(HealthDay News) — By combining a special type of chemotherapy (TACE) with another treatment called radiofrequency ablation (RFA), Chinese researchers boosted the survival of people with advanced liver cancer by an average of 13 to 15 months compared to either treatment alone.

Results of the study were published in the April 9 issue of the Journal of the American Medical Association.

Hepatocellular carcinoma is responsible for as many as 90 percent of all liver cancers, according to the U.S. National Institutes of Health. Cirrhosis of the liver, often caused by hepatitis B or C or alcoholism, is usually at the root of such cancers. Cirrhosis can make treatment for this type of cancer more difficult, because it damages the liver so much that the liver can’t process medications effectively. Only 10 percent to 20 percent of these cancers can be successfully treated with surgery.

For those whose tumors can’t be removed with surgery, liver transplantation, chemotherapy and radiofrequency ablation are all options. TACE (transarterial chemoembolization) is a special type of chemotherapy that delivers chemotherapy drugs directly to the blood vessels feeding the tumor. Radiofrequency ablation uses electrodes to produce heat and destroy cancerous tissue.

The most commonly used treatment in the United States for advanced liver cancer is transplantation, according to Dr. Milan Kinkhabwala, chief of abdominal transplantation at Montefiore Medical Center in New York City. “If the tumor can’t be resected [surgically removed], liver transplantation is the definitive treatment,” he said, adding that transplantation might not be as available in China as it is in the United States.

Although TACE and RFA used individually can extend survival, the Chinese researchers hoped that by combining the techniques, they could increase survival times even more.

In a randomized, controlled trial, the researchers used one of three treatment techniques on people with hepatocellular carcinoma larger than 3 centimeters. Ninety-six people were assigned to the TACE-RFA combination, 95 to TACE alone and 100 to RFA alone.

Average survival time was 37 months for the combination therapy group compared to 24 months for TACE alone and 22 months for RFA alone.

The rate of responses lasting for at least six months rose to 54 percent in the combination group, versus 35 percent for the TACE group and 36 percent for the RFA group, the researchers found.

Side effects were similar between the groups, though RFA had the lowest rate of certain side effects, such as a low white blood cell count.

Cheng cautioned that these results may not be as applicable in the Western world, such as the United States or Japan, because the underlying cause of liver cancer in China is hepatitis B, whereas in the Western world, it tends to be hepatitis C or alcohol abuse. He hopes that similar clinical trials will be performed in the United States, Europe or Japan to see if the results are the same.

“Many of us have become aware that the standard approach of attacking a tumor with one modality isn’t as good. Multimodal therapy is the new buzzword in cancer treatment,” said Kinkhabwala. “It’s really a belt-and-suspenders approach. You’re targeting the tumor in different ways. This paper is important, because it’s the first to look at this combination in a controlled way, and the combo approach does work. This confirms what our expectations were.”

Kinkhabwala said he’d also like to see how a combination of these therapies with the new targeted medication, sorafenib (Nexavar), could affect outcomes. “Combining sorafenib with either or these or using all three might give better survival,” he said.

Source: HealthDay - www.nlm.nih.gov/medlineplus/news/fullstory_63179.html

(HealthDay News) — U.S. researchers boosted the level of early-stage ovarian cancer detection by 20 percent through use of a blood test to detect a tumor marker as well as a woman’s report of new-onset symptoms.

Using either test alone only uncovered about 60 percent of early-stage ovarian cancers in a high-risk group of women, while the two techniques together found 80 percent of early-stage tumors, according to finding published Monday in the online version of the journal Cancer.

“They appear to act complementary, and appear to be able to identify women who would not be identified by a blood sample alone, and conversely would not be identified by symptoms alone,” said the study’s lead author, M. Robyn Andersen, an associate member of the Public Health Sciences Division at the Fred Hutchinson Cancer Research Center in Seattle.

More than 21,000 women are diagnosed with ovarian cancer annually, and more than 15,000 women die from the disease each year, according to the American Cancer Society (ACS). Currently, only about 20 percent of ovarian cancers are caught in their earliest, potentially curable stages, according to Andersen.

