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"One day MRI brain scans may help predict whether older people will develop dementia new research suggests. In a small study MRI brain scans predicted with percent accuracy who would go on to develop dementia within three years according to research at Washington University School of Medicine in St. Louis and the University of California San Francisco. The findings presented Sunday Nov. at the Radiological Society of North America meeting in Chicago suggest that doctors may one day be able to use widely available tests to tell people their risk of developing dementia before symptoms arise. Right now its hard to say whether an older person with normal cognition or mild cognitive impairment is likely to develop dementia said lead author Cyrus A. Raji MD PhD an assistant professor of radiology at Washington Universitys Mallinckrodt Institute of Radiology. We showed that a single MRI scan can predict dementia on average . years before memory loss is clinically detectable which could help doctors advise and care for their patients. Alzheimers disease is a progressive irreversible brain disorder that destroys memory and thinking skills. The disease affects . million Americans according to the National Institutes of Health NIH. Neurologists can get a ballpark estimate of a patients risk of Alzheimers dementia using the MiniMental State Examination questionnaire or by testing for the highrisk form of the gene ApoE which increases a persons risk of Alzheimers by up to fold. Both tests were about to percent accurate in this study. Other assessments such as PET scans for plaques of Alzheimers proteins in the brain are good at detecting early signs of Alzheimers disease but available to few patients. PET scans cost thousands of dollars and require radioactive materials not found in a typical hospital. MRI brain scans are widely available and give doctors a glimpse into whats going on inside a persons brain. Raji and colleagues at the School of Medicine including Tammie Benzinger MD PhD a professor of radiology Parinaz Massoumzadeh PhD and Adedamola Adedokun as well as radiologist Pratik Mukherjee MD PhD of the University of California San Francisco analyzed MRI scans for physical signs of impending cognitive decline. They used a technique called diffusion tensor imaging to assess the health of the brains white matter which encompasses the cables that enable different parts of the brain to talk to one another. Diffusion tensor imaging is a way of measuring the movement of water molecules along white matter tracts Raji said. If water molecules are not moving normally it suggests underlying damage to white tracts that can underlie problems with cognition. Using information from the Alzheimers Disease Neuroimaging Initiative a multisite collaboration that pools data funding and expertise to improve clinical trials for Alzheimers disease Raji and colleagues identified people whose cognitive skills declined over a twoyear period and matched them by age and sex with people whose thinking skills held steady. The average age of people in both groups was . Then the researchers analyzed diffusion tensor MRI scans taken just before the twoyear period for all people. The researchers found that people who went on to experience cognitive decline had significantly more signs of damage to their white matter. The researchers repeated their analysis in a separate sample of people using a more refined measure of white matter integrity. With this new analysis they were able to predict cognitive decline with percent accuracy when looking at the whole brain. When the researchers focused on specific parts of the brain most likely to show damage the accuracy rose to percent. We could tell that the individuals who went on to develop dementia have these differences on diffusion MRI compared with scans of cognitively normal people whose memory and thinking skills remained intact Raji said. What we need now before we can bring it into the clinic is to get more control subjects and develop computerized tools that can more reliably compare individual patients scans to a baseline normal standard. With that doctors might soon be able to tell people whether they are likely to have Alzheimers develop in the next few years. Although there are no drugs available yet to prevent or delay the onset of Alzheimers disease identifying those at high risk of developing dementia within the next few years could still be beneficial the researchers said. People could make decisions on their financial and living arrangements while they are still in full control of their faculties."

"A firstofitskind drug targeting a fused gene found in many types of cancer was effective in percent of pediatric patients tested researchers at UT Southwesterns Simmons Cancer Center announced. Most cancer drugs are targeted to specific organs or locations in the body. Larotrectinib is the first cancer drug to receive FDA breakthrough therapy designation for patients with a specific fusion of two genes in the cancer cell no matter what cancer type. The research appears in The Lancet Oncology. In some cancers a part of the TRK gene has become attached to another gene which is called a fusion. When this occurs it leads to the TRK gene being turned on when its not supposed to be and that causes the cells to grow uncontrollably. Whats unique about the drug is it is very selective it only blocks TRK receptors said lead author Dr. Ted Laetsch Assistant Professor of Pediatrics and with the Harold C. Simmons Comprehensive Cancer Center. More information Lancet Oncology paper News release on NEJM paper Larotrectinib targets TRK fusions which can occur in many types of cancer. While the TRK fusions occur in only a small percentage of common adult cancers they occur frequently in some rare pediatric cancers such as infantile fibrosarcoma cellular congenital mesoblastic nephroma and papillary thyroid cancer said Dr. Laetsch who leads the Experimental Therapeutics Program ETP in the Pauline Allen Gill Center for Cancer and Blood Disorders at Childrens Health in Dallas. Every patient with a TRK fusionpositive solid tumor treated on this study had their tumor shrink. The nearly universal response rate seen with larotrectinib is unprecedented Dr. Laetsch said. Among them was yearold Briana Ayala of El Paso who aspires to a career in fashion design. In Briana was found to have a rare tumor in her abdomen wrapped around her aorta the largest artery in the body. Surgeons in her hometown said it would be too dangerous to operate so her family brought Briana to Childrens Health in Dallas where UT Southwestern Professor of Surgery Dr. Stephen Megison had to remove portions of her aorta while removing most of the tumor. But the cancer started to grow again and no further treatments were available. Dr. Laetsch sent her tumor for genetic testing and found that Brianas cancer had the TRK fusion meaning the new drug might help. Briana enrolled in the phase clinical trial of larotrectinib and began taking the drug twice a day. Within weeks her pain and the swelling in her abdomen diminished and scans showed her tumors had shrunk significantly. Nearly two years later Briana is back in school and playing with her dog Goofy and the familys seven parakeets. Shes also been able to pick up her sketch pad and her dreams of a New York City fashion career. These are the kind of amazing responses weve seen with larotrectinib said Dr. Laetsch and this is why Im so excited about it. The results of the larotrectinib trial in adult patients a percent response rate were published last month in the New England Journal of Medicine. The TRKfusion mutation can be present in many types of cancers including lung colon thyroid and breast cancer as well as certain pediatric tumors. TRK short for tropomyosin receptor kinase is a gene that plays a key role in brain and nervous system development and has a limited role in nervous system functions such as regulating pain in later life. Larotrectinib belongs to a class of molecules known as kinase inhibitors which work by cutting back on the enzymatic activity of a key cellular reaction. The selectivity of the drug means it does not cause the severe side effects associated with many traditional cancer treatments and none of the patients with TRK fusions had to quit the study because of a druginduced side effect. Equally important the response was longlasting for most patients. For some of the targeted drugs in the past many patients responded initially but then resistance developed quickly. To date the response to this drug seems to be durable in most patients said Dr. Laetsch who investigates the use of tumor molecular profiling to guide therapy in UT Southwesterns Pediatric Hematology and Oncology Division. A next step in the research is a clinical trial involving a similar drug for those patients who developed resistance. Dr. Laetsch will be the national leader for that clinical trial in children. The larotrectinib research was supported by Loxo Oncology Inc. the National Institutes of Health the Cancer Prevention and Research Institute of Texas the National Center for Advancing Translational Sciences and Alexs Lemonade Stand Foundation. Dr. Laetsch is a paid consultant for Loxo Oncology Inc. The Harold C. Simmons Comprehensive Cancer Center is the only NCIdesignated Comprehensive Cancer Center in North Texas and among just U.S. cancer research centers to be designated by the NCI as a National Clinical Trials Network Lead Academic Participating Site. UT Southwestern Medical Center is recognizing its th year this year. About UT Southwestern Medical Center UT Southwestern one of the premier academic medical centers in the nation integrates pioneering biomedical research with exceptional clinical care and education. The institutions faculty has received six Nobel Prizes and includes members of the National Academy of Sciences members of the National Academy of Medicine and Howard Hughes Medical Institute Investigators. The faculty of more than is responsible for groundbreaking medical advances and is committed to translating sciencedriven research quickly to new clinical treatments. UT Southwestern physicians provide care in about specialties to more than hospitalized patients emergency room cases and oversee approximately . million outpatient visits a year."

"Antidepressant drugs really do work a major new international study has proven. Pooling data from trials including nearly patients researchers found all drugs analysed were more effective than placebos in the treatment of adults with acute depression. Authors of the studypublished yesterday in the Lancet http many more people could benefit from antidepressant medication. The study results represent the most comprehensive evidence currently available they wrote. In the international study published in the Lancet authors found that fluoxetinecommonly sold under then trade name Prozacwas one of the least effective antidepressants. Stephen CherninGetty Images More than million people worldwide have depression according to the World Health Organization http of which less than half recieve effective treatments. In many countries the rate drops to less than percent. In the U.S. the National Institute of Mental Health estimates https . million adults experienced at least one major depressive episode in . Approximately percent of these people received no treatment. In the U.K where a number of the study authors are based at least one million more people could benefit from drugs or psychotherapy senior author John Geddes said. Some drugs more effective than others The researchers analyzed existing studies of different drugs and found some were much more effective than others. Drugs ranged from more than one third more effective than a placebo to more than twice as effective. The best performers included amitriptyline and escitalopram while the worst included fluoxetinecommonly sold under the trade name Prozacand reboxetine which is not approved for sale in the U.S. A complex treatment picture The results add up to a complex treatment picture for what authors called one of the most common burdensome and costly psychiatric disorders worldwide in adults. Antidepressants do not improve symptoms in about percent of people study author Andrea Cipriani of Oxford University told a press briefing. While these results should reassure many people with depression that antidepressants can be effective this does not necessarily mean antidepressants should always be the first line of treatment he said. Talking therapies are thought to be about as effective as antidepressant medication but these are often much more expensive. Experts not involved in the research agreed the results were significant. Helen StokesLampard chair of the U.K.s Royal College of GPs expressed concern about the stigma surrounding antidepressant use. She said in a statement http Taking antidepressants is frequently portrayed as a negative thing or something done only when other therapies are not available or have failed but this in itself can add to the unfortunate stigma that sometimes exists around people with mental health conditions. But she also urged caution. Although antidepressants are of proven benefitas this study shows she said no doctor wants their patients to become reliant on medication. Putting a longheld controversy to bed Carmine Pariante a professor at the UKs Institute of Psychiatry Psychology and Neuroscience and spokesperson for the Royal College of Psychiatrists said the study finally puts to bed the controversy on antidepressants. James Warner an Imperial College London psychiatrist added Depression causes misery to countless thousands every year and this study adds to the existing evidence that effective treatments are available."

"Could root canal procedures go by the wayside in the nottoodistant future Scientists from the University of Nottingham and Harvard Universitys Wyss Institute hope so. Theyre developing a new treatment strategy that could someday help heal a damaged tooth using the patients own stem cells. Though the work is still in its early stages and has not yet been tested in people the scientists won an award from the Royal Society of Chemistry for their idea regenerative dental fillings. When dental pulp disease and injury happen a root canal is typically performed to remove the infected tissues explained Dr. Adam Celiz Marie Curie Research Fellow at the University of Nottingham. Instead of the current dental materials used on fillings https which are toxic to cells the new approach harnesses stem cells instead. What we found is a material that can potentially regenerate https components of a patients tooth https Celiz told CBS News. Were trying to provide an alternative material an alternative therapy he said because the current method involves the dentist removing all of the infected pulp tissue scraping it out and it can be very painful. The process works by stimulating native stem cells https_VAoHhAWCAUwAAclientinternaludscseusgAFQjCNEiGAgFaDFoMiYoDfdPQpYzwA inside teeth triggering repair and regeneration of pulp tissues. We hope to eventually encourage dentin regeneration. Dentin is the protective layer that sits on top of the pulp tissue. Its a barrier between enamel and the soft tissue that contains all the blood vessels and cells Celiz explained. CBS News chief medical correspondent Dr. Jon LaPook put it in simple terms The cells in the area of a root canal in the pulp those are normally asleep. Its like this material goes over and just taps it on the shoulder and says Wake up wake up and then it starts to repair itself. The stem cell procedure is in the earliest stages of development said Celiz. We have tested it in cell cultures and were moving it along into rodents he said. Its hard to put timeline on it but were talking years before we test it in humans. Were hoping this approach can bring regenerative medicine into the dentistry field said Celiz. If successful a treatment like this could someday offer significant benefits for millions of dental patients https each year."

"The controversial drug Avastin should be phased out as a treatment for metastatic breast cancer the Food and Drug Administration said Thursday citing recent studies that show its benefits may be outweighed by dangerous side effects. However patients currently taking Avastin as part of their chemotherapy regimen will not immediately be affected and doctors should use their medical judgment on whether to continue its use said Dr. Janet Woodcock of the FDAs Center for Drug Evaluation and Research. The announcement does not affect Avastins status as an approved therapy for lung cancer kidney cancer colorectal cancer and brain cancer. Reflecting splits in the medical community the European Medicines Agency said Thursday that Avastin would remain an approved therapy for breast cancer in European Union countries although only in one particular combination with the drug paclitaxel. Avastin first approved as a cancer treatment in helps by inhibiting a tumors blood supply. In the FDA granted Avastin whats known as accelerated approval of its use as a therapy for metastatic breast cancer cancer that has spread from one part of the body to another. The move was based on data in one preliminary study known as E. At that time researchers reported that Avastin when used in combination with other drugs extended the time that patients went without their illness getting worse a measure known as progressionfree survival or PFS. Along with the initial approval the FDA required Genentech Avastins maker to complete larger studies. The results of those studies were a bitter pill for patients thriving on Avastin and researchers excited by the promise of the early data. The E study found that for women taking Avastin plus paclitaxel the cancer stopped spreading for an average of fiveandahalf months more compared to those just taking standard chemotherapy. In the subsequent three larger studies the benefit was much smaller ranging from just days to about two months. None of the studies including the E study showed that patients getting Avastin lived longer than patients on standard chemotherapies. We now have four studies that show no survival benefit Woodcock said. Along with those disappointing findings serious side effects became apparent in patients taking Avastin including high blood pressure internal bleeding perforated internal organs heart failure and heart attacks and in some cases even swelling of the brain. Based on the new data an FDA advisory panel voted to reverse the accelerated approval in July. Thursdays announcement is only a first step in removing the FDAs approval for this drug in treating breast cancer patients. As part of the complex process Genentech has a right to appeal and company spokeswoman Charlotte Arnold said it would request a hearing to press its case. Physicians who favor Avastins use say the FDA is being overly cautious and that the drug can be used safely if patients are closely monitored. This is a very sad and confusing day for our patients said Dr. Joseph Sparano of MontefioreEinstein Center for Cancer Care in New York. Survival was consistently better at one year in all of the studies indicating that this is a safe and effective option. What makes this even more frustrating is that the drug will still be available to prescribe but will only be an option for those who can afford it rather than those who really need it. Avastins cost which can run to several thousand dollars a month has sometimes been used as an example by critics of the health care system who fear that costcutting may win out over patient care. After the advisory committees decision in July Sen. David Vitter RLouisiana wrote a letter to the FDA complaining that the FDA advisory committees concerns appear to have been based on costeffectiveness and adding that a reversal on accelerated approval would amount to costrationing. The FDA says it does not consider cost when evaluating the safety or effectiveness of a drug. Dr. Len Lichtenfeld deputy chief medical officer of the American Cancer Society said its clear that some women with metastatic breast cancer have benefited from Avastin but others not only have not benefited theyve been harmed. What we clearly need is a way for doctors to more accurately predict which women will have a better chance of benefitting from this important targeted therapy he said in a statement on the American Cancer Society website. Thursday Woodcock held out the possibility that Avastin might eventually prove helpful in a targeted group of patients. We certainly hope that additional data could be generated to see if there is a subset of tumors that would respond more than others she said. The FDA stands ready to work with Genentech on future studies. Such research is already underway Arnold said but its too early to discuss the findings. This is something Genentech is very committed to. Our scientists are dedicated to learning more about who might derive a greater benefit from Avastin she explained."

"An injection of stem cells into the eye may soon slow or reverse the effects of earlystage agerelated macular degeneration according to new research from scientists at CedarsSinai http Currently there is no treatment that slows the progression of the disease which is the leading cause of vision loss in people over . This is the first study to show preservation of vision after a single injection of adultderived human cells into a rat model with agerelated macular degeneration said Shaomei Wang MD PhD http lead author of the study published in the journal STEM CELLS and a research scientist in the Eye Program http at the CedarsSinai Board of Governors Regenerative Medicine Institute. http The stem cell injection resulted in days of preserved vision in laboratory rats which roughly equates to years in humans. Agerelated macular degeneration affects upward of million Americans. It occurs when the small central portion of the retina known as the macula deteriorates. The retina is the lightsensing nerve tissue at the back of the eye. Macular degeneration may also be caused by environmental factors aging and a genetic predisposition. When animal models with macular degeneration were injected with induced neural progenitor stem cells which derive from the more commonly known induced pluripotent stem cells healthy cells began to migrate around the retina and formed a protective layer. This protective layer prevented ongoing degeneration of the vital retinal cells responsible for vision. CedarsSinai researchers in the Induced Pluripotent Stem Cell iPSC Core http directed by Dhruv Sareen PhD http with support from the David and Janet Polak Foundation Stem Cell Core Laboratory first converted adult human skin cells into powerful induced pluripotent stem cells iPSC which can be expanded indefinitely and then made into any cell of the human body. In this study these induced pluripotent stem cells were then directed toward a neural progenitor cell fate known as induced neural progenitor stem cells or iNPCs. These induced neural progenitor stem cells are a novel source of adultderived cells which should have powerful effects on slowing down vision loss associated with macular degeneration said Clive Svendsen PhD http director of the Board of Governors Regenerative Medicine Institute and contributing author to the study. Though additional preclinical data is needed our institute is close to a time when we can offer adult stem cells as a promising source for personalized therapies for this and other human diseases. Next steps include testing the efficacy and safety of the stem cell injection in preclinical animal studies to provide information for applying for an investigational new drug. From there clinical trials will be designed to test potential benefit in patients with laterstage agerelated macular degeneration. Additional CedarsSinai authors include Dhruv Sareen PhD Yuchun Tsai PhD Bin Lu MD PhD Benjamin Bakondi PhD Sergey Girman PhD and Anais Sahabian PhD. This work was supported by the Simon and Beathrice Apple Stem Cell Fund for Eye Research the David and Janet Polak Foundation Stem Cell Core Laboratory National Institutes of Health R EY Department of Defense WXWH Foundation Fighting Blindness and the Knights Templar Eye Foundation Inc. Citation STEM CELLS. April Human iPSCderived neural progenitors preserve vision in an AMDlike model."

"COLUMBUS Ohio Antiinflammatory diets which tend to be high in vegetables fruits fish and whole grains could boost bone health and prevent fractures in some women a new study suggests. Researchers examined data from the landmark Womens Health Initiative to compare levels of inflammatory elements in the diet to bone mineral density and fractures and found new associations between food and bone health. The study led by Tonya Orchard an assistant professor of human nutrition at The Ohio State University appears in the Journal of Bone and Mineral Research. Women with the leastinflammatory diets based on a scoring system called the Dietary Inflammatory Index lost less bone density during the sixyear followup period than their peers with the mostinflammatory diets. This was despite the fact that they started off with lower bone density overall. Furthermore diets with low inflammatory potential appeared to correspond to lower risk of hip fracture among one subgroup of the study postmenopausal white women younger than . The findings suggest that womens bone health could benefit when they choose a diet higher in beneficial fats plants and whole grains said Orchard who is part of Ohio States Food Innovation Center. This suggests that as women age healthy diets are impacting their bones Orchard said. I think this gives us yet another reason to support the recommendations for a healthy diet in the Dietary Guidelines for Americans. Because the study was observational its not possible to definitively link dietary patterns and bone health and fracture outcomes. Rebecca Jackson the studys senior author and director of Ohio States Center for Clinical and Translational Science said the new findings support a growing body of evidence that factors that increase inflammation can increase osteoporosis risk. By looking at the full diet rather than individual nutrients these data provide a foundation for studying how components of the diet might interact to provide benefit and better inform womens health and lifestyle choices said Jackson who is national chair of the Womens Health Initiative steering committee. Previous studies have connected high levels of inflammatory markers in the blood to bone loss and to fractures in older women and men which prompted Orchard and her colleagues to wonder what theyd find if they took one more step back to the dietary choices that contribute to inflammation in the body. The Dietary Inflammatory Index developed to assess the quality of diet from maximally to minimally inflammatory based on nutrients consumed helped them accomplish that. Dietary information as well as data on bone density and fracture were collected from a large group of the participants in the Womens Health Initiative the largest study of postmenopausal womens health undertaken in U.S. history. Participants in the WHI were to when they enrolled in the study of prevention and control of common diseases impacting older women. Enrollment ran from to . For the new analysis the first of its kind the research team looked at dietary data from women and assigned inflammation scores based on food components that the women reported consuming in the three months prior to their enrollment. The researchers used bonemineraldensity data from a subset of women. Fracture data was collected for the entire study group. Orchard and her colleagues found a correlation only between highinflammatory diets and fracture in younger white women in the study. Higher scores were associated with an almost percent larger risk of hip fracture in Caucasian women younger than compared with the risk for women in the group with the lowest inflammatory scores. This suggests that a highquality lessinflammatory diet may be especially important in reducing hip fracture risk in younger women the researchers wrote. But in the study group overall moreinflammatory diets were not linked to fracture and in fact the researchers found a modestly lower risk of lowerarm and total fracture in women with the highest dietary inflammation scores. One possible explanation included in the study The women with lower inflammation scores were more physically active as a group and therefore were at a slightly greater risk of falls. Women with the leastinflammatory diets had lower bone mineral density overall at the start of the study but lost less bone than their highinflammation peers the researchers found. The lower bone density to start could be because women with healthier diets are more likely to be of a smaller build Orchard said. Larger people have higher bone density to support their larger frames. These women with healthier diets didnt lose bone as quickly as those with highinflammation diets and this is important because after menopause women see a drastic loss in bone density that contributes to fractures Orchard said. Vedat Yildiz of Ohio States Center for Biostatistics also worked on the study which was supported by the National Heart Lung and Blood Institute and the U.S. Department of Health and Human Services. CONTACT Tonya Orchard Orchard.osu.edu mailtoOrchard.osu.edu"

"Overweight people who used a new motivational intervention called Functional Imagery Training FIT lost an average of five times more weight than those using talking therapy alone shows new research published today by the University of Plymouth and Queensland University. In addition users of FIT lost .cm more around their waist circumference in six months and continued to lose weight after the intervention had finished. Led by Dr Linda Solbrig from the School of Psychology the research involved participants who were allocated either to FIT or Motivational Interviewing MI a technique that sees a counsellor support someone to develop highlight and verbalise their need or motivation for change and their reasons for wanting to change. FIT goes one step further than MI as it makes use of multisensory imagery to explore these changes by teaching clients how to elicit and practice motivational imagery themselves. Everyday behaviours and optional app support are used to cue imagery practice until it becomes a cognitive habit. Maximum contact time was four hours of individual consultation and neither group received any additional dietary advice or information. Dr Solbrig who completed the work as part of a PhD funded by The National Institute for Health Research NIHR Collaboration for Leadership in Applied Health Research and Care CLAHRC South West Peninsula said Its fantastic that people lost significantly more weight on this intervention as unlike most studies it provided no dietphysical activity advice or education. People were completely free in their choices and supported in what they wanted to do not what a regimen prescribed. The study showed how after six months people who used the FIT intervention lost an average of .kg compared with an average of .kg among the MI group. After months six months after the intervention had finished the FIT group continued to lose weight with an average of .kg lost compared with .kg in the MI group. Dr Solbrig continued Most people agree that in order to lose weight you need to eat less and exercise more but in many cases people simply arent motivated enough to heed this advice however much they might agree with it. So FIT comes in with the key aim of encouraging someone to come up with their own imagery of what change might look and feel like to them how it might be achieved and kept up even when challenges arise. We started with taking people through an exercise about a lemon. We asked them to imagine seeing it touching it juicing it drinking the juice and juice accidently squirting in their eye to emphasise how emotional and tight to our physical sensations imagery is. From there we are able to encourage them to fully imagine and embrace their own goals. Not just imagine how good it would be to lose weight but for example what would losing weight enable you to do that you cant do now What would that look sound smell like and encourage them to use all of their senses. As well as being delighted by the success of the study in the short term there are very few studies that document weight loss past the end of treatment so to see that people continued to lose weight despite not having any support shows the sustainability and effectiveness of this intervention. Trisha Bradbury was one of the participants allocated to the FIT study and she explains I lost my mum at and being myself with a variety of health problems my motivation was to be there for my daughter. I kept thinking about wearing the dress Id bought for my daughters graduation and on days I really didnt feel like exercising kept picturing how Id feel. Ive gone from stone to stone and have managed to lower the dosage I need for my blood pressure tablets. Id still like to lose a touch more but Im so delighted with the mindset shift. Professor Jackie Andrade Professor in Psychology at the University of Plymouth is one of the cocreators of FIT and she explains FIT is based on two decades of research showing that mental imagery is more strongly emotionally charged than other types of thought. It uses imagery to strengthen peoples motivation and confidence to achieve their goals and teaches people how to do this for themselves so they can stay motivated even when faced with challenges. We were very excited to see that our intervention achieved exactly what we had hoped for and that it helped our participants achieve their goals and most importantly to maintain them. The full study entitled Functional Imagery Training versus Motivational Interviewing for Weight Loss A randomised controlled trial of brief individual interventions for overweight and obesity is available to view in the International Journal of Obesity doi .s."

"Cancer patients undergoing chemotherapy may be able to avoid the accompanying muscle loss and malnutrition by taking fish oil supplements that contain omega fatty acids new research suggests. The finding is based on a small study involving just lung cancer patients. Nevertheless it raises hope that a simple noninvasive intervention might go a long way towards countering the fatigue poorer prognosis and impaired quality of life that can result from chemoinduced muscle mass loss. Fish oil may prevent loss of weight and muscle by interfering with some of the pathways that are altered in advanced cancer study author Dr. Vera Mazurak of the University of Alberta in Edmonton Canada said in a news release. This holds great promise because currently there is no effective treatment for cancerrelated malnutrition. Mazurak and her colleagues report their observations in the Feb. online edition of Cancer. To explore the therapeutic potential of fish oil supplements the authors offered cancer patients undergoing an initial week chemotherapy regimen a daily dose of . grams of a particular omega fatty acid called eicosapentaenoic EPA. While these patients took fish oil supplements throughout their chemotherapy treatment a second group of patients underwent the same regimen minus the fish oil. The results continual muscle and fat measurements revealed that the group that took no fish oil supplementation lost an average of just over pounds the supplement group lost no weight. Whats more blood analyses revealed that those in the fish oil group who had the biggest bump in bloodstream EPA concentrations also had the greatest muscle mass gains. Specifically nearly percent of those in the fish oil group either kept their prechemo muscle mass or gained muscle. By comparison less than percent in the nonsupplement group kept their original muscle mass. Total fat tissue measurements were unaffected by fish oil supplementation the team noted and no side effects were observed. The authors concluded that fish oil supplementation appears to be a safe and effective way to prevent malnutrition among cancer patients and may ultimately prove to be of benefit for other groups of people such as elderly patients who also face a significant ongoing risk for muscle loss. Lona Sandon a registered dietitian and assistant professor of clinical nutrition at the University of Texas Southwestern Dallas reacted with cautious optimism to the findings. Malnutrition is a big concern with cancer patients undergoing chemotherapy and radiation she noted. Because first of all they do have wasting from the cancer itself which is very metabolically active and eats up your energy stores. And then with chemotherapy there is some inflammation thats detrimental to the heart and muscle as it can cause muscle breakdown. And preservation of lean muscle tissue we know leads to better outcomes. So certainly this does seem to be promising Sandon said. And other similar studies have looked at omega and muscle preservation and have also suggested that fish oil can act to prevent inflammation caused by both disease and hardcore medications like chemotherapy agents. But I would caution that the amount of pure concentrated fish oil supplement the people in this study were given is a lot she added. Much much more than any recommended dietary allowance along the lines of two to three servings of fish per week. But she said I would say this is certainly worthy of continuing research and exploration. But meanwhile people should definitely not go out and start consuming huge amounts of fish oil. More information For more on chemotherapy visit the American Cancer Society http SOURCE Cancer Feb. news release Lona Sandon dietitian and assistant professor clinical nutrition University of Texas Southwestern Dallas"

"The gene responsible for cystic fibrosis httpshealth.nytimes.comhealthguidesdiseasecysticfibrosisoverview.htmlinlinenytclassifier was discovered in . Now years later a drug that tries to compensate for the genetic defect might be nearing the market. Vertex Pharmaceuticals https announced Wednesday morning that the drug VX https improved lung function in people with cystic fibrosis in a latestage clinical trial. The drug also reduced the frequency of disease exacerbations that required treatment with antibiotics httpstopics.nytimes.comtopnewshealthdiseasesconditionsandhealthtopicsantibioticsindex.htmlinlinenytclassifier. The caveat is that VX is designed to counter one specific genetic mutation that accounts for about percent of cases of cystic fibrosis. Vertex is working on another drug for the most common mutation but that one is further behind in development. Still the news is expected to be greeted favorably by doctors and patients and by Wall Street. Ive been doing clinical trials for years in C.F. and these are amazing results Dr. Bonnie W. Ramsey https_Bonnie.html a lead investigator in the trial said in an interview. Dr. Ramsey a professor of pediatrics httpstopics.nytimes.comtopnewshealthdiseasesconditionsandhealthtopicspediatricsindex.htmlinlinenytclassifier at the University of Washington httpstopics.nytimes.comtopreferencetimestopicsorganizationsuuniversity_of_washingtonindex.htmlinlinenytorg was briefed on the results by Vertex. The results were announced by a press release httpsinvestors.vrtx.comreleasedetail.cfmReleaseID and have not been peer reviewed by experts. About Americans and people worldwide have cystic fibrosis a disease caused by defects in a gene responsible for the transport of chloride ions across cell membranes. People with the disease tend to have very thick mucus in their lungs which leads to infections and lung damage. Many do not live past age . Two inhaled antibiotics and one drug that loosens mucus are approved to treat cystic fibrosis but nothing that directly improves chloride ion transport. In the trial those who received VX gained . percentage points more on a lung function test after weeks than those getting a placebo a difference that statistically was highly significant. Patients continued to take either drug or placebo for another weeks and the improvement was sustained. Lung function the primary endpoint of the trial was measured by how much a person could exhale in one second a standard test. Investors had been expecting around a percentage point improvement. In a note to clients Tuesday evening before the results were known an analyst at ISI Group Mark Schoenebaum https said that an improvement of percent would be a home run that could lead to million in annual sales for the drug. Dr. Ramsey who has received research grants from Vertex said that some patients could perceive a percentage point change in lung function. She said other results of the trial were encouraging. These included fewer exacerbations of the disease in those who got the drug fewer selfreported respiratory symptoms and a gain in weight which is good for people with cystic fibrosis who often have digestive problems. The saltiness of their sweat a measure used to diagnose the disease was markedly reduced suggesting that the drug was having an effect on chloride ion transport. The trial involved people age and older all with at least one copy of the particular mutation known as GD. The main side effects Vertex said were headache httpshealth.nytimes.comhealthguidessymptomsheadacheoverview.htmlinlinenytclassifier upper respiratory tract infections nasal congestion httpshealth.nytimes.comhealthguidessymptomsnasalcongestionoverview.htmlinlinenytclassifier rash and dizziness httpshealth.nytimes.comhealthguidessymptomsdizzinessoverview.htmlinlinenytclassifier. Vertex said it hoped to apply in the second half of the year for approval of VX in the United States and Europe. The company is awaiting results of a second trial of the drug this one in younger children. Vertex has not said how much it will charge for VX. But since there are only about Americans who are candidates for the drug the price is likely to be tens of thousands of dollars a year. Vertex based in Cambridge Mass. was founded in coincidentally the same year the cystic fibrosis gene was discovered. It has not yet had a big commercial success and had a . billion net loss in the last five years. The company is hoping that by late May it will win approval to sell a new type of drug for hepatitis C httpshealth.nytimes.comhealthguidesdiseasehepatitiscoverview.htmlinlinenytclassifier which analysts expect will be a blockbuster. The long time needed to develop a drug for cystic fibrosis is a lesson for those expecting a quick payout from the sequencing of the human genome which was completed a decade ago. It is not enough to know the gene behind a disease. It can take years of research to determine how a mutation actually causes a disease and then to design a drug that corrects the problem. Vertex received million in financial support from the Cystic Fibrosis Foundation one of the first nonprofit disease groups to give money to companies. These results are highly encouraging Robert J. Beall president of the foundation said in a statement Wednesday. They provide scientific evidence that support our longstanding belief that targeting the underlying defect of C.F. may have a profound effect on the disease."

"Reversing memory deficits and impairments in spatial learning is a major goal in the field of dementia research. A lack of knowledge about cellular pathways critical to the development of dementia however has stood in the way of significant clinical advance. But now researchers at the Lewis Katz School of Medicine at Temple University LKSOM are breaking through that barrier. They show for the first time in an animal model that tau pathology the secondmost important lesion in the brain in patients with Alzheimers disease can be reversed by a drug. We show that we can intervene after disease is established and pharmacologically rescue mice that have tauinduced memory deficits explained senior investigator Domenico Pratic MD Scott Richards North Star Foundation Chair for Alzheimers Research Professor in the Departments of Pharmacology and Microbiology and Director of the Alzheimers Center at Temple at LKSOM. The study published online in the journal Molecular Neurobiology raises new hope for human patients affected by dementia. The researchers landed on their breakthrough after discovering that inflammatory molecules known as leukotrienes are deregulated in Alzheimers disease and related dementias. In experiments in animals they found that the leukotriene pathway plays an especially important role in the later stages of disease. At the onset of dementia leukotrienes attempt to protect nerve cells but over the long term they cause damage Dr. Pratic said. Having discovered this we wanted to know whether blocking leukotrienes could reverse the damage whether we could do something to fix memory and learning impairments in mice having already abundant tau pathology. To recapitulate the clinical situation of dementia in humans in which patients are already symptomatic by the time they are diagnosed Dr. Pratic and colleagues used specially engineered tau transgenic mice which develop tau pathology characterized by neurofibrillary tangles disrupted synapses the junctions between neurons that allow them to communicate with one another and declines in memory and learning ability as they age. When the animals were months old the equivalent of age in humans they were treated with zileuton a drug that inhibits leukotriene formation by blocking the lipoxygenase enzyme. After weeks of treatment animals were administered maze tests to assess their working memory and their spatial learning memory. Compared with untreated animals tau mice that had received zileuton performed significantly better on the tests. Their superior performance suggested a successful reversal of memory deficiency. To determine why this happened the researchers first analyzed leukotriene levels. They found that treated tau mice experienced a percent reduction in leukotrienes compared with untreated mice. In addition levels of phosphorylated and insoluble tau the form of the protein that is known to directly damage synapses were percent lower in treated animals. Microscopic examination revealed vast differences in synaptic integrity between the groups of mice. Whereas untreated animals had severe synaptic deterioration the synapses of treated tau animals were indistinguishable from those of ordinary mice without the disease. Inflammation was completely gone from tau mice treated with the drug Dr. Pratic said. The therapy shut down inflammatory processes in the brain allowing the tau damage to be reversed. The study is especially exciting because zileuton is already approved by the Food and Drug Administration for the treatment of asthma. Leukotrienes are in the lungs and the brain but we now know that in addition to their functional role in asthma they also have a functional role in dementia Dr. Pratic explained. This is an old drug for a new disease he added. The research could soon be translated to the clinic to human patients with Alzheimers disease. Other researchers contributing to the study include Phillip F. Giannopoulos and Jian Chiu at the Alzheimers Center at Temple LKSOM. The research was funded in part by grants from The Wanda Simone Endowment for Neuroscience and the Scott Richards North Star Charitable Foundation. About Temple Health Temple University Health System TUHS is a . billion academic health system dedicated to providing access to quality patient care and supporting excellence in medical education and research. The Health System consists of Temple University Hospital TUH ranked among the Best Hospitals in the region by U.S. News World Report TUHEpiscopal Campus TUHNortheastern Campus Fox Chase Cancer Center an NCIdesignated comprehensive cancer center Jeanes Hospital a communitybased hospital offering medical surgical and emergency services Temple Transport Team a ground and airambulance company and Temple Physicians Inc. a network of communitybased specialty and primarycare physician practices. TUHS is affiliated with the Lewis Katz School of Medicine at Temple University and Temple University Physicians which is Temple Healths physician practice plan comprised of more than fulltime and parttime academic physicians in clinical departments. The Lewis Katz School of Medicine LKSOM established in is one of the nations leading medical schools. Each year the School of Medicine educates approximately medical students and graduate students. Based on its level of funding from the National Institutes of Health the Katz School of Medicine is the secondhighest ranked medical school in Philadelphia and the thirdhighest in the Commonwealth of Pennsylvania. According to U.S. News World Report LKSOM is among the top most appliedto medical schools in the nation. Temple Health refers to the health education and research activities carried out by the affiliates of Temple University Health System TUHS and by the Katz School of Medicine. TUHS neither provides nor controls the provision of health care. All health care is provided by its member organizations or independent health care providers affiliated with TUHS member organizations. Each TUHS member organization is owned and operated pursuant to its governing documents."

"A clinical trial published in The Lancet a top medical journal shows that an intensive procedure that completely wipes out the immune system and then regenerates a new one using blood stem cells can eliminate all signs of damaging brain inflammation in people with early aggressive multiple sclerosis MS and facilitate lasting recovery. Led by Dr. Harold Atkins and Dr. Mark S. Freedman of The Ottawa Hospital and the University of Ottawa the trial included participants who were followed for up to years. The . million trial was funded by the MS Society of Canada and its affiliated Multiple Sclerosis Scientific Research Foundation. The research was also supported by The Ottawa Hospital Foundation The Ottawa Hospital Department of Medicine and Canadian Blood Services. Our trial is the first to show the complete longterm suppression of all inflammatory activity in people with MS said Dr. Atkins a stem cell transplant physician and scientist at The Ottawa Hospital and associate professor at the University of Ottawa. This is very exciting. However it is important to note that this therapy can have serious side effects and risks and would only be appropriate for a small proportion of people with very active MS. People with MS who have had significant disability for a long time would likely not benefit. This procedure should be considered as a treatment option for people with early aggressive MS said Dr. Freedman a neurologist and senior scientist at The Ottawa Hospital and professor at the University of Ottawa. Although this trial was relatively small it was intensive with the longest prospective followup of any such treatment group to date and that is what makes the results so convincing. However this is a very complex procedure that should only be performed at very specialized centres with expertise in both the management of MS patients and blood stem cell transplantation. MS affects approximately . million people around the world causing symptoms that range from blurred vision to extreme fatigue to partial or complete paralysis. It occurs when the immune system which normally protects against foreign diseasecausing organisms mistakenly attacks the bodys own central nervous system which includes the brain spinal cord and optic nerve. Early in the disease people often experience temporary episodes of worsening symptoms accompanied by active inflammation in the brain called relapses whereas later on disease progression is inevitable. The trial evaluated a treatment called immunoablation and autologous hematopoietic stem cell transplantation IAHSCT. The procedure begins by giving a person medication to coax their hematopoietic stem cells to migrate from their bone marrow into their blood. These stem cells are then collected from the blood purified and frozen. Then high doses of chemotherapy drugs are used to eliminate the persons diseased immune system. The stem cells are then transplanted back into the same person so that they can give rise to a new immune system that has no memory of the previous pattern of attacking the central nervous system. The trial included participants with aggressive relapsing MS. They were followed for anywhere between four and years after treatment with a median posttreatment follow up of . years. After the treatment Not a single participant experienced a clinical relapse zero relapses in patientyears whereas before treatment the participants experienced an average of . relapses per year relapses in patientyears. Not a single new active inflammatory lesion could be detected in the brains of any of the participants zero lesions on MRI scans whereas before the treatment participants had lesions on scans. Not a single participant required MSspecific drugs to control their disease. percent of participants experienced a complete stop in disease progression. The average rate of brain shrinkage typically a measure that correlates with MS progression returned to levels associated with normal aging. percent of participants experienced some lasting reversal of symptoms such as vision loss muscle weakness and balance problems. Some participants were able to return to work or school regain the ability to drive get married and have children. Trial participant Jennifer Molson was diagnosed with MS in when she was just . She received her transplant in . Before my transplant I was unable to walk or work and was living in assisted care at The Ottawa Hospital Rehabilitation Centre she said. Now I am able to walk independently live in my own home and work full time. I was also able to get married walk down the aisle with my Dad and dance with my husband. Ive even gone downhill skiing. Thanks to this research I have been given a second chance at life. The MS Society is proud to be a part of an important turning point in the treatment of MS said Yves Savoie CEO and President of the MS Society of Canada. What started as a bold idea has translated into a treatment option for people living with highly active relapsing MS. Publication of the results from this study will inform clinicians of the risks and benefits of the procedure and pave the way for further research which could help people with all forms of MS. A variation of this procedure has been used to treat leukemia for decades but its use for autoimmune diseases is relatively new said Dr. Atkins who is also the Medical Director of the Regenerative Medicine Program at the Ottawa Hospital Research Institute. It is only used in very severe cases because participants face a significant risk of infection and other sideeffects including death. The risks are similar to those faced by leukemia patients undergoing this kind of treatment. Indeed one participant in this study died of liver failure due to the treatment and another required intensive care for liver complications. The treatment regimen was modified over the course of the study to reduce toxicity but all participants still developed fevers which were frequently associated with infections. Several recent clinical trials from other groups have examined this procedure in people with MS said Dr. Freedman who is also the Director of MS Research at The Ottawa Hospital. Our study is unique in that we used a stronger cocktail of drugs to eliminate the immune system we followed the participants for a very long time and the majority of our participants have had significant longlasting responses. People who are interested in this therapy should speak with their own neurologist who can request a referral to The Ottawa Hospital MS Clinic or another major hospital with experience in this area. Note that The Ottawa Hospital cannot treat people without valid Canadian health coverage. This study was approved by the Ottawa Health Sciences Network Research Ethics Board and is registered at httpsclinicaltrials.govctshowNCT. The lead researchers are affiliated with the Stem Cell Network the Ontario Institute for Regenerative Medicine and the University of Ottawa Brain and Mind Research Institute. We thank the patients from across Canada who participated in this clinical trial as well as their family members said Marjorie Bowman trial coordinator and advanced practice nurse at The Ottawa Hospital. Their courage and dedication are remarkable. Full reference Immunoablation and autologous haemopoietic stemcell transplantation for aggressive multiple sclerosis a multicentre singlegroup phase trial. Harold L Atkins Marjorie Bowman David Allan Grizel Anstee Douglas L Arnold Amit BarOr Isabelle BenceBruckler Paul Birch Christopher Bredeson Jacqueline Chen Dean Fergusson Mike Halpenny Linda Hamelin Lothar Huebsch Brian Hutton Pierre Laneuville Yves Lapierre Hyunwoo Lee Lisa Martin Sheryl McDiarmid Paul OConnor Timothy Ramsay Mitchell Sabloff Lisa Walker Mark S Freedman. The Lancet. Epub June . http Audiovisual Photos of Dr. Atkins Dr. Freedman Marjorie Bowman and Jennifer Molson are available here. Video clips and additional photos of trial participants are available upon request. About The Ottawa Hospital Inspired by research. Driven by compassion. The Ottawa Hospital is one of Canadas largest learning and research hospitals with over beds approximately staff and an annual budget of over . billion. Our focus on research and learning helps us develop new and innovative ways to treat patients and improve care. As a multicampus hospital affiliated with the University of Ottawa we deliver specialized care to the Eastern Ontario region but our techniques and research discoveries are adopted around the world. We engage the community at all levels to support our vision for better patient care. See http for more information about research at The Ottawa Hospital. About the Multiple Sclerosis Society of Canada and Multiple Sclerosis Scientific Research Foundation The MS Society of Canada is dedicated to finding a cure for multiple sclerosis by funding leadingedge research and improving the quality of life of those affected by the disease. The Multiple Sclerosis Scientific Research Foundation funds large innovative multicentre collaborative studies that will lead to major advances in the field of MS. A unique Canadian resource the Foundations main funding source is the MS Society of Canada. Please visit mssociety.ca or call to make a donation or for more information. About the University of Ottawa The University of Ottawa is home to over students faculty and staff who live work and study in both French and English. Our campus is a crossroads of cultures and ideas where bold minds come together to inspire gamechanging ideas. We are one of Canadas top research universitiesour professors and researchers explore new approaches to todays challenges. One of a handful of Canadian universities ranked among the top in the world we attract exceptional thinkers and welcome diverse perspectives from across the globe. http"

"Cognitive behavioural therapy could help many people with a dental phobia overcome their fear of visiting the dentist and enable them to receive dental treatment without the need to be sedated according to a new study by Kings College London. Anxiety about visiting the dentist is common and becomes a phobia when it has a marked impact on someones wellbeing people with dental phobias typically avoid going to the dentist and end up experiencing more dental pain poorer oral health and a detrimental effect on their quality of life. Estimates from the most recent Adult Dental Health Survey in the UK suggest around one in ten people suffers from dental phobia. Cognitive behavioural therapy CBT is a shortterm therapy typically lasting sessions. CBT has been shown to help with a range of psychological problems most notably for depression and anxietyrelated disorders. Both cognitive and behavioural interventions have been shown to be successful in reducing dental anxiety and increasing dental attendance. The latest study published in the British Dental Journal looked at the characteristics of patients women and men attending a psychologistled CBT service and the outcomes of their treatment. Patients attending a clinic run by the Kings College London Dental Institute Health Psychology Service at Guys and St Thomas NHS Foundation Trust were surveyed for their levels of dental anxiety general anxiety depression suicidal thoughts alcohol use and oral healthrelated quality of life. Threequarters of those assessed scored or higher on the Modified Dental Anxiety Scale MDAS indicating dental phobia. The remainder all scored high on one or more items of the MDAS suggesting a specific fear of some aspect of dentistry. Fear of dental injections and the dental drill were the most common high scoring items on the MDAS. Nearly all patients reported a knockon effect from problems with their teeth mouth or gums on their daily living and quality of life. A proportion of the patients surveyed were found to have other psychological conditions had high levels of general anxiety and had clinically significant levels of depression. Suicidal thoughts were reported by of patients and four reported a recent intent to commit suicide. Individuals were referred to support services via the care of their GP and for suicide risk immediate action was taken based on local service guidelines. Of all patients referred fourfifths went on to have dental treatment without the need for sedation and had their dental treatment under sedation. The average number of CBT appointments required before a patient received dental treatment without sedation was five. Professor Tim Newton from the Dental Institute at Kings College London and lead author of the study said People with dental phobia are most commonly given sedation to allow them to become relaxed enough for a short period of time to have their dental treatment performed. However this does not help them to overcome their fear in the long term. The primary goal of our CBT service is to enable patients to receive dental treatment without the need for sedation by working with each individual patient to set goals according to their priorities. Our study shows that after on average five CBT sessions most people can go on to be treated by the dentist without the need to be sedated. However there is a need for people with dental phobia to be carefully assessed by trained CBT practitioners working with dental health professionals. Some of the patients referred to us were found to be experiencing additional psychological difficulties and needed further referral and management. CBT provides a way of reducing the need for sedation in people with a phobia but there will still be those who need sedation because they require urgent dental treatment or they are having particularly invasive treatments. Our service should be viewed as complementing sedation services rather than as an alternative the two together providing a comprehensive care pathway for the ultimate benefit of patients. A recent study published in the same journal coauthored by Professor Tim Newton showed that more women than men reported dental phobia in the Adult Dental Health Survey. Those with dental phobia were more likely to come from a lower income background have more caries in their teeth and suffer from poorer oral health overall."

