GENE THERAPY: VISION SAFELY RESTORED IN THREE YOUNG PATIENTS
In a clinical trial at The Children’s Hospital of Philadelphia, researchers from The University of Pennsylvania have used gene therapy to safely restore vision in three young adults with a rare form of congenital blindness. The patients have not achieved normal eyesight, but the researchers said the preliminary results set the stage for further studies of a treatment for this and possibly other retinal diseases. The researchers, which included members from the Second University of Naples and the Telethon Institute of Genetics and Medicine in Italy, and several other American institutions, reported their findings in an online article in the New England Journal of Medicine. The patients all had Leber congenital amaurosis, or LCA, a group of inherited blinding diseases that damages light receptors in the retina. Currently, there is no treatment for LCA. Starting two weeks after the injections, all three patients reported improved vision in the injected eye. The researchers also reported that each injected eye became approximately three times more sensitive to light, and each was improved compared to the uninjected, previously better functioning eye. The LCA gene therapy vector showed no signs of causing inflammation in the retina or other toxic side effects. One of the three patients had an adverse event, a hole in the retina that did not affect eyesight and may have been surgery-related, rather than related to biological effects of the therapeutic gene or the vector used to carry it.

BRAIN DAMAGE: CONTRACEPTIVE PILL INGREDIENT COULD OFFER NEUROPROTECTION AFTER BRAIN INJURY

Progesterone, a female hormone used in the contraceptive pill, could improve the neurologic outcome for patients with severe head injuries, according to researchers at Hangzhou Normal University and Zhejiang University in China. The study, published in BioMed Central’s open-access journal Critical Care, shows that progesterone can improve the neurologic outcome of patients with this kind of brain injury for up to six months. Traumatic brain injury, such as that caused by traffic accidents, falls, and sporting injuries, is a major cause of death and disability. A number of neuroprotective drugs have been shown to prevent nerve-cell death in animal models of traumatic brain injury, but these findings have not been translated into trials involving people with head injuries.

 

BREAST CANCER: DAILY ASPIRIN MAY REDUCE RISK OF ONE COMMON FORM OF THE DISEASE
Taking aspirin on a daily basis may lower women’s risk of a particular type of breast cancer, according to researchers at the National Cancer Institute. The results, published in BioMed Central’s open-access journal Breast Cancer Research, linked aspirin use to a small reduction in estrogen receptor-positive breast cancers. However, unlike in some previous research, aspirin and related painkillers were not found to reduce the total risk of breast cancer. Around 75 percent of breast cancers are estrogen receptor-positive, or ER+, which means the cancer cells have receptors for the female hormone estrogen on their surface. Estrogen helps the cancer cells grow, so drugs that block the action of estrogen are often used to treat ER+ cancer.

 

MULTIPLE SCLEROSIS: PROZAC MAY HELP CURB PROGRESSION OF MS
The antidepressant Prozac may help to curb disease activity in the relapsing remitting form of multiple sclerosis (MS), according to researchers at the University Medical Center Groeningen in the Netherlands. The preliminary research, published online in the Journal of Neurology, Neurosurgery, and Psychiatry, found the effects began to become evident after eight weeks, which corresponds to the time the selective serotonin reuptake inhibitor (SSRI) class of drugs, of which Prozac is one, start to work on relieving depression. Detailed brain scans every four weeks were used to check for new areas of neurological inflammation, a hallmark of active MS. The scans showed that those in the placebo group had more new areas of inflammation than those treated with Prozac. One in four scans from patients treated with Prozac showed new areas of inflammation compared with four out of 10 of those taking placebo. During the last 16 weeks of treatment, almost two thirds of patients (63 percent) in the group given Prozac had no new areas of inflammation compared with only one in four (26 percent) in the group given placebo.

