October 12, 2006, 4:42 AM CT
Refocusing On Patients With HIV, Hepatitis
As HIV patients live longer thanks to advanced therapies, scientists are looking for better ways to treat accompanying maladies such as hepatitis that traditionally were not emphasized.
"People are living longer with HIV now, but then we see people developing complications from liver disease due to hepatitis," said Dr. Mamta Jain, assistant professor of internal medicine at UT Southwestern Medical Center. "Before we had effective HIV treatment, there was no interest in treating hepatitis C because the thought was the patient would die of AIDS. Well, they're not dying of AIDS, so we are making an effort to try to treat more patients for hepatitis C".
Other diseases, such as cirrhosis or hepatocellular cancers, progress faster in co-infected HIV and hepatitis patients. As a result, health-care providers are trying to intervene as early as possible, said Dr. Jain, who specializes in infectious diseases.
Dr. Jain oversees a co-infection clinic at Parkland Memorial Hospital where patients are reviewed for hepatitis and HIV and can participate in clinical trials. Generally, co-infection rates range from 10 percent to 33 percent of HIV patients. Rates run at about 25 percent at the clinic in Parkland, which is the teaching hospital for UT Southwestern.
UT Southwestern has several ongoing clinical trials for which doctors are recruiting potential patients. The latest study involves whether giving hepatitis C, or HCV, medications early on during HIV disease speeds recovery or improves hepatitis therapies.........
Posted by: Mark Permalink Source
October 11, 2006, 8:58 PM CT
Test To Predict Response In Pancreatic Cancer
Antonio Jimeno, M.D.
By slicing up bits of patient tumors and grafting them into mice, Johns Hopkins Kimmel Cancer Center specialists have figured out how to accurately "test drive" chemotherapy drugs to learn in advance which drug therapys offer each individual pancreas cancer patient the best therapeutic journey.
Eventhough "xenografting" with either cells or fresh tissue is already used widely to test cancer therapies, the Hopkins design is personalized to each patient who has relapsed after an initial course of chemotherapy. "Eventually our approach offers a promising way to individualize treatment earlier in therapy instead of first giving everyone the standard drug gemcitabine, which has a success rate of less than 10 percent," says Antonio Jimeno, M.D., instructor in oncology at the Johns Hopkins Kimmel Cancer Center.
Results of preliminary tests of the Hopkins method in 14 patient samples taken after surgery shows that each xenografts' genetic profile remained stable through three and four generations of mice so that "test drives" would accurately represent a patient's tumor. The researchers also found they could build xenografts in 80 percent of their pancreatic patients, a success rate higher than efforts with patients with colon cancer, for which rates are typically less at about 50 percent.........
Posted by: Sue Permalink Source
October 11, 2006, 8:20 PM CT
Allergy Runs In The Family
Nurse practitioner Sherry Stanforth evaluates a child's allergic reactions to a skin prick test.
Infants whose parents have allergies that produce symptoms like wheezing, asthma, hay fever or hives risk developing allergic sensitization much earlier in life than previously reported, as per a research studyby Cincinnati researchers.
The study suggests that the current practice of avoiding skin testing for airborne allergens before age 4 or 5 should be reconsidered, so children in this high-risk group can be detected early and monitored for the possibility of later allergic respiratory disease.
Produced by researchers in UC's departments of environmental health and internal medicine and at Cincinnati Children's Hospital Medical Center, the study is published in the October 2006 edition of The Journal of Pediatrics.
The Cincinnati scientists collected data on 680 children being reviewed for enrollment in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS), sponsored by the National Institute of Environmental Health Sciences (NIEHS), and compared their results with findings in a 2004 Swedish study.
Using the skin-prick allergy test, the Swedish group observed that in their general population-which included children whose parents did not suffer from allergies-7 percent had allergic sensitivity at age 1. The Swedes tested five allergens, two of which were food allergens.........
Posted by: JoAnn Permalink Source
October 11, 2006, 5:22 AM CT
Innovative Surgery Corrects Vision
Lawrence Tychsen performs a visual examination of a young patient in his clinic.
Children with cerebral palsy and other neurological problems often have extremely poor eyesight. Their ability to read, pick up objects and "see" the world is so impaired and complicated to treat that a number of go untreated, even though they may be legally blind.
Janice Brunstrom, M.D., assistant professor of neurology and pediatrics at Washington University School of Medicine in St. Loius and a neurologist at St. Louis Children's Hospital, saw firsthand how her patients' poor vision interfered with every aspect of their daily lives. Having cerebral palsy herself and wanting to help reverse the isolation that a number of of these children endure because of their poor vision, she approached pediatric ophthalmologist Lawrence Tychsen, M.D., to help devise some solutions.