"Take two tablets and a selfie Your doctors orders may one day include a smartphone video to make sure you took your medicine. Smartphone apps that monitor pilltaking are now available and researchers are testing how well they work when medication matters. Experts praise the efficiency but some say the technology raises privacy and data security concerns. Selfie medicine works like this Open an app on your phone show your pills put them in your mouth and swallow. Dont forget to show your empty mouth to the camera to prove todays dose is on its way. Then upload the video proof to the clinic. Fans say the technology addresses a big problem About half of drugs for chronic conditions arent taken as prescribed because of cost side effects or patient forgetfulness. With treatment for opioid addiction https a skipped dose can mean a dangerous relapse. The National Institute on Drug Abuse is funding research to tailor a smartphone app for those patients and see if theyll use it. If we can keep patients engaged we can keep them in treatment longer said lead researcher Dr. Judith Tsui of the University of Washington School of Medicine in Seattle. The next phase of her research will compare a group of patients who use the monitoring app called emocha with those who dont to see if theres a difference. At one Tennessee treatment center some patients with opioid addiction are already using the app to upload selfies of their daily dose and answer questions about how theyre doing. Every time they sign on it allows us to capture data. Are they having cravings Suicidal tendencies said Scott Olson CEO of Dallasbased Pathway Healthcare which is trying the app at its Jackson Tennessee site. Maybe a phone call from a counselor might make the difference between staying clean and a relapse. Olson thinks insurers will pay for the service with more evidence. For monitoring tuberculosis patients health departments pay roughly to per patient each month for systems that include encrypted data storage. A small health department might pay as little as a month. The idea of watching someone take their medicine called directly observed therapy or DOT has roots in tuberculosis https where one persons forgetfulness can be serious for everyone. If patients dont take all their antibiotics https their infectious TB germs can get stronger developing drug resistance and endangering the broader community. But taking a handful of pills daily for up to a year is difficult so public health departments traditionally sent workers to peoples homes and workplaces to watch them take their doses. Today many TB patients prefer remote monitoring. Nurses like it too. Nurse Peggy Cooley has used Skype for years to chat live with patients taking TB medicine. We can accomplish in a twominute phone call something that might have taken an hour to do and most of that hour was in the car said Cooley who works for the TacomaPierce County Health Department in Washington state. The new uploaded selfies dont need an appointment. They are a daily routine for many tuberculosis patients in Seattle San Francisco Los Angeles and Houston where savings on mileage and worker time amounted to in a recent year. In Boston Albuquerque and five other cities researchers are studying whether the technology works for hepatitis C a bloodborne virus thats surging among a new generation of injection drug users. New drugs for hepatitis C https can cure but theyre expensive for a week course of treatment so insurers want to make sure patients take them. I think it holds a lot of promise said researcher Dr. Alain Litwin of University of South Carolina School of Medicine whos testing whether patients do better when someone watches them take their pills. Whats next An insurer in Maryland plans to use the technology in diabetes and high blood pressure https to make sure Medicare and Medicaid patients take their medicine. Startups selling the apps say they could be used by faraway adult children monitoring an elderly parents daily pilltaking. Experts worry about privacy data security and penalties for poor pilltaking. Thats the biggest ick factor said Carolyn Neuhaus a medical ethicist at the Hastings Center in New York. You can imagine a program where benefits are tied to compliance and the insurer says We wont pay for medication anymore unless youre taking it correctly. Globally the rapid spread of smartphones creates an opportunity to eradicate TB say the app developers. But eliminating TB may take simpler cheaper technologies that can be scaled for millions of cases said Dr. Daniel Chin who leads TB efforts for the Bill and Melinda Gates Foundation. The group supports research in China and India on two homegrown technologies. Chinas tool about the size of a childs shoebox reminds patients to take their pills and saves data for review. In India the government favors a blister pill pack printed with phone numbers a patient punches out a daily pill then calls the revealed number. Worldwide TB kills more than . million people annually even though most deaths are preventable with treatment. If we are going to eliminate the disease we need technology said Dr. Richard Garfein of the University of California San Diego School of Medicine who helped develop one of the smartphone apps SureAdhere."

"This could be good news for those trying to prevent preterm labor New research published online in The FASEB Journal http suggests that exposing bitter taste receptors in the uterus to certain substances can stop many unwanted contractions that occur during premature labor. The biological mechanism of labor initiation remains unknown and a large percentage of preterm pregnancies do not respond well to current medications said Ronghua Zhuge Ph.D. associate professor within the University of Massachusetts Medical Schools Department of Microbiology and Physiological Systems in Worcester Massachusetts. The bitter taste receptors that we have found on uterine muscle could be one more piece of the puzzle to understand the onset of labor both at term and preterm and develop new therapeutics for preterm labor. Zhuge and colleagues attached strips of human and mouse uterine myometrium tissue also known as smooth muscle to a machine that measured their contraction efforts. The researchers first exposed the tissue to native hormones such as oxytocin and chemical compounds to make it contract mimicking normal or premature labor. They then exposed the tissue to bitter substances. By activating the bitter taste receptors in the uterus the bitter substances relaxed the contracted uterine muscle tissue more completely than the current drugs used to prevent preterm labor in humans. The researchers also found that giving mice bitter substances before they showed any premature contractions prevented them from having early deliveries. Submit to The FASEB Journal by visiting httpfasebj.msubmit.net and receive monthly highlights by signing up at http The FASEB Journal is published by the Federation of the American Societies for Experimental Biology FASEB. It is the worlds most cited biology journal according to the Institute for Scientific Information and has been recognized by the Special Libraries Association as one of the top most influential biomedical journals of the past century. FASEB is composed of societies with more than members making it the largest coalition of biomedical research associations in the United States. Our mission is to advance health and welfare by promoting progress and education in biological and biomedical sciences through service to our member societies and collaborative advocacy. Details Kaizhi Zheng Ping Lu Ellen Delpapa Karl Bellve Ruitang Deng Jennifer C. Condon Kevin Fogarty Lawrence M. Lifshitz Tiffany A. Moore Simas Fangxiong Shi and Ronghua Zhuge. Bitter taste receptors as targets for tocolytics in preterm labor therapy. FASEB J. doi.fj.RR http"

"Researchers have stopped a study of a new lung cancer drug saying its so effective they want to offer it to all the patients in the trial. The drug Keytruda is the same drug http former president Jimmy Carter says helped stall advanced melanoma that had spread to his brain. Keytruda was being tested for the first time in lung cancer patients who had not been treated at all yet. The researchers wanted to see how it worked against the standard chemotherapy cocktails. It worked at least as well if not better than the chemo so the researchers have stopped the study to give everyone a chance to take Keytruda Merck the company that makes the drug said. It helped patients live longer overall and helped them live longer without their tumors growing or spreading Merck said. The details are not available yet. We look forward to sharing these data with the medical community and with regulatory authorities around the world said Dr. Roger Perlmutter president of Merck Research Laboratories. Independent committees look at the details of the patients and how well they are doing in drug trials like these. It was one of these independent committees that recommended stopping the trial based on what they saw but that doesnt necessarily mean they shared the details with the company or anyone else. I suspect the findings were significant enough that this will be a practicechanging finding Dr. Pasi Janne lung cancer specialist at Harvard Medical School and the DanaFarber Cancer Institute told NBC News. Cancer research goes forward in slow steps. In tests of new drugs patients always get either the very best therapy already available or the new drug. Often they get both. Usually cancer drugs are only tested at first in patients who have tried everything else available and their cancer has come back anyway. I suspect the findings were significant enough that this will be a practicechanging finding. So its an important break for a company if its drug is the first one a patient gets and it works better than the socalled standard of care. The company now can ask the Food and Drug Administration if it will approve Keytruda to use as the first treatment a lung cancer patient tries. The FDA has given speedy approval to several new drugs in a class called checkpoint inhibitors including Keytruda. They treat cancer by stopping tumor cells from cloaking themselves against the normal healthy immune system response. They work on the principle that its not where cancer starts that matters but the genetic mutation http causes the cancer. So a lung tumor in one patient may look like the melanoma in another. Keytruda known generically as pembrolizumab http targets the activity of genes called PD antiprogrammeddeathreceptor and PDL. The interaction between the two genes lets some tumors escape detection and destruction by immune system cells. PD stops immune cells from attacking normal healthy cells by mistake. Tumor cells make PDL turn on PD when immune cells approach. This trial only included patients whose tumors cells made a lot of PDL. That is only a portion of people with lung cancer percent in one recent trial. Having seen patients benefit who failed existing therapies now doing well on these new therapies is fantastic. A rival drug BristolMyers Squibbs Opdivo works in a similar way to Keytruda and it has slightly different approval from the FDA for how it should be used. Immunotherapy is a whole new way of treating cancer including lung cancer said Janne who was not involved in the study. Having seen patients benefit who failed existing therapies now doing well on these new therapies is fantastic. Keytruda approved October last year for lung cancer and in for melanoma is pricey costing about a year for a course of treatment. Its approved for use with a specific test for PDL activity. The new drugs are less toxic and more precise than standard chemotherapy. But they are not free of sideeffects. Some are severe and can damage the lung colon liver kidneys hormoneproducing glands and the brain the FDA says. Lung cancer is the top cancer killer in the U.S. Its diagnosed in more than people a year and it killed nearly people last year according to the National Cancer Institute"

"The promise of genetic medicine is beginning to be fulfilled but its been a long hard slog. Take the story of Kalydeco http Its designed to treat people with a lung disease called cystic fibrosis. While not quite a cure the drug is extremely effective for some CF patients. But the success of Kalydeco has been more than two decades in the making. A good starting point for the story is Aug. . Thats the day scientists from the U.S. and Canada announced the discovery of the gene associated with the disease. It was the early days of gene hunting and the CF gene was a big prize. CF is the most common genetic disease in Caucasians. When people inherit a damaged form of the CF gene a critical protein inside cells doesnt work properly. As a result sticky mucus builds up in a patients lungs causing infections and making it hard to breathe. The announcement was supposed to be made in conjunction with three papers http in the Sept. issue of Science but a reporter for Reuters got hold of the story early. Science took the unusual step of allowing the scientists to speak to the media before publication. Article continues after this message from our sponsor At the time scientists predicted that a genetic test for CF was just around the corner. But they also thought a drug to treat the disease was in reach. The first prediction turned out to be right. But it wasnt until years later that we were able to find drugs that directly target the underlying cause of cystic fibrosis says Fred Van Goor who led the team at what is now Vertex Pharmaceuticals http that developed Kalydeco. So it was a long time between the discovery of the gene and the discovery of Kalyedco. It took awhile to find a drug that would help restore the function of the protein the CF gene makes. We tested over chemicals in cells with the defective protein that causes cystic fibrosis says Van Goor. One of those chemicals ultimately became a successful drug but it had to be modified so patients could take it by mouth and so it would last the right length of time in a patients body. From the start Van Goor and his colleagues knew there was a problem with Kalydeco It only works on a small subset of people with CF. They have to have a particular mutation in the CF gene or the drug is of little use. But for people who do have that mutation the drug works remarkably well. Emily Schaller was in one of the early studies of Kalydeco. As part of the study researchers first gave her a placebo then switched her to the active drug. She knew within days that something was different. I was with my brother in Florida and we were walking down the street and I took a deep breath and when I took a deep breath in and I let it out I didnt cough says Schaller. But not only did I not cough but I felt that my lungs were clear and that something huge had happened. It was just something I had never felt in my life before. Schaller isnt cured. She still has a damaged CF gene. The only way to fix that would be gene therapy http where a healthy form of the gene would supplant the damaged one. Although it seems simple in theory in practice gene therapy has been incredibly difficult to accomplish. Schaller isnt particularly bothered by that. Everyone talks about curing a disease cure CF cure these other diseases. But Kalydeco controls CF at the basic defect so Im OK with the other c word control because Im living it and Ive never felt better in my life. The time from gene discovery to successful drug may be shortening but there are only a handful of successful drugs so far and for a while at least the appearance of new ones will be slow. Theyre also likely to be expensive. Kalydeco costs in the neighborhood of per year."

"A small study claims children with autism may benefit from fecal transplants which involves introducing donated microbes into people with gastrointestinal disease to rebalance the gut. The Ohio State University Northern Arizona University and Arizona State University httpsnews.osu.edunewsyes researchers found a parallel between behavioral symptoms of autism and gastrointestinal distress and improvements to both after fecal transplant. Transplants are working for people with other gastrointestinal problems lead study author Ann Gregory a microbiology graduate student at The Ohio state University said in a news release. httpsnews.osu.edunewsyes And with autism gastrointestinal symptoms are often severe so we thought this could be potentially valuable. The researchers built off of previous findings that children with autism typically have fewer types of important bacteria in their guts and less bacterial diversity overall. The research team surmises the disparity is due to antibiotics prescribed within the first three years of life. The study which was published in the journal Microbiome included children with autism and moderate to severe gastrointestinal problems. The children ranged from to years old. A questionnaire was used to assess social skills irritability hyperactivity and communication. Parents and doctors reported improvements that lasted at least eight weeks after treatment. Children without autism were used as a control for the study the news release reported. httpsnews.osu.edunewsyes On average the score on a scale for ranking gastrointestinal symptoms dropped percent from the beginning to the end of treatment while average developmental age increased by . years according to the release. Researchers also asked the childrens doctors to perform pre and postdiagnostic evaluations which suggested lasting benefits. One of the studys limitations is its small size and researchers cautioned that families should not try to replicate the treatment at home. We have to be mindful of the placebo effect and we have to take the findings with a grain of salt Matthew Sullivan an associate professor of microbiology at The Ohio State University said in the release httpsnews.osu.edunewsyes. But it does give us hope."

"A Delaware team including Erin Crowgey PhD associate director of Bioinformatics with Nemours Biomedical Research has published a study in the peerreviewed journal BMC Bioinformatics showing that DNA patterns in circulating blood cells can be used to help identify spastic cerebral palsy CP patients Crowgey et al.. The work represents a collaboration among researchers at Nemours the University of Delaware UD and Genome Profiling LLC GenPro for short. Coauthors of the paper include Robert Akins PhD the project principal investigator who directs the Center for Pediatric Clinical Research and Development at NemoursAlfred I. duPont Hospital for Children UD molecular biologist Adam Marsh PhD who is chief science officer at GenPro and Karyn Robinson MS and Stephanie Yeager MS of Nemours Biomedical Research. Early diagnosis supports early intervention Cerebral palsy is a common yet understudied neurodevelopmental problem in the U.S. In fact there is no national surveillance here but the CDC estimates that in American children have the condition. CP is a group of disabilities with a wide spectrum of severity. Spastic CP the most common type is a lifelong condition characterized by joint stiffness spasms and muscle tightness that affects movement and posture and restricts the activity of affected children. Although most children with cerebral palsy are born with it diagnosis may be delayed until years of age. A diagnosis is made by monitoring motor milestones infants thought to be at risk for CP are enrolled in early intervention programs where their progress is closely watched. New and better ways to identify infants with CP are needed so that interventions can start earlier for more children. Nemours internationally recognized for its CP center at Alfred I. duPont Hospital for Children serves a diverse population of more than children and young adults with CP one of the largest programs in the U.S. Clinicians and researchers at Nemours continuously seek to improve the diagnosis and care of CP patients. Funding from the Swank Foundation enabled Nemours to develop a cerebral palsy tissue bank that stores blood and tissue samples from hundreds of surgical patients at Nemours. In the study the research team profiled blood samples collected in a blinded study from children and adolescents years to explore whether patients with spastic CP showed differences at the cellular level that routine orthopedic patients needing ACL repairs spinal fusions or other surgeries did not. The researchers identified a strong set of methylation markers or patterns that indicate differences in the genome between children with spastic CP and those without it. In a second study using samples from children aged years the researchers were able to validate their results and predict with percent accuracy whether the blood samples came from children who had CP. The evidence suggests that there is some epigenetic connection said Crowgey. If we can do a better job of screening for these at time of birth versus waiting for the disorder to be diagnosed at years of age then potentially well be able to deliver earlier therapeutics and have better outcomes and lower medical costs. Medicaid data show that annual medical costs for a child with CP are to times higher than for those without CP. The power of data science analytics and machine learning The study leverages a unique statistical method and software platform originally developed by Dr. Marsh at UD and commercialized by GenPro to measure methylation patterns in DNA a cells genetic code using next generation sequencing NGS data. NGS is a technique that enables scientists to decode DNA faster and more cheaply than traditional DNA sequencing methods. Each persons genome or complete set of DNA is like a word thats the length of billion characters but spelled with only the letters A T C or G. Traditional DNA sequencing techniques decode sections of DNA characters at a time while NGS takes advantage of parallel computing capabilities enabling scientists to decode millions of DNA fragments. Subtle changes in a patients physical health are paralleled by changes in DNA methylation making it a useful tool to understand disease. Many of the signals that we pick up are based on immune system shiftsmeaning the way a persons immune system responds to external stress events. When we find that epigenetic response or signal in the genetic sequencing it provides another line of evidence for clinicians to use in making decisions said Marsh. The approach uses sophisticated machine learning techniques and algorithms to sort through hundreds of gigabytes of NGS data looking for these distinct DNA methylation patterns. The data set is massive. Its not something a human can do. You need infrastructure machine learning data analysis and data science said Crowgey. Promising results more testing needed While the study findings indicate that there is a consistent signal present in circulating blood cells of children with spastic CP that remains from early childhood to the teenage years the researchers say they need to further study samples from different age groups including teenagers toddlers and infants from birth to years. Learning more about methylation signals across ages will allow the approach to be further refined to identify cases and also could provide researchers new clues to understanding the cellular processes involved in advancing CP and consequently new therapeutics to manage the disease. Were still in the early phases but the results are extremely promising and were excited about the sensitivity of the test that we are seeing in our retrospective analysis said Crowgey. If successful the researchers say the type of blood test in development also may be useful for other disorders such as infant leukemia. Akins was optimistic. This is an example of the kind of innovation that can happen when people with different skill sets collaborate. The experimental testing went from idea to validated execution in less than months. Were now working toward a goal of eventually forming a clinical diagnostic test and applying it to a broad population. Akins added that Nemours is in a unique position for such an undertaking with its large CP population its growing strength in data science and analytics and its recent acquisition of newborn screening for the state of Delaware. Many issues will need to be addressed but we predict routine screening for CP in the near years future he said. This research is funded by the Delaware Bioscience Center for Advanced Technology the National Science Foundation the American Academy for Cerebral Palsy and Developmental Medicine and Nemours. Pull out quote This blood test could be a game changer. The earlier the diagnosis the earlier we can direct therapies at the child. Specifically high intensity physical therapy and possibly early surgery to prevent more significant problems in the future and hopefully improve overall function and quality of life. M. Wade Shrader MD Chief Cerebral Palsy Center NemoursAlfred I. duPont Hospital for Children About Nemours Childrens Health System Nemours is an internationally recognized childrens health system that owns and operates the two freestanding childrens hospitals the NemoursAlfred I. duPont Hospital for Children in Wilmington Del. and Nemours Childrens Hospital in Orlando Fla. along with outpatient facilities in six states delivering pediatric primary specialty and urgent care. Nemours also powers the worlds mostvisited website for information on the health of children and teens KidsHealth.org and offers ondemand online video patient visits through Nemours CareConnect. Nemours ReadingBrightstart.org is a program dedicated to preventing reading failure in young children grounded in Nemours understanding that child health and learning are inextricably linked and that reading level is a strong predictor of adult health. Established as The Nemours Foundation through the legacy and philanthropy of Alfred I. duPont Nemours provides pediatric clinical care research education advocacy and prevention programs to families in the communities it serves."

"A study from Exact Sciences Corp. Nasdaq EXAS httpstudio.financialcontent.comprnewsPageQuoteTickerEXAS and Mayo Clinic released today by the American Association of Cancer Research AACR shows promise for the development of a bloodbased lung cancer test. Researchers conducted a multiround study of nearly patients which demonstrated high accuracy for detecting lung cancer at all stages. These results reveal an opportunity to detect lung cancer from a simple blood draw said Kevin Conroy chairman and CEO of Exact Sciences. Our collaboration with Mayo Clinic is efficiently identifying biomarkers for additional cancer applications on the same technology platform as Cologuard. AACR released an abstract of the study today ahead of the presentation of the results on April during the AACR annual meeting. The findings from the study of patients controls and cancers demonstrate that biomarkers in plasma achieved high accuracy for all types and stages of lung cancer. Using two independent regression modeling approaches a panel of four novel methylated DNA markers demonstrated a sensitivity of percent at a specificity of percent. More studies are needed to corroborate accuracy however this plasma DNA test approach appears to be a promising new method and may serve as a rational followup to the common findings of lung nodules on CT scanning and may have application in screening for lung cancer said David E. Midthun M.D. a pulmonologist at Mayo Clinic. Lung cancer is the leading cause of cancer mortality resulting in . million deaths globally and more than deaths in the United States every year. Most symptoms present in the late stages of the disease when the survival rate is only four percent. Early detection of lung cancer offers the opportunity to reduce mortality. Lung cancer screening is approved for smokers using chest CT scanning. This approach has a sensitivity for lung cancer above percent but its specificity may fall below percent a false positive rate of more than percent because indeterminate lung nodules are so common. Evaluation of these falsepositives leads to unnecessary costly and potentially harmful procedures. A bloodbased test may help guide next steps after a scan reveals an indeterminate nodule Mr. Conroy said. For example a positive blood test might suggest the need for a biopsy or surgery. In contrast a negative test might suggest a less aggressive approach. Such a test could offer the opportunity to significantly improve health outcomes and reduce the financial impact on the health care system. The abstract is available here http A poster presentation of the findings will take place Sunday April from p.m. to p.m. EDT at the Walter E. Washington Convention Center in Washington D.C. Halls AC Poster Section . About Exact Sciences Corp. Exact Sciences Corp. is a molecular diagnostics company focused on the early detection and prevention of the deadliest forms of cancer. The company has exclusive intellectual property protecting its noninvasive molecular screening technology for the detection of colorectal cancer. For more information please visit the companys website at http follow Exact Sciences on Twitter ExactSciences or find Exact Sciences on Facebook. Safe Harbor Statement This news release contains forwardlooking statements within the meaning of Section A of the Securities Act of as amended and Section E of the Securities Exchange Act of as amended that are intended to be covered by the safe harbor created by those sections. Forwardlooking statements which are based on certain assumptions and describe our future plans strategies and expectations can generally be identified by the use of forwardlooking terms such as believe expect may will should could seek intend plan estimate anticipate or other comparable terms. All statements other than statements of historical facts included in this news release regarding our strategies prospects financial condition operations costs plans and objectives are forwardlooking statements. Examples of forwardlooking statements include among others statements we make regarding expected future operating results anticipated results of our sales and marketing efforts expectations concerning payer reimbursement and the anticipated results of our product development efforts. Forwardlooking statements are neither historical facts nor assurances of future performance. Instead they are based only on our current beliefs expectations and assumptions regarding the future of our business future plans and strategies projections anticipated events and trends the economy and other future conditions. Because forwardlooking statements relate to the future they are subject to inherent uncertainties risks and changes in circumstances that are difficult to predict and many of which are outside of our control. Our actual results and financial condition may differ materially from those indicated in the forwardlooking statements. Therefore you should not rely on any of these forwardlooking statements. Important factors that could cause our actual results and financial condition to differ materially from those indicated in the forwardlooking statements include among others the following our ability to successfully and profitably market our products and services the acceptance of our products and services by patients and healthcare providers our ability to meet demand for our products and services the willingness of health insurance companies and other payers to cover Cologuard and reimburse us for our performance of the Cologuard test the amount and nature of competition from other cancer screening products and services the effects of the adoption modification or repeal of any healthcare reform law rule order interpretation or policy the effects of changes in healthcare pricing coverage and reimbursement recommendations guidelines and quality metrics issued by various organizations such as the U.S. Preventive Services Task Force the American Cancer Society and the National Committee for Quality Assurance regarding cancer screening or our products and services our ability to successfully develop new products and services our success establishing and maintaining collaborative licensing and supplier arrangements our ability to maintain regulatory approvals and comply with applicable regulations and the other risks and uncertainties described in the Risk Factors and in Managements Discussion and Analysis of Financial Condition and Results of Operations sections of our most recently filed Annual Report on Form K and our subsequently filed Quarterly Reports on Form Q. We undertake no obligation to publicly update any forwardlooking statement whether written or oral that may be made from time to time whether as a result of new information future developments or otherwise."

"A novel radionuclide drug tackles the challenge of prostate cancer imaging and takes a turn as a cancerkilling therapy for tumors in and out of the prostate according to research presented during the Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging SNMMI. The drug works by delivering diagnostic or therapygrade radionuclides to cells that express a protein called prostatespecific membrane antigen PSMA found on the surface of prostate cancer cells and their metastatic counterparts throughout the body. Clinicians can diagnose or stage disease and monitor therapy with the aid of a special hybrid scanner used to perform minimally invasive positron emission tomography PET. Prostate cancer still represents one of the main causes for cancerrelated deaths among men said Matthias Eder PhD coauthor of the study and a researcher in the division of radiopharmaceutical chemistry at the German Cancer Research Center in Heidelberg Germany. The diagnosis and therapy of metastatic prostate cancer is still challenging. The current clinical methods are not sensitive enough for detecting disease beyond the prostate but we are convinced that this novel theranostic radiotracer represents a significant step forward that could have a major impact on the future of prostate cancer care. The PSMAinhibiting theranostic agent called PSMA is still in its initial stages but it could be ideal for the treatment of patients with hormonerefractory prostate cancers which are notoriously difficult to control and linked to poor prognosis. Options for these patients are few and they come with substantial adverse effects. Diagnosis and therapy with the theranostic agent PSMA could offer more effective and sensitive visualization better staging and significantly higher therapeutic potential. To be clear other PSMAbased theranostics have reached the research bench but previous contenders had too many limitations in terms of instability in live subjects a lack of imaging contrast between targeted tissue and background signal and increased PSMAassociated binding to normal organs such as the kidneys. This new radionuclide drug shows strong binding to the protein PSMA and is readily and safely taken up by malignant PSMApositive tumors. PSMA could represent a watershed moment for prostate cancer theranostics. For this research scientists first imaged mice with an imaginggrade radionuclide gallium to assess the diagnostic value of PSMA. Diagnostic imaging was followed by a therapygrade radionuclide lutetium which delivers a more powerful dose of radiation that penetrates and destroys the cells and tissues of tumors when combined with PSMA. This phase was followed by a firstinhuman clinical trial of both imaging and therapy in a single person. Results of the human study showed that imaging was effective for the evaluation of metastatic prostate cancer and subsequent therapy resulted in a drop in prostatespecific antigen levels from . to . nanograms per milliliter. Positive response to therapy was verified via combined PET and computed tomography PETCT a hybrid imaging system that shows both functional and structural aspects of the body. Approximately one out of seven men will be diagnosed with prostate cancer in their lifetime according to statistics from the American Cancer Society. About new prostate cancer diagnoses and prostatecancerrelated deaths are expected to occur in the U.S. this year. Scientific Paper PSMA a novel theranostic PSMA inhibitor for both diagnosis and endoradiotherapy of prostate cancer M. Benesova M. Schfer U. BauderWst K. Kopka M. Eder Radiopharmaceutical Chemistry German Cancer Research Center Heidelberg Germany C. Kratochwil A. AfsharOromieh W. Mier U. Haberkorn Department of Nuclear Medicine University Hospital Heidelberg Heidelberg Germany SNMMIs nd Annual Meeting June Baltimore Md. About the Society of Nuclear Medicine and Molecular Imaging The Society of Nuclear Medicine and Molecular Imaging SNMMI is an international scientific and medical organization dedicated to raising public awareness about nuclear medicine and molecular imaging a vital element of todays medical practice that adds an additional dimension to diagnosis changing the way common and devastating diseases are understood and treated and helping provide patients with the best health care possible. SNMMIs members set the standard for molecular imaging and nuclear medicine practice by creating guidelines sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice. For more information visit http"

"A twoweek course of the antibiotic rifaximin https Xifaxan https helps to relieve the symptoms of irritable bowel syndrome https IBS https and the relief lasts up to weeks after stopping the medication https according to new research. The major finding was that all IBS symptoms https improved says Mark Pimentel MD director of the GI Motility Program at CedarsSinai Medical Center Los Angeles who led the clinical trial https of the drug at Cedars. The study looked only at those IBS https patients with the nonconstipation https form he tells WebMD. For those with this type of IBS symptoms can include abdominal pain https bloating https and changes in bowel function such as diarrhea https IBS is considered a functional gastrointestinal disorder without a known physiologic cause with the symptoms recurring and often worsened by stress. Existing treatment options diet and lifestyle modification psychological therapy and other drugs do not help all people with the condition. With the new antibiotic treatment Pimentel tells WebMD many participants say they are improved improved that kind of results. The stool was more solid the diarrhea https goes away and the bloating is much less. That can translate to big changes in the lives of those with IBS estimated to affect about of adult Americans. With the drug treatment Pimentel says those with the IBS can enjoy social outings without the worry of having to run to the bathroom and having diarrhea. The drug is approved by the FDA only for travelers diarrhea https and hepatic encephalopathy a brain https disorder caused by chronic liver failure https Rifaximin for IBS Study Details Experts believe that those with IBS may have changes in their intestinal microorganisms leading them to consider targeting these gut microorganisms to treat the condition. They chose to study rifaximin because it is minimally absorbed and stays in the gut so they thought it might perform better than the antibiotics https widely absorbed by the body which have produced mixed results for IBS patients. Pimentel and colleagues conducted two parallel studies of the antibiotic. In both trials known as TARGET and TARGET they assigned IBS patients with mild to moderate diarrhea and bloating to take either a milligram dose of rifaximin or a placebo https three times a day for two weeks. The patients reported on their symptoms and were followed for weeks after the twoweek doses. For the two studies combined . of those taking the drug had adequate relief of their symptoms during the first four weeks after treatment but just . of those on placebo. While . of those on the drug had relief from bloating . of those in the placebo group did. The drug Pimentel says passes through the gut and gets rid of the bacteria in the small bowel that are believed to cause the problems. The studies were funded by Salix Pharmaceuticals Inc. which makes rifaximin. Pimentel serves as a consultant to Salix and serves on its scientific advisory board. He discovered the use of the antibiotic for IBS. CedarsSinai holds the patent and has licensed the rights to Salix. Salix has applied for FDA approval of the drug for the nonconstipation https form of IBS and IBSrelated bloating says Mike Freeman company spokesman. Rifaximin for IBS Second Opinion In an editorial published with the study results Jan Tack MD PhD a professor of medicine at University Hospital of the University of Leuven in Belgium writes that The TARGET studies have some attractive findings including the sustained benefits and short treatment course. It also seems to relieve the bloating which he calls one of the most challenging symptoms. But he has some caveats calling for more studies before the drug is widely used. In an email interview he says his main concern is antibiotic resistance so far not shown to be a problem in research studies and that the study followup needs to be longer. This issue is relatively easy to address with a longerterm followup study or a retreatment trial he tells WebMD. For now he suggests that the antibiotic be reserved for those patients in whom overgrowth of the small intestine bacteria has been confirmed or to limit treatment to a single cycle for those not responding to other medications. Tack has severed as a scientific adviser to companies evaluating IBS drugs. Another doctor Christine Frissora MD an associate professor of medicine at Weill Cornell Medical College of Cornell University says the results show promise. She was not involved in the studies but has been prescribing rifaximin for IBS patients with the nonconstipation form offlabel. Offlabel refers to uses that have not been approved by the FDA. As for the new study findings she says they wont change my practice but they will probably encourage other doctors to try it especially primary care doctors who may not yet know about this data. The patients who have diarrhea cramping urgency and frequency gas and bloating will be most likely to respond she says. It could also work she says in those with constipation. We just dont know yet. Pimentel says he is studying those patients now. Frissora reports research funding from Tioga Pharmaceuticals for a study of an IBS drug and serving on the speakers bureaus for Prometheus Therapeutics and Diagnostics Salix Pharmaceuticals and Takeda Pharmaceuticals North America."

"In a bold new approach ultimately aimed at trying to cure AIDS scientists used genetic engineering in six patients to develop blood cells that are resistant to HIV the virus that causes the disease. Its far too early to know if this scientific first will prove to be a cure or even a new treatment. The research was only meant to show that so far it seems feasible and safe. The concept was based on the astonishing case of an AIDS patient who seems to be cured after getting blood cells from a donor with natural immunity to HIV nearly four years ago in Berlin. Researchers are seeking a more practical way to achieve similar immunity using patients own blood cells. The results announced Monday at a conference in Boston left experts cautiously excited. For the first time people are beginning to think about a cure as a real possibility said Dr. John Zaia head of the government panel that oversees gene therapy experiments. Even if the new approach doesnt get rid of HIV completely it may repair patients immune systems enough that they can control the virus and not need AIDS medicines what is called a functional cure he said. Carl Dieffenbach AIDS chief at the National Institute of Allergy and Infectious Diseases agreed. Were hopeful that this is sufficient to give the level of immune reconstitution similar to what was seen with the patient from Germany he said. This is the first time researchers have permanently deleted a human gene and infused the altered cells back into patients. Other gene therapy attempts tried to add a gene or muffle the activity of one and have not worked against HIV. The virus can damage the immune system for years before people develop symptoms and are said to have AIDS acquired immune deficiency syndrome. The virus targets special immune system soldiers called Tcells. It usually enters these cells through a protein receptor or docking station called CCR. Some people about percent of whites fewer of minorities lack both copies of the CCR gene and are naturally resistant to HIV. One such person donated blood stem cells in to an American man living in Berlin who had leukemia and HIV. The cell transplant appears to have cured both problems but finding such donors for everyone with HIV is impossible and transplants are medically risky. So scientists wondered Could a patients own cells be used to knock out the CCR gene and create resistance to HIV A California biotechnology company Sangamo SANGuhmoh BioSciences Inc. makes a treatment that can cut DNA at precise locations and permanently edit out a gene. Dr. Jacob Lalezari director of Quest Clinical Research of San Francisco led the first test of this with the company and colleagues at the University of California in San Francisco and Los Angeles. He warned that it would be way overstated to suggest that the results so far are a possible cure. Its an overreach of the data. There are a lot of people out there with hopes and dreams around the Cword so caution is needed. In the study six men with HIV had their blood filtered to remove a small percentage of their Tcells. The genesnipping compound was added in the lab and about onefourth of the cells were successfully modified. The cells were mixed with growth factors to make them multiply and then infused back into the patients. Three men received about . billion modified cells. Three others received about billion. Three months later five men had three times the number of modified cells expected. As much as percent of their total Tcells appear to be the new type resistant to HIV Lalezari said. The sixth man also had modified cells but fewer than expected. In all six patients the antiHIV cells were thriving nearly a year after infusion even in tissues that can hide HIV when it cant be detected in blood. The cells are engrafting theyre staying in the bloodstream theyre expanding over time said Lalezari who has no personal financial ties to Sangamo the studys sponsor. The only side effect was two days of flulike symptoms. It will take longer to determine safety but several AIDS experts said they were encouraged so far. It is a huge step and a first for the field of genetics said John Rossi a researcher at City of Hope in Duarte Calif. where he and Zaia plan another study to test Sangamos approach. The idea is if you take away cells the virus can infect you can cure the disease. On Wednesday Dr. Carl June a gene therapy expert at the University of Pennsylvania will report partial results from a second federally funded study of people testing Sangamos product. He treated his first patient with it in July . Many questions remain People born without the CCR gene are generally healthy but will deleting it have unforeseen consequences Will HIV find another way into cells Certain types of the virus can use a second protein receptor though this is less common and usually when AIDS is advanced. Sangamo is testing a similar approach aimed at that protein too. How long will the modified cells last Will more be needed every few years Could doctors just infuse Sangamos product rather than removing cells and modifying them in the lab What might this cost Sangamo spokeswoman Liz Wolffe said its too early in testing to guess but it would be a premierpriced therapy in the neighborhood of Dendreon Corp.s new prostate cancer immune therapy Provenge . Yet AIDS drugs can cost a year so this could still be costeffective especially if its a cure. Jay Johnson who works for Action AIDS an advocacy and service organization in Philadelphia had the treatment there in September. My results are excellent he said. The overall goal is to not have to take medication and then hopefully lead maybe to a cure. Matt Sharp of suburban San Francisco also had the treatment in September. I would trade anything to not have to take a handful of medications every day for the rest of my life and suffer all the consequences and side effects he said. I may not live long enough to see the cure but I always hoped for a chance. Online AIDS informationhttp andhttp"

"Switching to public transport or cyclingwalking to get to work might help shed the pounds Strengthens case for incentivising walking or cycling to boost population health say researchers Switching from driving to work to using public transport walking or cycling might help commuters shed weight within a couple of years suggests res earch published online in the Journal of Epidemiology Community Health . Given that car use is high the findings strengthen the case for incentivising walking or cycling to boost population health suggest the researchers. They base their findings on t he responses of people to three waves of the British Household Panel Survey BHPS in and . The BHPS is a long term annual study of a representative sample of adult Britons which began in . At each time point respondents described their usual main mode of transport for their daily commute and provided details of their height and weight BMI in and in . The researchers used a series of analyses to see if changes in mode of transport were linked to changes i n weight over a two year period. In the first analysis which included respondents people had stopped driving to work and were either walking orcycling or taking public transport . The switchers tended to be younger and less likely to have access to a car than those who continued to drive. Those who chose to walk or cycle instead tended to have a lower household income and a shorter commute which became shorter still after making the switch while those who opted for public transport were significantly more likely to be more highly educated. Switching from a car to walking cycling or public transport was associated with a statistically significant average reduction in BMI of . kgm after taking account of other influential fac tors equivalent to a difference of around kg a person on average. The longer the commute the stronger was the association with a reduction in BMI of . kgm equivalent to a weight loss of around kg associated with journeys of more than minu tes and . kgm associated with journeys of more than minutes equivalent to weight loss of around kg on average. In the second analysis which included people switched from active to passive travel. Some stopped walkingor cycling an d switched from public transport usually a bus or coach to the car. Once again the switchers tended to be younger than those who continued with their mode of transport. Those who stopped walking or cycling to work were significantly less likely than those who stopped using public transport to be in a managerial or professional post. They also tended on average to have a shorter commute which lengthened after the switch. Those who had previously used public transport on the other hand had a short commute after the switch. But switching to a car was associated with a significant weight gain of around kg per person or . kgm after taking account of other influential factors. This is an observational study so no definitive conclusions can be drawn about cause and effect. Nevertheless the analysis of individual level changes in BMI over time between the two groups of switchers using data from a nationally representative survey strengthens their findings say the researchers. If a la rger proportion of commuters were able to abandon their cars for a more physically active commute this could help drive down the average population BMI they suggest. Combined with other potential health economic and environmental benefits associated with walking cycling and public transport these findings add to the case for interventions to promote the uptake of these more sustainable forms of transport they write. Research Impact of changes in mode of travel to work on changes in body mass index evidence from the British Household Panel Survey httpjech.bmj.comlookupdoi.jech About the journal The Journal of Epidemiology Community Health is one of more than specialist journals published by BMJ. The title is the official journal of the Society of Social Medicine. httpjech.bmj.com"

"U.S. prisons are experimenting with a highpriced monthly injection that could help addicted inmates https stay off opioids after they are released but skeptics question its effectiveness and say the manufacturer has aggressively marketed an unproven drug to corrections officials. A single shot of Vivitrol given in the buttocks lasts for four weeks and eliminates the need for the daily doses common with alternatives such as methadone. But each shot costs as much as and because the drug has a limited track record experts do not agree on how well it works. Proponents say Vivitrol could save money compared with the cost of locking up a drug offender about a year for each inmate at the Sheridan Correctional Center miles southwest of Chicago. Dr. Joshua Lee of New York Universitys medical school said more evidence is needed to determine whether the medication can help substantial numbers of people and whether its worth paying for but the early results are encouraging. It sounds good and for some of us it feels like the right thing to do said Lee a leading researcher on the treatment. Vivitrol is emerging as the nation searches for ways to ease an opioid epidemic https that affects more than million Americans and an estimated percent of the U.S. prison population. Many experts view prisons where addictions human toll can be seen most clearly as a natural place to discover what works. Christopher Wolf had already served prison time for nonviolent crimes when he was ordered into treatment for a heroin addiction by a judge who suggested Vivitrol. Three months later the yearold from Centerville Ohio is clean and working full time as a cook. He now suggests the medication to other addicts https I dont have cravings Wolf said. I see how much better life is. It gets better really fast. Vivitrol targets receptors in the brains reward system blocking the high and extinguishing urges. In some programs prisoners get an injection before release then followup shots from any clinic. For decades researchers have recognized addiction as a relapsing brain disease with medication an important part of therapy. But most jails and prisons reject methadone and buprenorphine the other governmentapproved medications for opioid addiction because they are habitforming and can be abused. Just ask Joshua Meador an inmate at Sheridan who hopes to get into the Vivitrol program before his release in January. Before incarceration he abused both older treatment drugs. When given takehome doses of methadone for the weekend he would sell them for heroin. When Im on Vivitrol I cant get high he said. The drug has no street value or abuse potential. You couldnt design something better for the criminal justice system said David Farabee of the University of California at Los Angeles who leads a Vivitrol https study in a New Mexico jail. Theres been pushback with other medications people saying Were just changing one drug for another. That argument goes out the window when youre talking about a blocker like Vivitrol. Prison systems in Illinois Vermont Wyoming and Wisconsin are trying the drug on a small scale. Michigan is offering Vivitrol to parolees who commit small crimes if addiction is the reason for their new offense. The federal Bureau of Prisons ran a field trial in Texas and plans to expand the program to the Northeast next year. The drugs manufacturer hopes prisons will be the gateway to a larger market. Also known as extendedrelease naltrexone the medication won Food and Drug Administration approval for alcohol dependence in and in to prevent relapse in postdetox opioid users. The evidence for giving Vivitrol to inmates is thin but promising. In the biggest study sponsored by the National Institute on Drug Abuse about offenders most of them heroin users on probation or parole were randomly assigned to receive either Vivitrol or brief counseling and referral to a treatment program. After six months the Vivitrol group had a lower rate of relapse percent compared with percent. A year after treatment stopped there had been no overdoses in the Vivitrol group and seven overdoses including three deaths in the other group. The results published in March in the New England Journal of Medicine have been promoted by the drugmaker Irelandbased Alkermes as it markets Vivitrol to U.S. correctional systems. Yet addiction is stubborn. When the injections stopped many in the study relapsed. A year later relapse rates looked the same in the two groups. It does suggest six months wasnt enough said Lee the lead author. T.J. Voller was a Vivitrol success story until he wasnt. After Vivitrol was approved by the FDA Voller talked about getting the shot with The Associated Press and Dr. Sanjay Gupta in a CNN segment. The yearold was back at work and seemed proud of his recovery. But after months on Vivitrol he died of a heroin overdose https He was alone for the weekend and picked up that needle one last time said his mother Kathi Voller of Raynham Massachusetts. Advocates argue that inmates have a constitutional right to all FDAapproved addiction medications throughout their incarceration. Treatment should be offered from the moment they are brought into the system said Sally Friedman legal director of the New Yorkbased Legal Action Center which is looking for a test case to bring to court. Physicians have learned to be cautious about pharmaceutical company marketing said Andrew Kolodny senior scientist at the Heller School for Social Policy and Management at Brandeis University. Not so for criminal justice officials who may be too trusting Kolodny said. When the drug company sends someone in to give them a talk and buy them pizza they think theyre getting a scientific lecture he said. Alkermes spokeswoman Jennifer Snyder said the companys sales team helps educate corrections staff and community care providers only after they have shown interest in Vivitrol. Theres widespread agreement that counseling support groups and treatment for underlying problems such as depression are crucial for Vivitrol patients said Dr. Joseph Garbely of Pennsylvaniabased Caron Treatment Centers which supports medicationassisted treatment and prefers Vivitrol. The disease of addiction is a cunning baffling and powerful one Garbely said. And you need all hands on deck."

