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Dingo
03-25-2009, 09:59 PM
Scientists are testing Tamoxifen (http://en.wikipedia.org/wiki/Tamoxifen), a breast cancer drug with a variety of other uses for Scoliosis. This drug was FDA approved in 1977.

Here are links to two very recent studies

February 26, 2009 - The effect of calmodulin antagonists on scoliosis: bipedal C57BL/6 mice model (http://www.ncbi.nlm.nih.gov/pubmed/19242737)

"This study has demonstrated that TMX is effective in changing the natural history of scoliotic deformities in C57BL6 mice model favorably."

March 15, 2009 - The Effect of Calmodulin Antagonists on Experimental Scoliosis: A Pinealectomized Chicken Model (http://journals.lww.com/spinejournal/Abstract/2009/03150/The_Effect_of_Calmodulin_Antagonists_on.2.aspx)

"Conclusion. The incidence and magnitude of scoliosis in pinealectomized chicken may be decreased by the administration of TMX, presumably because of this drugs' calmodulin antagonism. Further studies on higher animals and dosage and timing are required."

Tamoxifen blocks Calmodulin (http://en.wikipedia.org/wiki/Calmodulin) which is why scientists believe it reduces curve progression. The following paper explains how Calmodulin relates to curve progression.

Platelet Calmodulin Levels in Adolescent Idiopathic Scoliosis (AIS): A Predictor of Curve Progression and Severity? (http://www.spineuniverse.com/displayarticle.php/article378.html)

"Conclusions: It appears that increasing platelet calmodulin levels correlate closely with curve progression and severity and that both treatment (brace or surgery) and skeletal maturity correlate with decreasing calmodulin levels."

I assume that Calmodulin is a marker for inflammation. If you have knowledge of how this molecule works please post. Evidently the larger the curve the more Calmodulin the body produces. The more Calmodulin the body produces the faster the curve progresses. It's a dangerous feedback loop.

I believe that the Scoliosis blood test (http://www.nationalreviewofmedicine.com/issue/2006/06_30/3_advances_medicine03_12.html) that is due out in 2009/2010 is designed to measure circulating levels of Calmodulin. The test also measures cAMP (http://en.wikipedia.org/wiki/Cyclic_adenosine_monophosphate) levels to determine which of the 3 types of Scoliosis a child has. The blood test is based on this 2004 study (http://pico.sssup.it/files/allegati/2004_1469.pdf). Scroll to page 5 to see the chart that visually explains the 3 types of Scoliosis. cAMP levels in Osteoblasts (http://en.wikipedia.org/wiki/Osteoblast) (cells that make bone) are supposed to decline as Melatonin (http://en.wikipedia.org/wiki/Melatonin) levels increase. All children with AIS in this study had a dysfunction in that system.

Group 1: (17% of sample) cAMP levels increase as Melatonin concentrations increase
Group 2: (49% of sample) cAMP levels do not decline as Melatonin concentration increases
Group 3: (34% of sample) cAMP levels slightly decline as Melatonin concentrations increase
Group 4: (3 subjects) In the healthy control group cAMP levels decline rapidly as Melatonin increases

Note: -9 is the level of Melatonin a healthy body produces. -7 and -5 levels of Melatonin are achieved with drugs.

Dingo
03-25-2009, 10:12 PM
Dec 13, 2005 - Tamoxifen May Boost Short Boys' Height (http://children.webmd.com/news/20051213/tamoxifen-may-boost-short-boys-height)

Tamoxifen is thought to lengthen the total growth cycle for children, this increases their final, adult height.

Nov 30, 1999 - Tamoxifen may lower osteoporotic fracture risk (http://www.medicexchange.com/Radiology-Articles/tamoxifen-may-lower-osteoporotic-fracture-risk.html)

Tamoxifen increases bone mineral density and reduces the risk of osteoporotic bone fractures.

