Category Archives: West Virginia Stem Cells

Two decades ago, Luis Antonio Cabrera received devastating news: He likely had only three months to live.

The Puerto Rican truck driver, then 50, had attributed his growing leg pain to spending so many hours on the road. The real culprit was a malignant tumor in his left kidney that was pressing on nerves from his lower spine.

His initial treatment involved removing the organ, a complex surgery that proved insufficient, as the cancerous cells had already spread to his lungs. His primary care physician in Puerto Rico contacted doctors at the National Institutes of Health, in Bethesda, Maryland, to enroll Cabrera in a medical study to test an innovative therapy: transplanting blood stem cells to destroy the cancer cells.

Today, at 70, Cabrera a father of five and grandparent who moved to West Virginia with his wife to be closer to NIH feels strong and healthy.

I come to do tests every six months Im like a patient at large, he said.

However, Cabrera is one of a relatively small number of Hispanics who participate in clinical trials.

Less than 8 percent of enrollees are Hispanic, even though Hispanics comprise 17 percent of the population, said Dr. Eliseo Prez-Stable, director of NIHs National Institute on Minority Health and Health Disparities.

That means not only do Hispanics have less access to experimental, cutting-edge treatments, but also that researchers have less data on how a drug works in that population.

Studies have shown that different ethnic groups can respond differently to the same treatment.

The lack of patients from minority groups is an endemic problem in clinical trials; minorities typically are represented at a very low rate.

Studies should represent the demographics of the country, said Dr. Jonca Bull, an assistant commissioner on minority health at the U.S. Food and Drug Administration. We need to close that gap so we can better understand how a particular drug or therapy works in different communities.

There are many reasons why Hispanic people do not enroll in these studies, Prez-Stable said: lack of information, disparities in access to health care and lack of fluency in English are among main factors.

Dr. Otis Brawley, chief medical officer with the American Cancer Society, said Latinx families are open to participating in clinical trials, especially to help treat a sick son or daughter, but they need a doctor to initiate and navigate the process.

Federal officials aim to augment Hispanic enrollment in clinical trials.

In March, the FDA launched a campaign to educate Hispanics about medical studies. Primary care physicians have to be the champions. In addition, the community health centers can help, because they are places of care that people trust, said Bull.

As of early July, there were 94,545 ongoing clinical trials in the United States, according to the NIHs official website, clinicaltrials.gov. As in Cabreras case, the primary physician usually helps a patient find a medical study, although the advent of the internet in recent decades has meant a growing number of patients discover trials themselves online.

The American Cancer Society also has an information service to help patients find clinical trials that match their medical condition. This service is available in Spanish.

To participate in a trial, a person must meet the researchers criteria for eligibility, including factors like age, gender or condition. Often, the center conducting the study covers related costs of drugs, treatments and tests.

For Brenda Aldana, receiving care at Holy Cross Hospital in Silver Spring, Maryland, made all the difference.

Aldana, 34, arrived in the United States from El Salvador nine years ago. During her first year here, she felt tired and her hair began to fall out. She initially thought those were symptoms of the stress of starting a new life in a new country, but while visiting her sister in Frederick, Maryland, Aldana fainted. It turned out she was suffering more than nerves: She had a pulmonary embolism.

Within two weeks of tests, she was diagnosed with lupus, a debilitating chronic condition with a high incidence among Latinas.

At Holy Cross, the doctors told me that they were going to help me get into a medical program for a medication to treat arthritis (caused by her lupus), said Aldana, who has three children, ages 17, 6 and 5.

Aldana travels from Olney, Maryland, to the NIH Clinical Center once a month to receive intravenous medication.

These days, Hispanics receive less quality medical care, so its important for them to be more involved in clinical trials, said Brawley, noting that enrolling in a clinical trial gives patients access to high-quality physicians they might not otherwise see.

In a medical study, instead of having the opinion of a single doctor, youll get the opinion of a group of highly qualified doctors who can say, This is good for people like you, Brawley said.

John Vasquez, 21, of San Antonio, Texas, needed only internet access and a cellphone to find the medical study that could change his life.

In September 2015, while on his way to his brothers football game, he lost feeling in his leg, arm and the right side of his face. I thought I was having a stroke, he said.

He had aplastic anemia, a potentially deadly, rare blood disorder that was destroying his red and white cells and his platelets, which aid the bodys clotting mechanism.

In a Facebook group for people with severe blood conditions, he was advised to contact the NIH, which sent him a kit for blood tests. After analyzing his clinical history, they told him he was eligible to participate in a medical study, which opened the gates to an innovative transplant that could change the course of his disease. Temporarily living with a sister in Maryland, he was scheduled for a bone marrow transplant this month. His donor: his 14-year-old brother.

Kaiser Health News is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

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Hispanics left out of clinical trials and cutting-edge treatments - Wisconsin Gazette

Tom Parham remembers the time his Woodrow Wilson baseball team was playing Class AAA power Huntington East.

