martes, 4 de octubre de 2011

Biothera Completes Second Phase I Clinical Trial For Cancer Drug

Biothera, the immune health company, announced today that it has successfully completed its second Phase I clinical trial for Imprime PGG(TM), its lead compound for
activating the body's own immune system to fight multiple types of cancer.



The randomized, double-blind, placebo-controlled clinical study in
healthy volunteers indicates that Imprime PGG is safe and well tolerated
over a wide dose range. The results of the study support the continued
development of the drug candidate in multiple indications.



The dose-escalation study evaluated safety, pharmacokinetic and
pharmacodynamic responses at three dose levels (1, 2 and 4 mg/kg)
administered intravenously daily for seven continuous days. This study
followed a previous Phase I study in which Imprime PGG administered in
single doses was also shown to be safe and well tolerated in healthy
volunteers. A total of 36 volunteers participated in the two Phase I
studies.



"The consistent results of these studies confirm our expectations and
demonstrate that Imprime PGG has a strong safety profile," said Myra
Patchen, Ph.D., Biothera executive vice president of pharmaceutical
development. "We are looking forward to now quickly implementing our Phase
II clinical program in cancer patients."



Biothera's Phase II clinical trial program is scheduled to begin in the
fourth quarter of 2006.



"We are encouraged by these clinical findings and confident in the
ability of Imprime PGG to work synergistically with monoclonal antibodies
to treat numerous types of cancer," said Daniel Conners, Biothera founder
and chairman.



Preclinical research demonstrated that the combination of Imprime PGG
and various anti-cancer monoclonal antibodies significantly improved on the
effectiveness of antibodies alone as evidenced by reductions in tumor size
and increases in survival in multiple types of cancer, including breast,
lung and liver cancer.



About Biothera, the Immune Health Company



Biothera is a biotechnology company dedicated to improving immune
health. The company's primary focus is developing pharmaceuticals that
engage the immune system to fight cancer. Pharmaceuticals are also in
development to facilitate immune system recovery after damage from
chemotherapy or acute radiation exposure. In addition, Biothera
manufactures and markets food-grade ingredients that support healthy immune
function to the nutritional supplement, functional food, cosmetic and
animal nutrition markets. Website: biotherapharma.



Biothera

biotherapharma

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Metabolic Syndrome A Risk For Veterans With PTSD

Veterans with post-traumatic stress disorder (PTSD) are more likely to have metabolic syndrome than veterans without PTSD, according to a study led by Pia Heppner, Ph.D., psychologist with the University of California, San Diego School of Medicine and Veterans Affairs of San Diego, VA Center of Excellence for Stress and Mental Health (CESAMH). The study will be published online January 8 by the journal BMC Medicine.


Metabolic syndrome is composed of a cluster of clinical signs including obesity, high blood pressure and insulin resistance and is also associated with cardiovascular disease.


The researchers studied a group of male and female veterans presenting for screening and treatment within the PTSD programs at the Cincinnati Veterans Affairs Medical Center. The sample was primarily male (92%) and Caucasian (76%), with an average age of 52 years. A majority of the sample had served in the U.S. Army (71%), and close to 70 % were Vietnam-era veterans. Clinical data indicate that over half (55%) of these veterans had moderate to severe levels of PTSD and 64% met criteria for major depressive disorder (MDD). About 40% of the veterans met criteria for metabolic syndrome.


Controlling for other factors such as age, gender, depression and substance abuse, the researchers found that those with a higher severity of PTSD were more likely to meet the diagnostic criteria for metabolic syndrome. Additionally, the rate of metabolic syndrome was higher among those with PTSD (34%) than in those with MDD (29%). For those with both PTSD and MDD, 46% met criteria for metabolic syndrome.


"Our research indicates that stress and post-stress responses are related to long-term health outcomes," said Heppner. Studies show that veterans, prisoners of war and individuals exposed to severe trauma have higher rates of disease and increased use of health care, she continued. "Our findings suggest that metabolic syndrome provides a useful framework for assessing and describing the physical burden of PTSD and can be used prospectively to evaluate health risk that may be associated with combat exposure and PTSD."


Any traumatic event or series of events can cause PTSD and nearly 7.7 million Americans suffer from PTSD in any given year, according to the National Institute of Mental Health. A neuropsychiatric illness that was first formally diagnosed in soldiers and war veterans, it is now recognized to afflict many civilians as well. PTSD is caused by horrific, life-threatening and traumatic experiences that can occur during combat deployments. Symptoms include re-experiencing the trauma through flashbacks, intrusive thoughts and nightmares, avoidance of reminders of the trauma, excessive anxiety and trouble concentrating. Many people with PTSD also develop depression and substance abuse problems. Recent data from Afghanistan and Iraq suggest that more than one in ten military personnel involved in these conflicts develop PTSD.


The authors suggest that future research is needed to evaluate the specific mechanisms in which physiological responses to stress can increase long-term health risk.


Additional contributors to the paper include principal investigator Dewleen G. Baker, M.D., Niloofar Afari, Ph.D. and Richard L. Hauger, M.D.,VA San Diego Health Care System and UC San Diego Department of Psychiatry; Uzair A. Haji, M.D. and Sarah E. Nunnink, Ph.D.,VA San Diego Health Care System; Eric F. Crawford, Ph.D., Durham Veterans Affairs Medical Center; Boris A. Dashevsky, Ph.D.,Cincinnati VA Medical Center; and Paul S. Horn, Ph.D., Cincinnati VA Medical Center and University of Cincinnati.


Funding for the research was provided by VACO Research funds, the National Institutes of Health and the VA Center of Excellence for Stress and Mental Health.


University of California San Diego Health Sciences

200 W Arbor Dr.

San Diego

CA 92103

United States

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Researcher Transplants Stem Cells To Try To Save Patients' Legs

A Northwestern University Feinberg School of Medicine researcher has launched the first U.S. trial in which a purified form of subjects' own adult stem cells was transplanted into their leg muscles with severely blocked arteries to try to grow new small blood vessels and restore circulation in their legs.



The first two subjects in the 20-site national trial recently underwent the stem cell transplant process at Northwestern Memorial Hospital.



Severely blocked arteries in the leg and sharply diminished blood flow can result in wounds that don't heal, the breakdown of tissue and gangrene. This painful condition is called critical limb ischemia (CLI) and results in the amputation of more than 100,000 limbs every year in the United States. It's a serious, emerging health problem that affects 1.4 million people. An estimated 15 percent of the population will have this disease by the time they reach age 70.



The Northwestern-led phase I/IIa study -- which will include 75 people with CLI around the country -- targets patients who have exhausted all other medical options including angioplasty, stents and bypass surgery to repair blocked circulation in their legs.



"They're at the end of the therapeutic road and they're ultimately facing potential amputation," said Douglas Losordo, M.D., the Eileen M. Foell Professor of Heart Research and principal national investigator for the study. "This is hopefully a way to help them avoid that."



Losordo is director of the university's Feinberg Cardiovascular Research Institute and director of cardiovascular regenerative medicine at Northwestern Memorial Hospital.



"The stem cells themselves can assemble into blood vessels," Losordo said. "They can also secrete growth factors that stimulate and recruit other stem cells to come into the tissue and help with the repair. It's an amazing biology we're trying to leverage in these folks."



He said preclinical studies transplanting stem cells into the limbs have shown this approach to be effective in mice and rats. "Based on that, we think it has a good chance of helping humans," Losordo noted.



"This is a dreadful disease in which the profession has failed to offer much in the way of relief for these patients," Losordo said. "We're hoping this will have some impact."



Critical limb ischemia is the result of advanced peripheral artery disease, which affects about 10 million people in the United States. In peripheral artery disease, people develop blockages in their arteries and vessels that slow or stop the blood flow to their legs. When they have pain at rest in their lower legs and wounds on their legs or feet that will not heal, the condition is called CLI. If left untreated, CLI can result in a patient having toes, a foot or even a leg amputated.
















As CLI progresses, people begin to experience pain when they walk, then when just sitting. The worst pain is at night because blood flow is decreased when people lie down. Some have to sleep in chairs to aid the blood flow and lessen the pain.



"Peripheral artery disease is a big health problem," Losordo said. "There is an emerging awareness of this disease on public health."



High blood pressure, high cholesterol, smoking and diabetes all raise the risk of having the condition. But some people don't smoke, have diabetes or high blood pressure and can still have blocked arteries in their legs, Losordo said.



For the randomized, double blind, placebo-controlled trial, Losordo uses the subject's own purified stem cells. The subject first takes a drug for five days to stimulate the release of his or her stem cells, called CD34+ cells, from bone marrow. An intravenous line is then inserted into a subject's vein to collect blood through a machine that removes a population of blood cells that contains the CD34+ stem cells. Losordo further selects and enriches the cells to select only CD34+ cells.







