Alzheimer's Disease Early Cognitive Problems Identified

Alzheimer's Disease Early Cognitive Problems Identified31 Dec 2012-nbsp;-nbsp;-nbsp;

Early indicators of Alzheimer's disease have been discovered and published in the latest issue of American Journal of Psychiatry. The findings reveal that people who are beginning to develop the disease often show problems with processing semantic and knowledge based information before severe symptoms of the disease begin showing.

The study is the first of its kind to review mild cognitive impairment (MCI) associated with Alzheimer's disease in a systematic way and reveal the early indicators, signs and symptoms. Terry Goldberg, PhD, director of neurocognition at the Litwin Zucker Center for Research in Alzheimer's Disease, and his colleagues developed a test to identify any problems with a person's ability to process semantic or knowledge based information.

The results of the test showed that there are a number of semantic impairments that are associated with MCI. In order to prevent adding further confusion to the study, the researchers implemented an element of the test that did not require any verbal response. This part of the test measured a person's ability to make a judgment of two sets of facts by their ability to differentiate size. For example, they would be shown a picture of an ant and a house and asked which was bigger. The time it took for them to answer the question would reveal the extent of their inability to process semantic information.

A total of 122 people were tested, of whom 25 had MCI, 27 had Alzheimer's and the other 70 were cognitively "normal". There was a big difference in the ability to process the information among the MCI and Alzheimer's patients compared to the healthy controls. According to Dr. Goldberg: "This finding suggested that semantic processing was corrupted. MCI and AD (Alzheimer's disease) patients are really affected when they are asked to respond to a task with small size differences."

The researchers then added an element to the task by showing the participants pictures of a big house and small ant and also a big ant and small house. The MCI and AD patients were able to successfully complete the first part of this task but had a lot difficulty (unable to answer or delayed response) when shown the picture where the big ant looked just as big as the small house. The patients with MCI were functioning better than the Alzheimer's patients but not nearly as well as the healthy controls.

They used the UCSD Skills Performance Assessment scale to determine how much of an effect impaired semantic processing has on carrying out everyday functions. It assesses stuff like a person's ability to organize day trips out and write complex checks. The authors of the study said: "The semantic system is organized in networks that reflect different types of relatedness or association. Semantic items and knowledge have been acquired remotely, often over many repetitions, and do not reflect recent learning."

This indicates that it could well be possible to repair semantic processing connections through training. According to Dr. Goldberg: "It tells us that something is slowing down the patient and it is not episodic memory but semantic memory."


David P. Salmon, PhD, of the Department of Neurosciences at the University of California in San Diego, said in an accompanying editorial:

"semantic memory deficit demonstrated by this study adds confidence to the growing perception that subtle decline in this cognitive domain occurs in patients with amnestic mild cognitive impairment. Because the task places minimal demands on the effortful retrieval process, overt word retrieval, or language production, it also suggests that this deficit reflects an early and gradual loss of integrity of semantic knowledge."

Recess Crucial For Schoolchildren

Recess Crucial For Schoolchildren31 Dec 2012-nbsp;-nbsp;-nbsp;

School recesses are vital parts of academic life for schoolchildren and adolescents and should never be done away with, the American Academy of Pediatrics emphasized.

The AAP (American Academy of Pediatrics) added that physical education in schools is also essential for the promotion of activity and a healthy lifestyle.
The AAP issued its new policy statement, "The Crucial Role of Recess in Schools", in the January 2013 issue of its academic journal Pediatrics.


Recess offers schoolchildren physical, emotional, social and cognitive benefits when it is safe and properly supervised, the authors wrote.

Recesses should not substitute physical education classes, but should be a complement, and vice-versa. Regardless of whether recess occurs indoors or outdoors, it should be a period of free, unstructured play or activity. There can be many reasons for having recesses indoors, including "bad air days".

Teachers should never withhold recess as a form of punishment, according to the policy statement. Recesses serve as fundamental components of social interaction and development, which they may not get in other more complex academic environments.

Schools may be tempted to minimize or do away with recesses in order to cram in more academic hours each week; this should not occur, the authors state. The result could be counter-productive; with negative consequences for academic achievement.

According to recent studies, recesses improve a child's social skills, cognitive development and physical health.

In an Abstract in Pediatrics, the authors wrote:

"The American Academy of Pediatrics believes that recess is a crucial and necessary component of a child's development and, as such, it should not be withheld for punitive or academic reasons."

What is a recess?

A recess is a period in which people have a break from their duties.

In schools, recess is an American/Canadian term for "break" (UK/Ireland), and morning tea (New Zealand) as well as "playlunch" or "little lunch" in some other parts of the world.

School recesses usually last from ten minutes to half an hour. In elementary schools children typically go outside into an outdoor playground during recess. In most countries in the industrialized world, recesses are part of daily school life from elementary all the way through to the end of senior high school. Educators see recesses as vital for peer communications, going to the toilet, quiet study, consuming quick snacks and some other activities.

Sociologists and psychologists say that recess is an integral contributor to child development during the school day. During this period, children practice their social skills and become much more physically active.

Play and unstructured free time at school helps children develop their:

Physical abilities
Intellectual abilities
Social skills
Moral capabilities


As children we learn about the world around us through play.

Written by Christian Nordqvist
Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Cholesterol Plays Key Role In Cell Signaling

Cholesterol Plays Key Role In Cell Signaling31 Dec 2012-nbsp;-nbsp;-nbsp;

Healthy organisms rely on tightly controlled pathways of cellular signals that pass from protein to protein, each protein modifying the

next in some way. Now an international team of researchers has discovered that cholesterol plays a key role in regulating the proteins in these

pathways, and may also be important for other processes inside cells.

Principal investigator Wonhwa Cho, professor of chemistry at the University of Illinois at Chicago, and colleagues, write about their discovery in a

paper published earlier in December in the journal Nature Communications.

Usually, news about cholesterol tends to focus on its role in heart disease, as a result of which it has acquired somewhat of a bad reputation. But

cholesterol is an essential component of healthy cells.

Until recently, however, because it is found sandwiched between the inner and outer surfaces of cell membranes, cell biologists thought

cholesterol's main work was confined to interactions with other molecules in the membrane.

For instance, in 2011, a team of scientists at the National Institute of Standards and Technology (NIST) and University of California, Irvine, using

neutron diffraction, revealed how cholesterol helped to "maintain order"

within the cell membrane.

But Cho and colleagues have discovered cholesterol also appears to interact with proteins in the interior of the cell.

In this latest study, they reveal how cholesterol interacts with a scaffold protein. A scaffold protein uses its physical structure to bring together

other proteins so they can pass signals to each other. They have protein binding sites that offer the signaling proteins a place to latch

onto.



The authors found that cholesterol binds to a region on the scaffold protein where one of its signaling partners also binds. And they discovered that

disruption of the cholesterol binding to that site also stopped the partner from activating.

"Here we show that cholesterol specifically binds many PDZ domains found in scaffold proteins, including the N-terminal PDZ domain of

NHERF1/EBP50 ... Disruption of the cholesterol-binding activity of NHERF1 largely abrogates its dynamic co-localization with and activation of

cystic fibrosis transmembrane conductance regulator, one of its binding partners in the plasma membrane of mammalian cells," they

write.



In their paper, they give a detailed description of how the scaffold protein attaches itself to the membrane and reaches into it to find and bind the

cholesterol.

The team suggests this way of interacting with cholesterol could be used by many proteins inside cells and sheds light on the importance of

cholesterol to healthy cell functioning.

Cho says much of the existing data on how cholesterol behaves in cell processes has been difficult to interpret. He says their discovery is

important because it "will help people understand how cholesterol may regulate other cellular processes".








Written by Catharine Paddock PhD









Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Most Disciplined Doctors Trained Abroad, UK

Most Disciplined Doctors Trained Abroad, UK31 Dec 2012-nbsp;-nbsp;-nbsp;

63% of doctors who are either struck off or suspended in the United Kingdom were trained abroad, yet only 36% of all the doctors in the UK medical register are from overseas.

A total of 669 doctors have been either suspended or struck off by the GMC over the last five years. Only 249 (37%) of them were British while 420 (63%) were trained overseas.

The General Medical Council (GMC) has decided to do something about this disproportionate number of foreign-trained doctors being struck of the medical register or suspended. New reforms include better checks, an overhaul of the current testing system for foreign doctors who wish to work in the UK, and an induction program.

Chief Executive of the GMC, Niall Dickson, admitted that they absolutely acknowledge that "when it comes to the serious end of the scale, those from overseas are more likely to appear, and we have set about a series of reforms to address this."

