Overall sales growth in the U.S. prescription market slowed to 3.8 percent in 2007, the slowest rate of growth for the industry since 1961, according to IMS Health. That compared with more than an 8 percent increase in 2006. IMS said the loss of expiration of patents, a dearth of new products, and maturation of Medicare Part D contributed to the slowing growth. Total U.S. prescription sales reached $286.5 billion, with slower sales growth resulting from loss of exclusivity of branded medicines, fewer new product approvals, the leveling of year-over-year growth from the Medicare Part D program, and the impact of safety issues, the market research firm said. Total U.S. dispensed prescription volume grew at a 2.8 percent pace compared with 4.6 percent in 2006. Antidepressants ranked as the leading therapy class by dispensed prescription volume in 2007. 

Five consecutive years of flat funding for the budget of the National Institutes of Health is deterring promising young researchers and threatening the future of Americans’ health, a group of seven preeminent academic research institutions warned. In a report released in Washington D.C., the institutions described the toll that cumulative stagnant NIH funding is taking on American medical research. They warned that if NIH does not get consistent and robust support in the future, the nation will lose a generation of young investigators to other careers and other countries and, with them, a generation of promising research that could cure disease for millions for whom no cure currently exists. The report, “A Broken Pipeline? Flat Funding of the NIH Puts a Generation of Science at Risk,” was co-authored by Brown University, Duke University, Harvard University, The Ohio State University, Partners Healthcare, the University of California Los Angeles, and Vanderbilt University. Between 1998 and 2003, the Clinton and Bush Administrations and Congress doubled the budget of the NIH. However, in 2003, the budget increases stopped and, since then, the NIH has experienced a 13 percent drop in real purchasing power. As a result, the group said research progress has slowed, and leading researchers’ new ideas for funding are stuck at a toll-gate that only allows one in 10 grants to be funded upon first submission. 

 

ALZHEIMER’S: OFFSPRING OF PARENTS WHO BOTH HAVE AD MAY BE MORE LIKELY TO DEVELOP THE ILLNESS
Adult-age offspring of parents who have both been diagnosed with Alzheimer’s disease appear to have an increased risk of developing the disease compared with the general population, according to a report in Archives of Neurology. Alzheimer’s disease is a common cause of dementia in the United States and the leading cause of cognitive impairment in the elderly. Identifying genes in Alzheimer’s disease patients can help detect others who are at risk for the condition. Researchers at the University of Washington at Seattle and colleagues studied the frequency of Alzheimer’s disease in adult children of 111 families in which both parents had been clinically diagnosed with the disease. Ages at onset of dementia were also noted. Of the 297 offspring who reached adulthood, 22.6 percent developed Alzheimer’s disease compared with an estimated 6 percent to 13 percent of the general population. The risk of developing the disease increased with age—31 percent of those older than age 60 were affected and 41.8 percent of those older than age 70 were affected. Of the 240 unaffected individuals, 189 (78.8 percent) had not yet reached age 70 years. The researchers said that suggests that the incidence of Alzheimer’s disease (22.6 percent) is an underestimation of the final incidence rate of Alzheimer’s disease in this population.

 

Researchers at the University of South Florida report that when human umbilical cord blood cells were injected into aged laboratory animals, they found improvements in the microenvironment of the hippocampus region of the animals’ brains and a subsequent rejuvenation of neural stem/progenitor cells. In a study published online in BMC Neuroscience, the research presents the possibility of a cell therapy aimed at rejuvenating the aged brain. The increase in neurogenesis, which dramatically decreases with aging, came after the injections and seemed to be due to a decrease in inflammation. Umbilical cord blood cells may have a similar potential to reduce inflammation and to restore some of the lost capacity of stem/progenitor cells to proliferate and differentiate into neurons, the researchers said.