Losordo's study is supported by Baxter Healthcare Corporation, which manufactures the Isolex 300i Magnetic Cell Selection System machine used in this investigational study. The Isolex 300i Magnetic Cell Selection System, which is approved for use in oncology patients, purifies the subject's stem cells to provide only the CD34+ stem cells. Losordo is also a paid consultant to Baxter.



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News From The Journal Of Clinical Investigation Online: April 11, 2011

EDITOR'S PICK Protein could improve recovery from heart attacks



Angiogenesis, the development of new blood vessels, is required during embryonic development and wound healing, as well as during disease processes such as tumor growth. The signals that direct angiogensis are incompletely understood, but could represent novel targets for the development of therapies that promote or inhibit this process.



In this paper, Young-Guen Kwon and colleagues, of Yonsei University in Seoul, Korea, investigated the role of two related proteins- DKK1 and DKK2- in angiogenesis. These proteins are known to have similar functions in inhibiting a particular cell signaling pathway, but Kwon and colleagues found that they played opposite roles in directing angiogenesis. Remarkably, they discovered that injection of DKK2 improved vascular regeneration in a mouse model of myocardial infarction (heart attack). The researchers are hopeful that pharmacological manipulation of DKK1 and DKK2 could be used to treat various vascular diseases.



TITLE: The WNT antagonist Dickkopf2 promotes angiogenesis in rodent and human endothelial cells



METABOLISM Mouse model reveals multiple roads to control blood sugar



Diabetes is a disease of uncontrolled blood sugar levels that results from absolute or relative insufficiency of the hormone insulin. Other hormones contribute to the regulation of blood sugar control and insulin release, and can also be dysregulated in diabetic patients. One of these is glucagon; diabetic patients display disordered glucagon signaling, and drugs that inhibit glucagon action are known to improve blood sugar levels in diabetic mouse models. When glucagon signaling is absent in mice, they are resistant to developing diabetes, but the interpretation of this model is complicated because the mice also have increased levels of a glucagon-related peptide called GLP-1, which itself is known to have similar physiological effects.



In order to better understand the roles of glucagon and GLP-1, Daniel Drucker and colleagues, from the University of Toronto, in Canada, generated mice in which the receptors for both had been deleted. Remarkably, the absence of GLP-1 signaling did not alter the improved glucose tolerance of mice lacking glucagon signaling. These mice had pancreatic islets that were more sensitive to other molecules that promote insulin release because they upregulate receptors for those alternative signals. The authors believe that their results demonstrate a plasticity of the many pathways that control insulin secretion.



TITLE: Dual elimination of the glucagon and GLP-1 receptors in mice reveals plasticity in the incretin axis
















ENDOCRINOLOGY Insight into a common disorder of the critically ill



Critically ill patients often display characteristic changes in levels of thyroid hormones, a condition called non-thyroidal illness syndrome (NTIS). One of the initial signs of NTIS is a low level of the active hormone triiodothyronine (also called T3), and lower T3 levels correlate with poor prognosis and survival. Therefore, understanding how hormone metabolism goes awry in patients without pre-existing thyroid gland disorders could help improve the outcome of individuals who suffer from multiple diseases. Increased levels of cell signaling molecules called cytokines, particularly Interleukin-6 (IL-6), are also associated with NTIS, but how these contribute to changes in T3 levels is not understood.



In this paper, Ana Maia and colleagues, of the Universidade Federal do Rio Grande do Sul, in Porto Alegre, Brazil, examined the effect of IL-6 on the enzymes that process T3. They found that IL-6 suppressed the action of the enzymes that generate T3, and promoted the action of the enzyme that deactivates T3. In addition, the effect of IL-6 could be inhibited by antioxidants. The researchers believe that these results suggest that a state of oxidative stress, common to many acute and chronic illnesses, may underlie the activation of IL-6 and initiation of NTIS.



TITLE: IL-6 promotes nonthyroidal illness syndrome by blocking thyroxine activation while promoting thyroid hormone inactivation in human cells



ONCOLOGY Research identifies pathway involved in breast cancer metastasis



In breast cancer, lymph node metastasis is a common occurrence, and the progression of the cancer in this way is a reliable predictor of patient survival. These metastases occur first in the lymph node close to the breast called the sentinel, and then progressively move to new lymph nodes. The mechanisms that control this movement of tumor cells are not well understood, but could represent novel targets to impede the progression of metastatic cancer.



In new research, Dontscho Kerjaschki and colleagues, of the Medical University of Vienna in Austria studied samples from human breast cancer patients, and found that in order to move into new lymph nodes, tumors cells first invade the lymphatic vessels that connect them. They further found evidence in model systems that this invasion requires that tumor cells generate an enzyme called 15-lipoxygenase. The researchers believe that this work suggests that inhibition of 15-lipoxygenase and related enzymes might be an effective strategy to prevent tumor spread.



TITLE: Lipoxygenase mediates invasion of intrametastatic lymphatic vessels and propagates lymph node metastasis of human mammary carcinoma xenografts in mouse



ONCOLOGY Autoimmune reaction could help fight melanoma



One potential approach to fighting cancer involves directing the T cells of the immune system to recognize molecules produced by tumor cells (antigens) and then attack those cells, a method called immunotherapy. However, the antigens produced by tumor cells may be identical to molecules produced by non-cancerous cells, and T cell recognition of these can result in an undesirable autoimmune attack. A naturally-occurring example of this is melanoma-associated vitiligo, in which immune cells directed against a skin cancer lesion also attack healthy melanocytes, resulting destruction of those cells and patches of skin that lack normal pigmentation.



In this paper, Mary Jo Turk and colleagues, of Dartmouth Medical School and the Dartmouth-Hitchcock Medical Center in Hanover, New Hampshire, investigated how vitiligo affected T cell responses to melanoma in mice. They found that destruction of melanocytes was required for tumor immunity, and further, that the T cells associated with vitiligo provided a lasting protection against tumor growth. The researchers believe that these data show that autoimmune destruction of normal tissues is a beneficial process that occurs as the body fights cancer, and propose that inducing vitiligo in melanoma patients might enhance their natural immune response.



TITLE: Autoimmune melanocyte destruction is required for robust CD8+ memory T cell responses to mouse melanoma



IMMUNOLOGY Targeting multiple pathways improves vaccine efficacy



One of the goals of vaccine design is to elicit strong reactions from multiple groups of immune cells, both those that confer an acute response to infection, and those that will provide a lasting immune memory. To achieve this, scientists have begun physically linking molecules that activate responses through different pathways. Researchers have previously immunized mice with proteins coupled to nucleic acids (so-called conjugate vaccines) so that they might stimulate both the adaptive and innate immune responses simultaneously. However, the mechanisms that explain the improved responses to these conjugate vaccines are not completely understood.



In this paper, Bob Seder and collaborators at the National Institutes of Health in Bethesda, Maryland, found that conjugating proteins to nucleic acids increased the uptake of the vaccine by dendritic cells. In addition, they found that conjugate vaccines induced the production of cytokines that contributed to the overall response. The authors believe that this work helps to define the responses to conjugate vaccines, and suggest new methods to enhance vaccine efficacy.



TITLE: Protective T cell immunity in mice following protein-TLR7/8 agonist-conjugate immunization requires aggregation, type I IFN, and multiple DC subsets



NEPHROLOGY Gene responsible for nephrotic syndrome and deafness identified



Nephrotic syndrome (NS) is a disorder that causes protein to leak from the blood into the urine, and a form of the disease that is resistant to treatment with steroids (SRNS) is frequent cause of end stage renal disease. SRNS has been linked to mutations in a few genes that are expressed in the podocyte cells of the kidney, but the genetic cause of the disease is unknown in the majority of cases, complicating the search for medical therapies. In new research, Friedhelm Hildebrandt and colleagues, of the Howard Hughes Medical Institute and the University of Michigan in Ann Arbor, performed genetic linkage studies to identify additional mutations that could cause SRNS. They found that in 13 patients, SRNS could be linked to mutations in the gene encoding COQ6, which is required for the synthesis CoQ10, an antioxidant enzyme with an additional role in the generation of cellular energy. Remarkably, treating these patients with CoQ10 improved renal function. Interestingly, the patients with COQ6 mutations also suffered from deafness, suggesting that this gene also plays a role in the nerve cells of the inner ear, though treatment with CoQ10 did not improve this defect. The researchers hope that by identifying the causitive mutations in NS patients, they may be better able to offer effective medical treatments.



TITLE: COQ6 mutations in human patients produce nephrotic syndrome with sensorineural deafness



IMMUNOLOGY Designing better CARs for cancer therapy



One new method of cancer treatment is the delivery of immune cells that have been genetically altered to express receptors that recognize tumor-specific molecules (so-called chimeric antigen receptors, CARs), and thus are directed to attack tumor cells. The addition of co-stimulatory molecules which enhance and sustain the immune response has improved the efficacy of this approach in pre-clinical studies. However, the precise design of CARs has been controversial, and it remains unclear whether they will be effective in human patients.



