The death rates of children with HIV have decreased ninefold since doctors started prescribing cocktails of antiretroviral drugs in the mid-1990s, concludes a large-scale study of the long-term outcomes of children and adolescents with HIV in the United States. In spite of this improvement, however, young people with HIV continue to die at 30 times the rate of youth of similar age who do not have HIV, found researchers from the National Institutes of Health and other institutions.Earlier studies have shown that adults with HIV are living longer because of improved multi-drug antiretroviral regimens known as highly active antiretroviral therapy (HAART). However, limited information has existed about the effectiveness of HAART in improving the survival of children with HIV. The current analysis, published in the Dec. 15 issue of the Journal of Acquired Immune Deficiency Syndromes, delineates the effects of HAART on the rates and causes of death for HIV-infected children and adolescents.

Conducted by the Pediatric AIDS Clinical Trials Group, the study was co-funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Institute of Allergy and Infectious Diseases (NIAID), both part of NIH. The study’s first author is Michael T. Brady, M.D., of Nationwide Children’s Hospital in Columbus, Ohio.

In 1994, the mortality rate for HIV-infected children and youth younger than 21 years of age in the United States was 7.2 deaths per 100 person years (a rate based on the number of children in the study and the total number of years each child was followed). By 2000, that rate had plummeted to 0.8 deaths per 100 person years and remained stable through 2006. The mean age at death for HIV-infected youth in the study more than doubled from 8.9 years in 1994 to 18.2 years in 2006.

Although this represents a dramatic improvement in survival, the death rate for children with HIV is approximately 30 times higher than that of similarly aged U.S. children who do not have HIV. Multi-organ failure and kidney disease are now major causes of death for HIV-infected children and adolescents. Infections also continue to cause deaths in this group of patients. However, the type of infections has changed, from infections traditionally associated with AIDS to infections that are more common in children without HIV infection.

"The findings are very encouraging, but they still show a need for improvement," said Alan Guttmacher, M.D., acting director of NICHD. "For both adults and children, combination antiretroviral therapy is highly effective in preventing the opportunistic infections and other complications resulting from HIV infection. We must now better understand and pursue treatments for children and adolescents to address the other conditions resulting from HIV infection."

"Basic research and clinical studies funded by NIH beginning in the 1980s laid the foundation for the development of the more than two dozen drugs now available to fight HIV, enabling many children infected with the virus to live into adulthood,"said NIAID Director Anthony S. Fauci, M.D. "Now we face the challenge of effectively treating the consequences of long-term HIV infection in people who have been infected since childhood."

Between 1993 and 2006, the researchers tracked 3,553 U.S. children and adolescents infected with HIV. Of those children, 298 died. Growing numbers of children with HIV began receiving HAART between 1994 and 2000, and death rates declined annually during that period. Nearly 60 percent of all deaths in the study occurred before 1997, before the advent of HAART for the treatment of children; moreover, children who died were almost four times as likely to have never received HAART as those who survived.

"A wonderful change has occurred: Most HIV-infected children now reach adulthood," said Lynne Mofenson, M.D., an author of the paper and chief of the Pediatric, Adolescent and Maternal AIDS branch at NICHD. "Will these children have a normal lifespan? Unfortunately, we don’t have all the answers yet. Currently, we don’t have the means to prevent all the complications of HIV infection."

In the early years of the study, secondary infections killed more than one-third of the children who died, but from 2002 to 2006, that proportion fell to less than one-fourth. Over time, children and adolescents with HIV became more likely to die of kidney failure, stroke, or AIDS-induced multiple organ failure.

To try to prevent these deaths, another long-term study of children with HIV called the Pediatric HIV/AIDS Cohort Study is being funded by NICHD, NIAID, the National Institute on Drug Abuse, the National Institute on Deafness and Other Communication Disorders, the National Heart, Lung, and Blood Institute, and the National Institute of Mental Health. This study is monitoring how children and adolescents with the virus grow and develop, what complications they experience, and whether they experience side effects from their medication.

"To keep these children healthy, we need to learn more about how HIV and anti-HIV drugs affect their growing bodies," said Dr. Mofenson. "We took a big leap in our understanding with this study, and the next pediatric cohort study will lead to even more improvements in understanding HIV infection and its treatment in youth."

Guarantees Women Health Care Access 

12-7-2009 From Senator Barbara Mikulski: Last week, the Senate put women first in health care reform when it passed my amendment to guarantee women access to preventive care and screenings at no cost. It was the first amendment considered and approved in the Senate's debate on health care reform.

We must end the punitive practices of the private insurance companies that treat simply being a woman as a preexisting condition. That's why I support the Senate health reform bill and why I introduced my amendment. In the United States of America, health care is a women's issue. Health care reform is a must-do women's issue, and health insurance reform is a must–change women's issue.

Too often women face the punitive practices of insurance companies that charge women more and give them less in benefits. A 25–year–old woman pays more for health insurance than her male counterpart of the same health status. A 40–year–old woman pays almost 35 percent more for her insurance than a man of similar age and health status.

More than half of American women report that they skip or delay needed care due to cost. My amendment guarantees that women of all ages will receive, at no cost, an annual women's health exam, which will include screenings for the leading causes of death for women — cancer, heart disease, and chronic illnesses such as diabetes.

Right now, insurance company bureaucrats decide what preventive services will be covered for women. But we know that early detection saves lives, curtails the expansion of disease, and, in the long run, saves money. That's why my amendment expands key preventive services for women based on recommendations of women's health experts - scientists and doctors - and supported by the Centers for Disease Control and the Health Resources and Services Administration.

And under my amendment, decisions about preventive care and screenings - like mammograms - will be made between a woman and her doctor in a medical office. It will not be made by an insurance company, a member of Congress or by a stranger.

Without this amendment, there would be no guarantee that women under 50 would be covered for mammograms, no guarantee of an annual women's health exam that would include screenings for heart disease, and no guarantee that women would have access to this preventive care at no cost. Insurance companies have used every trick in the book to deny coverage to women. This amendment makes sure that the insurance companies must cover the basic care that women need at no cost.

It's a big step forward. But with votes on the final legislation ahead, the fight's not over yet. Women can count on me to keep fighting for them on the Senate floor and all the way to the White House to end punitive insurance company practices that discriminate against women in the insurance marketplace.

WASHINGTON, D.C. – The United States Senate today passed in a 61 to 39 vote an amendment authored by U.S. Senator Barbara A. Mikulski (D-Md.) that guarantees women preventive health care screenings and care at no cost. It is the first amendment to The Patient Protection and Affordable Care Act approved by the Senate.

Diabetes Sufferers

According to the American Diabetes Association: There are 23.6 million people in the United States, or 8% of the population, who have diabetes. The total prevalence of diabetes increased 13.5% from 2005-2007. Only 24% of diabetes is undiagnosed, down from 30% in 2005 and from 50% ten years ago

17.9 million people have been diagnosed with diabetes in 2007, and there are 57 million people who are predisposed to the disease.  

What can be done to help prevent this disease and the foot and hand removal surgeries that must be done when it gets too bad? Diabetes is preventable in many cases. What can be done to improve someones chances of not having to remove their feet, legs or hands is to change their diets immediately, and get them to exercize regularly. Easier said than done I know, however, eating smarter can literally save their lives.

Acccording to the Diabetes Association:

Under 20 years of age: 186,300, or 0.22% of all people in this age group have diabetes. About one in every 400 to 600 children and adolescents has type 1 diabetes.

Two (2) million adolescents (or 1 in 6 overweight adolescents) aged 12-19 have pre-diabetes.

Although type 2 diabetes can occur in youth, the nationally representative data that would be needed to monitor diabetes trends in youth by type are not available. Clinically-based reports and regional studies suggest that type 2 diabetes, although still rare, is being diagnosed more frequently in children and adolescents, particularly in American Indians, African Americans, and Hispanic/Latino Americans.

Age 20 years or older: 23.5 million, or 10.7% of all people in this age group have diabetes.

Age 60 years or older: 12.2 million, or 23.1% of all people in this age group have diabetes.

>Men: 12.0 million, or 11.2% of all men aged 20 years or older have diabetes although nearly one third of them do not know it.

Women: 11.5 million, or 10.2% of all women aged 20 years or older have diabetes although nearly one quarter of them do not know it. The prevalence of diabetes is at least 2 to 4 times higher among non-Hispanic Black, Hispanic/Latino American, American Indian, and Asian/Pacific Islander women than among non-Hispanic white women. For additional information see

Famous People Who Have Diabetes Include:

Elizabeth Taylor, The Legendary Elvis Presley,Kelli Keuhne - LPGA golfer,Billie Jean King - Tennis,Walt Frazier - NBA - New York Knicks,“Smokin’ Joe” Frazier - Boxing,Ayden Byle - Runner - First insulin-dependent man to run 6521.5 km across North America.Ralph Bunche - Nobel Peace Winner, U.N. Diplomat,Winnie Mandela - South Africa Anti-Apartheid Leader,Sonia Sotomayor - Federal Judge on the US Court of Appeals for the Second Circuit; nominated by President Barack Obama for appointment to the US Supreme Court.

More:

Thomas Edison - Inventor of the light bulb, phonograph, Dr. George Minot - First person with diabetes to receive Nobel Prize for Medicine,Ernest Hemingway - Author (For Whom the Bell Tolls; A Farewell to Arms; The Sun Also Rises,Mario Puzo - Author (The Godfather),Anne Rice - Author (Interview With a Vampire),Carl Rowan - Nationally-syndicated columnist and author.

Colorectal Cancer Screening Demonstration Program and Activities Across the Nation

9-4-2009

In 2005, the Centers for Disease Control and Prevention (CDC) established five new colorectal cancer screening demonstration programs to provide screening and diagnostic services to U.S. adults aged 50 years and older. Five program sites were selected to participate in this three-year program. Each site is focusing efforts on screening low-income men and women who have inadequate or no health insurance coverage for colorectal cancer screening. The program sites also provide diagnostic follow-up; conduct public education and outreach; have established standards, systems, policies, and procedures; develop and maintain partnerships; collect and track data; and evaluate the effectiveness of the demonstration program.

The demonstration program sites are—

Baltimore City Colon Cancer Screening Program (Maryland Department of Health and Mental Hygiene)

Missouri Screen for Life (Missouri Department of Health and Senior Services)

Nebraska Colon Cancer Screening Program (Nebraska Department of Health and Human Services)

Project SCOPE (Stony Brook University Medical Center/SUNY, New York)

Washington Colon Health Program (Public Health - Seattle and King County, Seattle, WA) 

Accolades to Senator Edward M. (Teddy) Kennedy

"I was terribly saddened to hear of the death of Ted Kennedy tonight. Given our political differences, people are sometimes surprised by how close Ronnie and I have been to the Kennedy family. But Ronnie and Ted could always find common ground, and they had great respect for one another. In recent years, Ted and I found our common ground in stem cell research, and I considered him an ally and a dear friend. I will miss him." Nancy Reagan.

"Today America lost a great elder statesman, a committed public servant, and leader of the Senate. And today I lost a treasured friend. Ted Kennedy was an iconic, larger than life United States senator whose influence cannot be overstated. Many have come before, and many will come after, but Ted Kennedy's name will always be remembered as someone who lived and breathed the United States Senate and the work completed within its chamber."Senator Orrin Hatch.

Washington, DC—Senate Majority Leader Harry Reid made the following statement today… “The Kennedy family and the Senate family have together lost our patriarch. My thoughts, and those of the entire United States Senate, are with Vicki, Senator Kennedy’s children, his many nieces and nephews, and his entire family. “It was the thrill of my lifetime to work with Ted Kennedy. He was a friend, the model of public service and an American icon.

"As we mourn his loss, we rededicate ourselves to the causes for which he so dutifully dedicated his life. Senator Kennedy’s legacy stands with the greatest, the most devoted, the most patriotic men and women to ever serve in these halls. Because of Ted Kennedy, more young children could afford to become healthy. More young adults could afford to become students. More of our oldest citizens and our poorest citizens could get the care they need to live longer, fuller lives. More minorities, women and immigrants could realize the rights our founding documents promised them. And more Americans could be proud of their country.

Ted Kennedy’s America was one in which all could pursue justice, enjoy equality and know freedom. Ted Kennedy’s life was driven by his love of a family that loved him, and his belief in a country that believed in him. Ted Kennedy’s dream was the one for which the founding fathers fought and for which his brothers sought to realize.

The liberal lion’s mighty roar may now fall silent, but his dream shall never die." Senate Majority Leader Harry Reid.

Electronic Health Records

CHICAGO, IL – Vice President Joe Biden today announced the availability of grants worth nearly $1.2 billion to help hospitals and health care providers implement and use electronic health records. The grants will be funded by the American Recovery and Reinvestment Act of 2009 (ARRA) and will help health care providers qualify for new incentives that will be made available in 2010 to doctors and hospitals that meaningfully use electronic health records.