"An experimental procedure aimed at repairing spinal cord injuries is showing promise. It uses stem cells in the damaged areas in hopes of restoring function and movement. And for one patient it is promising. On April James Mason was an accident waiting to happen. There was nothing we could have done to change that night said Bob Gambuti. During an argument James Masons stepfather Bob Gambuti tried to stop him from getting into a car after Mason had been drinking. He grabbed onto me I grabbed onto him said Gambuti. He pulled my leg out and we fell back and his neck broke. CBS News I remember just hitting the ground said Mason. I remember the whole way with the stretcher. Gambuti said the most devastating part of the whole process was the first day that they lifted Mason out of a bed. And nothing moved Gambuti said. Just his head. That really hit hard. At that point I really wanted to go jump off a bridge. Mason was left a quadriplegic with just the slightest ability to move his arms. Doctors said he would never walk again. Gambuti a retired cop became his full time caregiver and found an experimental trial at New Yorks Mount Sinai Hospital. CBS News spoke with Mason just before he underwent delicate neck surgery to try and repair the demaged part of his spinal cord by injecting stem cells. CBS News Im just super excited ready to just get it done and go back to rehab and start proving the doctors wrong even more said Mason. The surgery performed by Dr. Arthur Jenkins took four hours. Researchers have followed Mason and five other patients all with the most severe spinal cord injuries. CBS News met up with Mason again three months after the surgery. Mason said he was already noticing changes. My wrist has gotten a lot stronger. Im able to grasp around a lot other things he said. CBS News And after six months he was noticing changes then too. I think its almost doubled with how much Ive gotten better he said. And got sensation back into my feet. I can feel pressure onto em throughout my legs. And theyve noticed that I have a little bit of movement into my hips now. Today the company sponsoring the trial reported four of the six patients experienced improvement in both motor strength and function. Dr. Jenkins who is not affiliated with the company has continued to monitor Mason. My two cents is it worked that this actually changed his neurological recovery and function Dr. Jenkins said. That his actual functional improvement is from the stem cells that were injected. Whats that like for Mason I mean I just have to keep pushing forward he said. Mason does not blame his stepfather for the accident in fact he is grateful. If I had gotten into my car I could have killed someone else someones mother someones father someones child. If I would have survived through that I wouldnt have been able to live with myself he said. Its odd and its tough and people say Im sorry. Dont be sorry. I still have him here Gambuti said. Mason believes the stem cells accelerated his recovery. But its hard to know what would have happened without them. More research will be needed to try to establish whether they actually repair damage to the spinal cord."

"By the time yearold Ava Christianson got to the National Institutes of Health this summer she had lost several grueling rounds to leukemia and was bracing for the next one. Intensive chemotherapy which cures up to percent of children with the most common type of leukemia hadnt kept her cancer from coming back. Neither had a painful bonemarrow transplant nor an experimental treatment. Her careworn father cried in the shower to hide his anguish. Her mother couldnt help but wonder Why is this happening to our child But Ava was fortunate in one respect. Discoveries in the burgeoning field of immunotherapy are offering lifelines to desperate patients who previously had none. Five years ago said her mother Bethany Christianson our doctor would have just had to tell us to go home. Instead in a fiveminute procedure at the NIH Clinical Center in late July the freckleface girl got another chance to beat the acute lymphoblastic leukemia ALL that has stalked her since age . She was infused with million of her own T cells a key part of the immune system that had been genetically modified to track down and kill her cancer like a pack of crazed dogs. Avas treatment called CAR Tcell therapy is one of the new immunotherapies that attempt to rally the bodys own defenses to fight malignancies. Unlike other cancer advances it is being tested widely in children because of its stunning effectiveness in ALL the most common pediatric cancer. In earlystage trials many patients who had repeatedly relapsed saw their leukemia disappear. Some remain cancerfree. Yet big questions surround the therapy and many scientists are urging caution. Theres very real promise with this approach but the immune system is complicated said Terry Fry the National Cancer Institute NCI scientist who is running Avas trial. Theres a lot that still needs to be worked out. Heres what you need to know about immunotherapy https Complications can be lethal one clinical trial was briefly halted in July after three young adults died of brain swelling. It is also far from clear that such a personalized approach possibly costing hundreds of thousands of dollars is economically viable on a large scale or will produce the lasting remissions that everyone hopes to see. U.S. researchers running CAR Tcell trials for children and adults with leukemia and lymphoma have reported remission rates up to percent in some cases. Thats a major achievement in a group whose cancer is emboldened by every treatment failure. But rates in other trials are considerably lower and many patients eventually relapse. The treatment is great about getting people into remission but not at keeping everyone in remission said Rebecca Gardner a pediatric oncologist at Seattle Childrens hospital. She ran an earlystage trial using CAR Tcell therapy in which of patients went into complete remission. By a year about half had relapsed either because their T cells had inexplicably disappeared or their cancer had changed so that the T cells could no longer recognize it. Leukemia is really smart she said. Avas family understands that better than most. She underwent her first CAR Tcell procedure in Minnesota last year but her leukemia returned within six months. Her treatment at NIH involved a nextgeneration version developed by NCI that used a different target for her marauding T cells. In this firstinhumans trial she is Patient No. . In late August the Christiansons learned that Ava had gone into remission. She and her mother who were still at the Clinical Center in Bethesda Md. gleefully rushed home to Wisconsin so Ava could start third grade. Her parents so frequently disappointed remain guardedly optimistic. Hope is all you have said her father Jay Christianson. Her mother added We just need this to work and to stay working. NCIs Fry is careful not to make any promises about an extended remission. I cant say thats going to be the case he said because we just dont know. Its too soon. Scientists have wanted for decades to marshal the immune system to vanquish cancer but their attempts have mostly been frustrated. In the past few years however breakthroughs have led to the development of two types of immunotherapy checkpoint inhibitors and CAR T cells that are generating enormous excitement. Checkpoint inhibitors are offtheshelf therapies aimed at unleashing the immune systems power to see and attack the disease. Used mostly in adults to date they are producing impressive results albeit in a minority of cases. The most prominent Jimmy Carter. The former president became the poster patient when he was successfully treated last year with a checkpoint inhibitor called Keytruda along with surgery and radiation for his advanced melanoma. Much of the earliest research for customized CAR Tcell therapy was conducted at NCI the University of Pennsylvania the Memorial Sloan Kettering Cancer Center and Seattle Childrens. The technology of CAR T cells is really a breakthrough especially for children said Michael Jensen director of the Ben Towne Center for Childhood Cancer Research at Seattle Childrens Research Institute. Almost all the initial work focused on CD a protein found on the surface of Bcell acute lymphoblastic leukemia. Scientists figured out ways to use a chimeric antigen receptor or CAR to reprogram T cells to recognize the protein and kill the cancer. Immunotherapy is showing benefits in an increasing number of cancers https Zane Esposito a yearold from Plano Tex. calls himself the TCell Explorer. He was diagnosed with ALL in June . I just thought my back hurt he said. I couldnt walk up the steps very well. Almost three years of treatment including punishing chemotherapy provided a couple of years of remission. His leukemia returned in January and this time it did not respond to treatment. Soon after Zane relapsed he and his father bumped into friends in a local doughnut shop who told them about a TV segment on CAR Tcell therapy. Paul Esposito searched online and found Gardners clinical trial in Seattle. Zane signed on got the treatment went back into full remission and gained pounds. His Texas doctors have talked about a bonemarrow transplant to increase the chance of a true cure but the Espositos have resisted. The Seattle doctors say it is not clear yet whether that is necessary or whether there would be still other options should Zanes cancer recur. Zane is moving on with dreams of competing on Chopped Junior to show off his homemade pasta and pizza. On July the day that Ava got her T cells he celebrated his th birthday. Ava was when she started having leg pains then trouble standing up. Her mother suspected Lyme disease. You never think of cancer with a child she said eyes filling as she recalled her daughters cancer diagnosis in November . The doctors assured the family that it was typical leukemia and curable. Like most children Ava quickly went into remission after starting the prescribed months of chemotherapy. But at home in Prescott a small Wisconsin city at the confluence of the Mississippi and St. Croix rivers things did not get easier for the Christiansons. In early Ava was hospitalized in Minneapolis for a lung infection. About the same time the couples second daughter Audrey was born weeks premature and hospitalized in a neonatal intensive care unit in St. Paul. Bethany who manages occupational therapists for a nursinghome chain and Jay a rural mail carrier shuttled between the Twin Cities visiting their daughters. I would be with Ava during the day and then when Jay got home he would stay with Ava and I would spend time with Audrey she said. No matter what you do you feel like a bad mom. A year or so after treatment began Ava relapsed. Now she was in a much more dangerous category children whose leukemia no longer responds to chemo. Her doctors arranged for a bonemarrow transplant with her baby sister as the donor. The transplant made her sick and the whole family miserable. Ava spent months in the hospital and then a year at home. Because of fears of infection she couldnt go out much. She missed all of first grade. But her parents had hope that the transplant would keep her cancer at bay. Brain cancer now the leading cause of cancer deaths in children https At a sixmonth checkup tests showed that the leukemia was back again. There were no more conventional treatments to try. But because of her two relapses Ava was now eligible for a CAR Tcell trial at the University of Minnesota Masonic Childrens Hospital. Her T cells would be genetically altered to go after CD.The number of cells then would be vastly increased and reinfused. It sounded like science fiction but Bethany Christianson found comfort in talking to the father of Emily Whitehead. In the yearold Pennsylvania girl became the first child to be treated with reprogrammed T cells for leukemia. She has been in remission ever since. Ava got her treatment in April after her cells were extracted via a tube inserted into her neck and five days later had a massive immune reaction with a high fever and intense pain. While that is typical some patients become dangerously ill. Yet Ava recovered fast went into remission and attended summer school where she learned how to make pigsinablanket and wrote her own cookbook. By then her parents had gotten used to living in the midst of remissions and relapses. When she felt better we would do everything we could Bethany said. They visited Robot World a scientifically themed attraction a few hours from Prescott. You dont put things off because you are always thinking What if Last fall doctors delivered the bad news. Avas cancer had changed. It was no longer producing the CD protein which meant her modified T cells could no longer recognize the disease. But the leukemia was still producing another common protein called CD and that offered an opportunity. As it happened Fry head of the bloodcancer section in NCIs pediatric oncology branch had already launched the worlds first trial using CAR Tcell therapy to focus on CD. It seemed an equally promising target that could broaden the therapys impact researchers thought. At the time they did not realize that a significant percentage of patients in the other trials might relapse because of changes in their cancer. Fry insisted as he designed the study that children be included despite everpresent concerns about exposing them to safety risks. He wanted to avoid a delay in testing what could be a lifesaving pediatric treatment. I didnt want to take two to three years on adults and then go back and do children he said. For a yearold with cancer a future staked on medicines hottest field http_story.html The clinical trial already has treated nearly two dozen leukemia and lymphoma patients through age . The majority have gone into remission although some have had their cancer return. While it is far too early to know longterm outcomes Fry said he is convinced the CD treatment holds much potential. He is planning another trial next year with the Stanford University School of Medicine. It will target both proteins CD and CD simultaneously. Once Ava relapsed after the Minnesota trial Frys study at the NIH Clinical Center appeared to be the only option. But there was no slot immediately available. With Ava deteriorating doctors put her on an experimental treatment that sent her into remission but had serious side effects. They immediately stopped the medication when they learned Ava might get her Tcell therapy in January she actually needed a high level of leukemia in her body to participate. But on this wrenching roller coaster of research and treatment it turned out that she still had to wait several more months. Avas cancer returned in June. Her T cells were extracted in preparation for the trial even as she got sicker and sicker. She was admitted to the Clinical Center in midJuly to a room with dancing penguins painted on the windows. The day before her therapy an ebullient Audrey burst into the room and the two sisters ran down the hall to a play space. Her mother was ready this time for the intense immune reaction that followed treatment although she still found it hard to watch Ava spike a fever of . When you see that temperature on the thermometer every bone in your body says its wrong to let it get that high Bethany said. Then suddenly its over. If his daughters cancer returns yet again I have no idea what well do Jay said. Were kind of up against the edge. Fry thinks she might be able to undergo a second round of her latest immunotherapy as long as her cancer is still producing CD proteins. Doctors in Minnesota also might recommend a second bonemarrow transplant something her parents dread saying it was the roughest treatment of all. For now Ava is happily back in school. I just want her to be a kid Bethany Christianson said. She has missed out on a lot of that."

"The American Academy of Pediatrics on Monday announced its first major shift on circumcision in more than a decade concluding that the health benefits of the procedure clearly outweigh any risks. There is clear evidence that supports the health benefits of circumcision said Susan Blank who led the member task force that formulated the new policy httppediatrics.aappublications.orgcgidoi.peds. being published in the journal Pediatrics. The statement and accompanying technical report httppediatrics.aappublications.orgcontente marks the first revision of the organizations position since when the academy backed away from circumcision. At that time the group which represents about pediatricians nationwide concluded that there was no clear evidence for or against circumcising newborns. The group affirmed that position in . Since then the popularity of circumcision in the United States has declined. Only about percent of newborn males are circumcised. The academys task force spent seven years combing through the latest research analyzing more than a thousand studies. Their conclusion For starters Blank says circumcision helps baby boys pretty much immediately. The health benefits of male circumcision include a drop in the risk of urinary tract infection in the first year of life by up to percent she says. Article continues after this message from our sponsor But theres a much bigger reason to do it Blank said. Circumcised males are far less likely to get infected with a long list of sexually transmitted diseases. It drops the risk of heterosexual HIV acquisition by about percent. It drops the risk of human papillomavirus HPV herpes virus and other infectious genital ulcers she says. It also reduces the chances that men will spread HPV to their wives and girlfriends protecting them from getting cervical cancer. Weve reviewed the data and you know we have gone through them with a finetooth comb and the data are pretty convincing she says. Critics however were not convinced. They liken the procedure to female genital mutilation. We have no right as parents or as physicians or adults to strap them down and chop off a normal part of their body. To do that is a human rights violation and an ethical travesty says Georgeanne Chapin httpintactamerica.orggchapin of the anticircumcision group Intact America http Chapin and other critics argue that the scientific evidence is questionable. For one thing the studies about HIV have only been done in Africa where AIDS is much more common among heterosexuals. Theyre cherrypicking their evidence she says. They act as though theres this huge body of literature. Its all the same couple of studies that have been regurgitated and reprogrammed. Over the past years all kinds of medical benefits have been proposed as resulting from cutting off the foreskin and they have all been disproven. Critics also question the safety of the procedure saying too many boys are damaged for life by botched circumcisions. But many experts say the academy is making the right call. They dismiss any comparison to female genital mutilation as grossly misleading and say male circumcision is about as safe as any procedure could be. Some think the academys position is long overdue and that the group should have gone even further and more forcefully recommended circumcision. I think that all healthy newborn babies should be circumcised says Edgar Schoen http_qualifications.html a professor emeritus at the University of California San Francisco. I feel about newborn circumcision the way I do about immunization Its a potent preventive health procedure that gives you a health advantage. For its part the pediatricians group hopes the new recommendations will encourage more parents to circumcise their sons and more insurance plans to pay for it. As Shots reported last week a lot of state Medicaid programs have stopped covering http_sthdl circumcision. Those families who choose circumcision should have access to circumcision. Cost should not be a barrier Blank says. The federal Centers for Disease Control and Prevention http has been promising for years now to issue the governments first guidelines about circumcision. But the CDC keeps delaying it and still has not said when that will happen."

"Pancreatic cancer is currently very difficult to detect while it is still resectable. A new blood test developed by researchers at Lund University in Sweden Herlev Hospital Knight Cancer Center and Immunovia AB can detect pancreatic cancer in the very earliest stages of the disease. The results have been published in the Journal of Clinical Oncology. Due to diffuse symptoms pancreatic cancer is usually diagnosed very late in the disease progression. Therefore despite pancreatic cancer representing less than of all cancer cases more people currently die from it than breast cancer. By pancreatic cancer is expected to be the second deadliest type of cancer in the world. Our test can detect pancreatic cancer with accuracy at stage I and II while there is still the possibility of successful surgical intervention. There is currently no cure and few treatment options for advanced pancreatic cancer which is the late stage when pancreatic cancer is usually diagnosed explains Carl Borrebaeck professor at the department of Immunotechnology at Lund University. The study used samples from patients in both Denmark and the US at different stages of the disease. The blood test is developed on a socalled antibody microarray that consists of hundreds of recombinant antibody fragments. These antibody fragments are specific for a number of immuneregulatory proteins cancerassociated antigens and so on. Since the immune system is the first to respond to threats like complex diseases such as cancer autoimmune diseases and infections the microarray was designed to mirror this early response. This provides information about the development of tumours long before being visible on CT or detected by ctDNA. From those hundreds of markers markers were selected to detect pancreatic cancer with accuracy at stage I and II. In the future the screening method could be used to screen people who are at a higher risk of developing pancreatic cancer such as those with a hereditary risk newly onset diabetes patients and patients with chronic inflammation of the pancreas. The next step has already been initiated which is a large US prospective study for high risk individuals."

"People with wellcontrolled type diabetes httpsdiabetes.webmd.comguidediabetesoverviewfacts had even better sugar control used less insulin https and lost an average of pounds in six months when taking the type diabetes httpsdiabetes.webmd.comguidediabetes_symptoms_types drug Victoza in a small clinical study. Those who continued treatment for a full year continued these improvements and felt much better overall says study leader Paresh Dandona MD of the State University of New York Buffalo. It is a dramatic change. They can see that their unexpected and unpredictable oscillations of blood sugar https are minimized. They also lost weight https Dandona tells WebMD. Over a protracted period of time as their diabetes https continues to be well controlled there is delightful improvement in patients wellbeing. At the annual meeting of the Endocrine Society in Boston Dandona reported the results of a study in which adults whose type diabetes https was well controlled with insulin https given via an insulin pump https received oncedaily Victoza for either one week or weeks. Continuous glucose monitoring showed that their blood sugar was as tightly controlled as possible with insulin https treatment. Yet all patients blood sugar peaked and dipped at unpredictable intervals. Adding Victoza to insulin therapy quickly eliminated these peaks and dips in blood sugar. After one week average fasting https and weekly blood sugar levels https each dropped by about . And during Victoza treatment patients needed less and less insulin. Their average dose of mealtime insulin decreased by seven units and their need for allday insulin dropped by eight units . Patients who continued treatment for weeks had further decreases in insulin doses and lost an average of pounds. This appeared to be due to reduced appetite and food intake. Hemoglobin Ac https levels dropped from . to a normal level of .. Some patients have now been treated for up to a year and the effect is as good as it was at the beginning Dandona said at a news conference webcast from Boston. Why Victoza Might Help Type Diabetes Victoza is a class of drug called a GLP receptor agonist. Its taken by injection one daily. Byetta https the other FDAapproved GLP agonist requires twicedaily injections. The GLP receptor agonists mimic the natural GLP peptide which is released from the gut after a meal. GLP increases insulin secretion from the pancreas https when blood https sugar is high and slows sugar absorption from the gut. It also lowers levels of glucagon a hormone that counteracts the effects of insulin. Victoza and Byetta slow the progression of type diabetes https But they hadnt previously been tested in type diabetes https because people with this type of diabetes https lack insulinproducing beta cells. But Dandona and colleagues wondered whether the glucagonlowering effects of these drugs might benefit people with type diabetes https Their clinical findings suggest that lowering glucagon may be a much greater benefit in type diabetes https than previously thought. Would Byetta work as well as Victoza in type diabetes That hasnt yet been tested but Dandona says it should have much the same effect. Neither Victoza nor Byetta is approved for use in type diabetes. Doctors could prescribe these medications https for type diabetes known as offlabel use but Dandona says this should be tried only by a endocrinologist specializing in diabetes and only with careful and frequent patient monitoring. GLP inhibitors act on the brain https to reduce appetite. Because of the weight loss https thin people with type diabetes should not use these drugs. However some of people with type diabetes are overweight https so the weight loss would be a benefit to such patients. Victoza has other more serious side effects. The most important are abdominal pain https nausea https and vomiting https although these side effects tend to lessen or go away after a week or two of treatment. Even so Dandona says these side effects cause about of type diabetes https patients to stop taking the drug. Although the Dandona study was performed without drug company support Victoza maker Novo Nordisk is paying for a larger clinical trial https Dandona already has asked the National Institutes of Health to support a largescale study if this larger study yields similar results to the current pilot study."

"Amsterdam The Netherlands A test that measures the levels of five chemicals in the breath has shown promising results for the detection of cancers of the oesophagus and stomach in a large patient trial presented at the European Cancer Congress . Together stomach and oesophageal cancer account for around . million new cancer diagnoses each year worldwide . Both tend to be diagnosed late because the symptoms are ambiguous meaning the fiveyear survival rate for these two types of cancer is only . The new research involving more than patients showed that the test could diagnose cancer with an overall accuracy of . Dr Sheraz Markar an NIHR Clinical Trials Fellow from Imperial College London under the supervision of Professor George Hanna told the Congress At present the only way to diagnose oesophageal cancer or stomach cancer is with endoscopy. This method is expensive invasive and has some risk of complications. A breath test could be used as a noninvasive firstline test to reduce the number of unnecessary endoscopies. In the longer term this could also mean earlier diagnosis and treatment and better survival. The trial was based on the results of previous research that suggested differences in the levels of specific chemicals butyric pentanoic and hexanoic acids butanal and decanal between patients with stomach or oesophageal cancer and patients with upper gastrointestinal symptoms without cancer. The new research aimed to test whether this chemical signature that seemed to typify cancer could be the basis of a diagnostic test. In the new study the research team collected breath samples from people at St Marys Hospital Imperial College Healthcare NHS Trust University College London Hospital and the Royal Marsden Hospital London. Of these had been diagnosed with stomach or oesophageal cancer and showed no evidence of cancer when they had an endoscopy. All the samples were analysed with a technique called selected ion flowtube mass spectrometry which is able to accurately measure small amounts of different chemicals in mixtures of gases such as breath. Researchers measured the levels of the five chemicals in each sample to see which ones matched to the chemical signature that indicated cancer. The results showed that the test was accurate overall with a sensitivity of and a specificity of . This means that not only was the breath test good at picking up those who had cancer sensitivity it was also good at correctly identifying who did not have cancer specificity. Dr Markar said Because cancer cells are different to healthy ones they produce a different mixture of chemicals. This study suggests that we may be able detect these differences and use a breath test to indicate which patients are likely to have cancer of the oesophagus and stomach and which do not. However these findings must be validated in a larger sample of patients before the test could be used in the clinic. Over the next three years the researchers will continue with a larger trial using the test with patients who are being given an endoscopy for gastrointestinal symptoms but not yet diagnosed with cancer. This will assess the ability of the test to pick up cases within a group that is likely to contain only a small percentage of cancers. The team is also working on breath tests for other types of cancer such as colorectal and pancreatic which could be used as firstline tests in general practice surgeries."

"An implanted combination cardiac resynchronization device and defibrillator reduces deaths from mild heart failure by compared with a defibrillator alone researchers reported Sunday. The report is the second one indicating that such combination devices which are about the size of a cellphone can save the lives of many of the million Americans with heart failure and many surgeons are already using them for that purpose. About of heart failure patients have the milder form of the disease for which the new study was conducted. The condition requires frequent hospitalizations and costs the U.S. healthcare system an estimated billion per year according to the American Heart Assn. Heart failure occurs when the muscles of the heart weaken and the ventricles fail to coordinate properly or synchronize reducing the ability of the organ to move blood throughout the body. In the most severe cases patients become so weak that they are bedridden or suffer a variety of symptoms such as shortness of breath buildup of fluid in the lungs and other organs confusion and fatigue. Patients with mild heart failure typically have few or no symptoms but both groups have an equally high risk of atrial fibrillation erratic heartbeats or death. A defibrillator applies a small electrical shock to the heart to halt the erratic heartbeats and restore normal function. Cardiac resynchronization therapy delivers a regular small electrical signal to the heart to maintain regular beating increasing the ejection fraction the amount of blood pushed into the cardiovascular system with each beat. The device has leads going to both ventricles to ensure that they are synchronized. Such devices are approved in the United States for treating patients with severe heart failure. Last year U.S. researchers reported that httparticles.latimes.comsepsciencesciheart a combination device manufactured by Boston Scientific reduced the death rate by for patients with moderate heart failure in a study of about patients. In September the Food and Drug Administration gave the company approval to market the device for this indication. In the new study Dr. Anthony S. L. Tang of the Ottawa Heart Institute and his colleagues studied mild heart failure patients at centers in Canada Australia Europe and Turkey. About half were given an implantable defibrillator manufactured by Medtronic Inc. of Minneapolis and half a combination device manufactured by the same company. The patients were followed for months. Tang reported at a Chicago meeting of the American Heart Assn. and in a report published online in the New England Journal of Medicine that the team observed a reduction in deaths in the patients treated with the combination device and a reduction in deaths and heart failurerelated hospitalizations. Fourteen patients had to be treated with the device to prevent one death. Complications were about twice as common with the combination device primarily because connecting the leads to the ventricles takes longer and requires a higher skill level. The extra leads also increase the possibility of infections. The study gives us reason for renewed enthusiasm about heart failure treatment said Dr. Clyde Yancy of the Baylor University Medical Center the immediate past president of the American Heart Assn. There has been a dearth of significant trials in mild heart failure for some time.... Whats good is that when we compare this to the other two studies we see some consistency of response. Dr. Alfred Bove a professor emeritus at Temple Medical School and an immediate past president of the American College of Cardiology noted that many surgeons are already installing the devices in patients with mild heart failure and only connecting the defibrillators not hooking up the second function until it is needed. The new study he said supports the idea that doing this works."

"New clinical trial results provide evidence that highdose immunosuppressive therapy followed by transplantation of a persons own bloodforming stem cells can induce sustained remission of relapsingremitting multiple sclerosis MS an autoimmune disease in which the immune system attacks the central nervous system. ...these fiveyear results suggest the promise of this treatment for inducing longterm sustained remissions of poorprognosis relapsingremitting MS. Richard Nash M.D. Principal iInvestigator HALTMS study Five years after receiving the treatment called highdose immunosuppressive therapy and autologous hematopoietic cell transplant HDITHCT percent of trial participants had survived without experiencing progression of disability relapse of MS symptoms or new brain lesions. Notably participants did not take any MS medications after receiving HDITHCT. Other studies have indicated that currently available MS drugs have lower success rates. The trial called HALTMS was sponsored by the National Institute of Allergy and Infectious Diseases NIAID part of the National Institutes of Health and conducted by the NIAIDfunded Immune Tolerance Network link is external https ITN. The researchers published threeyear results https from the study in December and the final fiveyear results appear online Feb. in Neurology the medical journal of the American Academy of Neurology. These extended findings suggest that onetime treatment with HDITHCT may be substantially more effective than longterm treatment with the best available medications for people with a certain type of MS said NIAID Director Anthony S. Fauci M.D. These encouraging results support the development of a large randomized trial to directly compare HDITHCT to standard of care for this oftendebilitating disease. MS symptoms vary widely and may include motor and speech difficulties weakness fatigue and chronic pain. The most common form of MS is relapsingremitting MS which is characterized by periods of mild or no symptoms interspersed with symptom flareups or relapses. Over years the disease can worsen and shift to a progressive form. In HALTMS researchers tested the safety efficacy and durability of HDITHCT in volunteers aged to years with relapsingremitting MS who despite taking clinically available medications experienced active inflammation evidenced by frequent severe relapses and worsened neurological disability. The experimental treatment aims to suppress active disease and prevent further disability by removing diseasecausing cells and resetting the immune system. During the procedure doctors collect a participants bloodforming stem cells give the participant highdose chemotherapy to deplete the immune system and return the participants own stem cells to rebuild the immune system. The treatment carries some risks and many participants experienced the expected side effects of HDITHCT such as infections. Three participants died during the study none of the deaths were related to the study treatment. Five years after HDITHCT most trial participants remained in remission and their MS had stabilized. In addition some participants showed improvements such as recovery of mobility or other physical capabilities. Although further evaluation of the benefits and risks of HDITHCT is needed these fiveyear results suggest the promise of this treatment for inducing longterm sustained remissions of poorprognosis relapsingremitting MS said Richard Nash M.D. of Colorado Blood Cancer Institute and PresbyterianSt. Lukes Hospital. Dr. Nash served as principal investigator of the HALTMS study. If these findings are confirmed in larger studies HDITHCT may become a potential therapeutic option for patients with active relapsingremitting MS particularly those who do not respond to existing therapies said Daniel Rotrosen M.D. director of NIAIDs Division of Allergy Immunology and Transplantation. This work was sponsored by NIAID NIH and conducted by the ITN under award number AI and NIAIDfunded statistical and clinical coordinating centers under award number AI. The ClinicalTrials.gov identifier for the Phase study HighDose Immunosuppression and Autologous Transplantation for Multiple Sclerosis HALTMS is NCT httpsclinicaltrials.govctshowNCT. NIAID conducts and supports research at NIH throughout the United States and worldwide to study the causes of infectious and immunemediated diseases and to develop better means of preventing diagnosing and treating these illnesses. News releases fact sheets and other NIAIDrelated materials are available on the NIAID website https About the National Institutes of Health NIH NIH the nations medical research agency includes Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic clinical and translational medical research and is investigating the causes treatments and cures for both common and rare diseases. For more information about NIH and its programs visit https NIHTurning Discovery Into Health Reference RA Nash et al. Highdose immunosuppressive therapy and autologous HCT for relapsingremitting MS. Neurology DOI .WNL. ."

"An experimental vaccine that could hold off Alzheimers disease showed promising results in animal testing according to researchers at the University of Texas Southwestern Medical Center. Testing in mice showed that the vaccine safely prevents the buildup of substances in the brain associated with the fatal disease the team reported this week in the journal Alzheimers Research Therapy httpsalzres.biomedcentral.comarticles.s. There has been research in monkeys and rabbits as well and the researchers hope the vaccine will progress to human trials. If the vaccine proves safe and effective in humans it could slice the number of dementia diagnoses in half the studys senior author told USA TODAY. More The hidden side of dementia Families fight over care endoflife decisions finances estates https Dementia is a term used to broadly describe symptoms of cognitive decline Alzheimers disease is the most common cause of dementia. Doris LambrachtWashington a professor of neurology and neurotherapeutics at the University of Texas Southwestern Medical Center said researchers believe the vaccine could extend lives by preventing the disease from developing. If the onset of the disease could be delayed by even five years that would be enormous for the patients and their families LambrachtWashington said in a statement. The number of dementia cases could drop by half. Nov. MRI scan may predict which people will develop Alzheimers disease https Nov. Dark roast coffee might reduce risk of Alzheimers Parkinsons study suggests https LambrachtWashington said the study marks major progress toward a safe and effective vaccine. Previous attempts to find an Alzheimers vaccine either caused harmful side effects such as brain inflammation or used less effective approaches she said. The vaccine works by prompting the body to produce antibodies inhibiting the buildup of amyloid and tau two proteins that are hallmarks of the degenerative brain disease. The vaccine is one of several promising treatments aimed at reducing the buildup of those substances before they become deadly plaques and tangles in the brain. Top of Form Bottom of Form About . million Americans have Alzheimers disease according to the University of Texas. The number could double by ."

"New research offers hope for the first pill to treat a common problem in young women fibroids in the uterus. The growths can cause pain heavy bleeding and fertility problems and they are the leading cause of hysterectomies. In two studies a lower dose of a morning after contraceptive pill stopped the bleeding and shrank the fibroids. It worked as well as shots of a hormoneblocking drug that has unpleasant side effects. This is very very good news. The results are better than we expected said research leader Dr. Jacques Donnez of SaintLuc hospital at the Catholic University of Louvain in Brussels. Hes now testing intermittent longterm use of the pill to see if that could help women avoid surgery. The pill is called Esmya and it is awaiting marketing approval in Europe. Its a lowdose version of an emergency birth control pill called ella that came on the market in the United States about a year ago. The new fibroid pill still needs to be tested in the U.S. and wont be available anytime soon. Fibroids are benign growths in the uterus that are common in women during their childbearing years mostly in their late s and s. They usually go away after menopause. Treating fibroids isnt easy. Removing the uterus is the only cure other treatments include surgery to remove them or procedures to shrink them with ultrasound or pellets that cut off their blood supply. With the discovery that the hormone progesterone as well as estrogen promotes fibroid growth scientists have been looking at a class of drugs that can block progesterones effect on the uterus. Donnez and his colleagues in several European countries tested Esmya made by Swissbased PregLem. Their findings are in Thursdays New England Journal of Medicine. The two studies involved about premenopausal women whose fibroid symptoms were serious enough that surgery was planned. One study compared two doses of Esmya with a dummy pill for three months. The second tested Esmya against a monthly hormoneblocking shot that shrinks fibroids but causes hot flashes and with longterm use can thin bones.. Women in that study got a daily Esmya pill and a dummy shot each month or a hormone shot and a dummy pill. In both studies Esmya stopped the bleeding and shrank fibroids in most patients and worked as well as the shot but with fewer side effects. Menstrual bleeding was controlled in over percent of the women on Esmya many within a week compared to percent of those who took a dummy pill. At the end of the three months only about half of the participants went ahead with any kind of fibroid surgery. That allowed the researchers to observe whether improvements lasted over the next six months. They did for many of the Esmya patients while fibroids started growing after a month in the group that got the hormone shot. Donnez is now studying whether Esmya could be used longterm given periodically if symptoms return until menopause when fibroids usually disappear. That means some women depending on their age might avoid having surgery at all said Donnez. He does between six and hysterectomies a week for fibroids. Despite newer less invasive alternatives the rate of hysterectomies remains high Dr. Elizabeth Stewart a professor of obstetrics and gynecology at Mayo Clinic wrote in an editorial in the journal. Theres a need for good medical treatments and the new research represents an important step in that direction. Its amazing to me that so many women have uterine fibroids and yet the treatments we have available are pretty few and far between she said. The new pill is awaiting final European approval as a treatment before surgery following a recommendation from the European Medicines Agency in December. In the U.S. and Canada Esmya will be developed by Watson Pharmaceuticals Inc. which also sells prescription ella the contraception pill that helps prevent pregnancy for up to five days after sex. Watson spokesman Charlie Mayr said the company will soon start a study of the fibroids pill in the United States but it will be several years before it is ready for government review. It will seek approval in Canada early this year he said. Drugmaker PregLem paid for the latest studies. The researchers included company employees Donnez and others have been on its scientific advisory board."

"Each year five million people have wisdom teeth removed but its up in the air whether all of those surgeries were necessary. Wisdom teeth httpmyoms.orgprocedureswisdomteethmanagement also called the third molars are four teeth that grow at the very back of each corner of the mouth. For most people they start to grow in between ages and . Theyre thought to crowd out other teeth or cause tooth decay which is why many dentists and oral surgeons think its better to just nip those problems in the bud and take them out as a preventative measure. But theres a serious debate between dentists and oral surgeons should they preemptively remove someones wisdom teeth if the patient doesnt have any symptoms Simply put theres no right answer. It comes down to what you as a patient want. Heres what you need to know to figure that out. Dentists and oral surgeons are fighting over wisdom teeth Dentists and oral surgeons agree across the board that theres cause to remove wisdom teeth if a patient is in pain or if there are signs of disease popping up like tooth decay or infection. Thats an obvious choice. But taking out wisdom teeth when there arent any symptoms is where the professionals get into it. Many dental professionals stick with a watch and wait approach with wisdom teeth to avoid surgery if possible. Many people dont have adequate space in their jaw for the teeth to come into full position but that alone isnt justification of having them all removed says Dr. Scott Tomar of University of North Carolinas School of Dentistry. Tomar says that as a dentist he feels the risks of complication including infection and hitting nerves during surgery outweigh any benefits of preventative removal. In oral surgeon Dr. Jay Friedman called the preventative removals a public health hazard http in the American Journal of Public Health. The American Public Health Association has sided with this argument since when it formally opposed http the preventative removal of wisdom teeth. The same thing happened with tonsils http which doctors no longer remove just to get rid of the chance of infection later on. Americans spend an estimated billion a year having their wisdom teeth removed Some doctors though still see preventative oral surgery as being two steps ahead of the problem. If youre going to need your wisdom teeth out eventually why not have them removed when youre younger and are more likely to recover more easily Some think of removing the wisdom teeth early on as a way to lessen the crowding of other teeth You might not have symptoms now but you cant assume its gonna be that way for the rest of your life says Dr. Ray White an oral surgeon working at University of North Carolina. Rather than let the teeth cause problems later on many oral surgeons remove them. But a Cochrane review httpsummaries.cochrane.orgCDORAL_surgicalremovalversusretentionforthemanagementofasymptomaticimpactedwisdomteeth of randomized clinical trials found theres no evidence that removing wisdom teeth will prevent or reduce crowding of other teeth down the line. And a different Cochrane review http found that watching and waiting can may reduce the number of surgical procedures by percent or more. The question comes down to which side of the fence medical professionals fall on Its worth noting that oral surgeons make a good chunk of their paychecks by removing wisdom teeth so there is a financial incentive involved. Are there people gaming the system Sure. You dont get paid much for not doing anything White says. But Id hope we can get past that. The American Association of Oral and Maxillofacial surgeons says There is no pat answer https_based_third_molar_surgery.pdf cookbook recipe or flow chart that is universally accepted regarding the decision making process in these cases. So the question comes down to which side of the fence medical professionals fall on and what works best for their patients. The risks and benefits of removing your wisdom teeth Theres a chance that if you opt not to have your wisdom teeth taken out they might be fine for the rest of your life. Theres also a chance that theyll need to come out later. If thats the case you cant always plan for it. Opting to have them removed gives patients time to plan around the procedure which leaves people out of commission for about three days. But inconvenience isnt the only risk. The risk for complications increases as people get older and the duration of disability after the operation gets longer as people get older says oral surgeon Dr. Thomas Dodson. In some cases the extraction can be more painful if you wait Dodson says. Thats because the tooth is easier to remove if its roots arent fully developed. The common risks http related to the surgery include poor wound healing infection pain and uncontrolled bleeding. Nerve injury in rare cases of wisdom teeth removal can leave people with permanent numbness around the face and mouth according to the APHA. Americans spend billions each year on wisdom teeth Americans spend an estimated billion a year having million wisdom teeth removed http according to the American Public Health Association. Thats a hefty bill for something we may or may not need. How much it costs depends on how the molars are situated. A simple surgical extraction for a wisdom tooth thats showing through the gums should run about httpshealthcarebluebook.compage_ProcedureDetails.aspxiddatasetdentalgSurgicaltoothremoval according to Healthcare Bluebook. If its impacted pushed against another tooth and unable to fully come through the gum the cost jumps to about httpshealthcarebluebook.compage_ProcedureDetails.aspxiddatasetdentalgImpactedtoothremovalcompletelybony per tooth."

