Partial cholecystectomy as a safe and viable option in the emergency treatment of complex acute cholecystitis: a case series and review of the literature.


Abstract

Partial cholecystectomy (PC) is an alternative choice to standard cholecystectomy in situations with increased risk of Calot’s components injury. We reported our experience with the patients treated with PC and reviewed the literature. Fifty-four patients with complex acute cholecystitis underwent PC, including conventional partial cholecystectomy (CPC; n = 48) and laparoscopic partial cholecystectomy (LPC; n = 6). The clinical diagnosis was verified by ultrasonography. In addition, we reviewed 1190 published cases (1972-2005) who underwent a “nonconventional” surgery for severe cholecystitis, including cholecystostomy, CPC, or LPC. Review of the literature, including our cases, showed a male:female ratio of 1.3:1. The major operative indication was severe acute cholecystitis. Procedures included cholecystostomy (65.8%) and PC (34.2%). In the follow-up (n = 1190), biliary leak (4.8%), retained stones (4.6%), recurrent symptoms (2.3%), wound infections (1.9%), persistent biliary fistula (0.9%), and prolonged biliary drainage (0.2%) were found, with an overall mortality rate of 9.4 per cent. In 133 patients, because of postoperative complications (e.g., recurrent symptoms, remaining common bile duct stones, or persistence of bile fistula), reoperation was necessary, including 121 cases (90.1%) of cholecystectomy, whereas the other 11 patients underwent other procedures such as common bile duct exploration or closure of the fistula. The surgical trend for complex acute cholecystitis treatment has been changed from only cholecystostomy to a spectrum of cholecystostomy, CPC, and LPC with the progressive increase of PC. The proportion of the LPC compared with CPC has also increased during recent years. It seems that PC is a safe procedure for treating complicated acute cholecystitis. Whether the indication and need for alternative techniques to standard cholecystectomy is changing should be evaluated in future studies.

A new way to generate insulin-producing cells in Type 1 diabetes .


A new study by researchers at Sanford-Burnham Medical Research Institute (Sanford-Burnham) has found that a peptide called caerulein can convert existing cells in the pancreas into those cells destroyed in type 1 diabetes-insulin-producing beta cells. The study, published online July 31 in Cell Death and Disease, suggests a new approach to treating the estimated 3 million people in the U.S., and over 300 million worldwide, living with type 1 diabetes.

“We have found a promising technique for type 1 diabetics to restore the body’s ability to produce insulin. By introducing caerulein to the pancreas we were able to generate new —the cells that produce insulin—potentially freeing patients from daily doses of insulin to manage their blood-sugar levels.” said Fred Levine, M.D., Ph.D., professor and director of the Sanford Children’s Health Research Center at Sanford-Burnham.

The study first examined how mice in which almost all beta cells were destroyed—similar to humans with —responded to injections of caerulein. In those mice, but not in normal mice, they found that caerulein caused existing in the pancreas to differentiate into insulin-producing beta cells. Alpha cells and beta cells are both endocrine cells meaning they synthesize and secret hormones—and they exist right next to one another in the pancreas in structures called islets. However, alpha cells do not normally become beta cells.

The research team then examined human pancreatic tissue from type 1 diabetics, finding strong evidence that the same process induced by caerulein also occurred in the pancreases of those individuals. The process of alpha cells converting to beta cells does not appear to have any age limitations—it occurred in young and old individuals—including some that had type 1 diabetes for decades.

“When caerulein is administered to humans it can cause pancreatitis. So our next step is to find out which molecule(s) caerulein is targeting on alpha cells that triggers their transformation into beta cells. We need to know this to develop a more specific drug,” said Levine.

Caerulein is a peptide originally discovered in the skin of Australian Blue Mountains tree frogs. It stimulates gastric, biliary, and pancreatic secretions, and has been used in humans as a diagnostic tool in pancreatic diseases.

“In addition to creating new beta cells, another issue that needs to be addressed to achieve a cure for type 1 diabetes is that any new beta cells will be attacked by the present in every patient with type 1 diabetes. We are currently working with Linda Bradley, Ph.D., professor in the Immunity and Pathogenesis Program, and co-author of the study, to couple our approach with an approach to reining in the autoimmune response,” added Levine.

