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Microendoscope Provides An Alternative To Painful Muscle Biopsy
07.25.08 (1:15 pm)   [edit]
Using an unusual microscope with a tip the size of a needle, Stanford researchers are now able to look at tiny fibers of working muscles in live humans, with minimum discomfort to the patient - a development patients are sure to welcome.

This microendoscopy technique for viewing sarcomeres - microscopic lengths of muscle fiber about 3 millionths of a meter long - has advantages over the uncomfortable alternative, a muscle biopsy in which a portion of the muscle is removed for examination.

Sarcomeres are the basic contracting engines of muscle. They generally pull in a coordinated fashion, allowing us to walk down the sidewalk or throw a sinking curveball from the pitcher's mound. But out-of-sync sarcomeres are implicated in muscular dystrophy and other diseases of diminished muscular control. It is thought that disease may change the length of sarcomeres and cause havoc with muscle control because the force exerted by muscle is critically dependent on length.

To observe sarcomeres in action, researchers from Stanford's Bio-X program have devised a needle-thin probe, which is inserted through the skin into muscle. When a flash of finely tuned laser light is sent through the probe, the sarcomeres respond with light of their own to form a snapshot of muscle in action.

The researchers see the images in real time on a display screen. A change in the depth of focus of the rapidly scanning device can provide a three-dimensional movie.

"This is a method that does not require any operative procedures," said Mark Schnitzer, an assistant professor of biology and of applied physics. For the first time, "it allows us to view individual sarcomeres in live humans."

The breakthrough was reported online in the journal Nature on July 6.

The technology could prove useful in understanding how muscles are altered by spinal cord injuries or strokes as well as muscular diseases, according to another of the researchers, Scott Delp, a professor of bioengineering and of mechanical engineering and, by courtesy, of orthopedic surgery.

Other areas of interest include biomechanics, orthopedic reconstructions, prosthetic devices and tendon transfers, in which tension adjustments are a crucial element for patients relearning how to walk or grasp. "If you measure the length of the sarcomeres during surgery, then you can adjust them to work at their optimal length, giving maximum muscle strength," Delp said.

------------------------- ---
Article adapted by Medical News Today from original press release.
------------------------- ---

Research funding came in part from the Wallace H. Coulter Foundation and involved co-investigators from the Department of Bioengineering and the School of Medicine. Additional funding was provided by a Stanford Bio-X Interdisciplinary Initiatives award. The authors of the research paper, in addition to Schnitzer and Delp, are graduate students Michael Llewellyn, bioengineering and medicine, and Robert Barretto, biophysics.

Related information: Source: Dan Stober
Stanford University
 
Physician Owned Hospitals Linked To Shifts In Care
07.25.08 (1:15 pm)   [edit]
After physicians become part-owners of specialty hospitals, referrals for surgery and other hospital tests and treatments increase significantly, suggests a study in the July issue of Medical Care. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.

"Given the growth in physician-owned hospitals, these findings suggest that health care expenditures will be substantially greater for patients treated at these institutions relative to persons who obtain care from non self-referral hospitals," writes Jean M. Mitchell, Ph.D., of Georgetown University, Washington, D.C.

Dr. Mitchell analyzed patterns in the care of Oklahoma workers compensation patients treated for back and spine problems from 2001 to 2004. Her focus was on how physicians' practice patterns changed after they became part-owners of specialty hospitals. Recent years have seen a growing number of physician-owned specialty hospitals, which are limited to providing specialized, relatively profitable services such as spine, orthopedic, or heart surgery.

During the period studied, two new physician-owned specialty hospitals an orthopedic hospital and a spine hospital opened in the Tulsa area. Dr. Mitchell compared changes in practice patterns for doctors who did and did not become part-owners of one of these two hospitals.

Referrals for complex spinal surgery jumped 650 percent

The results showed a significant increase in referrals for certain treatments and tests after physicians gained ownership interest. The most dramatic change was a 650 percent increase in patients referred for "complex" spinal fusion surgery: from 0.1 percent before ownership to 6.51 percent after ownership. In contrast, for non-owner physicians, referrals for complex spinal fusion surgery remained stable at less than one percent.

At the same time, physician-owners became less likely to refer patients for less-costly "simple" spinal fusion surgery, compared to an increase in such referrals for non-owners. Physicians who became owners also became more likely to refer patients for ancillary services performed at specialty hospitals, including physical therapy and diagnostic tests such as MRI scans.

Specialty hospitals are generally exempted from federal and state laws banning physicians from referring patients to facilities where they have an investment interest. Proponents of specialty hospitals contend that, by concentrating on a single area, these facilities can lower costs while potentially enhancing quality. However, critics suggest that financial incentives create an inherent conflict of interest for physician owners.

The new results suggest that physicians' behavior changes after they become owners of specialty hospitals, including a dramatic increase in referrals for complex and costly spinal operations. As the market share of physician-owned specialty hospitals continues to rise, health care costs may be higher for patients treated at these centers than for patients treated by physicians who do not profit from self-referrals, Dr. Mitchell believes. She concludes, "These findings should be of interest to policymakers and third party insurers who are concerned about increased utilization associated with physician self-referral arrangements and its subsequent contribution to escalating health care expenditures for individuals with good insurance coverage."

About Medical Care

Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. Medical Care provides timely reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services. In addition, numerous special supplementary issues that focus on specialized topics are produced with each volume. Medical Care is the official journal of the Medical Care Section of the American Public Health Association. Visit the journal website at http://www.lww-medicalcare.com" title="http://www.lww-medicalcare.com" target="_blank"http://www.lww-medicalcare.co....

About Lippincott Williams & Wilkins

Lippincott Williams & Wilkins (http://www.LWW.com" title="http://www.LWW.com" target="_blank"http://www.LWW.com) is a leading international publisher for healthcare professionals and students with nearly 300 periodicals and 1,500 books in more than 100 disciplines publishing under the LWW brand, as well as content-based sites and online corporate and customer services. LWW is part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.

