Disease

FDA Clears for Marketing Real-Time Test for Respiratory Viruses

2008-01-18T11:12:00.000-08:00

The U.S. Food and Drug Administration has cleared for marketing a test that simultaneously detects four common respiratory viruses, including the flu, in a patient’s respiratory secretions. The ProFlu+ test provides results in as few as three hours. Other diagnostic tests for respiratory viruses are fast but not as accurate or are accurate but not as rapid.

The real-time test employs a multiplex platform that allows several tests to be processed using the same sample to detect influenza A virus, influenza B virus, and respiratory syncytial virus A and B (RSV).

These viruses can cause influenza, an infection of the airways called bronchiolitis, and pneumonia. All are among the leading causes of lower respiratory tract infections.

“Antiviral drugs are most effective when initiated within the first two days of symptoms,” said Daniel Schultz, M.D., director of FDA’s Center for Devices and Radiological Health. “This new test, which is part of the new era of molecular medicine, can help the medical community quickly determine whether a respiratory illness is caused by one of these four viruses and initiate the appropriate treatment.”

ProFlu+ uses a molecular biology process to isolate and amplify viral genetic material present in secretions taken from the back of the throat in patients.

While ProFlu+ is faster than conventional tests, it is specific to the four viruses, and is more accurate when used with other diagnostics, such as patient data, bacterial, or viral cultures, and X-rays, in diagnosing a patient. Positive results do not rule out other infection or co-infection and the virus detected may not be the specific cause of the disease or patient symptoms.

An estimated 5 percent to 20 percent of the U.S. population contracts influenza each year, resulting in more than 200,000 hospitalizations and up to 36,000 deaths. Influenza A, one of three types of human influenza, is the most severe and has been the cause of major epidemics. Influenza B is less severe than influenza A.

Bronchiolitis usually affects children under the age of 2, and is a common, sometimes severe illness. A common cause of the disease is RSV.

Pneumonia is a common illness that affects millions of people each year in the United States and is usually caused by an infection. People most at risk are older than 65 or younger than 2 years of age, or already have health problems.

Source:www.fda.gov

Bengal pays for not paying dues

2008-01-18T11:05:00.000-08:00

West Bengal has compounded its earlier folly of not informing the Centre in time of the unusual mortality of birds by not paying compensation to poultry owners, whose birds are presently being culled.

The animal husbandry department was officially informed on Thursday by its officers touring the state that farmers were just being promised compensation but were not being paid.

Highly placed sources told TOI that the department wrote a letter to the state government on Thursday asking them to compensate farmers as soon as their birds are culled.

The rate finalized stands at Rs 40 per egg-laying adult chicken, Rs 30 for those used for meat and Rs 10 per chick. A compensation package of Rs 1 crore has already been sanctioned for Birbhum and Rs 25 lakh for South Dinajpur.

"The speed of culling has been seriously affected by this. Because compensation is not being given, farmers aren’t letting their poultry to be culled. In the last two days, we have culled around 35,000 birds whereas our target is to cull over 4 lakh birds in one week. We can’t achieve this target if the state does not compensate farmers fairly," sources said.

Ironically, top health and veterinary scientists, policy-makers and ministers from 105 nations and 20 international and intergovernmental organizations, who had recently attended the International Ministerial Conference on Avian and Pandemic Influenza in Delhi in December, had applauded India’s "swift, fair and efficient disbursement of compensation to poultry owners" hit by bird flu in Maharashtra, Gujarat and Manipur in 2006 and 2007. This, they said, had actually helped the country contain the outbreak without mass animal casualties or a single case of human infection.

Peter Harrold, World Bank’s director of avian and human pandemic influenza overall operational response team, had told TOI that compensation was most vital during a bird flu outbreak. "Farmers have to feel they are getting a fair price. Or else they will hide their poultry and bird flu can go undetected. They may even resort to clandestinely selling the infected animals," he added.

Health minister A Ramadoss had said, "Our national action plan for preparedness, control and containment of avian influenza recognizes that culling of affected birds will succeed only if poultry farmers are adequately compensated immediately after an outbreak is confirmed."

David Nabbaro, senior UN system influenza coordinator, said, "India’s philosophy to compensate quickly and fairly at the district level is commendable. That’s why farmers came out in the open and declared when their birds died in the past two outbreaks."

Meanwhile, the present outbreak of Avian Influenza in West Bengal seems to be more serious and threatening that the two previous outbreaks in Maharashtra and Manipur.

Admitting this, the Centre and WHO on Thursday said more serious risk factors are associated with this current outbreak than previously encountered, including that the affected areas are more widespread. Officials say ground zero’s proximity to extended border areas makes it even more threatening.

Officials have started to fear that West Bengal’s initial laid back attitude towards poultry deaths and late reporting to the Centre may have led to the virus spreading. Birds have started to drop dead in new districts like Nadia, Murshidabad, Burdwan and South 24 Parganas. Samples have been collected and are presently being tested for H5N1 infections.

An official admitted: "We feel Murshidabad deaths may also be due to H5N1." According to the Centre’s latest estimates, a total of 61,075 poultry birds have died in Birbhum, South Dinajpur and Murshidabad districts of West Bengal in the last 10 days.

Fresh cases of mortality have also been reported from the Khargram and Burwan blocks of Murshidabad district, adjoining the affected areas of Birbhum. Fresh mortality of 347 poultry birds was also located in the Gangarampur block in South Dinajpur district.

Officials said: "As per a message received from the state government, there are reports of unusual mortality in Terhatta block of Nadia district, Kalna block of Bardhman district and Baruipur village of South 24 Parganas. Except for a mortality of 40 poultry birds from Baruipur village, figures of mortality in the other two blocks are not yet available. Scientists have collected samples and sent it to the High Security Animal Disease Laboratory, Bhopal, to ascertain whether it is H5N1 infections or not. Active surveillance is being undertaken in these areas," officials added.

Source:timesofindia.indiatimes.com

Avoiding the holiday bug (next time)

2008-01-18T11:01:00.000-08:00

his time of the year is back to reality. The magical season of blissful partying, giving and receiving is over. When the dust of holiday glitters has settled down, all of us now feel the fatigue, the toll of lack of sleep, the extra servings we have eaten and extra two-for-the-roads we have drunk and everything not exactly healthy from the happy festivities that all cluster into one season.

After the holidays, we just feel we need to take a break and really enjoy a peaceful, healthful holiday wherein you can rest and recover from the holiday burnout.

A good number of my patients who came back for follow-up last week also had respiratory tract and other infections during the holiday extending up to that time. Is it due to the change in weather? Probably, but personally, I don’t think so. I think it’s more part of the holiday strain on the health, specifically on the immune system, reducing one’s resistance to fight off bacteria and other hazards to wellness.

Dr. Howard Heller, an infectious disease specialist, puts it nicely: “With holiday-related parties and travel, we are exposed to more people than usual, and larger numbers of germs. This increases our odds of picking up a respiratory viral infection like influenza.”

Tips for staying healthy

Dr. Heller offers these tips for staying healthy in the next holiday rush of partying:

• Wash your hands frequently. You just can’t overdo this simple but most effective way to prevent catching an infection. The more parties we attend and more hands we shake, the more we have to do it. Our most frequent source of viruses and bacteria are the contaminated objects which we hold, and then touching our nose or mouth. We should avoid touching our face unless we have washed them first, especially when traveling.

• Be ambidextrous. This may sound odd but wise. In parties wherein we need to shake a lot of hands, we should handle food only with our left hand. “It will keep that right hand, which is full of other people’s germs, away from your nose and mouth,” Dr. Heller says.

• Get a flu shot once a year. This is best done before the flu season, so toward the end of the first quarter. Vaccination against influenza is one way to reduce our chances of getting a bad strain of flu during the holidays.

Go a long way

The good old advice of sleeping well, eating a balanced diet and exercising regularly despite the hectic holiday schedule will also go a long way to keep our immune system healthier.

The funny thing about the holiday season is that when it’s over—beyond the fond recollections and peaceful reflections—the disappointment creeps that despite all attention to details, we realize there were a few friends and relatives we’ve not given gifts or send greetings to or reunited with. We already have probably the longest Christmas season in the world, yet, somehow we wish it were longer to give us more time to fit family and social obligations into an already crazily hectic schedule.

The holiday phenomenon is that there’s always too much to do and not enough time to do all the shopping, card-sending, baking, partying and you fill in the blanks of all else that you wish you had more time to do.

But despite all the hassles of the holiday season, thank God we have such a season to celebrate.

Source:showbizandstyle.inquirer.net

Foot And Mouth, Bluetongue & Avian Influenza

2008-01-18T10:57:00.000-08:00

Foot and Mouth Disease, Bluetongue and Avian Influenza have developed beyond expectations in 2007. The impact on markets has, however, been limited to mostly smaller, temporarily intra-EU disruptions. These disease outbreaks run counter to the Animal Health Strategy 2007-2013. This report consolidates reporting on these animal disease developments in the EU from all EU FAS offices.

2007 has been a bad year for the European animal heath status. While the Bovine Spongiform Encephalopathy (BSE) situation has further improved and the fight against Classical Swine Fever (CSF) in the newer EU Member States (NMS) is celebrating success, Foot and Mouth Disease (FMD), Bluetongue (BT) and Avian Influenza (AI) H5N1 have demonstrated the EU’s vulnerability for animal diseases.

Foot and Mouth Disease in the United Kingdom (UK)

In the second half of 2007, the United Kingdom suffered from an outbreak of FMD, which apparently resulted from a biosecurity breach at Pirbright laboratories as a result of weak maintenance of wastewater discharges. In total, six cases of FMD were identified in August and September 2007 in the broader vicinity of the facility. Because no further outbreaks occurred, all restrictions, including for export, were lifted as of December 31, 2007. Details on this latest situation are available from the DEFRA website. While the UK escaped a major disaster like the 2002 FMD outbreak and meat exports were only disrupted in a limited way, the economic loss for the UK agriculture and meat sector have been massive.

Bluetongue spreads throughout Europe

Until the summer of 2006, BT was a tropical disease that occasionally made inroads into the Mediterranean countries of the EU with only few local consequences. However, in 2006 a BT strain of serotype 8 seemed to have adapted to temperate host mosquitoes and a new BT epidemic started in the east of Belgium, which rapidly spread to neighboring Germany, The Netherlands and France. The winter of 2007 was extremely mild and soon in 2007 it became clear that the virus had survived winter. A spectacular expansion of the disease continued through the summer and autumn of 2007 as no vaccine was available to stop the disease. BT outbreaks of this serotype 8 strain were identified from the UK to Poland and the Czech Republic, and from Denmark to the center of France by the end of 2007. Other BT serotypes have also made considerable progress in invading the Mediterranean EU MS.

The impact of the BT epidemic on EU meat trade is very limited, because meat is not infected by BT. Also, EU exports of susceptible living animals had already considerably decreased as a result of animal welfare constraints. Intra-EU trade has been hampered because of the increase in administrative burden to transport animals within the infected areas. This serotype 8 BT is, however, having an important economic impact because of its relatively important mortality. Mortality in sheep is over 50 percent, while reports of mortality in cattle, especially for weaker animals like calving cows, indicate doubled mortality of vulnerable cattle from normal levels. Together with a decrease in milk productivity, this BT epidemic is held co-responsible for below quota milk production in the most heavily affected MS. Unless an effective vaccine becomes available in early 2008, it can be anticipated that this BT epidemic will further spread and become endemic in a large part of the EU. The economic impact is also expected to increase exponentially, particularly for sheep breeders if the disease were to invade the UK sheep flocks.

Is Avian Influenza here to stay?

After initial outbreaks of AI H5N1 led consumers in southern Europe to a confidence crisis in poultry meat in the winter of 2006, reports of AI outbreaks have become familiar to consumers. Strict discipline by poultry producers in the application of biosecurity measures has kept AI outbreaks in commercial poultry production to a strict minimum. The majority of outbreaks in various EU MS have been in small backyard flocks, which are exposed to contact with wild birds. While most cases of AI H5N1 infections occurred in Germany and the NMS, occasionally infections have been discovered in France and the UK.

The impact of AI H5N1 on European poultry markets in 2007 has been fairly low because most outbreaks occurred in economically insignificant flocks. However, throughout 2007 EU poultry producers have kept production tight in order to avoid overproduction and major problems in case of important AI outbreaks. The production limitation was further mandated by the increased feeding costs and the expectations of increased imports as a result of the newly implemented TRQs, which resulted from the WTO case on poultry tariffs[1]. As a result, EU poultry prices remained at a high level and poultry production remained profitable. The continued threat of AI H5N1, however, hangs like a sword over the sector, which is very aware that no mistakes on biosecurity are allowed.

Other diseases

BSE/TSE

While BSE in cattle herds seems to be under control and incidences of BSE are rapidly decreasing in all EU MS, the appearance of increasing numbers of atypical TSE cases in sheep and goats have drawn the attention of the EC, which has stepped up the control measures for these small ruminants.

Classical Swine Fever

The newly acceded MS in 2004 have made good progress in eradicating CSF, although infected wild boar populations in remote mountainous areas occasionally continue to cause CSF outbreaks in pig farms. The newest MS, Bulgaria and Romania, faced more serious outbreaks of CSF in 2007 and are therefore not eligible to export pigs and pork to the EU. Neighboring MS are also very concerned to bring CSF under control through vaccination programs in these newest MS, because of the threat for their pig farms.

Source:www.cattlenetwork.com

Influenza cases increasing rapidly in eastern Austria

2008-01-18T10:53:00.000-08:00

The number of influenza cases is rising rapidly in eastern Austria. Doctors are reporting a big increase in Vienna, Lower and Upper Austria and Styria. Michael Kunze from the Institute for Social Medicine says that there have been 15,300 new cases in the first two weeks of January. He adds that the peak of the outbreak should occur within two-to-three weeks. Older people, the chronically ill and the young are especially in danger from the flu. Vaccination against the flu is the best means of preventing it, but relatively few Austrians bother to obtain it. A poll at the beginning of 2007 showed that only 18 per cent of Austrians had been vaccinated against the flu during the first part of the 2006/2007 flu season. Other means of prevention are frequent washings of one's hands and the avoidance of shaking hands with others. A face mask is also useful in crowded places like undergrounds. Kunze notes that it is not too late to benefit from vaccination against influenza.

Source:www.wienerzeitung.at

Equine influenza outbreak contained

2008-01-18T10:50:00.000-08:00

THE equine influenza (EI) outbreak that devastated horse-related industries is contained, the nation's chief veterinary officer says.

Andy Carroll of the Department of Agriculture Fisheries and Forestry said government officials visiting the infected areas of Queensland and NSW had determined the virus was contained and unlikely to return.

"We have a large number of already immune horses because they've had the disease or they've been vaccinated," Dr Carroll said on ABC television.

"We also are quite conservative before moving an area or a property from infected to clean. We take a conservative stance and we don't see a large risk of areas reverting back."

An inquiry into the outbreak which began last August is being overseen by retired High Court judge Ian Callinan.

Mr Callinan is expected to hand down his findings before April 25.

The first case of EI in Australia was detected at Sydney's Eastern Creek quarantine facility on August 23 in a thoroughbred stallion which had travelled from the northern hemisphere and was awaiting release.

The outbreak, which brought horse racing to a halt in NSW and Queensland, is estimated to have cost the industry more than $500 million.

Source:www.news.com.au

65 -- INFLUENZA VACCINE (NASAL SPRAY)

2008-01-18T10:46:00.000-08:00

Defense Logistics Agency, Acquisition Management, Defense Supply Center Philadelphia - Medical, 700 Robbins Avenue, Philadelphia, PA, 19111-5096, UNITED STATES

SUBJECT: 65 -- Influenza Vaccine (Nasal Spray)

CLASSIFICATION CODE: 65 - Medical, dental & veterinary equipment & supplies

SOLICITATION NUMBER: SPM2DP-08-R-0004

CONTACT: Neil McAvinue, Contracting Officer, Phone 215-737-3123, Fax 215-737-2816, Email Neil.McAvinue@dla.mil - Anna Podlas, Contracting Officer, Phone 215-737-5768, Fax 215-737-3127, Email Anna.Podlas@dla.mil

PLACE OF PERFORMANCE ADDRESS: N/A

NOTICE TEXT: Defense Logistics Agency Acquisition Management Defense Supply Center Philadelphia - Medical The Defense Supply Center Philadelphia is soliciting proposals for the supply of Influenza Virus Vaccine (Nasal Spray) for the 2008/2009 flu season. Approximately 167,897 PG (10 dose per package) are included in this requirement. (Quantities may increase or decrease substantially pending receipt of Service requirements.) Shall be a live, trivalent nasally administered vaccine intended for active immunization for the prevention of influenza. Each 0.2 ml dose shall be formulated to contain 10 median tissue culture infectious doses of live attenuated influenza virus reassortants of the strains recommended by the U.S. Public Health Service (USPHS) for the 2008-2009 season. Shall be indicated for active immunization for the prevention of disease caused by influenza A and B viruses in healthy children ages 2 -17 years of age and healthy adults ages 18-49 years of age. Shall be suitable for nasal administration only. Shall be supplied in a commercially available nasal syringe unit considered acceptable to the FDA. The formula for the 2008-2009 season shall be as required in the solicitation. Expiration date shall be not more than 9 months from the date of manufacture but shall not exceed 30 June 2009. Material shall be shipped frozen at or below -10" C (14" F). No EXCURSIONS are acceptable. Unit. Package (PF). One package containing 10 pre-filled commercially available nasal syringe units, as specified, constitutes one unit. Each pre-filled nasal syringe unit shall contain a single 0.2 ml dose. Other Spec. data included in the solicitation. National Stock Numbers will be established at time of award. An indefinite quantity contract is proposed. The quantities indicated are annual estimates only. The guaranteed minimum will be 75% of the annual estimate, and the contract maximum will be established at 150% of the annual estimate. Contractor shall deliver to various locations, provided at time of award. For information on this Solicitation please contact Todd Stackhouse (215-737-2849/todd.stackhouse@dla.mil)

Source:www.tradingmarkets.com

Most GPs "are against extending influenza injection"

2008-01-18T10:35:00.000-08:00

More than 25% of GPs believe influenza immunisation is unnecessary, and almost three-quarters are against plans to extend the number of people eligible for it, a new survey shows.

GP magazine questioned 310 family doctors, and found widespread opposition to the Government's flu jab programme.

The annual policy offers the injection to anyone over 65, and to people with chest problems and low immunity, at a cost of around £115m in England every year.

But 72% of GPs are against proposals to extend the jab to people aged over 50, and children under two years old.

However, Dr George Kassianos, immunisation spokesman for the Royal College of GPs, said: "Evidence shows that the flu jab is beneficial, but we do not give it to enough people.

"If you do not vaccinate enough people, then it is not as effective.

"By extending the programme to include people aged 50 to 65 and children, we can reduce the chances of the virus circulating in the community."

And a Department of Health spokesman said: "Although vaccination may not protect all people from flu virus infection, experts advise that the majority of those immunised benefit by suffering a less severe illness.

Source:www.managementinpractice.com

Gastritis

2008-01-17T10:57:00.000-08:00

Gastritis is inflammation of the gastric mucosa of the stomach. Depending on the cause, gastritis may persist acutely or chronically and may coincide with more serious conditions such as atrophy of the stomach.

[hide]

[edit] Causes

The following are known causes and factors related to gastritis:

Bacterial infection (most often by Helicobacter pylori and other Helicobacter spp.)
Fungal infection (most often in people with immunodeficiency)
Parasitic infection (most often by Anisakis spp. from poorly cooked seafood)
Bile reflux
NSAIDs
Cigarette smoke
Autoimmune disorders
Excessive alcohol consumption
Excessive caffeine consumption
Certain allergens
Certain types of radiation
Steroid treatments for other conditions
Stomach injury
Stress

[edit] Symptoms

The following symptoms can be a result of gastritis or can be related to the underlying cause:

[edit] Diagnosis

In suspected cases, a doctor usually orders a barium meal test and gastroscopy to determine gastritis and related conditions such as peptic ulcers and gastric cancer. It is always important that the doctor reviews a patient's history regarding medications, alcohol intake, smoking, and other factors that can be associated with gastritis. In some cases, the appearance of the stomach lining seen during gastroscopy and the results of the barium meal test are reliable in determining gastritis and the cause. However, the most reliable method for determining gastritis is doing a biopsy during gastroscopy and checking for histological characteristics of gastritis and infection. For Helicobacter infection (the most common cause), one can test non-invasively with a urea breath test, stool antigen test, or blood antibody test.

If diarrhea is present also, the correct diagnosis may be not gastritis but rather gastroenteritis.

[edit] Treatment

Treatment for gastritis usually consists of removing the irritant or the infection. In cases of infection, a doctor will most often prescribe antimicrobial drugs. Helicobacter infection typically responds well to the triple therapy protocol (consisting of two antibiotics, and a proton pump inhibitor). Regimens that work well include PCA or PCM triple therapy (PPI, Clarithromycin, Amoxicillin) or (PPI, Clarithromycin, Metronidazole). Quadruple therapy has a >90% success rate and includes PPIs, Bismuth subsalicylates, Metronidazole, and Tetracycline.

[edit] See also

en.wikipedia.org
Source:

Gastritis

2008-01-17T10:48:00.000-08:00

Gastritis is not a single disease, but several different conditions that all have inflammation of the stomach lining. Gastritis can be caused by drinking too much alcohol, prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, or infection with bacteria such as Helicobacter pylori (H. pylori). Sometimes gastritis develops after major surgery, traumatic injury, burns, or severe infections. Certain diseases, such as pernicious anemia, autoimmune disorders, and chronic bile reflux, can cause gastritis as well.

The most common symptoms are abdominal upset or pain. Other symptoms are belching, abdominal bloating, nausea, and vomiting or a feeling of fullness or of burning in the upper abdomen. Blood in your vomit or black stools may be a sign of bleeding in the stomach, which may indicate a serious problem requiring immediate medical attention.

Gastritis is diagnosed through one or more medical tests:

Upper gastrointestinal endoscopy. The doctor eases an endoscope, a thin tube containing a tiny camera, through your mouth (or occasionally nose) and down into your stomach to look at the stomach lining. The doctor will check for inflammation and may remove a tiny sample of tissue for tests. This procedure to remove a tissue sample is called a biopsy.
Blood test. The doctor may check your red blood cell count to see whether you have anemia, which means that you do not have enough red blood cells. Anemia can be caused by bleeding from the stomach.
Stool test. This test checks for the presence of blood in your stool, a sign of bleeding. Stool test may also be used to detect the presence of H. pylori in the digestive tract.

Treatment usually involves taking drugs to reduce stomach acid and thereby help relieve symptoms and promote healing. (Stomach acid irritates the inflamed tissue in the stomach.) Avoidance of certain foods, beverages, or medicines may also be recommended.

If your gastritis is caused by an infection, that problem may be treated as well. For example, the doctor might prescribe antibiotics to clear up H. pylori infection. Once the underlying problem disappears, the gastritis usually does too. Talk to your doctor before stopping any medicine or starting any gastritis treatment on your own.

Source:digestive.niddk.nih.gov

Harvester, new varicose veins treatment

2008-01-15T07:29:00.000-08:00

Board certified vascular surgeon Dr. Heshmat Majlessi is a fellow of the American College of Surgeons and International College of Surgeons and the director of Park Avenue Vein Center.

He finished his surgical residency in NY Medical College. Following his training in open heart surgery and vascular surgery he came in contact with Professor George Fegan in England who was the father of non-surgical treatment of varicose veins. Since then he has confined his practice to varicose veins.

He has several inventions and patents under his name (all medical in nature); the latest one is for permanent varicose veins treatment.

Q. What attracted you to this field initially?

A. I received training as a vascular surgeon. For many years, the field of varicose veins was neglected. I chose this field 20 years ago. Recently many young doctors have been showing interest in this field.

Q. Can you please explain what varicose veins are?

A. There are hundreds of small superficial veins under the skin in the legs and thighs. These tiny veins become larger and sometimes twisted, mostly due to the pressure from so called leaks in different part of the legs (perforators) and result in varicose veins. These in turn produce many tiny spider veins which are not attractive.

Q. Why are varicose veins considered to be more than a cosmetic problem?

A. Varicose veins can cause pain, swelling, cramp, clots (phlebitis), ulcers and bleeding.

Q. The general belief is that varicose veins are limited to the legs. Could you tell us which organs are frequently affected by this syndrome?

A. Varicose veins are mainly seen in the legs but they can also develop in other parts of the body like the intestine (stomach, esophagus). Varicose veins of the rectum are called hemorrhoids.

Q. Why are women more prone to developing varicose veins?

A. Pregnancy is the most important cause of varicose veins; therefore women are affected about 5 times more than men.

Q. What are the major risk factors for developing varicose veins?

A. Pregnancy, family history, weight, being on the feet for long periods of time and possibly hormones like progesterone.

Q. What happens if a person does not seek treatment for the syndrome?

A. As I mentioned before, it will result in several medical complications. All the pain and swelling disappears after treatment. Getting rid of the unpleasant looking veins is also very important for many patients.

Q. What are the available treatment methods?

A. In the old treatment which is still practiced today, the doctor makes numerous incisions over the veins and removes them under anesthesia.

Another technique which has become common over the past five years is to use laser or a hot wire to burn the saphenous vein in the thigh (electrofrequency).

The Harvester technique which uses my device is the latest development in this field. It is intended to permanently eliminate varicose veins and even spiders by closing ALL responsible leaks. The method has resulted in a near perfect leg in 99% of the patients.

Q. Could you tell us more about your treatment method?

A. The patented Harvester technique is a 15 minutes local procedure which completely eliminates the large leaks responsible for the varicose veins and spiders.

The procedure does not require any major anesthesia or disability. Patients can immediately fly back to their country of origin after the treatment. They will need a couple more visits to treat all the tiny leftover veins and spiders.

Q. What are the advantages of the Harvesting technique over regular treatments?

A. Lack of severe pain and disability, no need for major anesthesia and excellent cosmetic outcome.

Q. What are the complications of this method?

A. The common side effect is slight bruising in the inner thigh which disappears after a few days. We have not had any reported infections or bleeding.

Q. What is its prognosis?

A. The present varicose veins disappear permanently in all patients. We recommend the patients to follow up every couple of years in order to treat any developed tiny veins or spiders before they become bigger.

Q. Are there any criteria for selecting the patients who benefit most from this method? What are the success rate predicting factors?

A. All patients with superficial varicose veins are candidates for Harvester technique. The only exceptions are patients taking blood thinner coumadin.

Q. How many patients have benefited from this therapy so far?

A. Over 1500 patients

Q. What were some of the most rewarding and/or challenging moments you experienced in this project?

A. For me seeing a patient's reaction after the operation is the most rewarding moment. Many of them have had pain, swelling and cramps for years thinking it is normal to have these symptoms.

Source:www.presstv.ir

“Clinical and Economical Considerations For IV Push Drug Delivery” By Industry Expert Richard Rosenfeld Is Now Accessible on Expert411.com For Media a

2008-01-15T07:24:00.000-08:00

IV push of cephalosporin antibiotics and other drugs is an alternative method of administration that can be safe, efficacious and cost effective. This paper concentrates on IV push of cefazolin as a case study, since it is a high-use cephalosporin with physical and chemical properties similar to other drugs that can be administered by the IV push method.

Rosenfeld has personally implemented the use of IV push antibiotics within two hospital systems. During the first year that this IV push program was in place, more than 50,000 doses of cefazolin were administered by the IV push method with no occurrences of phlebitis or adverse drug events directly associated with the change in the administration method of this drug. The paper discusses the economical advantages of moving to IV push, as well as the resulting nurse satisfaction and patient benefits seen through the resulting research follow up.

Executive Director of Pharmacy Management for the Scripps Health Hospital System in San Diego, CA, Rosenfeld has responsibility for all system pharmacy services through his position with Cardinal Technology and Services. Prior to joining the Scripps Health team, he served as a consultant at Sharp Healthcare, a five-hospital IDN in San Diego, California, where the IV push method of administration for cephalosporins was implemented.

Rosenfeld earned a BS in Pharmacy from Ferris State University and a BA in Chemistry from San Diego State University. He holds an MBA from California State University, San Marcos.

Source:www.prleap.com

Good things don't come in 3s for BMW

2008-01-15T07:21:00.000-08:00

That ornate gothic style was just slightly out of date. In the same way that swanning around in Joan Collins Dynasty shoulder pads would be slightly out of date today. And just as risible.

The thing is, though, that now absolutely everyone loves the museum, and the person who loves it most of all is me. I know it's more gaudy than Paris Hilton's knicker drawer, and I know it's full of ecologist schoolteachers telling groups of uninterested children that unless they stab their gas-guzzling parents all animals will end up as bones in glass boxes in there.

But my, oh my, what a temple, what ambition, what detailing!

Paid for with money generated from the Great Exhibition of 1851, the Natural History Museum is like all the world's best cathedrals. It's much more interesting to look at than anything that's going on inside it.

It is brilliant, and every time I come into London on the M4 I fervently wish for a traffic jam on the Cromwell Road just so that I can spend a little more time drinking it all in.

And naturally this brings me on to the boot lid of the 7 Series BMW.

There was a problem with it from the start. You see, BMW had employed an American stylist by the name of Chris Bangle, who had a beard and a not-bad CV from Fiat, where he'd done the 1990s Fiat Coupe. Not a bad-looking car in many ways, except that Chris had given it four eyebrows.

Anyway, Johnny Yank had arrived at BMW determined to breathe some new life into the brand, which -- until that point -- had stuck very rigidly to the principle that all cars should be styled using nothing more than a sturdy 2HB pencil and a ruler.

Bangle's first attempt was the 7 Series, and it was a complete disaster, chiefly because he'd fitted a boot lid and then left it in the oven for too long. So it had melted and sort of dribbled down over the rear valance. Horrified by slow sales of this unlovely monster, BMW quickly ordered a redesign.

But Chris mucked this one up as well. And the one that followed shortly thereafter.

And by this stage he'd set to work ruining the 6 Series too -- a job he completed spectacularly well. This one had an even bigger, even more melted, boot lid, which if you squinted looked like a forgotten souffle. In the meantime he was starting work on a sportscar called the Z4. It was imperative that this car should look good, because good looks are the raison d'etre for cars of this type. But I'm afraid he made a complete hash of it.

And then, to make matters worse, he came up with a trendy designer handle for what he was doing, calling it flame surfacing.

Others called it bollocks. The designer J.Mays at Ford laughed openly, while Marc Newson, an industrial designer, said the Z4 appeared to have been designed with a machete.

Meanwhile, Renault's stylist, Patrick Le Quement, politely described it as hollow. And as for me? Well, I'm sorry, but Bangle said that his influence for the Z4 was the Guggenheim Museum in Bilbao.

I see. So you modelled a car on what looks like an aircraft carrier that has crashed into a city. Wouldn't it have been better to maybe have used a shark, or perhaps a tiger, as your starting point? Just a thought.

Sadly, Chris wasn't listening. He was busy working on the new BMW 5 Series -- his absolute worst effort so far, with headlamps like Dame Edna Everage's spectacles and lines that make no sense at all.

Then, after the 1 Series came out looking like a severely kicked-in bread van, BMW had plainly had enough, so it booted its American whiz-kid upstairs, where he could do less harm.

And that's a pity, because it was at this exact moment that I realised that the flame-surfaced Z4 is just as striking and wonderful as the Guggenheim building that inspired it; and that the 6 Series is in fact perfectly balanced and gorgeous; and that the 5 Series -- when it has the right wheels on -- makes the rival models from Audi and Mercedes-Benz look as dumpy and lumpy as phlebitis.

And that brings us on to the BMW 3 Series. Frightened that any more mad Banglism might scare away buyers of the cash cow, the company high-ups insisted that this model should be a fairly normal-looking affair.

And so it turned out to be. Fairly normal. And as boring as a bucket of wallpaper paste.

This is a car you would buy like you would curtain material -- by the foot.

Yes, I'd like 15ft of car, please. Certainly, sir. How about a 3 Series? It is a magnolia bathroom suite. It is beige paint. It is biscuit carpeting. And worst of all, from the back it looks like a Kia.

In a BMW showroom full of Bangle's brilliant early works, it sticks out like an art school doodle in the Tate Modern's engine room.

And the convertible is worse. As is the norm these days, the convertible roof is made from metal, and that's just fine. But to stow such a large lump of ironmongery, and the rear window, the boot has to be as big -- and as stylish -- as a Korean grain carrier.

To make matters worse the model I tested was the big-engined 335i, which is all yours -- fitted with a few necessary extras -- for a whopping pound stg. 46,000 ($103,000), though a basic model costs pound stg. 38,035.

Make no mistake, this is not a bad car. No, the manual gearbox is not completely precise, and yes, there is a whisper of wind noise from the point where the roof meets the windscreen, but this is only audible on the M26 motorway at 7pm, when you have a 7.50pm flight to catch from Gatwick.