Why do people often put on weight after they quit smoking?


Most smokers eat junk food nearly every day of their smoking lives, because they know that the cigarettes are already destroying most of their “healthy living,” so why bother to eat right, right? There are 45 million smokers in the United States, and coincidentally Americans eat about 50 billion hamburgers a year, so go figure. In fact, McDonald’s alone sells 75 burgers every second of every day.

smoke

How is this relevant? Fast food, beer and aspirin are a typical consumption regimen for many smokers, who don’t sleep well, have sicknesses last longer than non-smokers and have that constant hack cough. So no matter what weight a smoker may be “weighing in” at while smoking, that weight is likely to skyrocket after coming off nicotine. The hourly or bi-hourly stimulant keeps many smokers skinny or at the weight that they were when they started smoking, but there’s more health detriment in store for the “ex-smoker” who doesn’t understand a thing about nutrition.

Nicotine is a stimulant and a sedative – it kills appetite, but feeds long-term depression

Nicotine is a heavily used addictive drug and the leading preventable cause of disease, disability and death in the United States. Ninety percent of lung cancer cases involve cigarette addiction. So exactly what is nicotine? Nicotine is a naturally occurring clear liquid that turns brown when burned and smells like tobacco when exposed to air. It has very complex and UNPREDICTABLE effects on the brain and body.

Forget for a second about how nicotine makes smokers feel while they smoke it, and let’s talk about the long-term “feeling” that keeps them reeling backwards, losing not only the benefits of healthy living but the drive and motivation to fuel a progressive lifestyle. It has long been known that smokers have higher rates of depression than nonsmokers, but research reveals a deeper link, one of a causal relationship. Depression, quite often, leads to uncontrolled eating “binges” and a “lack of caring” about much at all. When smokers quit, they still have a need to feel enthusiastic, and without changing what they eat, that “enthusiasm” may be for convenient junk-science addictions like cheap chocolate, fried foods and just plain eating to occupy their time.

Quit smoking and eat more vegetables – the organic ones

If you quit smoking, you can get healthy and lose weight or simply maintain proper weight, without medication, surgery or consuming artificial sweeteners, which are all usually very detrimental to holistic health. Start first by reading articles and books that talk about oxygen-killing cancer cells. Organic vegetables feed your cells oxygen and can make you feel “full” even when your stomach is only half full. This is a strategy. Also, true spring water alkalizes an ex-smoker’s highly acidic body and brings energy and vitality into the new equation, fueling the innate desire to exercise. This is also a strategy. Strategies for obtaining and maintaining optimal health can be very simple. That leads us to talking about omega-3s (healthy fats) and how vitamin B complex can balance the central nervous system. This is a key third strategy to never putting on unhealthy weight after quitting smoking.

Omega-3s and vitamin B complex can help eliminate stress, anxiety and depression

The 7,000 chemicals in cigarettes disrupt the CNS, the central nervous system. This creates anxiety, nervousness and doubt. Nicotine provides just enough kick to make smokers feel normal for 20 minutes. Little do most smokers know when they quit that specific natural foods, vitamins and supplements boost dopamine and serotonin production, and balance the central nervous system. Vitamin B complex, mucuna, and cabbage are great examples of this.

Also, many nutrients, such as the B vitamins, are critical to proper brain function. In fact, fatty acid deprivation works against optimal brain power. The brain is almost entirely composed of fatty acids. Insert one avocado into your daily diet. Buy some coconut oil and flax seed oil. These will replace whatever salad dressings you were using. Remember to rotate your greens, including collard, spinach, kale and mustard greens. It’s no huge secret that this works. If you smoke, become a non-smoker today, and never put on a single pound of unwanted, unneeded weight; in fact, find your perfect balance with Natural News.

“It’s no secret that long-term diet and nutrition choices have an effect on the way we look and feel,” wrote Alexis Black for Natural News, “but new studies show that nutrition can also affect the way we think. As it turns out, there really is such a thing as ‘food for thought.'”