In new research, Gianpietro Dotti and colleagues, at Baylor College of Medicine in Houston, Texas, directly compared the efficacy of two CAR designs in patients with non-Hodgkin lymphoma. They found that the addition of the co-stimulatory molecule greatly enhanced the immune response, and made it more durable. The researchers hope that this clinical study will have far-reaching implications for the design of this type of immunotherapy.



TITLE: CD28 costimulation improves expansion and persistence of chimeric antigen receptor-modified T cells in lymphoma patients



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Versartis Presents Preclinical Data For Novel Type 2 Diabetes Drug

Versartis, Inc. today presented preclinical data demonstrating the potential for monthly dosing of its lead product, VRS-859 (exenatide-XTEN), for the treatment of type 2 diabetes. The data were presented by Jeffrey Cleland, Ph.D., Founder and Chief Executive Officer of Versartis, at the IBC Protein Engineering & Design Conference in San Diego.


In his talk, "Half-life Extension and In Vivo Biological Activity of Peptide and Protein Therapeutics," Dr. Cleland presented VRS-859 preclinical data in models of diabetes and pharmacokinetics in mice, rats, dogs and monkeys. Versartis has begun development activities for VRS-859 including manufacturing and regulatory meetings. A clinical study of VRS-859 in patients with type 2 diabetes is planned for the first half of 2010.


Versartis is also finalizing lead selection for VRS-317 (human growth hormone-XTEN), a monthly dosage form. Dr. Cleland presented preclinical proof of concept and pharmacokinetic data. Versartis plans to begin Phase I clinical trials of VRS-317 in patients with growth hormone deficiency in the second half of 2010.


In addition to the reduced dosing frequency, Versartis' XTEN products enable room temperature stability and low cost manufacturing. The XTEN properties allow for co-formulation and co-administration of proteins and peptides that are normally incompatible. Versartis is conducting research on combination products for metabolic disease to exploit these novel properties.


"Versartis is focusing on treatments for metabolic and endocrine diseases that currently require daily or weekly dosing," explained Dr. Cleland. "Our results to date demonstrate the potential for monthly dosing of our compounds. The potential for improved convenience along with other XTEN properties provide a distinct advantage for Versartis' products over other products on the market or in development."


Source

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Dementia Won't Improve With Procaine, And Health Might Suffer

Procaine, a medication that functions as a topical anesthetic normally, has been touted as an anti-aging drug that might prevent or even reverse dementia. However, a new Cochrane Review suggests that the risks of bad side effects outweigh any benefit.


"There is a lot of information, especially on the Internet, about the effect of procaine, promoting this drug for age-related problems, including dementia," said lead author Szabolcs Szatm? ri at the University of Medicine and Pharmacy in Romania. "At the same time, there were no available updated medical guidelines or evidence-based data for doctors and patients about procaine."


The review included three studies involving 427 patients. Data from these studies showed high incidence of side effects such as restlessness, dizziness, migraine headaches and systemic lupus erythematosus, a disease in which a person's immune system attacks itself.


The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.


The authors found two older studies of healthy elderly persons suggesting that procaine might have a positive effect on memory in those who have no cognitive impairment. A third study, however, showed a worsening effect on people with dementia after one month of procaine treatment.


"There is not enough evidence to recommend procaine compounds for preventing or treating dementia," Szatm? ri said. "Using procaine preparations carries some risks, and there are more useful interventions related to cognitive impairment. Yet there is still strong marketing activity despite this lack of evidence of effect and also despite the decision of the Food and Drug Administration in 1982 to prohibit the importation of procaine preparations into the United States."


Procaine preparations are available in more 70 countries and estimates indicate that more than 100 million people might use them. Although officially banned in the United States, offshore Internet pharmacies can provide the compound to American consumers.


"The compound appears to be widely used outside the U.S. as an over-the-counter cognitive enhancer," said Paul Newhouse, M.D., a professor of psychiatry at the University of Vermont College of Medicine. "But there is no evidence that it does anything at all and even some evidence it is toxic. At this point, it cannot be recommended for any use as a cognitive enhancer or a way to treat dementia."


Newhouse, who is also the research director of the Memory Clinic at the university, said he had heard about this use for procaine compounds 25 years ago, but thought it had fallen out of use in the interim. However, the advent of the Internet apparently has renewed interest.


"I guess I shouldn't be surprised since people are trying to sell many different unproven remedies through the Internet," he said.


There is no rational biological reason for procaine to work as a way to enhance cognitive function, Newhouse said.


"Usually, you have to at least come up a plausible theory about why your drug might be useful," he said. "Procaine works to inhibit sodium channels (in the cells) and thus chemically stabilize nerve cells and actually reduces their ability to fire. Why that should have cognitive enhancing effects eludes me."


The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit cochrane for more information.


Szatm? ri S, et al. Procaine treatments for cognition and dementia (Review). Cochrane Database of Systematic Reviews. 2008, Issue 4.


Health Behavior News Service

Center for the Advancement of Health, 2000 Florida Ave. NW, Ste. 210

Washington, DC 20009

United States

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Potential Detection Of Breast Cancer Spread: New Technique

A new phase III clinical trial of early stage breast cancer patients has shown that a molecule designed to home in on nearby lymph nodes is just as accurate as current techniques, but faster, more specific and easier to use.



"These results will really enable molecular biology to enter the operating room for lymph node detection," said breast surgeon Anne Wallace, MD, professor of clinical surgery at the UC San Diego School of Medicine and the Moores UCSD Cancer Center, and one of the study leaders. Wallace described her team's results May 7, 2009 at the 3rd International Symposium on Cancer Metastasis and the Lymphovascular System in San Francisco.



When a woman has breast cancer, doctors want to be sure that the disease has not spread to her lymph nodes, the first place a cancer may go. The lymphatic system is a network of vessels, ducts and glands that usually carry disease-fighting cells throughout the body, but also can act as a conduit for cancer cells to access the bloodstream.



According to Wallace, the presence or absence of cancer in lymph nodes is an important predictor of breast cancer prognosis, and as a result, the appropriate treatment. But finding the right lymph nodes to test and a standardized method of doing so hasn't been easy.



Wallace and David Vera, PhD, professor of radiology at the UC San Diego School of Medicine, were instrumental in the early development and testing of the molecule, called Lymphoseek®, a radiopharmaceutical that binds to the receptor on lymph node white blood cells called macrophages. The radioactive portion of the molecule essentially lights up, enabling detection of such nearby "sentinel nodes" that are the most likely candidates to biopsy for possible cancer.



The trial, led by research teams at the Moores UCSD Cancer Center, the Moffit Cancer Center in Tampa, FL and other centers, along with the Dublin, OH-based Neoprobe Corporation, which developed Lymphoseek, compared the molecule's ability to detect nearby sentinel lymph nodes to that of the standard method using blue dye and a radioactive tracer substance.



In the trial, the Moores Cancer Center team, which also examined the technique separately in melanoma patients, looked at 46 early stage breast cancer patients. Each patient received Lymphoseek, and a short time later, blue dye - which can also be detected and imaged as it enters the lymph nodes.



The surgeons removed the detected lymph nodes, which were subsequently sent to pathologists to determine whether cancer was present. The researchers found that more than 98 percent of sentinel lymph nodes containing blue dye also had Lymphoseek. Twenty-eight percent of the lymph nodes were positive for cancer, 100 percent of which were detected by Lymphoseek.



"The advantage in Lymphoseek is that we now have an agent that is tested and designed specifically for detection of sentinel lymph nodes," Wallace said, noting that blue dye is not specific for this use, lasts a shorter time in the body and may not always go to only sentinel nodes. "Lymphoseek is easier to use, takes less time to find lymph nodes and is cleared faster from the body. This could standardize the process of lymph node mapping and make the process easier, particularly for less experienced surgeons."



According to Wallace, these results could lead to other research on receptor binding imaging for different types of cancers, and propel the field of imaging cancer based on molecular profiling.



Wallace received early funding support from Susan G. Komen for the Cure, the American Cancer Society and the National Institutes of Health.



Karl Limmer, MD, UC San Diego, is study co-author.



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Cyclacel Initiates Phase 2 Sapacitabine Trial In Elderly Acute Myeloid Leukemia Patients

Cyclacel Pharmaceuticals, Inc. has announced the opening of an open-label, multicenter, randomized Phase 2 clinical trial of oral sapacitabine in elderly patients with acute myeloid leukemia (AML) who are previously untreated or in first relapse. This study follows the encouraging anti-leukemic activity observed in a Phase 1 trial of oral sapacitabine in patients with advanced leukemias or myelodysplastic syndromes (MDS) in which previously treated patients with AML or MDS achieved complete remission (CR) or complete remission without platelet count recovery.