Of more interest is the twin-turbo motor. This is a straight six, and any engineer will tell you that this is the smoothest cylinder configuration you can have for an engine. He will also tell you -- if you don't punch him in time -- why that is.

But in this BMW it isn't smooth. In fact on tickover it rumbles and judders like a big American V8, and I think they may have done this on purpose by messing with the crankshaft or the firing order. Maybe they wanted to give it some character, and if that's the case it's worked -- I liked it a lot.

As you'd expect, it's a dream to drive on really good roads. When the going is empty, all BMWs feel balanced and neutral, and while they may not all be as fast as the ultimate driving machine tag would have you believe, the 335i Convertible ... er ... is. Especially when you're really, really late for a plane.

In sixth gear it will accelerate even faster than the old M3 would, but it won't shake your head off in the process. Yes, the ride is firm, but it's bearable.

And while we're on the subject of comfort, full marks -- plus a star -- for all the oddment stowage space they've provided in the cabin. It's especially useful in a convertible, and doubly especially useful when the boot, despite outward appearances, really isn't that big at all.

But I'm sorry, we have to go back to that price tag. At pound stg. 46,000 it is dangerously close to the Audi RS4 Cabriolet, and probably not that far behind what one of the new soft-top M3s will cost.

And I'm sorry again, but anyone with a 335i is going to spend his entire life explaining to colleagues why he didn't go the extra mile and get the big boy instead.

It will be particularly painful when the time comes to sell. M3s on the secondhand market are always fairly cheap, so to make your 335i look attractive you'll have to sell it on for mere pennies.

And even that might not do the trick, because of the way it looks. I stand corrected with other BMW models. But with the 3 Series, I'm sorry.

It's not the Natural History Museum or the Trellick Tower, and it never will be. It is, I'm afraid, Coventry Cathedral. A turd that even time cannot succeed in polishing.

Source:www.theaustralian.news.com.au

Herbal Medicines For Common Breathing Problems

2008-01-15T07:19:00.000-08:00

Breathing problems are becoming more common as air becomes more polluted. Many alternative therapies, especially herbal medicine and homeopathy, can help in many of the more common conditions that affect the respiratory system.

Coughs

Coughing is the body's natural way of clearing irritation and congestion from the lungs and airways. A dry cough is reacting to an irritant, a productive cough helps to expel congested phlegm. A common cold or influenza is usually accompanied by a cough. But coughs can be a sign of other respiratory problems (a hoarse cough may indicate laryngitis in an adult and croup or whooping cough in a child), or more serious breathing disorders (see Pleurisy, Pneumonia, Tuberculosis, Emphysema, and Asthma).

Treatment

Herbal Medicine Make infusions of the following:

for most coughs white horehound is effective

for a hard cough use mullein

for an irritating cough in adults use wild lettuce, and in children wild cherry bark (a mild sedative)

for a cough with a fever use yarrow or angelica

for a catarrhal cough use elecampane or elderflower.

Diet and Nutrition Biochemic tissue salts, taken in tablet form:

for a hard, dry cough with fever - Ferrum phos.

for a cough with thick, white phlegm - Kali mur.

for a cough with yellow phlegm that is worse at night - Kali sulf.

for a spasmodic painful cough - Magnesia phos.

for a loose, rattling cough with watery phlegm Calcarea, alternating with Ferrum phos.

Aromatherapy Massage chest and back with essential oils-eucalyptus, sandalwood, frankincense, and myrrh are recommended. Add essential oils to hot water and inhale to help expel phyegm. For a dry, hard cough, try cypress, hyssop, bergamot, or cammomile oil used as steam inhalations.

Consult a qualified practitioner/therapist for:

Acupressure Coughing spasms in the upper back can be relieved by pressure on the point between the shoulder blade and spine, at heart level.

Acupuncture An imbalance in the flow of energy to the lungs can be treated by inserting needles into the Lung meridian on the arms, or into the meridian of another organ with a related rhythm.

Bronchitis/wheezing

Bronchitis is an inflammation of the airways that connect the windpipe to the lungs (bronchi). Acute bronchitis lasts up to two weeks and is caused by a variety of viruses and bacteria. It can be dangerous in the elderly and those with heart disease. Chronic bronchitis is more serious and can last for months, getting progressively worse. It is usually caused by breathing polluted air or smoking. Coal miners and construction workers, for example, are particularly susceptible.

Source:www.americanchronicle.com

Stay away from refined white flour

2008-01-15T07:18:00.000-08:00

To The Editor: "I noticed an article in a medical journal suggesting that restoring roughage (whole grain fiber) might treat constipation, hemorrhoids, and irritable bowels ... three conditions my father suffered from for 30 years before he died of colon cancer," wrote Dr. David Reuben (1975) in The-Save-Your-Life-Diet.

His later studies revealed that 600 scientific publications (world wide) had definitely linked these ailments, plus divirticulitis, hypertension, phlebitis, diabetes and obesity to cancers and heart diseases after a lag-time of 30 to 50 years.

British doctors set out to prove these connections to refined flour! They traveled to rural Africa where white man's diseases didn't exist.

They studied their natural plant diets and bowel fecal material.

It was odor-free, soft, bulky and passed two to three times a day; opposite the white-flour-eating British who'd adopted refined grain diets.

White flour (refined whole grains) is used in 60 to 90 percent of our bakery products and is continuing to lead to constipation (other bowel ailments), obesity and diabetes, followed by heart attacks and cancers. Deaths aren't easy or cheap!

Source:www.blueridgenow.com

Changes to prevent acid reflux not hard to swallow

2008-01-15T07:16:00.000-08:00

SMOKING cigarettes, eating fatty foods, or downing caffeinated drinks can all contribute to a health problem shared by more than 15 million Americans: gastroesophageal reflux disease.

Commonly known as acid reflux, GERD is a condition in which stomach acids back up into the esophagus, causing a warm or burning sensation in the lower chest and upper stomach.

While that sensation of heat in the chest may be dismissed as simple heartburn, it can actually signal more serious problems. If left untreated, the constant backup of stomach acid can damage the lining of the esophagus, causing bleeding, ulcers and, possibly esophageal cancer.

Anyone experiencing heartburn twice a week or more may have GERD. But while heartburn is the most common symptom, it is not the only one; some people may have GERD without any heartburn at all. A chronic dry cough, laryngitis, asthma, nausea, belching or difficulty with swallowing can also indicate the presence of GERD.

Infants with this condition may spit up or arch their backs in pain more frequently than babies without it. Most infants outgrow these problems in the first year, but if GERD persists, it can cause repeated vomiting, coughing or respiratory problems, and older children may complain of abdominal or chest pain.

Weak muscle vs. strong acid

GERD can develop when a muscle ring at the end of the esophagus — the lower esophageal sphincter — becomes weak. This muscle is designed to
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act as a one-way valve that allows food to flow through the esophagus into the stomach. If this sphincter muscle contracts or relaxes improperly, then the strong acids from digested food in the stomach can push past it and move back up toward the esophagus and chest, causing heartburn and other problems associated with GERD.

Weakness in the muscle is also viewed as one cause of the acid reflux experienced by about 75 percent of pregnant women. When a woman is carrying a full-term baby, the uterus pushes against the stomach and chest and that puts more pressure on the esophageal sphincter so it cannot function properly.

Hiatal hernias, in which the upper portion of the stomach protrudes into the chest cavity, can also interfere with the ability of the muscle to prevent acid reflux. A hernia can displace the muscle from its proper position and the hernia sac can also trap stomach acids too close to the esophagus. While a majority of patients with GERD have hiatal hernias, not all do; and not every person with a hiatal hernia has GERD.

Change habits, not prescriptions

Over-the-counter and prescription medications can often relieve symptoms of GERD. Antacids, such as Tums or Rolaids, work quickly but provide relief for only 30 to 40 minutes. Taking too many antacid tablets can cause diarrhea because they contain magnesia; and, while post-menopausal women may take Tums for calcium, they should not ingest more than three tablets per day.

Histamine or H2 blockers such as Zantec, Pepcid and Tagamet can relieve GERD, as can proton pump inhibitors such as Prilosec, Nexium, Prevacid, Protonix and Acifex. In cases of severe acid reflux, patients may be given a short-term prescription for a medication called Reglan. Surgery may be advised for a small minority of patients.

But by far, the most common and effective treatment plan requires patients to make these lifestyles changes to minimize the impact of acid reflux on their health:

-Quit smoking, because smoking substantially reduces the clearance of acid from the esophagus, and this effect can last for up to six hours after the last cigarette.

-Avoid chocolate, peppermint and alcohol as well as fatty foods. Also stay away from spicy or acid-containing foods such as citrus juices, carbonated beverages and tomato juice.

-Limit the intake of coffee, black tea, sodas or other caffeinated beverages; drink them with meals since food neutralizes acid, or switch to decaffeinated products.

-Try chewing gum after meals — it stimulates the production of saliva and increases the rate of swallowing, which can neutralize acid in the esophagus.

Source:www.insidebayarea.com

ADVENTRX Announces ANX-530 Safety Data and Provides NDA Submission Guidance

2008-01-15T07:14:00.000-08:00

ADVENTRX Pharmaceuticals, Inc. today announced safety results from its marketing-enabling bioequivalence clinical study of ANX-530 (vinorelbine emulsion). ANX-530 demonstrated a statistically significant reduction in injection site reactions when compared to Navelbine(R) (p<0.05). The incidence of injection site reactions attributed to Navelbine was consistent with its product label. Furthermore, ANX-530 was determined to be safe and well-tolerated with no significant differences observed in any other safety parameters. In November 2007, ADVENTRX announced that it met the primary endpoint in this study, with pharmacokinetic equivalence observed between ANX-530 and Navelbine. Full results from this study have been submitted for presentation at an upcoming oncology conference.

ADVENTRX also announced that it intends to submit to the U.S. Food and Drug Administration (FDA) a Section 505(b)(2) New Drug Application (NDA) for ANX-530 in the fourth quarter of 2008. In December 2007, ADVENTRX met with the FDA to discuss its commercial manufacturing plans for ANX-530. The Company reached agreement with the FDA regarding commercial manufacturing requirements for ANX-530, as well as requisites for the Chemistry Manufacturing and Controls (CMC) section of the NDA. As a follow up, ADVENTRX anticipates holding a pre-NDA meeting with the FDA in the second quarter of 2008.

"We are extremely encouraged by these data, and pleased that our goal to improve the safety of vinorelbine was observed in the clinic. Particularly compelling is that even in a small study we were able to observe a statistical difference in injection site reactions," stated Evan M. Levine, chief executive officer of ADVENTRX. "We are excited by the continued progress of ANX-530 and look forward to our NDA submission later this year."

ANX-530 is a novel emulsion formulation of vinorelbine. Vinorelbine, marketed under the brand name Navelbine and available in generic versions, is an anti-cancer agent approved to treat advanced non-small cell lung cancer as a single agent or in combination with cisplatin. Worldwide sales of Navelbine and generic vinorelbine in 2006 were in excess of $200 million.

The bioequivalence study of ANX-530 was an open-label crossover comparison of ANX-530 and Navelbine in 31 patients, with a primary objective of demonstrating the pharmacokinetic equivalence of ANX-530 and Navelbine. Determining the safety of a single dose of ANX-530 was a secondary objective. In the first week, patients were dosed with either ANX-530 or Navelbine, and after a washout period, were dosed with the opposite drug during the second week of treatment. The FDA has indicated that this single clinical study, should it demonstrate pharmacokinetic equivalence between ANX-530 and Navelbine, would provide sufficient clinical data to support a Section 505(b)(2) NDA.

Adverse events in the study were analyzed by logistic regression models with factors for treatment (ANX-530 vs. Navelbine), phase (days 1-7 vs. days 8-14), sequence (ANX-530 followed by Navelbine vs. Navelbine followed by ANX-530) and subject within a sequence. The most common adverse events were neutropenia, leucopenia, injection site phlebitis, and constipation. Injection site reactions were the only adverse events that were statistically different between the control arm and the study arm.

About ANX-530 (vinorelbine emulsion)

ANX-530 is designed to reduce the incidence and severity of injection site reaction from intravenous-delivery of vinorelbine tartrate. Vinorelbine tartrate works by disrupting microtubule formation and is a member of the vinca alkaloid class of antineoplastic agents. Vinorelbine is indicated as a single agent or in combination with cisplatin for treatment of advanced non-small cell lung cancer and has also shown activity in breast, ovarian, and other cancers.

About Section 505(b)(2)

Section 505(b)(2) of the U.S. Food, Drug & Cosmetic Act (FDCA) allows the FDA to approve a follow-on drug on the basis of data in the scientific literature or conclusions regarding safety or effectiveness made by the FDA in the approval of other drugs. This regulatory pathway potentially makes it easier for drug manufacturers to obtain rapid approval of new forms of drugs based on the FDA's approval of the original drug. Some examples of products that may be allowed to follow a 505(b)(2) path to approval are drugs that have a new dosage form, strength, route of administration, formulation or indication. Upon approval, a drug may be marketed only for the FDA-approved indications in the approved dosage forms. Further clinical trials are necessary to gain approval for the use of the product for any additional indications or dosage forms. To the extent a Section 505(b)(2) applicant is relying on the FDA's findings for an already-approved drug, the applicant is required to certify to the FDA concerning any patents listed for the approved drug in the FDA's Orange Book publication, which may include a certification that listed patents are invalid or will not be infringed by the manufacture, use or sale of the new drug.

About ADVENTRX Pharmaceuticals

ADVENTRX Pharmaceuticals is a biopharmaceutical research and development company focused on commercializing proprietary product candidates for the treatment of cancer and infectious diseases. The Company seeks to improve the performance and safety of existing treatments by addressing significant problems such as drug metabolism, bioavailability, excessive toxicity and treatment resistance. More information can be found on the Company's web site at http://www.adventrx.com.

Forward Looking Statement

ADVENTRX cautions you that statements included in this press release that are not a description of historical facts are forward-looking statements that involve risks and assumptions that, if they materialize or do not prove to be accurate, could cause ADVENTRX's results to differ materially from historical results or those expressed or implied by such forward-looking statements. These risks and uncertainties include, but are not limited to: the risk of investigator bias in reporting adverse events as a result of the study's open-label nature, including bias that increased the reporting of adverse events associated with Navelbine and/or that decreased the reporting of adverse events associated with ANX-530; the risk the FDA will determine that ANX-530 and Navelbine are not bioequivalent, including as a result of performing pharmacokinetic equivalence analysis based a patient population other than the population on which ADVENTRX based its analysis; difficulties or delays in manufacturing, marketing and obtaining regulatory approval for ANX-530, including validating commercial manufacturers and suppliers and the potential for automatic injunctions regarding FDA approval of ANX-530 and other challenges by patent holders during the Section 505(b)(2) process; the risk that ADVENTRX will be unable to raise sufficient capital to fund the projects necessary to meet its goals, including funding the continued development and commercialization of ANX-530; the potential for regulatory authorities to require additional preclinical work or other clinical requirements to support regulatory filings; patent and non-patent exclusivity covering Navelbine; ADVENTRX's lack of long-term agreements with suppliers of ANX-530 components and contract manufacturers of ANX-530, including its inability to timely secure commercial quantities of ANX-530 or its components on commercially reasonable terms, or at all; uncertainty under Section 505(b)(2) resulting from legal action against the FDA and the potential that future interpretations of Section 505(b)(2) could delay or prevent the FDA from approving any Section 505(b)(2) NDA; and other risks and uncertainties more fully described in ADVENTRX's press releases and periodic filings with the Securities and Exchange Commission. ADVENTRX's public filings with the Securities and Exchange Commission are available at http://www.sec.gov.

Source:money.cnn.com

When in Tenerife, do as the Finns do

2008-01-15T07:12:00.000-08:00

This paper has been kind enough to allow me to write this feature about our sauna company – “Pasidee S.L”. My name is Dee and my husband Pasi and I started up this business when we realised how difficult it was to get authentic Finnish saunas on the Island. Pasi is from Finland and he and his family have been working with saunas for the past 40 years, the last three generations, so it only made sense that we should give our expert advice and knowledge to others. We work alongside “Harvia” who is The World’s leading sauna manufacturer, all the wood that is used is slowly grown from Northern countries for its durability and we only supply the best Harvia products and accessories.

Some people still have the perception that a sauna is a dark sweat box to feel claustrophobic and hot, but anybody who has had the pleasure of using one of our designs would say that it was a pleasurable and relaxing experience, providing a great sense of well being. Not only an enjoyable environment to help relax and unwind from the day’s stresses and strains, there are also many professed health benefits from saunas, here are just a few:
· Your heart rate increases between 50-70% during a 10-20 minute sauna session, the increased cardiac load is the equivalent to a brisk walk, this causes a nominal effect in blood pressure because the heat also causes blood vessels in the skin to expand to accommodate increased blood flow.
· Such increased blood flow brings important nutrients to the surface tissue promoting cellular activity and growth, resulting in healthy, glowing skin.
· Skin is the largest organ of the body and saunas induce sweating to provide a comprehensive cleansing of the skin and sweat glands.
· Such profuse sweating enhances detoxifying capacity of the skin, by opening the pores and flushing impurities from the body.
· Research has shown that sweat is much more effective than water in emulsifying fat, which results in removing the bacteria and allowing essential fluids to be moved to the skins surface, showing a continued wrinkle free complexion.
· When taking a sauna, skin temperature rises to 40’C (104’F) and internal body temperature rises to 38’C (100.4’F) such heat creates an artificial fever state, which stimulates the immune system in increased production of disease fighting white blood cells and antibodies, which is all part of the bodies natural healing process. Also excellent treatment for keeping tension headaches and migraines at bay.
· Steam inhalation is an excellent treatment for many respiratory problems, such as chest congestion, bronchitis, laryngitis and sinusitis. The moist air loosens secretions and relieves inflammation.
· Saunas are often used alongside a massage, to loosen fatty tissue and assist in the battle against cellulite or to revive tired and strained muscles after physical exertion.
· A sauna relaxes the body and soothes your inner self whilst unlocking tension. Limbs feel supple, muscles at ease and the whole mind and body light.
All our saunas are custom designed to suit specific requirements, virtually any size, no matter how small can be built, for indoor or outdoor and as basic or exclusive as required. Personalised with windows, doors, colour lights and speakers to suit the mood. Either a traditional wood burning or a more economical electric stove, however, the Finns aren’t overly keen (although we would supply) on the infrared cabins, these nowhere near could ever compare to the feeling of the exuberance when the water is thrown on the hot stones and the steam, which can be fragranced or herbal, encompasses the air. We are quite relieved that we are yet to sell an infrared and when people enquire about them it’s only because they are uneducated on the alternatives.

Source:www.tenerifenews.com

Horses aid therapists in treating patients

2008-01-15T07:09:00.000-08:00

I just heard about a program that uses horses to help handicapped kids. What can you tell me about this type of therapy?

You're referring to "hippotherapy," a term that means treatment with the help of a horse. It is designed for people who have problems with balance, posture, mobility and even psychological, behavioral and communication functions because of such disorders as cerebral palsy, multiple sclerosis, traumatic brain injury, stroke, autism, Alzheimer's disease and even learning disabilities and language problems.

Hippotherapy is not merely recreation for the handicapped. It has specific therapeutic goals. Treatment takes advantage of a horse's natural rhythmic and repetitive movements to help improve patients' muscle tone, balance, posture, coordination, strength, flexibility and cognitive skills. In addition, the horse's movements can improve responses that patients need for walking.

Physical and occupational health therapists who have special training also offer hippotherapy to their patients, and mental health professionals and their patients may work with certified riding instructors in equine facilitated psychotherapy. Here, the goal is to provide experiences that promote self-esteem, awareness of others and better trust and social skills.

Although this form of therapy appears to be growing, I could find only 26 medical studies on the subject, suggesting that we have a lot to discover about its specific effects.

To learn more about it, I suggest visiting the Delta Society's Web site at deltasociety.org. You'll also find useful information there about animal-assisted therapy in general, a trend that appears to be accelerating.

What causes laryngitis? For the past week, my voice has been so weak that I can barely be heard. I haven't had a cold recently.

Laryngitis is an inflammation of the vocal cords, usually because of an infection, fatigue or irritation.

A cold or sore throat can lead to laryngitis. So can overuse of your voice. This is most common among singers and others who have to use their voices constantly - politicians, for example.

Drinking alcohol and smoking also can irritate the vocal cords and larynx. If so, laryngitis may be your body's way of telling you to cut back on drinking and to stop smoking. Another common cause is gastroesophageal reflux disease, in which stomach acid backs up into the esophagus. Sometimes, acid can get into the back of the throat and irritate or even damage the surface tissue of the vocal cords.

(Hoarseness or even voice loss can be a symptom of an underactive thyroid. Blood tests can begin to determine whether your thyroid is to blame. A rare cause of persistent hoarseness is laryngeal cancer.)

The most important thing you can do when you have laryngitis is rest your voice. Inhaling steam can help, as can sucking on lozenges to soothe your throat.

Drink plenty of fluids but avoid alcohol and caffeine, which are irritating. Try not to clear your throat - it can increase the swelling of the vocal cords.

If you have chronic hoarseness that you can't attribute to any of the common causes mentioned above, see your physician to get a proper diagnosis.

Source:www.rockymountainnews.com

Flu Bug to Bite Southern Illinois

2008-01-15T07:07:00.000-08:00

Doctors are anticipating the virus will be here in full force in the next couple of weeks.

According to the latest map from the Centers for Disease Control and Prevention, there are local outbreaks of the flu in Illinois.

Family physician Kurt Martin practices at the Center for Medical Arts in Carbondale.

On News Three This Morning Friday, he talked about the potential spread in our area.

"We have seen some flu in St. Louis. We've seen some at the Center for Medical Arts. I've tested a couple of dozen people. Haven't seen it yet, but I'm pretty certain it will be here in the next couple of weeks."

Doctor Martin says in addition to the flu threat right now there is a nasty virus going around. People are experiencing fever, sore throat, and pink eye with it.

"Take some non steroidal anti inflammatories, ibuprofen. Aleeve. Get plenty of fluids, take some Mucinex. If it persists, gets worse, hard to breath, fever for three days, go get it checked out."

As for the flu, doctor Martin says the onset is sudden and most people know they've got it right away.

Things to look out for include a fever of 103 degrees or higher and--

"Your muscles hurt all over. It feels like someone beat you. A dry cough, sore throat. Flu does not cause runny nose. Flu does not cause laryngitis. If you have these symptoms you probably don't have influenza."

Doctor Martin suggests good personal hygiene and covering your mouth when you cough to prevent the spread of germs.

He also says it's not too late to get vaccinated against influenza.

"It takes three or four weeks before you're going to get the maximum benefit from the vaccine, but if we do get a flu outbreak in two weeks, it won't protect you now. But flu epidemics aren't one day. They're an event that usually take several weeks to unfold."

Doctor Martin says the virus going around has been turning into pneumonia in some patients.

He also suggests drinking plenty of fluids, getting lots of rest, and eating right in order to stay healthy.

Source:www.wsiltv.com

Eminem Is Recovering From Pneumonia

2008-01-14T04:26:00.000-08:00

Eminem is recovering from a bout with pneumonia that sent him to the hospital. "Over the holidays, Marshall Mathers, aka Eminem, was under doctor's care at a Detroit-area hospital for complications due to pneumonia," the rapper's publicist, Dennis Dennehy, said Tuesday. "He has since been released and is doing well recovering at home."

Eminem's illness first was reported by celebrity Web site TMZ.com.

Eminem, 35, rose to stardom thanks to a number of best-selling CDs, personal lyrics and a starring role in the hit 2002 film "8 Mile."

He has won Grammys, including best rap album for "The Slim Shady LP," "The Marshall Mathers LP" and "The Eminem Show," as well as an Oscar for the song "Lose Yourself" from "8 Mile.Eminem appears at the MTV Video Music Awards in New York in this, Aug. 28, 2003, file photo. Eminem is recovering from a bout with pneumonia that sent him to the hospital. "Over the holidays, Marshall Mathers, aka Eminem, was under doctor's care at a Detroit-area hospital for complications due to pneumonia," the rapper's publicist, Dennis Dennehy, said Tuesday. "He has since been released and is doing well recovering at home." (AP Photo/Julie Jacobson, file)

Source:ap.google.com

It's unusual to meet someone happy to be on a waiting list

2008-01-14T04:25:00.000-08:00

Jim Bair, the Keizer man awaiting a double-lung transplant, is keeping his regularly scheduled doctor's appointment today in Seattle. That might not sound noteworthy, until you hear about what he just went through.

He came down with pneumonia, was removed from the national transplant list, suffered a mild stroke, recovered from both ailments, and then returned to the waiting list.

The 50-year-old husband and father of two teenager boys is breathing a sigh of relief, as much as he's able.

His lungs are working at about 18 percent capacity because of obliterative bronchiolitis, which is characterized by inflammation and scarring of the tiny airways. The disease eventually turns fatal without a transplant.

Bair, who believes his lungs are scarred from working years amid the toxic fumes at an agriculture seed-cleaning plant, has been on the list since Oct. 3. The average wait time at the University of Washington Medical Center, where he will have the transplant, is about four months.

He's eager for his monthly checkup today with the transplant team. Just a few days ago, he had doubts that he would be able to keep the appointment, let alone get back on the waiting list.

"It's been really scary," Bair said. "Having the stroke was the scariest thing I've ever been through in my life. I actually shouldn't even be here."

Doctors had warned if he ever came down with pneumonia, he probably wouldn't survive. But here he is.

Jim and his wife, Lisa, have had their bags packed -- as recommended -- since he made the list. And for three months, their lives have been in agonizing limbo.

"It's the waiting and living out of a suitcase and every time the phone rings thinking, 'Is it the call?' That part of it is very stressful," Lisa Bair said.

The Bairs have been told that Jim has only one person on the transplant list ahead of him with his blood type. They've known that since before Christmas, and were devastated when a mild stuffy nose to start the New Year turned quickly into pneumonia.

Jim wasn't well enough to stay on the transplant list, and they knew it.

"You don't want to have to make that phone call and tell them he's sick," Lisa said. "But you have to."

Jim naturally was depressed. It helped to learn that he could go back on the list, in exactly the same spot, if the pneumonia cleared.

He was taking antibiotics and on the mend when he was dealt another blow Jan. 5. He called his wife at work to tell her he thought the right side of his face was sagging. She hurried home and called 911. He had suffered a mild stroke. But by the next day, the right side of Jim's face was back to normal and he was feeling much better. Just three days after the stroke, he was back on the list. Lisa believes he was able to bounce back so quickly because he had lost 80 pounds to prepare for the transplant and had been walking two to three miles a day.

The Bairs will discuss with doctors today the possibility of relocating soon to Seattle, something they'll have to do eventually. Once Jim has the transplant and leaves the hospital, he needs to be nearby for up to three months.

Friends and family continue to raise money for the Bairs, who had to sell their Keizer home when they became a one-income family. Jim has been unable to work since May 2006, and Lisa is a hair stylist. They have insurance, but it doesn't cover all medical expenses.

Source:www.statesmanjournal.com

Doctors caring for Indonesia's former dictator Suharto said Monday he had contracted pneumonia in one of his lungs — one of the most dangerous threats

2008-01-14T04:24:00.000-08:00

The doctors said they were amazed that Suharto was still clinging to life after their weekend prognosis that he had only a slim chance of recovering from multiple organ failure. Family members, meanwhile, said they would leave it to physicians to decide if and when the 86-year-old should be taken off life support.

Pulmonologist Hadiarto Mangunnegoro said one of Suharto's lungs had become infected with mild pneumonia — one of the gravest threats to patients suffering from organ failure. Doctors were trying to make sure it did not spread to the second lung, he said, which "would be very dangerous."

Hospital visitation rights had been strictly limited, Mangunnegoro said.

But while Suharto's lungs and kidneys were barely functioning, the condition of his heart appeared to be improving Monday, and he was conscious and able to respond when asked to take someone's hand, said Marjo Subiandono, the chief presidential doctor.

"We are quite amazed at how strong he is ... maybe because he is a former soldier, a general," Subiandono told reporters. "If I was in the same state, I don't think I would have made it this far."Suharto, whose 32-year regime was widely regarded as one of the 20th century's most brutal and corrupt, was rushed to the hospital on Jan. 4 with anemia and a dangerously low heart rate.

He initially responded well to a blood transfusion and dialysis treatment, but his condition has fluctuated almost daily since then. Aides said privately he had been on the verge of death at least twice, but fought back.

Suharto was ousted one decade ago amid massive student protests and nationwide riots, opening the way for democracy in this predominantly Muslim nation of 235 million people. He withdrew from public life, venturing from his comfortable villa in the capital, Jakarta, only to attend family functions or for medical emergencies.

He has been accused of overseeing a purge of more than half a million leftist opponents soon after seizing power in a 1965 coup. Hundreds of thousands more were killed or imprisoned in the decades that followed — crimes for which no one has ever been punished.

Transparency International, an anti-corruption watchdog, has said Suharto and his family amassed billions of dollars in state funds, an allegation he has denied.

A series of strokes in recent years have left Suharto with permanent brain damage and impaired speech, keeping him from facing trial.

Over the past week a steady stream of high-profile visitors have come to visit the former strongman, including Malayisa's former Prime Minister Mahathir Mohamad on Monday and Singapore's former Prime Minister Lee Kuan Yew on Sunday, two old friends who like Suharto oversaw decades of rapid economic growth at the expense of democratic freedom in their neighboring countries.

Indonesian President Susilo Bambang Yudhoyono, Cabinet ministers and ruling party leaders, many of whom held positions in the government during Suharto's reign, also have flocked to Suharto's bedside in recent days — a sign of his continuing influence over the ruling elite.

"As a human being, like other leaders, certainly he made mistakes and committed wrongdoing, but it would not hurt us to thank him and appreciate his achievements and services to the country," Yudhoyono said over the weekend.

Source:ww.foxnews.com

Docs: Home Care OK for Kids' Pneumonia

2008-01-14T04:22:00.000-08:00

Children with severe pneumonia can be treated just as effectively at home as in a hospital, according to new research. Doctors in Pakistan found that children taking antibiotics at home were as likely to survive serious pneumonia as those treated in hospitals. The study was published Friday in the British medical journal, The Lancet.

"If this (home) treatment was implemented on a wide scale, then we could potentially save millions of children," said Dr. Renee Van de Weerdt, a child health expert at UNICEF, who was not involved in the study.

"This shows us that we can do something about pneumonia at the community level," Van de Weerdt said. "It doesn't always require a sophisticated hospital."

Pneumonia is the top killer of children under five worldwide, causing one-fifth of the 10 million deaths every year.

Pneumonia is an inflammation of the lungs that causes coughing, breathing difficulties, fever and muscle pain. About five to 10 percent of all children under five in developing countries get pneumonia every year. Children with HIV or malaria are at particular risk.

Under current World Health Organization guidelines, health workers refer children with severe pneumonia to hospitals to receive antibiotics through injections. But in many poor countries, children referred to hospitals often don't receive care if their parents cannot afford it or if there is no nearby hospital.

In the Lancet study, doctors in Pakistan randomly assigned children with serious pneumonia to either receive antibiotic shots in the hospital for two days, or to take antibiotics at home for five days. Parents of the children sent home were instructed how and when to give their children the antibiotics.

The research was conducted at seven sites across Pakistan: 1,012 children were hospitalized and 1,025 were treated at home. The children were aged between about three months and five years old.

Among the hospitalized children, 87 children did not respond to the treatment or developed complications. That compared to 77 children in those treated at home. Five children died during the study; four were in the hospitalized group and one was at home.

The study was conducted by researchers at Boston University's School of Public Health and colleagues, and was paid for by WHO and the U.S. Agency for International Development.

Treating children with severe pneumonia at home would also save health systems thousands of dollars. A course of medicines to be taken at home costs $2 at most.

Based on the Pakistani results and those of previous studies, WHO said it would soon revise its guidelines for children with pneumonia.

UNICEF said that trained community health workers, rather than parents, should be the ones giving drugs to children at home with severe pneumonia. "At the implementation level, there are quality control challenges," Van de Weert said. "We don't want antibiotics to be used wildly by anyone."

WHO said that not all children with severe pneumonia could be treated at home, and that a small percentage would still require hospitalization.

"Pneumonia is the single biggest killer of children in the world," said Dr. Shamim Qazi, a pediatrician at WHO. "We are hopeful that with the results from this study, we may be able to change that."

Source:ap.google.com

Small children are particularly susceptible to pneumonia

2008-01-14T04:17:00.000-08:00

A cold can sometimes lead to pneumonia in infants, the Munich-based professional association of paediatricians said. Certain viruses can cause serious obstructive bronchitis or pneumonia, said Ulrich Fegeler, a spokesman for the association. Breathing becomes especially difficult and requires a lot of effort. Children with such illnesses typically can be treated only in a hospital.

