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Swedish Presents Research at 2013 AAN Annual Meeting

Neurologists and neuroscience professionals this week from around the world gathered at the American Academy of Neurology (AAN) 65th Annual Meeting in San Diego. The Multiple Sclerosis Center at Swedish Neuroscience Institute was pleased to co-author a few research trials presented at the meeting:

 

Teriflunomide and pregnancy

Dr. Lily Jung-Henson speaking at the AAN 65th Annual MeetingDr. Lily Jung-Henson, neurologist and Chief of Staff at Swedish Issaquah, spoke on behalf of a team of researchers about teriflunomide and a report on the safety of women who became pregnant on the medication. Teriflunomide is a once-daily, oral disease-modifying therapy (DMT) recently approved in the United States to treat relapsing multiple sclerosis. Clinical trials for teriflunomide took place among the many research studies for new treatments Swedish Neuroscience Institute offers patients with multiple sclerosis. (Read the full abstract here.)

Subset of a trial looking at endurance effects of Dalfampridine (AMPYRA®)

Dr. Angeli Mayadev, physical medicine and rehabilitation specialist at the MS Center, participated in this study of a medication to improve walking speed in people with MS. Dalfampridine -ER 10 mg twice daily significantly improved 6-minute walking distance compared to placebo. Dalfampridine 5 mg twice daily did not improve distance compared to placebo. Researchers also found that ....

New Cancer Center to Open April 1 at Swedish/Edmonds; Outpatient Facility to Provide Medical Oncology, Infusion Services Close to Home


 
 


  
Cancer-Center-Opening-2.jpg

Swedish Cancer Institute at Edmonds opens to the public at an April 17 ribbon-cutting ceremony on the Swedish/Edmonds campus. (Left to right) David Loud, aide from Congressman Jim McDermott, M.D.; Swedish Cancer Institute Medical Oncologist Richard McGee, M.D.; Swedish/Edmonds Chief Executive Dave Jaffe; and Swedish Cancer Institute Executive Director Thomas D. Brown, M.D., MBA, cut the ribbon during the event that attracted 250 visitors. The two-story facility, located at 21632 Highway 99 in Edmonds, provides high-quality and comprehensive medical oncology to patients through an infusion unit, laboratory, pharmacy, and access to Swedish’s electronic medical record system.
 
EDMONDS, WASH.
, March 21, 2013 – Swedish Health Services will open a new outpatient cancer center at the Edmonds campus on Monday, April 1, 2013 in response to the growing need for medical oncology and infusion (chemotherapy) services in the south Snohomish and north King County area. The new two-story, 17,102-square-foot facility is anticipated to handle as many as 175 patient visits each day and provide increased access to cancer-care services for people living north of Seattle.

MS Research Update: Pulse therapy for breakthrough multiple sclerosis

A small pilot study from the University of Southern California suggests a pulse adrenocorticotropic hormone (ACTH) therapy could be effective in patients with breakthrough multiple sclerosis attacks while on beta-interferon. “Breakthrough” attacks that occur after starting a disease modifying therapy (DMT).

 

The study compared the safety and benefits of monthly pulse ACTH to monthly methylprednisone (MP) pulse in patients on beta-interferon. Over 15 months, researchers found that those treated with ACTH had fewer relapses and fewer psychiatric side effects. ACTH gel is currently used to treat MS relapses, but researchers note it may be able to alter the body’s immune responses beyond producing steroids.

 

As I discussed with the Medscape reporter, Megan Brooks, last week, the results of this study are ....

Clinical Trials and Personalized Medicine - Interpreting Studies

Medicine does not search for truth. It searches for cure. It does not look for the universal, it tries to create exceptions.

Medicine emerged from witchcraft. It has always utilized the most advanced technology of its day. Medical models and reasoning always evolve and that evolution makes the previous model obsolete. One of the foundation models of modern medicine is the randomized controlled clinical trial.

The principal of the randomized controlled clinical trial is that a single observation needs to be validated and reproduced. The clinical trial provides an estimate of how often a particular observation will occur. It tells us that chemotherapy improves survival for patients with non-small cell lung cancer at one year from 20% to 29%. It tells us that FOLFOX treatment for advanced colon cancer gives a median time to progression of 8.7 months, response rate of 45%, and median survival time of 19.5 Months. This is accurate information about populations. It's use for the individual is a difficult problem.