Bodybuilders' 'breast drug abuse' (http://news.bbc.co.uk/2/hi/health/5080640.stm)

Bodybuilders who abuse steroids can develop "manboobs." They use Tamoxifen to counteract this effect.

txmarinemom
03-26-2009, 12:49 AM
March 15, 2009 paper concludes:

"Conclusion. The incidence and magnitude of scoliosis in pinealectomized chicken may be decreased by the administration of TMX, presumably because of this drugs' calmodulin antagonism. Further studies on higher animals and dosage and timing are required."

Uh, yeah ... I can see them lining up for chemo now ...


I assume that Calmodulin is a marker for inflammation. If you have knowledge of how this molecule works please post. Evidently the larger the curve the more Calmodulin the body produces. The more Calmodulin the body produces the faster the curve progresses. It's a dangerous feedback loop.

Wow. Dude, you're really reaching over your head here, playing lay geneticist, and assuming/interpreting a LOT of crap based on a molecule you admit you don't even understand. Furthermore, I'll believe the existence/efficacy of the cAMP test when I see it. It was (according to your 2006 article) due out last year. The only test currently used (and even on the horizon) to *remotely* predict progression is the Axial Biotest/Scolioscore, and it's only applicable to a *small* subset of female patients. It's basically useless to most in its current form.

If they've attempted to gather test subjects for cAMP, wonder why they haven't tapped this community, or anyone known to this community? (unless someone is just staying extremely close-mouthed about this revolutionary discovery). Hmmm.

Run a search on melatonin here, and see what you find. Same ol' bunch of nothing.

Pam

Pooka1
03-26-2009, 06:35 AM
Okay I have had only one biochem course (albeit a 500 level one) and I can't wrap my mind around why in the world anyone would think cAMP would be specific for one medical condition as opposed to a million other things. That just sounds wacky but what do I know?

I'll look at the paper and may comment further.

Dingo
03-26-2009, 09:44 AM
Pooka1

In Dr. Moreau's sample all children with Scoliosis had a dysfunction in the Melatonin signaling process. This is believed to be true for the general population. Put simply Melatonin's job is to clear out cAMP molecules from Osteoblasts. For children with Scoliosis this system doesn't work properly or in some cases at all. Recent studies (http://www.ncbi.nlm.nih.gov/pubmed/18507714?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed) have strongly indicated that this has something to do with Estrogen.

The Scoliosis blood test will be out in 2009/2010. All children with Scoliosis will get this test. The first test measures cAMP levels to determine if a child has "Scoliosis" or just a physical abnormality. The second test measures blood levels of Calmodulin (99.9% sure). This second test is given 3 times several months apart to establish a baseline for Calmodulin levels. Children with Scoliosis will continue to get blood tests every 3 to 6 months. If these levels rise doctors will know that a child is entering the danger zone for curve progression.

This gives doctors an important diagnostic tool. Should a child be in a brace 23/7? Is night bracing good enough or are levels so low that a child doesn't need a brace at all? In addition doctors will be able to measure Calmodulin levels when a child gets a new brace. A good brace will lower Calmodulin levels, a bad brace won't.

Pooka1
03-26-2009, 11:45 AM
There is too much to comment on in this last post. I will demur.

txmarinemom
03-27-2009, 02:12 PM
There is too much to comment on in this last post. I will demur.

You ain't kiddin', sister! I do, however, have to comment on:


A good brace will lower Calmodulin levels, a bad brace won't.

... but only to say ~*HUH???*~!

Where in the world are you finding this crap?

Pam

concerned dad
03-27-2009, 02:40 PM
Pam, I think you are being a bit harsh.
Dingo posted the links of where he was getting this stuff from.

This is, after all, the "research" forum and lets not forget the "idiopathic" qualifier on the condition.

But the conclusion of the paper authored by no less than 7 folks with MD
after their name says

It appears that increasing platelet calmodulin levels correlate closely with curve progression and severity and that both treatment (brace or surgery) and skeletal maturity correlate with decreasing calmodulin levels. Further investigation is necessary to determine whether in conjunction with standard radiographs, calmodulin may serve as a biochemical marker to assist in following patients with potential curve progression and to identify curves which have stabilized.