In 2006, Andersen’s colleague, Dr. Barbara Goff, director of gynecologic oncology at the University of Washington School of Medicine, published the ovarian cancer symptom-screening index tool, in an effort to help women and doctors clarify which women might have a heightened risk of ovarian cancer.

Important symptoms include pelvic or abdominal pain, bloating, increased abdominal size, difficulty eating, or feeling full quickly. These symptoms must occur more than 12 times per month, and have just recently begun occurring (within the past year), to be considered positive on the symptom-screening tool. For example, if a woman has had abdominal pain for the past 10 years, it’s probably not related to ovarian cancer, but to another disorder, such as irritable bowel syndrome.

For the current study, Andersen and her colleagues used the symptom-screening index and a blood test that looks for CA 125, a protein that is often elevated in ovarian cancer. However, CA 125 can sometimes be elevated in women who don’t have ovarian cancer, the researchers noted.

The study involved 254 healthy women at high-risk for ovarian cancer because of family history, as well as 75 women about to undergo surgery to remove an ovarian cancer. The women were asked to fill out a questionnaire about their symptoms. All of the women also gave a blood sample to have their levels of CA 125 measured.

The two methods together correctly identified almost 90 percent of the ovarian cancers — 80.6 percent of the early cancers and 95.1 percent of the later-stage cancers.

About 14 percent of women who had symptoms and had elevated levels of CA 125 did not have ovarian cancer, according to Andersen. These women received transvaginal ultrasound tests for follow-up, according to Andersen.

“This study continues to add on to the work that’s been done, but we still have a long way to go with ovarian cancer,” commented Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society.

None of the current screening tools is as accurate as the ACS and other experts would like them to be, she explained. Any of the tests alone misses a significant number of cancers, and unnecessarily worries women who don’t have cancer. Saslow said transvaginal ultrasound can be a good test, but it has to be done by an experienced sonographer, and there are no current guidelines to define how much experience is enough.

Additionally, Saslow said that no research has been done to prove that early detection saves lives.

Andersen said the researchers recommend that if you have any of the symptoms of ovarian cancer, and they’re new-onset symptoms, that you should discuss them with your doctor. But, she added that, “even with this specific pattern of symptoms, most women probably don’t have ovarian cancer, just as most women with a breast lump don’t have breast cancer.”

Source: HealthDay - www.nlm.nih.gov/medlineplus/news/fullstory_66116.html

(HealthDay News) — Most general anesthetics — used to put patients to sleep during surgery — can increase the discomfort patients feel when they wake up, according to Georgetown University Medical Center researchers.

This finding, the first to scientifically explain anecdotal observations, may lead to increased use of general anesthetics that do not have this side effect or to the development of new anesthetics, the researchers said.

They found that “noxious” anesthesia drugs — which most general anesthetics are — activate and then sensitize specific receptors on neurons in the peripheral nervous system. These sensory nerves in the inflammation and pain pathway aren’t affected by general anesthesia drugs that target the central nervous system (brain and spinal cord).

“The choice of anesthetic appears to be an important determinant of post-operative pain. We hope these findings are ultimately helpful in providing more comfort to patients,” lead investigator Gerard Ahern, an assistant professor in the department of pharmacology, said in a prepared statement.

It was known that general anesthetics cause irritation at the infusion site or in the airways when inhaled and that they can activate pain-sensing nerve cells in the peripheral nervous system, Ahern explained.

But the specific mechanism by which anesthetics affect sensory neurons wasn’t known, nor the fact that anesthetics can continue to cause pain and inflammation even as they’re used during surgery.

Ahern and colleagues found that the noxious effects of anesthetic drugs are caused by their effect on the nerve cell receptor TRPA1. They also found that nerve-mediated inflammation was greater when pungent (chemical irritants) versus non-pungent inhaled general anesthetics were used on patients.

Both findings suggest that sensory nerve stimulation throughout the body just before and after surgery contributes to the pain felt by patients when they wake up after surgery.

“This is a provocative finding in terms of the clinical setting, because it was not really recognized that use of these drugs results in release of lots of chemicals that recruit immune cells to the nerves, which causes more pain or inflammation,” Ahern said.