Do you know somebody who wants to quit smoking? Tell them about the natural method! (http://programs.naturalnews.com/14AndOut__TV.htm)

Sources for this article include:

http://psychcentral.com

http://addictions.about.com

http://www.womenshealthmag.com

http://science.naturalnews.com

http://science.naturalnews.com

Learn more: http://www.naturalnews.com/046230_quit_smoking_weight_gain_nicotine_addiction.html?utm_content=bufferadecf&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer#ixzz399kBGzG4

Psychologists Find a Surprising Thing Happens to Kids Who Read Harry Potter .


psychologists, find, a, surprising, thing, happens, to, kids, who, read, harry, potter,

Psychologists Find a Surprising Thing Happens to Kids Who Read Harry Potter

The news: Harry Potter’s greatest feat might not have been defeating Voldemort, but teaching young people around the world to battle prejudice. At least that’s the finding of a new paper in the Journal of Applied Social Psychology, which claims reading the Harry Potter series significantly improved young peoples’ perception of stigmatized groups like immigrants, homosexuals or refugees.

The studies: The Pacific Standard broke down the three studies used in this paper.

The first took 34 Italian fifth-graders and plunged them into a six-week course on Potter. The researchers began by having the students fill out a questionnaire on immigrants, and then split them into two groups which read selected passages from the series. The students in the first group discussed prejudice and bigotry as themes in the books, while the others didn’t, serving as a control group. The students in the first group showed “improved attitudes towards immigrants,” but only if they identified with Potter.

A second study with 117 Italian high school students found that a reader’s emotional identification with Harry was associated with more positive perceptions of LGBT people in general. A third, which surveyed U.K. college students, ultimately found no association between an emotional bond with Harry and perceptions of refugees. But it did indicate that students who had less of an emotional identification with Voldemort had “improved attitudes toward refugees.”

In all three studies, the researchers credited the books with improving the readers’ ability to assume the perspective of marginalized groups. They also claimed that young children, with the help of a teacher, were able to understand that Harry’s frequent support of “mudbloods” was an allegory towards bigotry in real-life society.

Why you should care: It’s impossible to rule out that there were inevitably other factors at work beyond the scope of the study, but if you’re a Harry Potter fan, this is wonderful news. It provides some experimental backing for J.K. Rowling’s opinion that, “The Potter books in general are a prolonged argument for tolerance, a prolonged plea for an end to bigotry.”

More importantly, it shows that conveying messages of tolerance through literature actually works. Potter’s journey of self-discovery, then, might some day be immortalized in projects that aim to teach tolerance to young children.

Penn team makes cancer glow to improve surgical outcomes .


The best way to cure most cases of cancer is to surgically remove the tumor. The Achilles heel of this approach, however, is that the surgeon may fail to extract the entire tumor, leading to a local recurrence.

With a new technique, researchers at the University of Pennsylvania have established a new strategy to help surgeons see the entire tumor in the patient, increasing the likelihood of a positive outcome. This approach relies on an injectable dye that accumulates in cancerous tissues much more so than normal tissues. When the surgeon shines an infrared light on the cancer, it glows, allowing the surgeon to remove the entire malignancy.

“Surgeons have had two things that tell where a cancer is during surgery: their eyes and their hands,” saidDavid Holt, first author on the study and professor of surgery in Penn’s School of Veterinary Medicine. “This technique is offering surgeons another tool, to light tumors up during surgery.”

Holt collaborated with a team from Penn’s Perelman School of Medicine led by Sunil Singhal, an assistant professor of surgery. Their paper appears in the journal PLOS ONE.

Between 20 and 50 percent of cancer patients who undergo surgery end up experiencing a local recurrence of their cancer, indicating that the surgeon failed to extract all of the diseased tissue from the site. Identifying the margins of a tumor can be difficult to do during a procedure, and typically surgeons have had to do this by simply looking at the tumor and feeling for differences with their fingers.

Seeking an alternative, Holt, Singhal and colleagues turned to near-infrared, or NIR, imaging. They chose to test the only Food and Drug Administration-approved contrast agent for NIR, a dye called indocyanine green, or ICG, that fluoresces a bright green under NIR light. ICG concentrates in tumor tissue more than normal tissue because the blood vessels of tumors have so-called “leaky” walls from growing quickly.

