EFFORTS  NEWSLETTER
OCTOBER 2001

The following represents items that have been shown on our list by our members from time to time.  They contain information that might be of interest to some, but would normally be missed, as would other information, if one is not a regular subscriber of EFFORTS.  

The information shown, is not meant to include or omit any interested parties concepts or intent, but merely to inform.  In all cases, where possible, we have attempted to show the credits necessary in posting this information and apologize for the instances where this was accidentally omitted.  

The information included may be controversial to some, but is reported as information only.  It is our goal to help educate and inform folks, as much as possible, about what is being done specifically about research into COPD and related lung disease, as well as what could enhance discoveries about our disease through other seemingly unrelated research.  This includes drugs or resources  that might be discovered serendipitously or through "The faculty of making fortunate discoveries by accident."   

NEWSLETTER ARCHIVES:
AUGUST 2000 (YES, 1 YEAR AGO)
JULY 2001
AUGUST 2001
SEPTEMBER 2001

~Word For October - "BROTHERHOOD"~~

DR. RON KARPICK, M.D., F.A.C.P., F.C.C.P. is the official CONSULTING PULMONOLOGIST for EFFORTS and writes a monthly article for our Newsletter.  Click here to see his background.  Dr. Karpick also has a regular Questions and Answers page where he responds to member's and others questions about COPD.  Please visit
Dr. Karpick's Korner to view questions that may also be of importance to you.

ASK THE DOCTOR
Dr. Ron Karpick, M.D, F.A.C.P., F.C.C.P.
 

Anxiety and COPD    

               Again, the disclaimer, I am not a psychiatrist.
As a follow-up of last months column on therapy of anxiety and depression, let us look at Anxiety.
               Anxiety is common in individuals with obstructive lung diseases. Some studies report as many as 30% of individuals with COPD have it, as opposed to 3-5% of the general population. Anxiety is characterized by an increased heart rate, sweating, more rapid breathing rate, feeling of smothering, faintness, numbness or tingling sensations a sense of impending doom and irrational fear or apprehension, fear of dying. If there is concern that these feelings will occur again, that they represent life-threatening illness or if one avoids situations because they maybe associated with recurrence of the feelings, then a diagnosis of Panic Disorder, a subheading under Anxiety, is made. This can affect 20% of people with COPD.  Other subgroups of Anxiety include Phobias, Obsessive-Compulsive Disorder, Post-traumatic Stress Disorder and Generalized Anxiety Disorder.
               Not being able to breathe properly can certainly cause apprehension and fear, but the addition of  Anxiety makes life much more difficult.  Anxiety reduces ones usual daily activities, reduces enjoyable activities, increases disability and reduces ones social role within the family and society.  Obviously, COPD can do the same, but the addition of the disease Anxiety only heightens or magnifies these effects on your life. Tests such as the Beck Anxiety Inventory (BAI) and the Hospital Anxiety and Depression scale (HAD) can be given to determine if an individual   dysfunction to make the diagnosis of Anxiety, as opposed to just the feelings related to COPD.
               Therapy may include drugs such as the Azaspirone, BuSpar, whose effects are gradual taking 2-4 weeks, but not associated with significant side effects or drug interactions. Other drugs we discussed last month include the Benzodiazepines, such as Ativan. Valium and Librium.  These work rapidly, but can be habit forming, can depress respiration and cause drowsiness. Beta blockers can reduce symptoms, but can worsen bronchospasm so may not be prescribed to individuals with asthma. Tricyclics and SSRI’s round out the profile.  Please see last months article.
               Nonmedical therapy includes education about the disorder. Remember, knowledge is power.  Also working with a Psychologist or other mental health provider in order to learn coping skills and management of triggers is very helpful.
               Anxiety disorders may complicate your COPD. If you think you have it, check with your health care provider. Also you can check on the following sites:
1)      www.nimh.nih.gov/anxiety
2)      http://anxiety-panic-stress.com
3)      http://www.stressrelease.com 

Dr. Ron      September 30, 2001
 

Hypnosis Can Cut the Cost of Medical Procedures  By Melissa Schorr (Reuters Health) -- Using hypnosis in the operating room could cut costs of some medical procedures in half, Harvard researchers reported Monday at the annual meeting of the American Psychological Association. "Doing hypnosis on the operating room table certainly makes sense, but unless it saves money, you will not be doing it,'' said study author Dr. Elvira V. Lang, associate professor of radiology and medicine at Beth Israel Deaconess Medical Center in Boston, Massachusetts. The research was funded by the National Institutes of Health.                       Sharon AL

Is Paxil Addictive? By Neil Sherman (HealthScoutNews) - A just-filed lawsuit claims that Paxil, one of the world's best-selling antidepressant drugs, is addictive, a claim the manufacturer strongly denies. Meanwhile, a former national drug czar says the suit is based on a misunderstanding of what addiction is. But, he adds, Paxil does cause withdrawal problems. The class action lawsuit, filed in Los Angeles Aug. 23, charges that Paxil's maker, GlaxoSmithKline, "actively deceived . . . in its labeling and oral communications" that the drug is not addictive and does not cause withdrawal symptoms.

For more on Paxil, see http://www.paxil.com.                                                                                                     Sharon AL

Even Temporary Smoking Cessation Cuts Decline in Pulmonary Function (Reuters Health) - Long-term follow-up of more than a thousand men indicates that even intermittent smoking cessation helps delay a decline in pulmonary function and reduce the risk of mortality, according to Finnish researchers. In the September issue of Thorax, Dr. Margit Pelkonen of the University of Kuopio and colleagues note that "little is known in the long term about individuals who give up smoking temporarily or quitters with lower initial pulmonary function." To investigate, the researchers studied data from two Finnish cohorts in a 30_year international epidemiologic study. In the 1007 participants who were evaluated during the first 15 years, the adjusted decline in lung function (FEV 0.75) was 46.4 mL/year in those who had never smoked, 55.5 mL/year in permanent quitters, 55.5 mL/year in intermittent quitters and 66.0 mL/year in "continuous" smokers (p < 0.001 for trend). Permanent and intermittent quitters, considered together, had a slower decline in pulmonary function than continuous smokers "across the entire range" of baseline lung function, according to the report. Furthermore, among both never smokers and continuous smokers, those who died had a significantly more rapid decline in lung function than survivors (p <0.001). Over the 30 years of follow-up, "never smokers, past smokers, and [intermittent] quitters had significantly lower total mortality than continuous smokers," the researchers say, "partly because of their slower decline in FEV 0.75." The advantageous effect of even a temporary cessation of decline in pulmonary function, Dr. Pelkonen told Reuters Health, "is encouraging, because for many smokers the process of quitting requires several attempts before the habit is eliminated." The results also suggest "that the beneficial effect of smoking cessation on mortality may partly be mediated through a reduced decline in pulmonary function. Thus, too much emphasis cannot be given for smoking cessation." Thorax 2001;56:703_707.

http://www.medscape.com/reuters/prof/2001/08/08.29/20010828epid001.html                                                     Sharon AL

Virus May Fool Cancer Cells Into Self-Destructing By Merritt McKinney (Reuters Health) - A common virus that tricks cells into destroying themselves may be a promising treatment for cancer, Swiss researchers report. Therapies incorporating the virus, the adeno-associated virus (AAV), might be able to treat cancer without the debilitating side effects of conventional cancer treatments, one of the study's authors told Reuters Health. "AAV DNA, with its unusual hairpin structure, may trick the cancer cell into thinking its own DNA is damaged,'' said Dr. Peter Beard of the Swiss Institute for Experimental Cancer Research in Epalinges.

SOURCE: Nature 2001;412:865_866, 914_917 http://dailynews.yahoo.com/h/nm/20010829/hl/virus_2.html             Sharon AL

AMA Discourages Drug Co. Gifts By LINDSEY TANNER, AP Medical Writer CHICAGO (AP) - The American Medical Association is spending a big chunk of drug company money to tell doctors not to accept large gifts from drug companies in a campaign that critics say smacks of hypocrisy. The AMA is contributing about $400,000 to the $1 million effort, but most of the balance comes from payments between $50,000 and $100,000 from nine major drug companies. The AMA says it makes sense to involve the industry in a campaign that's also designed to inform drug makers about what is considered unethical behavior.

