February 17, 2010, 7:38 AM CT

A primer on migraine headaches

Migraine headache affects a number of people and many different preventative strategies should be considered, states an article in CMAJ (Canadian Medical Association Journal) (pre-embargo link only) http://www.cmaj.ca/embargo/cmaj081657.pdf. The article, a primer for physicians, outlines various therapys and approaches for migraine headaches.

Migraine headache is a common, disabling condition. When migraine headaches become frequent, treatment can be challenging. Preventative treatment for migraines remains one of the more difficult aspects, as while there are valid randomized controlled trials to aid decision making, no drug is completely effective, and most have side effects.

Medications used for migraine can be divided into two broad categories: symptomatic or acute medications to treat individual migraine attacks, or preventative medications which are used to reduce headache frequency. Symptomatic migraine treatment alone, eventhough helpful for a number of patients, is not adequate therapy for all. Patients with frequent migraine attacks may still have pain despite treating symptoms, and when symptomatic medications are used too often, they can increase headache frequency and may lead to medicine overuse headache.

Physicians need to educate patients about migraine triggers and lifestyle factors. Common headache triggers include caffeine withdrawal, alcohol, sunlight, menstruation and changes in barometric pressure. Lifestyle factors such as stress, erratic sleep and work schedules, skipping meals, and obesity are linked to increased migraine attacks......... Posted by: Daniel      Read more         Source

February 17, 2010, 7:37 AM CT

Erlotinib marginally cost-effective

Weighing both magnitude of survival benefit and expense, scientists observed that the drug erlotinib, which was found to improve overall survival by 2 months in patients with advanced non-small cell lung cancer, is marginally cost-effective. The results of their economic analysis using clinical trial data were reported in a newly released study published online February 16 in the Journal of the National Cancer Institute

Natasha B. Leighl, M.D., of the University Health Network in Toronto, Canada, and his colleagues performed an analysis of erlotinib therapy in the NCIC Clinical Trials Group BR.21 trial to determine the cost-effectiveness of treating various populations with the drug, a tyrosine kinase inhibitor. The scientists also calculated the incremental cost-effectiveness ratio.

The incremental cost-effectiveness ratio for erlotinib therapy in the trial population was $94,638 (2007 Canadian dollar) per life-year gained (95% confidence interval = $52,359 to $429,148).

As per the researchers, this figure exceeds the threshold historically accepted as cost-effective ($50,000 per quality-adjusted life year). The ratio was in the higher range of cost-effectiveness ratios that high-resource countries may consider acceptable. Thus, it appears to be possible to enhance the cost-effectiveness of this therapy through the clinical and molecular selection of patients for therapy, the authors report......... Posted by: Scott      Read more         Source

February 17, 2010, 7:29 AM CT

Daclizumab for treating MS

Biogen Idec (NASDAQ: BIIB) and Facet Biotech Corporation (NASDAQ: FACT) today announced the publication of Phase 2 data showing that the addition of daclizumab to interferon beta (IFNβ) led to a significant reduction in the number of new or enlarged multiple sclerosis (MS) lesions when in comparison to IFNβ alone in patients with active relapsing forms of MS. The trial, called CHOICE, also showed that daclizumab led to an increase in a subset of the natural killer (NK) cells that help regulate the immune system. These data were published in Online First, the online edition of The Lancet Neurology, and would be reported in the recent issue of the Lancet Neurology

Study results showed that daclizumab 2mg/kg administered subcutaneously every two weeks in combination with IFNβ reduced the number of new or enlarged gadolinium contrast-enhancing lesions (Gd-CELs) by 72 percent versus IFNβ treatment alone. The presence of Gd-CELs is thought to indicate inflammation within the central nervous system that corresponds with MS disease activity. In addition, therapy with daclizumab resulted in a seven- to eight-fold increase of CD56bright NK cells, which was linked to a decrease in disease activity. Daclizumab was well-tolerated in the CHOICE trial and common adverse events occurred with a similar frequency in each of the therapy groups......... Posted by: Daniel      Read more         Source

February 17, 2010, 7:28 AM CT

Influenza vaccines in elderly

Evidence for the safety and efficacy of influenza vaccines in the over 65s is poor, despite the fact that vaccination has been recommended for the prevention of influenza in older people for the past 40 years. These are the conclusions of a new Cochrane Systematic Review.