"Women who take hormone replacement therapy HRT to ease menopause symptoms like hot flashes and night sweats may be no more likely to die prematurely than women who dont take hormones a new study suggests. Many women have been reluctant to use hormones for menopause symptoms since when the federally funded Womens Health Initiative WHI study linked the treatments containing manmade versions of the female hormones estrogen and progestin to an increased risk of breast cancer heart attacks and strokes. The current study however looked at longerterm data from the WHI study and found no increased risk of death from all causes or from cancer or cardiovascular issues in particular associated with hormone use. Women seeking treatment for distressing hot flashes night sweats or other menopausal symptoms may find the mortality results reassuring said lead study author Dr. JoAnn Manson of Brigham and Womens Hospital and Harvard Medical School in Boston. Women go through menopause when they stop menstruating typically between ages and . As the ovaries curb production of the hormones estrogen and progesterone in the years leading up to menopause and afterward women can experience symptoms ranging from irregular periods and vaginal dryness to mood swings and insomnia. For the study researchers looked at data on women ages to who joined two WHI trials between and and were followed through . One trial tested estrogen alone against a placebo or dummy pill while the other trial tested estrogen taken in combination with progestin. Women were years old on average when they joined the trials and had already gone through menopause. They took hormones or a placebo for five to seven years and were followed for a total of years altogether. During the study period women died. Death rates were similar at about percent among women who took hormones and women who didnt researchers report in JAMA. Younger women in the study appeared to have better survival odds with HRT. Over the initial five to seven years when women were randomly assigned to take hormones or a placebo death rates were about percent lower among women aged to when they took HRT than when they didnt. For women who started hormones in their s or s however there wasnt a meaningful difference in death rates according to whether they got the treatment or a placebo during the initial years of the study. After years including both the treatment period and a decade or more of followup womens age when they joined the study no longer appeared to significantly influence death rates. One limitation of the study is that the WHI didnt look at different dosages of hormone pills and the findings may be different for other dosages or different types of therapy such as gels or creams or skin patches. Still the current study should ease concerns raised by earlier results from the WHI trials that an increased risk of breast cancer or heart attacks might translate into higher longterm mortality rates said Dr. Melissa McNeil author of an accompanying editorial and a womens health researcher at the University of Pittsburgh. Taking a combination of estrogen and progestin is associated with an increased risk of breast cancer but advances in screening and treatment since the WHI started now mean these tumors are unlikely to be fatal McNeil said by email. With additional years of followup it also appears that the increased heart attack risk associated with HRT in the initial results from the WHI trials is limited to older women McNeil added. Hormone therapy has been in and out of favor first it was good for all menopausal women then it was dangerous for all women McNeil said. The takehome message now is that for the right patient hormone therapy is safe and effective. SOURCE bit.lyjkqUFE httpbit.lyjkqUFE and bit.lyjopiX httpbit.lyjopiX JAMA online September . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"A Wisconsin woman traveled hundreds of miles to MedStar Georgetown University Hospital in Washington for a delicate operation replacing underarm lymph nodes lost in cancer surgery. A small but growing number of hospitals offer the procedure. See photos. A Wisconsin woman traveled hundreds of miles to MedStar Georgetown University Hospital in Washington for a delicate operation replacing underarm lymph nodes lost in cancer surgery. A small but growing number of hospitals offer the procedure. See photos. WASHINGTON AP Breast cancer treatment left Susan WolfeTank with an arm too painfully swollen to lift anything heavy or even fit into her usual clothing a debilitating condition that gets little attention and has no cure. Desperate the Wisconsin woman traveled hundreds of miles to seek a delicate operation replacing underarm lymph nodes lost in cancer surgery as a small but growing number of hospitals offer microsurgical attempts at relief from lymphedema that help some patients but not all. Right in this area feel that that is your lymph node Dr. David Song of MedStar Georgetown University Hospital in Washington told WolfeTank during a recent checkup. Song Georgetowns plastic surgery chief had removed healthy lymph nodes from WolfeTanks back and side and implanted them in the affected arm. As the new nodes took root her arm was shrinking. A delighted Songs only caution Take care of them by wearing a compression sleeve as prescribed. This isnt a cure. I will still have to be careful said WolfeTank of Hurley Wisconsin. But I will be able to crosscountry ski again just live a normal life. Look at my arm its incredible. Lymphedema is a chronic swelling often in an arm or leg that in severe cases can be disfiguring impair mobility cause disabling pain harden the skin and lead to infection. Lymph nodes work like biological pumps in a network thats part of the immune system. They drain watery fluid called lymph that traveling through tiny channels brings nutrients to cells and takes away bacteria and waste material. Lose or damage enough lymph nodes or channels in a particular area and that fluid builds up. Theres no good count but millions of Americans are estimated to have some degree of lymphedema and while it can be hereditary or result from injury many U.S. cases are a lasting side effect of treatment for a variety of cancers. Consider breast cancer. While better surgical techniques in recent decades have lowered the risk experts estimate that still about percent of breast cancer survivors who undergo a sentinel node biopsy removing a few nodes to check for spreading cancer will develop lymphedema. That risk jumps to about percent for women like WolfeTank who need additional lymph nodes removed because of more advanced cancer. Radiation causes further harm. Yet too often women arent warned about symptoms or checked for early signs when lymphedema is more easily treated said Dr. Sheldon Feldman of New Yorks Montefiore Einstein Center for Cancer Care. He coauthored physician guidelines issued this fall by the American Society of Breast Surgeons on prevention and treatment of breast cancerrelated lymphedema. Typical patients have had that swelling for a while Feldman said. Now the treatment is an uphill battle. The main treatment consists of wearing compression bandages and massage to bring down swelling. A lymphedema specialist initially prescribed a large pump that massaged WolfeTanks arm for an hour a night temporarily relieving some of the pain. But if I used my arm I was back to square one WolfeTank said. I didnt fit into my coat anymore. I live in the snow capital of Wisconsin. Im not supposed to shovel. Weve got to fix this. WolfeTank had struggled for four years when an oncologist recommended lymph node transfer. The rationale There are more lymph nodes in the bodys trunk than in the limbs more avenues to drain off fluid and thus it should be safe to move a few. Hunting for a surgeon WolfeTank found Song who transferred about five nodes along with supportive blood vessels and other tissue hoping theyd grow new channels to drain fluid. Its not the only option. A technique called lymphovenous bypass reroutes lymphcarrying channels going around damaged or missing nodes to drain into veins instead. Some surgeons use a variation of that technique protectively in hopes of preventing lymphedema from forming in the first place. During the initial cancer surgery they check which lymphcarrying channels the node removal left dangling and connect them to blood vessels to drain. Surgical options offer great potential note the breast surgeons new guidelines. But they dont work for everyone. About a third of lymph node transfer patients see some positive effect Song said. And Feldman noted that over about the past decade the microsurgeries have been studied only in small research trials and results vary with surgeon experience. One debate is whether to offer lymph node transfer early before patients build up as much damage as WolfeTank did. Insurance coverage also varies. Feldmans bottom line Patients considering microsurgery should be evaluated in a comprehensive lymphedema program to determine their best options. Copyright The Associated Press. All rights reserved. This material may not be published broadcast written or redistributed."

"Millions of people visit the websites of the Mayo Clinic American Cancer Society and the Centers for Disease Control and Prevention among others seeking authoritative health information. But are they receiving it When it comes to learning about the differences in risk among certain types of nicotine products many government websites are actually misleading or underinforming the public according to two researchers who analyzed the content of numerous health websites. This information quarantine in turn helps explain the woeful lack of public knowledge about relative risks violating basic consumer rights as well as the public health principles of individual rights and health literacy the researchers say. Writing in the International Journal of Drug Policy http Lynn Kozlowski of the University at Buffalo and David Sweanor of the University of Ottawa point out that many websites omit information showing that products such as ecigarettes smokeless tobacco and snus are far less harmful than traditional cigarettes. Public health ethics always has a concern to avoid any net harm to population health explains Kozlowski professor of community health and health behavior at UB and the papers lead author. The fear has been that much safer tobacco and nicotine products like snus smokeless tobacco and vape will possibly cause a net loss to public health because more people will use these products and these products may lead to cigarette use. This fear however is not based on actual evidence and cannot be used to suppress or otherwise keep the public uninformed of what is clearly known about the lower risks of these products adds Kozlowski PhD one of the worlds leading researchers on smoking behavior. An information quarantine functions similarly to a medical quarantine think of your favorite zombie movie or television show in which the infected person is secluded from everyone else to protect the overall public. In order to justify a quarantine there has to be clear evidence that the need to protect population health should overrule personal autonomy. In the case of providing information on differential health risks of nicotine products The evidence to date does not come close to establishing that there would be a loss to public health from making this information widely available from credible sources Kozlowski says. Kozlowski and Sweanor reviewed several major health websites including the CDC Mayo Clinic American Cancer Society Substance Abuse and Mental Health Services Administration and the National Cancer Institute and found three types of examples of information on smokeless tobacco but notomodest efforts to inform consumers of the significantly lower risks compared to cigarettes for lifelong users the researchers write. In fact they found that the Mayo Clinic perpetuated a misrepresentation discovered in erroneously informing visitors that smokeless tobacco was as dangerous as cigarettes. The day after the article was released the Mayo Clinic removed the headline replacing it with the still misleading statement that smokeless tobacco was not a safe product. People can only make as good a decision as the information available to them allows said Sweanor an adjunct professor in the University of Ottawas Faculty of Law who has spearheaded the development of worldleading tobacco control initiatives in Canada since the early s. The public is dramatically misinformed about the relative risks of substitutable tobacco and nicotine products. The risk differentials are huge but this is simply not known by a vast majority of those whose lives are at risk adds Sweanor. England has an example of a website Action on Smoking and Health ASH that gets it right on vaping the researchers said. A briefingDownload pdf http_.pdfqcigarettes posted on the site specifically states Compared to tobacco products electronic cigarettes are significantly safer. In their paper the researchers note that information on comparative risks is common for other products and activities like overthecounter medicines and even safety ratings of vehicles. They argue that the U.S. Food and Drug Administration FDA which regulates the sale of tobacco products isnt doing its part to inform consumers of important differences in harm among tobacco products. To illustrate their point Kozlowski and Sweanor use the example that if one type of alcoholic beverage caused in regular users to die prematurely as is the case with smoking traditional cigarettes while another caused massively fewer deaths consumers would want to know which product was the safer alternative. It would be scandalous even criminal to keep such facts from consumers the researchers write. Yet such facts are being kept from adult consumers of legal tobacconicotine products either by not informing or actively misinforming consumers. It is as if tobacco consumers were blindfolded and not allowed to see dramatic differences in harm from different products."

"U.S. researchers say they have found clear signs that blood clots in the lungs are being overdiagnosed exposing patients to potentially dangerous side effects from unnecessary drugs. Using national data the researchers found the rate of socalled pulmonary embolisms or PEs nearly doubled with the introduction of a new powerful diagnostic test more than a decade ago. Yet there was only a slight drop in deaths from the condition over the same period suggesting many of the clots were too small to cause harm. Rather than an epidemic of disease we think the increased incidence of PE reflects an epidemic of diagnostic testing that has created overdiagnosis the researchers write in the Archives of Internal Medicine. Its been estimated that more than Americans have a pulmonary embolism each year. The condition usually occurs when a blood clot travels from the legs to the lungs sometimes with fatal results. But with increasingly sophisticated tools doctors may be spotting clots that would never have been fatal in the first place. One such tool is called a CT chest scan which produces detailed images with highdose xrays and is being used in millions of patients every year in the U.S. In the years before when the technique was introduced per Americans were diagnosed with a pulmonary embolism annually. After that number rose to per . The number of deaths caused by the condition dropped only little however from . per in to . per in . This is consistent with overdiagnosis of pulmonary embolisms that may have caused very little harm may not have caused death said Dr. Renda Soylemez Wiener of Boston University who worked on the study. On the other hand the bloodthinning drugs used to treat blood clots increase the risk of bleeding in the brain or gastrointestinal tract for example. According to the new results such complications rose from three to five per people hospitalized with PE per year after doctors began using chest CT scans. The new findings add to other evidence showing that medical testing is on the rise across the U.S. although in many cases the impact on overall health remains unclear. CT scans expose patients to radiation for example which can increase the likelihood of developing cancer. And the dyes used to enhance the scan also cause kidney damage in a significant portion of people. I think doctors should think carefully about the pretest probability of a pulmonary embolism before they order this test Wiener told Reuters Health. Yet there is no easy solution at this point because untreated blood clots can be fatal she added. Right now it is a difficult place for the patient to be in Wiener said. SOURCE bit.lymmZKK httpbit.lymmZKK Archives of Internal Medicine online May . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Patients with newly diagnosed advanced lung cancer who received an immunotherapy drug plus standard chemotherapy lived significantly longer than those who got chemo alone according to a new study that is expected to change the way such patients are treated. The report was one of several highly anticipated studies on immunotherapy and lung cancer presented Monday at the annual meeting of the American Association for Cancer Research in Chicago. The studies simultaneously were published by the New England Journal of Medicine on a day that some experts called the Super Bowl of lung cancer immunotherapy. The reports underscore the increasingly important firstline role that immunotherapy https_story.htmlutm_term.afa which unleashes the immune system to destroy cancer cells is taking against the deadliest cancer. Immunotherapy is rapidly in combination with other treatments and on its own dramatically changing the standard of care for lung cancer said Leena Gandhi an oncologist at NYU Langone Health who led the study on the immunotherapychemotherapy combination called Keynote. Instead of chemo being the backbone on which to improve immunotherapy is now the backbone on which we build. Lung cancer is the secondmostcommon malignancy https_story.htmlutm_term.afaaf in the United States after breast cancer. The American Cancer Society estimates that people will be diagnosed with the disease this year and will die of it. Most patients diagnosed with advanced lung cancer disease that has spread beyond its original site initially receive chemotherapy which provides only marginal benefit. But the disease is so lethal that many patients dont survive long enough to try second or thirdline treatments so researchers are trying to develop and use more effective approaches earlier. The trial that grabbed much of the spotlight Monday is a randomized effectiveness study that involved more than untreated patients with advanced nonsquamous nonsmall cell lung cancer a common type of the disease. The patients did not have cancercausing mutations. One group was treated only with chemo while the other got an immunotherapy drug called Keytruda https_story.htmlutm_term.efec plus chemo. Some of the results had been released previously but not specific details.After a median followup time of . months Gandhi said the patients in the combination group were percent less likely to die compared with patients in the chemoonly arm. For the first time adding another drug has significantly impacted the longterm outlook for those patients she said. Scientists who werent involved in the study agreed that it was highly significant. H. Jack West an oncologist at Swedish Medical Center in Seattle said It is literally practicechanging immediately. Roy Herbst an oncologist at Yale Cancer Center said that most lung cancer patients now will be offered immunotherapy in some form much earlier than before. Still he said the approach was not a cure and there is a lot of room for improvement. The estimated proportion of patients in the combination therapy group who were alive and whose disease had not gotten worse at a year was about percent about double the proportion for the chemoonly group. Last May the Food and Drug Administration approved the Keytrudachemo combination based on an earlystage trial. But many doctors did not adopt it because the trial was small and didnt initially show a survival benefit Gandhi said. Experts said it was especially significant that the study showed that patients benefited from the Keytrudachemo combination regardless of the levels of a protein called PDL found on their cancer cells. Researchers already had known https_story.htmlnoredirectonutm_term.adea that patients with high levels of the protein were more likely to respond to immunotherapy. Last week in a related development Merck which makes Keytruda reported that a different trial showed that the medication prolonged survival even when used alone compared with chemo. Experts said they will have to see more details before they can determine whether the medication is better used alone or with chemo. In a second study published Monday researchers used two other immunotherapy medications Opdivo and Yervoy both made by BristolMyers Squibb to treat newly diagnosed patients with advanced nonsmall cell lung cancer with a high number of mutations in their tumors. The patients experienced a significantly longer period during which their disease did not worsen compared with people who received only chemotherapy said Memorial Sloan Kettering Cancer Center oncologist Matthew Hellmann who led the study. He said the results established the doubleimmunotherapy combination as a firstline treatment for patients with a high tumor mutational burden but that it was too early to know whether the treatment leads to longer survival. And he said the trial showed that tumor mutational burden is a reliable way to predict who will benefit from the medications. Another study published Monday used immunotherapy in a different way for patients with earlystage lung cancer. Researchers at Johns Hopkins and Memorial Sloan Kettering gave patients two doses of Opdivo the first a month before surgery the second two weeks before the operation to try to stimulate antitumor activity and reduce the risk of relapse. Nine of the patients who got Opdivo had a major pathologic response a sharp reduction in the number of cancer cells found in the tumors removed by surgery. Drew Pardoll director of Hopkins BloombergKimmel Institute for Cancer Immunotherapy said that it is too early to know whether the findings will translate into longer survival. But if future studies show that he added then immunotherapy might be used to augment or even replace chemo typically given before surgery."

"The first year of free lung cancer screening in the Augusta Georgia area found more than double the rate seen in a previous large national study as well as a Massachusettsbased screening for this number one cancer killer. The higher rates coupled with the majority of cases being found in early treatable stages point toward the need for ongoing accessible free screening in highrisk populations and underserved regions say researchers at the Georgia Cancer Center at Augusta University. High risk includes those who have smoked a pack of cigarettes daily for two or three decades and if theyve quit smoking did so less than years ago. The screening of highrisk individuals within a mile radius of Augusta found percent had lung cancer and percent of those were caught early said Dr. Carsten Schroeder thoracic oncology surgeon at the Georgia Cancer Center and Medical College of Georgia at AU. The researchers note that a percentage of the patients presenting at screening had early symptoms like a persistent cough so the rate of cancer detection in patients who showed no indication of disease was . percent still double the rates of previous studies. Lung cancer is still the number one cancer killer in the United States and in our world Schroeder said. If we catch it in the early stages ideally before symptoms surface we can operate and patients can have an overall survival rate of percent. Fiveyear survival rates are closer to percent in more advanced disease. The pioneering National Lung Screening Trial which began in and included largely urban centers found cases of lung cancer among the highrisk individuals screened in the first year for a rate of . percent. That study also provided the first broad evidence that lowdose computed tomography or LDCT was a more effective screening tool than the traditional chest Xray. A decade later the Massachusettsbased Lahey Hospital Medical Center on which the Augusta screening was modeled found a . percent prevalence in the first months of screening. Like the previous experiences the Augusta area screening that started in also reiterated the ability of LDCT to find lung cancer early said Schroeder corresponding author of the study in Southern Medical Journal. Six of the eight cases found in the screening were considered potentially curable with surgery. Positive results were communicated directly to the participants primary care provider negative results were communicated to primary care docs and participants along with a reminder for another screening in a year. Participants particularly from surrounding more rural communities have limited access to health care Schroeder said. The areas median household income is percent lower than the national average and the poverty level is percent higher according to the U.S. Census Bureau. The Augustaarea experience found generally younger patients who started smoking earlier in life and had multiple risk factors. Augusta area participants were an average of years old about half male and female more than percent were white and nearly percent were black. It doesnt matter how old you are if you have smoked years you might want to consider a lungcancer screening Schroeder said referencing the reality that some adults started smoking as children. Part of his drive to start a screening program in the Augusta area was that when he relocated here three years ago from the Cleveland area he found patients were often referred to him with later lesstreatable disease. In the Cleveland area where Schroeder previously practiced as a faculty member at Case Western Reserve University and where access to health care andor health insurance was more widely available early lung cancers might even be detected incidentally when patients had CT scans for a variety of other reasons. Augusta researchers were able to offer free screening by utilizing natural downtime of the combined positive emission tomography or PET and computed tomography or CT scanner said Dr. Norman B. Thomson III chief of generalcardiothoracic radiology in the MCG Department of Radiology and Imaging and study coauthor. The combination technology is often used to visualize other tumor types throughout the body and many patients require an injection of sugar dye which will be taken up by the tumor but must first circulate for about an hour before the scan is done. That means the machine is staffed at times when it is not able to be fully used for other diagnostic procedures time that provides a natural window for lung screening using just the CT imaging capability in under five minutes from arrival to exit Thomson said. More typically a scan could cost between . In the last decade CT technology has gotten increasingly adept at picking up early small nodules Thomson said. Low radiation doses work well in the lungs which are mostly filled with air that provides a blank background for nodule surveillance. Thomson notes that means LDCT is also adept at finding things like scar tissue and small inflammatory nodules that also are more common in the lungs of smokers. Nodules a third of an inch or smaller tend not to be cancer and more solid masses tend to be Thomson said. They may follow up on smaller nodules in six months then if the nodule is stable go back to annual reviews. And while some lung cancers are super aggressive screening also may uncover some slowgrowing versions that like some prostate cancers will not threaten life but need to be treated andor closely followed once found. Thats why the acid test for screening is not how many cancers you find or what stage the cancer is Thomson said rather what screening does to lung cancer death rates. Current evidence definitely supports screening he said. Also like lung cancer has been coincidently found in CT scans for other reasons physicians like Thomson and Schroeder are now incidentally finding cardiovascular disease in their lung cancer screening. To date about individuals have been screened in the Augusta area and Schroeder is working to expand statewide hoping to use the state public medical schools extensive campus network that has students learning from physicians at practices and hospitals across Georgia as a natural base. We want to reach as many people as we can as early as we can he said. Also about half of patients screened continue to smoke so screening might also be a logical point for smoking intervention Schroeder said. The original National Lung Screening Trial orchestrated by the National Cancer Institute and the American College of Radiology was launched in and enrolled nearly patients nationally. Fiveyear survival rates were about percent for early cancers and about percent for lung cancer found late. Following the trial the National Comprehensive Cancer Network a nonprofit organization of cancer centers that develop guidelines for cancer diagnosis and treatment along with the United States Preventive Services Task Force which makes recommendations for preventive medicine recommended screening highrisk individuals on a slightly broader scale which the Lahey and Augusta area screening used. The group recommends screening for those age with a pack year or greater history who have stopped smoking for years or less and those age or older with a pack year smoking history and an additional risk factor other than secondhand smoke such as family history of lung cancer or a personal cancer history. A pack year means smoking one pack a day for years or a variation like two packs daily for years. After years of not smoking the lung cancer risk tends to diminish but never vanishes. Schroeder would prefer the screening still not stop there. A total of individuals signed up for the Augusta area screening qualified and actually had LDCT. More than patients were not screened in the first year primarily because of socioeconomic and travel limitations that created a sixweek backlog. Ninety percent of lung cancer is related to cigarette smoking the leading cause of preventable disease and death in the United States according to the Centers for Disease Control and Prevention. Symptoms of lung cancer include persistent intense coughing shortness of breath pain in the chest shoulder or back and changes in the color andor volume of phlegm or mucus hoarseness and coughing up blood. A survey of smoking by adults by the Centers for Disease Control and Prevention found about percent of adults in the country smoked rates for Georgia and adjacent South Carolina were between percent. Rates in Massachusetts where the Lahey screening occurred are . to . percent. Rates were highest in certain demographics. As examples smoking rates were highest among those without a graduate education degree certificate and lowest among those with a graduate degree higher among those living below the poverty level versus above it and higher among some minorities such as American Indians and Alaska Natives multiple race individuals and blacks. For more information about free lung cancer screening at the Georgia Cancer Center and MCG call or email lungaugusta.edu mailtolungaugusta.edu."

"For men diagnosed with prostate cancer the decision about how to treat it or even whether to treat it can be agonizing. Surgery radiation or some combination of both may lead to miserable side effects such incontinence impotence and rectal damage. Doctors usually cant predict whether a man will suffer all or none of those side effects. While some risk factors are wellknown including age diabetes and poor cardiovascular health whether a man suffers harsh sideeffects is often chalked up to random luck. So what if it were possible to know before treatment which men might be more likely to suffer complications New research published Thursday in the International Journal of Radiation Oncology discovered a set of genetic markers that appear to indicate a significantly greater risk of collateral damage from radiation treatment for prostate cancer. Knowing a mans susceptibility to fallout from radiation may steer a doctor toward surgery instead of other potentially damaging therapy http More often than not its not clearcut which way to go explained Barry Rosenstein professor of radiation oncology at Mt. Sinai School of Medicine in New York City. If you see a surgeon hes likely to say surgery is best. If you see a radiation oncologist hell say oncology. Determining what type of treatment a man should receive is only part of the dilemma of prostate cancer. The debate whether to even test http_healthtnewstudyfuelsdebateprostatecancertestsfor it is ongoing. This earlystage study represents a big step toward doctors and their patients making that decision. The researchers started with a pool of men treated with radiation for prostate cancer. Patients were assessed every three to six months for signs of sexual dysfunction for up to five years. The number of men studied was eventually winnowed down to patients with erectile dysfunction and controls. The scientists then performed DNA analyses on the men looking for genetic variations called single nucleotide polymorphisms httpghr.nlm.nih.govhandbookgenomicresearchsnp or SNPs pronounced snips slight differences in the spelling of our DNA. After sifting through hundreds of thousands of SNPs they settled on suspect genetic variations. It turned out that when the SNPs were combined to create a score that could be used to measure individual risk of treatment complications having just one of the SNPs more than doubled the risk. The more of the a man had the greater his chances of radiation therapy complications. It is cumulative Rosenstein explained. If a man has five or six it increases his chances quite a bit. The research is still in the early stages so doctors arent likely to be using the genetic markers to determine treatment any time soon. This is still not nearly good enough yet he said. But hes part of an international consortium that is trying to make that very scenario a practical reality. The next step he said is for group members to validate the predictive power of the markers his team found. If they can then doctors really will be able to assign patients to treatments and see if we maintain the same level of control of cancer and lower the incidence of complications he said. And if we can do that then therell be enough confidence to put it into use in the clinic. Even better he suggested it may one day be possible to use drugs to target the SNiPs or the biological processes they influence as a way to prevent damage from therapy. That hope is evident to other researchers such as Dr. Ithaar Derweesh a urologic oncologist and associate professor of surgery at the University of California San Diego Moores Cancer Center. This is a study that in certain ways is groundbreaking and also elegantly performed Derweesh said. While Derweesh agreed with Rosenstein that such a technique will take time to validate and be used to steer patients toward a particular therapy something he called the holy grail he suggested that in the nearer term such markers might be used as a trigger to preemptively begin erectile rehabilitation or to take measures that might lessen the potential damage. This kind of work is important not just for prostate cancer but all cancers. While there has been greater success in treating cancer survivors may live many years with side effects after treatment. If Rosensteins hopes are fulfilled it may one day be possible to prevent some of the damage before its done and still effectively treat the cancer. Brian Alexander http is coauthor with Larry Young Ph.D. of The Chemistry Between Us Love Sex and the Science of Attraction http now on sale."

"New research published online in The FASEB Journal http suggests that tendon stem TSCs may be able to significantly improve tendon healing by regulating inflammation which contributes to scarlike tendon healing and chronic matrix degradation. This has implications for the treatment of acute tendon injuries and chronic tendon disease. Inflammation plays a critical role in acute and chronic tendon injuries and healing said Chang H. Lee Ph.D. a researcher involved in the work and an assistant professor at the Regenerative Engineering Laboratory Columbia University Irving Medical Center New York. Our findings represent an important foundation for the development of a new treatment that would regulate overwhelmed inflammation for tendon ruptures and tears tendonitis tendinopathy and other tendon injuries and diseases. In their study Lee and colleagues used both in vitro human models and in vivo rat models. In vitro isolated TSCs were stimulated with proinflammatory cytokines proteins that can influence interactions between cells and the expression of genes involved in inflammatory regulation was measured. In vivo the researchers evaluated inflammatory responses by TSCs including infiltration of macrophages white blood cells that consume damaged or dead cells and expression of antiproinflammatory cytokines at different time points. Connective tissue growth factor CTGF was used in both models to stimulate the antiinflammatory roles of TSCs. The researchers found that CTGF stimulation induced TSCs production of antiinflammatory cytokines consequently leading to improved tendon healing and matrix remodeling. Many would have predicted that tendon healing is inflammationlinked said Thoru Pederson Ph.D. EditorinChief of The FASEB Journal but that the antiinflammatory roles of TSCs could be so potent and so amplifiable is a striking finding. Submit to The FASEB Journal by visiting httpfasebj.msubmit.net and receive monthly highlights by signing up at http The FASEB Journal is published by the Federation of the American Societies for Experimental Biology FASEB. It is the worlds most cited biology journal according to the Institute for Scientific Information and has been recognized by the Special Libraries Association as one of the top most influential biomedical journals of the past century. FASEB is composed of societies with more than members making it the largest coalition of biomedical research associations in the United States. Our mission is to advance health and welfare by promoting progress and education in biological and biomedical sciences through service to our member societies and collaborative advocacy. Details Solaiman Tarafder Esther Chen Yena Jun Kristy Kao Kun Hee Sim Jungho Back Francis Y. Lee and Chang H. Lee. Tendon stemprogenitor cells regulate inflammation in tendon healing via JNK and STAT signaling. FASEB J. doi .fj.R http"

"The new drug sold as Xofluza is about as effective as Tamiflu in shortening flu symptoms and is expected to work against drugresistant strains. CreditGenentech via Associated Press the first new flu drug in years won approval Wednesday from the Food and Drug Administration. The new antiviral generically known as baloxavir marboxil but sold under the brand name Xofluza is a single dose treatment. It is for use only in those aged or more the F.D.A. said and should be taken only in the first two days after symptoms like fever aches and sniffles appear. The pill will cost according to a spokeswoman for Genentech which will sell Xofluza in this country. Genentech will offer coupons that lower the price to for patients with health insurance and to about for the uninsured. Flu season has already begun and last years was one of the most lethal in decades about Americans died of flu or its consequences https the Centers for Disease Control and Prevention said earlier this month. The new drug is no miracle cure and it is not approved for young children who are one of the most vulnerable groups so the C.D.C. still strongly recommends that every American over the age of six months get a flu shot as soon as possible. Advertisement Several other antiflu drugs exist the bestknown of which is oseltamivir sold as Tamiflu but none cure the illness quickly. Also the influenza virus mutates very rapidly and has split into many strains that circulate simultaneously each winter and several have evolved resistance to older drugs. Having safe and effective treatment alternatives is critical said Dr. Scott Gottlieb the F.D.A. commissioner in a statement https This novel drug provides an important additional treatment option. Like the Science Times page on Facebook. httpon.fb.mepaTQh Sign up for the Science Times newsletter. httpnyti.msMbHaRU Xofluza works in a new way by blocking an enzyme the virus needs to copy itself. So at least in theory circulating flu strains resistant to earlier drugs should not have any resistance to it. It has been shown to work against both A and B strains which circulate each year and it is expected to work against dangerous bird flus known to occasionally infect humans such as the A strains of both HN and A HN. Advertisement However it is virtually inevitable that resistance to Xofluza will evolve as more people use it. To prevent that doctors treat several diseases including H.I.V. and tuberculosis with cocktails of three or four different drugs but that is not the norm for flu treatment. Xofluza was invented by Shionogi a Japanese company that also created the statin Crestor. It does not cure a bout of flu as rapidly as for example antibiotics clear susceptible bacterial infections. But it may alleviate some symptoms and shorten the time that patients feel sick said Dr. Debra Birnkrant the F.D.A.s director of antiviral products. Xofluza was approved after two clinical trials in patients. In both trials those treated with it recovered more quickly than those who got a placebo. In one trial there was no difference between Xofluza and Tamiflu. Tamiflu which is sold by Roche Genentechs parent company is now available cheaply as a generic drug. It requires two pills a day for five days. Xofluzas most common side effects were diarrhea and bronchitis the F.D.A. said. Further research is underway to see whether it is safe and effective in children and whether it lowers rates of hospitalization and death. In June the F.D.A. granted Shionogi and Genentech priority review status https_trialsfdagrantspriorityreviewgenentechsbaloxavirmarboxilinfluenza.html expediting the approval process because it was considered an important drug. Sign up for Science Times Well bring you stories that capture the wonders of the human body nature and the cosmos. Donald G. McNeil Jr. is a science reporter covering epidemics and diseases of the worlds poor. He joined The Times in and has reported from countries."

"Research published today in Scientific Reports shows that light from RayVios nm ultraviolet UV LED is more efficient than sunlight at producing vitamin D in skin samples. Tyler Kalajian and his research team led by Dr. Michael F. Holick Ph.D. M.D. and supported by Boston University School of Medicine and a Boston University Ignition Award found that skin samples exposed to RayVios UV LED for just . minutes produced more than twice as much vitamin D as samples exposed to . minutes of sunlight. We tested ultraviolet LEDs from different sources and at different wavelengths. RayVios nm LED showed the most significant potential for vitamin D production in the shortest amount of time said Dr. Holick a Professor of Medicine Physiology and Biophysics at Boston University School of Medicine and endocrinologist at Boston Medical Center. This study will lead to a new generation of technology that can be labeled as photopharmacology in which the use of LEDs with targeted wavelengths can cause specific biologic effects in human skin to help treat and prevent chronic illnesses. Vitamin D deficiency is associated with osteoporosis rickets and other metabolic bone diseases and is more prevalent in northern and southern latitudes where sunlight is limited for a significant part of the year. This device for making vitamin D is ideally suited for patients with fat malabsorption syndromes including inflammatory bowel disease and gastric bypass surgery. The research shows that RayVios UV LEDs could be used for treating patients that are vitamin D deficient. A vitamin D producing UV LED device could be used on skin areas that experience less exposure to sunlight such as upper legs and arms and abdomen and back thus minimizing risk for developing nonmelanoma skin cancer. The UV LED device also emits a much narrower band of UVB light and thereby decreasing likelihood of skin damage that can occur when the skin is exposed to higher wavelengths of UV radiation. The potential of digital UV technology for phototherapy is enormous said Dr. Robert C. Walker RayVios CEO. Dr. Holicks research with our UVB LEDs demonstrates the potential for new applications that can potentially improve and save hundreds of thousands of lives. About Vitamin D Two forms of vitamin D are important to humans vitamin D produced by plants yeast and mushrooms and vitamin D produced by skin when exposed to sunlight or the appropriate wavelength of ultraviolet light. U.S. alone seventyfive percent of teens and adults are vitamin D deficient. Thanks to the work of the research team and the pioneering work of the Boston University Photonics Center on UV LEDs we may soon see innovative treatment options like simple integration with a wearable device could aid millions of people. Coauthors on the paper all from Boston University are T.A. Kalajian A. Aldoukhi A.J. Veronikis K. Persons and M.F. Holick."

"Stanford University scientists have described a new type of test that can detect genetic mutations in minute amounts of DNA released from cancer cells into the blood. The test which is called single color digital PCR requires only a fraction of a tube of blood and can detect as few as three mutationbearing molecules in a single reaction. According to the report httpdx.doi.org.j.jmoldx... in The Journal of Molecular Diagnostics httpjmd.amjpathol.org this highly sensitive test has the potential to be personalized to recognize mutations unique to any individual cancer. For monitoring patient tumors only a handful of blood tests are available which are limited to only several types of cancers. Nearly all cancer patients require monitoring by whole body imaging which can be costly complex and timeconsuming. In contrast molecular tests like the one we have developed will enable patients to be monitored at every visit and thus have the potential for quickly tracking cancer growth and spread. Moreover the tests rapid turnaround and relatively low cost especially compared to nextgeneration DNA sequencing provide a potential opportunity for universal monitoring of more patients than is currently done explained lead investigator Hanlee P. Ji MD Associate Professor in the Department of Medicine at Stanford University and Senior Associate Director of the Stanford Genome Technology Center. The report describes the use of the test to analyze samples from six patients. Five patients were previously diagnosed with colorectal cancer and one with cholangiocarcinoma. After generation of customized mutation detection assays the researchers were able to identify tumorderived circulating DNA from three out of six patients. In one patient the assay was able to show the presence of three different mutations. The three patients whose samples did not show elevated cancer DNA were undergoing active treatment at the time of collection. The singlecolor digital PCR test offers several advantages over other methods of circulating tumor DNA analysis compared to nextgeneration targeted sequencing and fluorescent probebased digital PCR assays. The main advantage is that the new technique does not rely on preamplification which can introduce errors and biases. This test is simple enough to set up and analyze without extensive training and therefore it can be implemented by anyone making it highly accessible to any laboratory. It has been truly motivating to work with a technology that will help transform the way that we monitor and treat individuals with cancer. I am excited to share our findings with the cancer research community noted lead author and researcher Christina Wood Bouwens of the Stanford Genome Technology Center and the Division of Oncology Department of Medicine Stanford University School of Medicine Stanford California."

"The most common sexually transmitted disease is often silent and invisible human papillomavirus http also called HPV. But in some people HPV leads to genital warts and cancers notably cervical cancer. The vaccines Gardasil and Cervarix were designed as a prevention for young women who have not yet been exposed to HPV. Men up to age are also eligible for Gardasil to protect against HPV. But there are a lot of people out there who still have HPV and nothing protects against all strains of the virus. At least half of all sexually active males and females have had HPV according to the Centers for Disease Control and Prevention http A Pennsylvania startup company called Inovio Pharmaceuticals has developed an experimental vaccine for people who already have HPV and precancerous lesions that are associated with it. A new study demonstrating the vaccines safety and potential effectiveness was published this week in the journal Science Translational Medicine httpstm.sciencemag.orgcontentra. The experimental vaccine does not use the live HPV virus it is formulated in synthetic DNA and pure water. It uses the immune system of the treated women to fight off cancer said Joseph Kim president and CEO of Inovio Pharmaceuticals and study coauthor. Worldwide cervical cancer is the second most common cancer after breast cancer with about new cases and deaths annually the study said. HPV causes about of cancers globally http Some women because of their particular genetic makeup can clear precancerous lesions on their own and would not need this vaccine. This happens in anywhere from to of women infected with HPV Kim said. No one knows why some women have this capability and others do not but for those who lack it the Inovio vaccine is giving our immune system a little boost Kim said. Eighteen women with highgrade precancerous cervical lesions participated in the phase study. Study authors say the vaccine is formulated to work against all cancers caused by HPV types and including cervical anogenital anal and genital and head and neck cancers. The researchers did not observe any side effects. In the next phase of this research women worldwide are participating but they are not included in these published results Kim said. The phase results are very early in the experimentation of this vaccine. The study was not done as a randomized controlled trial the gold standard for determining whether a drug works better than chance. Also people is a small number for examining the effects of a medication. Given those drawbacks its not appropriate to draw too many conclusions from this study says Dr. Diane Harper a prominent HPV researcher at the University of Missouri Kansas Citys School of Medicine. Harper contributed to the studies on both HPV vaccines that are currently available Cervarix and Gardasil and is not involved with this research. Several therapeutic vaccines have shown great promise in phase and then not panned out in phase she noted in an email. The vaccine consists of three injections in the arm over three months Kim said. The vaccine trains Tcells in the body to go after cervical cells with potentially cancerous genes embedded in them. Inovio is using this technology to develop vaccines for prostate cancer and HIV also Kim said. We certainly have a technology that can change the medical field by being able to program and generate strong immune responses that are specific and effective he said. Kim said the next phase results should be out at the end of then comes a larger phase trial with about patients to be concluded around or . HPV is spread through genital contact including oral sex httpthechart.blogs.cnn.comyesoralsexissexanditcanboostcancerrisk and partners can bounce the virus back and forth between them making it harder to clear naturally. Kissing is not known to deliver this STD."

"New research suggests that Opdivo a drug that works with the immune system to fight melanoma is more effective than the current standard of care for patients whove had surgery to remove advanced tumors. The international study was funded by Opdivos maker BristolMyers Squibb and included more than patients with stage III and stage IV melanoma. Patients were treated at medical centers across countries. All underwent surgery for their cancer before they began treatment with either Opdivo nivolumab or Yervoy ipilimumab the drug thats the current standard of care. Both drugs are immunotherapies which work by boosting the immune systems ability to spot and destroy tumor cells. After a year of treatment percent of patients in the Opdivo group were alive without any recurrence of the disease compared with percent of those treated with Yervoy. And at months the rate was percent for Opdivo and percent for Yervoy the findings showed. According to the Skin Cancer Foundation metastatic melanoma accounts for only about percent of skin cancer cases but causes the majority of skin cancer deaths. Our results demonstrate that Opdivo is more effective in treating patients with stage III and IV melanoma cutting the risk of relapse by a third lead researcher Dr. Jeffrey Weber professor of medicine at NYU School of Medicine said in a university news release. Results like this will change how we practice medicine. Hopefully physicians will embrace the use of Opdivo in these highrisk patients as adjuvant therapy added Weber who also helps direct NYUs Perlmutter Cancer Center in New York City. One cancer surgeon who reviewed the findings was impressed. Based on this study it appears that patients with advanced melanoma who have their disease completely removed by surgery should go on to receive additional therapy with Opdivo said Dr. Gary Deutsch. He is a surgical oncologist at Northwell Healths Imbert Cancer Center in Bay Shore N.Y. Not only did these patients have a better survival outcome at one year but they had only onethird the side effects compared to Yervoy Deutsch said. The study found that patients taking Opdivo had fewer severe side effects than those taking Yervoy at percent versus percent. Five percent of patients on Opdivo had to stop treatment due to side effects compared with percent of those on Yervoy. The most common side effects for both drugs were fatigue and diarrhea. Weber added that the safety of Opdivo is very promising. The study is scheduled for presentation Monday in Madrid Spain at the annual meeting of the European Society for Medical Oncology. It was also published online Sept. in the New England Journal of Medicine. Both Opdivo and Yervoy are already approved by the U.S. Food and Drug Administration to treat advanced metastatic melanoma. In some patients the drugs are used in combination. Dr. Michele Green is a dermatologist at Lenox Hill Hospital in New York City. She said any advance in the care of aggressive melanomas is welcome news for patients. It is amazing that there is now an alternative that is superior to conventional chemotherapy for advanced metastatic disease Green said after reviewing the new study findings. With these advanced melanomas that have high risks of recurrences and have poor outcomes it is vital to look at alternative treatments. The future in cancer treatments lies in immunotherapy and other targeted options. More information The U.S. National Cancer Institute has more on melanoma https SOURCES Gary B. Deutsch M.D. surgical oncologist Northwell Healths Imbert Cancer Center Bay Shore N.Y. Michele Green M.D. dermatologist Lenox Hill Hospital New York City NYU School of Medicine news release Sept."

"Shares of Evofem Biosciences Inc jumped as much as percent on Monday after its birth control gel showed effectiveness in a latestage study bringing the first hormonefree contraceptive close to approval. Male condoms and oral pills dominate the . billion contraceptive market in the United States. However oral pills cause side effects such as bleeding between periods mood swings and nausea in women. These results pave the way for Amphoras disruption of the contraception market as a novel highly effective nonhormonal and womancontrolled method that finally answers womens longawaited desire to avoid hormones Roth Capital Partners analyst Yasmeen Rahimi said. Evofems Amphora gel works by regulating vaginal pH within the normal range of . to . creating a hostile environment for sperm and certain viral and bacterial pathogens that can cause sexually transmitted diseases. An estimated . million women in the United States do not use any method of contraception according to the company on fear of side effects leaving them highly susceptible to unwanted pregnancies and sexually transmitted diseases. Amphora was found to have an percent efficacy rate in avoiding pregnancies and no serious sideeffects were observed in the study which evaluated about healthy women belonging to the age group years Evofem said. Condoms the most common nonhormonal method of contraception have an efficacy rate of percent. The rate stands at about percent for oral pills and intrauterine devices according to brokerage Roth Capital Partners. Our research and current understanding of women suggests the time is now for there to be a new nonhormonal category in contraception Chief Executive Saundra Pelletier said on a conference call with analysts. The companys shares were up . percent at . in midmorning trade after touching a high of .. Oppenheimer analyst Leland Gershell said he expects Amphora the companys lead product to bring in sales of up to million by . The company plans to resubmit the marketing application for Amphora in the second quarter next year and if approved plans to launch the product in January . Evofem is also testing Amphora as a preventive treatment for chlamydia and gonorrhea two of the worlds most common sexually transmitted infections."

"Two highly effective contraceptivesthe intrauterine device IUD and the implantactually last much longer than they are currently recommended according to new research. In a new study httpjournals.lww.comgreenjournalAbstractpublishaheadUse_of_the_Etonogestrel_Implant_and_Levonorgestrel..aspx published in the journal Obstetrics Gynecology researchers discovered that the hormonal IUD and the implant are highly effective a year after they are currently approved for use. MORE The IUD Answer Why The Best Form of Birth Control is the One No One Uses httptime.comthebestformofbirthcontrolistheonenooneisusing The researchers followed women who were using an implant like Implanon and Nexplanon and women using the Mirena hormonal IUD. The implants are currently approved for three years and the hormonal IUD used in the study is approved for five. There is also a nonhormonal IUD that is approved for years but it was not included in the current study. All the women were between the ages of and and their contraceptives were within six months of expiring before they enrolled in the study. The women were informed of the pregnancy risk associated with using their device longer than recommended and the researchers called them for followup every months for months or until the women had their device removed. By the end of the trial period none of the women using the implant were pregnant and there was one pregnancy among the women using the IUD. Still the failure rate was similar to the failure rate of the IUD when used during the fiveyear period which is under http The study is still ongoing and the researchers plan to recruit up to women and ultimately test whether the IUDs and implants were effective for up to three years after their current FDAapproved duration. The benefit of being able to use the implant and IUD for a longer period of time is that it could reduce costs for individuals and insurance. The longer use also makes the IUD and implant more convenient for women since maintenance is reduced. Though the data is preliminary the researchers say they believe that the hormonal IUD and the implant can both be used for an additional year longer than the FDA recommends. That doesnt mean you should extend your own use of the contraceptives without talking to your doctor. The study is still continuing and it could be quite a long time before any changes to clinical recommendations are considered."