It was 1980, and the Flying Eagles were hosting the Pony Express at Harry Lewin Field. Not known to be a cavernous venue, the field lent itself to an offensive barrage and Huntington East was the last team standing.

A few weeks later, Parham led Woodrow to the state championship game and a rematch with the Express. Woodrow fell short again, but this time it was by the more purist-friendly score of 2-1.

It was then that Parham knew the Eagles needed a new field.

In stepped Doug Epling, Beckley businessman and community leader. He would later be known for refurbishing the old East Bank High School field for WVU Tech to use, as well as the construction of Linda K. Epling Stadium in Beckley, the home of the West Virginia Miners.

The latter, of course, bears the name of Epling's wife. The Tech field is named for Epling himself.The field he helped build on the Woodrow Wilson campus doesn't have an official name.

That will change Saturday.A ceremony will be held at 2 p.m. in the school cafeteria to officially rename the field for Thomas Parham.

The effort to honor the longtime coach was started by Sheila Brown.

"Words cannot describe how it feels," Parham said. "When Mrs. Brown started talking about it, I always told her, nah (modestly). I just thought, 'Let it go.' And finally she told me in April, 'Well, I'm going to the board. I'm going to ask them.' So she did and they told her what to do (at the next meeting)."

The Raleigh County School Board laid out a plan for Brown, and at the next meeting former coaches, colleagues and friends voiced their support.

Legendary boys basketball coach Dave Barksdale. State championship-winning football coach Pete Culicerto. Fellow New Hope Baptist Church member C.W. Claytor. Even Epling himself. They all showed up to see that Parham got the respect they feel he deserves.

"It was just touching to hear former coaches Coach Barksdale, Coach Culicerto, and I even heard from one of my coaching buddies from out of town, Ron Rose," Parham said. "He told Pete what (he wanted) to say. It was just touching, and a humbling experience."

Parham is being recognized for a career that spanned nearly three decades. He was hired as a biology teacher by Ross Hutchens before the start of the 1974-75 academic year.

"He said, 'I need a good biology teacher. I can get a coach anywhere,'" Parham said, laughing.

His first season as head baseball coach was 1975, and he remained there until his retirement in 2000. Along the way, his teams rolled up over 200 wins and appeared in the state tournament five times. Two of those trips resulted in runner-up finishes the 1980 meeting with Huntington East, and in 1983 against Martinsburg.

And the list of star players Parham coached seems endless Chuck Tate, Andy "Bam Bam" Wakefield, Larry Maiolo, Mason Basham, Larry Hickman, Joe Joe Maiolo, Larry Pat Farley, Phil Culicerto, Tim Epling, Phil Lane, Ronnie Fama, John O'Dell.

There were many others, and many of themare members of the Woodrow Wilson Baseball Hall of Fame.

"I was fortunate I came across some good ball players," Parham said. "You don't like to toot your own horn, but like a fella said, we put Woodrow Wilson baseball on the map."

Another was Ronnie Scott, who went on to work for NASA in Florida before returning to Beckley in 2010. Sadly, he passed away in May at age 59.

"He wanted to see baseball dominant again like it was when he played," Parham said.

When Parham retired from baseball in 2000 he stayed on as a biology teacher for one more year it was the emphatic end of an era at the school. Not only did Parham retire, but Culicerto retired after the 1999 football season, and Barksdale left the bench just months before Parham to take a coaching job in Aiken, S.C.

"Indeed it was," said Parham, now 74. "I enjoyed working with Coach Culicerto (as an assistant football coach). He was a great football coach, and he was a baseball supporter. He had seven sons play baseball for me. Three of them played in the state tournament."

After his retirement, Parham's was a familiar face in the stands at Woodrow baseball games. But in 2009, his ability to be a spectator slowed down when it was discovered that he had cancer.

Parham was diagnosed with multiple myeloma, a blood cancer that develops in the plasma cells located in bone marrow. The cancer did eventually go into remission, but Parham was still getting checkups when something told him he needed to go to Johns Hopkins in Baltimore.

It was there that he was introduced to autologous stem cell transplant. It's a procedure that involves collecting the patient's stem cells and following it up with high doses of chemotherapy or a combination of chemo and radiation. The process kills cancer cells while also killing blood-producing cells left in the bone marrow.

The collected stem cells are later transplanted back into the patient, allowing the marrow to produce new blood cells.

"I met a very interesting and a caring doctor up there, Dr. (Ivan) Borrello. He told me (about the transplant)," Parham said. "As a matter of fact, they have been doing this since 1980. He asked, 'What do you think about a stem cell transplant?' And I said yeah. Anything to get rid of this cancer.

"At that time my cancer was in remission, so he couldn't do anything. He said we would have to wait until it comes back. He hoped it didn't come back, but if it does ..."

It did, and in February he had the procedure performed.