 

PSYCHOSIS: RESEARCHERS DISCOVER EPIGENETIC CHANGES IN MENTAL ILLNESS
Scientists at the Krembil Family Epigenetic Laboratory at the Centre for Addiction and Mental Health in Toronto have discovered epigenetic changes (chemical changes to a gene that do not alter the DNA sequence) in individuals with schizophrenia and bipolar disorder. The study, the first epigenome-wide investigation in psychiatric research, may be a significant step on the journey to fully understanding major psychosis, the researchers said. They studied 12,000 locations on the genome using an epigenomic profiling technology. Approximately one in every 200 of these genes showed an epigenetic difference in the brains of psychiatric patients. Significantly, these changes were noted on genes involved in neurotransmission, brain development, and other processes linked to disease origins.

 

A test that profiles molecular biomarkers in blood could become the first accurate diagnostic test for Parkinson’s disease, researchers from Weill Cornell Medical College in New York City show. The screen relies on changes in dozens of small molecules in serum. These “metabolomic” alterations form a unique pattern in people with Parkinson's disease. The findings, published in the journal Brain, could eventually lead to an early-detection blood test for Parkinson’s disease, the researchers said. Changes in a few well-known metabolites linked to oxidative stress were clearly linked to Parkinson’s. These included low levels of the antioxidant uric acid; an increase in blood levels of another antioxidant, glutathione; and increased levels of a marker for oxidative damage called 8-OHdG. Right now, a Parkinson’s diagnosis is made solely on a clinical review of symptoms. An early-detection test would also be enormously useful in tracking the health of patients who may be at higher risk for Parkinson's, such as those with a family history of the disease, the researchers said.

 

GENE THERAPY: LONG-TERM MUSCLE IMPROVEMENTS SHOWN IN MICE
Injecting a gene responsible for making a specific protein into a mouse that’s used as a model for muscular dystrophy can lead to long-term improvements in the animal’s muscle size and strength, according to researchers from Ohio State University. In a study published online in the Proceedings of the National Academy of Sciences, the researchers said the results warrant testing the same approach in human clinical trials for diseases associated with muscle wasting, including Duchenne muscular dystrophy, the most common form of the childhood disorder. Scientists used a virus to deliver a protein called follistatin into the leg muscles of young and older mice that have a disorder similar to human Duchenne muscular dystrophy. The protein inhibits the activity of myostatin, identified in previous research as a protein that limits muscle growth. Both young and old mice treated with the therapy responded with increased muscle mass and improvements in strength. The researchers said because the older mice in the study responded well to the protein, the therapy might hold promise for older patients with Duchenne muscular dystrophe who have few treatment options once their muscles have experienced progressive degeneration.

 

Researchers at the University of Michigan Health System have found a key linkage between pain and a specific brain molecule, a discovery that lends new insight into the often-baffling chronic pain condition known as fibromyalgia. In patients with fibromyalgia, pain decreased when levels of the brain molecule called glutamate went down. Glutamate is a neurotransmitter. The results of this study, which appears in the journal Arthritis and Rheumatism, could be useful to researchers looking for new drugs that treat fibromyalgia. If these findings are replicated, investigators performing clinical treatment trials in fibromyalgia could potentially use glutamate as a surrogate marker of disease response, the researchers said.

 

ALCOHOL: MODERATE CONSUMPTION IN MIDDLE AGE CAN LOWER CARDIAC RISK
Though studies have pointed out the benefits of moderate alcohol consumption as a factor in lowering cardiovascular risk, researchers at the Department of Family Medicine at the Medical University of South Carolina have found that middle-aged non-drinkers who began consuming moderate amounts of alcohol saw an immediate benefit of lower cardiac disease morbidity with no change in mortality after four years. The study, published in The American Journal of Medicine, studies 7,697 people between 45 and 64 who were non-drinkers and who were participating in the Atherosclerosis Risk in Communities study over a 10-year period. The researchers found that 6 percent began moderate alcohol consumption (1 drink per day or fewer for women and 2 drinks per day or fewer for men) during the follow-up period. After four years of follow-up, new moderate drinkers had a 38 percent lower chance of developing cardiovascular disease than did their non-drinking counterparts. Even after adjusting for physical activity, body mass index, and demographic and cardiac risk factors, this difference persisted. The study also identified a subset of new drinkers who consumed only wine. When comparing non-drinkers to wine-only drinkers, drinkers of other types of alcohol, and heavy drinkers, the wine-only drinkers had the most significant reduction in cardiovascular events.