Wolters Kluwer Health is a division of Wolters Kluwer, a leading global information services and publishing company with annual revenues (2007) of €3.4 billion ($4.8 billion), maintains operations in over 33 countries across Europe, North America, and Asia Pacific and employs approximately 19,500 people worldwide. Visit http://www.wolterskluwer.com" title="http://www.wolterskluwer.com" target="_blank"http://www.wolterskluwer.com for information about our market positions, customers, brands, and organization.

Lippincott Williams & Wilkins
530 Walnut St.
Philadelphia, PA 19106
United States
http://www.lww.com" title="http://www.lww.com" target="_blank"http://www.lww.com
 
Published Study Demonstrates Effectiveness Of Vitalstim Therapy For Patients Suffering With Dysphagia
07.25.08 (1:14 pm)   [edit]
A recent study published in the April 2008 issue of the Annals of Otology, Rhinology & Laryngology has revealed the positive clinical effect of the adjunctive use of VitalStim® Therapy. A leading brand within the Empi Recovery Sciences line of pain management and rehabilitation products, VitalStim is a non-invasive neuromuscular electrical stimulation (NMES) device for the treatment of dysphagia. Results of the study were also originally presented at the American Association of Speech-Language Pathology Conference in Miami, Fla. in November 2006.

Dysphagia, or difficulty swallowing, is a sorely neglected medical condition which affects 15 million Americans and is generally caused by a neurological disorder or event, such as a stroke, degenerative neurological diseases and head and neck cancer. Without proper management, dysphagia can lead to aspiration, pneumonia, choking, chronic malnutrition, severe life-threatening dehydration, an increased rate of infection, longer hospital stays, long-term institutional care and even death.

VitalStim Therapy is a non-invasive external electrical stimulation therapy that was cleared to market by the FDA in December 2002. VitalStim is a portable, dual-channel electrotherapy system that is used with electrodes specifically designed for application to the muscles of the throat to promote swallowing.

Entitled "Adjunctive Neuromuscular Electrical Stimulation for Treatment-Refractory Dysphagia," the study details the measured clinical effect of the VitalStim program on six patients with chronic, treatment-refractive dysphagia. The study describes a prospective case series using validated outcome measures to represent different domains and a standard program of dysphagia therapy, which includes a consistent application of NMES following VitalStim Therapy protocol.

Patients received an average of 12 treatment sessions throughout the study. Following the treatment, patient measurements demonstrated key findings, including:

- 80 percent of patients reached the defined primary end-point of clinical improvement in swallowing ability, with significant Mann Assessment of Swallowing Ability (MASA) score improvements;

- All patients in the study significantly increased the range and amount of materials consumed orally - 83 percent of the patients increased their Functional Oral Intake (FOIS) score by at least two scale points, with most of the patients progressing from a restricted, single-consistency diet to a full oral diet;

- The average weight gain for the group over the three-week treatment period was two pounds;

- Patients involved in the study perceived significant improvement in their ability to swallow after treatment - no patient rated their post-therapy swallowing ability as lower than their baseline score;

- No patient experienced any swallowing-related medical complication over the treatment period.

The study was led by Giselle D. Carnaby-Mann, MPH, Ph.D., associate research scientist in the Department of Behavioral Science and Community Health at the University of Florida, and Michael A. Crary, Ph.D., professor in the Department of Communicative Disorders at the University of Florida. In addition, both are co-directors of the Swallowing Research Laboratory at the University of Florida.

Six months following completion of the treatment period, four of the patients completing the protocol returned for a medical review. Post-treatment examinations showed no statistically significant changes in clinical outcome measures, showing sustained efficacy after cessation of treatment.

For more information, please visit http://www.vitalstimtherapy.com/research" title="http://www.vitalstimtherapy.com/research" target="_blank"http://www.vitalstimtherapy.c....

About Empi, Inc.

Headquartered in St. Paul, Minnesota, Empi is a leading manufacturer and provider of non-invasive medical products for pain management and physical rehabilitation. Empi is committed to delivering positive patient outcomes and providing innovative products specifically designed to meet the needs of the patient, medical professional, and payor. For additional information on the company, please visit http://www.empi.com" title="http://www.empi.com" target="_blank"http://www.empi.com. Empi is a DJO company.
 
MAKO Uses SolidWorks Software To Design Robotics And Implants For Minimally Invasive Surgery Alternative
07.25.08 (1:13 pm)   [edit]
More than 1,000,000 stiff and aching knees worldwide get replaced every year, many of which are now candidates for a breakthrough, minimally invasive knee surgery option called MAKOplasty®. All of the procedure's key components - including a robotic arm and minimally-invasive resurfacing knee implants - were designed in SolidWorks® 3D CAD software.

Based on more than 200 licensed or owned patent applications and patents, MAKOplasty enables orthopedic surgeons to treat patient-specific, early- to mid-stage osteoarthritic knee disease with consistent, reproducible precision. The procedure employs the MAKO Tactile Guidance System™ (TGS™), a proprietary, FDA-cleared surgeon-interactive robotic arm system that controls surgeons' movements through the use of tactile resistance technology. Computer-generated virtual surfaces guide surgeons and the robotic arm along their planned path and focus cutting on patient-specific 3D visualizations, based on pre-operative imaging. The surgeon can confidently make complex tissue-sparing and bone-conserving cuts. Any necessary adjustments can be made during the operation, and patients stand to recover faster.