Even children who are not as critically ill often need inhalation therapy that includes medicines for opening the respiratory passages and reducing swelling, the association said. Breathing is so exhausting that the babies cannot be nursed. Their bodies lose fluids due to fever. Parents therefore must ensure their children get enough to drink.

In less serious cases, drops to reduce swelling of the nasal passages are helpful as is propping up the upper body in bed. The room also should be well ventilated and not too warm.

The contagion spreads through the air or is passed from person to person on dirty objects or on the hands. Only careful hygiene and avoiding people with colds can help reduce the risk of getting sick, said the association. Parents should consult a doctor if their children have a persistent cough.

"Young children should not be given medicine to loosen phlegm or nasal drops without a doctor's advice," said Fegeler.

When cough relief medicines, which are popular among parents, but viewed skeptically by paediatricians, are taken in combination with cough suppressants, it can lead to a dangerous backup of secretions.

"And some nasal drops can affect the circulation or damage the mucous membrane inside the nose," Fegeler warned.

Source:www.earthtimes.org

Indonesia's Suharto in Hospital

2008-01-12T05:08:00.000-08:00

Former Indonesian dictator Suharto was hospitalized with anemia and intestinal swelling Friday after being treated at home for several days, doctors said.

Suharto's condition was not considered life-threatening, but he would spend at least one night under observation at Pertamina Hospital, said Dr. Marjo Subiandono, head of the country's presidential medical team.

The 86-year-old, who brutally ruled Indonesia for more than three decades until being toppled by a pro-democracy uprising in 1998, has been in and out of the hospital in recent years for strokes and intestinal bleeding. He is said to have suffered permanent brain damage and some speech loss from the ailments.

Hospital spokesman Dr. Joko Sanjoto told reporters that tests were being carried out to determine why Suharto was suffering from anemia and intestinal swelling.

The former strongman was stable and conscious, he said, adding that he was admitted "because we are concerned."

His feet and other parts of his body were also experiencing some swelling, said Dr. Joko Raharjo, a member of Suharto's medical team at the hospital.

Suharto lives a secluded life in a mansion on a leafy lane in Jakarta and is rarely seen in public. During recent Islamic holidays, he received a stream of high-profile guests and gave a rare media interview in November after winning a defamation lawsuit against Time magazine.

Two years after his ouster, Suharto was indicted for allegedly embezzling $600 million, but legal proceedings were suspended due to his poor health.

Source:ap.google.com

A new way to boost red blood cell numbers

2008-01-12T05:06:00.000-08:00

A common treatment for anemia — a deficiency in red blood cells (rbcs) caused by their insufficient production, excessive destruction, or excessive loss — is administration of recombinant erythropoietin (Epo), a hormone that stimulates the production of rbc precursors by the bone marrow. Unfortunately, many patients with anemia do not respond to treatment with Epo. However, a new study in mice, by Anne Angelillo-Scherrer and her colleagues at the University Hospital Center and University of Lausanne, Switzerland, has indicated that the protein Gas6 might augment or replace Epo in the treatment of patients who are hyporesponsive or resistant to Epo, respectively.

It was shown that following treatment with Epo, mouse rbc precursors released Gas6, which increased cell signaling in response to Epo treatment. In addition, mice deficient in Gas6 had decreased sensitivity to Epo and a reduced ability to recover from anemia. Administration of Gas6, either alone or in combination with Epo, was successful at treating both chronic and acute anemia in mice. The authors therefore concluded that Gas6 has a role in rbc formation and might have valuable therapeutic potential for the treatment of individuals with anemia who fail to respond to treatment with Epo.

Source:www.eurekalert.org

Amgen CEO Says '07 Profits Beat Forecast

2008-01-12T05:05:00.000-08:00

Biotech company Amgen Inc. predicted Tuesday that its cost-cutting would push its 2007 profits higher than it forecast in October.

Amgen, the world's largest biotech company, now expects 2007 earnings near $4.30 per share, Amgen chief executive Kevin Sharer said in a presentation at this year's JP Morgan Healthcare Conference in San Francisco.

Last January, before the U.S. Food and Drug Administration raised concerns about side effects of some anemia drugs, Amgen had forecast 2007 earnings between $4.30 per share and $4.50 per share.

In October, after sales fell in response to an FDA warning, Amgen predicted 2007 earnings per share between $4.13 and $4.23.

Analysts surveyed by Thomson Financial forecast, on average, an annual profit of $4.24 per share, excluding some one-time expenses.

Amgen shares jumped 94 cents, or 2.1 percent, to $46.33 Tuesday. The stock has fallen from its 52-week high of $76.95, reached last January.

The company's stock price fell as the FDA's concerns about drugs intended to treat anemia by stimulating production of red blood cells, as Amgen's Aranesp and Epogen do, cut into sales. The drugs are used to treat the blood disorder when it is caused by kidney-failure or chemotherapy.

In August, Amgen said it would cut between 12 percent and 14 percent of its work force because of the downturn.

The FDA issued a "black box" warning, its most serious, on erythropoiesis-stimulating agents, include Aranesp and Epogen, after research suggested high doses increased patients' risk of tumors and death.

The Centers for Medicare and Medicaid Services changed the reimbursement policy for Aranesp and drugs in the same class so doctors would be paid only for prescribing a low dose of the drugs.

Amgen could see its sales take a hit in 2008 if private insurers follow suit, according to some industry analysts.

Still, "the changes in Medicare reimbursement have not, to date, had an adverse effect on key drivers of Amgen sales, such as Aranesp," biotech analyst Jim Reddoch of Friedman, Billings, Ramsey & Co., Inc. wrote in a research note released Tuesday.

Sharer also said Amgen is on track to deliver cost savings in 2008 as a result of the restructuring and expects research and development costs to decline slightly as a percentage of sales.

Source:ap.google.com

Physicians say the well-nourished rank-and-file don't need extra Vitamin B12, but that hasn't dulled its luster among those who say it boosts energy

2008-01-12T05:01:00.000-08:00

New York Yankees pitcher Roger Clemens is feeling the heat. A former trainer has said he injected the seven-time Cy Young winner with steroids and human growth hormone, but Clemens says the only injections he received were of vitamin B12 and lidocaine, an analgesic. Lidocaine is sometimes injected into joints to dull joint pain -- a potential problem for an aging athlete -- but B12 injections are more commonly used to treat pernicious anemia and address diet deficiencies in the elderly. Physicians generally believe that the well-nourished rank-and-file don't need it, but the vitamin hasn't lost its luster among those who say it boosts energy.

Vitamin B12 is an essential vitamin found primarily in animal foods. The body uses it in the formation of DNA and red blood cells, and it's necessary for the healthy functioning of the nervous system. For people who are deficient or at risk of deficiency, injections can be helpful. For a well-nourished pitcher hoping to improve his fastball, not so much.

"Some athletes believe that vitamin B12 injections will increase oxygen [supply to the muscles] and that that enhances performance," says Andrea Giancoli, a spokeswoman for the American Dietetic Assn. and consultant for the L.A. Unified School District on nutrition and policy. "But in the absence of a vitamin B12 deficiency, the studies don't support that."

Aside from a 1989 report in the International Journal for Vitamin and Nutrition Research, which found that a combination of B1 (thiamin), B6 (pyridoxine) and B12 (cyanocobalamin) improved fine motor skill in target shooting, the evidence is scant, writes Thomas Brenna, professor of human nutrition at Cornell University, in an e-mail.

And B12 injections are not going to give the average person an energy boost, says Dr. David Baron, chief of staff at Santa Monica-UCLA Medical Center and Orthopaedic Hospital.

"For my entire career, I have encountered patients who have requested B12 shots, and I've been explaining to them that they serve no useful purpose," Baron says. "Honestly, this is an argument that's been going on between Western scientific physicians and complementary and alternative healthcare providers for many, many years."

Some weight-loss programs even recommend B12 injections, says James Hill, director of the human nutrition center at the University of Colorado. "But there's no indication that they're doing any good," he says.

In fact, when the body is drenched with B12, the kidneys will filter out whatever isn't needed, says Dr. Michael Karp, an internist and assistant professor of clinical medicine at USC School of Medicine. The upside is that too much B12 probably won't hurt you, he says.

The basis for the belief that vitamin B12 shots can provide energy goes back decades, Baron says. "Before we knew how to manufacture B12 in an injectable form, people who were deficient for various reasons were quite ill," he says. Once physicians began giving B12 shots to this population, "people who were horribly chronically anemic from B12 deficiency just basically came to life," he says. "It was a miracle."

The average person needs 2.4 micrograms of B12 per day, and most people get sufficient amounts in their food, particularly given how many foods -- such as cereals, nondairy milk, meat substitutes and protein bars -- are now fortified with B12, Giancoli says.

Vitamin B12 has a somewhat tangled path to absorption. The vitamin needs an acidic environment in the stomach in order to be released from food. It then binds with a glyco-protein compound called intrinsic factor, which allows it to be absorbed through the small intestine. If the stomach doesn't have a sufficient hydrochloric acid or lacks intrinsic factor, absorption will be limited.

To be sure, a deficiency of B12 can have serious consequences -- including pernicious anemia and nerve damage. "The nerve damage can start with memory problems, declined cognitive function, tingling in the extremities and can progress," Giancoli says. "And the neurological changes may not be apparent in everyone. There may be very general symptoms, like fatigue, weakness, weight loss, constipation, loss of appetite."

People most at risk for B12 deficiency are patients with certain types of gastrointestinal disorders (such as Crohn's disease), vegans and the elderly. The elderly are at risk for a number of reasons, says Dr. Marie Bernard, a spokeswoman for the American Geriatrics Society.

"As you get older, you're more likely to have accumulated medical problems that might prevent you from absorbing B12 optimally," Bernard says. Those events would include surgery to remove part of the intestine, and use of certain medications, such as acid-suppressing drugs.

As for that other segment clamoring for injections -- the worried well who believe the shots boost energy -- B12 may also have a benefit of sorts: a nice little placebo effect.

"Quite frankly," Karp says, "I'll sometimes get a new patient who says that they're getting a monthly vitamin B12 injection and that it makes them feel better, so I'll continue to give it to them. If it makes them feel better, that's still something."

Source:www.latimes.com

Fresh concerns about Amgen's anemia drugs

2008-01-12T04:58:00.000-08:00

Anemia drugs sold by Amgen Inc. took another hit Thursday when government regulators said two new studies indicated that the drugs may increase the risk of death in some patients.

Based on the studies, the Food and Drug Administration may further restrict the use of the drugs, which already carry the agency's strictest "black box" warning.

"This new information further underscores the safety concerns," said Janet Woodcock, acting director of the FDA's Center for Drug Evaluation and Research. She said the agency "is reviewing these data and may take additional action."

In recent years, six studies have found that the drugs -- all manufactured by Amgen and marketed by Amgen as Aranesp and Epogen and by Johnson & Johnson as Procrit -- can lead to an increased risk of heart attack, stroke, heart failure and cancer tumor growth in some patients.

Amgen, based in Thousand Oaks, until recently enjoyed an unusually charmed life in the often treacherous biotech industry, with profit and a market value higher than many top-shelf pharmaceutical companies. A large share of the company's fortunes came from Aranesp and Epogen, which accounted for more than half of its net income.

Since the summer, Amgen's stock has fallen to a five-year low and has lost $17 billion in value. The company laid off 14% of its employees late last year.

Known as erythropoietin-stimulating agents or ESAs, the anemia drugs are bioengineered versions of a natural protein made in the kidney that stimulates bone marrow to produce more red blood cells. Cancer and dialysis patients use injectable ESAs to treat anemia and boost energy.

Fallout from the earlier studies' findings rankled patients and regulators. The FDA added the black box warning last year and the federal Medicare agency followed with limits on what dosages of anemia drugs it would reimburse, severely affecting the company's sales.

The results of the two most recent research studies appear to reinforce concern that some cancer patients die sooner when taking the drugs than those who don't.

The first involved 733 women who received chemotherapy before undergoing surgery for breast cancer. After three years, 14% of the patients who received Aranesp to treat their anemia had died, compared with 9.8% who didn't receive the drug. Tumors also grew faster in patients receiving Aranesp.

Amgen informed FDA officials about the findings in late November and regulators have been reviewing the data since.

A separate trial by the National Cancer Institute's Gynecologic Oncology Group, the results of which Amgen disclosed to federal regulators in December, reviewed patients receiving chemotherapy and radiation for advanced cervical cancer. The patients were administered either Procrit or blood transfusions as needed. After three years, 66% of patients who did not take Procrit were alive and free of cancer growth, compared with 58% given the drug.

The FDA previously said it would hold a meeting early this year to look at the safety of the drugs in cancer patients, but a date has not yet been set.

Roger M. Perlmutter, executive vice president of research and development at Amgen, said in a statement in December that "as new information, including additional study results, becomes available, Amgen will communicate the data and, where appropriate, work with the FDA to update our product labels."

Wall Street appeared to take Thursday's news in stride, perhaps because many of the risks facing the company had already been priced into the stock. Shares of Amgen fell 91 cents, or 2%, to $45.69.

Joel Sendek, senior biotechnology analyst at Lazard Capital Markets, said in a note to clients that "we continue to forecast revenue decline in 2008 and limited [stock price] growth to 2010."

Source:www.latimes.com

FDA Reports New Risks Posed by Anemia Drugs

2008-01-12T04:57:00.000-08:00

Two new studies offer further evidence of the health risks posed by the anemia drugs known as erythropoiesis-stimulating agents (ESAs), U.S. officials announced Thursday.The studies showed that patients with breast or advanced cervical cancer who took the drugs as treatment for chemotherapy-induced anemia died sooner or had more rapid tumor growth than patients not on the drugs, U.S. Food and Drug Administration officials said in a prepared statement.

On Nov. 8, the FDA approved new "black box" warnings on labels of the three ESAs -- Aranesp, Epogen and Procrit. The warnings detailed the dangers to patients with cancer and patients with chronic kidney failure. Those dangers include heart attack, stroke, heart failure and cancer tumor growth and shortened survival, the FDA said.

The drugs had been touted as a treatment to lessen fatigue and improve quality of life among cancer, HIV and other patients with anemia, but the revised label said there was no evidence to back that claim. The label change was the fifth such change since Procrit was approved in 1989, FDA officials said.

Results of the two studies released Thursday were not among the six studies that led to the Nov. 8 label revision. Taken together, all eight studies show more rapid tumor growth or shortened survival when patients with breast, non-small cell lung, head and neck, lymphoid or cervical cancers received ESAs compared to patients who didn't get this therapy, the FDA said.

The FDA said it plans to discuss the new findings and re-examine the risks and benefits of ESAs for patients with chemotherapy-induced anemia at a public advisory committee meeting in the next few months.

"This new information further underscores the safety concerns regarding the use of ESAs in patients with cancer, which FDA addressed in previous communications," Dr. Janet Woodcock, the FDA's deputy commissioner for scientific and medical programs, chief medical officer, and acting director of the Center for Drug Evaluation and Research, said in the statement.

"FDA is reviewing these data and may take additional action. In the meantime, FDA recommends that health care providers review the risks and benefits of ESAs outlined in the product label and discuss this information with their patients."

According to the FDA statement:

* On Nov. 30, Amgen Inc., manufacturer of the three ESAs -- Aranesp, Epogen, and Procrit -- provided the FDA with information from the 733-patient PREPARE study of women who received chemotherapy before undergoing surgery for breast cancer. After three years, 14 percent of the patients who received Aranesp to treat their anemia had died, compared to 9.8 percent who did not get the drug. Tumor growth was also faster in patients receiving Aranesp.
* On Dec. 4, Amgen informed the FDA of the results of a study by the National Cancer Institute's Gynecologic Oncology Group of patients receiving chemotherapy and radiation for advanced cervical cancer. The patients were given either Procrit to maintain hemoglobin levels above 12 grams per deciliter of blood or blood transfusions as needed. After three years, 66 percent of the patients who did not take Procrit were alive and free of cancer growth, compared to 58 percent who had received the drug.

In announcing the label revision in November, Dr. John Jenkins, director of the FDA's Office of New Drugs, said, "We are emphasizing that ESAs should be used at the lowest dose necessary to avoid blood transfusions, since that is the only identifiable benefit for ESAs. Doctors should have discussions with their patients about whether to use ESAs at all."

The three drugs are synthetic versions of a protein made in the kidney that tells bone marrow to produce red blood cells. The drugs are manufactured by Amgen, of Thousand Oaks, Calif. Procrit is marketed and distributed by Ortho Biotech LP of Bridgewater, N.J., a subsidiary of Johnson & Johnson.

For cancer patients, November's revised warnings emphasized that the drugs can cause tumor growth and reduce survival among patients with advanced breast, head and neck, lymphoid and non-small cell lung tumors. This is especially true when the dose is designed to produce a hemoglobin level of 12 grams per deciliter of blood or more.

For hemoglobin levels less than 12 grams per deciliter, the label says there's no evidence to determine if the drugs cause any of these problems, the FDA said.

The revised label also made it clear that ESAs should be used in cancer patients only when their anemia is caused by chemotherapy and not from other causes. Also, ESAs should be stopped when the patient's chemotherapy has ended, the FDA said.

Source:health.usnews.com

Former Indonesian dictator is placed on a ventilator

2008-01-12T04:56:00.000-08:00

Doctors placed Indonesia’s ailing former dictator Suharto on a ventilator yesterday in their struggle to save the life of the man who led a government accused of killing hundreds of thousands of people.

Suharto, 86, who was deposed amid mass protests and rioting in 1998, was taken to the hospital a week ago, suffering from a weakening heart and anemia.

Doctors said that his health had deteriorated yesterday as his blood pressure and hemoglobin levels dropped

Source:www.journalnow.com

Rapper's jail sentence put on hold as he deals with reported complications from sickle cell.

2008-01-12T04:54:00.000-08:00

Rapper Prodigy, one half of the duo Mobb Deep, was rushed to the hospital Monday night (Jan. 7) from what sources say were complications from sickle cell anemia, reports Allhiphop.com.

The 33-year-old performer was scheduled to begin his three and a half year prison term the following day, but he was granted a 30-day stay due to the emergency room visit, the Web site reports.

Prodigy, born Albert Johnson, was arrested in New York in October 2006 along with his producer The Alchemist after police caught him driving the wrong way down a one way street. Upon searching his SUV, they found a .22 caliber handgun hidden in a console.

Source:www.eurweb.com

Women with Postpartum Anemia

2008-01-12T04:52:00.000-08:00

As we head into 2008 it’s time to get your health in check. If you are low on energy or feel overly tired or weak—you could be suffering from iron deficiency anemia—especially if you are a new mom.

As many as one in five women will suffer from excessive blood loss during their reproductive years. This causes a condition called anemia, which can have debilitating physical and emotional effects. Of the approximately 4 million women who give birth each year, about 2 million become iron deficient, and more than 1 million will suffer from postpartum anemia

“Postpartum anemia not only affects maternal mood, thinking and behavior – but can also have adverse effects on the baby and has been shown to cause developmental delay, said Dr. Mary Jane Minkin, clinical professor of Obstetrics and Gynecology in the Department of Obstetrics and Gynecology at Yale University School of Medicine and author of A Women’s Guide to Sexual Health.

Infants of mothers who are anemic at 10 weeks postpartum have been shown to experience developmental delay; moreover, these early deficits in infants may not be reversible by subsequent successful treatment of the mother’s anemia.

Despite the high prevalence, iron deficiency anemia tends to go unrecognized and under-diagnosed because many women assume that it’s normal to feel tired, weak or irritable, particularly when you have a new baby. Women with postpartum anemia need more blood transfusions, longer hospital stays and more emergency department visits. Studies to date indicate current methods for quantifying blood loss during delivery often under-estimate the severity of blood loss in conditions associated with pregnancy and postpartum-related bleeding, such as postpartum hemorrhage. For these reasons, many women are at risk for developing postpartum anemia (sounds like something is missing here?) may not be adequately screened prior to discharge or during the postpartum period.

“The good news is that anemia is treatable once it is diagnosed,” said Dr. Minkin.

According to the Centers for Disease Control and Prevention, multiple births are on the rise so it’s even more important for women to get checked out. This is especially true for African-American and Hispanic women, who are at a greater risk for postpartum anemia.

Source:www.healthnewsdigest.com

Further Review of Anemia Drugs by the FDA

2008-01-12T04:47:00.000-08:00

The United States Food and Drug Administration (FDA) has announced that it is reviewing new data regarding erythropoiesis-stimulating agents (ESAs). ESAs are drugs used to treat anemia. They include Procrit® (epoetin alfa), Epogen® (epoetin alfa), and Aranesp® (darbepoetin alfa).

Anemia is a common side effect of chemotherapy and cancer. It is characterized by low levels of circulating red blood cells, which are responsible for delivering oxygen to tissues throughout the body. Severe anemia often requires treatment with blood transfusions.

ESAs stimulate the body to produce more red blood cells. Use of ESAs to treat anemia caused by chemotherapy has been shown to decrease the need for blood transfusions.

ESAs are approved for the treatment of anemia in chronic kidney failure patients, in patients with cancer whose anemia is caused by chemotherapy, in patients with HIV whose anemia is caused by AZT (zidovudine), and to reduce the number of transfusions during and after major surgery (except heart surgery).

Serious adverse effects of ESAs have been reported in certain groups of patients, particularly patients who have used ESAs for indications other than for which they are approved. The FDA has recently received additional data from two clinical studies that add to a list of concerns regarding use of ESAs.

The two studies that the FDA is now reviewing include data from the PREPARE study. The first study included 733 patients with breast cancer who were treated with chemotherapy prior to undergoing surgery. A portion of patients received Aranesp, while others did not. At three years 14% of patients who had been treated with Aranesp had died compared with approximately 10% who had not received Aranesp.

The second study includes data conducted by the National Cancer Institute’s Gynecologic Oncology Group and includes patients who were being treated with chemotherapy and radiation therapy for advanced cervical cancer. Patients received either Procrit or blood transfusions for anemia. At three years 66% of patients who had not received Procrit were alive compared with 58% of patients who had not received Procrit. this does not make sense?

It is not clear whether the ESAs were actually associated with the reduction in survival in these patients.

The FDA states that they are currently “reviewing these data and may take additional action. In the meantime, FDA recommends that health care providers review the risks and benefits of ESAs outlined in the product label and discuss this information with their patients.”

Patients who are undergoing chemotherapy may wish to speak with their healthcare provider regarding their individual risks and benefits of treatment with ESAs.

Source:professional.cancerconsultants.com

Cancer diagnosis? Advice for dealing with what comes next

2007-08-01T08:42:00.000-07:00

A Mayo Clinic cancer specialist explains what to expect after your cancer diagnosis.
Photo of Edward T. Creagan, M.D.Edward T. Creagan, M.D.

About half of all men and a third of all women in the United States will receive a cancer diagnosis during their lifetimes. A cancer diagnosis often comes with little warning. Here, Edward Creagan, M.D., a cancer specialist at Mayo Clinic, Rochester, Minn., offers his advice on what to expect and how to cope after a cancer diagnosis.
What advice would you give someone who has just received a cancer diagnosis?

I would tell him or her to:

* Know the details of the cancer diagnosis. First, find out the name of the cancer, its size and location, where it started and if it has spread. Learn whether it's viewed as a slow-growing cancer or an aggressive one. Ask about the available treatment options, the success rate of each treatment and what side effects to expect from each. Without that information, you can't get an accurate understanding of the problem and what to expect from the treatment.
* Bring someone with you. Second, recognize that this is a time of personal crisis, and your ability to retain any meaningful information may be practically zero. So bring someone with you — preferably someone who is reliable and knows how to be your advocate. Choose someone you like. It can be helpful to have someone with you to help unscramble the messages.

When should you consult a specialist in cancer diagnosis and treatment (oncologist)?

This depends on the type of cancer, its stage and the treatment options that are available. Many different types of cancer exist and not all require an oncologist. For example, some cancers, such as basal cell skin cancers, can be surgically removed and have virtually no probability of recurring. Other cancers, such as certain thyroid tumors, are better treated by thyroid specialists, as these doctors treat those types of cancers much more often than oncologists do. For the vast majority of cancers, it's always a good idea to at least consult an oncologist to get his or her opinion. Discuss with your doctor who is the best specialist for your type of cancer.
Is it a good idea to seek a second opinion after a cancer diagnosis?

It's always reasonable to seek a second opinion from an oncologist. You may wish to see someone at a center that specializes in cancer care, such as one of the National Cancer Institute-designated cancer centers around the country. Typically these centers are part of a university or large medical center. While second opinions are very reasonable, don't waste time by going to six or seven different cancer centers to see multiple doctors who may tell you the same thing. If the two opinions are similar, it's very likely that all other cancer specialists will tell you the same thing.
What qualities should you look for in a doctor?

Look for a doctor who:

* Listens. It's important to find a doctor who will listen to your concerns. It will be easier for you to ask this doctor questions.
* Explains. You want a doctor who can use plain language to explain what you have, what the treatment options are and what your prognosis is in terms you can understand.
* Understands. You want that elusive quality of chemistry between you and your doctor — a doctor who understands you. If it isn't there, find someone else. He or she may have all of the credentials, but if the chemistry between you and the doctor isn't positive, you might do well to switch.

Make the relationship with your doctor a working partnership. The best treatment relationship is a proactive, participatory one.
What should you consider when discussing treatment options?

When discussing treatment options with your doctor, understand that:

* Treatment is evolving. Traditionally, surgery has been the mainstay of treatment for most cancers. Know that there has been a movement toward less extensive operations to treat cancer. For example, a generation ago, women with breast cancer were treated with radical mastectomy. Today, in many cases the breast is preserved by removing only the cancerous lump and a safety margin around the cancer, and following this with radiation therapy and sometimes chemotherapy and hormone treatments. This approach is as effective as more extensive operations.
* Treatment options vary. Learn about your disease and the approaches commonly used to treat it. Some cancers respond better to radiation, others to chemotherapy or hormonal treatments. Some require one type of therapy, others a combination. At times, simple observation rather than treatment is enough. Some cancers present few if any symptoms and cause few problems and little to no pain. They may even remain inactive for long periods of time. Treatment in those cases usually doesn't enhance your quality of life. Other cancers are aggressive and will likely cause major problems. Treatment in those cases may be warranted. Ask what would happen without any treatment, and compare the answer with the expected results of treatment.
* Treatments have side effects. Understand what side effects to expect and what benefits the treatment offers. Then weigh your willingness to tolerate the side effects to reap the benefits. The goals of therapy can vary, and only you can decide what side effects you're willing to accept to achieve your goal. For example, if you're a young person with a curable disease, you may be willing to tolerate very severe, short-term side effects for a chance at eliminating your disease. But if you're 85 years old and have an incurable disease, you may decide not to accept a bad side effect if the goal is only to live an additional month or two.

Ask your doctor what the treatment will accomplish. For example, the doctor's statement that treatment will increase survival by 50 percent sounds great. But if 50 percent means increasing life from eight weeks to 12 weeks, and those remaining weeks are spent vomiting and battling nausea, weakness and fatigue, maybe you haven't gained much.

Source:www.mayoclinic.com

Noven to Receive $25 Million Daytrana(TM) Sales Milestone

2007-08-01T08:38:00.000-07:00

Noven Pharmaceuticals, Inc. (NASDAQ:NOVN) today announced that it has been advised by Shire plc that Shire's net sales of Daytrana(TM) (methylphenidate transdermal system) have triggered the second of three potential $25 million milestone payments to Noven.

Daytrana(TM), licensed globally to Shire, was launched in June 2006. Payment of the first milestone was triggered upon Shire's net sales of Daytrana(TM) exceeding $25 million in 2006. Payment of the milestone announced today was triggered upon Shire's net sales of Daytrana(TM) exceeding $50 million in the 12-months preceding June 30, 2007.

Under the Daytrana(TM) transaction agreement, a third $25 million milestone is payable upon Shire's achievement of $75 million in annual net sales of Daytrana(TM). For purposes of the sales milestones, Shire's annual net sales are measured quarterly on a trailing 12-month basis. From an accounting standpoint, Noven expects to defer the sales milestones and recognize them as license revenues over time.

About Daytrana(TM)

Daytrana(TM) is a methylphenidate transdermal system for the treatment of ADHD and is currently the only transdermal product approved for ADHD therapy. It is approved for children aged six to twelve years with ADHD.

Daytrana(TM) should not be used in patients with allergy to methylphenidate or patch components; marked anxiety, tension and agitation; glaucoma; tics, diagnosis or a family history of Tourette's syndrome; seizures; or during or within 14 days after treatment with monoamine oxidase inhibitors (MAOIs). Sudden death has been reported in association with CNS stimulant treatment at usual doses in children and adolescents with structural cardiac abnormalities or other serious heart problems.

Sudden deaths, stroke, and myocardial infarction have been reported in adults taking stimulant drugs at usual doses in ADHD. Physicians should take a careful patient history, including family history, and physical exam, to assess the presence of cardiac disease. Patients who report symptoms of cardiac disease such as exertional chest pain and unexplained syncope should be promptly evaluated. Use with caution in patients whose underlying medical condition might be affected by increases in blood pressure or heart rate.

New psychosis, mania, aggression, growth suppression, and visual disturbances have been associated with the use of stimulants. Use with caution in patients with a history of: psychosis; EEG abnormalities; bipolar disorder; depression. Growth and hematologic monitoring is advised during prolonged treatment. Patients should avoid applying external heat to the Daytrana(TM) patch. Skin irritation or contact sensitization may occur.

Daytrana(TM) should be given cautiously to patients with a history of drug dependence and alcoholism. Chronic abuse can lead to marked tolerance and psychological dependence. Frank psychotic episodes can occur, especially with parenteral abuse. Careful supervision is required during withdrawal from abusive use, since severe depression may occur. Withdrawal following chronic therapeutic use may unmask symptoms of the underlying disorder.

Common adverse events reported by patients who received Daytrana(TM) in clinical trials were decreased appetite, insomnia, nausea, vomiting, decreased weight, tics, affect lability, and anorexia, consistent with adverse events commonly associated with the use of methylphenidate.

For Full Prescribing Information, go to www.daytrana.com.

About Noven

Noven Pharmaceuticals, Inc., headquartered in Miami, Florida, is a leading developer of advanced transdermal drug delivery technologies and prescription transdermal products. Noven's prescription patches are approved in over 30 countries and include Vivelle-Dot(TM) (the most prescribed estrogen patch in the U.S.) and Daytrana(TM) (the first and only patch approved for ADHD). Noven is committed to expanding the universe of available transdermal therapies for the benefit of patients, partners and shareholders. See www.noven.com for additional information. Daytrana(TM) and DOT Matrix(TM) are trademarks of Shire Pharmaceuticals Ireland Limited and Noven, respectively.

Except for historical information contained herein, the matters discussed in this press release contain forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934 that involve substantial risks and uncertainties. When used in this press release, the word "expect" and similar expressions identify certain of such forward-looking statements. Actual results, performance or achievements could differ materially from those contemplated, expressed or implied by the forward-looking statements contained herein. These forward-looking statements are based largely on the current expectations of Noven and are subject to a number of risks and uncertainties that are subject to change based on factors which are, in many instances, beyond Noven's control. These risks and uncertainties include: the risk that past Daytrana(TM) results may not be indicative of future Daytrana(TM) results; the risk that the market for Daytrana as well as future sales of Daytrana(TM) could be adversely affected by a number of factors, including as a result of: (i) supply interruptions of methylphenidate, (ii) delays or inability to obtain necessary DEA methylphenidate procurement quota, (iii) issues relating to difficulties in removing the release liner from the Daytrana(TM) patch, (iv) the resolution of the observations made by the FDA in the Form 483 that Noven received in July 2007, and (v) new market entrants, including from other ADHD products marketed or under development by Shire; the risk that any adverse effect to the market for Daytrana(TM) due the foregoing or other factors could adversely affect Noven's results of operations and/or its financial position, including limiting Noven's ability to achieve the additional milestone payments under its agreement with Shire. For additional information regarding these and other risks associated with Noven's business, readers should refer to Noven's Annual Report on Form 10-K for the year ended December 31, 2006 as well as other reports filed from time to time by Noven with the Securities and Exchange Commission.

Source:www.genengnews.com

Multidimensional Approach Recommended for Fibromyalgia Treatment

2007-08-01T08:35:00.000-07:00

Management of fibromyalgia requires a multidimensional approach including patient education, cognitive behavioral therapy, exercise, and other treatment, according to a review published in the July 15 issue of American Family Physician.

"Fibromyalgia is an idiopathic, chronic, nonarticular pain syndrome with generalized tender points," write Sangita Chakrabarty, MD, MSPH, and Roger Zoorob, MD, MPH, from Meharry Medical College in Nashville, Tennessee. "It is a multisystem disease characterized by sleep disturbance, fatigue, headache, morning stiffness, paresthesias, and anxiety. Nearly 2 percent of the general population in the United States suffers from fibromyalgia, with females of middle age being at increased risk."

