Protect yourself and your partners health from getting Sexually Transmitted Diseases by using a condom each time you have intimate relations. Always brush your teeth before being intimate, and always wash your entire body before and after being intimate, with soap and water. Take extra care that your hands are clean.

911 Breaking Health News

Tips To Keep Two Year Old Kids Safer

12-14-11Each year, one of every 150 two–year–olds visits an emergency department in the United States for an unintentional medication overdose, most often after finding and eating or drinking medicines without adult supervision. To inform parents and caregivers about safe medication storage and what to do in case of an emergency, CDC, the Consumer Healthcare Products Association Education Foundation and a coalition of partners are launching an educational program, Up and Away and Out of Sight, encouraging parents to follow a few simple steps to protect children.

“Parents may not be aware of the danger posed by leaving medications where young children can reach them. In recent years, the number of accidental overdoses in young children has increased by 20 percent,” said Dan Budnitz, M.D., M.P.H., director of CDC’s Medication Safety Program. “A few simple steps – done every time – can protect our children.”

To protect children, parents and caregivers can:

Any medicine or vitamin can cause harm if taken the wrong way, even medicine you buy without a prescription.

Put medicines and vitamins away every time you use them. Never leave medicines or vitamins out on a kitchen counter or at a sick child’s bedside, even if you have to give the medicine again in a few hours.

Hear the click. Make sure the safety cap is locked. If the medicine has a locking cap that turns, twist it until the click is heard.

Teach children about medicine safety. Never tell children that medicine is candy to get them to take it, even if the child does not like to take his or her medicine.

Tell guests about medicine safety. Ask houseguests and visitors to keep purses, bags, or coats that have medicines in them up and away and out of sight when they are visiting.

Be prepared in case of emergency. Program the poison control number into home and cell phones (1–800–222–1222).

Estrogen Resistance In Women Cancer Patients

11-13-11 Hopkins study shows resistance is reversible in dozens of experiments in mice and in human cancer cells, a team of Johns Hopkins scientists has closely tied production of a cancer-causing protein called TWIST to the development of estrogen resistance in women with breast cancer. Because estrogen fuels much breast cancer growth, such resistance — in which cancers go from estrogen positive to estrogen negative status — can sabotage anticancer drugs that work to block estrogen and prevent disease recurrence after surgery. Estrogen resistance develops in over half of women taking estrogen-blocking medications, such as tamoxifen, and exists from the start in many other women.

The Johns Hopkins-led team of cancer experts also reports that stalling TWIST production significantly reverses estrogen resistance. “Now that we know TWIST has a major role in controlling estrogen resistance in breast cancer, we can investigate the value of anti-TWIST therapies and how they make possible postsurgical hormone therapy for all women who have had invasive breast cancer,” says senior study investigator and breast cancer biologist Venu Raman, Ph.D. “We suspect that TWIST production may be an underlying cause of estrogen resistance,” adds Raman, an associate professor in the Department of Radiology at the Johns Hopkins University School of Medicine and its Kimmel Cancer Center.

“Now that we know TWIST has a major role in controlling estrogen resistance in breast cancer, we can investigate the value of anti-TWIST therapies and how they make possible postsurgical hormone therapy for all women who have had invasive breast cancer,” says senior study investigator and breast cancer biologist Venu Raman, Ph.D. “We suspect that TWIST production may be an underlying cause of estrogen resistance,” adds Raman, an associate professor in the Department of Radiology at the Johns Hopkins University School of Medicine and its Kimmel Cancer Center.

Estrogen resistance, Raman says, not only renders tamoxifen or aromatase inhibitors, such as anastrozole and letrozole, ineffective in women whose original estrogen receptor status was positive, but also rules out these standard treatment options for the one-quarter of women who at the time of their diagnosis already are estrogen receptor negative.

The latest findings of Raman and his team, to be published in the journal Oncogene online Nov. 7, are the first to demonstrate a detrimental link between TWIST activity and estrogen resistance. Previous work by Raman and others had shown that TWIST was more active in women with aggressive breast cancer and less active in women whose breast tumors were benign. But researchers had not yet established the direct connection to lowered levels of estrogen receptors.

In five separate cancerous cell lines grown in the laboratory, some from women with aggressive forms of breast cancer and the rest without, TWIST activity was shown in all cells to be strongly active where estrogen receptor activity was low. Further tests in human tissue samples showed the same result. In additional experiments in mice injected with breast cancer cells, researchers found that TWIST activation led to continuous and aggressive tumor growth despite tamoxifen therapy, while in mice tumors with low levels of TWIST, tumor growth waned within two months of treatment.

Stop Organ Rejections

10-25-11 Johns Hopkins researchers have developed a way to stimulate a rat’s stem cells after a liver transplant as a means of preventing rejection of the new organ without the need for lifelong immunosuppressant drugs. The need for anti-rejection health medicines, which carry serious side effects, is a major obstacle to successful long-term transplant survival in people.

With a combination of a very low, short-term dose of an immunosuppressive drug to prevent immediate rejection and four doses of a medication that frees the recipient’s stem cells from the bone marrow to seek out and populate the donor organ, the rats lived more than 180 days with good liver function despite stopping both drugs after one week. The researchers are also testing the method on other transplanted organs, including kidneys, in rats and other larger animals.

Essentially, the Hopkins scientists transformed the donor liver from a foreign object under attack by the rat’s immune system into an organ tolerated by the recipient’s immune system — all in a matter of three months from the date of transplant, they report.However, it may take a long time to fevelop for humans.

The technique, if replicated in humans, could mark a major shift in the process of organ transplantation, the researchers say. An article describing the experiment appears in the current issue of the American Journal of Transplantation.

“It is the dream for all scientists in the transplant field to erase the need for lifelong immunosuppressant drugs,” says study leader Zhaoli Sun, M.D., Ph.D., an associate professor of surgery at the Johns Hopkins University School of Medicine. “Currently, if a patient survives for 10 or 20 years with a new liver, that organ is still seen as foreign inside its new body because immunosuppression puts blinders on the immune system that must stay on to prevent rejection. Our idea was to find a way to turn that organ into something that ‘belongs’ and is never at risk of rejection.”

Although thousands of people with end-stage liver disease have gotten lifesaving liver transplants in recent years, rejection remains a chronic risk. And the expensive immunosuppressant drugs they need increase the chance of developing severe infections and many kinds of cancers. Some patients have difficulty sticking to the cocktail of drugs, which must be taken every day.

For their study, researchers transplanted portions of the livers of one kind of rat (dark agouti, or DA) into another (Lewis-type). For seven days after transplantation, the Lewis rats were treated with low-dose tacrolimus (an immunosuppressant), plerifaxor (a stem-cell stimulator) or a combination of the two. Twelve of the 13 rats that received a combination of the two drugs had long-term liver function and survived more than 180 days, while nearly all of the remaining rats rejected their new livers after 12 days.

“This short-term treatment had long-term results,” says Sun, who also is director of Hopkins’ Transplant Biology Research Center.

Typically, organ transplant recipients receive full doses of immunosuppressant drugs, such as tacrolimus, immediately after they receive new livers. Otherwise, rejection quickly results and patients may die.

Sun and his colleagues gave the Lewis rats in their experiment the equivalent of one-tenth the standard dose of tacrolimus. The goal was to have the new liver experience some mild rejection, but not enough to kill it. This “controlled rejection,” Sun says, appears to create injury signals in the body that cry out for stem cells to come and repair the damage being done to the new liver. It also prevents the new liver from regenerating itself with cells from the donor because it is under immunologic attack, leaving an opening for the recipient’s stem cells to jump in and play that role.

Sun and his colleagues used plerifaxor, a relatively new drug, known to free stem cells from the bone marrow and release them to circulate in the bloodstream. The drug is currently approved for patients about to undergo chemotherapy whose stem cells are harvested frozen and then returned to the body after cancer treatment.

Sun says that, in his experiment, many of these stem cells travel to the damaged liver to repopulate it with cells from the recipient, slowly taking over for the donor cells. Sun says the mechanism that brings the stem cells into the liver is becoming better understood, while the mechanisms by which stem cells become liver cells remain elusive. Equally interesting, Sun says, the stem cells also appear to modulate the immune response, increasing the number of regulatory T-cells and helping to reduce the chances of rejection.

“In our study, the risk of organ rejection is eventually eliminated because the liver is no longer a foreign object, but comprised of many of the recipient’s own cells,” Sun says. “Once the recipient’s stem cells take over, the body sees the regenerated liver as its own and works to protect it, not attack it.”

Within three months, Sun and his colleagues found that the majority of the liver cells in the transplanted organ belonged to the recipient, not the donor. When they used whole livers instead of partial livers, the process took a year. This suggests that the transformation process is jumpstarted by using partial livers for transplant, because the organ already “needs” to regenerate itself to most effectively function, he says.

Risks of Heart Transplant

9-13-2011 Johns Hopkins researchers say they have developed a formula to predict which heart transplant patients are at greatest risk of death in the year following their surgeries, information that could help medical teams figure out who would benefit most from the small number of available organs.

“Donor hearts are a limited resource,” says John V. Conte, M.D., a professor of surgery at the Johns Hopkins University School of Medicine and the senior author of the study. “Now, we have a simple-to-use tool that is highly predictive of safe survival after a heart transplant, and can help guide organ allocation decisions.”

Conte and his colleagues, writing in the September issue of Annals of Thoracic Surgery, pulled together a series of risk factors already associated with poor outcomes, such as age, race, gender, the cause of a patient’s heart failure and whether he or she was on dialysis, and then assigned a number of points to each factor. The sum of those points created a score. The higher the score, the higher the risk of death one year after transplant and the less safe people are from death.

Some factors were weighted more heavily than others, such as female gender (three points); African-American race (three points), and the need for dialysis in the time between being put on the transplant waiting list and getting a transplant (five points).

Patients with the lowest scores — between zero and two — had a 92.5 percent chance of being alive 12 months after surgery.

Patients with so-called IMPACT scores — the acronym the researchers came up with for the Index for Mortality Prediction After Cardiac Transplantation — above 20 points had a less than 50 percent chance of survival one year after surgery. Every point on the scale increased the chance of death within one year by 14 percent.

Treating Hepatitis

5-14- 2011 The U.S. Department of Health and Human Services today launched its action plan to prevent and treat viral hepatitis, a silent epidemic affecting 3.5 – 5.3 million Americans.

Though viral hepatitis is a leading infectious cause of death in the U.S., many people who have it don’t know they are infected, so they are at greater risk for severe – or even fatal – complications of the disease. Exacerbating the problem is the fact that health care providers often lack the appropriate training to conduct risk assessments, offer prevention counseling, provide diagnoses and treat viral hepatitis.

“These infections have fueled a tragic cascade of human suffering,” said Howard K. Koh, MD, MPH. “The new HHS action plan on viral hepatitis represents an unprecedented call to action for better health education, treatment and prevention.”

In January 2010, the Institute of Medicine (IOM) released a report on hepatitis, highlighting barriers that impede efforts for hepatitis prevention and control. The new HHS plan -- Combating the Silent Epidemic: US Department of Health and Human Services Action Plan for the Prevention, Care and Treatment of Viral Hepatitis -- is a response to the IOM report. It outlines a comprehensive action plan to raise awareness about viral hepatitis; creates more opportunities to train health professionals to diagnose, treat, vaccinate, and ultimately save lives; and builds upon the new health insurance reform law to improve patient access to comprehensive viral hepatitis-related prevention and treatment services through expanded coverage.

The plan’s success is contingent on leadership of government at all levels and the active and informed participation of communities, non-governmental organizations, health care providers, and the private sector.

“No one government agency can fight viral hepatitis alone, and here at CDC, we believe this action plan will not only strengthen the work we’ve been doing, but help all of us across the government collaborate to take our nation’s prevention efforts to the next level,” said CDC Director Thomas R. Frieden, MD, MPH. “Far too many Americans are unaware of the serious impact of viral hepatitis and the devastating consequences that can result from leaving it untreated. The time for action is now.”

According to officials at thh CDC:Hepatitis C virus (HCV) is a single-stranded RNA virus that is most efficiently spread through direct blood exposure to contaminated blood or blood products. Both HIV and HCV can be transmitted by percutaneous exposure to blood, through sexual intercourse, and from a mother to her infant. However, the relative efficiency of transmission by these routes varies. HCV is approximately 10 times more infectious than HIV through percutaneous blood exposures, but sexual transmission of HCV is inefficient compared with HIV.

“We have seen the increasing prevalence of viral hepatitis in our network of health centers and among people living with HIV/AIDS in underserved areas and we know that minorities and medically vulnerable populations are disproportionately affected,” said Health Resources and Services Administrator Mary K. Wakefield, RN, PhD. “This action plan is our best chance at stopping the disease with increased access to information and quality care for those at risk and those who are already infected.

NIH Announces New Plan for Diabetics

3-25-2011 A new strategic plan to guide diabetes-related research over the next decade was announced today by the National Institutes of Health. The plan, developed by a federal work group led by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), identifies research opportunities with the greatest potential to benefit the millions of Americans who are living with or at risk for diabetes and its complications.

"By setting priorities and identifying the most compelling research opportunities, the strategic plan will guide NIH, other federal agencies and the investigative community in efforts to improve diabetes treatments and identify ways to keep more people healthy," said NIDDK Director Griffin P. Rodgers, M.D.

The plan, Advances and Emerging Opportunities in Diabetes Research: A Strategic Planning Report of the Diabetes Mellitus Interagency Coordinating Committee, focuses on 10 areas of diabetes research with the most promise. The goal is to accelerate discovery on several fronts, including:

the relationship between obesity and type 2 diabetes, and how both conditions may be affected by genetics and environment

the autoimmune mechanisms at work in type 1 diabetes

the biology of beta cells, which release insulin in the pancreas

development of artificial pancreas technologies to improve management of blood sugar levels

prevention of complications of diabetes that affect the heart, eyes, kidneys, nervous system and other organs

reduction of the impact of diabetes on groups disproportionately affected by the disease, including the elderly and racial and ethnic minorities

Under the plan, NIH will continue to emphasize clinical research in humans, which already has led to highly effective methods for managing diabetes and preventing complications, Rodgers said.