 

WEIGHT LOSS: PERSONAL COUNSELING BEATS WEB-BASED INFORMATION
Individuals are less likely to regain lost weight when they get monthly tips straight from trained counselors rather than from a weight-loss website, according to researchers from Johns Hopkins University and seven other institutions. In a study published in JAMA, the researchers compared different interventions aimed at preventing weight regain among 1,032 volunteers who had recently lost, on average, about 19 pounds each. The volunteers were separated into three groups and tracked over two and a half years. One group received regular, personal contact from trained weight-loss counselors. A second group was given access to a custom-built weight-loss website loaded with information and tools to track weight, record food diaries, and monitor physical activity levels. A third set of volunteers received some printed information with diet and lifestyle recommendations at the beginning of the study. Volunteers in the group who received personal contact regained the least amount of weight, averaging about 9 pounds each. Those in the website and self-directed groups regained slightly more, about 12 pounds apiece. The researchers speculate that being personally accountable to a caring counselor could be an important motivator for people to maintain healthy eating habits. 

 

A study from researchers at Zuyd University in The Netherlands published in the open access journal Particle and Fibre Toxicology reveals that an hour of sniffing exhaust induces a stress response in the brain's activity. Previous studies have already suggested that very small particles, called nanoparticles, breathed in from polluted air can end up in the brain. But this is the first time that scientists have demonstrated that inhalation actually alters brain activity. Ten volunteers spent one hour in a room filled with either clean air or exhaust from a diesel engine. The concentration of diesel exhaust that the subjects breathed was set to the highest level that people might encounter in the environment or at work, for example on a busy road or in a garage. They were wired to an electroencephalograph, or EEG, a machine that records the electrical signals of the brain, and their brain waves were monitored during the exposure period and for one hour after they left the room. The researchers found that after about 30 minutes of exposure, the diesel exhaust began to affect brain activity. The EEG data suggested that the brain displayed a stress response, indicative of changed information processing in the brain cortex, which continued to increase even after the subjects had left the exposure chamber.

 

A blood test could enable doctors to rule out tuberculosis infection within days rather than weeks, according to a study published in the journal Annals of Internal Medicine. The study, by researchers from Imperial College London and the University of Oxford, shows that doctors can determine that a patient does not have tuberculosis with 99 percent accuracy when using the new blood test, ELISpot-Plus, in conjunction with a skin test known as tuberculin skin testing, already in use. TB is difficult to diagnose because many of its symptoms, such as fever, fatigue, and loss of appetite, are also commonly found in many other conditions. The test looks for a type of protein known as interferon-Y. This is secreted by T cells in the immune system when they encounter antigens found in the bacterium Mycobacterium tuberculosis, which causes most cases of TB. 

 

OBESITY: PROTEIN DEFICIENCY LEADS TO FASTER FAT BURNING IN MICE
Researchers have developed a new, lean mouse with characteristics suggesting that someday, using medication to manipulate a specific protein in humans could emerge as a strategy to treat obesity and disorders associated with excess weight, such as diabetes and metabolic syndrome. Researchers at Ohio State University crossed mice deficient in protein kinase C beta (PKCB) with the C57 black mouse, a common animal used in research for studying diabetes and obesity. At first glance, compared to mice with no deficiency, these new hybrid mice were smaller and leaner. And when the researchers looked under their skin, they saw the mice had less fat distribution in the skin itself and less fat tissue overall. They also had less fat in their livers and muscles. The fat cells they did have were smaller than fat cells in other mice. And despite the propensity for obesity from their original genes, the new mice lost weight while eating up to 30 percent more food than other mice. This means their lower weight was not caused by less eating, suggesting the protein deficiency corrected for the obesity tendencies by increasing the hybrids’ ability to burn fat.

