Archive for March, 2009

Stem Cellers in NIH’s Hands

March 31st, 2009 | No Comments | Source: Washington Post

In 2001, George W. Bush signed an order limiting federal funding for stem cell research to already existing lines. Many believe the move squelched progress on the most promising medical frontier in a generation.

oregonducksstemcellsThe Big O promised during the campaign that he’d overturn the ban, and the minute the polls closed back in November the NIH began drafting guidelines assuming he’d do just that.

Most assumed that when Obama got around to following through on his promise, he’d specify that federal dollars should be used only to support research on unused embryos produced as a byproduct of in vitro fertilization; embryos that would otherwise be discarded.

Instead, he chose not to specify anything about the sources of stem cells for medical research.

He tasked the NIH to make recommendations in this regard, and he wants answers in 120 days.

This neatly fulfilled another campaign promise, which was to reinvolve scientists in deliberations regarding ethics. The punt also leaves open the possibility that taxpayer dollars could be used to support broader, more controversial experiments.

Would it be OK to use embryos created specifically for research purposes or by cloning, for example?

Obama quickly closed the door on latter, saying “we will ensure that our government never opens the door to the use of cloning for human reproduction.” 

NIH officials were surprised and delighted to receive the broader assignment.

They promised to consult guidelines created by the National Academy of Sciences and the International Society for Stem Cell Research, which already permit research on stem cells from multiple sources.

“The president’s order offers us the opportunity to look carefully at how we might best identify responsible and scientifically worthy science that the NIH should be funding,” Story Landis told the Washington Post.

He’s the man in charge of the NIH stem cell task force and the clock is ticking.



Anybody for a Shirley Temple?

March 31st, 2009 | No Comments | Source: Cancer Epi. Bio. & Prev., MedPageToday

thisiskillingmeSadly, the adage that moderate alcohol intake carries minimal risk and may actually be beneficial in some ways has taken a beating lately.

First,  a study out of Oxford  showed that one lousy alcoholic beverage per day increases the risk of multiple cancers in women.

And now, scientists at the Harvard School of Public Health are reporting that people who consume 2 or more alcoholic drinks per day have a 22% higher risk for pancreatic cancer.

Stephanie Smith-Warner and colleagues published the disquieting news in Cancer Epidemiology Biomarkers and Prevention.

The scientists had noted that in several prospective cohort analyses, risk ratios for developing pancreatic cancer were greater than one when high alcohol intake cohorts were compared with teetotalers, but in none of these studies did the difference reach statistical significance.

nateskiesoverdwightThat’s a situation that begs for a meta-analysis, and Smith-Warner’s team jumped all over it.

The scientists rolled-up 14 studies involving 860,000 people, spun the numbers and eked out the finding.

The increased risk for pancreatic cancer remained intact after full multivariate adjustment for known risk factors like age, diabetes, smoking and BMI.

Oddly, it held for women only. There was a trend in the same direction for men, but it wasn’t significant.

A similar, non-significant trend was found for those consuming fewer than 2 drinks per day, but the association only achieved significance in the 2+ drinks per day cohort.

The type alcoholic beverage didn’t matter, by the way. Wine, beer, hard stuff, it was all the same.



That’s a lot of HIV

March 30th, 2009 | No Comments | Source: Washington Post

At least 3% of Washington, DC residents have HIV or AIDS, according to a CDC-funded report by the George Washington University School of Health and Health Services.

wewillturnthisaroundThat’s a 22% increase in just 2 years and 3 times the threshold normally reserved for describing a generalized and severe epidemic. 

In black men, the infection rate approaches 7%. The rate is 3% in black women.

“Our rates are higher than West Africa,” Shannon Hader told the Washington Post. Currently director of the District’s HIV/AIDS Office, Hader once ran CDC projects in Zimbabwe.

“We have every mode of transmission,” she added. “Men having sex with men, heterosexual and injected drug use (they’re all) going up.” 

Hader took over 2 years ago. She is the District’s 12th AIDS Office director in 19 years, and the third in last 5.