The NIH strategy for fighting diabetes addresses type 1 and type 2 diabetes. Type 1 diabetes, which affects about 5 percent of individuals with diagnosed diabetes, is an autoimmune disease that most often develops during childhood. Type 2 diabetes accounts for 90 to 95 percent of diagnosed diabetes cases in the United States, and is strongly associated with overweight and obesity. In addition, the plan addresses gestational diabetes, a condition that some women develop during pregnancy, but which usually goes away after their child is born. Women who develop gestational diabetes during pregnancy are at increased risk for developing type 2 diabetes, and the child of that pregnancy may also be at increased risk for obesity and type 2 diabetes.

Today, about 1 in 10 adults in the United States has diabetes, according to the Centers for Disease Control and Prevention. About 1.9 million Americans aged 20 years or older were newly diagnosed with diabetes in 2010. In addition, an estimated 79 million American adults have pre-diabetes, a condition in which blood sugar levels are higher than normal but not high enough to be diagnosed as diabetes. By 2050, as many as 1 in 3 adults could be diagnosed with diabetes if current trends continue, according to the CDC. The projection assumes that recent increases in new cases of diabetes will continue and people with diabetes will also live longer, which adds to the total number of people with the disease.

Stroke is Number Four in Deaths

According to the CDC:Stroke is now the fourth leading cause of death in the United States, down from the third place ranking it has held for decades, according to preliminary 2008 death statistics released today by CDC's National Center for Health Statistics. While deaths from stroke and several other chronic diseases are down, deaths due to chronic lower respiratory disease increased in 2008.

There were 133,750 deaths from stroke in 2008. Age-adjusted death rates from stroke declined 3.8 percent between 2007 and 2008. Meantime, there were 141,075 deaths from chronic lower respiratory disease and the death rate increased by 7.8 percent.

Some of the increase in deaths may be due to a modification made by the World Health Organization in the way deaths from chronic lower respiratory diseases are classified and coded. The National Center for Health Statistics will conduct a thorough analysis on this change and its effect on the chronic lower respiratory disease category before the final 2008 deaths data are released.

"Deaths: Preliminary Data for 2008," also finds that life expectancy at birth dropped slightly to 77.8 years from 77.9 years in 2007. Life expectancy was down by one-tenth of a year (a little over a month) for both men and women. However, black males had a record high life expectancy in 2008 of 70.2 years – up from 70 years in 2007. The life expectancy gap between the white and black populations was 4.6 years in 2008, a decrease of two-tenths of a year from 2007.

The data are based on 99 percent of death certificates reported to NCHS through the National Vital Statistics System from all 50 states, the District of Columbia and U.S. territories.

Other findings:

Heart disease and cancer, the two leading causes of death, still accounted for nearly half (48 percent) of all deaths in 2008.

In addition to stroke, mortality rates declined significantly for five of the other 15 leading causes of death: accidents/unintentional injuries (3.5 percent), homicide (3.3 percent), diabetes (3.1 percent), heart disease (2.2 percent), and cancer (1.6 percent).

In addition to chronic lower respiratory disease, death rates increased significantly in 2008 for Alzheimer's disease (7.5 percent), influenza and pneumonia (4.9 percent), high blood pressure (4.1 percent), suicide (2.7 percent), and kidney disease (2.1 percent).

The preliminary infant mortality rate for 2008 was 6.59 infant deaths per 1,000 live births, a 2.4 percent decline from the 2007 rate of 6.77 and an all-time record low. Birth defects were the leading cause of infant death in 2008, followed by disorders related to preterm birth and low birth weight. Sudden infant death syndrome (SIDS) was the third leading cause of infant death in the United States.

Overall, there were 2,473,018 deaths in the United States in 2008, according to the preliminary deaths report – 49,306 more deaths than the 2007 total.

The age-adjusted death rate for the U.S. population fell to 758.7 deaths per 100,000 in 2008 compared to the 2007 rate of 760.2.

No Known Tobacco Product is Safe

1-5-2011 “No known existing tobacco product is safe, and a market order issued by the FDA for these products should never be interpreted as such” Lawrence R. Deyton, M.S.P.H., M.D., director of the agency’s Center for Tobacco Products.. “One of the FDA’s missions required by a new law is to ensure new products do not pose an increased threat to the American public health. These products will not be safer, but we are required by this law to not allow even more dangerous products to cause further harm to your health for those Americans who use tobacco products.”

The U.S. Food and Drug Administration announced today that certain tobacco products introduced or changed after Feb. 15, 2007 must be reviewed by the agency. In FDA guidance published today, the agency outlines a pathway for marketing a product whereby the company marketing the product must prove that it is “substantially equivalent” to products commercially available on Feb. 15, 2007.

“Substantially equivalent” means the products must be the same in terms of ingredients, design, composition, heating source and other characteristics to an existing, single predicate product or have different characteristics, but not raise different questions of public health.

“This specific part of the law is meant to ensure that new tobacco products are evaluated by the FDA before they are cleared to enter the marketplace. The law requires FDA to carefully examine the impact those products may have on the public health,” said Lawrence R. Deyton, M.S.P.H., M.D., director of the agency’s Center for Tobacco Products. “Products that are equivalent to those which were on the market on February 15, 2007, may be cleared to go to market; those that are not may be prohibited from the market, or withdrawn if they are already available, if the changes raise different questions of public health.

The Family Smoking Prevention and Tobacco Control Act, which became law June 22, 2009, granted the FDA regulatory authority over tobacco products. Generally, the law allows the FDA to deny applications for new products if marketing the product poses a harm to public health. FDA may deny applications for substantial equivalence if the marketing of that modified product would raise different questions of public health. An example would be a product that poses an increased health risk to users of the product or to nonusers by causing more of them to start smoking.

In general, in order to continue to market these products, manufacturers of tobacco products that were introduced or changed after Feb. 15, 2007, which include cigarettes, roll-your-own tobacco and all smokeless products must apply for equivalency by Mar. 22, 2011. Manufacturers intending to introduce new products into the market after that date must submit an application for the new product and obtain a marketing order from the FDA before introducing the product to market.

“No known existing tobacco product is safe, and a market order issued by the FDA for these products should never be interpreted as such” said Deyton. “One of the FDA’s missions required by this new law is to ensure new products do not pose an increased threat to the American public. These products will not be safer, but we are required by this law to not allow even more dangerous products to cause further harm to those Americans who use tobacco products.”

FDA also intends to issue guidance on materials the agency believes would show that a tobacco product was on the market on Feb. 15, 2007, as well as hold a Webinar Series in order to provide more assistance to manufacturers.

Smoking and Your Health

12-11-2010 According to the Surgeon General Regina M. Benjamin, “The chemicals in tobacco smoke reach your lungs quickly every time you inhale causing damage immediately,” Benjamin said in releasing the report. “Inhaling even the smallest amount of tobacco smoke can also damage your DNA, which can lead to cancer.”

"Over the last two years we have stepped up efforts to reduce tobacco use, including implementing legislation to regulate tobacco products, investing in local tobacco control efforts and expanding access to insurance coverage for tobacco cessation" said Secretary of Health and Human Services Kathleen Sebelius. "This will remain a key priority of this Administration."

The report also explains why it is so difficult to quit smoking. According to the research, cigarettes are designed for addiction. The design and contents of current tobacco products make them more attractive and addictive than ever before. Today’s cigarettes deliver nicotine more quickly and efficiently than cigarettes of many years ago.

Tobacco smoke contains a deadly mixture of more than 7,000 chemicals and compounds, of which hundreds are toxic and at least 70 cause cancer. Every exposure to these cancer-causing chemicals could damage DNA in a way that leads to cancer. Exposure to smoke also decreases the benefits of chemotherapy and other cancer treatments. Smoking causes more than 85% of lung cancers and can cause cancer almost anywhere in the body. One in three cancer deaths in the U.S. is tobacco-related.

The report describes how the delicate lining of the lungs becomes inflamed as soon as it is exposed to the chemical mixture in cigarette smoke. Over time, the smoke can cause chronic obstructive pulmonary disease including emphysema and chronic bronchitis.

Even brief exposure to secondhand smoke can cause cardiovascular disease and could trigger acute cardiac events, such as heart attack. The report describes how chemicals from tobacco smoke quickly damage blood vessels and make blood more likely to clot. The evidence in this report shows how smoking causes cardiovascular disease and increases risks for heart attack, stroke, and aortic aneurysm.

Smoking causes many other harmful effects throughout the body, including making it harder for diabetics to control their blood sugar. Smoking makes it harder for women to get pregnant and can cause a miscarriage, preterm delivery, low birth weight, as well as damage to fetal lungs and brain tissue. Babies who are exposed to secondhand smoke are more likely to die from sudden infant death syndrome, the report finds.

“This report makes it clear – quitting at any time gives your body a chance to heal the damage caused by smoking,” the Surgeon General said. “It’s never too late to quit, but the sooner you do it, the better.”

Fortunately, there are now more effective ways to help people quit than ever before. Nicotine replacement is available over the counter and doctors can prescribe medications that improve the chances of successful quit attempts. Smokers can also call 1-800-QUIT-NOW for help.

To help communicate the report findings as widely as possible, the Surgeon General unveiled an easy-to-read guide with practical information about how tobacco smoke causes disease, A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You.

Copies of the full report, executive summary, and the easy-to-read guide may be downloaded at www.surgeongeneral.gov/library/tobaccosmoke/index.html.

Compound Slows Cancer Cell Growth

12-7-2010 According to scientists at Johns Hopkins they have identified a compound that could be used to starve cancers of their sugar-based building blocks. The compound, called a glutaminase inhibitor, has been tested on laboratory-cultured, sugar-hungry brain cancer cells and, the scientists say, may have the potential to be used for many types of primary brain tumors.

The Johns Hopkins scientists, who are inventors on patent applications related to the discovery, caution that glutaminase inhibitors have not been tested in animals or humans, but their findings may spark new interest in the glutaminase pathway as a target for new therapies.

Glutaminase is an enzyme that controls how glucose-based nutrients are converted into the carbon skeleton of a cell. Additional enzymes that help construct the so-called "bricks" of the carbon skeleton are controlled by a gene called IDH1. In some brain cancer cells, IDH1 is mutated and the resulting enzyme grinds up the bricks into nutrients that feed cancer cells.

"Cancer cells with mutated IDH1 become addicted to the glutaminase pathway, and this pathway may represent an Achilles' heel of cancer cells," says Chi Dang, M.D., Ph.D., the Johns Hopkins Family Professor in Oncology Research and vice dean for research at the Johns Hopkins University School of Medicine. "To combat cancer, we might block the flow of materials that help create the bricks, starting with glutaminase."

To establish proof of the principle, the Johns Hopkins scientists and a team of chemists and geneticists at Princeton University used a glutaminase-blocking agent on cells engineered to have IDH1 mutations. The compound, called BPTES, reduced growth of the cancer cells by 30 percent. Their findings were published online Nov. 2 in Cancer Research.

1,000 Cholera Deaths

Haiti On Sunday 11-14-2010, a “marathon six-hour programme on cholera” had aired on all national radio stations and many television stations, Mr. Fisher said.  In addition, health education messages are being disseminated via cell phone messages, posters and other media, while volunteer “camp committees” toured camps for the displaced to disseminate information about cholera directly in the Creole language.

But while the majority of those in the camps have access to safe, chlorinated water and latrines, the situation of people living in slums is more worrisome, Mr. Fisher said, noting that cases were rising faster in such places than elsewhere in the country.  Another challenge is stemming the tide of demonstrations against the opening of new treatment centres, he says, adding that protests had been recorded in locales including Saint-Marc and Cap-Haïtien, among other places.

The protests are the result of fear and a lack of proper information, he added.  In the face of those concerns, the United Nations communication strategy is now broadening to include messages counteracting fear, he said.  “To have a cholera treatment centre in your locality is actually an advantage; it is not a threat to your health,” he stressed, identifying one targeted message.  Further complicating the situation is the approach of the national election season, said the Deputy Special Representative.  “With elections coming up, we’re concerned that these issues around cholera not be manipulated for political ends.”

Responding to a question about the relationship between the cholera outbreak and the upcoming elections, Mr. Fisher said there have already been initial reports of one politically-motivated demonstration against a new health centre.  Despite those concerns, the United Nations was supporting the Government’s current strategy of exploring ways to go ahead with the elections, adding that they included protecting voters from infection while they visited polling booths.

In response to another question about the protests, he said that while MINUSTAH had been involved in the engineering aspect of new treatment centres, it has not been involved in providing security against protests or demonstrations.

Asked about the source of the cholera outbreak, Mr. Fisher confirmed that the particular strain active in the country was new to Haiti, but could have come from anywhere around the world.  “Our emphasis today is on trying to contain the number of deaths from what is going to be a very severe outbreak,” he added.

FDA Announes Partnership with the University of Rochester Plan for Pain Relieving Drugs

11-4-2010 To Streamline Process for Pain-relieving Drugs, the U.S. Food and Drug Administration today announced a partnership agreement with the University of Rochester to form the Analgesic Clinical Trial Innovations, Opportunities, and Networks (ACTION) Initiative.

The initiative is aligned with the FDA's recently launched Initiative for the Advancement of Regulatory Science, and is designed to streamline the discovery and development process for new pain-reducing (analgesic) drug products. This multi-year, multi-phased initiative will address major gaps in scientific information that can slow down analgesic clinical trials and analgesic drug development. Key objectives include:

Establishing a scientific and administrative infrastructure to support a series of projects;

Establishing relationships with key expert stakeholders, industry, professional organizations, academia and government agencies;

Coordinating scientific workshops with key experts in the field of anesthesia and analgesia;

Conducting in-depth and wide-ranging data analyses of analgesic clinical trial data to determine the effects of specific research designs and analysis methods.

Hopkins Awarded $3.84 Million Dollars

The Johns Hopkins University School of Medicine has been awarded a $3.84 million federal grant to support the creation of the Osler Urban Health Residency Track (UHRT), which will bolster the institution’s mission to produce primary healthcare physician leaders versed in the medical and social issues that afflict the underserved of Baltimore City.

