October 15, 2006, 7:37 PM CT

Physicians Hinder Use Of Cutting Edge Technology In Diabetes

Diabetic patients who use newer technologies such as insulin pumps and blood glucose monitoring devices are better able to manage their disease and adhere to treatment regimens, with less daily pain, than with conventional treatments, according to Duke University researchers. Yet researchers have found that the newer methods to manage diabetes are not being widely used because physicians may be reluctant to prescribe them, and even patients who are using them may not be deriving their full benefits.

According to the Duke researchers, the lack of strong scientific evidence on the efficacy of newer devices, combined with insufficient patient-education resources for physicians and their patients, hinders the diffusion of new devices and contributes to their incorrect use. In addition, the researchers pointed to the higher costs of newer medical technologies and the demographics of diabetes as probable causes of low usage - i.e., its disproportionate prevalence among racial and ethnic minorities, persons of low socioeconomic status, and the elderly.

These findings have emerged from a literature review conducted by the Medical Technology Assessment Working Group at Duke University, focusing on technologies used to monitor glucose and deliver insulin outside of conventional methods, such as daily injections and finger stick tests.........

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October 15, 2006, 7:21 PM CT

Drug Might Give Prolonged Arthritis Relief

Researchers at Duke University have devised a new way to significantly prolong the effects of an anti-inflammatory drug, potentially making it useful for providing longer-lasting treatment for osteoarthritis, the most common form of arthritis.

The modified drug, which would be injected directly into arthritic joints, could last for several weeks rather than just the few hours the unmodified drug would last, the researchers said.

In their study, the researchers modified a drug called interleukin-1 receptor antagonist (IL1RA). They found that the drug, which is a protein, could be improved by attaching a second protein that clumps together at normal body temperatures. The combined drug likewise would assemble into clumps in the body to serve as "drug depots" that gradually release active drug particles, the researchers said.

"Although the conventional drug is being used for autoimmune diseases, no one yet knows how much of it would be needed to achieve a therapeutic effect for osteoarthritis," said Lori Setton, associate professor of biomedical engineering and surgery. "Current estimates suggest it would require perhaps two injections per week of the unmodified drug.

"With this advance, we believe treatments could go from twice a week to perhaps twice a month, and that would be a huge clinical gain," she said.........

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October 15, 2006, 6:54 PM CT

Reward Perception In Cocaine Addiction

People addicted to cocaine have an impaired ability to perceive rewards and exercise control due to disruptions in the brain's reward and control circuits, according to a series of brain-mapping studies and neuropsychological tests conducted at the U.S. Department of Energy's Brookhaven National Laboratory.

"Our findings provide the first evidence that the brain's threshold for responding to monetary rewards is modified in drug-addicted people, and is directly linked to changes in the responsiveness of the prefrontal cortex, a part of the brain essential for monitoring and controlling behavior," said Rita Goldstein, a psychologist at Brookhaven Lab. "These results also attest to the benefit of using sophisticated brain-imaging tools combined with sensitive behavioral, cognitive, and emotional probes to optimize the study of drug addiction, a psychopathology that these tools have helped to identify as a disorder of the brain".

Goldstein will present details of these studies at a press conference on neuroscience and addiction at the Society for Neuroscience (SfN) annual meeting in Atlanta, Georgia, on Sunday, October 15, 2006, 2 to 3 p.m., and at a SfN symposium on Wednesday, October 18, 8:30 a.m.*.

Goldstein's experiments were designed to test a theoretical model, called the Impaired Response Inhibition and Salience Attribution (I-RISA) model, which postulates that drug-addicted individuals disproportionately attribute salience, or value, to their drug of choice at the expense of other potentially but no-longer-rewarding stimuli -- with a concomitant decrease in the ability to inhibit maladaptive drug use. In the experiments, the scientists subjected cocaine-addicted and non-drug-addicted individuals to a range of tests of behavior, cognition/thought, and emotion, while simultaneously monitoring their brain activity using functional magnetic resonance imaging (fMRI) and/or recordings of event-related potentials (ERP).........

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October 15, 2006, 6:27 PM CT

Potential New Treatments For Birth Defects

May be after a while those babies need not be born with cleft lip and palate. New research is paving way for treatment of these birth defects while they are still in womb.

University of Manchester researchers have uncovered the causes behind two genetic conditions that lead to facial anomalies including clefts, where the lip and often the roof of the mouth, or palate, fail to form properly.