On the Net: American Medical Association: http://ama_assn.org

http://dailynews.yahoo.com/h/ap/20010829/hl/ama_gifts_2.html                                                                         Sharon AL

Asthma Drugs Protect Against Bowel Disorder By Pippa Wysong (Reuters Health) - Although asthmatics may have a slightly increased risk of developing a type of intestinal disorder compared with the general population, those who take medications commonly prescribed to treat asthma appear to be protected against developing the disorder, researchers reported here Monday. The study, led by Dr. Consuela Huerta in Madrid, Spain, found that asthmatics are 1.3 times more likely to develop irritable bowel syndrome (IBS), a cluster of symptoms including bouts of constipation, diarrhea, abdominal pain and bloating, than are non-asthmatics. A link between the two diseases has been suggested in studies in the past. However, asthmatics who were regularly taking a class of drugs known as oral corticosteroids--which includes commonly prescribed prednisone--at the start of the study were slightly less likely to develop IBS during the study period, compared with other asthmatics.

http://dailynews.yahoo.com/h/nm/20010829/hl/bowel_1.html                                                                             Sharon AL

Scientists Put Their Bet On Last Hope To Maintain Mice Bred For Research -- Efforts to breed two old mice, the only survivors of a unique genetic strain used in the study of lung disease, are down to one last chance. The mice were dubbed the "Allison Twins" by Dr. Michael Blackburn, a molecular geneticist at the University of Texas Health Science Center here, after his colony of 200 genetically engineered mice was wiped out in flooding from Tropical Storm Allison June 8. The two mice rode out the flood in New York, where they had been shipped to a research colleague months before.

http://biospace.com/news_story.cfm?StoryID=5899615                                                                                         Sharon AL

HMOs Expected to Drop More Medicare Patients: Administration Seeks Looser Rules on Managed Care By Amy Goldstein Washington Post Staff Writer - The head of the federal agency that runs Medicare predicted yesterday that "several hundred thousand" elderly Americans will be dropped from private health plans this winter, despite the Bush administration's efforts to lighten the regulatory burdens on HMOs and coax them to keep taking Medicare patients....

http://www.washingtonpost.com/                                                                                                                             Sharon AL

Technical Note - Comparison of a New Desktop Spirometer (Diagnosa.) with a Laboratory Spirometer  
Respiration 68:4:2001, 400_404.

Abstract Background: The Diagnosa is a fully integrated system, able to determine spirometry, ECG, blood pressure and body composition. Real time data can be transferred via Internet to a remote receiving center.

Objectives: The aim of this study was to perform biological testing of the spirometry component in subjects with normal and pathological pulmonary function.

Methods: A group of 45 patients was tested on both the Diagnosa and the standard Jaeger Masterlab spirometer according to the guidelines of the American Thoracic Society. Three subgroups of 15 subjects each (normal spirometry, obstructive and restrictive airflow limitation) were selected.

Results: All measurements performed with the Diagnosa correlated closely with those performed with the Jaeger spirometer and showed good limits of agreement (the largest difference between the two devices being 0.2

liter for FEV1). Analysis of the 3 subgroups showed no difference for any parameters compared to the overall group. Electronic transfer of all data was successful.

Conclusions: The Diagnosa spirometer is comparable to a standard laboratory spirometer and can be used reliably for telemedicine purposes.

http://www.pulmonologylinx.com/thearts.cfm?artid=213478&specid=14                                                                 Sharon AL

TB Drug Therapy Linked to Liver Injuries, Deaths By D. Paul Simao (Reuters) -- U.S. health officials on Thursday warned doctors to limit their use of a promising drug cocktail when treating cases of latent tuberculosis because the therapy caused severe liver injuries and death in some patients. The Centers for Disease Control and Prevention and the American Thoracic Society issued the advisory after a CDC investigation revealed that at least six people with latent TB had died since 1999 after being prescribed a two month course of the antibiotics rifampin and pyrazinamide. Another 17 people were hospitalized with hepatitis or other liver injuries after taking the drugs, which are used to treat both the latent asymptomatic form of TB as well as the potentially fatal active strain of the lung disease. An estimated 10 million to 15 million Americans are infected with latent TB, which is caused by an airborne bacteria spread through coughing or other close contact with infected persons. Antibiotics cure most cases of TB. The CDC said a nine month course of isoniazid was the preferred treatment for latent TB, especially in cases where patients suffered from alcoholism or were taking other medications linked to liver problems.

http://dailynews.yahoo.com/htx/nm/20010830/sc/health_tuberculosis_dc_1.html                                                     Sharon AL

Protein May Point the Way to New Antibiotics By Emma Hitt, PhD (Reuters Health) -- Researchers have proposed a new explanation for the stubborn antibiotic resistance of the ''staph'' bacteria that are a notorious cause of hospital related infections. They say their findings--that one protein plays a far more crucial role in drug resistance than previously believed--may pave the way for the development of better antibiotics. According to the investigators, led by Dr. Mariana Pinho of The Rockefeller University in New York, methicillin-resistant Staphylococcus aureus (MRSA) first arose in the 1960s and has since become one of the leading causes of infections during hospital stays. A class of antibiotics called beta-lactams, which includes methicillin and penicillin, is able to kill non-resistant S. aureus. But the drug resistant MRSA produces a protein that helps the bacteria evade these antibiotics. The protein, called PBP2A, is governed by a gene that is thought to have ``jumped'' into the DNA of S.aureus from another species, although researchers are unsure which species it came from. According to Pinho's team, PBP2A has a similar function to four other types of protein that--unlike PBP2A--are "native" to MRSA. All of the proteins help the bacteria build their cell walls. Previously, investigators thought that antibiotics inactivated only the native proteins, and not PBP2A, and that PBP2A could substitute for the inactivated native proteins. This then allowed the bacteria to maintain their cell walls and survive the antibiotic onslaught. But writing in the August 21st online edition of the Proceedings of the National Academy of Sciences, Pinho's team reports evidence that certain functions of PBP2A are, in fact, inactivated by antibiotics and at the same time, the native proteins are not completely inactivated.

SOURCE: Proceedings of the National Academy of Sciences 2001;98.http://dailynews.yahoo.com/htx/nm/20010830/hl/protein_4.html                                                                     Sharon AL

Flu Season 2001_02  -- Vaccine supplies increase, but delays are expected This season more vaccine is expected to be available than in previous years. Some delays in distribution are projected, but they are not expected to be as great those in the 2000_01 season. In years without delays, most flu vaccine is distributed by the end of October. This year, however, manufacturers have told us to expect 60 percent of the vaccine to be delivered by the end of October, 30 percent by the end of November, and the final 10 percent in early December. The projected distribution of influenza vaccine for 2001, based on aggregate manufacturersb9 estimates as of August 6, 2001 is 79.1 million doses, which is greater than in 2000 and comparable with 1999. Timing for the 2001_02 flu shot Please allow those people who will benefit most from the vaccine: those over 64 years old and those with chronic (long-term) health conditions, to get their shots as soon as vaccine becomes available. Everyone else should wait until November and later to get protection when the supplies are more plentiful. Even if you get the vaccine after November, you can still be protected as the flu season runs from November through April.

http://www.cdc.gov/nip/flu/

* * *

Orders for flu vaccine maxed out already -- The health system is gearing up for flu season, but some physicians, as reported in an AMA_CDC study, are having trouble placing vaccine orders. Others say they just won't administer it.

http://www.ama_assn.org/sci_pubs/amnews/pick_01/hll20910.htm

* * *

Aventis Pasteur to Complete Partial Shipments of Influenza Vaccine to All Customers by End of September Every Customer Will Receive Vaccine in September; Smaller Customers to Receive Complete Order, Larger Customers Will Receive Balance in October/November /PRNewswire/ -- Aventis Pasteur, the nation's leading supplier of influenza vaccine, today announced that it anticipates shipping influenza vaccine to all of its customers by the end of September, with smaller customers receiving their entire vaccine order. Larger customers, such as resellers and distributors, will receive about 25% of their order in September with the balance to be shipped in October and November. "We are pleased that all Aventis Pasteur customers will receive influenza vaccine this month with many receiving complete orders, allowing them to prioritize immunization of high risk persons, including the elderly and chronically ill, before the influenza season begins," said Wayne Pisano, senior vice president, marketing and sales at Aventis Pasteur. The company's smaller customers include office-based physicians, hospitals and nursing homes, which had placed orders for relatively small numbers of doses of Fluzone(R), Influenza Virus Vaccine USP. This made it possible for Aventis Pasteur to ship these customers' complete vaccine orders in September. Those customers who ordered larger quantities of vaccine received partial orders this month and are scheduled to receive the balance of their vaccine shipments in October and November. The company plans to ship all orders for influenza vaccine orders before the end of November. Aventis Pasteur changed its shipping schedule to facilitate equitable distribution of influenza vaccine among customers. The new shipping system was designed to ensure all of the company's direct customers received a portion of their influenza vaccine order in September to allow them to prioritize vaccination among the elderly and chronically ill, according to CDC recommendations. This year, Aventis Pasteur made a significant capital investment to expand production of Fluzone(R) which, combined with higher yields, will increase production by 20 percent over last year. This vaccine quantity is considerably higher than Aventis Pasteur has produced in previous years and represents the largest volume of influenza vaccine supplied by one manufacturer to the U.S. market. The company also is in the process of evaluating a still greater expansion within the next several years to meet growing demand. For more information, please visit: http://www.aventis.com                                                                                 Sharon AL