“Since 1958 when ICG was initially FDA approved, it has been used to examine tissue perfusion and clearance studies,” Singhal said. “However, our group has been experimenting with new strategies to use ICG to solve a classic problem in surgical oncology: preventing local recurrences. Our work uses an old dye in a new way.”

To see if visualizing ICG under NIR could help them define cancerous from non-cancerous tissues, the Penn-led team first tested the approach in mice. They administered ICG to mice with a type of lung cancer and found that they could use NIR to distinguish tumors from normal lung tissue as early as 15 days after the mice acquired cancer. These tumors were visible to the human eye by 24 days.

Next the researchers evaluated the technique in eight client-owned dogs, of various breeds and sizes, that had naturally occurring lung cancer and were brought to Penn Vet’s Ryan Veterinary Hospital for surgery. They received ICG intravenously a day before surgery, then surgeons used NIR during the procedure to try to visualize the tumor and distinguish it from normal tissue.

“It worked,” Holt said, the tumors fluorescing clearly enough to permit the surgeon to rapidly distinguish the cancer during surgery. “And because it worked in a spontaneous large animal model, we were able to get approval to start trying it in people.”

A human clinical trial was the final step. Five patients with cancer in their lungs or chest participated in the pilot study at the Hospital of the University of Pennsylvania. Each received an injection of ICG prior to surgery. During the procedure, surgeons removed the tumors, which were then inspected using NIR imaging and biopsied.

All of the tumors strongly fluoresced under the NIR light, confirming that the technique worked in human cancers.

In four of the patients, the surgeon could easily tell tumor from non-tumor by sight and by feel. In a fifth patient, however, though a CT and PET scan indicated that the tumor was a solitary mass, NIR imaging revealed glowing areas in what were thought to be healthy parts of the lung.

“It turns out he had diffuse microscopic cancer in multiple areas of the lung,” Holt said. “We might have otherwise called this Stage I, local disease, and the cancer would have progressed. But because of the imaging and subsequent biospy, he underwent chemotherapy and survived.”

Some other research teams have begun investigating NIR for other applications in cancer surgery, but this is the first time a group has taken the approach from a mouse model to a large animal model of spontaneous disease and all the way to human clinical trials.

One drawback of the technique is that ICG also absorbs into inflamed tissue. So in some patients that had inflamed tissues around their tumors, it was difficult or impossible to tell apart cancer from from inflamed tissue. The Penn researchers are working to identify an alternative targeted contrast agent that is specific to a tumor cell marker to avoid this problem, Holt said.

Is the Diagnosis of “Pre-Diabetes” More Harmful than Helpful?


The diagnosis of “pre-diabetes” is an all too common event across the entire globe. And while that term “pre-diabetes” was designed to help patients become aware of their impending risk of developing “type 2 diabetes,” a joint team of British and American researchers fear that labeling patients as “pre-diabetics” is both ‘unhelpful and unnecessary.’

Walgreens-Free-Blood-Sugar-Testing222421

Currently, the article reports that over 3 million people in the United Kingdom have type 2 diabetes and 30 million in the USA.

While there has been speculation that the diagnosis of “pre-diabetes” is actually harmful because patients may not take it seriously enough and dismiss how quickly they could progress to “type 2 diabetes”…these researchers concerns are actually heading in the opposite direction:

Prediabetes, also referred to as borderline diabetes, is often a precursor to developing type 2 diabetes. The researchers, writing in the British Medical Journal, state that many of those labelled as having prediabetes will not develop type 2 diabetes. For that reason, the researchers claim that there is no proven benefit of prescribing drugs.

Pre-diabetes is diagnosed based merely on a blood sugar reading that is trending towards the higher level of normal, and is accompanied by no symptoms of actual diabetes (such as thirst, fatigue, blurry vision, weight-loss, and increased need to urinate).

fasting plasma glucose test or an HbA1c test may be used to diagnose prediabetes. If test results are above the ceiling for prediabetes, a type 2 diabetes diagnosis may be given or further tests may be required.