The Fort Lauderdale, Fla., MAKO Surgical Corp. used SolidWorks software to design the TGS, which uses proprietary cable-drives instead of gears to make the robotic arm extremely human-interactive, enabling very high-fidelity tactile response. Knee replacement doesn't have to be 'total'

"The implants and instruments benefit from SolidWorks' rapidly improving surfacing capabilities, and the TGS design benefits from SolidWorks' large assembly and motion simulation capabilities," said MAKO CTO, Senior Vice-President and Co-founder Rony Abovitz. "We also use SolidWorks to design the virtual volumes - the safe cutting zones, if you will - that guide the surgeon in reshaping patients' bone surfaces prior to implanting. SolidWorks handles all of these jobs well, and the software is easy for our engineers to learn no matter what platform they've learned on."

The MAKOplasty design effort has been under way since 1997, tracing its surgical navigation and medical robotics roots to a wide range of licensed and internally developed technologies, notably the MIT Artificial Intelligence (AI) Lab, Northwestern University's Lab for Intelligent Machines, and The Cleveland Clinic. One of the original seats of SolidWorks was used by William Townsend, CEO of Barrett Technology and the co-inventor of core cable-drive robot technologies (WAM™ arm) at the MIT AI Lab.

"Bill Townsend introduced me to SolidWorks co-founder Jon Hirschtick in the late 1990's - the two had been friends for some time. Since the introduction, we have had a long connection and affinity with SolidWorks - the karma is good, and the results we have produced to date with it have been great," said Abovitz.

SolidWorks Corporation Vice President of Worldwide Marketing and Strategy Rainer Gawlick said, "MAKOplasty represents a substantial leap in the state of the art, one that stands to benefit a vast and rapidly growing population. It will be interesting to see patients benefit and the company gradually expand its range of robotic arm-assisted procedures."

MAKO Surgical relies on authorized SolidWorks reseller The SolidExperts for ongoing software training, implementation, and support.
 
Increased Risk Of Developing Rheumatoid Arthritis When Birth Weight Exceeds 10 Pounds
07.25.08 (1:12 pm)   [edit]
People who have a birthweight over 10 pounds are twice as likely to develop rheumatoid arthritis when they are adults compared to individuals born with an average birthweight, according to a study published by researchers from Hospital for Special Surgery online in advance of print in the Annals of the Rheumatic Diseases. While the mechanism for this association is unclear, the study identifies a potentially modifiable risk factor and highlights a potential way to decrease the incidence of the disease.

"There may be a relationship between being born over 10 pounds and getting rheumatoid arthritis later in life," said Lisa Mandl, M.D., MPH, who led the study and is an attending rheumatologist at Hospital for Special Surgery (HSS) in New York City. "If there was some way that you could prevent someone from getting rheumatoid arthritis by making sure their birth weight wasn't over 10 pounds, this is a risk factor that could be modifiable. You can't change someone's age. You can't change someone's gender, but potentially you could change someone's birth weight. This is however only speculative at this point."

Previously, investigators have demonstrated that an increased risk of adult onset chronic disease can be a function of the fetal environment. Strong associations between low birth weight and an increased risk of type 2 diabetes mellitus, coronary heart disease and hypertension have been documented in a number of different populations. Published in 2003, a case-control study of roughly 400 individuals in Sweden identified an association between high birthweight and rheumatoid arthritis.

To see if this association played out in a larger population, Dr. Mandl and colleagues turned to a study of 87,077 women in the Nurses' Health Study. In 1976, nurses were invited to participate in this study that involved a baseline survey and then a biennial questionnaire regarding health status, lifestyle, family medical history and health practices. The investigators excluded women who had cancer or any type of connective tissue disease at baseline or follow-up because these can cause joint swelling, symptoms that can be confused with rheumatoid arthritis. Also excluded were women who reported having rheumatoid arthritis or connective tissue disease during follow-up, but in whom the diagnosis could not be confirmed by review of their medical record. The study population included only women who answered a 1992 survey that collected information about birthweight. After these exclusions, 87,077 individuals were included in the study and 619 of them developed rheumatoid arthritis.

Through statistical analysis, the investigators discovered that a birthweight of greater than 4.54 kg doubled the risk that a person would develop rheumatoid arthritis as an adult compared with individuals who had an average birthweight.

"In utero, the fetus will react appropriately to different stressors. However, this may preprogram the fetus so that when it gets out into the world, this preprogramming is not helpful out in the 'real world'," said Dr. Mandl. In other words, the fetal environment may be preprogramming people's brains or endocrine systems to be maladapted in later life.

"There have now been two different groups, in different countries with different patients born at different times, that both suggest a similar relationship between birthweight and rheumatoid arthritis," said Dr. Mandl. "I hope that other people will think about looking for this association in other populations."

Dr. Mandl says that patients with rheumatoid arthritis are known to have a dysregulated hypothalamic-pituitary-ad renal (HPA) axis, and this axis may be affected in utero. The HPA axis is the body's neuroendocrine system that involves the hypothalamus, pituitary and adrenal glands; this system is responsible for handling stress by regulating the production of cortisol, neurotransmitters and key hormones.

"If you look at this as a theoretic biologic underpinning for why this might be true, it might give basic scientists interesting ideas to think about regarding what causes rheumatoid arthritis, and provide support for a new hypothesis," Dr. Mandl said.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, about 2.1 million people, or between 0.5 and 1 percent of the U.S. adult population, have rheumatoid arthritis, an autoimmune disease that causes chronic inflammation of the joints. The disease is more common in women and has no cure, but can be managed in a way that allows individuals to live productive lives.

------------------------- ---
Article adapted by Medical News Today from original press release.
------------------------- ---

In addition to researchers from Hospital for Special Surgery and Weill Cornell Medical College, investigators from the Brigham and Women's Hospital, Harvard Medical School contributed to the study. This research was supported by grants from the National Institutes of Health.