"With electronic health records, we are making health care safer; we’re making it more efficient; we’re making you healthier; and we’re saving money along the way, "said Vice President Biden. "These are four necessities we need for healthcare in the 21st-century."

"Expanding the use of electronic health records is fundamental to reforming our health care system," said HHS Secretary Sebelius. "Electronic health records can help reduce medical errors, make health care more efficient and improve the quality of medical care for all Americans. These grants will help ensure more doctors and hospitals have the tools they need to use this critical technology."

The grants made available today include:

Grants totaling $598 million to establish approximately 70 Health Information Technology Regional Extension Centers, which will provide hospitals and clinicians with hands-on technical assistance in the selection, acquisition, implementation, and meaningful use of certified electronic health record systems.

Grants totaling $564 million to States and Qualified State Designated Entities (SDEs) to support the development of mechanisms for information sharing within an emerging nationwide system of networks.

"With these programs, we begin the process of creating a national, private and secure electronic health information system. The grants are designed to help doctors and hospitals acquire electronic health records and use them in meaningful ways to improve the health of patients and reduce waste and inefficiency," said Dr. David Blumenthal, National Coordinator for Health Information Technology. "They will also help states lead the way in creating the infrastructure for health information exchange, which enables information to follow patients within and across communities, wherever the information is needed to help doctors and patients make the best decisions about medical care."

Alzheimers

Alzheimer’s affects more than 5 million Americans; costs country $148 billion a year

WASHINGTON, D.C. – U.S. Senators Barbara A. Mikulski (D-Md.) and Kit Bond (R-Mo.) today introduced legislation to strengthen our nation’s commitment to Alzheimer’s research and to finding cures and treatments for this devastating disease affecting millions of Americans. The bill, the Alzheimer’s Breakthrough Act of 2009, builds on past efforts by Senators Mikulski and Bond to advance Alzheimer’s research. A companion bipartisan bill was introduced in the House of Representatives today by Congressmen Edward J. Markey (D-Mass.) and Chris Smith (R-N.J.).

“Wouldn’t you like to find a cure for Alzheimer’s? Wouldn’t you like to be part of a Congress that saved millions of lives? Well I do, and so do a bipartisan group of my colleagues,” said Senator Mikulski, Chairwoman of the Health, Education, Labor and Pensions (HELP) Committee’s Subcommittee on Retirement and Aging. “We know that more and more Americans are being diagnosed with Alzheimer’s disease every year. We must act now

“The tragic effects of Alzheimer’s disease continue to be felt by millions of Americans and their families every day,” said Senator Kit Bond. “This bipartisan legislation will dramatically increase our Nation’s efforts to find a cure for this debilitating disease and I am pleased to join again with Senator Mikulski in leading this effort.”

The Alzheimer’s Breakthrough Act of 2009 will:

• Increase funding for Alzheimer’s research at the National Institute of Health (NIH) from $400 million to $2 billion in 2010. The increase will give researchers the resources they need to make breakthroughs that are on the horizon in diagnosis, prevention and intervention.

• Establish a National Summit on Alzheimer’s disease to bring together the best researchers, policymakers and public health professionals to identify priorities for moving forward in the fight against Alzheimer’s and look at the most promising breakthroughs.

• Expand the Alzheimer’s 24/7 call center and provide updated news, resources and tools for caregivers, families and physicians. The call center would have a multilingual capacity.

• Expand the Alzheimer’s State Matching Grant Program.

Pelosi and Health Care Reform

7-22-2009

"Here we are today, one day closer than we have ever been in history — to enacting real health care reform. We’ve made great progress — two of our three Committees in the House, one of the two Committees in the Senate, as you know, have reported out legislation and the other two committees are hard at work in doing their jobs.

"Today, we are joined by four Americans who have tried to work hard and play by the rules and have ended up with crushing health care costs and debt. Vernon Le Count from Freedom, Maine, with tens of thousands of dollars in medical debt because of his health insurance had a waiting period and a high deductible. Molly Secours of Nashville, Tennessee, whose medical debt from uterine cancer could result in foreclosure on her home. Catherine Howard of San Francisco, California, and Jaclyn Michalos of Norwood, Massachusetts, who both beat cancer but had radically different experiences with their health insurance.

"America’s Affordable Health Choices Act takes a number of steps to ensure that when Americans face a health crisis, they also don’t face a financial crisis. Consumers will have more choices, so they can find plans without waiting periods and high deductibles. There will be an annual limit on out-of-pocket expenses and no lifetime limits on care. There will be no more co-pays or deductibles for preventive care that can catch devastating illnesses in time. And if you change your job or lose your job, or have pre-existing medical condition, you cannot be denied coverage.

"As you have heard, our Members of Congress have had experience in their lives and in their families and they have acted upon them in a public policy way. Our guests here today have been very generous; the generosity of their sprit, the eloquence of their words, sharing their stories with us speaks more eloquently to the need for this health care reform than anything that we can say as policymakers.

Spain and the US Immigration

Madrid, Spain—Department of Homeland Security (DHS) Secretary Janet Napolitano met with Spanish Interior Minister Alfredo Pérez Rubalcaba today and signed a Declaration of Principles formalizing the Immigration Advisory Program (IAP)—which allows for the identification of high-risk travelers at foreign airports before they board aircraft bound for the United States—at Madrid Barajas International Airport.

The arrangement will help combat the use of fraudulent travel documents, prevent terrorists and other criminals from entering the United States, disrupt alien smuggling and promote cooperation between DHS and the Ministry of the Interior. “Protecting our nation from terrorism requires close coordination with our international allies,” said Secretary Napolitano. “This collaboration enhances the capabilities of United States and Spain to facilitate legal travel and deter dangerous people attempting to enter our country.”

has operated as an extended pilot program in Madrid since February 11, 2008. Since its implementation, IAP Madrid has identified or prevented the travel of 402 improperly documented travelers, intercepted 23 persons with fraudulent documents, and stopped 10 terrorism-related suspects.

The IAP represents the third document signed between the United States and Spain in the past week. Along with the Letter of Intent to expand science and technology cooperation, signed on June 23, and the Agreement to Prevent and Combat Serious Crime, signed on June 24, the IAP will help both countries combat common threats and promote global security.

Secretary Napolitano’s visit to Spain was her fourth stop in a weeklong trip to the United Kingdom, Portugal, Kuwait and Ireland. In Ireland on Monday, Secretary Napolitano toured the new DHS secondary screening facility set to open on July 29 at Shannon Airport and discussed the implementation of a landmark Preclearance Agreement between the United States and Ireland with Irish Transport Minister Noel Dempsey. Secretary Napolitano also met with Irish Justice, Equality and Law Reform Minister Dermot Ahern to discuss a future information sharing agreement.

Smoking and Families

The President expressed his appreciation for Senator Ted Kennedy. Lamenting that the senator could not be there for the signing of Family Smoking Prevention and Tobacco Control Act, he called it "change that's been decades in the making." By all accounts, it is the strongest measure protecting children from the dangers of smoking to date.

He spoke on his personal experience:

I know -- I was one of these teenagers, and so I know how difficult it can be to break this habit when it's been with you for a long time. And I also know that kids today don't just start smoking for no reason. They're aggressively targeted as customers by the tobacco industry. They're exposed to a constant and insidious barrage of advertising where they live, where they learn, and where they play. Most insidiously, they are offered products with flavorings that mask the taste of tobacco and make it even more tempting.

We've known about this for decades, but despite the best efforts and good progress made by so many leaders and advocates with us today, the tobacco industry and its special interest lobbying have generally won the day up on the Hill. When Henry Waxman first brought tobacco CEOs before Congress in 1994, they famously denied that tobacco was deadly, nicotine was addictive, or that their companies marketed to children. And they spent millions upon millions in lobbying and advertising to fight back every attempt to expose these denials as lies.

>Fifteen years later, their campaign has finally failed. Today, thanks to the work of Democrats and Republicans, health care and consumer advocates, the decades-long effort to protect our children from the harmful effects of tobacco has emerged victorious. Today, change has come to Washington.

This legislation will not ban all tobacco products, and it will allow adults to make their own choices. But it will also ban tobacco advertising within a thousand feet of schools and playgrounds. It will curb the ability of tobacco companies to market products to our children by using appealing flavors. It will force these companies to more clearly and publicly acknowledge the harmful and deadly effects of the products they sell. And it will allow the scientists at the FDA to take other common-sense steps to reduce the harmful effects of smoking.

This legislation is a victory for bipartisanship, and it was passed overwhelmingly in both Houses of Congress. It's a victory for health care reform, as it will reduce some of the billions we spend on tobacco-related health care costs in this country. It's a law that will reduce the number of American children who pick up a cigarette and become adult smokers. And most importantly, it is a law that will save American lives and make Americans healthier.

Making clear that this legislation does not represent the end of the road on fighting back the health risks of smoking, the President nonetheless described it as another very significant sign of change in Washington:

>Despite the influence of the credit card industry, we passed a law to protect consumers from unfair rate hikes and abusive fees. Despite the influence of banks and lenders, we passed a law to protect homeowners from mortgage fraud. Despite the influence of the defense industry, we passed a law to protect taxpayers from waste and abuse in defense contracting. And today, despite decades of lobbying and advertising by the tobacco industry, we've passed a law to help protect the next generation of Americans from growing up with a deadly habit that so many of our generation have lived with.

Despite its small size, the study suggests that as few as eight weekly family sessions of cognitive behavioral therapy go a long way to prevent or minimize the psychological damage of childhood anxiety. Results of the study will appear in the June issue of the Journal of Consulting and Clinical Psychology.

“If psychiatrists or family doctors diagnose anxiety in adult patients, it’s now clearly a good idea that they ask about the patients’ children and, if appropriate, refer them for evaluation,” says senior investigator Golda Ginsburg, Ph.D., a child psychologist at Hopkins Children’s and associate professor of psychiatry at the Johns Hopkins School of Medicine. “Right now, most doctors don’t think about this, let alone broach the subject.”

Ginsburg says data show that the children of parents diagnosed with an anxiety disorder are up to seven times more likely to develop an anxiety disorder themselves, and up to 65 percent of children living with an anxious parent meet criteria for an anxiety disorder.

Prevention, rather than treatment, of childhood anxiety is critical because anxiety disorders affect one in five U.S. children but often go unrecognized, according to a recent editorial in The New England Journal of Medicine. Delay in diagnosis and treatment can lead to depression, substance abuse and poor academic performance throughout childhood and well into adulthood.

The Hopkins team studied 40 children between 7 and 12 not diagnosed with anxiety themselves but who had one or both parents diagnosed with an anxiety disorder. Half of the children and their families were enrolled in an eight-week cognitive behavioral therapy, while the other half were put on a waiting list and received no therapy at the time of the study, but were offered therapy a year later.

The program, consisting of hour-long weekly sessions was designed to help parents identify and change behaviors believed to contribute to anxiety in the children, while at the same time teaching children coping and problem-solving skills.

Within a year, 30 percent of the children in the no-intervention group had developed an anxiety disorder, compared to none of the children who participated in the family-based therapy. Parents along with researchers who evaluated the children and their parents independently reported a 40-percent drop in anxiety symptoms in the year following the prevention program. There was no reduction of anxiety symptoms among children on the waiting list.

The parental behaviors modified with treatment included overprotection, excessive criticism and excessive expression of fear and anxiety in front of the children. The program targeted such childhood risk factors as avoiding anxiety-provoking situations and anxious thoughts.

The Hopkins Children’s team is now conducting a larger study involving 100 families. Interested parents can obtain more information by e-mailing CAPS@jhmi.edu

Johns Hopkins

Makes list of 09 Business Ethics and Social Responsibility

May 28, 2009- The Ethisphere Institute, a New York-based think-tank established to advance best practices in business ethics and corporate social responsibility, has named The Johns Hopkins Hospital to its 2009 list of the business world’s most ethical companies and institutions.

The Johns Hopkins Hospital was one of 99 organizations selected from among hundreds of nominees in more than 100 countries and 35 industries. Criteria for selection include corporate citizenship and responsibility, corporate governance, innovation that contributes to public well-being, industry leadership, executive leadership, legal and regulatory performance, and solid ethics compliance programs. Further details of the methodology and selection process for the awards can be found at http://ethisphere.com/wme2009/.

“All of us at The Johns Hopkins Hospital are honored,” says Ronald R. Peterson, president of The Johns Hopkins Hospital. “The Hospital was established more than a century ago by a visionary man who clearly understood that not only must the finest health care be delivered within its walls, but also that this care must be delivered within a highly principled and ethical environment.”

Others on this year’s list include Patagonia, Toyota Motors, Dell, General Electric, General Mills, Cleveland Clinic, Marriott International, Safeway, Target, Time Warner, IKEA, Starbucks, and UPS.

Magazine, which publishes the World’s Most Ethical Companies Ranking™, is the quarterly publication of the Ethispher Institute. More information on the institute can be found at http://www.ethisphere.org.