HHS Launches New Web Site Dedicated To Global Health Issues -- HHS Secretary Tommy G. Thompson announced the launch of a new Web site that addresses the inextricable link between domestic and international health. The site, http:\\www.globalhealth.gov, provides information on the department's work on global health issues as well as worldwide health statistics, reports and publications, and links to the department's global health partners. "The global health challenges for this new century are daunting. These problems require a solution that is driven by compassion and that includes the very best research, practice and service from HHS," said Secretary Thompson. "Because our health, economies and humanitarian values have become truly global in nature, our responses must likewise be global in nature." The site was developed to be a portal of global health information for policymakers, researchers, doctors and the general public. It underscores the administration's commitment to health as a priority in America and worldwide. HHS works with partners from around the world to combat global health problems such as AIDS, malaria, tuberculosis and tobacco use. The ease of travel in today's global economy means that no nation can be isolated from global health threats. The movement of more than 2 million people each day across national boarders and the growth of international trade in goods are responsible for increased health risks, including infectious diseases, contaminated foods, and biological and chemical threats. The new globalhealth.gov Web site is administered by HHS' Office of International and Refugee Health.                                                                                                                                                             Sharon AL

Seniors and Computers -- In July 1999, the Department of Commerce issued a report showing that while more Americans than ever have access to information technology, the gap between information "haves" and "have nots" persists and has widened significantly. Traditionally, senior citizens have been underserved because of the lack of online resources at their disposal. The Clinton Administration has focused national attention on bridging the digital divide by providing digitally disadvantaged groups with Internet access. The Commerce Department's http://www.digitaldivide.gov/ Digital Divide Website is a comprehensive clearinghouse for information about the Clinton Administration's efforts to provide all Americans with access to the Internet and other information technologies that are crucial to their economic growth and personal advancement. The web site identifies a range of grant and loan programs that provide assistance to Americans vulnerable to falling on the wrong side of the digital divide. In addition, the site provides direct links to several private sector educational and funding initiatives. Finally, the site provides updates on funding programs, policy debates, and recent studies that address digital divide issues. Through efforts such as the digital divide, seniors have become the fastest growing group of Internet users. Because of this, a number of websites and organizations have started to cater specifically to the computer training and resource needs of senior citizens.

http://www.seniors.gov/computers.html                                                                                                                 Sharon AL

Protein After Exercise Boosts Muscle in Older Men (Reuters Health) -- Consuming a high protein supplement shortly after strength training may help healthy older men ward off the muscle loss that comes with age, findings from a small Danish study show. The findings give weight to the beliefs of many bodybuilders, who routinely follow up their workouts with a dose of protein, lead researcher Brigitte Esmarck told Reuters Health. "However, the age group we focused on does not appear to have the same tradition for integrating protein and exercise," she said. "I think many older people...could benefit tremendously from integrating a well timed protein intake with their training programs and thereby gain muscle mass and strength."

SOURCE: Journal of Physiology 2001;535:301_311. http://www.nlm.nih.gov/medlineplus/news/fullstory_3292.html         Frank NV

A Phase III Study of an Investigational Medication to Determine Efficacy in Patients with Chronic Obstructive Pulmonary Disease -- As an individual with COPD (Chronic Obstructive Pulmonary Disease), you are most likely aware of how much it can affect your well-being and the quality of your life. Not only can COPD take your breath away, it can destroy your ability to work and play. The most serious cases can even take your life. The BOLD (Battling Obstructive Lung Disease) Study Team in association with Acurian, Inc. and a local physician is currently seeking volunteers to participate in a national medical research study. If you have quit smoking at least 12 months ago, or are willing to quit now, this study may be right for you. All participants will receive study related medications, laboratory tests, medical care, entrance into a smoking cessation program, and physical examinations at no charge.

http://www.acurian.com/diseases/                                                                                                                     Helen MO

Lotteries and Tobacco Money: Basic Research Bonanza -- Boosted by revenue from lotteries and tobacco company settlements, state financed basic research in the life sciences is soaring. The goal of such funding is usually to create wealth by attracting federal and private money. But this strategy raises difficult questions about how best to measure research outcomes, policy specialists say. At least 17 states have directed tobacco settlement money into research and all but three of them are focusing on fundamental studies rather than direct commercialization, observes Walter H. Plosila, vice president of public technology management at the nonprofit Battelle Memorial Institute, a technology developer in Columbus, Ohio. For example, Michigan has a $1 billion life sciences research initiative, Florida is spending $1.7 billion on biomedical research, and California has put into place a competitive program to fund its universities in a variety of research fields. However, Plosila warns, "The federal government is hardly a model for trying to gauge and measure the impact of these programs."

http://www.the_scientist.com/yr2001/sep/bunk_p6_010903.html                                                                         Sharon AL

New Internet Tool Helps People Apply for Disability Benefits -- Do you or someone you know need to apply for disability benefits? There's a new tool to help. When an adult applies for disability benefits, they need to complete a Disability Report (SSA_3368). The report helps us obtain information about your medical condition, and is the key to obtaining medical records. Now you can get tips right over the Internet on how to complete this report. A well completed form can shorten the disability interview and speed up your claim. Just click on any section of the form and you'll get a "plain language" explanation of what we're looking for, why we need the information, and how your answers help us decide if you can get disability benefits. This new site is your key to having the Disability Report completed before your disability interview. To take a look, visit http://www.ssa.gov/disabilityformhelp/

                                                                                                                                                                            Sharon AL

Promising melanoma predictor studied - Victoria Stagg Elliott, AMNews staff. -- For this deadly variety of skin cancer, effective treatment continues to be bedeviled by challenges in detection. Researchers are proposing that a protein found in many early stage melanomas may become the basis for an early diagnostic test for the cancer that kills 7,800 people annually . The protein in question appears to deactivate a tumor suppressor gene. Its identification could improve patients' chances for early detection __ crucial because melanoma has a high cure rate if caught early. Few patients whose cancer has spread survive beyond five years. "Melanoma is a disease that progresses very quickly, and it kills you very quickly," said Rhoda Alani, MD, assistant professor of oncology, dermatology, molecular biology and genetics at Johns Hopkins University in Baltimore. But early diagnosis is not easy. It depends on patient alertness and the pathologist's ability to distinguish between an atypical mole and early stage melanoma. The study was small, but researchers say a large study is their next step. Skin cancer experts say that in addition to early diagnosis, a tool to determine who is most likely to experience a recurrence is also needed. "With melanomas, no matter how big or how small they are, there's always a chance it may come back. . Melanoma, although it is the least common skin cancer, is also the most deadly.

http://www.ama_assn.org/sci_pubs/amnews/pick_01/hl01.htm                                                                                 Sharon AL

Good news for all of us chocolate lovers. Gary can vouch for me that I am among the top of the chocolate lover’s category! 
                                                                                                                                                                        Sharon AL

By Patricia Reaney (Reuters) _ Good news for chocoholics. The treat favored by millions not only tastes delicious but is healthy for you, American researchers said on Monday. Chocolate contains compounds called flavonoids that can help maintain a healthy heart and good circulation and reduce blood clotting -- which can cause heart attacks and strokes. "More and more, we are finding evidence that consumption of chocolate that is rich in flavonoids can have positive cardiovascular effects,'' Carl Keen, a nutritionist at the University of California, Davis, told a science conference. "We not only have observed an increase in antioxidant capacity after chocolate consumption, but also modulation of certain compounds which affect blood vessels.' 'Antioxidants are substances that help reduce the damage of cancer causing charged particles in the body. Fruits, vegetables, nuts and whole grains are high in antioxidant vitamins such as C and E. Flavonoids in chocolate are derived from cocoa, which is rich in the compounds. Research has shown that a small bar of dark chocolate contains as many flavonoids as six apples, 4.5 cups of tea, 28 glasses of white wine and two glasses of red. But Dr. Harold Schmitz said there were variations in the levels of flavonoids in chocolate and cocoa products depending on the production process, in which many flavonoids are destroyed. All chocolates are not created equal in regards to flavonoid content,'' Schmitz, a scientist with confectionery maker Mars Inc, told a news conference. Flavonoids are thought to reduce the risk of cardiovascular disease, the number one killer in many industrialized countries, by reducing platelet aggregation __ when blood platelets combine into a sticky mass and form clots. Keen and his colleagues measured the impact of chocolate on platelets in the blood in 25 volunteers. They presented their findings to the British Association for the Advancement of Science.