"The opening of this study marks the expansion of the Phase 2 program of sapacitabine," said Dr. Judy Chiao, Vice President of Clinical Development and Regulatory Affairs of Cyclacel. "Sapacitabine is also undergoing Phase 2 evaluation in patients with advanced cutaneous T-cell lymphoma and has been given as a single agent to approximately 170 patients in four Phase 1 studies."


The Phase 2 study is led by Hagop Kantarjian, M.D., chair of the Department of Leukemia at The University of Texas M. D. Anderson Cancer Center in Houston, Texas. The primary objective of this study is to evaluate the 1-year survival rate of three dosing schedules of sapacitabine in elderly patients with previously untreated or first relapsed AML. Secondary objectives are to assess the number of patients who have achieved a CR or CR without blood count recovery (CRi), duration of CR or CRi, transfusion requirements, number of hospitalized days and safety.


The study uses a selection design with the objective of identifying a dosing schedule which produces a better 1-year survival rate in the event that all three dosing schedules are active. The trial will enroll a total of approximately 60 patients or approximately 20 patients in each arm. The study uses a Bayesian continuous monitoring rule to stop accrual in one or more arms of the study in the event that a dosing schedule does not appear to have a sufficient number of responses.


About sapacitabine


Sapacitabine appears to act through a dual mechanism. It interferes with DNA synthesis by causing single-strand DNA breaks and also induces arrest of cell cycle progression mainly at G2/M-Phase. Both sapacitabine and CNDAC, its major metabolite or a substance into which the drugs converts after ingestion by patients, have demonstrated potent anti-tumor activity in preclinical studies. In addition, in a mouse model of liver metastasis, sapacitabine was shown to be superior in terms of delaying the onset and growth of liver metastasis to either gemcitabine (Gemzar®; Lilly) or 5-FU, two widely used nucleoside analogs. Gemcitabine is indicated for the palliative treatment of breast, lung, ovarian and pancreatic cancer, but it has not been reported to be active in leukemias or MDS.















The Phase II study opened today follows three Phase 1 trials in solid tumors or lymphomas involving over 120 patients which evaluated safety and pharmacokinetics of a variety of dosing schedules for future Phase 2 studies and combination studies with other anti-cancer agents. A fourth Phase 1 trial evaluated two treatment schedules of sapacitabine in 47 patients with advanced leukemias or myelodysplastic syndromes (MDS) in which previously treated patients with AML or MDS achieved complete remission (CR) or complete remission without platelet count recovery. In addition to the Phase 2 study in elderly AML patients, a further Phase 2 study of sapacitabine is currently ongoing in patients with advanced cutaneous T cell lymphoma.


Sapacitabine is part of a deep pipeline of small molecule drugs designed to target and stop uncontrolled cell division. Cyclacel's other development programs include seliciclib, a CDK (cyclin dependent kinase) inhibitor in two randomized Phase 2 clinical trials for non-small cell lung cancer and nasopharyngeal cancer, and CYC116, an Aurora kinase and VEGFR2 inhibitor in Phase 1 development in patients with solid tumors.


About Cyclacel Pharmaceuticals, Inc.


Cyclacel is a biopharmaceutical company dedicated to the discovery, development and commercialization of novel, mechanism-targeted drugs to treat human cancers and other serious disorders. Cyclacel's ALIGN Pharmaceuticals subsidiary markets directly in the U.S. Xclair® Cream for radiation dermatitis, Numoisyn® Liquid and Numoisyn® Lozenges for xerostomia. Three Cyclacel drugs are in clinical development. Sapacitabine (CYC682), an orally-available, cell cycle modulating nucleoside analog, is in two randomized Phase 2 studies for the treatment of cutaneous T-cell lymphoma (CTCL) and elderly acute myeloid leukemia (AML) and in Phase 1 in patients with hematologic malignancies. Seliciclib (CYC202), an orally-available CDK (cyclin dependent kinase) inhibitor, is in two randomized Phase 2 studies for the treatment of lung cancer and nasopharyngeal cancer. CYC116, an orally-available, Aurora kinase and VEGFR2 inhibitor, is in Phase 1 development in patients with solid tumors. Several additional programs are at an earlier stage. Cyclacel's strategy is to build a diversified biopharmaceutical business focused in oncology, hematology and other therapeutic areas based on a portfolio of commercial products and a development pipeline of novel drug candidates.


The Cyclacel logo and Cyclacel® are trademarks of Cyclacel Pharmaceuticals, Inc. Numoisyn® and Xclair® are trademarks of Sinclair Pharma plc.


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Forward-Looking Statements & Risk Factors


This news release contains certain forward-looking statements that involve risks and uncertainties that could cause actual results to be materially different from historical results or from any future results expressed or implied by such forward-looking statements. Such forward-looking statements include statements regarding, among other things, the efficacy, safety, and intended utilization of Cyclacel's product candidates, the conduct and results of future clinical trials, plans regarding regulatory filings, future research and clinical trials and plans regarding partnering activities. Factors that may cause actual results to differ materially include the risk that product candidates that appeared promising in early research and clinical trials do not demonstrate safety and/or efficacy in larger-scale or later clinical trials, the risk that Cyclacel will not obtain approval to market its products, the risks associated with reliance on outside financing to meet capital requirements, and the risks associated with reliance on collaborative partners for further clinical trials, development and commercialization of product candidates. You are urged to consider statements that include the words "may," "will," "would," "could," "should," "believes," "estimates," "projects," "potential," "expects," "plans," "anticipates," "intends," "continues," "forecast," "designed," "goal," or the negative of those words or other comparable words to be uncertain and forward-looking. These factors and others are more fully discussed under "Risk Factors" in the Annual Report on Form 10-K for the year ended December 31, 2006, as supplemented by the interim quarterly reports, filed with the SEC.


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Errors Lead To Physician Distress, With Distress Making Errors More Likely

Physicians who believe they have committed a major medical error in the previous three months are more likely to report symptoms of burnout and depression, which may also increase the risk of a future error, according to findings of a Mayo Clinic study published in the current issue of Journal of the American Medical Association (JAMA).



Since the Institute of Medicine's 1999 report that as many as 100,000 patients die each year because of preventable medical errors, several studies of physicians in medical and surgical residency programs have found that a significant proportion of medical trainees make medical errors. "In addition to the obvious negative effects of errors on patients, studies have shown that the physicians involved often experience guilt, shame, distress and depression," says Tait Shanafelt, M.D., the Mayo Clinic physician who led the current study. "Better understanding these effects on physicians, and how they may affect the care future patients receive, is the goal of our research."



Previous studies asking residents about errors either had taken a single snapshot in time or asked residents to look back on their entire residency and recollect whether they had made a serious error. The Mayo study is the first to follow a group of residents prospectively, enabling researchers to examine the relationship between physician distress and the future likelihood of an error.



"We knew from previous studies some of the effects on physicians of making an error," explains Dr. Shanafelt. "This new study takes it a step further, enabling us to see the time relationship between errors and burnout, and vice versa."



The researchers followed 184 medical residents from 108 U.S. and international medical schools who were continuing their training in the Mayo Clinic Rochester Internal Medicine Residency program. Residents completed quarterly surveys asking, "Are you concerned you have made any major medical errors in the last three months?" They also completed validated survey instruments to measure quality of life and burnout, and to screen for depression.



On average, 14.7 percent of the participants reported making an error in the previous three months on each quarterly survey. Those who reported an error experienced substantially higher levels of burnout and were more than three times more likely to have a screening test indicate possible depression.



The connection between errors and various measures of distress also operated in reverse; those who scored high on burnout measures were twice as likely to report an error in the next three months as those with low burnout. The study also found a trend toward increased future errors for physicians with symptoms of depression.



"Not only are physicians who perceive they have made errors more likely to experience burnout and symptoms of depression, but those who are distressed appear more likely to make an error in the next three months," says Dr. Shanafelt.



"Much of the quality improvement movement has rightly focused on adjusting systems to prevent errors," says study author Colin West, M.D., Ph.D. "It's important to do whatever we can in the practice environment and care system to build in safeguards, but our study highlights the human dimension. If a physician is experiencing personal distress, it makes a future error more likely. Making an error also has a strong effect on burnout, empathy and depression, and this forms a vicious cycle that can negatively impact patient care."



The researchers say additional study is needed to identify effective approaches to assist physicians who have made medical errors, and that residency programs, HMOs, and hospital administrators should also establish efforts to prevent, identify and treat burnout in physicians, for the benefit of their patients. Mayo Clinic is committed to continue to study this problem and identify solutions, and has made several strategic changes to its residency program to address physician burnout.