New Induction Program

The GMC has announced that a New Induction Program for all doctors coming in from overseas will be launched as a pilot scheme, during the first quarter of 2013.

The GMC says that doctors who are new to UK practice need to understand the ethical and professional standards they are required to meet when practicing in the United Kingdom.

The GMC's aim is to address the wide variations in medical practice standards listed in its report "The State of Medical Education and Practice in the UK 2011" (pdf).

The GMC believes that an induction program for all physicians new to its register will help improve medical practice in Great Britain, which in turn will benefit patients.

Doctor shortage - the GMC says that there is a shortage of doctors in the UK. Therefore health authorities in the country have to make sure that:

There are enough doctors to treat the country's population
In order to do this, many have to come in from overseas
The ones who come in from abroad must be given adequate support


The PLAB (Performance and Linguistic Assessment Board) test for foreign doctors will also be reviewed. PLAB tests doctors' clinical skills and competence for practicing in the UK.

Revalidation - this is a system of checks that started in December 2012 which makes it compulsory for all doctors practicing in the UK to show that they are keeping up to date and are fit to practice. The revalidation is based on an annual review (appraisal) and feedback from colleagues and patients.

The Process Of Revalidation will occur every five years and will apply to all doctors in all UK settings, including locums and those who work in the private sector.

Dame Sally Davies, Chief Medical Officer, has become one of the first UK doctors to be revalidated after receiving confirmation from the GMC this week.

Chief Medical Officer Dame Sally Davies said "I am delighted to have confirmation of my revalidation from the GMC. Being revalidated was an incredibly useful experience, and allowed me to reflect on my own practice and approach. All feedback is useful to doctors - and for many it is about improving their already high standards. This is the biggest change to medical regulation in over a hundred years, but must importantly the process provides huge reassurance to patients and the public."

According to the General Medical Council, the United Kingdom is the first country worldwide to introduce such a comprehensive system across the nation's healthcare system.

Language competence - UK hospital and medical agencies are not allowed to test the language skills of the doctors who come in from other European Union countries to determine whether they can communicate properly (whether their English is good enough to work). Britain has interpreted EU law as meaning that health care professionals who qualify in any of the European Union's 27 nations "must" be free to work elsewhere, with no restriction whatsoever.

According to the British Medical Association's director of professional activities, Dr Vivienne Nathanson:

"It is clear that doctors who have qualified overseas are more likely to be subject to disciplinary action. However, more research is needed to understand why this is the case. The UK is still short of doctors and so we must ensure that those who come from overseas are given adequate support to be able to practise medicine in the UK.

It is critical that all doctors that work in the UK have appropriate clinical and communication skills as well as an understanding of UK law and culture and of how the NHS works."

Written by Christian Nordqvist
Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Statin Drug Shows Promise For Fighting Malaria Effects

Breast Cancer Diagnosis Could Benefit Greatly From Spectroscopy

Breast Cancer Diagnosis Could Benefit Greatly From Spectroscopy31 Dec 2012-nbsp;-nbsp;-nbsp;

The analysis of small deposits of calcium in breast tissue can help differentiate cancerous and benign tumors, but it is sometimes not easy

to make such a diagnosis. Now a team of researchers in the US believes a new method that uses a special type of spectroscopy to locate calcium

deposits during a biopsy, could greatly improve the accuracy of diagnosis.

The team, from Massachusetts Institute of Technology (MIT) and Case Western Reserve University (CWRU), writes about the work that led them to

this conclusion in a paper published online in Proceedings of the National Academy of Sciences on 24 December.

Calcium Deposits

Microcalcifications, or small deposits of calcium, form when calcium from the bloodstream deposits onto degraded proteins and fats left behind by

injured and dying cells.

They can be a telltale sign of breast cancer, but most tumors that contain them are benign.

Microcalcifications are most often seen in breast tumors, but they can also occur, albeit rarely, in other types of cancer, says co-senior author

Maryann Fitzmaurice, senior research associate and adjunct associate professor of pathology and oncology at CWRU, in a statement.

Calcification also plays a major role in atherosclerosis, or hardening of the arteries.

Biopsy Can Be Long and Arduous Procedure

When microcalcifications show on a mammogram, doctors do a follow-up biopsy of the suspect tissue to test for cancer.

Figures show that in around 1 in 10 cases with such microcalcifications, the tumor is cancerous, so the follow-up biopsy is critical.

During the procedure, the radiologist takes X-rays from three different angles to locate the tiny calcium deposits, then inserts a needle into the

tissue and removes up to 10 tissue samples.

A pathologist then tests these samples to see if they contain microcalcifications.

But in 15 to 25% of cases, it is not easy to locate and take a tissue sample accurately, resulting in an inconclusive diagnosis. This means the

patient has to have more X-rays and undergo more invasive surgery to retrieve further samples.

But, as Fitzmaurice explains, this second attempt is rarely successful:

"If they don't get them on the first pass, they usually don't get them at all."

"It can become a very long and arduous procedure for the patient, with a lot of extra X-ray exposure, and in the end they still don't get what

they're after, in one out of five patients," she adds.

New Method Uses Special Type of Spectroscopy

Spectroscopy is a way of determining the composition of a material by studying how it absorbs or scatters radiation such as light. It is often used in

physical and analytical chemistry, and there are many applications now in medicine too.

One of the challenges in applying the technique to medicine is cost and speed: often the equipment is very expensive and slow to deliver results in

"real time".

For the past several years, the MIT and CWRU team has been working on overcoming this challenge to help the radiologist determine, in a matter

of seconds, if the tissue contains microcalcifications or not.

At first they tried a method based on Raman spectroscopy, which uses light to measure energy shifts in molecular vibrations, revealing precise

molecular structures. The advantage of this method is that it is very accurate at identifying microcalcifications. But the disadvantage is the

equipment is expensive and the analysis takes a long time.

In this latest study, the researchers describe how they turned to another method, called "diffuse reflectance spectroscopy", and found it gave

results just as accurately as Raman spectroscopy, but much faster and at less cost.

Co-lead author Narahara Chari Dingari, a postdoc at MIT, says:

"With our new method, we could obtain similar results with less time and less expense."

97% Success Rate with Diffuse Reflectance Spectroscopy

Diffuse reflectance spectroscopy collects and analyzes light after it has interacted with the sample. This gives a unique "spectrographic

signature".

In their PNAS paper, the authors describe how they examined 203 tissue samples within minutes of their removal from 23

patients.

Each sample could be one of three types, each with its own spectrographic signature. It could be healthy, it could contain lesions with no

microcalcifications, or it could contain lesions with microcalcifications.

By analyzing these patterns, the team produced a computer algorithm that showed a success rate of 97% in identifying tissue with

microcalcifications.

Jaqueline Soares, another lead author and MIT postdoc, suggests the changes in the way the different tissues absorb light are probably due to

altered levels of specific proteins (elastin, desmosine and isodesmosine) that are often cross-linked with calcium deposits in diseased tissue.



Simple Technology with High Accuracy Is a "Good First Step"

James Tunnell is an associate professor of biomedical engineering at the University of Texas and was not involved in the study. He describes the

study as a "good first step" toward a system that could have a big impact on breast cancer diagnosis.

"This technology can be integrated into the system that is already used to take biopsies. It's a very simple technology that can get the same

amount of accuracy as more complicated systems."

The team envisages their technique being used by radiologists to provide enhanced "real time" guidance to current biopsy procedures.

Because it provides the analysis results within seconds, the new technique could help the radiologist to move the needle to another spot before

taking any samples.

The researchers are planning to carry out a new study to test the approach in "real time": as biposies are being carried out in

patients.


Funds from the National Institutes of Health, the National Institute of Biomedical Imaging and Bioengineering and the National Cancer Institute

helped finance the study.




Written by Catharine Paddock PhD









Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Alzheimer's Disease Early Cognitive Problems Identified

Alzheimer's Disease Early Cognitive Problems Identified31 Dec 2012-nbsp;-nbsp;-nbsp;

Early indicators of Alzheimer's disease have been discovered and published in the latest issue of American Journal of Psychiatry. The findings reveal that people who are beginning to develop the disease often show problems with processing semantic and knowledge based information before severe symptoms of the disease begin showing.

The study is the first of its kind to review mild cognitive impairment (MCI) associated with Alzheimer's disease in a systematic way and reveal the early indicators, signs and symptoms. Terry Goldberg, PhD, director of neurocognition at the Litwin Zucker Center for Research in Alzheimer's Disease, and his colleagues developed a test to identify any problems with a person's ability to process semantic or knowledge based information.

