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Leicester Geneticists Unearth The Roots Of Human Genetic Variation
A new study at the University of Leicester is using advanced single molecule methods to explore processes that lie at the very core of DNA variation in humans.
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AACE Response To Insulin Glargine Cancer Risk Articles In Diabetologia
On June 26, 2009 several articles published online in Diabetologia by the European Association for the Study of Diabetes investigated the possible relationship between use of insulin glargine (Lantus, sanofi-aventis) and the development of certain malignancies. The authors themselves, and the accompanying editorial, cautioned against over-interpretation of their limited data and analyses, which precluded them from drawing any firm conclusions. For example, there were contradictory findings among the studies, patient populations were not always comparable, and the duration of observation was short. Nonetheless, since the relationship of type 2 diabetes to cancer is of critical importance, further study is warranted.
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Ever Shorter Hospital Stays After Orthopaedic Operations Present A Major Challenge To Rehabilitation - Pre-operative Training Can Improve Results
"Rehabilitation medicine is facing a major challenge today," says Dr. Karsten Dreinh̦fer (Head of Department for Orthopaedics and Orthopaedic Surgery, Medical Park Berlin Humboldtm̿hle, Germany) speaking at the EFORT Congress in Vienna. "Not only in Germany but in many other European countries too, the trend is towards the shortest possible stay in an acute hospital after orthopaedic or trauma-related surgery. This means patient care is shifting increasingly to the rehabilitation sector, which must then be appropriately equipped and trained." But demographic developments are also presenting a significant challenge to orthopaedic rehabilitation: with modern surgical procedures, surgery such as joint replacement operations can be carried out on more and more patients, including the elderly and the very elderly, who then require special care and mobilization assistance, says Dr. Dreinh̦fer, who has been appointed to the professorship for musculoskeletal rehabilitation, prevention and health care research at the Charit̩ in Berlin. Broad interdisciplinary cooperation is also necessary, he says. "Multimodal concepts have proven to be especially effective in numerous diseases of the musculoskeletal system," says Dr. Dreinh̦fer, speaking of a further important trend. "This involves orthopaedics working together with other disciplines, such as physiotherapy, psychotherapy and sports sciences, to be able to help effectively such common complaints as back pain." He says it is also important to cooperate across various health sectors. "It is increasingly important to optimise, via treatment pathways, the transition from the pre-inpatient sector, to acute care and to rehabilitation."
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Complaints Of Fatigue And Tiredness In People With OSA Improve With CPAP Treatment

A study in the June 15 issue of the Journal of Clinical Sleep Medicine shows that the complaints of fatigue and tiredness in patients with obstructive sleep apnea (OSA) improved significantly with good adherence to continuous positive airway pressure (CPAP) therapy, suggesting that - like the symptom of excessive daytime sleepiness - these complaints are important symptoms of OSA. Results indicate that good adherence to CPAP therapy for an average of five or more hours per night resolved baseline complaints of fatigue in 45 of 80 participants (56 percent), tiredness in 56 of 96 participants (58 percent) and sleepiness in 48 of 72 participants (67 percent); improvement of each symptom was significantly better among CPAP-adherent participants than among inadequately treated subjects. A baseline complaint of lack of energy also was resolved in 47 of 100 participants with good CPAP adherence, but this improvement failed to reach statistical significance when compared with inadequately treated participants. According to senior investigator Ronald D. Chervin, M.D., M.S., of the Michael S. Aldrich Sleep Disorders Laboratory in Ann Arbor, Mich., physicians should consider the possibility of OSA as a treatable underlying cause not just for the complaint of sleepiness, but also for the chief complaints of fatigue, tiredness and lack of energy. "We found that sleep apnea patients who used their CPAP regularly, in comparison to those who did not, had much greater success in reducing their fatigue, tiredness and sleepiness," he said. "This suggests that sleep apnea may be the cause of these symptoms, as it is a cause of sleepiness." The study involved 313 OSA patients with an average age of 54.7 years; 178 (56.9 percent) were men. It compared 183 participants who reported using CPAP for an average of five or more hours per night with 96 subjects who either had no active treatment (55 subjects) or reported using CPAP for an average of less than five hours per night (41 subjects); 34 participants were excluded from the analysis because they received a treatment other than CPAP. Compared with inadequately treated patients, participants who had good adherence to CPAP had a higher severity of OSA at baseline and lower self-reported sleepiness at follow-up. Both before and after treatment, women reported a complaint of lack of energy statistically more often than men. According to the American Academy of Sleep Medicine, OSA is a sleep-related breathing disorder that involves a decrease or complete halt in airflow despite an ongoing effort to breathe. It occurs when the muscles relax during sleep, causing soft tissue in the back of the throat to collapse and block the upper airway. This leads to partial reductions (hypopneas) and complete pauses (apneas) in breathing that can produce abrupt reductions in blood oxygen saturation. Most people with OSA snore loudly and frequently, and they often experience excessive daytime sleepiness. The authors suggest that their findings are in agreement with previous research demonstrating that CPAP adherence is associated with improvements in OSA symptoms, daytime sleepiness, cognitive impairments, blood pressure and quality of life. Information about OSA for patients and the public is available at http://www.sleepeducation.com/Disorder.aspx?id=7. Kelly Wagner American Academy of Sleep Medicine


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