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Daily Health News
Last Updated - 04th January 2007
Genes Affect Response to Heart Failure Drugs
A person's genes may determine how he or she responds to heart failure drugs, say researchers in Germany.
Beta blockers are drugs used to treat people who have chronic heart failure. They slow nerve impulses traveling through the heart to reduce the heart's workload. They work on beta-adrenergic receptors, which are present in cardiac cells.
In a study that appears in the January issue of the Journal of Clinical Investigation, researchers from the University of Wurzburg, Germany, explained why some heart failure patients respond better to others to certain beta blockers.
The researchers examined variations in the genes that code for beta-adrenergic receptors in rat cardiac cells. They looked at how the receptors responded to three different beta blockers -- bisoprolol, metoprolol, and carvedilol.
While each drug caused a conformational change in the receptors, the effect of bisoprolol and metoprolol was minor in certain variations of the genes. Carvedilol, on the other hand, induced a 2.5-fold response in one of the variants.
It seems that beta-adrenergic receptors may vary from person to person, which alters the receptor's conformation, subsequently altering the receptor's response to a given beta blocker.
The authors of a commentary that accompanied the study proposed that these findings may help researchers figure out why there are ethnic differences in the response to beta blockers, since some receptor variations are more common in certain ethnicities.
Future studies are needed to determine if genetic testing could help doctors decide which heart failure medication would work best on a given patient.
Simple Steps Safeguard Diabetics' Feet
The estimated 20 million Americans with diabetes need to remember that simple foot care can reduce their risk of toe, foot or leg amputations, say experts at the American College of Foot and Ankle Surgeons (ACFAS).
People with diabetes are 10 times more likely to have a lower limb amputated than people who don't have the illness, which can cause poor blood circulation and nerve damage in the feet. This makes feet more vulnerable to ulcers, infections, deformities and brittle bones.
The ACFAS offers the following foot care tips for people with diabetes:
- Inspect feet daily for injuries that could lead to dangerous ulcers.
- Gently wash feet in lukewarm -- not hot -- water.
- Moisturize feet but avoid the areas between the toes.
- Never trim corns or calluses. Doing so can lead to serious infections.
- Inspect the inside of shoes before you put them on.
At the first sign of trouble, see a doctor. Early treatment can prevent foot problems from worsening and reduce the risk of amputations.
November is National Diabetes Awareness Month in the United States.
Exercise helps smokers quit, study concludes
WASHINGTON (Reuters) - Want to quit smoking? Hit the gym.
A study released on Tuesday by the American College of Chest Physicians found smokers who combine exercise with nicotine gum or transdermal patches are more likely to quit than those who rely on nicotine replacement therapy alone.
Sixty-eight patients at two Austrian hospitals were randomly assigned either a treatment program that included exercise or one that only used nicotine replacement therapy.
After three months, 80 percent of those who exercised had quit smoking, while 52 percent of those in the group that did not exercise had quit.
And those who exercised were more likely to reduce their cigarette smoking if they did not quit, the study found. They also scored better on several tests measuring respiratory health.
The study was conducted at Otto Wagner Hospital and Lainz Hospital in Austria.
Full face transplant gets go-ahead in UK
LONDON (Reuters) - The world's first full face transplant is possible within months after British surgeons got the final go-ahead on Wednesday to perform an operation regarded as the holy grail of plastic surgery.
The UK Face Transplantation team at the Royal Free Hospital in London received permission for four transplants from the hospital's Research Ethics Committee.
"We can now begin to evaluate patients and draw up a shortlist of four people who want to undergo this procedure," said Peter Butler, the plastic and reconstruction surgeon who will head the team.
People whose faces have been destroyed by fire, accident and infection could be among those to benefit.
Surgeons in France performed the first partial transplant in a 15-hour operation last year on Isabelle Dinoire who received a new nose, lips and chin after being mauled by her dog.
Butler said his team have developed psychological and surgical selection criteria to make sure they select the right patients for the surgery.
"We will continue to take a cautious and careful approach and we will not be rushed. It may be many months before we are ready to carry out an operation," Butler said in a statement.
The ethics committee said it reached its decision after reviewing a decade of research results by Butler and his team.
"Ground-breaking research is always difficult and there will always be doubters and detractors," said Andrew Way, chief executive of the hospital.
"Face transplantation has been shown to be a successful treatment elsewhere and our team will now be able to begin the latest and most difficult phase of their work."