A New Influenza Virus

Novel influenza A (H1N1) is a new flu virus of swine origin that was first detected in April, 2009. The virus is infecting people and is spreading from person-to-person, sparking a growing outbreak of illness in the United States. An increasing number of cases are being reported internationally as well.

It’s thought that novel influenza A (H1N1) flu spreads in the same way that regular seasonal influenza viruses spread; mainly through the coughs and sneezes of people who are sick with the virus.

It’s uncertain at this time how severe this novel H1N1 outbreak will be in terms of illness and death compared with other influenza viruses. Because this is a new virus, most people will not have immunity to it, and illness may be more severe and widespread as a result. In addition, currently there is no vaccine to protect against this novel H1N1 virus. CDC anticipates that there will be more cases, more hospitalizations and more deaths associated with this new virus in the coming days and weeks.

Novel influenza A (H1N1) activity is now being detected through CDC’s routine influenza surveillance systems and reported weekly in FluView. CDC tracks U.S. influenza activity through multiple systems across five categories. The fact that novel H1N1 activity is now detected through seasonal surveillance systems is an indication that there are higher levels of influenza-like illness in the United States than is normal for this time of year. About half of all influenza viruses being detected are novel H1N1 viruses.

Plastic Medical Devices

May 2009- Researchers at the Johns Hopkins University School of Medicine have found that a chemical commonly used in the production of such medical plastic devices as intravenous (IV) bags and catheters can impair heart function in rats. Reporting online this week in the American Journal of Physiology, these new findings suggest a possible new reason for some of the common side effects—loss of taste, short term memory loss--of medical procedures that require blood to be circulated through plastic tubing outside the body, such as heart bypass surgery or kidney dialysis. These new findings also have strong implications for the future of medical plastics manufacturing.

In addition to loss of taste and memory, coronary bypass patients often complain of swelling and fatigue. These usually resolve within a few months after surgery, but they are troubling, sometimes hinder recovery, but generally go away.

His personal experience with coronary bypass surgery propelled his search for a root cause for the loss of taste phenomenon, reports principal investigator Artin Shoukas, Ph.D., professor of biomedical engineering, physiology and anesthesiology and critical care medicine at Johns Hopkins. “I’m a chocoholic, and after my bypass surgery everything tasted awful, and chocolate tasted like charcoal for months.”

Shoukas and Caitlin Thompson-Torgerson, PhD, a postdoctoral fellow in anesthesiology and critical care medicine suspected the trigger for these side effects might be a chemical compound of some kind.

To test their theory, Shoukas and his team of researchers took liquid samples from IV bags and bypass machines before they were used on patients. The team analyzed the fluids in another machine that can identify unknown chemicals and found the liquid to contain a chemical compound called cyclohexanone. The researchers thought that the cyclohexanone in the fluid samples might have leached from the plastic. Although the amount of cyclohexanone leaching from these devices varied greatly, all fluid samples contained at least some detectable level of the chemical.

The researchers then injected rats with either a salt solution or a salt solution containing cyclohexanone and measured heart function. Rats that got only salt solution pumped approximately 200 microliters of blood per heartbeat and had an average heart rate of 358 beats per minute, while rats injected with cyclohexanone pumped only about 150 microliters of blood per heartbeat with an average heart rate of 287 beats per minute.

In addition to pumping less blood more slowly, rats injected with cyclohexanone had weaker heart contractions. The team calculated that cyclohexanone caused a 50 percent reduction in the strength of each heart contraction. They also found that the reflex that helps control and maintain blood pressure is much less sensitive after cyclohexanone exposure. Finally, the team observed increased fluid retention and swelling in the rats after cyclohexanone injections.

According to Thompson-Torgerson and Shoukas, they would like to figure out how these side effects—decreased heart function and swelling—occur and to what degree cyclohexanone is involved. Despite the findings in this study, they emphasize that patients should listen carefully to the advice of their physicians. “We would never recommend that patients decline this type of treatment if they need it,” says Shoukas. “On the contrary, such technologies are life-saving medical advances, and their benefits still far outweigh the risks of the associated side effects. As scientists, we are simply trying to understand how the side effects are triggered and what the best method will be to mitigate, and ultimately remedy, these morbidities.”

Swine Flu

CDC is working very closely with officials in states where human cases of swine influenza A (H1N1) have been identified, as well as with health officials in Mexico, Canada and the World Health Organization. This includes deploying staff domestically and internationally to provide guidance and technical support. CDC has activated its Emergency Operations Center to coordinate this investigation.Reports of infrctions have come from California 7 cases,Kansas 2 cases,New York City 8 cases,Ohio 1 case, and Texas 2 cases. Twenty cases all tgether in the US at the moment.

According to the CDC, Laboratory testing has found the swine influenza A (H1N1) virus susceptible to the prescription antiviral drugs oseltamivir and zanamivir and has issued interim guidance for the use of these drugs to treat and prevent infection with swine influenza viruses. CDC also has prepared interim guidance on how to care for people who are sick and interim guidance on the use of face masks in a community setting where spread of this swine flu virus has been detected. This is a rapidly evolving situation and CDC will provide new information as it becomes available.

CDC Reccomends everyday actions you can take to stay healthy:

* Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

* Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.

* Avoid touching your eyes, nose or mouth. Germs spread that way.

Try to avoid close contact with sick people.

* Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.

* If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

Swine Flu cannot be caught by eating pork products. At this time, CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with swine influenza viruses. You have to have come in contact with pigs somewhere, like a country fair, or farm, or work on a pig farm to get the flu.

Doctors Get New Test and Tools

Washington, D.C. – The National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, recently unveiled its first comprehensive Physicians’ Outreach Initiative, NIDAMED, which gives medical professionals tools and resources to screen their patients for tobacco, alcohol, illicit, and nonmedical prescription drug use. The NIDAMED resources include an online screening tool, a companion quick reference guide, and a comprehensive resource guide for clinicians. The initiative stresses the importance of the patient-doctor relationship in identifying unhealthy behaviors before they evolve into life threatening conditions.

"Many patients do not discuss their drug use with their physicians, and do not receive treatment even when their drug abuse escalates," said Dr. Volkow. "NIDAMED enables physicians to be the first line of defense against substance abuse and addiction and to increase awareness of the impact of substance use on a patient’s overall health."

In 2007, an estimated 19.9 million Americans aged 12 or older (around 8 percent of the population) were current (past month) users of illegal drugs—nearly 1 in 5 of those 18 to 25 years old—and many more are current tobacco or binge alcohol users. The consequences of this drug use can be far-reaching—playing a role in the cause and progression of many medical disorders, including addiction. Yet only a fraction of people who need addiction treatment receive it.

"I have long worked with NIDA to increase access to effective treatment in the battle against addiction," said Sen. Levin. "By encouraging physicians to consult with, screen and refer their patients who are in need of treatment, the NIDAMED initiative is a critical step towards achieving that goal. We must find ways to disseminate these important clinical tools, that can aid in mending lives and families, once torn asunder due to the scourge of addiction."

The NIDAMED tools were developed because doctors are in a unique position to discuss drug-taking behaviors with their patients before they lead to serious medical problems. Research shows that screening, brief intervention, and referral to treatment by clinicians in general medical settings, can promote significant reductions in alcohol and tobacco use.

"Not only will these tools potentially help clinicians identify the use of drugs such as cocaine and heroin, they can also identify patients who are misusing prescription medications," said Dr. Galson, a rear admiral in the U.S. Public Health Service. "In 2007, 16.3 million Americans age 12 and older had taken a prescription pain reliever, tranquilizer, stimulant, or sedative for nonmedical purposes at least once in the past year — behaviors that can lead to serious health problems, including addiction.”

"My doctor literally saved my life," said Mink Rockmoore, a former Boston-area radio announcer who is a recovering heroin addict. "He worked hard to build my trust; he listened to my fears in a non-judgmental way; and he arranged for me to get both detox and treatment."

Chronic Heart Failure

Regular exercise is safe for heart failure patients and may slightly lower their risk of death or hospitalization, according to results from the largest and most comprehensive clinical trial to examine the effects of exercise in chronic heart failure patients. Supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health, the study also found that heart failure patients who add regular, moderate physical activity to standard medical therapy report a higher quality of life compared to similar patients who receive medical therapy only.

Researchers with HF-ACTION (Heart Failure – A Controlled Trial Investigating Outcomes of exercise TraiNing) have published two papers in the April 8, 2009, issue of the Journal of the American Medical Association. The study was conducted at 82 centers in the United States, Canada, and France.

"Many patients and health care providers have continued to be concerned about the safety of aerobic exercise for heart failure," said NHLBI Director Elizabeth G. Nabel, M.D. "With the results of this robust clinical trial, we can now reassure heart failure patients that, with appropriate medical supervision, regular aerobic exercise is not only safe but it can also improve their lives in really meaningful ways."

About 5 million people in the United States have heart failure, a potentially life-threatening condition in which the heart has a reduced ability to pump blood through the body. The number of people with heart failure is growing, and each year, another 550,000 people are diagnosed for the first time.

The leading cause of hospitalization among Americans age 65 and older, heart failure usually develops over several years and commonly results from coronary artery disease, high blood pressure, or diabetes. Treatment typically includes lifestyle changes, medicines, and regular outpatient follow-up with a health care provider. Some patients also need medical devices to help the heart pump better, or surgeries, such as a coronary artery bypass operation or heart transplant

Earlier, smaller clinical trials have suggested that exercise is beneficial for heart failure patients, and clinical guidelines recommend moderate exercise for this condition. Nonetheless, safety concerns have persisted.

HF ACTION followed 2,331 patients with moderate-to-severe systolic heart failure (average age 59) for up to four years (average of 2.5 years). About one-half of the participants were randomly assigned to receive usual care alone, which included medical and device therapy as prescribed by their physicians and educational materials on disease management. They were also asked to engage in 30 minutes of moderate physical activity on most days of the week.

The other half of the participants were in the exercise training group, and they received usual care plus 36 sessions of group-based, supervised aerobic exercise training (walking or stationary cycling) of up to 35 minutes three times per week. These participants were asked to transition to home-based training at the same intensity five times per week for the remainder of the study and received a treadmill or stationary bike for home use and a heart rate monitor.

Compared to the usual care group, the exercise training group had slightly fewer (statistically non-significant) deaths or hospitalizations from any cause. When researchers adjusted the findings (as specified in the study design) for the strongest predictors of death or hospitalization — initial exercise capacity, history of atrial fibrillation, depression, cardiac pumping function, and cause of heart failure — exercise training was linked to an 11 percent lower risk of all-cause death or hospitalization and a 15 percent lower risk of cardiovascular-related death or heart failure hospitalization. In addition, there was no significant difference in serious adverse events between the two groups, such as an abnormal heart rhythm, hip fracture, or hospitalization related to exercise, suggesting that exercise training was well tolerated and safe.

The researchers note that the benefit of exercise may be underestimated by the observed study results because many of the usual care participants also exercised. In addition, adherence to prescribed exercise in the exercise training group was below goal in the majority of participants.

Overall, the exercise training was well tolerated. There was no significant difference between the two study arms in serious adverse events, including an abnormal heart rhythm, hip fracture, or hospitalization related to exercise.

Furthermore, after training, participants in the exercise group scored significantly higher than those in the usual care group on a standard, self-administered quality-of-life questionnaire. Participants reported fewer physical and social limitations and symptoms, and improved quality of life after three months. The improvements persisted throughout the follow-up period and were consistent regardless of sex, race, or age.

According to Senator Barbara Mikulski:7-9-2010 As we celebrate the 45th anniversary of Medicare, it's important that we continue to strengthen the program that makes sure seniors get the quality health care they need without going bankrupt. Seniors in Medicare Part D face the donut hole - a gap in prescription drug coverage where they don't get help paying for drugs once their medication expenses reach $2,830 through $6,440 in a single year. The health care reform law - the Patient Protection and Affordable Care Act - gives seniors who hit the donut hole this year relief with a $250 rebate check. Beginning in 2011, seniors will receive a 50 percent discount on brand-name drugs while in the donut hole, and the donut hole will be completely closed by 2020.

Because of health care reform, we are beginning to close that donut hole that's been so hard to swallow. Seniors have worked hard and played by the rules all their lives. They paid into the system so that they would have health care they can count on. Medicare is not an entitlement, it's an earned benefit. That's why I've fought so hard to save and strengthen Medicare in health care reform.

The Patient Protection and Affordable Care Act will help people like Fran Garfinkle - a 70-year old retired small business owner and cancer survivor from Bethesda, Maryland. She's one of four million seniors who will be trapped in the Medicare Part D coverage gap this year. Fran hit the donut hole for the first time last summer and was suddenly faced with a very serious problem. Like so many others, she's on a fixed income. She and her husband pay for a Medicare plan, Medicare supplemental plan, prescription drug plan, and dental plan. Now on top of all of the co pays, they are paying 100% of her drug costs because she fell into the donut hole.