The study was funded by a Medicine Innovation Development and Advancement System (MIDAS) grant from the Mayo Clinic Department of Medicine. In addition to Dr. Shanafelt and Dr. West, other authors of the paper include Mashele Huschka; Paul Novotny; Jeff Sloan, Ph.D.; Joseph Kolars, M.D. and Thomas Habermann, M.D.



Contact: John Murphy


Mayo Clinic


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President Clinton's surgical procedure successful

On Thursday, former President Bill Clinton underwent a surgical procedure to remove scar tissue and fluid from his left
chest cavity.


The surgery - called decortication - was deemed a success by his medical team at New York-Presbyterian Hospital/Columbia
University Medical Center.


Patients typically "make a full recovery and have no limitations in the future," according to Hartzell Schaff, M.D.,
professor of surgery, Mayo Clinic, in Rochester, Minn., and an American Heart Association spokesperson.


Decortication is the removal of scar tissue and fluid build from the chest cavity. Fluid build up in the chest cavity - a
condition called pleural effusion - can be a complication of coronary artery bypass surgery. Clinton had quadruple bypass
surgery in September.


About 5 percent to 10 percent of heart bypass surgery patients develop pleural effusion, Schaff said. Most of the time, the
body reabsorbs the fluid. However, fluid can been removed with a needle.


If the fluid buildup is chronic, scar tissue can form a wall around a portion of the lung and interfere with lung expansion.
This may cause the patient to experience shortness of breath. Less than one percent of heart bypass patients who develop
pleural effusion require surgery to correct it, Schaff said.


A 2002 study in the New England Journal of Medicine noted that pleural effusion in the United States occurs in 60,000
coronary artery bypass surgery patients annually.


Pleural effusion requiring surgical correction rarely reoccurs.


Media Advisory - American Heart
Association

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Sunshine Pill For Prostate Cancer In 2009?

A tablet designed to emulate the healing power of the sun could be available for the treatment of advanced prostate cancer as early as 2009. But it remains to be seen whether the drug will be the revolution in prostate cancer care that its makers claim.



The drug, Asentar (DN-101), is based on vitamin D and is given to patients in the advanced stages of prostate cancer along with chemotherapy drugs. Drug makers came up with the idea because vitamin D from sunlight improves the prognosis of certain cancers. But taking natural levels of the vitamin has no effect. Novacea, the company that makes Asentar, produced a novel formulation that reproduces the healing effect without the dangerous side-effects of a vitamin D overdose. If the on-going phase III trial goes to plan, the new drug should be available in 2009, reports Chemistry & Industry, the magazine of the SCI.



'If the results of the phase III trial are as good as those of the phase II trial, that would be significant,' says Nick James, professor of oncology at the University of Birmingham. In the phase II trials, Asentar significantly improved survival rates, 9 months over patients taking chemotherapy drugs (taxotere) alone. 'On average, patients in the advanced stage of the disease survive about 18 months, so an extension of 9 months would be very significant in my view,' says James.



Asentar provides levels of vitamin D 50-100 times higher than normal. Patients would be expected to take one tablet once a week with their weekly regime of taxotere for three weeks out of every four.



Business analysts say Asentar is a potential blockbuster, because prostate cancer rates are expected to soar in the next few years. But James is not so sure. 'A confounding factor is that if you go looking for more cases of cancer, you will find them. But this does not give you an accurate estimate of how many people will go on to develop advanced disease. In fact death rates are going down, which means that the market for this drug is probably pretty static.'



James also points out that it is far from certain that the Phase III trials will repeat the success of early trials. 'The phase II trial used a less than optimal taxotere regime so the survival rate may have been artificially inflated,' he says. He points out, however, that it may be that the Asentar will eventually prove applicable in the earlier stages of the disease.



Prostate cancer is the second leading cause of cancer death in men. Prostate cancer kills one man every hour in the UK.






Chemistry & Industry


Please acknowledge Chemistry & Industry as the source of these items. If publishing online, please include a hyperlink to chemind/ Please note Chemistry & Industry uses '&' in its title, please do not correct to 'and'.



About Chemistry & Industry


Chemistry & Industry magazine from SCI delivers news and comment from the interface between science and business. As well as covering industry and science, it focuses on developments that will be of significant commercial interest in five- to ten-years time. Published twice-monthly and free to SCI Members, it also carries authoritative features and reviews. Opinion-formers worldwide respect Chemistry & Industry for its independent insight.



About SCI


SCI is a unique international forum where science meets business on independent, impartial ground. Anyone can join, and the Society offers a chance to share information between sectors as diverse as food and agriculture, pharmaceuticals, biotechnology, environmental science and safety. As well as publishing new research and running events, SCI has a growing database of member specialists who can give background information on a wide range of scientific issues. Originally established in 1881, SCI is a registered charity with members in over 70 countries.



Contact: SCI Press Office


Society of Chemical Industry



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Could Supplementation Of Docosahexaenoic Acid Suppress Colon Tumor Cell Growth?

Colon cancer is one of the leading causes of death in Western countries. The role of n-3 and n-6 PUFAs in colorectal carcinoma cell growth has not been well studied. It is known that PGE2, generated from AA, is an important factor in the tumorigenesis of colorectal cancer. However, previous in vitro observations have led to uncertainty regarding a differential role of n-3 and n-6 PUFA for growth of tumor cells, as some findings are contradictory, and most studies have not addressed the effect of a changed n-3/n-6 PUFA ratio on cell proliferation.



A research article published on March 7, 2009 in the World Journal of Gastroenterology addresses this problem. The research team around Piet Habbel and Karsten H. Weylandt from the Charit?© University Hospital in Berlin (Germany) and led by Jing X. Kang from the Massachusetts General Hospital in Boston (USA) used the LS-174T colon cancer cell line, for which several previous studies have shown an important role of PGE2 as growth promoting agent. The study showed differential effects of n-6 PUFA AA and n-3 PUFA DHA. While proliferation was promoted by AA, incubation with DHA reduced cell growth and viability. In addition, this study demonstrated that the n-3 PUFA DHA can directly suppress AA- as well as PGE2-induced colon cancer cell growth.



These results add evidence to the argument that the ratio of n-6/n-3 PUFA (and in particular the ratio of AA versus DHA) may be a critical determinant of proliferation and tumor growth in the colon, and that DHA supplementation can suppress tumor cell growth, even in the presence of high AA- and PGE2 levels. These results suggest that supplementation of DHA may be a powerful tool to counteract AA- and PGE2-promoted colon cancer cell growth that is associated with the predominant Western diet.



Notes:



Reference: Habbel P, Weylandt KH, Lichopoj K, Nowak J, Purschke M, Wang JD, He CW, Baumgart DC, Kang JX. Docosahexaenoic acid suppresses arachidonic acid-induced proliferation of LS-174T human colon carcinoma cells. World J Gastroenterol 2009; 15(9): 1079-1084
wjgnet/1007-9327/15/1079.asp



Correspondence to: Karsten H Weylandt, MD, PhD, Dr. Kang's Lab, Massachusetts General Hospital, 149-13th Street, Room 4433, Charlestown, MA 02129,United States.



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Acellular Dermal Matrix And Short Bowel Syndrome

Acellular dermal matrix (ADM) is a dermal biomaterial in which all of the cellular elements have been removed. The biologic properties of ADM, including its ability to support tissue regeneration repopulation with fibroblasts, revascularization, new collagen deposition and eventual absorption and replacement with native tissue permit its use in tissue reconstruction. A few studies for intestinal elongation have been performed, but the results are uncertain.



The research, led by Professor Wang from Department of General Surgery of Beijing Chaoyang Hospital, was published on April 28,2010 in World Journal of Gastroenterology. The study was designed to use both the home-made and commercial acellular dermal matrix materials to investigate the efficacy of acellular dermal matrix for intestinal elongation. Different species were transplanted with the allograft materials respectively. Severe adhesions were found between the graft and surrounding intestine. The grafts were completely absorbed within postoperative two or three months except one. Histological observation showed inflammation in the grafts with fibrinoid necroses, infiltration of a large amount of neutrophils and leukomonocytes, and the degree varied in different stage. The neointestine with well-formed structures wasn't observed in the study.



It is believed that the ADM can be used as a scaffold for tissue regeneration with the normal morphology of the mucosa, submucosa, muscle and serosa layers. But it is not always the truth. In this study, the grafts were almost completely absorbed in two or three months. Pus could be seen in the lumens of ADM and histological examination showed the inflammatory exudates of neutrophils and pus cells. The authors presumed inadequate blood supply and the rapid absorption perhaps were the most likely reasons.



This study was well designed according to previous work, but it showed a different result. The authors gave some possible reasons, which were worthy of in-depth study. Perhaps ADM can be used for intestinal elongation, but this study showed that some reforms were necessary.