Criteria for diagnosis of fibromyalgia are those issued by the American College of Rheumatology (ACR) in 1990. These include widespread pain with a minimum duration of 3 months and the presence of 11 or more tender points at 18 specific anatomic sites.

Conditions that should be considered in the differential diagnosis of fibromyalgia include myofascial pain syndrome, chronic fatigue syndrome, and hypothyroidism. Furthermore, these conditions may also be present in patients with fibromyalgia, which renders the diagnosis more difficult.

In recent years, recognition, understanding, and diagnosis of fibromyalgia have improved. Despite the absence of well-established treatment recommendations, the authors suggest that a multidimensional approach can be effective.

Specific treatment recommendations are as follows:

* Suggested treatment modalities include patient education, cognitive behavior therapy, exercise, physical therapy, and pharmacotherapy (level of recommendation, A, based on 5 randomized controlled trials).

* Antidepressant medications may alleviate pain and improve sleep quality and global well-being in patients with fibromyalgia (level of recommendation, B, based on few randomized controlled trials).

* Cyclobenzaprine, 10 to 30 mg at bedtime, may decrease pain and improve sleep quality in patients with fibromyalgia (level of recommendation, A, based on systematic review of randomized controlled trials).

* Aerobic exercise training may ameliorate fibromyalgia symptoms (level of recommendation, A, based on systematic review of randomized controlled trials).

Fibromyalgia treatments for which there is strong evidence of effectiveness include amitriptyline, 25 to 50 mg at bedtime; cyclobenzaprine, 10 to 30 mg at bedtime; cardiovascular aerobic conditioning exercise; cognitive behavioral therapy; multidisciplinary therapy as discussed earlier; and patient education, which may take place in a group format using lectures, written materials, and demonstrations.

Fibromyalgia treatments for which there is moderate evidence of effectiveness include the dual-reuptake inhibitors duloxetine, venlafaxine, and fluoxetine, at doses of 20 to 80 mg at bedtime, either alone or in combination with a tricyclic antidepressant. Other pharmacotherapies backed by moderate evidence of effectiveness include pregabalin and tramadol, 200 to 300 mg daily, either alone or in combination with acetaminophen.

Nonpharmacologic therapies with moderate evidence of effectiveness in fibromyalgia are acupuncture, balneotherapy, biofeedback, hypnotherapy, and strength training.

Evidence to support the use of chiropractic therapy, electrotherapy, manual and massage therapy, or ultrasonography in patients with fibromyalgia is weak. Evidence to justify the use of corticosteroids, melatonin, nonsteroidal anti-inflammatory drugs, opioids, thyroid hormone, flexibility exercises, and injections of tender or trigger points is altogether lacking.

"The effectiveness of acupuncture and biofeedback has been supported by some studies," the authors conclude. "Serum levels of substance P and serotonin were significantly elevated after acupuncture treatment, suggesting possible mechanisms in pain relief. Although their effectiveness has not been proven by controlled trials, other treatment modalities employed include chiropractic therapy, yoga, tai chi, massage therapy, magnetic therapy, and tender-point injections."

The authors have disclosed no relevant financial relationships.

In an accompanying editorial, Christine N. Huynh, MD, from Virginia Commonwealth University School of Medicine in Richmond, and colleagues note that clinicians have often felt frustrated when faced with a patient with fibromyalgia because of the dearth of evidence and consensus.

However, this review, an earlier systematic review in 2004 of treatment options, and the 2005 consensus guidelines from the American Pain Society assist in the definition and management of fibromyalgia. The 1990 ACR diagnostic criteria are also clinically useful, with the caveat that fibromyalgia can be diagnosed even if the ACR's tender point criteria are not met, provided the history is highly suggestive.

"Now that there is an evidence- and consensus-based practical approach to the diagnosis and management of fibromyalgia, a higher quality of care can be provided to patients with this syndrome," Dr. Huynh and colleagues write. "Screening for disorders that may initiate or exacerbate symptoms of fibromyalgia is critical. If comorbid disorders are not identified early and treated appropriately, therapies that target fibromyalgia only as a primary disorder may be ineffective."

The editorial also highlights the controversy regarding the usefulness of opioids in fibromyalgia management, as well as the paucity of evidence supporting their use and the potential for opioid-induced hyperalgesia.

"As with any chronic pain syndrome, patients should be carefully selected for opioid therapy, and a plan should be in place for appropriate follow-up and monitoring for pain reduction, outcome improvement, side effects, and misuse," Dr. Huynh and colleagues conclude. "Physician awareness of effective nonpharmacologic and pharmacologic therapies can minimize ineffective prescribing and patient frustration associated with failure of therapy. As growing evidence from well-designed studies becomes available, physicians can confidently employ a practical and evidence-based approach to this once ill-defined syndrome."

Source:www.medscape.com

Meniere’s disease: Loud ringing in your ears, vertigo and nausea

2007-08-01T08:33:00.002-07:00

Faryal stood up to get a glass of water while watching television. In the very next moment, she fainted. Her husband and daughter woke her up. They told her that she had been unconscious for nearly ten seconds.

“Even after I had regained consciousness, I felt dizzy,” explains Faryal. “I had to lie down immediately. There was a loud ringing in my ears which only subsided a day later. My left ear also felt heavy.”

Faryal visited an E.N.T. specialist who told her that she might be suffering from Meniere’s disease. “The doctor said that he needed to carry out a hearing test to ascertain that I was suffering from Meniere’s syndrome,” recalls Faryal. “In the test, I was asked to distinguish between different words. The results indicated that my left ear was affected. The doctor gave me anti-vertigo medication and warned me to take it as soon as I suspected the onset of an attack. Three months later, my ears began to ring again and I immediately took the medicine so that I wouldn’t get dizzy.”

In layman’s terms, the Meniere’s disease or condition is caused by heaviness in the inner ear, explains Dr Mubashir Ikram, consultant otolaryngologist at the Aga Khan University and Hospital. “The pressure of liquid inside the inner ear increases and the patient feels it as ‘heaviness’ in his or her ear. We don’t know what causes this condition – anybody may fall victim to it.”

A patient of Meniere’s disease suffers through a number of symptoms. The patient experiences vertigo, which begins suddenly, rises to a peak and may cause vomiting, nausea, sweating or beating in the eyes from side to side. “The dizziness will slowly subside over a period that may be as short as 20 minutes or as long as two hours,” says Dr Ikram. “During this time, it is recommended for the patient to lie down and take some anti-vertigo medication. If patients experience excessive vomiting or nausea, then it sometimes becomes necessary to admit them to the hospital and give them fluids through a drip.”

Another symptom is that the patient will hear ringing in his or head, also known as tinnitus. During an attack, this ringing may become very loud and at other times, it may not be heard at all. In addition, the affected ear feels heavy or full. Lastly, there is episodic hearing loss. For some time, the patient may not be able to hear at all or not be able to hear clearly. Over time, and with frequent attacks, hearing loss may become more long lasting and hearing may not be recovered completely even after the attack subsides. In advanced stages, permanent hearing loss occurs.

Even if an individual experiences all these symptoms, it is not necessary that he or she has the Meniere’s syndrome. “A hearing test, called pure-tone audiometry, has to be carried out for complete diagnosis,” explains Dr Ikram. A clinical examination of the ear relays absolutely nothing since in the clinical examination, we can only see the eardrum and Meniere’s affects the inner ear only, which is not visible to us, he said.

Mansoor, a 35-year old businessman, fainted while he was working in his office. He underwent a hearing test and was told that he had the Meniere’s disease. Two weeks later, he had another bout of dizziness, accompanied by severe nausea, while he was at home. Since then, he has lived in perpetual fear of yet another attack. “I am afraid that I will get an attack while I am driving or alone in a room,” he admits. “I am completely helpless during an attack. My ears begin to ring loudly, my eyes throb and before I know it, I faint. My business requires me to travel overseas extensively. It has been five months since I was diagnosed with Meniere’s and so far, I haven’t been able to muster the courage to travel. I carry anti-vertigo medicines with me at all times and take them when I even slightly suspect the beginning of an attack.”

Sundus, a 40-year-old woman, has been a victim of Meniere’s for the past 10 years and has an attack at least once in every five months. “Aside from the physical discomforts of an attack, this syndrome is also highly traumatizing,” she says. “The stress of anticipating an attack at any time often makes me cranky, depressed and frustrated. My family life has suffered due to this disease.”

Yet another disadvantage of Meniere’s is that it can lead to permanent hearing loss. If this occurs, Dr Ikram recommends surgery. “In such cases, an operation is carried out which does away with the affected ear altogether. After the operation, the patient may suffer vertigo for a few months because he or she will be hearing from only one ear. With time, the body will adjust and the patient will be able to live normally again. However, if both the ears get affected by Meniere’s, and there is permanent hearing loss, the patient can do nothing except resort to hearing aids.”

Source:/www.dailytimes.com.pk

Cancer fatigue: Why it occurs and how to cope

2007-08-01T08:33:00.001-07:00

The exact causes of cancer fatigue and how best to treat it aren't known. Find out what doctors know about cancer fatigue and what you can do about it.

Fatigue, usually described as feeling tired, weak or exhausted, affects most people during cancer treatment. Cancer fatigue can result from the side effects of treatment or the cancer itself. For some people, cancer fatigue is mild and temporary. For others, cancer fatigue lasts months after treatment and makes going about daily activities impossible.
Causes of cancer fatigue

Cancer fatigue may be caused by many factors, and the factors that contribute to your cancer fatigue may be completely different from those of someone you know. However, possible contributing factors include:

* Your cancer. Your cancer itself can cause changes to your body that can lead to fatigue. For instance, some cancers release proteins called cytokines, which are thought to cause fatigue. Other cancers can increase your body's need for energy, weaken your muscles or alter your body's hormones, all of which may contribute to fatigue.
* Cancer treatment. Chemotherapy, radiation therapy, surgery, bone marrow transplantation and biological therapy may all cause fatigue. You may experience fatigue when chemotherapy or radiation therapy destroys healthy cells in addition to the targeted cancer cells. Fatigue may occur as your body tries to repair the damage to healthy cells and tissue. Some treatment side effects — such as anemia, nausea, vomiting, pain, insomnia and changes in mood — also may cause fatigue.
* Anemia. You might develop anemia if your treatment destroys too many healthy red blood cells. You can also develop anemia as a result of the cancer itself if the cancer has spread to your bone marrow and interferes with blood cell production or causes you to lose blood. Anemia may also result from unrelated medical conditions, such as thyroid problems.
* Pain. If you experience chronic pain, you may be less active, eat less, sleep less and become depressed, all of which may add to your fatigue.
* Emotions. Anxiety, stress or depression associated with your cancer diagnosis also may lead to fatigue.
* Lack of sleep. If you're sleeping less at night or your sleep is frequently interrupted, you may experience fatigue.
* Poor nutrition. In order to work efficiently, your body needs the energy that a healthy diet provides. When you have cancer, changes can occur in your body's need for and ability to process nutrients. These changes can lead to poor nutrition, resulting in fatigue. For example, your body may need more nutrients than usual or it may not be able to process nutrients adequately. You may also take in fewer nutrients if your appetite wanes or treatment side effects, such as nausea and vomiting, make it difficult to eat.
* Medications. Certain medications, such as pain relievers, can cause fatigue.
* Lack of exercise. If you're used to being on the go, slowing down can make you feel fatigued. Though you will have good days and bad days, try to maintain your normal level of activity if you can.
* Hormonal changes. Many hormonal changes can occur during cancer treatment. Hormonal therapies may alter hormones as a way to treat cancer. Hormonal changes may occur as side effects of treatments, such as surgery, radiation therapy or chemotherapy. Changes to the thyroid gland, adrenal glands, testes or ovaries can all cause fatigue.

Not everyone who has cancer experiences fatigue. And if you do, the level of cancer fatigue you experience can vary — you may feel a mild lack of energy, or you may feel completely wiped out. Your cancer fatigue may occur episodically and last just a short while, or it may last for several months after you complete treatment.

Source:www.mayoclinic.com

Partnering against cancer

2007-08-01T08:31:00.002-07:00

A $62.4 million “house of hope” for cancer patients opened in north Everett in June, though it’s officially known as the Providence Regional Cancer Partnership headquarters facility.

But for people suffering from the scourge of cancer, and enduring the emotional and physical stress of healing treatments, the new center is without doubt a fortress of hope in their war against this disease.Four leading, and usually competing, nonprofit and for-profit health-care providers in Snohomish County joined forces for the first time in a venture that leverages their individual skills and resources. The partnership makes their individual efforts not only more effective but also more helpful to patients and their families.

Credit for the 100,000-square-foot, world-class cancer center goes not only to Providence Everett Medical Center, The Everett Clinic, Western Washington Medical Group and Northwest Washington Radiation Oncology Associates but also to hundreds of people in the community who contributed nearly $5 million to the Providence General Foundation to support construction of the new building.

While each of the partners has been involved with cancer treatment for years, particularly Providence Everett Medical Center’s Flynn Cancer Center, a new facility for applying newer technology and improved processes for handling patients’ records and treatment needs has long been needed.

Health-care evolution for the county
“This opening marks a great day in the evolution of health care in Snohomish County,” said Dr. Elie Saikaly, medical director of the Providence Regional Cancer Partnership. “There has been a determined focus on recruiting the top cancer-care experts to this region — oncologists, surgeons and other health-care experts — to pool their expertise and experience for a new level of multi-disciplinary medicine. Add in world-class technology and all the patient-centered amenities this cancer partnership offers, and patients will get the most advanced care available, right here in Everett.”

Considering medical studies have found that two of every three men and one of every three women develop cancer in their lifetimes, the new center is decidedly a community asset that will provide increasing benefits for residents of Snohomish County and surrounding communities for decades to come.

“The whole facility is designed with the patient in mind,” said the center’s executive director, Jean McMahon, during a news media tour of the five-floor building. “Our main lobby and waiting rooms have been decorated with appropriate artwork — nothing with abstract work, which often has a negative effect on cancer patients — and we use wood and color furnishings that reflect a homelike setting.”

Source:www.heraldbusinessjournal.com

Tips for avoiding and treating mosquito bites

2007-08-01T08:31:00.001-07:00

* The hours from dusk to dawn are peak biting times for a number of mosquito species.
* To prevent bites, wear protective clothing when outdoors for a long period of time or when mosquitoes are active.
* Consider using repellent, but do not overspray, as excessive exposure poses health risks, especially in children.
* Most mosquitoes do not transmit disease. If West Nile virus is found in your area, those at highest risk for the disease -- adults 50 and over -- should take extra care to use repellent and protective clothing at peak mosquito times or consider avoiding outdoor activities then.
* Use hydrocortisone cream, calamine lotion or a baking soda paste to ease discomfort of an itchy bite.
* A cold pack or plastic bag filled with crushed ice may help.
* If a mosquito bite seems to be causing more serious signs and symptoms -- such as fever, severe headache, body aches, nausea, vomiting, swollen glands, a rash, lethargy, confusion or sensitivity to light -- contact your health care provider. These signs and symptoms may indicate West Nile fever or, rarely, encephalitis. Prompt diagnosis and treatment are important.

Source:www.newsday.com

Misfiring nervous system alters heartbeat fast

2007-08-01T08:29:00.000-07:00

After multiple tests and visits to neurologists for symptoms similar to multiple sclerosis, one doctor finally recognized in our daughter the characteristics of postural orthostatic tachycardia syndrome -- POTS. She now sees a doctor who specializes in this disorder. Many others have told her that they too have the illness but suffered terribly until they obtained the correct diagnosis. Please let readers know how important this is. -- P.R.

A: POTS -- postural orthostatic tachycardia syndrome -- is a relatively new addition to the catalog of illnesses. It's something that happens most often to younger people between the ages of 14 and 45. The syndrome takes its name from one of its signs: the speeding up of the heart (tachycardia) upon standing (orthostatic).

Other symptoms are dizziness and the feeling of being on the verge of fainting. People with the syndrome are tired all the time. They often suffer from nausea and stomach cramps.

The trouble is a misfiring in the autonomic nervous system. It's the part of the nervous system not under our willful control. It operates on automatic pilot and takes care of such things as heartbeat regulation, blood pressure adjustments and the rate of breathing. In POTS, something has gone wrong with the chemical messengers of that underground nervous system.

One diagnostic test is the tilt table test. The patient is strapped to a table that can be tipped 90 degrees vertically. When that is done, a person with POTS develops a very rapid heartbeat.

Medicines can often alleviate symptoms and permit a person to live a normal life. One is fludrocortisone. It keeps blood volume on the high side to prevent the symptoms of POTS. Beta-blocker medicines are also effective. Aerobic conditioning, when supervised by a person experienced in this condition, is another important aspect of treatment.

DEAR DR. DONOHUE: Can you guide me in the right direction regarding the Baker's cyst behind my knee? It is so very painful. My doctor drained it with a needle, but it filled up again. What kind of doctor takes care of this problem? -- T.M.

A: An orthopedic surgeon is the doctor who's a Baker's cyst expert.

A Baker's cyst is a behind-the-knee bursa that's filled with fluid. Bursas are flat discs that nature puts between tendons and bones to reduce friction as tendons rub against the bones. The one behind the knee has a connection with the knee. Fluid from the knee finds its way into that bursa and distends it. The actual trouble is usually in the knee itself, and elimination of the knee problem -- a torn cartilage, for example -- eliminates the Baker's cyst.

If a doctor drains the cyst and then injects a cortisone drug into the bursa, that can often prevent recurrence.

In resistant cases, and it sounds like yours is one, removal of the bursa takes care of the problem forever.

READERS: People with swollen ankles and feet can find answers to the problem in the booklet on edema and lymphedema. To obtain a copy, write: Dr. Donohue -- No. 106, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 with the recipient's printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I hope you can help me with a loved one. She never ventures outdoors except for a yearly doctor's appointment. She's retired and has no friends and no social life. All she does is eat, sleep and watch TV. Because I was once depressed, I wonder if she's suffering from depression. What do you think? -- R.S.

A: I think your friend has a serious psychological problem that's making her life miserable. Many such problems are due to a quirk in the production of brain-chemical messengers, and medicines can often correct the chemistry. Depression is one of those illnesses that often respond to drugs with this capability. She might also have agoraphobia, a fear of public places. It makes a person want to stay inside the house at all times. It, too, yields to talk treatment and medicines. Her doctor can recommend a specialist.

Source:www.timesfreepress.com

Meanwhile, neurologist engages in dizzying hobbies

2007-08-01T08:27:00.000-07:00

Whether it's flying at supersonic speeds in one of his refurbished Russian MiG jet fighters or climbing to the top of a towering mountain, the San Diego physician gets a rush from pushing his body to extremes in altitude and G-forces. But it's a different story when he's in his office at Senta Medical Clinic at Alvarado Hospital in the College Area.

Purcell is an otoneurologist, one of a handful of neurologists in the United States who specializes in finding the cause of people's vertigo and ending it.

At the center of his practice is an array of unusual machines – some that he built himself – that he uses to diagnose and treat all forms of dizziness, including extreme cases that can last for months or years and leave sufferers unable to drive, shop or even walk without assistance.

A large circular steel contraption that fills one of Purcell's examination rooms in Alvarado Hospital looks like one of those spinning gyroscope rides that can be found at shopping malls or amusement parks.

Profile | Ian Purcell

Career: Senta Medical Clinic, partner, 2004 to present.

Education: Bachelor of science degree from Southwestern University in Georgetown, Texas, 1985; doctorate in philosophy in neuroscience from University of Texas in Galveston, 1997; medical degree from University of Texas in Galveston, 2001; University of California San Diego, neurology resident, 2004.

Personal: 42; has a wife, Tracy, and two children.

Hobbies: Flying and restoring Russian fighter jets; mountain climbing; restoring antique Packard automobile
Another room houses a mechanical pulpit with a breakaway floor that sits under a mirrored disco ball. The device tests a patient's ability to maintain balance while being bombarded with sensory challenges, such as a shifting floor and floating spots on the walls and ceiling.

When patients visit the clinic for the first time, they're usually at the end of their ropes, Purcell said.

They've been to emergency rooms. They've consulted their family physicians and been referred to a host of other medical specialists. They've had their brains scanned for signs of hemorrhages or strokes. They've been checked for arterial blockages and viruses and screened for adverse reactions to medications.

Oftentimes, even the patient has trouble explaining what is wrong, Purcell said. “Describing vertigo is like describing air. Sometimes it's there. Sometimes it's not,” he said.

Purcell's partner in the clinic, Dr. Michael O'Leary, said that caring for a vertigo patient requires a broad-based, multi-specialty team approach.

“It's bigger than any one person,” said the head and neck surgeon, a retired Navy captain. “This diagnosis overwhelms a single doctor.”

When other diagnostic efforts come up short, the patient becomes a prime candidate for testing for benign paroxysmal positional vertigo, an inner ear condition that can be hard to pinpoint and equally difficult to treat.

BPPV occurs when tiny crystals made of calcium carbonate – a naturally occurring compound that helps make sea shells and egg shells hard – break free from tiny hairs in the inner ear and float into one of the fluid-filled canals that help the brain determine the body's position to maintain balance.

Normally, the crystals act as weights on the hairs, bending them in the direction of gravity's pull. As the hairs move, their positions are transmitted through nerves to the brain, which combines that information with eyesight and feeling to compose a complete picture of the body's position in space.

Vertigo can occur when broken crystals bend some of the hairs the wrong way.

Diagnosing BPPV can be difficult because most of the common symptoms – a sense of spinning, lightheadedness, blurred vision, nausea or vomiting – can be caused by other problems.

O'Leary recalled one patient who had been told for more than a year by other doctors that her recurring dizziness was psychological because they failed to find any physiological explanation. A visit to Senta, however, indicated the problem wasn't in her head, or more specifically was in her ear. She had BPPV.

“She broke down when we gave her the diagnosis,” O'Leary said.

To determine whether BPPV is the cause of vertigo, a patient is strapped into a canalith repositioning chair, the large steel machine built by Purcell that nearly fills one of the clinic's exam rooms.

His homemade device is a knockoff of a design developed by Dr. John Epley, a Portland, Ore., otoneurologist who pioneered the diagnosis and treatment of BPPV.

Only six of the Epley chairs are in use, Purcell said, and the machines have not yet received approval from the Food and Drug Administration. “All of them are considered experimental,” he said.

The steel beams for Purcell's contraption were supplied by NASA Ames Research Center in Mountain View, where he worked as a researcher in the early 1990s. Patients sit in a jet fighter pilot seat, taken from Purcell's considerable stash of aviation spare parts, that is bolted to the circular steel frame.

The doctor assembled the machine in his father's workshop on Adams Avenue in San Diego. He said he spent about $30,000 on parts and materials.

The patient is strapped in, then tilted, turned and rolled in every direction by the device as infrared goggles record the tiniest eye movements. That's critical because BPPV triggers telltale eye motions that identify a sufferer.

Once a BPPV diagnosis is made, Purcell moves the patient in the chair to maneuver the dislodged crystals out of the sensitive inner ear canals and into an area where they can be absorbed by the body.

Think of the treatment as a human-sized version of the child's toy that requires subtle tilts to roll a marble into a game-winning hole.

The treatment can have stunning and immediate results, Purcell said. He said some patients leave the spinning chair symptom-free.

Purcell's vertigo-inducing hobbies don't seem to faze his patients, who are exposed to evidence of his favorite pastimes at every turn.

Office end tables are stacked with books about flight and issues of Air Force Magazine and Climbing. The walls are decorated with vintage bomber jackets, autographed photos and lapel pins from members of the Flying Tigers, the legendary volunteer pilot corps that flew missions in Asia during World War II. And on a recent afternoon, the movie “Top Gun” played on a large flat-screen television hanging in the waiting room.

Purcell said he doesn't know what developed first, his love of experiencing dizziness or his passion for curing it.

Source:www.signonsandiego.com

Family Medicine

2007-08-01T08:26:00.001-07:00

Question: My 13-year-old just told me her friend had been diagnosed with viral meningitis. They had been on a church camping trip, with several other kids, and this girl was diagnosed when they all got home. Do I need to get shots or medicine for my daughter? Is there anything I can do to keep her from getting sick?

Answer: I am sorry your child's friend is ill but the good news is that viral meningitis is usually mild and the patient makes a full recovery. In fact, even if your child gets the virus in her system, she probably won't come down with meningitis.

Viral meningitis is the most common type of meningitis, with about 50,000 people hospitalized with it every year in the U.S. This is a viral infection in the tissues that cover the brain. The symptoms are usually fairly classic, including a bad headache, sensitivity to bright light, fatigue, fever and sometimes nausea and vomiting. Viral meningitis is rarely fatal and the patient usually makes a full recovery in about a week. About 90 percent of cases of viral meningitis are caused by members of a group of viruses known as enteroviruses, such as coxsackieviruses and echoviruses. Outbreaks due to these viruses are more common during summer and fall months. Other viruses - including herpes viruses and the mumps virus - can also cause viral meningitis.

The diagnosis of viral meningitis is based on physical examination and a spinal tap. By looking at the spinal fluid, your physician is able to tell if the meningitis is viral or the more serious bacterial meningitis. Once the diagnosis of viral meningitis is made, the treatment is aimed at relief of the symptoms -- medication for the headache, nausea and fever. Neither antiviral medications nor antibiotics are appropriate.

Will you daughter get sick? I don't know. She was exposed to the virus that made her friend sick but most people who are exposed to not become ill. The incubation period for enteroviruses is usually between three and seven days from the time you are infected until you develop symptoms. So once that period of time has elapsed, if your daughter doesn't become ill, you are probably home free. If your daughter had a lot of close personal contact with this other child, you want to be sure to wash common objects well in hot soapy water. This will help to prevent others in your household from becoming infected.

Finally, for the benefit of my other readers, let me say a little more about that other more dangerous form of meningitis I mentioned earlier - bacterial meningitis. This is a very serious medical condition that can be fatal if it's not treated right away. It can strike adults but it is most common among babies and very young children. Symptoms include a high fever, chills, headache and vomiting. Muscles may stiffen, especially in the neck.

Within a few hours, the victim ma become delirious, slip into a coma or have convulsions. Infants may become irritable and develop a high-pitched cry.

As you can see, the initial symptoms can be very similar to those for viral meningitis. A spinal tap is needed to distinguish one type of meningitis from the other. That's why anyone who is suffering from these symptoms should be taken to a hospital emergency room right away.

Source:www.heraldstandard.com

New Oral Acne Medications Poised to Benefit Patients

2007-08-01T08:25:00.001-07:00

While laser and light-based therapies continue to make their mark on many dermatologic procedures, some dermatologists believe the tried-and-true oral medications for treating moderate to severe acne offer patients the best long-term treatment outcomes. In fact, the introduction of new oral acne medications demonstrates that the demand for systemic acne therapies is still strong.

Speaking today at the American Academy of Dermatology’s Summer Academy Meeting 2007, dermatologist Hilary E. Baldwin, MD, FAAD, associate professor of clinical dermatology at the State University of New York (SUNY) in Brooklyn, N.Y., discussed the newest developments in oral medications for the treatment of acne.

“The current systemic acne medications have staying power for one simple reason – they work,” said Dr. Baldwin. “Recently, some exciting new treatments have expanded our options for acne patients and have even addressed some of the potential drawbacks of oral acne medications, such as bacterial resistance with long-term antibiotic use.”

New Oral Medications
Dr. Baldwin reported that one of the most innovative new systemic acne medications is extended-release minocycline, which is the first time a weight-based oral medication has been introduced to control acne. This dose-based medication is taken once per day, and the extended-release nature of the drug means that the peak serum levels that are obtained in the bloodstream are not nearly as high as with immediate-release minocycline. Dr. Baldwin added that it is the peak serum levels in the bloodstream that is thought to cause the relatively high degree of side effects, such as dizziness, headaches and nausea.

Since extended-release minocycline can be taken with or without meals, Dr. Baldwin noted that patient compliance with taking this medication improves dramatically – especially among teenage boys who tend to eat frequently throughout the day and find it hard to take a medication that needs to be taken on an empty stomach once a day, much less twice a day.

Another new area of acne research that is proving promising is using antibiotics for a period of a few months to start a successful treatment regimen, then replacing them with other non-antibiotic medications to maintain results over time. Dr. Baldwin explained that this “step-down” approach is important, as an increasing concern of long-term antibiotic use is that bacteria are evolving to become resistant to these medications – prompting dermatologists to seek alternative therapies in order to get their patients off of oral antibiotics as soon as possible. Recent clinical studies using the step-down approach from antibiotics and a topical retinoid to topical retinoids alone have shown positive results in maintaining improvement in acne patients, despite the abrupt discontinuation of oral antibiotics.

Another category of oral medications that dermatologists are using to treat acne is anti-inflammatory medications, which can be used in some cases to lessen the severity of acne. Used by some dermatologists to reduce the redness and swelling of acne, controlled-release doxycycline is one new anti-inflammatory medication recently approved by the U.S. Food and Drug Administration (FDA) for treating rosacea.

“Since controlled-release doxycycline is not an antibiotic, it does not kill the bacteria involved in the pathogenesis of acne and is therefore not expected to be as effective as antibiotics in controlling acute acne,” said Dr. Baldwin. “But for some patients, such as women who may be prone to yeast infections from using antibiotics, this anti-inflammatory medication may offer noticeable improvement in the inflammation caused by acne.”

Dr. Baldwin also added that a new oral medication on the horizon could be another viable alternative for acne patients in the next few years. Incyclinide, a chemically modified tetracycline that is not an antibiotic, is now in phase two of clinical trials and shows promise in treating both acne and rosacea.

“We’re hopeful that the new systemic acne medications will lead to improved treatment outcomes for acne patients,” said Dr. Baldwin. “However, with so many treatment options available, it’s important that acne patients involve a dermatologist to oversee their treatment regimen – as only a dermatologist can determine which acne medications are best for each patient.”

Source:www.newswise.com

Marijuana component opens the door for virus that causes Kaposi's sarcoma

2007-08-01T08:24:00.001-07:00

The major active component of marijuana could enhance the ability of the virus that causes Kaposi’s sarcoma to infect cells and multiply, according to a team of researchers at Harvard Medical School. According to the researchers, low doses of Ä-9 tetrahydrocannabinol (THC), equivalent to that in the bloodstream of an average marijuana smoker, could be enough to facilitate infection of skin cells and could even coax these cells into malignancy.

While most people are not at risk from Kaposi’s sarcoma herpes virus (KSHV), researchers say those with lowered immune systems, such as AIDS patients or transplant recipients, are more susceptible to developing the sarcoma as a result of infection. Their findings, reported in the August 1 issue of Cancer Research, a journal of the American Association for Cancer Research, offer cautionary evidence that those with weakened immune systems should speak with their doctors before using marijuana medicinally or recreationally.

“These findings raise some serious questions about using marijuana, in any form, if you have a weakened immune system,” said lead study author Jerome E. Groopman, M.D., professor of medicine at Harvard Medical School. “While THC is best known as the main psychotropic part of marijuana, an analog of THC is the active ingredient of marinol, a drug frequently given to AIDS patients, among others, for increasing appetite and limiting chemotherapy-induced nausea and vomiting.”

While previous studies indicated that marijuana smoking was associated with Kaposi’s sarcoma, this is the first to demonstrate that THC itself can assist the virus in entering endothelial cells, which comprise skin and related tissue.

According to Dr. Groopman, the study illustrates the complicated role marijuana and other cannabinoids play in human health. Numerous types of cells display cannabinoid receptors on their outer surfaces, which act as switches that control cellular processes. Dr. Groopman’s laboratory had previously demonstrated that THC could have a protective effect against a certain form of invasive, drug-resistant lung cancer.

To study the combined effect of THC and KSHV, the researchers examined a culture of human skin cells, which are susceptible to infection and could provide a model of Kaposi’s sarcoma. These culture cells display many copies of two prominent cannabinoid receptors. Dr. Groopman and his colleagues found that by bonding to these receptors, low doses of THC activate two proteins responsible for maintaining a cell’s internal framework, or cytoskeleton. By altering the cytoskeleton, THC effectively opens the door for KSHV, allowing the virus to more easily enter and infect the cell. “We can take away that effect by using antagonists that block the two cannabinoid receptors, which adds evidence that THC is the culprit,” Dr. Groopman said.

Once a cell is infected, the presence of THC may also promote the cellular events that turn it cancerous, the researchers say. They found that THC also promotes the production of a viral receptor similar to one that attracts a cell-signaling protein called interleukin-8. Previous studies have noted that this receptor could trigger the cell to reproduce, causing Kaposi’s sarcoma-like lesions in mice. Indeed, the researchers saw that THC induced the infected cells to reproduce and form colonies in culture.

“Here we see both infection and malignancy going on in the presence of THC, offering some serious concerns about the safety of THC among those at risk,” Dr. Groopman said. “Of course, we still do not know the exact molecular events that are occurring here, but these results are just the first part of our ongoing research.”