Already this year, 80,000 seniors have fallen into the donut hole and began receiving the first rebate checks on June 10. Checks are mailed out automatically about three months after seniors reach the coverage gap. Seniors do not have to do anything to prove that they have paid more than $2,830 in out-of-pocket drug costs. Medicare tracks these costs for them.

In addition to closing the donut hole, the Patient Protection and Affordable Care Act extends Medicare's solvency until 2026, provides seniors with new benefits such as a wellness visit to help prevent disease, improves care coordination and patient safety to help reduce hospital readmissions, and establishes a new voluntary long-term care insurance program to help cover the costs of support services that help seniors age in place.

Our seniors' health care should never depend on the bull of political promises or the bear of the market. Health care reform helps assure that seniors have access to the healthcare they need and deserve. I will continue to fight to make sure that the federal government is doing all it can to help all seniors live healthy lives. You can count on me to make sure we honor the promises made to our seniors - today, tomorrow and always.

WHO H1N1 Update

2 July 2010 -- As of 27 June, worldwide more than 214 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including over 18239 deaths. Overall, in the temperate regions of the northern hemisphere (North America and Europe), pandemic and seasonal influenza viruses have been detected sporadically or at very low levels during the past month.

Summary: Worldwide, overall pandemic and seasonal influenza activity remains low. In the temperate regions of the Southern Hemisphere, Chile, and Argentina report low activity and only sporadic detections of both pandemic and seasonal influenza viruses during the early part of winter. South Africa, New Zealand, and Australia have all recently noted slight increases in the rate of respiratory disease. South Africa recently reported their first case of confirmed H1N1; however, the predominant influenza virus there currently is seasonal influenza A(H3N2). The H3N2 virus detected in South Africa is similar to the Perth-like strain, which is currently a component of the trivalent seasonal influenza vaccine. Active transmission of pandemic influenza virus still persists in localized areas of the tropics, particularly in South and Southeast Asia, the Caribbean and West Africa. During the last 2 to 3 weeks, seasonal influenza H3N2 viruses have also been detected at increasing levels in Nicaragua, and low levels or sporadically in Australia, Central America, South Africa and East Africa. Global circulation of seasonal influenza virus type B viruses persists at low levels in parts of East Asia, Central Africa, and Central America.

Regional Details: In most countries of the temperate zone of the southern hemisphere (Chile, Argentina, South Africa, Australia, and New Zealand) pandemic and seasonal influenza viruses have been detected only sporadically in June 2010 and activity is low, indicating a late start of the influenza season compared to 2008. Overall levels of respiratory disease in the population remain low. In Argentina, small numbers of influenza type B viruses were detected during mid June 2010. In both Chile and Argentina, respiratory syncitial virus (RSV) continued to be the predominant circulating respiratory virus resulting in high rates of respiratory illness in children. In South Africa, small and slightly increasing numbers of seasonal H3N2 and type B viruses were detected during mid June 2010. In both Australia and New Zealand, levels of ILI are increasing, but still below recent historical seasonal levels.

We Eat Too Much Salt

CDC Survey Finds Nine in 10 U.S. Adults Consume Too Much Sodium

6--25-2010 Majority of sodium comes from most commonly eaten foods. Less than 10 percent of U.S. adults limit their daily sodium intake to recommended levels, according to a new report, "Sodium Intake in Adults – United States, 2005-2006," published today in CDC's Morbidity and Mortality Weekly Report. The report also finds that most sodium in the American diet comes from processed grains such as pizza and cookies, and meats, including poultry and luncheon meats.

According to the report, U.S. adults consume an average of 3,466 milligrams (mg) of sodium per day, more than twice the current recommended limit for most Americans. Grains provide 36.9 percent of this total, followed by dishes containing meat, poultry, and fish (27.9 percent). These two categories combined account for almost two-thirds of the daily sodium intake for Americans.

An estimated 77 percent of dietary sodium comes from processed and restaurant foods. Many of these foods, such as breads and cookies, may not even taste salty. "Sodium has become so pervasive in our food supply that it's difficult for the vast majority of Americans to stay within recommended limits," said Janelle Peralez Gunn, public health analyst with CDC's Division for Heart Disease and Stroke Prevention and lead author of the report. "Public health professionals, together with food manufacturers, retailers and health care providers, must take action now to help support people's efforts to reduce their sodium consumption."

The 2005 Dietary Guidelines for Americans recommends that people consume less than 2,300 mg of sodium per day. Specific groups, including persons with high blood pressure, all middle-aged and older adults and all blacks, should limit intake to 1500 mg per day. These specific groups comprise nearly 70 percent of the U.S. adult population. This study found that only 9.6 percent of all participants met their applicable dietary recommendation, including 5.5 percent of the group limited to 1,500 mg per day and 18.8 percent of the 2,300 mg per day group.

Brain Research Institute

June 7, 2010 The Lieber Institute for Brain Development, a neuroscience research institute dedicated to developing novel treatments, diagnostic tests, and insights into disorders arising from abnormalities in brain development, has announced that it will establish a permanent research facility at the Science + Technology Park at Johns Hopkins, next to the Johns Hopkins East Baltimore medical campus.

Officials of the Institute say its decision to locate at the Park was based on Hopkins’ position as one of the world’s premier centers for brain diseases and neuroscience research.

“The Lieber Institute’s research team complements Hopkins own neuroscience researchers in this field very nicely, and together they will make significant inroads on this disabling disease,” says Johns Hopkins University President Ron Daniels.

Maryland Governor Martin O’Malley notes that the move “is further confirmation of the growth and importance of Maryland’s health care institutions and life-science industry as a major cluster and critical mass in the U.S.”

The focus of staff scientists at the Institute will be on developing new and improved diagnostics and medical therapies to prevent and treat schizophrenia and related conditions. Although several U.S. private research foundations fund development of new therapies and diagnostics for various diseases, the Lieber Institute is one of few to actually have its own research staff and facility.

The Lieber Institute staff plans to work closely with the Johns Hopkins Brain Science Institute (BSI), founded in 2007 to bring together both basic and clinical neuroscientists from across the Johns Hopkins campuses. BSI, also located in the Science & Technology Park, has four of the top 25 most-cited neuroscientists in the United States and boasts an annual research budget of $120 million. It recently expanded to include a neurotranslation lab and development team, hired from the pharmaceutical industry to accelerate the development of new neuroscience-based drugs at Hopkins.

The Leiber Institute’s planned collaboration with the BSI will establish a Baltimore cluster for neuroscience collaboration in drug and diagnostic development. Solomon Snyder, M.D., former director of neuroscience at Johns Hopkins will become director of drug discovery as well as remain a professor at Johns Hopkins University School of Medicine.

“We’re honored to have this unique opportunity to pool our talents and resources in the fight against schizophrenia,” says Edward D. Miller, M.D., Frances Watt Baker and Lenox D. Baker Jr. Dean of the School of Medicine and chief executive officer of Johns Hopkins Medicine.

In seeking a permanent location, the Lieber Institute considered several other states and academic institutions, including the University of Pennsylvania, Yale University, Columbia University and Northwestern University. However, the Governor’s Office, the Maryland Department of Business and Economic Development, Johns Hopkins University, East Baltimore Development, Inc., the Economic Alliance of Greater Baltimore, Baltimore Development Corporation, Abell Foundation and Forest City Science + Technology Group collaborated to recruit the move.

The Maryland location also facilitates a partnership with the National Institutes of Health in Bethesda. Daniel R. Weinberger, M.D., a renowned expert in schizophrenia research at the National Institute of Mental Health (NIMH) where he is the director of the Genes, Cognition and Psychosis Program will coordinate projects with Lieber, and Ronald McKay, Ph.D., who leads a stem cell research program at the NIH and was among the first to show that stem cells may provide new cell therapies for degenerative diseases, will join the Lieber Institute as its director of basic science. 

The Lieber Institute joins a growing cluster of institutional organizations and life science companies at the Science + Technology Park at Johns Hopkins, including the Johns Hopkins Institute for Basic Biomedical Sciences, the Johns Hopkins Bloomberg School of Public Health, the Howard Hughes Medical Institute, several Hopkins biotech companies (Biomarker Strategies, Iatrica, and Champions Biotechnology), the preclinical contract research organization Sobran, and laboratory services company Spectrum Biosciences.

Schizophrenia is a chronic, severe and disabling brain disorder affecting 2.4 million Americans, striking young men in their late teens and early 20s and women in their 20s and early 30s, according to NIMH. People with schizophrenia hear voices that others don’t hear, believe that others are broadcasting their thoughts to the world, or become convinced that others are plotting to harm them. The causes of schizophrenia are unknown, and current treatments are focused on the treatment of the symptoms. Drug therapies can have serious side effects and there is no cure. No adequate diagnostic test exists for the disease or its progression.

EKG Wireless

5-25-2010 A consortium of five Baltimore hospitals, led by the Johns Hopkins Department of Emergency Medicine, has acquired and donated to Baltimore city new wireless technology able to transmit electrocardiograms from the field over the Internet to hospital-based medical specialists.

The donation to the Baltimore City Fire Department includes 36 broadband units, enough to equip every paramedic unit in the city and have others available during peak service periods. In addition, the five hospitals each have acquired and installed matching software so that emergency physicians and cardiologists can see EKG data as it’s transmitted by emergency responders.

“This is all about patients — getting the best technology and the best treatment to heart attack victims when they absolutely need it the most,” says James Scheulen, P.A., the chief administrative officer for the Department of Emergency Medicine at Johns Hopkins Hospital, who initiated the effort to acquire and donate the new technology to Baltimore. “This technology holds the potential to dramatically improve the treatment and outlook for heart attack patients.”

The consortium includes The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, Saint Agnes Hospital, Sinai Hospital and Union Memorial Hospital.

When fully operational — sometime in the next month or so — emergency physicians at the five hospitals will be able to review EKG data in real time as it is sent remotely by city medic units. They’ll be able to quickly diagnose whether the patient is experiencing what’s known as an ST-elevation myocardial infarction, or STEMI. This is considered a very dangerous form of heart attack.

Hospital emergency teams also will be able to get appropriate intervention equipment and other resources ready before the patient even arrives at the hospital, thus saving critical time for doctors to intervene and protect heart muscle from serious damage.

Currently, hospital emergency teams wait for a patient to arrive and then confirm their condition on an EKG machine before beginning treatment to limit heart muscle damage, usually with a balloon angioplasty or stents to reopen blood flow to the heart. Research and clinical experience have shown that the faster STEMI patients get appropriate treatment — known as “door-to-balloon” or “door-to-intervention” time — the more likely they are to have a strong recovery.

Hospital-based doctors will be able to get the real-time, diagnostic-quality EKG data streamed to them on a variety of devices, including a PC, blackberry or smart phone.

Scheulen, who initiated talks with the other hospitals earlier this year to acquire and distribute the equipment, said the consortium institutions moved quickly to form a partnership and get the job done as part of an ongoing commitment to improving health care in Baltimore.

Exercize in the ICU

Baltimore, MD, United States (AHN) - A new report from critical care experts at Johns Hopkins Hospital reveals that mild workout programs can be introduced to the care of critically ill patients in the intensive care unit. By limiting the use of drowsiness-inducing medications, patients are able to exercise, reducing muscle weakness linked to long periods of bed rest.

In a report published online Friday, researchers said limiting drugs and increasing exercise reduces bouts of delirium and hallucinations and speeds up ICU recovery times by as much as two to three days.

Mild exercise even while laying flat in bed, sitting up or standing, or even walking slowly in the corridors of the ICU is encouraged. Researchers point out there are numerous exercise movements that can be done using a patient's arms or legs. The Johns Hopkins team spearheading the research found even cycling in bed using a specially designed peddling device or stimulating contractions of the leg muscles is beneficial. Even patients attached to life support equipment reaped the benefits of exercise if it was deemed safe.

"Our work challenges physicians to rethink how they treat critically ill patients and shows the downstream benefits of early mobilization exercises," says critical care specialist Dr. Dale Needham, who led the project.

"Our patients keep telling us that they do not want to be confined to their beds, they want to be awake, alert and moving, and engaged participants in their recovery," said Needham, an associate professor at the Johns Hopkins University School of Medicine. "Patients are not afraid of exercising while they are in the ICU, and they are embracing this new approach to their care in the ICU. It actually motivates them to get well and reminds them that they have a life outside the four walls surrounding their hospital beds."

Needham's recent work supports previous research done and confirms how early physical rehabilitation and mild exercise helped ICU patients move about, sit and stand up. Medical experts agree that patients can lose as much as 5 percent of leg muscle mass every week when confined to bed rest.

The study found that overall time spent in intensive care and in the hospital also dropped after exercising was promoted, by 2.1 days and 3.1 days, respectively.