The five-year grant, part of $320 million in funding available under the new Affordable Care Act (ACA), is designed to expand primary care residency programs throughout the nation. The UHRT, the primary care arm of the renowned Osler Medical Housestaff Training Program, will annually match four residents who will undergo three years of training in the Department of Medicine, with a focus on addressing the growing medical needs of underserved populations. The new track will partner with its sister program, the combined internal medicine-pediatrics urban health residency program, which began training four residents in July of 2010.

“The need for primary care physicians and leaders has never been more acute nationwide,” says Edward D. Miller, M.D., dean and CEO of Johns Hopkins Medicine. “Major U.S. cities, including our own, clearly face a primary care workforce crisis at a time when health care issues prevalent in our inner cities are rising. This grant sends a clear message about the importance of primary care in managing the complex health problems of our urban populations. “

The ACA grant will cover the costs of the residents’ salaries, malpractice and health insurance, and expenditures for recruitment and residency-related activities, according to internist and pediatrician Lenny Feldman, M.D., the UHRT director.

“With the passage of health care reform, primary care’s central role in health has been reaffirmed, and the emergence of primary care physician (PCP) leaders is crucial,” says Feldman. “This grant will help us in our attempts to address the growing medical needs in underserved communities by providing resident physicians with specialized training in managing the myriad health problems — from high blood pressure and diabetes, to alcoholism, AIDS and domestic violence.”

After three years of training in internal medicine, the graduates will receive full tuition support from Baltimore Medical System (BMS) to earn a master’s degree in public health, business administration, or a similar advanced degree in an area of interest while practicing part-time as primary care physicians at BMS.

“The track will focus on the social and medical issues that are underemphasized in traditional training,” explains Rosalyn Stewart, M.D., the associate track director. “Healthy living only comes about when all of those issues are dealt with in a coordinated and comprehensive fashion.

Eat Dark Chocolate to Prevent Brain Injury from a Stroke

5-12-2010 Researchers at Johns Hopkins have discovered that a compound in dark chocolate may protect the brain after a stroke by increasing cellular signals already known to shield nerve cells from damage.

Ninety minutes after feeding mice a single modest dose of epicatechin, a compound found naturally in dark chocolate, the scientists induced an ischemic stroke by essentially cutting off blood supply to the animals’ brains. They found that the animals that had preventively ingested the epicatechin suffered significantly less brain damage than the ones that had not been given the compound.

While most treatments against stroke in humans have to be given within a two- to three-hour time window to be effective, epicatechin appeared to limit further neuronal damage when given to mice 3.5 hours after a stroke. Given six hours after a stroke, however, the compound offered no protection to brain cells.

Sylvain Doré, Ph.D., associate professor of anesthesiology and critical care medicine and pharmacology and molecular sciences at the Johns Hopkins University School of Medicine, says his study suggests that epicatechin stimulates two previously well-established pathways known to shield nerve cells in the brain from damage. When the stroke hits, the brain is ready to protect itself because these pathways — Nrf2 and heme oxygenase 1 — are activated. In mice that selectively lacked activity in those pathways, the study found, epicatechin had no significant protective effect and their brain cells died after a stroke.

Hopkins Researchers Elected to National Academy of Science

April 30, 2010- Nancy L. Craig, Ph.D., a professor of molecular biology and genetics, and King-Wai Yau, Ph.D., a professor of neuroscience and ophthalmology, both in the Johns Hopkins University School of Medicine, are among 72 scientists nationwide newly elected to membership in the National Academy of Sciences, an honorary society that advises the government on scientific matters.

“Johns Hopkins is very proud that the Academy has chosen to recognize Nancy and King-Wai,” says Stephen Desiderio, M.D., Ph.D., director of the Johns Hopkins Institute for Basic Biomedical Sciences. “Both have made seminal discoveries in their respective fields over the years and their elections are well deserved.”

A Howard Hughes Medical Institute investigator, Craig studies the molecular mechanisms by which so-called transposable elements move and how they can be exploited for genetic engineering. Composed of DNA sequences with no fixed address, these travelling salesmen of the genome are present in virtually all organisms and contribute to both genome structure and function. One important consequence of transposon insertion is that information encoded by the transposon becomes stably linked with its DNA target. About one half of the human genome is composed of DNA sequences related to transposable elements, which are emerging as potentially important predictors of human traits and diseases. Craig currently is focusing her research efforts on how several different transposons choose their new insertion sites.

Craig, who joined the Hopkins faculty in 1991, was previously a faculty member in the Department of Microbiology & Immunology at the University of California, San Francisco. She earned an A.B. in biology and chemistry from Bryn Mawr College and a Ph.D. in biochemistry from Cornell University after graduating from Concord High School in Concord, CA.

Yau’s primary research interest lies in the flow of signals important in sight and smell. Among his discoveries are the critical roles played by two key signaling molecules — calcium and cyclic GMP — in the process of converting light into electrical signals by the rod and cone photoreceptor cells in the retina, a process known as visual transduction. In addition to advancing the understanding of hereditary blinding diseases that affect rod and cone cells, Yau characterized the light-response behaviors of a newly discovered photoreceptor cell in the retina. These cells can react to light and affect circadian rhythms and other non-visual aspects of the brain’s visual system. Yau also contributed to finding the cause of one form of central vision loss.

Yau, who joined the Johns Hopkins faculty in 1986, earned an A.B. in physics from Princeton University and a Ph.D. in neurobiology from Harvard University.

“Nancy’s and King-Wai’s election to the Academy attests to the strength of the research enterprise at Johns Hopkins,” says Chi V. Dang, M.D., Ph.D., vice dean for research. “We couldn’t be happier for them.”

The election of Craig and Yau, held during the 147th annual meeting of the Academy in Washington, D.C., brings the total number of active members to 2,097.

The National Academy of Sciences is a private organization of scientists and engineers dedicated to the furtherance of science and its use for the general welfare. It was established in 1863 by a congressional act of incorporation signed by Abraham Lincoln that calls on the Academy to act as an official adviser to the federal government, upon request, in any matter of science or technology.

Sexually Transmitted Diseases Transmission Conference

3-10-2010 More than 750 public health leaders convened in Atlanta for the 2010 National STD Prevention Conference, the only conference focused exclusively on reducing the burden of sexually transmitted diseases (STDs) in the United States. The three-day conference features more than 300 new studies, including a CDC analysis finding continued high rates of herpes (HSV-2) in the United States, particularly among women and African-Americans. CDC will also release the results of a new analysis of HIV and syphilis rates among gay and bisexual men.

"As the studies presented at this conference show, the disparities in STD rates among women, African-Americans, and gay and bisexual men remain stark," said Kevin Fenton, M.D., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. "Given everything we know about how to prevent, diagnose and treat STDs, it is unacceptable that STDs remain such a widespread public health problem in the United States today."

Several studies presented at the conference provide additional evidence of what works to reduce the spread of STDs, including retesting for chlamydia after initial treatment to monitor for repeat infections, and expedited partner therapy – a clinical practice that allows health care providers to provide treatment to sexual partners of those diagnosed with chlamydia or gonorrhea without giving them a full medical exam.

Other studies provide new insights into socioeconomic and other factors that contribute to STD disparities, including lack of access to health care, racial discrimination, and misinformation about STDs.

"We have a better understanding than ever of the reasons for STD disparities," said John M. Douglas, Jr., M.D., director of CDC's Division of STD Prevention. "It's critical that we address the root causes of this problem because it is affecting our most vulnerable populations. We must use insights gained through research and conferences like this to guide the development of STD prevention programs."

Conference keynote speakers, including Thomas Frieden, M.D., director of CDC, and William Foege, M.D., senior fellow of the Bill & Melinda Gates Foundation and the Carter Center, will discuss the future of STD prevention at a time when severely limited resources at all levels have taken a heavy toll on the nation's public health infrastructure.

"It is clear that public programs alone won't be able to dramatically reduce STD rates. Everyone must be involved in the solution," said Douglas. "We need to collaborate with the private sector to expand public awareness, increase the role of private health care providers in STD screening and treatment, and encourage open discussions about sexual health within our families and communities to reduce the stigma of STDs."

CDC estimates that there are 19 million new STD infections every year, making STDs the most commonly reported infectious diseases in the United States. STDs are estimated to cost the U.S. health care system about $16 billion annually, and can cause serious long-term health consequences. Left untreated, STDs such as chlamydia and gonorrhea can lead to infertility, and many STDs increase the risk of HIV infection."As the studies presented at this conference show, the disparities in STD rates among women, African-Americans, and gay and bisexual men remain stark," said Kevin Fenton, M.D., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. "Given everything we know about how to prevent, diagnose and treat STDs, it is unacceptable that STDs remain such a widespread public health problem in the United States today."

Several studies presented at the conference provide additional evidence of what works to reduce the spread of STDs, including retesting for chlamydia after initial treatment to monitor for repeat infections, and expedited partner therapy – a clinical practice that allows health care providers to provide treatment to sexual partners of those diagnosed with chlamydia or gonorrhea without giving them a full medical exam.

Other studies provide new insights into socioeconomic and other factors that contribute to STD disparities, including lack of access to health care, racial discrimination, and misinformation about STDs.

"We have a better understanding than ever of the reasons for STD disparities," said John M. Douglas, Jr., M.D., director of CDC's Division of STD Prevention. "It's critical that we address the root causes of this problem because it is affecting our most vulnerable populations. We must use insights gained through research and conferences like this to guide the development of STD prevention programs."

Conference keynote speakers, including Thomas Frieden, M.D., director of CDC, and William Foege, M.D., senior fellow of the Bill & Melinda Gates Foundation and the Carter Center, will discuss the future of STD prevention at a time when severely limited resources at all levels have taken a heavy toll on the nation's public health infrastructure.

"It is clear that public programs alone won't be able to dramatically reduce STD rates. Everyone must be involved in the solution," said Douglas. "We need to collaborate with the private sector to expand public awareness, increase the role of private health care providers in STD screening and treatment, and encourage open discussions about sexual health within our families and communities to reduce the stigma of STDs."

CDC estimates that there are 19 million new STD infections every year, making STDs the most commonly reported infectious diseases in the United States. STDs are estimated to cost the U.S. health care system about $16 billion annually, and can cause serious long-term health consequences. Left untreated, STDs such as chlamydia and gonorrhea can lead to infertility, and many STDs increase the risk of HIV infection.

"As the studies presented at this conference show, the disparities in STD rates among women, African-Americans, and gay and bisexual men remain stark," said Kevin Fenton, M.D., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. "Given everything we know about how to prevent, diagnose and treat STDs, it is unacceptable that STDs remain such a widespread public health problem in the United States today."

Several studies presented at the conference provide additional evidence of what works to reduce the spread of STDs, including retesting for chlamydia after initial treatment to monitor for repeat infections, and expedited partner therapy – a clinical practice that allows health care providers to provide treatment to sexual partners of those diagnosed with chlamydia or gonorrhea without giving them a full medical exam.

Other studies provide new insights into socioeconomic and other factors that contribute to STD disparities, including lack of access to health care, racial discrimination, and misinformation about STDs.

"We have a better understanding than ever of the reasons for STD disparities," said John M. Douglas, Jr., M.D., director of CDC's Division of STD Prevention. "It's critical that we address the root causes of this problem because it is affecting our most vulnerable populations. We must use insights gained through research and conferences like this to guide the development of STD prevention programs."

Conference keynote speakers, including Thomas Frieden, M.D., director of CDC, and William Foege, M.D., senior fellow of the Bill & Melinda Gates Foundation and the Carter Center, will discuss the future of STD prevention at a time when severely limited resources at all levels have taken a heavy toll on the nation's public health infrastructure.

"It is clear that public programs alone won't be able to dramatically reduce STD rates. Everyone must be involved in the solution," said Douglas. "We need to collaborate with the private sector to expand public awareness, increase the role of private health care providers in STD screening and treatment, and encourage open discussions about sexual health within our families and communities to reduce the stigma of STDs."

CDC estimates that there are 19 million new STD infections every year, making STDs the most commonly reported infectious diseases in the United States. STDs are estimated to cost the U.S. health care system about $16 billion annually, and can cause serious long-term health consequences. Left untreated, STDs such as chlamydia and gonorrhea can lead to infertility, and many STDs increase the risk of HIV infection.

Risk of Heart Disease

New analyses from the Women's Health Initiative (WHI) confirm that combination hormone therapy increases the risk of heart disease in healthy postmenopausal women. Researchers report a trend toward an increased risk of heart disease during the first two years of hormone therapy among women who began therapy within 10 years of menopause, and a more marked elevation of risk among women who began hormone therapy more than 10 years after menopause. Analyses indicate that overall a woman’s risk of heart disease more than doubles within the first two years of taking combination HT.

The difference in the initial level of risk does not appear related to age, based on findings that the increased risk of heart disease was similar between women in their 50s on combination hormone therapy and women in their 60s.

The study is in the Feb. 16, 2010, Annals of Internal Medicine. The WHI is sponsored by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH).

"Today, most women who take hormone therapy for menopausal symptoms begin therapy shortly after menopause. Based on today’s report, even these women appear to be at increased risk of heart disease for several years after starting combination hormone therapy," noted Susan B. Shurin, M.D., NHLBI acting director. "It is clearer than ever that women who are considering postmenopausal hormone therapy for menopausal symptoms should discuss their risk of heart disease and other risks – such as breast cancer, stroke, and dangerous blood clots – with their doctors before starting therapy."

Jacques E. Rossouw, M.D., chief of the NHLBI Women's Health Initiative Branch and a coauthor of the paper, added, "Although the number of recently menopausal women who would be expected to suffer a heart attack during the first years of combination hormone therapy is small, the risk is likely to be real. Our findings continue to support FDA recommendations that postmenopausal hormone therapy should not be used for the prevention of heart disease."

Combination hormone therapy includes progestin in combination with estrogen. Adding progestin is known to prevent endometrial cancer in women with a uterus. Today's findings do not apply to women who have had a hysterectomy and take estrogen-only hormone therapy. Similar analyses on the results of the clinical trial of estrogen only therapy are planned.

Researchers from the Harvard School of Public Health and the NHLBI reanalyzed data from the landmark WHI clinical trial of the effects of combination hormone therapy in 16,608 postmenopausal women with an intact uterus, ages 50 to 79 years (average age of 63) at enrollment.

