Archive for August, 2011

Hair Restoration Surgery Market Increased 47% Worldwide In 2010

- Middle East and Asia Experience Largest Gains

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Despite slow economic growth worldwide, the demand for procedures to correct hair loss proved to be stronger than ever, according to statistics released from a recent member survey conducted by the International Society of Hair Restoration Surgery (ISHRS) – the world’s leading medical authority on hair loss and hair restoration.  From 2008 to 2010, the total extrapolated market size for hair restoration surgery increased 47.9 percent.

Specifically, the extrapolated worldwide number of surgical hair restoration procedures performed in 2010 was approximately 279,381, up 11 percent from 2008. Since the ISHRS starting compiling membership data in 2004, the number of procedures performed around the world jumped 66 percent – with the Middle East (454 percent increase) and Asia (345 percent increase) experiencing the largest growth.

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Catherine Zeta-Jones and Patrick Dempsey earn top Hair Honors

Members of the International Society of Hair Restoration Surgery (ISHRS) know good hair when they see it, and they like what they see in Catherine Zeta-Jones and Patrick Dempsey.

According to results released today of a new member survey conducted by the ISHRS, 43.8 percent of members voted Catherine Zeta-Jones as the female celebrity with the best tresses, while 71.5 percent of members chose Patrick Dempsey as the male celebrity with the best hair.

Catherine Zeta-Jones
- Catherine Zeta-Jones

The spotlight will be on all things hair at the ISHRS’s 19th Annual Scientific Meeting when more than 500 physicians and surgical assistants from around the world dedicated to advancing the art and science of hair restoration are expected to attend this premier educational event, September 14-18, 2011, at the Dena?ina Civic and Convention Center in Anchorage, Alaska, USA.

This year’s scientific program, with the theme “New Vistas & Trusted Techniques in Hair Transplantation,” will feature presentations by the world’s foremost hair restoration experts on the latest research and scientific advances in diagnosing and treating hair loss.

“The growth we are seeing in hair restoration surgery is a testament to the great strides made over the years in the field and our commitment as a medical specialty to ongoing medical education and research,” said Jerry E. Cooley, MD, president of the ISHRS.  “Exciting new technologies are being investigated that will only further expand our ability to perfect the science of hair restoration and further help more people with hair loss.”

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Risk of Bladder Cancer From Smoking Greater Than Previously Reported

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An analysis of data that includes nearly 500,000 individuals indicates that the risk of bladder cancer among smokers is higher than reported from previous population data, and that the risk for women smokers is comparable with that of men, according to a study in the August 17 issue of JAMA.

More than 350,000 individuals are diagnosed with bladder cancer per year worldwide, including more than 70,000 per year in the United States. Tobacco smoking is the best established risk factor for bladder cancer in both men and women, with previous studies indicating that current cigarette smoking triples bladder cancer risk relative to never smoking, according to background information in the article. “However, the composition of cigarettes has changed during the past 50 years, leading to a reduction in tar and nicotine concentrations in cigarette smoke, but also to an apparent increase in the concentration of specific carcinogens, including beta-napthylamine, a known bladder carcinogen…,” the authors write. They add that changing smoking prevalence and cigarette composition warrant revisiting risk estimates for smoking and bladder cancer.

Woman Smoking

Neal D. Freedman, Ph.D., M.P.H., of the National Cancer Institute, Department of Health and Human Services, Rockville, Md., and colleagues conducted a study to examine the association between tobacco smoking and bladder cancer using data from men (n = 281,394) and women (n = 186,134) in the National Institutes of Health-AARP (NIH-AARP) Diet and Health Study, who completed a lifestyle questionnaire and were followed up between October 1995 and December 2006. Previous studies of smoking and incident bladder cancer were identified by systematic review of the available literature.

During the course of follow-up, 3,896 men and 627 women were newly diagnosed with bladder cancer. Cigarette smoking was a significant risk factor for bladder cancer in both sexes. Relative to never smokers, former and current smokers had increased risk of bladder cancer in both men and women. Analysis of the data indicated that former smokers had a 2.2 times increased risk of bladder cancer and that for current smokers, the risk was about 4 times higher, relative to never smokers. “In contrast, the summary risk estimate for current smoking in 7 previous studies (initiated between 1963 and 1987) was 2.94,” the authors write.

Ever smoking explained a similar proportion of bladder cancer in both sexes, with population attributable risks of 50 percent in men and 52 percent in women.

The researchers write that factors that may have strengthened the cigarette smoking-bladder cancer association include changes in the constituents of cigarette smoke (such as increased concentrations of beta-napthylamine), and increased awareness of bladder cancer risk in smokers, which may prompt earlier diagnostic workup.

“These results support the hypothesis that the risk of bladder cancer associated with cigarette smoking has increased with time in the United States, perhaps a reflection of changing cigarette composition. Prevention efforts should continue to focus on reducing the prevalence of cigarette smoking.”

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Tests That Use DNA From Mother’s Blood to Determine Sex of Fetus Often Effective

As a noninvasive method of determining the sex of a fetus, tests using cell-free fetal DNA obtained from the mother’s blood after 7 weeks gestation performed well, while urine-based tests appear to be unreliable, according to a review and analysis of previous studies, reported in the August 10 issue of JAMA.