While some general anesthetics don’t activate the TRPA1 receptor, they may not be as effective in other ways.

“This tells us that there is room for improvement in these drugs,” Ahern said.

The study was published in the June 23 issue of the journal Proceedings of the National Academy of Sciences.

By Robert Preidt
Source: HealthDay - nlm.nih.gov/medlineplus/news/fullstory_66127.html

TUESDAY, June 24 (HealthDay News) — Oral cannabis (a form of medical marijuana) was ineffective in treating certain types of acute pain and actually increased sensitivity to some other kinds of discomfort, say researchers at the Medical University of Vienna, Austria.

Their study included 18 healthy women who were given oral cannabis or a placebo. The women were then evaluated for heat and electrical pain thresholds in skin areas that had induced sunburn. This is an accepted method of assessing response to acute pain.

“The surprising result of our study was the absence of any kind of analgesic activity of THC-standardized cannabis extract on experimentally induced pain using well-established human model procedures,” study author Dr. Birgit Kraft said in a prepared statement. “Our results also seem to support the impression that high doses of cannabinoids may even cause increased sensitivity in certain pain conditions.”

The study is published in the July issue of the journal Anesthesiology.

Previous research has suggested that cannabis and tetrahydrocannabinol (THC — the main psychoactive component of marijuana) may help ease chronic pain in cancer patients, spinal cord injury patients, and people with multiple sclerosis. There have been inconsistent findings about the effects on acute pain.

This new study’s findings about oral cannabis and acute pain are seemingly conclusive, according to the researchers.

“From comparisons with previous clinical data, the lack of pain relief from the cannabis dosage and oral administration in our study cannot be considered the result of inadequate dosage or insufficient intestinal absorption,” Kraft said. “The high levels of THC detected in the blood of our subjects as well as the occurrence of typical THC side effects argue for sufficient availability, and thus we draw the conclusion that THC was not effective in treating acute pain.”

However, cannabis may remain a viable treatment option for certain types of chronic pain.

“Pain is a very complex and subjective phenomena,” Kraft said. “Chronic pain has not only been shown to lead to changes in peripheral and central neural processing, but also to be associated with psychosocial problems, physical disorders, and functional disabilities. Recent studies have indicated that cannabis can be effective in treating certain types of chronic pain and helping patients to cope by improving quality of life.”

By Robert Preidt
Source: HealthDay - nlm.nih.gov/medlineplus/news/fullstory_66162.html

ANNOUNCER: It’s estimated that over fifty million Americans suffer from chronic pain. Experts define chronic pain as pain lasting more than three months or past the normal healing time for an injury or illness.

RUSSELL PORTENOY, MD: Chronic pain has no biological function. Chronic pain is an illness in its own right. When pain persists beyond the healing of an — of an injury or it occurs in the absence of an injury, then pain becomes the problem for the patient.

ANNOUNCER: Chronic pain has been associated with a variety of medical conditions.

RUSSELL PORTENOY, MD: The most common type of chronic pain is chronic joint pain which is becoming more common as our population ages. It’s typically a disease of the elderly and is what most people call osteoarthritis; affects the hips, the low back, the neck, the shoulders, the hands. Cancer is a cause of chronic pain.

Another very common cause of pain is headache. Other common causes of chronic pain include low back pain, chronic neck pain, fibromyalgia and some specific types of what is known as neuropathic pain, like diabetic nerve pain or diabetic painful neuropathy or postherpetic neuralgia, which is also known as shingles.

ANNOUNCER: The pain often persists twenty-four hours a day and can affect a patient’s quality of life.

RUSSELL PORTENOY, MD: Pain can interfere with a person’s ability to function physically, it can interfere with a person’s psychological functioning, cause depression or anxiety, produces a sleep disturbance, chronic fatigue.

ANNOUNCER: And it’s often undertreated by health care providers.

BILL H. MCCARBERG, MD: Unfortunately, we don’t have enough pain experts to treat chronic pain, so most of the burden for treatment falls on the primary care provider — the internist, the family medicine doctor, the pediatrician, the OB/GYN doctor. And unfortunately, many of these doctors aren’t trained to treat it, and they tend to depreciate the patient’s complaint of pain.

