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NHS Patients To Benefit From New Measures To Improve Access To Drugs, UK

2009-03-03T14:00:00.001+02:00

A package of measures designed to speed up access to new drugs and treatments for NHS patients, was announced by the National Institute for Health and Clinical Excellence (NICE) and Health Minister Lord Darzi today.

The four proposed changes will ensure that more NHS patients receive the life-saving, clinically and cost effective drugs and treatments they need faster. It will also ensure that where NICE guidance has not yet been issued for a new drug or treatment the local NHS makes more robust and transparent decisions about what treatments it will fund.

The measures announced today by Lord Darzi and NICE are:

- A consultation on a new and faster system for referring drugs to NICE for appraisal - proposals will enable NICE to issue more timely guidance, in turn giving patients faster access to drugs and treatments.

- An additional new appraisal committee - to ensure that NICE has the capacity it needs to appraise new drugs and treatments as promptly as possible;

- Increased investment in "horizon scanning" to ensure that new drugs are identified early on for appraisal; and

- A guidance document for the NHS - detailing good practice on how decisions on new drugs should be made by Primary Care Trusts where there is no existing NICE guidance . This will be supported by a programme of training and support to assist theNHS to implement the guidance.

Announcing the package of measures, Health Minister, Lord Darzi, said:

"Last year in High Quality Care for All I set out our commitment to speed up the NICE process. Together, the measures set out today build on this commitment and will help provide faster and fairer access to new drugs and treatments - great news for patients.

We are delighted to be working in partnership with NICE to ensure that new drugs and treatments are assessed sooner and more quickly in future, leading to improved and higher quality care for patients.

"The guidance for PCTs will help the NHS to ensure that local decisions are robust and transparent, leading to more consistency in those exceptional cases where there is no existing NICE guidance."

Chief Executive of NICE, Andrew Dillon, said:

"This is an important consultation on the way that topics are chosen and referred for NICE's world-leading appraisals of new drugs and treatments. We are very keen to ensure that our guidance is produced as quickly as possible to benefit patients and the NHS.

"Speeding up non-cancer appraisals by at least three months to come in to line with the cancer appraisals, and increasing transparency by clarifying topic selection criteria, are just some of the potential improvements we and the Department of Health are suggesting.

"The views of patients, the public, health professionals and other stakeholders on the proposed changes to the topic selection process will be very helpful, and we look forward to receiving their comments."

The consultation on the proposed changes to the NICE topic selection will run for 3 months whilst the guidance to PCTs will be issued to the NHS with immediate effect.

The new appraisal process which will be consulted on will include the following:

- New joint DH/NICE exclusion and prioritisation criteria for technology appraisals. The new criteria apply to both cancer and non-cancer appraisals. We believe these new criteria will allow NICE to operate the early stage of the process with less DH involvement.

- No "minded" referral stage for any technology appraisal topics. This change will mean there is a single point of Ministerial referral for all drugs.

- Smaller, more frequent batches of topics referred to NICE, up to 6 times a year rather than 3 times as now.

The consultation document can be downloaded from http://www.nice.org.uk/getinvolved

The additional investment in "horizon scanning" capacity will be through the Department of Health's existing contract with the University of Birmingham. The guidance to PCTs sets out in detail the framework for rational decision-making and contains realistic examples of processes that are seen to be working in the NHS. It is intended to be an evolving document, which will be modified to take account of experience. It can be accessed on the National Prescribing Centre's website http://www.npc.co.uk

The measures also support the implementation of the recommendations in Mike Richard's review on the funding of additional private care. Following his review new guidance was issued to the NHS which made clear that the NHS should not withdraw treatment from the few patients who still choose to pay privately for drugs which are not funded by the local NHS

National Prescribing Centre

France Biotech Publishes 3rd Edition Of Its Review Of Product Development Pipelines In French Life Science Companies

2009-03-03T14:00:00.000+02:00

France Biotech has published the 3rd edition of its annual Drug Pipeline Review. The survey was part-funded by the French Ministry of the Economy, Industry & Finance.

The study summarizes and analyses data collected in 2008 on 227 healthcare products under development, including 158 drugs (at 51 life science companies), 41 in vitro diagnostics (at 22 companies) and 28 medical devices (at 17 companies). This year's review included in vitro diagnostics and medical devices for the first time. In all, 85 French life science SMEs developing healthcare products participated in the survey. Most were incorporated fairly recently - 45% in the last 5 years, half of which are developing drugs.

"The dynamic growth of France's life science industry - as revealed by the increasing number of very innovative products in the pipeline - may well slacken off. In fact, with a 79% drop in investment in 2008, our innovative SMEs are going to have trouble funding all their drug development programs because the latter are very resource-intensive! To help our innovative SMEs generate jobs and economic growth and become tomorrow's business champions, France Biotech has asked the French government (on February 5) to implement a stimulus plan based on innovation", commented Philippe Pouletty MD, Chairman of France Biotech.

Click here to view the key results.

France Biotech

TissueGene Announces Regulatory Allowance To Initiate Phase IIa Study Of TG-C In South Korea For Osteoarthritis Of The Knee

2009-03-03T09:00:00.000+02:00

TissueGene, Inc. announced that its South Korean licensing partner Kolon Life Science, Inc. (KLS) has received regulatory allowance from the Korea Food and Drug Administration (KFDA) to initiate a Phase IIa clinical trial of TissueGene-C (TG-C) in patients with severe osteoarthritis of the knee. TG-C has been developed for the localized delivery of allogeneic human cells expressing TGF-beta1 in order to induce the regeneration of cartilage.

In Asia, TissueGene has licensed intellectual property rights to KLS, a subsidiary of Kolon, for the clinical development and commercialization of TissueGene's lead product candidates TG-C and TG-B, developed for the regeneration of cartilage and bone, respectively. Under the terms of the agreement, TissueGene has received an undisclosed up-front payment and will receive on-going royalty payments based upon future sales. TissueGene is currently completing Phase I clinical trials in the U.S. and continues to work closely with KLS in order to coordinate their regulatory efforts and efficiently conduct parallel clinical trials for TG-C in both the U.S. and Korea.

The Phase IIa clinical trial is designed as a randomized, multi-center study in order to evaluate the safety and efficacy of TG-C in patients with Grade IV Degenerative Joint Disease (DJD) of the knee, who have been unresponsive to existing therapies. The patients will receive an intra-articular injection to the damaged joint area at one of two dose levels of TG-C. The primary endpoint of the trial will be evidence of symptomatic improvement and the secondary endpoint will be evidence of cartilage regeneration through MRI evaluation.

"The launch of this Phase II study represents a critical step in the development of a commercially and clinically viable mechanism to initiate regeneration of cartilage for patients suffering from osteoarthritis," stated Dr. Kwan Hee Lee, President and CEO of TissueGene. "And I believe our success thus far can be attributed primarily to the strategic alliance between TissueGene, Kolon and KLS. By bridging our domestic and international resources, this business model has not only enabled for rapid preclinical and clinical development, but has allowed for innovative cost control mechanisms and significant long-term growth opportunities."

About TissueGene, Inc.

TissueGene, Inc. is a Maryland-based biopharmaceutical company with a strong global vision focused on developing a proprietary and innovative suite of regenerative orthopedic therapeutic products. Founded in 1999, the Company's primary pipeline is focused on the treatment and regeneration of damaged cartilage, bones, disc and nerves. The Company's core technology employs a form of cell-mediated gene therapy to deliver well-known therapeutic proteins to localized areas of damaged tissue. The sustained expression of such proteins, along with the cellular matrix it is delivered in, initiates rapid and permanent repair of injured tissue without the need for invasive surgical procedures. The Company has successfully demonstrated the growth of cartilage, bone, nerve and tendons in animals. For more information, please visit http://www.TissueGene.com.

About Kolon Life Science, Inc.

Kolon Life Science, Inc. (KLS), a subsidiary company of Kolon, is a leading biochemical company in Korea focused on research and discovery in the life sciences. In 2006, Kolon established KLS by merging TissueGene Asia Co., Ltd with their existing active pharmaceutical ingredients (APIs) and specialty chemicals business. For more information, please visit http://www.kolonls.co.kr.

TissueGene, Inc.

http://www.tissuegene.com

Lupus Foundation Of America Advocates Say 50 Years Without A New Treatment Is Too Long To Wait

2009-03-02T15:00:00.000+02:00

November 20, 2008, marked 50 years since the U.S. Food and Drug Administration approved a new therapy for lupus. This sad anniversary has motivated approximately 300 individuals with lupus, their families, and health professionals from across the country to serve as the voices of the estimated 1.5 million people with lupus before Members of the United States Congress on March 3rd when the Lupus Foundation of America (LFA) conducts its Eleventh Annual Advocacy Day in Washington, D.C.

Advocates will share their personal stories and tell Congress why there is a critical need for increased funding for sound biomedical research and education programs.

Their message is more important than ever before. Medications currently prescribed for lupus have unacceptable side effects that are life-diminishing and may actually cause other health problems worse than lupus itself. Side effects of these medications include bone loss and osteoporosis, infertility, infections, joint replacements, cancer, and more.

The medical research effort on lupus has also not kept pace with efforts for other similar chronic, life-threatening diseases. The FDA has not approved a drug for lupus in 50 years, in part, because there has been a lack of robust investment by the federal government. Pharmaceutical and biotechnology companies depend upon the scientific base of knowledge developed by the federal medical research enterprise. In the past the lack of investment by the federal government on lupus has deterred industry from investing in the discovery of new, safer, more tolerable, and effective treatments for individuals with lupus.

Senator Barbara Mikulski (D-MD) will be presented with the Distinguished Leadership Award at the Advocacy Day luncheon on March 3, 2009 at 12:30 p.m. in the Dirksen Senate Building, Room G-50. As a healthcare champion and patient advocate, she is being recognized for her leadership on the Lifespan Respite Care Act, and past support of the Lupus REACH Amendments.

Lupus is an acute and chronic (lifelong) autoimmune disease in which the immune system is unbalanced, causing inflammation and tissue damage to virtually any organ in the body. Its health effects include heart attacks, strokes, seizures, miscarriages, and organ failure. Ninety percent of the people with lupus are women, and it is two to three times more common among African Americans, Hispanics/Latinos, Native Americans, and Asians.

From a small beginning ten years ago with a handful of individuals affected by lupus, the LFA nationwide grassroots network has grown substantially to include tens of thousands of lupus advocates, supporters, and volunteers from every state in the country. These advocates send letters and email messages, make telephone calls, and visit congressional offices to educate elected officials on the impact of lupus.

LFA advocates have been effective in advancing lupus research and education programs conducted by the federal government, including:

- coordinating efforts among the various federal agencies with an interest in lupus;

- securing millions of dollars for the first-ever comprehensive national epidemiological study on lupus;

- opening new sources of federal agency funding for biomedical research on lupus;

- obtaining changes in draft Social Security Disability regulations which will enable more people disabled by lupus to receive benefits;

- securing changes to regulations governing the Medicare Part D Prescription Drug Benefit to pay for prescription drugs required to treat lupus;

- partnering with the U.S. Department of Health and Human Services Office on Women's Health for the first-ever national public awareness campaign on lupus produced by the Ad Council.

About the Lupus Foundation of America

The LFA is the foremost national nonprofit voluntary health organization dedicated to finding the causes of and cure for lupus, and providing support, services, and hope to all people affected by lupus. Founded in 1977, the LFA has a nationwide network of nearly 300 chapters and support groups and operates programs of research, education, and advocacy. For more information about the lupus and LFA, go online to www.lupus.org or call toll-free 1-888-38-LUPUS to request a free brochure.