Risk Of Lung Damage From Ultrasound Greater Than Once Thought -- Pumping more energy into a beam of diagnostic ultrasound could produce a better image and therefore a better diagnosis but studies at the University of Illinois suggest the risk of ultrasound induced lung damage is greater than many scientists previously believed. While there has been no evidence that clinical use of ultrasound has had any adverse effects in humans, safety concerns were raised recently when scientists discovered that diagnostic treatment levels could produce acute lung hemorrhages in laboratory animals. The big question is whether human lungs can be damaged by diagnostic ultrasound, and if so, under what exposure conditions.                                        Sharon AL

http://www.sciencedaily.com/releases/2001/09/010904072302.htm 

Conventional Bronchodilator Testing in COPD Evaluation  (Reuters Health) -- Bronchodilator reversibility may be useful in excluding significant asthma in patients with chronic obstructive pulmonary disease, but according to UK researchers, it is relatively ineffective at predicting significant benefit in severe disease. The September issue of Thorax noted that the investigation of the utility of certain respiratory tests in assessing improvement in breathlessness after administration of beta agonists and anticholinergics. On two separate occasions the researchers repeatedly measured various pulmonary parameters in 20 clinically stable patients with severe COPD. During one of these periods, the patients received nebuliser administration of saline, followed by 5 mg of nebulised salbutamol (albuterol) and then 5005g of nebulised ipratropium bromide. During the other period, the order of salbutamol and ipratropium administration was reversed. No changes were seen in measures of lung function such as FEV1 after saline administration, but the degree of tidal flow limitation varied. After both the dose of salbutamol and the dose of ipratropium, there was a significant improvement in FEV1 and in volume related measurements. Further significant improvements were seen after the combination treatment. Breathlessness fell significantly only after both agents had been administered. Unlike results using negative expiratory pressure, all volume based measurement showed "a continuous response to bronchodilators with no sign of a clear break between responders and non-responders," the researchers note. Furthermore, "changes in inspiratory capacity were significantly larger than those in FEV1 and may be more easily detected.

Thorax 2001;56:713_720.  http://respiratorycare.medscape.com/reuters/prof/2001/09/09.05/20010904clin001.html      Frank NV

Lung Cancer Leads Global Cancer Statistics List -- There were 10 million new cases of cancer in the world in the year 2000, 6 million deaths and approximately 22 million people living with cancer worldwide, according to a new report on global cancer statistics. Lung cancer heads the list as the most common type of cancer in terms of new cases (1.2 million, accounting for 12.3% of the world total) and deaths (1.1 million, or 17.8% of the world total). After lung cancer, the most common types of new cancer cases were breast, colorectal, stomach and liver. The report, by Dr. D. Maxwell Parkin of the International Agency for Research on Cancer in Lyon, France, is published in the September issue of The Lancet Oncology. Parkin predicts that stomach cancer rates, which are decreasing, will continue to do so. However, he points out that the increasing risk of prostate and breast cancer ``is likely to be maintained for some time. ''He also notes that while lung cancer in some nations has started to decrease, the numbers are likely to be offset by rising rates in certain eastern European countries and future increases in developing nations. Since the largest changes in population growth and increasing age of populations are expected to take place in developing countries as opposed to developed nations, ``more and more of the future cancer burden will be in these regions,'' according to Parkin. For instance, by 2020, projections suggest there will be as many as 9 million new cases of cancer in developing nations, as opposed to 6 million new cases in developed nations. "These simple projections,'' Parkin writes, "illustrate the increasing toll that cancer will take in our aging world populations, and highlight the need to seek and apply effective preventative measures, as well as to strive for continued improvements in the effectiveness of treatment.''

SOURCE: The Lancet Oncology 2001;2:533_543 http://dailynews.yahoo.com/h/nm/20010904/hl/cancer_7.html         Sharon AL

Study: Heart Attack Risk for Celebrex, Vioxx -- A new study in the Journal of the American Medical Association suggests that the arthritis drugs Celebrex and Vioxx may significantly raise the risk of a heart attack, possibly because they tend to increase blood pressure. The majority of arthritis sufferers are over 65 and are more likely to suffer heart problems as it is. And rheumatoid arthritis itself raises cardiovascular risk. Researchers looked at clinical trials of the two drugs and found that patients in one large trial who took Vioxx were more than twice as likely to have a serious heart problem as were those who took Naproxen. Another analysis comparing Vioxx or Celebrex with a placebo found that patients on the drugs had roughly 50 percent more heart attacks. But even with the increased risk, the actual incidence was low. The study authors aren't urging that the drugs be abandoned, but suggest offsetting the possible risk of taking a Cox_2 drug by adding a baby aspirin or half an adult aspirin a day in patients with a known cardiovascular risk. The Arthritis Foundation, in a statement following the study's release, concurred.

Source: US News & World Report http://adserver.ads360.com/bin/creative.cgi?publisher=usnews&cid=433              Sharon AL

Thomas Record Report--Daily Digest  - Here's our name in the Congressional Daily Report. All who have not written their letters. Please take the time to do so now or send your name address and zip code to Gary and he will arrange for them to be done. This is our golden opportunity. Thanks Pam..

TOBACCO LITIGATION Committee on the Judiciary: Committee concluded hearings to examine the management of tobacco litigation, focusing on the Department of Justice's lawsuit currently pending against leading U.S. cigarette manufacturers, after receiving testimony from Stuart E. Schiffer, Acting Assistant Attorney General, Civil Division, Department of Justice; Connecticut Attorney General Richard Blumenthal, Hartford; David W. Ogden, Wilmer, Cutler, and Pickering, former Assistant Attorney General, Civil Division, Department of Justice, and Jonathon Turley, George Washington University Law School, both of Washington, D.C.; Pamela DeNardo, St. Charles, Illinois, on behalf of the American Lung Association and Emphysema Foundation For Our Right To Survive; G. Robert Blakey, University of Notre Dame Law School, Notre Dame, Indiana; and David Adelman, Morgan Stanley, New York, New York

http://www.senate.gov/~judiciary/hr090501f.htm

Importing Medicines from Canada -- Pharmacists and drug distributors should be allowed to obtain U.S.-made medicines from Canada, where they are cheaper, and resell them to American consumers at a reduced price, senators said Wednesday. They said they would pursue legislation despite contentions by the Bush administration that it cannot guarantee the safety of drugs brought back into United States from other nations. "I would argue that FDA must stop telling us what will not work, and must now tell us what will work,'' said Sen. James Jeffords, the Vermont independent who led the push for the original drug law, which was delayed by officials in the Clinton and Bush administrations.

http://dailynews.yahoo.com/h/ap/20010905/pl/drug_reimportation_2.html                                                                  Frank NV

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Key U.S. Senator Wants Canada Drug Re-import Plan -- A key US Senate Democrat said Wednesday he will introduce legislation to let Americans obtain lower priced prescription drugs from Canada now that the US government refuses to implement a broader law passed last year. Declaring that Americans pay more for prescription drugs than anyone in the world, Sen. Byron Dorgan (D-ND) lambasted the Republican administration of President George W. Bush and his Democratic predecessor, Bill Clinton, for frustrating congressional efforts to fix the situation.

http://dailynews.yahoo.com/h/nm/20010905/hl/drugs_1.html                                                                                 Frank NV

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Web Company Offers Drugs in U.S. at Canadian Prices -- A Canadian Internet company plans to launch a new service in January that will enable Americans to buy prescription drugs from Canada at savings of 40% to 70%. The move by Online Direct, Online Direct Inc., a 2_year_old company formed through the consolidation of three Canadian Internet companies, comes just weeks after the US House of Representatives passed a bill that would allow Americans to buy prescription drugs directly from foreign countries. The bill has yet to be approved by the Senate and the president. Sen. Byron Dorgan (D-ND) said that he would introduce legislation to let Americans obtain lower priced prescription drugs from Canada because the US government refuses to implement the Medicine Equity and Drug Safety Act law passed last year. A recent Money magazine survey reported that more than 60% of Americans said that they would drive into Canada to buy prescription drugs if they lived close enough. With the Online Direct service, everyone in the US could save money on prescription drugs. The new online pharmacy service will be promoted and managed by Traverse City, Michigan-based Wellness Web, an Online Direct subsidiary. Wellness Web will post which prescriptions are available to be filled, and patients will be able to contact the subsidiary through the Internet, e-mail, fax or phone. After initial contact with Wellness Web, patients will have to supply a hard copy of a current prescription that will be sent to http://lepharmacy.com/ in Montreal. A Canadian physician would then review the prescription, make contact with a US doctor if necessary, and reissue a new Canadian prescription. LePharmacy.com would then manage distribution of the prescription directly to the patient in America. Mark Lazar, chairman of LePharmacy.com, said in a statement that an average person who requires a continuing supply of a prescription drug could save $1,000 to $2,000 a year compared with the price the individual would pay in the US.

http://dailynews.yahoo.com/h/nm/20010907/hl/drugs_2.html                                                                                 Frank NV

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Judge Blocks Prescription Discount Plan -- Amy Goldstein Washington Post Staff Writer - A federal court blocked President Bush's plan to offer prescription drug discount cards to elderly Americans by the beginning of next year, finding that the administration may have lacked the authority to create such a program without congressional approval.