Source:www.eurekalert.org

Ebola-Like Virus Hits Kamwenge

2007-08-01T08:23:00.000-07:00

TWO suspected cases of Marburg haemorrhagic fever, a virus similar to Ebola, have been reported in western Uganda, according to the Ministry of health.

"The Ministry of Health would like to inform the general public that two suspected cases of Marburg haemorrhagic fever have been reported, of whom one has died," a press release by the director general of health services, Dr. Sam Zaramba, said.

"Both cases were mine workers in Kitaka mine, located in Kakasi Forest Reserve in Kamwenge district."

Kamwenge is about 250km west of Kampala with a population of 295,000, according to the 2002 census.

"The first test was positive. We are waiting for the results of the confirmatory test, which we shall have at 9:00am tomorrow," Dr. Zaramba told The New Vision last night.

"But it is most probably the Marburg virus. We thought we should send out this information early enough."

Marburg, like Ebola, is a severe and highly fatal disease. It is characterised by sudden bleeding and high fever, resulting into death within a few days.

Transmission is through close contact with blood and other body fluids from patients with clinical signs of the illness. It can also be transmitted following exposure to contaminated items, such as bedding and clothing of patients.

The virus is named after Marburg, a city in Germany where the first outbreak occurred in 1967 among laboratory workers who had been doing research on monkeys which were imported from Uganda in order to prepare a polio vaccine.

"The Ministry of Health has set up a national task force that is tracing all potential contacts of the above cases for further investigations and tests," the statement added.

It advised people to report any suspicious cases to the nearest heath unit. The ministry asked the public not to panic "as no new cases have been reported in the last two weeks".

What is Marburg hemorrhagic fever?

Marburg hemorrhagic fever is a rare, severe type of hemorrhagic (internal bleeding) fever, which affects both humans and monkeys. Caused by a genetically unique animal-borne RNA virus of the 'filovirus' family, its recognition led to the creation of this virus family. The four species of Ebola virus are the only other known members of the filovirus family.

Where have cases occurred?

Marburg virus was first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt (Germany) and in Belgrade (Yugoslavia). A total of 37 people became ill. They included laboratory workers as well as several medical personnel and family members who had cared for them. The first people infected had been exposed to African green monkeys. In Marburg, the monkeys had been imported for research and to prepare a polio vaccine.

Recorded cases have appeared in only a few locations. While the 1967 outbreak occurred in Europe, the disease agent had arrived with imported monkeys from Uganda. No other case was recorded until 1975, when a traveler most likely exposed in Zimbabwe became ill in Johannesburg, South Africa - and passed the virus to his traveling companion and a nurse. 1980 saw two other cases: one in Western Kenya not far from the Ugandan source of the monkeys implicated in the 1967 outbreak.

This patient's attending physician in Nairobi became the second case. Another infection was recognized in 1987 when a young man who had traveled extensively in Kenya became ill and later died. In 1998, an outbreak occurred in Durba, the Democratic Republic of the Congo. Cases were linked to individuals working in a gold mine. After the outbreak subsided, there were still some sporadic cases that occurred in the region.

Source:allafrica.com

For some vets, battles never end

2007-08-01T08:22:00.000-07:00

When Marine Lance Cpl. Jeffrey Lucey returned from his tour of duty in Iraq, he looked like a kid who had lucked out. No visible wounds.

But looks aren't everything. He had nightmares, nausea, episodes of heavy drinking and other signs of depression. He called himself a "murderer." He told his sister he had "a rope and tree picked out" behind the family home.

Then in June 2004, a few months after his return, he went to the basement of his parents' home in Belchertown, Mass., arranged photos of his family and his platoon on the floor and hanged himself with a garden hose. He was 23.

His parents, Kevin and Joyce Lucey, filed suit last week charging that the Department of Veterans Affairs denied help for their son's mental problems, beyond 3½ days of involuntary commitment at a local Veterans Affairs hospital.

The Luceys, who joined the anti-war group Military Families Speak Out after their son's death, are not seeking monetary damages. They say that they only hope that their lawsuit will force the Bush administration to take swift action to overhaul the VA.

A few days before the Lucey lawsuit, a group called Veterans for Common Sense accused the VA of unlawfully denying disability pay and mental-health treatment to injured Iraq war vets.

Both lawsuits name as defendants the U.S. government and James Nicholson, secretary of Veterans Affairs, who abruptly announced in mid-July that he is leaving his job soon. The biggest rap against Nicholson, a decorated Vietnam veteran, is that he didn't fight hard enough to get more money and attention from Congress for a department that has been overwhelmed by casualties from Iraq and Afghanistan.

Those casualties include post-traumatic stress disorder. The VA denied the existence of PTSD for years, until it became official in 1980. Today, there's a new charge that many Iraq and Afghanistan veterans who might have PTSD have been urged to settle for a "personality disorder" diagnosis, which makes it more difficult for them to claim treatment or disability benefits for PTSD later. It may take years for symptoms to show up.

The Luceys' case sounds painfully similar to that of John Erby, president of the Cincinnati chapter of the Vietnam Veterans of America. Before he became one of the first black coaches in the PAC-8 conference at the University of California at Berkeley in 1968, he was a platoon leader in Vietnam, where he lost a leg in battle.

After years of waking up in the middle of the night, reliving his nights of "walking the perimeter" in 'Nam, he learned he had PTSD. He now goes to weekly counseling sessions and counsels veterans from all wars.

"PTSD isn't new," the former Army first lieutenant told me after we met at the Vietnam Veterans of America's recent convention in Springfield. "In past wars, they called it shell shock or battle fatigue or something else. But those previous war veterans came home to beautiful parades. That was their medicine. There was no medicine when we came home. So, we had to have doctors come up with these studies to tell us we had a problem we didn't know about."

After years of working with fellow veterans and their various disorders, the Luceys' case sounds painfully familiar to Erby's. The young Marine had to be involuntarily committed, his parents say, because he was too embarrassed to seek help himself for fear of letting down his buddies.

"Ah, that Marine pride," Erby groans. "You see it in other services too. They're afraid they won't be allowed to go back and rejoin their unit if they admit to any weakness. I remember a sergeant in Texas who would stop the car for a string across the road. That's why I'm happy to talk to any of these young people who have doubts. They need to know when they need help and get it."

The good news about the bad news from the VA is that at least somebody's paying attention. The department is chronically underfunded and understaffed. But new legislation is being debated on Capitol Hill to improve counseling and care of returning veterans and reduce a backlog of VA claims that has grown to almost 400,000.

Veterans groups have a slogan: "Leave No Vet Behind." That's an order we Americans need to follow. It's our best way to thank a veteran.

Source:www.chicagotribune.com

INOVA Diagnostics, Inc. Lauded for its Leadership in the U.S. Autoimmune Disease Diagnostic Markets

2007-08-01T08:21:00.000-07:00

Frost & Sullivan recognizes INOVA Diagnostics, Inc. with the 2007 North American Award for Market Leadership in the U.S. autoimmune disease diagnostic markets.

INOVA has been the only industry participant that has excelled in every aspect of autoimmune disease testing and continues to outpace the market with exceptional growth. In presenting this Award, Frost & Sullivan commends the company's dedication to excellence and quality in all its products and services.

"The company was founded in 1987 by research leaders which included those responsible for the very first commercial autoantibody test kits," notes Frost & Sullivan Research Analyst Kevin Leong. "Their exclusive dedication to autoimmune disease diagnostics has led to their undisputed leadership in this field."

With a broad range of customers that include large reference laboratories, esoteric test facilities, and esteemed medical research centers, INOVA is widely recognized and enjoys a reputation that is clearly reflected in its market success.

As the specialist in autoimmune disease diagnostics, INOVA provides products and services for every disease state. Its comprehensive test menu helps healthcare practitioners address common ailments such as rheumatoid arthritis and celiac diseases as well as rare disorders that include autoimmune hepatitis and Wegener's granulomatosis.

"The company is the only market leader that participates in all the segments of the autoimmune disease diagnostics market," explains Leong. "Clearly, with the increasing awareness of autoimmune diseases, INOVA is well poised to leverage its expertise and capitalize on growth across all the market segments."

In 2006, INOVA held the largest market share in the gastrointestinal autoimmune disease diagnostics market and the autoimmune liver disease diagnostics market. With a leading position in systemic autoimmune disease diagnostics as well, INOVA nurtured the growth of a revolutionary marker for rheumatoid arthritis, cyclic citrullinated peptide (CCP) antibody, and continues to be the leading provider of anti-CCP tests in the country.

All products are produced in INOVA's sole base of operations in San Diego, CA, allowing for full quality control on every shipment. In addition, by selling directly to the clinical laboratory, the company avoids any complex distribution structure that can negatively impact loyalty, reliability, and costs. Truly, INOVA strives to deliver optimum test solutions and values its relationships with each and every client.

The company's market performance stems from the reputation it has earned as a result of its commitment to excellence in quality and customer support. With an ever-expanding R&D pipeline that is brimming with innovative test solutions, INOVA is certain to maintain its leadership in autoimmune disease diagnostics and capture further markets.

The Frost & Sullivan Award for Market Leadership is presented to the company that has exhibited market share leadership through the implementation of market strategy. The recipient has displayed excellence in all areas of the market leadership process, including the identification of market challenges, drivers and restraints, as well as strategy development and methods of addressing these market dynamics. Furthermore, the Award recipient has continually demonstrated solutions for monitoring market changes and for implementing superior market strategies.

Frost & Sullivan Best Practices Awards recognize companies in a variety of regional and global markets for demonstrating outstanding achievement and superior performance in areas such as leadership, technological innovation, customer service, and strategic product development. Industry analysts compare market participants and measure performance through in-depth interviews, analysis, and extensive secondary research in order to identify best practices in the industry.

About INOVA Diagnostics, Inc.

INOVA Diagnostics, Inc. is dedicated exclusively to autoimmune disease diagnostics. Our single focus allows us to offer unmatched quality, reliable consistency and excellent value on the most comprehensive menu of autoimmune disease testing reagents available anywhere. INOVA's autoimmune product groups include kits and components for testing in the areas of connective tissue disease, rheumatoid arthritis, celiac disease, coagulation, gastrointestinal disorders, vasculitis, endocrine, autoimmune liver disease and related infectious diseases. Among the many customers who rely on INOVA to meet their growing autoimmune testing needs are America's largest clinical laboratory systems, regional reference facilities, and many of the nation's most prestigious medical centers and universities. In addition, INOVA reagents are sold in more than 90 countries around the world. INOVA's unique commitment to autoimmune disease diagnostic testing is reflected in the extraordinary level of technical proficiency, product support and in the impeccable service we provide to all our customers.

Source:www.earthtimes.org

A cup of joe does more good than harm

2007-08-01T08:18:00.000-07:00

If you enjoy reading your morning paper while sipping a cup (or two) of coffee, it seems there's no reason to stop. Mounting evidence suggests that, for most people, drinking coffee does more good than harm.

It wasn't long ago when coffee was linked to heart disease, osteoporosis, infertility and pancreatic cancer. Now research suggests that if you drink enough of it, you'll lower the risk of developing Type 2 diabetes, heart disease, asthma, gallstones, Parkinson's disease, liver cancer and possibly colon cancer. And you'll feel more alert and work out harder at the gym.

That's positive news for coffee-loving Canadians who prefer the beverage over tea, milk, juice, soft drinks and beer. According to the Coffee Association of Canada, nearly two-thirds of Canadians drink an average of 2.33 cups of coffee every day.

The most promising evidence for coffee's health benefits come from studies on diabetes. In a report that combined data from nine large studies, people who drank four to six cups of coffee a day were 28 per cent less likely to develop Type 2 diabetes compared with those who drank two cups or fewer. Drinking more than six cups each day reduced the risk by 35 per cent.Despite earlier concerns that coffee might be bad for your heart, studies haven't found a connection. In fact, one study conducted among 41,836 healthy women, aged 55 to 69, found that drinking one to six cups of coffee a day - caffeinated and decaffeinated - reduced the risk of dying from heart disease. A daily intake of four to six cups was found to be most protective.

Several studies have connected habitual coffee consumption with protection from Parkinson's disease. In two studies, Harvard researchers found that men who consumed the most caffeine reduced their risk for Parkinson's disease by 48 per cent. Among women, those who drank one to three cups of coffee a day had a 50-per-cent reduction in risk.

Coffee also seems to protect the liver from the effects of alcohol and toxins. A recent analysis of findings from nine studies on more than 240,000 people with and without a history of cirrhosis concluded that the risk of liver cancer was cut by 43 per cent for each two cups of coffee a day.

In terms of performance, studies suggest that two cups of coffee can improve endurance performance in activities such as running, cycling and cross-country skiing. Coffee also stimulates the brain and enhances mental alertness, particularly if you spread your intake out over the course of the day.

Researchers suspect that some of coffee's benefits are linked to its antioxidants, some of which become more potent during roasting. Antioxidants in coffee - both caffeinated and decaffeinated - are thought to dampen inflammation in the body and improve how it uses insulin, the hormone that lowers blood sugar. Coffee also contains magnesium, a mineral linked to blood sugar regulation.

Caffeine is also thought to play a role. The caffeine in coffee helps treat asthma symptoms, enhances physical performance and boosts mental alertness. Coffee's protective effects against gallstones and Parkinson's disease are also attributed to caffeine.

But regular coffee isn't for everyone. Studies suggest that excess caffeine can boost blood pressure and heart rate, a concern for people with high blood pressure and heart disease. In postmenopausal women who don't get enough calcium, consuming 450 milligrams of caffeine a day - about three eight-ounce cups of coffee - has been linked with having a lower bone density. (Caffeine increases the amount of calcium your kidneys excrete in the urine.) And some studies suggest that high intakes of caffeine during pregnancy can increase the risk of miscarriage.

Caffeine is a stimulant drug that's mildly addictive. If you're a habitual coffee drinker and you miss your daily dose, you can experience indigestion, muscle soreness, headache, irritability and even slight depression.

Caffeine sensitivity - the amount it takes to elicit an effect - varies by person. In general, the smaller the person, the less caffeine it takes to produce side effects. But regardless of body size, the more caffeine you consume, the less sensitive you become to its effects. In other words, it takes more caffeine to feel its jolt.

A standard cup (eight ounces) of coffee is often assumed to provide 100 milligrams of caffeine, but tests conducted in 2004 for The Globe and Mail and CTV News showed that caffeine content of coffee ranged from 78 to 165 milligrams a cup, depending on the coffee house. (Most coffee shops don't offer eight-ounce cups of coffee. The smallest serving is usually 10 or 12 ounces.)

Based on a review of the evidence, Health Canada contends that healthy adults are not at risk for adverse effects from caffeine, provided you limit your daily intake to 450 milligrams. During pregnancy, women are advised to consume no more than 300 milligrams a day but some experts suggest a stricter limit of 200 milligrams. Having high blood pressure, insomnia and osteoporosis are other sensible reasons to limit your caffeine intake.

Yet for most people, coffee in moderation is harmless, and there's no reason to cut back. It seems that coffee's perks extend beyond kick-starting your day.

Leslie Beck, a Toronto-based dietitian at the Medcan Clinic, is on CTV's Canada AM every Wednesday. Visit her website at lesliebeck.com.

lesliebeck.com

HOW MUCH CAFFEINE

Healthy adults are advised to consume no more than 450 milligrams a day and pregnant women no more than 300 milligrams. Children, aged 12 and under, should consume no more than 2.5 milligrams of caffeine for each kilogram body weight a day.
Coffee, brewed, 8 ounces 100 mg
Coffee, instant, 8 ounces 66 mg
Coffee, decaffeinated, 8 ounces 3 mg
Espresso, 2 ounces 54 mg
Starbucks coffee, venti, 20 ounces 415 mg
Second Cup coffee, large, 20 ounces 391 mg
Timothy's, large, 18 ounces 245 mg
Tim Hortons, large, 20 ounces 270 mg
Tea, black, 8 ounces 43 mg
Tea, green, 8 ounces 30 mg
Cola, 1 can, 355 ml 37 mg
Diet Cola, 1 can, 355 ml 50 mg
Red Bull energy drink, 250 ml 80 mg
Dark chocolate, 1 ounce 20 mg

Source:www.theglobeandmail.com

Transplant helped coach back to the ice

2007-08-01T08:17:00.000-07:00

A skating coach who gives group and private lessons for figure skating and hockey, Pitman has been working at Carmel Ice Skadium for 13 years. She also celebrated the two-year anniversary of her liver transplant on July 13.
Now, the effervescent 34-year-old will compete at the World Transplant Games Aug. 25-Sept. 2 in Thailand.
A former competitive figure skater, Pitman was the 1996 National Collegiate Senior Ladies Silver Medalist, a 16-year regional competitor and a six-year sectional competitor. She will compete in swimming (50 meter freestyle and 50 meter breaststroke) and 3K road race at the World Transplant Games, since figure skating is not among sports offered.
Q: How have your health problems affected you? (Pitman has Crohn's disease and ulcerative colitis, collectively known as inflammatory bowel disease.)
A: I was 17 years old when I was diagnosed with bowel problems, but I was 28 when I had my first surgery. They removed my large intestine, and then I had all kinds of reconstructive surgery . . . The liver problem stemmed from the IBD, Crohn's disease, ulcerative colitis . . . Our liver filters everything that goes in our body and it filtered all the drugs, and since I refused to be put on steroids because of skating, because I wouldn't be able to compete, they used a different drug that they think sped up the process. Eventually (my liver) would have failed, but it sped up the process. . .
On Jan. 31, 2005, I became so ill I had to go to the hospital, and they found out that I had spontaneous bacterial peritonitis, which meant the fluid in my abdomen was infected, which meant the liver couldn't filter out what it needed to. Within six weeks I was in the hospital weekly to remove fluid from my abdomen and began the rigorous testing that they put you through for a transplant.
Q: Where did your donated liver come from?
A: I've not been able to meet my donor family . . . Because it's very confidential, I gave a letter to my post-transplant coordinator to send. Hopefully I'll be able to meet them and keep in touch with them because of how they affected by life. I can't thank them enough. I consider them my angels. With the literally horrific situation they were in, to have to make that decision, they gave me a second chance.
Q: How long until you were back at the rink after your transplant?
A: It took me a little longer in the hospital to recover because I had a couple of setbacks, some reactions, but I was out of the hospital in two weeks. Most people are out within seven to 10 days. I didn't have my skates on, but I was back at the rink sitting on the boards coaching after six weeks . . . I was back on the ice in eight weeks. I don't know what I would have done without my job and being around kids.
Q: After going through all that, what will it mean for you to compete in the 2007 World Transplant Games?
A: It's such an honor . . . Of course, everybody wants to win or do well, but it's just the idea that we are able to be there. We are living proof that it works and that organ donation is so important.
Q: What is your advice to athletes who also are transplant recipients interested in competing? (Eleven months out of surgery, Pitman was competing at the 2006 U.S. Transplant Games in Louisville, barely missing a medal.)
A: Becoming active helps your health . . . They said to me, "You would not be able to recover as quickly as you did without being an athlete and having the motivation to go out and do this." We are a special group but we're just like anybody else. If someone is interested in being in any part of the Transplant Games, they don't have to be an athlete, they can contact the National Kidney Foundation in Indiana . . . It's just a fun experience for any transplant recipient because we can do stuff and we can kick people's butts, too.

Source:www.indystar.com

Nausea might mean overmedication

2007-08-01T08:15:00.000-07:00

Dear Dr. Gott: I am concerned that my 65-year-old niece, who is a petite 100 pounds, takes 20 pills a day. She has been taking these since she had surgery for a clogged artery on the right side of her neck. The doctor tells her she has to take all of them to live.

She has high blood pressure and when she left the recovery room and went back into her hospital room, they lost her twice. She has only one kidney and only about 60 percent of it is functional.

She is a real estate salesperson and is working, but the pills make her nauseated, and her hands shake, which I feel is due to overmedication. Should she get a second opinion?

Dear Reader: There is a definite possibility that your niece is overmedicated. I urge her to obtain a second opinion.

This can be done appropriately without giving the impression that the family distrusts her present physician.

Your niece should call the doctor (or schedule an office visit) to review her concerns, describe her symptoms and ask for a referral to a specialist because she fears that she is reacting adversely to one (or more) of her current medications.

I am particularly concerned about her remaining kidney, which might be unable to excrete the medicines, thereby increasing the possibility of toxicity. Perhaps her kidney specialist could solve this issue.

Dear Dr. Gott: I am a 69-year-old male in good health. Every time I have routine blood work done, I am told that I have high bilirubin. All other blood tests are normal. My doctor tells me this is nothing to worry about. Should I?

Dear Reader: Bilirubin is a byproduct of liver metabolism. Although your elevated levels may simply reflect a genetic tendency, they may indicate liver damage or malfunction.

I assume that you have had appropriate blood tests for common liver diseases, but before reassuring you not to worry, I want to avoid missing an undiagnosed condition.

I encourage you to request a consultation with a liver specialist. You need a diagnosis.

Source:www.nwherald.com

Doctors save child in need of liver

2007-08-01T08:14:00.000-07:00

Doctors at Children’s Hospital No. 2 successfully performed a liver transplant yesterday on a one-year old patient who’s organ had failed earlier.

Her mother, the donor, is also out of danger and is awake and aware after the operation.

However, doctors are still cautious about their recovery because they said it was a complex, eight-hour surgery and the little girl could still reject the liver in the next few days.

Professor Tran Dong A, head of the operation team, said at a press briefing also yesterday that Nguyen Anh Kim Tram had been diagnosed with congenial biliary atresia, a disease of the bile ducts, when she was six months old.

However, at that time it was too late to perform a temporary operation that would have replaced her damaged liver ducts with a length of her intestine to act as drain ducts for bile. That procedure would have allowed her to grow until she was strong enough for a new liver.

Doctors decided to go ahead with the transplant after her 29-year-old mother agreed to be the donor.

The girl suffered from multiple organ failure, malnourishment, lung inflammation and a respiratory disorder and faced the constant risk of burst vessels or hemophilia, which could prove fatal.

The bilirubin in her blood was also 675mg per litre, considered too high compared to the permitted level of less than 5mg per litre.

After consulting with Belgian doctors who have worked with Children’s Hospital No.2’s liver transplant programme for the past two years, the hospital decided to conduct the operation.

In the past two years, Professor Dong A’s team at the Children’s Hospital No.2 have successfully performed liver transplants on three children aged less than 2 years old before Tram’s surgery. They are all doing well.

Professor Dong A said that according to the agreement of the joint liver transplant between his hospital and his Belgian counterparts, Vietnamese doctors will begin to operate independently following the completion of six successful transplants with their Belgium partners at their side.

The success of these transplants will be a strong foundation for the hospital to set up a transplant centre for HCM City as per request from the municipal People’s Committee and the Department of Health.

Source:vietnamnews.vnagency.com.vn

Bleeding From the Gallbladder

2007-08-01T08:12:00.000-07:00

Although hemorrhage from the gallbladder is not a common event,1 urgent treatment is required. A case is described herein in which the use of contrast-enhanced ultrasonography (CEU) showed the potential to be a first-line modality for a prompt diagnosis of this entity.

A 53-year-old man with right upper abdominal pain was transferred to our emergency department by ambulance. He had a medical history of renal failure and had been receiving chronic hemodialysis for 7 years. He also had a diagnosis of hemophilia A in early childhood. Blood examination showed anemia (hemoglobin level, 8.3 g/dL). Liver enzyme values, including the total bilirubin level, were within normal limits. Ultrasonography showed an enlarged gallbladder with slightly hyperechoic heterogeneous material occupying almost all of the lumen (Figure 1AGo). A power Doppler ultrasonographic study, which was arranged to detect minute vascular structures, depicted only faint flow signals along the gallbladder wall, suggesting the cystic artery (Figure 1BGo). To evaluate detailed hemodynamics of the gallbladder, CEU using the intravenous contrast agent Levovist (SH U 508A; Schering AG, Berlin, Germany) was arranged after informed consent was obtained. The instrument used was a commercially available ultrasonography system (Aplio; Toshiba Medical Systems Co, Ltd, Tokyo, Japan) with a 4-MHz curved linear array transducer. Advanced dynamic flow imaging (wideband Doppler imaging) was conducted with a 1.5-second intermittent scan. Thirty seconds after injection of Levovist, localized enhancement began to emerge inside the lumen at the neck of the gallbladder (Figure 1CGo). Because of progressive enlargement of the gallbladder, surgical treatment was conducted 1 week after CEU. Surgical findings involved bloody ascites in the intraperitoneal cavity and an enlarged gallbladder occupied by a massive amount of blood clots. A ruptured cystic artery was identified after the blood clot was removed at the neck portion of the gallbladder lumen. Pathologic findings of the gallbladder showed gangrenous chronic cholecystitis. There were 2 stones impacted into the neck of the gallbladder.

Source:www.jultrasoundmed.org

Cancer Patient Shares Amazing Survival Story

2007-08-01T08:11:00.000-07:00

A Maryland man and his wife are calling what happened to them at Monongahela Valley Hospital nothing short of a miracle.

The wife had been given only six months to live but a news segment and a cancer surgeon changed all of that.

Cindy Russell says every hospital she went to, every doctor she spoke with gave her a death sentence.

At one point, she prepared to mail her Christmas cards early thinking she would not be around for the holidays but now Cindy and her husband Neil are looking ahead to the future.

It's been a long and frightening road for Neill Russell and his wife Cindy.

They call it their journey.

Back in march, 52-year old Cindy was diagnosed with liver cancer.

Doctors from some of the nation's best cancer centers, including Johns Hopkins and the Mayo Clinic told Cindy her cancer was terminal and that she only had six months to live.

But, the Russells never gave up hope.

Cindy related what happened next: "My mother-in-law was watching KDKA-TV 2 and that's when she found Doctor Canady," she recalled. "So, we contacted Doctor Canady and that very night he called us back and he wanted to see me."

Cindy's mother-in-law was watching a story KDKA did back in April.

Clinton Rhodes, 78, a liver cancer patient was also told there was no hope.

It turns out Cindy's mother-in-law knew Rhodes.

"I've know him for years and also he lives a quarter of a mile from me," said Selma Russell. "Right after that program… I'll back up. He said that Doctor Canady saved his life. He had liver cancer. They told him the same thing they my daughter-in law -- go home and die. So anyhow I called him immediately and I spoke with him and his wife and within ten minutes Doctor Canady called me."

"He looked at me and said 'Cindy, I can do something for you' and that's when I started crying because he finally gave me hope when there was no hope and I love him," said Cindy. "I really love that man."

"Every patient that I get a call from, and I get them from all over the country, I am their last resort," said Dr. Jerome Canady. "They have already been operated on two or three times."

Cancer had taken over 75-percent of Cindy's liver.

Doctor Gene Manzetti worked right along side Doctor Canady.

During Cindy's surgery, Doctor Canady used one of the instruments he invented.

He completed his fellowship at Yale University and UPMC under Doctor Thomas Starzl.

He has also studied in Japan and Germany.

He says what he does with 3D imaging and digital mapping is the wave of the future.

"Currently she is cancer free," said Dr. Canady. "Her liver function tests, her bilirubin, they are all normal and they were abnormal when she came to us."

"There is nothing worse than not having hope," said Cindy's husband Neill. "We found hope at this little hospital and in a man named Dr. Canady and I just want people to know who are searching like we did… because it's horrible. There is a hospital and there is a doctor in this little valley who can save lives."

Eight days after surgery Cindy was released from Monongahela Valley Hospital.

"God brought that doctor to her. He knew just what doctor to bring and I am thankful for him," said Cindy's mother Olive Pulaski.

Source:kdka.com

Type 2 Diabetes Drug Avandia Should Be Pulled, PC Testifies

2007-08-01T08:10:00.000-07:00

Diabetes Drug Avandia Should Be Removed From the Market, Public Citizen Tells FDA Advisory Committee

Popular Drug Associated With Risks to Multiple Organ Systems Has No Benefit Over Older, Safer Type 2 Diabetes Drugs

WASHINGTON, July 30, 2007 – The popular type 2 diabetes drug Avandia should be removed from the U.S. market, according to testimony delivered today by Public Citizen before a Food and Drug Administration (FDA) advisory committee panel investigating the medication.

Dr. Sidney Wolfe, director of the Health Research Group at Public Citizen, testified about the risks of Avandia (rosiglitazone), detailing pre-approval and post-approval evidence of cardiac toxicity, liver toxicity and anemia. Wolfe also discussed post-approval evidence of increased bone fractures in women and damage to patients’ vision associated with the drug.

“Does the overall risk-benefit profile of Avandia support its continued marketing in the United States?” said Wolfe. “The answer is clearly no.”

According to Wolfe’s testimony, in FDA adverse reaction reports filed since marketing began for the drug in 1999 through the end of last year, there was a 15.2 times higher adjusted rate of heart failure reported with Avandia than for the older diabetes drug Glucotrol. The adjusted rate of liver toxicity with Avandia was 9.5 times higher, and 14.8 times higher for liver failure.

In addition, the adjusted rate of post-approval adverse reaction reports for anemia in patients was 13.3 times higher for Avandia than with Glucotrol. In patients already damaged by heart failure or other cardiac risks associated with the drug, the addition of anemia could significantly worsen their clinical condition, Wolfe warned. Wolfe also cited in his testimony a recently completed study finding statistically significant increases in bone fractures in women using Avandia compared to those using another diabetes drug.

Vision impairment, a major complication of diabetes, is also made worse by Avandia, Wolfe said. A mechanism related to heart failure and fluid accumulation has produced macular edema – a swelling in the retina – in many patients, causing usually reversible damage to vision. The adjusted reporting rate for macular edema was 35.3 times higher for Avandia than for Glucotrol.

“There is no evidence of any uniquely beneficial clinical outcome for Avandia and growing evidence of unique risks in multiple organ systems,” concluded Wolfe. “If Avandia were up for approval today, based on what is now known, it would be summarily rejected. There should not be a double standard for removing it from the market.”

Because of the dangers associated with the drug that are not present in older, safer diabetes medications, Public Citizen is preparing a petition to the FDA to remove Avandia from the market.

Testimony Before the FDA Advisory Committee Meeting on Rosiglitazone (HRG Publication #1820)

FDA Endocrine Metabolic Drugs Advisory Committee Meeting on Rosiglitazone: July 30, 2007

Testimony of Sidney Wolfe M.D., Elizabeth Barbehenn Ph.D. and Ben Wolpaw, Health Research Group of Public Citizen

I will focus on the fourth question to the committee: Does the overall risk-benefit profile of rosiglitazone (Avandia) support its continued marketing in the US?

The evidence presented today concerning the increased risk of ischemic heart disease including myocardial infarctions appears to justify the removal of this drug from the market, but due to the ubiquitous nature of PPAR gamma receptor sites in so many parts of the body, it is hardly surprising that there are many other significant kinds of damage this drug is causing to patients.

Preclinical (Pre-Approval) and Post-Approval Evidence of Cardiac Toxicity

In a 1999 FDA pharmacology review of animal toxicity, "rosiglitazone produced various toxicities such as left atrial thrombosis, hydrothorax, cardio hypertrophy and elevations of hepatic enzymes in the high dose group. In this reviewer's opinion, it is not possible to anticipate potential human toxicities" and stated that "these findings appear as long term clinical concern." The final recommendation states "Pharmacology recommends not to approve rosiglitazone for the proposed indication for long-term human use."

In dogs, at doses only 1.2 times higher than the human dose, there was evidence of significant cardiac hypertrophy after 26 weeks.

Avandia1c

In her review of animal and human evidence of cardiac toxicity of PPAR gamma agonists such as rosiglitazone last year, former FDA Pharmacologist Dr. Jeri El-Hage stated:

* There was fluid accumulation in all species (mouse, rat, dog, rabbit, monkey, human).
* Fluid accumulation leads to weight gain, edema, cardiac hypertrophy with resultant heart failure in all species.
* Drug-induced heart failure and death were observed with chronic treatment (>6 months in animals and man).
* In people, the longer a patient was on a PPAR gamma, the lower the dose needed to produce edema or CHF.

In a recently published meta-analysis of randomized trials with rosiglitazone (2 trials) and pioglitazone (1 trial) co-authored by Dr. Curt Furberg, the increased risk of heart failure compared to placebo was 2.1 (95% CI of 1.08-4.08)

Finally, in FDA adverse reaction reports filed since marketing began through the end of last year, there were 698 cases of heart failure reported with Avandia compared with 39 for the older diabetes drug, Glucotrol. Adjusting for differences in the number of prescriptions for the two drugs, the rate of heart failure reports for Avandia compared with Glucotrol was 15.2 times higher.

Avandia2

Preclinical (Pre-Approval) and Post-Approval Evidence of Liver Toxicity

In the pre-clinical 1999 FDA pharmacology review, evidence of liver toxicity was seen in dogs at a dose only 1.2 times higher than the human dose that included ALT, AST and LDH in males that increased to being statistically significant in males and females (ALT only) by 25 weeks in the next higher dose.