Lupus Foundation of America

Stem Cell Breakthrough: Pluripotency Without Using Viruses

2009-03-02T09:00:00.000+02:00

Scientists from Canada and the UK have found a new way to create stem cells without using viruses to introduce genetic material into the nuclei to make the cells pluripotent, instead they insert four genes that reprogram the cells then remove them later. The researchers said their work could lead to possible cures for a range of degenerative diseases that destroy tissue, such as spinal cord injury, macular degeneration, diabetes and Parkinson's disease.

The researchers in Canada were from the Samuel Lunenfeld Research Institute at Mount Sinai Hospital in Toronto, Ontario and the Department of Molecular Genetics at the University of Toronto, and the researchers in the UK were from the The Wellcome Trust Sanger Institute in Hinxton, Cambridgeshire, and the MRC Centre for Regenerative Medicine at the Institute for Stem Cell Research in the University of Edinburgh. The study is published in an advanced online 1 March issue of Nature.

The researchers found that introducing just four genes that act as transcription factors, called c-Myc, Klf4, Oct4 and Sox2 was enough to reprogram cells from adult tissue into pluripotent cells.

The pluripotent cells resembled embryonic stem cells in that they acquired the potential to differentiate into a wide range of adult cell types.

The current method for achieving this relies on using viruses (such as retroviruses, lentiviruses and adenoviruses) and plasmids (small pieces of DNA that self-replicate like viruses inside host cells) that introduce genetic material to induce pluripotency.

Retroviruses and lentiviruses bring with them the risk that they will damage host cell DNA and unleash uncontrolled cell growth, rather like cancer, and while the other two, lentiviruses and plasmids don't, they have limited reprogramming potential.

So given these disadvantages, finding a new way to induce pluripotency without disrupting healthy genes is a real breakthrough in adult stem cell science, diminishing reliance on embryonic stem cells, which is controversial because it involves the destruction of embryos.

Senior author Dr Andras Nagy, who is a Senior Investigator at the Samuel Lunenfeld Research Institute of Mount Sinai Hospital, an Investigator at the McEwen Centre for Regenerative Medicine, and Canada Research Chair in Stem Cells and Regeneration, said:

"We hope that these stem cells will form the basis for treatment for many diseases and conditions that are currently considered incurable."

"This new method of generating stem cells does not require embryos as starting points and could be used to generate cells from many adult tissues such as a patient's own skin cells," he added.

Nagy and colleagues used a new "wrapping" method to deliver the four transcription factor genes into the adult cells to reprogram then into stem cells. They wrote that this method, which is called "piggyBac (PB) transposition" is "host-factor independent, and has recently been demonstrated to be functional in various human and mouse cell lines".

In this study the researchers were able to show successful and efficient reprogramming of mouse and human fibroblasts taken from embryonic stem cell lines, but there is no reason in principle why this could not happen to fibroblasts taken from adult tissue.

The stable pluripotent cells they created displayed all the characteristic markers of pluripotency and succeeded in a "series of rigorous differentiation assays".

Nagy and colleagues also showed it was possible to remove the PB wrapping seamlessly from established pluripotent cell lines, which gives scientists an important tool for research.

They concluded that:

"We anticipate that the unique properties of this virus-independent simplification of iPS [induced pluripotent stem] cell production will accelerate this field further towards full exploration of the reprogramming process and future cell-based therapies."

An important step in the study took place in the lab of co-author Dr Keisuke Kaji from the Medical Research Council (MRC) Centre for Regenerative Medicine at the University of Edinburgh. That work is the subject of a separate study in the same issue of the journal.

Kaji told the press that:

"I was very excited when I found stem cell-like cells in my culture dishes. Nobody, including me, thought it was really possible."

"It is a step towards the practical use of reprogrammed cells in medicine," Kaji added.

In 2005 Nagy created Canada's first embryonic stem cell lines from embryos no longer needed by couples undergoing fertility treatment.

The Canadian Stem Cell Network and the Juvenile Diabetes Research Foundation (United States) paid for the research.

"piggyBac transposition reprograms fibroblasts to induced pluripotent stem cells."

Knut Woltjen, Iacovos P. Michael, Paria Mohseni, Ridham Desai, Maria Mileikovsky, Riikka Hämäläinen, Rebecca Cowling, Wei Wang, Pentao Liu, Marina Gertsenstein, Keisuke Kaji, Hoon-Ki Sung & Andras Nagy.

Nature Advance Online Publication, 1 March 2009.

doi:10.1038/nature07863

Click here for Abstract.

"Virus-free induction of pluripotency and subsequent excision of reprogramming factors."

Keisuke Kaji, Katherine Norrby, Agnieszka Paca, Maria Mileikovsky, Paria Mohseni & Knut Woltjen.

NatureAdvance Online Publication, 1 March 2009.

doi:10.1038/nature07864

Click here for Abstract.

Sources: Journal abstract, Samuel Lunenfeld Research Institute press statement.

Written by: Catharine Paddock, PhD

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

Alcohol Consumption And Male Erectile Dysfunction: An Unfounded Reputation For Risk?

2009-03-01T09:00:00.000+02:00

UroToday.com - The report, one of four published articles from a population-based cross-sectional study principally on male erectile dysfunction (ED), is based on the responses of 1,580 participants to questions on their alcohol drinking behaviour. To assess the effects of alcohol on erectile function was not the primary objective of the study.

The finding that alcohol consumption within the current guidelines for low-risk drinking was associated with lower odds of ED provides rationale for counseling alcohol drinkers with ED in day-to-day clinical practice. Men with ED need not harbour a sense of guilt about their past or current drinking if they consume alcohol within guidelines.

This should not be interpreted as encouragement for non-drinkers to commence alcohol drinking. A decision by a non-drinker to commence drinking warrants careful consideration and informed decision, as it may be associated with multiple medical, socioeconomic and other implications, some of which could be serious.

Written by Kew-Kim Chew, MD as part of Beyond the Abstract on UroToday.com

UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice.

To access the latest urology news releases from UroToday, go to: www.urotoday.com

Copyright © 2009 - UroToday

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

Cell Microenvironments Hold Key To Future Stem Cell Therapies

2009-02-28T09:00:00.000+02:00

Adult stem cells and their more committed kin, progenitor cells, are prized by medical researchers for their ability to produce different types of specialized cells. The potential of using these cells to repair or replace damaged tissue holds great promise for cancer therapies and regenerative medicine. However, the question that must first be answered is what determines the ultimate fate of a stem or progenitor cell? A team of researchers led by Berkeley Lab's Mark LaBarge and Mina Bissell appear to be well on the road to finding out.

Working with unique microenvironment microarrays (MEArrays) of their own creation, LaBarge and Bissell and their collaborators have shown that the ultimate fate of a stem or progenitor cell in a woman's breast - whether the cell develops normally or whether it turns cancerous - may depend upon signals from multiple microenvironments.

"We found that adult human mammary stem and progenitor cells exhibit impressive plasticity in response to hundreds of unique combinatorial microenvironments," said LaBarge, a cell and molecular biologist in Berkeley Lab's Life Sciences Division. "Our results further suggest that rational modulation of the microenvironmental milieu can impose specific differentiation phenotypes on normal stem or progenitor cells, and perhaps even impose phenotypically normal behavior on malignant cells during tissue genesis. All of this points to the rational manipulation of adult stem and progenitor cells as a promising pathway for beneficial therapies."

Previous studies on how microenvironments affect the development of adult human stem or progenitor cells have been based on the behavior of these cells in culture (in vitro) where they are exposed to a single molecular agent. However, when these cells are in an actual human being (in vivo) they are surrounded by a multitude of other cells plus a supporting network of fibrous and globular proteins called the extracellular matrix (ECM), as well as many other nearby molecules, all of which may be simultaneously sending them instructional signals.

"With our MEArrays, we can use combinations of proteins from a select tissue to create multiple microenvironments on a single chip about two square centimeters in area," said LaBarge. "We think this approach will give us a much more realistic picture as to how stem and progenitor cells actually behave in vivo."

Said Bissell, a Distinguished Scientist with Berkeley Lab's Life Sciences Division and one of the world's leading researchers on breast cancer, "We have demonstrated that each discrete cell fate decision requires the integration of multiple pathways, and we have identified combinations of components in the human mammary microenvironment that impose distinct cell fates. These results are exciting because they indicate that we can test a large number of effectors and determine which ones to use to direct the fate of adult stem and progenitor cells. This give hope that one day - sooner rather than later - the information could be used for therapy."

Collaborating with LaBarge and Bissell on this study were Jason Ruth, now at the University of Pennsylvania, Martha Stampfer of Berkeley Lab, Celeste Nelson, now with Princeton University, and Rene Villadsen, Agla Fridriksdottir and Ole Petersen, of the Panum Institute in Denmark.

Human breast tissue harbors two types of epithelial cells: luminal - the cells that are able to produce milk and generally the ones that become cancerous; and myoepithelial - the cells that surround the luminal cells and push milk down the ducts to the nipples, but which rarely become cancerous. Like cells in other types of tissue these breast epithelial cells are spawned from stem and progenitor cells that despite being primitive - essentially a cellular blank slate - possess the exact same genome as their differentiated daughters. Once it was widely held that adult stem and progenitor cells intrinsically "know" when to self-renew and when to differentiate into one specific tissue cell or another based on pre-determined genetic programs. However, pioneering research by Bissell, in which it has been demonstrated that interactions between an epithelial breast cell and its ECM play a major role in determining whether that cell becomes cancerous, pointed the way to the idea that the ultimate fate of a stem or progenitor cell is heavily influenced by interactions with its neighboring microenvironments.

"Adult stem cells are maintained inside a specialized microenvironment called a niche, whereas progenitor cells migrate to surrounding microenvironments that are distinct from the one around the niche," said LaBarge. "The ability of adult stem cells to self-maintain, as well as to give rise to progenitor cells that are targeted to become a specific tissue cell, indicates an ability to respond to changing microenvironmental demands, which would mean that a stem or progenitor cell is receiving instructional information from its surroundings."

The fact that normal cells often lose their tissue-specific functions when placed in culture is further evidence of cell fate being tied in to signals from the microenvironment. However, proving such a hypothesis has been difficult in the past because the composition of cell microenvironments is extremely complex and requires a method by which a combination of carefully choreographed interactions can be observed. Given that experiments with human adult stem cell niches cannot be done in vivo and that scientists can only learn so much from mouse models, this means that cell culture studies must be done under as close as possible to in vivo conditions.

"Our technology mimics actual in vivo conditions and enables us to perform highly parallel functional analysis of combinatorial microenvironments, and image analysis of 3-D organotypic cultures and micro patterned culture substrata," said LaBarge. "The 3-D capability is crucial because our studies show that orientation of the stem or progenitor cells with respect to the signaling molecules can be critical to what happens next."

The MEArrays were fabricated using micro patterning technology originally adapted by co-author Nelson that LaBarge "tweaked." A robot imprinted arrays of 2,304 individual combinations of molecules onto a rubber-coated glass microscope slide (the rubber facilitates adsorption of the proteins onto the slide). An individual MEArray consisted of 192 unique combinatorial microenvironments replicated 12 times, with a plastic barrier running along the perimeter so that cell cultures could be placed on top.

In addition to possible contributors to the stem cell niche, the microenvironments also comprised many ECM and signaling molecules that are expressed in the breast but had not been directly linked to stem cell function before.