Half the DC residents with ties to particularly hard hit neighborhoods reported having overlapping sexual partners in the last year, and only 30% reported using a condom the last time they had sex.

Meanwhile, Congress had until last year, prevented the District’s AIDS office from using tax dollars for a needle exchange program.

And the report cautions that “that the true number of (District) residents currently infected and living with HIV is certainly higher” than 3%, because this number is based only on people who’ve gotten tested. 

Mayor Adrian Fenty added that “to solve an issue as complex as HIV/AIDS, you have to step up.  It’s the mayor and other elected officials, but it’s also the community. You have this problem affecting us, and you tell people how serious it is and it literally goes in one ear and out the other.”


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Gilead Lookin’ Good

March 30th, 2009 | No Comments | Source: Fortune

When Gilead Sciences agreed to acquire CV Therapeutics for $1.4 billion in cash, the prize was Ranexa, the first totally new anti-angina drug approved for first line therapy in 30 years.

Gilead believes Ranexa can boost its cardiovascular business as it gathers itself to launch its hypertension drug Darusentan, which looks solid late in Phase III.

gileadBut unlike other pharmaceutical players that are using acquisition as a primary growth strategy, Gilead also generates growth internally.

California-based Gilead has been on Fortune’s list of Fastest Growing Companies for 3 out of the last 4 years. Its stock has doubled since 2004, and it’s down only 10% since the Feds played Russian roulette with Lehman Brothers and the chamber turned out to be loaded.

The S&P has dropped 47% since then.

The secret to Gilead’s success is a trio of HIV treatments which drove nearly 90% of its $5.3 billion revenues in 2008.

These drugs all leverage Gilead’s proprietary compound, tenofovir, which is prescribed in one form or another for 80% of new HIV patients in the US, and nearly that many in the EU.

goodstuff1New HHS guidelines now list these drugs, and no others, as the preferred backbone therapy for HIV/AIDS.

Patients find Gilead’s one-a-day combo pills, Truvada and Atripla easier to manage, so they’re more likely to stick with the plan and that drives better outcomes.

Gilead also stands to benefit from evidence-driven public policy shifts towards earlier detection and treatment of HIV which will increase the size of the treated population and the duration of therapy.

“Gilead identified the importance of convenience, less frequent dosing, and combination pills earlier than anyone else,” said Geoffrey Porges, an analyst at Sanford Bernstein.



Pope gets it wrong in Africa

March 30th, 2009 | 1 Comment | Source: Economist

popebenedictPope Benedict XVI commands respect and reverence from his flock of 135 million Catholics in Africa, and that showed during his recent visit to Cameroon and Angola.

In response, he delivered a message of compassion and heartfelt recognition that the continent suffers disproportionately from poverty, famine, financial upheaval and climate change.

But he did flub one matter.

When asked to comment about the role of condoms in Africa’s war on AIDS, Pope Benedict stated, again, this time even more explicitly than usual, his belief that they are not just unhelpful in assuaging the epidemic, but that they exacerbate the scourge.

AIDS, he said, can be licked by abstaining from sex and following “correct behavior.”

justthefactsHe said this on a continent where 20 million have already died from AIDS and even more than that are HIV positive.

Certainly condom distribution by itself is not an answer.

Other strategies are required such as education, helping women achieve control over their sex lives, delaying onset of sexual behavior, broadening distribution of antiretroviral therapies and so forth.

But condom distribution programs work. According to the WHO, properly used condoms reduce HIV transmission by 90%. And when Uganda’s president, Yoweri Museveni talked openly about “ABC” habits—abstain, be faithful, use condoms, infection rates fell in his country.

Conversely, public figures that ignore the facts or get them wrong endanger the lives of many.

Harvard scientists estimated last year for example that that the callous behavior of South Africa’s Thabo Mbeki has caused 330,000 avoidable deaths due to AIDS.

In denying the facts about condoms in AIDS prevention, Pope Benedict turned a cold shoulder to the world’s weakest. That’s the group he should be working hardest to defend.