In eight published case reports of rosiglitazone-caused liver toxicity, with human exposures ranging from two weeks to 15 months, for the seven patients for whom follow-up data was available, five recovered within two weeks to four months after the drug was stopped. Two of the patients died. Bilirubin levels in these patients, consistent with the similar hepatocellular toxicity seen with troglitazone (Rezulin), ranged from 2.9 to 22.3 with an average of 10.5.

Avandia3

Finally, in FDA adverse reaction reports filed since marketing began through the end of last year, there were 594 cases of hepatic toxicity (including 122 cases of liver failure) reported with Avandia compared with 53 cases of toxicity (and only seven cases of liver failure) for Glucotrol. Adjusting for differences in the number of prescriptions for the two drugs, the increased adjusted rate of reports for Avandia compared with Glucotrol was 9.5 times higher than Glucotrol for all reports of hepatic toxicity and 14.8 times higher for hepatic failure.

There were 46 reports of deaths from hepatic failure with Avandia, and six with Glucotrol, for an adjusted rate of 6.5 times higher with Avandia.

Avandia4

Avandia5

Post Approval Evidence of Increased Bone Fractures in Women

The recently completed ADOPT study found statistically significant increases in total and lower limb fractures in women using Avandia compared to those using either glyburide or metformin.

Avandia6

Avandia7

Pre-Approval and Post-Approval Clinical Evidence of Anemia

* In pre-approval clinical trials, anemia was reported in 1.9% of patients receiving Avandia as monotherapy compared to 0.7% on placebo.
* Severe anemia (male: Hct less than 31; female: Hct less than 28) was seen in clinical trials in 9/2,121 patients on rosiglitazone, 0/485 patients given placebo. A lesser degree of anemia was seen in many more patients.
* Anemia was seen most commonly in combination therapy with rosiglitazone plus metformin (7.1%) compared to those receiving placebo plus metformin (2.2%).

Post-approval adverse reaction reports included 407 cases of anemia in patients using Avandia and 26 in patients using Glucotrol for an adjusted reporting rate of 13.3 times higher for Avandia.

In patients already damaged by heart failure or other cardiac risks of this drug, the addition of anemia can significantly worsen their clinical condition.

Macular Edema

Although one of the major worries as far as microvascular complications of diabetes is visual impairment, not only does Avandia lack evidence of improving this situation but, through a mechanism related to heart failure and fluid accumulation, many patients have developed macular edema—swelling in the critical macular portion of the retina—with Avandia with concomitant, usually reversible, damage to their vision.

Post-approval adverse reaction reports included 83 cases of macular edema in patients using Avandia and two in patients using Glucotrol, for an adjusted reporting rate of 35.3 times higher for Avandia.

Summary

In a recent editorial in the New England Journal of Medicine, Dr. David Nathan, a diabetes expert from the Mass General Hospital wrote:

In theory, newer classes of antidiabetes medications might be welcome additions to the existing armamentarium; however, those that have been developed recently are generally no more potent, and often less effective in lowering glycemia, than the three oldest classes (insulin, the sulfonylureas, and the biguanides), all of which are more than 50 years old.

Moreover, the newer classes are uniformly more expensive and are associated with adverse effects — some that are shared by the older drugs, but others that are new.

He added that “The failure of clinicians and their patients with diabetes to implement currently available interventions aggressively and effectively is, I suspect, the major barrier to good care. This problem will not be fixed by making more medications available.”

Our answer to the question, "Does the overall risk-benefit profile of Avandia support its continued marketing in the US?" is clearly no.

There is no evidence of any uniquely beneficial clinical outcome for Avandia and growing evidence in multiple organ systems (cardiac, liver, bone, bone marrow) of unique risks. If this drug were up for approval today, based on what is now known, it would be summarily rejected. There should not be a double standard for removing it from the market.

Source:www.pharmalive.com

Child wins huge damages over medical care

2007-08-01T08:09:00.000-07:00

A Glendale Superior Court civil jury has awarded an estimated $96 million in future damages in the case of a child who developed a rare but serious neurological disorder caused by untreated jaundice shortly after his birth four years ago at Verdugo Hills Hospital.

The jury's 9-3 verdict, which came late Monday, is calculated in two ways. The current value of the award is $15 million, but it is expected to reach $96 million over the course of medical care for the boy during his lifetime, said attorneys for Aidan Ming-Ho Leung. That would make it one of the largest jury awards in recent California court history, according to a website that tracks the top jury awards.

Michael Thomas, a lawyer for the nonprofit hospital, said the award would be appealed. Thomas also said he would seek a mistrial based on what he said were jury deliberation irregularities and other problems involving the court's receipt of evidence. He declined to elaborate.

Aidan was born March 24, 2003, at Verdugo Hills Hospital under the care of Dr. Steven Wayne Nishibayashi, who also was listed as a defendant in the case.

According to the lawsuit, Aidan exhibited several risk factors for kernicterus, a neurological disorder that can cause mental retardation, cerebral palsy and hearing loss, when he developed jaundice shortly after birth. The jaundice was a sign of the buildup of bilirubin, a yellow bile pigment, produced in greater quantities than a baby's liver can excrete.

The hospital and the doctor, the plaintiff's attorneys argued, should have been alert to that possibility and given him appropriate medical treatment to reduce the bilirubin buildup.

Aidan's parents were concerned just days after his birth because he became lethargic and was barely feeding, said Aidan's attorney, Luan K. Phan, but they were told that the jaundice would go away by itself. Phan said the hospital gave the parents a pamphlet that said jaundice did not produce a serious medical risk. Instead, Phan said, Aidan wound up in an emergency room at another hospital, where two attempts to remove the buildup through blood transfusions failed.

Aidan's condition "was never on the radar of the doctors and nurses" at Verdugo Hills Hospital, Phan said.

The hospital presented a dramatically different version of events. Thomas said that Aidan was born healthy and that his mother requested a discharge from the hospital while he was still in excellent health. When she left with Aidan, the baby was then beyond the hospital's responsibility, Thomas said.

"It's the hospital's position that they did nothing wrong and that all follow-up care was out of their hands," Thomas said.

Aidan, now 4, requires constant medical attention, said Phan, whose firm employs Aidan's father.

"He has normal intelligence, but he can't walk. He can't talk, can't feed himself. He can't control a single muscle and it was all preventable," Phan said.

Lawyers USA Online, which covers court decisions, legislation and litigation trends, said the largest California verdict last year was a $106-million award to the family of a murder victim seeking to prevent a defendant from profiting from book or movie deals. That award was reduced to $16 million and is on appeal.

Source:www.latimes.com

Disputed Diabetes Drug Avandia Okay to Sell

2007-07-31T12:43:00.000-07:00

For a while it looked as though the diabetes drug Avandia was heading toward its demise after an FDA scientist said the drug was too risky. But an advisory committee may have just secured a longer shelf life for the widely-used drug.

With his recent diagnosis, Henderson resident Ron Buehler suddenly found himself caught up in the world of chronic disease. And like millions of other diabetics, he's also has to trust a huge pharmaceutical industry for safe drugs.

Buehler said, "How does the average diabetic know? He doesn't until somebody tests that drug and says uh-huh."

However, testing doesn't always ease concerns. Several months ago, a federal scientist said the widely used diabetes drug Avandia increases the risk of heart attack and suggested it be removed from the market. Government health advisers have now recommended that Avandia stay.

Dr. Reid Litchfield, Henderson endocrinologist, is relieved. "I think the overall risk of heart disease, of inducing a heart attack with this drug is quite low."

About one million Americans with Type 2 diabetes use Avandia to control blood sugar by increasing the body's sensitivity to insulin. Dr. Litchfield says studies haven't produced significant proof that it raises the risk of heart attack.

In fact, because diabetics already have a high incidence of heart disease, it's hard to isolate any effect from Avandia. "You're looking for a needle in a haystack full of needles," Dr. Reid Litchfield said.

The non-binding recommendation by the panel keeps Avandia on the shelf until a final decision by the FDA, which is not required to follow the panel's advice, but usually does.

Source:www.klas-tv.com

Bridging The Gap In the Fight Against Alzheimer's

2007-07-31T12:42:00.000-07:00

Dementia has struck hard in Maritza Ciliberto's family. First, it was her grandmother. And then her mother, diagnosed even though she's just 61.

One relative said the family, rooted in Puerto Rico, is cursed - reflecting a common misconception among some in the Latino community, Ciliberto says, where a lot of folk beliefs about disease persist. Some say Alzheimer's is caused by spirits. For others, the disease carries so much stigma that they don't seek diagnosis or care.

Ciliberto chose another path, and as she helped her mother get treatment, she decided she wanted to do more. She recently took a newly created job at the Massachusetts chapter of the Alzheimer's Association, reaching out to Latinos and teaching health professionals how they can break down some of the barriers posed by language and culture.

"Our people are not receiving the care and the education they need" about the disease, said Ciliberto, who lives in Allston.

Ciliberto's outreach is part of a stepped up effort nationally by the Alzheimer's Association and others to address cultural barriers to dementia care. The effort targets African-Americans, Asian-Americans, and Latinos, among other ethnic and racial groups. The association is creating and distributing educational materials in English and Spanish for patients and clinicians, planning a bilingual media campaign, and trying to help doctors identify people at risk.

Driving the initiatives is concern that increasing numbers of African-Americans and Latinos are at high risk of Alzheimer's and other types of dementia because they have cardiovascular disease or diabetes, and because they are reaching their 60s, 70s, and 80s, when dementia typically strikes. In addition, new treatments are on the horizon.

"As we enter an era in which there will be treatments to slow progression of dementia, it's going to be very important to make sure that such treatments move" into ethnic communities as well, said Dr. Robert C. Green, a neurology professor at the Boston University School of Medicine.

The outreach efforts are drawing on research suggesting that dementia may affect different races and ethnic groups in different ways.

A study of residents in upper Manhattan found that Caribbean Hispanics and African-Americans were twice as likely as whites to develop Alzheimer's, even when researchers controlled for other health differences. And a study of African-Americans across the country - led by Green - found that they were 80 percent more likely to develop all types of dementia than whites. But other research has found rates of the disease that are about equal across racial and ethnic groups within the United States.

Scientists are increasing research on these potential differences and looking for possible explanations that could help prevent the disease. So far, neither genetics nor the higher rates of cardiovascular diseases among African-Americans and diabetes among Hispanics has explained possible differences.

One line of research seems particularly applicable to Ciliberto's family. A study conducted by University of Pennsylvania researchers found that Latinos developed symptoms of Alzheimer's about seven years earlier than other people, according to material presented at an international Alzheimer's conference in 2004.

And when Latinos and African-Americans seek diagnosis, they frequently run up against a shortage of bilingual health professionals and bias in cognitive testing that can hinder the process and slow access to treatment, the Alzheimer's Association says.

Some researchers also suggest that testing bias might account in part for higher rates of diagnosed Alzheimer's in African-Americans.

"The real issue is the norms that we have for these tests and the issue of cultural fairness," said Yaakov Stern, a neuropsychologist at Columbia University Medical Center who studies cognitive testing. For example, the scores considered normal are often adjusted for years of schooling, but that may set false expectations if the schooling was poor, due to segregation or other factors, Stern said. Or tests may use shapes or objects that are unfamiliar to new immigrants, he added. Most memory clinics and academic medical centers are aware of these problems and use multiple tests for diagnosis, he said. But that's not always true for community doctors.

"In primary care, a doctor might rely on a mental status exam for an initial diagnosis," he said, "so they have to be aware that relying on a fixed cut ((off)) score is not valid."

Studies of the attitudes of caregivers, done in Boston, have found cultural beliefs that may pose barriers to care. Chinese families told researchers that they tried to hide loved ones with dementia because of perceived stigma. Ironically, in some cases, this harmful reaction was exacerbated by a positive tradition of respect and protection of elders. It's a reaction that Ciliberto hopes to change, with cultural sensitivity.

"We can't keep hiding people," Ciliberto said. "We need to get them help."

"We need to be respectful of what people believe and what gives people hope," she said. "But we also need to present the alternatives."

For example, she said, if a family thinks there's a curse and wants to pray about it, she supports the prayer, but explains that Alzheimer's is a disease.

"Let's fight it with prayer," she tells the family. But let's also "fight it with every weapon available. Let's go get the medication, let's go participate in research."

Ciliberto's mother is enthusiastic about her daughter's work. "I've been very concerned and worried about what's happening in our family and in other families as well," she said in Spanish, as her daughter translated.

Her illness is in the early stages, and she is still working as a teacher's assistant in a private school in Puerto Rico. From her daughter and her doctor, she is learning about Alzheimer's and getting treatment, and she no longer dismisses her forgetfulness as a normal sign of aging.

Misconceptions about dementia are also widespread in African-American communities, researchers say. In some studies, African-Americans were more likely than whites to dismiss memory loss as typical of old age and to feel that they were not at risk for the illness. That may help explain why studies find that African-Americans often don't get care until the disease has progressed significantly.

"We missed the opportunity to have our Magic Johnson in the world of Alzheimer's, to show everyone that this is not a predominantly white disease," said Michael Kincade, coordinator of medical and community outreach for the state Alzheimer's Association chapter. Kincade said there have been several prominent African-Americans with Alzheimer's, but they have not been public about their illness, in the way that Johnson was about HIV. "The most frustrating thing is trying to get people to grasp that the memory loss and other symptoms are not normal."

Kincade and Ciliberto work on parallel tracks and are expanding their efforts in Boston and Springfield, funded by two small grants received this month. They are targeting middle-aged people with diabetes, obesity or heart disease - who are at higher risk for Alzheimer's and whose parents may already be suffering from it - and educating primary care physicians about risks for, or early signs of dementia.

"If an African-American women is being seen for diabetes and hypertension, there should be red flags that go up," said Gerald Flaherty, director of medical and scientific programs for the Alzheimer's Association in Massachusetts. "We hope to uncover that untreated parent at home."

"There's clear evidence that by intervening with the family and treating the stress of caregiving, the patient will do better," he said.

Source:health.theledger.com

Article; In Matters of the Heart, Prevention Is Key

2007-07-31T12:40:00.000-07:00

If you were a cardiologist or an optimist, you might say the glass was half-full. But if you were an epidemiologist or pessimist, you would be more inclined to say the glass was half-empty.The glass, in this case, is the death rate from coronary heart disease in the United States, which declined sharply in the last two decades of the 20th century. From 1980 through 2000, the age-adjusted death rate for coronary heart disease fell to 266.8 deaths per 100,000 men from 542.9 deaths, and to 134.4 deaths per 100,000 women from 263.3.

This change, which meant 341,745 fewer coronary deaths in 2000 than would otherwise have occurred (along with a continued decline in such deaths in the years since), catapulted cancer last year into the lead position as a killer of Americans under age 85, even though cancer death rates are also declining.

Nonetheless, the pessimists would say, far more people are still dying of heart disease than should be, often before reaching age 30, even though the tools are at hand to virtually eliminate this scourge. And there are now strong indications that as Americans continue to get fatter and fatter, the decline in heart disease deaths will soon grind to a halt and may even reverse itself.

Furthermore, the pessimists note, the direct and indirect costs of coronary heart disease are still breaking the health care bank, at $142.5 billion last year and rising.

Why the Death Rate Fell

In the June 7 issue of The New England Journal of Medicine, a team led by public health specialists from the national Centers for Disease Control and Prevention analyzed the changes that have occurred in American medicine and habits to account for the impressive drop in deaths from coronary heart disease (the most common kind of heart disease, which results from blocked blood vessels feeding the heart).

About 47 percent of the decrease in coronary deaths among Americans aged 25 to 84, the researchers concluded, could be attributed to “a revolution in the treatments for established coronary heart disease”: the use of medical or surgical therapies that help prevent or postpone deaths from heart disease in patients already afflicted. These are therapies administered to patients who have suffered and survived a heart attack, people with chest pains indicative of blocked coronary arteries and patients with heart failure.

The remedies range from cheap (bystander CPR to forestall death from a heart attack, for example, and daily aspirin to prevent clots that can precipitate an attack) to costly and sometimes hazardous (angioplasty, stents and coronary bypass surgery to open or circumvent blocked arteries). Other therapies include clot-dissolving drugs, drugs that lower blood pressure and cholesterol levels and rehabilitation programs to improve cardiac function.

All told, the researchers estimated, nearly 160,000 of the coronary deaths that were prevented or postponed in 2000 “were attributable to medical therapies” administered to patients already known to have had heart disease.

While patients and their loved ones are no doubt extremely grateful for the ability of modern medicine to keep people alive and often well when their hearts are on the verge of giving out, the therapeutic approach to curbing the coronary death rate is like shutting the barn door after the horse has escaped. A more economical, not to mention less terrifying, approach is to prevent the development of this life-threatening and costly disease.

According to the new analysis, about 44 percent of the decline in coronary mortality during the 20 years studied was due to improvements in risk factors for heart disease: reduced cholesterol levels, better control of high blood pressure, a decline in smoking and a small rise in physical activity.

These changes have occurred largely through the seriously underfinanced efforts of public health advocates who for decades have championed the cause of primary prevention of heart disease. They started in the early 1960s with campaigns against smoking, continued with efforts to curb saturated fats, cholesterol and salt in the American diet and moved on to still-lagging efforts to get more Americans to be physically active.

The pharmaceutical industry, which spends billions of dollars to develop and test new drugs and convince doctors to prescribe them for their patients, has also contributed to better control of risk factors, often in people not yet known to have heart disease. There is now a plethora of risk-reducing medications available both to healthy people and to those already afflicted, including old-school but still front-line diuretics to lower blood pressure and relatively new (and very effective) statins to lower dangerously high cholesterol levels.

There are also many aids sold over the counter and by prescription, as well as therapies like hypnosis, to help people quit smoking. In addition, a growing public intolerance for tobacco smoke, increasing limits on where people can smoke and the rising cost of cigarettes have prompted many people to quit smoking or at least cut down on how much they smoke.

What Next?

But there are two countertrends that are cause for serious concern about the future of heart disease in this country: the overall increase in weight and the accompanying increase in the prevalence of diabetes. The researchers calculated that “increases in the body-mass index accounted over all for about 26,000 additional deaths from coronary heart disease in 2000, and increases in the prevalence of diabetes for about 33,500 additional deaths.”

So far, there is no indication of a reversal of these trends. But unless the weight issue is brought under control, two other risk factors for heart disease will also increase: serum cholesterol levels will rise, and so will blood pressure. And along with Type 2 diabetes, these increases can change the direction of coronary mortality.

No one would argue that it’s better to shut the barn door while the horse is still inside. So let’s talk about primary prevention.

¶We’re doing a lot better with controlling elevated cholesterol through diet and drugs, and the recent widespread elimination of trans fats from processed foods will help even more.

¶We’ve done a lot, but could still do a lot more, to control hypertension by making sure not only that everyone with high blood pressure gets a diagnosis and treatment, but that the treatment effectively controls blood pressure and is maintained indefinitely.

¶Smoking, a major cause of heart attacks and sudden cardiac death, declined among adults by 50 percent from 1965 to 2005. But 45 million American adults and 20 percent of teenagers still smoke, and more effort is needed to eliminate this noxious behavior and to keep youngsters from taking it up.

¶Most important, perhaps, is to nip in the bud the current rise in weight and diabetes. These increases in coronary risk are environmental, not genetic, and can only be resolved by changing how and what people eat and how much they exercise.

So, my fellow Americans, I urge you to tighten your lips to culinary temptation and instead expand your lungs and blood vessels by exercising more and more often. Your heart, which will become a more efficient and effective pump, will thank you for it.

Source:www.nytimes.com

Scientists grow insulin in tobacco plants

2007-07-31T12:39:00.000-07:00

U.S. researchers have discovered insulin grown in plants can resolve diabetes in mice -- a finding holding promise for humans afflicted with the disease.

University of Central Florida biomedical scientists led by Professor Henry Daniell found insulin might someday be grown in genetically modified plants and then be used to prevent diabetes before symptoms appear or to treat the disease in its later stages

Daniell's research team genetically engineered tobacco plants with the insulin gene and then administered freeze-dried plant cells to five-week-old diabetic mice as a powder for eight weeks. By the end of the study, the scientists found the diabetic mice had normal blood and urine sugar levels, and their cells were producing normal levels of insulin.

Daniell has since proposed using lettuce instead of tobacco since lettuce can be produced cheaply and avoids the stigma associated with tobacco.

The National Institutes of Health provided $2 million to fund the UCF study, which is reported in the July issue of the Plant Biotechnology Journal.

Source:www.earthtimes.org

Sex Differences In Brains Reflect Disease Risks

2007-07-31T12:37:00.000-07:00

Women’s brains are different from men’s. That’s not news. What is news is that the differences are smaller than most people believe. They are not big enough to say that one sex is smarter or better at math than the other. What is also news is that the small differences can be significant when it comes to memory, arousal, reasoning, and risk of some diseases. The latter include depression, anxiety, schizophrenia, drug abuse, Alzheimer’s, diabetes, and heart disease.

“Brain differences, though small, help us to understand the nature of sex differences in disease, and thus will hopefully aid in devising sex-specific treatments and prevention strategies,” notes Jill Goldstein, a professor of psychiatry and medicine at Harvard Medical School (HMS).

Here are some examples. Medical experts advise men to take a baby aspirin a day to help protect them against heart attacks. But Julie Buring, a Harvard professor of medicine who works at the Brigham and Women’s Hospital in Boston, found that aspirin does not work the same in women.

More women suffer from Alzheimer’s disease than men, and it’s not just because they live longer. They also have a much greater risk than men for contracting type 1 diabetes, rheumatoid arthritis, lupus, and other diseases caused by a defective metabolic and immune system. Premenopausal women recover from stroke sooner and with less disability than men of the same age or postmenopausal women.

Why? Goldstein and her many colleagues at the Connors Center for Women’s Health and Gender Biology at Brigham and Women’s are working on answers. They have found a number of brain regions that are significantly different in size in men and women. This has led many people to think that such variations result in sex differences in function and behavior, such as memory and emotionality.

For example, part of the hippocampus at the center of the brain and other areas at the front of the brain contribute to short-term memory, and are larger in women. Does this mean they have better working memories? Other areas in the brain, believed to be seats of mating and arousal, grow larger in males, leading to conclusions that men are more aggressive. “This is not always the case,” Goldstein points out. “Size alone does not drive function.”

In tests of short-term memory, Goldstein and her colleagues showed that although brain activity differs between sexes, their short-term memory performance is the same. “Such results show that male and female brains can take different actions to arrive at the same behavioral response,” she notes. However, these variations in activity may account for a small advantage that women have over men in verbal fluency and speed of perception.

Stressing research

Research to date leads to the conclusion that more variability exists in the size of brain regions and behavior within each sex than between the sexes. “The great value in exploring this variability is to understand the role that these differences play in certain diseases,” Goldstein explains.

Another conclusion is that specific behaviors are not driven solely by one region of the brain, notwithstanding those neat diagrams of how the brain works in popular magazines and Sunday supplements. “No single brain region controls a particular behavior,” is the way Goldstein puts it. “The hippocampus is important in memory but other brain regions are involved. Most functions are regulated by a network of brain regions.”

Both hormones and genes drive these subtle but significant sex differences in human brains from the womb to puberty and beyond. Goldstein’s team studies normal sex differences in order to better understand what goes wrong in mental disorders. The tools they use include scanning techniques that produce images of activity in various brain regions as men and women engage in various tasks.

In a series of experiments, Goldstein’s team investigated sex differences in response to stress. While in a scanner, women watched a series of pictures showing both neutral scenes, like cows grazing in a pasture, and those that stimulate high arousal, like horrible car crashes. The women were tested at the beginning of their menstrual cycles and again at ovulation, after eggs leave the ovaries.

Stress regions showed greater activity during the beginning of the cycle than during ovulation, but, surprisingly, the women felt no change in mood. When the same brain networks were examined in men, their brains looked similar to those in women at the cycle start. Goldstein and her team are now mapping out which hormones, like estrogen and progesterone, are associated with the differences.

“This is only one of many studies to identify the role of hormones and genes in regulating sex differences in response to stress,” Goldstein notes. “We hope that these findings help us understand the higher rates of depression and anxiety in women than in men.” Such findings could also shed light on the diminished sensitivity to trauma in men with depression and anxiety disorders. This new understanding of normal reactions to stress is the first step in putting together sex-specific treatments for women and men who must deal with these mental disorders.

As an aside, the natural lessening of anxiety during ovulation may increase a woman’s availability, receptivity, and desire to mate during this crucial time. “That idea goes beyond what our data shows us,” admits Goldstein, “but it’s reasonable to think it may be adaptive for survival of the species.”

What’s more, the brain’s stress response network has been implicated in other mental disorders, such as psychosis in which a person loses contact with reality, and in medical problems that include heart disease and diabetes. Stress and anxiety disorders are co-companions with a host of physical problems that show critical sex differences. Studies are under way by Goldstein and others to understand the connections and, perhaps, find effective ways to treat them.

Source:www.sciencedaily.com

Aging U.S. population at risk for eye disease

2007-07-31T12:35:00.001-07:00

More than 43 million Americans will develop age-related eye diseases by 2020, and the majority of those who are most at risk are unaware, an eye doctors' association reports today.

To reverse the trend, the American Academy of Ophthalmology is launching its EyeSmart campaign — which includes a new set of screening recommendations and a website, geteyesmart.org.

"Many of these diseases are preventable, but people don't get checked until they begin experiencing symptoms," says H. Dunbar Hoskins, executive vice president of the academy. "And at that point, it might be too late in the process."

The academy now recommends all adults be screened for eye disease at age 40, when symptoms and vision changes typically appear.

Everyone considered "at risk" — those with a family history of eye disease, diabetes or high blood pressure — should be screened immediately, Hoskins says. The campaign aims to raise awareness about and prevent five major eye diseases: age-related macular degeneration, cataracts, diabetic retinopathy, dry eye and glaucoma. Symptoms include pain or redness in the eye and impaired vision, Hoskins says. If untreated, serious vision loss or blindness is likely to occur.

"The earlier you begin treatment, the more likely it is to be successful," Hoskins says. "But most Americans either don't think they're at risk or think it's a trivial issue."

The academy today released a 1,200-person survey that reports only 11% of Americans consider themselves at risk for eye disease. The academy estimates that each year, eye disease costs the U.S. about $51.4 billion. Medicare costs for indirect eye disease expenses — including nursing care and assisted-living facilities — are about $2 billion.

Source:www.usatoday.com

Experimental Therapy Reverses Type 1 Diabetes in Mice

2007-07-31T12:34:00.001-07:00

Researchers have accomplished what might be a cure of type 1 diabetes -- at least in mice --- and they're taking the first steps toward a human trial.

Type 1 diabetes is the autoimmune form of the disease, affecting about five percent of diabetics. It usually emerges in childhood and occurs when the body's immune system attacks insulin-producing beta cells in the pancreas.

Now, a three-drug regimen that not only stops the destruction of beta cells but also preserves the function of cells that receive and metabolize insulin has eliminated type 1 diabetes in laboratory mice, said lead researcher Maria Koulmanda, director of nonhuman primate research at the Transplant Research Center, Beth Israel Deaconess Medical Center in Boston.

Her team published its report July 30 in this week's online edition of the Proceedings of the National Academy of Sciences.

"We stopped the progression of automimmunity. The animals could become normoglycemic," meaning they had normal levels of blood sugar, Koulmanda said.

Another major discovery is that inflammation appears to play a major role in type 1 diabetes, she added. In fact, one drug used in the treatment regimen reduced the inflammation of cells that metabolize insulin.

"Basically, by blocking inflammation, we were getting the animals to be insulin-sensitive," Koulmanda said.

Another drug successfully reduced the autoimmune destruction of beta cells, but that was not the key to reversing the disease, she said. Instead, success was linked to blocking inflammatory processes that impair cells' responses to insulin.

Some of the cells involved in insulin metabolism were found to be resistant to insulin's effects -- a common phenomenon seen in much more common, adult-onset, obesity-linked type 2 diabetes, Koulmanda said. "This is the first time anyone has seen insulin-resistant cells in type 1 diabetes," she noted.

A course of treatment lasting less than four weeks restored normal blood sugar function in the test mice. In contrast, mice that did not get the treatment died during that month-long period.

Based on these promising results, the first work need to start a human trial of the regimen are about to begin, said Dr. Terry B. Strom, director of the Transplant Research Center.

"We have tried something like this for monkey models," he said. "The results have been very good."

The next step will be tests to ensure that the regimen is safe for human use.

"We anticipate toxicology trials very soon," Strom said. "We are making the proteins needed for those trials."

The fact that success was achieved in the mice trials with a relatively short course of treatment indicates that, for humans, "one might be able to use relatively brief periods of treatment to restore normal function," he said.

Source:www.forbes.com

Avandia should come with warning on heart disease, FDA told

2007-07-31T12:32:00.000-07:00

GlaxoSmithKline's diabetes drug Avandia should stay on the market with a strong warning about increased risks of heart diseases, an expert panel recommended to the Food and Drug Administration on Monday. The scientists on the panel said they were frustrated by the data presented at a day-long meeting. The committee of scientists voted 20-3 to conclude that Avandia does increase risks of heart disease in type 2 diabetes, but the committee declined to recommend that the drug be pulled from the market. The experts urged the FDA to study the effects of the drug and of a substitute drug, Actos, marketed by Takeda Pharmaceuticals.

Source:www.marketwatch.com

When the Kidney fails

2007-07-31T12:30:00.000-07:00

How do you treat end-stage renal failure? Patients with ESRF can be treated by dialysis or kidney transplantation. Dialysis is of two varieties hemodialysis or blood dialysis and CAPD or water dialysis. Kidney transplantation is the best treatment that can be offered to a patient with ESRF.

What is kidney transplantation? Kidney transplantation or renal transplantation is the organ transplant of a kidney in a patient with ESRF. The main types of kidney transplant are living donor transplant and cadaveric. In the former, the kidney originates from a deceased (brain-stem-death) person.

In the latter, the kidney is being donated by an organ donor. It is possible to transplant a kidney from a living donor because the body can work just as well with one kidney as with two.

What are the tests done to evaluate a kidney transplant recipient? A transplant evaluation includes many tests to make sure that the recipient is healthy enough to have a transplant. To make sure that the new kidney will be a good match, tests will be done to find out the blood and tissue type. Other tests include a check-up for any active infections, blood clotting profile, a chest x-ray, an ECG and cardiac evaluation, and abdominal ultrasound. Women must be cleared by a gynecologist. Other tests may be required depending on the age and medical history of the patient.

Can patients with kidney failure (ESRF) due to diabetes undergo transplantation? Patients with diabetic kidney failure form the majority of patients in a dialysis unit these days. Some diabetics tend to have concurrent heart problems or blood vessel (vascular insufficiency) blockages, and this has to be attended to before they are cleared for transplantation.

What kind of testing does a living donor go through? A person who wants to be a living donor will go through a set of tests, which will increase the chances of a successful match. They will also make sure that the donor will not be placed at risk. The tests include blood tests, urine tests, chest x-ray, ultrasound scan of the abdomen and ECG. Like the recipient, the donor is also tested for any active infections. Also, a CT/MR scan or arteriogram (an examination of the blood vessels) of the kidney is done.

Potential donors will be examined by a surgeon and a nephrologist.

Anyone with kidney disease, diabetes or high blood pressure would not be considered.

Does the transplant recipient have to take special medications after the transplant? Yes, the patient will have to take immunosuppressive medications such as prednisolone, cyclosporine or tacrolimus, and mycofenolate, but with significant reductions in dosages with time.

What is the most common cause of chronic kidney failure?

Diabetic nephropathy is fast becoming the leading cause of chronic renal failure. It is also one of the most significant long-term complications in terms of morbidity for the individual patients with diabetes.

Diabetes is responsible for more than 50 per cent of all end-stage renal disease cases in India.

Although both type 1 diabetes mellitus (insulin-dependent diabetes mellitus (IDDM) and type 2 diabetes mellitus (non-insulin-dependent diabetes mellitus (NIDDM) lead to ESRD, the great majority of patients are those with NIDDM.

Are there any guidelines for patients at risk for kidney disease? Patients with diabetes mellitus and hypertension (high blood pressure) are at risk for developing kidney disease. Patients with glomerulonephritis (kidney inflammation) and recurrent urinary infections/ obstruction are also at risk of developing kidney failure. Such patients are advised to undergo regular follow-up with a nephrologist.

Regular checks on urine-protein levels (proteinuria) and kidney function (urea and creatinine levels) are mandatory. Aggressive blood pressure control (aim for BP 20/80 mm Hg) and the use of newer medicines (ACEI and ARB) hold the key to the management of such patients with a view to prevent progression of kidney disease.