Reference:
Xu HM, Wang ZJ, Han JG, Ma HC, Zhao B, Zhao BC. Application of acellular dermal matrix for intestinal elongation in animal models. World J Gastroenterol 2010; 16(16): 2023-2027



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Lab Group Recognizes The National Changing Diabetes Program For New Study On Quality Measures In Diabetes

The American Clinical Laboratory Association's Results for Life Campaign (RFL) recognized the National Changing Diabetes Program (NCDP) for funding a newly published study on quality measurement in diabetes care. The NCDP, funded by Novo Nordisk, is a multi-faceted initiative to help bring about dramatic improvement in the prevention and care of diabetes.


The study, by researchers from Thomas Jefferson University in Philadelphia and published today in the journal, Population Health Management, evaluated the strengths and weaknesses of current quality measurement efforts in diabetes.


"This is another important study in the battle against diabetes because it helps all parties -- providers, payers, patients, and policymakers -- better understand the strengths of quality measures, as well as areas in which they can be improved, for one of the most damaging and costly diseases we face," said David Mongillo, Vice President of Policy and Medical Affairs of the American Clinical Laboratory Association. "If we are to make serious progress against diabetes, we must have the best metrics to show which strategies are most successful in improving prevention, patient outcomes, and cost-effectiveness."


Mongillo said he was also pleased that the study reinforced a Lewin Group report released by ACLA/RFL in late September that found that the HbA1c blood test is playing an increasingly significant role in identifying and managing diabetes. Lewin reported that the test, which reflects the average blood sugar levels during the preceding 2-3 months, improves clinical decision-making for early lifestyle and therapeutic interventions that can reduce the incidence of type 2 diabetes. Lewin found also that the test was more likely to yield reliable data because it did not require patients to fast beforehand.


"The data from the HbA1c test will be among the most important tools in measuring performance, not only of individual providers and institutions, but also of our entire population in battling diabetes," said Mongillo. "So we are pleased with efforts to seek the best ways of using that data in quality measures and related metrics."


NCDP also recently supported publication of a study in the health policy journal, Health Affairs, entitled "Using Clinical Information to Project Federal Health Care Spending." That study focused on the long-term costs and savings of efforts to control diabetes and its complications.


The American Clinical Laboratory Association represents the nation's clinical reference laboratories. The group's educational campaign, Results for Life, focuses on the value of laboratory medicine.


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Popular New Generation Of Candy Almost Like Eating Battery Acid, Say California Dental Hygienists

Looking for a really frightening costume to wear for Halloween this year? How about dressing up as a piece of sour acid candy, which attacks teeth like Freddy Kreuger goes after his victims?


While this new generation of candy is highly popular, most of it contains acid levels so high that it approaches the ph level of battery acid, according to the California Dental Hygienists' Association (CDHA), which today issued a statewide warning to parents about the dangers of sour candy.


"This Halloween, we are advising adults to think twice about buying sour candies for trick-or-treaters," said Erika Feltham, a Registered Dental Hygienist and CDHA member who has studied this issue for more than a decade. "We also are encouraging parents to comb through their child's bag at the end of the night to remove sour acid candies and replace them with a small piece of non-sour sugarless candy or gum."


Sour candy comes in dozens of varieties and forms including hard, soft, chewy, gummy, gels, liquid sprays, crystals, foam sprays, powders, cotton candy and chewing gums. Most people think this type of candy is safer because it has less sugar, said Feltham, but they don't know that the acid content is toward the extreme end of the acidic spectrum.


"It is not at all surprising that this candy is a contributing factor to acid erosion," she said. "With repeated exposure and frequency, sour candy can also lead to a host of oral health problems, including increased cavities, tooth sensitivity, staining, soft-tissue sensitivities and loss of shine."


Because of this, CDHA is offering the following tips for this Halloween:


- Avoid, limit or seriously reconsider choosing or eating candy labeled "sour or tart";


- Remember that "sour" means "acid," which is bad for teeth;


- Look for the following acids on the back label of ingredients and avoid them: citric, lactic, malic, tartaric, fumaric, adipic, ascorbic;


- Don't be fooled by "concentrated fruit juice extracts," which is a code phrase for ingredients that can be highly acidic;


- If you choose to consume sour candies, rinse your mouth with water immediately afterwards to reduce the damaging effects from the acids;


- DO NOT brush your teeth directly after eating sour candy as the toothbrush and toothpaste are abrasive. This will scratch and will remove more of the already softened enamel.


"Most consumers and even many dental professionals are so focused on eliminating sugar that they haven't paid attention to the newer and more serious candy ingredients containing multiple acids," said Feltham, who believes the problem is so bad that the Food & Drug Administration (FDA) should require warnings on all sour acid candies.


"These acids are what make the sour candies so tart and appealing," she said, "but also what makes teeth more susceptible to oral diseases."


The California Dental Hygienists' Association (CDHA) is the authoritative voice of the state's dental hygiene profession. The organization was established 20 years ago when two regional associations merged to form a unified professional group. CDHA represents thousands of dental hygienists throughout the state and is dedicated to expanding opportunities for the profession and access to care for all Californians.

California Dental Hygienists' Association (CDHA)

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A First For The West: Robotic-Assisted Surgery For Thyroid Tumor

UC Irvine Healthcare is the first medical center on the West Coast and the only one in California to perform robotic thyroidectomies, a procedure that removes the diseased gland without leaving a visible scar on the neck. Dr. Jason Kim, associate clinical professor of otolaryngology and a head and neck cancer specialist, has performed robotic-assisted surgery using the daVinci Surgical System on three patients with thyroid tumors.



"We're excited to be able to offer this kind of surgery to the Orange County community and beyond," Kim said. "Traditional 'open' surgery to remove the thyroid gland requires a three- to five-inch incision across the front of the neck, and other minimally invasive surgical techniques can reduce the scar to about one inch. But using the robot, we avoid the neck incision altogether by making a small, easily hidden cut in the patient's armpit. That opening provides access for the robot's arms, which then are maneuvered by the surgeon to the thyroid bed."



Kim and UCI oncologic surgeon Dr. John Butler are two of a select number of doctors in the world who were trained in robotic thyroidectomy using the daVinci robot earlier this year in South Korea. In addition to treating thyroid tumors and cancer, the technique could be useful for other conditions such as hyperthyroidism.



"This is an important addition to services in our new Robotic Oncology Center at UCI," said Dr. Ralph Clayman, dean of the UCI School of Medicine and an internationally recognized expert in minimally invasive renal cancer surgery. "The center, which focuses on the specific application of robotic technology to cancer surgery, enables us to continually advance this exciting new technology and create university-led innovations for the betterment of every patient who seeks our care."



Surgery using the daVinci robot has been performed for years in heart, prostate and gynecologic conditions, but minimally invasive robotic thyroidectomies are new. The American Cancer Society estimates that about 38,000 cases of thyroid cancer alone in addition to other thyroid diseases will be diagnosed in the U.S. in 2010, and it usually strikes people younger than 55.



"The good news is that thyroid cancer is among the most curable of malignancies, with most patients cured from treatment and the vast majority of patients living a normal lifespan," said Dr. William Armstrong, professor and chair of UCI's otolaryngology department. "But since the location of the thyroidectomy scar from open surgery can be very visible, the cosmetic effects of the operation were a serious concern for patients who tend to be between the ages of 20 and 50. Robotic-assisted surgery changes all that."



Next on the horizon for the Robotic Oncology Center are procedures to treat stomach and colorectal cancers and the expansion of gynecologic cancer treatment. The center is part of UCI's Chao Family Comprehensive Cancer Center, one of only 40 National Cancer Institute-designated comprehensive cancer centers in the U.S. and the only one in Orange County.



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"Minister Pat The Cope Gallagher Calls On Smokers To TRY To Quit Smoking", Ireland

Mr Pat The Cope Gallagher, T.D. Minister for Health Promotion & Food Safety has called on smokers to try to quit smoking. He is urging smokers to resolve to use 6th February, "Ash Wednesday", as the starting point to try to give up smoking.


"Ash Wednesday is a traditional day that smokers attempt to quit. There is more support available today to help smokers quit than ever before. The link between cardiovascular disease, cancers and smoking is well documented. Giving up smoking is the single most important thing smokers' can do for their own health and the health of those around them",Minister Gallagher said.


Anyone wishing to quit or needing further information should contact the National Smokers Quitline at 1850 201 203 run by the Health Services Executive (HSE) in partnership with the Irish Cancer Society.


Irish Cancer Society

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Azithromycin Pills Equal To Penicillin Shots For Treating Early Syphilis: Clinical Trial

What:
In a clinical trial involving HIV-negative volunteers with early-stage syphilis, researchers have found that antibiotic pills (azithromycin) are as effective as penicillin injections in curing early-stage syphilis. The study was supported by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.