ANNOUNCER: Chronic pain can also prove difficult to diagnose.

RUSSELL PORTENOY, MD: Pain is inherently subjective and what we mean by that is there is no test that can determine whether or not a person’s experiencing pain. There is no laboratory test, there’s no X-ray, there is no test that can tell a doctor or — or any other person that another human being has pain. The only way that we can tell if a person has pain is that they report it verbally or they show it in the way they move.

ANNOUNCER: There are different types of medications used to treat chronic pain. A group of medications called non-steroidal anti-inflammatory drugs, or NSAIDs, provide pain relief by reducing swelling and inflammation.

RICHARD PAYNE, MD: So, these are medications that can be quite effective in relieving pain in which there is an inflammatory component. So some arthritic pains can be very well-managed. A pain that’s from acute strain of muscle or even a more chronic musculoskeletal condition can be managed with NSAIDs.ANNOUNCER: Common NSAIDs include over-the- counter products like ibuprofen, or aspirin, and prescription drugs like celecoxib and diclofenac. These products are effective pain medications, but there are serious risk factors associated with all NSAIDs.

RUSSELL PORTENOY, MD: All of these drugs can produce kidney problems and all of these drugs can produce high blood pressure. So doctors who prescribe these drugs are supposed to be monitoring the kidney function and measuring the blood pressure.

ANNOUNCER: For moderate to severe pain, doctors often turn to powerful pain-relieving prescription drugs called opioids.

Common opioids prescribed in the U.S. are codeine, hydrocodone, oxycodone, morphine, tramadol and fentanyl.

RUSSELL PORTENOY, MD: Without any question at all, opioids are the strongest and most reliable painkillers we have. And, because of that, these drugs have become considered the mainstay approach, the most important approach for the treatment of pain related to cancer, to HIV disease and to other advanced medical illnesses.

ANNOUNCER: Opioids, however, can be addictive, and potentially abused.

RICHARD PAYNE, MD: Opioid drugs, as a class, have a property that the NSAIDs don’t have in that they can cause — be associated with compulsive use or with what is commonly called addiction. The other property of opioid drugs is that, when they are taken over a long period of time, the body becomes used to the medication and so, if it’s stopped abruptly, it can cause a withdrawal symptom.

BILL H. MCCARBERG, MD: Now, who shouldn’t get the opioids? Well, there are a particular population of patients who are more at risk for developing problems with the opioids, and that is people who have had a history of addiction.

ANNOUNCER: Although medication can help manage chronic pain, it’s not the only way to treat it.

BILL H. MCCARBERG, MD: We have biofeedback. Self-hypnosis is particularly good. We all know about heat and ice and rest. Those are all very effective for certain types of chronic pain conditions. They don’t work in everybody, but they certainly work in a lot of patients.

And that’s why it’s so important to use multiple different therapies — the medications, the non-medications — and to control it as long as the patient has the pain, which would be 24 hours a day for some patients.

Source: NBC10.com

WASHINGTON (Reuters) - The osteoporosis drug Evista can help prevent breast cancer — but only the type fueled by the hormone estrogen, researchers reported on Tuesday.
So-called estrogen-receptor-positive breast cancer is the most common type and women who took Eli Lilly and Co’s Evista were 55 percent less likely to develop this type of cancer than women taking a placebo, the researchers reported in the Journal of the National Cancer Institute.

Evista, known generically as raloxifene, is already approved for reducing the risk of breast cancer in women past menopause who have osteoporosis.

Because it acts on estrogen, scientists had assumed it would be more effective against estrogen-receptor-positive breast cancer but no one had demonstrated this.

Dr. Deborah Grady of the University of California, San Francisco and colleagues tested this, using a group of 10,000 women who originally volunteered for a study to see if the drug can lower the risk of heart disease.

The Raloxifene Use for the Heart (RUTH) trial showed that the drug did not protect against heart disease. But it did reduce the risk of invasive breast cancer by 44 percent over 5.6 years, compared with women not taking the drug.

Half the women got Evista and half got a placebo. Those who took raloxifene had a 55 percent reduction in the risk of developing invasive ER-positive breast cancer.