In all, adult mammary stem and progenitor cells were exposed to 8,000 different combinations of breast tissue protein and biological molecules. LaBarge, Bissell and their collaborators were able to distinguish between effects resulting from cell interactions with other cells and those resulting from cell interactions with the ECM or other signaling molecules. Both immortalized and primary human breast progenitors were analyzed with the MEArrays and the results were used in conjunction with physiologically relevant 3-D human breast cultures. This approach enabled the research team to identify conditions that induced cells to convert into normal breast cell types as well as conditions that kept the cells in their original, non-specialized state.

One of the most intriguing results in this study was the suggestion that modulation of stem and progenitor cell differentiation pathways might be used to "normalize" malignant breast cells.

"Normal and malignant mammary epithelial cells in 3-D cultures have distinct phenotypes," LaBarge said. "By impairing a signaling pathway known as Notch, we are able to revert malignant breast cancer cells to a normal phenotype."

In previous studies, Bissell and her group had identified signaling pathways that could cause "phenotypic reversion" of breast cancer cells but this had never been tried before with stem cells.

Said Bissell, "The MEArray approach may be able to teach us how to direct stem cell function in a therapeutic setting and possibly to re-program non-stem cells to acquire other stem cell fates."

While the MEArrays in this study were used to study adult stem and progenitor cells in breast tissue, the technique should also be applicable to any of the other 200 different types of tissue cells within other organs, LaBarge said.

----------------------------

Article adapted by Medical News Today from original press release.

----------------------------

This research was supported in part by grants and a distinguished Fellow Award from the U.S. Department of Energy's Office of Biological and Environmental Research and low dose program, by grants from the National Cancer Institute and from the U.S. Department of Defense's breast cancer research program. LeBarge was a fellow of the American Cancer Society.

Source: Lynn Yarris

DOE/Lawrence Berkeley National Laboratory

Stem Cell Research Scientists To Call For Faster Experimentation

2009-02-27T15:00:00.000+02:00

Some of Britain's leading stem-cell research supporters are calling for further tests on human embryos to be speeded up.

Leading British doctors and academics will tell an Oxford conference the opportunities created by the new Human Fertilisation and Embryology Act must be acted upon quickly.

Controversial scientific experimentation has been given a recent boost by President Obama, who as one of his first acts on taking office was to relax federal restrictions on embryonic stem cell research.

Among the speakers at the conference - organised by the Oxford International Biomedical Centre (OIBC) - will be UCL's Professor Martin Birchall, who cultivated the stem cells used in the first ever successful tracheal transplant.

In his speech, Professor Birchall will warn that the opportunities created by the transplant are being squandered.

"We hope we will encourage others to be more permissive of making the leap from laboratory to patients in the field of tissue engineering" says Professor Birchall.

"Although our tracheal transplant patient is completely healthy eight months post-operatively, enthusiasm has to be curbed slightly by the need for more patients and more time in follow-up. The recent discovery that unregulated stem cell treatments in Russia are causing tumours reminds us of this. However, this fear of uncertainty must not stop us from trying and must not stop clinical trials."

For this event the OIBC has teamed up with Oxford University's Dept of Continuing Education and with St Edward's School, the venue for the conference.

"It is particularly appropriate to hold the event at St Edward's," says OIBC's Director, Dr Charles Pasternak, "as the day will conclude with the opening of the school's new £3.4 million state-of-the-art science block by Baroness Ruth Deech, a former Principal of St Anne's College Oxford, and former Chair of the Human Fertility and Embryology Authority (HFEA)."

The conference has been organised as part of the OIBC's efforts to promote the understanding of stem cell research and regenerative medicine.

"Now that US government funding has been restored to embryonic stem cell research," says Dr Pasternak, Director of the OIBC, "we will no doubt see great scientific advancement, which could not be timelier than in the 200th year of Charles Darwin's birth. The OIBC for one will be at the very forefront of this evolution."

Other contributors include Baroness Ruth Deech, who will be addressing top academics with a speech on embryonic stem cell research in the 2nd Dame Anne McLaren Memorial Lecture.

"I welcome the way in which the 2008 Act has opened the doors to further scientific research," says Baroness Deech, "I thought that the protests against the extension of permission for work with admixed embryos were unwarranted: there is of course no intention of allowing those admixed embryos to grow beyond a few cells, not some man-beast hybrid as the media portrayed."

The OIBC conference will take place at 0930 on Wednesday 4th March 2009 at St Edward's School, Woodstock Road, Oxford, OX2 7NN

Notes

The media is warmly invited to attend the reception and opening ceremony, which is scheduled to take place at 6.30pm

Background information on St Edward's School:

Founded in 1863, St Edward's (also colloquially known as "Teddies") is an independent, co-educational boarding school situated in north Oxford. There are presently 658 pupils, of whom 502 are boarders. The school has been fully co-educational since 1997, and girls now represent 35% of the total pupil body.

OIBC

Obama's Health Plan

2009-02-27T09:00:00.000+02:00

President Barack Obama's health budget outlines eight principles of reform to expand coverage and bring down costs, and comes with a price ticket of 76.8 billion dollars for fiscal year 2010.

The budget also proposes a reserve fund of more than 630 billion dollars over 10 years to finance the overhaul, half funded from new revenue and half from savings anticipated to accrue from increasing efficiency and accountability, aligning incentives to quality and sharing responsibility, said the 2010 Health and Human Services Department budget outline released from the White House earlier this week.

According to a report in the Los Angeles Times (LAT), the president wants to raise nearly 318 billion dollars over the next ten years by capping itemized income tax deductions for families earning more than 250,000 dollars a year so that they would only get 28 per cent of deductions like charitable donations back, instead of the higher amounts allowed under current regulations.

According to the LAT, such a proposal means that a couple in the 35 per cent tax bracket would only get back 2,800 dollars compared to the 3,500 dollars they can currrently claim back for a 10,000 dollar charity donation.

The president also sees more than 316 billion in extra revenue coming from changes to the way central government pays for Medicare and Medicaid, where more than 175 billion would come from cutting payments to insurers that contract with the government through the Medicare Advantage program.

Also, the budget proposal stresses that the reserve fund will not be enough to "put the Nation on a path to health insurance coverage for all Americans". Additional funds will be needed to cover the cost of the plan; it will require "an effort beyond this down payment", says the White House.

The 8 principles of Obama's health plan are to:

Speed up use of electronic health records and information technology.

Support more research into comparing treatments so doctors and patients have better information on what works best.

Double research on cancer, including a 6 billion injection at the National Institutues of Health.

Improve services for American Indians and Alaskan Natives.

Recruit more health professionals, including 330 million dollars for more doctors, nurses and dentists in regions of shortage.

Expand child care such as Early Head Start and Head Start and create Nurse Home Visitation to support first time mothers.

Strengthen quality and efficiency of Medicare, the government insurance program for seniors.

Increase food safety and prevention of foodborne illness by investing over 1 billion dollars for more Food and Drug Administration inspections, labs, and surveillance.

In this plan one sees much influence from recently published reasearch, such as the High Performance Health System that the Commonwealth Fund released last week and America's Uninsured Crisis: Consequences for Health and Health Care that the Institute of Medicine published earlier this week.

In their report, the Commonwealth Fund proposes a set of recommendations for insurance, payment and system reforms that could "guarantee affordable coverage for all by 2012, improve health outcomes, and slow health spending growth by 3 trillion dollars by 2020", as long they are enacted now and put in place in 2010.

Central to their proposal is the idea of a national insurance exchange that offers consumers a choice of affordable and accessible private plans and a new public plan that also cost less to administer.

With this as the foundation the focus then shifts to other areas such as reforming how care is paid for. For this they propose moving from a fee-for-service system to more "bundled" methods of paying that "encourage coordinated care and hold providers accountable for improving health outcomes and prudent use of resources".

The Commonwealth Fund also recommends increasing the use of information technology and the creatiion of a center for "comparative effectiveness to enhance knowledge and appropriate use of evidence-based care".

Click here for the White House health budget plan for 2010 (opens as PDF).

Sources: whitehouse.gov, Commonwealth Fund, Institute of Medicine, LA Times.

Written by: Catharine Paddock, PhD

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

BrachySciences Only Company To Offer All Three Isotopes For Low Dose Rate Prostate Brachytherapy

2009-02-26T15:00:00.000+02:00

BrachySciences, the leader in providing innovative medical devices for the treatment of early stage prostate cancer, has announced a distribution agreement with IsoRay Inc., manufacturer of Proxcelan™, the only Cesium-131 radioactive source available for brachytherapy. By adding the unique Cesium-131 source to its distribution portfolio of Advantage Iodine-125™ and the TheraSeed® Palladium-103 device, BrachySciences is now the only company capable of providing all three radioactive isotopes used in low dose rate (LDR) prostate brachytherapy.

The agreement leaves BrachySciences uniquely positioned to service the requirements of any physician performing LDR prostate brachytherapy. "We're very excited about what the availability of all three isotopes means for physicians," said Jim Matons, President, BrachySciences. "We'll be able to effectively fulfill all of their LDR prostate brachytherapy needs. Not only will physicians have access to all three isotopes, but they will now be able to obtain them all in BrachySciences' most advanced devices, such as AnchorSeed™, EchoStrand™, and VariStrand™, for any of their treatment techniques."

Anthony G. Pasqualone, IsoRay Vice President of Sales and Business Development, added "We are extremely pleased to announce this agreement with BrachySciences. Proxcelan represents a major innovation in brachytherapy isotope offerings. As such, it only makes sense for us to extend the presence of Cesium-131 in brachytherapy by distributing Proxcelan through BrachySciences, which has a reputation for bringing innovative products to the industry. We are confident our agreement will offer a compelling option to physicians practicing brachytherapy."

In addition to physicians, administrators and purchasing departments stand to benefit from the agreement. With access to all three isotopes and a diverse brachytherapy product portfolio capable of satisfying any pre-planned or real-time implant technique, BrachySciences has the ability to function as a solitary vendor and complete service provider to hospitals and clinics with LDR implant programs.

About BrachySciences

BrachySciences, a division of Biocompatibles, Inc., is dedicated to improving and expanding the use of brachytherapy implants for the treatment of early stage prostate cancer. The company develops, markets, sells, and distributes radioactive seeds as well as unique delivery systems and ancillary equipment used in brachytherapy implants. BrachySciences is committed to optimizing the quality and efficiency of prostate brachytherapy implants by providing state of the art brachytherapy products, innovative technologies, and services to the physicians and institutions that treat patients diagnosed with prostate cancer. BrachySciences is based in Oxford, Connecticut. More information about BrachySciences is available at http://www.brachysciences.com

About IsoRay

IsoRay, Inc., through its subsidiary, IsoRay Medical, Inc., is the sole producer of the Cesium-131 brachytherapy seed, used to treat prostate and other cancers. The Cesium-131 seed offers a significantly shorter half-life than the two other isotopes commonly used for brachytherapy, which results in a substantially faster delivery of therapeutic radiation, lower probability of cancer cell survival, and reduction of the longevity of common brachytherapy side effects(a)(b). IsoRay is based in Richland, Washington. More information is available about IsoRay at http://www.isoray.com.

(a) Armpilia CI, Dale RG, Coles IP, et al. The Determination of Radiobiologically Optimized Half-lives for Radionuclides Used in Permanent Brachytherapy Implants. Int. J. Radiation Oncology Biol. Phys. 2003; 55 (2): 378-385.

