A 10-year-old girl with a deadly blood clot underwent a life-saving surgery that showed the power of using stem cells to regenerate healthy organs.
 

The girl developed a clot in the blood vessel between her intestine and liver during her first year of life, creating the risk of potentially fatal bleeding. Michael Olausson, a surgeon at Sahlgrenska University Hospital at the University of Gothenburg took a blood vessel from a donor, chemically removed tissue and DNA from it, then seeded stem cells from the girl’s bone marrow to create a healthy, living blood vessel.

“We carried out the surgery over three months ago now, and the result was very good, with no serious complications,” Olausson, of the hospital in Gothenburg, Sweden, said today in a statement. “The girl is in good health, and we believe that her prognosis is very good. Since the vessel was created with the girl’s own stem cells, she does not need to take drugs to prevent rejection.”

A similar procedure was used in 2008 by surgeons in Barcelona to create a new windpipe for a 30-year-old woman whose airway collapsed from a tuberculosis infection.

More research may lead to the ability to remake other organs and arteries, Olausson said. This might help patients who need kidney dialysis or surgery on arteries leading to their heart, Olausson said.

While blood vessels from other parts of a patient’s body are sometimes used to repair such defects, liver failure can result if the vessels are inadequate, according to the hospital’s statement.

For the full article: http://www.bloomberg.com/news/2011-05-09/stem-cells-of-10-year-old-help-create-blood-vessel-in-life-saving-surgery.html

To contact the reporter on this story: Rob Waters in San Francisco at rwaters5@bloomberg.net.

 

EXTRACTED FROM MEDPAGE TODAY, MAY 2011

A marked decline in the rate of coronary artery bypass graft (CABG) surgery led the way to a 15% overall decline in coronary revascularization procedures from 2001 to 2008, a nationwide survey showed.

The annual rate of CABG declined by almost 40%, whereas the rate of percutaneous coronary intervention (PCI) held steady during the study period, as reported in the May 4 issue of JAMA.

"Our findings suggest the possibility that several thousand patients who underwent PCI in 2008 would have undergone CABG surgery had patterns of care not changed markedly between 2001 and 2008," Andrew J. Epstein, PhD, of the Philadelphia Veterans Affairs Medical Center, and co-authors wrote.

"Our data imply a sizable shift in cardiovascular clinical practice patterns away from surgical treatment toward percutaneous, catheter-based interventions."

Since the beginning of the 21st century, the technology, published evidence, and clinical guidelines for coronary revascularization have changed substantially. How the changes affected the overall volume of revascularization and the different types of interventions has not been studied extensively, Epstein and co-authors noted in their introduction.

To determine the impact of innovation and evolution of coronary revascularization, investigators looked at the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample for the years 2001 to 2008. The dataset contains patient-level discharge information from about 1,000 hospitals in 42 states.

Using standard procedure and diagnosis codes, the authors identified all coronary revascularization procedures, and then categorized them as CABG, PCI with stent deployment (further subdivided into drug-eluting and bare-metal categories), and angioplasty without the use of a stent.

The authors also identified outpatient PCI procedures from the Centers for Medicare and Medicaid Services claims data.

Overall, the rate of coronary revascularization procedures declined from 5,569 per one million adults during 2001 to 2002 to 4,748 per one million adults during 2007 to 2008 (P<0.001).

During the same time period, the CABG rate declined from 1,742 to 1,081 per one million adults (P<0.001). The rate declined in a linear manner to 1,457 per one million during 2003 to 2004 and to 1,261 per one million adults during 2005 to 2006.

The total rate of PCI procedures did not change significantly from 2001 to 2002 (3,827 per one million adults) and 2007 to 2008 (3,667 per one million).

However, the rate of PCI procedures involving bare-metal stents declined 3,326 per one million in the first two years of the study period to 1,167 during the last two years (P<0.001). In fact, the rate reached a nadir of 468 per one million during 2005 to 2006 before increasing by more than twofold during 2007 to 2008.

No data were available for use of drug-eluting stents during the first two years of the study period. The rate increased from 2,040 per one million during 2003 to 2004 to a high of 3,507 per one million in 2005 to 2006 (P=0.001) before declining to 2,383 per one million during 2007 to 2008 (P=0.003).

Use of angioplasty without stents declined from 501 per one million during 2001 to 2002 to 117 per one million in the last two years (P<0.001).

The number of hospitals offering CABG increased by 12% (241 versus 212) from 2001 to 2008 (P=0.03), and the number of hospitals offering PCI increased by 26% (331 versus 246, P<0.001).

The median CABG caseload declined by 28%, from 253 per hospital in 2001 to 183 in 2008 (P<0.001). At the same time, the number of hospitals performing fewer than 100 CABG surgeries annually increased substantially from 23 in 2001 to 62 in 2008 (P<0.001).