HOLY GRAIL FOR PLASTIC SURGEONS
The pioneering surgery on Dinoire by Professor Bernard Devauchelle and his team at the Center Hospitalier Universitaire Amiens in northern France sparked an ethical debate and raised questions about the psychological impact of the procedure on both the recipient and the donor's family.
Although the microsurgery techniques needed for a full transplant are well established, little is known about the psychological impact and the long-term risk of the drugs the patient will take to avoid rejection of the new face.
Changing Faces, a charity that represents people with disfigurements, said it would have preferred the decision to have been delayed until the Royal College of Surgeons updated their recommendations on face transplants.
"Our main concern is to ensure that any patient who is being considered for this procedure has a full understanding of the risks and benefits, especially the risks associated with the immunosuppressant drug regime," the charity said in a statement.
Other experts welcomed the decision.
"Aesthetic replacement of the deformed or destroyed face has been a holy grail for plastic surgeons, with teams across the world exploring all aspects of this challenging process for the last 10 years," said Chris Cady of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS).
Andrew George, a professor of molecular immunology at Imperial College London, said the surgery will enhance the quality of life for a small number of patients.
"However, this will not be without risks, both physical and psychological, and it would be important that the patients are fully informed of these risks before surgery -- as the ethics committee would insist," he said.
The Face Trust, a charity which has been set up to fund research for surgical reconstruction and facial transplantation, launched an appeal for money to fund the transplants, which are expected to cost at least 25,000 pounds ($46,940) each.
Fatty Liver Disease Endangers 6.5 Million U.S. Kids
It's a silent problem that can lead to liver failure, experts warn
As many as 6.5 million American children could have a dangerous condition called non-alcoholic fatty liver disease (NAFLD), new research suggests.
NAFLD - an accumulation of fat in the liver cells can lead to cirrhosis of the liver, end-stage liver disease requiring a transplant, and liver cancer. Until now, there has been little research into the prevalence of NAFLD in children.
For this study, researchers at the University of California, San Diego (UCSD) analyzed 742 autopsy reports and tissue samples from San Diego County children and adolescents, aged 2 to 19, who died from traumatic accidents, murder or suicide between 1993 and 2003.
They found that 13 percent of the children and teens in the study had NAFLD. Based on that, they estimated that 9.6 percent of the children and adolescents in San Diego County have NAFLD.
"Fatty liver disease is a very common problem that has gone largely unnoticed," study leader Jeffrey Schwimmer, an associate professor of pediatrics and director of the Fatty Liver and Weight and Wellness Clinics at Rady Children's Hospital, said in a prepared statement.
"If the prevalence in the United States is similar to the prevalence in San Diego, this would translate to 6.5 million children. The scale of the problem has enormous ramifications for the future health of these children," Schwimmer said.
He and his colleagues identified several major risk factors for NAFLD in children:
- Age - Fatty liver was found in 0.7 percent of children aged 2-4 and in 17.3 percent of those aged 15-19.
- Ethnicity - Hispanic-American children had a higher rate (11.8 percent) of fatty liver than Asians (10.2 percent), whites (8.6 percent) or blacks (1.5 percent).
- Gender - Boys had a much higher rate of fatty liver than girls.
- Obesity - Overweight and obese children accounted for 81 percent of all cases of fatty liver in the study.
Scientists identify agent that regulates appetite
HONG KONG (Reuters) - Scientists in Japan have identified a molecule responsible for making mammals feel full, a discovery that could lead to new ways to treat obesity in humans.
Scientists believe appetite is controlled in a region of the brain called the hypothalamus, and the group of researchers claims to be the first to pinpoint an agent that triggers an increase or decrease in appetite.
In an article published on Sunday in the online version of the journal Nature, the scientists identified the molecule as nesfatin-1, which is produced naturally in the brain.
After injecting the molecule into the brains of rats, the scientists observed that the rodents began to eat less and lose weight.
The researchers also were able to induce the rats to eat more, by blocking nesfatin-1.
"After we injected anti-nesfatin-1 antibody, these rats showed increased appetite and finally showed a progressive increase in body weight," Masatomo Mori of the medicine and molecular science department at Gunma University Graduate School of Medicine told Reuters in a telephone interview.
Mori said the finding could pave the way for treating obesity, which has become a major health problem in the developing world as well as in economically advanced countries.
There are at least a billion overweight adults across the world, 300 million of them considered obese, according to the World Health Organization.
Obesity has been linked to chronic diseases, such as type 2 diabetes, cardiovascular disease, hypertension and stroke, and some forms of cancer.
Mouthwash, ice chips relieve oral chemotherapy sores
LONDON (Reuters) - An antiseptic mouthwash or ice chips can prevent painful mouth sores in cancer patients having chemotherapy, researchers said on Monday.