(b) Prestidge B.R., Bice W.S., Jurkovic I.,et al. Cesium-131 Permanent Prostate Brachytherapy: An Initial Report. Int. J. Radiation Oncology Biol. Phys. 2005; 63 (1): 5336-5337.

BrachySciences

IsoRay

Hard Economic Times Affect Patients, Dentists - And The Tooth Fairy

2009-02-26T09:00:00.000+02:00

In preparation for the Chicago Dental Society's 144th annual Midwinter Meeting, which will draw more than 30,000 dental professionals to Chicago this February, society members were asked about oral care tips, current trends, their personal dental habits, and more. More than 300 of the society's member dentists responded to the fall 2008 survey.

As we countdown to CDS's annual Midwinter Meeting, one of the largest displays of dental products in North America, here are the topline findings from the survey:

Does the Tooth Fairy account for inflation? More than half of dentists surveyed feel $1 is a fair amount for the tooth fairy to pay for a child's tooth -- and the same percentage of dentists felt the same way in 2003. However more than 16 percent suggested a bump in pay to $2, and a little more than 17 percent feel the tooth fairy should pony up $5 per tooth!

Dentists brush up and often More than 30 percent of dentists surveyed brush more than three times a day. And half of dentists brush the recommended twice a day.

Floss friendly More than 60 percent of dentists floss once a day. Only 11 percent of dentists surveyed floss more than twice a day and 22 percent floss less than daily.

Forecast for ABC-7's Tracy Butler: sunny skies and bright smiles Of local Chicago TV weather personalities, ABC-7's Tracy Butler won "best smile" with nearly 35 percent of votes from surveyed dentists. FOX-32 Amy Freeze's smile came in second, with 28 percent of votes.

Dentists slowly warming up to the online world 11 percent of dentists surveyed said they occasionally scan "review" websites such as Yelp.com and Angie's List to find out what patients say about their practice.

Hard times push patients to halt dental care With the recent economic crisis pinching wallets, more than 60 percent of dentists surveyed report that their patients are putting off cosmetic procedures. More than half say their patients are putting off needed dental work. Visits for preventative dental care are also on the decline according to more than 40 percent of dentists.

Julia Roberts is still on the A-List When patients are asked what they want their smile to look like, a majority of dentists report that Julia Roberts leads the pack for most requested celebrity smile. Men seek Brad Pitt's smile the most -- in 2006 Tom Cruise had that starring role. Other frequently requested famous smiles include Angelina Jolie, Jennifer Aniston, Tom Cruise and President Barack Obama.

Friend your dentist? Twenty percent of dentists surveyed used online networking sites, with Facebook as their top choice (15%). Other popular sites were LinkedIn (7%) and MySpace (4%).

Data was collected for the Chicago Dental Society's 144th annual Midwinter Meeting, which begins at McCormick Place in Chicago on February 26, 2009. The exhibit floor opens on February 27.

Chicago Dental Society

http://www.cds.org

New Appointments To Health Protection Agency Board, UK

2009-02-25T15:00:00.000+02:00

Sir William Stewart, Chairman of the Health Protection Agency announced the appointment of four new non-executive Board members who will take up their posts on 1 April. They are:

Michael Carroll, who has 35 years' experience in the pharmaceutical and biotech industries, working for Glaxo, Novartis, BMS, British Biotech and Scotia in a variety of technical and senior management executive roles both in the UK and internationally. He has extensive practical expertise in the operational management of complex research and development and manufacturing environments and in assisting organisations to deliver their strategic objectives through the execution of effective cultural change programs. Most recently he was Site Director for Novartis UK which focuses on product research, development and manufacturing.

Mr Carroll has served on national committees of the Association of the British Pharmaceutical Industry and the BioIndustry Association where he was active in promoting the UK manufacturing base and industry best practice. He is a founder QP Assessor, a practising QP and a former vice president of the International Society for Pharmaceutical Engineering.

Helen Froud has specialised in Human Resources for more than 15 years. Currently running her own HR and management consultancy carrying out specific HR projects for local authorities, she has previously held executive posts in the financial services and local authority sectors.

A Chartered Member of the Institute of Personnel and Development, and an experienced management trainer and lecturer in Human Resources, Ms Froud is grant-funded by the Commission for Equalities and Human Rights to work on HR projects with small local businesses. She is a Board Member of One Parent Families Scotland and is a regular contributor to professional journals on specialist HR topics, as well as to consumer publications on HR issues for the general public.

Martin Hindle has extensive Board and executive level experience in the UK and international markets in pharmaceuticals and telecommunications. His Board experience covers both private and public sectors. Particular areas of focus include financial management, strategic planning, commercial development, drug development, change and operational management.

As a non executive director of the National Biological Standards Board (NBSB), he chairs the Audit Committee of the National Institute of Biological Standards and Control which is due to become part of the Health Protection Agency in April. Mr. Hindle already serves on the Agency's Finance Committee and will take over the chairmanship of this at the beginning of April.

Mr Hindle is Chairman of the University Hospitals of Leicester NHS Trust.

Deborah Oakley worked in the Financial Services Industry for 20 years until 2006 as an investment manager. She worked for the same company, from its entrepreneurial start up to its eventual sale to a large US corporation, by which time she had become a Board Director. Whilst with the company, Mrs Oakley personally managed assets of £100 million and her team managed assets of £500 million.

Mrs Oakley has been a member of the board of Camden Primary Care Trust for the last two years. She is currently Chair of their Audit Committee and a member of the Finance Committee. She is also a governor of the Royal Free Hospital which hopes to attain Foundation Trust status in the near future.

Sir William Stewart said: "I am delighted to announce these appointments which will significantly strengthen the work of the Board. Michael Carroll's experience in the pharmaceutical and biotech industries will bring an important dimension to the Agency's expanded brief in these areas. Helen Froud's extensive experience in the field of human resources will also be invaluable both to the Board and the wider Agency. Martin Hindle has already served on the National Biological Standards Board and I have no doubt will continue to add value to the Agency's Board. Deborah Oakley's financial and management expertise will bring further rigour to the Board's scrutiny of the Agency's work. I very much welcome these appointments and look forward to all of them contributing fully across the wide spectrum of the Agency's activities."

Notes

All non-executive appointments are made on merit and political activity plays no part in the selection process. However, in accordance with the original Nolan recommendations, there is a requirement for appointees' political activity (if any declared) to be made public.

1. The appointments have been made by the Appointments Commission in accordance with the Commissioner for Public Appointments' Code of Practice.

2. The remuneration for non-executive Board members is currently £7,765 annually.

3. Each of the appointments will run from 1 April 2009 to 31 March 2012.

4. For more information about the HPA Board, go here.

Health Protection Agency

Cardiovascular Disease Treatment Guidelines Frequently Not Based On Solid Evidence

2009-02-25T09:00:00.000+02:00

A study in the February 25 issue of JAMA reports that evaluation of clinical practice procedure for treating cardiovascular disease finds that present recommendations mainly rely on inferior levels of evidence or expert opinion.

According to background data in the article, practitioners base their decision for suitable heath care for particular patients' circumstances on clinical practice guidelines which are frequently considered as standard of evidence-based medicine.

Clinical practice guidelines have been released to offer recommendations on how to care for cardiovascular disease patients by the American College of Cardiology (ACC) and the American Heart Association (AHA), for more than two decades. Degree of evidence and class of recommendations are the basis for the grading system presently used by the ACC/AHA guidelines. The combination of an objective description of evidence and the types of studies sustaining the recommendation and expert opinion is used for the classification of level of evidence, and categorized as A (higher level of evidence), B, or C (lower level of evidence).

The level of recommendation is indicated by class of recommendation. It involves an opinion of the guideline writers on the comparative strengths and weaknesses of the study information, as well as an evaluation of the relative consequence of the risks and benefits identified by the evidence. The classes are ranked as I (evidence that a treatment or procedure is effective), II, IIa, IIb and III (evidence that a treatment or procedure is not effective).

It is unknown if the rise in cardiovascular disease studies increases the certainty of guideline recommendations and supporting evidence. The changes in recommendations in ACC/AHA cardiovascular guidelines and the evaluation of the adequacy of the evidence used for present guideline recommendations were studied by Pierluigi Tricoci, M.D., M.H.S., Ph.D., Duke University, Durham, N.C. and team. Information from ACC/AHA practice guidelines issued from 1984 to September 2008 was used in the study. A total of 7,196 recommendations and fifty-three guidelines on twenty-two topics were analyzed.

The total number of recommendations had a 48 percent increase (1,330 to 1,973), from the earliest guideline to the present version, taking into account only the current guidelines with at least one review. In general, there was a shift to class II recommendations, a drop in class II recommendations, while the use of class I remained invariable. In a total of 2,711 recommendations, in the sixteen present guidelines reporting levels of evidence, 11 percent (314) of the recommendations were classified as level of evidence A, and 48 percent (1,246) as level of evidence C.

In the total of 1,305 class I recommendations of guidelines reporting evidence, only 19 percent (245) have a level of evidence A, 36 percent (481) have a level of evidence C. In the different categories of guidelines (disease, intervention, or diagnosis) and the different individual guidelines, the level of evidence considerably varies.

In conclusion, the authors write: "Our finding that a large proportion of recommendations in ACC/AHA guidelines are based on lower levels of evidence or expert opinion highlights deficiencies in the sources of definitive data available for the generation of cardiovascular guidelines. To remedy this problem, the medical research community needs to streamline clinical trials, focus on areas of deficient evidence, and expand funding for clinical research. In addition, the process of developing guidelines needs to be improved with information about the impact that recommendations based on lower levels of evidence has on clinical practice. Finally, clinicians need to exercise caution when considering recommendations not supported by solid evidence."

JAMA. 2009; 301[8]:831-841

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: Re-evaluation of Clinical Practice Guidelines

Terrence M. Shaneyfelt, M.D., M.P.H., and Robert M. Centor, M.D., University of Alabama School of Medicine, Birmingham, in a complementary editorial, note that there is a need for important changes in clinical practice guidelines if they are to be maintained.

"However, it seems unlikely that substantial change will occur because many guideline developers seem set in their ways. If all that can be produced are biased, minimally applicable consensus statements, perhaps guidelines should be avoided completely. Unless there is evidence of appropriate changes in the guideline process, clinicians and policy makers must reject calls for adherence to guidelines. Physicians would be better off making clinical decisions based on valid primary data."

JAMA. 2009 ;301[8]:868-869.

Written by Stephanie Brunner (B.A.)

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

Benvenue Medical Receives CE Mark Approval For Kiva™ VCF Treatment System

2009-02-24T15:00:00.000+02:00

Benvenue Medical, Inc., a developer of minimally invasive solutions for spine repair, announced today that it has received CE Mark approval in Europe for the Kiva™ Vertebral Compression Fracture (VCF) Treatment System. Initial clinical cases in Europe using the Kiva System have been successfully performed and the company is preparing for the commercial launch of the product throughout the region.

The Kiva System addresses unmet needs of spine physicians who treat painful VCFs due to osteoporosis, trauma, and cancer. The Kiva System incorporates Benvenue Medical's proprietary, flexible spinal implant technology. The implant, which is manufactured from PEEK, is introduced using a percutaneous, over-the-wire technique. It reduces and stabilizes the fracture and is designed to provide containment during delivery of PMMA bone cement.

In over one year of clinical use, the Kiva System has provided VCF patients with immediate pain relief and consistent functional improvement, while requiring significantly less bone cement than is customarily used in kyphoplasty and vertebroplasty procedures.