Noninvasive prenatal determination of fetal sex could provide an important alternative to invasive cytogenetic determination, which is currently the gold standard for determining sex and single-gene disorders. Amniocentesis has small but measurable rates of procedure-related pregnancy loss; and sonography can be performed as early as 11 weeks’ gestation to determine fetal sex, although not reliably, according to background information in the article. “The availability of a reliable noninvasive alternative to determine fetal sex would reduce unintended fetal losses and would presumably be welcomed by pregnant women carrying fetuses at risk for disorders,” the authors write.

Pregnant Mother and Son

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New approach to Thyroid Surgery eliminates neck scar

- Minimally invasive approach allows surgeons to remove thyroid tumors by way of the armpit
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As the rate of thyroid cancer continues to climb, doctors are urging patients to be more cautious about thyroid nodules, a common disorder that is responsible for a small but growing number of thyroid cancer cases. Thyroid nodules affect nearly 13 million Americans and are a result of abnormal cell growth on the gland. Until recently, the only way to remove nodules and rule out cancer was through surgery that required a five centimeter incision across the front of the neck. The procedure, and the large scar that resulted, was a deterrent for many patients who feared altering their appearance for something that may not be life threatening. Today however, a new option exists that allows surgeons to access the neck through the armpit, allowing for a biopsy of tissue with no visible scar.

“We now have a minimally invasive way of determining if a thyroid nodule is cancerous,” said Jose Dutra, MD, head and neck surgical oncologist and director of the Thyroid Surgical Clinic at Northwestern Memorial Hospital. “It’s an approach that more patients are comfortable pursuing. If we can identify cancerous cells earlier we increase the chance of removing the cancer before it spreads.”

The procedure, transaxillary robotic thyroid surgery, utilizes 3D cameras and specially designed robotic arms to create a small incision within the armpit, the mechanical arms work just like hands allowing the specialized surgeon to operate remotely with precise control and movements to remove suspicious nodules.

“The underarm area has fewer nerve endings than the anterior neck area, so there’s less pain, no scarring on the neck, and with good care, the incision will heal faster,” said Dutra who is also an associate professor at the department of otolaryngology/head and neck surgery at Northwestern University Feinberg School of Medicine.

This summer, Socorro Delaluz became one of the first patients at Northwestern Memorial to undergo transaxillary thyroid robotic surgery. The mother of two was impressed to have the option that left no visible scar and the quick recovery associated with the technique.

“I didn’t want to be reminded constantly, every morning when I get dressed that I had a scar across my neck. I would have to explain to everyone what happened all the time,” expressed Delaluz.

Another benefit of the minimally invasive approach is that the precision of the robot allows physicians to remove all of the potentially cancerous tissue while sparing more of the structure surrounding the gland.

“The thyroid gland controls how the body uses energy. Changes to the gland can cause a myriad of health issues,” explained Dutra, member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

Thyroid nodules are six-times more common in women than men and can be difficult to diagnose because they often do not present signs or symptoms. Most nodules are small and are often found incidentally during a routine physical or imaging for an unrelated condition. Conditions that can cause one or more nodules to develop in the thyroid gland range from overgrowth of normal thyroid tissue, tumors, a cyst, inflammation and goiters. Individuals should routinely check their neck and should talk with their doctor if they notice any lumps or experience symptoms such as swelling, trouble swallowing, and pain in the throat or hoarseness of the voice.

Robotic surgery is currently widely used for minimally invasive heart and lower abdominal procedures, only recently have the robotic arms been applied to the confined space involved in neck and head surgery. The benefits for robotic thyroid surgery include shorter recovery period, less pain in neck following surgery and better preservation of the laryngeal nerves and the parathyroid glands.

Jennifer Panaro recently had a large nodule removed from her thyroid gland by way of transaxillary thyroid robotic surgery and was back on the tennis court just six weeks after her surgery. The 28 year old was impressed with the speedy recovery and was pleased her voice was protected. “I was thrilled to not experience any changes in my voice or to have deal with a large scar on my neck. As an accountant, I talk to clients all day and I would be self conscious about having a foreign mark across my throat,” said Panaro, patient at Northwestern Memorial.

While the new technology has great advantages, Dutra stresses this option is not the best for all patients and not all tumors can be removed with this approach.

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Botox Receives A Positive Opinion for Urinary Incontinence

- Botox injections can provide long-lasting bladder control for patients with neurogenic bladder
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Marlow, United Kingdom – Allergan is pleased to announce that BOTOX® (botulinum toxin type A) has received a positive opinion from the Irish Medicines Board for the management of urinary incontinence in adults with neurogenic detrusor overactivity (NDO) resulting from neurogenic bladder due to stable sub-cervical spinal cord injury, or multiple sclerosis. This is an important step towards securing national licences in the 14 European countries involved in the Mutual Recognition Procedure and marks a key milestone in bringing this innovative treatment to patients suffering from urinary incontinence due to neurogenic detrusor overactivity. The positive opinion is specific for BOTOX® and is based on Allergan’s successful global phase III programme.