"It came back in 2016, and when you're over 70 they don't usually do these things," Parham said. "But he felt like I was in good shape, which I think well, I know I am. I went through it, successful, no problems whatsoever.

"After teaching biology, I thought I knew some things. Now I know I know some things."

Just like baseball.

Email: gfauber@register-herald.com and follow on Twitter @GaryFauber

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Woodrow Wilson baseball field to be renamed for Tom Parham - Beckley Register-Herald

Two decades ago, Luis Antonio Cabrera received devastating news: He likely had only three months to live.

The Puerto Rican truck driver, then 50, had attributed his growing leg pain to spending so many hours on the road. The real culprit was a malignant tumor in his left kidney that was pressing on nerves from his lower spine.

His initial treatment involved removing the organ, a complex surgery that, by itself, proved insufficient, as the cancerous cells had already spread to his lungs. Therefore, his primary care physician in Puerto Rico contacted doctors at the National Institutes of Health (NIH), in Bethesda, Md., and managed to enroll Cabrera in a medical study to test an innovative therapy: transplanting blood stem cells to destroy the cancer cells.

Today, at 70, Cabrera, a father of five and grandparent who moved to West Virginia with his wife to be closer to NIH, feels strong and healthy. I come to do tests every six months Im like a patient at large, he said.

This story also ran in USA Today. It can be republished for free (details).

However, Cabrera is one of a relatively small number of Hispanics who participate in clinical trials. Only less than 8 percent of enrollees are Hispanic, even though Hispanics comprise 17 percent of the population, said Dr. Eliseo, director of NIHs National Institute on Minority Health and Health Disparities. In California, Latinos outnumber non-Hispanic whites.

That means not only do Hispanics have less access to experimental cutting-edge treatments but researchers have less data on how a drug works in that population. Studies have shown that different ethnic groups might respond differently to treatments. The lack of patients from minority groups is an endemic problem in clinical trials; minorities typically are represented at a very low rate.

Studies should represent the demographics of the country, said Dr. Jonca Bull, an assistant commissioner on minority health at the Food and Drug Administration. We need to close that gap so we can better understand how a particular drug or therapy works in different communities.

One of the few studies focused 100 percent on the Hispanic community has been the The Hispanic Community Health Study of Latinos, led by the National Heart, Lung and Blood Institute. This study has been analyzing a group of more than 16,000 Hispanics of different backgrounds in five cities since 2006, helping researchers learn more about the incidence of conditions such as diabetes, cholesterol, smoking and depression within the community.

In addition, an NIH-led initiative of the 21st Century Cures Act, a law in force since December, is compiling a database of about 1 million potential volunteers for medical studies, with a goal of including thousands of Hispanics.

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Meanwhile, the University of California has been awarded a nearly $14.7 million multi-year grant from the National Institutes of Health to study contributors to dementia in the Latino population in the United States. The multicenter study will examine the biological underpinnings of stroke, mild cognitive impairment and Alzheimers disease among Hispanics, and pursue new therapeutic directions to reduce brain health disparities.

This is the largest study of Latinos with cognitive impairment ever done, said co-principal investigator Charles DeCarli, director of the UCD Alzheimers Disease Center. Latinos are the fastest growing minority population in our aging population, so cognitive impairment in this group is an important public health concern.

UC Davis and nine other institutions across the country will participate in the research. The investigators will draw from the more than 16,000-patient cohort of the ongoing Hispanic Community Health Study/Study of Latinos, a multicenter epidemiologic study primarily focused on cardiovascular and pulmonary diseases. An ancillary study, the Study of Latinos-Investigation of Neurocognitive Aging, is examining genetic and cardiovascular disease risk factors for neurocognitive deficits, and will also provide important data for this research.

DeCarli, a UCD Health professor of neurology, noted that the Latino population is especially important to study in the field of dementia because they have a higher prevalence of diabetes, hypertension and obesity compared to non-Hispanic Caucasians, all risk factors for stroke and dementia. Rates of Alzheimers disease are about 1.5 times higher than in white non-Hispanics.

However, there are many reasons why Latinos do not enroll in these studies, Perez-Stable said: lack of information, disparities in access to health care and not being fluent in English are among main factors. Dr. Otis Brawley, chief medical officer with the American Cancer Society (ACS), said Latino families are open to participating in clinical trials, especially to help treat a sick son or daughter, but they need advice from a doctor to navigate the process.

Federal officials aim to augment these numbers. In March, the FDA launched a campaign to educate Hispanics about medical studies. Primary care physicians have to be the champions. In addition, the community health centers can help, because they are places of care that people trust, said Bull.

There are efforts in different states to encourage minorities to participate in clinical studies. In March, the California Medical Association Foundation launched a statewide campaign called Encouraging Diversity in Clinical Trials to reach Latinos and other minorities. The campaign features posters in doctors offices and educational videos.

