “old age” compared with just 50% of caregivers of other races. And African American caregivers were more likely to report that stigma of the diagnosis affected their decision to obtain a diagnosis for a family member.

CAIDE Dementia Risk Score Validated: This risk score predicts the likelihood of a middle-aged person developing dementia within 20 years. It has been independently validated in an ethnically diverse population.

Imaging Compound Pittsburgh B May Help Track Alzheimer’s: The investigational Pittsburgh B compound that binds to cerebral -amyloid and is visible on positron emission tomography — PET scans — maintains its promise as a way to distinguish the elderly patients presenting with memory problems who will go on to develop Alzheimer’s disease from those who won’t progress.

Stroke in Early Alzheimer’s Ups Dementia Risk: The interaction of cerebrovascular disease and Alzheimer’s disease pathology appears to significantly increase the risk of dementia from Alzheimer’s, even when only a small amount of Alzheimer’s pathology is present.

And Last but not least: Marijuana’s active ingredient, THC, acts as a cholinesterase inhibitor and may slow the progression of Alzheimer’s disease.

Next week’s show: Our 5th installment of Vulnerability in Neurology - Potential challenges for neurologists on the clinical front lines. Tune in as we discuss insights about the doctor shortage from the results of a large survey done on hospital CEOs. We’ll have other important vulnerability-related news too.

Weblink (other): Alzheimer’s is the 3rd most expensive medical condition in the US. The direct and indirect costs of Alzheimer’s disease add up to essentially $150 billion each year. That?s on the ?billions scale? the Iraq war is costing us each year. BTW: Click here for an interesting website showing a running total estimate of the ongoing costs of the Iraq war.

• What Triggers Huntington’s Disease?
  • Listen and learn how oxidative DNA damage to the genes leads to subsequent defective enzymes, resulting in the formation and accumulation of toxic proteins.
  • This may be a model for how other neurodegenerative diseases progress - Alzheimer’s and Parkinson’s included.
  • Essentially with this information, we are treated to an exposition of how aging likely results in disease-mediated neuronal death.
  • Treatment for Huntington’s may some day be primarily gene-based (for example using ‘neurturin.’ Until then, might antioxidants like CoQ10, carotenoids, ascorbate, tocopherols, selenium, bioflavanoids be of help? Experimental data are consistent in demonstrating neuroprotection from some of the antioxidants.
• Glial Cells Worsen ALS Pathology - through mechanism involving mutated superoxide dismutase gene:
  • In more ‘oxidation-antioxidation’ news related to neurodegeneration we learn that a defective form of this key antioxidant enzyme (SOD) in glial cells is the probable cause of amyotrophic lateral sclerosis (ALS).
  • Maybe SOD enzyme therapy, gene therapy, stem cell therapy or anti-SOD immunotherapy will someday be found helpful for treating or curing ALS.

And Last but not least: Do shifty eyes mean lies, or better learning?

Next week’s show: Our 7th installment of Defeating Dementia - Promising news and approaches for progressive brain disorders. Focus: The pros and cons of the cholinesterase inhibitors (Exelon, Aricept and Razadyne). We’ll also cover the newly validated CAIDE dementia risk score and more news on the promising Bittsburg B compound, which makes beta-amyloid in the brain visible on PET scans. It’s an exciting potential tool to assess and track Alzheimer’s progression.

Weblinks:

• Review of antioxidants for neuroprotection (NIH).
• Early evidence of CoQ10’s ability to help Huntington’s.
• Research suggesting CoQ10 may help Parkinson’s and Alzheimer’s.

Other References:

• Coenzyme Q10 enrichment decreases oxidative DNA damage in human lymphocytes: Tomasetti M., Littarru G.P., Stocker R., Alleva R.: Free Radic Biol Med. 27: 1027-1032, 1999
• Energy metabolism defects in Huntington’s disease and effects of coenzyme Q10: Koroshetz WJ, Jenkins BG, Rosen BR, Beal MF. . Ann Neurol. 1997;41(2):160-165.

Installment #5 of Ideology for Neurology — working toward neurological perfection Focus: Stem cell therapy.