About Hospital for Special Surgery

Founded in 1863, Hospital for Special Surgery (HSS) is a world leader in orthopedics, rheumatology and rehabilitation. HSS is nationally ranked No. 1 in orthopedics and No. 3 in rheumatology by U.S. News & World Report (2007), and has received Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center. In 2008 and 2007, HSS was a recipient of the HealthGrades Joint Replacement Excellence Award. A member of the NewYork-Presbyterian Healthcare System and an affiliate of Weill Cornell Medical College, HSS provides orthopedic and rheumatologic patient care at NewYork-Presbyterian Hospital at New York Weill Cornell Medical Center. All Hospital for Special Surgery medical staff are on the faculty of Weill Cornell Medical College. The hospital's research division is internationally recognized as a leader in the investigation of musculoskeletal and autoimmune diseases. Hospital for Special Surgery is located in New York City and online at http://www.hss.edu/" title="http://www.hss.edu/" target="_blank"http://www.hss.edu/.

Source: Phyllis Fisher
Hospital for Special Surgery
 
New Drug Prevents Dangerous Complications Of Hip And Knee Surgery, Says McMaster Professor
07.25.08 (1:10 pm)   [edit]
A McMaster University researcher predicts a new oral blood thinner will revolutionize treatment for preventing dangerous blood clots in patients undergoing hip and knee surgery.

Dr. Alexander Turpie, professor of medicine in the Michael G. DeGroote School of Medicine, oversaw four major international studies on the drug rivaroxaban (Xarelto). All studies found the drug was significantly more effective than the current standard enoxaparin (low molecular weight heparin) in preventing venous thrombosis (VTE).

VTE begins with a blood clot in a vein and is a serious, frequent and potentially fatal complication of major orthopedic surgery.

Heparin and warfarin are the anticoagulants commonly used to treat this condition but warfarin, in particular, is difficult to monitor because it changes with diet, other drugs and alcohol. "Much of that will be overcome with this new drug," Turpie said.

Turpie chairs the executive committee for the RECORD clinical program (Regulation of Coagulation in major Orthopedic surgery reducing the Risk of DVT and PE), a global program of four clinical trials (RECORDS1, 2, 3 and 4) involving more than 12,500 patients which is comparing oral rivaroxaban with injectable enoxaparin.

He is presenting a meta-analysis of the four studies today (Thursday, June 26) at the 20th International Congress on Thrombosis in Athens, Greece. "It will be the first time people will see the dramatic benefits," he said. "When you put it all together, you can see the growth and potential for this drug."

Results of the RECORD3 clinical trial, of which Turpie is the senior author, appear today (Thursday, June 26) in the New England Journal of Medicine (NEJM).

RECORD3 is a randomized, double-blind trial of 2,531 patients undergoing total knee replacement surgery. Patients received either oral rivaroxaban, 10 mg once daily, beginning six to eight hours after surgery, or a 40 mg injection of enoxaparin once a day, beginning 12 hours before surgery.

Both treatments continued for 10 - 14 days.

For patients treated with rivaroxaban, there was a 49 per cent relative risk reduction (RRR) in total VTE and a 62 per cent RRR in major VTE compared with those treated with enoxaparin. Both drugs showed a low rate of bleeding.

In the same NEJM issues, other researchers reported on the RECORD1 study which also found rivaroxaban was "significantly more effective" than enoxaparin.

An accompanying editorial in the NEJM suggested the positive reports from the two RECORD studies raises questions that reach far beyond individual drugs to the overall process of drug development, such as: What are the guiding principles for developing safe, effective and widely applicable anticoagulants?

Rivaroxaban is a novel, oral, once-daily direct Factor Xa inhibitor in advanced clinical development for a wide range of indications to prevent and treat blood clots. It works at a pivotal stage in the complex coagulation process to directly inhibit the enzyme Factor Xa. Based on extensive studies, the drug has been shown to have a wide therapeutic window without the need for routine monitoring.

The drug is being jointly developed by Bayer HealthCare and Johnson & Johnson Pharmaceutical Research & Development, L.L.C.

It is not licensed for sale in Canada. Bayer Inc. has submitted a regulatory filing to Health Canada for approval to market rivaroxaban.

The number of total knee and total hip replacements is rising in Canada, with the majority of procedures being performed on people aged 55 and older.

From 2004 to 2005, close to 60,000 people underwent hip and knee replacement surgeries in Canada. Among these patients, blood clots are the most common cause of re-hospitalization. VTE is considered the most frequent preventable serious and potentially fatal complication following major orthopedic surgery.

The threat of blood clots goes far beyond orthopedic surgeries: Blood clots are one of the leading causes of global disease and death in many patients, including those with atrial fibrillation, heart attack, acutely ill hospitalized patients, such as those with cancer.

McMaster University
 
Anesiva Commences Phase 2 Trial Of Adlea(TM) In Arthroscopic Shoulder Surgery
07.25.08 (1:09 pm)   [edit]
Anesiva, Inc. (Nasdaq: ANSV) announced that it has begun a Phase 2 clinical trial of Adlea(TM), the company's long-acting, site specific, non-opioid drug candidate for the management of acute pain in patients undergoing arthroscopic shoulder surgery involving rotator cuff repair.

Adlea is currently in two pivotal Phase 3 trials in the U.S.: one in total knee replacement surgeries and one in bunionectomy surgeries. An additional Phase 2 Adlea trial is in progress in total hip replacement surgeries. These trials are among those intended to support an Adlea label indication for the management of acute pain following orthopedic surgery.

The Phase 2 arthroscopic shoulder surgery trial is being conducted in South Korea. Unlike the United States, where the procedure is often conducted on an outpatient basis, arthroscopic shoulder surgery patients in South Korea are routinely hospitalized for up to two days, thus allowing more extensive near-term follow-up.

"We believe Adlea holds promise for treating pain associated with a number of orthopedic surgical indications, and may reduce the need for other pain treatments such as opioids," said Michael L. Kranda, Anesiva's president and chief executive officer. "As we pursue a broad indication of management of post-surgical pain following orthopedic procedures, each specific procedure that we can evaluate will add to the breadth of available data for Adlea."