Working with colleagues at the University of Iowa, Manchester husband and wife team Mike and Jill Dixon together with researcher Rebecca Richardson, have identified the role of a gene called IRF6.

"We had previously shown that a mutation in the IRF6 gene causes Van der Woude syndrome a rare inherited form of cleft lip and palate," said Professor Mike Dixon, a dentist based in the Faculty of Life Sciences.

"It has also been found that defects in this gene are responsible for a significant number of other cleft lip and palate disorders that are not related to any particular syndrome".

The team established that mice missing the gene developed abnormal skin as well as cleft palate. Further analysis revealed that IRF6 controls the development of keratinocytes the main type of cells in the outer layers of the skin, known as the epidermis.

"Put simply, mutations of IRF6 in Van de Woude syndrome make the skin cells too sticky, so they stick to each other and other types of cell much sooner than they should resulting in these facial anomalies," said Professor Dixon.........

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October 12, 2006, 4:46 AM CT

Researchers Refocus Studies On Patients With HIV, Hepatitis

"People are living longer with HIV now, but then we see people developing complications from liver disease due to hepatitis," says Dr. Mamta Jain, assistant professor of internal medicine at UT Southwestern Medical Center. "Before we had effective HIV treatment, there was no interest in treating hepatitis C because the thought was the patient would die of AIDS. Well, they're not dying of AIDS, so we are making an effort to try to treat more patients for hepatitis C".

Other diseases, such as cirrhosis or hepatocellular cancers, progress faster in co-infected HIV and hepatitis patients. As a result, health-care providers are trying to intervene as early as possible, said Dr. Jain, who specializes in infectious diseases.

Dr. Jain oversees a co-infection clinic at Parkland Memorial Hospital where patients are reviewed for hepatitis and HIV and can participate in clinical trials. Generally, co-infection rates range from 10 percent to 33 percent of HIV patients. Rates run at about 25 percent at the clinic in Parkland, which is the teaching hospital for UT Southwestern.

UT Southwestern has several ongoing clinical trials for which doctors are recruiting potential patients. The latest study involves whether giving hepatitis C, or HCV, medications early on during HIV disease speeds recovery or improves hepatitis therapies.........

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October 11, 2006, 8:21 PM CT

Allergy Runs In The Family

Infants whose parents have allergies that produce symptoms like wheezing, asthma, hay fever or hives risk developing allergic sensitization much earlier in life than previously reported, according to a study by Cincinnati researchers.

The study suggests that the current practice of avoiding skin testing for airborne allergens before age 4 or 5 should be reconsidered, so children in this high-risk group can be detected early and monitored for the possibility of later allergic respiratory disease.

Produced by scientists in UC's departments of environmental health and internal medicine and at Cincinnati Children's Hospital Medical Center, the study is reported in the October 2006 edition of The Journal of Pediatrics.

The Cincinnati researchers collected data on 680 children being evaluated for enrollment in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS), sponsored by the National Institute of Environmental Health Sciences (NIEHS), and compared their results with findings in a 2004 Swedish study.

Using the skin-prick allergy test, the Swedish group found that in their general population-which included children whose parents did not suffer from allergies-7 percent had allergic sensitivity at age 1. The Swedes tested five allergens, two of which were food allergens.........

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October 11, 2006, 4:55 AM CT

Rheumatoid Arthritis Patients Face Unofficial Postcode Lottery

People suffering from the debilitating pain of rheumatoid arthritis (RA) face a postcode lottery over whether they can have access to a treatment that is known to improve their condition significantly.

New research published in the medical journal Rheumatology [1] today (11 October 2006) reveals that, despite the National Institute for Health and Clinical Excellence (NICE) approving anti-tumour necrosis factor alpha (TNF) therapy for RA in 2002, many primary care trusts are refusing to fund it adequately or are putting a cap on the numbers of patients that can be treated.

The picture is even worse for the use of anti-TNF therapy in other arthritic conditions such as psoriatic arthritis (PsA) and ankylosing spondylitis (AS) where NICE approval has only just been given or is being awaited.

As a result of these findings, rheumatologists are calling on the Government and primary care trusts to end the unofficial postcode lottery and ensure that every patient who meets the NICE criteria can receive anti-TNF therapy if their consultants consider it appropriate.