I have to admit the "good" brace "bad" brace thing is a leap. But I would like to hear the viewpoint defended/elaborated on.

I have to question the chicken or the egg aspect of the statement in the conclusion where they say treatment correlates with decreased calmodulin levels.

Pooka1
03-27-2009, 02:41 PM
Originally Posted by Dingo:

A good brace will lower Calmodulin levels, a bad brace won't.


... but only to say ~*HUH???*~!

Where in the world are you finding this crap

Dingo's statement should be nominated for "something" of the month but I'll demur on what. :eek:

txmarinemom
03-27-2009, 10:00 PM
CD ... I'll cut you slack ... you're also new - and wanting an answer.

Dingo ... what's your slant?

txmarinemom
03-27-2009, 10:10 PM
Pam, I think you are being a bit harsh.

Been said before. Several times over a few years.


This is, after all, the "research" forum and lets not forget the "idiopathic" qualifier on the condition.

But the conclusion of the paper authored by no less than 7 folks with MD
after their name says

It appears that increasing platelet calmodulin levels correlate closely with curve progression and severity and that both treatment (brace or surgery) and skeletal maturity correlate with decreasing calmodulin levels. Further investigation is necessary to determine whether in conjunction with standard radiographs, calmodulin may serve as a biochemical marker to assist in following patients with potential curve progression and to identify curves which have stabilized.

A dermalogist (M.D. following name) could have penned this. I know you're not that niave.


I have to admit the "good" brace "bad" brace thing is a leap. But I would like to hear the viewpoint defended/elaborated on.

Please. That was HIS leap.



I have to question the chicken or the egg aspect of the statement in the conclusion where they say treatment correlates with decreased calmodulin levels.

So ... give proof y'all have solved the things neither of your docs (the scoli specialists/researchers) say (we'll exclude Rivard/Colliard as IF they were) and MAYBE I'll listen. You two are intent on dx why the rest of us progressed and instrumented, and frankly, it irritates me everytime I see either of you pen you know more than MY *scoli MD's*.

Neither of you are qualified. PERIOD.

Pam

concerned dad
03-28-2009, 01:42 AM
So ... give proof y'all have solved the things neither of your docs (the scoli specialists/researchers) say (we'll exclude Rivard/Colliard as IF they were) and MAYBE I'll listen. You two are intent on dx why the rest of us progressed and instrumented, and frankly, it irritates me everytime I see either of you pen you know more than MY *scoli MD's*.

Neither of you are qualified. PERIOD.

Pam

Wow, I wasnt expecting THAT. What, one minute you'll 'cut me some slack" because I'm new here and 10 minutes later I'm irritating?

Maybe I'm missreading this. But my take on the "you two" and "everytime either of you pen" seems to be directed at me as Dingo looks like he only has 7 posts.

Look, I never claimed any more qualifications than a concerned dad. But I never said or implied that I "know more than your Scoli MDs". Did I miss your post where you shared the opinions of your scoli MD's on the topic Dingo brough up here? I didnt question your Dr's opinion of the topic, perhaps I questioned YOUR opinion.

And the truth be told, I read your post asking where Dingo "got this crap" and I wanted to know the same thing. I was simply pointing out that he posted his source, and the the fact that 7 of the study authors we MD's. Dont you think it is good form to post a link to a source. I wish I had been able to do it on another thread where we were discussing something w/PNUTRO and I didnt post the paper. I wasnt defending or attacking the merit of the calmodulin link to scoliosis. Seems like a valid thing to discuss in a scoliosis research thread. And I dont think "where did you get this crap" really adds to the discussion. Perhaps asing him to elaborate on the leap he seemingly made coorelating calmodulin with good or bad braces would be interesting. Yeah, it seems really strange, but lets ask him to back it up.