As of July 5, there were 94,545 ongoing clinical trials in the United States, according to the NIHs official website, clinicaltrials.gov. As in Cabreras case, the primary physician usually helps a patient find a medical study, although the advent of the internet in recent decades has meant a growing number of patients discover trials themselves online. To participate, the person must meet the researchers criteria for eligibility: age, gender or condition. Often, the center conducting the study covers related costs of drugs, treatments and tests.

For Brenda Aldana, receiving care at Holy Cross Hospital in Silver Spring, Md., made all the difference.

Aldana, 34, arrived in the United States from Zacatecoluca, El Salvador, nine years ago. During her first year in the U.S., she began to feel tired and her hair began to fall out. She initially thought those were symptoms of the stress of starting a new life in a new country, but while visiting her sister in Frederick, Md., Aldana fainted. It turned out she was suffering more than nerves: She had a pulmonary embolism. Within two weeks of tests, she was diagnosed with lupus, a debilitating chronic condition with a high incidence among Latinas.

At Holy Cross, the doctors told me that they were going to help me get into a medical program for a medication to treat arthritis [caused by her lupus], said Aldana, who has three children, ages 17, 6 and 5.

Aldana travels from Olney, Md., to the NIH Clinical Center once a month to receive intravenous medication.

These days, Hispanics receive less quality medical care, so its important for them to be more involved in clinical trials, said Brawley, noting that enrolling in a clinical trial gives patients access to a high-quality physician they might not otherwise see.

In a medical study, instead of having the opinion of a single doctor, youll get the opinion of a group of highly qualified doctors who can say, This is good for people like you, Brawley said. The American Cancer Society has an information service to help patients find clinical trials that match their medical condition. This service is also available in Spanish.

John Vasquez, 21, of San Antonio, Texas, needed only internet access and a cellphone to find the medical study that could change his life. In September 2015, while on his way to his brothers football game, he lost feeling in his leg, arm and right part of his face. I thought I was having a stroke, he said.

He had aplastic anemia, a potentially deadly rare blood disorder that was destroying his red and white cells, and platelets, which aid the bodys clotting mechanism.

In a Facebook group for people with severe blood conditions, he was advised to contact the NIH, which sent him a kit for blood tests. After analyzing his clinical history, they told him he was eligible to participate in a medical study, which opened the gates to an innovative transplant that could change the course of his disease. Temporarily living with a sister in Maryland, he is scheduled for a bone marrow transplant on Aug. 1. His donor: his 14-year-old brother.

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. Dorsey Griffith of UC Davis contributed to this article.

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Latinos left out of clinical trials and possible cures - Daily Democrat

Transplant Center User Guide

This guide will help you understand how to read the transplant program reports in the Transplant Center Directory. All information provided in these reports is obtained directly from the transplant center. We make every effort to keep the information up to date but changes can occur. Consult directly with each transplant center for the most current information about their program.

Type of Transplant Unit

If the transplant center treats only adult patients, the word "Adult" will appear in this section. If only pediatric patients are accepted for treatment, the word "Pediatric" will appear. If the center treats both pediatric and adult patients, but at separate facilities, the words "Both Adult/Ped" will appear. If both pediatric and adult patients are treated at the same facility and by the same medical personnel, the words "Adult/Ped Combined" will appear.

NMDP Center

NMDP stands for National Marrow Donor Program, the organization that provides bone marrow, stem cell and cord blood donors for patients. A "Y" in this space means that NMDP will provide unrelated donors to patients treated at this center. An"N" or blank space means it will not.

FACT Approved

FACT stands for the Foundation for the Accreditation of Cellular Therapy. This group establishes standards for the collection, storage and transplantation of bone marrow, stem cells and cord blood. A "Y" after FACT approved means the center has been certified as a quality transplant center.

An "N" or blank space after FACT approvedmeans the center has not yet been rapproved by FACT. This may be because they did not apply for FACT approval, were denied approval or they are currently being reviewed."P" means the center has filed for FACT approval, and their application is pending. For more information about FACT, visit their website at http://www.factwebsite.org

Age of Program

The year the autologous and allogeneic transplant programs began

Transplant Center Staff

Lists the primary medical directors and nurse/program coordinators. It does not include staff physicans or other nurses who staff the transplant unit.

Number of Transplants Performed

This section provides data about the number and type of transplants the center has performed. in the last few years.These numbers reflect transplants done for ALL diseases, not just your disease. You'll need to consult with the center directly about their experience treating your specific disease. Consult the Department of Health and Human Services' web page for informatio on the number of transplants a center has performed for patients with a specifc disease.

If the center did not provide us with the number of transplants performed in a particular year a zero will appear in the space.

Type of Transplant:

There are several different types of bone marrow or stem cell transplants. "Autologous" means the patient's own stem cells or marrow are used. "Allogeneic" means stem cells and bone marrow are from a donor is used in the transplant. The donor may be related or unrelated. In addition, the donor may be "matched", meaning that his marrow type is nearly identical to the patient's marrow type, or "mis-matched" meaning the marrow types of the patient and donor differ.