Up to 40 percent of patients given a common chemotherapy drug suffer from the painful sores known as oral mucositis which can make eating and swallowing difficult.
But Danish scientists have discovered that mouthwash containing chlorhexidine reduced the frequency and the duration of mouth sores, and ice chips were even more effective.
"The results point toward a role for chlorhexidine in prevention of oral mucositis in adult patients with solid tumors treated with chemotherapy in conventional doses," Dr Jens Benn Sorensen, of the National University Hospital in Copenhagen, Denmark, said in a statement.
He and his team compared the effectiveness of mouthwash, ice chips and a placebo in 225 patients being treated for gastrointestinal cancer. Thirteen percent of patients using the mouthwash developed painful mouth sores that impaired eating, compared with 11 percent of those given ice chips and 33 percent in the placebo group.
Sorensen, who presented the findings at the 31st Congress of the European Society for Medical Oncology (ESMO) in Istanbul, Turkey, said it is the first study to evaluate chlorhexidine in a large group of cancer patients given a chemotherapy drug that is likely to cause mouth sores.
"Patients suffering from this complication have difficulty eating and swallowing. In the most severe form, they cannot eat or drink at all and must receive nutrition and fluid replacement through tubes into the stomach or intravenously," he said.
More than 8,500 doctors and scientists are attending the cancer conference.
Teen with medical microchip dies in Fla.
BOCA RATON, Fla. - A teen engineering prodigy who gained national attention in 2002 when he and his family received identification chip implants on live television was killed in a motorcycle accident, authorities said.
Derek Jacobs, 18, lost control of his motorcycle early Saturday and crashed into a guardrail and a pole, the Palm Beach County sheriff's office said. He was wearing a helmet.
"It was just a crazy accident of a bump or something, and he was catapulted," said his mother, Leslie Jacobs. "He had, of course, potential, because he was brilliant, and he was just a wonderful son. He wanted to make a difference in the world."
Derek was set to get his engineering degree this year after only two years at Florida International University. He wanted to be a neurosurgeon, his mother said.
At age 12, Derek became certified by Microsoft as a systems engineer. He was qualified to run corporate computer networks.
Two years later, he and his family had identity chips implanted on live television. They were the first family to get VeriChip IDs, made by Applied Digital Solutions.
Derek pushed his parents to look into the chips as a way to help store medical information for his father, who suffered a host of health problems, including cancer.
Anthrax dispute suggests Bioshield woes
SAN FRANCISCO - By now, millions of anthrax vaccine shots developed through cutting-edge genetic engineering were supposed to be filling a new national stockpile of biodefense drugs. Instead, five years after anthrax attacks left five dead, sickened 17 and panicked the country, the nearly $1 billion contract awarded by the U.S.
Department of Health and Human Services to a tiny and struggling San Francisco Bay Area biotechnology company is plagued with misfortune and delays.
Delivery has been put off until at least 2008 — and maybe later — while the government and VaxGen Inc. trade barbs over who is at fault. The dispute has further tarnished Project Bioshield, a government program that has alienated many potential biodefense contractors.
"We have all come to understand that there is more complexity than it originally appeared," said Thomas Inglesby, deputy director of the University of Pittsburgh's Center for Biosecurity.
The anthrax attacks of 2001 prompted passage of Project Bioshield, which promised to build national drug stockpiles to be used in case of a bioterror attack.
The project was supposed to jump start a national security renaissance among drug makers by guaranteeing contracts to develop drugs for combatting potential bioweapons. But it has been greeted with skepticism by many in the industry.
The anthrax project, the first and largest Bioshield contract, was to be the crown jewel.
In November 2004, the $877.5 million contract was awarded to VaxGen to genetically engineer a replacement for the current anthrax vaccine, which requires six shots to be administered over 18 months. VaxGen's is expected to require no more than three shots.
Since winning the contract, however, VaxGen has repeatedly stumbled, starting with its disclosure it would miss the original deadline of November 2005 by a year.
Even before winning the contract, the Brisbane-based company had a checkered past highlighted by the 2003 flop of its experimental
AIDS vaccine, which failed to protect inoculated volunteers from getting infected.Since then, it was dropped from the Nasdaq Stock Market for failing to file financial reports, its chief scientific officer left the company in July, and its stock price hovers near $4.40 — at the low end of its 52-week range — as VaxGen and the government try to work out their differences.