In the new analyses, the researchers compared the effects of hormone therapy on heart disease risk among women who began hormone therapy within 10 years of menopause and women who began therapy more than 10 years after menopause. The researchers used models that adjusted for adherence, or the actual amount of medication that participants took during the study. They also studied the effects of hormone therapy on heart disease over time (up to eight years). In addition, they compared the findings with similar analyses of 34,575 women in the Nurses Health Study, an observational study with an average follow-up of 9.3 years. The researchers report similar effects of hormone therapy from both studies.

In the WHI clinical trial of estrogen-plus-progestin, 8,506 participants were randomly assigned to receive a combination of estrogen (0.625 milligrams of conjugated equine estrogens per day) plus progestin (2.5 mg of medroxyprogesterone acetate), and 8,102 women were given placebo (inactive pill). The study was stopped in 2002 after an average of 5.6 years of treatment due to an increase in breast cancer in the women on hormone therapy. Compared to women on placebo, women on combination hormone therapy were also at increased risk of stroke, dangerous blood clots, and heart disease, while their risk of colorectal cancer and hip fractures was lower.

Overall, among the 8,506 women assigned to combination hormone therapy during the study, there were 188 cases of coronary heart disease (80 in the first two years), compared to 147 heart disease cases (51 in the first two years) among the 8,102 women on placebo. When adjusted for adherence, the analysis shows that women on combination hormone therapy were about 2.4 times more likely to develop heart disease in the first two years. At eight years, the women on combination hormone therapy were 69 percent more likely to develop heart disease.

The new analyses also showed:

Women who were within 10 years of menopause had a trend toward an increased risk of heart disease, with a 29 percent higher risk at two years from the start of hormone therapy. Although the increased risk of heart disease was not statistically significant, this finding is consistent with a similar analysis of data from the larger Nurses Health Study.

Women who started combination hormone therapy less than 10 years after menopause remained at increased risk of heart disease on average for about six years, after which those in the treatment group appeared to have a lower risk of heart disease compared to similar women who were not on combination hormone therapy. In the nurses study, the initially increased risk on combination hormone therapy changed toward lower risk of heart disease after about three years.

In contrast, women who started hormone therapy 10 years or more after menopause were nearly 3 times more likely to develop heart disease within the first two years of treatment compared to women on placebo. These women continued to be at increased risk of heart disease throughout the 8 years of follow-up.

Migrane Headaches and Light

Most migraine sufferers know that light can intensify headache pain. A new study of blind patients with migraine may help explain why. The finding ultimately may lead to new approaches for calming severe light-induced headaches.

More than 1 in 10 people nationwide experience recurring headaches known as migraines. They're often described as a pulsing or throbbing in one side of the head. Other symptoms include nausea, vomiting and extreme sensitivity to sound. Exposure to light often triggers or intensifies the pain, but the underlying mechanism has been unclear.

To gain a better understanding of light's role, Dr. Rami Burstein of Harvard Medical School and his colleagues evaluated 20 migraine sufferers who were also blind. Six participants were unable to detect any light, either because their optic nerves had been damaged or their eyes removed due to disease. The remaining 14 were unable to perceive images, but their eyes could detect some light, even if they were not aware of it. Their sleep-wake cycles were normal, whereas the other 6 had disrupted sleep patterns. The study was supported by NIH's National Institute of Neurological Disorders and Stroke (NINDS) and by Research to Prevent Blindness.

As reported in the January 10, 2010, online edition of Nature Neuroscience, the researchers found that light exposure intensified migraine pain in the 14 people with some light detection but not in the remaining 6 who were totally blind. The researchers concluded that the optic nerve, which carries light signals to the brain, must be key to light-induced migraine. But because the 14 had faulty rods and cones—the main light-detecting and image-producing cells in the eye—the scientists suspected that some other type of light-detecting cell must contribute to light-sensitive pain.

The scientists turned to rats to gain a better sense of the brain pathways that might be involved. They focused on rare light-sensing cells in the eye called intrinsically photosensitive retinal ganglion cells (ipRGCs). These cells, discovered only a decade ago, are crucial for maintaining sleep-wake cycles and for pupil response to light, but play no role in image formation.

The researchers traced the path of ipRGC signals through rat optic nerves, where they later converged on brain cells that transmit pain. Exposure to light rapidly activated the ipRGCs and the pain-transmitting cells, which previously had been linked to migraine pain. When the light was removed, the brain cells remained activated for several minutes.

"This helps explain why patients say that their headache intensifies within seconds after exposure to light, and improves 20 to 30 minutes after being in the dark," says Burstein.

Washignton D.C. AIDS Epidemic

1-26-2010 Officials from the National Institutes of Health and the city of Washington, D.C. today announced the new D.C. Partnership for HIV/AIDS Progress, a collaborative research initiative between NIH and the D.C. Department of Health designed to decrease the rate of new HIV infections in the city, improve the health of district residents living with HIV infection, and strengthen the city’s response to the HIV/AIDS epidemic. The partnership is being co-led by the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH, and the D.C. Department of Health.

NIH has allocated $26.4 million for the first two years of the partnership through funding from NIAID and the NIH Office of AIDS Research.

"Tragically, our nation's capital has one of the highest rates of HIV/AIDS, where about 3 percent of adults and adolescents are infected with the virus," says NIAID Director Anthony S. Fauci, M.D. "By collaborating with Mayor Fenty’s administration to establish the new D.C. Partnership for HIV/AIDS Progress, NIH will seek to answer critical HIV research questions that could positively affect the district’s HIV/AIDS problem and serve as a model for programs in other U.S. cities as well."

The D.C. Partnership centers on four research efforts:

Identifying populations at high risk for HIV acquisition and developing effective interventions for reducing their risk.

Establishing a D.C.-wide data analysis mechanism to identify and address health issues and outcomes for people receiving HIV care and treatment.

Augmenting the city's HIV-related subspecialty medical care and enhancing access to research studies

Conducting a pilot program to study the voluntary test-and-treat concept aimed at stemming new cases of HIV infection

"As the nation’s capital and a national leader in the fight against HIV, the District of Columbia is excited to launch a new, innovative partnership for HIV/AIDS progress with NIH," says Washington Mayor Adrian M. Fenty. "This comprehensive collaboration will generate fresh ideas, new services and technical knowledge to enable the city and NIH to prevent new infections and improve health care services for all residents living with HIV/AIDS."

Identifying, Helping HIV At-risk Populations

>African-Americans represent the overwhelming majority — 76 percent — of the district’s HIV/AIDS cases. To better understand the risk factors for HIV infection and develop effective interventions for reducing risk, NIAID is conducting two observational studies through its HIV Prevention Trials Network (HPTN). The first study, HPTN 061, is collecting sexual and social networking information from black men who have sex with men (MSM). Participants receive HIV risk-reduction counseling and condoms; testing for HIV and other sexually transmitted infections; screenings for substance use, mental health issues, partner and/or homophobic violence; and a peer system to help them navigate the health care system and utilize HIV services. Already under way, the two-year study will assess the impact of these services on HIV incidence. HPTN 061 will enroll 2,460 men in six U.S. cities, including about 400 Washington participants.

vHPTN 064, also a two-year observational study in six U.S. cities, aims to estimate HIV incidence among African-American women from areas with high rates of both HIV and poverty. The study characterizes their sexual behavior, alcohol and drug use, prevalence of domestic violence, and mental health indicators, and explores issues that facilitate and hamper HIV testing. HPTN 064 will enroll 1,200 women including 200 women from the district.

Both local studies are being conducted through a HPTN clinical site at The George Washington University School of Public Health and Health Services.

Tracking HIV Care, Measuring Success

The new D.C. Partnership will help track HIV-associated health issues and outcomes by linking information from 13 of the city’s largest health care providers covering roughly 12,000 district residents living with HIV. By establishing this system, the partnership aims to better assess the clinical and treatment status of individual HIV-infected patients, evaluate outcomes of specific clinics and health programs and measure the impact of HIV testing and treatment initiatives within the city. The partnership will benefit providers by helping develop data-driven public health strategies.

"Our collaboration with NIH will allow us to continue our work to make sustainable and measurable improvements in the health and wellness of people living with HIV/AIDS," says D.C. Department of Health Director Pierre Vigilance, M.D., M.P.H.

According to Shannon L. Hader, M.D., M.P.H, senior deputy director of the DC HIV/AIDS, Hepatitis, STD and TB Administration, the new partnership will both "bring D.C. medical providers together to yield extraordinary knowledge about the district’s HIV epidemic and put D.C. on the map to recruiting new scientists and medical practitioners as the place to fight HIV/AIDS."

Enhancing Care for HIV-related Medical Issues

Non–AIDS defining illnesses and HIV coinfections, such as cardiovascular disease, diabetes and hepatitis, are significant causes of illness and death for many HIV-infected patients. In the district, however, few medical providers can provide targeted, specialized medical services that address these issues in underinsured residents. To address this gap, NIH and the D.C. Department of Health are working with Washington medical providers to establish clinics designed to provide HIV-related subspecialty care to underinsured patients in district communities most in need. The three clinics established to date are collaborative efforts with Family & Medical Counseling Service, Inc. in Southeast Washington; Walker Jones Health Center of Unity Health Services in Northeast Washington; and Whitman-Walker Clinic in Northwest Washington.

Led by program director Henry Masur, M.D., chief of the Critical Care Medicine Department in the NIH Clinical Center, and D.C. Partnership Medical Director Dawn Fishbein, M.D., the three clinics will initially focus on treating HIV-infected patients who have hepatitis B or C. Subsequently, HIV-related metabolic disorders, mental health issues and cardiovascular disease will be targeted at future clinical sites.

"The goals of the clinics are to enhance subspecialty medical care for underinsured HIV-infected patients, assess the need for specific clinical trials on given issues, and if clinical trials are deemed necessary, provide those patients with access to the latest treatments available," Dr. Masur explains. "This program also will focus on mentoring promising young leaders in HIV medicine who could enhance the district’s reputation as a leader in developing new strategies for the prevention, diagnosis and treatment of HIV/AIDS."

Piloting Test-and-Treat

The partnership also will provide a real-world examination of the test-and-treat hypothesis—the model published by World Health Organization scientists in early 2009 that proposed that the HIV epidemic can be significantly curtailed through annual, voluntary HIV testing and immediate antiretroviral treatment for individuals who test positive for HIV infection.

"NIAID already is conducting several studies designed to answer the key research questions that underpin the test-and-treat concept," says Carl Dieffenbach, Ph.D., director of NIAID’s Division of AIDS. "Through this partnership, NIAID is working with the Centers for Disease Control and Prevention to design a study to answer whether implementing a combined strategy of expanding HIV testing, diagnosing infection early and bringing HIV-infected patients to medical care and treatment is feasible."

Specifically, the test-and-treat pilot study will compare current community standards for HIV testing and treatment with accelerated expansion of routine testing services to identify HIV-infected people and evaluate enhanced methods for rapidly linking those patients to care and successful treatment. The results of the project will be analyzed to determine the cost-effectiveness of the test-and-treat approach.

NIAID and CDC also plan to conduct a pilot study in the Bronx, New York. The overall study plan is being finalized and, once initiated, is expected to last for three years.

NIAID conducts and supports research — at NIH, throughout the United States, and worldwide — to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov.

Survival of Children With AIDS

12-22-2009 Survival of Children with HIV in the United States Has Improved Dramatically Since 1990s, New Analysis Shows

911 Breaking Health News

Pfeizer Recalls Birth Controll Pills

2-1-2012 Pfizer Inc. announced today that it has voluntarily recalled 14 lots of Lo/Ovral®-28 (norgestrel and ethinyl estradiol)Tablets and 14 lots of Norgestrel and Ethinyl Estradiol Tablets (generic)for customers in the U.S. market. An investigation by Pfizer found that some blister packs may contain an inexact count of inert or active ingredient tablets and that the tablets may be out of sequence. The cause was identified and corrected immediately.

These products are oral contraceptives indicated for the prevention of pregnancy in women who elect to use oral contraceptives as a method of contraception. These tablets were manufactured and packaged by Pfizer Inc., commercialized by Akrimax Rx Products and labeled under the Akrimax Pharmaceuticals brand. This product is distributed to warehouses, clinics and retail pharmacies nationwide.

As a result of this packaging error, the daily regimen for these oral contraceptives may be incorrect and could leave women without adequate contraception, and at risk for unintended pregnancy. These packaging defects do not pose any immediate health risks. However, consumers exposed to affected packaging should begin using a non-hormonal form of contraception immediately. Patients who have the affected product (lot numbers are provided below) should notify their physician and return the product to the pharmacy.

These products are packaged in blister packs containing 21 tablets of active ingredients and seven tablets of inert ingredients. Correct dosing of this product is important in avoiding the associated risks of an unplanned pregnancy.

Any adverse events that may be related to the use of these products should be reported to Akrimax Medical Information at 1-877-509-3935 (8 AM to 7 PM Mon-Fri CST) or to FDA's Med Watch Program either online, by regular mail or by fax.

Online: www.fda.gov/medwatch/report.htm1

Regular Mail: Use postage-paid, pre-addressed Form FDA 3500 available at: www.fda.gov/MedWatch/getforms.htm2. Mail to the address on the pre-addressed form. Fax:1-800-FDA-0178

Over 65 Need Kidney Transplant?

1-17-2012 Thousands more American senior citizens with kidney disease are good candidates for transplants and could get them if physicians would get past outdated medical biases and put them on transplant waiting lists, according to a new study by Johns Hopkins researchers.

The Hopkins investigators estimate that between 1999 and 2006, roughly 9,000 adults over 65 would have been “excellent” transplant candidates and approximately 40,000 more older adults would have been “good” candidates for new kidneys. None, however, were given the chance.

“Doctors routinely believe and tell older people they are not good candidates for kidney transplant, but many of them are if they are carefully selected and if factors that really predict outcomes are fully accounted for,” says transplant surgeon Dorry L. Segev, M.D., Ph.D., an associate professor of surgery at the Johns Hopkins University School of Medicine and leader of the study being published in the January issue of the Journal of the American Geriatric Society. “Many older adults can enjoy excellent transplant outcomes in this day and age,” he says, and should “be given consideration for this lifesaving treatment.”