He did. Tychsen, professor of ophthalmology and visual sciences, of pediatrics and of neurobiology and ophthalmologist in chief at St. Louis Children's Hospital, developed specialized testing and now does vision correction, or refractive surgery, on children with cerebral palsy, Down syndrome and neurobehavioral disorders such as autism. To date, St. Louis Children's Hospital is one of the only U.S. medical centers performing refractive surgery on these children and has the highest volume, operating on about 60 special-needs children a year.........
Posted by: Mike Permalink Source
October 11, 2006, 5:17 AM CT
Hiv Gets A Makeover
Tweaking HIV. A newly engineered version of the AIDS virus, dubbed stHIV, replicates robustly in rhesus monkey cells.
The slow pace of AIDS research can be pinned, in no small part, on something akin to the square-peg-round-hole conundrum. The HIV-1 virus won't replicate in monkey cells, so scientists use a monkey virus - known as SIVmac, or the macaque version of simian immunodeficiency virus - to test potential therapies and vaccines in animals. But therapies and vaccines that are effective on SIV don't necessarily translate into human success. Now, using a combination of genetic engineering and forced adaptation, scientists at Rockefeller and the Aaron Diamond AIDS Research Center have created a version of the AIDS virus that replicates vigorously in both human and monkey cells - an advance that has the potential to revolutionize vaccine research.
In a paper published in today's issue of Science, Paul Bieniasz, associate professor and head of the Laboratory of Retrovirology, describes how he and colleagues maneuvered around the intrinsic immunity of primate cells by replacing just a few parts of the human virus - the ones responsible for blocking replication in monkey cells - with components from SIV. "Overall, the virus is a mixture of engineering and forced evolution," Bieniasz says. "It sounds simple, in theory, but it took us two years to do".
Bieniasz and Theodora Hatziioannou, a research scientist in the lab and the paper's first author, had to overcome two major obstacles: the first was a protein called TRIM5 that, in monkeys, recognizes the outer shell or "capsid" of HIV-1 but not that of SIV. By swapping out the capsid region of the HIV-1 genome for that of the monkey virus, and then selectively growing the viruses that replicated most robustly, over several generations Hatziioannou created an HIV-1 mutant that could evade the monkey cells' TRIM5 recognition.........
Posted by: Mark Permalink Source
October 11, 2006, 4:54 AM CT
Rheumatoid Arthritis Patients Face Unofficial Postcode Lottery
People suffering from the debilitating pain of rheumatoid arthritis (RA) face a postcode lottery over whether they can have access to a therapy that is known to improve their condition significantly.
New research reported in the medical journal Rheumatology  today (11 October 2006) reveals that, despite the National Institute for Health and Clinical Excellence (NICE) approving anti-tumour necrosis factor alpha (TNF) treatment for RA in 2002, a number of primary care trusts are refusing to fund it adequately or are putting a cap on the numbers of patients that can be treated.
The picture is even worse for the use of anti-TNF treatment in other arthritic conditions such as psoriatic arthritis (PsA) and ankylosing spondylitis (AS) where NICE approval has only just been given or is being awaited.
As a result of these findings, rheumatologists are calling on the Government and primary care trusts to end the unofficial postcode lottery and ensure that every patient who meets the NICE criteria can receive anti-TNF treatment if their consultants consider it appropriate.
Dr Lesley Kay, a member of the British Society for Rheumatology Biologics Register (BSRBR) management committee and co-author of the research, said: "The BSRBR urges the Government and primary care trusts to put an end to this patently unfair situation, which is in direct contravention of government policy. The postcode lottery continues to operate, even though NICE aims to stop this happening. It's unfair on patients with these devastating, painful and unglamorous conditions to be forced to take a low priority and to be deprived of this very successful therapy".........
Posted by: Mark Permalink Source
October 10, 2006, 10:28 PM CT
Decaffeinated coffee is not caffeine-free
Coffee addicts who switch to decaf for health reasons may not be as free from caffeine's clutches as they think. A new study by University of Florida scientists documents that almost all decaffeinated coffee contains some measure of caffeine.
Caffeine is the most widely consumed drug in the world. And because coffee is a major source in the supply line, people advised to avoid caffeine because of certain medical conditions like high blood pressure should be aware that even decaffeinated brew can come with a kick, UF scientists report in this month's Journal of Analytical Toxicology.
"If someone drinks five to 10 cups of decaffeinated coffee, the dose of caffeine could easily reach the level present in a cup or two of caffeinated coffee," said co-author Bruce Goldberger, Ph.D., a professor and director of UF's William R. Maples Center for Forensic Medicine. "This could be a concern for people who are advised to cut their caffeine intake, such as those with kidney disease or anxiety disorders".