Apparently even the World Health Organization doesn’t not actually use or recognize the term “pre-diabetes” but the term is used “frequently in research papers.”

Prof John Yudkin of University College London, explained that he feels “the current definitions of prediabetes risks “unnecessary” medicalisation and created ‘unsustainable burdens’ for healthcare systems.”

 

Medication Not Working? Your DNA May Explain Why .


A drug that worked wonders for your neighbor triggers nasty side effects in you — or triggers no effects at all. Why? According to the study of pharmacogenomics, the answer may come from your DNA.

Pharmacogenomics infographic

 

Child malaria vaccine ‘milestone’


 

Children being examined by doctors
Making malaria vaccine available for routine use will be a major milestone, researchers say

Reporting in PLOS Medicine, researchers found that for every 1,000 children who received the vaccine, an average of 800 cases of illness could be prevented.

And in continuing trials it went on to provide protection some 18 months after the injections were given.

Manufacturers GSK have now applied for regulatory approval – making this the first vaccine to reach this step.

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The landscape of malaria vaccine development is littered with carcasses, with vaccines dying left, right and centre – to get to this stage is very exciting”

Prof Sanjeev KrishnaSt George’s, University of London

Malaria affects millions of people worldwide and results in 800,000 deaths each year – the majority in children under five who live in sub-Saharan Africa.

Early defence

In the most advanced trial to date, involving several African countries, 15,000 infants and children were given the RTS,S vaccine.

Revisiting them 18 months after the last injection, researchers found that in young children the vaccine almost halved the number of cases of malaria.

And for infants (who were aged six to 12 weeks at first vaccination) the drug reduced episodes of malaria by a quarter.

Though the effectiveness of the vaccine was seen to wane over time, the report suggests it may have the largest impact in areas with high rates of disease.

For example, in some Kenyan cities, 2,000 cases of clinical malaria were prevented for every 1,000 children who received the drug (people in this area are at risk of repeated infections).

GlaxoSmithKline has now asked the European Medicine’s Authority to approve it for global use.

Booster doses

And the drug-makers say together with other preventative measures such as bed nets and insecticides, this could represent a huge step forward in malaria control.

Scientists are investigating whether a booster could further improve the chances of success.

Prof Sanjeev Krishna of St George’s University of London who was not involved in the research but reviewed the paper for the journal said: “This is a milestone. The landscape of malaria vaccine development is littered with carcasses, with vaccines dying left, right and centre.

“To get to this stage is very encouraging indeed. We eagerly await the next results to see how long-lasting protection is and whether a booster adds further potential.

“We need to keep a watchful eye for adverse events but everything appears on track for the vaccine to be approved as early as next year.”

Prof Brian Greenwood of the London School of Hygiene and Tropical Medicine, who was involved in the research, told the BBC: “To finally get a malaria vaccine licensed would be a huge leap forward.

“Though it does not provide 100% protection, for areas where malaria is commonplace this has the potential to have a real impact.”

GlaxoSmithKline (GSK) is developing RTS,S with the non-profit Path Malaria Vaccine Initiative, supported by funding from the Bill & Melinda Gates Foundation.

Middle-aged drinking ‘impairs memory’


 

Drinking
Patterns of alcohol consumption may have an impact on dementia risk
Problem drinking in middle age doubles the risk of memory loss in later life, research suggests.

A US study found men and women in their 50s and 60s with a history of alcohol abuse were more likely to have memory problems up to two decades later.

The study, in The American Journal of Geriatric Psychiatry, adds to growing evidence that excessive drinking can impair mental processing later.

Researchers say it is a public health issue that needs to be addressed.

Scientists questioned 6,500 US middle-aged adults about their past alcohol consumption.

They were asked three specific questions:

  • Had people annoyed them by criticising their drinking?
  • Had they ever felt guilty or bad about their drinking?
  • Had they ever had a drink first thing in the morning to steady nerves or get over a hangover?

Those who answered yes to one of these questions were considered to have a problem with alcohol.

They had more than double the risk of developing severe memory impairment, the study found.

“We know that alcohol is bad for the brain in general, but it’s not just how much you drink but how it affects you,” lead researcher, Dr Iain Lang, from the University of Exeter Medical School, told the BBC.

