Medicalindustry Blog

Cigarette smoking is beginning to be recognized as a form of severe drug addiction. Unlike addictive drugs, the effects of tobacco are slow in developing, usually requiring decades of exposure before causing premature disability and death.

Tobacco is the leading preventable cause of death with more than five million dying from the effects of tobacco every year, more than from HIV/AIDS, malaria, and tuberculosis combined.

Tobacco is the only legal consumer product that kills. Through promotional campaigns, the industry continues to divert attention from the deadly effects of its products. More countries are fighting back by requiring that tobacco packages graphically show the dangers of tobacco, a requirement called for in the World Health Organization Framework Convention on Tobacco Control. Effective health warnings, especially those that include pictures have been proven to motivate users to quit and to reduce the appeal of tobacco for those who are not yet addicted.

The theme of World No-Tobacco Day on May 31, 2009, “Tobacco Health Warnings” cautions people about nicotine as a highly addictive substance. Requiring warnings on tobacco packages is a simple, effective strategy that can vastly reduce tobacco use and save lives. If left unchecked, the lung cancer burden of tobacco will more than triple in the next 25 years.

We must help and convince current smokers to quit and prevent the tobacco industry from using its marketing techniques to lure the world’s children into deadly cigarette addiction.

We have to act now to eliminate the global scourge of tobacco and save hundreds of millions of lives in the next decades.

Government warning: Smoking is dangerous to your health. So quit smoking and live longer.

If you’re near a park in Ogden, don’t light up.

The city unveiled its new smoke free outdoor recreation signs this afternoon.

It’s part of the new law in Weber and Morgan Counties that kicks in on Monday. It bans smoking in outdoor public places.

Anyone caught violating the new law will face a $25 fine.

Hormone therapy taken by women to counter the effects of menopause can increase the risk of dying from lung cancer, researchers reported here on Saturday.

The findings represent the latest black mark against a therapy already being used much more sparingly than it once was. But researchers said the new data should serve as a caution to women who did continue to take hormones not to smoke.

“We shouldn’t be using both combined hormone therapy and tobacco at the same time,” said Dr. Rowan Chlebowski of the Harbor-U.C.L.A. Medical Center in California and lead author of the study, which was presented at the annual meeting of the American Society of Clinical Oncology.

Dr. Chlebowski said there was one avoidable lung cancer death over eight years for every 100 women who both smoked and took hormone therapy.

The new analysis used data from the Women’s Health Initiative study, in which women took either Prempro, a drug combining estrogen and progestin, or a placebo. The study was discontinued in 2002 after it was found that the hormone therapy increased the risk of breast cancer.

The new analysis looked specifically at lung cancer for the five and a half years that the women took either the drug or the placebo and for more than two years afterward.

There were 96 cases of non-small-cell lung cancer, the most common type of the disease, among the roughly 8,000 women who used hormone therapy, compared with 72 cases among the nearly equal number who took the placebo. That difference was not statistically significant, meaning it could have occurred by chance.

But there were 67 deaths from lung cancer among the hormone users versus 39 among those who took the placebo, a result that was statistically significant.

Among smokers, 3.4 percent of hormone users died from lung cancer, compared with 2.3 percent of those who got the placebo. Among women who never smoked, 0.2 percent of hormone users died from lung cancer, compared with 0.1 percent of those who got the placebo.

Dr. Otis Brawley, the chief medical officer of the American Cancer Society, said he was not convinced that the results were not due to chance, given that there was a meaningful difference in deaths but not in number of cases.

In another study presented here, researchers reported that the drug Avastin showed signs that it could help prevent the recurrence of colon cancer, but the effect wore off after patients stopped taking it.

Avastin, which blocks the flow of blood to tumors, has been a best-selling cancer drug that is used for late-stage cancers. But the new study, involving 2,700 patients, looked at whether the drug could be given earlier, immediately after a colon tumor was removed by surgery. The idea was to keep cancer from coming back and effectively “cure” the patient.

Genentech, the manufacturer of the drug, announced in April that the drug had failed to prevent recurrence, though it provided no details at that time.

The data released here on Saturday showed that after three years, 77.4 percent of those who received a year of Avastin along with six months of standard chemotherapy were alive and disease free. That compared with 75.5 percent of those who got the chemotherapy alone, an insignificant difference.

After only the first year, however, when patients were taking Avastin, 94.3 percent of those who got the drug were cancer-free and alive compared with 90.7 percent of those who got chemotherapy alone, a difference that was statistically significant.

