The Lakes Surgical Center is one of the locations we perform surgeries

Lakes Surgical CenterThe Lakes Surgical Center in West Bloomfield is one of the locations that we perform spine and neuro surgeries.

The center includes four operating rooms, two procedure rooms, pre-operative and post-operative recovery areas and a large reception area. It is licensed by the State of Michigan and is fully accredited by the Joint Commission for Accreditation of Healthcare Organizations. Lakes Surgery Center is affiliated with National Surgical Hospitals.

Advanced Breast Cancer in Young American Women: On the Rise?

breast-cancerIn the past 30 years, there has been a small but significant increase in the incidence of advanced breast cancer in American women 25 to 39 years of age, according to a study published in the February 27 issue of JAMA.

During the same period, there was no increase in advanced disease in older women, according to the researchers, led by Rebecca H. Johnson, MD, from the Seattle Children’s Hospital and the University of Washington.

In the young women, the incidence of breast cancer with distant involvement at diagnosis increased from 1.53 per 100,000 women in 1976 to 2.90 per 100,000 women in 2009. This is an absolute difference of 1.37 per 100,000, and is an average compounded increase of 2.07% per year (P < .001) over a 34-year interval.

The findings come from an analysis of incidence trends from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database.

[Read more…]

Rare Mutation Triples Risk of Alzheimer’s

NIHA mutation found in about one in 200 Icelanders older than 85 raised the risk of developing Alzheimer’s disease threefold, researchers said.

The mutation, in an immunoregulatory gene known as TREM2, was more common in Alzheimer’s disease patients than in the general 85-and-older population in Iceland with an odds ratio of 2.91 (95% CI 2.09 to 4.09, P=3.42×10-10), reported Kari Stefansson, MD, PhD, of deCode Genetics in Reykjavik, Iceland, and colleagues.

Because of the gene’s function within the central nervous system, the mutation “may lead to an increased predisposition to Alzheimer’s disease through impaired containment of inflammatory processes,” the researchers wrote online in the New England Journal of Medicine. [Read more…]

PET Scan Shows Caffeine’s Effect on Brain

coffee-beansFor the first time, researchers have been able to use positron emission tomography (PET) to visualize binding sites of caffeine(Drug information on caffeine) in the living human brain, making it possible to explore possible effects of caffeine consumption.

Caffeine, a neuroactive agent, is one of the most commonly consumed psychoactive substances worldwide. Caffeine has also been found to have some protection against some neurodegenerative diseases. In the U.S., it is estimated that 80 percent of adults consume an average of 200 mg of caffeine daily, the equivalent of two 5-ounce cups of coffee or four sodas.

But until now, researchers have not been able to visualize or quantify the effect of caffeine on the brain. In vitro studies have shown that commonly consumed quantities of caffeine have led to high A1 adenosine(Drug information on adenosine) in the brain, David Elmenhorst, MD, lead author of a study published in the November issue of The Journal of Nuclear Medicine, said in a press release. The A1 adenosine receptor is the most abundant in the human brain. Researchers sought to measure the A1 adenosine receptor occupancy with in vivo imaging. [Read more…]

Do Sleep Patterns Affect the Risk of Cognitive Decline?

Older CoupleVANCOUVER—The quality and quantity of sleep may be associated with the risk for cognitive decline, according to four studies presented at the 2012 Alzheimer’s Association International Conference. Treatments for insomnia or circadian rhythm delay might reduce or prevent cognitive decline, investigators reported.