Adults aged 65 and over are some of the most vulnerable during influenza season and a priority for vaccination programmes. However, very few systematic reviews of the effectiveness of vaccines in this group have ever been carried out.

The scientists conducted a thorough search of studies based on prior vaccine trials. Randomised controlled trials (RCTs) are often considered the "gold standard", but of the 75 studies included in their review, the scientists were only able to identify one recent RCT with "real" outcomes. In other words, this was the only RCT that used influenza cases as an outcome, as opposed to surrogate outcomes such as measurements of influenza antibodies in the blood. All the other studies included in the review were deemed of low quality and open to bias.

Limited reliable evidence from the studies suggests that the effectiveness of influenza vaccines is modest at best. "Our estimates are consistently below those commonly quoted by economists and in decision making," says lead researcher Tom Jefferson of the Cochrane Collaboration in Rome, Italy. "But until we have all available evidence, it is hard to reach any clear conclusions about the effectiveness of influenza vaccines in older people"......... Posted by: Mark      Read more         Source

February 17, 2010, 7:27 AM CT

What the brain values may not be what it buys

It's no wonder attractive human faces are everywhere in media and advertising when we see those faces, our brains are constantly computing how much the experiences are worth to us. New brain-imaging research shows it's even possible to predict how much people might be willing to pay for a particular face.

Scientists at Duke University Medical Center observed that as participants were watching a sequence of faces, their brains were simultaneously evaluating those faces in two distinct ways: for the quality of the viewing experience and for what they would trade to see the face again.

The work was reported in the Journal of Neuroscience online on Feb. 16.

They showed college-aged men a parade of female faces, intermixed with images of money, while measuring brain activation using functional magnetic resonance imaging (fMRI). In a later experiment, the same participants could pay more or less money to view more or less attractive faces.

"One part of the frontal cortex of our participants' brains increased in activation to more attractive faces, as if it computed those faces' hedonic (quality of the experience) value," said senior author Scott Huettel, Ph.D., an associate professor of psychology & neuroscience who directs the Center for Neuroeconomic Studies at Duke. "A nearby brain region's activation also predicted those faces' economic value specifically, how much money that person would be willing to trade to see another face of similar attractiveness."........ Posted by: JoAnn      Read more         Source

February 17, 2010, 7:26 AM CT

Genetic link between mammographic density and breast cancer

A University of Melbourne study has revealed that certain breast cancer genetic variants increase mammographic density, confirming the link between mammographic breast density and breast cancer.

Professor John Hopper of the University's School of Population Health says women vary greatly in their underlying risk of breast cancer. "These findings provide an insight into possible new pathways into the development of breast cancer".

"We hope our research on mammographic density will eventually help identify women at higher risk of getting breast cancer. That is still a way off, but for now women should follow national guidelines for screening," he says.

The research was conducted in the University's School of Population Health and Department of Pathology along with key national and international collaborators. The paper was published recently in the prestigious international journal Cancer Research

"Prior twin studies have suggested there is a genetic link between mammographic density and breast cancer. For the first time, we have been able to identify some of the breast cancer genetic variants involved".

The amount of light areas on a mammogram reveals the mammographic density of a woman's breast. Women who have high mammographic density for their age are at an increased risk of breast cancer......... Posted by: Janet      Read more         Source

February 17, 2010, 7:24 AM CT

Key interaction that controls telomeres

In the dominoes that make up human cells, scientists at the University of Michigan Comprehensive Cancer Center have traced another step of the process that stops cells from becoming malignant.

It starts with the enzyme telomerase, which affects the caps, or telomeres, at the end of a chromosome. Telomeres shorten over time. But telomerase prevents this from happening, making the cell immortal. If cancer is triggered in the cell, the presence of telomerase leads to the growth of the cancer.

Telomerase is kept in control by the protein TRF1, which keeps the telomeres operating correctly. But another protein, Fbx4, can bind to TRF1 and degrade it, causing the telomeres to lengthen.

Now, scientists have discovered, a third protein, TIN2, can step in and override Fbx4 by binding to TRF1 first and preventing Fbx4 from attaching to it.

This finding paves the way for developing a drug that acts like TIN2, keeping everything in check and stopping the first domino from falling.

Results of the study appear in the Feb. 16 issue of Developmental Cell.