The first clinical cases in Europe using the Kiva System were recently performed by Dr. Stephan Becker at the Orthopedic Hospital Speising in Vienna, Austria.

"Among all of the new approaches to VCF repair that I have seen, the Kiva System offers a new unipedicular method to improve the treatment of these painful fractures," said Dr. Becker. "The system deploys an implant that can restore height and provide a safe containment for low viscosity cement."

VCF treatment represented a global market of approximately $600 million and over 200,000 procedures in 2008. The market remains underpenetrated, with roughly 700,000 additional VCF patients diagnosed each year worldwide. The fast growing European VCF market currently represents about 25% of the global market.

"The CE Mark is an important milestone for the company because it allows us to commercialize the Kiva System in some of the largest and fastest growing VCF markets in the world, and further validate the benefits delivered by the system through expanded clinical use," said Laurent Schaller, president and CEO of Benvenue Medical.

Mr. Schaller will provide additional information regarding the Kiva System, and an update regarding the company's progress in the field of minimally invasive spinal fusion, at the Canaccord Adams Musculoskeletal Conference in Las Vegas on Tuesday, February 24, 2009.

About Benvenue Medical, Inc.

Founded in 2004 and headquartered in Santa Clara, California, Benvenue Medical, Inc. is advancing spine repair through the development of proprietary, minimally invasive surgical and interventional solutions. The company is privately held.

Benvenue Medical, Inc.

Calcium Linked To Lower Risk Of Intestinal Cancer

2009-02-24T09:00:00.000+02:00

A new US study found that higher calcium intake was linked to a lower risk of total cancers in women only; and for both men and women, it was linked to lower risk of of cancers of the digestive system, and colorectal cancer in particular.

The study was the work of researchers from the National Cancer Institute in Bethesda, Maryland and the AARP in Washington, DC and was published online on February 23 in the Archives of Internal Medicine , one of the JAMA/Archives journals.

Previous studies have linked dairy food and calcium intakes to cancer risk but the results have been inconsistent and limited, and the effect on overall cancer risk is also unclear, wrote the authors in their background information.

They also wrote that calcium is known to be good for healthy bones and because of this the Institute of Medicine recommends adults aged 50 and over have 1,200 milligrams of calcium a day and the 2005 dietary guidelines for Americans says they should have 3 cups per day of low-fat or fat-free dairy foods.

For the study the authors analyzed data on 293,907 men and 198,903 women from the NIH-AARP Diet and Health and Study. NIH stands for National Institutes of Health and the AARP was formerly known as the American Association of Retired Persons.

When they enrolled in the study between 1995 and 1996 the participants had completed a food frequency questionnaire that asked them about the foods they ate and whether they took supplements. The researchers correlated their answers with state cancer registeries to identify new cancer cases from the start of the study until 2003.

Using a statistical tool called Cox proportional hazard they estimated the relative risks of individual and total cancers in men and women in relation to calcium intake.

The results showed that:

During an average follow up of 7 years, there were 36,965 cases of cancer in the men and 16,605 in the women.

There was no link between calcium intake and total cancer in men.

There was a non-linear link between calcium intake and total cancer in women, and the risk went down as daily calcium intake went up to approximately 1,300 mg a day; no further risk reduction occurred above this level.

In both men and women dairy food and calcium intake were inversely linked to cancers of the digestive system.

Comparing the 20 per cent of participants who ate the most calcium (1,530 and 1,881 mg/day for men and women respectively) with the 20 per cent who ate the least (526 and 494 mg/day) showed a relative risk of cancer of the digestive system of 0.84 (16 per cent lower) for men and 0.77 for women (23 per cent lower).

This decrease was even more pronounced for colorectal cancer.

Calcium intake from supplements was also linked to lower colorectal cancer risk.

Calcium and dairy food intake was not linked with prostate cancer, breast cancer or cancer in any other anatomical system besides the digestive system.

The authors concluded that:

"Our findings suggest that calcium intake consistent with current recommendations is associated with a lower risk of total cancer in women and cancers of the digestive system, especially colorectal cancer, in both men and women."

The authors also wrote that dairy food is high in nutrients that are thought to have anti-cancer properties, these include calcium, vitamin D and conjugated linoleic acid. Also calcium has been shown to reduce abnormal growth and promote normal turnover of cells in the intestine and breast and it binds to bile and fatty acids, which is thought to reduce damage to the mucous membrane of the large intestine (includes the colon and the cecum).

The study was funded by the Intramural Research Program of the National Cancer Institute, which is part of the National Institutes of Health.

"Dairy Food, Calcium, and Risk of Cancer in the NIH-AARP Diet and Health Study."

Yikyung Park; Michael F. Leitzmann; Amy F. Subar; Albert Hollenbeck; Arthur Schatzkin.

Arch Intern Med Vol. 169 No. 4, pp 391 - 401, February 23, 2009.

Click here for Abstract.

Sources: Journal abstract, JAMA and Archives Journals press statement.

Written by: Catharine Paddock, PhD

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

IKEA Social Initiative Adds $48 Million To UNICEF's Child Health Programme

2009-02-23T15:00:00.000+02:00

UNICEF announced that IKEA, through its corporate philanthropy arm, IKEA Social Initiative, is further expanding its support for children with a $48 million donation for UNICEF programmes in India.

This most recent donation will support UNICEF programmes aimed at improving the health and survival of tens of millions of women and children in some of India's most deprived areas.

UNICEF also announced that, with this donation, IKEA Social Initiative has become the agency's biggest corporate partner, with total commitments of more than $180 million from 2000 to 2015.

"The IKEA Social Initiative makes a serious corporate commitment toward improving the living conditions in countries where it is working," said Saad Houry, UNICEF Deputy Executive Director. "IKEA's investment in children's wellbeing, despite the downturn in the global economy, sets a high standard for corporate partnership."

In 2000, UNICEF, IKEA and the Government of India created a partnership aimed at addressing the root causes of child labour in the carpet belt of India such as debt, poverty, the lack of access to education, disability and ill health. It was implemented in 500 villages in Eastern Uttar Pradesh region of India. This program made it possible for 80,000 out of school children to get an education and 140,000 children and 150,000 women were immunized. The program also empowered more than 22,000 women to create sustainable economic opportunities through self-help groups.

The partnership between UNICEF and IKEA Social Initiative has bloomed over the past decade into a multi-faceted long term association that is delivering tangible benefits in health, education and protection for millions of children and women not only in India, but also elsewhere in Asia, Africa and Central and Eastern Europe.

In India, one woman dies every seven minutes from causes related to pregnancy and childbirth and nearly one million newborn babies die every year. The country is home to almost 40 per cent of malnourished children worldwide with a record 25 million children under five year of age suffering from wasting and 61 million children stunted due to malnutrition.

The extended commitment of IKEA Social Initiative will allow UNICEF to provide additional support for national and state-led strategic and integrated programmes to improve the health of women and children in India. These programmes will address the causes of high mortality among children and mothers and improve children's nutritional status.

The donation will contribute to health, nutrition, clean water and sanitation projects. e.g. by providing infants with immunisation and vitamin A supplements, as well as advocating for breastfeeding and the importance of nutritious food for children under the age of 24 months; by creating a healthy environment for children at home and in school; and by ensuring water safety and better sanitation, such as better access to toilets and learning about basic hygiene.

"The resources being provided will allow us to implement critical long-term programmes that seek to improve child survival, development and protection," said Karin Hulshof, UNICEF India Country Representative from New Delhi. "IKEA Social Initiative has chosen to concentrate its long-term commitments on South Asia, where the needs of children and women are great, and where IKEA has long business experience."

The announcement was made on the occasion of International Corporate Philanthropy day, celebrated at the ECOSOC Chambers at the United Nations in New York. Read more about IKEA's work at http://www.unicef.org

About UNICEF

UNICEF is on the ground in over 150 countries and territories to help children survive and thrive, from early childhood through adolescence. The world's largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, safe water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments.

About IKEA Social Initiative

IKEA Social Initiative manages social involvements on a global level. The mission of IKEA Social Initiative is to improve the rights and life opportunities of the many children - fighting for children's rights to a healthy and secure childhood with access to quality education. UNICEF and Save the Children are the main partners, with a range of projects take a holistic approach for creating a substantial and lasting change: improving the health of mothers and children, enabling access to a quality education for children, and empowering women to create a better future for themselves and their communities.

UNICEF

BMA Launches Campaign To Promote Fair Trade Of Medical Supplies Ahead Of Fair Trade Fortnight, UK

2009-02-23T09:00:00.000+02:00

The BMA today launched a campaign to promote fair trade in medical supplies ahead of Fair Trade Fortnight (23 Feb - 8 March). The campaign1 calls on healthcare workers and the public to contribute to the NHS consultation on ethical purchasing.

Dr Mahmood Bhutta, BMA advisor on the BMA's Medical Fair and Ethical Trade Group said:

"There is evidence to suggest that many supplies used in the NHS are produced in unhealthy, unsafe and unfair working conditions. Workers in the developing world are poorly paid and are exposed to hazardous conditions where they risk serious injury and even death. For example, many surgical instruments are made in Pakistan2 where workers work twelve hours a day, seven days a week. Some suffer serious injuries due to poor standards of health and safety. There is also a use of child labour, with some workers as young as seven. It seems perverse that labourers around the world are risking their lives to supply us with equipment to save British lives."

He added:

"Fair trade is not just about the products we purchase, it is also about things that are purchased on our behalf. Taxpayers have an opportunity to tell the NHS they want medical equipment purchased in line with fair and ethical trade guidelines. The NHS body responsible for advising GPs and hospitals on the purchasing of medical equipment has recently produced a consultation document on this issue. I would urge anyone who cares to submit a response to that consultation."

1 The BMA has launched a facebook group for people who want to keep up with the latest information on the campaign: http://tinyurl.com/BMAFairTrade and is encouraging doctors and the public to take part in an NHS consultation on ethical procurement of medical supplies.

Details of the consultation are here and the consultation questions can be found hhere ttp://tinyurl.com/NHSPASA2

2 Pictures of the working conditions in Pakistan are available here.

http://www.bma.org

One Thing Leads To Another In Exacerbations In COPD

2009-02-22T09:00:00.000+02:00

New research shows that individual exacerbations in chronic obstructive lung disease (COPD) themselves increase the likelihood of repeat exacerbations, even after five days of full, asymptomatic recovery - bad news for patients with COPD, where each exacerbation can drive the progression of the disease.

"This concept that exacerbations are not random has important implication for the analysis of clinical trial data and identifies a specific high-risk period for recurrent exacerbation during which preventative interventions might be targeted," wrote lead author, John Hurst, M.D., of the Royal Free and University College Medical School, in London.

The results appeared in the first issue for March of the American Journal of Respiratory and Critical Care Medicine, a publication of the American Thoracic Society.

In patients with COPD, exacerbations are generally defined as an acute worsening of symptoms. Exacerbations in and of themselves are inherently dangerous and can lead to hospitalization and serious complications. But beyond their acute dangers, exacerbations drive lung function decline, and many patients never recover their baseline level of lung function after exacerbations. Prior to this research, however, exacerbations were assumed to be isolated events unrelated to one another despite observational data that suggested a dependency.

To test the validity of this assumption, which not only informs treatment plans for patients with COPD, but also forms the basis of research design and analysis, Dr. Hurst and colleagues analyzed daily symptom diaries that were kept for at least one year by 297 COPD patients, describing nearly 2,000 distinct exacerbation events. Two or more new or worsening symptoms, one of which must be "major" (e.g., dyspnea, more sputum, or a change in color of sputum) constituted an exacerbation, and after five days of symptoms reverting to baseline severity, the exacerbation was considered to be over. A second exacerbation occurring within an eight-week period was considered to be a recurrent exacerbation. The researchers further analyzed seasonality of exacerbations, comparing their winter (November to January) frequency with their summer (June-August) frequency.