Edward W. Hook, III, M.D., of the University of Alabama at Birmingham, led the trial. Between June 2000 and March 2007, HIV-negative volunteers aged 18 to 55 enrolled at eight sites in the United States and Madagascar. Volunteers were randomly assigned to receive either two injections of benzathine penicillin G or four tablets of the broad-spectrum antimicrobial macrolide drug azithromycin. Of 517 total enrollees, 469 were included in an intention-to-treat analysis. Among azithromycin recipients, 77.6 percent (180 out of 232) were cured of syphilis, while cure rate among penicillin recipients was 78.5 percent (186 out of 237).



Although long-acting penicillin delivered by injection is recommended as the preferred treatment for early syphilis, the authors note that this therapy has shortcomings, particularly in resource-limited settings. Penicillin injections can cause allergic reactions, and the drug must be refrigerated and administrated by trained personnel. The orally administered azithromycin may provide a good alternative for treating HIV-negative people with early-stage syphilis, the scientists conclude. They note that there is a potential for syphilis-causing bacteria to acquire resistance to macrolide drugs such as azithromycin and they recommend continued research into this possibility.



Detailed information about the study's design is available at clinicaltrials.



Article:
EW Hook et al. A phase III equivalence trial of azithromycin versus benzathine penicillin for treatment of early syphilis. Journal of Infectious Diseases DOI: 10.1086/652239 (2010).



Who:
NIAID Director Anthony S. Fauci, M.D., and Carolyn Deal, Ph.D., chief, Sexually Transmitted Diseases Branch, Division of Microbiology and Infectious Diseases, NIAID.



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Reaching Kids Early On To Prevent Skin Cancer

Melanoma is killing young people as never before, and a new educational program created in part by a group of medical students and dermatology faculty from Saint Louis University School of Medicine is hoping to reverse this deadly trend. "Through SPOTS (Sun Protection Outreach Teaching by Students), we are training medical school students to go into middle schools and teach the kids about sun protection and skin cancer," says Summer Youker, M.D., assistant professor of dermatology at Saint Louis University. Washington University School of Medicine also is participating in the program, believed to involve medical professionals in educating teens about preventing skin cancer.


Saint Louis University Medical Center

St. Louis, MO 63103

United States

slu/pr/

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New Therapy Boosts Cure Rate By 20% In A Deadly Childhood Cancer

Using immunotherapy biologic agents that stimulate the body's immune system pediatric oncologists have achieved the first substantial increase in over a decade in cure rates for the childhood cancer neuroblastoma. A newly released study shows that the new treatment improved survival rates by 20 percent, compared to standard treatment for an aggressive form of neuroblastoma, a cancer of the nervous system.


"We expect these findings will change clinical practice, setting a new gold standard of treatment for this often-deadly disease," said John M. Maris, M.D., a co-author of the study and director of the Center for Childhood Cancer Research at The Children's Hospital of Philadelphia. Maris is the chair of the neuroblastoma committee of the Children's Oncology Group (COG), the cooperative multicenter research organization that sponsored the study.


The study appears in the Sept. 30 issue of the New England Journal of Medicine, along with a separate COG study on intermediate-risk neuroblastoma. The corresponding author of the immunotherapy study is Alice L. Yu, M.D., Ph.D., of the University of California, San Diego.


Neuroblastoma, a cancer of the peripheral nervous system, usually appears as a solid tumor in the chest or abdomen. It accounts for 7 percent of all childhood cancers, but because it frequently occurs in an aggressive form, it causes 15 percent of all childhood cancer deaths. While low-risk forms of neuroblastoma may spontaneously disappear, in high-risk forms, the cancer tends to return after initial treatment, usually with lethal results.


In the current study, researchers assigned 226 high-risk patients at multiple cancer centers to receive either the standard therapy (the chemotherapy drug isotretinoin) or immunotherapy three biological agents in combination with isotretinoin. Immunotherapy consisted of the monoclonal antibody ch14.18, plus two cytokines: granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-2. Monoclonal antibodies are molecular "guided missiles" engineered to kill cancer cells by targeting a substance appearing on those cells. Cytokines are naturally occurring signaling proteins that regulate immune responses.


Approximately 54 percent of the neuroblastoma patients receiving standard treatment suffered a disease relapse, which is almost uniformly fatal. In contrast, only 34 percent of patients receiving the experimental immunotherapy regimen had their disease return, resulting in a much higher cure rate. The immunotherapy group of patients did experience pain and other toxic side effects at a higher rate than the standard treatment group. Nonetheless, the evidence of clear benefits from immunotherapy allowed the researchers to halt the trial earlier than expected.


The Cancer Center at The Children's Hospital of Philadelphia has been using this immunotherapy regimen as part of standard treatment for children with high-risk neuroblastoma for more than a year, since preliminary trial results were reported in June 2009. Children have arrived from around the world to receive this treatment at Children's Hospital, which has a long-established research and clinical program in neuroblastoma.















Maris is internationally prominent as a neuroblastoma expert; among many other findings, in 2008, he led the first study that identified the gene location in which neuroblastoma originates. Earlier this year, the New England Journal of Medicine selected Maris to write a review article, "Recent Advances in Neuroblastoma," describing the current state of the science.


In addition to the current immunotherapy study, Maris also co-authored a second study in the same issue of the journal, reporting on a separate COG phase 3 clinical trial of intermediate-risk neuroblastoma. The corresponding author was Katherine K. Matthay, M.D., of the University of California, San Francisco. That study found that physicians could substantially reduce the dose and duration of chemotherapy used for neuroblastoma, and still achieve very high survival rates of 98 percent among children receiving the treatment. The benefits of lower doses include better quality of life, reduced costs, and an expected reduction in late effects of chemotherapy, which may occur years after treatment.


"Together, these studies report important advances in care for children with this challenging cancer," said Maris. "We will continue to investigate treatments to further refine the standard of care."


Grants from the National Institutes of Health and the Food and Drug Administration supported the immunotherapy study. Grants from the National Cancer Institute, part of the National Institutes of Health, supported the study of intermediate-risk neuroblastoma. Both studies were conducted through the Children's Oncology Group.


"Anti-GD2 Antibody with GM-CSF, Interleukin-2 and Isotretinoin for Neuroblastoma," and "Outcome after Reduced Chemotherapy for Intermediate Risk Neuroblastoma," New England Journal of Medicine, Sept. 30, 2010.


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Reps. Thompson And Ramstad's Bill Helps More Seniors Prevent Cancer, USA

Recently, Reps. Mike Thompson (D-CA) and Jim Ramstad (R-MN) introduced legislation to improve beneficiary access to Medicare's cancer screening services.


The Medicare Early Detection of Cancer Promotion Act will waive co-pays for colonoscopy and mammography services and extend the eligibility period for the "Welcome to Medicare" visit from the current time frame of six months to one year.


"The vast majority of cancer diagnoses and deaths happen to older Americans, so we should be making it as easy as possible for seniors to get regular cancer screenings," said Thompson. Sixty percent of new cancer diagnoses and 70 percent of cancer deaths occur in people over 65. "Co-pays for these services create a barrier to care," added Thompson. "If we eliminate the co-pays, more seniors will get screened, saving lives and money."


"Nearly 100,000 Americans will die this year from colorectal and breast cancer, yet many of these deaths could have been prevented" said Ramstad. "By passing the Medicare Early Detection of Cancer Promotion Act, we can expand access to life-saving colonoscopy and mammography services, services that are truly the first line of defense in preventing cancer deaths."


Currently, beneficiaries pay no coinsurance for most cancer screening services covered by Medicare, but they must pay a 20 percent co-pay for colonoscopy and mammography services. This legislation will eliminate co-pays for mammograms and colonoscopies, prompting more seniors to utilize these live-saving services.


In addition to saving lives, promoting cancer prevention also saves Medicare - and the American taxpayer - money. Preventive services cost considerably less than caring for people with cancer. For example, Medicare pays between $200 and $400 for a colonoscopy - but if colon cancer metastasizes, total costs of care can exceed $58,000 per patient.


The efficacy of cancer prevention screening is clear. When caught in the first stages, the five year survival rate for breast cancer is 98 percent and the five year survival rate for colorectal cancer is 90 percent. However, if these cancers move into more advanced stages, the survival rates are only 26 percent for breast cancer and 10 percent for colorectal cancer.


This legislation will also increase the number of seniors who seek cancer prevention services by extending the "Welcome to Medicare" period. During these physicals, Medicare beneficiaries can take advantage of certain screening and preventive health services and learn about others. Currently, fewer than 5 percent of new beneficiaries are seeking appointments for the "Welcome to Medicare" visit, and extending the eligibility period means that more people will be able to benefit from it.