http://www.washingtonpost.com/wp_dyn/health/A54335_2001Sep6.html                                                             Sharon AL

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FDA Official Testifies on Importing Prescription Drugs -- William K. Hubbard, an FDA senior associate commissioner, testified Sept. 5 before a congressional subcommittee on issues related to personal importation of drugs.

http://www.fda.gov/ola/2001/importation0905.html                                                                                             Sharon AL

Hattler Respiratory Catheter -- University of Pittsburgh Medical Center is set to test a device that temporarily performs up to 60% of the lung's natural action. Called the Hattler Respiratory Catheter, it is a catheter that is snaked through the leg and positioned in the Vena Cava (the major vein returning blood to the heart). It consists of 1000 hollow fibers wrapped around a tiny balloon that inflates and deflates as many as 300 times a minute. In the process blood pumps back and forth over the fibers, allowing O2 to enter and CO2 to pass out. Conventional ventilators oxygenate the body by expanding and compressing the lungs themselves which causes the lungs to work overtime. With this new devise, when blood arrives at the lungs, the lungs don't have to do anything. They can just rest and heal. The catheter can be left in as long as three weeks. Clinical trials are expected to begin in Europe next year and a commercial model may be available in 2004.

http://www.upmc.edu/McGowan/SpinOff/ALUNG.htm                                                                                     Sharon AL

Advair Diskus 100/50 (Fluticasone/Salmeterol) More Effective In Asthma Maintenance Than Singulair - RESEARCH TRIANGLE PARK, NC -- A study published in the American Journal of Respiratory Critical Care Medicine is the first to compare the safety and efficacy of new Advair Diskus100/50 (fluticasone propionate and salmeterol inhalation powder) twice daily with Singulair 10mg (montelukast) once daily as initial maintenance therapy.

http://www.docguide.com/news/                                                                                                                 Sharon AL

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Thrush -- Advair is a combination of both Serevent and Flovent. Flovent is famous for causing thrush, that is why it is so very important to rinse your mouth carefully and try to swallow the rinse water. I have found that if I take out my partial denture when I use it I don't have to worry about it getting under my partial and not getting rinsed out. I think that all with any sort of denture should remove it when inhaling this power or any steroid product. That is NOT medical information only my own belief. There are some products for Thrush but I think that you need to call your doc and get a script. One is Nystatin Rinse and Swallow which is a liquid there are also oral pills that are very fast acting but expensive.

Advair can cause localized Infection of the Pharynx with Candida Albicans according to the insert. The complete insert can be found at: http://www.glaxowellcome.com/pi/advair_diskus.pdf                                                                                 Sharon AL

GPC Biotech Announces Issuance of Two Patents for Anti-fungal Drug Discovery Program --GPC Biotech AG (Frankfurt Stock Exchange: GPC) announced that the United States Patent and Trademark Office has issued two patents covering geranylgeranyl transferase type 1 (GGTase) as an anti-fungal drug target. The GGTase program is the Company's most advanced anti-fungal drug discovery program. These patents provide GPC Biotech with a significant competitive advantage; they cover novel anti-fungal drug discovery assays and the commercial development of important new therapeutics for fungal diseases, based on a novel mechanism of action distinctly different from conventional therapies.

http://biospace.com/news_story.cfm?StoryID=6216615&full=1                                                                             Sharon AL

TB Dormancy Insight Could Help Wipe Out The Disease -- New knowledge about the way tuberculosis causing bacteria can survive in a dormant state for years in our bodies could pave the way for treatments that will finally wipe out this dread disease. This is what experts heard at the biannual meeting of the Society of General Microbiology at the University of East Anglia in Britain. Dr. Lawrence Wayne of the Department of Veterans Affairs Medical Center, Long Beach, California, says, "We have had powerful drugs to treat tuberculosis for over 50 years, but we have failed to eradicate the disease. "This is due in part to socioeconomic factors as well as to AIDS, which destroys our immunity to the tubercule bacteria, but also because the bacteria can go into a dormant state in our bodies, surviving for months or years without multiplying, protected from the anti-tuberculosis drugs. "According to Dr. Wayne, the tubercule bacteria adapt their biochemistry to conserve energy, which allows them to survive without any oxygen, although they usually need at least 10% oxygen to grow. As inflamed and infected tissues slowly run out of oxygen, the bacteria stop reproducing and become dormant. The bacteria can also switch to alternative energy sources, reduce their need to make proteins, and protect their essential enzymes from breaking down. Dr. Wayne says, "As medical scientists gain further genetic information about these adaptations, it should be possible to design drugs that will interfere with them and prevent the bacteria from surviving in oxygen depleted tissues, solving the problem of latent tuberculosis disease."

http://unisci.com/stories/20013/0910011.htm                                                                                                 Sharon AL

Anti-Nicotine Addiction Vaccine TA-NIC Enters Phase I Trials /PRNewswire/ -- Xenova Group today announces that its novel therapeutic vaccine, TA-NIC, which is being developed for the treatment of nicotine addiction, has entered Phase I clinical trials. The Phase I study is a double-blind, randomized, placebo controlled study to assess the safety, tolerability and immunogenicity of the TA-NIC vaccine in both smokers and nonsmokers. The vaccine is administered by intra-muscular injection. In the first instance, two different dose levels are to be investigated in a variety of dosing regimens. TA-NIC is believed to be the first anti-nicotine addiction vaccine to enter clinical testing. TA-NIC uses a novel mode of action whereby it seeks to prevent nicotine from entering the brain. Currently available therapies for nicotine addiction include nicotine replacement therapy, delivered via skin patches, chewing gum or inhalers or treatment with the nicotine free drug bupropion. For further information about Xenova and its products please visit the Xenova website at http:\\www.xenova.co.uk

http://biospace.com/news_story.cfm?StoryID=6216115&full=1                                                                         Sharon AL

PRNewswire -- Aventis Pharmaceuticals, the U.S. pharmaceutical company of Aventis Pharma AG, and ViroPharma Inc.  announced that they have formed a collaboration to co develop and co promote ViroPharma's Picovir(TM) (pleconaril) in the United States. Picovir(TM) is a first-of-a-kind oral antiviral product being studied for the treatment of viral respiratory infection (VRI), otherwise known as the common cold.

http://biospace.com/                                                                                                                                     Sharon AL

Adding Pecans to Your Diet May Lower Bad Cholesterol (CBS HealthWatch) -- First it was peanuts: Once thought bad for the heart, they turned out to be good for us after all. Then it was walnuts, and now pecans may be added to the list of foods that can lower cholesterol. Adding about 2 ounces of pecans a day to the diet recommended by the American Heart Association (AHA) can significantly lower cholesterol levels, according to study results published in the September issue of the Journal of Nutrition.

http://cbshealthwatch.medscape.com/cx/viewarticle/404613_print                                                                     Sharon AL

Fat Melting Gene Found in Mice; Could Help Humans By Anne Harding (Reuters Health) -- Scientists have identified a gene that gives mice leaner bodies and allows them to eat a diet high in fat without gaining weight. The gene, called FOXC2, could provide the basis for obesity treatment in humans, the researchers report in the September 7^th issue of Cell. "We have preliminary results that indicate that the human FOXC2 gene very well could do similar things in humans,'' the study's lead author, Dr. Sven Enerback of Goteborg University in Sweden, told Reuters Health. "This work opens up a new possible way to treat type 2 diabetes and obesity." When some people eat too much, they store the excess calories in their fat cells. Excess body fat leads to obesity, high levels of fats like cholesterol and triglycerides in the blood, and a decreasing ability to respond to the effects of insulin--the hormone that helps the body to remove sugar from the blood and use it for fuel. All of these factors can also lead to type 2 diabetes. But when other people overeat, they dissipate the excess in heat energy without packing on the pounds. The difference between these two groups, Enerback and colleagues explain, is probably genetic. To discover more about these differences in fat metabolism, the investigators bred mice that had overactive FOXC2 genes. While fat represented 30% of the body weight of normal mice, mice with the overactive FOXC2 gene had 10% body fat. They had lower levels of triglycerides and free fatty acids in their blood, as well as lower blood sugar levels. They also had lower levels of insulin in their blood, suggesting that they were more susceptible to the hormone's effects. The specially bred mice gained the same amount of weight as their normal counterparts when given a regular diet, but had leaner bodies. When given a high fat diet, the overactive FOXC2 mice gained 28% less weight than the normal mice, the report indicates. The fat cells of the specially bred mice had more and larger mitochondria, which are the cellular engines that produce energy from food. These cells also consumed four times more oxygen than the fat cells of the normal mice. The overactive FOXC2 mice also did not eat more to compensate for their lo ss of fat, which the researchers suggest could mean that the gene somehow affects satiety, or fullness, signaling to the brain. So-called thrifty genes are believed to have evolved so humans could conserve energy when food was scarce by building up their fat stores. These genes can produce obesity in today's world. Enerback and colleagues believe that FOXC2 may be an ''anti-thrifty'' gene that balances the effects of thrifty genes by mobilizing food energy. "This balance allows survival during periods of food deprivation, frequently encountered during evolution, without the maladaptive consequences of an excess of adipose (fatty) tissues in times when food is available," they write.