Those ages 65 and older make up over one-half of people with end-stage renal disease in the United States, and appropriately selected patients in this age group will live longer if they get new kidneys as opposed to remaining on dialysis, Segev says. The trouble is, he adds, that very few older adults are even put on transplant waiting lists. In 2007, only 10.4 percent of dialysis patients between the ages of 65 and 74 were on waiting lists, compared to 33.5 percent of 18- to 44-year-old dialysis patients and 21.9 percent of 45- to 64-year-old dialysis patients.

Segev cautions that some older kidney disease patients are indeed poor transplant prospects, because they have other age-related health problems. But he says his team's new findings, in addition to other recent research, show that new organs can greatly improve survival even in this age group.

Segev and his team constructed a statistical model for predicting how well older adults would be expected to do after kidney transplantation by taking into account age, smoking, diabetes and 16 other health-related variables. Using those data to define an “excellent” candidate, the information was then applied to every person 65 and older on dialysis during the seven-year study period. The researchers also determined whether these candidates were already on the waiting list.

“We have this regressive attitude toward transplantation in older adults,” Segev says, “one based on historical poor outcomes in older patients, which no longer hold up. Anyone who can benefit from kidney transplantation should at least be given a healthy chance. They should at least be put on the list.”

Segev says he knows there is a shortage of kidneys and some will question whether scarce organs would be put to better use in younger patients. But Segev's study predicts that more than 10 percent of older patients would get kidneys from living relatives or friends, which would have little impact on the nationwide shortage of deceased donor kidneys. But finding a living donor first requires referral for transplantation.

“By not referring older adults for transplant, we’re not just denying them a chance at a kidney from a deceased donor, but we’re potentially denying them a kidney from a live donor,” he adds.

HIV/AIDS Prevention

1-7-2012 The Centers for Disease Control and Prevention has begun awarding a total of almost $339 million to state and local health departments across the United States to fund HIV prevention activities this year. The awards are for the first year of a five-year funding cycle and represent a new direction for CDC HIV funding designed to achieve a higher level of impact with every federal HIV prevention dollar spent.

The awards are a critical component of CDC's new high-impact approach to HIV prevention and better align resources to reflect the geographic burden of the HIV epidemic today. As part of this funding announcement, CDC is also providing the health departments with new, specific guidance for prioritizing the most effective prevention programs that will have the greatest impact on reducing new HIV infections.

Providing funding to health departments has long been CDC's single largest investment in HIV prevention, accounting for approximately half of CDC's overall HIV prevention budget.

"With 50,000 new HIV infections every year and a tough economic environment, the need to do more with existing resources is greater than ever," said Kevin Fenton, M.D., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. "This new approach to prevention funding is designed to focus on the places where needs are most urgent and on the programs that will have the most far-reaching impact. It will help us achieve the ambitious goals of the National HIV/AIDS Strategy with the efficiency and urgency the HIV epidemic demands."

Funds were awarded to health departments in all 50 states, eight cities, the District of Columbia, Puerto Rico, US Virgin Islands, and the six Pacific Island jurisdictions.

The funds are allocated to individual health departments according to a formula that better matches resources to the geographic burden of HIV, as measured by the number of people reported living with HIV in each jurisdiction. This new funding approach ensures that many areas with heavier HIV burdens receive urgently needed funding increases.

CDC will award an additional $20 million to health departments by March 2012 as part of this funding cycle to implement innovative HIV prevention demonstration projects. CDC is currently reviewing applications for this competitive round of funding.

"State and local health departments are the backbone of the nation's HIV prevention efforts," said Jonathan Mermin, M.D., director of CDC's Division of HIV/AIDS Prevention. "This latest round of funding will help them lead the nation to slow, and ultimately end, the HIV epidemic in the United States – a public health imperative that could finally be achieved."

Heart Health Care and Diet

A team of Johns Hopkins researchers has uncovered further evidence of the benefits of a balanced diet that replaces white bread and pasta carbohydrates with unsaturated fat from avocados, olive oil and nuts — foods typical of the so-called “Mediterranean diet.”

In a report prepared for the American Heart Association’s scientific sessions in Orlando next week, the Johns Hopkins investigators say swapping out certain foods can improve heart health in those at risk for cardiovascular disease, even if the dietary changes aren’t coupled with weight loss.

“The introduction of the right kind of fat into a healthy diet is another tool to reduce the risk of future heart disease,” says Meghana Gadgil, M.D., M.P.H., a postdoctoral fellow in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine who will be presenting the research.

Gadgil and her colleagues analyzed data from the OmniHeart Trial, which studied the cardiovascular effects of three different balanced diets on 164 people with mild hypertension but no diabetes. The researchers compared the body’s ability to regulate blood sugar and maintain healthy insulin levels while on a carbohydrate-rich diet, a protein-rich diet and a diet rich in unsaturated fats. People whose bodies fail to effectively use insulin usually develop type 2 diabetes, which is a major risk factor for heart disease.

The researchers found that a generally balanced diet higher in unsaturated fats such as those in avocados, olive oil and nuts improves insulin use significantly more than a diet high in carbohydrates, particularly such refined carbs as white bread and pasta. The preferred diet is very similar to the Mediterranean diet, inspired by the foods of southern Italy and Greece and emphasizing healthy fats, fruits and vegetables.

Children After Cardiac Surgery

11-15-11 Johns Hopkins research finds racial, gender disparities among those living 10 years after surgery. White heart transplant patients under the age of 18 are more than twice as likely to be alive a decade after surgery as their African-American counterparts, new Johns Hopkins research suggests.

The findings, part of a large-scale review of factors that appear to significantly influence long-term survival among pediatric heart transplant patients, will be presented this week at the American Heart Association’s annual Scientific Sessions in Orlando.

“It’s unclear whether these racial disparities are due to biological differences or socio-economic differences that have an impact on access to care, or some combination of the two,” says Arman Kilic, M.D., a surgical resident at The Johns Hopkins Hospital in Baltimore who is scheduled to make the AHA presentation. “That’s been hotly debated, but these data tell us we need to do a lot more research to figure out why those disparities exist and how we can narrow the gap.”

Kilic analyzed United Network of Organ Sharing (UNOS) data from the 2,721 pediatric heart transplants performed in the United States between 1987 and 1999. Forty-two percent of patients (1,143) were alive 10 years or more after transplant. The average age of the recipients at the time of transplant was less than six years.

In addition to racial disparities in longterm survival, the analysis also showed that boys are 26 percent more likely than girls to survive a decade after their transplants; and children who had their surgeries at hospitals where large numbers of transplants are done annually were more likely to be alive 10 years later. For every 10 additional pediatric heart transplants conducted at a hospital each year, the chance of 10-year survival for patients transplanted there increased 36 percent. Patients at high-volume centers do better not only because their surgeons likely have more experience with heart transplants, Kilic says, but also because the staff and facilities are likely better equipped to manage the complex post-operative care of these patients.

The findings also show that patients transplanted later in the study period and those who got their hearts from younger donors were also significantly more likely to survive long term. Those who were on mechanical ventilation prior to their transplant were less likely to live a decade than those who were breathing on their own before surgery.

“Children are potentially a group of patients whose survival after transplantation could be several decades, so it’s especially important to better understand why some do well and others do not,” Kilic says.

Elevated Protein May Help Prevent Brain Injury in Infants 

Results Also Shed Light on Value of Whole Body Cooling to Prevent Brain Damage

10-21-11 Johns Hopkins researchers have discovered that increased blood levels of a protein specific to central nervous system cells that are vital to the brain’s structure can help physicians identify newborns with brain injuries due to a healthy lack of oxygen.

Measurements of the protein can also track how well a body-cooling therapy designed to prevent permanent brain damage is working. A detailed report of the Hopkins team’s finding is published in the current American Journal of Obstetrics and Gynecology.

The yearlong study looked at levels of glial fibrillary acidic protein (GFAP) in 23 newborns born between 36 and 41 weeks’ gestation who were diagnosed with clinical oxygen deficiency to the brain (hypoxic-ischemic encephalopathy, or HIE) and compared them with those in babies born at the same point in the pregnancy without brain injury.”

HIE may cause death in the newborn period or result in developmental delay, mental retardation or cerebral palsy. In the United States, the incidence of HIE is 1 to 8 cases per 1000 healthy births.

“GFAP, a circulating brain-specific protein, is already measured in adult patients after stroke, cardiac arrest or traumatic brain injury in an effort to provide a prognosis for survival or brain damage,” says Ernest M. Graham, M.D., associate professor of gynecology and obstetrics and a maternal-fetal medicine expert at Johns Hopkins. “Now we know this biomarker can serve as a valid predictor of disease, injury evolution and outcome in newborns health,” he adds.

As part of the study, researchers obtained the GFAP protein from cord blood at the time of birth, from neonatal blood drawn upon admission to the neonatal intensive care unit (NICU) and from daily blood specimens over a seven day period. GFAP levels were significantly higher in babies with brain injury due to a healthy lack of oxygen during the first week of life.

“Obstetricians and neonatologists face the challenging task of quickly identifying HIE in newborns, because current markers for identification have been imprecise,” says Graham. “GFAP tests may fill that need.”

Infants in the study who had abnormal brain MRI scans and were treated with whole-body cooling had the highest levels of GFAP. The treatment lowers body temperature to 92.3 degrees Fahrenheit, beginning within six hours of birth and continuing for three days.

“Even though cooling therapy decreases the risk of death and neurological damage in newborns, it is far from perfect therapy, and its effectiveness varies from baby to baby,” says co-investigator Allen Everett, M.D., a pediatric cardiologist at the Johns Hopkins Children’s Center. “We don’t really know for sure if during the 72 hours of cooling the brain is actually recovering. Biomarkers like GFAP can remove that uncertainty by telling physicians how the brain is responding, allowing them to tailor treatments accordingly.”

Breast Cancer Surgery

10-20-11 Doctors at Johns Hopkins have shown that during an increasingly popular type of breast-reconstruction surgery, they can safely preserve the internal mammary artery, in case it is needed for future cardiac surgery.

“Some breast-reconstruction patients might need a cardiac bypass in the future, so we implemented and studied a new technique that spares this artery used for that purpose,” says Gedge D. Rosson, M.D., associate professor of plastic and reconstructive surgery at the Johns Hopkins School of Medicine and lead researcher on the new report, which appears in the October issue of the journal, Plastic and Reconstructive Surgery.

The chance that any woman will need cardiac bypass surgery during her lifetime is low. But radiation therapy is sometimes required after mastectomy, and radiation damage to heart vessels is known to increase heart disease risk. Studies suggest that fatal cardiac events may be as much as two times more likely in women who have had radiotherapy for breast cancer on the left side, closest to the heart. “All else being equal, it’s better to leave this artery available, just in case,” Rosson says.

During breast-reconstruction surgeries, doctors often effectively perform a “tummy-tuck” type of operation, and use the removed flap of abdominal skin and fat to reconstruct a breast lost to mastectomy. They can attach the blood supply of the removed abdominal tissue to the chest wall by connecting it to the internal mammary artery, usually with an “end-to-end anastomosis” in which most of the internal mammary artery is cut away and the new tissue is attached to its base.

However, the internal mammary artery is normally the first choice of cardiac surgeons when they need to bypass diseased or damaged arteries that nourish the heart, and its unavailability would leave patients with poorer options in such cases.

Sickle Cell Disease

10-1-11 National Institutes of Health-funded scientists have corrected sickle cell disease in adult laboratory mice by activating production of a special blood component normally produced before, but not after, birth.

“This discovery provides an important new target for future therapies in people with sickle cell disease,” said Susan B. Shurin, M.D., acting director of the NIH’s National Heart, Lung, and Blood Institute, which co-funded the study. “More work is needed before it will be possible to test such therapies in people, but this study demonstrates that the approach works in principle.”

Researchers at Harvard Medical School in Boston and the University of Texas at Austin corrected sickle cell disease in mice that had been bred to have the inherited blood disorder. The National Heart, Lung, and Blood Institute, the National Cancer Institute, and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) – all part of the NIH – funded the research. The results of the study will appear online Oct. 13 in the journal Science.

Sickle cell disease results from an abnormality in hemoglobin, the protein found in red blood cells that is responsible for transporting oxygen throughout the body. People living with sickle cell disease have two copies of an altered gene that produces sickle hemoglobin instead of normal adult hemoglobin. Sickle hemoglobin changes shape after releasing its oxygen, causing the red blood cell to become stiff, misshapen and sticky, and slowing blood flow to tissues. This process damages organs and causes pain.

The study tested a new approach to increasing the production of a third form of hemoglobin—fetal hemoglobin. Production of fetal hemoglobin predominates before birth, but turns off thereafter as adult hemoglobin production takes over. People with sickle cell disease are unable to make normal adult hemoglobin, and instead make sickle hemoglobin starting in infancy.

An elevated level of fetal hemoglobin within the red blood cell reduces the tendency of sickle hemoglobin to change the shape of red blood cells. Considerable NIH- supported research has shown that the drug hydroxyurea increases production of fetal hemoglobin and reduces the number of pain crises and other complications of sickle cell disease in adults and children. However, not all patients respond well to hydroxyurea, and adverse side effects are a concern.

The current study explores a more targeted approach to increasing fetal hemoglobin production. It builds upon earlier studies by Stuart Orkin, M.D., and his team at Harvard Medical School, Children’s Hospital of Boston, and the Howard Hughes Medical Institute, Boston, which discovered that a protein called BCL11A normally suppresses the production of fetal hemoglobin soon after birth. The researchers viewed the BCL11A protein as a target for therapy and decided to see what would happen if they blocked production of the protein.

“This important advance in the battle against sickle cell disease is another outstanding example of how great things can happen when work proceeds from bench to bedside, and back to the bench,” said Griffin P. Rodgers, M.D., M.A.C.P., director of NIDDK. “We hope that one day, this discovery and any that build upon it will translate into a viable treatment option for those suffering from this devastating illness.”

-Prostrate Biopsy Complications Rise

9-28-2011 In a study of health complication rates following prostate biopsy among Medicare beneficiaries, Johns Hopkins researchers have found a significant rise in serious health complications requiring hospitalization. The researchers found that this common outpatient procedure, used to diagnose prostate cancer, was associated with a 6.9 percent rate of hospitalization within 30 days of biopsy compared to a 2.9 percent hospitalization rate among a control group of men who did not have a prostate biopsy. The study, which will be published in the November 2011 issue of The Journal of Urology, was posted early online.