HYPERTENSION: FOUR OUT OF FIVE HIGH BLOOD PRESSURE-RELATED DEATHS OCCUR IN DEVELOPING WORLD
Long thought to be a problem only for high-income countries, now 80 percent of deaths connected to high blood pressure occur in the developing world, according to a study from researchers at the University of Auckland, New Zealand. In an article in the journal The Lancet, the researchers report cardiovascular disease is now endemic worldwide and no longer limited to economically developed countries. They found that 7.6 million premature deaths (about 13.5 percent of the global total) and 92 million disability-adjusted life years (6.0 percent of the global total) were attributed to high blood pressure. Within high-income countries (including richer European countries, North America, Australia), the proportion of premature deaths due to high blood pressure was higher (17.6 percent) than within low- and middle-income countries (12.9 percent). However, overall about 80 percent of the burden occurred in low- and middle-income countries. Eastern Europe, central Asia, East Asia, and the Pacific (including China), followed by South Asia (including India) bore the brunt of these high blood pressure-related deaths.

 
SURGERY: MINIMALLY INVASIVE APPROACH TO PANCREAS REMOVAL LEADS TO FEWER COMPLICATIONS
The use of minimally invasive techniques when surgeons need to remove part of the pancreas offers patients a shorter hospital stay and fewer complications, researchers at Emory University School of Medicine and the Emory Winship Cancer Institute report. A study of more than 660 operations to remove pancreatic tumors and cysts over five years found that after laparoscopic surgery, patients stayed a third less time in the hospital without experiencing more complications such as leaks. During laparoscopic surgery, doctors make smaller incisions than in traditional surgery and monitor their progress with fiber optics and video cameras. In a presentation of the finding at the American Surgical Association meeting in New York, the researchers said that this approach is not only viable but may be preferable for the pancreas. They found laparoscopic procedures had fewer complications than standard surgery (40 percent vs. 57 percent), and patients experienced less blood loss and stayed about six days in the hospital compared with the standard nine.

 

Researchers at the University of Warwick have found markers that indicate endothelial dysfunction, or changes in the cells that line the blood vessels, and systemic inflammation not clinically manifest can help identify a far greater number of people at high risk for future development of type 2 diabetes. The researchers looked at a protein called E-selectin, whose presence is an indication of endothelial dysfunction, white blood cell count and levels of albumin, which are markers for sub-clinical systemic inflammation. They found high levels of E-selectin and white blood cell count with low levels of serum albumin were clear predictors of high risk for type 2 diabetes. In a study published in the online edition of the journal Obesity, the researchers said they found that traditional risk factors such as obesity or family history helped identify 65 percent of all patients who were at high risk of developing type 2 diabetes. But when the information from these three markers was added this increased to 73 percent, which means doctors could be able to spot a greater number of people at risk of type 2 diabetes at an early stage.

 

MUSCULAR DYSTROPHY: RESEARCHERS FIND MOLECULAR BASIS OF ONE FORM OF MD
A team of French and German researchers report in The FASEB Journal that people with limb-girdle muscular dystrophy are missing a protein called c-FLIP, which the body uses to prevent the loss of muscle tissue. By targeting the cellular and molecular mechanisms responsible for creating this protein, scientists could develop new drugs to stop muscle wasting from limb-girdle muscular dystrophy and other conditions. The researchers used tissue from biopsies to analyze the molecular pathways involved in each step of the disorder’s progression to identify the role of c-FLIP. The researchers found that the c-FLIP protein, which is responsible for blocking the death of muscle cells, is not produced as it should in people with limb-girdle muscular dystrophy, and that the creation of the c-FLIP protein is controlled by another protein called calpain-3. According to the authors, this finding may have implications for other types of muscular dystrophy and other situations that cause the death of muscle fibers, such as long-term immobilization, denervation, aging, or cachexia.