SOURCE: Cell 2001;106:563_573.http://dailynews.yahoo.com/htx/nm/20010907/hl/fat_1.html                             Sharon AL

Finding Lung Cancer May Have Just Gotten Easier from Yahoo! News (HealthScout) - "A new kind of "imaging agent" can improve the detection of lung cancer that has spread beyond the lungs, leading to better care and fewer unnecessary or inappropriate surgeries, contends new research. The imaging agent, Tc_99m Depreotide, was 30 percent more effective than a CT scan alone in detecting cancer that had spread from the lungs to the lymph nodes in the central area of the chest, called the pulmonary hilum and mediastinum, the study says."                                                                                         Sharon AL

Breathing and Your Brain -- Scientists have identified the small group of brain cells believed to originate and control breathing in mammals, according to a news release from the University of California, Los Angeles Health Sciences (UCLA.) This discovery could bring about new approaches to the treatment of sleep breathing disorders like sleep apnea.

http://sleepdisorders.about.com/                                                                                                                     Joan IN

Objective: The aim of the study was to assess the effect of target flow inspiratory muscle training (IMT) on respiratory muscle function, exercise performance, dyspnea, and health related quality of life (HRQL) in patients with COPD.

Patients and methods: Twenty patients with severe COPD were randomly assigned to a training group (group T) or to a control group (group C) following a double-blind procedure. Patients in group T (n = 10) trained with 60 to 70% maximal sustained inspiratory pressure (SIPmax) as a training load, and those in group C (n = 10) received no training. Group T trained at home for 30 min daily, 6 days a week for 6 months.

Measurements: The measurements performed included spirometry, SIPmax, inspiratory muscle strength, and exercise capacity, which included maximal oxygen uptake (>O2), and minute ventilation (>E). Exercise performance was evaluated by the distance walked in the shuttle walking test (SWT). Changes in dyspnea and HRQL also were measured.

Results: Results showed significant increases in SIPmax, maximal inspiratory pressure, and SWT only in group T, with significant differences after 6 months between the two groups. The levels of >O2 and >E did not change in either group. The values for transitional dyspnea index and HRQL improved in group T at 6 months in comparison with group C.

Conclusions: We conclude that targeted IMT relieves dyspnea, increases the capacity to walk, and improves HRQL in COPD patients.

http://www.chestjournal.org/cgi/content/abstract/120/3/748                                                                                 Frank NV

How does emphysema cause disability? -- Patients with emphysema are often unable to carry out daily activities. They frequently find themselves short of breath (called "dyspnea" in medical terms) during normal activities. There are several reasons for this shortness of breath........

http://www.chestsurg.org/emphnew1.htm                                                                                                         Sharon AL

Groups Urge Heart Safety Trial for Vioxx, Celebrex By Ransdell Pierson (Reuters) -- Three prominent patient advocacy groups have urged Merck & Co. and Pharmacia Corp. to test whether their hot selling arthritis drugs increase the risk of heart attack and stroke, but the U.S. drug makers said they remain unconvinced such safety trials are warranted. The American Heart Association, the National Stroke Association and the Arthritis Foundation said safety studies on Merck's Vioxx and Pharmacia's Celebrex should begin as soon as possible. Their concern was prompted by a recent study suggesting the new medicines may cause blood clots that slightly increase the risk of heart disease.

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Celebrex Under Study for Lung Cancer Prevention at UCLA's Jonsson Cancer Center (AScribe News) -- Can a common anti-inflammatory drug help prevent lung cancer? Researchers at UCLA's Jonsson Cancer Center are seeking volunteers for two new research studies to find out. For the first time, the studies will investigate whether the anti-inflammatory drug Celebrex has the potential to prevent lung cancer in people at high risk of developing the disease, which is expected to kill more than 157,000 American men and women this year. One study involves lung cancer survivors who are at high risk of experiencing a recurrence or developing a new lung cancer. The other study involves individuals who smoke and are at high risk of developing lung cancer. Celebrex, a non-steroidal pill used to treat arthritis and other inflammatory diseases, has been approved by the U.S. Food & Drug Administration for use in preventing colon cancer in a group of patients who are at particularly high risk for the disease....

For more information on the studies, please call the Jonsson Cancer Center clinical trials hotline at 888-798-0719. http://newsstand.ascribe.org/medical/index.html                                                                                             Sharon AL

Study Reveals Clues to Muscle Decline in Elderly By Keith Mulvihill (Reuters Health) -- Contrary to the general belief about why muscle wanes with age, a new study shows that a decline in protein production is not the culprit. Researchers say this could be good news, since such a fundamental decline would be tough to prevent or reverse. Differences in the natural breakdown and synthesis of muscle protein between young and old men ``do not appear to explain muscle loss that occurs with age,'' according to the report in the September 12th issue of The Journal of the American Medical Association.

http://us.news2.yimg.com/f/42/31/7m/dailynews.yahoo.com/htx/nm/20010913/hl/elderly_2.html                             Sharon AL

The following is a Monday 'pome' about my recent visit to the Doctor. 

I walk in the office and say to the Doc, "I'm a member of EFFORTS. He goes into shock.
He asks in a whisper: "Is it the Feds?" I say, "No, it's an update on lung disease meds.
Read all these printouts, they don't need explaining. Learn how to treat me and upgrade your training."
He looks at the papers, then jumps to his feet. "I'll do it," he says. My mission's complete.

Beam me up, Gary                                                                                                                                            Ann UK

UCLA Neurobiologists Identify Brain Cells That Control Breathing -- For the first time, UCLA scientists have identified the small group of brain cells believed to originate breathing in mammals. Reported in the September issue of Nature Neuroscience, their discovery could lead researchers to new approaches to addressing serious health problems, such as sleep apnea and sudden infant death syndrome. In a previous study, the UCLA team had pinpointed a specific region of brain tissue called the preBotzinger Complex as the command post for controlling breathing in mammals. Now, within the region, they distinguished a small group of neurons responsible for issuing the commands that generate breathing.

http://www.ucsd.edu/                                                                                                                                         Sharon AL

Germany Breaks New Ground in Stem Cell Treatment BERLIN (Reuters) -- A German hospital said on Friday it had successfully treated a heart patient using adult stem cells, a first for the medical world. Ten weeks after the groundbreaking treatment the strength of the 46_year_old man's heart had significantly increased, the Heinrich-Heine University in the western city of Duesseldorf said. "The results of the treatments show the huge potential of adult stem cells,'' according to Bodo Eckehard Strauer, the heart specialist responsible. The university said the condition of six other heart patients who had undergone treatment using their own stem cells had also improved. The ethics of modern biotech research using stem cells from human embryos has triggered a heated debate around the world. At the heart of the issue is whether it is ethical for scientists to harvest stem cells--master cells that can develop into a variety of cells in the human body--from early stage human embryos for research, or whether life begins at conception and the cells should not be touched. Harvesting the cells destroys the embryo. Advocates of their use pin their hopes on studies that show stem cells may be useful in the development of new treatments for such ailments as heart disease, diabetes, Alzheimer's and Parkinson's disease. Those who argue against it say destroying human embryos is ending one human life to benefit another. Some scientists have argued that research using adult stem cells is sufficient and there is no need for research using embryonic stem cells. German scientists are not allowed to carry out research on German embryonic cells but are allowed to work with imported cells. Several German laboratories have announced their intention to begin such research.

http://dailynews.yahoo.com/htx/nm/20010824/hl/stemcell_germany_1.html                                                     Sharon AL

Human Kidney Kept Alive in Machine By DEANNA BELLANDI, (AP) -- A machine that simulates a warm human body kept a kidney functioning for almost 24 hours in a test of a technique researchers say could longer preserve donated organs. The team at the University of Chicago Hospitals announced Saturday that the kidney, the first human organ to be connected to the machine, functioned just as it would inside a human body after they connected it Friday at 5:30 p.m. It survived until researchers disconnected it later for study. Researcher Dr. David Cronin said the technique could also be used to test organs deemed questionable for transplantation to see if they're acceptable. Dr. Alan Langnas, chief of transplantation at the University of Nebraska Medical Center in Omaha, called the discovery exciting. ``If we can apply it to humans then I think it will have important implications in the practice of kidney transplanting in the United States,'' said Langnas, who was not involved in the research. He said a warm blood pumping system could help reduce the number of kidneys that don't work immediately after transplantation because kidneys are kept in cold storage before they are transplanted. Organs can become less effective the longer they are kept on ice, Cronin said. He said that puts tremendous pressure on transplant teams. Cronin would not disclose where the donor kidney came from, but he said it wasn't one that could have been used for a transplant. The warm blood preservation machine was developed by TransMedics Inc. of Woburn, Mass. The company is sponsoring the research. The machine works with a heart like pump that pushes blood through tubes into the kidney, which was kept at about body temperature. The kidney filtered the blood and produced urine that was collected in a bag. The kidney was also being fed with oxygen and nutrients. "That organ is happy,'' Cronin said of the kidney, which was placed in a plastic container next to the electronic equipment that runs the machine. Dr. Waleed Hassanein, president and CEO of TransMedics, said the company will submit its trials to the FDA in the fall and hopes to market its machine by next year. The machine is being tested at nine U.S. and British hospitals. Cronin said the next step is to test other organs on the machine. More than 500 animal organs, including hearts, lungs and livers, have already been tested.