Arthroscopic surgery is performed through small incisions using an arthroscope, or camera, to visualize the inside of a joint. Through the incisions, a surgeon inserts a camera and small instruments to perform the procedure. According to the American Academy of Orthopedic Surgeons, about six million Americans go to the doctor each year for shoulder pain, dislocation, or other shoulder problems and up to 500,000 arthroscopic shoulder surgeries are performed in the United States each year.

This multicenter, randomized, double-blind, dose-escalating, placebo-controlled study is evaluating the safety, tolerability, efficacy, and pharmacokinetics of a single dose of Adlea administered via injection following surgical closure of the wound. The trial is designed to enroll 74 patients.

Anesiva announced approval of its investigational new drug application for Adlea in South Korea in June 2008.

How Adlea May Address the Need for Long-Duration, Well-Tolerated Pain Relief

Adlea is a long-acting, non-opioid drug with the potential to provide pain relief for weeks to months after a single localized treatment. Its novel mechanism of action results in site-specific analgesia, which has the potential to reduce the use of and minimize the side effects associated with systemically administered analgesic drugs, such as opioids and NSAIDs.

Adlea is a highly purified form of capsaicin (derived from chili peppers) that acts primarily on C-fiber neurons, which transmit long-term pain, by binding to and desensitizing the TRPV1 pain receptors. This leads to a prolonged, reversible and localized desensitization of the pain fibers. The drug generally has a short half-life of 1 to 2 hours, and is undetectable in the blood after 24 hours.

Adlea's short duration of systemic exposure relative to the longer duration of analgesia may offer a safe, additive treatment option in the management of post-surgical orthopedic pain, as well as pain due to moderate to severe osteoarthritis. In clinical trials to date, adverse events have been similar in patients receiving Adlea or placebo.

About Anesiva and its Diverse Pipeline of Pain Products

Anesiva, Inc. is a late-stage biopharmaceutical company that seeks to be the leader in the development and commercialization of novel pharmaceutical products for pain management. The company's first commercial product, Zingo(TM), is available in the U.S. for the reduction of pain associated with peripheral venous access procedures in children ages three to 18.

The next product in Anesiva's pipeline, Adlea(TM), is currently being evaluated in two pivotal Phase 3 clinical trials to support an indication for the management of acute pain following orthopedic surgery. Adlea has been shown to reduce pain after only a single administration for weeks to months in multiple settings in mid-stage clinical trials for site-specific, acute and chronic, moderate-to-severe pain.

Anesiva is based in South San Francisco, CA. For more information about Anesiva's leadership in the development of products for pain management, and an overview of the clinical challenges being addressed by its product candidates, go to http://www.anesiva.com" title="http://www.anesiva.com" target="_blank"http://www.anesiva.com.

Forward Looking Statements

This press release includes "forward-looking statements" within the meaning of the safe harbor provisions of the United States Private Securities Litigation Reform Act of 1995. Words such as "expect," "estimate," "project," "budget," "forecast," "anticipate," "intend," "plan," "may," "will," "could," "should," "believes," "predicts," "potential," "continue," and similar expressions are intended to identify such forward-looking statements. Forward-looking statements in this press release include matters that involve known and unknown risks, uncertainties and other factors that may cause actual results, levels of activity, performance or achievements to differ materially from results expressed or implied by this press release. Such risk factors include, among others: the timing and results of our clinical trials, and our regulatory approval strategy for Adlea. Actual results may differ materially from those contained in the forward-looking statements in this press release. Additional information concerning these and other risk factors is contained in Anesiva's annual report on Form 10-K for the year ended December 31, 2007 and most recently quarterly report on Form 10-Q.

Anesiva undertakes no obligation and does not intend to update these forward-looking statements to reflect events or circumstances occurring after this press release. You are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this press release. All forward-looking statements are qualified in their entirety by this cautionary statement.

Anesiva, Inc.
http://www.anesiva.com" title="http://www.anesiva.com" target="_blank"http://www.anesiva.com
 
Orthopedic Surgeon Offers Tips For Avoiding Throwing Injuries In Young Athletes
05.30.08 (2:08 pm)   [edit]
As the weather begins to warm, major leaguers are not the only athletes reporting to spring training. Chicago's south suburbs are home to one of the largest collections of youth sports clubs in the country. With baseball season approaching, area physicians anticipate seeing an increase in shoulder and elbow injuries in young athletes. "Over-use injuries are a very common problem for young athletes, particularly throwing athletes," explained orthopedic surgeon and sports medicine specialist Gregory Primus, M.D., of Advocate South Suburban Hospital in Hazel Crest, Ill. "Athletes, parents, and coaches can take steps to prevent over-use injuries by recognizing the symptoms and understanding the importance of proper technique."

Over-use injuries can occur in any sport, but are particularly common in young baseball pitchers whose bodies are still developing. "Pitching is not a natural movement for the arm and forces stress on both the elbow and shoulder," Dr. Primus explained. "Throwing a high pitch count that is unregulated can cause damage and inflammation to the growth plates in the arm. This is known as little leaguer's elbow or shoulder."

According to the American Academy of Orthopedic Surgeons (AAOS) this condition occurs when repetitive throwing creates an excessively strong pull on the tendons and ligaments of the elbow or shoulder. Continued pulling can stress the ligament and tendons attachments to bone resulting in abnormal bone growth, small tears, or at worst deformity.

"When little league elbow occurs, there is pain on the inside of the elbow," Primus explained. "At the first sign of pain or any restriction in the range of motion, the player should consult a sports medicine physician. Another symptom to note is if the child's elbow joint locks when he or she throws."

In rare cases, it may be necessary to discontinue pitching for a short period in order to prevent further damage and start the healing process. "Over-use injuries can be serious if the condition is not addressed early," Dr. Primus said. "If the child does not take a break from throwing, his or her future ability to play the sport may be jeopardized. Serious complications can arise if the arm is not rested and treated."