• Stem Cell Victory in California: CA Supreme Court just cleared the way for the state to use bond funding to pay for the Institute of Regenerative Medicine - a very large-scale stem cell research initiative.
• Stem Cells Treat Rat Paralysis: Paralyzed rats that received mouse embryonic stem cells (and differentiation factors) regrew motor neurons that resulted in roughly 50% recovery of strength in their limbs.
• Palliation Clinically Effective, Reduces Hospital Care Costs: In one patient group the savings were essentially $350 per day.
• Chronic Severe Pain Can Mean Death To Those Left Untreated: With adequate pain control, the % of patients with abnormal serum cortisol levels dropped to just 4% of the patients.
• Conduction Studies Don’t Imperil Cardiac Devices: Electrical output during nerve conduction studies probably don’t imperil implanted cardiac devices.
• Abusive head trauma easily missed in the ED: Shaken baby syndrome misdiagnosed in almost 30% of children.

And Last but not least: Honey-Maggot medicine–anyone?

Next week’s show: Nerve University — education, research and scholarship in neurology.

Weblinks:

• Harvesting one cell from the blastomere (image): www.sfgate.com
• Information on appellants to the CA stem cell legislation: www.curesforcalifornia.com
• Other than the official California Institute for Regenerative Medicine (the California stem cell agency) website, here’s the only other website devoted solely to news and information about CIRM: www.californiastemcellreport.blogspot.com/
• This website lists the hospitals which accept cord blood donations for stem cells, and has contact information for Cryobanks International, which accepts cord blood donations from anywhere in the continental US: www.marrow.org.

Installment #3 of Podcast for Peds: Issues related to problems of the developing nervous system, and the young folks who have them. Focus: Autism.

• Online Autism Registry Offers Research Portal: The Interactive Autism Network already has 6000 registered autistic children. This project is analogous to when researchers banded together to successfully fight childhood leukemias!
• Familial Versus Sporadic Autism: DNA microarray technology has revealed that the majority of cases of autism spectrum disorders likely result from de novo genetic mutations after conception. An important question to be answered is: What factor or factors are causing the gene mutations? Mercury from the thimerisol preservative in vaccines is in the ‘lineup’ up suspects.

And last but not least: the alkaloid theobromine in chocolate may be superior to fluoride for preventing tooth decay (for ‘kids of all ages’).

Next week’s show: 5th installment of Ideology for Neurology-working toward neurological perfection. Hear news about last month’s stem cell victory in California; also how palliative care medicine is cost-effective medicine; and more.

Weblinks:

• Interactive Autism Network: www.ianproject.org.
• Lyme-Autism speculation: http://autism.about.com/b/a/257714.htm
• Book information: Healing The New Childhood Epidemics: Autism, ADHD, Asthma And Allergies by Kenneth Bock, MD - http://www.amazon.com/Healing-New-Childhood-Epidemics-Groundbreaking/dp/0345494504
• Mercury and DNA damage — potential for gene mutations from mercury: http://cat.inist.fr/?aModele=afficheN&cpsidt=16655361

• Glioma Palliation Focuses on Seizure Prevention: Palliation specialist physician provides what he calls “simple medication regimen at the end of life.”
• Assessing Pediatric Seizure Drugs — Ativan versus Valium: The NIH’s Pediatric Seizure Study.
• Gamma Knife For Epilepsy May Spare Verbal Recall: Gamma Knife radiosurgery may be superior to gross excisional surgeries for epilepsy.
• Prior Consent For Anticonvulsant Generic Switch Is ‘Crucial’ To Patients: the American Academy of Neurology supports legislation that would require insurers to get the informed consent of physicians and patients with epilepsy - before pharmacies can switch to generics.

And last but not least: Hair products as the “new frontier” in anti-seizure medication drug delivery, with the slogan, “Less Flake, Less Shake”? Next week’s show: 3^rd installment of Podcast for Peds: Issues related to problems of the developing nervous system. We?ll report important news related to autism research, and other peds-specific insights. Thanks for staying subscribed to STAT — The Podcast of Clinical Neurology News.

Weblinks:

• http://www.nih.gov/news/pr/may2007/nichd-23.htm - for detailed information on the Pediatric Seizure Study.
• http://www.nichd.nih.gov/news/releases/study_pediatric_seizure_QA_052207.cfm - for the list of the 11 medical centers involved in the Pediatric Seizure Study.

• Photodynamic Therapy for Gliomas — reactive oxygen species are the active agents.
• Glioma Stem Cells: Radiation Proof — cancerous stem cells increased four-fold after irradiation.
• New Angle on Brain Tumor Therapy — force differentiation of cancerous stem cells with bone morphogenic protein, and we may someday be able to cure glioblastoma (and other cancers).