There was no reduction in the risk of other types of breast cancer, including noninvasive breast cancer, often called carcinoma in situ.

Raloxifene is a selective estrogen receptor modulator, or SERM, and prevents osteoporosis in a different way than other types of drugs known as bisphosphonates.

“Overall, clinical evidence is accumulating that the SERMs hold great promise in being able to control multiple diseases,” Craig Jordan of the Fox Chase Cancer Research Center in Philadelphia wrote in a commentary.

“This is the good news because, until recently, it was generally believed that hormone replacement therapy was the answer to controlling the development of coronary heart disease and osteoporosis but at the price of an enhanced risk of invasive breast cancer,” Jordan said.
Source: Reuters Health MedlinePlus

Demyelination also occurs in people with multiple sclerosis.

Previous research has examined the use of cell transplantation for restoring absent or lost myelin to diseased nerve fibers. But, until now, no transplantation of human neural stem cells or of their derivatives (glial progenitor cells) had been successful in test animals.

In this new study, researchers from the University of Rochester Medical Center and a number of other universities (Cornell, UCLA and Baylor) created a new method for harvesting and purification of human fetal glial progenitor cells.

They also developed a new cell delivery strategy that uses multiple injection sites to encourage widespread and dense take-up of the transplanted cells through the central nervous system.

When the researchers used these new approaches, the transplanted cells took hold throughout the brain and spinal cord, and the mice showed robust, efficient and functional myelination. Some of the mice showed neurological improvement and a fraction of them were save by the procedure.

“The neurological recovery and survival of the mice receiving transplants was in sharp contrast to the fate of their untreated controls, which uniformly died by five months,” researcher Dr. Steve Goldman, of the departments of neurology and neurosurgery at the University of Rochester Medical Center, said in a prepared statement.

“To our knowledge, these data represent the first outright rescue of a congenital hypomyelinating disorder by means of stem or progenitor cell transplantation,” Goldman said. “Although much work needs to be done to maximize the number of individuals that respond to transplantation, I think that these findings hold great promise for the potential of stem cell-based treatment in a wide range of hereditary and ischemic myelin disorders in both children and adults.”

The study was published in the June issue of Cell Stem Cell.

Source: medlineplus

A new study found significant reductions in both dry mouth and pain and shoulder dysfunction after neck dissection in patients receiving acupuncture.

“Although further studies are needed, this does support the potential role of acupuncture,” said study author Dr. David Pfister, chief of the head and neck medical oncology service at the Memorial Sloan-Kettering Cancer Center in New York City. He presented the findings Saturday at the American Society of Clinical Oncology annual meeting, in Chicago.

Neck dissection, or removal of the lymph nodes and surrounding tissue, is common in treating head and neck cancers. The dissection can be severe, involving removing of all the lymph nodes, the muscle involved in turning the head, a vein and a nerve which allows patients to lift their arms above their head.

“Side effects vary with the extent of the procedure,” Pfister said. “Pain and shoulder dysfunction are common following a comprehensive neck resection. Although exercise and anti-inflammatory drugs are widely prescribed to address pain and dysfunction, efficacy is often disappointing or incomplete. Postoperative radiation is also frequently administered, leading to dry mouth, which further adds to the burden of symptoms.”

In the study, 70 patients were randomized to receive weekly acupuncture sessions for four weeks or “usual care” (suggestions for physical therapy exercises and anti-inflammatory pain relievers).

Almost 40 percent of participants receiving acupuncture experienced improvements in both pain and mobility, compared with just 7 percent in the standard-care group.

There was also a notable decrease in dry mouth. “Five people in the acupuncture group had improvements as opposed to none in the usual-care arm,” Pfister said.

A second study presented Saturday at the meeting found the narcolepsy drug Provigil (modafinil) provided significant relief for patients suffering from chemotherapy-related fatigue.

The drug is usually prescribed to sleep-related disorders. “These are basically non-amphetamine-based stimulants. They don’t have the same type of typical problems that amphetamines do,” explained study author Dr. Gary Morrow, associate director for community research at the University of Rochester Cancer Center.