Regarding me being
intent on dx why the rest of us progressed, well, I suppose I am although I dont know if I would put it exactly that way. It is very important to me to try to understand this stuff. I dont think I ever attempted to diagnose (DX) why anyone progressed but yeah, I have expressed an interest in understanding predictors of curve progression (Like age, curve type, Risser, menarch status....) but that is because these are the exact issues relevant to my daughter. Yes, I have very selfish reasons for participating on this forum. Just ignore me if I irritate you.

But please, elaborate on this statement.
So ... give proof y'all have solved the things neither of your docs (the scoli specialists/researchers) say (we'll exclude Rivard/Colliard as IF they were) and MAYBE I'll listen.

That leaves me scratching my head.
:confused:

concerned dad
03-28-2009, 02:34 AM
A dermalogist (M.D. following name) could have penned this. I know you're not that niave.




Yes, it could have been a dermatologist, but I just found another paper from the same authors presenting the same data in the Journal Spine.

They concluded by saying
AcknowledgmentsThe authors thank the Scoliosis Research Society for their generous support of this project.

I hope the SRS isnt funding dermatologists

I read the whole paper. It didnt say anything about calmodulin coorelating with a brace being good or bad.
But there was a heck of a coorelation with calmodulin levels and progressing (10 degrees or more) curves.

Platelet Calmodulin Levels in Adolescent Idiopathic Scoliosis
Do the Levels Correlate With Curve Progression and Severity?

in Spine Volume 27 Number 7 2002

time for bed

Pooka1
03-28-2009, 08:39 AM
From the link Dingo posted, all the kids who progressed more than 10* had increasing calmodulin levels whereas a fourth of the kids who progressed less than 10* had increasing calmodulin levels.

They later say that wearing a brace after surgery has an effect on the calmodulin levels. This suggests that levels are at least in part controlled by the curvature or stability of the spine and do not predict the future but rather reflect the present. They would have an interesting case if the 26% of kids who presently haven't progressed more than 10* but have increasing calmodulin levels go on to increase more than 10*. That would be tight if I'm understanding this correctly. In other words, it might be a more precise, earlier indicator of real-time progression than radiographs.

concerned dad
03-28-2009, 09:01 AM
and do not predict the future but rather reflect the present.

thats where I was going with my chicken or the egg thing. you stated it much better.

Pooka1
03-28-2009, 09:13 AM
thats where I was going with my chicken or the egg thing. you stated it much better.

Yes I knew where you were going with it and was trying to support the idea. The fact that post-surgical braced patients have different [calmodulin] trajectories from those of post-surgical non-braced patients is very important in this regard. There is no reason the concentration trajectories should differ if not due to real-time physical movement of the spine it seems.

Pooka1
03-28-2009, 09:17 AM
And we are talking TINY TINY movement, perhaps limited to above and below the fusion, since the modern instrumentation is so good at immobilizing the spine that 95% of kids don't have to have any physical restrictions whatsoever.

Also, so few kids wear a brace after surgery that I'm wondering if the sample size was so small as to be completely meaningless. The group that does wear a brace post-op is by definition not representative of the vast majority of fused kids.

Pooka1
03-28-2009, 11:06 AM
Okay I changed my mind and will comment on this one part of your post...


This gives doctors an important diagnostic tool. Should a child be in a brace 23/7? Is night bracing good enough or are levels so low that a child doesn't need a brace at all? In addition doctors will be able to measure Calmodulin levels when a child gets a new brace. A good brace will lower Calmodulin levels, a bad brace won't.

These comments presume that:

1. even if a tight connection can be established between [calmodulin] trajectories and curve progression, that IN NO WAY implies that any brace we currently have is going to stop any progression.

2. There is no evidence either way whether night bracing is not as effective as 23/7 bracing or whether either is superior to observation.