http://dailynews.yahoo.com/htx/ap/20010825/hl/organ_transplants_2.html                                                             Sharon AL

Low Dose Theophylline Cuts Airway Inflammation in Mild Asthmatics (Reuters Health) -- Low dose theophylline is effective in reducing levels of airway eosinophils but does not change levels of exhaled nitric oxide (NO) in certain asthmatics, according to researchers in the UK and Germany. Dr. Kian Fan Chung of Imperial College, London, and colleagues note that there is "some" evidence that theophylline has an anti-inflammatory effect in asthma. However, the agent's effect on inflammatory markers such as sputum eosinophils and exhaled NO has not been established in corticosteroid-naive mild asthmatics. To do so, the researchers conducted a double-blind crossover study of 15 such patients who were randomized to treatment with theophylline 250 mg twice daily or placebo. At the end of each of two 5_week periods, measurement of exhaled NO was made, airway biopsies were taken and eosinophil levels in sputum and bronchoalveolar lavage (BAL) fluid were determined. There was no significant reduction in exhaled NO or improvement in lung function following theophylline treatment, the team reports in the July 15th issue of the American Journal of Respiratory and Critical Medicine. However, compared with placebo there was a significant reduction in sputum eosinophils (11.3% to 8.0%). This was also true of eosinophils in BAL fluid (3.4% to 1.7%) and in biopsy tissue (1.83% to 1.20%). Commenting on the findings, Dr Chung told Reuters Health that the main clinical implication is that "theophylline can be classed definitely as an anti-inflammatory agent for the treatment of asthma." Although compared with corticosteroids its anti-inflammatory activity may be weak, he added, "we should now consider whether to use it in combination therapy with inhaled corticosteroid therapy where additive benefit has been demonstrated." Am J Respir Crit Care Med 2001;164:273_276. 

http://www.medscape.com/reuters/prof/2001/08/08.27/20010824clin006.html                                                     Sharon AL

Foradil Better than Atrovent says Journal -- New results just published show Novartis' fast acting, long-lasting bronchodilator ForadilB. (formoterol fumarate) to be significantly better than the current gold standard therapy, ipratropium bromide, in reducing clinical symptoms of chronic obstructive pulmonary disease (COPD) and their impact on patients' lives. Results from a head-to-head clinical trial, published in the current issue of the American Journal of Respiratory and Critical Care Medicine demonstrate that the bronchodilating action of Foradil was significantly better than that of ipratropium bromide as early as five minutes after dosing and was still evident up to 12 hours later. While similar improvements in lung function were seen with each drug, only Foradil demonstrated a statistically significant improvement in all domains of patients' quality of life, as measured by the St George's Respiratory Questionnaire. By contrast, the effect of ipratropium bromide was similar to that of placebo. The improvement in pulmonary function produced by Foradil was associated with a reduction in daily symptoms, less use of rescue medication, and fewer 'bad days' _ defined as days where patients scored two or more on at least two of the marked individual symptoms and/or had a reduction in the peak expiratory flow rate from baseline of more than 20 %. Although this study did not compare Foradil with salmeterol, the other available long acting beta2_agonist, previous studies have shown that Foradil produced a more rapid onset of bronchodilation than salmeterol. Foradil, which is available in most major markets, was launched in the US earlier this year and is currently under review for approval by the US Food & Drug Administration (FDA) in the treatment of COPD. It is already available in several European countries.

http://dominoext.novartis.com                                                                                                                         Sharon AL

Sleep Apnea Ups Risk of Post Surgical Complication By Charnicia E. Huggins (Reuters Health) - People with serious breathing problems during sleep may be more likely to experience complications after hip or knee replacement surgery than their peers who do not have the sleep disorder, study findings suggest. In obstructive sleep apnea, the throat collapses during sleep causing sufferers to snort and gasp for breath. People with severe cases may have hundreds of these episodes every night, causing daytime sleepiness and possibly increasing their risk of high blood pressure and heart problems. "Most patients easily agree to see a heart doctor before surgery, but (they) are not urged to have their snoring and possible apnea evaluated because there was little information about possible complications of this during surgery," study author Dr. Peter C. Gay of the Mayo Clinic in Rochester, Minnesota, told Reuters Health. To investigate such complications, Gay and his colleagues studied 101 patients with obstructive sleep apnea who underwent hip or knee replacement surgery. For comparison, their study also included 101 hip and knee replacement patients who did not have the sleep disorder. Overall, the sleep apnea patients experienced more postoperative complications and more serious complications than did the comparison group, the investigators report in the September issue of Mayo Clinic Proceedings. And most complications occurred within the first 24 hours after surgery. Twenty individuals in the sleep disorder group had unplanned transfers to the hospital's intensive care unit (ICU) for reasons ranging from severely low blood oxygen levels to heart attack. In comparison, six individuals from the comparison group had unplanned ICU transfers. Patients with the sleep disorder also stayed in the hospital about 2 days longer than did their peers. "Since these patients tend to be more obese, receive sedating and narcotic medications, and are placed on their back after surgery, they would be more prone to have apnea leading to complications,'' Gay explained. However, among the 33 sleep apnea patients who reported using home continuous positive airway pressure (CPAP)--the standard treatment for moderate to severe sleep apnea, at the time of their surgery--there were fewer ICU transfers and a decreased incidence of serious complications. These individuals also had a slightly shorter hospital stay than did their peers who did not use CPAP. In CPAP, a facemask is used to introduce a gentle stream of air into the nose to keep the airway from collapsing. "What remains to be seen is whether we can prevent complications of (obstructive sleep apnea) in surgery patients by treating them with CPAP beforehand and in the hospital,'' Gay said. ``We have started a study to answer these questions as well.'' http://dailynews.yahoo.com/htx/nm/20010925/hl/apnea_1.html                                             Sharon AL

Study Confirms Obesity Is in the Genes (Reuters Health) - New study findings confirm what many would believe to be common sense--that overweight parents are more likely to have overweight children. The idea that body composition--the distribution of fat and muscle within the body--is a trait genetically passed on to children from their parents is not new, but for the first time researchers have confirmed previous findings by using an instrument called a dual energy x-ray absorptiometry (DXA). The investigators report their results in the October issue of the American Journal of Clinical Nutrition. "`This study used a DXA scan to determine the composition of the body. Previous studies had relied on weight and height measures only,'' lead author Dr. Margarita S. Treuth of Johns Hopkins University in Baltimore, Maryland, said in an interview with Reuters Health. "In addition, young girls and their parents were studied, whereas other studies have examined this in adult offspring,'' she added. In the study, 101 normal-weight girls between the ages of 8 and 9 and their biological parents participated in a battery of body measurements. The researchers measured body fat, body composition, levels of potassium and body mass index (BMI), a measure of weight in relation to height that is used to assess obesity in adults. In general, the investigators found that the girls' body fat composition, as measured by DXA, was similar to that of their parents. Girls with overweight parents tended to be on the heavier side of normal body weight for their age, while girls with leaner parents were more likely to be on the lighter side of normal, Treuth explained. The findings point to heredity as a factor that contributes to a person's body composition, she noted. "Now we know (which children) need to be targets for intervention,'' Treuth told Reuters Health. "Treatment and prevention of obesity may need to be targeted to children of overweight or obese parents in particular, since they will be at higher risk of related complications of obesity,'' she concluded.