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Obama to Pitch Just for Men?

March 27th, 2009 | No Comments | Source: NY Times

The economy’s doing its Titanic impression, nobody wants to play with Tiny Tim, and now his NCAA hoops bracket is shot to smithereens.

Is it any wonder the Big O’s going gray?

The Coronated One takes after his 2 predecessors when it comes to rapid acquisition of the Salt ‘n Pepa look.

Clinton went from  Mongrel Half-Brown to Silver in 2 years. George W. Bush morphed from Heavily Flecked, Blended Black-Brown to Neutral Gray almost overnight.

“I started noticing it toward the end of the campaign and leading up to inauguration,” Deborah Willis told the New York Times.

The co-author of “Obama: The Historic Campaign in Photographs,” Willis examined 5,000 Big O jpegs last year alone.

Obama’s gray-outs wax and wane with his haircuts, which happen every other week. His barber, who goes by Zariff and that’s it, is on record denying the flip-flops are caused by the Big O dyeing his hair.

“His hair is 100 percent natural,” Zariff thundered to the New York Times. “He wouldn’t get it colored.”

Obama claims his staff hasn’t been ribbing him about the unfortunate turn of events, but surely Rahm Emanuel wouldn’t miss an opportunity slip in a shiv here and there.

Meanwhile, noted authorities are eager to weigh in on the matter. For Walt Frazier, who knew a thing or two about cool back in the day, it was a no-brainer. Obama should dye his hair.

It’s “no play for Mr. Gray,” Clyde warned.




March 27th, 2009 | No Comments | Source: J. Studies on Alcohol & Drugs, MedPageToday

Mom and dad can’t handle liquor the way they used to even though they think they can, and it’s a matter of time before the same fate befalls younger revelers.

one'senoughMillie!That’s what Rebecca Gilbertson and her team at U. Kentucky concluded after performing a randomized double-blind experiment to evaluate the impact of age on intoxication at alcohol levels typically associated with social, or moderate drinking.

The scientists probably had no trouble recruiting 42 adults between 50-74 years of age and another 26 adults between 25 and 35 for the study. Participants owned up to drinking in moderation at least once a month.

Gilbertson’s group used controlled alcohol administration techniques known to produce breath alcohol concentrations similar to a bout of social drinking (40 mg/100 ml), administered psychomotor coordination tests and collected self-reported data regarding perceived intoxication and impairment.

They did that once while blood alcohol levels were rising in participants’ bloodstreams and once while they were descending.

It turned out that on the ascending limb of the trip, older adults exhibited more psychomotor impairment and tended to underestimate how impaired they were compared with the hotshot 25-35 year-olds.

The results “reinforce common knowledge that self-reported measures of alcohol intoxication may not provide an accurate reflection of performance outcomes and that older adults may be impaired even at a moderate dose of alcohol,” wrote the authors. 

“This potential disconnection between self-reported and behavioral effects of alcohol may have significant implications for public health and safety, particularly among active, older social drinkers.”

The write-up is in Journal of Studies on Alcohol and Drugs.



Let’s Spread MRSA!

March 27th, 2009 | No Comments | Source: BurrillReport

When Giant Food began offering free antibiotics to shoppers in the DC area, it was just catching up with competitors like ShopRite, Stop and Shop and Wegman’s.

We “are committed to improving the health and wellness in our communities during the winter season when families are susceptible to coughs, colds, and bacteria-borne illnesses,” the Giant’s Andrea Astrachan said back in December at the time of the launch.

igotanideaForget that antibiotics don’t work against viruses, the proud sponsors of cold and flu season!

Don’t worry that inappropriate use of antibiotics spreads MRSA, methicillin-resistant Staphylococcus aureus which can maim, even kill!

Overlook the study in Clinical Infectious Diseases which found that antibiotics trigger 142,000 ED visits per year, mostly to deal with allergic reactions!

“Taking an antibiotic when you don’t need it won’t help you, and may in fact do more harm than good,” Anne Gershon understated to BurrillReport.