3. I see no way to connect the decision to brace or not to this research, irrespective of which way it goes. That is, even if you can show a tight connection between [calmodulin] concentration or trajectory and progression, that says NOTHING about the ability of any brace to stop that progression.

4. Your suggestion to define "good" braces as those that lower [calmodulin] and "bad" braces as those that fail to do this can't relate to the final outcome of bracing because there is no evidence that I can see from the research blurb that manually manipulating the [calmodulin] with a brace is going to affect curve progression. The brace comments in the blurb strongly suggest [calmodulin] is tracking after (tiny?) the fact intra-spine movement.

Pooka1
03-28-2009, 12:54 PM
Upon re-reading, it seems like points # 1 and #3 are the same. Apparently I felt strongly enough about it to note it twice. :D

If bracing manually affects [calmodulin] in a good way then why isn't there any good data that any braces work?

Isn't that consistent with the thought that [calmodulin] or trajectory isn't going to be helpful? That is, because some braced patients still go on to need fusion, and if it is only a predictor of progression, then that still leaves us with the question of whether any brace can work better than observation, yes?

Maybe I'm missing something here.

Pooka1
03-28-2009, 01:05 PM
[...] I assume that Calmodulin is a marker for inflammation. If you have knowledge of how this molecule works please post.

The blurb you posted says what calmodulin is...

"Calmodulin is a calcium binding receptor protein which mediates muscle contractility (actin and myosin) in the platelet."

concerned dad
03-28-2009, 01:19 PM
3. I see no way to connect the decision to brace or not to this research, irrespective of which way it goes. That is, even if you can show a tight connection between [calmodulin] concentration or trajectory and progression, that says NOTHING about the ability of any brace to stop that progression.

.

Yes, but it sure would be nice to know when you should try or not.

I think the point they made in the Spine paper was that perhaps, with further research, they could determine if a curve was prone to progress. So, perhaps one day they will be able to say,
"take this blood test, if your level is low, yeah, you have scoliosis but dont bother bracing because it doesnt look likely to progress" and
"if it is high you may want to give bracing a try"
That may reduce the number of kids needlessly braced.

of course, for all this to work, the data has to actually be valid/meaningful.

There is a correlation between fox deaths and divorce in Finland. Not likely they have anything to do with each other.

Pooka1
03-28-2009, 01:32 PM
Yes, but it sure would be nice to know when you should try or not.

I think the point they made in the Spine paper was that perhaps, with further research, they could determine if a curve was prone to progress. So, perhaps one day they will be able to say,
"take this blood test, if your level is low, yeah, you have scoliosis but dont bother bracing because it doesnt look likely to progress" and
"if it is high you may want to give bracing a try"
That may reduce the number of kids needlessly braced.

Yes I see that point but about a quarter of the kids who didn't (hadn't yet?) progressed more than 10* had increasing [calmodulin], the same situation as all the kids who progressed. The test would suggest those kids would progress but they didn't. SO if this goes down this way, at least a quarter of the kids who might not progress will think they will and might be needlessly braced.


of course, for all this to work, the data has to actually be valid/meaningful.

There is a correlation between fox deaths and divorce in Finland. Not likely they have anything to do with each other.

:D Good points.

Dingo
03-28-2009, 04:18 PM
I will respond to the rest of this thread tonight.

Concerned Dad

I have to question the chicken or the egg aspect of the statement in the conclusion where they say treatment correlates with decreased calmodulin levels.

Scientists know that by reducing Calmodulin levels they can reduce or perhaps eliminate curve progression.

February 26, 2009 - The effect of calmodulin antagonists on scoliosis: bipedal C57BL/6 mice model (http://www.ncbi.nlm.nih.gov/pubmed/19242737)

"This study has demonstrated that TMX is effective in changing the natural history of scoliotic deformities in C57BL6 mice model favorably."