H1N1 Drug Resistant Influenza

3-31-2010 Rapid Development of Drug-Resistant 2009 H1N1 Influenza Reported in Two Cases. Reevaluation of treatment strategies for prolonged infection urged. Two people with compromised immune systems who became ill with 2009 H1N1 influenza developed drug-resistant strains of virus after less than two weeks on therapy, report doctors from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. Doctors who treat prolonged influenza infection should be aware that even a short course of antiviral treatment may lead to drug-resistant virus, say the authors, and clinicians should consider this possibility as they develop initial treatment strategies for their patients who have impaired immune function.

Both patients described in the new report developed resistance to the key influenza drug oseltamivir (Tamiflu), and one also demonstrated clinical resistance to another antiviral agent, now in experimental testing, intravenous peramivir, note senior authors Matthew J. Memoli, M.D., and Jeffery K. Taubenberger, M.D., Ph.D. This is the first reported case of clinically significant peramivir-resistant 2009 H1N1 illness, say the scientists. The report is scheduled to appear in print on May 1 in Clinical Infectious Diseases and is now online.

The people in the current case report had immune limitations due to blood stem cell transplants that occurred several years previously. Both recovered from their influenza infections.

"While the emergence of drug-resistant influenza virus is not in itself surprising, these cases demonstrate that resistant strains can emerge after only a brief period of drug therapy," says NIAID Director Anthony S. Fauci, M.D. "We have a limited number of drugs available for treating influenza and these findings provide additional urgency to efforts to develop antivirals that attack influenza virus in novel ways."

The 2009 H1N1 influenza virus is susceptible to just one of the two available classes of anti-influenza drugs, the neuraminidase inhibitors. Besides oseltamivir, other neuraminidase inhibitors are zanamivir (Relenza), which is inhaled, and the intravenously administered investigational drug peramivir. As the H1N1 influenza pandemic unfolded, laboratory tests of virus strains isolated from patients showed that some strains contained a genetic mutation (the H275Y mutation) that makes the virus less susceptible to some neuraminidase inhibitors.

The two people in the current case study had pre-existing medical conditions that impaired their immune system function before contracting 2009 H1N1 flu. Strains of 2009 H1N1 influenza containing the H275Y mutation had been reported previously in people with diminished immune function, but in previous cases the mutation arose after more than 24 days of continuous therapy. In the newly described cases, the mutation appeared after 14 days in one individual and after nine days in the second.

"Although the recommended length of treatment with oseltamivir is five days, it is common for physicians to continue giving this first-line drug longer if the patient does not improve," says Dr. Memoli.

Both people in the current report received oseltamivir for extended periods but they continued to shed virus in their nasal secretions throughout treatment. When one patient’s condition worsened despite 24 days of oseltamivir treatment, doctors administered peramivir for 10 days. The drug did not reduce viral shedding and the patient remained ill, demonstrating what the authors described as clinically significant resistance to peramivir. Next, doctors administered the only other available flu drug, zanamivir, for 10 days. The person then fully recovered.

Healthcare Insurance Coverage Bill Signed by President Obama 3-22-2010

According to the White House Blog,Posted by Lynn Rosenthal on March 23, 2010 at 05:50 PM EDT, "Sunday night’s historic vote on health care reform helps women across the board.

A greater percentage of women are more likely than men to be uninsured or underinsured and to struggle to make ends meet. In addition, those women who manage to get coverage are more likely to pay higher premiums than men. Women who suffer from preexisting conditions are often denied coverage altogether.

For all women, the advent of health care reform is a victory. For domestic violence victims, it is a lifeline. 

Obesity

Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. A crude population measure of obesity is the body mass index (BMI), a person’s weight (in kilograms) divided by the square of his or her height (in metres). A person with a BMI of 30 or more is generally considered obese. A person with a BMI equal to or more than 25 is considered overweight.

Overweight and obesity are major risk factors for a number of chronic diseases, including diabetes, cardiovascular diseases and cancer. Once considered a problem only in high income countries, overweight and obesity are now dramatically on the rise in low- and middle-income countries, particularly in urban settings.

Preterm Birth Risk

Findings Support View of Preterm Labor As Immune Response to Infection or Injury

Researchers at the National Institutes of Health have identified DNA variants in mothers and fetuses that appear to increase the risk for preterm labor and delivery. The DNA variants were in genes involved in the regulation of inflammation and of the extracellular matrix, the mesh-like material that holds cells within tissues.

"A substantial body of scientific evidence indicates that inflammatory hormones may play a significant role in the labor process," said Alan E. Guttmacher, M.D., acting director of the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). "The current findings add evidence that individual genetic variation in that response may account for why preterm labor occurs in some pregnancies and not in others."

Like sensitivity to allergens such as house dust or pollen, the severity of the immune response appears to vary from individual to individual, accounting for why some pregnancies end in early labor and delivery. The findings may one day lead to new strategies to identify those at risk for preterm birth, and to ways to reduce the occurrence of preterm birth among those at risk.

The findings were presented today at the 30th Annual Society for Maternal-Fetal Medicine meeting by Dr. Roberto Romero, M.D, chief of the perinatology research branch and program head for perinatal research and obstetrics at the NICHD. At the meeting, Dr. Romero and his team received the March of Dimes Excellence Award for innovative research on preterm birth for this study.

Premature birth affects 13 million infants worldwide each year (http://www.who.int/bulletin/volumes/88/1/08-062554.pdf). According to the National Center for Health Statistics, roughly one half million preterm births occur in the United States each year (http://www.cdc.gov/nchs/fastats/birthwt.htm). Infants born preterm are at risk for infant death, life-threatening infections, blindness, breathing problems, learning and developmental disabilities, and cerebral palsy.

The finding is the most recent in a body of research by Dr. Romero and his colleagues. On the basis of earlier studies, the scientists had determined that an estimated 1 of every 3 preterm infants is born to a mother who has a silent infection of the amniotic fluid. A silent infection is one which does not show any outward signs or symptoms.

Blood Stem-Cell Transplant Reverses Sickle Cell Disease in Adults

1-26-2010 A modified blood adult stem-cell transplant regimen has effectively reversed sickle cell disease in 9 of 10 adults who had been severely affected by the disease, according to results of a National Institutes of Health study in the Dec. 10 issue of the New England Journal of Medicine. The trial was conducted at the NIH Clinical Center in Bethesda, Md., by NIH researchers at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the National Heart, Lung and Blood Institute (NHLBI), and the National Institute of Allergy and Infectious Diseases. 

"This trial represents a major milestone in developing a therapy aimed at curing sickle cell disease," said NIDDK Director Griffin P. Rodgers M.D., a co-author of the paper. "Our modified transplant regimen changes the equation for treating adult patients with severe disease in a safer, more effective way."

Sickle cell disease is caused by an altered gene that produces abnormal hemoglobin, the protein in normal red blood cells that carries oxygen throughout the body. When affected red cells lose oxygen, they collapse into a sickle, or C, shape and become stiff and sticky. Clumps of these cells block blood flow and can cause severe pain, organ damage from lack of oxygen, and stroke. Anemia often develops in people with the disease because sickle cells die off quickly and bone marrow does not make new ones fast enough.

In trials by other investigators, nearly 200 children with severe sickle cell disease were cured with bone marrow transplants after undergoing a regimen in which their own marrow was completely destroyed with chemotherapy. That regimen, however, had proven too toxic for adults, who have years of accumulated organ damage from the disease and are less able to tolerate complete marrow transplantation.

In contrast to the established method in children, this adult trial sought to reduce toxicity by only partially replacing the bone marrow. The much longer lifespan of normal red blood cells, compared to sickle red blood cells, allows the healthy cells to outlast and completely replace the disease-causing cells.

To achieve this goal, the investigators used a low dose of radiation to the whole body and two drugs, alemtuzumab and sirolimus, to suppress the immune system. Alemtuzumab depletes immune cells, but does not adversely affect blood stem cells. Sirolimus does not block the activation of immune cells, but inhibits their proliferation, creating a balance that potentially helps prevent rejection of the new stem cells.

The radiation favorably conditions the bone marrow, where donor stem cells move in and begin producing new, healthy red blood cells. After a median two and one half years follow-up, all 10 recipients were alive and sickle cell disease was eliminated in nine.

"Our patients have had a remarkable change in their lives," said John F. Tisdale, M.D., the trial’s principal investigator in the NIH Molecular and Clinical Hematology Branch. "They are no longer being admitted to the hospital for frequent pain crises, they have been able to stop chronic pain medications, go back to school and work, get married and have children. Given these results, our regimen will likely have broad application to other nonmalignant diseases and can be performed at most transplant centers."

Transplanted cells or tissue are known as grafts. To reduce the possibility of the immune system’s rejection of the graft or development of graft-versus-host disease, in which immune cells from the donor attack the recipient’s tissues, investigators tested the patient and the potential donor to determine if they are a good immunological match. This is called human leukocyte antigen (HLA) typing.

The investigators performed HLA typing on 112 people with severe sickle cell disease and 169 healthy siblings. Of these, 10 patient-sibling identical matches were found. Blood stem cells collected from the blood of healthy donors were then infused into their siblings, ages 16 to 45 years.

This relatively low toxicity regimen allowed patients to become tolerant to the donor immune cells and to achieve stable mixed donor chimerism. Chimerism is a condition in which an individual has two genetically distinct types of cells in the blood. This mixture of host and donor cells was sufficient to reverse sickle cell disease. In most patients the donor’s red blood cells completely replaced the recipient’s.

"Remarkably, the treatment did not result in graft-versus-host disease for any of the participants," noted Susan B. Shurin, M.D., acting director of the NHLBI. GVHD is a common complication of stem cell transplantation and can lead to serious problems, such as rash, diarrhea and nausea, liver disease, or death. "We are continuing to explore better treatments with fewer side effects to help the millions of sickle cell patients worldwide. This is a very important study because it lessens the toxicity of a therapy known to be highly effective."

In the United States, approximately 80,000 people have sickle cell disease, found mainly in people of African ancestry. It occurs to a lesser extent in people of Hispanic, Middle Eastern, Asian and white ancestry. Worldwide, millions of people have sickle cell disease. The pain and complications associated with sickle cell disease can have a profound impact on patients’ quality of life, ability to work, and long-term health and well-being.

One of the main obstacles in treating a larger number of African-Americans with sickle cell disease is the relative lack of an available HLA-matched donor. Dr. Tisdale explained, "Most white Americans can easily find a matched donor in the unrelated bone marrow or cord blood registries; yet when we screened a number of the people in our trial who were without an HLA-matched sibling donor, we could not find a compatible unrelated donor."

However, there may be a way beyond this health care disparity, Tisdale indicated. If participants in the current trial continue to do well with their transplants it may be possible to move to what he calls "haplo-transplantation," or a half-match from a sibling, parent or child. "This would allow most people with sickle cell disease to be treated and enjoy a better quality of life," he said.

The NIH Clinical Center's Department of Laboratory Medicine and Transfusion Medicine provided clinical laboratory and transfusion medicine support and patient care for the stem cell donors and transplantation recipients in trial. The Sidney Kimmel Cancer Center at Johns Hopkins Medical Institute provided conceptual input into the design of the trial’s immunological component. The trial is registered as NCT00061568 in www.clinicaltrials.gov.

Health care providers — and sickle cell patients and family members who may be interested in joining NIH blood stem-cell transplant studies — may call 301-402-6466 for more information. Calls will be returned within 48 hours. To search for other clinical trials, visit www.clinicaltrials.gov.

Huntingtons Disease News

1-4-2010 In Huntington's disease, a mutated protein in the body becomes toxic to brain cells. Recent studies have demonstrated that a small region adjacent to the mutated segment plays a major role in the toxicity. Two new studies supported by the National Institutes of Health show that very slight changes to this region can eliminate signs of Huntington's disease in mice.

Researchers do not fully understand why the protein (called mutant huntingtin) is toxic, but one clue is that it accumulates in ordered clumps of fibrils, perhaps clogging up the cells' internal machinery.

"These studies shed light on the structure and biochemistry of the mutant huntingtin protein and on potentially modifiable factors that affect its toxicity," said Margaret Sutherland, Ph.D., a program director at NIH's National Institute of Neurological Disorders and Stroke (NINDS). "They reveal sites within the huntingtin protein and within broader disease pathways that could serve as targets for drug therapy."

Both studies were published online this week. One study, published in the Journal of Cell Biology, was led by Leslie Thompson, Ph.D., and Joan Steffan, Ph.D., of the University of California, Irvine. The other study, in Neuron, was led by X. William Yang, M.D., Ph.D., of the University of California, Los Angeles in collaboration with Ron Wetzel, Ph.D., of the University of Pittsburgh School of Medicine.

Huntington's disease is inherited, and usually strikes in middle age, producing uncontrollable movements of the legs and arms, a loss of muscle coordination, and changes in personality and intellect. It is inexorably progressive and leads to death of affected persons usually within 20 years after symptoms first appear. Individuals with the disease carry mutations that affect the huntingtin protein. The mutations involve a triple repeat DNA sequence, a type of genetic miscue similarly found in Friedreich's ataxia, Kennedy's disease, fragile X syndrome, and other neurodegenerative disorders.