The results of the test showed that there are a number of semantic impairments that are associated with MCI. In order to prevent adding further confusion to the study, the researchers implemented an element of the test that did not require any verbal response. This part of the test measured a person's ability to make a judgment of two sets of facts by their ability to differentiate size. For example, they would be shown a picture of an ant and a house and asked which was bigger. The time it took for them to answer the question would reveal the extent of their inability to process semantic information.

A total of 122 people were tested, of whom 25 had MCI, 27 had Alzheimer's and the other 70 were cognitively "normal". There was a big difference in the ability to process the information among the MCI and Alzheimer's patients compared to the healthy controls. According to Dr. Goldberg: "This finding suggested that semantic processing was corrupted. MCI and AD (Alzheimer's disease) patients are really affected when they are asked to respond to a task with small size differences."

The researchers then added an element to the task by showing the participants pictures of a big house and small ant and also a big ant and small house. The MCI and AD patients were able to successfully complete the first part of this task but had a lot difficulty (unable to answer or delayed response) when shown the picture where the big ant looked just as big as the small house. The patients with MCI were functioning better than the Alzheimer's patients but not nearly as well as the healthy controls.

They used the UCSD Skills Performance Assessment scale to determine how much of an effect impaired semantic processing has on carrying out everyday functions. It assesses stuff like a person's ability to organize day trips out and write complex checks. The authors of the study said: "The semantic system is organized in networks that reflect different types of relatedness or association. Semantic items and knowledge have been acquired remotely, often over many repetitions, and do not reflect recent learning."

This indicates that it could well be possible to repair semantic processing connections through training. According to Dr. Goldberg: "It tells us that something is slowing down the patient and it is not episodic memory but semantic memory."


David P. Salmon, PhD, of the Department of Neurosciences at the University of California in San Diego, said in an accompanying editorial:

"semantic memory deficit demonstrated by this study adds confidence to the growing perception that subtle decline in this cognitive domain occurs in patients with amnestic mild cognitive impairment. Because the task places minimal demands on the effortful retrieval process, overt word retrieval, or language production, it also suggests that this deficit reflects an early and gradual loss of integrity of semantic knowledge."

Recess Crucial For Schoolchildren

Recess Crucial For Schoolchildren31 Dec 2012-nbsp;-nbsp;-nbsp;

School recesses are vital parts of academic life for schoolchildren and adolescents and should never be done away with, the American Academy of Pediatrics emphasized.

The AAP (American Academy of Pediatrics) added that physical education in schools is also essential for the promotion of activity and a healthy lifestyle.
The AAP issued its new policy statement, "The Crucial Role of Recess in Schools", in the January 2013 issue of its academic journal Pediatrics.


Recess offers schoolchildren physical, emotional, social and cognitive benefits when it is safe and properly supervised, the authors wrote.

Recesses should not substitute physical education classes, but should be a complement, and vice-versa. Regardless of whether recess occurs indoors or outdoors, it should be a period of free, unstructured play or activity. There can be many reasons for having recesses indoors, including "bad air days".

Teachers should never withhold recess as a form of punishment, according to the policy statement. Recesses serve as fundamental components of social interaction and development, which they may not get in other more complex academic environments.

Schools may be tempted to minimize or do away with recesses in order to cram in more academic hours each week; this should not occur, the authors state. The result could be counter-productive; with negative consequences for academic achievement.

According to recent studies, recesses improve a child's social skills, cognitive development and physical health.

In an Abstract in Pediatrics, the authors wrote:

"The American Academy of Pediatrics believes that recess is a crucial and necessary component of a child's development and, as such, it should not be withheld for punitive or academic reasons."

What is a recess?

A recess is a period in which people have a break from their duties.

In schools, recess is an American/Canadian term for "break" (UK/Ireland), and morning tea (New Zealand) as well as "playlunch" or "little lunch" in some other parts of the world.

School recesses usually last from ten minutes to half an hour. In elementary schools children typically go outside into an outdoor playground during recess. In most countries in the industrialized world, recesses are part of daily school life from elementary all the way through to the end of senior high school. Educators see recesses as vital for peer communications, going to the toilet, quiet study, consuming quick snacks and some other activities.

Sociologists and psychologists say that recess is an integral contributor to child development during the school day. During this period, children practice their social skills and become much more physically active.

Play and unstructured free time at school helps children develop their:

Physical abilities
Intellectual abilities
Social skills
Moral capabilities


As children we learn about the world around us through play.

Written by Christian Nordqvist
Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Cholesterol Plays Key Role In Cell Signaling

Cholesterol Plays Key Role In Cell Signaling31 Dec 2012-nbsp;-nbsp;-nbsp;

Healthy organisms rely on tightly controlled pathways of cellular signals that pass from protein to protein, each protein modifying the

next in some way. Now an international team of researchers has discovered that cholesterol plays a key role in regulating the proteins in these

pathways, and may also be important for other processes inside cells.

Principal investigator Wonhwa Cho, professor of chemistry at the University of Illinois at Chicago, and colleagues, write about their discovery in a

paper published earlier in December in the journal Nature Communications.

Usually, news about cholesterol tends to focus on its role in heart disease, as a result of which it has acquired somewhat of a bad reputation. But

cholesterol is an essential component of healthy cells.

Until recently, however, because it is found sandwiched between the inner and outer surfaces of cell membranes, cell biologists thought

cholesterol's main work was confined to interactions with other molecules in the membrane.

For instance, in 2011, a team of scientists at the National Institute of Standards and Technology (NIST) and University of California, Irvine, using

neutron diffraction, revealed how cholesterol helped to "maintain order"

within the cell membrane.

But Cho and colleagues have discovered cholesterol also appears to interact with proteins in the interior of the cell.

In this latest study, they reveal how cholesterol interacts with a scaffold protein. A scaffold protein uses its physical structure to bring together

other proteins so they can pass signals to each other. They have protein binding sites that offer the signaling proteins a place to latch

onto.



The authors found that cholesterol binds to a region on the scaffold protein where one of its signaling partners also binds. And they discovered that

disruption of the cholesterol binding to that site also stopped the partner from activating.

"Here we show that cholesterol specifically binds many PDZ domains found in scaffold proteins, including the N-terminal PDZ domain of

NHERF1/EBP50 ... Disruption of the cholesterol-binding activity of NHERF1 largely abrogates its dynamic co-localization with and activation of

cystic fibrosis transmembrane conductance regulator, one of its binding partners in the plasma membrane of mammalian cells," they

write.



In their paper, they give a detailed description of how the scaffold protein attaches itself to the membrane and reaches into it to find and bind the

cholesterol.

The team suggests this way of interacting with cholesterol could be used by many proteins inside cells and sheds light on the importance of

cholesterol to healthy cell functioning.

Cho says much of the existing data on how cholesterol behaves in cell processes has been difficult to interpret. He says their discovery is

important because it "will help people understand how cholesterol may regulate other cellular processes".








Written by Catharine Paddock PhD









Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Most Disciplined Doctors Trained Abroad, UK

Most Disciplined Doctors Trained Abroad, UK31 Dec 2012-nbsp;-nbsp;-nbsp;

63% of doctors who are either struck off or suspended in the United Kingdom were trained abroad, yet only 36% of all the doctors in the UK medical register are from overseas.

A total of 669 doctors have been either suspended or struck off by the GMC over the last five years. Only 249 (37%) of them were British while 420 (63%) were trained overseas.

The General Medical Council (GMC) has decided to do something about this disproportionate number of foreign-trained doctors being struck of the medical register or suspended. New reforms include better checks, an overhaul of the current testing system for foreign doctors who wish to work in the UK, and an induction program.

Chief Executive of the GMC, Niall Dickson, admitted that they absolutely acknowledge that "when it comes to the serious end of the scale, those from overseas are more likely to appear, and we have set about a series of reforms to address this."

New Induction Program

The GMC has announced that a New Induction Program for all doctors coming in from overseas will be launched as a pilot scheme, during the first quarter of 2013.

The GMC says that doctors who are new to UK practice need to understand the ethical and professional standards they are required to meet when practicing in the United Kingdom.

The GMC's aim is to address the wide variations in medical practice standards listed in its report "The State of Medical Education and Practice in the UK 2011" (pdf).

The GMC believes that an induction program for all physicians new to its register will help improve medical practice in Great Britain, which in turn will benefit patients.

Doctor shortage - the GMC says that there is a shortage of doctors in the UK. Therefore health authorities in the country have to make sure that:

There are enough doctors to treat the country's population
In order to do this, many have to come in from overseas
The ones who come in from abroad must be given adequate support


The PLAB (Performance and Linguistic Assessment Board) test for foreign doctors will also be reviewed. PLAB tests doctors' clinical skills and competence for practicing in the UK.