Every person is a unit, no one is 20% or 29% or 45%. The question is...

SNI Research Aims to Expand Cerebral Palsy Therapy Options

Before they learn to crawl or walk, about 10,000 babies every year in the United States will develop a condition that will change how they will do just that. Cerebral palsy (CP) is a neurological condition caused by a brain injury before birth, during delivery or before a child’s second birthday. An estimated 800,000 Americans live with CP.

The most common symptom in CP is spasticity, an increase in muscle tension that impairs proper movement. Abnormal postures or movements, weakness or loss of muscle control and rigidity are also part of the constellation of CP signs and symptoms. While physical therapy remains the cornerstone for treatment, new medications and therapies for CP are being developed to help improve and manage symptoms.

Currently, Swedish Neuroscience Institute is participating in a study to determine the safety and tolerability of one such medication. Dalfampridine (AMPYRA ®) is a medication currently used to help improve walking speed in multiple sclerosis (MS) patients. This phase I clinical trial aims to evaluate AMPYRA’s® safety, tolerability and its effect on sensorimotor function of adults with CP. The study will look at how single and multiple doses of the medication have on CP patients, including:

  • Hand strength
  • Manual dexterity
  • Walking speed
  • Gait

There is no cure for cerebral palsy. Therapies for CP ...

Lung Cancer Screening

We screen for breast cancer with mammography, colon cancer with colonoscopy, and prostate cancer with blood tests and exams – why not lung cancer?

If you’re a smoker or a former smoker, or even if you’ve had significant second-hand smoke exposure, you’ve probably worried about your chances of getting lung cancer, and whether there is anything you can do about it. Perhaps you even asked your doctor about getting an x-ray; he or she may have told you that there is no proof that it helps. That’s because a national study done years ago showed no benefit from getting chest X-rays, and therefore it’s not recommended.

The studies

However, since 2000, Swedish has participated in an international study – the International Early Lung Cancer Action Project (I-ELCAP) - to see whether CT scans or CAT scans – very highly detailed X-rays – might be able to find lung cancer earlier and improve cure rates. The study was begun by a group of investigators from Cornell University in New York. They knew that CT scans were very sensitive and would probably show a lot of abnormalities, and that most of them wouldn’t be cancer, so they worked out a system to determine which abnormalities were likely to be cancer. Their system worked, and they showed that when lung cancer was discovered through their screening system the cure rate was over 80%. That’s remarkable, because the normal cure rate for lung cancer is only 15%.

Because of their success, the National Cancer Institute (NCI) began a randomized study with over 50,000 participants. Half of them got annual CT scans and the other half got only chest X-rays. The results were just completed and were very exciting. The group that got CT scans had 20% fewer deaths from lung cancer than the other group!

The results are still being analyzed and there are concerns about safety from too many interventions, radiation exposure, and cost. It will take time to work through these issues, and there is still no general endorsement of lung cancer screening. However, several national organizations now cautiously support screening in high risk groups that meet the criteria for the national study.

Who should get screened, and how?

Change your clock this weekend: it may help your ticker

Here’s a great reason to remember to turn your clocks back and sleep in an extra hour this weekend: it may be good for your heart.

More than 1.5 billion people reset their clocks every year, turning clocks backward by an hour in the fall and forward by an hour in the spring. These transitions can disrupt internal biologic rhythms and influence the duration and quality of sleep. But does losing or gaining that one hour have health consequences? A 2008 report in the New England Journal of Medicine by Dr. Janszky and colleagues suggests that it does. The authors showed that there is a significant increase in the daily rate of heart attack in the first few days after we “spring ahead” and get an hour less of sleep, but that in the first few days after we “fall back” and gain an hour of sleep, there are fewer heart attacks.

Sleep deprivation carries a high risk. Sleeping less than 5-6 hours per night is associated with significant increase in the risk of heart disease, stroke, diabetes, obesity and depression. But 40% of Americans...

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