March 15, 2009 - The Effect of Calmodulin Antagonists on Experimental Scoliosis: A Pinealectomized Chicken Model (http://journals.lww.com/spinejournal/Abstract/2009/03150/The_Effect_of_Calmodulin_Antagonists_on.2.aspx)

"Conclusion. The incidence and magnitude of scoliosis in pinealectomized chicken may be decreased by the administration of TMX, presumably because of this drugs' calmodulin antagonism. Further studies on higher animals and dosage and timing are required."

---

Half of the scoliosis blood test (http://www.nationalreviewofmedicine.com/issue/2006/06_30/3_advances_medicine03_12.html) due out in 2009/2010 is based on that discovery. It's actually 2 tests. The first measures cAMP levels to determine if a child has "Scoliosis" or just a physical abnormality. The second half of the test measures what I am 99.9% sure is Calmodulin. This test is given a few times per year to predict curve progression. When a spine is "out of whack" Calmodulin levels rise. Calmodulin is closely related to inflammation. That's why this test can be used to see if a brace is working for a particular child.

If you read Dr. Moreau's comments in this article (http://www.aaos.org/news/bulletin/nov07/clinical3.asp)from 2007 they make a considerable amount of sense now that his blood test is imminent.

concerned dad
03-28-2009, 05:59 PM
hmmmmm,

Dr. Moreau: By observing plasma levels of molecular and biochemical markers, clinicians will be better able to monitor bracing efficacy as well as improve bracing systems. This will help us to identify the best brace for a specific child.

Based on these changes, orthopaedic surgeons will be able to alter treatment options. Instead of putting a child in the same brace for 2 to 3 years to determine its effectiveness, physicians may be able to determine whether this is the most appropriate brace for the patient within a month, based on specific markers.

Interesting, so THIS is where you get this "crap".
Looks interesting.
He's from St Justine's though

PNUTTRO
03-28-2009, 07:14 PM
I cannot reconcile in my mind why ANYONE would recommend an estrogen receptor blocker for adolescents.

concerned dad
03-28-2009, 09:30 PM
I cannot reconcile in my mind why ANYONE would recommend an estrogen receptor blocker for adolescents.

I dont think they are recommending it for humans.
They are recommending it for chickens.
Maybe because it is a convienent calmodulin antagonist.

If it works, maybe they will look for a more appropriate drug for use in children that also blocks calmodulin.

I'll let Dingo speak for him/her self but perhaps a more appropriate title for the thread would have been
Researchers testing Tamoxifen for Scoliosis in chickens
or
Researchers testing calmodulin antagonist for scoliosis

I too cant imagine anyone giving a kid tamoxifen.
But you never know what will come out of the chicken research,
Why, thats as crazy sounding as injecting botulism toxin for cosmetic reasons........ wait a minute :confused:

Dingo
03-28-2009, 11:01 PM
Concerned Dad might be correct. They are using Tamoxifen for testing purposes but plan to make a different drug for children.

However it's important to keep in mind that although altering Estrogen levels in a growing child sounds bad there is a good chance that Estrogen levels are messed up to begin with.

November 2008 - Estrogen cross-talk with the melatonin signaling pathway in human osteoblasts derived from adolescent idiopathic scoliosis patients. (http://www.ncbi.nlm.nih.gov/pubmed/18507714)

Tamoxifen is both an estrogen agonist and antagonist. It may get estrogen levels closer to normal than they would otherwise be. I don't know if that's true but it might be why scientists are testing this particular drug.

Dingo
03-28-2009, 11:20 PM
Pooka1

1. even if a tight connection can be established between [calmodulin] trajectories and curve progression, that IN NO WAY implies that any brace we currently have is going to stop any progression.

2. There is no evidence either way whether night bracing is not as effective as 23/7 bracing or whether either is superior to observation.

The blood test will tell your doctor if a bracing strategy is working or not. If Calmodulin levels don't drop after bracing it's probably a waste of time. If they drop like a rock you'll know that the brace is doing it's job. Right now there is no rapid way to find out if a brace is helping or even hurting. Calmodulin is closely related to inflammation. I'm not sure if that's why the feedback is so helpful but I suspect so. For obvious reasons a curved spine probably produces more inflammation than a straight spine. Calmodulin is probably a useful marker in that process.