The researchers emphasize that this new data should serve as a reminder to physicians to carefully weigh the risks and benefits of biopsy for individual patients and take all precautions to prevent infections and other complications.

The Johns Hopkins team’s findings are the result of the largest analysis ever performed of Medicare records of American men age 65 and older who underwent prostate biopsies in the last two decades. They found that having a prostate biopsy makes patients more than twice as likely to need hospitalization in the immediate post-procedure period. Those hospitalized had a range of complications, such as bleeding and infection, as well as flare-ups of underlying medical conditions, such as heart failure or breathing disorders.

Overall, mortality rates in men undergoing prostate biopsies did not increase. However, men hospitalized with biopsy-related infections had a 12-fold higher risk of death compared to men who did not have a biopsy.

Contagion Reality

9-14-2011 Infectious disease and disaster preparedness experts at Johns Hopkins Medicine say the premise of the soon-to-be-released Hollywood movie Contagion, in which a lethal airborne virus spreads quickly around the globe, is realistic and should serve as a reminder that the United States has much work to do to prepare for a serious national emergency posed by a deadly virus that spreads quickly.

In fact, the Department of Homeland Security list pandemic and plague as one of 15 likely national emergencies that the United States should prepare to respond to in its Catastrophic Disaster Planning document to address health and safety needs.

Gabor Kelen, M.D., director of the Johns Hopkins Office of Critical Event Preparedness and Response, says the movie, regardless of whatever dramatic license may have been taken with how a lethal virus might be spread or contained, spotlights the fact that hospitals, health care workers and public health agencies will be on the front lines of a major deadly health disease outbreak. Thus, they should be well trained and prepared to respond to such an unhealthy emergency situation.

Kelen, who has published a number of scholarly research papers and editorials on hospital surge capacity and disaster planning, says that although medical institutions are much better prepared than a decade ago, much work remains at many centers to effectively prepare and respond to a rapidly spreading lethal virus that would tax all healthcare resources. Capacity restraints and the ability to isolate infectious patients are major concerns. In addition, doctors and other health care workers need a clear set of policies to help make urgent safe and ethical decisions to allocate equipment, medicine and manpower during a major disaster with potentially large numbers of affected patients, says Kelen, who is also a professor and the director of the Johns Hopkins Department of Emergency Medicine.

The country also needs a dedicated discipline of knowledgeable and well-trained scientists to test different policies and practices and determine how best to ready for future catastrophic events, says Kelen, who is heading up an effort to launch a new professional society dedicated to disaster medicine.

Trish Perl, M.D., M.Sc., a leading epidemiologist and infectious disease expert and a professor in the departments of Medicine, Pathology and Epidemiology at Johns Hopkins, says the movie, which debuts Sept 9., starkly reminds us that global pandemics do occur and can result in enormous casualties. The Spanish Flu of 1918 killed an estimated 50 million worldwide.

Perl, the author of a number of research papers on flu transmission and prevention, says more work needs to be done to determine the best practices for preventing the spread of emerging new infections, especially among health care workers who are often on the front lines of a deadly health disease outbreak, such as SARS or Swine Flu.

Developing such effective practices, Perl says, will ensure that the health care workforce isn’t decimated by a deadly new virus and will be able to respond adequately to those in need of safe health services.

Joshua Epstein, Ph.D., professor of emergency medicine and a social and behavior modeling expert at Johns Hopkins, says the film’s theme of exploring the nature of fear, and what happens when fear and panic take hold in a disaster situation, is a subject worth serious scientific investigation.

Fear can be highly contagious in disaster situations and can cause people to act in highly unpredictable ways, said Epstein, an internationally recognized pioneer in agent-based computational modeling and director of the Johns Hopkins Center for Advanced Modeling in the Social, Behavioral and Health Sciences.

This contagion of fear is not fully understood, yet such human emotions as fear and distrust can have a profound effect on whether people follow government or other official guidance—such as a request for vaccininations—and it can cause them to behave in a way that makes the crisis worse, says Epstein, who has developed advanced computer models simulating how a novel pathogen would spread around the globe and across the United States.

A deeper understanding of fear and other human emotions and behaviors in emergencies could help develop smarter and more effective policies and plans for responding to major public health crisis, says Epstein, who has published numerous scholarly papers and articles on how computer modeling can help stem disease transmission.

A pandemic such as the one depicted in the movie will bring a host of ethical challenges, such as the equitable distribution of scarce resources, notes Holly Taylor, Ph.D., M.P.H., of the Johns Hopkins Berman Institute of Bioethics and an assistant professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health.

While many efforts have been made post 9/11 to prepare the nation for a major disaster, additional consideration ought to be given to how best to make the public aware of the plans made. A public made aware that plans have been made and what their role is if such plans have to be implemented may serve to immunize some from the fear to which Dr. Epstein refers, says Taylor.

“It’s always better to plan in advance how scarce resources may be allocated or in what way the freedom of movement may be restricted rather than address them in the midst of a disaster, notes Taylor. The more the public is aware that there are plans in place to help make difficult ethical decisions, says Taylor, the more likely the public will view official response to the crisis as credible. 

Brain Cancer Cells Are Green

7-8-2011 Researchers at the Johns Hopkins University School of Medicine have developed a technique that delivers gene therapy into human brain cancer cells using nanoparticles that can be freeze-dried and stored for up to three months prior to use.The shelf-stable particles may obviate the need for virus-mediated gene therapy, which has been associated with safety concerns. The report appears in the August issue of Biomaterials.

"Most nonviral gene therapy methods have very low efficacy," says Jordan Green, Ph.D., an assistant professor of biomedical engineering at Johns Hopkins. "Nanoparticle-based gene therapy has the potential to be both safer and more effective than conventional chemical therapies for the treatment of cancer."

To develop the nanoparticle, Green's team started with store-bought small molecules and systematically mixed combinations together to generate chemical reactions that resulted in different polymers. They then mixed DNA that encodes a glowing protein with each different polymer to allow the DNA to bind to the polymers and form nanoparticles. Each different sample was added to human brain tumor cells and human brain tumor stem cells. After 48 hours, the team examined and counted how many cells glowed from having taken up the nanoparticles and made the glowing protein encoded by the introduced DNA.

The team rated success by counting how many cells survived and what percentage of those cells glowed.

Of the many combinations they tested, the researchers found that one particular formulation of so-called poly(beta-amino ester) nanoparticles did particularly well at getting into both glioblastoma and brain tumor stem cells. The researchers then freeze-dried these nanoparticles and stored them at different temperatures (freezer, refrigerator and room temperature) for different lengths of time (one, two and up to three months), and then retested their ability to get into cells. According to Green, after six months in storage, the effectiveness dropped by about half, but they found that up to three months of storage at room temperature there was virtually no change in effectiveness.

Furthermore, the team found that certain nanoparticles had a particular affinity for brain tumor cells over healthy brain cells.

"I could imagine particles based on this technology being used in conjunction with, and even instead of brain surgery," says Alfredo Quinones-Hinojosa, M.D., Ph.D., an associate professor of neurosurgery and oncology at Johns Hopkins. "I envision that one day, as we understand the etiology and progression of brain cancer, we will be able to use these nanoparticles even before doing surgery-how nice would that be? Imagine avoiding brain surgery altogether."

This study was funded by the Institute for NanoBioTechnology at The Johns Hopkins University, the Maryland Stem Cell Research Fund, National Institutes of Health, the Howard Hughes Medical Institute and the Robert Wood Johnson Foundation.

Authors on the paper are Stephany Tzeng, Hugo Guerrero-Cazares, Elliott Martinez, Joel Sunshine, Alfredo Quinones-Hinojosa and Jordan Green, all of Johns Hopkins.

Diabetes Nerve Cell Damage

6-20-2011 Blood vessels and supporting cells appear to be pivotal partners in repairing nerves ravaged by diabetic neuropathy, and nurturing their partnership with nerve cells might make the difference between success and failure in experimental efforts to regrow damaged nerves, Johns Hopkins researchers report in a new study.

About 20 percent of diabetics experience neuropathy, a painful tingling, burning or numbness in the hands and feet that reflects damage to nerves and sometimes leads to infections and amputation of the toes, fingers, hands and feet over time. Current treatments for diabetic neuropathy focus on relieving symptoms, but don’t address the root cause by repairing nerve damage. Previous research has shown that nerve cells’ long extensions, known as axons, regenerate slowly in diabetics, scuttling various experiments to regrow healthy nerves, explains study leader Michael Polydefkis, M.D., M.H.S., associate professor of neurology at the Johns Hopkins University School of Medicine.

Searching for the reasons behind this slow regeneration, Polydefkis, along with Johns Hopkins assistant professor of neurology Gigi Ebenezer, M.B.B.S., M.D., and their colleagues recruited 10 patients with diabetic neuropathy and 10 healthy people of similar ages and took tiny (3 millimeters) “punch” biopsies from the skin of each participant’s thigh. Several months later, they took 4 mm biopsies from the same site to see how the nerves, blood vessels and nerve-supporting cells, called Schwann cells, were growing back into the healing biopsy site.

In both the neuropathy patients and the healthy individuals, results reported in the June issue of Brain showed that the first to grow into the healing skin were blood vessels, followed soon after by Schwann cells and then axons, which appeared to use the blood vessels as scaffolds. However, the entire process was significantly delayed for the neuropathy patients. Not only was axon regeneration slower compared to the healthy patients, as expected, but blood vessel growth rate was also slower, and fewer Schwann cells accompanied the growing axons into the healing skin.

“Our results suggest that regenerative abnormalities associated with diabetes are widespread,” Polydefkis says. “They’re not just affecting nerves—they’re also affecting blood vessel growth and Schwann cell proliferation.”

Additionally, he says, the findings could explain why blood vessel-related problems, such as heart attacks and strokes, often accompany diabetes. Slowed regeneration of damaged blood vessels could contribute to these conditions as well, he explains.

Polydefkis says the findings provide potential new targets for treating neuropathy and vascular problems. By promoting blood vessel and Schwann cell growth, researchers might be able to speed up axon regeneration and successfully repair damaged nerves and blood vessels, potentially combating diabetic neuropathy and vascular complications simultaneously.

Safety of Inhalers for Chronic Lung Disease

6-15-2011 People who use a mist inhaler to deliver a drug widely prescribed in more than 55 countries to treat chronic obstructive pulmonary disease (COPD) may be 52 percent more likely to die, new Johns Hopkins-led research suggests.

The findings, published by BMJ, the British medical journal, raise concerns not only about the mist inhaler — a device that delivers the soluble form of the medication tiotropium — but also about the drug itself. The mist inhaler has not yet gained regulatory approval in the United States, but the drug in its powdered form is commonly used to treat COPD here.

“What we think is going on is that the mist inhaler is delivering a higher concentration of tiotropium than it should be and that may be increasing the risk of death,” says Sonal Singh, M.D., M.P.H., an assistant professor of general internal medicine at the Johns Hopkins University School of Medicine and the lead author of the study.

COPD, the fourth leading cause of death worldwide, includes the chronic lung diseases emphysema and bronchitis, which are usually due to decades of smoking. Tiotropium is routinely given to COPD patients with symptoms such as shortness of breath, and those with hospitalizations as a result of their breathing problems.

Singh says the increased deaths linked to the inhaler are primarily from cardiovascular disease. Anticholinergics, the class of drugs that includes tiotropium, increase the risk of heart rhythm disturbances (arrhythmias), especially among those with existing heart conditions.

In the United States and throughout the world, the medication is available in a powdered form, delivered using a device known as the Handihaler, and sold under the brand name Spiriva. Fifty-five countries now allow tiotropium to also be administered using the mist inhaler. Overseas, people with poor manual dexterity tend to be prescribed the mist inhaler because it is easier to use.

For the study, Singh and his colleagues from the United States and the United Kingdom reviewed and analyzed published findings comparing treatment with the mist inhaler containing tiotropium to treatment with a mist inhaler containing a placebo. They looked at five randomized, controlled trials, which included data on more than 6,500 participants. Both the drug and the placebo were delivered with the Respimat Soft Mist Inhaler. The results show a 52 percent increased risk of death among those who used the mist inhaler with tiotropium, as compared to the mist inhaler with placebo. Singh says his new research shows one excess death due to the mist inhaler for every 124 patients with chronic obstructive lung disease treated for one year. What concerns Singh now is that there is a large, 17,000-patient multicenter study under way in several countries, including the United States, comparing the two types of devices using the same drug.

“I'm worried about the participants assigned to the use of the mist inhaler,” he says. "They are not fully informed about what could be serious safety issues with the device.”

Singh emphasizes that while the current study only focused on tiotropium delivered through mist inhaler, the findings also raise serious questions about whether the drug tiotropium, in particular, and the class of inhaled anticholinergics, in general, are safe for COPD patients, particularly those with known heart problems. The shortness of breath caused by COPD can be treated with other long-acting bronchodilators, such as the long-acting beta-agonists. The risk of additional hospitalizations for these chronic lung diseases can be reduced somewhat by other COPD inhalers. At this point, Singh recommends that patients discuss the risks and benefits of COPD treatments with their doctors. <

Heat Stroke Tips

6-10-2011 According to the CDC Heat Strokeis the most serious heat-related disorder. It occurs when the body becomes unable to control its temperature: the body's temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. When heat stroke occurs, the body temperature can rise to 106 degrees Fahrenheit or higher within 10 to 15 minutes. Heat stroke can cause death or permanent disability if emergency treatment is not given.

Symptoms of heat stroke include:

Hot, dry skin or profuse sweating

Hallucinations

Chills

Throbbing headache

High body temperature

Confusion/dizziness

Slurred speech

CDCs Recommendations Include:

Take the following steps to treat a worker with heat stroke:

Call 911 and notify their supervisor.

Move the sick worker to a cool shaded area.

Cool the worker using methods such as:

Soaking their clothes with water.

Spraying, sponging, or showering them with water.

Fanning their body.