 

A study by the Woolcock Institute of Medical Research in Sydney is the first to demonstrate that in patients with very mild or well-controlled asthma, regular treatment with low-dose inhaled corticosteroids leads to significantly better day-to-day lung function. The study, published in Primary Care Respiratory Journal, compared the effects of inhaled corticosteroids and placebo on asthma control in mild asthmatics over an 11-month period. The results of the study raise questions about the current emphasis in asthma treatment, which is based largely on controlling symptoms, and which does not advocate inhaled corticosteroids for patients who experience symptoms two days a week or less. Results showed significant and clinically important treatment benefits on markers such as lung function, airway hyperresponsiveness, and exhaled nitric oxide, which are all predictors of the risk of future adverse outcomes such as exacerbations.

 

OSTEOPEROSIS: WOMEN STOP THEIR TREATMENT WITHIN ONE YEAR
Women who do not comply with treatment instructions for osteoporosis or who do not respond to treatment are more likely to suffer further fractures, according to researchers at the University of Southampton in the UK. Therapies currently available to treat osteoporosis have been shown to reduce the risk of fragility fractures in postmenopausal women. Most patients gain bone mineral density within a year of treatment. However, surveys of osteoporotic patients show that compliance to treatment is low in practice, and up to 50 percent of patients stop their treatment within a year due in part to side effects. The study, which will be published in the April issue of Osteoporosis International, looked at the number of fractures suffered by women who did not respond to drug therapy, and how treatment failure affected their health-related quality of life. They found that women who had suffered fractures in the past were more likely to sustain a new fracture than those who had not. They also found that the risk of fracture is high in women after failed osteoporosis therapy and the presence of a previous fracture in the previous 12 months strongly predicts a fracture in the next 12 months.

 

Researchers at Duke University Medical Center say they may have figured out why poor sleep does more harm to cardiovascular health in women than in men. The study, appearing online in the journal Brain, Behavior and Immunity, found that poor sleep is associated with greater psychological distress and higher levels of biomarkers associated with elevated risk of heart disease and type 2 diabetes. They also found that these associations are significantly stronger in women than in men. Researchers studied 210 apparently healthy, middle-aged men and women without any history of sleep disorders. The researchers found that about 40 percent of the men and the women were classified as poor sleepers, defined as having frequent problems falling asleep, taking 30 or more minutes to fall asleep, or awakening frequently during the night. But while their sleep quality ratings were similar, men and women had dramatically different risk profiles. The researchers note that it appears that it’s not so much the overall poor sleep quality that was associated with greater risk, but rather the length of time it takes a person to fall asleep that takes the highest toll.

 

While life expectancy in the United States has been rising, recent data shows that not everyone has benefited from this trend. Researchers at Harvard Medical School and Harvard University found that individuals with more than 12 years of education have significantly longer life expectancy than those who never went beyond high school. The researchers combined death certificate data with census population estimates and data from the National Longitudinal Mortality Study. Restricting analyses to whites and non-Hispanic blacks, the team created two separate data sets, one covering 1981-1988, and the other 1990-2000. In both data sets, life expectancy rose for individuals who had more than 12 years of education. For those with 12 years or less, it plateaued. Overall in the groups studied, as of 2000, better educated at age 25 could expect to live to age 82; for less educated, 75. The researchers found that much of the mortality gap can be attributed to smoking related-illnesses.

 

QUALITY OF CARE: STUDY FINDS MINORITIES AND WHITES GET EQUAL TREAQTMENT IN HOSPITALS
A University of Maryland study of whether people receive different quality of hospital care because of their race or ethnicity found that when whites and minorities are admitted to a hospital for the same reason, they receive the same quality care in that hospital. The study, published in Health Affairs, compared the quality of treatment for blacks, Hispanics, and Asians to that of whites over a broad range of services at 1,841 hospitals in 13 states. It found that only a few hospitals provide lower quality care to minorities than to whites. The study confirms that all patients in low performing hospitals are at higher risk for mortality and complications, and suggests the need to look at other areas to find where disparities are originating, such as getting access to the good hospitals in the first place, the researchers said.