And last but not least: Alcohol consumption may shrink the brain.

Related News Coverage:

• Hormonal Changes in Chronic Stress Can Cause Brain to Rewire.
• Patients’ Artwork Grants Insight Into Living With Epilepsy
• Migraines: Are they Harbingers of Post Traumatic Stress Disorder in Iraq War Vets?

And last but not least: Beef Bones, Belly Rubs Pass Now (an FDA-approved drug to help your dog with separation anxiety).

Weblinks:

• www.pnirs.org - The Psychoimmunology Research Society (conferences, training, journal).
• www.med.umich.edu/1libr/wha/wha_ptsd_bha.htm - University of Michigan Health System website with outline and descriptions for PNI-related treatments for Post Traumatic Stress Disorder.

Publication Date: Jun 8th, 2007.

Focus: Stealth infections, and the possible effect that ONE of the numerous hidden invaders has on Parkinson’s disease.

The bug is Helicobacter pylori. It’s back in the limelight. And Parkinson’s pathogenesis may be eased from its eradication.

And does herpes simplex virus play a role in Alzheimer’s?

Listen and learn about other concealed infectious entities possibly cohabitating, within our bodies, and causing varying degrees of stress on our physiological systems - our “psychoneuroimmunology.”

And last but not least (on the flip side): “Filth and Felicity” - Is our obsession with having a sterile environment for daily living contributing to us humans being a bunch of “psycho-enodo-neuro-immunological” wimps?
(more…)

Focus: Neurologists’ role in the event of a chemical agent terrorist attack.

1. Basic Training On Nerve Agents For Neurologists - neurologists are expected to take the lead in the event of an attack.
2. Sources on Biotoxins - resources for knowledge and understanding on the topic.

And last but not least: serpent venom - how one man’s toxin may be another man’s therapy.

Weblinks: www.ccc.apgea.army.mil. For the U.S. Army Medical Research Institute of Chemical Defense - where you can access state-of-the-art information, resources and training on the topic.

Publication Date: May 25th, 2007.

Jeff Evans - we welcome you as STAT reporter! Jeff is a neuroscientist, and an International Medical News Group Senior writer.

Focus: Opioid analgesia - controversies and potential solutions.

1. Point/Counterpoint - Are opioids an appropriate treatment for chronic nonmalignant pain?
2. Matching Drug to the Pain Can Limit Opioid Abuse
3. NIH Launches Addiction Study - using Suboxone
4. Combination Therapy Relieved Neuropathic Pain in Close to 80%: antidepressant + antiepileptic.
5. Steroid Injections Have Limited Role in Lubosacral Care.

And last but not least: A mysterious golden earring called “Zerosmoke”

Publication Date: May 18th, 2007.

Focus: New AHA/ASA Stroke Guidelines - EMS emphasis.

1. New Stroke Guidelines Emphasize Role of EMS: The new Guidelines recommend that EMS personnel bypass a hospital that doesn’t have the resources or institutional commitment to treat stroke patients.
2. Two States’ Mandates Increased TPA Use in Stroke: In Massachusetts, for example, when ambulances with stroke patients were forced to take those patients to stroke centers, use of IV TPA increased from 30% to 50% after the law went into effect (an increase of 20 percentage points).
3. Metabolic Syndrome Found To Be Risk Factor for Stroke: According to data from the Northern Manhattan Stroke Study, metabolic syndrome is a significant risk factor for intracranial atherosclerosis-related stroke.

And last but not least: Give me the chocolate, and no one gets hurt!

Weblinks: www.stroke.ahajournals.org (to download latest Stroke Guidelines).

Publication Date: May 11th, 2007.

Publication Date: May 4th, 2007.

Show Summary:
Researcher and pathologist Dr. Alan MacDonald explores the link between Borrelia burgdorferi infection - neuroborreliosis - and Alzheimer’s disease. Previous STAT coverage of his work: #23, #26 and #65.

On this episode, ‘Reflections on Recent Alzheimer’s News,” Dr. Macdonald mirrors his thoughts about recent news from Clinical Neurology News based on: 1) the neuroborreliosis hypothesis, 2) what he learned during the recent 10th International Conference on Alzheimer’s Disease in Madrid, Spain (Jul, 2006).