“The amount that you drink is important – what is also important is if you experience any problems in your drinking or if other people tell you you have a problem.”

He advised drinking within recommended daily and weekly amounts and to cut down if affected by any of the items in the questionnaire, as this could increase dementia risk.

Hidden cost

Dr Doug Brown, director of research and development at the Alzheimer’s Society charity, said there was a hidden cost of alcohol abuse, given mounting evidence that alcohol misuse can impact on cognition later in life.

“This small study shows that people who admitted to alcohol abuse at some point in their lives were twice as likely to have severe memory problems, and as the research relied on self-reporting that number may be even higher.

“This isn’t to say that people need to abstain from alcohol altogether. As well as eating a healthy diet, not smoking and maintaining a healthy weight, the odd glass of red wine could even help reduce your risk of developing dementia.”

Dr Eric Karran, science director at Alzheimer’s Research UK, said: “Although studies such as this one can be very useful for observing health trends, it’s important to note that they are not able to show cause and effect, and it’s not clear whether other factors may also have influenced these results.”

Broken robots ‘learn to keep going’


Engineers have taken a step towards having machines that can operate when damaged by developing a robot that can teach itself to walk, even with a broken leg.

Broken robot

Using “intelligent trial and error”, their six-legged robot learned how to walk again in less than 2 minutes.

“This new technique will enable more robust, effective, autonomous robots,” the engineers behind the robot said.

They said the aim was to mimic the behaviour of injured animals.

The trial-and-error methodology could have ramifications for robots used in the workplace and for military purposes. A robot that can keep attacking – no matter how damaged – brings to mind the relentless android from the Terminator films.

Terminator
The Terminator – though fictional – could figure out how to keep going when injured

According to one expert, adaptive robotics is the cutting edge of the field. Most robots currently sit in factories and perform very specific functions. Scientists want to get robots to understand new and changing situations.

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There are lots of applications beyond the military… such as robots on the Moon and Mars”

Dr Fumiya IidaUniversity of Cambridge

“The real challenge we are pursuing in robotics is robots that can adapt to uncertain and unstructured environments,” Dr Fumiya Iida, of the Machine Intelligence Laboratory at the University of Cambridge, told the BBC.

The scientists – Antoine Cully and and Jean-Baptiste Mouret of the Sorbonne in Paris and Jeff Clune of the University of Wyoming – published a research paper on their robot on Arxiv, a platform to release early versions of academic research that is overseen by Cornell University’s library.

Locomotion ‘a challenge’

“When animals lose a limb, they learn to hobble remarkably quickly,” Arxiv said in a blog post on the research. “And yet when robots damage a leg, they become completely incapacitated.”

The scientists’ robot has solved this by trying to mimic animals – by discovering which leg is broken and then then using trial and error to figure out the best way to continue walking.

“Locomotion is a major challenge,” Dr Iida said. “It’s an issue of energy efficiency. Robots are unusually very inefficient compared to animals.”

Other companies are also trying to mimic animals, such as Boston Dynamics, which is now owned by Google. It makes a variety of robots, including the internet sensation Big Dog, which can attain locomotion on a variety of different and difficult terrains.

Big Dog was funded by the US Defense Advanced Research Projects Agency (Darpa) and Boston Dynamics contracts for the US military – which is an area where the trial-and-error algorithms could be applied, especially to machines injured in warfare.

But Dr Iida said that military use was only one aspect of better adaptive robots.

Big Dog is one of the most advanced adaptive robots

“There are lots of applications beyond the military,” he said. “You can think of robots in extreme environments, so not only in warfare, but in space such as robots on the Moon and Mars, and in nuclear power plants. Think of Fukushima, for example, where humans can’t go.”

While these engineers are focused on self-learning robots, others are developing robots and materials that can “heal themselves” when they are damaged.

BAE Systems said recently that in the future, it could build drones that contained a lightweight fluid that would allow jets to heal themselvesfrom damage sustained in flight, as well as on-board 3D printers that can make new parts, while a new plastic that can fix itself has beendeveloped by engineers at the University of Illinois.