International Medical Educational Project

6-1-2011 A new institute dedicated to international medical education has been inaugurated at the Johns Hopkins School of Medicine in Baltimore. The inauguration ceremony for the medical school and teaching hospital, named for Malaysian physician, businessman and donor Tan Sri Datuk Dr. Mohan Swami, was held at the Johns Hopkins University Medicine School of Medicine in Baltimore, Maryland, on May 19, 2011. It was attended by Dato Sri Haji Mohd Najib bin Tun Haji Abdul Razak, prime minister of Malaysia, and other dignitaries.

"We are proud that Johns Hopkins was chosen as a home to the Institute for International Medical Education," says Edward D. Miller, dean and chief executive officer, Johns Hopkins Medicine. "For more than 120 years, Johns Hopkins has been?recognized as?one of the national and global leaders in research, patient care and education. It is our firm belief that this landmark endeavor will help us to continue our vital mission of helping to raise the standards of health care around the globe."

The Johns Hopkins Dr. Mohan Swami Institute for International Medical Education will use the new Genes to Society curriculum as its core platform and provide services globally to spread the mission of Johns Hopkins in medical education.?The new institute will be housed at Johns Hopkins and led by David Nichols, M.D., vice dean for education, Johns Hopkins University School of Medicine.

"Educating and guiding the next generation of health care professionals the experts who will be capable of addressing the needs of the world’s growing population, is a challenging and rewarding task, and I am proud to be able to contribute to it," says Tan Sri Datuk Dr. Mohan Swami. "I am especially proud that I have the opportunity to join forces in this project with such a renowned institution as Johns Hopkins. I believe that our work will pave the way for many wonderful advancements in the area of medical education around the world."

"It is a great privilege for me to lead the new institute," says Dr. Nichols.?"We hope that the new Institute for International Medical Education will have a transformational impact on the quality of medical education, research and health care delivery, and will help us nurture a new generation of health care leaders around the world."

In November 2010, Johns Hopkins officials signed an agreement in Kuala Lumpur to help Malaysia develop its first fully integrated, private, four-year graduate medical school and teaching hospital. Johns Hopkins will also advise Malaysian colleagues on the development and integration of research programs across the entire medical enterprise. All education, patient care and research functions and programs will be managed in accordance with the Johns Hopkins Medicine organizational and operational model.

Genes, Cholesterol and Pregnant Women

5-20-2011 Altered gene involved in both faulty cholesterol regulation and pregnancy hormone production

The Hopkins group has also developed a simple blood test for this variation of the scavenger receptor class B type 1 gene (SCARB1) but emphasized there is no approved therapy yet to address the problem in infertile women.

Following up studies in female mice that first linked a deficiency in these receptors for HDL — the so-called “good” or “healthy” cholesterol — and infertility, researchers report finding the same link in studies of women with a history of infertility. If the new study’s findings hold up on further investigation, the John Hopkins team says they not only will offer clues into a genetic cause of some infertility, but could also lead to a treatment already shown to work in mice.

“Infertility is fairly common and a lot of the reasons for it are still unknown,” warns endocrinologist Annabelle Rodriguez, M.D., an associate professor of medicine at the Johns Hopkins University School of Medicine and the leader of the study published online in the journal Human Reproduction. “Right now, the benefit of this research is in knowing that there might be a genetic reason for why some women have difficulty getting pregnant. In the future, we hope this knowledge can be translated into a cure for this type of infertility.”

Between November 2007 and March 2010, Rodriguez and her colleagues analyzed ovarian cells and fluid collected from 274 women unable to become pregnant for various reasons and undergoing in vitro fertilization (IVF). Some 207 of them went on to have their eggs collected, fertilized in a test tube and implanted in their wombs.

The scientists then measured whether there was evidence of a gestational sac or a fetal heartbeat 42 days after embryo transfer. None of the nine women in the group found to have the mutated SCARB1 had such evidence, meaning none were pregnant.

Rodriguez says she believes the genetic variation could be present in 8 to 13 percent of the population.

The researchers also showed that the nine women with the altered gene had low levels of progesterone, a hormone critical to sustaining pregnancy in its earliest stages, despite being supplemented with progesterone as part of the IVF process.

Rodriguez, who is also director of the Johns Hopkins Diabetes and Cholesterol Metabolism Center, based her work on research with mice genetically engineered without the receptor for good cholesterol. Without the receptor, the mice had abnormally high levels of HDL in the blood since their bodies were unable to uptake the cholesterol. They were also at increased risk for heart disease, and the female mice were infertile.

The Massachusetts Institute of Technology researchers who studied the genetically engineered mice also found a treatment for their infertility in a cholesterol medication developed decades ago. Called probucol, it lowered levels of cholesterol circulating in the blood and restored the rodents’ fertility. The drug is no longer approved for use in the United States, partly because of concerns that it unsafely lowers HDL, but that very “side effect” seemed a good fit for mice with missing HDL receptors. It is available in Japan for use in some conditions.

“I’m an optimist that this drug or one like it could also restore fertility in women,” Rodriguez says. “Everything else that was found in mice so far has borne out in humans.”

AIDS Prevention

12 May 2011 –United Nations agencies fighting HIV/AIDS today lauded the results of an international study that shows that if an HIV-positive person immediately follows an appropriate treatment of anti-retroviral drugs, the risk of transmitting the virus to an uninfected sexual partner is nearly entirely eliminated.

The trial, conducted by the HIV Prevention Trials Network, tracked more than 1,700 couples across Africa, Asia, Latin America and the United States and found that the risk of infection fell by 96 per cent.

The reduction in risk was so large that the trial was stopped some three to four years ahead of schedule.

“This breakthrough is a serious game changer,” said Michel Sidibé, the Executive Director of the Joint UN Programme on HIV/AIDS (UNAIDS), who added that “now we need to make sure that couples have the option to choose treatment for prevention and have access to it.”

Margaret Chan, Director-General of the World Health Organization (WHO), described the results of the study as “a crucial development, because we know that sexual transmission accounts for about 80 per cent of all new infections.”

UNAIDS said it will convene a meeting with other key organizations tackling the scourge of AIDS to discuss the trial and its implications for the response to the disease. In July, WHO is also releasing new guidance to assist HIV-positive people to protect their partners.

The two agencies stressed the need for couples to make evidence-based decisions on which combination of HIV prevention options is best for them, and that anti-retroviral therapy serve as one of the options made available.

“No single method is fully protective against HIV,” the agencies said in a joint press statement. “Treatment for prevention [anti-retroviral therapy] needs to be used in combination with other HIV prevention options. These include correct and consistent use of male and female condoms, waiting longer before having sex for the first time, having fewer partners, male circumcision, and avoiding penetrative sex.”

Asthma Health Awareness-You Can Control Your Asthma

The National Institute of Environmental Health Sciences (NIEHS), the National Heart, Lung, and Blood Institute (NHLBI), and the National Institute of Allergy and Infectious Diseases (NIAID) renew our commitment to advancing studies that will help improve asthma prevention, diagnosis, and management. Our diverse programs provide a critical foundation for improving outcomes for patients with asthma. Each of our institutes focuses on a fundamentally different aspect of asthma, and we work closely together to coordinate our research programs. Our goal is to make this year’s theme, You Can Control Your Asthma Health, not just a slogan but a reality.

Asthma is a chronic inflammatory disorder of the airways, affecting more than 17 million American adults and 7 million children under 18 years of age. Asthma disproportionately affects minorities, people with lower incomes, females, and children. The disorder is characterized by mild to life-threatening episodes of airway narrowing and obstruction, causing wheezing, coughing, chest tightness and shortness of breath. Asthma has no cure, but daily preventive treatment can enable individuals to manage their symptoms and lead active lives.

As the lead NIH institute focusing on how environmental factors impact human health, NIEHS is working to understand how exposures to environmental agents trigger diseases such as asthma, and how we can prevent, diagnose and treat these diseases.

In addition to identifying environmental factors contributing to asthma, NIEHS is developing and testing new technologies to help determine environmental triggers and reduce asthma symptoms. PIPER, or the Pre-toddler Inhalable Particulate Environmental Robotic sampler, is a robot developed by NIEHS grantees capable of mimicking children’s floor activities while collecting better estimates of young children’s exposure to indoor air pollutants, such as particulate matter, pesticides, allergens, endotoxins and airborne fungi. PIPER is being used as part of a study that will compare measurements of particulates obtained by PIPER with those from standard adult height monitoring stations and examine their association with asthma symptoms.

NIEHS is also supporting research to find improved asthma interventions. Through collaborative programs such as the Head-off Environmental Asthma in Louisiana (HEAL) Project, implemented in New Orleans soon after Hurricane Katrina, we are learning about the important role that comprehensive home-front interventions can have on children with asthma.

Cancer Rates Down

4-21-2011 Rates of death in the United States from all cancers for men and women continued to decline between 2003 and 2007, the most recent reporting period available, according to the latest Annual Report to the Nation on the Status of Cancer. The report also finds that the overall rate of new cancer diagnoses for men and women combined decreased an average of slightly less than 1 percent per year for the same period.

The drop in cancer death rates continues a trend that began in the early 1990s. The report finds, for the first time, lung cancer death rates decreased in women, more than a decade after rates began dropping in men.

The report is co-authored by researchers from the North American Association of Central Cancer Registries (NAACCR), the National Cancer Institute (NCI), part of the National Institutes of Health, the Centers for Disease Control and Prevention, and the American Cancer Society. It appeared online March 31, 2011, in the Journal of the National Cancer Institute, and in print on May 4, 2011.

Of special note, childhood cancer incidence rates (rates of new diagnoses) continued to increase while death rates in this age group decreased. Childhood cancer is classified as cancers occurring in those 19 years of age or younger.

Overall cancer incidence rates in men were essentially unchanged. There was a very small uptick in prostate cancer rates, and if these rates were excluded from the analysis, there would be a continued decline in overall male incidence rates.

In the Special Feature section of the report, the authors explore the diversity of brain tumors and other nervous system cancers beyond those that are identified as malignant, including those that are borderline and benign. The researchers analyzed data between 2004 and 2007 and found that in adults, non-malignant tumors were about twice as common as malignant tumors.

“Our new data show that non-malignant brain tumors are far more common than malignant brain tumors, and affect different population groups. Brain tumors have a far-reaching effect on our families and friends, yet they are difficult to study due to their diversity,” said Betsy Kohler, executive director, NAACCR. “We hope that the collection of both malignant and non-malignant brain tumors by central cancer registries will continue to provide a significant source of information and insight to researchers.”

Other highlights from the report show that, in men, incidence rates have declined for cancers of the lung, colon and rectum, oral cavity and pharynx, stomach, and brain (malignant only) while rates have risen for kidney, pancreas and liver cancers, as well as melanoma of the skin. In women, incidence rates decreased for breast, lung, colorectal, uterine, cervical, bladder, and oral cavity cancers, but increased for kidney, pancreas, and thyroid cancers as well as for leukemia and melanomas of the skin.

"It is gratifying to see the continued steady decline in overall cancer incidence and death rates in the United States — the result of improved methods for preventing, detecting, and treating several types of cancer," said Harold Varmus, M.D., NCI director. "But the full repertoire of numbers reported today also reflects the enormous complexity of cancer, with different trends for different kinds of cancers, important differences among our diverse people, and different capabilities to prevent, detect, and treat various cancers. Moreover, as our population continues to age, we have an obligation to discover and deliver better ways to control all types of cancers."

Among racial/ethnic groups, cancer death rates were highest among black men and black women, but this group also showed the largest decline for the period between 1998 and 2007 compared with other racial groups. For new cancers, black men had the highest incidence rates in the 2003 to 2007 period studied. Among women, white women had the highest overall incidence rates. Breast cancer was the most commonly diagnosed cancer among women regardless of race or ethnicity. The differences and fluctuations in death rates by racial/ethnic group, sex, and cancer site may reflect differences in risk behaviors, socioeconomic status, and access to and use of screening and treatment.

“As we work towards reducing the cancer burden in the population as a whole, it is important that we apply what we know about prevention, detection and treatment of cancer to populations at highest risk,” said John R. Seffrin, Ph.D., chief executive officer of the American Cancer Society. “While it's promising that mortality gaps are closing for some racial/ethnic groups, continued efforts are needed to prevent the avoidable deaths that these gaps represent.”

Despite the drop in lung cancer deaths among women nationwide, lung cancer still kills more people than any other type of cancer. “Lung cancer can become a rare disease if states support well-funded tobacco control programs,” said CDC Director Thomas Frieden, M.D. “Aggressive ad campaigns that show the impact of smoking, combined with higher cigarette prices and strong state laws that protect nonsmokers from secondhand smoke, will decrease the number of adult smokers and save lives."

Are You Afraid You May Be Bipolar

4-10-2011 NARSAD, the Mental Health Research Association states that: "More than 2 million American adults or 1 percent of the population age 18 or older in any given year have bipolar mental health disorder." In other words you are not alone.

Many extremely intelligent people suffer episodes of bipolar manias,including hollywood stars,high profile athletes,and politicians. People such as Jean-Claude Van Damme, singer Sinead O’Connor, actress Patty Duke, actress Carrie Fisher, tv journalist Jane Pauley, and now actress Catherine Zetta-Jones. She has just announced that she has gone for treatment. Astronaut Buzz Aldren, author Jack London, Napoleon Bonaparte, scientist Isaac Newton,actress Elizabeth Taylor, President Abraham Lincoln, and british politician Winston Churchill. Thats not a too shabby group of people to aligned with even though they have mental health issues with being bipolar.

According to NIMH, it is an inherited disease. More than two-thirds of people with this health disorder have at least one close relative with the illness or with unipolar major depression. "Bipolar disorder affects approximately 5.7 million adult Americans, or about 2.6% of the U.S. population age 18 and older every year." (National Institute of Mental Health)

What can you do if you think your health suffers from bipolar episodes? You can contact the Mental Health Research Association in your area. In particular, bipolar statistics show that combining psychotherapy with medications such as lithium is especially effective:

- using Family-Focused Treatment (FFT) in addition to medication produced significantly less relapse (11%) than medication alone (61%) over a 9 month follow-up period.

Bipolar Symptoms Include:

* Some people with bipolar disorder cycle between the two extremes every few months or weeks. Other people with bipolar disorder may cycle several times within the same day. This is referred to as rapid cycling.