"In 90 percent of cancers, no matter what caused the cancer to form, it needs telomerase activity to maintain the cell. Without telomerase, the cell will die. Our work is key to understanding a detailed mechanism for how these molecules interact and how to design a drug to block Fbx4," says senior author Ming Lei, Ph.D., assistant professor of biological chemistry at the University of Michigan Medical School......... Posted by: Janet      Read more         Source

February 11, 2010, 8:20 AM CT

Bowel disease link to blood clots

People living with Inflammatory Bowel Disease (IBD) are known to be at high risk of blood clots when admitted to hospital during a flare-up of their disease but now new research by researchers at The University of Nottingham has shown that those who are not admitted to hospital during flare-ups are also at risk.

The two main types of IBD are Ulcerative Colitis and Crohn's Disease which affect about one in every 250 people in the UK. The research published recently in the medical journal, The Lancet, could eventually mean new advice for GPs and patients on how to reduce the risk of developing this dangerous side-effect of bowel disease.

IBD has been known to predispose sufferers to blood clots (thromboembolism) for some time. Clots in the leg veins have a mortality rate of six per cent, rising to as much as 20 per cent if the embolism is in the lungs. Prior research has suggested that most patients who develop thromboembolism do so when their IBD is 'active', i.e. has flared up and they are three times more likely to have a blood clot than non-sufferers. This has led to the use of anti-clotting drugs as standard care for patients with active IBD who are admitted to hospital.

The new research at Nottingham was undertaken to find out what the blood-clotting risk is to patients with IBD who manage their flare-ups outside the hospital environment, with medical care from primary care sources like their GP. The team used the UK General Practice Research Database from November 1987 to July 2001 to compare patients with IBD with controls without the disease. They concluded that non-hospitalised sufferers with active IBD were 16 times more likely to develop a blood clot than the general population......... Posted by: Sue      Read more         Source

February 11, 2010, 8:09 AM CT

Silver Nanoparticles

Diamonds and gold may make some hearts flutter on Valentine's Day, but in a University at Buffalo laboratory, silver nanoparticles are being designed to do just the opposite.

The nanoparticles are part of a new family of materials being created in the laboratory of SUNY Distinguished Professor and Greatbatch Professor of Advanced Power Sources Esther Takeuchi, PhD, who developed the lithium/silver vanadium oxide battery. The battery was a major factor in bringing implantable cardiac defibrillators (ICDs) into production in the late 1980s. ICDs shock the heart into a normal rhythm when it goes into fibrillation.

Twenty years later, with more than 300,000 of these units being implanted every year, the majority of them are powered by the battery system developed and improved by Takeuchi and her team. For that work she has earned more than 140 patents, thought to bemore than any other woman in the United States. Last fall, she was one of four recipients honored in a White House ceremony with the National Medal of Technology and Innovation.

ICD batteries, in general, now last five to seven years. But she and her husband and co-investigator, SUNY Distinguished Teaching Professor of Chemistry Kenneth Takeuchi, PhD, and Amy Marschilok, PhD, UB research assistant professor of chemistry, are exploring even-better battery systems, by fine-tuning bimetallic materials at the atomic level......... Posted by: Mark      Read more         Source

February 10, 2010, 8:20 AM CT

Chronic Illnesses and Acupuncture

Doctors at Rush University Medical Center are offering pediatric patients diagnosed with chronic illnesses acupuncture treatment to help ease the pain and negative side effects like nausea, fatigue, and vomiting caused by chronic health conditions and intensive therapys. The confluence of Chinese and Western medicine at Rush Children's Hospital is part of a study to analyze and document how acupuncture might help in reducing pain in children and increase quality of life.

"Treating children with acupuncture is a new frontier," said Dr. Paul Kent, pediatric hematology and oncology expert, Rush Children's Hospital. "We are looking to see if there is an effective pain management treatment we can offer that does not have the serious side effects that can be caused by narcotics and other serious pain medications".

The lack of options for pain management in children has been reported as one of the most difficult aspects of providing care to pediatric patients. Research indicates that up to 70 percent of pediatric patients experience pain and those with chronic illnesses often do not have adequate relief or prevention of pain.

"Acupuncture could be a potential solution to this dilemma of controlling pain in pediatric patients," said Angela Johnson, Chinese medicine practitioner at Rush......... Posted by: Janet      Read more         Source