 

OBESITY: ASPIRIN-LIKE COMPOUNDS INCREASE INSULIN SECRETION IN OTHERWISE HEALTHY PEOPLE
Aspirin-like compounds known as salicylates increase the amount of insulin produced by otherwise healthy obese people, according to researchers at Institut d’Investigacio Biomedica de Girona and CIBEROBN Fisiopatologia de la Obesidad, Spain. Obesity is associated with insulin resistance, the first step toward type 2 diabetes. Aspirin and other salicylates are known to reduce blood glucose in diabetic patients. The research, accepted for publication in the Journal of Clinical Endocrinology & Metabolism, reveals a similar beneficial effect among obese individuals by increasing the amount of insulin secreted into the bloodstream.

KIDNEY DISEASE: TIGHT BLOOD PRESSURE CONTROL FOR AFRICAN-AMERICANS NOT ENOUGH TO SAVE KIDNEY FUNCTION
Even when their blood pressure is kept strictly under control with the best available medicine, African-American patients with chronic kidney disease continue to lose their kidney function over time, according to researchers at Johns Hopkins University. The finding suggests that treating CKD in this population may be vastly more complex than researchers had previously thought, with blood pressure control being only one piece of the therapeutic puzzle. The study, published in the Annals of Internal Medicine, is the longest to date focusing on blood pressure in patients with CKD. The researchers said their findings suggest that other factors beyond just blood pressure may be at play in worsening CKD.

EPILEPSY: DRUG CAUSES BONE LOSS IN YOUNG WOMEN
Young women who took the commonly used epilepsy drug henytoin for one year showed significant bone loss compared to women taking other epilepsy drugs, according to a study published in the journal Neurology. Researchers tested the bone health of 93 women with epilepsy who were between the ages of 18 and 40 and were taking the epilepsy drugs phenytoin, carbamazepine, lamotrigine, or valproate. Bone mineral density was measured at the spine and two areas of the hip at the beginning of the study and one year later. Researchers also evaluated each woman’s nutrition and physical activity, along with other factors that affect bone health. The study found women taking phenytoin for one year lost 2.6 percent of the bone density in the femoral neck of the hip. Women taking the other epilepsy drugs did not lose any bone density in the femoral neck. There was no bone loss at the spine or the total hip in any group. The researchers said this is a significant amount of bone loss and raises serious concerns about the long-term effects of taking phenytoin in young women with epilepsy.

AIDS: PROTEIN OFFERS NOVEL TARGET FOR BLOCKING HIV INFECTION
Researchers at the National Human Genome Research Institute and Boston University have uncovered a new route for attacking the human immunodeficiency virus, or HIV, that may offer a way to circumvent problems with drug resistance. In findings published in the online edition of the Proceedings of the National Academy of Sciences, the researchers report that they have blocked HIV infection in the test tube by inactivating a human protein expressed in key immune cells. Most of the drugs now used to fight HIV target the virus’s own proteins, but the ability of the virus to mutate can lead to the emergence of drug-resistant strains. Interest has grown in attacking HIV by developing drugs that target proteins of human cells, which are far less prone to mutations than are viral proteins. In the new study the researchers found that when they interfered with a human protein called interleukin-2-inducible T cell kinase or ITK they inhibited HIV infection of the immune system’s T cells. ITK is a signaling protein that activates T cells as part of the body’s healthy immune response.

HORMONE THERAPY: TREATMENT RAISES RISK OF STROKE IN POST-MENOPAUSAL WOMEN
Post-menopausal women taking hormone therapy appear to have an increased risk of stroke regardless of when they started treatment, according to a report in the Archives of Internal Medicine. Researchers at Brigham and Women’s Hospital and Harvard Medical School, both in Boston, evaluated stroke risk associated with hormone therapy in 121,700 women (age 30 to 55 at the beginning of the study) who participated in the Nurses’ Health Study from 1976 to 2004. There were 360 cases of stroke among women who had never used hormones and 414 cases of stroke among women who were currently using hormones. Compared to women who had never used hormones, women currently taking hormone therapy had an increased risk for stroke (39 percent for those taking estrogen and 27 percent for those taking estrogen with progestin). The researchers said the findings indicate that hormone therapy is associated with an increased risk of stroke regardless of the hormone regime or the timing of hormone therapy initiation. For younger women, though, who are at lower absolute risk of stroke, the attributable risk of stroke owing to hormone use is modest. The researchers said that risk might be further minimized by lower doses and shorter duration of treatment.

