November 21, 2007, 4:43 AM CT
SARS: a model disease
A new model to predict the spread of emerging diseases has been developed by scientists in the US, Italy, and France. The model, described in the online open access journal BMC Medicine, could give healthcare professionals advance warning of the path an emerging disease might take and so might improve emergency responses and control.
Severe acute respiratory syndrome (SARS) spread rapidly in 2002-2003, revealing just how vulnerable we might be to emerging diseases and how global transportation is critical to the spread of an epidemic.
Now, Vittoria Colizza and Alessandro Vespignani of Indiana University, Bloomington, USA and the Institute for Scientific Interchange Foundation, in Turin, Italy, and his colleagues in France have developed a predictive model of the spread of emerging diseases based on actual travel and census data for more than three thousand urban areas in 220 countries. The model provides predictions of how likely an outbreak will be in each region and how widespread it might become. The research highlights just how the accuracy in predicting the spreading pattern of an epidemic can be correlation to clearly identifiable routes by which the disease could spread.
In order to assess the predictive power of their model, the scientists turned to the historical records of the global spread of the SARS virus. They reviewed the initial conditions before the disease had spread widely, based on the data for the arrival of the first patient who left mainland China for Hong Kong, and for the resulting outbreak there. They then simulated the likelihood that SARS would emerge in specific countries thereafter, as brought by infectious travelers. The simulated results fit very accurately with the actual pattern of the spread of SARS in 2002. Analysis of the results also identified possible paths of the virus' spread along the routes of commercial air travel, highlighting some preferred channels which may serve as epidemic pathways for the global spread of the disease.........
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November 19, 2007, 8:32 PM CT
Gene therapy normalizes brain function in Parkinson's patients
Brain scans used to track changes in a dozen patients who received an experimental gene treatment show that the therapy normalizes brain function - and the effects are still present a year later.
Andrew Feigin, MD, and David Eidelberg, MD, of The Feinstein Institute for Medical Research collaborated with Michael Kaplitt, MD, of Weill Cornell Medical Center in Manhattan and others to deliver genes for glutamic acid decarboxylase (or GAD) into the subthalamic nucleus of the brain in Parkinsons patients. The study was designed as a phase I safety study, and the genes were delivered to only one side of the brain to reduce risk and to better assess the therapy.
A recently published study included the clinical results of the novel gene treatment trial, but this new report from the same study focuses on the power of modern brain scans to show that the gene treatment altered brain activity in a favorable way. This latest study is published this week in the Proceedings of the National Academy of Sciences.
The patients only received the viral vector-carrying genes to the side of the brain that controls movement on the side of their body most affected by the disease. It was a so-called open-label study -- everybody received the gene treatment so the researchers knew that there could be a placebo effect. That is why brain scans were so critical to the experiment. Dr. Eidelberg and colleagues pioneered the technology and used it to identify brain networks in Parkinsons disease and many other neurological disorders.........
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November 19, 2007, 8:30 PM CT
New HPV vaccine under study
A new vaccine against nine of the most harmful strains of human papillomavirus is under study at the Medical College of Georgia.
The vaccine, called nine-valent, is being compared with Gardasil, a quadrivalent vaccine already on the market that works against the two most deadly HPV types.
"We're testing Gardasil against three different doses of the investigational vaccine," says Dr. Daron Ferris, family medicine doctor and director of the MCG Gynecologic Cancer Prevention Center. "This study will determine the best dose of the new vaccine and whether it is safe, well-tolerated and effective in preventing HPV infection and disease compared with what's already out there".
Gardasil, approved by the U.S. Food and Drug Administration in 2006, protects against HPV types 16 and 18, which cause about 70 percent of HPV-related cervical cancer cases, and types 6 and 11, which cause about 90 percent of genital wart cases.
The new drug could prevent infection from those four types and five other cancer-causing types, Dr. Ferris says.
"Women infected with those five types of HPV also have an increased risk of developing severe premalignant cervical disease and cervical cancer," he says. "While genital warts go away on their own in most cases, cervical premalignant lesions are less likely to disappear without therapy".........