In addition to the finding that exacerbations were clustered in time within individuals, the researchers found that they were significantly more common in the winter than the summer. They also noted that "isolated" exacerbations tended on average to be about 25 percent more severe than the first of serial exacerbations.

But most importantly, the researchers identified an eight-week period of time during which monitoring and follow-up is crucial to prevent or minimize further exacerbations in the COPD patient. "Our finding of a high-risk period for recurrent exacerbation may be important in guiding patient follow-up," wrote Dr. Hurst.

"The mechanisms of exacerbation recurrence remain unexplored, and it is unknown whether recurrence is due to persistence of an existing organism or to acquisition of a new one," noted Dr. Hurst. However, there are some clues that may guide future research. "The failure to eradicate bacteria with exacerbation therapy has been associated with an incomplete recovery in inflammatory markers and we have recently reported a relationship between elevated C-reactive protein during the recovery period of an initial exacerbation and shorter time to the next." Furthermore, the paper noted that "symptoms more typical of viral infection are significantly more common during isolated events."

"This knowledge is very important for physicians," wrote Shawn D. Aaron, M.D., of the Ottawa Health Research Institute, in Canada, in an editorial in the same issue of the journal. "Clinicians should now be aware that their patients with COPD who experience an exacerbation may be particularly 'brittle' during a subsequent eight-week period. Close monitoring and follow-up during this time would hopefully lead to earlier therapy for recurrent exacerbations that may improve clinical outcomes."

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Article adapted by Medical News Today from original press release.

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Source: Keely Savoie

American Thoracic Society

Focusing On Nanotechnology At American Chemical Society National Meeting, March 22-26

2009-02-21T09:00:00.000+02:00

The scientific field that focuses on the ultra-small - nanotechnology - will play the biggest single role in the 237th National Meeting & Exhibition of the American Chemical Society (ACS), which takes place here from March 22-26. ACS, the world's largest scientific society, has scheduled more than 135 major symposia on aspects of nanotechnology. The topics, which will be discussed in nearly 1,000 research papers, range from "green" manufacturing processes to the medical, commercial, and industrial applications of nanotech that are predicted to spawn new multi-billion-dollar industries.

The nanotech sessions are part of a larger program, expected to bring more than 11,000 scientists and others to the capital city of Utah. The scientific sessions include 7,200 presentations on new discoveries that span science's horizons, from astronomy to zoology. The topics include food and nutrition, medicine, health, energy, the environment, and other fields where chemistry plays a central role. Sessions will be held in the Salt Palace Convention Center and downtown hotels. In addition, the meeting - among the largest scientific gatherings of 2009 - will feature a sprawling exhibit area, with more than 200 exhibits of scientific instrumentation, journals, and other items.

In keeping with the meeting theme, "Nanoscience: Challenges for the Future," several special Presidential Events will be held, organized by ACS President Thomas H. Lane, Ph.D. Among them are a keynote address, "From Nature and Back Again: Giving New Life to Materials for Energy," March 22 , by noted Massachusetts Institute of Technology scientist Angela Belcher, Ph.D.; "The Kavli Foundation ACS Presidential Plenary Session on Challenges in Nanoscience," on March 23; and "Naturally Nano," a symposium on March 24.

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Article adapted by Medical News Today from original press release.

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The American Chemical Society - the world's largest scientific society - is a nonprofit organization chartered by the U.S. Congress and a global leader in providing access to chemistry-related research through its multiple databases, peer-reviewed journals and scientific conferences. Its main offices are in Washington, D.C., and Columbus, Ohio.

Source: Michael Woods

American Chemical Society

Drugs Just As Good And Much Cheaper Than Stents For Delayed Treatment Of Heart Attacks

2009-02-20T21:00:00.000+02:00

A new US study confirms earlier findings that patients receiving delayed treatment for heart attack do just as well and have similar long term quality of life with drugs alone as with drugs plus a stent to prop open a blocked artery; the new study also shows that non-invasive drug options are cheaper.

The study was the work of lead author Dr Daniel Mark, a member of the Outcomes Research Group at the Duke Clinical Research Institute in Durham, North Carolina, and colleagues, and was published on 19 February in the New England Journal of Medicine, NEJM.

Mark said in a press statement that the finding was:

"Just one more reason to question the use of routine stenting in late-treatment patients when cheaper, less invasive options are just as effective."

About 1 million Americans have heart attacks every year in the US and studies show that the sooner patients are treated the better, ideally within the first two hours of an attack.

However for about a third of heart attack patients the reality is they don't get treatment until more than 12 hours after their symptoms appear. Many of these are found to have a completely blocked artery and many doctors are of the view that this should be treated by putting in a stent to prop it open, since it is too late for clot busting drugs.

The Occluded Artery Trial (OAT) was set up to compare treatment with drugs alone versus drugs plus stenting among patients who did not receive treatment for their heart attack until days and even weeks after onset of symptoms.

Dr Judith Hochman from New York University and Mark and colleagues presented the initial results of the trial in an earlier paper where in a group of 2,166 patients, drugs only therapy was just as effective as drugs plus PCI (percutaneous coronary intervention where balloons and stents are used to unblocked clogged arteries) in treating stable heart attack patients whose treatment was delayed.

In this latest study, Mark, Hochman and colleagues enrolled 951 patients from the same OAT trial and compared the quality of life issues between those treated with drugs alone and those treated with drugs plus PCI.

The patients in the new study had suffered a heart attack between 3 to 28 days before enrollment and had a completely blocked artery and although classed as high risk they were clinically stable and did not have chest pains. All had received the optimal drug therapy, but half of them had been randomly assigned to receive PCI as well.

Quality of life measures were taken at month 4, month 12 and month 24 when the participants filled in questionnaires comprising a number of recognized scales. These included: the DASI, the Duke Activity Status Index to assess cardiac function; a 36-item short form version of the Medical Outcomes Study scale to assess things like pain, physical limitations, vitality and social function; and the Mental Health Inventory, which assesses psychological wellbeing.

The researchers also compared costs of treatment for 458 of 469 patients who were treated in the US.

The results showed that:

At month 4, the patients who had drugs and PCI reported less chest pain and had a higher DASI score than the ones in the drugs only group.

However, those differences gradually disappeared over the period of the study.

By the end of the study, the patients in the drugs only group appeared to be doing just as well as those who had drugs and PCI.

During the first month of treatment, the drugs plus PCI group stayed in the hospital 1.2 days longer compared to the drugs only group, mostly because of longer stays in intensive care.

The average medical cost for the first 30 days following treatment was 22,859 dollars for the drugs and PCI group, and only 12,683 dollars for the drugs only group.

The overall cumulative 2-year costs were about 7,000 dollars higher for the drugs plus PCI group.

The researchers concluded that:

"PCI was associated with a marginal advantage in cardiac physical function at 4 months but not thereafter. At 2 years, medical therapy remained significantly less expensive than routine PCI and was associated with marginally longer quality-adjusted survival. "

Mark said that:

"What we have here is one of those cases where less is more."

"While it may seem that going an extra step in opening up clogged arteries even days after a heart attack, we know that clinically, it doesn't seem to offer the advantages we expected. Coupling that with the higher cost, we now know that adding PCI to standard medical care in opening blocked arteries more than a day after a heart attack is not good value," he added.

He said this study showed how it was possible to offer high quality of care at less cost.

The National Heart, Lung, and Blood Institute supported the study. Their director, Dr Elizabeth G Nabel said:

"All heart attack patients should seek treatment right away to limit damage to the heart muscle."

"For the one-third of patients who do not receive immediate care - but who are otherwise stable - we have greater evidence of how treatments really affect them," she added, emphasizing that:

"Medical care is not just about immediate results and survival, but it is also about providing good quality of life and minimizing medical costs."

"Quality of Life after Late Invasive Therapy for Occluded Arteries."

Mark, Daniel B., Pan, Wenqin, Clapp-Channing, Nancy E., Anstrom, Kevin J., Ross, John R., Fox, Rebecca S., Devlin, Gerard P., Martin, C. Edwin, Adlbrecht, Christopher, Cowper, Patricia A., Ray, Linda Davidson, Cohen, Eric A., Lamas, Gervasio A., Hochman, Judith S., the Occluded Artery Trial Investigators.

N Engl J Med Volume 360, Number 8, pp 774-783, February 19, 2009.

Click here for Abstract.

Sources: Journal abstract, DukeHealth.org.

Written by: Catharine Paddock, PhD

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

Academy Award Recognition For India's Fight To Eradicate Polio

2009-02-20T15:00:00.000+02:00

The Final Inch, a film documenting the historic effort to eradicate polio in India, has been nominated for an Academy Award in the category of Best Documentary (Short Film). Winners will be announced in Los Angeles this Sunday.

The documentary film made by Vermilion Films and Google.org honours the work, spirit and resilience of the millions of frontline workers in the Indian polio eradication programme. The nomination comes at a critical time for the polio eradication programme, when the government of India inches closer to eradicating the disease. Transmission of the virus has been confined to only two northern states - Uttar Pradesh and Bihar. Type 2 poliovirus has already been eradicated in India. What is required now is to continue the relentless efforts to stop the most virulent type 1 polio virus, which is very near elimination, by 2009. This achievement will bring the programme closer than the "final inch" to Polio eradication in India.

In endemic states of U.P. and Bihar, more than 465,000 health workers go door-to-door every six to eight weeks vaccinating over 58 million children under five, overcoming physical, logistical and sometimes cultural barriers to ensure every child takes the oral polio vaccine. The film celebrates this extraordinary human effort that makes up one of the "world's largest, non-military armies" in history.

"We have a very narrow window of opportunity to eradicate polio from India because of climate change," said Dr. Larry Brilliant, Executive Director of Google.org. "If we miss it now and sea levels rise and water borne diseases increase, we will never have another chance to rid Asia of this terrible disease. I worked in the smallpox and polio eradication programs at the World Health Organization before coming to Google.

We at Google.org made this film because we wanted to make sure all partners continue to unite together for this final battle in India's war against polio."

"Polio eradication is the largest public health programme in India, with very strong community support behind it," said Dr. Sunil Khaparde from the Ministry of Health. "This massive mobilization of the state machinery is a demonstration of the nation's commitment to eradicate this terrible disease from India."

The Final Inch was shot in Uttar Pradesh, Bihar and Maharashtra and documents the many facets of the polio eradication programme there, including the government's extensive mobilization efforts to tackle the virus amidst extremely challenging conditions. "The effort that has gone into the polio eradication initiative has been colossal. Everyone in the community is involved in a polio round, from school children all the way up to the highest levels of state government,"says Deepak Kapur, India Polio Plus Chairman of Rotary International which has leveraged millions of dollars and international commitment in support of the Polio Programme. "We will continue our intense mobilization to ensure that resources and the will of the world remain available to eradicate polio in India."

The story told in The Final Inch is as much about the importance of the messengers as it is about the message itself. The movie follows Munzareen Fatima, a dedicated and passionate community mobilizer who works with the UNICEF-led Social Mobilization Network. Munzareen's tenacious house-to-house visits demonstrate the communication hurdles these workers must overcome to ensure every child under five receives the oral polio vaccine each round. "The community mobilizers are at the heart of the communication effort for polio. Without them the eradication of polio simply will not happen. They are from the local communities and they work tirelessly to make sure every family knows the importance of vaccinating their child every round," says Lieven Desomer, UNICEF's Chief of Polio.