The authors had no definitive explanations for the decline in CABG rate.

"The decreasing CABG surgery rate during this period of stable evidence and guidelines implies either overuse of CABG surgery in 2001, which has been progressively corrected by better patient selection, or increasing underuse of CABG surgery between 2001 and 2008 because patients who would have been optimally treated with CABG surgery were instead treated with PCI," the authors wrote in the discussion of their findings.

 

Primary source: JAMA

Source reference:

The Stem Cell Industry has madesome great strides, and 60% of stem-cell-treated Traumatic Brain Injury patients have their brain functions improved. But what happens after stem cells is at least as important, as this RN shows us.

 

Janet Cromer has a good idea of what Mark Kelly will be doing when he gets back from outer space.

Soon Kelly will be leaving his wife, Congresswoman Gabrielle Giffords – who is recovering from being shot in the head more than a month ago – to lead the Space Shuttle Endeavor’s last mission. However, one expert knows that the shuttle mission isn’t the only thing on Kelly’s mind. The way she knows is that she lived through a similar experience.

“My husband, Alan, suffered a severe brain injury as the result of a heart attack and cardiac arrest,” said Janet Cromer, a career RN and healthcare writer who specializes in brain injury. “Mark is going to have a dual role as spouse and caregiver and he is going to be as much a part – if not more – of his wife’s recovery as any doctor working on her case. I know that as he prepares for his mission in space, he is likely also thinking about his mission for when he gets home – what he will do to help his wife recover.”

Cromer is also author of the book Professor Cromer Learns to Read: A Couple’s New Life after Brain Injury (www.janetcromer.com),a chronicle of how she tended to her husband’s recovery, and how it affected them in terms of both their emotional health and their physical health, as well as their marriage. “Her 35 years in the healthcare field, along with her personal journey as wife and caregiver, led her to create the following tips for helping a brain injury victim learn how to read, write and think again.

 

 

·        Prepare for a Long Mission -- Cognitive rehab usually starts in the hospital or outpatient setting. But that’s just the beginning. Healing and recovering from a brain injury can take a long time.  Many people can continue to make progress in specific ways for months and years after a brain injury with ongoing treatment, motivation, and practice.

·        Take Breaks -- The brain consumes an enormous amount of energy while concentrating and relearning material. Build frequent rest breaks into sessions. Take days off from intensive rehab work. We stopped our “rehab week” on Friday at 5 PM and just enjoyed the weekend. The brain also benefits from time to let new information settle in and integrate.

·        Set Realistic Goals -- Set a few realistic goals. Alan cared most about learning to read and write, so our goals reflected his priorities. Make your goal measurable. For example, “Alan will write three sentences in his log book five days a week.”

·        Prepare Training Materials -- We set up a table in Alan’s office as his new “learning center.” I put away his work as a physics professor. Then we added a children’s computer, children’s dictionary, and two reading books at a time. It can be humiliating to start learning basic skills as an adult, so we selected computers and puzzles that looked like they were made for adults. V-Tech makes such products. As long as the tool looked grown-up, Alan was willing to try it.

·        Make Rehab a Routine -- Doing cognitive and physical rehab became part of our “new normal” life. We scheduled time for certain practice sessions in a distraction-free room. Then we practiced spelling at the grocery store or reading comprehension while talking over a newspaper story. Sometimes I asked Alan to read me a poem before bed. We memorized poems together and enjoyed reciting them.

·        Use Music -- The brain stores and accesses music in different ways than spoken words. Alan loved to sing, and sang long lyrics much easier than he spoke sentences. We sang TV commercials as cues to brush his teeth. Alan remembered the lyrics to camp songs and Broadway musicals, so I asked him to teach me. Playing an instrument and listening to music stimulate several parts of the brain and can be a lot of fun.

·        Enjoy -- Revel in hope and love- a new relationship and life can flourish when nurtured with hope and love.

 

 

 

 

Janet Cromer, RN, MA, LMHC, has a career that spans thirty-five years as a medical and psychiatric RN, twenty-three years as a licensed psychotherapist, and seven years as an award-winning healthcare writer, most recently from the American Medical Writers Association New England Chapter. Janet held clinical and leadership positions in hospitals and community mental health programs, and managed her successful private psychotherapy practice for ten years. Janet is a brain injury and family caregiver support group facilitator, educator and advisory board member.

To interview Janet Cromer or request a review copy of Professor Cromer Learns to Read contact Ginny Grimsley at Ginny@newsandexperts.com.


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TBI IN YOUR FAMILY? Right now treatments are running about $25k. Let us know if you wish more info: don@RepairStemCells.org