IDIOPATHIC PULMONARY FIBROSIS: BIOMARKERS FOUND TO DIAGNOSE AND MONITOR LETHAL LUNG DISEASE
Researchers at the University of Pittsburgh School of Medicine reported in the open-access journal PLoS Medicine the first evidence of a distinctive protein signature that could help to transform the diagnosis and improve the monitoring of the devastating lung disease idiopathic pulmonary fibrosis. The researchers describe a unique combination of blood proteins that appears to distinguish IPF patients from healthy people with extraordinary sensitivity and precision. The findings, they said, suggest doctors may be able to monitor what is happening in the lungs by measuring certain proteins in the peripheral blood. IPF is a degenerative illness distinguished by progressive lung scarring and diminished breathing capacity, typically leading to death within about five years of diagnosis. It is estimated that 5 million people worldwide and 130,000 in the United States are affected by pulmonary fibrosis and about 30,000 people die of the disease every year. The researchers analyzed the concentrations of 49 proteins in the plasma of 74 patients with IPF and 53 without. A combination of five proteins related to normal tissue breakdown and remodeling and certain disease processes, including arthritis and cancer, was found to be highly indicative of IPF. 

NANOTECHNOLOGY: RESEARCHERS USE DNA TO MAKE INTRICATE NANO-SIZED OBJECTS
Researchers at the Biodesign Institute at Arizona State University are using DNA to make intricate nano-sized objects. DNA, often thought of as the molecule of life, is an ideal building block for nanotechnology because they self-assemble, snapping together into shapes based on natural chemical rules of attraction, the researchers said. In an article published in the Journal of the American Chemical Society, researchers report they have made the first self-assembled nanostructures composed entirely of glycerol nucleic acid (GNA)—a synthetic analog of DNA. The DNA helix is made up of just three simple parts: a sugar and a phosphate molecule that form the backbone of the DNA ladder, and one of four nitrogenous bases that make up the rungs.

 

QUALITY OF CARE: AFRICAN-AMERICANS HAVE FIVE TIME HIGHER RATE OF AMPUTATIONS IN NORTHERN ILLINOIS
The overall amputation rate in northern Illinois is declining due to improved care for diabetes and peripheral vascular disease, but researchers from Northwestern University's Feinberg School of Medicine has found people in African-American communities on Chicago’s south and west sides have a five times higher rate of lower limb amputations than people in the predominantly white suburbs and exurbs. The researchers called amputations “the canary in the coal mine for quality of care.” The high amputation rate is linked to lack of access to primary care and specialty care for diabetic patients and patients with vascular disease, according to the researchers. In addition, patients without diabetes may not get a screening for peripheral arterial disease, an inexpensive test to indicate risk factors for circulation problems. About half of the people who have amputations are diabetic patients with decreased circulation to the feet. Almost all who have amputations are smokers, a habit that can cause hardening of the arteries and clots in the legs.

 

CANCER: SURVIVORS WHO PRACTIVE HEALTHY HABITS HAVE HIGHER QUALITY OF LIFE
A study from the American Cancer Society finds cancer survivors who follow health behavior recommendations – avoiding tobacco, eating more fruits and vegetables, and getting adequate exercise—have higher health-related quality of life scores than those who do not follow such recommendations. The study, which appears in the Journal of Clinical Oncology, also finds cancer survivors have low rates of smoking, but few are meeting physical activity recommendations or meeting the “5-A-Day” fruit and vegetable consumption recommendation, suggesting a cancer diagnosis may change smoking behavior but have little impact on exercise and healthy eating. The analysis revealed that eight out of 10 survivors were not meeting the 5-A-Day recommendation. Up to seven out of 10 were not meeting recommendations for physical activity.