Highlighted in the film in addition to Munzareen Fatima are Rotary volunteers preparing to mobilize children to the Polio Booth and Dr. Ashfaq Bhat from WHO's National Polio Surveillance Project, who travels into the backwaters of India's Ganges Basin in Bihar by boat and foot to detect cases of polio and monitor the quality of the vaccination campaign.

"This illustrates the dedication of the tremendous workforce that is working to vaccinate every child in the most tenacious polio reservoirs of U.P. and Bihar,"says Dr. Hamid Jafari, Project Manager of the WHO's National Polio Surveillance Project in India. "These heroes are not only writing history, they are paving the way for other endemic countries - Afghanistan, Pakistan, and Nigeria - to succeed."

Today, the Indian Polio Eradication programme is one of the largest and most successful public health initiatives in history. The Polio Partnership, which consists of Rotary International, WHO, UNICEF, and the U.S. Centers for Disease Control, has been partnering with the Government of India since the inception of the programme and applauds "The Final Inch" to record this sterling endeavour.

Filmed in a high-definition cinematic style, The Final Inch captures the stories of the campaign's frontline workers and serves as a tribute and an inspiration of hope that polio can and will be eradicated in India.

The Final Inch will air in the U.S. on HBO on World Health Day, April 7th 2009. Please visit: http://www.thefinalinch.org/ to view clips from the film.

UNICEF

Minimally Invasive Surgical Treatment For Breast Cancer Gives Cause For Concern

2009-02-20T09:00:00.000+02:00

A senior doctor in an editorial published today on bmj.com, alerts that minimally invasive breast surgery may compromise rates of healing in favor of improved cosmetic results.

Monica Morrow, chief of Breast Service at Memorial Sloan Kettering Cancer Center, New York, explains that when planning a breast cancer surgery, effectiveness, safety, and aesthetics need to be considered. However, surgical procedures have gradually committed to cosmetics results over the past 30 years.

Oncoplastic and endoscopic surgery are new techniques with minimal skin incision, but some evidence indicates that in most cases, the oncological safety of these new procedures should be carefully evaluated.

The author worries that the gains in survival rates seen in the last ten years can be lost due to low demand for thorough oncological and cosmetic evaluations.

Morrow says, "We must ensure that surgical approaches designed to improve cosmetic outcomes do not increase local failure and the risk of subsequent death from breast cancer."

She also indicates that oncoplastic surgery and minimally invasive breast surgery are emergent fields that require a meticulous evaluation of patient reported outcomes to guarantee that new surgeries truly improve results essential to patients.

She concludes, "The local treatment of breast cancer is based on the results of numerous high quality clinical trials and is therefore a model for evidence based care. As we attempt to advance from good to great cosmetic outcomes it is important that we remember this."

Editorial: "Minimally invasive surgery for breast cancer."

BMJ online

Click here to see article on line

Written by Stephanie Brunner (B.A.)

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

Breakthrough's Comment On New Cancer Waiting Times Statistics For Scotland

2009-02-19T15:00:00.000+02:00

Audrey Birt, Director for Scotland, Breakthrough Breast Cancer said:

"These latest figures highlight welcome progress that the majority of patients diagnosed with breast cancer across Scotland receive treatment within the two month target.

"However, patients in some areas are waiting longer and it's important that every effort is made to ensure that all breast cancer patients are diagnosed and treated as quickly as possible."

Breakthrough Breast Cancer

AIDS Top Killer In China

2009-02-19T09:00:00.000+02:00

AIDS was the top fatal infection among the Chinese in 2008, followed by TB, rabies, hepatitis, and infant's tetanus, said a government report released earlier this week by China's Ministry of Health.

China's state-run news agency, Xinhua reported that the official figures show that AIDS claimed 6,897 lives in China between January and September 2008, putting it at the top of the list of infectious diseases for that country for the first time, jumping from the third position it occupied three years ago.

There were 264,302 confirmed cases of people with HIV in September last year, said the Ministry of Health, 34,864 of whom have since died; five times the equivalent number of three years ago. The accumulated cases is nearly double the figure for 2005, which showed 135,630 Chinese had been infected by the virus.

Although the Chinese government did not elaborate on the reasons behind the jump in HIV/AIDS cases and deaths, a recent report in the Associated Press (AP) suggests that the Chinese government's willingness to gradually acknowledge the presence of the disease could be a factor.

There has been no reaction to the figures from UNAIDS or the World Health Organization in Geneva, said the AP report, which mentions that UNAIDS estimates there are 700,000 people living with HIV in China, of whom around 85,000 have AIDS.

According to the Chinese authorities, AIDS came to China in 1982 and their first death from the disease was three years later.

Since 2003 there has been a government policy of "four frees, one care" for all HIV carriers and AIDS patients in China. "Four frees" are free testing for HIV, free counselling and treatment fro HIV infected people in rural areas, free drugs for all pregnant women with HIV, and free education for children orphaned by AIDS.

The "one care" is help for those impoverished by AIDS and the "elimination of AIDS-related discrimination", said the Xinhua report.

According to the AP report, HIV spread in China was caused by tainted blood transfusions and unsanitary blood plasma, but a government report last year said that sex and drugs had now overtaken other causes of HIV spread in the country.

Earlier this week, AHN reported that the World Health Organization is predicting a rise in HIV/AIDS infection rates in Asia among men who have sex with men and this group urgently needs better access to healthcare if the rise is to be avoided.

WHO's adviser on HIV/AIDS in the Western Pacific, Mssimo Ghidinelli told the press that the spread of HIV through men who have sex with men was much bigger than they first thought.

WHO suggests there are some 10 million men who have sex with men in Asia, the highest number of any region in the world.

At the WHO Technical Consultation on Health Sector Response to HIV/AIDS held in Hong Kong on Wednesday, York Chow, Hong Kong's secretary for food and health, said that HIV prevention among men who have sex with men has been the main focus of the city's five-year HIV/AIDS programme which runs from 2006 to 2011.

Chow said HIV rates among men who have sex with men have risen sharply in recent years, accounting for 30 per cent of the 300 to 400 new cases reported every year, reported Xinhua. Chow said most men who have sex with men don't know their HIV status and unprotected sex is a major factor in the spread of the virus.

Government officials from throughout Asia plus representatives from Australia and New Zealand attended the conference.

Click here for WHO webpage on HIV/AIDS.

Sources: Xinhua, AP, AHN.

Written by: Catharine Paddock, PhD

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

Dreams Can Carry More Weight Than Conscious Thoughts, Say Researchers

2009-02-18T15:00:00.000+02:00

While science tries to understand the stuff dreams are made of, humans, from cultures all over the world, continue to believe that dreams contain important hidden truths, according to newly published research.

In six different studies, researchers surveyed nearly 1,100 people about their dreams. "Psychologists' interpretations of the meaning of dreams vary widely," said Carey Morewedge, an assistant professor at Carnegie Mellon University and the study's lead author. "But our research shows that people believe their dreams provide meaningful insight into themselves and their world."

The article appears in the February issue of the Journal of Personality and Social Psychology, published by the American Psychological Association.

In one study that surveyed general beliefs about dreams, Morewedge and co-author Michael Norton, an assistant professor at Harvard Business School, surveyed 149 university students in the United States, India and South Korea. The researchers asked the students to rate different theories about dreams. Across all three cultures, an overwhelming majority of the students endorsed the theory that dreams reveal hidden truths about themselves and the world, a belief also endorsed by a nationally representative sample of Americans.

In another study reported in the article, the researchers wanted to explore how dreams might influence people's waking behavior. They surveyed 182 commuters at a Boston train station, asking them to imagine that one of four possible scenarios had happened the night before a scheduled airline trip: The national threat level was raised to orange, indicating a high risk of terrorist attack; they consciously thought about their plane crashing; they dreamed about a plane crash; or a real plane crash occurred on the route they planned to take. A dream of a plane crash was more likely to affect travel plans than either thinking about a crash or a government warning, and the dream of a plane crash produced a similar level of anxiety as did an actual crash.

Finally, the researchers wanted to find out whether people perceive all dreams as equally meaningful, or whether their interpretations were influenced by their waking beliefs and desires. In another study, 270 men and women from across the United States took a short online survey in which they were asked to remember a dream they had had about a person they knew. People ascribed more importance to pleasant dreams about a person they liked as compared to a person they did not like, while they were more likely to consider an unpleasant dream more meaningful if it was about a person they disliked.

"In other words," said Morewedge, "people attribute meaning to dreams when it corresponds with their pre-existing beliefs and desires. This was also the case in another experiment which demonstrated that people who believe in God were likely to consider any dream in which God spoke to them to be meaningful; agnostics, however, considered dreams in which God spoke to be more meaningful when God commanded them to take a pleasant vacation than when God commanded them to engage in self-sacrifice."

The authors say more research is needed to explore fully how people interpret their dreams, and in what cases dreams may actually reveal hidden information.. "Most people understand that dreams are unlikely to predict the future but that doesn't prevent them from finding meaning in their dreams, whether their contents are mundane or bizarre," said Morewedge.

----------------------------

Article adapted by Medical News Today from original press release.

----------------------------

Article: "When Dreaming Is Believing: The (Motivated) Interpretation of Dreams," Carey K. Morewedge, PhD, Carnegie Mellon University, Michael I. Norton, PhD, Harvard University; Journal of Personality and Social Psychology, Vol. 96, Issue 2.

(Full text of the article is available from the APA Public Affairs Office and at http://www.apa.org/journals/releases/psp962249.pdf)

The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 150,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.

Source: Audrey Hamilton

American Psychological Association

Roles Of Physicians And NPs In Improving Access To Care: Internists Issue Policy Paper

2009-02-18T09:00:00.000+02:00

"The American College of Physicians (ACP) has always recognized the unique role that a personal physician plays in meeting the needs of individual patients," Jeffrey P. Harris, MD, FACP, president of the American College of Physicians, noted upon the release of a new policy monograph. "But even the most committed physician can't do it alone. ACP shares its ideas on how nurse practitioners and physicians can work together - as teammates that respect and recognize each profession's unique contributions and skills - to provide patients with the best possible care."

By covering seven positions, Nurse Practitioners in Primary Care updates and clarifies ACP stands in areas that include:

Coverage of physician and NP training, knowledge, skills and abilities
Coordinated care to of primary importance in improving health outcomes
Licensing and certification exams
Multidisciplinary care in the patient-centered medical home model
Research efforts for patient management among physicians and NPs
Education and training of all health professionals
Workforce policies to improve patient access to quality care

The 18-page monograph's executive summary notes that "anticipated and actual shortages of primary care physicians have led policymakers to consider the roles of nurse practitioners (NPs) in improving access to primary health care services. "Physicians and nurse practitioners not only share a commitment to providing high quality care, the paper says, but also face similar challenges regarding reimbursement and workforce outlook. Recognizing and building on the common ground between the two professions is vital to improving collaboration to meet the complex health care needs of the population.

However, the paper also cautions "that advanced practice nursing should not substitute for, or replace, primary care medical practice as provided by general internists, family physicians and other physicians."

"The ACP hopes that this paper will strengthen the dialogue between the medical and nurse practitioner communities to improve future health care delivery," said Dr. Harris. "A high-quality and efficient health care system requires effective multidisciplinary teams that collaborate to provide patient-centered care."