The president of the Infectious Diseases Society of America added that “at a time when… few new antibiotics are being developed, supermarkets need to be responsible in how they promote antibiotics.”

Recently, the IDSA and the CDC asked supermarkets to help promote a CDC-sponsored consumer education program known as “Get Smart: Know When Antibiotics Work.”

Meanwhile Jamie Miller, Giant Food’s public affairs director reminded everyone that the policy is helpful to consumers battered by The Great Economic Crisis.

“Doctors who prescribe antibiotics are…making decisions on what they feel is best…and oftentimes that is a prescription for an antibiotic and we are there to help.” Miller told Burrill. igotabetteridea

And next year maybe Giant Foods’ll just go with a flu shot campaign and leave it at that.



The Avatar will see you now II

March 26th, 2009 | 1 Comment | Source: Wall Street Journal

In January, the Hawaii Medical Service Association began offering Internet-based “house calls” in which physicians communicate with patients using streaming video, text chat or phone.

HMSA-covered patients pay $10 for a 10-minute exchange but anyone can get the same 10 minutes in heaven for $45.

Boston-based American Well is choreographing that show, and now other companies have entered the market.

swiftmdSwiftMD offers services in the New York-New Jersey area and TelaDoc is giving it a go in Dallas.

They all have immediate plans to expand, according to the Wall Street Journal.

teladocThey have to be careful though since physicians’ licenses to practice medicine are good only for the issuing state.

And the scope of practice matter is dicey for the new tool, so the companies are going slowly.

SwiftMD for example lists on its site the ailments in its wheelhouse: allergies, colds and flu, rashes, things like that.

The very young and very old are not eligible, nor are those with pregnancy-related issues or serious mental health issues like psychoses.

morningroundsBig Apple resident Leah Light received a subscription to SwiftMD as a gift from her mom.

Light takes prescription meds for an anxiety disorder.

She recently used the service to refill her prescription.

The online visit lasted 55 minutes and cost $55 with a discount.

 Last time she did things the old fashioned way. The doctor visit was time-consuming and set back the uninsured graduate student $260.

“I feel reassured (that) if I need to talk to a doctor, I can without having to blow my food budget for a month,” Light told the Journal. “It makes me feel a lot better.”


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In the Midnight Hour

March 26th, 2009 | No Comments | Source: CNN, National Sleep Foundation

Recent studies have shown that sleep-deprived people are 3 times more likely to catch a cold than the well rested and that each hour of rack time above 5 is associated with a 33% drop in the risk of developing (egad) coronary artery disease.

Meanwhile, 40% of Americans believe that getting adequate sleep is as important to overall health and well being as diet and exercise.

thisisntmypillowIt doesn’t matter.

Americans are cutting back on sleep relentlessly.

According to a poll conducted by the National Sleep Foundation, the number of Americans who average less than six hours a night jumped from 13% to 20% between 2001 and 2008, while the number claiming to get at least eight fell from 38% to 28%.

In addition, 54% of adults-which works out to 110 million licensed drivers-report having driven while drowsy at least once last year. Frighteningly, nearly a third report nodding off or flat out falling asleep while driving a vehicle last year.

“The economy is a major factor why people are losing sleep,” understated sleep expert Raj Kakar to CNN.

To which David Cloud added, “it’s easy to understand why so many people are concerned over the economy and jobs, but sacrificing sleep is the wrong solution.”

The CEO of the National Sleep Foundation added, “sleep is essential for productivity and alertness and is a vital sign for one’s overall health.”

And besides, the sleep-skipping trend antedated the Great Economic Crisis, aided and abetted as it has been by SportsCenter, the Internet, cell phones and Crackberries, not to mention what Wilson Pickett had in mind.

imeanlightsOUT!And there’s a macho thing, too.

“Our society has valued people who brag about being able to function on very little sleep as a mark of someone who is aggressive, dynamic, successful,” Neil Kavey, Director of the Sleep Disorder Center at Columbia told CNN.



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