SOURCE: American Journal of Clinical Nutrition 2001;74:529-533.                                 http://biospace.com/linkto.cfm?link=dailynews.yahoo.com/htx/nm/20010925/hl/obesity_1.html                             Sharon AL

Brain Scans Suggest Hypertension Impairs Memory (Reuters Health) - High blood pressure may cause changes in blood flow and brain activity that affect short-term memory, according to new research. In patients with high blood pressure, or hypertension, blood vessels often remodel themselves in ways that can impair blood flow, researchers note. To investigate whether this remodeling affected brain function, Dr. J. Richard Jennings of the University of Pittsburgh and Western Psychiatric Institute and colleagues used a type of brain scan called positron emission tomography (PET) to compare blood flow in the brains of people with high blood pressure and those without hypertension. He presented his findings here at the American Heart Association's 55th Annual Fall Conference of the Council for High Blood Pressure Research. Jennings and his team performed PET scans on 33 patients with hypertension and 62 patients with normal blood pressure. The patients ranged in age from 50 to 70. All had ultrasound and MRI scans of their carotid arteries, as well as a series of tests of neurological and psychological function. The patients with high blood pressure were not taking medication and had no history of stroke. All study participants were asked to perform a series of standardized memory tests during the PET scans, Jennings explained. Overall, the patients with high blood pressure scored slightly worse on tests of short-term memory. And those with measurable working memory impairment had less blood flow in the prefrontal and parietal regions of the brain than the patients with normal blood pressure. "Our hypothesis was that the brain of hypertensive patients has to adjust to blood flow,'' Jennings explained in an interview with Reuters Health. He and his colleagues expected to see less blood flow in certain parts of the brain, and more blood flow in the corresponding regions on the opposite side of the brain to compensate. He said analysis of the PET scans did indicate an increase in left hemisphere blood flow among patients with hypertension who had memory loss. That compensation, according to Jennings, may explain the slight memory loss. "Other regions are compensating but they are doing it in a slightly less efficient way,'' he said. Thus memory changes are "very slight. Similar to the type of difference you might see between a healthy 45-year-old and a 55-year-old.''

http://biospace.com/linkto.cfm?link=dailynews.yahoo.com/htx/nm/20010925/hl/hypertension_1.html                     Sharon AL

Stopping Smoking: the Re-starting is Worse for Your Health than Not Stopping at All By Cameron Johnston, DG News -- Smokers who quit for a while and then resume the habit might be doing more damage to their lungs than those who continue smoking. Swedish investigators reported these findings yesterday (September 24) at the annual meeting of the European Respiratory Society, in Berlin, Germany. As part of the Obstructive Lung Disease in Northern Sweden (OLIN) study, investigators looked at a cohort of more than 1,100 smokers and ex-smokers. Subjects were divided into five groups: 1) never smokers; 2) they had quit smoking before the 10-year study began; 3) they quit smoking after the study began; 4) they had never stopped smoking, and still smoked; 5) they quit smoking at some point during the 10-year study, then restarted. In terms of forced expiratory volume over one second (FEV1), it was observed that those who had quit but restarted had a 4.77 percent decrease of lung function over 10 years, while those who continued smoking lost only 3.3 percent of lung function. Those who quit smoking and then restarted also lost a mean of 44 mL per year in FEV1, while those who continued smoking and had never quit lost almost 39 mL per year. Those who had never smoked actually showed a mean FEV1 increase of 0.5 percent , while those who stopped more than 10 years ago had a loss in FEV1 of just 0.10 mL, and those who stopped within the past 10 years had a loss of 1.2 percent. According to Dr. Bo Lundback, an associate professor of medicine at the National Institute of Working Life, in Stockholm, Sweden, an average man of around 40-50 years of age would be expected to lose approximately 25 mL per year of lung function merely as a product of the lungs aging. Therefore, for a man to lose an additional four per cent or thereabouts over 10 years should be considered significant, he said. Dr. Lundback speculated that part of the reason for this phenomenon is that long-term smokers develop a natural defense mechanism, which keeps working as long as they are smoking. However, when a person stops and the re-starts, this in effect kick-starts the defense mechanism each time a person starts smoking again, and this puts extra strain on the body's defense system creating an oxidant/anti-oxidant imbalance.

http://www.docguide.com/news/content.nsf/news/941117DBB631EC0085256AD20056E7DD                                 Sharon AL

Testosterone Leads to Improvements in Lean Mass for Men with Pulmonary Disease By Cameron Johnston, DG News -- Testosterone injections, coupled with a well-planned exercise program, can help men with chronic obstructive pulmonary disease add significantly to their lean muscle mass, and overall body mass. The injections also increase men's weight and contribute to a general improvement in their quality of life, according to Dr. R. Casaburi, of the department of respiratory medicine, Harbor-University of California - Los Angeles Research and Education Institute, in Torrance, California, who presented a study on testosterone injections yesterday (September 24) at the annual meeting of the European Respiratory Society, in Berlin, Germany. Men with chronic obstructive pulmonary disease (COPD) tend to have low testosterone levels, which can seriously affect their overall quality of life. Dr. Casaburi's study enrolled 40 men with COPD and who were diagnosed with either very lowor clinically deficient testosterone levels (mean levels of 319 ng/dL). They were, in general, in poor health as a result of the COPD, with mean forced expiratory volume in one second (FEV1) of only 40 per cent predicted. They were a mean of 67 years of age, and none was obese according to body mass index. Patients were randomized into one of four groups: 1) placebo; 2) placebo plus a planned exercise program of 45 minutes three times per week;3) weekly injections of 100 mg testosterone ethanate; 4) weekly injections of100 mg testosterone ethanate plus the same exercise program over a 10-week period. At the end of the 10-week period, the men who received testosterone but did not do the exercise program showed weight gain of approximately 2 kg, while those who received testosterone and exercise gained a mean of 3 kg. By comparison, those who did not receive the steroid continued to lose weight. Dr. Casaburi said that the men actually gained lean muscle mass and lost body fat. Dual energy X-ray absorptiometry (DEXA) showed a mean increase in lean muscle leg mass of 8.7 percent for those in the testosterone and exercise arm, and of 5.9 percent for those receiving testosterone alone. By comparison, those who received the placebo and did not exercise lost 1.7 percent of lean leg mass, and those who exercised but did not receive testosterone increased lean leg mass by 3.4 percent. The men who received testosterone alone had an improvement in the amount of weight they were able to leg-press of 70 lbs; those who underwent the exercise program but did not receive testosterone improved their leg-press weight by 100 lbs, and those who received testosterone and underwent the exercise program improved their leg-press weight by 130 lbs. Dr. Casaburi said there were no increases in levels of prostate-specific antigen, in liver enzymes, or in blood lipids, all of which might have been expected with exogenous testosterone use. It is known that testosterone is often low in men with COPD - as it is with any chronic disease - but the reasons are unclear, Dr. Casaburi said. One reason may be that the brain has stopped secreting luteinizing hormone and follicle stimulating hormone, or it might be that the testes have become refractory. "It's both a gonadal and a pituitary problem, but I think the reasons why are best left up to endocrinologists," he commented. 
                                                                                                   http://biospace.com/linkto.cfm?link=dailynews.yahoo.com/htx/nm/20010925/hl/hypertension_1.html                         Sharon AL

Early Steroids Treatment Might Not Arrest Lung Function Decline In Obstructive Airway Disease By Cameron Johnston DG News -- Early use of inhaled corticosteroids does not appear to arrest the decline in lung function among symptomatic patients with obstructive airflow disease. Results of the small study, which were presented today (September 25) at the annual meeting of the European Respiratory Society, in Berlin, Germany, suggest that more aggressive treatments will be required in newly diagnosed individuals, if the loss of lung function is to be halted. The study, conducted in the Netherlands, by Dr. Mieke Albers and colleagues, The Netherlands, involved 49 people who had recently been diagnosed with obstructive airway disease who showed a decline in forced expiratory volume in one second (FEV1) of more than 200 mL per year. Twenty-four subjects received the inhaled corticosteroid (fluticasonepropionate, 250 mg b.i.d.) and another 25 received placebo for two years, followed by a seven-month open label extension study in which all subjects received the steroid. Outcome measurements, taken every six months, included lung function, reversibility and bronchial hyperresponsiveness (BHR), symptoms, atopy, allergy, exacerbations, health-related quality of life, functional status, smoking behavior, work disability and health care cost. There were no statistically significant differences in changes to FEV1 between groups at any point during the entire study period. "Overall, between the groups we found no difference in the course of lung function decline," Dr. Albers said in her presentation. "Therefore, we have to conclude that based on lung function parameters, there is no convincing scientific evidence that early use of inhaled corticosteroids alters the long-term prognosis of subjects with a rapid decline in lung function." Dr. Albers stopped short of recommending that inhaled steroids be withheld from patients who are already taking them, saying that lung function represents only one measurement parameter. Other parameters such as the number of exacerbations, quality of life, airway symptoms, and functional status still need to be evaluated, she said. The study was controlled for the small numbers, and for its short duration, she said, "but when we look at our figures, we are looking at just one very small part of the picture" and lung function is far from being the only consideration to bear in mind when treating chronic obstructive pulmonary disease. http://www.docguide.com/news/content.nsf/news/CFAA21DD7E297DC385256AD2005CCBA5                             Sharon AL

Hair Dye Use Linked to Type of Arthritis NEW YORK (Reuters Health) - Women who use hair dyes for more than 20 years may be nearly doubling their risk of developing rheum