The normal huntingtin protein consists of about 3,150 amino acids (which are the building blocks for all proteins). In individuals with Huntington’s disease, the mutated protein contains an abnormally long string of a single amino acid repeat; lengthier chains are associated with worse symptoms and earlier onset of the disease. In recent years, however, researchers have begun looking at the effects of other, nearby amino acids in this large protein — and in particular, biochemical changes to those amino acids.

In their study, Drs. Steffan and Thompson investigated how a process called phosphorylation affects huntingtin. Phosphorylation is the attachment of chemical tags, known as phosphates, onto the amino acids in a protein. The process occurs naturally and is a way of marking proteins for destruction by cellular waste handling systems. The researchers liken it to putting a sign on a pile of junk that tells the garbage collectors to take it away. Their study shows that phosphorylation of just two amino acids, located at one end of huntingtin, targets the protein for destruction and protects against the toxic effects of the mutant protein.

"Clearance of mutant huntingtin is likely regulated at many levels, but our data establish that these two amino acids are critical," Dr. Steffan said.

Could boosting phosphorylation of those two amino acids reduce the buildup of huntingtin and improve symptoms of the disease? In parallel with the UC Irvine research, Dr. Yang and his team at UCLA were asking that question using an animal model of Huntington’s disease. Previously, Dr. Yang had created mice that carry the mutant huntingtin gene. These mice develop symptoms reminiscent of Huntington’s disease in humans, including poor coordination, mental changes such as increased anxiety, loss of brain tissue, and accumulation of clumps of huntingtin in brain cells.

Through further genetic engineering, Dr. Yang altered the same two critical amino acids at the end of the mutant huntingtin protein to either mimic phosphorylation (phosphomimetic) or resist it (phosphoresistant). Mice with the phosphoresistant version of the protein developed symptoms of Huntington's, but mice with the phosphomimetic version remained free of symptoms and huntingtin clumps up to one year.

Meanwhile, test tube experiments by Dr. Wetzel's group in Pittsburgh showed that phosphomimetic modification of a huntingtin fragment reduced its tendency to form clumps. Together, data from the mouse and test tube experiments provide strong support for the idea that phosphorylation acts as a molecular switch to alter clumping of the mutant protein, the researchers said.

The nearly complete lack of any signs of disease in the phosphomimetic Huntington mice may point toward new strategies to treat the disorder someday. Dr. Yang said, "Drugs that enhance or mimic the effects of phosphorylation may help to detoxify the mutant huntingtin protein."

If such drugs could be developed, Drs. Steffan and Thompson theorize, they would likely be most effective at early stages of the disease, but less so at later stages, when the clearance machinery appears to run down. Dr. Yang said he plans to examine older mice carrying the phosphomimetic version of mutant huntingtin to determine how long they are protected from the disease.

The researchers received major funding from NINDS, with additional support from the National Institute on Aging, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institute of General Medical Sciences. Several nonprofit foundations also contributed to the research, including the Hereditary Disease Foundation, the Fox Family Foundation and CHDI Inc.

U. S. Health Care for Christmas

12-24-09 “This is a historic day for our nation,” said U.S. Sen. Debbie Stabenow,Michigans' Democrat. “We have passed legislation that will provide health insurance reforms that save lives, save money, and save jobs,” said Stabenow. “The Patient Protection and Affordable Care Act provides over $430 billion in tax cuts for small businesses and individuals to help pay for health insurance. These tax cuts will reduce health care costs for small businesses and free up billions of dollars for large employers that can be reinvested in our economy to save 3.5 million jobs.”

Every since Teddy Roosevelt first called for reform in 1912, seven presidents - Democrats and Republicans alike - have taken up the cause of reform. Time and time again, such efforts have been blocked by special-interest lobbyists who perpetuated a status quo that works better for the insurance industry than it does for the American people. 

But with passage of reform bills in both the House and the Senate, we are now finally poised to deliver on the promise of real, meaningful health-insurance reform that will bring additional security and stability to the American people.

The reform bill that passed the Senate this morning, like the House bill, includes the toughest measures ever taken to hold the insurance industry accountable. Insurance companies will no longer be able to deny you coverage on the basis of a pre-existing condition. They will no long be able to drop your coverage when you get sick.

No longer will you have to pay unlimited amounts out of your own pocket for the treatments you need. And you'll be able to appeal unfair decisions by insurance companies to an independent party.

If this legislation becomes law, workers won't have to worry about losing coverage if they lose or change jobs. Families will save on their premiums. Businesses that would see their costs rise if we do not act will save money now and they will save money in the future.

This bill will strengthen Medicare and extend the life of the program. It will make coverage affordable for over 30 million Americans who do not have it - 30 million Americans.

And because it is paid for and curbs the waste and inefficiency in our health care system, this bill will help reduce our deficit by as much as $1.3 trillion in the coming decades, making it the largest deficit-reduction plan in over a decade.

As I've said before, these are not small reforms; these are big reforms. If passed, this will be the most important piece of social legislation since the Social Security Act passed in the 1930s and the most important reform of our health care system since Medicare passed in the 1960s.

What makes it so important is not just its cost savings or its deficit reductions. It's the impact reform will have on Americans who no longer have to go without a checkup or prescriptions that they need because they can't afford them, on families who no longer have to worry that a single illness will send them into financial ruin, and on businesses that will no longer face exorbitant insurance rates that hamper their competitiveness. It's the difference reform will make in the lives of the American people.

I want to commend Sen. Harry Reid, extraordinary work that he did, Speaker Pelosi, for her extraordinary leadership and dedication. Having passed reform bills in both the House and the Senate, we now have to take up the last and most important step and reach an agreement on a final reform bill that I can sign into law.

And I look forward to working with members of Congress in both chambers over the coming weeks to do exactly that. With today's vote, we are now incredibly close to making health insurance reform a reality in this country. Our challenge then is to finish the job.

We can't doom another generation of Americans to soaring costs and eroding coverage and exploding deficits. Instead, we need to do what we were sent here to do and improve the lives of the people we serve.

For the sake of our citizens, our economy, and our future, let's make 2010 the year we finally reform health care in the United States of America.

Everybody, merry Christmas, happy new year.

Affordable Health

5-6-2010 Fort Washington, PA (April 30, 2010) – McNeil Consumer Healthcare, Division of McNEIL-PPC, Inc., in consultation with the U.S. Food and Drug Administration (FDA), is voluntarily recalling all lots that have not yet expired of certain over-the-counter (OTC) Children’s and Infants’ liquid products manufactured in the United States and distributed in the United States, Canada, Dominican Republic, Dubai (UAE), Fiji, Guam, Guatemala, Jamaica, Puerto Rico, Panama, Trinidad & Tobago, and Kuwait. To see a ful list of recalled items click here.

WHO Reports on TB

18 MARCH 2010 | GENEVA | WASHINGTON DC -- In some areas of the world, one in four people with tuberculosis (TB) becomes ill with a form of the disease that can no longer be treated with standard drugs regimens, a World Health Organization (WHO) report says.

For example, 28% of all people newly diagnosed with TB in one region of north western Russia had the multidrug-resistant form of the disease (MDR-TB) in 2008. This is the highest level ever reported to WHO. Previously, the highest recorded level was 22% in Baku City, Azerbaijan, in 2007.

In the new WHO's Multidrug and Extensively Drug-Resistant Tuberculosis: 2010 Global Report on Surveillance and Response, it is estimated that 440 000 people had MDR-TB worldwide in 2008 and that a third of them died. In sheer numbers, Asia bears the brunt of the epidemic. Almost 50% of MDR-TB cases worldwide are estimated to occur in China and India. In Africa, estimates show 69 000 cases emerged, the vast majority of which went undiagnosed.

Encouraging signs

Tuberculosis programmes face tremendous challenges in reducing MDR-TB rates. But there are encouraging signs that even in the presence of severe epidemics, governments and partners can turn around MDR-TB by strengthening efforts to control the disease and implementing WHO recommendations.

Two regions in the Russian Federation, Orel and Tomsk, have achieved a remarkable decline in MDR-TB in about five years. These regions join two countries, Estonia and Latvia, which have reversed rising high rates of MDR-TB, ultimately achieving a decline. The United States of America and China, Hong Kong Special Administrative Region (SAR), have achieved sustained successes in controlling MDR-TB.

Slow progress

Progress remains slow in most other countries. Worldwide, of those patients receiving treatment, 60% were reported as cured. However, only an estimated 7% of all MDR-TB patients are diagnosed. This points to the urgent need for improvements in laboratory facilities, access to rapid diagnosis and treatment with more effective drugs and regimens shorter than the current two years.

WHO is engaged in a five year project to strengthen TB laboratories with rapid tests in nearly 30 countries. This will ensure more people benefit early from life-saving treatments. It is also working closely with the Global Fund to Fight AIDS, Tuberculosis and Malaria and the international community on increasing access to treatment.

First Genes for Stuttering Discovered

Bethesda, Md., Wed., Feb. 10, 2010 — Stuttering may be the result of a glitch in the day-to-day process by which cellular components in key regions of the brain are broken down and recycled, says a study in the Feb. 10 Online First issue of the New England Journal of Medicine. The study, led by researchers at the National Institute on Deafness and Other Communication Disorders (NIDCD), part of the National Institutes of Health, has identified three genes as a source of stuttering in volunteers in Pakistan, the United States, and England. Mutations in two of the genes have already been implicated in other rare metabolic disorders also involved in cell recycling, while mutations in a third, closely related, gene have now been shown to be associated for the first time with a disorder in humans.

For hundreds of years, the cause of stuttering has remained a mystery for researchers and health care professionals alike, not to mention people who stutter and their families," said James F. Battey, Jr., M.D., Ph.D., director of the NIDCD. "This is the first study to pinpoint specific gene mutations as the potential cause of stuttering, a disorder that affects 3 million Americans, and by doing so, might lead to a dramatic expansion in our options for treatment."

Stuttering is a speech disorder in which a person repeats or prolongs sounds, syllables, or words, disrupting the normal flow of speech. It can severely hinder communication and a person's quality of life. Most children who stutter will outgrow stuttering, although many do not; roughly 1 percent of adults stutter worldwide. Current therapies for adults who stutter have focused on such strategies as reducing anxiety, regulating breathing and rate of speech, and using electronic devices to help improve fluency.

Stuttering tends to run in families, and researchers have long suspected a genetic component. Previous studies of stuttering in a group of families from Pakistan had been done by Dennis Drayna, Ph.D., a geneticist with the NIDCD, which indicated a place on chromosome 12 that was likely to harbor a gene variant that caused this disorder.

In the latest research, Dr. Drayna and his team refined the location of this place on chromosome 12 and focused their efforts on the new site. They sequenced the genes surrounding a new marker and identified mutations in a gene known as GNPTAB in the affected family members. The GNPTAB gene is carried by all higher animals, and helps encode an enzyme that assists in breaking down and recycling cellular components, a process that takes place inside a cell structure called the lysosome.

They then analyzed the genes of 123 Pakistani individuals who stutter — 46 from the original families and 77 who are unrelated — as well as 96 unrelated Pakistanis who don't stutter, and who served as controls. Individuals from the United States and England also took part in the study, 270 who stutter and 276 who don't. The researchers found some individuals who stutter possessed the same mutation as that found in the large Pakistani family. They also identified three other mutations in the GNPTAB gene which showed up in several unrelated individuals who stutter but not in the controls.

GNPTAB encodes its enzyme with the help of another gene called GNPTG. In addition, a second enzyme, called NAGPA, acts at the next step in this process. Together, these enzymes make up the signaling mechanism that cells use to steer a variety of enzymes to the lysosome to do their work. Because of the close relationship among the three genes in this process, the GNPTG and NAGPA genes were the next logical place for the researchers to look for possible mutations in people who stutter. Indeed, when they examined these two genes, they found mutations in individuals who stutter, but not in control groups.

The GNPTAB and GNPTG genes have already been tied to two serious metabolic diseases known as mucolipidosis (ML) II and III. MLII and MLIII are part of a group of diseases called lysosomal storage disorders because improperly recycled cell components accumulate in the lysosome. Large deposits of these substances ultimately cause joint, skeletal system, heart, liver, and other health problems as well as developmental problems in the brain. They are also known to cause problems with speech.

Teen Drug Usage

Teen Methamphetamine Use, Cigarette Smoking at Lowest Levels in NIDA's 2009 Monitoring the Future Survey

Downward Marijuana Trend Stalls and Prescription Drug Abuse Worrisome

WASHINGTON – Methamphetamine use among teens appears to have dropped significantly in recent years, according to NIDA's annual Monitoring the Future (MTF) survey, released today at a news conference at the National Press Club in Washington. However, declines in marijuana use have stalled, and prescription drug abuse remains high, the survey reported. 