“It was effective, but that efficacy disappeared after the year in which bevacizumab was given,” said Dr. Norman Wolmark, chairman of the group of researchers, sponsored by the National Cancer Institute, who conducted the trial. Bevacizumab is the generic name for Avastin.

Dr. Wolmark said the research group hoped now to conduct a trial in which the drug would be given for two or more years.

But the prospect of giving Avastin for such a long duration is already raising concerns among doctors, not least because the drug costs about $50,000 a year when used to treat colon cancer. Moreover, the majority of patients with early colon cancer are already kept from relapsing by surgery and chemotherapy alone. So Avastin might have to be given for a long time to a lot of people to prevent a relatively few relapses.

“We have to think hard about long-term chemotherapy in our patients due to the impact on quality of life and the costs,” said Dr. Jennifer C. Obel, a gastrointestinal oncologist at NorthShore University HealthSystem in Chicago. “Are we going to be giving bevacizumab for three years, four years?”

Dr. Hal V. Barron, chief medical officer for Genentech, which is now owned by the Swiss drug company Roche, said the results “suggest promise for future trials.” He said the company offered programs to help patients obtain its drugs.

The use of hormone-replacement therapy by menopausal women increases their risk of death from lung cancer by 60 percent after five years, U.S. researchers reported on Saturday.

Doctors once thought that hormone therapy, or HRT, could protect women from chronic diseases, especially heart disease.

But use of the drugs plunged after 2002 when the large Women’s Health Initiative study was stopped after finding that HRT could raise the risk of breast and ovarian cancer, strokes and other serious conditions.

Tobacco smoking is the leading cause of lung cancer. About 85 percent to 90 percent of lung cancer deaths are directly caused by smoking, according to the American Cancer Society.

Among smokers, the use of HRT could be particularly problematic because they already have an increased risk of developing disease, researchers said.

“Women almost certainly shouldn’t be using combined hormone therapy and tobacco at the same time,” said Dr. Rowan Chlebowski, a medical oncologist at Harbor-UCLA Medical Center in Los Angeles and lead author of the study, which analyzed data from the Women’s Health Initiative.

Lung cancer is the leading cause of cancer death in U.S. women.

The trial studied the use of Wyeth’s (WYE.N) combined estrogen/progestin hormone-replacement therapy, Prempro.

Since 2001, sales of Wyeth’s hormone products have plunged by about 50 percent to around $1 billion a year, and the bulk of sales are now estrogen-replacement drug Premarin and cream formulations, said Joseph Camardo, head of medical affairs at Madison, New Jersey-based Wyeth.

“Practice has already changed significantly,” he said. “Guidance and the label have changed … use has shifted toward much shorter duration and lower doses.”

The Wyeth official noted that the average age of women in the Women’s Health Initiative was 63, and the participants used high doses of Prempro over long periods of time.

Chlebowski said previous research suggested that hormones play a role in non-small cell lung cancer, the most common form of the disease, because women tend to have higher survival rates than men and respond better to certain therapies.

His study, presented here at a meeting of the American Society of Clinical Oncology, was the first to show a correlation in a randomized clinical trial setting.

The World Health Organization (WHO) selects “Tobacco Health Warnings” as the theme for the World No Tobacco Day 2009, which will take place on 31 May 2009.

Tobacco health warnings appear on packs of cigarettes and are among the strongest defences against the global epidemic of tobacco.

WHO particularly approves of tobacco health warnings that contain both pictures and words because they are the most effective at convincing people to quit. Such pictorial warnings appear in more than a dozen countries.

On World No Tobacco Day 2009, and throughout the following year, WHO will encourage governments to adopt tobacco health warnings that meet all the criteria for maximal effectiveness, including that they cover more than half of the pack, appear on both the front and back of the pack and contain pictures.

The WHO Framework Convention on Tobacco Control obligates its more than 160 countries parties to require “health warnings describing the harmful effects of tobacco use” on packs of tobacco and their outside packaging and recommends that the warnings contain pictures. WHO works through its Tobacco Free Initiative department to help the parties to meet their obligation, providing technical and other assistance.

As WHO Director General Margaret Chan says, “We hold in our hands the solution to the global tobacco epidemic that threatens the lives of one billion men, women and children during this century.”

Tobacco health warnings are a big part of the solution about which Dr Chan speaks.