This section lists transplants by type of transplant performed. The number of cord blood and nonmyeloablative or reduced intensity transplants are listed separately.

Age Criteria

This section lists the minimum and maximum age of patients the center will accept for treatment. At many centers, the age criteria are flexible. Patients who exceed the maximum age criteria may still be considered if they're as physically fit as a younger person.

Donor Match Criteria

The minimumdonor match criteria required by the center for each type of transplant is presented in this section. At some centers, the match criteria varies according to the disease being treated and the protocol (treatment plan).

This section indicates whether support groups are available for patients and family members during and after treatment.

You may search for centers that transplant patients with a particular disease. Select a disease from the drop down table under "Disease" Leave the field blank if you do not want to narrow your search by disease.

The date last updated is the date on which any of the following elements were changed in our database: Number & Type of Transplants Performed, Diseases Treated, Age & Match Criteria, NMDP Affiliation, and FACT Approval. It is possible that further changes in the transplant program may have occurred since then.

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West Virginia University Hospitals | BMT InfoNet

TORY MCJUNKIN, MD Co-founder Arizona Pain Specialists Scottsdale, Arizona

PAUL LYNCH, MD Co-founder Arizona Pain Specialists Scottsdale, Arizona

TIMOTHY R. DEER, MD President and CEO The Center for Pain Relief

Clinical Professor of Anesthesiology West Virginia School of Medicine West Virginia University Charleston, West Virginia JACK ANDERSON, MD Fellow Arizona Pain Specialists Scottsdale, Arizona

RAHUL DESAI, MD Director Epic Imaging Sports Medicine and Interventional Pain Clinic Portland, Oregon

Drs. McJunkin, Lynch, and Deer have all received research funding from Mesoblast Limited. Dr. Desai has received consulting and research funding from Harvest Technologies and MiMedx Group.

Regenerative medicine, where the body regenerates or rebuilds itself, is a relatively new and rapidly evolving front in the field of interventional pain management. Although stem cell therapy has garnered much of the attention over the past several decades, multiple other regenerative medicine modalities also have caught the publics attention. As experts in our field, we should be ascertaining if and when to offer these treatments to our patients.

Stem Cells

Stem cells are characterized by the ability to renew themselves through cell division and differentiate into a diverse range of specialized cell types. There are multiple sources of stem cells, including human embryos, which contain pluripotent stem cells that can differentiate into any cell line. Human embryonic stem cell use has been and currently remains an ethically controversial topic. Induced pluripotent stem cells are generated by taking cells, such as skin cells, from a person and then injecting a small number of specific genes or molecules into the cells, which converts the cells into stem cells. A concern with this source of stem cells is introducing an oncogene, which can result in cancer. Adult stem cells are another category. Example sources of adult stem cells include bone marrow, peripheral blood, placental blood, placental tissue, and adipose tissue. Most adult stem cells are multipotent, which can differentiate into some, but not all cell types.

Stem cell technology has been used clinically since the 1960s, in the form of bone marrow transplants to treat conditions like leukemia. Since then, much research has focused on stem cell therapy and its application to a variety of medical conditions. For interventional pain applications, ongoing research is examining the application of stem cell therapy for the treatment of multiple chronic pain conditions, such as osteoarthritis and degenerative disk disease. Crevensten et al studied the effects of injecting mesenchymal stem cells into degenerative disks in rats and found a trend of increased disk height, suggesting an increase in matrix synthesis in the study group compared with the control subjects.1 Mesoblast is conducting the second phase of research on mesenchymal stem cell from bone marrow for degenerative disk disease in human subjects. Many interventional pain physicians are hopeful that stem cells will prove to be an effective treatment for conditions such as diskogenic pain, which currently has few treatment choices.

Future research should assess the relative effectiveness of the different stem cell sources to treat different types of pain conditions. This will help guide the choice of the source of stem cells to use and the types of conditions to treat.

Amniotic Membrane

Because of its unique properties and availability, the human amniotic membrane recently has been studied and is currently being used in regenerative medicine. The human amniotic membrane is composed of 2 cell types, human amnion epithelial cells and human amnion mesenchymal stromal cells. Both types display low immunogenicity and display characteristic properties of stem cells. Both cell types are able to differentiate in vitro into the major mesodermal lineages.2 Human amniotic membranes have been used extensively in ophthalmology and plastic surgery for the treatment of corneal and cutaneous wounds, respectively.3 Recent research has focused on the use of human amniotic membranes applied to other disciplines. Intraoperative placement of amniotic tissue at the site of laminectomy in dogs was effective in reducing epidural fibrosis and scar adhesion.4 Using a human amnion tissue patch after a right L45 decompression procedure significantly reduced both scar tissue formation and adherence to the underlying dura in the patient.

