New research from Karolinska Institutet in Sweden shows that patients with heart failure have high mortality and often are under-treated. According to a study many more of these patients would benefit from advanced treatment by heart specialists – something that could be decided by a simple evaluation of five common risk factors for early death due to heart failure.
Heart failure affects 2-3% of the overall population and over 10% of the elderly worldwide, and is associated with high risk for early death and reduced quality of life. Drug therapy improves symptoms and reduces mortality and is well used. However, modern heart failure pacemakers, heart pumps and also heart transplantation are of great benefit in selected patients, but are poorly utilised. Earlier studies have shown that, a major reason is that heart failure patients are generally cared for by generalist doctors with limited awareness of these treatments.
In the present study, a team comprising researchers at Karolinska Institutet, Link

Accurately diagnosing traumatic brain injuries (TBI) and concussions is difficult, as standard CT or MRI scans can

A 24-strong panel of judges have awarded one of this year

An interim study by Italian researchers showed that using a modelling programme together with IPSS and dosage measure can predict the severity of acute urinary symptoms in patients with early prostate cancer who underwent radiotherapy.
‘Quantitative models predicting the risk of acute (and late) genito-urinary (GU) toxicity in patients treated with high dose radiotherapy for prostate cancer are lacking. This work represents one of the first attempts to provide radiation oncologists with quantitative tools to reliably predict the risk of moderate-severe acute GU effects based on both clinical and dosimetric individual parameters,’ said Dr. Cesare Cozzarini of the San Raffaele Scientific Institute, Dept. of Radiation Oncology in Milan, Italy.
A prospective cohort study (DUE-01) which started in April 2010, Cozzarini and colleagues aimed to develop predictive models of genito-urinary (GU) toxicity and erectile dysfunction after high dose radiotherapy (RT) for prostate cancer.

Patients treated with conventional (1.8-2Gy/fr, CONV) or moderate hypo-fractionation (2.5-2.7Gy/fr HYPO) were included.
In their ad-interim analysis, the investigators also intended to find a link between pollakiuria (POLL), dysuria (DYS) and nicturia (NICT) as measured by IPSS at RT end and clinical/dosimetric risk factors.
IPSS questionnaire at the start and at the end of RT were prospectively collected by the researchers and planning data were recovered and analyzed with a dedicated program (Vodca, MSS GmbH, Zurich), including absolute (cc/cm2) and % bladder dose-volume/surface (DVH/DSH) parameters referred to both the whole treatment and to the weekly delivered dose (DVHw/DSHw).
In the study, relevant clinical factors were also prospectively collected including T stage, concomitant morbidities and drugs, use of hormonal therapy (HT), previous surgery, smoking, age, BMI and prostate volume. In IPSS, each item ranges from 0 to 5 with increasing score which indicates increasing toxicity severity: for each question, a score=4 at the end of the therapy was considered as the end point.
At the time of the analysis (January 2013), 339 patients have been enrolled by nine institutes. Clinical data of 212/339 patients were available (93 CONV and 119 HYPO). Of 172/212 patients both baseline and end-RT IPSS were collected. For 179/212 patients also DVH/DSH were available. Questions POLL, DYS and NICT (respectively 2, 3 and 7) showed the larger increase of the fraction of patients with scores =4 between basal and end questionnaire; consequently, the analysis focused on these symptoms.
The number of patients with scores=4 increased from 8 to 30 for POLL, from 5 to 20 for DYS and from 12 to 34 for NICT. At MVA (overall p<0.0001), the main independent predictors of acute POLL were: Smoking (OR:2.74, p=0.04) and S8.5w (OR:1.01, p=0.10); AUC=0.66. The model was confirmed also after the exclusion of patients with baseline IPSS-POLL =4 (AUC=0.69). 'This study (DUE01) is aimed at prospectively collecting an enormous number of patient-reported information concerning GU toxicity (and erectile dysfunction as well) before, during and at the end of radiotherapy and for a period of five years after its completion,' said Cozzarini. 'The study therefore has a high probability of helping to develop highly reliable models for the prediction of acute and late GU toxicity and erectile dysfunction and their impact on quality of life,' he added. 'As a consequence, the final results of this investigation should have a significant impact on the evolution of radiotherapy of prostate cancer in the next five to 10 years leading to a significant reduction of GU toxicity and sexual dysfunction deriving from a more refined 'tailoring' of the radiation therapy,' according to Cozzarini. EurekAlert

Nuclear Magnetic Resonance (NMR) Spectroscopy is an extremely powerful non-destructive technique for the characterization of molecules. Widely used by chemists from its origin, it is now essential in the synthesis and analysis laboratories and sees its scope extended in biological laboratories.
Coupled with NMR, Dynamic Nuclear Polarization (DNP) allows, thanks to polarizing agents, the enhancement of NMR signals from a wide range of molecules resulting in the significant reduction of the NMR acquisition time. It shows therefore strong advantages over ‘classical’ NMR and possibly over X-ray diffraction techniques used to characterize proteins on synchrotron type equipments.
NMR has also known an impressive development in the medicine with the development of Magnetic Resonance Imaging (MRI).
Up to now, the DNP has been efficiently applied to MRI for the early diagnosis of cancers in small animals (rats and porks) in pre-clinical studies and more recently to 30 human patients having prostate cancers. However, MRI using DNP can not be generalized to human diagnosis as polarizing agents used to activate biological tracers/contrast agents need to be quantitatively separated from the polarized solution before human injection and image acquisition. This technical hurdle is now fixed.
In this context, an innovative powder for the easy polarization of many molecules, including biological tracers, was developed in the frame of a European collaboration involving the Laboratory of Chemistry, Catalysis, Polymers and Processes (UMR 5265-LC2P2), the European Center for high field NMR (UMR 5280, CRMN-Lyon) and ETH Zurich. These innovative ‘powders’ open perspectives for the fast characterization of complex systems by means of solid state NMR using DNP but also in the field of medical imaging for early cancer diagnosis using MRI. In this latter field, the aforementioned materials can deliver a solution of polarized biological tracers /contrast agents free from any impurity and therefore injectable to humans. EurekAlert