"In November when he was just William Moller had his first epileptic seizure httphealth.nytimes.comhealthguidesdiseasegeneralizedtonicclonicseizureoverview.htmlinlinenytclassifier during a reading class at school. For about seconds he simply froze in place as if someone had pressed a pause button. He could not respond to his teacher. This is known as an absence seizure httphealth.nytimes.comhealthguidesdiseasepetitmalseizureoverview.htmlinlinenytclassifier and over the next year William now who lives with his family in Brooklyn went from having one or two a day to suffering constant seizures httphealth.nytimes.comhealthguidessymptomsseizuresoverview.htmlinlinenytclassifier. Not all were absence seizures others were frightening tonicclonics also known as grand mals during which he lost consciousness and convulsed. The seizures often came while he was eating. As his body went rigid William dropped his food and his eyes rolled back into their sockets. If he seized while standing he suddenly crashed to the ground in a corridor in the driveway on the stairs. Its the scariest thing for any mother to hear that thump and each time he would hit his head so it only made things worse and worse said his mother Elisa Moller a pediatric nurse. William is among the onethird of epilepsy httphealth.nytimes.comhealthguidesdiseaseepilepsyoverview.htmlinlinenytclassifier sufferers who do not respond or respond only poorly to antiepileptic medications. Now he and others with refractory epilepsy are benefiting from treatment that targets inflammation the result of new research into how epilepsy damages the brain. Many of us theorize that the two are tied inflammation causes seizures and seizures cause inflammation said Orrin Devinsky director of the Comprehensive Epilepsy Center at the New York University Langone Medical Center and Williams doctor. Over time both of them may feed off each other. About million people worldwide including more than . million people in the United States are struggling with epilepsy in some form. Half of all patients are children. Epilepsy can result from brain injury httphealth.nytimes.comhealthguidesinjuryheadinjuryoverview.htmlinlinenytclassifier but in most cases the cause is unknown and may be genetic. Refractory epilepsy its intractable form and the medications with which doctors attempt to treat it can cause lifelong problems with learning memory and behavior. An epileptic seizure occurs when large groups of neurons in the brain begin firing uncontrollably disrupting the balance of electrical activity and causing changes in mental function motor function and behavior. Its not known what sets off a seizure but lately scientists like Dr. Devinsky have been gathering evidence that inflammation the immune systems response to injuries or foreign organisms plays a pivotal role. Scientists have known since the s that inflammation is involved in a particularly vicious brain disorder called Rasmussens encephalitis httphealth.nytimes.comhealthguidesdiseaseencephalitisoverview.htmlinlinenytclassifier which starts seizures and usually affects children. Inflammation inflicts such severe damage to the brain that the standard treatment for the condition is hemispherectomy the surgical removal of one of the brains hemispheres. Some researchers also suspect an inflammatory link to another form of epilepsy infantile spasms because children with the disease respond to ACTH httphealth.nytimes.comhealthguidestestacthoverview.htmlinlinenytclassifier a hormone produced in the pituitary gland with strong antiinflammatory effects. Eleonora Aronica a neuropathologist at the University of Amsterdam has found signs of inflammation in autopsy specimens and surgical resections from patients with a wide range of epilepsies. Annamaria Vezzani a neuroscientist at the Mario Negri Institute for Pharmacological Research in Milan has induced epilepsy in mice and rats by injecting kainic acid into their brains and has observed the activation of a cellular pathway linked to inflammation before and during seizures. The amount of inflammation in the brain correlates with the frequency of seizures she also has found. This is a novel finding Dr. Vezzani said in an interview. It was not known that inflammation was a common feature of different types of epilepsy. Normal brain function is regulated by the glial cells which protect neurons and induce an inflammatory response httphealth.nytimes.comhealthguidesspecialtopicimmuneresponseoverview.htmlinlinenytclassifier if the brain is injured. But this response also can contribute to seizures some experts believe either because components of the immune system stimulate neurons or because the glial cells capacity to regulate the brain is diminished when they become distracted by an injury. As Dr. Devinsky noted seizures in turn may produce further inflammation perpetuating the cycle. Now Dr. Vezzani and colleagues are testing a molecule called VX that disrupts the inflammatory process she discovered. In one study high doses of the drug reduced the number of seizures by about twothirds in mice with treatmentresistant epilepsy. Sixty patients enrolled in a subsequent trial did not experience a statistically significant improvement after taking VX for six weeks but they did begin to experience fewer seizures at the end of the trial. Top of Form Bottom of Form Top of Form The drug is now the subject of a Phase trial involving patients. Antiinflammatory therapies could at least supplement and perhaps replace anticonvulsants said Dr. Jacqueline French a neurologist at the N.Y.U. Comprehensive Epilepsy Center who is leading the new trial. Replacing anticonvulsants is not merely an end in itself. Although they give many epileptics a better quality of life they do not affect the course of the disease only its symptoms. Researchers hope that antiinflammatories may help ameliorate epilepsys underlying causes. Giving a medication that could treat the epilepsy as opposed to treating the seizure would be absolutely novel Dr. French said. But there are dangers to this approach. Steroids potent antiinflammatories that some doctors are using for experimental treatments can have harmful longterm side effects. And it remains unclear whether inflammation might be implicated in all forms of epilepsy or which patients might benefit from antiinflammatory treatment. Like any new field theres a lot of enthusiasm and almost a bit of religion involved said Dr. Tallie Z. Baram an epilepsy expert at the University of California Irvine. The challenge for the next few years is to find out the limitations the boundaries the real mechanisms. Still whatever the role of inflammation in epilepsy Elisa Moller says that antiinflammatories were a miracle intervention for her son. At Williams worst point a night in July he had a seizure every time he fell asleep suffering grand mals between midnight and a.m. Dr. Devinsky had prescribed weekly doses of prednisone a steroid httptopics.nytimes.comtopnewshealthdiseasesconditionsandhealthtopicssteroidsindex.htmlinlinenytclassifier and in desperation Ms. Moller decided to administer a mega dose. I was taking his life into my hands I know she said. But the way I looked at it he was going to die anyway. Since that night William has not had another seizure. He continues with the steroids and also follows the ketogenic diet a highfat lowcarbohydrate regimen that has proved beneficial for many with intractable epilepsy. Steroids are the one thing I refuse to take him off of Ms. Moller said. The past year has been the best time of his life. Correction June An article on Tuesday about treatments for epilepsy that focus on the role of inflammation in the disease misidentified the drug regimen prescribed for William Moller a Brooklyn boy whose seizures abated with steroid therapy. Williams doctor prescribed weekly doses of prednisone in pill form not weekly injections of prednisone."

"Knee pain in active patients over is often difficult to treat but according to researchers presenting their work today at the American Orthopaedic Society for Sports Medicines AOSSM Annual Meeting in San Diego utilizing a special kind of allograft may be a step in the right direction. Our findings note that patients older than may benefit from using a fresh osteochondral allograft transplantation to treat focal cartilage defects a common cause of knee pain in adults said lead author Dennis Crawford MD PhD from the Oregon Health and Science University in Portland Oregon. Crawford and his colleagues looked at a total of patients broken into two groups. The study group consisted of patients women and men who were at least years of age and a control group with patients men and women who were years of age or younger. A statistically significant improvement for both groups was noted for the final followup for IKDC and all five KOOS subscores. Greatest changes were seen in the ability of patients to perform Sports and with improvement in healthful daily activity. Previous surgical treatment was performed on of knees in the study group and of the knees in the control group. This type of osteochondral allograft transplantation has traditionally been used in younger active patients with cartilage disorders. However seeing this type of success allows sports medicine physicians another option in older patients and serves as a predictable biologic joint preservation technique said Crawford. The American Orthopaedic Society for Sports Medicine AOSSM is the premier global sports medicine organization representing the interests of orthopaedic surgeons and other professionals who provide comprehensive health services for the care of athletes and active people of all ages and levels. We cultivate evidencebased knowledge provide extensive educational programming and promote emerging research that advances the science and practice of sports medicine. AOSSM is also a founding partner of the STOP Sports Injuries campaign to prevent overuse and traumatic injuries in kids."

"Results of a headtohead comparison study led by Johns Hopkins researchers show that noninvasive CT scans of the hearts vessels are far better at spotting clogged arteries that can trigger a heart attack http_healthheart_attack_P than the commonly prescribed exercise stress that most patients with chest pain undergo. A report on the findings comparing CT angiograms http_procedurescardiovascularcomputed_tomography_angiography_cta_ and stress tests http_diseaseselectrocardiogram_ekg_stress_test_holter_monitor_P published online Oct. in the journal Circulation Cardiovascular Imaging httpcircimaging.ahajournals.orgcontente.fullsidacecbbcadae show the scans correctly identified blockages in nine out of people while stress tests picked up blockages in six out of . What renders the results of the new study particularly powerful researchers say is that each patient underwent all three tests for providing a direct headtohead comparison of their ability to accurately spot blockages. No tests is percent accurate percent of the time but our findings indicate CT angiograms get pretty close to that coveted threshold says lead investigator Armin Zadeh M.D. Ph.D. http associate professor of medicine at the Johns Hopkins University School of Medicine. We hope our findings will settle any residual uncertainty about the effectiveness of these two common noninvasive heart tests. The researchers note that the gold standard for detecting blocked arteries remains invasive cardiac angiography a test using dye and Xrays http_P that requires a catheter to be threaded into the hearts vessels. But cardiologists have long relied on socalled stress testing as a simpler cheaper gatekeeper procedure to identify people more likely to benefit from the riskier more invasive and more costly catheterizations. CT angiograms have recently emerged as yet another noninvasive alternative. A handful of studies Zadeh says have suggested CT angiographies may be superior but uncertainty has persisted due the small number of people involved in these analyses and stress tests have remained the more popular choice among clinicians. Results of the new study the research team says should help settle lingering doubts among physicians and the nearly million Americans who seek medical attention each year for symptoms that signal a clogged artery including chest pain shortness of breath and extreme fatigue. In CT angiography clinicians use dye injected into the circulation to visualize blockages inside the arteries. When the dye reaches impenetrable or narrowed passages clogged by fatty buildups or clots the scan shows a blockage. The socalled nuclear exercise stress tests also use dye and CT scans but instead of directly visualizing the interior of the arteries they measure blood flow to the heart muscle immediately after a patient walks on a treadmill. Reduced blood flow to the heart muscle is a signal that a narrowed or blocked artery is not supplying the muscle with enough blood. Although exercise stress testing is generally safe for most people it can rarely trigger an abnormal heart rhythm or even an actual heart attack in people with seriously clogged arteries. Researchers emphasize that both nuclear stress tests and CT angiograms expose patients to radiation. While many newer CT scans deliver substantially lower doses of radiation than the scans used in nuclear stress tests the dose and protocols can vary widely from hospital to hospital researchers say. CT angiograms and nuclear stress tests carry similar price tags between and . Researchers say the total tab stemming from either test including downstream costs related to additional testing due to unclear or unrelated findings remains unclear and should be an important consideration in crafting any new testing recommendations. For the current study patients ages to seen at hospitals in eight countries underwent noninvasive CT angiograms followed by traditional catheterbased coronary angiographies. Within two months each patient also underwent an exercise stress test. All patients had symptoms suggestive of heart disease http_diseasescoronary_heart_disease_P but not all had a previous diagnosis of the condition. Overall noninvasive CT angiograms accurately detected or ruled out artery blockages in percent of patients compared with percent for stress testing. When researchers analyzed test performance in a subgroup of patients with very highrisk disease as identified on traditional angiography the diagnostic accuracy of CT angiograms went up to percent compared with percent for stress testing. In other words researchers report stress tests missed two out of every patients with severe disease marked by multiple blockages. Current guidelines from the American Heart Association and the American College Cardiology call for a stress tests in all patients who show signs of coronary artery disease to confirm the diagnosis and define the severity of the blockage. CT angiograms are generally reserved only for patients with borderline stress test results. But given its much higher accuracy the researchers say CT angiography may be a better firstline test in people with symptoms suggestive of a blocked artery. Other investigators from Johns Hopkins included Rodrigo Cerci Richard George Andrea Vavere Joo Lima Jeffrey Brinker https and Julie Miller. Other institutions involved in the research included Brigham and Womens Hospital Charit Hospital in Germany St. Lukes Hospital in Japan Beth Israel Deaconess Medical Center and the University of Sao Paulo in Brazil. The work was funded by the National Heart Lung and Blood Institute under grant number HL and by Toshiba Medical Systems manufacturer of the scanner used in the trials. Relevant disclosures Lima has received grant support from Toshiba Medical Systems."

"Child screams from the pain of earache exhausted parent ventures to drugstore in wee hours to findnothing. Eardrops dont work says Dr. Scott Morehouse founder of ClearPop because the Eustachian tube where the pain occurs is connected to the mouth not the outer ear. The beleaguered parent now drags hollering kid to the doctors office only to find the pediatrician reluctant to prescribe antibiotics. Since the American Academy of Pediatrics endorses a waitandsee approach seeking to let more earaches heal on their own without antibiotics. In light of this Morehouse developed a lollipop with a patented shape optimized to pull congestion out of the middle ear and into the mouth. ClearPop for Rapid Earache Relief has been shelved by Raleys CA NV select RiteAid locations and is available at boutique drugstores and Amazon. Moms have flooded https with glowing testimonials for this simple drugfree solution that doesnt require an ER or doctor visit. can be given along with analgesics or antibiotics. is increasingly used by frequent flyers to deal with ear pain that afflicts children disproportionately during air travel. is naturally flavored. is a delicious treat to a kid. CLINICAL TESTS Children diagnosed with Acute Otitis Media or ear infection consumed the xylitol and Vitamin Cbased product in pediatric offices. After minutes . reported their ear pain dramatically reduced or vanished. The earache episode was totally resolved for . Full study report at httpclearpop.com EAR INFECTION AND ANTIBIOTICS Ear infections are the Number One reason kids aged and under receive oral antibiotics. Due to increasing concern about antibiotic overuse and its links to obesity celiac disease and Superbugs the American Academy of Pediatrics now recommends against the use of antibiotics to treat routine ear infections in children over . ABOUT CLEARPOP ClearPop for Rapid Earache Relief represents a simple safe pediatrician recommended clinically effective and fun way to treat earaches. ClearPop is made by Try This First Inc. a physicianfunded small pharma organization aimed at reducing the estimated million antibiotics prescriptions written to children yearly for ear infection. Founder and Chairman Dr. Scott Morehouse scottclearpop.com mailtoscottclearpop.com Photo httpphotos.prnewswire.comprnh Logo httpphotos.prnewswire.comprnhLOGO SOURCE ClearPop Related Links http"

"As a particularly nasty flu season rages across the United States scientists have found a powerful new disinfectant that makes light work of the virus. Researchers say a certain spectrum of ultraviolet light called farUVC easily kills airborne flu viruses while posing no risk to people. It could offer a new inexpensive way to eliminate airborne flu viruses in indoor public spaces such as hospitals doctors offices schools airports and aircraft said the team from Columbia University Medical Center in New York City. The disinfecting success of initial experiments still need to be confirmed said lead research David Brenner. But he believes the use of overhead lowlevel farUVC light in public locations would be a safe and efficient method for limiting the transmission and spread of airbornemediated microbial diseases such as influenza and tuberculosis. As the researchers explained broadspectrum UVC light kills viruses and bacteria and it is currently used to decontaminate surgical equipment. But this type of light can cause skin cancer and cataracts so its not used in public spaces. However Brenner and his colleagues wondered if a much narrower spectrum of ultraviolet light farUVC might be a safer option. In prior studies they found that farUVC light killed methicillinresistant S. aureus MRSA bacteria a common and dangerous superbug without harming human or mouse skin. In this new study they found that farUVC light also killed airborne HN virus a common strain of flu virus. FarUVC light has a very limited range and cannot penetrate through the outer deadcell layer of human skin or the tear layer in the eye so its not a human health hazard said Brenner who directs Columbias Center for Radiological Research. However because viruses and bacteria are much smaller than human cells farUVC light can reach their DNA and kill them he said in a university news release. Lamps with this type of UV light currently cost less than Brenner said but that price would likely fall if the lamps were massproduced. And unlike flu vaccines farUVC is likely to be effective against all airborne microbes even newly emerging strains he said. Two flu experts were encouraged by the findings. The prospect of reducing the transmission of influenza and other respiratory viruses using farUV radiation is very exciting said Dr. Michael Grosso chief medical officer at Huntington Hospital in Huntington N.Y. Though handwashing remains critically important it does not prevent every instance of transmission Grosso said. Immunization and antiviral medications are also important but again have limitations. It appears that lowdose farUV light is safe and effective and has the advantage of inactivating a wide range of diseasecausing viruses. Dr. Len Horovitz a pulmonary specialist at Lenox Hill Hospital in New York City agreed. He noted that the technologys cost is not prohibitive and it is safe. This use can sterilize the air in a public space reducing the spread of respiratory droplets containing flu viruses and other bacteria and viruses. The findings were published online Feb. in the journal Scientific Reports. More information The U.S. Centers for Disease Control and Prevention has more on flu https SOURCES Michael Grosso M.D. chair pediatrics and chief medical officer Huntington Hospital N.Y. Len Horovitz M.D. pulmonary specialist Lenox Hill Hospital New York City Columbia University Medical Center news release Feb."

"Taking the pregnancy hormone estriol along with their conventional medications helped patients with relapsingremitting multiple sclerosis RRMS avoid relapses according to results of a Phase II randomized placebocontrolled study led by UCLA researchers. The study published online in Lancet Neurology was truly translational. The UCLA team took observations from the bedside tested them in the laboratory and took those findings back again to patients in clinical trials said the studys lead author Dr. Rhonda Voskuhl professor in the UCLA Department of Neurology and director of UCLAs Multiple Sclerosis Program. Its long been observed that during the second half of pregnancy women with RRMS have reduced relapses but the reason was unclear. It is also during this period that the fetal placenta produces estriol increasing the hormone levels in the blood. This protection during pregnancy occurs not only in MS but also in other autoimmune diseases such as psoriasis and rheumatoid arthritis. Voskuhl took this information to the lab. She hypothesized that increased estriol in the blood might play a role in suppressing a womans immune system so that the fetus is not rejected as being foreign having half of the fathers proteins. This temporary suppression of the immune system would be good for pregnant mothers with autoimmune diseases. Her team found that treatment with estriol was protective in the MS model. That led to a successful pilot clinical trial in at UCLA and then the Phase II trial launched in at UCLA and other sites across the United States. The beauty of estriol is that it is not a shot and can be taken in pill form and also that its not a new drug. It has decades of safety behind it said Voskuhl who holds the Jack H. Skirball Chair for Multiple Sclerosis in the UCLA Department of Neurology. Also current MS treatments are very complex to manufacture. These findings hopefully will pave the way for oral safe treatments that are more widely accessible since estriol is simple and naturally occurring. Multiple sclerosis is an autoimmune disease of the central nervous system where immune cells from the blood attack the tissue surrounding the brains nerve fibers. Called myelin this tissue is like the insulation wrapped around an electrical wire. When the myelin is damaged it interferes with the ability of the nerves to send signals to and from the brain resulting in symptoms including cognitive problems difficulty with walking poor vision and other disabilities. In RRMS there are clear episodes of inflammatory activity or relapses. During a relapse there are new or worsening symptoms accompanied by inflammatory lesions in the brain. A relapse can continue anywhere from several days to months. Relapses are usually followed by remission or improvement. However some residual symptoms may remain and after many years people with RRMS often transition to a progressive form of the disease. During the progressive phase there are no longer relapses but instead gradual worsening of permanent disabilities and loss of brain volume or atrophy. In the lab Voskuhl and her team discovered that estriol potentially provides a onetwo punch against the disease both reducing the ability of immune cells to attack the brain while also making brain cells more resistant to damage if any immune cells do make it through. Specifically they showed that estriol treatment improved cognition and prevented atrophy of the cognitive region of the brain. It seems that during pregnancy estriol can both suppress the immune system and protect the brain for not only is it important to avoid rejection of the fetus as foreign it is also critical to protect the developing fetal brain. While these two effects may be designed to protect the fetus they may also be exactly what the doctor ordered for women with MS. In Voskuhl completed the pilot study in which nonpregnant women with MS were given estriol yielding a greater than percent drop in inflammatory lesions in the brain within only six months of treatment. In the Phase II study researchers enrolled patients with allocated to the estriol group and to the placebo group. Both arms continued their conventional medication injectable glatiramer acetate. The team found that the patients taking estriol had a third to a half as many relapses compared to those taking the placebo with this improvement occurring over and above that provided by their conventional treatment. In addition when estriol levels were the highest there was improved cognitive function and less atrophy of the brain area related to cognition. The treatment was well tolerated during the two years the volunteers took estriol and the only significant side effect was irregular menstruation. To date there is no FDA approved treatment for MS that improves disabilities. These two trials are very unique in that neither were funded by a pharmaceutical company. Rather they were funded by the National Institutes of Health NIH and the National Multiple Sclerosis Society consistent with the new NIH policy that more research should focus on sex differences in disease. Additional major funding was from the Conrad N. Hilton Foundation whose mission it is to improve the lives of disadvantaged people throughout the world. Synthetic Biologics Inc. provided estriol and placebo for the multicenter trial and has licensed certain rights from UCLA. Going forward Voskuhl hopes to see a Phase III trial conducted to replicate these findings since this is necessary for FDA approval of estriol for MS. She continues to seek support to advance this as well as other MS research projects. It is estimated that more than . million people are affected by MS worldwide. Approximately percent of patients are diagnosed at onset with RRMS the most common form of MS. Story Source Materials https provided by University of California Los Angeles Health Sciences http Note Content may be edited for style and length. Journal Reference . Rhonda R Voskuhl HeJing Wang T C Jackson Wu Nancy L Sicotte Kunio Nakamura Florian Kurth Noriko Itoh Jenny Bardens Jacqueline T Bernard John R Corboy Anne H Cross Suhayl DhibJalbut Corey C Ford Elliot M Frohman Barbara Giesser Dina Jacobs Lloyd H Kasper Sharon Lynch Gareth Parry Michael K Racke Anthony T Reder John Rose Dean M Wingerchuk Allan J MacKenzieGraham Douglas L Arnold Chi Hong Tseng Robert Elashoff. Estriol combined with glatiramer acetate for women with relapsingremitting multiple sclerosis a randomised placebocontrolled phase trial. The Lancet Neurology DOI .S httpdx.doi.org.S"

"A stem cell therapy developed by Vericel Corp helped reduce deaths and hospitalizations in advanced heart failure patients according to data from a midstage study potentially providing a treatment that could delay the need for heart transplants. However the treatment failed to improve secondary goals of the trial such as heartpumping efficiency and sixminute walking distance and Vericel shares fell more than percent by afternoon trading on Monday. Its a little baffling that youre keeping patients alive but not having any effect on those secondary endpoints said Needham Co analyst Chad Messer. People were looking for downside and they had one. The data compared Vericels bone marrowderived ixmyelocelT stem cells with placebo in welltreated patients with advanced heart failure who had exhausted medical and device therapies. After one year the Vericel treatment led to a percent reduction versus placebo in a composite of adverse events including death heartrelated hospitalizations and unplanned clinic visits related to heart failure. Vericel last month reported that the study succeeded. Detailed results were unveiled on Monday at an American College of Cardiology meeting in Chicago and in the Lancet medical journal. The result was primarily driven by the difference in deaths of . percent in the placebo group or deaths compared with . percent or deaths for the ixmyelocelT group. In addition percent of stem cell patients required hospitalization versus percent for placebo. This is strong evidence in a welldesigned trial that we can decrease events said Dr. Timothy Henry the studys lead investigator and chief of cardiology at Cedars Sinai Heart Institute in Los Angeles. For patients this is a really hopeful thing. Henry who presented the data at the ACC meeting stressed the need for larger trials to prove the benefit of ixmyelocelT For the treatment bone marrow is taken from the patient and enhanced over two weeks to increase two types of cells associated with healing. They are then injected directly into the patients heart. With advanced heart failure a leading cause of hospitalizations bloodpumping ability is diminished as the hearts left ventricle becomes enlarged and weakened. If the disease worsens despite all available medicinal and interventional therapies the only options are heart transplant or a pumping assist device. The idea is to find a treatment for this group of people before they get to that stage Henry said. Vericel shares were down . or percent at . on Nasdaq. Editing by Bernadette Baum Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"When I was a kid my parents refused to let me drink coffee because they believed it would stunt my growth. It turns out of course that this is a myth http_rmoduleinline. Studies have failed again and again to show that coffee or caffeine consumption are related to reduced bone mass or how tall people are. Coffee has long had a reputation http as being unhealthy. But in almost every single respect that reputation is backward. The potential health benefits are surprisingly large. When I set out to look at the research on coffee and health I thought Id see it being associated with some good outcomes and some bad ones mirroring the contradictory reports you can often find in the news media. This didnt turn out to be the case. Just last year a systematic review and metaanalysis of studies looking at longterm consumption of coffee and the risk of cardiovascular disease was published httpcirc.ahajournals.orgcontent.long. The researchers found studies involving more than participants. The combined data showed that those who consumed a moderate amount of coffee about three to five cups a day were at the lowest risk for problems. Those who consumed five or more cups a day had no higher risk than those who consumed none. Of course everything Im saying here concerns coffee black coffee. I am not talking about the mostly milk and sugar coffeebased beverages that lots of people consume. These could include http_healthtworstcoffeedrinksamerica but arent limited to things like a McDonalds large mocha http_nutrition.mccafe..mccafemochalarge.html calories grams of fat grams of carbohydrates a Starbucks Venti White Chocolate Mocha http calories grams of fat grams of carbs and a Large Dunkin Donuts frozen caramel coffee Coolatta http_caramel.htmlDRP_DAIRYWholeMilkDRP_SIZELargeDRP_FLAVORCaramelDRP_BLENDFrozenCoffee calories grams of fat grams of carbs. I wont even mention the Cold Stone Creamery GottaHaveItSized Lotta Caramel Latte https calories grams of fat grams of carbs. Regular brewed coffee http has or fewer calories and no fat or carbohydrates. Back to the studies. Years earlier a metaanalysis a study of studies in which data are pooled and analyzed together was published looking at how coffee consumption might be associated with stroke httpaje.oxfordjournals.orgcontent.long. Eleven studies were found including almost participants. As with the prior studies consumption of two to six cups of coffee a day was associated with a lower risk of disease compared with those who drank none. Another metaanalysis published a year later http confirmed these findings. Rounding out concerns about the effect of coffee on your heart another metaanalysis examined how drinking coffee might be associated with heart failure httpcircheartfailure.ahajournals.orgcontent.long. Again moderate consumption was associated with a lower risk with the lowest risk among those who consumed four servings a day. Consumption had to get up to about cups a day before any bad associations were seen. No one is suggesting you drink more coffee for your health. But drinking moderate amounts of coffee is linked to lower rates of pretty much all cardiovascular disease contrary to what many might have heard about the dangers of coffee or caffeine. Even consumers on the very high end of the spectrum appear to have minimal if any ill effects. But lets not cherrypick. There are outcomes outside of heart health that matter. Many believe that coffee might be associated with an increased risk of cancer. Certainly individual studies httptheincidentaleconomist.comwordpresstheresareasoniusesystematicreviewsandmetaanalyses have found that to be the case and these are sometimes highlighted by the news media. But in the aggregate most of these negative outcomes disappear. A metaanalysis published in found that increasing coffee consumption by two cups a day was associated with a lower relative risk of liver cancer http by more than percent. Two more http recent studies http confirmed these findings. Results from metaanalyses looking at prostate cancer httponlinelibrary.wiley.comdoi.j.X...xabstract found that in the higherquality studies coffee consumption was not associated with negative outcomes httpannonc.oxfordjournals.orgcontent.long. The same http holds true httpjournals.plos.orgplosonearticleid.journal.pone. for breast cancer http where associations were statistically not significant. Its true that the data on lung cancer http shows an increased risk for more coffee consumed but thats only among people who smoke. Drinking coffee may be protective in those who dont. Regardless the authors of that study hedge their results and warn that they should be interpreted with caution because of the confounding and most likely overwhelming effects of smoking. A study looking at all cancers http suggested that it might be associated with reduced overall cancer incidence and that the more you drank the more protection was seen. Drinking coffee is associated with better laboratory values in those at risk for liver disease httponlinelibrary.wiley.comdoi.liv.abstract. In patients who already have liver disease its associated with a decreased progression to cirrhosis. In patients who already have cirrhosis its associated with a lower risk of death and a lower risk of developing liver cancer. Its associated with improved responses to antiviral therapy in patients with hepatitis C and better outcomes in patients with nonalcoholic fatty liver disease. The authors of the systematic review argue that daily coffee consumption should be encouraged httponlinelibrary.wiley.comdoi.liv.abstract in patients with chronic liver disease. The most recent metaanalyses on neurological disorders found that coffee intake was associated with lower risks of Parkinsons disease httponlinelibrary.wiley.comdoi.ggi.abstract lower cognitive decline httpadvances.nutrition.orgcontent.long and a potential protective effect against Alzheimers disease httpweb.a.ebscohost.comehostdetaildetailsiddfdffdaffebdaebsessionmgrvidhidbdataJnNpdGUZWhvcQtbGlZQdd but certainly no harm. A systematic review published in httpjama.jamanetwork.comarticle.aspxarticleid found that regular coffee consumption was associated with a significantly reduced risk of developing Type diabetes with the lowest relative risks about a third reduction seen in those who drank at least six or seven cups a day. The latest study published in httpcare.diabetesjournals.orgcontent.abstract used updated data and included studies and more than . million participants. Again the more coffee you drank the less likely you were to have diabetes. This included both caffeinated and decaffeinated coffee."

"How to treat patients who have microinvasive breast cancer tumors that are mm or less in size the thickness of a dime is somewhat controversial. Can these tiny tumors affect the lymph nodes and spread cancer to other areas of the body Physicians at the Virginia Piper Cancer Institute wanted to know if surgical procedures to test the lymph nodes for cancer were always necessary. They examined the outcomes of patients who were treated between and . Only . percent had positive lymph nodes indicating the rare possibility of metastatic cancer. And the only patients with positive lymph nodes had microinvasive tumors that were associated with relatively large noninvasive tumors ductal carcinoma in situ or DCIS. These findings allow surgeons to select which patients with microinvasive tumors may actually benefit from lymph node sampling while sparing other patients from this procedure said Tamera Lillemoe M.D pathologist and a study coauthor. The study funded by Engelsma Family Foundation and Abbott Northwestern Hospital Foundation was published recently in The Breast Journal the official journal of the National Consortium of Breast Cancers. About Virginia Piper Cancer Institute Abbott Northwestern Hospital The Virginia Piper Cancer Institute part of Allina Health provides comprehensive care through all aspects of cancer prevention early detection and treatment to help individuals maintain quality of life and find ways to live with and beyond cancer. The Institute was founded in at Abbott Northwestern Hospital. In addition to retaining its first place ranking for the best hospital in the Twin Cities and second in the State of Minnesota in the U.S. News World Reports best hospital rankings Abbott Northwestern has received nursing magnet certification a recognition earned by only five percent of hospitals nationwide. Allina Health is dedicated to the prevention and treatment of illness and enhancing the greater health of individuals families and communities throughout Minnesota and western Wisconsin. A notforprofit health care system Allina Health cares for patients from beginning to endoflife through its clinics hospitals retail pharmacies specialty care centers and specialty medical services home care home oxygen and medical equipment and emergency medical transportation services. For more information visit us at allinahealth.org httpallinahealth.org Facebook Twitter YouTube or Healthy Set Go."

"A new study from Australia may offer a new way of identifying people at risk of glaucoma https years before vision loss https happens. Glaucoma https is a leading cause of blindness. But because vision https damage often occurs gradually most people with the eye https disease do not realize they have it until a good deal of their sight has been lost. If caught early though there are medications https and procedures that may help treat glaucoma. In the study researchers were able to predict who was at increased risk of developing the eye https disease with some accuracy by measuring blood https vessel thickness in the retinas of study participants using a computerbased imaging tool. Those with the narrowest vessels at the beginning of the study were four times more likely to have developed glaucoma a decade later. Glaucoma a Vision Thief About million Americans and million people worldwide have glaucoma and the numbers are projected to rise over the next few decades as the population ages. The disease involves damage to the optic nerve which relays images from the retina to the brain https Early detection is key but without regular eye exams https most people dont know they have a problem says ophthalmologist Andrew Iwach MD. He is the executive director of the Glaucoma Center of San Francisco and an associate clinical professor of opthalmology at the University of California San Francisco. We call this disease a thief of vision https because most people with it have no idea that they have lost sight until it is too late to bring it back Iwach says. Vessel Narrowing Predicted Glaucoma In the study researchers from the University of Sydney followed nearly adults aged and older for years. None of the participants had glaucoma when they entered the study. Compared with the group as a whole those people who were diagnosed with the eye https disease during the following decade were older had higher blood pressure https and were more likely to be female. The researchers concluded that measuring retinalvessel narrowing could help identify people at risk for glaucoma. But they added that blood pressure and other factors that can contribute to vessel size would need to be considered. The study appears in the latest issue of the journal Ophthalmology. Exams Key by Age The researchers say that the findings also highlight the importance of having regular eye exams https as people age. The American Optometric Association recommends eye exams https for adults aged to every two years every year for adults and older or as recommended by their eye doctor. In addition to glaucoma regular exams can detect other eye diseases associated with aging including macular degeneration https and cataracts https Iwach says. Eye surgeon Mark Fromer MD of Lenox Hill Hospital in New York City agrees that having regular eye exams https is the best protection against vision loss https associated with aging. It remains to be seen if this approach will help us identify people at risk for glaucoma sooner he says. We have a number of tools now to help us do that but weve got to get people in our offices to use them."

"When taken as a supplement unroasted or green coffeebean extract can help people shed pounds according to a small preliminary study. The research which is being presented this week at the national meeting of the American Chemical Society in San Diego involved just overweight and obese patients who were given daily doses of green coffee extract in capsule form. All the patients were instructed to maintain their usual dietary habits while the study team monitored them for weight loss over a period of nearly six months. The apparent result Daily consumption of a small amount of green coffee extract translated into a nearly percent drop in body weight on average. The study was conducted in India and funded by Applied Food Sciences the American manufacturer of two greencoffeeextract products. It has not been published in a journal and therefore has yet to undergo peer review. Supplements of this kind however are not subject to the rigorous U.S. Food and Drug Administration safety and efficacy testing typically applied to all pharmaceutical medications. This was indeed a small study acknowledged corresponding study author Joe Vinson a professor of chemistry at the University of Scranton in Pennsylvania but he noted that prior research has been conducted in both France and Japan. Those studies demonstrated that patients experienced somewhat mild weight loss. But here with higher extract doses than have been used before the patients experienced what I would call rather large weight loss. While this of course needs to be confirmed with followup I do think the subject is absolutely worthy of further exploration Vinson added. Vinson said his team was not focused on the weightloss impact of caffeine as much as that of unprocessed unroasted coffees primary ingredient chlorogenic acid. Thats the main natural compound in unroasted coffee and roasted coffee has much much less of it than unprocessed coffee Vinson said. So were not talking about something that is interchangeable with the coffee we drink which is produced by roasting beans at a temperature between and degrees Fahrenheit. Green coffeebean extracts are sold online at prices ranging from about to for capsules. The study was broken into three sixweek sections. In one section study participants who were all between the ages of and consumed a capsule filled with milligrams of green coffee extract. In the second section participants took a milligram capsule. The third section had participants taking a placebo. Each patient ultimately cycled through each section. While maintaining their prestudy dietary and exercise regimens the patients lost an average of pounds by the studys close. On average patients lost . percent and percent of their body weight and body fat respectively. Basically there was steady weight loss without side effects while the active green coffee extract was being taken at either dose Vinson said. A followup study involving patients is now in the planning stages. Lona Sandon a registered dietitian and assistant professor of clinical nutrition at the University of Texas Southwestern in Dallas cautioned that the study is short on specifics making it difficult to draw any conclusions. First of all you need more than people to have any statistical significance attached to these findings Sandon said. And we really have no idea how this might be working. For example the patients were allowed to continue with their regular diet. But did this extract in any way influence their hunger and what they wanted to eat and then what they actually ate We dont know. What we have here is basically just a hypothesis that theres something about this compound that could be helpful. Just because it might cause weight loss doesnt mean its healthy she warned. Because supplements are not regulated as drugs they can be put on the market with no safety or efficacy testing. They dont even necessarily have to be tested for purity. That means that in the past various weightloss supplements have been found to contain weightloss drugs or other drugs at higher doses than what would be allowed in a prescription dose Sandon added. So while people might have this perception that its all natural since its coming from a coffee bean with supplements in general its still a buyerbeware market."

"More than years after the gene behind cystic fibrosis http_Genomeposterschromosomecftr.shtml was identified a pill that could fix the problem in some people is getting closer to reality. The experimental medicine taken twice a day goes by the code name VX. Now there are some promising results from a study httpclinicaltrials.govctshowNCTtermvxrank in people with a specific genetic mutation that affects about four percent of cystic fibrosis patients. Lung function got percentage points better on average in people who got the drug compared with those taking a placebo. The improvement at six months was still present almost a year after the studys start. That much improvement is a big deal for CF patients Robert Beall http president of the Cystic Fibrosis Foundation told Shots. It is larger than any other clinical intervention weve ever had in cystic fibrosis. Beall said there were no significant side effects. The foundation has championed the development of drugs including VX and has provided million to Vertex http to get the medicine this far. If the drug makes it to market the foundation will receive royalties from sales. This pill for people with the GD mutation http of the cystic fibrosis gene helps a defective protein in cell membranes httpghr.nlm.nih.govgeneCFTR do a better job moving things around. Lisa Jarvis has more details httpcenblog.orgthehaystackvertexunveilsexcitingdataforcysticfibrosisdrug on that at the Haystack blog. But a key takeaway is that the medicine gets at a root cause of cystic fibrosis in some people rather than just relieving their symptoms. Article continues after this message from our sponsor Now to be perfectly clear all we know about the latest data is from press releases. And the drug hasnt been submitted for review by the Food and Drug Administration though Vertex expects to do that later this year. But these results even with plenty of caveats suggest the drug is on the right track. Vertexs shares jumped percent Wednesday as investors figured VX looks even better than theyd expected. Wow wrote Dr. Mark Schoenebaum http a biotech and drug analyst ISI Group in a note to investors. The effectiveness of VX looks best case he wrote. Ultimately the drug might be used by around patients worldwide if approved and Schoenebaum expects it would be command a very high price perhaps a year."

"People who take drugs called bisphosphonates to prevent bone loss may also reduce their risk of developing colorectal cancer by almost percent compared to those not on the drugs a new study suggests. Bisphosphonates include such common drugs as Fosamax alendronate Boniva ibandronate Actonel risedronate and Reclast zoledronic acid. These drugs work by increasing bone thickness thereby reducing the risk of fractures the researchers said. In prior studies bisphosphonates have already been shown to be associated with a reduced odds for breast cancer. These new findings are meaningful because they point to a possible protective effect of this class of drugs being relevant to prevention of many different cancers said lead researcher Dr. Gad Rennert from the TechnionIsrael Institute of Technology Faculty of Medicine and chairman of the department of community medicine and epidemiology at the Carmel Medical Center of Clalit Health Services in Haifa Israel. This is similar to the effect that we and others have shown for cholesterollowering statins he said noting that bisphosphonates and statins share the same metabolic pathway. The results of the U.S. National Cancer Institutesupported study are published in the Feb. issue of the Journal of Clinical Oncology. For the study Rennerts team collected data on almost postmenopausal women who took part in the Molecular Epidemiology of Colorectal Cancer study which is a populationbased trial in northern Israel. The researchers found that taking bisphosphonates mostly Fosamax for at least a year was associated with a significant percent reduction in relative risk for colorectal cancer. The magnitude of the reduced risk is less important because this is an association study however it is very significant after controlling for a dozen other known risk factors Rennert said. They took into account factors such as family history ethnic background diet physical activity weight vitamin D consumption and the use of other drugs such as aspirin statins and hormone replacement therapy. The findings in this study show that bisphosphonates are associated with a reduced risk of developing colorectal cancer but they cannot confirm a causal effect that is the study doesnt prove that the use of bisphosphonates is responsible for the lower risk of colorectal cancer. However the lowered risk of colorectal cancer seen with bisphosphonates may be due to the way the drug acts in the body which is similar to how cholesterollowering drugs called statins work according to Rennert. These same researchers also found in another study that statin use also reduced the risk of colorectal cancer he noted. We also found a similar effect last year with risk of breast cancer which has already been replicated by three other groups Rennert added. A randomized trial is need to prove that bisphosphonates are protective against colorectal cancer Rennert said. It should be relatively easy as it seems that all that is needed is a year of treatment to see the effect he said. The researchers noted however that the risks of using bisphosphonates include the possibility in rare cases of osteonecrosis of the jaw destruction of the jawbone or jaw tissue. Bisphosphonates used for osteoporosis have also been linked to a rare fracture of the thigh according to the U.S. Food and Drug Administration. The adverse effects profile is of major importance if bisphosphonates are going to be recommended for cancer prevention in healthy people the study authors cautioned. Commenting on the study Eric Jacobs Strategic Director of Pharmacoepidemiology at the American Cancer Society said that the lower risk of colorectal cancer risk seen among bisphosphonate users in this study is intriguing. However these results should be interpreted with caution and require confirmation by additional studies he said. Results from the only other study of bisphosphonate use and colorectal cancer a recent large study from the United Kingdom do not support an important protective effect Jacobs noted. Fortunately there are other proven ways to help lower risk of colorectal cancer he said. In particular all Americans or older should get a screening test so that precancerous polyps can be detected and removed before they turn into cancer. More information For more information on colon cancer visit the American Cancer Society http SOURCES Gad Rennert M.D. Ph.D. TechnionIsrael Institute of Technology Faculty of Medicine chairman Department of Community Medicine and Epidemiology Carmel Medical Center of Clalit Health Services Haifa Israel Eric Jacobs Ph.D. Strategic Director of Pharmacoepidemiology American Cancer Society Feb. Journal of Clinical Oncology"

"Thirty percent of Americans https say theyre trying to reduce or eliminate gluten in their diets. But only about percent of the population has an autoimmune response to gluten. Somewhere in that gap a diet fad is thriving. There are two groups of people who should definitely avoid gluten those diagnosed with wheat allergies and those who have celiac disease. The latter is more common affecting about percent of the population. The former affects perhaps . percent of people http and is more common in children who often grow out of it. What is less clear is whether there is another group of individuals whose digestive systems have some gluten sensitivity and who would therefore benefit from avoiding gluten. The people who think theyre sensitive to gluten are filling the gap between those who should avoid gluten and those who are doing it anyway. But how many people really are sensitivehttpsfivethirtyeight.comfeaturesitshardtoknowwhereglutensensitivitystopsandtheplaceboeffectbegins Gluten for those of you who have not kept up with dietary fads is a component of wheat. You eat it in bread pasta pizza and so on. Glutenavoiders are helped by an increasing array of glutenfree breads pastas and other products. Entire aisles of Whole Foods Market stores appear to be devoted to this trend. Despite the growing availability of alternative products avoiding gluten can be a challenge. The satisfying slightly chewy texture of bread requires gluten. For those of us who care about our health but lets face it like a nice baguette it seems worth asking Is there any actual health benefit to gluten avoidance The earliest report on whether gluten could muck with some digestive tracts comes from the late s http Two authors reported on a woman in her early s who was experiencing significant gastrointestinal distress bloating gas diarrhea constipation etc. and did not have celiac disease or a wheat allergy. After being put on a glutenfree diet she improved immediately. When gluten was reintroduced to her diet as a test the symptoms returned only to disappear when the gluten was again removed. The authors diagnosed the woman with what they termed nonceliac gluten sensitivity NCGS. Gluten sensitivity fell off the radar for many years but researchers have returned to it http and adopted the same term. In contrast to celiac disease or a wheat allergy NCGS is not diagnosed through direct testing. Rather it refers to a condition in which someone experiences some problematic gastrointestinal symptoms that resolve when gluten is avoided. Gastrointestinal symptoms are the hallmark of NCGS although some people also complain of fatigue or a foggy head. Of course its difficult to distinguish between someone who is sensitive to gluten and someone who is sensitive to the placebo effect. Since there is no test for gluten sensitivity diagnoses are based on whether people say they feel better when they avoid gluten. But the mind is a powerful thing. If you think avoiding gluten will make you feel better there is a reasonable chance that it will even if gluten is irrelevant. This effect makes it hard to test for gluten sensitivities even in a randomized controlled trial. If a researcher enrolls people in a standard randomized controlled trial and has some participants eat bread and some not those who avoid bread may feel better simply because they think they should. The placebo effect may lead a researcher to falsely conclude that avoiding bread is beneficial. But thats not enough. To really get a sense of whether gluten sensitivity is a thing researchers need to conduct a doubleblind randomized controlled trial in which one group eats gluten another does not and no one knows which group they are in. That means putting everyone on a glutenfree diet and then directly supplementing some people with gluten protein and others with something that seems similar but has no gluten. There have been two small studies like this. They were run by the same team. And unfortunately for our ability to draw conclusions they find different results. The first of these http published in followed people for up to six weeks. The study population was made up of people who complained of gastrointestinal symptoms consistent with NCGS. Everyone participating in the study was on a glutenfree diet. Half had their diet supplemented with a regular muffin and regular bread the other half received a glutenfree muffin and glutenfree bread. The authors found that percent of patients on the entirely glutenfree diet reported a continuation of symptoms compared with percent of those who had consumed gluten. The groups also differed on such measures as satisfaction with stool consistency a phrase that I honestly never thought I would write. The second study http published in had a similar set up people complaining of gastrointestinal problems randomized into highgluten lowgluten and nogluten groups. This time rather than using bread and muffins the authors used gluten and whey protein supplements. They found no difference in symptoms among the groups. Why the results of these studies differ is unclear. One possibility is that some participants in the first study guessed which group they were in based on the muffin and bread and therefore the placebo effect became pronounced. Another possibility is simply that given how small the studies were the differences occurred by chance. Regardless of the reason we are left with little convincing evidence that gluten avoidance matters. But lets say you take heart in the first of these studies and now believe that avoiding gluten will make some people feel better even though they dont have an allergy or celiac disease. How many people Estimates of prevalence of NCGS are based more or less on information on gluten avoidance http In the National Health and Nutrition Examination Survey http about . percent of people without celiac disease or an allergy say their diet is glutenfree. And in a large Italian study http of people who complain of gastrointestinal problems the authors conclude that NCGS is slightly more common than celiac disease putting it at a prevalence of a bit above percent of the population. For those of you keeping track at home that means that while percent of Americans are trying to cut gluten from their diet probably at most only percent of Americans may have NCGS. If you dont have celiac disease or a wheat allergy and are experiencing distressing gastrointestinal symptoms after eating gluten lack of satisfaction with your stool consistency for example there is something like a in chance that the gluten is potentially responsible. If you cut out gluten and it makes you feel better great. Although it may all be in your head. If you are cutting out gluten for any other reason all that will happen is youll feel the same but without the pleasure of bread that tastes like bread. CORRECTION Feb. a.m. An earlier version of this article incorrectly state that it is hard to test for gluten allergies. Its hard to test for gluten sensitivities. The previous version also misstated the probability that gluten is responsible for gastrointestinal distress for those who experience gastrointestinal distress after consuming gluten and who dont have celiac disease or a wheat allergy. The probability is in not in ."