Fatigue is a leading complaint of cancer patients undergoing chemotherapy. Some nine out of 10 patients polled said they expected to experience this side effect, close to the percentage that actually do.

“The majority of patients expected fatigue and, unfortunately, they’re right,” Morrow said.

In this group of 631 patients, Provigil had a significant effect on excessive tiredness, and the effect was greater among patients who started out with more fatigue.

“The payoff was among patients who had severe fatigue,” Morrow said. “It was numerically different but not statistically different for people who had mild or moderate fatigue. Modafinil appears useful to treat severe fatigue. If found again through pivotal studies submitted through proper regulatory authorities, it might take place in the armamentarium.”

Source: MedlinePlus

The catch: The therapies that would use these stem cells have not yet been developed. Stem cell experts say such advances are years or decades away — if they ever come to pass.

And considering the cost of extracting and storing these stem cells — an initial price tag of $590, plus an annual fee of $100 — some experts say the slim chance that such stem cells would ever come in handy is not worth the expense.

Still, there are those that see potential. Grant Sadler is president of GMS Dental Centers in Houston, whose clinics began a collaboration last week with a Scottsdale, Ariz., company called StemSave that would offer parents the chance to bank the stem cells from their kids’ extracted teeth.

Sadler said that in the first week of its launch, parents who have brought their children to his offices have expressed a great deal of interest in the banking of their children’s baby teeth stem cells.

“They have responded very positively,” he said. “I announced it to the staff, and there were some parents who were waiting in the corner of the lobby. After I was done, two of them came up and said, ‘Boy, we really want to do this today. Can we use this?’”

He said the banking of these cells could be especially appealing to parents who did not have the option of having their children’s umbilical cord stem cells banked when they were born.

But Dr. Curt Civin, professor of cancer research at the Johns Hopkins University School of Medicine in Baltimore, said the cells extracted from the pulp of baby teeth are quite different from those extracted from umbilical cords.

“The last time I saw this, the stem cells from baby teeth were mesenchymal,” he said, adding that this layer forms such tissues as the cartilage, bone, fat and other “lining” cells.

This means that doctors would not be able to use these cells in the lifesaving procedures more commonly associated with therapeutic stem cell therapy today.

“Theoretically, if you wanted bone cells, maybe someday you could use these to produce them — but you probably couldn’t from what we know now,” Civin said. “[Mesenchymal cells] haven’t been used clinically yet, at least to my knowledge.”

Pay Now, Cure Later?

In contrast to mesenchymal stem cells, hematopoietic stem cells — the ones that come from umbilical cord blood — have already seen therapeutic use. Today, such stem cells can be used to treat as many as 70 different diseases. Civin estimated that about 2,000 people every year are treated with such stem cells. Most commonly, the cells are used to regenerate the immune systems of patients who have received treatment for leukemia.

In light of this, many parents have taken the step of banking their children’s umbilical cord stem cells when they are born — an arrangement that has been known to cost $1,200 upfront and $100 each year for storage.

Today there are dozens of private companies that will store a baby’s cord blood for a fee. Like a bank account, it will be available exclusively to the family of the donor — though the chances that anyone will ever need to make a withdrawal from such an “account” may be slim.

A more reasonable approach, Civin said, is for parents to donate their child’s umbilical cord to a public bank. Like a bone marrow registry, the bank keeps a database of the cells that are available and offers them to patients in need. Today, he said, most of the lifesaving procedures conducted with umbilical cord stem cells use cells that come from a public bank.

“These will be used by somebody who needs it, likely for cancer, or maybe a genetic disease,” Civin said. “That I would recommend, if that’s available at the hospital at which the baby is born. It’s sort of an altruistic gift to society.”

But Civin said since umbilical cord stem cells are seeing actual therapeutic use, “it’s not as big a leap as baby teeth. … The tooth cells may never be used.”

Other stem cell experts agreed that baby teeth stem calls are not ready for widespread banking.

“The benefits are entirely speculative,” said Jonathan Moreno, director of the Center for Biomedical Ethics at the University of Virginia in Charlottesville. “I would like to see an itemized bill that accounts for the … charges. After the cells are harvested and treated, it’s just a matter of holding them in a refrigerator, so the only real cost is the electricity.”