Dr. Macdonald will reflect on news about: the genetics and markers of Alzheimer’s disease; new research efforts and related political issues; diagnosis and treatment; the diabetes-Alzheimer’s comorbidity; and the importance of inflammation and oxidation in Alzheimer’s pathogenesis - all from the perspective of the neuroborreliosis paradigm.

Dr. Macdonald’s papers and presentations can be downloaded from www.molecularalzheimer.org. He can be contacted from the website too.

Publication Date: Apr 27th, 2007.

Focus: carotid artery stenting vs. endarterectomy.

1. Consensus limits carotid stenting to the sickest patients: a technology may have been introduced to humankind, before adequate safety and efficacy studies.
2. Restenosis may be an ongoing process after secondary stent: an early and long-term phenomenon.
3. Carotid stenting has low complication rate in registry: may help decide if benefits outweigh the risks.
4. Brain function may be boosted by carotid artery stenting.
5. Preventable errors cause stroke in carotid stenting: learning the errors might help reduce complications.

And last but not least: help your nicotine-addicted patients prevent a stroke, by ‘walking a mile for a camel’? Don’t even think about it!

Publication Date: Apr 20th, 2007.

You’ll hear news on transmissible spongiform encephalopathy:
1. Prion Disease May Be Viral: Virus-like particles produced prion protein.
2. Early Therapy for Prion Disease: Therapies aimed at reducing prion protein might be a potential therapeutic option.
3. FDA Proposes Bovine Ban: To keep medical products free of whatever ‘transmissible agent” really causes the disease.

And you’ll hear other infection-related news:
1. Herpes Zoster’s Cost Burden High, Increases With Age
2. Severe Septic Shock Could Trigger Later Brain Atrophy in Survivors.
3. Ventilator Pneumonia Haunts Neurocritical Care.

And last but not least, Urinetown? Urine for a real treat!

Publication Date: Apr 13th, 2007.

Senility Solutions feature now called Defeating Dementia.

Hear our second interview with pathologist researcher Dr. Alan MacDonald, discussing the possible link between Alzheimer’s disease and Borrelia burgdorferi (the Lyme disease spirochete). Might this constitute a “perfect medical crime”? You’ll learn about recent research from the CDC confirming Borrelia’s invasion of human neurons and glial cells. Also how this finding of the bacteria inside neurons and glia could change the Braak staging system for Alzheimer’s. This may be the start of a new era for understanding the pathogenesis of Alzheimers.

See references and images at www.MolecularAlzheimer.org.

And last but not least, is it time for you to suggest that your patients ask their bosses if they can nap 30 minutes on the job? Could be a heart-healthy habit!

Publication Date: Apr 6th, 2007.

Hear the interview with Dr. A. David Rothner from the Cleveland Clinic Foundation - specialist in pediatric headaches.

Rapid Fire News includes:
1. Topiramate may prevent pediatric migraine
2. CDC launches autism study
3. Diet plus vagal nerve stimulation calm refractory epilepsy in kids
4. Hyperbaric oxygen aids cognition in cerebral palsy

And last but not least: ban cheddar to beat blubber, or shave the fat by shelving the sugar?

Publication Date: Mar 30th, 2007.

1. Thimerosal Haunts Flu Shot Recommendations: The ‘jury is still out’ on the issue of thimerosal and autism, but there are plans to expand the recommended age range to receive annual flu shots - from the current 6 months to 5 years, to children up through age 18.
2. Is there a link between mobile phone use and gliomas? Overall, even among heavy and long-term users, the researchers found no link between cell phone use and gliomas, but certain users may be at risk.
3. The FDA eliminated two indications for the antibiotic telithromycin (Ketek), and added a black box warning to its label stating the drug is contraindicated in people with myasthenia gravis.
4. Data to date seem to suggest that the overall risk for Guillain-Barre syndrome following receipt of the meningococcal conjugate vaccine Menactra is not significantly increased.
5. A federal jury recently convicted a New Jersey physician (and her coconspirator) of defrauding patients with amyotrophic lateral sclerosis. Stem cell therapy was involved.
6. And last but not least: What happens when doctors attack…each other?

Show links: Environment, Health and Safety Online at www.ehso.com. A helpful website on the cell phone/brain tumor controversy.

Publication Date: Mar 23rd, 2007.