Botox

Between 60-80% of people with multiple sclerosis (MS) and 75-80% of people with spinal cord injury (SCI) will suffer from some degree of bladder dysfunction including urinary incontinence which can be distressing. Urinary incontinence in patients with MS or SCI is frequently caused by a condition called neurogenic detrusor overactivity (NDO), which results in involuntary contractions of the bladder during the filling stage when the bladder should be relaxed. This overactivity can lead to urinary incontinence (uncontrolled urinary leaking). Targeted injections of BOTOX® into the bladder muscle have been shown to reduce the involuntary contractions and increase bladder capacity. In turn, this reduces the number of urinary leaking episodes and may even stop leaking altogether in some patients.

In Europe, approximately 656,000 people live with MS and, on average, nearly 11,000 people are diagnosed with SCI per year. Many of these people face long-term mobility issues, yet remain professionally and socially active. Urinary incontinence can be a disabling and socially isolating condition. It is also associated with significant quality of life and emotional well-being implications such as embarrassment, low self esteem, depression and loss of independence. Other health implications of urinary incontinence in people living with MS or spinal cord injury include skin irritation and ulcers, kidney failure and recurrent urinary tract infections, which may lead to serious health consequences, if the overactivity of the detrusor muscle is not treated.

“We are pleased that BOTOX® has received a positive opinion following the Mutual Recognition Procedure for the treatment of urinary incontinence in people living with multiple sclerosis or spinal cord injury,” said Douglas Ingram, President of Allergan in Europe, Africa and the Middle East. “For many people with spinal cord injury or multiple sclerosis, gaining effective control over their bladder and staying dry can be a significant step towards improving daily functioning and overall quality of life. Our task now is to work closely with the national health authorities to secure the relevant national licences so that we can bring this valuable treatment option to patients, as quickly as possible.”

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Gastric Bypass Surgery changes food preferences

Gastric bypass surgery alters people’s food preferences so that they eat less high fat food, according to a new study led by scientists at Imperial College London. The findings, published in the American Journal of Physiology—Regulatory, Integrative, and Comparative Physiology, suggest a new mechanism by which some types of bariatric surgery lead to long-term weight loss.

A growing number of obese patients are choosing to undergo bariatric surgery in order to lose weight, with over 7,000 such procedures being carried out on the NHS in 2009-10. The most common and the most effective procedure is the ‘Roux-en-Y’ gastric bypass, which involves stapling the stomach to create a small pouch at the top, which is then connected directly to the small intestine, bypassing most of the stomach and the duodenum (the first part of the small intestine). This means that patients feel full sooner.

The new study involved data from human trials as well as experiments using rats. The researchers used data from 16 participants in a study in which obese people were randomly assigned either gastric bypass surgery or another type of operation, vertical-banded gastroplasty, in which the stomach volume is reduced but no part of the intestine is bypassed. The participants who had had gastric bypass had a significantly smaller proportion of fat in their diet six years after surgery, based on questionnaire responses.

In the rat experiments, rats given gastric bypass surgery were compared with rats that were given a sham operation. Rats that had gastric bypass surgery ate less food in total, but they specifically ate less high fat food and more low fat food. When given a choice between two bottles with different concentrations of fat emulsions, the rats that had gastric bypass surgery showed a lower preference for high fat concentrations compared with rats that had a sham operation.

Before and after gastric bypass surgery
- Before and after gastric bypass surgery

“It seems that people who’ve undergone gastric bypass surgery are eating the right food without even trying,” said Mr Torsten Olbers from Imperial College London, who performed the operations on patients in the study at Sahlgrenska University Hospital in Göteborg, Sweden.

Over 7,000 bariatric surgery procedures were carried out in England on the NHS in 2009-10.

Dr Carel le Roux, from the Imperial Weight Centre at Imperial College London, who led the research, said: “It appears that after bypass surgery, patients become hungry for good food and avoid junk food not because they have to, but because they just don’t like it any more. If we can find out why this happens, we might be able to help people to eat more healthily without much effort.”

The rat experiments suggested that the reduced preference for high fat food was partly due to the effects of digesting the food. There was no difference in preferences between gastric bypass rats and sham-operated rats when the rats were only given access to the bottles for a few seconds, suggesting that bypass rats did not dislike the taste of high fat emulsions when they were only allowed small volumes at a time.

Rats can learn to avoid foods that they associate with illness, so the researchers tested whether high fat foods would condition them to avoid certain tastes. They gave the rats saccharine-flavoured water while infusing corn oil into their stomachs. The gastric bypass rats learned to avoid saccharine, but the sham-operated rats did not, suggesting that the effect of digesting corn oil was unpleasant to the rats that had had gastric bypass surgery.

Levels of the satiety-promoting hormones GLP-1 and PYY were higher after feeding in the gastric bypass rats compared with sham-operated rats, suggesting a possible mechanism for the changes in food preferences. The team at Imperial plan to study the role of these hormones further to see if it might be possible to mimic the effects of gastric bypass without using surgery.

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