“This is ridiculous, modern snake oil,” agreed Sean Morrison, associate professor of cell and developmental biology at the University of Michigan Medical Center in Ann Arbor. “The difference relative to cord blood is that cells from baby teeth have never been used clinically to treat anything, and are unlikely to ever be used.”

Still, studies on the potential of these cells are ongoing. The National Institutes of Health has, in past research, cited the potential of the cells to yield dentin and bone — which means that future applications could include the repair of damaged teeth and bones.

Meanwhile, researchers at the University of Pittsburgh are also working to identify, characterize and come up with applications for the cells contained within human dental pulp.

When Marketing Comes Before the Science

Sadler said his clinics are planning to send information out to parents later this week about the banking option, and pamphlets outlining the procedure and its costs are available in the waiting areas of the offices.

“All of this is dependent upon the patient’s or the patient’s parent’s choice,” he said. “We’re taking the role of exposing the patient to this, and if they choose to do this, they do it.”

Still, Tim McCaffrey, vice chairman of biochemistry and molecular biology at the George Washington University Medical Center in Washington, D.C., said the marketing of this option is far too early.

“I’ll be conservative and say that this is very highly speculative, because most people would look at this and call it snake oil,” McCaffrey said in an e-mailed correspondence. “The part that annoys me is that it preys on parents’ fear of something dreadful happening to their child, and I will guarantee you that the company will not produce data on the viability or potency of the ’stem cells’ that they ‘isolate’ and store.

“There is no guarantee that this would work in 10 years when, heaven forbid, your child needs it. Do they give a money-back guarantee?”

Source: ABCnews.com

Two million American children have been diagnosed with attention deficit hyperactivity disorder, according to the National Institute of Mental Health. It’s so common now that one child in a classroom of 25 or 30 will have the disorder. But parents often struggle a long time to figure out exactly what’s going on in their child’s head. Is he tired? Is she confused? Is he just acting up? Does she need help?

Dr. Fernando Miranda, a neurologist at the Bright Minds Institute in San Francisco, says diagnosing children with behavioral disorders like ADHD and autism without looking at their brains is like trying to diagnose heart problems without actually looking at the heart.

On the other hand, some of Miranda’s patients have found they had an attention deficit problem and didn’t even know it. Miranda, and many other doctors, believe more objective tools for figuring out these puzzles are critical.

From an early age, 9-year-old Danny Rodgers had trouble speaking.

Danny’s words were in his head; they just couldn’t seem to find a way out. Embarrassed, he avoided talking altogether and stopped trying to make friends.

Danny’s grandparents, Jeanne and Howard Rodgers, who have been raising him and his sister, Meghan, since their mother died, said the school system recommended speech therapy, and patience.

“They kept saying, ‘He’ll grow out of it. He’ll grow out of it ‘,” said Jeanne Rodgers.

But he never did .

“He’d cry a lot and say, ‘I don’t’ like my life. I don’t like what I’m doing. I don’t want to go to school,’” said Danny’s grandmother.

They went to see Miranda at the Bright Minds Institute, and Miranda took a different approach to treating Danny.

Danny was wired for a qunatitative electroencephalography, or EEG, a very sophisticated test that measures a brain’s electrical output in response to certain stimuli. He also underwent a comprehensive neuropsychological exam, and magnetic resonance imaging of the brain.

Those tests revealed a lot of surprises.”This child’s IQ was 138,” Miranda said. “And that’s huge. That’s so bright.” One EEG measurement, called a P300, showed normal and abnormal electrical impulses in Danny’s brain with a series of bright colors.

Reading the scan, Miranda said Danny was not “perceiving” speech in the superior temporal gyrus.

Translation: Danny has what’s known as an auditory processing issue. It wasn’t so much that he was having trouble speaking or pronouncing things — his brain wasn’t understanding speech correctly.

Danny’s problem was not a standard speech issue at all, and his years of conventional therapy were off target.

Miranda pointed out a group of squiggly lines on the scan, showing Danny was likely to have an attention problem.

In a normal EEG, those squiggly lines would not be there in the frontal lobe section of this recording. Using those tests and other physical and behavioral information, Miranda diagnosed Danny with ADHD.