Thompson and Ramstad are both members of the Ways & Means Health Subcommittee.


mikethompson.house

house/ramstad

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First 3-D View Of Human Coronary Arteries

For the first time researchers are getting a detailed look at the interior of human coronary arteries, using an optical imaging technique developed at the Wellman Center for Photomedicine at Massachusetts General Hospital (MGH). In their report in the journal JACC: Cardiovascular Imaging, the research team describes how optical frequency-domain imaging (OFDI) gives three-dimensional, microscopic views of significant segments of patients' coronary arteries, visualizing areas of inflammation and plaque deposits.



"This is the first human demonstration of a technique that has the potential to change how cardiologists look at coronary arteries," says Gary Tearney, MD, PhD, of the MGH Pathology Department and the Wellman Center for Photomedicine at MGH, the study's lead author. "The wealth of information that we can now obtain will undoubtedly improve our ability to understand coronary artery disease and may allow cardiologists to diagnose and treat plaque before it leads to serious problems."



OFDI is an advance over optical coherence tomography (OCT), another imaging technology developed by the MGH investigators. While OCT examines tissues one point at a time, OFDI can look at over 1,000 points simultaneously using a device developed at MGH-Wellman. Inside a fiberoptic probe, a constantly rotating laser tip emits a light beam with an ever-changing wavelength. As the probe moves through the structure to be imaged, measuring how each wavelength is reflected back allows rapid acquisition of the data required to create the detailed microscopic images. Besides providing three-dimensional images of an artery's microstructure in seconds, the increased speed also reduces signal interference from blood, which had plagued the first-generation technology. In 2006 members of the MGH-Wellman team reported the successful use of OFDI to image the esophagus and coronary arteries of pigs.



The current study enrolled three patients scheduled to have stents placed in their coronary arteries at the Lahey Clinic in Burlington, Mass. After the completion of stent placement, OFDI was used to image 3- to 7-centimeter-long segments of the patients' coronary arteries including the stented areas. OFDI provided detailed images along the length of the arteries - visualizing lipid or calcium deposits, immune cells that could indicate inflammation, and the stents - and dramatic "fly-through" views looking down the artery's interior. More detailed, cross-sectional images of narrowed vascular segments revealed features associated with the type of atherosclerotic plaques that are likely to rupture and cause a heart attack.



Tearney and his colleagues note that these findings need to be duplicated in a larger group of patients, and the time required to process the "fly-through" images - currently several hours - needs to be reduced to provide the real-time information most useful for clinical applications. Combining OFDI with intravascular ultrasound might help with another of the technique's limitations, the inability to penetrate deep into tissues.



"While more work remains, the technology is advancing at a rapid pace. We expect to see commercial devices available in a one- to two-year time frame," says Brett Bouma, PhD, of the Wellman Center, senior author of the report. "Our goal now is to help put the pieces in place to ensure that this technique will be widely available to interventional cardiologists." Bouma is an associate professor of Dermatology, and Tearney an associate professor of Pathology at Harvard Medical School.







Additional co-authors of the JACC: Cardiovascular Imaging report are Milen Shishkov, PhD, Ben Vakoc, PhD, Melissa Suter, PhD, Adrien Desjardins, PhD, Wang-Yul Oh, PhD, Lisa Bartlett and Mireille Rosenberg, PhD, MGH-Wellman; and Sergio Waxman, MD, and Mark Freilich, MBBS, Lahey Clinic. The MGH has licensed cardiovascular applications of OFDI to Terumo Corporation, which has supported nonclinical OFDI studies by Tearney and Bouma. The current study was supported by a grant from the National Institutes of Health.



Massachusetts General Hospital (massgeneral), established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $500 million and major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, systems biology, transplantation biology and photomedicine.



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More City High Flyers Seeking Help As Credit Crunch Bites, London, England

The Priory Group has issued a list of top ten indicators for stressed City executives which should act as warning signs that professional help should be sought. As the global economy goes into meltdown, experts at the Priory Group are coping with escalating levels of depression and related conditions amongst staff in the financial sector, also leading to a rise in people seeking treatment for drink and drug abuse.


Priory hospitals across the country are reporting increasing numbers of professionals and City high flyers seeking help.



The credit crunch has wreaked havoc on some of the world's best known financial institutions in recent weeks. Lehman Brothers, HBOS, AIG and Bradford & Bingley are just some of the organisations facing major problems.


Only recently the City was in shock after the apparent suicide of a millionaire financier haunted by the pressures of dealing with the credit crunch. Kirk Stephenson is believed to have taken his own life after succumbing to mounting personal pressures as the world's financial markets went into meltdown.


Dr Richard Bowskill from The Priory Group explains: "What people sometimes forget is the human cost behind the headlines. The banks and other businesses suffering at the moment are household names but there are thousands and thousands of employees, pensioners and ordinary people for whom the knock-on effects are devastating.


"At times of financial uncertainty what we see is increased levels of anxiety disorders amongst City workers and often alcohol and cocaine misuse becomes a coping mechanism as the stress increases. Sleeplessness, intense anxiety and even suicidal thoughts are not uncommon symptoms."



Other indicators that can give an indication that professional help may be needed include:


1. Feeling miserable and sad.

2. Feeling exhausted a lot of the time with no energy.

3. Difficulty sleeping or waking up very early in the morning. Disturbing dreams.

4. Believing that even the smallest tasks are sometimes impossible.

5. No longer enjoying the things that you used to enjoy - you may be off sex or food or may 'comfort eat' to excess.

6. Feeling like a failure and/or feeling guilty a lot of the time.

7. Considering sometimes that life isn't worth living.

8. Irritation and anger.

9. Lack of confidence.

10. Feelings that life is unfair.


Dr Bowsill said: "Many younger people have not experienced difficult times before and this is a new experience for them. Fears of small bonus payouts, job loss and career shutdown are resulting in many bankers seeking medical help to assist them through these difficult times. And worse, some bankers could be prone to take their own lives, as their self-worth is so inextricably linked with the success and the financial rewards their profession so often brings."

The Priory Group

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Start Of Second Pivotal Phase III Clinical Trial For XERECEPT(R), A Therapy For Peritumoral Brain Edema, Celtic Pharma And Neurobiological Technologie

Celtic Pharmaceutical Holdings L.P. ("Celtic Pharma") and Neurobiological Technologies, Inc. (Nasdaq: NTII) ("NTI") today announced the enrollment of the first patient into the second of two Phase III pivotal trials of XERECEPT(R), Corticotropin-Releasing Factor, for the indication of peritumoral brain edema. This second study, termed the Acute Trial, will compare the treatment of dexamethasone with XERECEPT in patients already on low dose steroid whose dose must be escalated to treat their symptoms. Once patients complete the study, they have the option of entering a third, open-label, study allowing them to continue receiving XERECEPT. In November 2005, NTI sold the worldwide exclusive rights to XERECEPT to Celtic Pharma, and provides Celtic with contractual services surrounding the development of XERECEPT.


Paul E. Freiman, President and CEO of NTI said, "XERECEPT continues to hold great promise for those patients affected with the neurological symptoms related with swelling around brain cancers. We feel that the existing treatment utilizing steroids provides an extra burden to this critically ill patient population. We believe that XERECEPT represents an alternative and hope to these patients for a better quality of life."


"We are delighted to see this exciting drug candidate now in three Phase III programs, and we look forward to extending its clinical development into Europe and Japan in the course of this year. This product fits the Celtic Pharma mandate in that, if we can receive regulatory approval and bring it to market succesfully, we believe it could represent a substantive improvement over current therapeutic options for the treatment of edema, thus representing a potentially large commercial opportunity", said Stephen Evans-Freke, Managing General Partner, Celtic Pharmaceutical Holdings L.P.


About Celtic Pharmaceutical Holdings L.P.


Celtic Pharmaceutical Holdings L.P. (Celtic Pharma) is a global private equity firm focused on the biotechnology and pharmaceutical industries. Celtic Pharma was founded by Stephen Evans-Freke and John Mayo, CBE and is based in Bermuda. Celtic Pharma acquires late stage pharmaceutical programmes and drives these programmes through the final stages of regulatory approval. Celtic Pharma's aim is to bridge the gap between the established pharmaceutical companies' new product pipeline crisis and the biotech industry's capital drought. For further information, please visit Celtic Pharma's website at celticpharma.


About Neurobiological Technologies, Inc.


NTI is a drug development company focused on the clinical evaluation and regulatory approval of neuroscience drugs. The company's strategy is to in-license and develop early- and later-stage drug candidates that target major medical needs and which can be commercialized. NTI expects to continue to acquire and develop brain drug candidates and intends to develop the resources to market these drugs in selected world regions. NTI's goal is to develop and market drug candidates in the United States, Europe and Asia and may seek partnerships with pharmaceutical and biotechnology companies to assist in development and marketing. For further information, please visit NTI's website at ntii.

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