1. MRI Reveals New Epilepsy Surgery Candidates: Diffuse EEG patterns do not necessarily mean children don’t have a focal lesion amenable to the surgery.
2. Depression in Epilepsy Patients Is Common, but Undertreated: Consider using the PHQ-9 depression “instrument” in your practice.
3. New Approaches to Epilepsy: three intriguing new therapeutic approaches being funded by grants from the Epilepsy Research Foundation.
4. And last but not least: Relax, I Trained With Dr. Nintendo - You might want a neurosurgeon who plays at least 3 hours of video games per week!

Publication Date: Mar 16th, 2007.

1. TPA is used in pediatric stroke despite lack of guidelines: Children have started the ‘clot-buster’ therapy at time intervals ranging from 20 minutes 52 hours.
2. Anticlotting drug use in children varies widely after stroke: What percent of children who”ve had arterial ischemic strokes do you think receive no anticoagulation therapy after the stroke? Listen and learn.
3. One in four acute ischemic stroke patients rapidly respond to intra-arterial treatment: The investigators referred to the rapid recovery from intra-arterial infusion of thrombolytic as the “Lazarus phenomenon.”
4. And last but not least: Contraceptive peace of mind now in convenient chewable form!

Links: http://stroke.ahajournals.org/cgi/content/full/36/9/1825 According to the Stroke report, the annual incidence of pediatric stroke is 4.3 per 100,000, and the majority of the stroke cases were hemorrhagic. The researchers projected that future studies of pediatric stroke would have to draw from a patient population of up to essentially 60 million children to complete a case-control study within 4 years.

Publication Date: Mar 9th, 2007.

1. Tight glycemic control - does it help in acute stroke patients? Even in medicine, we make assumptions about what we think may result in best outcomes for our patients (like stabilizing glucose in stroke patients), but the research can prove us wrong!

2. Get with the guidelines: Diabetes is poorly addressed in acute stroke patients. Significant numbers of stroke patients with diabetes leave the hospital after a stroke without treatment plans that meet evidence-based guidelines.

3. Aspirin may be helpful for more than just pain, fever and thinning the blood. Even at low doses, it appears to prevent age-related declines in gray and white matter integrity.

4. And last but not least, the spirit of Seuss speaks: Call it the ‘bro,’ but into the dustbin, the boy-bras now go!

Links: Brain Awareness Week is coming up: Mar 12th to Mar 18th. It is an international program of public events to celebrate the brain. The campaign unites essentially 2000 partner organizations, including universities, medical and research organizations, patient advocacy groups, schools, government agencies, service groups, and professional organizations in 66 countries - all communicating the progress of brain research. For more information, go to www.dana.org.

Publication Date: Mar 2nd, 2007.

1. Neurologist shortage hits stroke centers: There clearly aren’t enough neurologists to go around! It’s a major obstacle for hospitals to find neurologists available to consult 24 hours a day, 7 days a week.
2. The Neurological Emergencies Treatment Trials Network: The mission is to improve outcomes of patients with acute neurological problems - through innovative research.
3. NINDS gains new leadership: Neurologist and researcher Dr. Walter Koroshetz has been named deputy director.
4. The Stroke Treatment and Ongoing Prevention Act introduced again: The bill calls for public education efforts to increase awareness of the warning signs of stroke, and the need to treat acute ischemic stroke as a medical emergency.
5. And last but not least: Swoons of ’skinnies’ are stalling subways!

Links: Brain Awareness Week is coming up: Mar 12th to Mar 18th. It is an international program of public events to celebrate the brain. The campaign unites essentially 2000 partner organizations, including universities, medical and research organizations, patient advocacy groups, schools, government agencies, service groups, and professional organizations in 66 countries - all communicating the progress of brain research. For more information, go to www.dana.org.

Publication Date: Feb 23rd, 2007.

Show Notes: Carotid stenting versus carotid endarterectomy: from a large meta analysis we now have the first statistically significant difference ever seen in the serious adverse events after treatment with these two surgical alternatives.

Gamma Knife for mesial temporal lobe epilepsy: the radiosurgery was performed on 30 patients. Essentially 70% of the patients were seizure free at 2 years.

In memoriam: Dr. Hugo W. Moser died on Jan. 20, 2007. His landmark study was on the preventive effects of Lorenzo’s Oil, profiled in the popular film of the same name, starring Susan Sarandon and Nick Nolte.