The application of human amniotic membranes within the field of interventional pain management is currently a topic of great interest. Much of the current research is investigating its role in the treatment of tissue damage and inflammation, such as tendonosis and tendonitis. After an intralesional injection of ovine amniotic epithelial cells into equine superficial digital flexor tendon defects, the amniotic epithelial cells participated in the deposition of new collagen fibers in the repairing area.6 Amniotic epithelial cells injected into calcaneal tendon defects in sheep resulted in a high number of reparative cells in active proliferation that were accumulating collagen within the extracellular matrix.7 Injecting amniotic epithelial cells into Achilles tendon defects in sheep resulted in much better structural and mechanical recoveries than control tendon defects during the early phase of healing.

Additional research in the field of human amniotic membrane applications in interventional pain management is needed, but animal model research studies and anecdotal reports of its use in human subjects are promising.

Platelet Rich Plasma

Platelet rich plasma (PRP) therapy was first introduced in the 1970s and has been used in many medical specialties, including orthopedic surgery, plastic surgery, sports medicine, wound care, and pain management, since the 1990s. PRP therapy involves the injection of concentrated platelets, autologous growth factors, and secretory proteins into the region of interest. PRP has been used for numerous conditions. In interventional pain management, it is commonly used for acute and chronic conditions such as tendinopathy, tendonosis, muscle strain, muscle fibrosis, ligamentous injury, arthritis, arthrofibrosis, articular cartilage defects, meniscal injury, and chronic synovitis or joint inflammation (Figure).

The PRP concentrate is made from the patients own blood. After the blood is centrifuged, it separates into the serum (top coat), the platelets and white blood cells (buffy coat or middle layer), and the red blood cells (bottom layer). The middle layer contains a platelet concentration of at least 1 million platelets/uL (normal range: 150,000350,000 platelets/uL) and a 3 to 5 fold increase in growth factor concentrations.10 There is significant variability between PRP centrifuge systems, each yielding varying products. There is no clear comparative evidence to date indicating a superior product. Some PRP protocols include white blood cells, whereas others involve activation with thrombin or calcium, and the platelet concentrations vary as well. The optimal concentration of platelets for PRP is debated. Giusti et al examined the optimal concentration of platelets for promoting angiogenesis in human endothelial cells and found 1.5 million platelets/uL to be the optimal concentration.11 With the system used in our practice, 20 cc of blood will yield approximately 3 cc of concentrate, adequate for small target areas like an epicondyle or acromioclavicular joint and 60 cc of blood will yield 7 to 10 cc of PRP for larger applications, such as a hip or shoulder injection.

Platelets synthesize and release more than 1,100 biologically active proteins, including those that promote tissue regeneration.12 PRP is thought to enhance the recruitment, proliferation, and differentiation of cells involved in tissue regeneration to promote healing.10 Studies have demonstrated that PRP positively affects gene expression and matrix synthesis in tendons. Cell proliferation and total collagen production is increased in human tenocytes cultured in PRP. In vivo, a platelet concentrate injected into the hematoma 6 hours after creation of a defect in a rat Achilles tendon demonstrated increased tendon callus strength and stiffness. Muscles treated with insulin like growth factor 1 and basic fibroblast growth factor showed improved healing and significantly increased fast twitch and tetanus strength.

Over the past decade, numerous published studies involving human subjects have emerged investigating the use of PRP for conditions such as lateral epicondylitis, patellar tendinopathy, Achilles tendinopathy, rotator cuff tendinopathy, rotator cuff tears, medial collateral ligament and anterior cruciate ligament tears, and osteoarthritis of the knee.13 Although most of the studies examined small populations, the results have been very promising, with many demonstrating significant pain relief and functional improvement. Future studies are needed in this emerging field to further delineate the optimal constituents and concentrations of the PRP solution and more clearly define the role of PRP in interventional pain management.

Conclusions Osteoarthritis and other degenerative conditions, which are largely a function of aging, are a major area of concern for pain physicians. Regenerative medicine is an exciting and rapidly evolving branch of medicine, which has the potential to let us turn back the clock and regenerate workout tissues. Based on current data, it is reasonable to integrate these regenerative techniques into treatment algorithms, usually after other traditional treatments have failed. As research progresses, if more conclusive evidence demonstrates superior efficacy over other modalities, the use of regenerative medicine techniques would be justified sooner in the treatment algorithm.