In most cases, over-use injuries can be treated with rest and icing of the affected area. "The athlete must not resume the activity until the pain is entirely gone," said Dr. Primus. "Apply an ice pack to the affected area for 15 to 20 minutes, four to five times a day until the pain dissipates."

A physical therapy plan will aid healing and get the child back in the game. "The child should work with his or her doctor to develop a plan with both strengthening and range of motion exercises," Dr. Primus said. "When returning to throwing, the child must ease into the activity. The coach should be involved with developing a plan to gradually increase the numbers of pitches the player can make." In extreme cases, some children may require surgery to repair damage. "Prevention is really key in avoiding over-use injuries," Dr. Primus said. "Young athletes need to be trained in proper technique and form. They should always warm-up and stretch their muscles before pitching in practice or a game."

Pitchers must limit the number of pitches that are thrown in a week. While there are not nationally standardized limits, most club leagues have set guidelines. "Coaches need to carefully track of the number of pitches thrown by young players," explained Dr. Primus.

Primus also wants to remind young athletes to play for fun and not let competitiveness get in the way of safety. "Club sports are very competitive and some athletes might not speak up if they are feeling pain because they don't want to miss playing time," said Dr. Primus. "What they have to remember is that the longer they wait to treat an injury, the more serious it will become. In the end, this is going to lead to even more missed playing time."

To make an appointment with Dr. Primus, or another Advocate South Suburban Hospital physician, call 1-800-3-ADVOCATE (1-800-323-8622). Advocate South Suburban Hospital is a 289-bed, acute care facility that serves Chicago's south suburbs. In addition to offering a wide array of hospital services, the not-for-profit facility provides free screenings and a variety of other outreach services throughout the community. As part of Advocate Health Care, Advocate South Suburban Hospital can be reached at http://www.advocatehealth.com/southsub" title="http://www.advocatehealth.com/southsub" target="_blank"http://www.advocatehealth.com....

Advocate South Suburban Hospital
 
Neurologic And Orthopedic Institute: One Of The First In The Country To Offer Custom-Fit Total Knee Replacement
05.30.08 (2:07 pm)   [edit]
Baby boomers who have it all, including custom clothes and sports equipment, are now beating the physical signs of old age with custom body parts, including knees. Patients with degenerative knee conditions can now benefit from custom-fit knee replacements that are tailored to an individual's unique body mechanics, size and gender variations.

Dr. Mitchell Sheinkop, orthopedic surgeon at the Neurologic and Orthopedic Institute of Chicago, is one of the first in the country to offer custom-fit total knee replacement. With this new technology, Sheinkop can precisely match the size and placement of the implant to the patient's unique and normal (non-arthritic) knee anatomy. Developed by California-based OtisMed Corporation, this new custom-fit approach enables surgeons to preserve more bone and ligaments, allowing for better implant fit and alignment. Learn more about Dr. Sheinkop here.

As compared to regular knee replacements, patients with "custom knees" will experience a quicker and less painful recovery, increased range of motion, and a greater ease in outdoor activities such as golfing, biking and gardening.

"We'd like to see boomers remain active well into old age," says Sheinkop. "A knee replacement doesn't have to mean a lifestyle with limits. I've seen patients continue very active lives with this new technology."

View videos of Dr. Sheinkop speaking about hip education, hip resurfacing, knee education and treatment at http://www.neuro-ortho.org/orthopedic/joint-repl acement.htm" title="http://www.neuro-ortho.org/orthopedic/joint-repl acement.htm" target="_blank"http://www.neuro-ortho.org/or....

The custom-fit total knee replacement is achieved in four easy steps. Prior to surgery, an MRI is performed to take very precise measurements of the patient's arthritic knee. Then, proprietary computer software creates a 3-D image of that knee, and virtually corrects the deformity to return the knee to its pre-arthritic state. Third, a computerized 3-D image of the implant to be used in the patient's surgery is then Shape-Matched to the anatomically correct virtual knee model. This helps determine the correct implant size and placement, based on the patient's normal knee anatomy. Last, using all of this information, special cutting guides are created for the surgeon to use during the procedure. These patient-specific cutting guides, which are accurate to within a few millimeters, indicate to the surgeon exactly where to make bone cuts so that the knee replacement is customized for the individual patient.

On Wed., Sept. 26, at 10 a.m., The Neurologic and Orthopedic Institute of Chicago will perform its first custom-fit knee replacement. The lucky recipient will be 59-year old Frank Dorgan of Chicago, who suffers from osteoarthritis, osteomyelitis and restless leg syndrome.

The Neurologic & Orthopedic Institute of Chicago is the country's first freestanding acute care hospital dedicated exclusively to neuroscience and orthopedic services. It utilizes breakthrough technology and minimally invasive techniques as well as advanced procedures for neurosurgery, orthopedics, pain management, neuro-oncology, sports medicine and rehabilitation.

http://www.neuro-ortho.org" title="http://www.neuro-ortho.org" target="_blank"http://www.neuro-ortho.org
 
California Hospital Provides Comprehensive Orthopedics Services
03.07.08 (2:32 pm)   [edit]

If athletic activity, osteoarthritis, or normal wear and tear make you think twice about possibly back injury, pulling a shoulder or threatening an already compromised knee or joint, it's time to see a specialist. Fortunately for those who live and/or work Downtown, California Hospital offers access to a comprehensive team of orthopedic specialists who have your body covered.

ladowntownnews.com

 
Neurologic And Orthopedic Institute: One Of The First In The Country To Offer Custom-Fit Total Knee Replacement
02.04.08 (4:43 pm)   [edit]
Baby boomers who have it all, including custom clothes and sports equipment, are now beating the physical signs of old age with custom body parts, including knees. Patients with degenerative knee conditions can now benefit from custom-fit knee replacements that are tailored to an individual's unique body mechanics, size and gender variations.