The Monitoring the Future survey is a series of classroom surveys of eighth, 10th, and 12th graders conducted by researchers at the University of Michigan under a grant from the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

The number of high school seniors reporting they used methamphetamine in the past year is now at only 1.2 percent — the lowest since questions about methamphetamine were added to the survey in 1999, when it was reported at 4.7 percent. In addition, the proportion of 10th graders reporting that crystal meth was easy to obtain has dropped to 14 percent, down from 19.5 percent five years ago.

"We are encouraged by the reduction of methamphetamine use, but we know that each new generation of teens brings unique prevention and education challenges," said NIH Director Francis S. Collins M.D., Ph.D. "What makes the Monitoring the Future survey such a valuable public health tool is that it not only helps us identify where our prevention efforts have been successful, it also helps us identify new trends in drug use and attitudes that need more attention."

The report says cigarette smoking was at the lowest point in the survey's history on all measures for eighth, 10th and 12th graders. For example, only 2.7 percent of eighth graders describe themselves as daily smokers, down from a peak rate of 10.4 percent in 1996. Similarly, 11.2 percent of high school seniors say they smoke daily, less than half of the 24.6 percent rate in 1997. However, one area of concern is the rate of smokeless tobacco use. The rate of 10th graders using smokeless tobacco in the past month is 6.5 percent, up from last year and the same as it was in 1999.

"The decline in cigarette smoking translates to longer, healthier lives for today's young people," said NIDA Director Dr. Nora Volkow. "And while it is disheartening that smokeless tobacco use is up again, the survey is telling us where to focus prevention efforts."

Marijuana use across the three grades has shown a consistent downward trend since the mid-1990s, however, the decline has stalled, with rates at the same level as five years ago. In the 2009 survey, reported past year marijuana use was about the same as the previous year: 32.8 percent of 12th graders, 26.7 percent of 10th graders, and 11.8 percent of eighth graders. However, marijuana use is still down significantly from its peak in the mid-late 1990s.

The MTF survey also measures teen attitudes about drugs, including perceived harmfulness, perceived availability, and disapproval, which are often harbingers of abuse. For example, the percentage of eighth graders who view occasional marijuana smoking as potentially harmful is down to 44.8 percent, compared to 48.1 percent last year and 57.9 percent in 1991.

"The 2009 Monitoring the Future survey is a warning sign, and the continued erosion in youth attitudes and behavior toward substance abuse should give pause to all parents and policymakers," said Director Gil Kerlikowske, of the White House Office of National Drug Control Policy. "Considering the troublesome data from other national and local surveys, these latest data confirm that we must redouble our efforts to implement a comprehensive, evidence-based approach to preventing and treating drug use."

The data on some illicit drugs is encouraging. Past year use of cocaine decreased to 3.4 percent from 4.4 percent in 2008 among 12th graders, and past year use of hallucinogens also fell among high school seniors to 4.7 percent, down from last year’s 5.9 percent rate and significantly lower than its 2001 peak of 9.1 percent.

For the first time this year the survey also measured 12th graders' use of the hallucinogenic salvia leaf, with 5.7 percent of high school seniors reporting past year use.

Perceived harmfulness of LSD, amphetamines, sedatives/barbiturates, heroin and cocaine have all increased among 12th graders, and the perceived availability of many illicit drugs has dropped considerably. For example, 33.9 percent of 12th graders reported this year that it is easy to get powder cocaine, down from 38.9 percent just a year ago. Similarly, 35.1 percent of 12th graders said ecstasy is easy to obtain, compared to 41.9 percent last year.

The 2009 MTF survey indicates a continuing high rate of non-medical use of prescription drugs and cough syrup among teens. Seven of the top 10 drugs abused by 12th graders in the year prior to the survey were prescribed or, purchased over the counter.

Nearly 1 in 10 high school seniors reported past year non-medical use of Vicodin, and 1 in 20 reported abusing Oxycontin, also a powerful opioid painkiller. Non-medical use of these painkillers has increased among 10th graders in the past five years.

For the first time this year the survey measured the non-medical use of Adderall, a stimulant commonly prescribed to treat ADHD. The survey reported that more than 5 percent of 10th and 12th graders reported non-medical use of the drug in the past year.

In addition, the survey recently started measuring how teens obtain the prescription drugs they took for non-medical use. Nineteen percent of 12th graders reported they got their drugs by a doctor's prescription, and 8 percent reported buying them from a dealer. However, the vast majority — 66 percent — said they got the drugs from a friend or relative. Of these, 12 percent reported they "took" them; 21 percent reported "buying" them and 33 percent said they were "given" the drugs. Internet purchases do not appear to be a major source of drugs for this age group.

Researchers also report a softening of attitudes in some alcohol measures. Fewer 10th graders viewed weekend binge drinking (five or more drinks once or twice each weekend) as harmful, and fewer high school seniors disapproved of having one or two drinks every day. Alcohol use however, has decreased in the past five years across all three grades

Overall, 46,097 students from 389 public and private schools in the eighth, 10th, and 12th grades participated in this year's survey. Since 1975, the MTF survey has measured drug, alcohol, and cigarette use and related attitudes in 12th graders nationwide; eighth and 10th graders were added to the survey in 1991. Survey participants report their drug use behaviors across three time periods: lifetime, past year, and past month. The survey has been conducted since its inception by a team of investigators at the University of Michigan, led by NIDA grantee Dr. Lloyd Johnston. Additional information on the MTF, as well as comments from Dr. Volkow can be found at www.drugabuse.gov.

World Health Organization

10-25-2009

H1N1 414,000 Cases Reported

As of 17 October 2009, worldwide there have been more than 414,000 laboratory confirmed cases of pandemic influenza H1N1 2009 and nearly 5000 deaths reported to WHO.

In general, influenza activity in the northern hemisphere is much the same as in the last week, though respiratory disease activity continues to spread and increase in intensity. In North America, the U.S.A. is still reporting nationwide rates of Influenza-Like Illness (ILI) well above baseline rates with high rates of pandemic H1N1 2009 virus detections in clinical laboratory specimens (29% of all specimens tested are positive for influenza A and all of those subtyped are pandemic H1N1 2009 virus. Canada reports increases in ILI rates for the fourth straight week but the highest level of activity is in the western province of British Columbia. Mexico still reports active transmission in some areas of the country. Although influenza activity is low in most countries in Europe, in Belgium, Israel, the Netherlands, Norway, and parts of the United Kingdom consultation ILI/ARI rates are above baseline levels. Similarly the number of influenza virus detections relatively high, which may indicate the early start of an influenza season.

Rates of respiratory illness in Eastern Europe and Northern Asia are increasing but are not yet at levels normally seen in an influenza season (baseline levels are not defined in many countries of the area). Of note, the proportion of cases in Asia that are related to seasonal influenza A(H3N2) continue to decline globally as the proportion related to pandemic H1N1 2009 virus increases. Currently, only East Asia is reporting any significant numbers of influenza A(H3N2) isolates

In tropical areas of the world, rates of illness are generally declining, with a few exceptions. Cuba, Colombia, and El Salvador are reporting increases in the tropical region of the Americas. In tropical Asia, of the countries that are reporting this week, all report decreases in respiratory disease activity.

World Health Organization 8-21-2009

21 AUGUST 2009 | GENEVA -- WHO is toay is issuing guidelines for the use of antivirals in the management of patients infected with the H1N1 pandemic virus.

The guidelines represent the consensus reached by an international panel of experts who reviewed all available studies on the safety and effectiveness of these drugs. Emphasis was placed on the use of oseltamivir and zanamivir to prevent severe illness and deaths, reduce the need for hospitalization, and reduce the duration of hospital stays.

The pandemic virus is currently susceptible to both of these drugs (known as neuraminidase inhibitors), but resistant to a second class of antivirals (the M2 inhibitors).

Worldwide, most patients infected with the pandemic virus continue to experience typical influenza symptoms and fully recover within a week, even without any form of medical treatment. Healthy patients with uncomplicated illness need not be treated with antivirals.

On an individual patient basis, initial treatment decisions should be based on clinical assessment and knowledge about the presence of the virus in the community.

In areas where the virus is circulating widely in the community, clinicians seeing patients with influenza-like illness should assume that the pandemic virus is the cause. Treatment decisions should not wait for laboratory confirmation of H1N1 infection.

This recommendation is supported by reports, from all outbreak sites, that the H1N1 virus rapidly becomes the dominant strain.Treat serious cases immediately.

Evidence reviewed by the panel indicates that oseltamivir, when properly prescribed, can significantly reduce the risk of pneumonia (a leading cause of death for both pandemic and seasonal influenza) and the need for hospitalization.

For patients who initially present with severe illness or whose condition begins to deteriorate, WHO recommends treatment with oseltamivir as soon as possible. Studies show that early treatment, preferably within 48 hours after symptom onset, is strongly associated with better clinical outcome. For patients with severe or deteriorating illness, treatment should be provided even if started later. Where oseltamivir is unavailable or cannot be used for any reason, zanamivir may be given.

This recommendation applies to all patient groups, including pregnant women, and all age groups, including young children and infants.

Surveillance systems and research studies supported by WHO to monitor antimalarial drug efficacy in countries are providing new evidence that parasites resistant to artemisinin have emerged along the border between Cambodia and Thailand. If local people, who walk for miles every day to clear forests, were infected with a drug-resistant form of malaria, it could set back recent successes to control the disease.

Huge strides have been made in the past 10 years to reduce the burden of malaria, one of the world's major killer diseases. Strong malaria control programmes have helped to lower infection rates in several countries. The recent shift from failing drugs to the highly effective artemisinin-based combination therapies.

ACTs has been a breakthrough treatment.

Appropriate treatment with ACTs succeeds in more than 90% of cases. But malaria drug resistance now emerging along the Thai-Cambodia border threatens these gains.

With a US$ 22.5 million grant from the Bill & Melinda Gates Foundation, WHO will endeavour to contain artemisinin-resistant malaria parasites before they spread.

WHO will work in collaboration with several key partners including the National Center for Parasitology, Entomology and Malaria Control of the Cambodian Ministry of Health, Bureau of Vector-Borne Disease of the Thai Ministry of Public Health, Faculty of Tropical Medicine of Mahidol University Bangkok, Institut Pasteur Cambodia, Mahidol Oxford Tropical Medicine Research Unit, Bangkok and the Malaria Consortium.

"If we do not put a stop to the drug-resistant malaria situation that has been documented in the Thai-Cambodia border, it could spread rapidly to neighbouring countries and threaten our efforts to control this deadly disease," said Dr Hiroki Nakatani, Assistant Director-General of WHO.

Resistance along the Thai-Cambodia border started with chloroquine, followed by resistance to sulfadoxine-pyrimethamine and mefloquine, drugs used in malaria control several years ago.

Malaria poses a risk to half of the world's population and more than one million people die of the disease each year. The malaria map, or the area where it is prevalent, has been reduced considerably over the past 50 years, but the disease has defied elimination in areas of intense transmission.

Obstacles to malaria control include drug resistance in the parasite that causes the disease, as well as resistance of the vector mosquito to insecticides, environmental factors and counterfeit medicines. The likelihood of drug resistance is increased with the use of single-drug therapies for malaria, especially monotherapies of artemisinin and its derivatives. Monotherapy fosters resistance because it is easier for the parasite to adapt and eventually overcome the obstacles presented by a single drug than a combination of drugs delivered together. This makes it crucial for monotherapies to be removed from the market. WHO's treatment policy is to treat all cases of uncomplicated falciparum malaria with artemisinin combination therapy (ACTs).

"We know that malaria can be treated and prevented,” said Dr Regina Rabinovich, Director of Infectious Diseases Development at the Bill & Melinda Gates Foundation, “and if we lose the key treatment available at this time, it's like living in a house with a half a roof.

*The grant will be used to meet the following key objectives:

* eliminate artemisinin-tolerant parasites by detecting all malaria cases in target areas and ensuring effective treatment;

* reduce exposure of the parasites to artemisinin to limit emergence of resistance;

* prevent transmission of artemisinin-tolerant malaria parasites through mosquito control and personal protection;

* limit the spread of artemisinin-tolerant malaria parasites by mobile populations;

* support the containment and elimination of artemisinin-tolerant parasites through comprehensive behaviour change, communication, community mobilization and advocacy;

* undertake basic and operational research to fill knowledge gaps and ensure that strategies applied are evidence-based; and provide effective management, surveillance and coordination to enable a rapid and high-quality implementation of the strategy.

Moving swiftly to bring real relief to Americans hit hard by the economic crisis, President Barack Obama announced today that states will be able to access the first two quarters of Federal Medical Assistance Percentage funding (FMAP) starting this Wednesday, February 25. FMAP – the federal match for Medicare – helps pay for health care for the families struggling during the economic crisis and some of the nation’s most vulnerable citizens. More than 49 million Americans rely on Medicaid for health care coverage and this funding could help 20 million more Americans get covered.* The President made the announcement at a meeting of the nation’s governors at the White House.