Revalidation - this is a system of checks that started in December 2012 which makes it compulsory for all doctors practicing in the UK to show that they are keeping up to date and are fit to practice. The revalidation is based on an annual review (appraisal) and feedback from colleagues and patients.

The Process Of Revalidation will occur every five years and will apply to all doctors in all UK settings, including locums and those who work in the private sector.

Dame Sally Davies, Chief Medical Officer, has become one of the first UK doctors to be revalidated after receiving confirmation from the GMC this week.

Chief Medical Officer Dame Sally Davies said "I am delighted to have confirmation of my revalidation from the GMC. Being revalidated was an incredibly useful experience, and allowed me to reflect on my own practice and approach. All feedback is useful to doctors - and for many it is about improving their already high standards. This is the biggest change to medical regulation in over a hundred years, but must importantly the process provides huge reassurance to patients and the public."

According to the General Medical Council, the United Kingdom is the first country worldwide to introduce such a comprehensive system across the nation's healthcare system.

Language competence - UK hospital and medical agencies are not allowed to test the language skills of the doctors who come in from other European Union countries to determine whether they can communicate properly (whether their English is good enough to work). Britain has interpreted EU law as meaning that health care professionals who qualify in any of the European Union's 27 nations "must" be free to work elsewhere, with no restriction whatsoever.

According to the British Medical Association's director of professional activities, Dr Vivienne Nathanson:

"It is clear that doctors who have qualified overseas are more likely to be subject to disciplinary action. However, more research is needed to understand why this is the case. The UK is still short of doctors and so we must ensure that those who come from overseas are given adequate support to be able to practise medicine in the UK.

It is critical that all doctors that work in the UK have appropriate clinical and communication skills as well as an understanding of UK law and culture and of how the NHS works."

Written by Christian Nordqvist
Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Statin Drug Shows Promise For Fighting Malaria Effects

Breast Cancer Diagnosis Could Benefit Greatly From Spectroscopy

Breast Cancer Diagnosis Could Benefit Greatly From Spectroscopy31 Dec 2012-nbsp;-nbsp;-nbsp;

The analysis of small deposits of calcium in breast tissue can help differentiate cancerous and benign tumors, but it is sometimes not easy

to make such a diagnosis. Now a team of researchers in the US believes a new method that uses a special type of spectroscopy to locate calcium

deposits during a biopsy, could greatly improve the accuracy of diagnosis.

The team, from Massachusetts Institute of Technology (MIT) and Case Western Reserve University (CWRU), writes about the work that led them to

this conclusion in a paper published online in Proceedings of the National Academy of Sciences on 24 December.

Calcium Deposits

Microcalcifications, or small deposits of calcium, form when calcium from the bloodstream deposits onto degraded proteins and fats left behind by

injured and dying cells.

They can be a telltale sign of breast cancer, but most tumors that contain them are benign.

Microcalcifications are most often seen in breast tumors, but they can also occur, albeit rarely, in other types of cancer, says co-senior author

Maryann Fitzmaurice, senior research associate and adjunct associate professor of pathology and oncology at CWRU, in a statement.

Calcification also plays a major role in atherosclerosis, or hardening of the arteries.

Biopsy Can Be Long and Arduous Procedure

When microcalcifications show on a mammogram, doctors do a follow-up biopsy of the suspect tissue to test for cancer.

Figures show that in around 1 in 10 cases with such microcalcifications, the tumor is cancerous, so the follow-up biopsy is critical.

During the procedure, the radiologist takes X-rays from three different angles to locate the tiny calcium deposits, then inserts a needle into the

tissue and removes up to 10 tissue samples.

A pathologist then tests these samples to see if they contain microcalcifications.

But in 15 to 25% of cases, it is not easy to locate and take a tissue sample accurately, resulting in an inconclusive diagnosis. This means the

patient has to have more X-rays and undergo more invasive surgery to retrieve further samples.

But, as Fitzmaurice explains, this second attempt is rarely successful:

"If they don't get them on the first pass, they usually don't get them at all."

"It can become a very long and arduous procedure for the patient, with a lot of extra X-ray exposure, and in the end they still don't get what

they're after, in one out of five patients," she adds.

New Method Uses Special Type of Spectroscopy

Spectroscopy is a way of determining the composition of a material by studying how it absorbs or scatters radiation such as light. It is often used in

physical and analytical chemistry, and there are many applications now in medicine too.

One of the challenges in applying the technique to medicine is cost and speed: often the equipment is very expensive and slow to deliver results in

"real time".

For the past several years, the MIT and CWRU team has been working on overcoming this challenge to help the radiologist determine, in a matter

of seconds, if the tissue contains microcalcifications or not.

At first they tried a method based on Raman spectroscopy, which uses light to measure energy shifts in molecular vibrations, revealing precise

molecular structures. The advantage of this method is that it is very accurate at identifying microcalcifications. But the disadvantage is the

equipment is expensive and the analysis takes a long time.

In this latest study, the researchers describe how they turned to another method, called "diffuse reflectance spectroscopy", and found it gave

results just as accurately as Raman spectroscopy, but much faster and at less cost.

Co-lead author Narahara Chari Dingari, a postdoc at MIT, says:

"With our new method, we could obtain similar results with less time and less expense."

97% Success Rate with Diffuse Reflectance Spectroscopy

Diffuse reflectance spectroscopy collects and analyzes light after it has interacted with the sample. This gives a unique "spectrographic

signature".

In their PNAS paper, the authors describe how they examined 203 tissue samples within minutes of their removal from 23

patients.

Each sample could be one of three types, each with its own spectrographic signature. It could be healthy, it could contain lesions with no

microcalcifications, or it could contain lesions with microcalcifications.

By analyzing these patterns, the team produced a computer algorithm that showed a success rate of 97% in identifying tissue with

microcalcifications.

Jaqueline Soares, another lead author and MIT postdoc, suggests the changes in the way the different tissues absorb light are probably due to

altered levels of specific proteins (elastin, desmosine and isodesmosine) that are often cross-linked with calcium deposits in diseased tissue.



Simple Technology with High Accuracy Is a "Good First Step"

James Tunnell is an associate professor of biomedical engineering at the University of Texas and was not involved in the study. He describes the

study as a "good first step" toward a system that could have a big impact on breast cancer diagnosis.

"This technology can be integrated into the system that is already used to take biopsies. It's a very simple technology that can get the same

amount of accuracy as more complicated systems."

The team envisages their technique being used by radiologists to provide enhanced "real time" guidance to current biopsy procedures.

Because it provides the analysis results within seconds, the new technique could help the radiologist to move the needle to another spot before

taking any samples.

The researchers are planning to carry out a new study to test the approach in "real time": as biposies are being carried out in

patients.


Funds from the National Institutes of Health, the National Institute of Biomedical Imaging and Bioengineering and the National Cancer Institute

helped finance the study.




Written by Catharine Paddock PhD









Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Alzheimer's Disease Early Cognitive Problems Identified

Alzheimer's Disease Early Cognitive Problems Identified31 Dec 2012-nbsp;-nbsp;-nbsp;

Early indicators of Alzheimer's disease have been discovered and published in the latest issue of American Journal of Psychiatry. The findings reveal that people who are beginning to develop the disease often show problems with processing semantic and knowledge based information before severe symptoms of the disease begin showing.

The study is the first of its kind to review mild cognitive impairment (MCI) associated with Alzheimer's disease in a systematic way and reveal the early indicators, signs and symptoms. Terry Goldberg, PhD, director of neurocognition at the Litwin Zucker Center for Research in Alzheimer's Disease, and his colleagues developed a test to identify any problems with a person's ability to process semantic or knowledge based information.

The results of the test showed that there are a number of semantic impairments that are associated with MCI. In order to prevent adding further confusion to the study, the researchers implemented an element of the test that did not require any verbal response. This part of the test measured a person's ability to make a judgment of two sets of facts by their ability to differentiate size. For example, they would be shown a picture of an ant and a house and asked which was bigger. The time it took for them to answer the question would reveal the extent of their inability to process semantic information.

A total of 122 people were tested, of whom 25 had MCI, 27 had Alzheimer's and the other 70 were cognitively "normal". There was a big difference in the ability to process the information among the MCI and Alzheimer's patients compared to the healthy controls. According to Dr. Goldberg: "This finding suggested that semantic processing was corrupted. MCI and AD (Alzheimer's disease) patients are really affected when they are asked to respond to a task with small size differences."

The researchers then added an element to the task by showing the participants pictures of a big house and small ant and also a big ant and small house. The MCI and AD patients were able to successfully complete the first part of this task but had a lot difficulty (unable to answer or delayed response) when shown the picture where the big ant looked just as big as the small house. The patients with MCI were functioning better than the Alzheimer's patients but not nearly as well as the healthy controls.