Dr. Mitchell Sheinkop, orthopedic surgeon at the Neurologic and Orthopedic Institute of Chicago, is one of the first in the country to offer custom-fit total knee replacement. With this new technology, Sheinkop can precisely match the size and placement of the implant to the patient's unique and normal (non-arthritic) knee anatomy. Developed by California-based OtisMed Corporation, this new custom-fit approach enables surgeons to preserve more bone and ligaments, allowing for better implant fit and alignment. Learn more about Dr. Sheinkop here.

As compared to regular knee replacements, patients with "custom knees" will experience a quicker and less painful recovery, increased range of motion, and a greater ease in outdoor activities such as golfing, biking and gardening.

"We'd like to see boomers remain active well into old age," says Sheinkop. "A knee replacement doesn't have to mean a lifestyle with limits. I've seen patients continue very active lives with this new technology."

View videos of Dr. Sheinkop speaking about hip education, hip resurfacing, knee education and treatment at http://www.neuro-ortho.org/orthopedic/joint-repl acement.htm" title="http://www.neuro-ortho.org/orthopedic/joint-repl acement.htm" target="_blank"http://www.neuro-ortho.org/or....

The custom-fit total knee replacement is achieved in four easy steps. Prior to surgery, an MRI is performed to take very precise measurements of the patient's arthritic knee. Then, proprietary computer software creates a 3-D image of that knee, and virtually corrects the deformity to return the knee to its pre-arthritic state. Third, a computerized 3-D image of the implant to be used in the patient's surgery is then Shape-Matched to the anatomically correct virtual knee model. This helps determine the correct implant size and placement, based on the patient's normal knee anatomy. Last, using all of this information, special cutting guides are created for the surgeon to use during the procedure. These patient-specific cutting guides, which are accurate to within a few millimeters, indicate to the surgeon exactly where to make bone cuts so that the knee replacement is customized for the individual patient.

On Wed., Sept. 26, at 10 a.m., The Neurologic and Orthopedic Institute of Chicago will perform its first custom-fit knee replacement. The lucky recipient will be 59-year old Frank Dorgan of Chicago, who suffers from osteoarthritis, osteomyelitis and restless leg syndrome.

The Neurologic & Orthopedic Institute of Chicago is the country's first freestanding acute care hospital dedicated exclusively to neuroscience and orthopedic services. It utilizes breakthrough technology and minimally invasive techniques as well as advanced procedures for neurosurgery, orthopedics, pain management, neuro-oncology, sports medicine and rehabilitation .

http://www.neuro-ortho.org" title="http://www.neuro-ortho.org" target="_blank"http://www.neuro-ortho.org
 
How To Go About Back Pain Exercises
02.04.08 (4:35 pm)   [edit]
Back Pain Exercises can help with healing. You see, back pain problem is common with adults. It is a more discussed topic because the successful treatment is not guaranteed by any doctor. The real solution is the prevention rather than cure. Back pain can be avoided if the person practices the regular exercise routine.

There are specific exercises for a healthy back. Before deciding the exercise routine you must examine yourself if you are having back pain. If you do the normal exercises before your pain is reduced, your muscles may be strained again. When you are fully relieved from the pain the new routine of exercise should be followed. Such exercises will help to make your muscles strong to support your spine. Afterwards you can do the exercises which are helpful for strengthening your back.

Once you start your exercises to strengthen the muscles, you should occasionally perform the previous routine which helped you to recover from the back pain problem. This enables to prevent recurrence of back pain problem.

The exercises program should be fixed after taking into account various individual factors. Back Pain exercises should be adopted in a more interesting activity of sport of any other activity which will improve person's interest in it. In initial stage a person needs motivation to continue the activity. If the exercises are formed in a specific theme then nobody will get bored. Once the person is used to the routine he will not quit easily as he will understand the advantages of these exercises.

You have to start your back pain exercises with the instructor. Then you can do it on your own when you have practiced it without any symptoms of back pain. These exercises can be done without anybody's assistance once you know it.

Back Pain exercises enable the better blood circulation and oxygen supply is improved. The lactic acid in muscles causes the fatigue and leads to back pain. The improved circulation of oxygen removes this lactic acid and thereby the back pain symptoms are decreased.

The orthopedic surgeons have prepared several back pain exercises which can be added to your regular aerobic exercise routine. These exercises improve the muscles and the spinal cord gets more support.

Before starting the new routine of exercises make sure you always consult your doctor . The problem area should be fixed and then you can carry on the exercise. Your aim should be fixed and then you should work in that direction.

The exercise is helpful for everybody if it is done in a right way. Back pain exercises are one part of your routine. It is beneficial for you as they prevent back pain symptoms with other advantages. When the back pain is chronic, recovery is fast only with the right type of exercise. Some back pain problems like lower back pain and back pain muscle spasms can be resolved only with the exercises. As the painkillers are not recommended on a daily basis, the back pain exercises are the one and only one solution of back pain.

Muna wa Wanjiru Has Been Researching and Reporting on Back Pain for Years. For More Information on Back Pain Exercises, Visit His Site at BACK PAIN EXERCISES


About the Author

Muna wa Wanjiru Has Been Researching and Reporting on Back Pain for Years. For More Information on Back Pain Exercises, Visit His Site at BACK PAIN EXERCISES

 
Rockford Orthopedic Associates
12.18.07 (4:43 pm)   [edit]
Rockford Orthopedic Associates (ROA) is dedicated to providing our patients with the highest quality orthopedic and musculoskeletal care.
 
Sierra Orthopedic Laboratory
12.18.07 (4:30 pm)   [edit]
Sierra Orthopedic Laboratory , Inc. began in 1979 when Jonathan and Rose Batzdorff established the first prosthetic facility in Sonoma County. They quickly realized that in addition to prosthetics, there was a need for modern light weight thermoplastic orthopedic braces for adults and children. The company grew as it successfully provided up-to-date custom orthopedic appliances and personal service to meet the increasing needs of amputees and orthopedically challenged individuals.
 