Sleep Duration and Cognition
Compared with a sleep duration of seven hours per day, sleep durations of five or fewer hours per day and of nine or more hours per day were associated with worse average memory at older ages, according to Elizabeth Devore, ScD, Associate Epidemiologist at Brigham and Women’s Hospital in Boston. Short and long sleep durations at midlife and in later life were both associated with worse memory in later life. [Read more…]

Perioperative Anticoagulation Management

Author: Brian James Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: William A Schwer, MD

In performing noncardiac surgery on patients on anticoagulation, the major concern is when it is safe to perform surgery without increasing the risk of hemorrhage or increasing the risk of thromboembolism (eg, venous, arterial) after discontinuing treatment. In treating patients on long-term Coumadin perioperatively, consider the risks of hemorrhage or thromboembolism versus the benefit from the operation. When considering noncardiac surgery, these factors and the need to weigh the risk of hemorrhage against that of thromboembolism must analyzed on an individual patient basis. Certain procedures (eg, oncologic procedures, threats to limb or life) are easy analyses. More complex discussions must be had for such cases as hernia repair of other elective nonurgent operations. [Read more…]

YouTube Videos of Vertigo Treatment Mostly Accurate

Video demonstrations of a common maneuver for managing benign paroxysmal positional vertigo (BPPV) are readily available on YouTube, and most are accurate depictions of the treatment, according to a new study.

The study, published in the July 24 issue of Neurology, shows that 64% of 33 videos had correct information on how to perform the Epley maneuver, with most of the other videos having only minor deviations from the accepted approach, said lead author Kevin A. Kerber, MD, assistant professor of neurology at the University of Michigan Health System in Ann Arbor.

A relatively common condition, BPPV is caused by freely moving particles called canaliths that are trapped in the semicircular canal of the inner ear. A main symptom of BPPV is transient, positionally triggered dizziness. [Read more…]

Coffee May Ward Off Progression to Dementia

Patients with mild cognitive impairment (MCI) may be able to avoid developing dementia by drinking several cups of coffee a day, the results of a new study suggest.

The study showed that patients with MCI who have a plasma caffeine level of 1200 ng/mL avoided progression to dementia over the following 2 to 4 years.

These patients exhibited a plasma cytokine profile that was exactly the same as that of Alzheimer’s disease (AD) transgenic mice that were given caffeinated coffee and didn’t progress to dementia. It’s therefore very likely that it’s caffeine from coffee, and not from other sources, that affords the cognitive protection, said study senior author Gary W. Arendash, PhD, research scientist, Bay Pines Veterans Affairs Hospital, St. Petersburg, Florida.

The research also suggests that certain cytokine patterns could signal for impending conversion to dementia among those with MCI, said Dr. Arendash. [Read more…]

RLS Drug Gets New Indication – in Public Health & Policy

By Cole Petrochko, Associate Staff Writer, MedPage Today

WASHINGTON — The FDA has approved the restless legs syndrome drug gabapentin enacarbil (Horizant) to treat postherpetic neuralgia.

The drug is administered in one 600 mg dose for the first 3 days of treatment, followed by 600 mg doses twice daily on day four and onward, a statement from makers GlaxoSmithKline and XenoPort said.

Patients with renal impairment should have adjusted doses, the statement added.

Safety and efficacy for the new indication were evaluated in a 12-week principal efficacy trial and two supportive studies of a combined 574 patients.

Adverse events in the studies included somnolence, dizziness, headache, nausea, and fatigue.

Patients taking anti-epileptic drugs, including other gabapentin formulations, may be at increased risk for suicidal ideation and behavior, as well as potentially fatal multi-organ hypersensitivity, symptoms of which include fever, rash, and lymphadenopathy.

The drug should be tapered to once daily for a week before ceasing treatment to reduce risk of withdrawal seizure, the statement said.

The drug was initially approved for the treatment of moderate-to-severe primary restless legs syndrome in April 2011.

More Evidence Dark Chocolate Is Cardioprotective

The blood pressure–lowering and lipid effects of dark chocolate could be an effective — and money-saving — strategy for preventing cardiovascular events in high-risk patients, a new study suggests.

“The findings of this study suggest that the blood pressure lowering and lipid effects of plain dark chocolate could represent an effective and cost effective strategy for the prevention of cardiovascular disease in people with metabolic syndrome (and no diabetes),” the researchers, with senior author Christopher M. Reid, PhD, CCRE Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Victoria, Australia, conclude. [Read more…]