I'm hoping that a microbiologist or someone who understands this molecule will explain how it functions. I can't find much helpful information on the specifics of Calmodulin.

Dingo
03-28-2009, 11:28 PM
Pam

Whenever I post something I've already done my best to understand it. I certainly don't understand everything. I'm simply doing my best to sift through the latest research. I always post links so that others can make up their own minds. Better yet you may see something that I missed and help me.

concerned dad
03-29-2009, 08:18 AM
Dingo, The thing you have to remember is that some folks here have seen a lifetimes worth of treatments and theories that have gone no where.
For example, electrical stimulation was once thought to be promissing.
I bet they could come up with other examples.

My point is, a new person coming here touting chemo for scoliosis is not going to get the warmest reception (even though I think it is worthwhile to at least discuss).

Pooka1
03-29-2009, 09:09 AM
hmmmmm,

Dr. Moreau: By observing plasma levels of molecular and biochemical markers, clinicians will be better able to monitor bracing efficacy as well as improve bracing systems. This will help us to identify the best brace for a specific child.

This almost certainly will be for a new generation of braces and none we presently have.


Based on these changes, orthopaedic surgeons will be able to alter treatment options. Instead of putting a child in the same brace for 2 to 3 years to determine its effectiveness, physicians may be able to determine whether this is the most appropriate brace for the patient within a month, based on specific markers.

It seems likely that they can go through all the present braces and find none are appropriate.


Interesting, so THIS is where you get this "crap".
Looks interesting.
He's from St Justine's though

Research groups generally operate independently. Each researcher needs to be judged on how they operate in the research and in their published results.

Pooka1
03-29-2009, 09:13 AM
I dont think they are recommending it for humans.
They are recommending it for chickens.

And "bipedal" mice.

I had no idea that amputation of the front legs of mice would reult in them walking around upright. :eek:

Pooka1
03-29-2009, 09:16 AM
Pooka1

1. even if a tight connection can be established between [calmodulin] trajectories and curve progression, that IN NO WAY implies that any brace we currently have is going to stop any progression.

2. There is no evidence either way whether night bracing is not as effective as 23/7 bracing or whether either is superior to observation.

The blood test will tell your doctor if a bracing strategy is working or not. If Calmodulin levels don't drop after bracing it's probably a waste of time. If they drop like a rock you'll know that the brace is doing it's job. Right now there is no rapid way to find out if a brace is helping or even hurting.

Yes but there are long-term ways from which we can see that there is no good evidence that any brace we presently have works. This calmodulin test, if accurate, might be the death knell for bracing as we presently know it.

Dingo
03-30-2009, 10:22 AM
Pooka1

You certainly might be right. With rapid testing scientists may determine that all of the braces on the market need to be dramatically improved. Many might be scrapped altogether.

However it might be that this blood test allows doctors to squeeze much more benefit out of the same braces.

For example scientists slowly improved the survival rate of childhood Leukemia from less than 20% to around 80%. They did this by painstakingly refining the use of old drugs. (http://www.slate.com/id/2193294/)

"The leukemia doctors saved lives simply by refining the use of old-school drugs like doxorubicin and asparaginase. Over the course of almost a dozen clinical trials, they painstakingly varied the doses of these older drugs, evaluated the benefit of continuing chemotherapy in some kids who appeared to be in remission, and tested the benefit of injecting drugs directly into the spinal column. The doctors gradually learned what drug combinations, doses, and sites of injection worked best. And they kept at it. With each small innovation, survival rates crept forward a bit—a few percent here and there every couple of years—and over decades those persistent baby steps added up to a giant leap."

Pooka1
03-30-2009, 12:09 PM
Good point. I knew about the childhood leukemia deal. Those guys are amazing. Science... more than just a good idea.