Source:www.newindpress.com

Experimental therapy reverses diabetes in mice

2007-07-31T12:25:00.000-07:00

An experimental new combination therapy has reversed type I diabetes in mice, thanks in part to a novel focus on combating insulin resistance in this form of the disease, US researchers said Monday.

Insulin resistance has long been a recognised feature of type II or late-onset diabetes, but has only recently been identified as a component of juvenile or type I diabetes.

With this study, investigators have shown for the first time that treating inflammation related to insulin resistance as well as the autoimmune component of the disease can successfully reverse the disease, if it is caught early enough.

"We believe this is the first study to show inflammation in insulin sensitive tissues plays an important role in this disease," said Terry Strom, a professor of medicine at Harvard Medical School and co-author of the paper.

Type I diabetes is an autoimmune disorder in which the body's own immune system attacks the pancreatic cells that produce the hormone insulin which regulates blood sugar.

The result is that the patient cannot produce enough insulin of their own, and has to supplement with synthetic versions of the hormone, typically by injection.

The condition raises an individual's risk for a host of complications, including heart disease, blindness and nerve damage.

In this experiment, investigators treated newly diabetic mice with a cocktail of three substances that prevented the body's own T-cells from destroying the pancreatic cells that produce insulin and also eliminated the inflammation that impaired the ability of tissues in the muscles, fat and liver to metabolise insulin properly.

The mice were treated for a period of 14 or 28 days, and within five to seven weeks, 95 per cent of them had normal blood sugar levels and were able to control their blood sugar for 300 days.

In contrast, the untreated diabetic mice became hypoglycemic and most died within seven weeks even with insulin treatment.

The results suggest any therapy that hopes to arrest the development of diabetes in humans must not only tackle the T-cell disorder, but it must also restore insulin responsiveness in tissues affected by an inflammatory disorder.

Otherwise, the body's remaining insulin-producing beta cells have to work twice as hard to regulate blood sugar levels.

"The remnants of the beta cells have to work overtime to try and maintain blood sugar levels," explained Strom.

Strom said that clinical trials of the treatment in humans would begin within 12 months.

The study appears in the Proceedings of the National Academy of Sciences.

Source:www.channelnewsasia.com

Panel votes to keep GSK's diabetes drug on market

2007-07-30T22:10:00.001-07:00

Avandia, the blockbuster diabetes treatment owned by GlaxoSmithKline, was yesterday given the green light to stay on the market despite data suggesting an increased incidence of heart attacks among those taking the drug.

Two committees at the US Food & Drug Administration, the Washington-based pharmaceuticals regulator, voted 22 to 1 in favour of recommending that American doctors be allowed to continue prescribing the drug to diabetes sufferers. It is not yet known who voted against.

The recommendation - which is usually followed by the FDA - will come as a relief to GlaxoSmithKline which last year made Pounds 1.4 billion in sales from the drug globally, of which Pounds1 billion was made in the USA. The treatment, which makes the body more sensitive to insulin, is the pharmaceutical company's second biggest selling drug after Advair, its asthma treatment.

Members of the panels, which included world experts on diabetes and scientists who specialise in analysing clinical trial data, were asked to vote on whether they believed that available data supported a conclusion that Avandia increased the risk of cardiac arrest. Seventeen members of the 23-man panel said they thought that the figures showed a "suggested" risk but still voted to keep the drug on the market.

The panel did not explicitly recommend that Glaxo change its labelling of the drug, although some members of the panel suggested that label changes could be made in some circumstances.

The FDA will now collate the comments from the members of the panel and publish its decision which could include a ruling to make Glaxo change the labelling on Avandia.

The row over the drug erupted in May when an American medical journal reported a 43 pc increased risk of a heart attacks from diabetes sufferers taking the drug. The drug has also been linked, subsequently, with increased numbers of bone fractures in women taking the drug.

Glaxo has maintained that if the drug is carefully prescribed, the benefits to diabetes sufferers outweigh the risks. It also claims that during the course of its own extensive trials, it found that there was no increased incidence of heart problems compared with diabetes sufferers taking rival treatments such as Actos, a Japanese drug.

More than 21 million people in the US suffer from diabetes, which is the leading cause of new cases of blindness. Diabetes sufferers either do not produce enough insulin to break down sugar, or their insulin fails to work properly. Unlike a number of older, generic drugs to treat diabetes which try to kick start the pancreas to produce more insulin, Avandia makes the body more sensitive to the insulin it already produces.

Worldwide sales in the three months to June dropped to £349 million from £477 million a year ago, the company reported last week.

Source:business.timesonline.co.uk

Hundreds of hospital fatalities 'avoidable'

2007-07-30T22:07:00.000-07:00

One third of deaths in hospital investigated by a patient safety watchdog could have been avoided, claims a report released today.

The National Patient Safety Agency looked into 1,804 fatal hospital incidents reported to it in 2005. It found that 576 were "potentially avoidable" if there had been better communication between staff, faster recognition of the patient's deteriorating state, improved training and more accurate interpretation of test results.

Some 425 of the deaths investigated by the NPSA in 2005 were in acute or general hospitals. Of these, 71 were reported to be related to diagnostic errors, in 64 cases the patient's deteriorating condition was not recognised or not acted upon, and 43 involved a problem with resuscitation after cardiac arrest.The remainder were connected to medication errors, suicide or still-birth.

In 14 of the patients who deteriorated, no checks had been made on them for a prolonged time and changes in their vital signs such as blood pressure, heart rate or temperature were not detected.

In a further 30 cases, the checks had been made but staff either did not recognise the patient's worsening condition or they did not act. In 17 other cases help was sought but there was a delay.

Professor Richard Thomson, the NPSA's director of epidemiology and research, said: "These are not new concerns but more effort is needed to recognise and act upon them.

"This work helps us to further raise the profile of these issues and support a programme of activities involving a range of national organisations and individual experts. Every preventable death is a tragedy, not only for the family but for the staff involved."

The report says all staff should be trained in dealing with cardiac arrest. Among the 43 deaths involving resuscitation, the study found that many of the incidents suggested that "medical and nursing staff did not have the depth of knowledge and skills required".

It said: "In most cases the delay in starting the resuscitation was reported to be because staff did not recognise the acute situation, failed to call the resuscitation team or did not make an attempt themselves to resuscitate the patient."

Fourteen reported incidents related to the use of equipment. One such report said: "During a cardiac arrest, defibrillator found not to have the correct leads and paddle to fit the defibrillator. This caused a delay of approx five minutes during the arrest."

During 2006, the Medicines and Healthcare products Regulatory Agency (MHRA) received 141 reports of adverse incidents involving defibrillators. Many were related to problems with electrodes or batteries.

In the first six months of 2007, the MHRA received 86 reports and receives an average of 14 incident reports a month on these devices, some of which are duplicate reports from manufacturers.

The NPSA report said: "Several of these incidents occurred in resuscitation situations, when user error may have contributed to the incident, for example, incorrect connection of suctioning tubes."

The report stresses that there may be many similar cases which have not been reported to the NPSA.

Researchers said that about 13 million people are admitted to hospitals in England and Wales each year.

The findings come as the National Institute for health and Clinical Excellence releases guidance to clinicians on how to manage patients in hospital who deteriorate rapidly.

It emphasises making a complete medical assessment of the patient, regular monitoring and improving communication between staff.

Source:www.telegraph.co.uk

What Is Sudden Cardiac Death

2007-07-30T22:05:00.000-07:00

If you can still remember, three young high profile professional athletes: Reggie Lewis (basketball player), Darryl Kile (baseball pitcher), and Marc Vivien Foe (football player) all died of sudden cardiac death or sudden death due to a fatal heart rhythm called ventricular fibrillation.

Sudden cardiac death is sudden and unexpected with death occurring within minutes after collapse. It is more common to older folks with serious heart ailments although it sometimes does happen to those young and healthy people with no outward sign of heart disease.

It is not the same as heart attack but a heart attack may actually cause sudden cardiac death either during the first few hours of the heart attack or many years after the attack. To differentiate the two, one can think of sudden cardiac death as an electrical malfunction and heart attack as one that is caused by blocked arteries (plumbing malfunction). To be more precise, sudden cardiac death arises when millions of “short-circuits” occur in the heart, causing the heart pump to fail and cease to deliver life-sustaining blood, oxygen and nutrients. The person thus becomes unconscious. Death can occur just within minutes if the situation is not remedies.

The only chance of survival for a victim of sudden cardiac death is to “re-start” his or her heart by an electrical shock from a machine known as a defibrillator. There are few types of defibrillators, namely manual external defibrillators (MED), automatic external defibrillators (AED), and implantable defibrillators (ICD).

Only trained personnel such as doctors, nurses, or paramedics can operate MED whereas AED can be operated by lay persons with minimal training. These machines automatically recognized heart rhythms that are treatable by electrical shock, and prompt the user to press the “shock” button. The machines are easy to operate and have been used successfully in airports, casinos and other public places to resuscitate victims of cardiac arrest.

ICD is implanted into a person’s body by surgery. It is fully automatic, and it can recognize and treat ventricular tachycardia and fibrillation without any external intervention, usually even before the person has lost consciousness.

In order to prevent sudden cardiac death, it is necessary to take a complete medical history, including a detailed family history of any cardiovascular disease, and carry out a thorough physical examination. If any symptom of heart disease, such as palpitations, fainting spells, chest pain, or breathlessness on physical exertion, is evident, and then further investigation that includes an electrocardiogram and echocardiogram is compulsory.

Source:pr-gb.com

Cardiac arrest not noticed by hospital staff, suit claims

2007-07-30T22:03:00.000-07:00

Paul and Beth Werner of Belleville are seeking in excess of $100,000 from Memorial Hospital of Belleville, claiming the hospital's emergency staff failed to recognize Paul Werner was having cardiac arrest during a visit on July 9, 2005.

According to a lawsuit filed July 9 in St. Clair County Circuit Court, Werner suffered loss of mental capacity, paralysis and loss of consciousness and memory.

He also claims he incurred medical expenses and pain and suffering as the result of his injuries.

The suit alleges the hospital violated the standard of care for a patient by failing to provide timely CPR and resistive services to Werner.

Beth Werner is seeking damages for loss of consortium.

The Werners are represented by James R. Williams of Williams, Caponi and Associates of Belleville.

Source:www.madisonrecord.com

Article; Four-Year Old Dies Of A Cardiac Arrest After Being Hit By Truck In Sydney

2007-07-30T22:02:00.000-07:00

A four-year old girl has died after being hit by a truck at a pedestrian crossing in Sydney on Tuesday.

The child's mother was carrying her when they were hit by a truck on Botany Road making a left-hand turn from McEvoy Street in Alexandria about noon. The girl went into a cardiac arrest after being struck.

A Spokesman for the crash investigation unit said both mother and daughter were on a pedestrian crossing at the time of the incident. A witness called triple-o emergency for an ambulance and said the child had been knocked out of her mother's arms.

She was taken to the Randwick's Sydney Children's Hospital in a critical condition and died soon after. The mother has suffered injuries to the head and leg. She was taken to the Royal Prince Alfred Hospital where she is in a serious but stable condition.

The driver of the work truck was not hurt and was taken to Redfern police station for questioning. Crash investigation unit officers spoke to witnesses at the scene.

Source:www.allheadlinenews.com

ICDs Effective In Helping To Prevent Sudden Cardiac Death In Patients With Certain Heart Disorder

2007-07-30T22:01:00.000-07:00

High-risk patients with hypertrophic cardiomyopathyappear to have reduced risk of sudden cardiac death with an implantable cardioverter-defibrillator that terminates dangerous heart rhythm disorders, according to a study in the July 25 issue of JAMA.
Hypertrophic cardiomyopathy (HCM) is the most common cause of sudden cardiac death in young people, including trained athletes. HCM is a genetic disease in which the heart muscle thickens abnormally, which can interfere with the heart's electrical system, increasing the risk for life-threatening abnormal heartbeats (arrhythmias).

Only in the last few years has the implantable cardioverter-defibrillator (ICD) been systematically used as a potentially life-saving treatment in high-risk patients with HCM, according to background information in the article. An ICD is a device designed to quickly detect a life-threatening, abnormal heart rhythm, and attempt to convert the rhythm back to normal by delivering an electrical shock to the heart. The effectiveness and appropriate selection of HCM patients for this therapy is not certain.

Barry J. Maron, M.D., of the Minneapolis Heart Institute Foundation, Minneapolis, and colleagues examined the clinical risk profile and incidence and effectiveness of ICD intervention in patients with HCM. The researchers analyzed data from a multicenter registry of ICDs implanted between 1986 and 2003 in 506 patients with HCM, average age 42 years. Patients were judged to be at high risk for sudden death. Average follow-up was 3.7 years.

Risk factors analyzed included history of premature HCM-related sudden death in 1 or more first-degree or other relatives younger than 50 years; massive left ventricular hypertrophy (enlargement); a certain type of nonsustained ventricular tachycardia (abnormally rapid heart rhythm); and prior unexplained syncope (temporary loss of consciousness).

Of the 506 patients, 20 percent experienced 1 or more appropriate device interventions, in which the ICD terminated ventricular fibrillation (severely abnormal heart rhythm that results in cardiac arrest) or ventricular tachycardia. Intervention rates were 10.6 percent per year for secondary prevention after cardiac arrest (5-year cumulative probability, 39 percent), and 3.6 percent per year for primary prevention (5-year probability, 17 percent).

Time to first appropriate discharge was up to 10 years, with a 27 percent probability 5 years or more after implantation. For primary prevention, 35 percent of the patients with appropriate ICD interventions had undergone implantation for only a single risk factor; likelihood of appropriate discharge was similar in patients with 1, 2, or 3 or more risk markers.

"The results of this international, multicenter study show the effectiveness and reliability of the ICD in prevention of sudden cardiac death in high-risk patients with HCM," the authors write. "An important proportion of these device interventions occurred in patients who had undergone prophylactic ICD implantation for a single risk factor. Therefore, a single marker of high-risk status may justify consideration for a primary prevention defibrillator in selected patients with HCM."

Reference: JAMA. 2007;298(4):405-412.

Editorial: Hypertrophic Cardiomyopathy, Sudden Death, and Implantable Cardiac Defibrillators -- How Low the Bar?

In an accompanying editorial, Rick A. Nishimura, M.D., and Steve R. Ommen, M.D., of the Mayo Clinic College of Medicine, Rochester, Minn., comment on the findings of the study by Maron and colleagues.

"Patients who have experienced cardiac arrest or documented sustained ventricular tachycardia definitely should be considered for implantation of an ICD. Patients with 2 or more risk factors likely present a high enough risk to warrant implantation of an ICD. However, the decision to implant an ICD in any patient, especially one with a single risk factor, must include a thorough and earnest discussion of the accuracy of the current risk assessment tools, the risks and benefits of ICD therapy, and the individual patient's viewpoints on procedures, devices, and death. Such an approach will allow the patient-physician team to arrive at an individualized decision regarding ICD implantation."

Source:www.sciencedaily.com

Newsweek Cover Story Examines Benefits of Lowering Body Temperature in Cardiac Arrest Victims

2007-07-30T21:59:00.000-07:00

Cardium Therapeutics (OTCBB:CDTP) and its operating unit, InnerCool Therapies, today announced that temperature modulation therapy in cardiac arrest patients was featured in Newsweek's July 23 cover story. The article, "This Man Was Dead. He Isn't Anymore" (http://www.msnbc.msn.com/id/19751440/site/newsweek/), examines how physicians at the University of Pennsylvania are using mild hypothermia to treat sudden cardiac arrest patients.

Patient temperature modulation is a rapidly-advancing field focused on preserving ischemic tissue and improving patient outcomes following major medical events such as heart attack, cardiac arrest and stroke, as well as in the management of patients experiencing trauma or fever. Internal or endovascular temperature modulation is intended to rapidly cool patients from within their bodies in order to reduce cell death and damage caused by acute ischemic events in which blood flow to critical organs such as the heart or brain is restricted, and to prevent or reduce associated injuries such as adverse neurologic outcomes. External or surface-based temperature modulation is designed to cool or warm patients from outside of their bodies and is intended for use in less acute settings such as in-hospital fever management.

"Temperature modulation therapy to safely and effectively cool patients represents an important new tool now being explored for protecting the brain from ischemia, especially in post cardiac arrest patients who are at higher risk of brain tissue damage due to the prolonged lack of blood flow. With the increase in survival of cardiac arrest victims resulting from the advent of automated external defibrillators, cooling patients is the next logical therapeutic approach especially in light of the large body of supporting scientific literature, and guidelines issued by the American Heart Association and the International Liaison Committee on Resuscitation recommending that cardiac arrest victims be treated with induced hypothermia. With an estimated 225 hospitals out of approximately 5,700 in the United States beginning to utilize hypothermia systems, temperature modulation therapies are now considered to represent a significant and growing market opportunity," stated Christopher J. Reinhard, Chairman and Chief Executive Officer of Cardium Therapeutics and InnerCool Therapies.

"InnerCool's new cost-effective CoolBlue Surface System and next-generation, high performance RapidBlue Endovascular System, both of which are expected to be launched within the next quarter, will establish InnerCool as the first and only comprehensive provider of temperature control solutions," added Reinhard. "Providing hospitals and clinicians with a one-source approach to effective patient temperature modulation should allow the medical community to expand the use of InnerCool systems for current indications and facilitate ongoing research regarding the potential uses of temperature modulation in a number of different patient populations that could benefit from these new therapies."

CoolBlue(TM) - Convenient Surface System

InnerCool's new easy-to-use, nurse-friendly CoolBlue(TM) surface temperature modulation system includes a console and a disposable CoolBlue(TM) vest with upper thigh pads, which is designed to provide a complementary tool for use in less acute patients or in clinical settings best suited to prolonged temperature management. InnerCool's CoolBlue vest and thigh pads, which effectively wrap the body without requiring any adhesives contacting the skin, is expected to enable cooling rates of around 1 degree Celsius per hour, similar to those of currently-marketed surface cooling systems and lower-performing endovascular systems using medium-sized, inflatable plastic balloon-based catheters.

RapidBlue(TM) - High-Performance Endovascular System

InnerCool's approach to endovascular temperature modulation makes use of a thin flexible catheter designed to facilitate quick deployment and minimize vascular occlusion - while at the same time accelerating and optimizing patient cooling and re-warming. InnerCool's next-generation RapidBlue(TM) system for high-performance endovascular temperature modulation includes a programmable console with an integrated easy to insert cassette, enhanced touch-screen user interface and a catheter designed to quickly modulate patient temperature in association with surgery or other medical procedures. The RapidBlue system powers InnerCool's Accutrol(TM) catheter, which has a flexible, low profile metallic temperature control element and a built-in temperature feedback sensor to provide fast, precise and reliable patient temperature control. Cooling rates with the RapidBlue system range from 4-5 degrees Celsius per hour which is 3-4 times as rapid as the CoolBlue and other surface or leading endovascular balloon-based technologies currently on the market.

InnerCool's "total solutions approach" also allows physicians to employ a rapid-cooling endovascular system for acute needs, followed by surface cooling for prolonged temperature management of patients remaining in intensive care units. InnerCool's novel approach to total temperature management is designed to provide clinicians with a comprehensive product portfolio to meet all of their temperature modulation needs.

About Patient Temperature Modulation

Numerous scientific and medical articles have described the usefulness of temperature modulation, such as induced hypothermia (cooling), which is designed to protect endangered cells, prevent tissue death and preserve organ function following acute events associated with severe oxygen deprivation such as stroke or cardiac arrest. Therapeutic hypothermia is believed to work by protecting critical tissues and organs (such as the brain, heart and kidneys) following ischemic or inflammatory events, by lowering metabolism and preserving cellular energy stores, thereby potentially stabilizing cellular structure and preventing or reducing injuries at the cellular, tissue and organ level. Two international clinical trials on hypothermia after cardiac arrest published in The New England Journal of Medicine demonstrated that induced hypothermia reduced mortality and improved long-term neurological function. Based on these and other results, the American Heart Association (AHA) and the International Liaison Committee on Resuscitation (ILCOR) have issued guidelines recommending that cardiac arrest victims be treated with induced hypothermia.

Ischemic diseases constitute the largest segment of the medical market in the United States and in almost all developed countries worldwide. In the U.S. and other developed countries, an estimated 1.4 million people experience cardiac arrest each year, of which an increasing number (currently about 350,000) survive to receive advanced care. The AHA guidelines now recommend the use of therapeutic cooling as part of the critical care procedures for patients with an out-of-hospital cardiac arrest following ventricular fibrillation. With respect to heart attacks, an estimated 325,000 people in the U.S., and approximately 375,000 people outside the U.S., receive emergency angioplasty or anti-clotting treatment as first-line care.

About InnerCool

InnerCool Therapies, Inc., a subsidiary of Cardium Therapeutics, Inc., is a San Diego-based medical technology company in the emerging field of patient temperature modulation, which is designed to rapidly and controllably cool the body in order to reduce cell death and damage following acute ischemic events such as cardiac arrest or stroke, and to potentially lessen or prevent associated injuries such as adverse neurological outcomes.

InnerCool's endovascular approach to patient temperature modulation is based on a single-use flexible metallic catheter and a fully-integrated cooling system, which allows for rapid and controlled cooling and re-warming. InnerCool's endovascular system integrates a number of desirable features including a slim catheter profile, a highly efficient flexible metallic thermal transfer element, a built-in temperature monitoring sensor, and a programmable console capable of rapidly and controllably inducing, maintaining and reversing therapeutic cooling. InnerCool's endovascular catheter-based Celsius Control System has received FDA 510(k) clearance for use in inducing, maintaining and reversing mild hypothermia in neurosurgical patients, both in surgery and in recovery or intensive care. The system has also received FDA clearance for use in cardiac patients in order to achieve or maintain normal body temperatures during surgery and in recovery/intensive care, and as an adjunctive treatment for fever control in patients with cerebral infarction and intracerebral hemorrhage. Potential additional applications of the technology include endovascular cooling for cardiac arrest, acute ischemic stroke and myocardial infarction (heart attack).

Source:www.genengnews.com

Mosquera recovering after cardiac arrest during training with German club

2007-07-30T21:58:00.000-07:00

Colombian forward John Jairo Mosquera is recovering after a cardiac arrest during training with Germany's Carl Zeiss Jena.

The second division club said 19-year-old Mosquera collapsed suddenly on Wednesday. He was revived by club doctor Heribert Zitzmann and taken in stable condition to the hospital in nearby Gifhorn.

"(He is) doing well at the moment," Dr. Ruediger Wacker said at the hospital.

Mosquera will now undergo checks to determine the cause of the heart problem.

The Colombian is on trial with Jena after being loaned to Wacker Burghausen last season by Werder Bremen.

Source:www.iht.com

Player dies after cardiac arrest

2007-07-30T21:56:00.000-07:00

A footballer in his 20s has died after suffering a cardiac arrest during a match in Warwickshire.

Several people and an off-duty nurse at the Recreation Ground, Victoria Road, Nuneaton, carried out resuscitation techniques before ambulances arrived.

The player was taken to George Eliot Hospital where he was pronounced dead.

"The quick actions of those at the match (on Saturday) gave the man the best possible chance of survival," an ambulance service spokesman said.

Source:news.bbc.co.uk

Police cars should have defibrillators to deal with cardiac arrest

2007-07-30T21:55:00.000-07:00

With the recent attention on sudden cardiac arrests, one Member of Parliament is advocating that police patrol cars be equipped with automated external defibrillators, or AED.

MP Fatimah Lateef, who is also a member of the National Taskforce for Pre-hospital Care Medicine, said this could greatly improve the survival chances of a cardiac arrest victim.

Medical experts say that if you experience sudden cardiac arrest outside the hospital, your rate of survival is only 2.7 percent.

Mass exercise events are increasingly popular among Singaporeans.

Even Senior Minister Goh Chok Tong gave his support at the community run at East Coast Park on Sunday and, with the recent attention on the level of sports safety, the organisers did not take any chances.

Ambulances, medical staff and first-aid volunteers were on standby at the event as well as an AED, a machine which can resuscitate the victim of sudden cardiac arrest.

But medical professionals say outside of such sporting events, Singaporeans are woefully unprepared to react.

Dr Charles Johnson, HOPE Ambulance Service, said: "Often we don't call for help early enough, or we call the wrong people. Working in the emergency department, a lot of times when somebody collapses at home, the first call for help is to uncle, auntie, children, then somewhere along the way, 'Oh yes, we haven't called the ambulance yet! Better call now', that kind of thing.

"People have to realise that calling for help is not the answer. You still have to do cardio-pulmonary resuscitation (CPR) until professional help arrives."

With the survival rate falling by an average of 10 per cent with every minute that passed, the experts say using an AED at the scene can mean the difference between life and death.

But there are other problems as well.

Dr Charles Johnson said: "From the time of call to the actual time of arrival at scene, there are problems, for example in terms of locating the exact block, which lift to take.

"We also have to realise that HDB lifts tend to be small. It is not easy to institute emergency medical care in the lift to a patient in a sitting position, because the standard lying down stretcher does not fit in a HDB lift door."

MP Fatimah Lateef believes one way to improve the survival rate of cardiac arrests here is to equip the police with AED sets.

She said: "Sometimes they do arrive before the paramedics or the ambulances arrive. So it will be good if the police who's first on scene could help with the assessment of patient, and assess whether there's a need to do CPR, or even to defibrillate. That would save time as well."

She noted that while many policemen could apply CPR and work the defibrillator, she felt there should be a training programme for all policemen.

Dr Fatimah added that CPR skills should be taught to more Singaporeans - even from as young as 12.

She estimated that at least 20 per cent of the population need to be trained before a one per cent change can be effected in the survival rate.

Dr Fatimah said another idea is to increase the number of AED sets at Changi Airport, which sees a large number of human traffic daily.

She cites a recent study done at Chicago's O'Hare International Airport, which gives the public access to AEDs within one minute in any direction.

Source:www.channelnewsasia.com

Heavy Hearts And The Risk Of Sudden Death

2007-07-30T21:54:00.000-07:00

Those with heavy hearts -- in the literal not figurative sense -- long have been known to be prone to cardiac arrest and sudden death. But many are not, and who among them is subject to serious risk is a mystery. To find clues to the puzzle, the National Heart Lung and Blood Institute (NHLBI) of the National Institutes of Health has just awarded $2 million to Sumeet Chugh, M.D., director of Oregon Health & Science University's cardiac arrhythmia center in the division of cardiovascular medicine.The condition known as left ventricular hypertrophy (LVH), or a thickening and swelling of the heart wall, can be found, by some estimates, in up to 20 percent of the middle-aged population with heart disease in the United States. Some $3 billion to $5 billion worth of pocket defibrillators are being implanted under Medicare guidelines annually to jump start hearts at risk of a cardiac arrest. Yet research studies show that only one out of 15 of the devices ever will be needed to save a life, which is why pinpointing who among those with LVH is at greatest risk of cardiac arrest is a multibillion dollar priority.

The five-year NHLBI grant will provide funds for Chugh, the principal investigator and an associate professor in the cardiovascular division of the OHSU School of Medicine, along with his team of clinicians, scientists and researchers, to continue the landmark Oregon Sudden Unexpected Death Study (Ore-SUDS), which Chugh initiated five years ago. The Ore-SUDS study is a community-based effort that includes a partnership with the emergency medical response system (Jonathan Jui, M.D., professor of emergency medicine, OHSU School of Medicine) the state medical examiner network (Karen Gunson, M.D.) and 16 area hospitals, thus enabling a systematic study of all sudden cardiac arrests that occur in the Portland metropolitan area.

Several findings have been published earlier including the only U.S. data on the current burden of cardiac arrest obtained in a prospective manner. A separate collaborative effort with the Donald W. Reynolds Cardiovascular Clinical Research Center at Johns Hopkins University Reynolds Cardiovascular Center (Eduardo Marban, M.D., Ph.D., director) focusing on the link between cardiac arrest and the human genome is also ongoing.

"We found in analyzing the Ore-SUDS data," said Chugh, "that if you have left ventricular hypertrophy in Multnomah County your risk of cardiac arrest is increased at least twofold and, in combination with specific other conditions such as a weakened pumping ability of the heart muscle, the risk can be much higher. But that doesn't mean everybody with the condition is at risk. Left ventricular hypertrophy is associated with high blood pressure, and lots of people have high blood pressure but not all of them are prone to cardiac arrest.

Chugh reported in the Journal of the American College of Cardiology in March that less than a third of the sudden cardiac deaths where left ventricular dysfunction had previously been evaluated in the Ore-SUDS data had dysfunction that was severe enough to warrant implantation of a cardioverter-defibrillator. "These findings support the aggressive development of alternative screening methods to enhance identification of patients at risk," Chugh wrote.

Speaking about his team's plans going forward, Chugh said: "We want to figure out what will significantly improve our ability to predict cardiac arrest," Chugh continued. "Our ultimate aim is to nip it in the bud, which for patients that will suffer cardiac arrest means averting disaster before it happens. The evaluation of information that we have gathered in Ore-SUDS combined with what we learn at the bedside from patients together with bench research we are doing on the molecular mechanisms involved represent a comprehensive approach that we think hold great promise of solving the puzzle. If we can predict who the high risk patient with left ventricular hypertrophy is, that is likely to have huge significance for our patients."

According to the American Heart Association, about 250,000 Americans succumb each year to sudden cardiac death, which is defined as death within one hour of the time a person displays symptoms such as chest pain or difficult breathing. About half have shown no prior evidence of heart disease and about 40 percent are under age 65. In most cases, cardiac arrest results from arrhythmia, or abnormal heart rhythm. The survival rate ranges between 5 percent and 10 percent despite improvement in emergency medical services and widespread training in application of CPR.

Source:www.sciencedaily.com

Sudden Cardiac Arrest Coalition Launches Advocacy

2007-07-30T21:51:00.000-07:00

SCA occurs when the heart stops working and no blood can be pumped to the rest of the body. In essence, the heart's electrical system malfunctions. One common misconception among the general public is that SCA is the same as a heart attack. It is not a heart attack, also known as a myocardial infarction, which is actually when a blockage in a blood vessel interrupts the flow of oxygen-rich blood to the heart, causing the heart muscle to die. 95% of all victims of SCA die because they do not receive life-saving defibrillation within 4 -- 6 minutes, before brain and permanent death start to occur. While the federal government has already made great strides in research, awareness, and treatment advances for many of our nation's major health threats -- like breast cancer, lung cancer, stroke and AIDS -- with SCA claiming more than 250,000 lives each year, the government must focus resources on a killer that takes more lives each year than any of those diseases. Sudden Cardiac Arrest Coalition

Source:/www.earthtimes.org

Comprehensive Site to Educate Public, Mobilize Supporters and Arm Decision-makers with Facts on this Leading Killer

2007-07-30T21:49:00.000-07:00

About Sudden Cardiac Arrest

SCA occurs when the heart stops working and no blood can be pumped to the rest of the body. In essence, the heart's electrical system malfunctions. One common misconception among the general public is that SCA is the same as a heart attack. It is not a heart attack, also known as a myocardial infarction, which is actually when a blockage in a blood vessel interrupts the flow of oxygen-rich blood to the heart, causing the heart muscle to die. 95% of all victims of SCA die because they do not receive life-saving defibrillation within 4 -- 6 minutes, before brain and permanent death start to occur. While the federal government has already made great strides in research, awareness, and treatment advances for many of our nation's major health threats -- like breast cancer, lung cancer, stroke and AIDS -- with SCA claiming more than 250,000 lives each year, the government must focus resources on a killer that takes more lives each year than any of those diseases.

Source:sev.prnewswire.com

Medcool Inc. Receives FDA Clearance for Its RapidCool (TM) System

2007-07-30T21:48:00.000-07:00

Medcool Inc. of Wellesley, MA, an emerging provider of non-invasive systems for therapeutic hypothermia and temperature management, announced today that its RapidCool(TM) System has received 510(K) clearance by the FDA to be marketed in U.S. for temperature reduction therapy.

The RapidCool System is indicated for use for "temperature reduction in patients where clinically indicated, e.g. in hyperthermic patients, and for monitoring of patient temperature."

The RapidCool System uses an innovative and patented disposable helmet that directs agitated cold water to the scalp, plus more standard body and neck pads, to rapidly cool the head and body of patients for whom cooling is indicated. The system rapidly reduces head and body temperature to a set point in the range of 32-37 degrees C, is non-invasive and does not interfere with cardiac catheterization and other hospital procedures.

A growing body of research indicates that mild hypothermia, in the range of 32-34 degrees C, could potentially have a protective effect, reducing damage from cardiac arrest, stroke, brain injury, and other traumatic events. Rapid cooling is believed to be important in reducing injury to the brain following these events. The recent cover article in Newsweek describes the evolving use of hypothermia following cardiac arrest (http://www.msnbc.msn.com/id/19751440/site/newsweek/).