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November 19, 2007, 8:18 PM CT
Sitting may increase risk of disease
Most people spend most of their day sitting with relatively idle muscles. Health professionals advise that at least 30 minutes of activity at least 5 days a week will counteract health concerns, such as cardiovascular disease, diabetes and obesity that may result from inactivity. Now, scientists at the University of Missouri-Columbia say a new model regarding physical activity recommendations is emerging. New research shows that what people do in the other 15 and a half hours of their waking day is just as important, or more so, than the time they spend actively exercising.
A number of activities like talking on the phone or watching a childs ballgame can be done just as enjoyably upright, and you burn double the number of calories while youre doing it, said Marc Hamilton, an associate professor of biomedical sciences whose work was recently published in Diabetes. Were pretty stationary when were talking on the phone or sitting in a chair at a ballgame, but if you stand, youre probably going to pace or move around.
In a series of studies that will be presented at the Second International Congress on Physical Activity and Public Health in Amsterdam, Hamilton, Theodore Zderic, a post-doctoral researcher, and their research team studied the impact of inactivity among rats, pigs and humans. In humans, they studied the effects of sitting in office chairs, using computers, reading, talking on the phone and watching TV. They found evidence that sitting had negative effects on fat and cholesterol metabolism. The scientists also observed that physical inactivity throughout the day stimulated disease-promoting processes, and that exercising, even for an hour a day, was not sufficient to reverse the effect.........
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November 19, 2007, 8:17 PM CT
Doubled calorie intake and obesity
Its not just sugary sodas that are adding to the obesity crisis its fruit drinks, alcohol and a combination of other high-calorie beverages, say University of North Carolina at Chapel Hill School of Public Health researchers. And during the holidays, when eggnog, cocktails and spiced cider are abundant, the problem can be even more apparent.
Over the past 37 years, the number of calories adults get through beverages has nearly doubled, as per a UNC study reported in the recent issue of Obesity Research by Kiyah J. Duffey, a doctoral candidate in the department of nutrition, and Barry M. Popkin, Ph.D., professor of nutrition and a fellow at the Carolina Population Center.
The study used nationally representative data to quantify both trends and patterns in beverage consumption among 46,576 American adults aged 19 and older. Patterns and trends of all beverages adults consumed were examined between 1965 and 2002. Scientists observed that, over these 37 years, total daily intake of calories from beverages increased by 94 percent, providing an average 21 percent of daily energy intake among U.S. adults. That amounts to an additional 222 calories from all beverages daily.
Water intake was measured from 1989 to 2002, and during that time, the amount of water consumed stayed roughly the same, but the average adult consumed an additional 21 ounces per day of other beverages, Popkin said.........
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November 19, 2007, 8:07 PM CT
Women aren't men
Women's bodies and medical needs are vastly different than men's way beyond their reproductive systems. Women wake sooner from anesthesia, have less familiar symptoms of cardiovascular disease and are more likely to suffer from depression and sleep problems-- just to name a few of the differences.
Yet, there's a cavernous void in research based on sex and gender. Historically, most studies have been done on men and the findings applied to women.
Northwestern University's Feinberg School of Medicine has launched the Institute for Women's Health Research to spur much needed research on health issues that affect women throughout their lifespan. Some topics on the ambitious research agenda: cancer, autoimmune disease, anesthesia, cardiovascular disease, depression, sleeping disorders, osteoporosis, osteoarthritis and menopause.
Another mission of the institute will be to create an Illinois Women's Health Registry to provide a large pool of potential study subjects for researchers, who often have trouble recruiting enough participants for their studies. Researchers at the institute also will identify gender-based guidelines for the therapy and prevention of disease in women. For example, do women need a differently designed knee joint than men in replacement surgery or do women need to be given anesthesia differently" The institute will link physicians to these guidelines as they are developed.........
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November 18, 2007, 9:18 PM CT
Treating Vomiting Caused By Chemotherapy
The subcutaneous administration of granisetron, an antiemetic pharmaceutical drug (suitable for control of vomiting), achieves similar blood concentrations to those administered intravenously. This was the conclusion of clinical tests undertaken by specialists at the University Hospital of Navarra, the results of which have been recently reported in the prestigious North American medical journal, The Oncologist.