Then, in March, the government said it wouldn't pay VaxGen until the company completed a costly and time-consuming human test to ensure the vaccine was safe. The new requirement forced the company to sell its stake in another biotechnology company for $79 million to stay afloat and finance the new test.
"We don't get paid until we deliver product and we have to shoulder the carrying cost," said VaxGen spokesman Lance Ignon. "The burden it puts on our company is abundantly clear to Wall Street as shown by our stock price."
For its part, VaxGen blames the government for the latest delays.
"The heart of the problem right now is the government's willingness to change the goal line," Ignon said. "The government unilaterally, and without compensation to VaxGen, changed the contract."
The government counters that the safety data was always required and that it made minor changes that allowed VaxGen to deliver the vaccine later than it had initially promised.
Last month, Sens.
Joe Lieberman and Susan Collins called for a congressional investigation of the VaxGen contract.
VaxGen's difficulties underscore the industry's disappointment with Bioshield, which has done little but generate indifference among the big pharmaceutical companies the government hoped to woo. Instead, drug makers are snubbing the program because of liability and intellectual property issues and confusion over what the government wants.
New legislation that would address many of the critics' concerns — such as protecting drug makers from liability lawsuits — has been bottled up in Congress for months and the prospect of a bill passing this year are dimming.
Big pharmaceutical companies, which can spend upward of $1 billion developing a single drug that can earn billions annually, are also turned off by the relatively paltry $5.6 billion available under Bioshield, analysts said.
Pharmaceutical Research and Manufacturers of America, the Washington-based trade group that represents drug makers, wouldn't comment on why its members have shunned Project Bioshield but said it supports the program.
"PhRMA continues to work closely with the Congress and the Administration to help ensure that America has the necessary tools to help prepare for and respond to a possible bioterror attack," Ken Johnson, the group's senior vice president, said in a statement.
Producing defensive measures has been largely left to small, financially struggling companies such as the oft-troubled VaxGen.
Despite its laundry list of failures, HHS has defended VaxGen's qualifications.
"The incentive is not there for the large pharmaceutical companies," said Noreen Hynes, director of research and development coordination in the HHS office responsible for biodefense. "Biotech companies, for the most part, are more inexperienced."
Since awarding the contract to VaxGen, HHS has doled out another $1 billion in contracts, including two this year worth a combined $505 million to the Canadian company Cangene Corp. for another anthrax treatment, as well as a drug to treat botulism.
None of the other drug developers have stumbled as spectacularly as VaxGen.
"The fact that a company doesn't deliver is always disappointing," Hynes said. But in vaccine and biological development, "delays are more the rule than the exception."
Breast cancer patients poorly informed about therapy
By Patricia Reaney
LONDON (Reuters) - Older European breast cancer patients without access to the Internet are not well informed about hormone treatments that can reduce the risk of a recurrence, researchers said on Saturday.
Only 22 percent of 547 cancer patients in nine European countries who took part in a survey knew about or had a say in deciding to take hormone therapy after undergoing surgery to remove their tumor.
Women over 60 years old were the least involved in their treatment decisions. Most of the breast cancer patients questioned in the poll said they were dissatisfied with their level of involvement.
"An older patient with a lower level of education and no access to the Internet has no involvement and little information, regardless if she is Italian, British, Spanish or Swiss," Dr Alberto Costa, the director of the European School of Oncology (ESO) in Milan, Italy, said in an interview.
The results of the poll by the GAEA Initiative, a research-based program to help women with early breast cancer, were presented at the congress of the European Society for Medical Oncology in Istanbul, Turkey.
The survey questioned women about their knowledge of the risk of recurrence in early breast cancer and their understanding and attitudes about hormone therapy.
"There is clearly a great demand for more explanation in terms of quantity and quality," Costa added.
"As doctors we are clearly failing some patients by not involving them in the decision about starting adjuvant endocrine (hormone) therapy and by not giving them the information they need to make these decisions," he added.
Each year about 350,000 European women are diagnosed with breast cancer. Most cases occur in women over 50 years old. Treatment depends on the stage or severity of the disease.
Surgery is performed to remove the tumor, radiotherapy is given to kill remaining cancer cells in the breast, and chemotherapy destroys cells that may have spread from the tumor site.
Hormone therapy includes the drug tamoxifen which has been used for decades. It interferes with the activity of the hormone oestrogen that can fuel tumor growth.
Newer drugs known as aromatase inhibitors are prescribed for post-menopausal women with hormone sensitive tumors to cut their risk of recurrence by blocking the enzyme aromatase which is needed to produce oestrogen. The drugs are usually taken for five years.
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