Over the past 20 years, the ACP paper notes, an increase in the numbers of nurse practitioners, enactment of state laws expanding scope of practice, prescriptive authority and third-party reimbursement, and national efforts to improve health care access, have resulted in expanded roles for NPs in providing primary care services. However, greater autonomy of NPs has been a point of contention between the medical and advanced practice nursing communities. At times, questions have been raised about the adequacy of NP training and certification, comparisons drawn by NPs to the care delivered by physicians, quality of patient outcomes and perceived intentions to displace or replace primary care physicians.

ACP's paper cited a study by the Association of American Medical Colleges that warns that the demand in the coming years for primary care physicians will outpace supply faster for primary care than for any other specialty group. It notes that another study published in Health Affairs projects a growing shortage of primary care physicians for adults, even as the contributions of nurse practitioners, as essential members of the primary care workforce, are taken into account.

In the process of developing its recommendations, ACP consulted with highly-regarded members of the nursing profession to gain a better understanding of their perspectives.

ACP intends to continue its dialogue with nurse practitioners, and to similarly engage in discussions with other professions - particularly physicians assistants - who play a vital role in meeting the nation's growing need for primary care.

"The key to high performance in multi-disciplinary teams is an understanding of the distinctive roles, skills, and values of all team members," Dr. Harris concluded. "Our hope is that ACP's new paper will help contribute to a better understanding of how physicians and nurse practitioners can work together to provide patients with the best care possible."

----------------------------

Article adapted by Medical News Today from original press release.

----------------------------

The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 126,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection and treatment of illness in adults.

Source: David Kinsman

American College of Physicians

CYPHER SELECT(R) Plus Sirolimus-eluting Coronary Stent Now Approved In The European Union For Treatment Of Patients With Diabetes

2009-02-17T15:00:00.000+02:00

The CYPHER SELECT®Plus Sirolimus-eluting Coronary Stent has received CE marking within the European Union (EU) for treatment of patients with diabetes, a complex and often difficult-to-treat patient population. CE marking means conformity to the applicable European Directive and in the specific context of diabetes, permits the CYPHER SELECT®Plus stent to be marketed for the treatment of diabetes in all Member States of the European Union.

The expanded indication for the CYPHER SELECT®Plus Stent is based on numerous clinical studies, both randomized clinical trials as well as non-randomized trials that have been presented at major medical meetings and/or appeared in international peer reviewed publications, supporting the safety and efficacy of the device in patients with diabetes.

"It is well documented that patients with diabetes have a high risk of complex coronary artery disease," said Campbell Rogers, M.D., Chief Scientific Officer, Cordis Corporation. "Today's announcement provides diabetic patients and their physicians with critical validation of an important treatment tool."

Patients with diabetes often present with challenging coronary anatomy. In addition to diabetes, CYPHER SELECT®Plus Stent has recently received CE marking for the following coronary conditions: Chronic Total Occlusion, Multi-vessel Disease and Bifurcations. In August 2008, CYPHER SELECT®Plus received CE marking for treatment of acute myocardial infarction (heart attack). CYPHER SELECT® Plus Stent was previously indicated for de novo lesions, in stent restenosis and small vessels. CYPHER SELECT® Plus has a total of eight different indications.

Dr. Rogers added, "When taken collectively, diabetes, heart attack, multi-vessel disease, chronic total occlusions and bifurcations, represent the most challenging coronary conditions we see today. It is an important step forward for patient care that the CYPHER SELECT® Plus Stent is now indicated for these complex conditions."

About the CYPHER SELECT® Plus Stent

Featuring an enhanced stent delivery system, the CYPHER SELECT® Plus Stent offers exceptional deliverability, as well as the excellent, long-term clinical performance for which the CYPHER® Stent is widely known.

In addition to its flexible stent design and short tip, CYPHER SELECT® Plus Stent features the CYPH2ONIC(TM) Hydrophilic Coating Technology, an innovative coating technology that is significantly more lubricious than previous CYPHER® Stent products, greatly increasing a physician's ability to successfully navigate challenging coronary arteries.

About Cordis Corporation

For 50 years, Cordis Corporation, a Johnson & Johnson company, has been a recognized worldwide leader in the development and manufacture of interventional vascular technology. Through the company's innovation, research and development, Cordis partners with interventional cardiologists worldwide to treat millions of patients who suffer from vascular disease.

*Cordis Corporation has entered into an exclusive worldwide license with Wyeth for the localized delivery of sirolimus in certain fields of use, including delivery via vascular stenting. Sirolimus, the active drug released for the stent, is marketed by Wyeth Pharmaceuticals, a division of Wyeth, under the name Rapamune®. Rapamune is a trademark of Wyeth Pharmaceuticals.

Johnson & Johnson

American Heart Association EMS Survey Uncovers Deficiencies In Response, Treatment And Transfer Of Patients With Most Deadly Heart Attacks

2009-02-17T09:00:00.000+02:00

Preliminary results of one of the nation's largest national surveys of Emergency Medical Services (EMS) systems indicate the need for improvements in the way heart attack, specifically ST-elevation myocardial infarction (STEMI), is managed.

STEMI is the most serious and deadly type of heart attack, characterized by a complete blockage of a coronary artery. It requires rapid response and treatment to reopen the artery and restore blood flow to the heart muscle. The preferred treatment is primary percutaneous coronary intervention (PCI), which involves mechanically opening the artery using a small balloon to clear the blockage followed by the insertion of a stent, a type of scaffolding used to prop open the artery.

The American Heart Association conducted the survey as part of its Mission: Lifeline initiative to improve the response and treatment of STEMI patients and ultimately all heart attack patients. The association gave the survey October - December 2008 to more than 5,400 EMS system or agency directors and asked questions about staffing, funding, training, and existing processes for handling patients who have experienced a STEMI.

The most significant findings:

-- Only half of EMS systems have 12-lead electrocardiograms (ECGs), used to detect STEMI, on 75 percent or more of their vehicles.

-- Of EMS systems with 12-lead ECGs:

-- Most lacked a standard method for EMS to communicate the 12-Lead ECG results to the hospital. Currently, paramedics use one or more of the following methods:

-- verbally reporting the ECG algorithm (an automatic, software-generated analysis of the ECG reading),

-- verbally reporting their own interpretation of the ECG reading, or

-- using an advanced technology like Blue Tooth or mobile phone to transmit the ECG algorithm or reading.

-- EMS field personnel remotely activate hospital catheterization ("cath") labs only 40 percent of the time. (Cath labs perform procedures like angioplasty and stenting). This can significantly delay evaluation and treatment.

-- Destination protocols are only used a third of the time to enable EMS to take STEMI patients directly to a hospital capable of providing angioplasty/stenting 24 hours a day, seven days a week. Instead, many EMS departments take patients to the closest hospital, which can cause significant delays to appropriate care.

-- Only about 20 percent of hospitals are able to perform procedures like angioplasty and stenting for STEMI patients 24 hours a day, seven days a week.

"We were encouraged that more EMS systems than anticipated had vehicles equipped with 12 lead ECGs, devices that diagnose STEMI and other heart attacks," said Robert E. O'Connor, M.D., chair of the American Heart Association's Mission: Lifeline Emergency Cardiovascular Care task force. "However, we found the need for better systems to allow EMS to transmit data from ECGs and activate the cath lab on the way to the hospital and for policies allowing them to take patients to the facility able to provide appropriate care, whether it's the closest facility or not."

According to the American College of Cardiology/American Heart Association guidelines, primary PCI, typically balloon angioplasty with stenting, is the preferred treatment over clot busting drugs if it can be achieved within 90 minutes. EMS is a critical part of the system of care to decrease time to treatment for STEMI patients.

In coming months, the association's staff will receive survey data for their state or region and share it with coalitions composed of EMS and hospital personnel, physicians and nurses and health policy makers. The coalitions will use the information to create appropriate plans to improve the care of STEMI patients.

"EMS systems are the point of entry for all heart attack patients and are extremely important to reducing delays to STEMI care," said Alice K. Jacobs, M.D., former president of the American Heart Association and chair of the Mission: Lifeline advisory working group. "Our survey provides the American Heart Association and its coalition partners a great snapshot of their local EMS and where we need to make progress. It confirms the need for better coordination between EMS, emergency departments and hospitals in order to do what's best for the patient."

Other findings include:

-- More paramedics should receive training on interpreting 12 lead ECGs.

-- Funding is needed for additional 12 lead ECG devices and training.

-- Information sharing between EMS and hospitals is poor, so it's difficult to track the quality of care a patient receives as they move from EMS to hospital-based care. Confidentiality requirements are hindering the process.

The need for Mission: Lifeline

Each year, about 400,000 people in the U.S. have a type of heart attack known as STEMI, in which blood flow is completely blocked to a portion of the heart. Unless the blockage is eliminated quickly, the patient's health and life are at serious risk. The American Heart Association recommends that STEMI patients receive PCI procedures like angioplasty to restore blood flow to the heart muscle within 90 minutes. The association created Mission: Lifeline to close the gaps that separate STEMI patients from timely access to appropriate treatment. For more information about Mission: Lifeline, visit http://www.americanheart.org/missionlifeline.

American Heart Association

http://www.americanheart.org

Committee For Advanced Therapies (CAT) Elects Chair And Vice-chair, Europe

2009-02-16T15:00:00.000+02:00

The European Medicines Agency's (EMEA) new Committee for Advanced Therapies (CAT) has elected Christian Schneider, from Germany, as chair and Anneli Salmikangas, from Finland, as vice-chair for a three-year mandate starting on 12 February 2009.

The CAT is a multidisciplinary committee, bringing together some of the best available experts in Europe to assess the quality, safety and efficacy of advanced therapy medicinal products (ATMPs) and to follow scientific developments in the field.

Setting out his priorities for the next three year, Dr Schneider said: "Our common goal is to establish the CAT as a strong and internationally highly recognized independent committee. A committee that fosters innovative medicines gathers scientific expertise and skills, whilst it collaborates effectively with the other scientific committees at the EMEA to perform top-level assessment in the best interest of patients".

Dr Schneider and Dr Salmikangas have contributed to the work of the EMEA with their expertise over many years. Dr Schneider is a member of the Committee for Medicinal Products for Human Use (CHMP), the Scientific Advice Working Party (SAWP) and he also chairs the Biosimilar Medicinal Products Working Party (BMWP). Dr Salmikangas is the chair of the EMEA's Cell-based Products Working Party (CPWP) and a member of the Biologics Working Party (BWP).

Notes:

1. Dr Schneider is a physician by training, specialising in immunology and rheumatology. He is currently head of division for EU cooperation/microbiology at the Paul-Ehrlich-Institut (PEI), in Langen, Germany. His areas of expertise include: quality and safety of biological medicines, including ATMP; clinical trials and risk mitigation strategies for first-in-man clinical trials; non-clinical development of biotechnology-derived medicinal products; unwanted immunogenicity of therapeutic proteins; concepts for comparability exercise for biotechnological medicinal products.

2. Dr Salmikangas is a biochemist. She is Senior Researcher, responsible for marketing authorisations of biological medicinal products at the National Agency for Medicines in Finland. She is also Associate Professor in Biochemistry, University of Helsinki. Her area of expertise is focused on cell and molecular biology of various inherited diseases.

3. An overview of the role and responsibilities, membership and other details about the Committee for Advanced Therapies is available here.

4. More information on the work of the EMEA in the area of advanced therapies is available here.

5. This press release, together with other information on the work of the EMEA, can be found on the EMEA website: http://www.emea.europa.eu

EMEA