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New teeth, new jawbone – all in a day

New teeth, new jawbone – all in a day

When the benign tumor in Luther Hunter's right jaw in April 2014 began to take over a sizable portion of his lower right jawbone and its teeth, his specialists at the University of Mississippi Medical Center knew it was time to act.

They had two surgical options. One is a fairly common procedure called a fibula free flap, in which a portion of Hunter's fibula would be transplanted to replace the section of jawbone and soft tissue that must be removed with the fast-growing tumor.

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Mosley tells Alzheimer’s conference what we know, what we need to know

Mosley tells Alzheimer’s conference what we know, what we need to know

When it comes to preventing or curing Alzheimer's disease, the promise of recent research is "like seeing a light on a distant shore," Dr. Thomas Mosley said Wednesday at a forum on the country's sixth leading cause of death.

Mosley, director of UMMC's Memory Impairment and Neurodegenerative Dementia (MIND) Center, made the comparison following his address to an audience of about 200 health-care educators, administrators and care givers in Meridian at "The Many Faces of Care" - the 16th annual Conference on Alzheimer's Disease and Psychiatric Disorders in Older Adults.

A nationally renowned authority on brain aging, Mosley was quoting a colleague when he described the potential to exploit the latest breakthroughs.

Each step forward "provides hope," said Mosley, a professor in geriatric medicine and neurology. "It's a beacon to us, but it's still a ways off."

Still, Mosley's message was mostly optimistic, as suggested by his presentation - "Mississippi Takes the Lead: Advances in Dementia Research and Technology." 

That optimism is based in part on MIND Center findings about the disease that afflicts 5.3 million Americans, including the 50,000 Mississippians who have been diagnosed with the only top 10 cause of death that cannot be prevented, cured or slowed.

An underdiagnosed disorder that affects more women than men, Alzheimer's is a specific type of a syndrome called dementia, a general term for severe loss of memory and other mental abilities.  Other conditions may also cause dementia, including stroke, Parkinson's disease and Lewy Body pathology.

"Saying someone has dementia doesn't tell you anything about the underlying cause. It's like saying someone has cancer; there are many different types of cancer," Mosley said during his presentation.

The MIND Center, the lead agency for a multi-center $26 million grant from the National Institutes of Health, is working with leading U.S. and European medical schools that have improved our understanding of Alzheimer's and related conditions that lead to older adults' loss of mental abilities.

This work includes the Atherosclerosis Risk in Communities (ARIC) Neurocognitive Study.

Among researchers' freshest conclusions is "certain changes in the brain are more common and start much earlier in life than previously believed," said Mosley, ARIC's principal investigator. Those include vascular disease and silent strokes, indicating a link between such brain changes and cardiovascular disease risk factors.

Recent results also raise the specter of diabetes. As reported from the Neurocognitive Study, people with diabetes at mid-life undergo eight years of additional "cognitive aging," or decline, over a 20-year period compared to those without diabetes; this raises their risk of dementia later in life, Mosley said. 

This waning of mental abilities can also be sped up by high blood pressure.

Relatively new advances in brain imaging technologies, Mosley said, have accelerated researchers' knowledge of Alzheimer's, enabling them to more closely, and quickly, examine the human brain, uncovering the presence of plaques, or abnormal buildup of protein, between the nerve cells - a condition believed to cause Alzheimer's.

Improvements in genetic research have also been a boon, he said. In 2001, the cost to study one genome - a person's complete set of DNA - was $100 million.

"Today, it's $4,000," Mosley said.

Taking advantage of rapid advances in genetics, Mosley leads an international consortium of researchers with over 30 studies representing more than 100,000 research participants in the U.S. and Europe.  In the past year, Mosley and his international team identified the first genetic regions related to memory loss and related cognitive abilities in non-demented older adults.

Identifying these regions could lead to the development of new treatments for memory loss.

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Female surgeons making a cut on the bias

Since its beginnings, surgery - like soldiering, car repair, sports and carpentry - was considered a male domain - a "boys' club," as one UMMC physician put it.

History even records a time when women who wanted to train as surgeons had to masquerade as men.

Those days are long past. Still, even by 2014, the American Medical Association reported, only 19 percent of surgeons are women, although one-third of all physicians are females.

The percentage of women who chaired surgery departments in 2014: 1, according to the AMA.

Residency applications reveal that women are more likely to choose certain fields, especially OB-GYN, as well as pediatrics, family medicine and psychiatry. But a surgery resident is much more likely to be a man: The 2015 Match List at UMMC shows that four women, compared to eight men, chose to train as surgeons.

Female medical students reject careers in surgery for many reasons, research reveals; among them: they are not encouraged, they lack role models, they believe it is not family-friendly and demands too much time.

To combat those barriers and perceptions, the Association of Women's Surgeons surfaced in 1981, which was also the year it published its first Pocket Mentor to help women surmount the "unique challenges" they face during surgical training. The texts of later, updated versions of the Pocket Mentor suggest that, while some of those problems aren't as pervasive today, others persist.

Permitting the Pocket Mentor to frame those issues, more or less, we asked six women in various stages of their careers, most of them at UMMC, to describe what it means to be a female surgeon - what it takes to survive it, and why they love it.


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Female surgeons making a cut on the bias

MAP meetings, Schwartz Rounds highlight week's events

MAP meetings, Schwartz Rounds highlight week's events

A number of interesting events is scheduled for the upcoming week at the Medical Center.

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