They used the UCSD Skills Performance Assessment scale to determine how much of an effect impaired semantic processing has on carrying out everyday functions. It assesses stuff like a person's ability to organize day trips out and write complex checks. The authors of the study said: "The semantic system is organized in networks that reflect different types of relatedness or association. Semantic items and knowledge have been acquired remotely, often over many repetitions, and do not reflect recent learning."

This indicates that it could well be possible to repair semantic processing connections through training. According to Dr. Goldberg: "It tells us that something is slowing down the patient and it is not episodic memory but semantic memory."


David P. Salmon, PhD, of the Department of Neurosciences at the University of California in San Diego, said in an accompanying editorial:

"semantic memory deficit demonstrated by this study adds confidence to the growing perception that subtle decline in this cognitive domain occurs in patients with amnestic mild cognitive impairment. Because the task places minimal demands on the effortful retrieval process, overt word retrieval, or language production, it also suggests that this deficit reflects an early and gradual loss of integrity of semantic knowledge."

Recess Crucial For Schoolchildren

Recess Crucial For Schoolchildren31 Dec 2012-nbsp;-nbsp;-nbsp;

School recesses are vital parts of academic life for schoolchildren and adolescents and should never be done away with, the American Academy of Pediatrics emphasized.

The AAP (American Academy of Pediatrics) added that physical education in schools is also essential for the promotion of activity and a healthy lifestyle.
The AAP issued its new policy statement, "The Crucial Role of Recess in Schools", in the January 2013 issue of its academic journal Pediatrics.


Recess offers schoolchildren physical, emotional, social and cognitive benefits when it is safe and properly supervised, the authors wrote.

Recesses should not substitute physical education classes, but should be a complement, and vice-versa. Regardless of whether recess occurs indoors or outdoors, it should be a period of free, unstructured play or activity. There can be many reasons for having recesses indoors, including "bad air days".

Teachers should never withhold recess as a form of punishment, according to the policy statement. Recesses serve as fundamental components of social interaction and development, which they may not get in other more complex academic environments.

Schools may be tempted to minimize or do away with recesses in order to cram in more academic hours each week; this should not occur, the authors state. The result could be counter-productive; with negative consequences for academic achievement.

According to recent studies, recesses improve a child's social skills, cognitive development and physical health.

In an Abstract in Pediatrics, the authors wrote:

"The American Academy of Pediatrics believes that recess is a crucial and necessary component of a child's development and, as such, it should not be withheld for punitive or academic reasons."

What is a recess?

A recess is a period in which people have a break from their duties.

In schools, recess is an American/Canadian term for "break" (UK/Ireland), and morning tea (New Zealand) as well as "playlunch" or "little lunch" in some other parts of the world.

School recesses usually last from ten minutes to half an hour. In elementary schools children typically go outside into an outdoor playground during recess. In most countries in the industrialized world, recesses are part of daily school life from elementary all the way through to the end of senior high school. Educators see recesses as vital for peer communications, going to the toilet, quiet study, consuming quick snacks and some other activities.

Sociologists and psychologists say that recess is an integral contributor to child development during the school day. During this period, children practice their social skills and become much more physically active.

Play and unstructured free time at school helps children develop their:

Physical abilities
Intellectual abilities
Social skills
Moral capabilities


As children we learn about the world around us through play.

Written by Christian Nordqvist
Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Cholesterol Plays Key Role In Cell Signaling

Cholesterol Plays Key Role In Cell Signaling31 Dec 2012-nbsp;-nbsp;-nbsp;

Healthy organisms rely on tightly controlled pathways of cellular signals that pass from protein to protein, each protein modifying the

next in some way. Now an international team of researchers has discovered that cholesterol plays a key role in regulating the proteins in these

pathways, and may also be important for other processes inside cells.

Principal investigator Wonhwa Cho, professor of chemistry at the University of Illinois at Chicago, and colleagues, write about their discovery in a

paper published earlier in December in the journal Nature Communications.

Usually, news about cholesterol tends to focus on its role in heart disease, as a result of which it has acquired somewhat of a bad reputation. But

cholesterol is an essential component of healthy cells.

Until recently, however, because it is found sandwiched between the inner and outer surfaces of cell membranes, cell biologists thought

cholesterol's main work was confined to interactions with other molecules in the membrane.

For instance, in 2011, a team of scientists at the National Institute of Standards and Technology (NIST) and University of California, Irvine, using

neutron diffraction, revealed how cholesterol helped to "maintain order"

within the cell membrane.

But Cho and colleagues have discovered cholesterol also appears to interact with proteins in the interior of the cell.

In this latest study, they reveal how cholesterol interacts with a scaffold protein. A scaffold protein uses its physical structure to bring together

other proteins so they can pass signals to each other. They have protein binding sites that offer the signaling proteins a place to latch

onto.



The authors found that cholesterol binds to a region on the scaffold protein where one of its signaling partners also binds. And they discovered that

disruption of the cholesterol binding to that site also stopped the partner from activating.

"Here we show that cholesterol specifically binds many PDZ domains found in scaffold proteins, including the N-terminal PDZ domain of

NHERF1/EBP50 ... Disruption of the cholesterol-binding activity of NHERF1 largely abrogates its dynamic co-localization with and activation of

cystic fibrosis transmembrane conductance regulator, one of its binding partners in the plasma membrane of mammalian cells," they

write.



In their paper, they give a detailed description of how the scaffold protein attaches itself to the membrane and reaches into it to find and bind the

cholesterol.

The team suggests this way of interacting with cholesterol could be used by many proteins inside cells and sheds light on the importance of

cholesterol to healthy cell functioning.

Cho says much of the existing data on how cholesterol behaves in cell processes has been difficult to interpret. He says their discovery is

important because it "will help people understand how cholesterol may regulate other cellular processes".








Written by Catharine Paddock PhD









Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Most Disciplined Doctors Trained Abroad, UK

Most Disciplined Doctors Trained Abroad, UK31 Dec 2012-nbsp;-nbsp;-nbsp;

63% of doctors who are either struck off or suspended in the United Kingdom were trained abroad, yet only 36% of all the doctors in the UK medical register are from overseas.

A total of 669 doctors have been either suspended or struck off by the GMC over the last five years. Only 249 (37%) of them were British while 420 (63%) were trained overseas.

The General Medical Council (GMC) has decided to do something about this disproportionate number of foreign-trained doctors being struck of the medical register or suspended. New reforms include better checks, an overhaul of the current testing system for foreign doctors who wish to work in the UK, and an induction program.

Chief Executive of the GMC, Niall Dickson, admitted that they absolutely acknowledge that "when it comes to the serious end of the scale, those from overseas are more likely to appear, and we have set about a series of reforms to address this."

New Induction Program

The GMC has announced that a New Induction Program for all doctors coming in from overseas will be launched as a pilot scheme, during the first quarter of 2013.

The GMC says that doctors who are new to UK practice need to understand the ethical and professional standards they are required to meet when practicing in the United Kingdom.

The GMC's aim is to address the wide variations in medical practice standards listed in its report "The State of Medical Education and Practice in the UK 2011" (pdf).

The GMC believes that an induction program for all physicians new to its register will help improve medical practice in Great Britain, which in turn will benefit patients.

Doctor shortage - the GMC says that there is a shortage of doctors in the UK. Therefore health authorities in the country have to make sure that:

There are enough doctors to treat the country's population
In order to do this, many have to come in from overseas
The ones who come in from abroad must be given adequate support


The PLAB (Performance and Linguistic Assessment Board) test for foreign doctors will also be reviewed. PLAB tests doctors' clinical skills and competence for practicing in the UK.

Revalidation - this is a system of checks that started in December 2012 which makes it compulsory for all doctors practicing in the UK to show that they are keeping up to date and are fit to practice. The revalidation is based on an annual review (appraisal) and feedback from colleagues and patients.

The Process Of Revalidation will occur every five years and will apply to all doctors in all UK settings, including locums and those who work in the private sector.

Dame Sally Davies, Chief Medical Officer, has become one of the first UK doctors to be revalidated after receiving confirmation from the GMC this week.

Chief Medical Officer Dame Sally Davies said "I am delighted to have confirmation of my revalidation from the GMC. Being revalidated was an incredibly useful experience, and allowed me to reflect on my own practice and approach. All feedback is useful to doctors - and for many it is about improving their already high standards. This is the biggest change to medical regulation in over a hundred years, but must importantly the process provides huge reassurance to patients and the public."

According to the General Medical Council, the United Kingdom is the first country worldwide to introduce such a comprehensive system across the nation's healthcare system.