This plan will also help ensure that you don’t need to make cuts to essential services Americans rely on now more than ever," the President told the Nation’s Governors in a meeting at the White House this morning. "To show you we’re serious about putting this recovery plan into action swiftly, I am announcing today that this Wednesday, our administration will begin distributing more than $15 billion in federal assistance under the Recovery Act to help you cover the costs of your Medicaid programs.

That means that by the time most of you get home; money will be waiting to help 20 million vulnerable Americans in your states get health coverage and 49 million Americans keep it.** Children with asthma will be able to breathe easier, seniors won’t need to fear losing their doctors, and pregnant women with limited means won’t need to worry about the health of their babies.

Beginning Wednesday, February 25, the first installment of more than $15 billion included in the American Recovery and Reinvestment Act will be available to States.

The first two quarters of FY 2009 funding for states has been set up in special Treasury accounts so that states, the District of Columbia, and the territories can start drawing down on those funds. This special, temporary increase in funding will be administered by the Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS).

States will need to meet Medicaid eligibility requirements outlined in the law to receive the new funding. CMS will be working with the States to ensure they meet the requirements as long as they wish to access the increased in Medicaid funding.

For more information on Salmonella, please visit the Centers for Disease Control and Prevention's Website at http://www.cdc.gov.

FDA and STD Warnings

The U.S. Food and Drug Administration today issued Warning Letters to six U.S. companies and one foreign individual for marketing unapproved and misbranded drugs over the Internet to U.S. consumers for the prevention and treatment of sexually transmitted diseases (STDs).

Some of these products, directed at U.S. consumers, falsely claim to have "FDA Approval" and some claim to be "more effective" than conventional medicine. The products are sold as Tetrasil, Genisil, Aviralex, OXi-MED, Imulux, Beta-mannan, Micronutrient, Qina, and SlicPlus. Consumers who are currently using these products should stop their use immediately and consult their health care professional if they have experienced any adverse effects that they suspect are related to the use of any of these products.

"The products pose a serious health threat to unsuspecting consumers who don’t know that these products are not FDA approved and have not been proven safe or effective," said Janet Woodcock, M.D., deputy commissioner for scientific and medical programs, chief medical officer, and acting director of the FDA’s Center for Drug Evaluation and Research. "STDs are very serious diseases and these products give consumers a false sense of security that they are protected from STDs."

The products claim to prevent or treat a variety of STDs, including Herpes, Chlamydia, Human Papilloma Virus, cervical dysplasia, and HIV/AIDS. The FDA considers these U.S. and imported products to be unapproved new drugs being marketed in violation of the Federal Food, Drug and Cosmetic Act. They are also misbranded under the law because they lack proper directions for use by consumers. In addition, some of the products are misbranded because they make false and misleading claims.

Examples of claims that these products make include "Treatment Kills all Herpes Viruses WITHOUT having to use conventional drugs or medications," "Greatest STD Protection Without Condoms," (SlicPlus) and "The active ingredient in our product is FDA certified to destroy 99.9992 percent of all pathogenic organisms [ie] Chlamydia" (OXi-MED).

The Warning Letters inform the companies that failure to properly resolve violations of the law may cause them to face further enforcement action that can include seizure of illegal products, injunction, and possible criminal prosecution.

Lack of Vitamin D Can Cause an Overall 26 percent Increased Risk of Death

Researchers at Johns Hopkins are reporting what is believed to be the most conclusive evidence to date that inadequate levels of vitamin D, obtained from milk, fortified cereals and exposure to sunlight, lead to substantially increased risk of death.

Of the 1,800 study participants known to have died by Dec. 31, 2000, nearly 700 died from some form of heart disease, with 400 of these being deficient in vitamin D. This translates overall to an estimated 26 percent increased risk of any death, though the number of deaths from heart disease alone was not large enough to meet scientific criteria to resolve that it was due to low vitamin D levels.

Michos, an assistant professor at the Johns Hopkins University School of Medicine and its Heart and Vascular Institute, recommends that people boost their vitamin D levels by eating diets rich in such fish as sardines and mackerel, consuming fortified dairy products, taking cod-liver oil and vitamin supplements, and in warmer weather briefly exposing skin to the sun’s vitamin-D producing ultraviolet light.

Aware of the cancer risks linked to too much time spent in the sun, she says as little as 10 to 15 minutes of daily exposure to the sun can produce sufficient amounts of vitamin D to sustain health. The hormone-like nutrient controls blood levels of calcium and phosphorus, essential chemicals in the body.

The U.S. Institute of Medicine suggests that an adequate daily intake of vitamin D is between 200 and 400 international units (or blood levels nearing 30 nanograms per milliliter). Previous results from the same nationwide survey showed that 41 percent of men and 53 percent of women are technically deficient in the nutrient, with vitamin D levels below 28 nanograms per milliliter.

Researchers say their next steps are to test various high doses of vitamin D to find out if the nutritional supplementation results in fewer deaths and lower incidence of heart disease, including heart attack or moments of prolonged and severe chest pain.

Melamed says that because vitamin D levels are known to fluctuate in direct proportion with daily physical activity, the growing epidemic of obesity and indoor sedentary lifestyles lend more urgency to act on the vitamin D factor.

Stop Smoking Stop Home Fires Save Your Life 8-15-2008

Home fire deaths are higher in states that have a greater percentage of smokers, according to a new Centers for Disease Control and Prevention (CDC) study published this month in the journal Injury Prevention. If smoking at home is reduced or stopped, fewer residential fire deaths may result, the study said.

Smoking is the leading cause of home fire deaths and accounts for approximately one quarter of the 3,000 home fire deaths in the United States each year. Quitting smoking, as well as following fire safety recommendations related to smoking, can help reduce the risk of cigarette-related home fire deaths. For free telephone-based counseling from anywhere in the United States, smokers can call 1-800-QUIT-NOW, a national number that connects people to their state-based quit line.

This study is the first to use national data to look at the percentage of current smokers and home fire deaths in the District of Columbia and all U.S. states except Hawaii. Nationally, an estimated 21 percent of adults smoked in 2004, with state averages ranging from 11 percent (Utah) to 28 percent (Kentucky). In that year, an estimated 2,804 individuals died in home fires, or nearly one death per 100,000 people in the United States.

“Our study suggests that even modest reductions in overall smoking rates may save lives. In fact, quitting smoking is the most important step smokers can take to improve their overall health and that of their loved ones. People who do smoke should smoke outside the house to help protect themselves and their families from home fires and exposure to secondhand smoke, a known human carcinogen,” said Shane Diekman, Ph.D., M.P.H., a behavioral scientist at CDC?s National Center for Injury Prevention and Control.

People who continue to smoke can reduce the risk of indoor fires by adopting strict smoke-free home rules; using deep, sturdy ashtrays securely set on tables; dousing cigarette and cigar butts in water or extinguishing with sand before dumping in the trash; and never smoking in bed or leaving burning cigarettes unattended. And everyone can reduce their risk of being harmed in a residential fire by making sure to have a working smoke alarm at home and testing that alarm regularly to make sure it is working.

“Home fire deaths have declined during the past several decades, and this decline has paralleled reductions in smoking,” said Ileana Arias, Ph.D., director of CDC?s Injury Center. “We work hard to keep our homes safe, and it just makes good sense to help people understand that if they can change their smoking habits, we may continue to reduce these tragedies.”

California Ban on Trans Fats

California is the first state in the US to ban Trans Fats which is the food oil particle that creates bad cholesterol .

Kidney Transplants

Contrary to prevailing assumptions, Johns Hopkins researchers have shown that kidneys recovered from black donors who died from cardiac death offer the best survival rate for black recipients of a deceased-donor kidney.

This discovery, released online this week and appearing in the October 2008 issue of the Journal of the American Society of Nephrology, challenges the long-held belief that kidneys from white brain-death donors offers the best deceased-donor transplant survival rate for either black or white recipients.

“Our findings indicate that increased use of kidneys from cardiac-death donors could help reduce the organ shortage and improve outcomes for black kidney transplant recipients,” says lead author Jayme Locke, M.D., M.P.H., of the Department of Surgery at Johns Hopkins.

Locke and a team of Johns Hopkins researchers examined the outcomes of more than 25,000 black adults who received a deceased-donor kidney transplant between 1993 and 2006.
Results showed that black recipients who received a kidney from a black cardiac-death donor had a 70 percent reduction in the risk of kidney loss and a 59 percent reduction in risk for death when compared to black recipients who received a kidney from a white brain-death donor.

“Our data is consistent with the previous observation that black recipients seem to do better with kidneys from white brain-death donors than they do with kidneys from black brain-death donors or white cardiac-death donors, however, the fact that black recipients have the best outcomes with kidneys from black cardiac-death donors is significant,” says co-lead author Daniel Warren, Ph.D., of the Department of Surgery at Johns Hopkins.

He says that the exact mechanisms responsible for racial differences in outcomes after kidney transplantation are not known, however, the results suggest that the genetic background of the donor and recipient likely have a significant impact on long-term outcomes.

“We believe that an improved understanding of the molecular consequences of cardiac and brain death is critical to improving outcomes for all kidney transplant recipients and warrants further investigation,” he added.

There are currently more than 70,000 Americans waiting for kidney transplants. Only about 600 deceased-donor kidneys donated after cardiac death are currently used for transplantation versus 7,000 donated after brain death.

This discrepancy is due in part to the belief that kidneys that are exposed to cardiac death generally suffer more damage than kidneys that are exposed to brain death.

“Our results show this is not always true, and that is significant news for all patients waiting for a kidney,” says Locke.

Jazz and the Brain Release of Creativity

A pair of Johns Hopkins and government scientists have discovered that when jazz musicians improvise, their brains turn off areas linked to self-censoring and inhibition, and turn on those that let self-expression flow.

A keyboard was specially designed for a study to assess brain activity in jazz musicians during improvisation. Because fMRI uses powerful magnets, the researchers designed the unconventional keyboard with no iron-containing metal parts that the magnets could attract.

The joint research, using functional magnetic resonance imaging, or fMRI, and musician volunteers from the Johns Hopkins University’s Peabody Institute, sheds light on the creative improvisation that artists and non-non-artists use in everyday life, the investigators say.

It appears, they conclude, that jazz musicians create their unique improvised riffs by turning off inhibition and turning up creativity.
In a report published Feb. 27 in Public Library of Science (PLoS) ONE, the scientists from the University’s School of Medicine and the National Institute on Deafness and Other

Communications Disorders describe their curiosity about the possible neurological underpinnings of  the almost trance-like state jazz artists enter during spontaneous improvisation.

“When jazz musicians improvise, they often play with eyes closed in a distinctive, personal style that transcends traditional rules of melody and rhythm,” says Charles J. Limb, M.D., assistant professor in the Department of Otolaryngology-Head and Neck Surgery at the Johns Hopkins School of Medicine and a trained jazz saxophonist himself. “It’s a remarkable frame of mind,” he adds, “during which, all of a sudden, the musician is generating music that has never been heard, thought, practiced or played before. What comes out is completely spontaneous.”

Though many recent studies have focused on understanding what parts of a person’s brain are active when listening to music, Limb says few have delved into brain activity while music is being spontaneously composed.

“HICY” DRUG REGIMEN REVERSES MS SYMPTOMS IN SELECTED PATIENTS

--New approach to immunosuppressant treatment tested in nine individuals shows promise
 
A short-term, very-high dose regimen of the immune-suppressing drug cyclophosphamide seems to slow progression of multiple sclerosis (MS) in most of a small group of patients studied and may even restore neurological function lost to the disease, Johns Hopkins researchers report. The findings in nine people, most of whom had failed all other treatments, suggest new ways to treat a disease that tends to progress relentlessly.
 
“We didn’t expect such a dramatic return of function,” says Douglas Kerr, M.D., Ph.D, associate professor of neurology at the Johns Hopkins University School of Medicine. “Although we’re very early in the game, we think this approach could be the linchpin of a significant advance for MS treatment.”

JOHNS HOPKINS RESEARCHERS DEVELOP HUMAN STEM CELL LINE CONTAINING SICKLE CELL ANEMIA MUTATION
--Improved Adult Cell Reprogramming Methods Open Doors for Disease Research

Researchers at Johns Hopkins have established a human cell-based system for studying sickle cell anemia by reprogramming somatic cells to an embryonic stem cell like state. Publishing online in Stem Cells on May 29, the team describes a faster and more efficient method of reprogramming cells that might speed the development of stem cell therapies.

“We hope our new cell lines can open the doors for researchers who study diseases like sickle cell anemia that are limited by the lack of good experimental models,” says Linzhao Cheng, Ph.D., an associate professor of gynecology and obstetrics, medicine and oncology and a member of the Johns Hopkins Institute for Cell Engineering.

The research team first sought to improve previously established methods for reprogramming of adult cells into so-called induced pluripotent stem (iPS) cells, which look and behave similarly to embryonic stem cells and can differentiate into many different cell types. After testing several different genes, they were able to improve reprogramming efficiency by adding a viral protein known as SV40 large T antigen.

Johns Hopkins Researcher Named Howard Hughes Medical Institute Investigator 5-28-2008