Granisetron is a pharmaceutical drug the efficacy of which against vomiting (antiemetic), when administered orally or intravenously, has already been shown, but never studied when given subcutaneously. The research shows that the antiemetic granisetron, administered subcutaneously, behaves in a similar manner as when injected intravenously. The advantage of the subcutaneous method is the ease of therapy for non-hospitalised patients. For these patients using the intravenous method it is problematic, requiring, as it does, specialised care; while administering orally may involve the patient vomiting.Home use and emergencies
This is why subcutaneous administration opens new perspectives, providing a comfortable and easy way of home-based therapy, either with self-medicine by the patients themselves or administered by their carers, in either case reducing the dependence on trained medical personnel.........
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November 18, 2007, 9:09 PM CT
Pharmacotherapy for obesity and overweight
Patients taking anti-obesity drugs will only see modest weight loss and a number of will remain significantly obese or overweight, as per a research studypublished on bmj.com today.
The study, which looked at the long-term effectiveness of anti-obesity medications, observed that three drugs recommended for long-term use - orlistat, sibutramine and rimonabant, reduced weight by less than 5kg (11 pounds). This equated to a loss of less than 5% of total body weight. Guidelines from the National Institute for Clinical Excellence recommend stopping the use of anti-obesity drugs if 5% of total body weight is not lost after three months.
While making changes to lifestyle and diet are recommended as the initial therapy for obesity, the use of anti-obesity drugs is common. Its estimated that in 2005 global sales of anti-obesity drugs reached $1.2billion. Current UK guidelines recommend using drug treatment in addition to making changes in lifestyle if a patient has a body mass index of greater than 30.
The Canadian scientists evaluated the evidence from thirty placebo-controlled trials where adults took anti-obesity drugs for a year or longer. The mean weight of the volunteers in all of the trials was 100kg (15.7 stone). The mean body mass index levels were 35 36.........
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November 18, 2007, 9:00 PM CT
Geisinger rheumatologists redesign rheumatoid arthritis care
With the nation collectively spending about $18 billion per year on osteoporosis related bone fractures, Geisinger scientists observed that streamlining the ordering process for osteoporosis bone density scans quadrupled the number of patients who received the exam.
An estimated 10 million Americans suffer from osteoporosis. Like most providers, Geisinger Health System measures the mineral content in the bones of patients who are at high-risk for osteoporosis through DXA scans.
Follow-up exams are commonly needed to assess how the disease has progressed. Geisingers rheumatology department removed some of the steps involved, shifted the responsibility of ordering the exam from the patients primary care provider to the rheumatology staff and made greater use of Geisingers $80 million Electronic Health Record.
Before the change, 18% of patients received the test. After the test, 88% received the scan.
A broken bone from osteoporosis can be excruciating and hard to recover from, said Eric Newman, MD, Geisingers Rheumatology Director. Testing for osteoporosis is the first step in preventing these breaks.
Results of the study were presented at the American College of Rheumatologys annual meeting in Boston recently. Geisinger had four presentations at the meeting, the most ever for the department.........
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November 18, 2007, 8:53 PM CT
Genomic Landscape Of Lung Cancer
An international team of researchers has produced the most comprehensive view yet of the abnormal genetic landscape of lung cancer, the world's leading cause of cancer deaths. Appearing in the Nov. 4 advance online issue of Nature, the research reveals more than 50 genomic regions that are frequently gained or lost in human lung tumors.
While one-third of these regions contain genes already known to play important roles in lung cancer, the majority harbor new genes yet to be discovered. Flowing from this work, the researchers uncovered a critical gene alteration--not previously associated with any form of cancer--that is implicated in a significant fraction of lung cancer cases, shedding light on the biological basis of the disease and a potential new target for treatment.
"This view of the lung cancer genome is unprecedented, both in its breadth and depth," said senior author Matthew Meyerson, a senior associate member of the Broad Institute of MIT and Harvard and an associate professor at Dana-Farber Cancer Institute and Harvard Medical School. "It lays an essential foundation and has already pinpointed an important gene that controls the growth of lung cells. This information offers crucial inroads to the biology of lung cancer and will help shape new strategies for cancer diagnosis and treatment."........
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