Language competence - UK hospital and medical agencies are not allowed to test the language skills of the doctors who come in from other European Union countries to determine whether they can communicate properly (whether their English is good enough to work). Britain has interpreted EU law as meaning that health care professionals who qualify in any of the European Union's 27 nations "must" be free to work elsewhere, with no restriction whatsoever.

According to the British Medical Association's director of professional activities, Dr Vivienne Nathanson:

"It is clear that doctors who have qualified overseas are more likely to be subject to disciplinary action. However, more research is needed to understand why this is the case. The UK is still short of doctors and so we must ensure that those who come from overseas are given adequate support to be able to practise medicine in the UK.

It is critical that all doctors that work in the UK have appropriate clinical and communication skills as well as an understanding of UK law and culture and of how the NHS works."

Written by Christian Nordqvist
Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Statin Drug Shows Promise For Fighting Malaria Effects

Breast Cancer Diagnosis Could Benefit Greatly From Spectroscopy

Breast Cancer Diagnosis Could Benefit Greatly From Spectroscopy31 Dec 2012-nbsp;-nbsp;-nbsp;

The analysis of small deposits of calcium in breast tissue can help differentiate cancerous and benign tumors, but it is sometimes not easy

to make such a diagnosis. Now a team of researchers in the US believes a new method that uses a special type of spectroscopy to locate calcium

deposits during a biopsy, could greatly improve the accuracy of diagnosis.

The team, from Massachusetts Institute of Technology (MIT) and Case Western Reserve University (CWRU), writes about the work that led them to

this conclusion in a paper published online in Proceedings of the National Academy of Sciences on 24 December.

Calcium Deposits

Microcalcifications, or small deposits of calcium, form when calcium from the bloodstream deposits onto degraded proteins and fats left behind by

injured and dying cells.

They can be a telltale sign of breast cancer, but most tumors that contain them are benign.

Microcalcifications are most often seen in breast tumors, but they can also occur, albeit rarely, in other types of cancer, says co-senior author

Maryann Fitzmaurice, senior research associate and adjunct associate professor of pathology and oncology at CWRU, in a statement.

Calcification also plays a major role in atherosclerosis, or hardening of the arteries.

Biopsy Can Be Long and Arduous Procedure

When microcalcifications show on a mammogram, doctors do a follow-up biopsy of the suspect tissue to test for cancer.

Figures show that in around 1 in 10 cases with such microcalcifications, the tumor is cancerous, so the follow-up biopsy is critical.

During the procedure, the radiologist takes X-rays from three different angles to locate the tiny calcium deposits, then inserts a needle into the

tissue and removes up to 10 tissue samples.

A pathologist then tests these samples to see if they contain microcalcifications.

But in 15 to 25% of cases, it is not easy to locate and take a tissue sample accurately, resulting in an inconclusive diagnosis. This means the

patient has to have more X-rays and undergo more invasive surgery to retrieve further samples.

But, as Fitzmaurice explains, this second attempt is rarely successful:

"If they don't get them on the first pass, they usually don't get them at all."

"It can become a very long and arduous procedure for the patient, with a lot of extra X-ray exposure, and in the end they still don't get what

they're after, in one out of five patients," she adds.

New Method Uses Special Type of Spectroscopy

Spectroscopy is a way of determining the composition of a material by studying how it absorbs or scatters radiation such as light. It is often used in

physical and analytical chemistry, and there are many applications now in medicine too.

One of the challenges in applying the technique to medicine is cost and speed: often the equipment is very expensive and slow to deliver results in

"real time".

For the past several years, the MIT and CWRU team has been working on overcoming this challenge to help the radiologist determine, in a matter

of seconds, if the tissue contains microcalcifications or not.

At first they tried a method based on Raman spectroscopy, which uses light to measure energy shifts in molecular vibrations, revealing precise

molecular structures. The advantage of this method is that it is very accurate at identifying microcalcifications. But the disadvantage is the

equipment is expensive and the analysis takes a long time.

In this latest study, the researchers describe how they turned to another method, called "diffuse reflectance spectroscopy", and found it gave

results just as accurately as Raman spectroscopy, but much faster and at less cost.

Co-lead author Narahara Chari Dingari, a postdoc at MIT, says:

"With our new method, we could obtain similar results with less time and less expense."

97% Success Rate with Diffuse Reflectance Spectroscopy

Diffuse reflectance spectroscopy collects and analyzes light after it has interacted with the sample. This gives a unique "spectrographic

signature".

In their PNAS paper, the authors describe how they examined 203 tissue samples within minutes of their removal from 23

patients.

Each sample could be one of three types, each with its own spectrographic signature. It could be healthy, it could contain lesions with no

microcalcifications, or it could contain lesions with microcalcifications.

By analyzing these patterns, the team produced a computer algorithm that showed a success rate of 97% in identifying tissue with

microcalcifications.

Jaqueline Soares, another lead author and MIT postdoc, suggests the changes in the way the different tissues absorb light are probably due to

altered levels of specific proteins (elastin, desmosine and isodesmosine) that are often cross-linked with calcium deposits in diseased tissue.



Simple Technology with High Accuracy Is a "Good First Step"

James Tunnell is an associate professor of biomedical engineering at the University of Texas and was not involved in the study. He describes the

study as a "good first step" toward a system that could have a big impact on breast cancer diagnosis.

"This technology can be integrated into the system that is already used to take biopsies. It's a very simple technology that can get the same

amount of accuracy as more complicated systems."

The team envisages their technique being used by radiologists to provide enhanced "real time" guidance to current biopsy procedures.

Because it provides the analysis results within seconds, the new technique could help the radiologist to move the needle to another spot before

taking any samples.

The researchers are planning to carry out a new study to test the approach in "real time": as biposies are being carried out in

patients.


Funds from the National Institutes of Health, the National Institute of Biomedical Imaging and Bioengineering and the National Cancer Institute

helped finance the study.




Written by Catharine Paddock PhD









Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Cholesterol Plays Key Role In Cell Signaling

Cholesterol Plays Key Role In Cell Signaling31 Dec 2012-nbsp;-nbsp;-nbsp;

Healthy organisms rely on tightly controlled pathways of cellular signals that pass from protein to protein, each protein modifying the

next in some way. Now an international team of researchers has discovered that cholesterol plays a key role in regulating the proteins in these

pathways, and may also be important for other processes inside cells.

Principal investigator Wonhwa Cho, professor of chemistry at the University of Illinois at Chicago, and colleagues, write about their discovery in a

paper published earlier in December in the journal Nature Communications.

Usually, news about cholesterol tends to focus on its role in heart disease, as a result of which it has acquired somewhat of a bad reputation. But

cholesterol is an essential component of healthy cells.

Until recently, however, because it is found sandwiched between the inner and outer surfaces of cell membranes, cell biologists thought

cholesterol's main work was confined to interactions with other molecules in the membrane.

For instance, in 2011, a team of scientists at the National Institute of Standards and Technology (NIST) and University of California, Irvine, using

neutron diffraction, revealed how cholesterol helped to "maintain order"

within the cell membrane.

But Cho and colleagues have discovered cholesterol also appears to interact with proteins in the interior of the cell.

In this latest study, they reveal how cholesterol interacts with a scaffold protein. A scaffold protein uses its physical structure to bring together

other proteins so they can pass signals to each other. They have protein binding sites that offer the signaling proteins a place to latch

onto.



The authors found that cholesterol binds to a region on the scaffold protein where one of its signaling partners also binds. And they discovered that

disruption of the cholesterol binding to that site also stopped the partner from activating.

"Here we show that cholesterol specifically binds many PDZ domains found in scaffold proteins, including the N-terminal PDZ domain of

NHERF1/EBP50 ... Disruption of the cholesterol-binding activity of NHERF1 largely abrogates its dynamic co-localization with and activation of

cystic fibrosis transmembrane conductance regulator, one of its binding partners in the plasma membrane of mammalian cells," they

write.



In their paper, they give a detailed description of how the scaffold protein attaches itself to the membrane and reaches into it to find and bind the

cholesterol.

The team suggests this way of interacting with cholesterol could be used by many proteins inside cells and sheds light on the importance of

cholesterol to healthy cell functioning.

Cho says much of the existing data on how cholesterol behaves in cell processes has been difficult to interpret. He says their discovery is

important because it "will help people understand how cholesterol may regulate other cellular processes".








Written by Catharine Paddock PhD









Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Most Disciplined Doctors Trained Abroad, UK

Most Disciplined Doctors Trained Abroad, UK31 Dec 2012-nbsp;-nbsp;-nbsp;

63% of doctors who are either struck off or suspended in the United Kingdom were trained abroad, yet only 36% of all the doctors in the UK medical register are from overseas.