 

MENOPAUSE: HORMONE MAY PREDICT AGE ON ONSET
Age at menopause may now be predicted more realistically, according to researchers at the University Medical Center Utrecht in Utrecht, the Netherlands. The study, which will be published in the Journal of Clinical Endocrinology & Metabolism, could help people make better informed decisions about family planning. The study revealed that anti-Müllerian hormone levels are related to the onset of menopause and are able to specify a woman’s reproductive age more accurately than chronological age alone. The levels of AMH in the blood reflect the number of small follicles present in a woman’s ovaries. This follicle stock enables reproduction by ensuring monthly ovulations. Depletion of the stock leads to menopause, which normally occurs between 40 and 60 years of age.

The five-year cost of care for elderly Medicare patients diagnosed with cancer in 2004 is estimated at $21.1 billion, according to a new study published online in the Journal of the National Cancer Institute. The five-year cost is highest for patients with lung, colorectal, and prostate cancers. As the U.S. population expands and ages, the incidence of cancer and its associated costs are expected to rise, researches at the National Cancer Institute in Bethesda, Maryland said.

 

CARDIOVASCULAR: SOME WOMEN MORE LIKELY TO IGNORE HEART ATTACK WARNING SIGNS
Many women under age 55 aren’t seeking timely treatment for a heart attack because they expect the warning signs to include tightening in the chest, shortness of breath, and clutching the chest while dropping to one knee, according to researchers from the Yale School of Medicine in New Haven, Connecticut. The researchers presented their study at the American Heart Association’s 9th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke. The researchers found in a study of 30 women with an average age of 48 who had heart attacks that most failed to connect their symptoms with a heart condition, commonly misattributing them to fatigue, indigestion, stress, or overexertion. The women were surprised that their actual symptoms differed from the “Hollywood heart attack” that they would have expected. They said they wish that they had known that symptoms such as neck and shoulder pain, abdominal discomfort that was easy to mistake for indigestion, or unusual fatigue could signal a heart problem.

 

HEALTHCARE COSTS: PUBLIC SPENDS $45 BILLION ON HEALTH COSTS FOR FULL TIME WORKERS AND FAMILIES
Health coverage for full-time workers and their family members without employer coverage costs the U.S. public $45 billion a year, according to a report from The Commonwealth Fund released today. This includes $33 billion in the cost of public coverage such as Medicaid and the State Children’s Health Insurance Program, and $12 billion in uncompensated care expenses—which are paid by Federal, state, and local governments and shifted to other payers—provided to uninsured workers and dependents. The study, conducted by researchers at Columbia University, found that 19 million full-time workers and their dependents were uninsured in 2004, compared to 16 million in 1999. Eleven million workers and their dependents were enrolled in public programs in 2004, up from 6 million in 1999, a 70 percent increase over the five-year period. The cost borne by the public for workers not covered by their own employers is largely a result of fewer workers and worker family members obtaining health insurance coverage through their employers, even among those employed by firms with more than 100 employees.

 

CARDIOVASCULAR: HARMFUL BLOOD GLUCOSE LEVELS LINKED TO GENETIC DEFECT
Researchers at Imperial College London, the French National Research Institute, and McGill University in Canada have identified a genetic mutation that can raise the amount of glucose in a person's blood to harmful levels. High levels of blood glucose increase the risk of cardiovascular disease and early death, even in healthy people who do not have diabetes and whose blood glucose levels are at the higher end of the range considered “normal” by doctors. In a study in the journal Science, the researchers reveal an association between high levels of blood glucose and a mutation in a gene known as G6PC2 or IGRP. The research shows that the mutated IGRP gene blocks the action of a sensor called glucokinase. By stopping glucokinase from doing its job, the gene prevents the body from keeping tight control over its levels of blood glucose. Glucokinase works by signaling to cells known as beta cells which then secrete insulin to keep blood glucose levels under control.