References

1. Crevensten G, Walsh AJ, Ananthakrishnan D, et al. Intervertebral disc cell therapy for regeneration: mesenchymal stem cell implantation in rat intervertebral discs. Ann Biomed Eng. 2004;32(3):430-434. 2. Daz Prado S, Muios Lpez E, Hermida Gmez T, et al. Human amniotic membrane as an alternative source of stem cells for regenerative medicine. Differentiation. 2011;81(3):162-171. 3. Gruss JS, Jirsch DW. Human amniotic membrane: a versatile wound dressing. Can Med Assoc J. 1978;118(10):1237-1246. 4. Tao H, Fan H. Implantation of amniotic membrane to reduce postlaminectomy epidural adhesions. Eur Spine J. 2009;18(8):1202-1212. 5. Ploska P. Summary of clinical outcome related to the use of human amnion tissue allograft in right L4-L5 decompression procedure. Jan 27, 2010. Applied Biologics. http://appliedbiologics.com/ images/pub/ploska.pdf. Accessed October 25, 2012. 6. Muttini A, Valbonetti L, Abate M, et al. Ovine amniotic epithelial cells: In vitro characterization and transplantation into equine superficial digital flexor tendon spontaneous defects. Res Vet Sci. 2012 Sep 3.

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Regenerative Medicine In Pain Management - Boost Medical

ON JULY 18, 2006, the U.S. Senate convened to vote on a proposed bill (H.R.810) that would amend the Public Health Service Act and provide federal funding for research on human embryonic stem cells. This bill was passed by the Senate but was later vetoed by President George W Bush. The two West Virginia Senators, Democrats Robert C. Byrd and Jay Rockefeller, both voted in support of the bill.

As of early 2008, the only hospital offering blood stem cell transplants for therapeutics in the state of West Virginia was the West Virginia University Hospital System, under the leadership of Solveig G. Ericson, M.D., Ph.D. Ericson is the director of the Blood and Marrow Transplant and Hmatologie Malignancy Program. This program offers blood stem cell transplants, ...

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SAGE Reference - West Virginia

DATE APPROVED: June 23, 2012

The American Lung Association strongly supports research to prevent lung disease, and reduce exacerbation of lung disease, discover cures and improve the diagnosis of lung disease. The research should include basic, translational clinical, biomedical, behavioral and environmental areas. In addition, research should investigate measures to eliminate disparities in lung disease morbidity and mortality for low socioeconomic and minority populations. Research should be conducted in a legal, ethical and humane manner.

The American Lung Association supports increased federal funding levels for biomedical, behavioral, epidemiological, environmental and intervention research and research training programs, including but not limited to those conducted by the National Institutes of Health, the Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, the Department of Veterans Affairs and the Environmental Protection Agency.

The American Lung Association recognizes the critical role animal research has played in making medical advances. The American Lung Association strongly supports full compliance with the existing rules and regulations that assure the humane and compassionate management of laboratory animals. We encourage all forms of biomedical research involving animals that have been carefully scrutinized and deemed worthy by qualified experts, and we oppose all efforts to exclude the use of animals whenever they are essential for research.

The American Lung Association recognizes that research with human stem cells offer significant potential to further our understanding of fundamental lung biology and to develop cell-based therapies to treat lung disease. The American Lung Association supports the responsible pursuit of research involving the use of human stem cells.

The American Lung Association requires that the research it supports follow ethical standards including adherence to all applicable federal, state and local rules and regulations. All relevant Institutional Review Boards (IRB)/Human Subjects Committees should review and approve research proposals involving human subjects. Research involving animal subjects must also undergo committee Institutional Animal Care and Use Care (IACUC) review and approval as well as all other review processes as appropriate for the proposed research. Failure to adhere to such processes should result in termination of research support.

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Statement on Stem Cells and Cell Therapies for Lung Diseases

COREY S. GOODMAN (Chair),

Renovis Inc., South San Francisco, California

ANN M. ARVIN,

Stanford University School of Medicine, Stanford, California

JEFFREY L. BENNETZEN,

University of Georgia, Athens, Georgia

RUTH BERKELMAN,

Emory University, Atlanta, Georgia

R. ALTA CHARO,

University of Wisconsin, Madison, Wisconsin

DENNIS CHOI,

Merck Research Laboratories, West Point, Pennsylvania

JEFFREY L. DANGL,

University of North Carolina, Chapel Hill, North Carolina

PAUL R. EHRLICH,

Stanford University, Palo Alto, California

JAMES M. GENTILE,

Research Corporation of America, Tucson, Arizona

ED HARLOW,

Harvard Medical School, Boston, Massachusetts

DAVID HILLIS,

University of Texas, Austin, Texas

KENNETH F. KELLER,

University of Minnesota, Minneapolis, Minnesota

RANDALL MURCH,

Virginia Polytechnic Institute and State University, Alexandria, Virginia

GREGORY A. PETSKO,

Brandeis University, Waltham, Massachusetts

STUART L. PIMM,

Duke University, Durham, North Carolina

BARBARA A. SCHAAL,

Washington University, St. Louis, Missouri

JAMES TIEDJE,

Michigan State University, East Lansing, Michigan

KEITH YAMAMOTO,

University of California, San Francisco, California

FRANCES E. SHARPLES, Director

KERRY A. BRENNER, Senior Program Officer

ROBIN SCHOEN, Senior Program Officer

MARILEE K. SHELTON-DAVENPORT, Senior Program Officer

ROBERT T. YUAN, Senior Program Officer

ADAM P. FAGEN, Program Officer

ANN REID, Program Officer

EVONNE P. Y. TANG, Program Officer

SETH STRONGIN, Senior Program Assistant

MATTHEW D. MCDONOUGH, Program Assistant

DENISE GROSSHANS, Financial Associate

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Front Matter | Guidelines for Human Embryonic Stem Cell ...