World No Tobacco Day is observed around the world every year on May 31. The member states of the World Health Organization created World No Tobacco Day in 1987. It draws global attention to the widespread prevalence of tobacco use and to its negative health effects. The day aims to reduce the 5.4 million yearly deaths from tobacco related health problems. From 1988 the WHO has presented one or more World No Tobacco Day (WNTD) Awards to organizations or individuals who have made exceptional contributions to reducing tobacco consumption. On May 31st, 2008 the WHO called for a complete ban on tobacco advertising; the organization said studies establish a relationship between exposure to cigarette advertisement and starting smoking.

MRI scans that detect shrinkage in specific regions of the mid-brain attacked by Alzheimer’s disease accurately diagnose the neurodegenerative disease, even before symptoms interfere with daily function, a study by the Florida Alzheimer’s Disease Research Center (ADRC) in Miami and Tampa found.

The study, reported earlier this month in the journal Neurology, adds to a growing body of evidence indicating MRI brain scans provide valuable diagnostic information about Alzheimer’s disease. The findings are important in light of many new disease-modifying drugs in trials — treatments that may prevent mild memory loss from advancing to full-blown dementia if administered early enough.

“We advocate, based on these findings, that the criteria for the diagnosis of Alzheimer’s disease should include MRI scans,” said the study’s lead author Ranjan Duara, MD, medical director of the Wien Center for Alzheimer’s Disease and Memory Disorders at Mount Sinai Medical Center who is affiliated with the University of Miami Miller School of Medicine and University of South Florida College of Medicine. “By incorporating MRIs into the assessment of patients with memory problems, early diagnosis can be standardized and done far more accurately.”

“This study demonstrates that MRI brain scans are accurate enough to be clinically useful, both in diagnosing Alzheimer’s disease itself at an early stage and in identifying people at risk of developing Alzheimer’s,” said Florida ADRC Center Director Huntington Potter, PhD, a neuroscientist at the Byrd Alzheimer’s Center and Research Institute, University of South Florida.

Alzheimer’s disease, the most common cause of dementia, is characterized by memory loss, disorientation, difficulty with reasoning and the decline of language and thinking skills. Alzheimer’s is diagnosed by a process of elimination since many other diseases and related disorders can mimic its symptoms, and autopsy is currently the only definitive way a diagnosis can be confirmed. The diagnosis often includes a medical history, mental status tests, neurological evaluations and blood tests. Physicians typically use brain scans only to exclude conditions that can also cause memory deficits, such as strokes and brain tumors.

The Florida researchers used a new visual rating system to evaluate the severity of shrinkage, or atrophy, in the brain’s medial temporal lobe – specifically in three structures essential for the conscious memory of facts and events. They compared the MRI brain scans of 260 people – a group with probable Alzheimer’s disease, two groups with varying degrees of mild cognitive impairment (mild memory problems), and a control group of normal elderly with no discernable memory loss. They found that scores generated by this MRI-facilitated test accurately distinguished each group from the other and correlated with the types of memory problems most frequently caused by Alzheimer’s disease. The more extensive the brain atrophy, the more advanced the clinical stage of Alzheimer’s disease.

The researchers even found brain atrophy in some people without memory complaints at the study’s onset who demonstrated memory decline when assessed a year or two later. This suggests MRIs could predict who will get the disease well before signs of dementia become apparent by other diagnostic methods as well as rule out an Alzheimer’s diagnosis in people experiencing memory problems, Dr. Duara said. “If you don’t have changes in these three particular areas of the brain, then you don’t have Alzheimer’s.”

Researchers at centers like Miami’s Wien Center and USF’s Byrd Institute are developing new Alzheimer’s drugs that attack mechanisms leading to the death of nerve cells and their connections. The emergence of these disease-modifying treatments has made an earlier diagnosis of Alzheimer’s increasingly important, Dr. Duara said. “Having an accurate diagnosis will allow us to start using drugs earlier. The earlier treatment begins, the more likely you are to stop disease progression and benefit the patient.”

Most participants in the MRI study were enrolled in the clinical arm of the Florida ADRC, which is supported by a grant from the National Institute on Aging.

The Florida ADRC, the first statewide, multi-center ADRC in the United States, was critical for the successful implementation of the study, said Dr. Potter, the study’s senior author. “To validate any new diagnostic test or treatment, you need a large number of diverse volunteers for good comparisons. Alzheimer’s research is a partnership between the scientific community and study volunteers; we need both to solve the complexities of Alzheimer’s disease.”

With the aid of a straightforward experiment, researchers have provided some clues to one of biology’s most complex questions: how ancient organic molecules came together to form the basis of life.

Specifically, this study, appearing online this week in JBC, demonstrated how ancient RNA joined together to reach a biologically relevant length.