Links:

• www.cms.hhs.gov: You can submit your comments regarding Center for Medicare Services proposed expanded coverage of carotid stenting. Deadline for submissions: Mar 3rd, 2007.
• www.myelin.org: Foundation started by Lorenzo Odone’s family. Focused on finding the solution for remyelination.

Publication Date: Feb 16, 2007.

Show Notes: Prions - the creepy culprits causing Mad Cow Disease in England, and Kuru in Papua New Guinea cannibals. Thanks to contaminated blood products from silent carrier-donors, they are back in the news. Given the possible 30-year incubation time frame for prions, there may be reason for concern.

And neuroimaging shows fibromyalgia is not just ‘all in the head’ - it’s affecting the peripheral nervous system too.

Links:

• www.blog.wired.com - Is transmissible spongiform encephalopathy really caused by a virus, not the prion?
• www.endfatigue.com - A doctor claims to provide relief to over 90% of his fibromyalgia/chronic fatigue patients.

Show Notes: A laboratory model for Multiple Sclerosis is being used in mice to demonstrate potential therapeutic efficacy of nicotinamide (niacin, vitamin B-3) for multiple sclerosis.

And in our other report, a vaccination against a cytokine may be efficacious against MS. The chemical messenger secreted by a newly discovered type of T-helper cell has been exposed as the ‘root of all inflammatory and autoimmune evils.’ Vaccination against this cytokine presents a potential therapeutic strategy against MS, and a host of other autoimmune - ‘auto-inflammatory’ - disorders.

Publication Date: Feb 2, 2007.

Show Notes: Some ‘alternative medicine’ approaches for treating Multiple Sclerosis (MS) are showing promise empirically, but controlled studies are largely lacking. If the scientific evidence of efficacy substantiates some of the treatments, it may then be time to integrate them more fully into ‘conventional medicine.’ Possible examples include omega-3 fatty acids, vitamin D, ginkgo biloba, cannabis sativa, bee sting therapy (’apitherapy), acupuncture, hyperbaric oxygen, and maybe even someday the avoidance of dairy in select people.

A French neurologist in the early 1990s conducted a prospective study on more than 200 women with MS. He found that the MS relapse rate dropped by about 80% during pregnancy. Early this year, investigators will start enrolling women with relapsing-remitting MS in a multicenter trial designed to evaluate whether treatment with physiologic levels of estriol - comparable with levels which can be measured during pregnancy - will induce the same reductions in MS activity that have been documented during pregnancy. And MRI measures will be used to assess the MS patients’ progression.

And finally: MRI has revealed that adolescents who play violent video games have less activation in their prefrontal lobes, compared to those who played non-violent video games. The pre-frontal region is not a part of the brain we want to be less active in our young (or older) society members!

Show links: www.vitasearch.com (review of vitamin D as possible preventive and treatment for MS).

Publication Date: Jan 26, 2007.

Show Notes: Conjuring up lies in the brain changes its magnetic resonance properties - so reproducibly and consistently that functional MRI images are over 90% accurate in actually viewing those lies! With neuroimaging research, potential benefits and thorny hazards abound!

A modern-day Pandora’s Box has been opened after revealing the secrets of modern-day imaging technology, releasing its potential societal woes. We invoke ‘contemporary mythology’ to address the neuroethical challenges being raised by the new imaging technologies. There are answers to help us survive the challenges, and progress efficiently and safely with neuroimaging. In fact, the answers are the only thing remaining in the mythical ‘Pandora’s Box’! Listen to learn some answers.

Show links: For a brief history of fMRI see www.ee.duke.edu.

Publication Date: Jan 19, 2007.

Show Notes: A low-cost alternative to sustained release opiates - methadone: has it led to increased vulnerability - increased morbidity and mortality - from sleep apnea?

And you’re trying to switch a patient from morphine-based opioids to methadone, should you use the standard conversion tables?

Your patient is told he should consider a carotid endarterectomy - what’s the patient’s chance of having post-CEA cognitive decline, and what genetic test might help you assess his risk for incurring that cognitive decline?

Publication Date: Jan 12, 2007.