A total of 669 doctors have been either suspended or struck off by the GMC over the last five years. Only 249 (37%) of them were British while 420 (63%) were trained overseas.

The General Medical Council (GMC) has decided to do something about this disproportionate number of foreign-trained doctors being struck of the medical register or suspended. New reforms include better checks, an overhaul of the current testing system for foreign doctors who wish to work in the UK, and an induction program.

Chief Executive of the GMC, Niall Dickson, admitted that they absolutely acknowledge that "when it comes to the serious end of the scale, those from overseas are more likely to appear, and we have set about a series of reforms to address this."

New Induction Program

The GMC has announced that a New Induction Program for all doctors coming in from overseas will be launched as a pilot scheme, during the first quarter of 2013.

The GMC says that doctors who are new to UK practice need to understand the ethical and professional standards they are required to meet when practicing in the United Kingdom.

The GMC's aim is to address the wide variations in medical practice standards listed in its report "The State of Medical Education and Practice in the UK 2011" (pdf).

The GMC believes that an induction program for all physicians new to its register will help improve medical practice in Great Britain, which in turn will benefit patients.

Doctor shortage - the GMC says that there is a shortage of doctors in the UK. Therefore health authorities in the country have to make sure that:

There are enough doctors to treat the country's population
In order to do this, many have to come in from overseas
The ones who come in from abroad must be given adequate support


The PLAB (Performance and Linguistic Assessment Board) test for foreign doctors will also be reviewed. PLAB tests doctors' clinical skills and competence for practicing in the UK.

Revalidation - this is a system of checks that started in December 2012 which makes it compulsory for all doctors practicing in the UK to show that they are keeping up to date and are fit to practice. The revalidation is based on an annual review (appraisal) and feedback from colleagues and patients.

The Process Of Revalidation will occur every five years and will apply to all doctors in all UK settings, including locums and those who work in the private sector.

Dame Sally Davies, Chief Medical Officer, has become one of the first UK doctors to be revalidated after receiving confirmation from the GMC this week.

Chief Medical Officer Dame Sally Davies said "I am delighted to have confirmation of my revalidation from the GMC. Being revalidated was an incredibly useful experience, and allowed me to reflect on my own practice and approach. All feedback is useful to doctors - and for many it is about improving their already high standards. This is the biggest change to medical regulation in over a hundred years, but must importantly the process provides huge reassurance to patients and the public."

According to the General Medical Council, the United Kingdom is the first country worldwide to introduce such a comprehensive system across the nation's healthcare system.

Language competence - UK hospital and medical agencies are not allowed to test the language skills of the doctors who come in from other European Union countries to determine whether they can communicate properly (whether their English is good enough to work). Britain has interpreted EU law as meaning that health care professionals who qualify in any of the European Union's 27 nations "must" be free to work elsewhere, with no restriction whatsoever.

According to the British Medical Association's director of professional activities, Dr Vivienne Nathanson:

"It is clear that doctors who have qualified overseas are more likely to be subject to disciplinary action. However, more research is needed to understand why this is the case. The UK is still short of doctors and so we must ensure that those who come from overseas are given adequate support to be able to practise medicine in the UK.

It is critical that all doctors that work in the UK have appropriate clinical and communication skills as well as an understanding of UK law and culture and of how the NHS works."

Written by Christian Nordqvist
Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Statin Drug Shows Promise For Fighting Malaria Effects

Breast Cancer Diagnosis Could Benefit Greatly From Spectroscopy

Breast Cancer Diagnosis Could Benefit Greatly From Spectroscopy31 Dec 2012-nbsp;-nbsp;-nbsp;

The analysis of small deposits of calcium in breast tissue can help differentiate cancerous and benign tumors, but it is sometimes not easy

to make such a diagnosis. Now a team of researchers in the US believes a new method that uses a special type of spectroscopy to locate calcium

deposits during a biopsy, could greatly improve the accuracy of diagnosis.

The team, from Massachusetts Institute of Technology (MIT) and Case Western Reserve University (CWRU), writes about the work that led them to

this conclusion in a paper published online in Proceedings of the National Academy of Sciences on 24 December.

Calcium Deposits

Microcalcifications, or small deposits of calcium, form when calcium from the bloodstream deposits onto degraded proteins and fats left behind by

injured and dying cells.

They can be a telltale sign of breast cancer, but most tumors that contain them are benign.

Microcalcifications are most often seen in breast tumors, but they can also occur, albeit rarely, in other types of cancer, says co-senior author

Maryann Fitzmaurice, senior research associate and adjunct associate professor of pathology and oncology at CWRU, in a statement.

Calcification also plays a major role in atherosclerosis, or hardening of the arteries.

Biopsy Can Be Long and Arduous Procedure

When microcalcifications show on a mammogram, doctors do a follow-up biopsy of the suspect tissue to test for cancer.

Figures show that in around 1 in 10 cases with such microcalcifications, the tumor is cancerous, so the follow-up biopsy is critical.

During the procedure, the radiologist takes X-rays from three different angles to locate the tiny calcium deposits, then inserts a needle into the

tissue and removes up to 10 tissue samples.

A pathologist then tests these samples to see if they contain microcalcifications.

But in 15 to 25% of cases, it is not easy to locate and take a tissue sample accurately, resulting in an inconclusive diagnosis. This means the

patient has to have more X-rays and undergo more invasive surgery to retrieve further samples.

But, as Fitzmaurice explains, this second attempt is rarely successful:

"If they don't get them on the first pass, they usually don't get them at all."

"It can become a very long and arduous procedure for the patient, with a lot of extra X-ray exposure, and in the end they still don't get what

they're after, in one out of five patients," she adds.

New Method Uses Special Type of Spectroscopy

Spectroscopy is a way of determining the composition of a material by studying how it absorbs or scatters radiation such as light. It is often used in

physical and analytical chemistry, and there are many applications now in medicine too.

One of the challenges in applying the technique to medicine is cost and speed: often the equipment is very expensive and slow to deliver results in

"real time".

For the past several years, the MIT and CWRU team has been working on overcoming this challenge to help the radiologist determine, in a matter

of seconds, if the tissue contains microcalcifications or not.

At first they tried a method based on Raman spectroscopy, which uses light to measure energy shifts in molecular vibrations, revealing precise

molecular structures. The advantage of this method is that it is very accurate at identifying microcalcifications. But the disadvantage is the

equipment is expensive and the analysis takes a long time.

In this latest study, the researchers describe how they turned to another method, called "diffuse reflectance spectroscopy", and found it gave

results just as accurately as Raman spectroscopy, but much faster and at less cost.

Co-lead author Narahara Chari Dingari, a postdoc at MIT, says:

"With our new method, we could obtain similar results with less time and less expense."

97% Success Rate with Diffuse Reflectance Spectroscopy

Diffuse reflectance spectroscopy collects and analyzes light after it has interacted with the sample. This gives a unique "spectrographic

signature".

In their PNAS paper, the authors describe how they examined 203 tissue samples within minutes of their removal from 23

patients.

Each sample could be one of three types, each with its own spectrographic signature. It could be healthy, it could contain lesions with no

microcalcifications, or it could contain lesions with microcalcifications.

By analyzing these patterns, the team produced a computer algorithm that showed a success rate of 97% in identifying tissue with

microcalcifications.

Jaqueline Soares, another lead author and MIT postdoc, suggests the changes in the way the different tissues absorb light are probably due to

altered levels of specific proteins (elastin, desmosine and isodesmosine) that are often cross-linked with calcium deposits in diseased tissue.



Simple Technology with High Accuracy Is a "Good First Step"

James Tunnell is an associate professor of biomedical engineering at the University of Texas and was not involved in the study. He describes the

study as a "good first step" toward a system that could have a big impact on breast cancer diagnosis.

"This technology can be integrated into the system that is already used to take biopsies. It's a very simple technology that can get the same

amount of accuracy as more complicated systems."

The team envisages their technique being used by radiologists to provide enhanced "real time" guidance to current biopsy procedures.

Because it provides the analysis results within seconds, the new technique could help the radiologist to move the needle to another spot before

taking any samples.

The researchers are planning to carry out a new study to test the approach in "real time": as biposies are being carried out in

patients.


Funds from the National Institutes of Health, the National Institute of Biomedical Imaging and Bioengineering and the National Cancer Institute

helped finance the study.