RNA, the single-stranded precursor to DNA, normally expands one nucleic base at a time, growing sequentially like a linked chain. The problem is that in the primordial world RNA molecules didn’t have enzymes to catalyze this reaction, and while RNA growth can proceed naturally, the rate would be so slow the RNA could never get more than a few pieces long (for as nucleic bases attach to one end, they can also drop off the other).

Ernesto Di Mauro and colleagues examined if there was some mechanism to overcome this thermodynamic barrier, by incubating short RNA fragments in water of different temperatures and pH.

They found that under favorable conditions (acidic environment and temperature lower than 70 C), pieces ranging from 10-24 in length could naturally fuse into larger fragments, generally within 14 hours.

The RNA fragments came together as double-stranded structures then joined at the ends. The fragments did not have to be the same size, but the efficiency of the reactions was dependent on fragment size (larger is better, though efficiency drops again after reaching around 100) and the similarity of the fragment sequences.

The researchers note that this spontaneous fusing, or ligation, would a simple way for RNA to overcome initial barriers to growth and reach a biologically important size; at around 100 bases long, RNA molecules can begin to fold into functional, 3D shapes.

The reason for the length of time in processing refunds under the nursing home repayment scheme is that the majority of the claim forms were deficient in some way, according to Health Minister Mary Harney

Minister Harney told the Dáil recently that three-quarters of all claim forms were deficient and that two-thirds of the forms were missing some piece of critical information, which meant that the claim could not be processed until the scheme administrator had written to the potential claimant and requested the required information. Over 13,400 estates who have lodged claims did not have a grant of representation, as required by law, and the scheme administrator has had to establish probate before the claim can be progressed.

According to the Minister, this is to ensure that the person entitled to claim on behalf of an estate is the person who ultimately receives the repayment. The HSE has advised the Minister that it is anticipated that the remaining offers, totalling over 300, will be processed by the end of the year. However, the Minister noted that the repayments offered cannot be paid until the statutory 28-day period for appeal has elapsed and a completed acceptance form has been re­turned to the scheme administrator.

To date, over 35,000 applications for living and deceased patients have been received by the scheme, which was established in 2005. Approximately 33,000 of the claims received by the scheme administrator have been pro­cessed, which in­cludes almost 19,000 offers of repayment totaling more than €362 million. Over 14,900 actual payments have been made totaling over €317 million. Spokesperson for Age Action Ireland Mr Eamon Timmins told IMN that the society welcomed the news that the repayments process is nearing completion and said the abiding lesson from the scheme is that the State cannot take money from patients without a legal framework to do so.

Trinity College Dublin’s Annual Med Day, held in Dublin in early November, has raised €57,500

A spokesperson for the project told IMN last week that they are donating €32,500 to the Centre for Cardiovascular Risk in Younger Persons, Tallaght Hospital, Dublin, for the purchase of an exercise machine. “We are giving €20,000 to the acute stroke services, St James’s Hospital, Dublin, to buy electrical beds, and finally €5,000 to TAP (Trinity Access Prog­ramme),” added the spokesperson. Over 400 students took to the streets of Dublin from 7am on Trinity Med Day on Nov­ember 7 to collect the money. The online donation site www.tcdmedday.com will be accepting donations for another four weeks.

One of the main obstacles encountered by young research scientists is the lack of a career structure, which makes becoming an independent researcher ex­tremely difficult, the Irish Cancer Society (ICS) has said

The Society has just introduced a fellowship scheme worth €450,000 aimed at bridging this gap by supporting career development in cancer research, and so help to cultivate the next generation of independent cancer researchers in Ireland.The initial grants will support two young researchers over the next three years, €75,000 per fellowship each year, said Prof Cliona O’Farrelly, Chairperson, Cancer Research Committee, ICS, who invited applications for next year’s awards from people at an early stage in their career. Further details are available on the website www.cri.cancer.ie.

This year’s recipients of the scheme, Ms Laura Barkley of the National Centre for Biomedical Engineering Science, NUI, Galway, and Ms Fiona Furlong, of the Conway Institute, UCD, are working in the topical areas of breast cancer and ovarian cancer research, respectively. Ms Furlong is investigating why some women suffering from ovarian cancer do not respond to paclitaxel chemotherapy. She hopes the understanding will help her design a predictive test that can be used in the hospital to discriminate between patients that should not be treated with this chemotherapeutic agent, and thus prevent unwanted side effects in the absence of any beneficial outcome.

Ms Barkley will investigate the regulation of specific proteins or molecules by microRNAs in both normal cells and cancer cells to help increase our understanding of how this regulation is lost in individuals that succumb to cancer.