 

Researchers from the Mayo Clinic report online in The Journal of Clinical Investigation that dopamine, a drug currently used to treat Parkinson’s disease and other illnesses also might work in cancer patients. The study, which was done in mouse and laboratory models, shows that dopamine could possibly prevent new blood vessels from growing and as a result, slow cancer progression. Dopamine is a neurotransmitter in the brain that regulates movement and affects behavior. In its synthetic form, dopamine is used to treat heart attack victims, Parkinson’s disease and pituitary tumors. But it wasn’t known until now that dopamine worked by blocking the growth of new blood vessels–-a process called angiogenesis. The study has not been replicated in humans, but the results said the results are encouraging.

 

TUBERCULOSIS: INHALED VACCINE IS MORE EFFECTIVE THAN TRADITIONAL SHOT
A novel aerosol version of the most common tuberculosis vaccine, administered directly to the lungs as an oral mist, offers significantly better protection against the disease in experimental animals than a comparable dose of the traditional injected vaccine, researchers report this week in the Proceedings of the National Academy of Sciences. The aerosol vaccine–under development through a collaboration between Harvard University and the international not-for-profit Medicine in Need–could provide a low-cost, needle-free TB treatment that is highly stable at room temperature, the researchers said. The vaccine, which uses nanoparticle technology, offers a potential new platform for immunizations. The researchers said if the animal test is confirmed in humans, it could be used to protect people against other infectious diseases.

 

A small dose of aspirin taken every other day can cut the risk of developing asthma among women, according to a study published in an online issue of Thorax. The findings were based on nearly 40,000 female healthcare professionals, who were part of the Women’s Health Study. Participants were either randomly assigned to take 100 mg of aspirin every other day, or a placebo. And their health was then monitored for around 10 years. During this time, there were 10 percent fewer new cases of asthma diagnosed among the women taking aspirin. The effect was evident, irrespective of age, menopausal status, exercise levels, and smoking, all factors that might be expected to influence the findings. But aspirin did not lessen the risk of asthma in women who were classified as obese. Previous research in male doctors showed that aspirin cut the risks of asthma by 22 percent, although the dose was much higher, at 325 mg every other day. Among people who have already been diagnosed with asthma, aspirin can worsen symptoms in around one in 10, say the authors.

DIABETES: EXTRA VITAMIN D IN EARLY CHILDHOOD CUTS RISK AS ADULTS
Vitamin D supplements in early childhood may ward off the development of type 1 diabetes in later life, according to a research review published online in an issue of the Archives of Disease in Childhood. Type 1 diabetes is an autoimmune disorder, in which insulin producing beta cells in the pancreas are destroyed by the body’s own immune system, starting in early infancy. A review of published evidence on vitamin D supplementation in children produced five suitable studies, the pooled data from which were analyzed. The results showed that children given additional vitamin D were around 30 percent less likely to develop type 1 diabetes compared with those not given the supplement. And the higher and the more regular the dose, the lower was the likelihood of developing the disease, the evidence suggested.

 

Giving up smoking during pregnancy may boost the chances of giving birth to an easygoing child, according to research published in the Journal of Epidemiology and Community Health. The findings are based on over 18,000 babies born in the United Kingdom between 2000 and 2002, who were taking part in the Millennium Cohort Study.Their mothers were classified as either non-smokers during pregnancy, quitters, light smokers, or those who smoked 10 or more cigarettes a day (heavy smokers). The infants’ temperaments were assessed when they were nine months old, using a validated scale, designed to pick up positive mood, receptivity to new things, and regular sleep and eating patterns in infants. The results showed that mothers-to-be who kicked their habit had the most easy-going infants, compared with non-smokers and smokers. Their children had the lowest chances of unpredictable behavior and of becoming distressed when faced with new situations or things. At the other end of the scale, heavy smokers had the most difficult children. Their children were much more likely to achieve the lowest scores for positive mood.