"A leukemia drug might also effectively treat severe asthma a smallscale clinical trial suggests. Gleevec imatinib reduced the twitchiness of airways making them less likely to reflexively constrict when exposed to an allergen or asthma trigger said senior researcher Dr. Elliot Israel. We showed we could decrease the amount of airway twitchiness by a third Israel said. Thats a substantial change and that was significant compared with the placebo group. Israel is director of the respiratory therapy department at Brigham and Womens Hospital in Boston. The drug also improved overall airway function an effect researchers hadnt expected Israel said. People whose severe asthma isnt controlled despite use of highdose steroid medications are at risk of declining lung function and poor quality of life the researchers said in background notes. But this powerful cancer drug cant be recommended for them on the basis of this small study Israel and other specialists noted. Gleevec fights leukemia by blocking a specific receptor on cancerous white blood cells inhibiting their ability to multiply and spread Israel said. That same action also affects mast cells a type of white blood cell distributed throughout the body that promotes inflammation and causes allergic reactions Israel said. For example mast cells in the skin are responsible for hives while mast cells in the lungs have been associated with severe asthma he said. By blocking the signal that helps keep mast cells alive we were hoping to reduce the number of these cells Israel said. By doing that we hoped to produce improvements beyond the maximal therapy that these patients with severe asthma are on. Israel and his colleagues recruited severe asthma sufferers for the study. All received topnotch asthma treatment and were randomly assigned to take either Gleevec or a placebo pill once daily during the month trial. Blood tests showed that Gleevec did reduce mast cell activity in patients Israel said. Further allergy challenge tests showed a decrease in airway reactivity among patients taking Gleevec the researchers reported. Airways became less likely to close off after exposure to an allergen. Physical examinations showed that people taking Gleevec actually experienced a slight overall widening of their airways Israel added. There was a small but significant improvement in the airway narrowing in these patients which we didnt expect because we didnt think the mast cells were necessarily promoting that airway narrowing all the time Israel said. Sideeffects were not as severe as expected he added. One person dropped out because of a sharp decline in white blood cells which bounced back after the drug was discontinued. Another person dropped out because of leg cramps associated with the drug. All in all we were expecting a significantly greater pattern of sideeffects and we didnt see it Israel explained. According to Dr. Len Horovitz a pulmonary specialist with Lenox Hill Hospital in New York City This drug represents a new mechanism for the immune modulation of severe asthma. Horovitz was not involved with the study. It has been a while since a new approach and treatment for severe asthma has emerged Horovitz said. Further studies will be needed to assess its utility in moderate asthma. Pulmonologist Dr. Theodore Maniatis is medical director of Staten Island University Hospital in New York City. He sounded a more cautionary note. This is a very early work that in no way should encourage asthmatics Maniatis said. While it is a very interesting study for pulmonologists and immunologists it is a very small study. Until now this immunemodulating drug has been used only for cancer and is toxic he added. It will take years of study to determine the usefulness of this drug in treatment. Israel agreed that further clinical trials are needed. Before you go out and recommend this be used in general you really want to repeat this in a larger population with greater numbers he said. It likely will be three to four years before Gleevec could be approved for asthma treatment Israel estimated. If proven effective Gleevec might provide a relatively inexpensive new treatment for asthma patients. Two generic versions of the drug were launched last year which could make it less pricey than newwave asthma drugs headed for the market Israel added. The study was published May in the New England Journal of Medicine. More information For more on asthma visit the U.S. National Heart Lung and Blood Institute https SOURCES Elliot Israel M.D. director respiratory therapy department and director clinical research pulmonary and critical care medicine division Brigham and Womens Hospital Boston Len Horovitz M.D. pulmonary specialist Lenox Hill Hospital New York City Theodore Maniatis M.D. medical director Staten Island University Hospital New York City May New England Journal of Medicine"

"A surprising but welcome side effect of a therapy for obsessivecompulsive disorder may pave the way for a new approach to treating type diabetes and offer new insights into the links between obesity and the metabolic disease that afflicts close to in American adults. The therapy in question is deep brain stimulation of the nucleus accumbens https a structure best known for its role in motivation reward and addiction. It now appears that deep brain stimulation also increases the livers and muscles ability to take up and use insulin researchers reported this week. Thats important because the ability to use insulin effectively is compromised in most people with obesity and seriously impaired in those with type diabetes. This curious side effect of deep brain stimulation became clear after an obese man with diabetes who had suffered the repetitive thoughts and behaviors of OCD was treated for the psychiatric condition with a device that delivers electrical impulses into the brain. Once the device was implanted and turned on it prompted the release of the neurotransmitter dopamine https throughout the ventral striatum in which the nucleus accumbens sits. In short order the patient noticed that his blood sugar control improved and his daily need for insulin injections decreased by roughly . The new study httpstm.sciencemag.org appeared this week in the journal Science Translational Medicine. The research is likely to generate renewed interest in understanding the addictive powers of food for some people and whether the brain processes behind that addiction also make people with obesity more vulnerable to diabetes depression heart disease and even some cancers. The connection between brain and metabolism is only partially understood said Dr. Miguel AlonsoAlonso httpsmbb.harvard.edupeoplemiguelalonsoalonsomdphd who directs Harvard Universitys Mind Brain Behavior Interfaculty Initiative. httpsmbb.harvard.edu Most research to date has focused on the hormonal influence of the hypothalamus a structure adjoining the ventral striatum on basic bodily functions he added. This is a new and exciting direction with the involvement of the striatum a key reward center AlonsoAlonso said. At the same time he cautioned that we first need to establish the nature of this association understand its magnitude and its clinical relevance before these early findings could be considered the basis for treatment. That a single patients metabolic function improved after he got a pacemaker in the brain might have met with a shrug anywhere else. But to the Dutch authors of the new research it was a clue that warranted further investigation. To explore the brains role in metabolism more rigorously the researchers led by Kasper W. ter Horst of the University of Amsterdams Academic Medical Center recruited patients who also had had a brain stimulator implanted at the edge of the nucleus accumbens as treatment for OCD. None of the subjects recruited had type diabetes. But even healthy people vary daily and hourly in the ability of fat liver and muscles to take up insulin from the bloodstream and use it to convert food to energy. This measure of metabolic health is called insulin sensitivity and it is one of many metabolic functions that goes awry in people with obesity. In those who develop type diabetes sensitivity to insulin becomes so impaired that the body is tricked into believing less insulin is needed and it pares back its production. The insulinproducing cells in the pancreas will often atrophy and die in response. As a persons insulin production declines an external supply of insulin is needed to control blood sugar and deliver fuel to muscles and organs. As the researchers turned the subjects brain stimulators on and off they could see the subjects insulin sensitivity rise and fall. Metabolic function was better when their brain stimulators were turned on than when the devices were silenced. The Dutch team ruled out that the performance improvement came from changes in other hormones that can affect metabolism such as cortisol https epinephrine https and norepinephrine. https The action of dopamine in the nucleus accumbens appeared to be effecting the changes. The researchers also gleaned a potentially important insight about how obesity may lead to worsening metabolic function The effect of the deep brain stimulation appeared to be greater in the seven research subjects who were lean than it was in the seven who were either overweight or obese. Since longterm obesity is linked to changes in the striatal dopamine system the differing responses of lean and overweight subjects suggest that those changes may start the ball rolling toward development of type diabetes.. In a further experimental group of healthy humans the researchers found that using drugs to reduce dopamine levels across the body generated the opposite response decreasing insulin sensitivity. In mice too the researchers explored the role of the dopaminefueled neurons of the nucleus accumbens. Using a technique called optogenetics they bred mice with certain brain cells that could be activated when light of a particular frequency is shined on them. Light stimulation of the dopamineexpressing neurons in the brains of mice was sufficient to improve glucose tolerance and improve insulin sensitivity the authors reported. That suggests a key role for striatal neuronal activity in the central regulation of metabolism they added. The emerging data suggest that the brain may play a much more active and complex role in the regulation of metabolism than we usually believe said AlonsoAlonso who has explored the brains role in metabolism by using a less invasive means of activation called transcranial magnetic stimulation. https This makes sense because at the end metabolic needs should align well with the overall state of the individual he said. It stands to reason that theres crosstalk among key physiological functions an individuals cognitive mental and social states and situational circumstances he added. I think there are real good opportunities here for this integrative research we need to learn more about this connection AlonsoAlonso said."

"The inexpensive tests that look for hidden blood in a persons stool are effective for colon cancer screening a study out Tuesday confirms. The findings reported in the Canadian Medical Association Journal give some extra weight to fecal occult blood testing FOBT as a valid option for early detection of colon cancer. Experts generally recommend that people at average risk of colon cancer start screening tests for the disease at age . And they can pick from a number of tests that have all been found to cut the risk of dying from colon cancer. Along with stool tests done once a year at home the choices include two invasive procedures colonoscopy done every years and flexible sigmoidoscopy done every five years. The U.S. Preventive Services Task Force a federally supported expert panel recommends that people at average risk of colon cancer choose any of the three methods. FOBT detects hidden blood in the stool which can be a sign of colon cancer or precancerous growths called polyps. Positive results on the screen prompt a followup colonoscopy to investigate the source of the blood. Advances in the stool tests in recent years have made them more effective. A newer version called immunochemical FOBT iFOBT is supposed to zero in on colon growths better than an older version known as guaiac FOBT which often picked up bleeding originating in the upper digestive tract such as from a stomach ulcer. Immunochemical FOBT is now largely replacing the older test. But theres been surprisingly little evidence that it really is highly specific to colon cancer according to Dr. YiChia Lee of National Taiwan University Hospital one of the researchers on the new study. So for their study the researchers followed nearly adults who all volunteered to have iFOBT a colonoscopy and an upper endoscopy to check for problems in the upper digestive tract. They found that of people confirmed to have colon tumors after a colonoscopy all but one had also a positive iFOBT result. It means that almost every case with colon cancer can be identified by iFOBT Lee told Reuters Health in an email. It is a strong support to iFOBT as an effective screening tool. The researchers also found that iFOBT had specificity for colon cancer of close to percent meaning the test would accurately give a negative result to almost percent of people who did not have colon cancer. Of three study participants who were found to have cancers of the stomach or esophagus for instance none had a positive result on the iFOBT test. Like any screening test iFOBT does have a risk of falsepositive results which leads to unnecessary invasive testing in some people. In this study about percent of all participants had a falsepositive finding on the stool test. Among the risk factors for falsepositives the authors identified were the use of anticlotting drugs and low levels of the ironrich molecule hemoglobin in the blood. In practice a positive iFOBT result would be followed by colonoscopy in which a scope is used to investigate the interior of the colon. Whether used for firstline screening or as a followup colonoscopy has the advantage of allowing doctors to spot and remove precancerous growths called polyps which means the test can prevent cases of colon cancer. But as far as cutting the risk of death from colon cancer stool testing is similarly effective according to the U.S. Preventive Services Task Force. And its much cheaper iFOBT is more expensive than the older stool tests but it is still roughly . A screening colonoscopy averages around . The downside of iFOBT being specific to colon tumors is that it is not useful for catching cancers of the stomach or throat. Thats particularly important in Asia where those cancers are common. Lee said researchers there are looking into whether combining iFOBT with the older guaiac test is useful for catching cancers in the lower and upper digestive tract and whether adding a third stool test which looks for the ulcercausing bacteria H. pylori can help as well. Infection with H. pylori is associated with increased risks of stomach and throat cancers. In the U.S. cancers of the upper digestive tract are relatively uncommon. The average American has a one in chance of developing esophageal cancer while the risk of stomach cancer is one in . In contrast Americans lifetime risk of colon cancer is about one in according to the American Cancer Society. More than Americans died of the disease in . SOURCE bit.lymUOj httpbit.lymUOj Canadian Medical Association Journal online August . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Energy drinks are the fastestgrowing part of the beverage industry with sales in the United States reaching more than billion in more than Americans spent on iced tea or sports beverages like Gatorade. Their rising popularity represents a generational shift in what people drink and reflects a successful campaign to convince consumers particularly teenagers that the drinks provide a mental and physical edge. The drinks are now under scrutiny http_rmoduleinline by the Food and Drug Administration after reports of deaths and serious injuries that may be linked to their high caffeine levels. But however that review ends one thing is clear interviews with researchers and a review of scientific studies show the energy drink industry is based on a brew of ingredients that apart from caffeine have little if any benefit for consumers. If you had a cup of coffee you are going to affect metabolism in the same way said Dr. Robert W. Pettitt an associate professor at Minnesota State University in Mankato who has studied the drinks. Advertisement Energy drink companies have promoted their products not as caffeinefueled concoctions but as specially engineered blends that provide something more. For example producers claim that Red Bull gives you wings that Rockstar Energy is scientifically formulated and Monster Energy is a killer energy brew. Representative Edward J. Markey of Massachusetts a Democrat has asked the government to investigate the industrys marketing claims. Promoting a message beyond caffeine has enabled the beverage makers to charge premium prices. A ounce energy drink that sells for . a can contains about the same amount of caffeine as a tablet of NoDoz that costs cents. Even Starbucks coffee is cheap by comparison a ounce cup that costs . has even more caffeine. As with earlier elixirs a dearth of evidence underlies such claims. Only a few human studies of energy drinks or the ingredients in them have been performed and they point to a similar conclusion researchers say that the beverages are mainly about caffeine. httponlinelibrary.wiley.comdoi.j....xabstract Caffeine is called the worlds most widely used drug. A stimulant it increases alertness awareness and if taken at the right time improves athletic performance studies show. Energy drink users feel its kick faster because the beverages are typically swallowed quickly or are sold as concentrates. These are caffeine delivery systems said Dr. Roland Griffiths a researcher at Johns Hopkins University who has studied energy drinks. They dont want to say this is equivalent to a NoDoz because that is not a very sexy sales message. Editors Picks https_idactionclickmoduleeditorContentpgtypeArticleregionCompanionColumncontentCollectionTrending A scientist at the University of Wisconsin became puzzled as he researched an ingredient used in energy drinks like Red Bull Hour Energy and Monster Energy. The researcher Dr. Craig A. Goodman could not find any trials in humans of the additive a substance with the tonguetwisting name of glucuronolactone that is related to glucose a sugar. But Dr. Goodman who had studied other energy drink ingredients eventually found two yearold studies from Japan that had examined it. In the experiments scientists injected large doses of the substance into laboratory rats. Afterward the rats swam better. I have no idea what it does in energy drinks Dr. Goodman said. Krating Daeng the Thai drink that inspired Red Bull. Energy drinks lift appears to come mainly from caffeine.CreditThomas FullerThe New York Times Energy drink manufacturers say it is their proprietary formulas rather than specific ingredients that provide users with physical and mental benefits. But that has not prevented them from implying otherwise. Consider the case of taurine an additive used in most energy products. On its Web site the producer of Red Bull for example states that more than reports have been published http_RB_Sports_EDversion_f_screen.pdf about taurine and its physiological effects including acting as a detoxifying agent. In addition that company Red Bull of Austria points to a safety study by a European regulatory group that gave it a clean bill of health. But Red Bulls Web site does not mention reports by that same group the European Food Safety Authority which concluded that claims about the benefits in energy drinks lacked scientific support http Based on those findings the European Commission has refused to approve claims httpec.europa.eunuhclaimseventsearchCFIDCFTOKENedeeaaEAFFEAECFBDEBjsessionidadbdTR that taurine helps maintain mental function and heart health and reduces muscle fatigue. Taurine an amino acidlike substance that got its name because it was first found in the bile of bulls does play a role in bodily functions and recent research suggests it might help prevent heart attacks in women with high cholesterol. However most people get more than adequate amounts from foods like meat experts said. And researchers added that those with heart problems who may need supplements would find far better sources than energy drinks. A spokeswoman for Red Bull did not respond directly to the European marketing claims report but said that the company did not make claims for individual ingredients but rather for the product in its entirety. Sign up for Science Times Well bring you stories that capture the wonders of the human body nature and the cosmos. To woo consumers companies have also used another tactic including huge amounts of wellknown nutrients that make for eyecatching numbers on labels. For example a twoounce bottle of Hour Energy contains micrograms of Vitamin B or percent of the recommended daily allowance. The energy shot also has times the recommended intake of Vitamin B. Bgroup vitamins serve many functions such as in the digestion of food. But several experts said that healthy people get adequate amounts of them from food and that huge added dosages do not provide benefits. They are not going to increase energy levels said Paul R. Thomas a scientific adviser with the National Institutes of Health Office of Dietary Supplements httpods.od.nih.gov. Elaine Lutz a spokeswoman for the distributor of Hour Energy Living Essentials of Farmington Hills Mich. said the amounts of B vitamins used were safe and effective. The body is going to use what it needs and it is going to excrete what it does not absorb said Ms. Lutz. The sugar found in some drinks does provide a quick source of energy. But as for glucuronolactone the additive that made rats swim better the authors of a recent report in a scientific journal Nutrition Reviews httponlinelibrary.wiley.comdoi.j....xabstract said they were clueless as to why it was used in the products or what it did. Certainly this is one ingredient for which evidencebased studies are needed to justify its popularity wrote the researchers. That same review which examined all published energy drink studies also concluded that there was an overwhelming lack of evidence to substantiate claims that The roots of the energy drink phenomenon and the claims surrounding ingredient mixes can be traced to Japan. Those origins appear tied to the emergence of supposed curealls after World War II a time when drugs there were in short supply. In the late s Taisho Pharmaceuticals http a Japanese drug maker began selling taurine extract apparently drawn to it by accounts citing its wartime use by the Japanese Imperial Navy to reduce fatigue among sailors and sharpen their vision at night a history of the drug company states. A formula that is so effective in treating unexplained fevers neuralgia fatigue whooping cough and other conditions for which there is no drug is very rare indeed an advertisement for the extract declared. But around Taisho executives decided to use taurine in a new product one that helped start the energy drink industry Lipovitan D. Lipovitan D which was sold in a small vial contained milligrams of caffeine milligrams of taurine various B vitamins and flavorings. The product which was sold cold in drugstores was a huge success during Japans economic boom years particularly with overworked office employees. However years and billion bottles later Taisho officials acknowledged they had not run a single clinical study involving Lipovitan D. Taurine is added to Lipovitan D not so much for specific medicinal benefits but for its multifaceted functions said Dr. Takanori Kouchiwa a Taisho executive. It was also in the s that a product appeared in Thailand that was similar to Lipovitan D in its ingredient mix. It was called Krating Daeng pronounced grating deng or Red Bull. An Austrian businessman named Dietrich Mateschitz reportedly discovered it when trying to cure a case of jet lag and in he and the drinks Thai creator founded Red Bull. Red Bull quickly became popular in Europe with truck drivers and students and as a mixer for alcoholic drinks. It arrived in the United States in the late s and soon inspired hundreds of competitors. In for example Monster Energy was marketed in a ounce can twice as large as Red Bulls ounce can and with twice as much caffeine. Over the years some producers have financed scientific studies to try to bolster performance claims. A British researcher Dr. Chris Alford said that Red Bull approached him about a decade ago while he was doing work on the ability of stimulants to reduce fatigue in drivers. In Dr. Alford a psychologist at the University of the West of England in Bristol who has received financing from Red Bull published a study that found test participants given the energy drink had better reaction times were more alert and showed increased physical endurance than test subjects given a placebo like flavored water. But studies like Dr. Alfords researchers say only underscore caffeines known benefits. And more recent attempts to tease out the impacts of drink ingredients have produced mixed results. Last August Scottish researchers reported httprd.springer.comarticle.sthat milligrams of taurine taken as a supplement appeared to improve the performance of middledistance runners. But other taurine studies have been negative or inconclusive. We found it difficult to make any conclusions about what taurine was doing said a graduate researcher at Tufts University Grace Giles who headed a study http that ran participants through a battery of mental reaction and memory tests. Dr. Goodman the University of Wisconsin researcher said he believed there was a reason for such equivocal results. The scientist who works at the schools college of veterinary medicine said that laboratory animals like mice or rats must be given huge dosages of taurine to see an effect. Hour Energy contains quantities of Vitamin B that dietary experts say offer no real benefits to those who take it.CreditSpencer PlattGetty Images You can force a mouse to drink a lot of taurine said Dr. Goodman. With humans it is harder to do. What may qualify as the strangest trial in the annals of energy drink studies was financed by Living Essentials the distributor of Hour Energy. The office of a proctologist in a small Maine town apparently served as a setting for the study the results of which were never published. But its findings and other details about it like its location emerged in a lawsuit filed by the maker of Monster Energy against Living Essentials. The study found that test subjects given Hour Energy experienced energy for about minutes longer than when given Red Bull or Monster Energy though it was not clear from court papers whether that difference reflected the energy shots higher levels of caffeine. But another finding from that study sheds an interesting light on one of Hour Energys central claims that the energy shot unlike competitors produces No Crash Later. According to the study percent of test participants who received Hour Energy had reactions similar to a moderately severe crash that left them extremely tired and in need of rest another drink or some other action lawsuit filings show. Ms. Lutz the Living Essentials spokeswoman said the bold No Crash Later statement on product labels was followed by a special mark. That mark which also appears on the back label explains in fine print that no crash means no sugar crash. That is hardly surprising because Hour Energy does not contain sugar. Asked whether consumers mistakenly believe that the shot does not produce a caffeinerelated crash Ms. Lutz said that the use of the special mark and its explanation were clear. I dont believe that it is misleading said Ms. Lutz who added that the advertising division of the Council of Better Business Bureaus had approved the No Crash Later claim. She added that another study showing the benefits of Hour Energy was undergoing peer review for possible publication in a scientific journal. But she declined to say why the results of the study which was apparently conducted five years ago had not yet appeared. That study found a benefit when Hour Energy was compared to a placebo like flavored water she said. Whatever the case the energy drink boom has come full circle in Asia the region where it started. Over the last decade sales of Lipovitan D have fallen and its maker Taisho Pharmaceuticals has tried various strategies to revitalize the brand. Among them bringing out Lipovitan Junior a caffeinefree version for children. In Thailand Krating Daeng has suffered a similar fate. Its producer has tried to freshen up that brand by proclaiming that the Vitamin B in it helps the functions of the nervous system and brain. Last year the Foundation for Consumers in Thailand an advocacy group started a publicity campaign against energy drinks like Krating Daeng arguing that producers were promoting unfounded health claims to push caffeine. This product just needed a way to add value to extend its life cycle said Patchara Klaewkla an official at the foundation. This product has been in the market for a long time."

"Min Read Deep brainstimulation device helped stabilise mood Half of patients in small trial gained weight Anorexia among most common psychiatric disorders in girls By Kate Kelland LONDON March Reuters Scientists have for the first time reported successful use of a brainstimulating implant to help patients with severe anorexia whose condition had not improved with other treatments. Doctors implanted a device similar to a pacemaker in the brains of six severe anorexics and found at least half put on weight and showed improvements in mood. Under previous therapies none had shown progress. This success in a small study designed as a pilot to test the safety of the technique suggests larger trials will confirm the effectiveness of the deep brain stimulation DBS device the researchers wrote in the medical journal The Lancet. Anorexia has one of the highest mortality rates of any psychiatric disorder and is among the most common psychiatric disorders in girls aged between and years. Symptoms include deliberate weight loss induced and sustained by the patient and a need to control calorie intake and output. Treatment usually focuses on changing behaviour but experts say up to percent of patients get no benefit from such treatments and are at risk of dying prematurely. Commenting on the results of this small trial Janet Treasure and Ulrike Schmidt of Kings College Londons Institute of Psychiatry said the technique looked promising and would give hope to patients with especially pernicious forms of anorexia. Sponsored ADVERTISING inRead invented by Teads The fact that the procedure was associated ... with improvements in affective and obsessional symptoms is of key importance they said. This will go some way towards reassuring patients that DBS is not just another treatment designed to fatten them up without making them feel better. DBS is used to treat several neurological illnesses including Parkinsons disease and chronic pain. Scientists are also investigating its use in depression and epilepsy but this was the first time it had been used in patients with anorexia. Implanting the DBS device requires minimally invasive surgery which can be completely reversed if problems occur the researchers said. For their study a team at the Krembil Neuroscience Centre and University Health Network in Canada identified an area of the brain known to be important when using DBS in depression. They implanted electrodes into the area and connected them to a pulse generator under the skin. The devices were activated days later and researchers measured changes in the patients mood and anxiety to help find the correct level of stimulation. The patients all women were aged between and and had had anorexia for between four and years. Initially all six lost weight but researchers said this was expected since studies of DBS in patients with depression also found a delay of a few months before treatment starts to work. Three months after treatment the weight loss began to reverse in some patients and after nine months three patients weighed more than before treatment the longest period of sustained weight increase since they had become ill. Around half also had better moods and less obsessivecompulsive behaviour. Land Rover Sponsored by Land Rover Land Rovers Main Event Enjoy Savings On Land Rover Discovery And Discovery Sport Read more Andres Lozano who led the study said the results were encouraging because they pointed to a genuine therapeutic effect rather than a placebo or hungerincreasing effect. He also said the improvements in mood and anxiety even in patients who were still underweight were especially striking given that severely anorexic patients did not respond well to conventional medicines or psychotherapies. Editing by Andrew Roche"

"Blood thinners are often prescribed to prevent strokes in people with the abnormal heart rhythm known as atrial fibrillation. But a new study suggests these drugs may also help keep dementia at bay. The researchers said that the key is to start blood thinners such as warfarin soon after atrial fibrillation is diagnosed. Thats true even for people at low risk of a stroke who wouldnt normally be given blood thinners. We found that people who are on warfarin the most common blood thinner used to prevent stroke in patients with atrial fibrillation experienced very low rates of dementia including Alzheimers disease said lead researcher Dr. T. Jared Bunch. Hes director of heart rhythm research at Intermountain Medical Center Heart Institute in Murray Utah. Atrial fibrillation is a common heart abnormality that affects nearly million American adults. It causes the heart to beat abnormally or quiver. This causes blood to pool and then it can clot. Atrial fibrillation can cause dementia by damaging tiny blood vessels in the brain through repeated tiny clots or small bleeds that people arent even aware of Bunch explained. While many patients are initially given aspirin Bunch said aspirins benefit in cutting the risk for dementia is limited and patients should be started on warfarin or another blood thinner. Although the study looked at patients taking warfarin Coumadin newer drugs including rivaroxaban Xarelto and apixaban Eliquis should reduce the risk of dementia even more Bunch said. In patients with atrial fibrillation the risk of stroke is usually measured using the socalled CHADS score the researchers said. This score assigns points for several risk factors such as age high blood pressure heart disease diabetes and a previous stroke. A score of zero to one usually means blood thinners arent needed because the risk for stroke is low. For patients with scores above one blood thinners are considered necessary as these patients are judged to be at moderate to high risk according to the researchers. In this study however the investigators said they found that even a short delay in giving blood thinners to patients at low risk for stroke increases the risk for dementia. In patients considered at lowrisk for stroke delaying bloodthinning treatment increased the risk for dementia percent. In highrisk patients a delay increased the risk percent the researchers reported. The longer the delay in giving blood thinners the more the risk for dementia the researchers said. For the study Bunch and his colleagues looked at information from more than atrial fibrillation patients who had no history of dementia. The average age of the study participants was and percent were male. The researchers looked at when treatment began either within days of atrial fibrillation diagnosis which was considered immediate or after a year which was considered delayed. Once you are diagnosed with atrial fibrillation starting strokeprevention strategies immediately is essential. We shouldnt wait longer than a month to begin treatment Bunch said. The delay in treating can be devastating to patients when they start developing mental decline years later he added. The results of the study were scheduled for presentation Friday at the meeting of the Heart Rhythm Society in Chicago. Findings presented at meetings are generally viewed as preliminary until theyve been published in a peerreviewed journal. According to Dr. Byron Lee of the University of California San Francisco UCSF There is a growing body of literature supporting the connection between atrial fibrillation and dementia. Lee is a professor of medicine and director of the electrophysiology laboratories and clinics at UCSF. Therefore he said we need to be extremely aggressive in treating atrial fibrillation patients with anticoagulants blood thinners when indicated. This study shows that treatment delays of even one month can greatly increase the incidence of cognitive mental decline Lee said. More information For more on atrial fibrillation visit the American Heart Association http_UCM__Article.jsp. SOURCES T. Jared Bunch M.D. director heart rhythm research Intermountain Medical Center Heart Institute Murray Utah Byron Lee M.D. professor of medicine director electrophysiology laboratories and clinics University of California San Francisco May presentation Heart Rhythm Society meeting Chicago"

"Researchers at Mayo Clinics campus in Florida http have conducted the worlds first prospective blinded and placebocontrolled clinical study to test the benefit of using bone marrow stem cells a regenerative medicine therapy to reduce arthritic pain http and disability in knees. The researchers say such testing is needed because there are at least stem cell clinics in the U.S. offering one form of stem cell therapy or another to an estimated plus patients who pay thousands of dollars out of pocket for the treatment which has not undergone demanding clinical study. The findings in The American Journal of Sports Medicine httpajs.sagepub.cominclude an anomalous finding patients not only had a dramatic improvement in the knee that received stem cells but also in their other knee which also had painful arthritis but received only a saline control injection. Each of the patients enrolled in the study had two bad knees but did not know which knee received the stem cells. Given that the stem celltreated knee was no better than the controltreated knee both were significantly better than before the study began the researchers say the stem cells effectiveness remains somewhat uninterpretable. They are only able to conclude the procedure is safe to undergo as an option for knee pain but they cannot yet recommend it for routine arthritis care. Our findings can be interpreted in ways that we now need to test one of which is that bone marrow stem cell injection in one ailing knee can relieve pain in both affected knees in a systemic or wholebody fashion says the studys lead author Shane Shapiro M.D. http a Mayo Clinic orthopedic physician. Journalists sound bites with Dr. Shane Shapiro are available in the downloads below. MEDIA CONTACT Kevin Punsky Mayo Clinic Public Affairs punsky.kevinmayo.edu mailtopunsky.kevinmayo.edu One hypothesis is that the stem cells we tested can home to areas of injury where they are needed which makes sense given that stem cells injected intravenously in cancer treatments end up in the patients bone marrow where they need to go he says. This is just a theory that can explain our results so it needs further testing. Another explanation is that merely injecting any substance into a knee offered relief from pain. That could be but both this idea and the notion that a placebo effect could be involved would be surprising given that some patients are still doing very well years after their study treatment ended says Dr. Shapiro. He adds that these findings are important because while use of a patients own stem cells for regenerative therapy is extraordinarily popular the treatments may be untested and are often poorly regulated. Stem cell clinics often offer expensive treatments for conditions that range from multiple sclerosis lung and heart disease to cosmetic treatments such as facelifts. None of these techniques have been studied because clinics maintain that use of a patients own cells is not a drug. But depending on how they are processed and used stem cells can in fact be regulated by the U.S. Food and Drug Administration as biological products or drugs requiring rigorous safety and efficacy approval processes. In early September the FDA held scientific meetings to clarify how to regulate such practices. Mayo Clinic researchers developed their study with FDA approval. We feel that if we are going to offer any stem cell procedures to our patients the science needs to be worked out Dr. Shapiro says. The study was conducted in Mayos Human Cell Therapy Lab. Researchers extracted to milliliters of bone marrow from each patient then filtered it removed all blood cells and concentrated it down to to milliliters. The solution which contained tens of thousands of stem cells was injected into a patients knee using ultrasoundguided imagery. We actually counted all of the stem cells with markers that are accepted by the FDA and we made sure they would be able to survive inside the patient Dr. Shapiro says. Counting is expensive. Most clinics just draw the cells from bone marrow or fat and inject them back into the patient without checking for stem cells hoping that patients get better he says. Dr. Shapiro and his colleagues are currently designing new studies that will test whether the stem cells home to distant areas of injuries as well as exploring other implications suggested in their findings. Study investigators include Mayo Clinic in Florida senior author Mary L. OConnor M.D. Shari E. Kazmerchak Michael G. Heckman and Abba C. Zubair M.D. Ph.D. http_ga... Dr. OConnor is now at Yale University. Funding for this study was from Mayo Clinics Center for Regenerative Medicine http_ga...."

"Remember melatonin In the s this overthecounter dietary supplement httptopics.nytimes.comtopnewshealthdiseasesconditionsandhealthtopicsdietarysupplementsandherbalremediesindex.htmlinlinenytclassifier was all the rage among frequent fliers promoted as the miracle cure for jet lag. Now it is back in vogue this time as a prominent ingredient in at least a halfdozen baked goods that flagrantly mimic the soothing effects of hash brownies and do so legally. At least for now. With names like Lazy Cakes Kush Cakes and Lulla Pies these products are sold online and at stores like Eleven Walgreens smoke shops and even at the Harvard Square Coop the universitys student bookstore for roughly to each. A bottle of milligram melatonin tablets costs about . At some places the drugpacked desserts can be paid for with food stamps. Although the Food and Drug Administration httptopics.nytimes.comtopreferencetimestopicsorganizationsffood_and_drug_administrationindex.htmlinlinenytorg has not approved melatonin as a food additive or deemed it safe the dessert makers are marketing their products as a harmless way to promote relaxation. And the snacks are increasingly being endorsed by fans on Facebook and Twitter as an antidote to stress and sleep deprivation. Who needs yoga httptopics.nytimes.comtopreferencetimestopicssubjectsyyogaindex.htmlinlinenytclassifier On the Facebook page http for Lazy Cakes one woman who said she has bipolar disorder httphealth.nytimes.comhealthguidesdiseasebipolardisorderoverview.htmlinlinenytclassifier wrote that the treat helps a lot with my sleeping and panic attacks httphealth.nytimes.comhealthguidesdiseasepanicdisorderoverview.htmlinlinenytclassifier I can lay off my Xanax a little. Gabby Bevel a writer from Norman Okla. and an insomniac who took Ambien and Lunesta in high school said in an interview that she slept hours after eating one Lazy Cakes snack recently. I dont like the idea of needing something unnatural to help me with anything she said. Really I think part of the appeal is it does come in a brownie. But these snacks contain roughly milligrams of melatonin per brownie or cookie so selling them is similar to a parent serving an unsuspecting child applesauce containing a crushed aspirin tablet to make it go down easier. Its making it much more difficult for the consumer to recognize that they are taking a drug said Dr. Charles A. Czeisler the chief of the division of sleep medicine at Harvards Brigham and Womens Hospital. Nick Collado a yearold insomniac and the founder of Lulla Pies argued that the melatonin they contain while synthetic is more natural than the Ambien he used to take. I realized theres got to be more people like me who dont want to take prescription drugs anymore who want to take an alternative Mr. Collado said. But Dr. David S. Seres the director of medical nutrition at Columbia Medical Center cautioned that consumers should consult their doctors before trying such products. The promoters of these are appealing to people who think its better to do things outside of the medical establishment he said adding that the desire to help people is an extremely strong motivator but so is money. He pointed to a section of the National Institutes of Healths Web site that lists several drugs including sedatives httptopics.nytimes.comtopnewshealthdiseasesconditionsandhealthtopicssedativesindex.htmlinlinenytclassifier like clonazepam and birth control httphealth.nytimes.comhealthguidesspecialtopicbirthcontrolandfamilyplanningoverview.htmlinlinenytclassifier pills whose efficacy might be altered by melatonin. A hangover effect has been reported with large doses said Anna Rouse Dulaney a toxicologist with the Carolinas Poison Center. But she added I dont want to go on the record saying this drug can cause respiratory issues that should be a may. Lazy Cakes appear harmless even amusing with swirly purple packaging Kush Cakes have a tiedyeprinted wrapper. But they are not to be underestimated. Of melatonin Dr. Seres warned If you take it while youre driving a car you will find yourself in a ditch. Maybe. Dr. Alfred J. Lewy http a professor of psychiatry httptopics.nytimes.comtopnewshealthdiseasesconditionsandhealthtopicspsychiatry_and_psychiatristsindex.htmlinlinenytclassifier at Oregon Health and Science University who has studied melatonin a neurohormone estimated that only a third of the population is susceptible to its effects in a supplement. Photo And yet Tracy Evans who owns a bar where musicians perform in Erie Pa. that has sold hundreds of Lazy Cakes said she instructs employees to tell partygoers I highly recommend you wait to where youre going to be at the end of the night before eating. Why It knocks you out in a good way not a bad way said Ms. Evans . For me its not to chill. For me its to get a good nights sleep. Yet the products intended for adults only are being marketed as a novel way to relax in a stressedout wired world. Labels on Lazy Cakes and Mary Js brownies that were bought online urge users to Take brownie two times a day. With tiny type the labels warn against operating heavy machinery or driving. Top of Form Bottom of Form Top of Form But some medical professionals are concerned that the chocolate taste might encourage indiscriminate gobbling. Its a colossally bad idea to put melatonin in food Dr. Czeisler said. It should not be permitted by the F.D.A. Technically it is not. Stephanie Yao a spokeswoman at the F.D.A. wrote in an email that any item that uses melatonin as an additive may be subject to regulatory action. That is why the makers of these new baked goods label them Not for food use. They want them to be considered dietary supplements which do not need the F.D.A.s premarket approval and are not required to be proved safe or effective. It sounds to me like they are trying to claim that the entire brownie is like a tablet which is of course preposterous Dr. Czeisler said. Tim Barham the vice president of HBB the maker of Lazy Cakes said We look at the brownie as a supplement. News reports have classified Lazy Cakes as dietary supplements but last month Douglas Karas an F.D.A. spokesman said in an email that the agency has not made a determination on Lazy Cakes status as either a food or a dietary supplement. In January last year the F.D.A. sent a warning letter to Peter Bianchi the creator of Drank http a purple drink with milligrams of melatonin in each can that went on the market in spawning several competitors. The letter cited safety concerns about melatonin in food specifically research indicating that melatonin reduced glucose tolerance for people with Type diabetes httphealth.nytimes.comhealthguidesdiseasetypediabetesoverview.htmlinlinenytclassifier and that some men using it had reported enlarged breasts. It also warned that women who are pregnant or trying to conceive should avoid melatonin based on possible hormonal effects. Dranks bottle now say it is a dietary supplement. Dr. Lewy dismissed the idea that harm might lurk in a melatoninlaced brownie. It really doesnt have any documented side effects except for making you sleepy at bedtime which is good he said. That said he would not advise eating Lazy Cakes partly because he was not sure that their other purportedly sleepinducing ingredients like valerian root work and partly because food delays rather than hastens the absorption of melatonin. Also Dr. Lewy said I dont need the calories httphealth.nytimes.comhealthguidesnutritiondietcaloriesoverview.htmlinlinenytclassifier."

