Cancer diagnosis? Advice for dealing with what comes next

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

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

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

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

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

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

* 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

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

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

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

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

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

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

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

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

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

Medical Marijuana

For more than 4,000 years, it was used medicinally. Then, in 1942, medical marijuana was banned in the United States. But that's not the end of the story. Today, patients with illnesses like cancer, AIDS and multiple sclerosis say it relieves pain and reduces nausea from their meds -- and is the only thing that gets them through.

Brian Klein takes three pills twice a day for HIV. He's also recovering from hepatitis C.

"It was pretty devastating getting both at the same time," Brian says.

Hepatitis C meds are known for their severe side effects like nausea. Brian tried lots of treatments to relieve it, but only one worked -- marijuana.

"Within a few minutes I could go eat. Whereas, before using it, I couldn’t even keep down water. So it was an amazing, dramatic difference," Brian says.

A study on hepatitis C patients showed smoking marijuana made them three-times more likely to get rid of the virus because it got them through treatment.

"If there's a patient for whom that medicine doesn't work, and they do get benefit from marijuana, then that could really be the difference between life and death," says Donald Abrams, M.D., an oncologist and HIV researcher from the University of California, San Francisco. "When we talk about the side effects, if you will, of marijuana compared to many, many prescription drugs that doctors prescribe on a daily basis, it's really quite safe."

Although medical marijuana is allowed in 12 states, the federal government has declared it "is not medicine" and "not safe." rce:Opponents say much more research is needed and that it's linked to a higher risk of cancer, heart attack and brain damage.

For Brian, it was a short-term fix. He's free of the hepatitis-C virus and has the energy to do simple things like read and exercise.

"This was relieving my nausea, and it worked. And I didn't need it for anything more or less," he says.

Dr. Abrams says patients with heart conditions or those who become paranoid, hyper or anxious from marijuana may want to steer clear.

source:www.wsiltv.com

Glaxo reports positive data on new anti-nausea pill at cancer seminar UPDATE

LONDON (Thomson Financial) - GlaxoSmithKline PLC revealed positive results from a final-stage trial of a new treatment to combat nausea and vomiting caused by chemotherapy and operations, as Europe's biggest drug maker showcased its portfolio of upcoming cancer drugs at a seminar for investors.

The company compared the drug, formally known as casopitant and now branded Rezonic, given in combination with Zofran, against Zofran alone. The older anti-nausea pill, also made by Glaxo, has recently lost patent protection.

The company saw a 69 pct improvement in patients given Rezonic combined with Zofran, both orally and intravenously, compared to responses of 59 pct and 53 pct in those given only the older treatment, respectively.

'That is a clear significant improvement in the control of nausea and vomiting over Zofran,' Glaxo's head of research and development Moncef Slaoui told reporters on a conference call ahead of the announcement.

Glaxo plans to file Rezonic for approval in the first half of next year.

Rezonic is one of five key new cancer-related drugs the company plans to launch by 2010, the result of an increased focus in Glaxo's R&D laboratories on one of the fastest growing areas of medicine.

The market is currently valued at 20 bln stg and is growing annually at 20 pct, the company estimates.

Alongside Rezonic, Glaxo hopes to launch cervical cancer vaccine Cervarix, pazopanib for renal cell carcinoma, Promacta for thrombocytopenia, a low blood platelet condition, and ofatumumab, in trials for non Hodgkin's lymphoma and chronic lymphocytic lymphoma.

The treatments follow the newly approved breast cancer pill Tykerb, seen as one of the company's most promising new products. Glaxo said since launch in the US in March, more than 3,000 patients have received the treatment.

Still, the company has to prove it can be used in a wider setting before sales climb significantly, analysts believe.

It can currently only be marketed to treat HER2 positive advanced breast cancer -- cancer that has spread to other parts of the body -- in combination with chemotherapy agent Xeloda, in women who have already been given Herceptin and are not responding to it.

At today's seminar, the company will highlight data released earlier this month at cancer conference ASCO, where it released data pointing to Tykerb's efficacy in brain metastases and as a first line therapy for breast cancer.

Slaoui said data comparing Tykerb to Roche's Herceptin will be available at the end of the year.

At 2.05 pm Glaxo shares were trading 6 pence lower at 1,320.

amy.brown@thomson.com

ab//cmr

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source:www.forbes.com

ProStrakan first-half earnings jump 28%

WILSON TOTTEN, head of Scottish pharmaceuticals business ProStrakan, said his company had made "first-rate progress" over the first half of 2007.

The Galashiels-based group made headway in European markets and secured a key product filing in the United States, the world's biggest drugs market.

Over the period, ProStrakan saw total revenues rise by 28 per cent with product sales rising 15 per cent, the company said in an update ahead of its interim results, due on September 12.

Within the overall sales jump was a 43 per cent climb in sales among recently launched pan-European products, including testosterone treatment Tostran; Rectogesic, a drug to treat chronic anal fissures; and Droperidol, an injectable drug used primarily for the treatment of post-operative nausea and vomiting.

ProStrakan - which recently obtained a new £50 million secured debt facility - also said it had just signed a distribution agreement with privately held Italian pharmaceutical company Keryos.

The deal gives Keryos exclusive distribution rights to Tostran and Rectogesic in Italy, boosting Pro-Strakan's ability to commercialise its products in the major EU markets. Further distribution agreements with Keryos are planned as new product approvals are received, ProStrakan said.

Last month, ProStrakan launched Tostran - a gel-based prescription medicine hailed as a "cure" for the male menopause - in the UK, a move described by Dr Totten as a "major milestone" in the company's development.

June also saw the group submit a new drug application (NDA) with the US Food and Drug Administration for chemotherapy-induced nausea treatment Sancuso, with a similar submission to EU medicine regulators expected "in coming weeks".

Pending the filing's successful approval, ProStrakan hopes to launch Sancuso in the US in the second half of next year, seeing it as "the trigger for our commercialisation plans in the USA".

"ProStrakan has performed strongly in the first half of 2007," said Dr Totten, noting that the firm had continued to see good growth for its UK market-leading product Adcal D3, used to treat osteoporosis.

The firm saw other revenues, including deferred milestone payments from agreements signed in the first half of 2006, rise to more than £2m, from £212,000.

Dr Totten said the strategic benefit of the many transactions the firm has completed in the last two years was now "bearing fruit".

"We have a well-funded business in the transformational stages of launching well-differentiated pan-EU products, which are expected to be the main drivers of revenue growth and margin improvement in coming years.

"The filing of our first NDA is a further milestone, and signals our intent to extend our commercial presence into the USA, the world's largest pharmaceutical market.

source:business.scotsman.com

West Nile Identified in Connecticut Mosquitoes

The mosquitoes trapped June :27 are the first West Nile-positive mosquitoes identified in the state this year, the Department of Public Health said.

This is the ninth year the West Nile virus has been found in Connecticut. Last year, the virus in mosquitoes or humans turned up in 25 towns.

Health officials are urging residents -- especially the elderly -- to take precautions to avoid mosquito bites. Symptoms in people include fever, headache, body aches, nausea or a rash.


source:www.foxnews.com