Intermountain Healthcare
12.18.07 (4:29 pm)   [edit]
Intermountain Healthcare is a nonprofit health system based in Salt Lake City, with over 28,000 employees. Serving the healthcare needs of Utah and southeastern Idaho residents, Intermountain's system of 21 hospitals, physicians, clinics, and health plans provides clinically excellent medical care at affordable rates.
 
Veterinary Orthopedic Society
12.18.07 (1:21 pm)   [edit]
The objectives of the organization shall be to provide for the association of persons engaged in the practice, teaching, or research in the area of orthopedics for the presentation and discussion of items of common interest, to further scientific investigation, and to upgrade the specialty of orthopedics in order to provide better patient care. Pursuant to this objective, membership is open to and encouraged from all interested people from the international community without prejudice to country, race, color, sex, or religion. Not withstanding any other provisions of the Articles of Incorporation, the corporation (a) is not organized for profit, and no part of the net earnings of the corporation shall inure to the benefit of any member; and (b) shall not conduct or carry on any activities not permitted to be conducted or carried on by an organization exempt under Section 501 of the Internal Revenue Code, as amended, or regulations thereunder. The term of this organization shall be perpetual; however, in the event of dissolution of the corporation, its property shall be dedicated to the American Veterinary Medical Association .
 
Orthoseek
12.13.07 (7:57 am)   [edit]
Orthoseek , the source of authoritative information on pediatric orthopedics and pediatric sports medicine. Here, you will find useful information regarding your child's orthopedic condition or sports injury, and you can find useful articles that you can reproduce for yourself or others.
 
Scott Orthopedic Center
12.13.07 (7:56 am)   [edit]
Scott Orthopedic Center is a center for expert orthopedic medicine serving West Virginia, Kentucky, and Ohio. Our goal is to offer you the finest orthopedic care available. All of our physicians are board-certified or fellowship-trained in orthopedic surgery, or have completed specialized training.
 
National Association of Orthopaedic Nurses
12.13.07 (7:56 am)   [edit]

The National Association of Orthopaedic Nurses (NAON) is a non-profit, volunteer-run organization that exists to enhance the lives and careers of Orthopaedic Nurses. Formed in 1980, NAON was designed to promote the highest standards of nursing practice by educating its practitioners, promoting research, and encouraging effective communication between orthopaedic nurses and other groups with similar interests. NAON Membership consists of more than 6,000 RNs, LPNs, LVNs, student nurses, and associate members from across the country and around the world who share an interest in musculoskeletal healthcare.

Find Orthopaedic nursing jobs online
 
Orthopedic Massage Education & Research Institute
12.10.07 (12:33 pm)   [edit]

After years of clinical research and practice in the healthcare setting, Lowe developed his Orthopedic Massage approach for massage therapists who treat pain and injuries with massage therapy. Wanting to help practitioners challenged with the demands of today's clients, Lowe spent years in research. His programs and books demonstrate his dedication to research-based approaches.

Lowe has been a massage educator for over 17 years. He is the author of the books, Orthopedic Assessment for Massage Therapy and Orthopedic Massage: Theory and Technique. He researches and authors articles on pain and injury assessment techniques in national journals and in his quarterly research newsletter, Orthopedic & Sports Massage Reviews. Whitney is a frequently featured author in Massage Magazine, Massage Today, Massage & Bodywork, and Journal of Bodywork and Movement Therapies.

Lowe teaches workshops across the country and internationally on orthopedic massage and assessment skills. He has been a valued faculty member at several massage schools and is currently the director of the Orthopedic Massage Education & Research Institute in Sisters, Oregon.
 
OrthoCarolina
12.10.07 (12:31 pm)   [edit]
OrthoCarolina was created by the 2005 merger of Miller Orthopaedic Clinic and Charlotte Orthopedic Specialists. For more than 80 years, each practice provided the highest quality orthopedic care to patients of the Charlotte, NC region. Our two groups merged because we have always shared the same passionate commitment to great service, easy access, physician education, quality research and outstanding care in all regional hospitals. Together as OrthoCarolina, we are able to combine our strengths to provide an even higher level of orthopedic service and patient care.
 
Orthopaedic Trauma Association
12.10.07 (12:30 pm)   [edit]
The mission of the Orthopaedic Trauma Association (OTA) is to promote excellence in care for the injured patient, through provision of scientific forums and support of musculoskeletal research and education of Orthopaedic Surgeons and the public.
 
American Orthopaedic Foot & Ankle Society
12.10.07 (12:29 pm)   [edit]
Founded in 1969, the AOFAS provides excellent continuing medical education opportunities designed to assist AOFAS members and other orhtopaedic surgeons in providing the highest quality foot and ankle care to patients. 

AOFAS members are orthopaedic surgeons with a special interest in the foot and ankle.  Members of the Society have completed medical school, and five or more years of orthopaedic residency training, including training in surgical and medical treatment of disease of the foot and ankle.  Active Members are certified by the American Board of Orthopaedic Surgeons or the American Osteopathic Board of Orthopaedic Surgery and hold membership in the American Academy of Orthopaedic Surgeons.
 
Orthopedic Foundation for Animals
12.04.07 (8:20 am)   [edit]
Founded and originally incorporated as a private not for profit foundation in 1966, this year the Orthopedic Foundation for Animals (OFA) celebrates its 40th anniversary.
 
Texas Orthopedic Hospital
12.04.07 (8:19 am)   [edit]

Texas Orthopedic Hospital

We are a specialty surgery, rehabilitation, and sports medicine center.  As one of the leading orthopedic specialty hospitals in the world, we are dedicated to improving patient results,&nbs p;by providing high-quality, cost-effective, specialized orthopedic care in a streamlined environment focused on wellness, mobility, and quick recovery.