"A new method of stimulating the renewal of living stem cells in tooth pulp using an Alzheimers drug has been discovered by a team of researchers at Kings College London. Following trauma or an infection the inner soft pulp of a tooth can become exposed and infected. In order to protect the tooth from infection a thin band of dentine is naturally produced and this seals the tooth pulp but it is insufficient to effectively repair large cavities. Currently dentists use manmade cements or fillings such as calcium and siliconbased products to treat these larger cavities and fill holes in teeth. This cement remains in the tooth and fails to disintegrate meaning that the normal mineral level of the tooth is never completely restored. However in a paper published today in Scientific Reports scientists from the Dental Institute at Kings College London have proven a way to stimulate the stem cells contained in the pulp of the tooth and generate new dentine the mineralised material that protects the tooth in large cavities potentially reducing the need for fillings or cements. The novel biological approach could see teeth use their natural ability to repair large cavities rather than using cements or fillings which are prone to infections and often need replacing a number of times. Indeed when fillings fail or infection occurs dentists have to remove and fill an area that is larger than what is affected and after multiple treatments the tooth may eventually need to be extracted. As this new method encourages natural tooth repair it could eliminate all of these issues providing a more natural solution for patients. Significantly one of the small molecules used by the team to stimulate the renewal of the stem cells included Tideglusib which has previously been used in clinical trials to treat neurological disorders including Alzheimers disease. This presents a real opportunity to fasttrack the treatment into practice. Using biodegradable collagen sponges to deliver the treatment the team applied low doses of small molecule glycogen synthase kinase GSK to the tooth. They found that the sponge degraded over time and that new dentine replaced it leading to complete natural repair. Collagen sponges are commerciallyavailable and clinicallyapproved again adding to the potential of the treatments swift pickup and use in dental clinics. Lead author of the study Professor Paul Sharpe from Kings College London said The simplicity of our approach makes it ideal as a clinical dental product for the natural treatment of large cavities by providing both pulp protection and restoring dentine. In addition using a drug that has already been tested in clinical trials for Alzheimers disease provides a real opportunity to get this dental treatment quickly into clinics. Notes for Editors The paper Promotion of natural tooth repair by small molecule GSK antagonists by Vitor Neves Rebecca Babb Dhivya Chandrasekaran and Paul T Sharpe will be published in Scientific Reports at am on Monday January http Professor Paul Sharpe is the head of the Craniofacial Development and Stem Cell Biology Division at the Kings College London Dental Institute. The Kings College London Dental Institute Kings College London Dental Institute is one of the foremost Dental Schools in the world. Recently ranked fourth in the world in dentistry by the QS World University Rankings and first in the UK the Dental Institute aims to maximise impact on health and wellbeing by integrating excellence across four areas Education teaching Worldclass science Clinical approaches Patient care The Facultys international reputation attracts students and staff from across the globe. The largest dental academic centre in the UK they teach over undergraduate students graduate taught students distance learning students and graduate research students. The Dental Institute has over academic staff and is organised into four research divisions Craniofacial Development Stem Cell Biology Mucosal Salivary Research Tissue Engineering Biophotonics and Population Patient Health. The research divisions complement the teaching and clinical service initiatives. As well as excellent research facilities the Dental Institute has internationally recognised education programmes. With highly skilled teachers and supervisors there are exceptional facilities including access to over patients each year across the two worldfamous hospitals Guys and St Thomas for handson clinical training. They are one of the most comprehensive dental academic health science centres in Europe. Further details of the Institute may be found on its website http"

"First FDAapproved ALS treatment option in more than years RADICAVA has been demonstrated to slow decline of physical function by percent Comprehensive clinical development program in ALS conducted over a year period JERSEY CITY N.J. MAY MT Pharma America Inc. today announced the U.S. Food and Drug Administration FDA has granted approval of RADICAVA edaravone as an intravenous infusion treatment for amyotrophic lateral sclerosis ALS a rapidly progressive neurodegenerative disease in which the majority of patients die within two to five years of diagnosis. People given RADICAVA showed significantly less decline in physical function compared to placebo as measured by the ALS Functional Rating ScaleRevised ALSFRSR a validated rating instrument for monitoring the progression of disability in patients with ALS. We believe RADICAVA offers new hope for people with ALS and exemplifies MT Pharma Americas commitment to innovative therapies for patients in the United States battling lifethreatening diseases said Atsushi Fujimoto President MT Pharma America. We recognize how important this therapy may be to people with ALS and are committed to helping provide access to this important treatment option with the goal of keeping outofpocket costs at a minimum for eligible patients. An estimated Americans are diagnosed each year with ALS an incurable disease that affects the nerve cells in the brain and spinal cord. Initial symptoms can be subtle at first and it can take to months to be accurately diagnosed with ALS. For people with ALS and their families having a new therapy which slows the decline of physical ability is incredibly significant said Jonathan S. Katz M.D. ALS Clinic Director Forbes Norris MDAALS Research and Treatment Center at California Pacific Medical Center. The approval of RADICAVA brings us into a new era of treatment by evolving how we manage this complex disease. This is an uplifting milestone for the ALS community especially since its been so long since we had anything new. The comprehensive clinical development program for RADICAVA in ALS spanned years and included multiple Phase trials. The pivotal Phase study MCI which evaluated people with ALS formed the basis for the FDA approval of RADICAVA. Data demonstrated patients who received RADICAVA for six months experienced significantly less decline in physical function by percent or . ALSFRSR points p.. The most common adverse reactions that occurred in greater than percent of patients and greater than placebo were bruising contusion problems walking gait disturbance and headache. MT Pharma America is helping to make RADICAVA accessible to all patients who need it and has created Searchlight Support a patient access program for people with ALS who are prescribed RADICAVA. As soon as a person receives a prescription he or she can access Searchlight Support including personal case management reimbursement support and clinical support. Some people with ALS who have received prescriptions for RADICAVA may be eligible to receive additional assistance from MT Pharma America. For more information on Searchlight Support contact SRCHLGT . This is an important time for people living with ALS. The approval of RADICAVA gives great promise for what we hope will be the first of many new treatments said Barbara Newhouse President and CEO ALS Association. We applaud the work MT Pharma America and the FDA are doing as they have taken unprecedented steps to get this treatment into the hands of patients as quickly as possible. About the MCI Study Study MCI was a pivotal Phase study that evaluated the efficacy and safety of RADICAVA compared with placebo in people with ALS. In the study after a week preobservation period eligible patients were randomized to receive RADICAVA mg intravenously for minutes or placebo during a sixmonth doubleblind placebocontrolled phase. The primary endpoint for the study was change in the ALS Functional Rating ScaleRevised ALSFRSR score from baseline to six months. About RADICAVA edaravone RADICAVA is administered in day cycles by intravenous infusion. It takes minutes to receive each mg dose. For the initial cycle the treatment is infused daily for consecutive days followed by a twoweek drugfree period. All cycles thereafter are infused daily for days within a day period followed by a twoweek drugfree period. Edaravone was discovered and developed for ALS by Mitsubishi Tanabe Pharma Corporation MTPC and will be commercialized in the U.S. by MT Pharma America. MTPC group companies began researching ALS in through a comprehensive clinical platform over a year period. In edaravone was approved for use as a treatment for ALS in Japan and South Korea. IMPORTANT SAFETY INFORMATION Before you receive RADICAVA tell your healthcare provider about all of your medical conditions including if you have asthma. are allergic to other medicines. are pregnant or plan to become pregnant. It is not known if RADICAVA will harm your unborn baby. are breastfeeding or plan to breastfeed. It is not known if RADICAVA passes into your breastmilk. You and your healthcare provider should decide if you will receive RADICAVA or breastfeed. Tell your healthcare provider about all the medicines you take including prescription and overthecounter medicines vitamins and herbal supplements. What are the possible side effects of RADICAVA RADICAVA may cause serious side effects including hypersensitivity allergic reactions and sulfite allergic reactions. Hypersensitivity reactions have happened in people receiving RADICAVA and can happen after your infusion is finished. RADICAVA contains sodium bisulfite a sulfite that may cause a type of allergic reaction that can be serious and lifethreatening. Sodium bisulfite can also cause less severe asthma episodes in certain people. Sulfite sensitivity can happen more often in people who have asthma than in people who do not have asthma. Tell your healthcare provider right away or go to the nearest emergency room if you have any of the following symptoms hives swelling of the lips tongue or face fainting breathing problems wheezing trouble swallowing dizziness itching or an asthma attack in people with asthma. Your healthcare provider will monitor you during treatment to watch for signs and symptoms of all the serious side effects. The most common side effects of RADICAVA include bruising contusion problems walking gait disturbance and headache. These are not all the possible side effects of RADICAVA. Call your healthcare provider for medical advice about side effects. You may report side effects to MT Pharma America Inc. at or FDA at FDA or http For more information including full Prescribing Information and Patient Information please visit ww.RADICAVA.com http About MT Pharma America Based in Jersey City N.J. MT Pharma America is a whollyowned subsidiary of Mitsubishi Tanabe Pharma Corporations MTPC percent owned U.S. holding company Mitsubishi Tanabe Pharma Holdings America Inc. MTPA is dedicated to delivering innovative products that address the unmet medical needs of patients in the U.S. It was established by MTPC to commercialize approved pharmaceutical products in the U.S. with plans to expand its product line through collaborations with partners. For more information please visit http or follow us on Twitter at httpstwitter.comMTPharmaUS. Overview of Mitsubishi Tanabe Pharma Corporation Mitsubishi Tanabe Pharma which was founded in has its headquarters in Doshomachi Osaka which is the birthplace of Japans pharmaceutical industry. With business centered on ethical pharmaceuticals Mitsubishi Tanabe Pharma is a wellestablished company and has the longest history of any listed company in Japan In accordance with the corporate philosophy of contributing to the healthier lives of people around the world through the creation of pharmaceuticals the Company formulated the key concept of Open Up the Future under the MediumTerm Management Plan . Through the discovery of drugs that address unmet medical needs centered on its priority disease areas autoimmune diseases diabetes and kidney diseases central nervous system diseases and vaccines Mitsubishi Tanabe Pharma will strive to contribute to the health of patients around the world. MTPC is the parent company of MTPA and the license holder of RADICAVA. For more information go to http National Institute of Neurological Disorders and Stroke. Amyotrophic Lateral Sclerosis ALS Fact Sheet. https Accessed April . RADICAVA U.S. Prescribing Information. May National Institute of Neurological Disorders and Stroke. Amyotrophic Lateral Sclerosis ALS Information Page. https Accessed April . Mehta P Kaye W Bryan L et al. . Prevalence of Amyotrophic Lateral Sclerosis United States . MMWR Surveill Summ No. SS Simon N. G. Turner M. R. Vucic S. AlChalabi A. Shefner J. LomenHoerth C. Kiernan M. C. . Quantifying Disease Progression in Amyotrophic Lateral Sclerosis. Annals of Neurology . Marin B Boumediene F Logroscino G et al. . Variation in worldwide incidence of amyotrophic lateral sclerosis a metaanalysis. Int J Epidemiol . ALS Association. Quick Facts about ALS. http Accessed April . ALS Therapy Development Institute. What is ALS. http Accessed April . Brooks BR. . Risk factors in the early diagnosis of ALS North American epidemiological studies. Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders sup SS. Research by TOKYO SHOKO RESEARCH LTD."

"Drinking concentrated blueberry juice improves brain function in older people according to research by the University of Exeter. In the study healthy people aged who drank concentrated blueberry juice every day showed improvements in cognitive function blood flow to the brain and activation of the brain while carrying out cognitive tests. There was also evidence suggesting improvement in working memory. Blueberries are rich in flavonoids which possess antioxidant and antiinflammatory properties. Dr Joanna Bowtell head of Sport and Health Sciences at the University of Exeter said Our cognitive function tends to decline as we get older but previous research has shown that cognitive function is better preserved in healthy older adults with a diet rich in plantbased foods. In this study we have shown that with just weeks of consuming ml of concentrated blueberry juice every day brain blood flow brain activation and some aspects of working memory were improved in this group of healthy older adults. Of the healthy adults in the study were given concentrated blueberry juice providing the equivalent of g of blueberries once a day while received a placebo. Before and after the week period participants took a range of cognitive tests while an MRI scanner monitored their brain function and resting brain blood flow was measured. Compared to the placebo group those who took the blueberry supplement showed significant increases in brain activity in brain areas related to the tests. The study excluded anyone who said they consumed more than five portions of fruit and vegetables per day and all participants were told to stick to their normal diet throughout. Previous research has shown that risk of dementia is reduced by higher fruit and vegetable intake and cognitive function is better preserved in healthy older adults with a diet rich in plantbased foods. Flavonoids which are abundant in plants are likely to be an important component in causing these effects. The new paper Enhanced taskrelated brain activation and resting perfusion in healthy older adults after chronic blueberry supplementation is published in the journal Applied Physiology Nutrition and Metabolism. The research was carried out in association with the University of the West of England and the concentrated blueberry juice BlueberryActive and some funding for the study was provided by CherryActive Ltd which produces cherry beetroot and blueberry products in concentrate and capsule form. The study was also supported by the charity BRACE which raises funds to support dementia research."

"In as whooping cough continued its deadly comeback the U.S. Centers for Disease Control and Prevention recommended that women get vaccinated against the bacterial infection during each pregnancy. A new CDC study finds that the preventive measure works. The vaccine http called Tdap tetanus diphtheria and pertussis cut the risk of whooping cough or pertussis by percent in babies younger than two months whose mothers got inoculated in their third trimester of pregnancy. The study published Thursday in Clinical Infectious Diseases used data from through on babies younger than two months from six states. Among babies who developed whooping cough despite their mothers vaccination percent had mild cases and did not require hospitalization. While the latest findings are heartening only about half of pregnant women in the U.S. are getting the vaccine the CDC said. Babies cannot be vaccinated against whooping cough until theyre months old. The respiratory illness induces such uncontrollable fits of coughing that it can be deadly for babies who can stop breathing have seizures develop pneumonia or suffer brain damage. Pediatrician Paul A. Offit a vaccine expert http Childrens Hospital of Philadelphia said Babies under months old are only going to be protected by their mother who passes antibodies on to the child. So we have to do a better job of educating women. I think obstetricians can do a better job too. Women have such a great opportunity to help protect their babies before they enter the world by getting Tdap Nancy Messonnier director of the CDCs center for immunization and respiratory diseases said in a news release. This study reinforces CDCs recommendation. Before the introduction of whooping cough vaccine http_kidsHereswhythefluandwhoopingcoughvaccinesareimportant.html in the s more than cases a year were reported in the U.S. By that number plummeted to fewer than a year. But the disease made a comeback in the s as the newer acellular https vaccine containing only cellular material but not whole cells was phased in. While it is safer and has fewer side effects than the old version studies have found that its protective effects wane more quickly http_Local_whooping_cough_cases_could_be_sign_of_weaker_vaccine.html than originally expected. Each year since tens of thousands of cases of whooping cough have occurred and up to babies have died. So far this year more than cases have been reported."

"Terri Bradford has suffered debilitating headaches all her life. Some days the pain is so bad she says By oclock in the morning Im on the couch in a darkened room with my head packed in ice. Ive had two spinal taps Ive had so many nerve blocks Ive lost count. Terri Bradford Over the years Bradford who is years old and lives in Bedford Mass. has searched desperately for pain relief. Shes been to the doctor countless times for countless tests. Everything Ive had Ive had twice she says. Ive had two spinal taps Ive had so many nerve blocks Ive lost count. Bradford is not alone. Its estimated that every year million Americans go to the doctor seeking help for headaches. Nearly one quarter of the population suffers from recurrent severe tension headaches or migraines http People who go to the doctor for headaches are increasingly likely to be sent for advanced testing and treatment a study http finds. That testing is expensive it may not be necessary and it could even be harmful says lead researcher Dr. John Mafi of Beth Israel Deaconess Medical Center http in Boston. Mafi looked at the rates of advanced imaging like CT scans and MRIs in people with headaches as well as referrals to other doctors presumably specialists. He found that from to the number of diagnostic tests rose from . percent of all doctor visits to . percent. At the same time referrals to other doctors increased from . percent to . percent. In other words almost double what it was a decade ago. Mafi says this isnt because more people are suffering headaches. The headache rate has remained virtually the same over the past decade. But what has changed is supply and demand. Today there are a lot more advanced diagnostic machines than there were a decade ago and more patients are asking to be tested. Article continues after this message from our sponsor Theres a subconscious perception that fancier more expensive tests are better and that equals better care. Dr. John Mafi Patients are more assertive than ever before Mafi says. They do research online are more informed and sometimes go to the doctor demanding I think I need an MRI. And while an informed patient is a good thing Mafi says sometimes the patient gets it wrong. I think theres a subconscious perception that more is better and that fancier more expensive tests are better and that equals better care. Mafis study did not include patients with tumors or other serious problems that can cause headaches. He only looked at otherwise healthy patients who suffered chronic headaches. And in these cases repeated diagnostic testing can lead to further unnecessary procedures like biopsies. On top of that exposure to radiation in tests like CT scans adds up over time and can increase the risk of certain cancers. For Terri Bradford the years of searching for effective treatment proved futile. Ive been to four neurologists. A lot of them have given up on me because I havent gotten any better she says. Eventually Bradford ended up at Beth Israel Deaconess Medical Center where neurologist Carolyn Bernstein http directs the Comprehensive Headache Center http Bernstein says she sees lots of desperate patients like Bradford. The majority of them have really been suffering a number of years and theyre really miserable with the pain Bernstein says. They say I hope you have a magic pill and of course there is no magic pill. There is just no single reason why people get chronic headaches although we do know that migraines have a genetic component and usually a trigger. If you are a migraine sufferer and I expose you to the right trigger youre going to have a migraine Bernstein says. But the triggers are different for different people. They can include poor diet too much sugar or certain types of alcohol. Problems sleeping stress lack of exercise or a combination of any number of these things can cause chronic headaches. At the headache center patients receive a thorough medical history that includes headache patterns disability and mood assessments. Then the center works with patients to try to identify what triggers their headaches and how they can avoid those triggers in the future. Some people find relief through exercise. I write an exercise prescription probably as often as I write a prescription for medication Bernstein says. She acknowledges its sometimes difficult to encourage a patient with cracking head pain to get up and exercise. But even a little can help and according to Bernstein it doesnt have to be jogging for miles and miles. It can be yoga tai chi or even just a little stretching. A big lifestyle adjustment worked for Terri Bradford. She started exercising and changed her diet giving up gluten dairy and sugar. And she learned how to meditate to reduce stress. All these changes she says have made a huge difference. She has far fewer headaches and when she does have them theyre far less severe. Im finally healing she says."

"Scientists have developed a simple threeinone blood test they believe could transform treatment of advanced prostate cancer helping to extend or save lives. The test developed by researchers at the Institute of Cancer Research ICR in London and the Royal Marsden NHS foundation trust picks out men suitable for treatment with olaparib part of a revolutionary class of drugs called PARPinhibitors https which stops damaged cells from repairing themselves. The liquid biopsy less invasive than a tissue biopsy also detects early signs of resistance to olaparib and monitors the cancers evolution over time according to the paper published in Cancer Discovery httpcancerdiscovery.aacrjournals.org on Monday. Prof Johann de Bono Regius professor of cancer research at the ICR and consultant medical oncologist at the Royal Marsden NHS foundation trust said Our study identifies for the first time genetic changes that allow prostate cancer cells to become resistant to the precision medicine olaparib. From these findings we were able to develop a powerful threeinone test that could in future be used to help doctors select treatment check whether it is working and monitor the cancer in the longer term. We think it could be used to make clinical decisions about whether a PARPinhibitor is working within as little as four to eight weeks of starting therapy. Not only could the test have a major impact on treatment of prostate cancer but it could also be adapted to open up the possibility of precision medicine to patients with other types of cancer as well. By testing cancer DNA in the bloodstream the researchers found they could pick out which men with advanced prostate cancer were likely to benefit from treatment with the drug. They also used the test to analyse DNA in the blood after treatment had started so people who were not responding could be identified and switched to alternative therapy in as little as four to eight weeks. Thirdly they used the test to monitor a patients blood throughout treatment to quickly pick up signs that the cancer was evolving genetically and might be becoming resistant to the drugs. The researchers collected blood samples from men at the Royal Marsden with advanced prostate cancer enrolled in the phase II clinical trial of olaparib. The drug is effective at killing cancer cells that have errors in genes which would otherwise keep them healthy. Some patients respond to olaparib for years but in others the treatment can fail early or the cancer can evolve resistance. The ICR chief executive Prof Paul Workman said the test could usher in a new era of precision medicine for prostate cancer. He said Blood tests for cancer promise to be truly revolutionary. They are cheap and simple to use but most importantly because they arent invasive they can be employed or applied to routinely monitor patients to spot early if treatment is failing offering patients the best chance of surviving their disease. The research was funded by the Prostate Cancer Foundation Prostate Cancer UK Movember Cancer Research UK and the National Institute for Health https Research."

"Bottom Line The investigational anticancer therapeutic abemaciclib which targets CDK and CDK showed durable clinical activity when given as continuous singleagent therapy to patients with a variety of cancer types including breast cancer nonsmall cell lung cancer NSCLC glioblastoma and melanoma according to results from a phase I clinical trial. Journal in Which the Study was Published Cancer Discovery a journal of the American Association for Cancer Research. Senior authors Amita Patnaik MD associate director of clinical research at South Texas Accelerated Research Therapeutics in San Antonio Texas and Geoffrey I. Shapiro MD PhD director of the Early Drug Development Center at the DanaFarber Cancer Institute in Boston. Background In February the U.S. Food and Drug Administration FDA approved the CDK inhibitor palbociclib Ibrance for use in combination with the aromatase inhibitor letrozole for treating postmenopausal women with estrogen receptorpositive HERnegative advanced breast cancer. The oral CDK inhibitor abemaciclib is a very different molecule from palbociclib with distinct attributes that contribute to its discrete therapeutic effects in particular its singleagent activity according to Shapiro. For example abemaciclib has greater selectivity for CDK compared with palbociclib which may explain why it does not affect white blood cell counts as severely allowing it to be taken on a continuous schedule without treatment holidays he said. Abemaciclib also penetrates the central nervous system whereas palbociclib does not raising the possibility that it could be used to treat primary or metastatic brain tumors he added. How the Study Was Conducted and Results Patnaik Shapiro and colleagues enrolled patients with a variety of types of advanced cancer in the phase I clinical trial designed to evaluate the safety and preliminary efficacy of abemaciclib. In the dose escalation phase the researchers determined that the maximum tolerated dose was milligrams mg every hours the doselimiting toxicity was grade fatigue. In the expansion phase singleagent abemaciclib was administered to patients with breast cancer with NSCLC with glioblastoma with melanoma and with colorectal cancer. Among these patients the most common treatmentrelated adverse events were fatigue diarrhea nausea vomiting anorexia weight loss kidney dysfunction and decreased red and white blood cell counts. Radiographic responses were observed for some patients with breast cancer NSCLC and melanoma. Among the patients with hormone receptorpositive breast cancer had a partial response with four of the responders having continued prior endocrine therapy and an additional patients had stable disease. Among the patients with NSCLC two had a partial response and had stable disease one patient who had a partial response and who had stable disease were known to have KRASmutant NSCLC. Among the patients with melanoma one had a partial response and six had stable disease. Three of the patients with glioblastoma had stable disease with two of them continuing to receive treatment without disease progression for and cycles respectively. Author Comment These data show that abemaciclib is an oral drug that can be taken on a continuous schedule and achieve durable clinical activity against multiple tumors including breast and lung cancers said Shapiro. The results of the trial supported the FDA decision to grant breakthrough therapy designation to abemaciclib previously known as LY for patients with refractory hormone receptorpositive advanced or metastatic breast cancer added Patnaik. Limitations Patnaik explained that because this study included patients with different types of cancer confirmatory clinical trials in specific patient populations are necessary to precisely define the role of abemaciclib in cancer care. Multiple clinical trials have already been initiated to evaluate abemaciclib as a treatment for certain groups of patients with breast cancer and NSCLC as well as children with primary brain tumors and adults with brain metastases she noted. Funding Disclosures The study was funded by Eli Lilly and Company. Patnaik has received research funding from Lilly. Shapiro served on an advisory board for Lilly during the conduct of the study reports receiving personal fees from Lilly GI Therapeutics Vertex Pharmaceuticals and grants from Lilly for work other than reported here and is an investigator on several trials using other CDK inhibitors including palbociclib and ribociclib. Follow us Cancer Research Catalyst httpblog.aacr.org Twitter AACR and Facebook http About the American Association for Cancer Research Founded in the American Association for Cancer Research AACR is the worlds first and largest professional organization dedicated to advancing cancer research and its mission to prevent and cure cancer. AACR membership includes more than laboratory translational and clinical researchers population scientists other health care professionals and patient advocates residing in countries. The AACR marshals the full spectrum of expertise of the cancer community to accelerate progress in the prevention biology diagnosis and treatment of cancer by annually convening more than conferences and educational workshops the largest of which is the AACR Annual Meeting with nearly attendees. In addition the AACR publishes eight prestigious peerreviewed scientific journals and a magazine for cancer survivors patients and their caregivers. The AACR funds meritorious research directly as well as in cooperation with numerous cancer organizations. As the Scientific Partner of Stand Up To Cancer the AACR provides expert peer review grants administration and scientific oversight of team science and individual investigator grants in cancer research that have the potential for nearterm patient benefit. The AACR actively communicates with legislators and other policymakers about the value of cancer research and related biomedical science in saving lives from cancer. For more information about the AACR visit http To interview Amita Patnaik or Geoffrey I. Shapiro contact Julia Gunther at julia.guntheraacr.org mailtojulia.guntheraacr.org or ."

"Pungent steam rises from a boiling pot of a mugwort tea blended with wormwood and a variety of other herbs. Above it sits a nude woman on an openseated stool partaking in a centuriesold Korean remedy that is gaining a toehold in the West. Vaginal steam baths called chaiyok are said to reduce stress fight infections clear hemorrhoids regulate menstrual cycles and aid infertility among many other health benefits. In Korea many women steam regularly after their monthly periods. There is folk wisdom and even some logic to support the idea that the carefully targeted steam may provide some physiological benefits for women. But there are no studies to document its effectiveness and few American doctors have even heard of it. It sounds like voodoo medicine that sometimes works said Dr. Vicken Sahakian medical director of Pacific Fertility Center in Los Angeles. Niki Han Schwarz believes it worked for her. After five steams she found she had fewer body aches and more energy. She also became pregnant eight months ago at the age of after attempting to conceive for three years. Han Schwarz and her husband orthopedic surgeon Charles Schwarz are determined to introduce vaginal steam baths to Southern California women. Their Santa Monica spa Tikkun Holistic Spa offers a minute VSteam treatment for . The identical treatment is available for men to steam the perineal area. At Daengki Spa in Koreatown a minute VHerbal Therapy treatment can be had for a squat. The steam includes a mixture of herbs imported from Korea by spa manager Jin Young. The spas website claims the treatment will rid the body of toxins and help women with menstrual cramps bladder infections kidney problems and fertility issues. It is a traditional Korean health remedy according to the website. Across the country chaiyok treatments are not easy to find. They are available in a scattering of alternative holistic health centers. The flashy Juvenex Spa in Manhattan offers its minute Gyno Spa Cure for . A complete setup for a doityourself steam openseated stool boiler and herbs can be purchased online at http for . The two predominant herbs in the steam bath mixture are mugwort and wormwood. Mugwort Artemisia vulgaris has been used in Eastern medicine for hundreds of years to balance female hormones. It contains natural antibiotics and antifungal agents according to herbalists and alternative medicine journals. It is also said to stimulate the production of hormones to maintain uterine health protect the uterus from ulcers and tumors stimulate menstrual discharge and ease fatigue headaches abdominal discomfort and nausea among other claims. Wormwood Artemisia herba an antimicrobial cooling herb is also popular in Eastern medicine. It has been used historically to induce uterine contractions and treat bladder infections fevers open sores constipation diarrhea hepatitis jaundice eczema and parasitic infections. The leaves and young shoots are antibacterial and antiviral and they also relax the blood vessels and promote the discharge of bile according to historical tradition. Neither herb has been subjected to the rigorous analysis used to vet Western medicines. But Han Schwarz says she and her husband became persuaded by the herbs healing abilities after conducting a factfinding mission in South Korea. They discovered that people there used the herbs to aid digestive disorders and immune system strength for reduction of headaches and pain from inflammatory conditions to improve energy to regulate the menstrual cycle and hormones and to detoxify the uterus. One of their clients Sherman Oaksbased writer Lanee Neil said she prefers the VSteam to the harshness of a douche and thinks of it as a facial for her private area. Its a simple relaxing treatment says Neil who hopes it will help her become pregnant. You can imagine people doing this in the forest somewhere. TaeCheong Choo who teaches at Samra University of Oriental Medicine in Los Angeles strongly endorses chaiyok treatment especially for gynecological problems and infertility. He says he used to administer it to his patients in Korea but he doesnt have the time to prepare the formula here. Many infertility problems are related to coldness and stagnation Choo says. The chaiyok treatment is effective for coldness or poor circulation in the lower part of the body because it increases the blood circulation and blood supplies nutrition so the more blood supply the faster the healing process. Dr. Suzanne GilbergLenz an obstetrician and gynecologist at Womens Care of Beverly Hills Medical Group says the idea of steaming the pelvic area is not insane. The heat boosts circulation and the increased blood flow brings more oxygen and immune factors to the region she says. However she notes its impossible to say whether the herbal steam does any good. Most of these kinds of treatments are not put through intensive clinical trials so it becomes challenging to evaluate the actual impact they have she says. In addition traditional practices like chaiyok have been cut off from the larger system they grew out of including factors of cultural and family life diet environment etc. Theres a bigger picture that were really missing."

"BUSINESS WIRE https Ltd. TSE Hitachi today announced that Johns Hopkins Medicine has selected Hitachi to provide its proton beam therapy httpcts.businesswire.comctCTidsmartlinkurlhttpAFF PBT system at Sibley Memorial Hospital located in Washington D.C. This collaboration which includes a year maintenance service marks the first multiroom PBT application in the nations capital. This will be Hitachis fifth PBT system in North America. The nextgeneration system PROBEAT which comes with IMPT Intensity Modulated Proton Therapy and conebeam CT will have improved spot scanning capability in all gantrytype treatment rooms along with a fixed irradiation room dedicated to cancer research. Toshiaki Higashihara President COO of Hitachi Ltd. stated that We are greatly honored that Johns Hopkins selected Hitachi as their proton partner. As one of the leaders in cancer research and treatment the Johns Hopkins Sidney Kimmel Comprehensive Cancer Centers philosophy of being at the leading edge of cancer treatment through research and development is very similar to our Social Innovation concept which supports a healthy and secure society through innovative technologies systems solutions and services. The proton center at Sibley Memorial Hospital will be an impressive demonstration of industry and academic medicine collaborating to bring a new technology and new cancer treatment modality to Washington D.C. and the surrounding communities. Thus we foresee an exciting long term relationship that will benefit cancer patients and cancer research. In December Hitachi was the first company in the U.S. to clear FDA Premarket Notification Special k for the PROBEAT system with its spot scanning irradiation technology. Hitachi has delivered the first hospital based spot scanning system in May and has treated over patients to date. The same spot scanning system has already been installed at Nagoya Proton Therapy Center and Hokkaido University in Japan. In fiscal year ending March one of Hitachis new PBT site is planning to start treatment of patients. Hitachi has shown great stability in the proton market through continued investment in research and development track record for high clinical availability of over along with a commitment to a long term partnership with all of its clients. Given the growing demand for technical and clinical advancements in the treatment of cancer interest in proton therapy is on the rise with more and more hospitals and cancer treatment facilities venturing into this area. Hitachi will continue to globally expand the healthcare business where proton therapy is its flagship solution and contribute to cancer treatment around the world. Overview of Proton Beam Therapy Proton Beam Therapy PBT is an advanced type of cancer radiotherapy. Protons from a hydrogen atom are extracted and accelerated up to the speed of light. Its energy is concentrated directly on the tumor while avoiding radiation dose to the surrounding healthy tissues. PBT improves the quality of life for cancer patients since the patient experiences no pain during treatment and the procedure has very few side effects compared with that of traditional radiotherapy. In most cases patients can continue with their normal daily activities while undergoing treatment. Because there are fewer side effects PBT is expected to expand especially for pediatric treatment. Overview of Spot Scanning Technology Unlike conventional scattering technology spot scanning technology delivers narrow beams to the tumor and the complex tumor shape can be irradiated through repetitive beam delivery with quick position change. Spot scanning technology has been achieved by advancing the uniform quality beam extraction technology from the accelerator and beam control technology with high accuracy. Three primary benefits are more accurate irradiation which reduces the side effects to healthy tissues surrounding the tumor compared with irradiation from conventional double scattering irradiation patientspecific collimators and boluses become obsolete shortening set up times for patients and high proton beam usage factor reducing unnecessary secondary radiation. About Hitachi Ltd. Hitachi Ltd. TSE headquartered in Tokyo Japan delivers innovations that answer societys challenges with our talented team and proven experience in global markets. The companys consolidated revenues for fiscal ended March totaled billion yen . billion. Hitachi is focusing more than ever on the Social Innovation Business which includes power infrastructure systems information telecommunication systems construction machinery high functional materials components automotive systems healthcare and others. For more information on Hitachi please visit the companys website at http httpcts.businesswire.comctCTidsmartlinkurlhttpAFF"

"Johnson Johnsons Stelara helped a significantly higher percentage of Crohns disease sufferers than those who received a placebo according to a study of patients who had not been helped by other commonly used drugs. In addition nearly percent of patients who stayed on Stelara beyond the initial six weeks of the midstage study continued to respond to the drug and there was a significantly higher rate of remission at weeks than in a placebo group. Stelara known chemically as ustekinumab is already approved to treat the skin condition plaque psoriasis and is in latestage testing for psoriatic arthritis. An approval for Crohns would give the drug entry into an estimated . billion U.S. market and . billion market worldwide. The intravenous biotech drug met the primary goal of the study as almost percent of patients who received the milligrams per kilogram of weight dose of Stelara achieved a clinical response defined as a point reduction in the Crohns Disease Activity Index CDAI after six weeks of treatment. That compared with a response rate of . percent of patients who received a placebo. Two lower doses of Stelara were also tested in the study of patients with moderate to severe Crohns disease who were not helped by or could not tolerate treatment with a widely used class of drugs known as TNF antagonists such as Abbott Laboratories Humira. Those who received mgkg had a . percent response rate and the mgkg dose led to a . percent response rate. To see these kind of outcomes where you have high response rates in the short term and then good remission rates out toward five or six months of therapy it shows unequivocally that the drug is effective for treating Crohns disease said Dr. William Sandborn the studys lead investigator who presented the data at the Digestive Disease Week meeting in Chicago on Sunday. Its effective in the patient population that has the greatest unmet need at this point in time Sandborn said of patients who do not respond to antiTNF drugs. He said a point drop in the CDAI was clinically meaningful to patients. Theyll feel measurably better. The patient population was really quite ill and had very high disease activity and despite that we saw nice response rates Sandborn said. In a second phase of the study those who responded to Stelara after six weeks of treatment were given either a mg injection of Stelara at week eight and week or a placebo. After weeks . percent of the Stelara patients maintained a clinical response and . percent were deemed to be in clinical remission. That compared with . percent who maintained a clinical response and a . percent remission rate in the placebo group. Clinical remission was defined as a CDAI score down to . Patients in the study on average started at or on the CDAI scale researchers said. Crohns is a chronic autoimmune disorder of the gastrointestinal tract that affects an estimated Americans. Common symptoms are abdominal pain and diarrhea and it can lead to bowel perforations. Many Crohns patients require surgery when medicines no longer control symptoms. The rate of infections and other serious side effects was similar in the Stelara and placebo groups researchers said. Well need more patients and longerterm data to really fully characterize the safety profile in Crohns disease but so far so good Sandborn said. Reporting by Bill Berkrot Editing by Tim Dobbyn and Dale Hudson Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Three years ago Tomas Sandoval was looking forward to the birth of his second child when he was diagnosed with a rare form of a blood cancer called lymphoma. Despite chemotherapy and a stem cell transplant the cancer returned before his daughters first birthday. Everything is at stake. Being around for my daughter my son my wife. Yeah it was a really tough time he said. Sandoval is alive today because of an experimental form of immunotherapy called CART. Normally our immune cells are good at killing invaders like bacteria but bad at fighting cancer. With CART a patients own immune cells are removed from the body reprogrammed to find and destroy cancer cells then put back into the bloodstream. On Friday Moffitt Cancer Center and MD Anderson reported test results of patients with advanced lymphoma who had failed previous therapy and were treated with CART. It puts a GPS navigation on the front of the cell so that when theyre infused back in they know where to go and kill the lymphoma said Dr. Frederick Locke who helped lead the trial. About eight months after a single treatment percent of patients had no evidence of cancer. Thats actually quite remarkable knowing that at best only one out of of these patients could have complete disappearance of their lymphoma with standard chemotherapy Locke said. Side effects included flulike symptoms and confusion and there were three treatmentrelated deaths. The FDA will review these results and could make a decision on approval by the end of the year."

"A daily supplement of pharmaceutical grade chondroitin is as good as celecoxib Celebrex at relieving arthritic knee pain and doesnt have dangerous side effects researchers say. Dr. JeanYves Reginster of Liege State University in Belgium and colleagues recruited people over age with knee osteoarthritis from five European countries and randomly assigned them to take mg of the extrapure chondroitin sulfate Chondrosulf mg of celecoxib Celebrex or a placebo every day for six months. Those who took chondroitin sulfate or celecoxib had similar levels of pain relief at the end of the study and in both groups the improvement was greater than for those taking just a placebo according to the report in Annals of the Rheumatic Diseases. Reginster told Reuters Health the findings are in line with earlier studies showing pharmaceuticalgrade chondroitin sulfate could significantly decrease the progression of knee osteoarthritis over a period of three years. He stressed that pharmaceuticalgrade chondroitin is not the same as overthecounter supplements which are made differently and cant get into the joint in high enough concentrations to combat the causes of cartilage degradation and pain. European regulatory bodies recommend pharmaceuticalgrade chondroitin sulfate as well as pharmaceuticalgrade glucosamine sulfate as firstline treatments for osteoarthritis Reginster said by email because of the side effects associated with celecoxib and other nonsteroidal inflammatory drugs NSAIDs including stomach ulcers bleeding liver and kidney problems. Dr. Michael Shepard of Hoag Orthopedic Institute in Orange California noted that the study had a relatively low number of participants and that most U.S. studies of this type would run two years rather than six months. In addition U.S.based studies of chondroitin have had mixed results said Shepard who wasnt involved in the study. Some have found the supplements to be as effective as ibuprofen also an NSAID and some have found that chondroitin sulfate is no more effective than placebo he told Reuters Health. I tell my patients buyer beware Shepard said in an email. I tell them about the mixed results of chondroitin in the literature. I tell them to try chondroitin for one month as a trial and if they like it and feel better with it then keep taking it. If chondroitin doesnt work for them he suggests taking an NSAID periodically and to be aware of the side effects. If you are going to stay on an NSAID for a prolonged period then you need regular follow up with your doctor Shepard cautioned. Dr. Rachel Wolfe of Wake Forest Baptist Medical Center in WinstonSalem North Carolina agreed that chondroitin is reasonable to try for some people especially those with contraindications to NSAIDs. However it should not replace other therapy such as quad strengthening exercises and weight loss which we know will provide benefit. It should be used in conjunction with these measures said Wolfe who wasnt involved in the study. Chondroitin is not a miracle pill but if it allows people to feel less pain and be more active thereby losing weight and strengthening muscles then I think there may benefit Wolfe told Reuters Health by email. Studies like this highlight that medicine is still an art we do not have perfect answers and we have to individualize for each patient. The study was sponsored by IBSA Institut Biochimique SA a pharmaceutical company based in Lugano Switzerland that makes the chondroitin sulfate supplements used in the test. SOURCE bit.lyrcPLh httpbit.lyrcPLh Annals of the Rheumatic Diseases online May ."

"About customers a day walk through the doors of Holy Smokes a vape and smoke shop in Philadelphia looking to buy kratom the herbal product derived from the leaves of a Southeast Asian tree. Users and businesses that sell and manufacture it say kratom pronounced Kraytuhm helps to relieve pain gives a mild boost like coffee the tree is part of the coffee family and can even help ease the pain of opioid withdrawal. The U.S. Food and Drug Administration says the product not regulated as a drug because it is classified as a dietary supplement is a dangerous addictive substance that acts on the brains opioid receptors and has been linked to deaths. There is no evidence to indicate that kratom is safe or effective for any medical use FDA Commissioner Scott Gottlieb said in February. And claiming that kratom is benign because its just a plant is shortsighted and dangerous. The agency issued a recall https November because of possible health risks. Earlier this month the Centers for Disease Control and Prevention linked kratom to a multistate outbreak of salmonella https has so far sickened people in states and issued a recommendation that people not use it in any form. Several states including Alabama Arkansas Indiana Tennessee and Wisconsin ban the substance others have legislation to ban it pending. It is also listed as a controlled substance like heroin in countries including Thailand and Malaysia where it is grown the FDA reports. The warnings havent stopped the clients at Holy Smokes S. Juniper St. said acting manager Charlie Goodine. We sell a lot of kratom he said. Some customers use the product to help with opioid withdrawal or as a replacement for prescription opioids such as OxyContin and Percocet. Its pretty much the cure for opioid withdrawal. Goodine said. It takes about two weeks for the physical symptoms to subside he said. Scientific studies have indicated that the most effective treatment for opioid withdrawal includes the medically supervised use of opioid medications such as methadone. http But the FDA has said there is no reliable evidence that kratom can safely be used this way. The FDA stands ready to evaluate evidence that could demonstrate a medicinal purpose for kratom. However to date we have received no such submissions and are not aware of any evidence that would meet the agencys standard for approval Gottlieb said. Goodine is aware of the FDAs position on kratom and thinks the agency is siding with big Pharma and against any product that might interfere with the sale of prescription drugs. Kratom is sold online in gas stations and in smoke shops. It is also known as Thank Kakua thom Ketom and Biak and is typically brewed as a tea chewed smoked or ingested in capsules. Holy Smokes gets kratom directly from Indonesia and not from the Oregonbased PDX Aromatix in Portland which recalled its kratom products due to salmonella Goodine said. The bitter taste could be compared to a really strong matcha powder made of groundup green tea leaves Goodine said. Ten onegram capsules of kratom cost while grams of powder is .. Goodine has used the herb and compared it to taking an aspirin and drinking coffee. Not surprisingly the American Kratom Association insists the substance it is not dangerously addictive and it is not dangerous said Mac Haddow the director of government relations for the group. The deaths associated with kratom have with one exception not been caused by the substance but by other drugs that were found in combination with kratom he said. You cant take enough to hurt yourself Haddow said echoing Goodines contention that opponents just want to cut out competition for the pharmaceutical industry. Haddow produced reports indicating kratom is a safe way to get a mild mood boost and some pain relief. He acknowleged some of the research was paid for by the association. He contended that kratom does not act on the brains opioid receptors the way prescription painkillers and heroin do. But back in the Journal of the American Chemical Society httpscen.acs.orgarticlesiRecreationaldrugkratomhitssame.html reported that kratom indeed works this way. Last month an FDA study https found that of the of the most prevalent compounds in kratom do bind to opioid receptors and so should be considered an opioid. The study also said most deaths did occur in people who used kratom in addition to other drugs though in one case only kratom was detected. The Philadelphia Medical Examiners Office has not attributed any deaths to kratom nor any of its active ingredients said James Garrow spokesperson for the Department of Public Health. However given that it is the subject of a voluntary U.S. FDA recall is currently implicated in a nationwide outbreak of salmonella and there exists no scientific evidence that it is safe or effective for any medical use it is our recommendation that people not consume any brand of kratom in any form he stated in an email. NMS Labs http a nationally known forensic laboratory in Willow Grove started testing for mitragynine the active component in kratom about five years ago said Kelly Ciliberto toxicology administrator. We see it fairly frequently in our post mortem case work Ciliberto said. Between percent and percent of the cases contain some evidence of the substance but it is found mostly alongside other drugs. The samples come from all states she said. The facility performed the toxicology tests in the August accidental death of a New York police officer from Tupper Lake a community about miles north of Albany who had been making the powdered kratom into a paste and eating it Ciliberto said. Sgt. Matthew Dana died of a hemorrhagic pulmonary edema or blood in the lungs which resulted from an overdose of mitragynine the Adirondack Daily Enterprise reported. http If people are saying kratom is like coffee that is misleading and dangerous Ciliberto said."