Disclaimer: The reports in Clinical Neurology News take a neutral position on Medicare issues. Dr. William Campbell Douglass III MD, MS makes this Report about Medicare more personal: Is the recently legislated Medicare ‘Pay-for-Performance’ (P4P) program all about creating ‘quality health care’ for America’s seniors? Or is it a masked attempt to try to fix, to save, the government-based healthcare plan? If so, is the attempted fix being done at your - and other U.S. doctor’s - expense? If so, how? Could the hoped-for solution be all about the ‘missing variable’ in the quality-cost equation: time - your time? Could you become the ’sacrificial lamb’ - the scapegoat - if the P4P experiment fails?

Also, what percent of doctors may feel that Medicare Part D is too complicated, increases their day-to-day hassles, and puts a burden on themselves or their staff? And ‘Experts Call for FDA Reform’: Vioxx-FDA whistle-blower Dr. David Graham in the spotlight again. Last But Not Least: Got the ‘Neurology Recertification Blues’? Dr. John Whyte from Discovery Health Channel may have a remedy for you!

Show website reference: www.abpn.com.

Show Notes: What ubiquitous dietary factor has recently been documented (using MRI) to result in brain atrophy and neurodegeneration in large numbers of humans? Listen and learn. And what substance normal to our physiology - at high-normal levels in the serum - is linked to significantly lower rates of progression of Parkinson’s disease? And last, but not least - believe it or not - the Institute for Condom Consultancy hopes to roll out a provoking new product in 2007.

Show website reference: www.celiac.com

Publication Date: Dec 29, 2006.

Remember the relationship between status epilepticus and structural damage to the heart? And how about the video game related to visually induced seizures, and the guidelines to prevent them? And remember what might be considered one of neurology’s ’silent epidemics,’ and how we might diagnose it? We also peak in again on ‘The Mystery of Epilepsy and the Missed Period,’ and then wrap this fiftieth episode of STAT with fresh seizure-related Rapid Fire News from Dec’s Clinical Neurology News.

Publication Date: 12/22/06.

Show Notes:

Join the STAT ‘podonauts’ to refresh your memory on the new Headache specialty; how to treat — and how NOT to treat — migraines; the guidelines for treating pain from diabetic peripheral neuropathy; and the link between migraines and hear disease (might PFO be related?). Also, neurology professionals and doctors of all types have had a bit of ‘pain’ in their hearts over the proposed cuts in Medicare payments - listen and learn how Congress has provided at least a little legislative analgesia for 2007. And learn how to ‘just say no’ to patients, and how to take a step back from overused migraine drugs.

Publication Date: 12/08/06.

Show Notes:

This show highlights the marvels of bioelectrical engineering for people with spinal cord injuries. Dr. Richard Caselli reported in Research Reports and Clinical Perspective in September’s Clinical Neurology News on the wonders of the brain-computer interface (BCI) from resent research by Dr. Leigh Hochberg published in Nature: Patients using their thoughts could control the cursor on the computer screen!

The ‘instrument’ of brain, plus microelectrode array plus computer interface is established, and it looks like we are close to being able to say that may be limited only by the technology behind the machines taking orders from the ‘interface.’ Listen and learn the remarkable physical and creative tasks a quadriplegic patient was able to accomplish by ‘thinking his intentions’ into being.

Show Links:
BCI demo: www.cyberkineticsinc.com
Dr. Caselli’s article: http://www.clinicalneurologynews.com/article/PIIS1553321206716600/fulltext

Publication Date: 12/15/06.

Show Notes:

From quantitative EEG for detecting vascular dementia, to CPAP for Alzheimer’s, and even neuroborreliosis ‘kinship’ to neurosyphilis, and biomarkers plus PIB-PET for Alzheimer’s diagnosis, we present to you a synopsis of Senility Solutions we think you will enjoy.

There are promising beacons of hope on the neurology horizon.

Publication Date: 12/01/06.

Show Notes:

In this first installment of Reap the Sleep we cover effects of obstructive sleep apnea (OSA) on brain compensatory mechanisms as we age. Clinical studies demonstrate that continuous positive airway pressure (CPAP) improves cognition in aged patients - and even in Alzheimer’s patients - who have OSA. We also explore the association between OSA and neurodegenerative/cardiovascular diseases, and we emphasize why early diagnosis and treatment of OSA are so important.

And on the high-tech behavioral therapy front: patients with insomnia may be able to fall asleep faster and sleep longer following a F.A.S.T. session. Listen and learn why.