Written by Catharine Paddock PhD









Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Benefits Of Higher Oxygen, Breathing Device Persist After Infancy

New Technique Catalogs Lymphoma-Linked Genetic Variations

Most Disciplined Doctors Trained Abroad, UK

Most Disciplined Doctors Trained Abroad, UK31 Dec 2012-nbsp;-nbsp;-nbsp;

63% of doctors who are either struck off or suspended in the United Kingdom were trained abroad, yet only 36% of all the doctors in the UK medical register are from overseas.

A total of 669 doctors have been either suspended or struck off by the GMC over the last five years. Only 249 (37%) of them were British while 420 (63%) were trained overseas.

The General Medical Council (GMC) has decided to do something about this disproportionate number of foreign-trained doctors being struck of the medical register or suspended. New reforms include better checks, an overhaul of the current testing system for foreign doctors who wish to work in the UK, and an induction program.

Chief Executive of the GMC, Niall Dickson, admitted that they absolutely acknowledge that "when it comes to the serious end of the scale, those from overseas are more likely to appear, and we have set about a series of reforms to address this."

New Induction Program

The GMC has announced that a New Induction Program for all doctors coming in from overseas will be launched as a pilot scheme, during the first quarter of 2013.

The GMC says that doctors who are new to UK practice need to understand the ethical and professional standards they are required to meet when practicing in the United Kingdom.

The GMC's aim is to address the wide variations in medical practice standards listed in its report "The State of Medical Education and Practice in the UK 2011" (pdf).

The GMC believes that an induction program for all physicians new to its register will help improve medical practice in Great Britain, which in turn will benefit patients.

Doctor shortage - the GMC says that there is a shortage of doctors in the UK. Therefore health authorities in the country have to make sure that:

There are enough doctors to treat the country's population
In order to do this, many have to come in from overseas
The ones who come in from abroad must be given adequate support


The PLAB (Performance and Linguistic Assessment Board) test for foreign doctors will also be reviewed. PLAB tests doctors' clinical skills and competence for practicing in the UK.

Revalidation - this is a system of checks that started in December 2012 which makes it compulsory for all doctors practicing in the UK to show that they are keeping up to date and are fit to practice. The revalidation is based on an annual review (appraisal) and feedback from colleagues and patients.

The Process Of Revalidation will occur every five years and will apply to all doctors in all UK settings, including locums and those who work in the private sector.

Dame Sally Davies, Chief Medical Officer, has become one of the first UK doctors to be revalidated after receiving confirmation from the GMC this week.

Chief Medical Officer Dame Sally Davies said "I am delighted to have confirmation of my revalidation from the GMC. Being revalidated was an incredibly useful experience, and allowed me to reflect on my own practice and approach. All feedback is useful to doctors - and for many it is about improving their already high standards. This is the biggest change to medical regulation in over a hundred years, but must importantly the process provides huge reassurance to patients and the public."

According to the General Medical Council, the United Kingdom is the first country worldwide to introduce such a comprehensive system across the nation's healthcare system.

Language competence - UK hospital and medical agencies are not allowed to test the language skills of the doctors who come in from other European Union countries to determine whether they can communicate properly (whether their English is good enough to work). Britain has interpreted EU law as meaning that health care professionals who qualify in any of the European Union's 27 nations "must" be free to work elsewhere, with no restriction whatsoever.

According to the British Medical Association's director of professional activities, Dr Vivienne Nathanson:

"It is clear that doctors who have qualified overseas are more likely to be subject to disciplinary action. However, more research is needed to understand why this is the case. The UK is still short of doctors and so we must ensure that those who come from overseas are given adequate support to be able to practise medicine in the UK.

It is critical that all doctors that work in the UK have appropriate clinical and communication skills as well as an understanding of UK law and culture and of how the NHS works."

Written by Christian Nordqvist
Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today

Breast Cancer Diagnosis Could Benefit Greatly From Spectroscopy

Breast Cancer Diagnosis Could Benefit Greatly From Spectroscopy31 Dec 2012-nbsp;-nbsp;-nbsp;

The analysis of small deposits of calcium in breast tissue can help differentiate cancerous and benign tumors, but it is sometimes not easy

to make such a diagnosis. Now a team of researchers in the US believes a new method that uses a special type of spectroscopy to locate calcium

deposits during a biopsy, could greatly improve the accuracy of diagnosis.

The team, from Massachusetts Institute of Technology (MIT) and Case Western Reserve University (CWRU), writes about the work that led them to

this conclusion in a paper published online in Proceedings of the National Academy of Sciences on 24 December.

Calcium Deposits

Microcalcifications, or small deposits of calcium, form when calcium from the bloodstream deposits onto degraded proteins and fats left behind by

injured and dying cells.

They can be a telltale sign of breast cancer, but most tumors that contain them are benign.

Microcalcifications are most often seen in breast tumors, but they can also occur, albeit rarely, in other types of cancer, says co-senior author

Maryann Fitzmaurice, senior research associate and adjunct associate professor of pathology and oncology at CWRU, in a statement.

Calcification also plays a major role in atherosclerosis, or hardening of the arteries.

Biopsy Can Be Long and Arduous Procedure

When microcalcifications show on a mammogram, doctors do a follow-up biopsy of the suspect tissue to test for cancer.

Figures show that in around 1 in 10 cases with such microcalcifications, the tumor is cancerous, so the follow-up biopsy is critical.

During the procedure, the radiologist takes X-rays from three different angles to locate the tiny calcium deposits, then inserts a needle into the

tissue and removes up to 10 tissue samples.

A pathologist then tests these samples to see if they contain microcalcifications.

But in 15 to 25% of cases, it is not easy to locate and take a tissue sample accurately, resulting in an inconclusive diagnosis. This means the

patient has to have more X-rays and undergo more invasive surgery to retrieve further samples.

But, as Fitzmaurice explains, this second attempt is rarely successful:

"If they don't get them on the first pass, they usually don't get them at all."

"It can become a very long and arduous procedure for the patient, with a lot of extra X-ray exposure, and in the end they still don't get what

they're after, in one out of five patients," she adds.

New Method Uses Special Type of Spectroscopy

Spectroscopy is a way of determining the composition of a material by studying how it absorbs or scatters radiation such as light. It is often used in

physical and analytical chemistry, and there are many applications now in medicine too.

One of the challenges in applying the technique to medicine is cost and speed: often the equipment is very expensive and slow to deliver results in

"real time".

For the past several years, the MIT and CWRU team has been working on overcoming this challenge to help the radiologist determine, in a matter

of seconds, if the tissue contains microcalcifications or not.

At first they tried a method based on Raman spectroscopy, which uses light to measure energy shifts in molecular vibrations, revealing precise

molecular structures. The advantage of this method is that it is very accurate at identifying microcalcifications. But the disadvantage is the

equipment is expensive and the analysis takes a long time.

In this latest study, the researchers describe how they turned to another method, called "diffuse reflectance spectroscopy", and found it gave

results just as accurately as Raman spectroscopy, but much faster and at less cost.

Co-lead author Narahara Chari Dingari, a postdoc at MIT, says:

"With our new method, we could obtain similar results with less time and less expense."

97% Success Rate with Diffuse Reflectance Spectroscopy

Diffuse reflectance spectroscopy collects and analyzes light after it has interacted with the sample. This gives a unique "spectrographic

signature".

In their PNAS paper, the authors describe how they examined 203 tissue samples within minutes of their removal from 23

patients.

Each sample could be one of three types, each with its own spectrographic signature. It could be healthy, it could contain lesions with no

microcalcifications, or it could contain lesions with microcalcifications.

By analyzing these patterns, the team produced a computer algorithm that showed a success rate of 97% in identifying tissue with

microcalcifications.

Jaqueline Soares, another lead author and MIT postdoc, suggests the changes in the way the different tissues absorb light are probably due to

altered levels of specific proteins (elastin, desmosine and isodesmosine) that are often cross-linked with calcium deposits in diseased tissue.



Simple Technology with High Accuracy Is a "Good First Step"

James Tunnell is an associate professor of biomedical engineering at the University of Texas and was not involved in the study. He describes the

study as a "good first step" toward a system that could have a big impact on breast cancer diagnosis.

"This technology can be integrated into the system that is already used to take biopsies. It's a very simple technology that can get the same

amount of accuracy as more complicated systems."

The team envisages their technique being used by radiologists to provide enhanced "real time" guidance to current biopsy procedures.

Because it provides the analysis results within seconds, the new technique could help the radiologist to move the needle to another spot before

taking any samples.

The researchers are planning to carry out a new study to test the approach in "real time": as biposies are being carried out in

patients.


Funds from the National Institutes of Health, the National Institute of Biomedical Imaging and Bioengineering and the National Cancer Institute

helped finance the study.




Written by Catharine Paddock PhD









Copyright: Medical News TodayNot to be reproduced without permission of Medical News Today