"Novartis will seek regulatory approval this year for a new kind of antiinflammatory heart drug though some experts fear fatal infection risks and a high price may overshadow the medicines limited benefits. FILE PHOTO A general view shows the Rhine river and the headquarters of Swiss pharmaceutical company Novartis AG in Basel Switzerland March . REUTERSArnd Wiegmann Keenly awaited clinical trial results released on Sunday showed heartattack survivors on one of three doses of canakinumab were percent less likely to suffer another major cardiac event than those on a placebo. Novartis had said in June that the drug met its goal in the study but details were only unveiled at European Society of Cardiology meeting in Barcelona. One leading expert described the benefit as modest. Patients getting canakinumab also suffered significantly more deaths from infections than those on placebo but on the positive side they appeared to be at lower risk of cancer. There was no significant difference in the rate of deaths from all causes between the placebo group and those on canakinumab. The modest absolute clinical benefit of canakinumab cannot justify its routine use in patients with previous myocardial infarction until we understand more about the efficacy and safety tradeoffs and unless a price restructuring and formal costeffectiveness evaluation supports it wrote Dr. Robert Harrington chair of the Stanford University School of Medicine in an editorial in the New England Journal of Medicine. Canakinumab had stirred considerable scientific interest because it appears to finally deliver proof that fighting inflammation offers a promising new way to counter heart disease in patients who already get cholesterollowering treatment. Subsequently some analysts boosted their revenue estimates for the Novartis medicine into the billions of dollars while awaiting the data announced on Sunday. Canakinumab is already approved as Ilaris for rare autoimmune conditions. Vas Narasimhan Novartiss head of global drug development said the drugmaker plans to go to regulators in the fourth quarter to seek approval for canakinumab to treat heartattack victims with high levels of inflammation. He downplayed critics who said the benefit was small saying that one large subgroup in the socalled Cantos trial had shown a percent reduction in cardiovascular risk. Novartis also plans to underscore canakinumabs potential cancer fighting properties with the European Medicines Agency and the U.S. Food and Drug Administration. SEPARATE TRIALS Thats after an analysis of Cantos data found total cancer mortality among patients getting canakinumab was significantly lower than in those receiving the placebo. Narasimhan who said the company now plans to start separate cancer trials for canakinumab said the drug could be particularly suitable for smokers with risks of both lung cancer and heart problems. With the oncology findings promising but only preliminary the company is planning additional studies in lung cancer starting next year he said. Ilaris now costs about per patient annually for treating rare immune conditions and brings in some million in yearly sales for the Swiss company though its price is likely to be slashed should it win approval in the heart setting. Novartis initially struggled with the sluggish launch of its last heart drug the peryear Entresto so it is understandably concerned about the reception for canakinumab. While Narasimhan said it was too early to discuss pricing he argued socalled PCSK cholesterol drugs that cost about annually should not be relied on as a yardstick. In view of the additional oncology findings we dont think you should just think about this as a cardiovascular drug Narasimhan said. I dont think you can necessarily just make comparisons to existing benchmarks such as the PCSKs. Even so Tim Anderson a Bernstein analyst said the marginal data are not compelling enough to dispel what for Novartis will remain a pricing conundrum should canakinumabs approval be expanded for heart patients. If the company cuts the price of the product in its current orphan indications then it instantly sacrifices sales which currently total about million per year with the hope that future sales in a new CV setting will more than offset this Anderson said in a note. Some have wondered whether a particularly highrisk subgroup could be identified where canakinumabs current price can be justified he said. We are not hopeful here. Reporting by John Miller Editing by Ben Hirschler and Ralph Boulton Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"The herpes zoster vaccine could prevent tens of thousands of cases of shingles each year if it was offered to everyone who is eligible with vaccinated adults half as likely to develop shingles a study said. In the U.S. Food and Drug Administration approved a vaccine against shingles a painful and potentially serious condition for adults over . The vaccine has been tested but never under realworld conditions in regular doctors offices. The study led by Hung Fu Tseng a research scientist at Kaiser Permanente in Southern California compared about vaccinated members of the Kaiser Permanente Health plan with about similarly aged members who werent vaccinated. We didnt know how well the vaccine actually performed in the community setting Tseng told Reuters Health. Shingles is a viral disease produced by the chicken pox virus a common childhood disease and is characterized by pain and a blistering rash along the nerves that have housed the dormant virus. Most shingles patients are older adults but people with a weak immune system or those under stress may also develop it. Everyone in the study published in the Journal of the American Medical Association was at least years old and the researchers didnt include anybody for whom the live vaccine is not recommended. Using electronic health records researchers tracked patients for up to three years after vaccination. About six out of every people vaccinated got shingles each year compared to of every unvaccinated patients. Researchers calculated that for every people who were vaccinated one case of shingles was prevented. But researchers cautioned that because they did not follow patients over the longer term they didnt know how effective the vaccine is years later. Despite the FDAs approval the vaccine has not caught on as much as some had hoped. Cost is one hurdle with the vaccine sometimes costing up to for people whose insurance doesnt cover it. It also requires stringent storage and handling. The human cost of shingles is enormous said Michael Oxman who studies infectious diseases at the University of California San Diego and was involved in a previous study of the vaccine. Adult medicine is really geared toward diagnosis and treatment of existing diseases. The adult medical community is not as attuned to preventing disease... as pediatricians are he told Reuters Health. SOURCE bit.lyfKolv httpbit.lyfKolv Reporting by Genevra Pittman at Reuters Health editing by Elaine Lies Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"University of North Carolina Lineberger Comprehensive Cancer Center researchers have found that mailing selfcollection kits to test for highrisk human papillomavirus infection has the potential to boost cervical cancer screening especially for lowincome women who are overdue for testing. In the journal Obstetrics Gynecology researchers published the results of mailing athome HPV selfcollection kits to lowincome women in North Carolina who were overdue for screening according to national guidelines. They reported this screening approach detected highrisk HPV in all of the cases of women who were found to have highgrade abnormal cervical precancerous growths showing that selfcollection at home for HPV may be a viable method to identify women at highrisk for cervical cancer. This is a demonstration that mailing selfcollection kits and returning them to test for highrisk HPV infection has big potential to increase screening access among underscreened women and to do that successfully said UNC Linebergers Jennifer S. Smith the studys senior author and a professor in the UNC Gillings School of Global Public Health. Although cervical cancer is preventable through early detection and treatment the American Cancer Society estimates that more than women will die from cervical cancer in the United States this year. Nearly percent of women in the United States who are eligible for cervical cancer screening report they havent been tested for cervical cancer within the recommended time interval national surveys have shown. Women are dying unnecessarily of cervical cancer because they either havent been vaccinated against HPV in adolescence or theyve not been getting screened according to national guidelines Smith said. Increasing screening rates among underscreened women is of paramount importance. In the U.S. Food and Drug Administration signed off on using an HPV test alone to screen for cervical cancer for women years and older in conjunction with the Pap test. Earlier this year the U.S. Preventive Services Task Force gave an A rating to HPV primary screening alone for women aged to . There are a lot of different barriers that cause women to be underscreened said the studys first author Andrea Des Marais MPH project manager with the UNC Gillings School of Global Public Health. HPV tests are being widely used now in the United States but only through physician collection in clinical practice which requires that women come to a clinic. Offering HPV testing using selfcollection by mail has a lot of potential to reach women who are the highest risk of being screened those who dont access regular medical care. For the study researchers mailed athome selfcollection kits to lowincome women in North Carolina who were overdue for screening by national guidelines. They included women between the ages of and years who had reported no history of receiving a Pap test which checks for precancerous or cancerous cells within the past four years. Researchers provided study participants with selfcollection brushes along with instructions for how to take a sample from inside the vagina. The brush samples were then tested in a lab for HPV and other sexually transmitted infections. Participants also selfcollected samples at a clinic and handed them to a nurse and had a pelvic exam for a clinician to collect a Pap smear sample. The researchers compared the results from self and cliniciansamples which were tested for highrisk HPV strains that are linked to cervical cancer to the Pap results and the results of cervical biopsies collected during colposcopy which is a secondary diagnostic test that confirms the presence of cervical precancerous lesions among women with abnormal Pap smear results. The home selfcollection test indicated that . percent of women were infected with highrisk HPV the selfcollection tests used in the clinic found . of the women had highrisk HPV infection and the cliniciancollected test identified . percent of the women had highrisk HPV infection. We found comparable detection between selfcollection and physiciancollection Des Marais said. All women found to have highgrade cervical lesions by Pap smear or by cervical biopsy were positive for highrisk HPV on their home selfcollected sample. We found in this sample all of the women who had highgrade lesions had HPVpositive home selfcollection results Smith said. We didnt miss any of those highgrade cases by conducting home selfcollection. Smith said there is more work to be done such as identifying ways to make the selfcollection process more efficient and costeffective and getting FDA approval for the clinical use of selfcollection for cervical cancer screening. This is a proofinprinciple study that we used to determine whether home selfcollection is highly effective for detecting highgrade disease Smith said. We are already working on the next step which is a clinical trial in which women who arent uptodate on screening get either a referral to a free clinic appointment to receive a screening or receive a selfcollection kit in the mail followed by referral to a free clinic appointment. This will allow us to determine the effect that selfcollection has on screening uptake. In addition to Des Marais and Smith other authors included Yuqian Zhao Marcia M. Hobbs Vijay Sivaraman Lynn Barclay and Noel T. Brewer. The study was supported by the National Cancer Institute the National Institutes of Health and the University Cancer Research Fund. Individual researchers were supported by the China Scholarship Council. Financial disclosure Highrisk HPV and sexually transmitted disease tests sample preservation media ThinPrep processor slides and other equipment were donated by Hologic Inc. Selfcollection brushes were donated by Rovers Medical Devices. Some travel expenses for Des Marais were paid by Hologic and others have consulted for the company. Smith has received research funding supply donations and consultancies and served as a paid speaker for Arbor Vita BD Diagnostics Hologic Rovers Medical Devices and Trovagene. Neither Hologic nor Rovers had input into the research design analysis or interpretation of results."

"Injecting a calciumbased cement into the bones of some people with knee or hip pain could help them avoid joint replacement surgery Ohio State University doctors say. The calcium phosphate cement flows into the spongy inside portion of the bone filling in microfractures and other damaged areas and it hardens in about minutes time said Dr. Kelton Vasileff an orthopedic surgeon at the universitys Wexner Medical Center. The cement braces the bruised or injured joint bone from the inside Vasileff explained and eventually is replaced by new bone as part of the bodys natural healing process. The procedure called subchondroplasty has been available to people with knee problems for years Vasileff said. Now he and his colleagues are testing to see whether hip patients also can benefit from it. It is much less invasive than a knee or hip replacement and typically is performed on an outpatient basis Vasileff said. The procedure involves a smaller incision than joint replacement surgery so theres less risk of infection and a quicker recovery time that means fewer of the side effects associated with being bedridden Vasileff said. However subchondroplasty is only feasible in a narrow range of patients. Those with fullblown boneonbone arthritis or joint pain caused by damage to the cartilage and ligaments will get little to no relief from the procedure Vasileff said. People who have significant arthritis where the cartilage itself is damaged and thinned this isnt going to fix the arthritis Vasileff said. But there are some people who may have some issues with the bone and mild arthritis. In these patients who might otherwise have needed a knee or hip replacement to deal with that this could be an alternative. Software engineer Ben Wallace underwent subchondroplasty in November to help shore up a damaged hip. The end of September I noticed I was really struggling to move around my left leg very well said Wallace who lives in Columbus Ohio. Imaging scans revealed a hip in very bad shape with a misshapen femur. A fivehour surgery cleaned up the femur and bolstered the bone with cement. Its been going really great. Im better than what they expected. One week after surgery I was off the crutches walking on my own Wallace said. I figured Im going to have a fake hip in there at the age of which was very depressing Wallace explained. The fact I was able to keep all my bones and joints in there was quite a surprise. Subchondroplasty has shown solid potential but orthopedic surgeon Dr. Matthew Hepinstall is concerned that it might be oversold to desperate patients who want to avoid joint replacement surgery. The claims that are being made are not evidencebased yet although they are intellectually appealing said Hepinstall. He is associate director of the Center for Joint Preservation Reconstruction at Lenox Hill Hospital in New York City. Its just important not to oversell this he added. The best candidates for the procedure are patients who still have some cartilage protecting their joint but have somehow overloaded and injured the bone causing swelling and pain Hepinstall said. If you inject this substance into the bone youre basically providing internal support a scaffold protecting the bone. That can theoretically reduce bone pain Hepinstall noted. The appealing thing about it is instead of going in and resurfacing a damaged joint youre injecting something to help the bone but keeping the patients own anatomy Hepinstall continued. But theres a very narrow window of patients who are good ideal candidates for this who basically have a real overload of their bone causing severe enough pain to warrant a surgical procedure but also have healthy enough cartilage that doing something about the bone swelling is going to alleviate the majority of their pain he stressed. We dont want to send the message to people who have boneonbone with big bone spurs and limited range of motion that theyre all of a sudden going to get relief from injecting a little bit of cement into their bone Hepinstall said. This is for people who have basically a normal joint that has normal range of motion and normal stability just a little thinning of the cartilage. More information For more on knee pain visit the Arthritis Foundation http SOURCES Kelton Vasileff M.D. orthopedic surgeon Wexner Medical Center Ohio State University Columbus Ohio Matthew Hepinstall M.D. associate director Center for Joint Preservation Reconstruction Lenox Hill Hospital New York City Ben Wallace Columbus Ohio"

"People who took a newer type of pain pill over a threeyear period were less likely to develop polyps that could lead to colorectal cancer but at the expense of a higher risk of heart problems new study findings report. And when participants stopped taking the pain pill Celebrex celecoxib out of concerns over side effects they eventually developed more polyps than people who had remained on an inactive or placebo drug throughout the study. So should people concerned about their risk of colorectal cancer consider Celebrex The findings in this study dont necessarily make that decision any easier said Dr. Andrew Chan of Massachusetts General Hospital and Harvard Medical School who did not participate in the research. The study published in the American Journal of Gastroenterology received financial support from Pfizer which sells Celebrex. This is not the first study to suggest Celebrex and similar drugs known as COX inhibitors may reduce the risk of developing colon cancer he said but people need to balance that potential benefit with the higher risk of cardiovascular complications. As a result he said he suspects most people would choose to rely on regular colonoscopies to catch the disease in its early stages rather than take a potentially risky drug for years. But to people who have no underlying cardiovascular problems and a particularly high risk of colon cancer they were diagnosed with it before perhaps or have a strong family history regular screening may not be enough Chan noted. So for those patients they might consider taking a drug like this he said. Colorectal cancer is the third most common cancer in men and women and strikes . million people each year. Other research has provided signs that COX inhibitors which block the COX enzyme that causes inflammation could also prevent colorectal cancer as well as lung cancer in heavy smokers. However most COX inhibitors ran into safety issues a few years after their approval and now only Celebrex remains on the U.S. market. At a cost of several dollars per day depending on dosage it is much more expensive than older pain relievers such as ibuprofen. During the study Dr. Nadir Arber of Tel Aviv University and his colleagues reviewed data collected from people with a history of colorectal cancer. More than half had received Celebrex for approximately years before concerns over the increased risk of cardiovascular problems caused researchers to discontinue the study. The scientists then followed the people willing to continue the research for another years noting who developed new polyps including advanced polyps with features that suggest theyre more likely to become cancerous. Approximately half of the people who started the study agreed to continue. Not surprisingly Celebrex users were more likely to develop cardiovascular problems including a percent higher risk of serious cardiac disorders. But over the total year period people who took Celebrex were also less likely to develop new and advanced polyps than people who took a placebo. Specifically new polyps were found in percent of people on placebo and only percent on Celebrex. However during the th year of the study alone after the trial had been over for years percent of Celebrex users developed new polyps versus only percent of people who had been on placebo translating to a percent higher risk among those who previously took Celebrex. Those who had been on Celebrex were also more likely to develop advanced polyps during that final year. This rebound in risk actually makes biological sense Chan told Reuters Health. If COX inhibitors protect against colon cancer by blocking an enzyme pathway when that blockage is released the disease could occur potentially at higher levels than had you never been on the drug in the first place he said. Still the results are very promising Arber told Reuters Health by email adding he is now working to identify people who could benefit from the drug without experiencing the side effects. Only half of the people who originally agreed to participate in the study remained after years and its unclear how this might affect the results noted Chan whose own research suggests aspirin could prevent deaths from colorectal cancer. However for a study that lasts this long those are acceptable numbers noted Arber. If patients asked him whether they should take celecoxib to prevent colorectal cancer Arber would tell them no he added. They should speak with their doctor. SOURCE bit.lymDNurd httpbit.lymDNurd The American Journal of Gastroenterology online April . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Seciera Meets Primary and Key Secondary Endpoints in Pivotal Trial Shows Efficacy at Weeks of Treatment Sun Pharma is Developing Seciera for Global Markets Sun Pharma announced successful Phase confirmatory clinical trial results for Seciera cyclosporine A . ophthalmic solution for the treatment of dry eye disease. Seciera is a patented novel proprietary nanomicellar formulation of cyclosporine A .. It is a clear preservativefree aqueous solution. Seciera is being developed by Ocular Technologies a company recently acquired by Sun Pharma. Following this acquisition Sun Pharma owns exclusive worldwide rights to Seciera and is developing it to commercialize for global markets including US Europe and Japan as well as several emerging markets. Logo httpphotos.prnewswire.comprnh In this week multicenter randomized doublemasked vehicle controlled Phase confirmatory study dry eye patients were treated either with Seciera or its vehicle. After weeks of treatment as compared to vehicle Seciera showed statistically significant improvement in the primary end point Schirmers score a measurement of tear production p.. The demonstration of efficacy by Seciera at weeks is earlier than other drugs approved for dry eye in the same class. Additionally several key secondary endpoints showed statistically significant improvements compared to vehicle with some showing an even earlier onset of action. Adverse events reported in the trial were mild to moderate in nature and similar to other approved drugs in the category. As Sun continues to analyze the data additional significant findings will be shared at upcoming medical conferences. Previously in a completed Phase b clinical trial in patients Seciera demonstrated a rapid onset of action and was well tolerated by the study population. Based on published data the efficacy and safety endpoints in these trials compared favorably to other formulations of cyclosporine A with the advantage of early onset. According to Dilip Shanghvi Managing Director Sun Pharma We are happy to see the early onset of action and strong efficacy results for Seciera. These results are highly encouraging for millions of Dry Eye patients across the globe that have yet to find relief for their condition. We look forward to discussing these results with US FDA and agree on next steps for the program. I am very excited to see these strong results for Seciera noted Dr. Joseph Tauber Study Investigator and founder of the Tauber Eye Center Kansas City Missouri. As a clinician who specializes in diagnosing and treating dry eye this novel formulation of cyclosporine A would be a unique and welcome addition to our armamentarium to treat these patients. Jerry St. Peter Vice President and Head of Sun Ophthalmics added A key strategic imperative for our ophthalmic business is to participate in the rapidly growing underserved and dynamic Dry Eye market which is expected to reach billion by . Based on this successful confirmatory Phase trial Seciera has the potential to strengthen our emerging ophthalmics pipeline which includes the recent launch of BromSite and late stage development programs for Xelpros and DexaSite. References . Sall K Stevenson OD Mundorf TK Reis BL. Two multicenter randomized studies of the efficacy and safety of cyclosporine ophthalmic emulsion in moderate to severe dry eye disease. CsA Phase Study Group. Ophthalmology. Apr. PMID . Sheppard JD Torkildsen GL Lonsdale JD DAmbrosio FA Jr McLaurin EB Eiferman RA Kennedy KS Semba CP. Lifitegrast ophthalmic solution . for treatment of dry eye disease results of the OPUS phase study. Ophthalmology. Feb. doi .j.ophtha.... Epub Nov . PMID . Tauber J Karpecki P Latkany R Luchs J Martel J Sall K Raychaudhuri A Smith V Semba CP. Lifitegrast Ophthalmic Solution . versus Placebo for Treatment of Dry Eye Disease Results of the Randomized Phase III OPUS Study. Ophthalmology. Dec. doi .j.ophtha.... Epub Sep . PMID . DEWS Research Subcommittee. Research in dry eye report of the Research Subcommittee of the International Dry Eye WorkShop . Ocul Surf. . . Paulsen AJ Cruickshanks KJ Fischer ME et al. Dry eye in the Beaver Dam Offspring Study prevalence risk factors and healthrelated quality of life. Am J Ophthalmol. . . Kantar Health. National Health and Wellness Survey The Global Health and Wellness Report .http Accessed May . . Market Scope Comprehensive Report on the Global Dry Eye Products Market December SOURCE Sun Pharma"

"Researchers have developed an ultraviolet UV lamp that kills the influenza virus but isnt harmful to human skin or eyes according to a new study in Scientific Reports httptime.comuvlightkillsfluvirusdx.doi.org.sw. They hope the technology can be commercialized and marketed to prevent the spread of seasonal flu in public places such as schools hospitals and airports. Weve known for a century that UV light is extremely efficient at killing microbes bacteria and viruses says study leader David Brenner director of the Center for Radiological Research at Columbia University Irving Medical Center. For that reason UV devices are often used for sterilization for medical equipment in hospitals for example or drinking water for backcountry campers. But conventional germicidal lamps arent safe for humans to be around. With prolonged exposure they can cause skin cancer and cataracts in the eyes. So up until now theyre only really practical when people arent around say Brenner. You can sterilize a hospital room but not when anyones inside. About five years ago Brenner says the Columbia team came up with a potential solution. Light on the far end of the UVC spectrum known as farUVC has very short wavelengths. The researchers suspected that it can penetrate and destroy microscopic bacteria and viruses but cant travel through the protective outer layers of human skin or eyes. We wanted to get all the benefits of UV light in terms of killing microbes but none of the health hazards says Brenner. Earlier studies on animals and humans have shown that exposure to farUVC light does indeed appear to be safe. We havent seen any biological damage to skin cells or eye cells whereas with conventional UV light weve always seen lots of biological damage he says. Previous research has also shown that farUVC light can kill MRSA bacteria a common cause of infections after surgery. Now Brenner and his colleagues have show that UVC light can effectively kill airborne influenza. In their new study aerosolized particles of the HN seasonal flu virus were released into a test chamber and exposed to very low doses of farUVC light. The light inactivated the viruses with about the same efficiency as conventional germicidal UV light while a control group of bacteria not exposed to light remained active. We think that this type of overhead light could be efficacious for basically any public setting says Brenner. Think about doctors waiting rooms schools airports and airplanesany place where theres a likelihood for airborne viruses. And unlike the flu vaccine he says farUVC light is likely to be effective against all airborne microbes including newly emerging virus strains. Brenner says his team is working with a company to develop a commercially available version of the lamp which could become a costeffective way to battle flu epidemics on a population level. The lamp were using at the moment costs less than and you can imagine that if it were put into general circulation the price would drop dramatically he says. We dont see cost as being a limiting factor here. UVC lamps could also have potential implications in clinical settings as well in the operating room during surgeries for example. No matter how well you sterilize a room beforehand the medical staff can still bring in dangerous bacteria like MRSA says Brenner. If you have a lamp over the surgical site that can sterilize the air you can prevent the bacteria from floating down and contaminating the wound. Brenner cant predict how long it might take for these lamps to be commercially available but he says hes extremely optimistic about the technology. There has been no way of killing viruses in the air in public spaces and this is an approach that may solve that problem."

"Human papillomaviruspositive oropharynx cancers cancers of the tonsils and back of the throat are on rise. After radiation treatment patients often experience severe lifelong swallowing eating and nutritional issues. However new clinical trial research shows reducing radiation for some patients with HPVassociated oropharyngeal squamous cell carcinomas can maintain high cure rates while sparing some of these late toxicities. We found there are some patients have very high cure rates with reduced doses of radiation said Barbara Burtness MD Professor of Medicine Medical Oncology Yale Cancer Center Disease Research Team Leader for the Head and Neck Cancers Program at Smilow Cancer Hospital and the chair of the ECOGACRIN head and neck committee. Radiation dose reduction resulted in significantly improved swallowing and nutritional status she said. The study published in the December issue of the Journal of Clinical Oncology showed that patients treated with reduced radiation had less difficulty swallowing solids percent versus percent of patients treated with standard doses of radiation or impaired nutrition percent versus percent of patients treated with regular doses of radiation. Today many younger patients are presenting with HPVassociated squamous cell carcinoma of the oropharynx said Dr. Burtness. And while traditional chemoradiation has demonstrated good tumor control and survival rates for patients too often they encounter unpleasant outcomes that can include difficulty swallowing solid foods impaired nutrition aspiration and feeding tube dependence said Dr. Burtness. Younger patients may have to deal with these side effects for decades after cancer treatment. We want to help improve our patients quality of life. The study included patients from ECOGACRIN Cancer Research Group sites who had stage three or four HPVpositive squamous cell carcinoma of the oropharynx and were candidates for surgery. Eligible patients received three courses of induction chemotherapy with the drugs cisplatin paclitaxel and cetuximab. Patients with good clinical response then received reduced radiation. Study results also showed that patients who had a history of smoking less than packs of cigarettes a year had a very high disease control compared with heavy smokers. Other authors on the paper include Shanthi Marur Johns Hopkins Medicine and Anthony Cmelak Vanderbilt University."

"Beetroot has been used since the Middle Ages as a treatment for ailments particularly those relating to the blood and digestion. Medical researchers have recently returned to this plant product to investigate its effect on blood pressure https and explore opportunities to put it to use in modern medicine and the home management of conditions. Researchers have concluded that one glass of beetroot juice a day is enough to significantly reduce blood pressure in people with high blood pressure https They conducted a placebocontrolled trial with dozens of participants. According to the Centers for Disease Control and Prevention CDC high blood pressure is either the primary cause of or contributes to more than deaths http_statisticsfact_sheetsfs_bloodpressure.htm in the United States every day. Because of the widespread impact of high blood pressure researchers are likely to investigate in some depth any simple dietary interventions that could potentially benefit the wider population. Research High blood pressure is a serious public health concern. It increases the risk http of more dangerous health conditions such as heart attack https stroke https and chronic heart failure https High blood pressure is also a major risk factor for kidney disease. Beetroot contains high levels of dietary nitrate NO which the body converts into biologically active nitrite NO and nitric oxide NO. In the human body NO relaxes and dilates blood vessels. Other leafy vegetables such as lettuce and cabbage also have high levels of the compound. They take it up from the soil through their roots. A metaanalysis of trials httpjn.nutrition.orgcontent.short was published in The Journal of Nutrition in . The researchers found that Inorganic nitrate and beetroot juice supplementation was associated with a significant reduction in systolic blood pressure. One major trial was carried out at Queen Mary University of London QMUL in the United Kingdom and published in the journal Hypertension. The research was funded by the British Heart Foundation. They found the following results This interesting study builds on previous research by this team and finds that a daily glass of beetroot juice can lower blood pressure in people with hypertension https even those whose high blood pressure was not controlled by drug treatment. Dr. Shannon Amoils British Heart Foundation senior research advisor For the trial Prof. Amrita Ahluwalia of the vascular pharmacology department at QMUL and her colleagues recruited people aged between and years. Half of the participants were taking prescribed medication for high blood pressure but did not reach their target blood pressure and the rest had been diagnosed with high blood pressure but were not yet taking medication for it. The participants were randomly assigned to one of two groups. One group consumed a milliliter ml glass of beetroot juice and the other group had the same except their beetroot juice was nitratefree. The nitratefree beetroot juice was the basis of the placebo https group. All groups consumed the juice daily for weeks. They were also monitored for weeks before and after the study bringing the total trial period to weeks. The trial was doubleblind which means neither the administering clinicians nor the patients knew whether the beetroot juice they were given was the placebo or the active supplement. During the weeks in which they were taking the juice patients in the active supplement group whose beetroot juice contained inorganic nitrate experienced a reduction in blood pressure of millimeters of mercury mmHg. The first figure is systolic pressure generated when the heart is pumping and the second figure is diastolic pressure created when the heart is relaxing and filling with blood. The mmHg reduction brought the blood pressure of many participants back into the normal range. In the weeks after they stopped drinking the juice their blood pressure returned to the higher levels noted at the start of the study. This is the first study that shows evidence of dietary nitrate supplementations longlasting benefit in a group of patients with high blood pressure. The patients in the active supplement group also experienced a percent or so improvement in blood vessel dilation capacity and their artery stiffness reduced by around percent. Studies show that these changes are linked to a reduced risk of heart disease httpjaha.ahajournals.orgcontente. There were no changes in blood pressure blood vessel function or artery stiffness in the placebo group. The authors note that the reduction achieved in the active supplement group is close to that achieved by medication. The average reduction in blood pressure caused by a single antihypertension drug is mmHg. The study concludes These findings suggest a role for dietary nitrate as an affordable readilyavailable adjunctive treatment in the management of patients with hypertension. To put the importance of these findings in context The authors note that largescale observational studies show that for every mmHg increase in blood pressure the risk of death from heart disease https goes up percent and the risk of stroke by percent. findings Prof. Ahluwalia says This research has proven that a daily inorganic nitrate dose can be as effective as medical intervention in reducing blood pressure and the best part is we can get it from beetroot and other leafy green vegetables. She says that one reason the findings are exciting is that they open up the potential for people with high blood pressure to increase dietary nitrate in a way that can be easily worked into their daily lives while still providing a positive benefit. It is hugely beneficial for people to be able to take steps in controlling their blood pressure through nonclinical means such as eating vegetables Prof. Ahluwalia adds. We know many people dont like taking drugs lifelong when they feel okay and because of this medication compliance is a big issue. The possibility of using a natural product rather than another pill to help lower blood pressure is very appealing adds Dr. Amoils. Prof. Ahluwalia advises that people looking to increase their daily nitrate intake should avoid boiling vegetables as the nitrate dissolves in water. Instead steaming roasting or drinking in a juice all has a positive effect she notes. As for the next step in confirming the relationship between beetroot juice and blood pressure she says this was a small trial. The next stage would be a larger study that tries to replicate the findings over a longer period with a much larger group of people who have high blood pressure. Here is a link to a wide range of natural beetroot products httpamzn.toCCkndO. Please note that this will open an external site."

"Preliminary research suggests that a single injection of a manmade protein might lower levels of bad cholesterol. Given in the abdomen AMG reduced lowdensity lipoprotein LDL cholesterol levels among a group of healthy volunteers. The shot turned off a newly identified cholesterol regulator PCSK which interferes with the livers ability to clear bad cholesterol from the bloodstream. The findings were presented Monday at the American Heart Association AHA annual meeting in Orlando Fla. The study was funded by AMG manufacturer Amgen Inc. High cholesterol is a major risk factor for heart disease. The first step toward lowering cholesterol is typically lifestyle changes which include eating a lowfat diet and regular physical activity. For some medications such as statins must be added to get cholesterol levels where they ought to be. Even this is not enough to get everyones numbers into the safety zone and not everyone can tolerate currently available medications. An LDL of less than mgdL of blood is considered optimal. Study author Clapton Dias medical sciences director of clinical pharmacology and early development at Amgen in Thousand Oaks Calif. said this shot could be given as an addon to current cholesterollowering therapies for people who are not getting as low as they should be or as a standalone treatment for people who cant tolerate existing lipidlowering drugs. Cardiovascular disease is the number one cause of death in the U.S. and while statins are very effective a good proportion of people are not meeting their goals and in this setting the shot could be a valuable addition he said. The study included men and two women aged to who did not have elevated cholesterol levels. Participants received one of five doses of the new drug delivered via shot or intravenously or a placebo. Researchers measured LDL cholesterol levels for to days after treatment. The new drug did hit its target PCSK and decreased levels of LDL cholesterol by up to percent. There were also decreases seen in levels of total cholesterol and apoB tiny fat particles in the blood that also increase the risk for heart disease. Levels of triglycerides and good HDL cholesterol were not altered by the medication and there were no serious side effects reported. Now researchers are testing the new shot in people who have high cholesterol. Cardiologists were cautiously optimistic about the novel therapy. Former AHA President Dr. Ralph Sacco said that it is too early to make any predictions about what role if any this therapy will have in lowering cholesterol levels but it could one day fill an important void. Even though statins are so effective at lowering cholesterol and reducing risk for heart disease and stroke they do need to be taken every day and they can have certain side effects in some people said Sacco who is also chairman of neurology at the University of Miami. Statin side effects can include liver damage andor muscle pain. This new shot may provide a more longlasting approach especially if it could be given once a month Sacco said. Dr. Dan Rader director of preventive cardiology at the University of Pennsylvania said that PCSK is the hottest target for new treatments to lower LDL cholesterol. And these study results will probably fuel that fire he added. A plus percent reduction in LDL with a single dose of this antibody is impressive he said. It is the early days but the data look strong. We now need more data with people who have repeated dosing and are followed for longer periods of time Rader added. There are still plenty of people who cant achieve adequate LDL levels with existing drugs including statins he noted. Plus people may find it easier to get a shot every two weeks or monthly than to take a pill every day. Research presented at meetings should be considered preliminary until published in a peerreviewed medical journal. More information Learn about existing treatments for high cholesterol at the American Heart Association http_UCM__Article.jsp. SOURCES Clapton Dias Ph.D. medical sciences director of clinical pharmacology and early development Amgen Inc. Thousand Oaks Calif. Ralph Sacco M.D. chairman neurology University of Miami Miller School of Medicine and past president American Heart Association Dan Rader M.D. director preventive cardiology University of Pennsylvania Philadelphia Nov. presentation American Heart Association annual meeting Orlando Fla."

"Authors from Lake Erie Research Institute in Pennsylvania report an adjustable foot wrap caused to treat restless legs syndrome RLS is . times more effective than the standard pharmaceutical treatment. The pilot study published today in The Journal of the American Osteopathic Association. The eightweek clinical trial involved otherwise healthy adults with moderate to severe restless leg syndrome. Researchers studied Clinical Global Impression responses as well as the mean change in the International Restless Leg Syndrome Study Group Study Scale IRLSSGS. A metaanalysis was then used to compare the RLS device with three historic studies of the medication ropinirole and a placebo. Clinical Global Impression responses indicated significantly greater improvement with the RLS device percent compared with ropinirole percent the current standard dopamine therapy for RLS. Additionally change in IRLSSGS score was significantly greater for the RLS device . compared to historic reports for ropinirole versus the placebo versus . respectively. Patients using the RLS device also reported an percent decrease in sleep loss. The RLS device was designed to put adjustable targeted pressure on two muscles in the foot known to relax symptoms of RLS the abductor hallucis and the flexor hallucis brevis. Researchers indicate that the pressure produced by the device may also stimulate a dopamine release similar to massage therapy or acupressure. By putting pressure on specific muscles in the feet we are able to create a response in the brain that relaxes the muscles activated during RLS said Phyllis Kuhn MS PhD and the studys lead researcher. Its a near perfect example of the body regulating itself without drugs many of which have the potential for significant adverse side effects. Restless leg syndrome RLS is a neurologic disorder causing unpleasant sensations and an urge to move the legs when at rest. The sleep loss associated with RLS can cause extreme fatigue anxiety and depression. According to the National Institute of Health RLS may affect as many as percent of the U.S. population with more than nine million experiencing moderate to severe symptoms. Until recently potent drugs including opioids depressants and dopamine agonists have been used to ease symptoms but each of these is accompanied by negative side effects such as dizziness nausea vomiting and the added risk of addiction. Restless legs syndrome really erodes quality of life because it causes extreme fatigue for many patients. As an osteopathic physician its a challenge to balance the need to restore sleep while preventing additional harm from medication. These results show promise in otherwise healthy individuals for a nonpharmaceutical option that appears to have rather minor temporary adverse effects for some users said Rob Danoff DO an osteopathic family physician and program at Aria Health Care in Philadelphia. Adverse effects were reported by seven patients in the study. The effects included pain pins and needles sensation irritability spasm and warm feet . Open access to the full review is available until September httpjaoa.orgarticle.aspxarticleid. Disclosures Dr Kuhn worked without compensation through Lake Erie Research Institute LERI during the years of the study of the device and is now receiving compensation for that work. She reports no financial interest in its sales. None of the other study authors reported any conflict of interest or financial disclosure relevant to the topic of this study. More details are available in the published article. About The Journal of the American Osteopathic Association The Journal of the American Osteopathic Association JAOA is the official scientific publication of the American Osteopathic Association. Edited by Robert Orenstein DO it is the premier scholarly peerreviewed publication of the osteopathic medical profession. The JAOAs mission is to advance medicine through the publication of peerreviewed osteopathic research."

"When patients present with neurologic symptoms such as severe headaches or seizures the symptoms could suggest anything from infection cancer or an autoimmune disease of the brain or spinal cord leaving physicians scrambling to find the cause in a short amount of time. The differences in diagnosis can mean having mere hours to act or being able to take days or weeks to devise a treatment plan. Now researchers at Jefferson https Philadelphia University Thomas Jefferson University have developed a test that could rapidly parse out infections of the brain from other diseases. The diagnostic could prove particularly useful in infants and young children. We have many tests for making diagnoses but the ones that conclusively indicate infection can often take more time than wed like especially in cases of childhood meningitis or encephalitis said Mark Curtis https MD PhD Associate Professor of Pathology Anatomy and Cell Biology who also works as a hospital pathologist. Once confirmed with additional research our test could provide a first rapid and less invasive way to look at whats happening in the brain and guide treatment or further testing. The results were published in the journal PLOS ONE httpsjournals.plos.orgplosonearticleid.journal.pone. on October st. Rather than testing for the presence of bacteria or virus the researchers looked at the first telltale signs of infection the cytokines produced by the patients immune system in response to pathogens and other injury processes. Cytokines are an alarm system in the body said Dr. Curtis. Infectious agents activate a multipronged inflammatory response a key component of which is the release of different combinations of cytokines tailored to combat pathogens. Changes in cytokine levels of cerebrospinal fluid offer a very early measurable sign of infection. Dr. Curtis and colleagues decided to see if they could detect patterns within the cytokines that might differentiate infections from other brain diseases or disorders. In the retrospective analysis the investigators looked at samples collected from patients who had received spinal taps during their hospital stays. The researchers then tested the cerebral spinal fluid CSF for the presence of different cytokines and noticed that patients with confirmed infection of the central nervous system had a different cytokine fingerprint from those confirmed as having tumors or autoimmune disease. This suggested the test could be used to tell the conditions apart. Additionally within the patients identified with central nervous system infections the CSF cytokine fingerprint was different in cases of viral infection compared to those with nonviral pathogens such as bacteria or fungi. With only a small amount of spinal fluid needed CSF cytokine analysis could be used as one of the first diagnostic tests to rapidly triage serious central nervous system disorders and guide immediate intervention said first author Danielle Fortuna MD an Assistant Professor in the Department of Pathology and Laboratory Medicine at the Hospital of the University of Pennsylvania. Worldwide meningitis and encephalitis affect more than four million adults and children each year. Infants and young children have an especially high risk of meningitis and encephalitis and the related often serious sequelae said Dr. Curtis. Being able to rapidly identify a central nervous system disorder as infectious can be crucial in rapid response. In addition the test could distinguish viral from nonviral infections a distinction that could spare a child with a viral infection from an unnecessary course of antibiotics and tailor the care toward antiviral and supportive measures as needed said Dr. Curtis. Moving forward our goal is to formally validate our findings with a larger sample size that includes both adults and children for future use in the clinical arena. Article reference Danielle Fortuna D Craig Hooper Amity L Roberts Larry A Harshyne Michelle Nagurney Mark T Curtis Potential role of CSF cytokine profiles in discriminating infectious from noninfectious CNS disorders PLOS ONE DOI .journal.pone. httpsjournals.plos.orgplosonearticleid.journal.pone. . Media Contact Edyta Zielinska edyta.zielinskajefferson.edu mailtoedyta.zielinskajefferson.edu ."

"For men diagnosed with prostate cancer uncertainty about what to do remains a big problem despite years of research on the options. Now a Swedish study http suggests that radical prostatectomy complete removal of the prostate gland is better than watchful waiting for the treatment of younger men with lowrisk prostate cancer. On the surface this seems to contradict a U.S. trend toward holding off on surgery and monitoring men who have lowrisk cancers with whats called active surveillance http But dont leap to any conclusions. Like every new study of prostate cancer the results need to be carefully parsed. First the study results http which appear in this weeks New England Journal of Medicine. Its actually an update of a report with an additional three years of data on the nearly men who volunteered for the trial up to years ago. All of them had earlystage prostate cancer at the beginning. The study found percent fewer prostate cancer deaths among men randomly assigned to the surgery group versus those in what the Swedes called the watchfulwaiting group. Men who had surgery had percent lower risk of their cancer spreading throughout the body and percent less risk of growth within the prostate. Article continues after this message from our sponsor The survival benefits were restricted to men under . For this group surgery saved one life for every seven men who had prostatectomies considered a favorable ratio http And it applied to men with tumors considered lowrisk meaning they have a relatively low Gleason score http a marker of tumor aggressiveness. Our findings show that some tumors that are considered to be lowrisk at diagnosis do pose a threat to life especially if they are not surgically removed the study authors write. So is this a slamdunk for radical prostatectomy Game over Far from it. In an editorial http accompanying the study Dr. Dr. Matthew Smith http of Massachusetts General Hospital makes some important points. First only about in men in the Swedish study had a prostate cancer diagnosis based on a high PSA level http Almost percent had tumors their doctors could feel on digital rectal exams. But in the U.S. most prostate cancers are identified by PSA screening and less than half have palpable tumors. This is important because experts believe many prostate tumors found by PSA are likely to be slowgrowing perhaps so slow they will never cause a problem before the man dies of something else. So low risk in the Swedish study means higherrisk than the current low risk men diagnosed in the United States. By the way out of prostate cancers in the U.S. these days is considered low risk. Second the Swedish study compared radical prostatectomy to watchful waiting. And Smith points out that watchful waiting does not mean the same thing as active surveillance. Watchful waiting means were not going to treat you now and if you progress clinically well treat you with hormone therapy not with curative intent Smith tells Shots. Active surveillance means observing the patient in a proactive way with regularly scheduled biopsies he adds. If theres a sign the cancer is progressing doctors currently would treat with intent to cure using surgery radiation or both. Smith makes another point Both surgical techniques and radiation therapy technology have improved since the Swedish study was done. So theres reason to think men followed with active surveillance and treated when necessary would fare better than the watchful waiting group in the newly published study. Unfortunately there havent been any large studies in which prostatectomy and radiation therapy have been compared in patients with earlystage prostate cancer who have been randomly assigned to one or the other. Two such studies are underway. Results are some years off. But Smith warns against assuming those results will settle the question of how men with earlystage prostate cancer should be treated. There will always be questions and an ongoing need to individualize therapy he says."

"Giving the antidepressant drug Prozac to people who have just had a stroke could help them to regain more control over their movements and allow more of them to live independently scientists said Monday. The antidepressant drug Prozac also known as fluoxetine are seen on a table in Leicester central England February in this posed photograph. REUTERSDarren Staples In the largest study yet of the effect of this type of antidepressant on stroke recovery French researchers found that stroke patients given Prozac improved their scores in motor skills tests more than those given a placebo or dummy pill. Experts commenting on the findings said they had enormous potential to change clinical practice and raised the question of whether most stroke patients with motor skill problems should be treated with this relatively cheap type of antidepressant. Stroke is the single largest cause of adult disability and the thirdlargest cause of death in the developed world. The cost of caring for its victims who often have motor function difficulties like paralysis or weakness on one side puts a heavy burden on already stretched healthcare systems. A few previous small trials had already suggested that giving drugs like Prozac which belongs to a drug class known as selective serotonin reuptake inhibitors SSRIs might improve motor skill recovery after stroke. Prozac was developed by Eli Lilly and is now available in a cheaper generic form as fluoxetine. Hemiplegia paralysis to one side of the body and hemiparesis weakness on one side of the body are the most common disabilities after stroke and scientists believe SSRIs might help improve movement by increasing the level of the brain chemical serotonin in the central nervous system. The positive effect of the drug on motor function... suggests that the neuronal ... action of SSRIs provides a new pathway that should be explored further said Francois Chollet of Toulouse University Hospital who led this research. In the study conducted between March and June and published in The Lancet Neurology journal Monday patients in France were given either Prozac or a placebo for three months starting between five and days after they had suffered a stroke. All patients were also given physiotherapy and had their motor skills tested at the start of the trial and on day . Significantly greater improvements in motor function were recorded after three months in patients taking Prozac where the average test score improved by . points than in the placebo group where the average improvement was . points. There were also more independent patients and depression was less common in the Prozac group than in the placebo group and side effects of the drug were rare and mild researchers said. Commenting on the study Robert Robinson and Harold Adams from the University of Iowa in the United States said it could change the way doctors treat stroke victims in future but more research is needed to see if the effects continue over time. Roger Bonomo director of stroke care at Lenox Hill Hospital in New York said another way to look at the implications of this trial would be as justification for treatment of poststroke depression before it progresses. Depression after stroke is a common enough complication to have raised the question of treating with antidepressants early after stroke he said in an emailed comment. If motor function is also more likely to improve then treating before symptoms of depression emerge is likely to be even more beneficial. Editing by Tim Pearce Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"