“The areas of the brain that are involved in attention deficits are many, and unless you know which one specifically is the one that you’re addressing, that is not functioning very well, you cannot prescribe the right medication for it,” Miranda said.

For Danny, that meant the puzzle was solved in ways his grandparents never would have guessed.

“He wasn’t a hyper child at all,” Jeanne Rodgers said

Now on ADHD medication and specific therapy for his decoding problem, Danny has a lot to say.

“I didn’t like learning. I thought it was boring ,” Danny admitted in Miranda’s office.

But now “it’s kind of fun,” he said. “He got nine out of 10 ‘outstandings’ on his report card! ” his grandmother marveled.

Danny’s unhappiness used to tear up his grandparents. Jeanne Rodgers and her husband, Howard, are spending all they can on his special therapy, and have also spent a bundle on the tests with Miranda, almost none of which were covered by insurance. But both of them said the costs have been well worth it.

Still, some leading doctors say it’s too soon to use sophisticated tests like these clinically, and that people might be wasting their money on them.

Dr. Bradley Peterson, director of the Pediatric Neuropsychiatry Research program at Columbia College of Physicians and Surgeons, said the technology is not there yet.

“No test can tell you that this child has ADHD and that one doesn’t,” Peterson said. “At least at present day. Hopefully, in the next year or coming years, we might have that, but we don’t yet.”

Others who work with the technology routinely, such as Dr. Sandlan Lowe, a professor in the departments of psychiatry, physiology and neuroscience at New York University School of Medicine, said it can help in reaching a diagnosis.

“In Europe, for instance, EEG and quantitative EEG is routinely done,” Lowe said. “In this country, I think there are a lot of neurologists who have the idea that it’s just not that helpful. And I have to tell you that in the right hands, it’s a very useful tool.”

So why isn’t it used more often? A number of doctors said reading the MRIs and EEGs is complicated, and not every neurologist is properly trained to read them. The tests are also expensive, and are often not covered by insurance.

Many scam artists have also claimed they could read these brain imaging tests when they could not, bilking people out of thousands of dollars.

But Miranda, as well as many patients, believe they are on the cutting edge of a new frontier in diagnosing and treating children’s cognitive problems.

Jan Jensen, a nurse whose husband is a surgeon, worried about the attention problems she saw in her three children. But she wasn’t happy that her family practitioner suggested prescribing Ritalin without doing any tests.

Lindsey, 12, always seemed restless and unfocused, Jensen said. Meagan, 8, was having significant trouble reading. But Jensen was especially worried about 9-year-old Zach.

“He’s like the energizer bunny on crack. I’m telling you, this kid is constantly going,” she said, adding he has almost no fear and little ability to understand the consequences of his actions.

All three had MRIs and quantitative EEGs, in addition to neuropsych workups. Lindsey’s results weren’t a surprise; she showed clear signs of attention deficit problems, Miranda said. But he recommended a different medication than Ritalin.

But the other children’s data yielded some surprises. Zach’s tests showed signs of ADHD but also structural problems in his brain.

“He has an area of lack of development of the hypocampus here. This is a finding that explains some of the problems that he does have sometimes remembering or paying attention,” Miranda said.

That information led Miranda to suggest not only medication but targeted therapy, in this case music lessons, to help teach the other side of Zach’s brain to pick up the slack.

Miranda contends specialized memory excercises that appeal to one particular side of the brain can train it to take over for the slower side.

Megan showed no signs of attention deficits or other brain issues.Miranda suggested simply helping her with her reading. Without this puzzle piece Megan would likely have been put on medication. Mom had assumed that Meagan, the youngest, likely had the same issue as her siblings.

Having evidence behind what was happening to her kids was a comfort to Jensen. “You truly understand what your’e looking at and what’s going on in your kids’ head,” she said. “And Dr. Miranda goes through each piece with you.”

For Danny Rodgers, looking inside his head opened up his future.

When his grandmother, Jeanne, asked him what he wanted to do when he grew up, Danny replied earnestly, “Save the turtles, lower gas prices, and bring home the soldiers.”

Source: ABCnews