Despite caffeine's widespread use, most medical texts have no guidelines for intake, Goldberger said, but even low doses might adversely affect some people. So UF scientists set out to conduct a two-phase study designed to gauge just how much caffeine is likely to turn up in decaffeinated coffees.........
Posted by: Janet Permalink Source
October 10, 2006, 10:23 PM CT
Poultry And Antibiotic Resistance
Clinic researcher and colleagues have found.
Results of the nearly $1.4 million three-year study, funded by the Centers for Disease Control and Prevention, Atlanta, Georgia, are in the November 1 issue of The Journal of Infectious Diseases.
Edward Belongia, M.D., Marshfield Clinic Research Foundation, Marshfield, Wis., and colleagues examined poultry exposure as a risk factor for antibiotic resistance in Enterococcus faecium, a gut bacterium that is increasingly the cause of infections in hospitals. The investigation team focused on use of a growth-promoting antibiotic, called virginiamycin, in poultry.
Virginiamycin is closely correlation to quinupristin-dalfopristin, an antibiotic licensed to treat patients with serious, antibiotic-resistant infections. The drug is prescribed under the brand name Synercid.
As per Belongia, "There is a relative lack of data on the impact of antibiotic use in livestock and its relationship to antibiotic resistance in humans, but there is a fair amount of indirect evidence suggesting that antibiotic use could pose a risk to human health".
"We've known for a long time that resistant bacteria can be found on retail poultry products, but our study is one of the first to show an association between human carriage of antibiotic resistance genes and eating poultry or handling raw poultry.........
Posted by: Mark Permalink Source
October 10, 2006, 10:18 PM CT
New Hope For Borderline Personality Disorder
For the first time, a major outcome study has shown that a high percentage of patients with Borderline Personality Disorder can achieve full recovery across the complete range of symptoms. The controlled study, appearing in a recent issue of the Archives of General Psychiatry published by the American Medical Association, shows that a new approach -- Schema Therapy -- is more than twice as effective as a widely practiced psychodynamic approach, Transference Focused Psychotherapy (TFP). Schema Therapy was also found to be less costly and to have a much lower drop out rate. Borderline Personality Disorder (BPD) has until recent years been considered untreatable, with little scientific justification for longer-term treatment.
This study demonstrates that schema treatment leads to complete recovery in about 50% of the patients, and to significant improvement in two-thirds. The success of the treatment is strongly correlation to its duration and intensity (two sessions a week for 3 years). The results clearly contradict the prevailing opinion that BPD cannot be fully cured, and that longer-term psychotherapy is ineffective.
As per the National Institute of Mental Health, Borderline Personality Disorder is found in about 1 to 2.5 percent of the general population--about 5.8 to 8.7 million Americans, most of whom are young women. Patients with the disorder live life on the edge: they're typically impulsive, unstable, exquisitely sensitive to rejection, have regular outbursts of anger, and live daily with extreme emotional pain. They often self-mutilate and make repeated suicide attempts. Identity problems, low stress tolerance, and fears of abandonment also make the disorder difficult for patients and for those who live with them. A number of with BPD either cannot work or do not function at levels that could be expected in light of their intellectual capacities. As a result, the disorder carries high medical and societal costs, accounting for more than one in every five inpatient psychiatric admissions.........
Posted by: JoAnn Permalink Source
October 10, 2006, 9:56 PM CT
Material That Stops Bleeding In Seconds
MIT and Hong Kong University scientists have shown that some simple biodegradable liquids can stop bleeding in wounded rodents within seconds, a development that could significantly impact medicine.
When the liquid, composed of protein fragments called peptides, is applied to open wounds, the peptides self-assemble into a nanoscale protective barrier gel that seals the wound and halts bleeding. Once the injury heals, the nontoxic gel is broken down into molecules that cells can use as building blocks for tissue repair.
"We have found a way to stop bleeding, in less than 15 seconds, that could revolutionize bleeding control," said Rutledge Ellis-Behnke, research scientist in the MIT Department of Brain and Cognitive Sciences.
This study, which will appear in the online edition of the journal Nanomedicine on Oct. 10, marks the first time that nanotechnology has been used to achieve complete hemostasis, the process of halting bleeding from a damaged blood vessel.
Doctors currently have few effective methods to stop bleeding without causing other damage. More than 57 million Americans undergo nonelective surgery each year, and as much as 50 percent of surgical time is spent working to control bleeding. Current tools used to stop bleeding include clamps, pressure, cauterization, vasoconstriction and sponges.........
Posted by: Scott Permalink Source