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Stem cell research has been a topic of promise and controversy in our culture, and scientists claim that these powerful cells can treat a number of human ailments. Baldness is one of them. Many studies on stem cells and hair loss have been conducted, a number of them showing potential for a baldness cure. New research on the subject reveals some interesting information, which could lead to effective hair regrowth.

The Journal of Clinical Investigation reported findings that male-pattern baldness is due to stem cells failing to produce progenitor cells in the scalp. Progenitor cells are similar to stem cells in that they can differentiate into several cell types, but their capabilities are more limited. Where stem cells are totipotent, meaning they are able to develop into any cell type many times over, progenitor cells can only morph into a certain number of cells. The body uses progenitor cells to replace cells as they get damaged or die off, and they are one of the main cells responsible for hair growth.

Researchers have observed that there are dormant stem cells in balding areas, and all they need is a little stimulation in order to grow new hair. Hair follicles work in stages, continuously cycling through growth, rest and regrowth, and there are times when hair can become very long. Hair loss and baldness occur when the follicles thin out and regrowth decreases. With baldness, stem cells are present on the scalp, but they are deficient, unable to produce progenitor cells to generate hair. There are signals involved in getting stem cells to create hair, and the study suggests that scientists need to figure out those signals so they can formulate an effective process for making progenitor cells. If they can accomplish this, stem cells could become a hair loss cure. As of right now, this study has only been conducted on men, and there are no details on how it may affect female hair-loss.

This is not the first time that information has sprouted up about the connection between stem cells and hair loss. In fact, there have been many previous studies attempting to uncover the mystery of baldness. One study last year identified a gene, APCDD1, that causes hereditary hypotrichosis simplex, which is progressive and begins in childhood. This condition makes hair follicles shrink and narrow down, causing hair to thin. Scientists believe that if they can manipulate the pathway of this gene, they could formulate a treatment for hair growth in humans. While this does not link hair loss to stem cells, it is a promising development in baldness research.

Another study found that a molecule called beta-catenin could be a key element in the battle against hair loss. This molecule instructs embryonic cells to become hair follicles. Another company created a treatment that identified wnt proteins as triggers for stem cells to form hairs. Most of this research is still being tested, and nothing has been verified as a legitimate cure for hair loss.

With all the studies being done and the data collected, it seems that stem cells offer a promising outlook for hair-loss sufferers. However, an approved treatment may still be a few years away. For those looking to take care of their thinning hair right now, there are some proven options that can help. Non-surgical treatments, such as Rogaine and Propecia, have shown to improve the look of hair and even help stimulate some growth. These are great methods to fight hair loss, especially for those in the early stages of baldness or those who do not want to undergo surgery.

One of the best and most advanced treatments for hair loss today is hair transplant surgery. Most hair restoration surgeons will use follicular unit transplantation, which takes follicle units from the donor area, or back of the head, and places them in the balding areas. This is one of the only ways to permanently stop hair loss and restore the look of your old hairline. So until scientists can perfect a stem cell treatment for baldness, hair restoration surgery may be your best option.

If youre interested in learning more about hair loss treatments, you can schedule a consultation with any one of our certified hair loss specialists. Contact us today, and well get you on your way to great looking hair.

Call 866-471-8869 for FREE Consultation

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Stem Cell Recount: A Hair Loss Cure On the Way?

Updated: Feb. 16, 2015 4:21 PM

A train carrying crude oil in southern West Virginia derailed Monday, setting at least one house on fire and spilling oil into the states largest river, according to local news reports.

Authorities ordered residents within a mile and a half of the derailment to evacuate, according to WSAZ. The Charleston Daily Mail reports a CSX train went off the tracks at 1:20 p.m. ET, according to a spokesman for the Department of Military Affairs and Public Safety.

Following the crash, West Virginia Gov. Earl Ray Tomblin declared a state of emergency for Kanawha and Fayette counties.

State officials are on site and will continue to work with local and federal officials, as well as CSX representatives, throughout the incident, said Tomblin in a statement released by his office.

No injuries have been reported, and a shelter was set up at a local high school. The spill into the Kanawha River shut down some sources of water typically supplied to residents and led the states health department to ask them to conserve resources.

A variety of state and local offices, including the Fayette County Fire Department, Bureau for Public Health, state police and the governors office, are responding to the derailment.

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Train Derailment in West Virginia Causes House Fire - TIME.com