"We are very pleased to be cleared for marketing in the U.S.," said Joe Caruso, Medcool CEO, "and are actively looking for strategic and distribution partners for this unique technology."

The Company's helmet design makes use of the fact that the body responds to decreasing temperature by increasing blood flow to the scalp while reducing blood flow to the periphery. As a result, the RapidCool System is capable of high rates of cooling compared to standard non-invasive cooling systems -- and directs most of its cooling to the head where it is most needed.

Source:www.earthtimes.org

Bristol-Myers Squibb And ImClone Systems Significantly Expand ERBITUX Clinical Development Program

2007-07-30T21:43:00.000-07:00

ImClone Systems Incorporated and Bristol-Myers Squibb Company recently announced that the companies have amended the terms of their agreement for the co- development and co-promotion of ERBITUX (Cetuximab) in North America. Under this amendment, the companies have jointly agreed to expand the investment in the ongoing clinical development plan for ERBITUX by up to several hundred million dollars. Development costs, up to a threshold value, will be the sole responsibility of Bristol-Myers Squibb; costs in excess of this threshold will be shared by both companies according to a pre-determined ratio.

With this additional funding, the companies will seek to add numerous Phase II and Phase III clinical trials that will further explore the activity of ERBITUX in a wide variety of therapeutic settings. The companies intend to utilize the results of these studies to support new registrational opportunities for ERBITUX. The comprehensive clinical program will supplement the significant body of clinical data existing for ERBITUX in colorectal and head and neck cancers by exploring the use of ERBITUX in additional tumor types including brain, breast, bladder, gastric, lung, pancreas and prostate.

"By broadening the ERBITUX development program with ImClone Systems and utilizing pharmacogenomic markers and other screening technologies, we intend to enhance cancer patient outcomes which may further differentiate ERBITUX from other commercially available antibodies," said Elliott Sigal, M.D., Ph.D., Executive Vice President, Chief Scientific Officer and President, Research and Development, Bristol-Myers Squibb. "This plan further demonstrates Bristol-Myers Squibb's focus on the development of innovative compounds, like ERBITUX, and highlights our company's dedication to partnerships that can maximize the potential of products in our portfolio."

"This new commitment to ERBITUX represents one of the largest and broadest cancer-focused development programs for any antibody. The agreement aligns the development and commercialization of ERBITUX at ImClone Systems and Bristol- Myers Squibb to benefit both companies' shareholders, and most importantly, cancer patients," stated Alexander J. Denner, Ph.D., Chairman, Executive Committee of ImClone Systems Incorporated. "We are very pleased by this agreement and look forward to the two companies working in harmony."

Jim Cornelius, Chief Executive Officer, Bristol-Myers Squibb, stated, "We value our partnership with ImClone Systems -- and this new agreement confirms our strong commitment to oncology patients and the importance of ERBITUX to our business."

Carl Icahn, Chairman of the Board, ImClone Systems Incorporated, stated, "As the new Chairman, I am happy that Bristol-Myers Squibb and ImClone Systems have come to this very amicable agreement which I have every hope should benefit greatly both parties."

Source:www.pharmaceuticalonline.com

Tiny survivor has a real fighting spirit

2007-07-30T08:27:00.000-07:00

Carsyn Grayce Wolford turns five months old. The day will represent yet one more milestone in the short life of the preemie born March 8 at St. Peter's Hospital.
At birth she weighed 15 ounces; less than one pound and measured just 10 inches. Her survival is nothing less than a miracle, according to Austyn Wolford, her mother. And her doctors agree.
Carsyn is the smallest baby to ever have survived at St. Peter's, weighing in at just 429 grams at birth. Her original due date was June 15 but because Austyn suffered in early March from pre-eclampsia (or pregnancy-related hypertension) and a placental disruption (when the placenta separates from the wall of the uterus prematurely) an emergency caesarean had to be performed.
Before Carsyn's birth, the smallest baby to survive at St. Peter's was born December 2004 at 23 weeks gestation (three weeks sooner than Carsyn), weighing 15.4 ounces.
Survival of babies weighing over 500 grams (more than one pound) is pretty commonplace, but for those that weigh less than 500 grams, survival to this point is rare, said physician Karen Narkewicz, chief of Neonatology at St. Peter's.
"She was strong and feisty, right from the start. ... Of the 75 to 80 percent of these babies that do survive, most have major problems. Carsyn does not appear to have any major problems. She will have challenges with gaining weight. ... Developmentally, she has met all of the milestones and is doing great," she said.
Carsyn is going home today after three and one-half months in the hospital's Neonatal Intensive Care Unit. She is now 18 inches long and weighs five pounds and five ounces.
"She's huge," said Austyn Tuesday afternoon, cradling the wriggling baby in her arms while mom and daughter posed for photographers and reporters.
At just over five pounds the infant even appeared large to Jackie Repscher, the nurse who has been at her side since the birth.
It's hard to believe that a tiny pair of leather moccasins no larger than 1 ½ inches each actually fit Carsyn's feet a few days after she was born. Now her feet are twice that size, Austyn said.
Merely holding her baby in her arms is something she cherishes.
The young mother has gotten used to the waiting game. She wasn't able to see her baby until a day after her birth. At the time her skin was transparent and her eyes had not yet opened
Austyn went home March 12, four days after the birth, and then began daily trips to the NICU to visit her child.
"I couldn't do anything except sometimes hold her hand, for seven weeks. I couldn't change a diaper or hold her. It was very difficult, but she was a fighter," she said.
The process has been an emotional rollercoaster ride.
"It's been a 138-day adventure. No one is ever prepared for something like this. No one ever thinks it's going to happen to them," she said.
At 27, she is a first-time mom and a medical billing specialist at Julie Blair Nursing Home in Albany. She plans on being the child's primary caregiver, but will move back to Stoneridge, Ulster County to live with her parents so they, too, can be an active part of the care-giving circle.
As a newborn, Carsyn faced a number of complications, Narkewicz said.
"She was small for her gestational weight. Her liver was very large at birth and her lungs were about the size of a postage stamp, which made it difficult to put her on a ventilator. ... Early on, she had a hole in her intestine but was too small to undergo surgery. She eventually underwent three surgeries and had to be fed through an IV," she said.
Challenges still lie ahead for the infant who has been nicknamed Sarah Bernhardt, after the 19th Century Parisian actress because of her apparent flair for the dramatic. But her doctors are confident that she'll continue to thrive and her mom plans to be there every step of the way.
"I never thought I could love something so much," Austyn said.

Source:www.troyrecord.com

Unborn babies at risk from weight change by mothers

2007-07-30T08:26:00.000-07:00

Mothers who drastically lose or gain weight between pregnancies could damage the health of their unborn babies, according to medical experts.

They say women are becoming increasingly pressurised after being "bombarded" with messages about body image, ranging from the "size zero" culture to fears about obesity.

However, they warn women whose weight fluctuates dramatically before becoming pregnant again could be putting their own health, and that of the child, at risk.
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Writing an editorial published today in the British Medical Journal, Dr Jennifer Walsh and Professor Deirdre Murphy, pointed to two separate studies on weight gain and loss between pregnancies.

They showed gaining weight could cause high blood pressure and diabetes in mothers and could also cause problems during childbirth, with a greater risk of forceps delivery, caesarean sections and an increased risk of stillbirths.

However, they also warned losing large amounts of weight very rapidly could cause premature births.

"Women of reproductive age are bombarded with messages about diet, weight and body image," they said. "There is growing concern on the one hand about an epidemic of obesity and on the other about a culture that promotes size zero' as desirable, irrespective of a woman's natural build.

"Pregnancy is one of the most nutritionally demanding periods of a woman's life, with an adequate supply of nutrients essential to support foetal wellbeing and growth.

"With at least half of all pregnancies unplanned, women need to be aware of the implications of their weight for pregnancy, birth and the health of their babies.

"However, the potential to provide women with conflicting information about weight, weight gain and weight loss extends to pregnancy and birth outcomes."

One study from Sweden, which examined 207,534 women, found increased rates of pre-eclampsia, high blood pressure and diabetes in the mothers whose body mass index (BMI) increased by one to two units between preg-nancies. A rise of more than three BMI units significantly increased the rate of stillbirths.

The second study found women whose BMI fell by five or more units between pregnancies had a higher risk of giving birth prematurely than those whose weight remained stable or increased.

Professor Murphy, professor of obstetrics at Trinity College, University of Dublin, said "swinging changes" in weight were harmful to both mothers and babies and women should try to maintain a healthy weight before, during and after pregnancy. She said women should also ignore pressure from celebrity mothers, many of whom are seen squeezing back into their pre-pregnancy clothes within weeks of giving birth.

"The issue is both for mother and baby," she said. "Most people realise being very overweight is bad for your health but some women don't realise being underweight causes problems with pregnancy.

"The health message is to try to be a normal weight for you and maintain a normal weight - neither going underweight, which some of these celebrities are, nor becoming relaxed about the fact you have put a lot of weight on.

"The important thing is to lose weight steadily so it is something you can maintain throughout your life, not just in the short term." She added it was important that healthcare professionals were able to advise women on the best way to protect their own and their children's health.

Gillian Smith, acting director of the Royal College of Midwives in Scotland, said it was important all agencies worked together to give the best advice. She added: "There has been huge publicity about obesity and the damage that causes but it is also about making sure a woman's low weight does not cause damage."

Source:www.theherald.co.uk

Too posh to push mums hike up Caesarian rates

2007-07-30T08:25:00.000-07:00

EXPECTANT mothers who are "too posh to push" have helped to almost double the rate of Caesarean births in Edinburgh.

Last year, more than one in four women who gave birth in the Capital had Caesarean sections to deliver their babies - higher than the UK and Scottish average, and up from 16 per cent in 1995.

There were 1647 Caesarean births at the Simpson maternity centre last year - 27 per cent of all births.

Midwives said one of the reasons for the rise was "a class of women" in the city who choose pre-planned Caesareans for non-medical reasons.

Other explanations include more professional women who give birth later in life, and the large number of high-risk births from all over south-east Scotland that are handled in Edinburgh.

And as the number of first Caesareans grows, so too does the repeat rate, as women who have had one surgical birth are more likely to have another.

Medical experts today said the rate was "undoubtedly too high" and questioned whether Caesareans were being done as a matter of course.

Gillian Smith, acting director for RCM Scotland, said: "There is no doubt that a 27 per cent Caesarean section rate is high. Some places get it below 20 per cent. It is a fallacy to purport that Caesareans are a safe option - there are risks associated with major abdominal operations."

Edinburgh-based Cynthia Clarkson, maternity services convener with the National Childbirth Trust, added:

"The World Health Organisation (WHO) said the rate should not exceed 15 per cent.

We need to look carefully at individual cases and decide if Caesareans are really beneficial."

The national average rate in 2005 was 24.9 per cent. At St John's Hospital in Livingston, there has been a steady year-on-year rise to 26 per cent in 2006.

In 2000, the former Simpson Memorial Maternity Pavilion in the city had a rate of 22.4 per cent, and just 16 per cent in 1995.

In the most recent figures, just over one third were elective - or unplanned - Caesareans, usually for medical reasons but sometimes by personal choice.

Dr Rhona Hughes, lead obstetrician with NHS Lothian, said: "A Caesarean section is only carried out when there is a clinical need. We always prefer to see a natural birth and we are proactively trying to encourage that.

"Senior midwives are also involved in a scheme to help and support mothers who have previously had a Caesarean section, to enable them to have natural births in subsequent pregnancies.

"Edinburgh's figures may be higher than the Scottish average for a number of reasons, including the fact our mothers are generally older than elsewhere in the country, we receive problematic pregnancies from all over the south-east of Scotland and we have an IVF service which tends to produce more twins and, therefore, increases the need for Caesarean section."
'I didn't want surgery but my baby was in distress'

NEW mother Louise Cumming was adamant she did not want a Caesarean birth.

But when the 33-year-old housewife was told that her unborn baby was in distress, she reluctantly agreed to go ahead with the emergency operation.

Mrs Cumming, from Mitchell Street in Leith, is still unsure if the decision was necessary.

She also fears she may be required to undergo an elective Caesarean in the future if she wants more children.

Daughter Emily is now nearly 21 months old, and in perfect health.

"I went to the ERI to be induced because I was showing symptoms of pre-eclampsia and my blood pressure was high," she said.

"On the Friday, I was told my baby was in distress so I had an emergency Caesarean. I was adamant I did not want a Caesarean birth, but I had had little sleep and was exhausted so I gave in.

"We live in a fourth floor flat, and for six weeks after the birth I was stuck inside recuperating.

"I hope it was the right decision to make, but you never know. Afterwards, my GP said my daughter may have come out on her own if left a bit longer, but there's no way of knowing."
NHS hails healthy rise in nursing staff

AN extra 390 nurses have been employed to work on Lothian hospital wards following a successful recruitment drive.

In the past two years, new figures show NHS Lothian has moved from having the highest to one of the lower vacancy levels in Scotland.

Currently the board employs 9268 full-time registered and unregistered nurses, up from 8876 at the same point in 2005.

Health chiefs have also dramatically cut the amount paid to nursing agencies from £11 million in 2003/04 to £4m in the most recent financial year, with the efficiency savings ploughed back into patient care.

Heather Tierney-Moore, NHS Lothian director of nursing, said: "The recruitment drive has been a great success. Nurses are increasingly attracted to Lothian because it is a flexible employer with family friendly policies, and is recognised as a centre of excellence."

The board has also developed a bank of experienced nurses, who are able to provide cover for holidays and sickness.

Source:news.scotsman.com

Weight change 'harms pregnancy'

2007-07-30T08:24:00.000-07:00

Women who lose or gain weight between pregnancies could be putting their unborn babies' health at risk, doctors warn today.

Two senior obstetricians, Dr Jennifer Walsh and Professor Deirdre Murphy, argue that fluctuating weight can have major health implications for the baby.

Writing in the British Medical Journal (BMJ), they outline the findings from a Swedish study relating to weight gain between pregnancies.

The researchers studied 207,534 women from the beginning of their first pregnancy to the beginning of their second.

They found that if a woman's body mass index (BMI) increased by just one to two units her risk of pre-eclampsia, diabetes and pregnancy-induced blood pressure increased. The baby was also more likely to have a high birth weight.

A rise of more than three BMI units significantly increased the rate of stillbirths.

Dr Walsh and Professor Murphy write that the findings show women of normal weight should avoid gaining weight between pregnancies and overweight or obese women could benefit from weight loss before becoming pregnant.

The second study found that women whose BMI fell by five or more units between pregnancies had a higher risk of giving birth prematurely than women whose weight remained stable or increased.

This risk was significantly higher (80 per cent) for women who had already had a premature birth than those who had not (28 per cent).

"Women are at increased risk of different but equally serious adverse pregnancy outcomes if they gain or lose an excessive amount of weight between pregnancies," Dr Walsh and Professor Murphy write.

"Although apparently conflicting, these studies show how important it is to attain and maintain a normal healthy weight before, during, and after pregnancy."

Source:www.inthenews.co.uk

Danger of losing too much weight after giving birth

2007-07-30T08:22:00.000-07:00

Mothers who lose too much weight quickly after giving birth could be putting their next baby at risk, doctors have warned.

On the other hand, gaining too much weight after a pregnancy can be just as dangerous.

Any rapid weight changes between pregnancies can increase the risk of babies suffering high blood pressure, along with the prospect of premature or stillbirth.

The warning comes from two studies highlighted yesterday by the British Medical Journal.

The researchers, from Coombe Women's Hospital, Dublin, urged women to maintain a healthy weight before, during and after pregnancy to give their children the best start in life.

Many women struggle to lose the extra weight they gain during pregnancy, despite following advice to exercise, eat healthily and breast feed where possible.

Source:www.dailymail.co.uk

Risks of Complications are Higher in ART Than in Natural Conception

2007-07-30T08:21:00.000-07:00

The risks of complications both during and after pregnancy achieved through assisted reproduction techniques (ART) are significantly higher than for natural conception, and long term follow-up of children born through ART is needed to fully understand the consequences of these techniques. The issues are addressed in a Review published in this week's edition of The Lancet.

Dr Alastair Sutcliffe, Institute of Child Health, University College London, UK and Dr Michael Ludwig, Endokrinologikum, Hamburg, Germany reviewed data published between 1980 and 2005 on in-vitro fertilisation (IVF) and intracytoplasmic sperm injection, and used 3980 articles to compile their analysis. They focussed mainly on ART single births, since multiple births bring with them their own set of confounding complications.

The authors say: “In-vitro fertilisation has been done for nearly 30 years; in developed countries at least 1% of births are from ARTs. These children now represent a substantial portion of the population but little is known about their health."

They say that there are several points for consideration when counselling couples seeking treatment for subfertility. The biggest risk for ART is that multiple births may occur, however a number of other risks are evident from ART techniques.

Spontaneous abortion rates are between 20-34% higher for ART couples compared to those spontaneously conceiving -- this could be because ART couples are generally older, and also due to endocrine disorders, organic abnormalities and the degree of ovarian stimulation. For couples using ART, the risk of pre-eclampsia occurring is increased by 55%, while there is also an increased risk of still birth (155%), low birthweight (70-77%) very low birthweight (170-200%), or the baby being small for gestational age (40-60% increased risk).

Source:www.medindia.net

With the ACLU's help in 1995, Kevin Knussman sued his employer, the Maryland State Police, to get family leave to care for his ailing wife, Kim (right

2007-07-30T08:19:00.000-07:00

Kevin Knussman arrived home in January 1995 at 3:30 a.m. from a night shift to the sound of his newborn daughter, Paige, wailing.

The Maryland State Police paramedic from Easton rushed to her and found his wife, Kim, in the same room, so overcome with exhaustion that she didn't hear Paige's cries.

Kim was suffering from pre-eclampsia, a disorder that occurs during pregnancy and postpartum. Symptoms include high blood pressure, headaches and changes in vision. Clearly, both mother and baby needed Knussman to stay home and be the family's primary caregiver.
When he asked for extended leave, the state police denied the request, even though a federal law had recently been passed giving all workers up to 12 weeks of unpaid parental leave. A Maryland law also allowed "primary care providers" up to 30 days of paid leave after the birth or adoption of a baby.

The police gave Knussman 10 leave days and said that if he took another day off he would be declared absent without leave. Stuck between the cares of home and the demands of work, Knussman didn't take another day off.

Instead, he took his employer to court.

His case was among the first gender-discrimination cases filed under the 1993 Family and Medical Leave Act, which at the time was viewed as a protection for women who need time off after the birth or adoption of a child.

"He didn't fit the stereotype of what people may have thought the law was about," said Jocelyn Frye, general counsel for the National Partnership for Women and Families. "His case put a face on the [FMLA] and made it a family issue."

Knussman became known as Trooper Dad. By the time the 1995 ACLU-assisted lawsuit went to trial in 1999, Paige was almost 5.

Three years later, Knussman was awarded $40,000 for emotional distress and an undisclosed six-figure amount in attorney's fees. To Knussman's supporters, equally important as the money was the fact that the case illustrated that the FMLA could not be ignored.

"It shows employers have to take these laws seriously," said Laura Kessler, an associate law professor at the University of Utah.

The man who spent 23 years as a state trooper, mostly as a helicopter paramedic, has since retired. Paige, now a preteen, recently won a contest to be an honorary batgirl during an Orioles game. His wife recovered long ago from her ailment. And the Knussmans had no family-leave worries when their now-10-year-old daughter, Hope, was born.

As he looks back on his battle, Knussman acknowledges mixed emotions. "I wouldn't condemn anyone else for not going through it," he said. "It's hard to fight the state, the government, because they have unlimited resources."

Knussman, who now works as a paramedic seven days a month, relishes the nationwide support he received. He still receives e-mails from people seeking to challenge employers for family leave permission.

Source:www.baltimoresun.com

More Health Risks Found in IVF Babies - Scientist Suggests IVF Children Should be Monitored into Adulthood

2007-07-30T08:18:00.000-07:00

A study of 3,980 articles in medical and scientific journals between 1980 and 2005 has shown significantly higher risks of long-term medical problems for children conceived through artificial procreation such as in vitro fertilisation or intracytoplasmic sperm injection, a method in which a selected sperm is injected into the ovum.

Dr. Alastair Sutcliffe, of the Institute of Child Health at University College London and Dr. Michael Ludwig, of the Centre for Reproductive Medicine and Gynaecologic Endocrinology in Hamburg, examined the data and have concluded that babies conceived through artificial means should be monitored well into adulthood.

The study showed the risk of miscarriage is between 20 and 34 per cent higher than naturally conceived children. It showed 55 per cent increase in the risk of pre-eclampsia, or hypertension in pregnancy; an increased risk of stillbirth at 155 per cent; low birth weight at 70 to 77 per cent and very low birth weight at 170 to 200 per cent.

Major malformations and cerebral palsy are also significantly more likely with artificially conceived children.

Dr Sutcliffe commented, “In-vitro fertilisation has been done for nearly 30 years; in developed countries at least 1% of births are from ARTs [assisted reproduction techniques]. These children now represent a substantial portion of the population but little is known about their health.”

The study coincides with numerous others showing that IVF and related fertility technologies produce significantly higher rates of serious health problems in children.

Most recently, a study published in the June 21, 2007 issue of Human Reproduction showed that children conceived through IVF visit hospitals significantly more times (1.76 vs. 1.07 times) than naturally conceived children.

Source:www.lifesite.net

Weight Gain or Weight Loss Can Affect Unborn Baby

2007-07-30T08:16:00.000-07:00

Gaining or losing weight in between pregnancies can have major health implications for an unborn baby, warn two senior obstetricians in the British Medical Journal in an editorial.

While weight and obesity have long concerned women in relation to body image and lifestyle issues, few are aware of the possible risks that fluctuating weight could have on their unborn child, write Dr Jennifer Walsh and Professor Deirdre Murphy.

They point to two studies. The first, from Sweden, which found that weight gain between pregnancies was strongly associated with major complications for the woman and baby in the months preceding, during and just after childbirth. This was independent of whether a woman was, by definition, overweight.

The researchers studied 207,534 women from the beginning of their first pregnancy to the beginning of their second. They found increased rates of pre-eclampsia, diabetes in the expectant mother, pregnancy induced high blood pressure and high birth weight if a woman's body mass index (BMI) increased by just one to two units. A rise of more than three BMI units significantly increased the rate of stillbirths.

The key message, say the authors, is that women of normal weight should avoid gaining weight between pregnancies, while overweight and obese women are likely to benefit from weight loss before becoming pregnant.

The second study looked at whether a change in the mother's nutritional balance increased the risk of a premature birth. They found that women whose BMI fell by five or more units between pregnancies had a higher risk of giving birth prematurely than women whose weight remained stable or increased. The risk was significantly higher for women who had already had a premature birth (80% versus 28%).

"Although apparently conflicting, these studies show how important it is to attain and maintain a normal healthy weight before, during, and after pregnancy," say the authors.

Most women want to achieve the best start in life for their babies, they add. This could be a powerful motivational factor in helping them change the way they eat.

Source:www.sciencedaily.com

Mums warned over post-pregnancy weight

2007-07-30T08:13:00.000-07:00

MOTHERS who gain or lose lots of weight between pregnancies could be putting their baby at risk, experts warn today.

The trend for new mothers to try to copy celebrity role models and lose lots of weight in a short amount of time could be detrimental to their child’s health. But women who pile on the pounds after giving birth also put their next child at risk, they said.

Effects can include premature birth, greater risk of stillbirth and high blood pressure.

Doctors and midwives say that women should try to maintain their “optimum” – or stable – weight before, during and after pregnancy to give their child the best start in life.

Helen Rogers, head of the Royal College of Midwives in Wales, said, “Women see so-called celebrities who lose two stone in a month and they look amazing but they forget that these people have personal trainers and nannies and nothing else to do except get back into shape, which is their job.

Source:icwales.icnetwork.co.uk

Stop the carnage on women and children

2007-07-30T08:12:00.000-07:00

The reality of the pervading maternal and infant mortality dawned on me last week when I went home for the burial ceremony of one of my relations. A woman in her early thirties, a widow and mother of four reportedly died while bringing to the world the next child.

Prior to this, she was said to be suffering from pregnancy-induced hypertension (pre-eclampsia). Medical attention was sought when it became very late for obvious reasons bordering on poverty, low level of education and attitude to issues of maternal and child health especially in a rural setting.

The death of the woman and subsequently her unborn child is one story that has become a common feature of the Nigerian health situation for some time now. Year in year out, the statistics keeps coming and reminding us of the grim nature of the problem which appears to be abetting at a low pace in some areas while alarmingly increasing in some others.

Over time, Nigerian government and its health authorities have vowed to reduce drastically the high incidence of morbidity especially in pregnant women and infants. They have emotionally sounded the unacceptability of women dying in hundreds while bringing forth babies into the Nigerian world. They have theoretically mapped out programmes in primary health care to help checkmate this problem.
But official statistics emanating from the Nigerian branch of the United Nations Children’s Fund (UNICEF) is as alarming as it is baffling.

According to Dr. Eather Obinya of UNICEF Office Abuja, the situation is growing worse everyday. Her talks on Accelerated Child Survival and Development (ACSD) and Integrated Maternal, Newborn and Child Health (IMNCH) at the recent Calabar meeting of journalists and UNICEF as well as officials of Child Rights Information Bureau of the Federal Ministry of Information and National Orientation provided much food for thought and bird’s eye view of the threatening health condition.
According to her, the worldwide distribution of such deaths are predominant in Africa. And Nigeria being the most populous country in the continent presents more of these deaths.

For instance, maternal mortality ratio in the country in 1999 and 2003 stood at 704 deaths for every 100,000 live births and 800 deaths for every 100,000 live births respectively. Infant mortality rate was reportedly 90 for every 1,000 births in 2003. The death of children under five years of age rose from 168 for every 1,000 births in 1999 to 201 for every 1,000 live births in 2003.

The grim picture of infant mortality is higher in the troubled oil bearing region of South-South and the three geo-political zones in the north. The reasons for this are largely due to high level of illiteracy of women in these areas and unavailability of basic health facilities and skilled health officials that attend to these women especially during child delivery. In most cases, these women deliver their babies at home at the mercy of the local unskilled birth attendants.

The situation in the South-West and South-East, which recorded low number, was traceable to the fact that more women here attend schools and as such are well informed about caring for their health and that of their unborn children. The case of the South-South is not helped by the upheavals and restiveness in the region occasioned by the festering militancy. The activities of the militants have invariably led to wanton destruction of health facilities which has made it virtually difficult and sometimes impossible for families to seek urgent medical attention.

The hostilities in the region have driven away health workers and sort of put a stop to any health intervention programme either by Nigerians or donor agencies.
The ACSD is a regional strategy to combat child mortality, which is one of the eight aims of Millennium Development Goals (MDGs) while the IMNCH is a national strategy to achieve MDGs of reducing child mortality as well as improving maternal health. The Women and Children Friendly Health Services (WCFHS) are the ways and manner services are offered in ACSD and IMNCH to achieve the MDGs of child and maternal health.

The MDGs are meant to, by 2015, eradicate extreme poverty and hunger and achieve universal primary education. It is also meant to promote gender equality and empower women. Its other goals include reduction of child mortality and improvement of maternal health. The MDGs would combat HIV/AIDs, malaria and other diseases, ensure environmental sustainability and evolve a global partnership for development. But how far has the nation gone in achieving these lofty goals? The prevalence of malaria has reduced from 1, 116, 982 in 1990 to 1,875,389 in 2004.
The HIV prevalence among 15-24 year old pregnant women has reduced from 1.8 percent in 1990 to 5.1 per cent in 2004.

The maternal mortality ratio was 1,000 deaths for every 100,000 births in 1990 and 704 deaths for every 100,000 live births in 2004. In 1990, the proportion of births attended by skilled health workers was 45 percent while in 2004 it was 36 percent whereas the target is 100 percent. The proportion of pregnant women with four or more Antenatal Clinic visits was 52 percent in 1990 and 45 per cent in 2004.

Under-five mortality rate was 191 deaths for every 1,000 live births in 1990 and 201 in 2004 while infant mortality rate was 91 for every 1,000 live births in 1990 and 100 in 2004.
With these grim statistics, it is very unlikely that Nigeria will meet the MDGs goals in reducing child mortality, improving maternal health and combating HIV/AIDs, malaria and other diseases.
Presently, Nigeria is the second largest contributor to maternal mortality rate globally. About 52,900 Nigerian women die annually due to pregnancy related causes.

Over one million children under five years of age will die this year. Daily, 145 women and 2,300 under–five children die, about 30 per cent being new born. Nigeria bears 13.5 per cent of the global burden of HIV in pregnant women yet access to antiretroviral drug is still very low.
Causes of maternal deaths include hemorrhage (23%), Infection (17%), Toxemia/Eclampsia (11%), Unsafe abortion (11%), Obstructed Labour (11%), Malaria (11%), Anemia (11%) and others (5%).

This is the time our various tiers of government should act in concert to stop this carnage on women and children. The resources to achieve this are available. What is needed now is a demonstration of the will to combat the scourge. Let our legislators and other political leaders rise up to this challenge. The MDGs initiatives are laudable and achievable. Let President Umaru Musa Yar’Adua galvanize other leaders in the country to achieve them and reduce the increasing number of child and maternal deaths whose figures have risen to an unacceptable range. Until then, see you after my vacation.

Source:www.sunnewsonline.com

Senior doctor exodus reaches crisis point

2007-07-30T08:11:00.000-07:00

Senior doctors are leaving New Zealand to work in Australia at the rate of one a week, according to a survey released exclusively to the Sunday Star-Times.

The union survey, by the Association of Salaried Medical Specialists, says 80 specialists have already gone or have resigned to work across the Tasman in the past 18 months.

That is leading to growing difficulties in caring for patients in certain areas, especially provincial areas which struggle to recruit specialists.

Even urban areas suffer ramifications, with Wellington Hospital last week announcing child cancer patients may have to travel to Auckland or Christchurch after one of its specialists resigned to work in Australia.

Paediatric oncologist Dr Wayne Nicholls left Auckland's Starship Hospital in April to work as a children's brain tumour specialist at Brisbane's Royal Children's Hospital.

Nicholls, 44, said his Australian salary package was 50% more than here, but the move was not just about money.

"In my case it was more money, significantly more money, but it was also better support for professional development."

He also gets significantly more in superannuation and has better opportunities, such as working on a team developing an adolescent cancer unit in Brisbane.

District health boards (DHBs) are embroiled in a pay spat with the union, which is threatening to take industrial action.

The union's survey showed those most likely to go were anaesthetists (13), followed by medical physicians (10), obstetricians and gynaecologists (nine), radiologists (eight), and psychiatrists and paediatricians (seven each).

Auckland and Counties-Manukau were worst hit, with 11 specialists leaving from each. Provinces like Southland, Northland and Bay of Plenty saw an exodus disproportionate to their populations.

College of Obstetricians and Gynaecologists NZ president Dr Alec Ekeroma said the exodus hit rural areas hard. Provincial hospitals, especially in Whangarei, Whakatane and Greymouth, all had vacancies in his specialty. Doctors in smaller hospitals were often on call every second night and lacked the resources of busier urban hospitals.

"It is a concern because it affects standards of care... you can be up all night dealing with a woman who has severe pre-eclampsia and be expected to person gynaecology clinics the next day until 5pm. By midday you're buggered... and thinking `I'm sure there's a better life somewhere else."'

Union executive director Ian Powell said Kiwi specialists were highly sought after in Australia because training and registration systems were similar. Pay rates were higher and conditions better overseas.

An Australian hospital recently offered a union member twice as much as he earns here, plus housing and a car, every fourth week off on top of annual leave, and frequent flights back to New Zealand.

The union is holding stopwork meetings nationwide as it tries to negotiate a new national collective agreement. So far, all have voted to hold a postal vote on whether specialists should take the unprecedented step of industrial action.

DHB spokesman David Meates, chair of the boards' medical workforce strategy group, said doctors had always left New Zealand to work offshore.

"If you look at the past 10 to 15 years, there hasn't been a change in doctors leaving New Zealand."

What has happened is a rise in foreign doctors working here, with a March report showing 41% of doctors registered here gained their early qualifications abroad.

Meates, Wairarapa DHB's chief executive, recently employed obstetricians from South Africa and the US because he could not find locally trained doctors.

Meates said the DHBs had made an offer of final position arbitration with the union. More meetings are scheduled in mid-August.

But that will come too late for Wayne Nicholls, who said it was unlikely he would return here to work because he would need similar opportunities and pay as in Brisbane.

Source:www.stuff.co.nz

Disease

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Foot And Mouth, Bluetongue & Avian Influenza

Influenza cases increasing rapidly in eastern Austria

Equine influenza outbreak contained

65 -- INFLUENZA VACCINE (NASAL SPRAY)

Most GPs "are against extending influenza injection"

Gastritis

Contents

[edit] Causes

[edit] Symptoms

[edit] Diagnosis

[edit] Treatment

[edit] See also

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