And last but not least a ’sexy’ mishap had Medicaid patients calling a phone-sex line instead of the Medicaid office. That mistake probably led to sleeplessness for some Medicaid bureaucrats, and less sleep for some Medicaid patients!

Publication Date: 11/24/06.

Show Notes:

Neurology’s Cutting Edge brings you important information on patients with brain injuries – especially SPECT scans for functional neuroanatomy of the brain, and cost issues for neurologists treating brain injured patients. Learn about beta blockers protective role in traumatic brain injury, more on hyperbaric oxygen for brain injury, and possible good news for research on the possible patent foramen ovale — migraine link. And last but not least, maggots for wound healing, without the maggots.

Show Links:
www.cdc.gov/ncipc/pub-res/tbi_toolkit/toolkit.htm
www.amenclinics.com

Publication Date: 11/17/06.

Show Notes:

1. Palliative Care recognized as new subspecialty.
2. Hyperbaric oxygen therapy benefits kids with brain injury.
3. Punch biopsy: key to small fiber neuropathy.
4. 2004 report on chronic fatigue languishes at hhs.
5. Blastomere advance: will it quell stem cell debate?
6. And last, but not least: mussels dosed with Prozac (not to their benefit), and Hollywood officials use DNA to track ocean sewage back to its source: Malibu homes by the sea.

Show Links:
http://www.nhpco.org/templates/1/homepage.cfm
http://www.capc.org/
http://www.nationalconsensusproject.org/
http://www.dermpathdiagnostics.com/
http://www.clinical-labs.org/members/companies/index.shtml

Publication Date: 11/10/06.

Show Notes: Emerging treatment and diagnostic strategies may transform AD from a death sentence to a disease patient’s can manage, much like HIV: SALAS = the operative acronym. And cannabinoids dronabinol and nabilone in the news, and the IOM and FDA have differing opinions on the medical use of marijuana. Plus, a narcolepsy drug might make your patients with primary brain cancer feel better, and TNF inhibitors may protect rheumatoid arthritis patients from stroke. Last but not least, learn about the faux flu fix distributed in China!

Publication Date: 11/03/06.

Publication Date: 10/27/06.

Show notes: More “Medicare madness”: the proposed 5% cut in your pay — equivalent 9% considering inflation - and what you can do about it, so you’re not singing ‘The Medicare Blues.’ Also a Medicare risk-reduction program: force or fluff? And what ‘factor of four’ fuels most Medicare costs? And you’ll find out why Americans with memory problems may want to check for early stages of AD, and some good news: prior authorizations for AD drugs dropped by some national and near-national Part D drug plans. Last, but not least, learn why to try not to get between juror smokers and their cigarette breaks.

Show Links:
thomas.loc.gov
molecularalzheimers.org

Our first installment of Information technology for neurology: information to optimize your medical IT efficiency — with focus on the electronic health record.

Publication Date: 10/20/06.

Show notes: Information technology is reaching into physician practices whether they are ready for it or not. The electronic health record will be a requirement in all practices within four years. What should you look for in an EHR system? What work has already been done for you in finding a system that’s suitable for an ambulatory setting? What’s the purported ‘Top 8’ HER solutions for neurology professionals? How do new regulations affect your electronic communications? And how can you make technology work for you? The answers to all these questions and more are on STAT!

Show Links:
www.aan.org
www.cchit.org
www.healthcomputing.com
www.ahima.org
www.centerforhit.org
www.hhs.gov

Publication Date: 10/13/06.

Show notes: We look at exciting clinical developments in epilepsy, with focus on medical imaging to locate origin of seizures. MRI is already able to identify seizure foci in infants. Our lead story is on combining different imaging modalities — in this case PET and CT — to find seizure foci even when MRI can’t.

Publication Date: 10/06/06.

Show notes: It’s all things headache-related today. Shortchanged by Medicare in your treatment of headache? We have some secrets, which may help you get paid what you deserve. And would you send your pediatric migraine patient to an adult ED? And much more, like, what are your thoughts on using placebos in clinical practice? Also, who is “Cranium Commando”?

Show Links:
http://www.chinadaily.com/
http://www.medicalnewspodcasts.com/

Publication date: September 22, 2006

Publication date: September 8, 2006

Publication date: September 1, 2006

Publication date: August 25, 2006

Publication date: August 18, 2006

Publication date: August 11, 2006

Publication date: July 28, 2006

Publication date: July 14, 2006

Publication date: July 7, 2006