Dr Lesley Kay, a member of the British Society for Rheumatology Biologics Register (BSRBR) management committee and co-author of the research, said: "The BSRBR urges the Government and primary care trusts to put an end to this patently unfair situation, which is in direct contravention of government policy. The postcode lottery continues to operate, even though NICE aims to stop this happening. It's unfair on patients with these devastating, painful and unglamorous conditions to be forced to take a low priority and to be deprived of this very successful treatment".........

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October 10, 2006, 9:57 PM CT

Material That Stops Bleeding In Seconds

MIT and Hong Kong University researchers have shown that some simple biodegradable liquids can stop bleeding in wounded rodents within seconds, a development that could significantly impact medicine.

When the liquid, composed of protein fragments called peptides, is applied to open wounds, the peptides self-assemble into a nanoscale protective barrier gel that seals the wound and halts bleeding. Once the injury heals, the nontoxic gel is broken down into molecules that cells can use as building blocks for tissue repair.

"We have found a way to stop bleeding, in less than 15 seconds, that could revolutionize bleeding control," said Rutledge Ellis-Behnke, research scientist in the MIT Department of Brain and Cognitive Sciences.

This study, which will appear in the online edition of the journal Nanomedicine on Oct. 10, marks the first time that nanotechnology has been used to achieve complete hemostasis, the process of halting bleeding from a damaged blood vessel.

Doctors currently have few effective methods to stop bleeding without causing other damage. More than 57 million Americans undergo nonelective surgery each year, and as much as 50 percent of surgical time is spent working to control bleeding. Current tools used to stop bleeding include clamps, pressure, cauterization, vasoconstriction and sponges.........

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October 9, 2006, 10:04 PM CT

Target For Leukemia Treatment

Cincinnati Children's Hospital Medical Center today announced the publication of pioneering research identifying the crucial role and novel mechanism of action of the protein RhoH GTPase in the development and activation of cells critical to the immune system. The findings, along with other studies, suggest that RhoH GTPase may provide a target for therapeutic intervention in some types of leukemia. The paper is due to appear in an upcoming edition of the journal Nature Immunology and was recently posted in the advance online publication section of the journal's website, http://www.nature.com/ni/index.html.

The paper describes detailed genetic and biochemical studies undertaken by researchers in the Division of Experimental Hematology and the Division of Immunobiology. The scientists succeeded in identifying a crucial role for RhoH GTPase in the development of thymocytes and activation of T-lymphocytes, both key processes in immune cell development. In addition, the researchers uncovered a novel mechanism for regulating RhoH activity, which may have broad implications in improving researchers' understanding of the mechanism of action of the Rho GTPase protein family and provide a potential target for leukemia drug development.

"We continue to make important progress in deciphering the molecular processes involved in the development and maintenance of the immune and blood system and how disruption of key proteins may contribute to leukemia," said David A Williams, M.D., Director of Experimental Hematology, Cincinnati Children's. "Through a collaboration with Ohio State University Comprehensive Cancer Center, we are now focused on translating these findings into developing new ways to target the protein as a novel approach to treating hematological malignancy".........

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October 9, 2006, 9:14 PM CT

Progress In HIV Research

How a harmless virus called GB Virus type C (GBV-C) protects against HIV infection is now better understood. Scientists at the Department of Veterans Affairs (VA) Iowa City Health Care System and the University of Iowa have identified a protein segment that strongly inhibits HIV from growing in cell models.

The team observed that an 85-amino acid segment within a GBV-C viral protein called NS5A greatly slows down HIV from replicating in cells grown in labs. The study results will appear online this week in the Proceedings of the National Academy of Sciences.

The finding builds on earlier VA and UI work showing that people with HIV who also are infected GBV-C live longer than those infected only with HIV, said Jinhua Xiang, M.D., a VA research health scientific specialist, UI researcher and the current study's principal author.

GBV-C and its role in HIV infection have been studied for nearly a decade by Xiang, along with another study author Jack Stapleton, M.D., staff doctor and researcher at the VA Iowa City Health Care System and professor of internal medicine at the UI Roy J. and Lucille A. Carver College of Medicine.

"Identifying a specific protein made by GBV-C that inhibits HIV growth in cell culture strengthens the argument that GBV-C is responsible for the prolonged survival observed in several studies of HIV-positive people," Xiang said. "Understanding how the protein works may allow us to develop target-specific therapies that can mimic these effects and inhibit HIV.........

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