* Substance abuse is common in people with bipolar disorder. The use of drugs or excessive alcohol use can trigger or worsen symptoms. Alternatively, some people may use drugs and alcohol in an attempt to treat their symptoms. Other conditions that may co-occur with BD include conduct disorders, eating disorders, attention-deficit/hyperactivity disorder, thyroid disorders, migraine, and anxiety.

Mania (the "high" of bipolar disorder): A person in the manic phase may feel indestructible, full of energy, and ready for anything. Other times, that person may be irritable and ready to argue with anyone who tries to get in the way.

Symptoms: from emedicine health

Search for your community health organization, or ask at the local YWCA they can give you information about where to go and what services are available.

You can also check online at the following sites:

National Alliance for Mental Illness help http://www.nami.org

Center for Disease Control http://www.cdc.gov

http://www.bipolar-lives.com

FDA Approves Test Cepheid Xpert C. difficile/Ep

The U.S. Food and Drug Administration today cleared a test called the Cepheid Xpert C. difficile/Epi assay that is designed to rapidly detect the toxin B gene associated with Clostridium difficile infection (CDI), a cause of diarrhea that can lead to colitis, other serious intestinal health conditions and death in severe cases.

Clostridium difficile (C. difficile) bacteria are found in the stool of an infected person. Others can become infected if they touch items or surfaces contaminated with the bacteria or spores and then touch their mouth.

The Cepheid Xpert C. difficile/Epi assay is automated and works on the Cepheid GeneXpert Dx System to detect toxin gene sequences associated with toxigenic C. difficile. The Cepheid GeneXpert Dx System consists of an instrument that houses single-use disposable cartridges, a personal computer, and software that allow a laboratory technician to run tests and view health test results quickly.

The test, Cepheid Xpert C. difficile/Epi assay, determines if C. difficile is in a patient’s stool and also detects if the C. difficile is the epidemic 027/NAP1/BI strain, which has been associated with a marked increase in the severity and incidence of CDI in North America and Europe over the past decade.

The test is intended for use as an aid in the diagnosis of CDI. The detection of the 027/NAP1/B1 strain is for epidemiological purposes only and should not be used to determine or monitor treatment. Health care facilities should monitor the number of C. difficile infections and, especially if rates at the health facility increase, the severity of disease and patient outcomes.

“Health care professionals in the infectious disease community who have seen various outbreaks of CDI associated with aggressive strains in recent years now have a new testing tool to detect this disease,” said Alberto Gutierrez, Ph.D., director of the Office of In Vitro Diagnostics Device Evaluation and Safety in the FDA’s Center for Devices and Radiological Health.

People at risk of developing the bacterial infection include the elderly, patients in hospitals or living in a nursing home, and people taking antibiotics for another infection. The most effective way to prevent CDI is thorough hand-washing with soap and warm water.

STD Prevention Spending for Maryland in 2009

From the CDC:

Total FY 2009 State GR Revenue $ 694,077

Total FY 2009 Federal STD funding $ 6,658,240

Total FY 2009 Investment in STD prevention (state + federal) $ 7,352,317

FY 2009 % of State investment to total STD investment 9.4402%

FY 2009 National rank: State investment as % total STD investment 21

State Public Health Funding FY 2008-2009 $ 211,160,801

State Population Estimates (Census, 2009) 5,699,478.0

Per capita state funding for public health FY 2008-2009 $ 37.05

Maryland ranks number 28 in the nation

National rank: Acute hepatitis B per 100,000

19. Data were received from STD and Hepatitis programs.

National rank: Chlamydia rates among women per 100,000 10

Have a Conversation With Potential Partners to Orevents STDs

AIDS Quilt Photo by Diane Knaus

Yahoo! Babel Fish 

Blood Pressure Drug Can Save Lungs from Cigarette Smoke

1-10-2012 Working with mice, scientists at Johns Hopkins have successfully used a commonly prescribed blood pressure medicine, losartan (Cozaar), to prevent almost all of the lung damage caused from two months of exposure to cigarette smoke. The treatment specifically targeted lung tissue breakdown, airway wall thickening, inflammation and lung over-expansion.

As a result of the experiments, efforts already are under way at Johns Hopkins for a clinical trial of the drug in people with smoking-related chronic obstructive pulmonary disease (COPD), the long-term consequence of smoking and for which, until now, there are no known potential treatments to prevent or repair the resulting lung damage. COPD is the third leading cause of death in the United States, mostly in people with either chronic bronchitis or emphysema, or both; some 12 million Americans have been diagnosed with COPD. Funding of the trial is from the National Heart, Lung and Blood Institute and the drug’s manufacturer, Merck & Co.

“The results of our study in mice suggest that losartan or similar drugs could serve as an effective treatment for smoking-related lung diseases in humans,” says study senior investigator for the animal experiments, Enid Neptune, M.D. “And because these drugs are already approved for use in the United States as safe and effective treatments for hypertension, incorporating them into our treatment regimen for COPD would be quite rapid,” adds Neptune, a pulmonologist and an associate professor at the Johns Hopkins University School of Medicine.

A report on the study, to be published in the Jan. 3 edition of the Journal of Clinical Investigation, is considered a breakthrough discovery, researchers say, because it is the first to show that a drug already in clinical use can prevent most the serious consequences of smoking in an animal test model, preserving both lung structure and function. The study is also believed to be one of the first to extend findings from research on other complex genetic conditions, specifically Marfan syndrome, for which losartan therapy is also being clinically tested, to probe how such treatments can be applied to other complex diseases that damage the lungs in a similar way.

In smoking-related COPD, breathing becomes difficult and progressively worsens, as the small airways and airspaces that conduct oxygen through the lungs and into the bloodstream become damaged. Airway walls thicken and are more readily obstructed by mucus, and the airspaces lose their elasticity.

“It is very exciting that an existing medication has proven capable in an animal model of not only treating the problems of COPD, but also disrupting the biological pathway that precipitated them,” says pulmonologist Robert A. Wise, M.D., a professor at Johns Hopkins who is piloting the clinical studies. “If our tests in people prove successful, we could help restore lung health to millions of people who have suffered from tobacco addiction.”

Sexual Violence Affects Health of Millions of People in the US

1-4-2012 New survey from the CDC finds these types of violence affect the health of millions of adults

On average, 24 people per minute are victims of rape, physical violence, or stalking by an intimate partner in the United States, according to findings released today by the Centers for Disease Control and Prevention. Over the course of a year, that equals more than 12 million women and men. Those numbers only tell part of the story – more than 1 million women reported being raped in a year and over 6 million women and men were victims of stalking in a year, the report says.We need to keep our families safer.

“This landmark report paints a clear picture of the devastating impact these violent acts have on the lives of millions of Americans,” said Secretary of Health and Human Services Secretary Kathleen Sebelius. “The information collected in this ongoing survey will serve as a vital tool in the Administration′s efforts to combat domestic violence and sexual abuse. And the report underscores the importance of our Administration′s workExternal Web Site Icon to combat domestic violence and sexual assault.”

The National Intimate Partner and Sexual Violence Survey, or NISVS, is one of CDC′s latest public health surveillance systems and is designed to better describe and monitor the magnitude of sexual violence, stalking and intimate partner violence victimization in the United States. It is the first survey of its kind to provide simultaneous national and state-level prevalence estimates of violence for all states. Launched in 2010, NISVS also provides data on several types of violence that have not previously been measured in a national population-based survey.

Key findings in the NISVS 2010 Summary Report include:

For women:

* High rates of sexual violence, stalking, and intimate partner violence were reported by women.

o Nearly 1 in 5 women has been raped at some time in her life.

o One in 4 women has been a victim of severe physical violence by an intimate partner in her lifetime.

o One in 6 women has experienced stalking victimization during her lifetime in which she felt very fearful or believed that she or someone close to her would be harmed or killed. Much of stalking victimization was facilitated by technology, such as unwanted phone calls and text messages.

* Almost 70 percent of female victims experienced some form of intimate partner violence for the first time before the age of 25.

* Approximately 80 percent of female victims of rape were first raped before age 25.

* Female victims of violence (sexual violence, stalking, intimate partner violence) were significantly more likely to report physical and mental health problems than female non–victims.

* Across all forms of violence (sexual violence, stalking, intimate partner violence), the vast majority of victims knew their perpetrator (often an intimate partner or acquaintance and seldom a stranger).

For men:

* About 1 in 7 men has experienced severe physical violence by an intimate partner at some point in their lifetime.

* One in 19 men has experienced stalking victimization at some point during their lifetime in which they felt very fearful or believed that they or someone close to them would be harmed or killed.

* Almost 53 percent of male victims experienced some form of intimate partner violence for the first time before age of 25

* More than one-quarter of male rape victims were first raped when they were 10 years old or younger.

* Male victims of violence (sexual violence, stalking, intimate partner violence) were significantly more likely to report physical and mental health problems than male non-victims.

“This report highlights the heavy toll that sexual violence, stalking, and intimate partner violence places on adults in this country. These forms of violence take the largest toll on women, who are more likely to report immediate impacts and long-term health problems caused by their victimization,” said Linda C. Degutis, Dr.P.H., M.S.N., director of CDC′s National Center for Injury Prevention and Control. “Much victimization begins early in life, but the consequences can last a lifetime.”

The report findings also underscore violence as a major public health burden and demonstrate how violence can have impacts that last a lifetime. For instance, the findings indicate female victims of violence had a significantly higher prevalence of long-term health problems, including irritable bowel syndrome, diabetes, frequent headaches, chronic pain, and difficulty sleeping. And nearly twice as many women who were victims of violence reported having asthma, compared to women who did not report violence victimization.

“The health problems caused by violence remind us of the importance of prevention,” said Howard Spivak, M.D., director of the Division of Violence Prevention in CDC′s Injury Center. “In addition to intervening and providing services, prevention efforts need to start earlier in life, with the ultimate goal of preventing all of these types of violence before they start.”

Is There an AIDS Cure Coming Soon? 

7-15-2011 A team of AIDS experts at Johns Hopkins and other institutions have embarked on a joint five-year research initiative to cure HIV disease by finding ways to completely purge the virus from the body in people already successfully suppressing the virus with antiretroviral drug therapy.

Major advances in anti-HIV drug treatment in the last two decades have meant viral control and relatively good health over long periods for millions of infected people worldwide, including hundreds of thousands of the estimated 1 million men and women living with HIV in the United States.

But ridding the body of small amounts of the virus hiding in immune system cells, as originally discovered by members of the Johns Hopkins team in 1995, have always been considered key to finding a cure.

“A lot of effort has gone into preventing the spread of HIV and into trying to develop a vaccine, so it is very exciting to tackle another cornerstone to the problem, which is how to eradicate HIV,” says virologist Janice Clements, Ph.D., vice dean for faculty and a professor at the Johns Hopkins University School of Medicine.

Clements and Johns Hopkins infectious disease specialist Robert Siliciano, M.D., Ph.D., will both serve as co-investigators of the research consortium, called the Martin Delaney Collaboratory. Named after a well known AIDS activist, the Martin Delaney group consists of researchers at nine U.S. universities and a major pharmaceutical company. The group is led by David Margolis, M.D., at the University of North Carolina at Chapel Hill.

Funding support, totaling $32 million, comes from the National Institute of Allergy and Infectious Diseases, a member of the National Institutes of Health. The group will pursue a dozen or more projects to determine how HIV remains dormant and almost undetectable in the immune system’s T-cells, and to develop possible drug treatments to counter these HIV reservoirs.

“This group approach has me much more optimistic,” says Siliciano, whose initial discoveries of the viral reservoirs and their ability to evade antiretroviral drug therapies led him initially to doubt the possibility of a real cure for the disease. Now, he adds, “after years of developing a better understanding of these HIV reservoirs, to the point where we can make and study latently infected T-cells in the laboratory, we are finally ready to go after them.” Siliciano is a professor at Johns Hopkins and a Howard Hughes Medical Institute investigator.

Your Insurance Rates Could Double

9-5-2011 According to thenew Federal and States review, double-digit price hikes must be justified. Health insurers seeking to increase their rates by 10 percent or more must submit their request to state or federal reviewers to determine whether they are reasonable or not. This rate review program, created by the Affordable Care Act, will bring greater transparency, accountability, and, in many cases, lower costs for families and small business owners who struggle to afford coverage.

In a growing number of states, regulators now have the authority to deny or reduce rate hikes found to be excessive. Insurers that insist on going ahead with double-digit rate increases are required to post their justifications on their website, and state and federal regulators will post them as well.

“For far too long, families and small employers have been at the mercy of insurance rate increases that often put coverage out of their reach. Rate review will shed a bright light on the industry’s behavior and drive market competition to lower costs,” said Kathleen Sebelius, Secretary of Health and Human Services. “We are pleased to team with states to bring this important new protection to consumers and employers.”

As of today, insurers proposing double digit increases will have to provide clear information that indicates what factors are causing proposed increases. Experts will closely examine information about the underlying cost trends in health care to flag instances when insurance companies are unjustly raising costs. This means consumers will no longer have to take the word of their insurance company; they will have an independent expert reviewing their proposed rate increase.

Starting mid-September, consumers in every state can go to HealthCare.gov to view easy-to-access, consumer-friendly disclosure information explaining proposed increases that are 10 percent or higher than last year’s rates. Consumers will see a summary of the key factors driving rate increases and an explanation provided by insurance companies for why the proposed increase is needed. And, for the first time, consumers in every state will also be given the ability to comment on large proposed rate increases.

“Thanks to the Affordable Care Act consumers no longer have to navigate the health insurance market blindly and on their own,” said Steve Larsen, director of the Center for Consumer Information and Insurance Oversight. “The next time your insurance company tries to raise your premium by double digits, it will have to give you and rate review experts a good reason – or be labeled as unjustified, or in some states denied.”

States continue to have the primary responsibility for reviewing insurance rates. Because many states have lacked the resources needed to perform strong rate review, the Affordable Care Act provides $250 million in Health Insurance Premium Review Grants to states over five years. These new resources will improve how states review proposed health insurance rate increases and hold insurance companies accountable for unjustified premium increases. States and territories are already using $48 million in rate review grants, and HHS has made an additional $200 million available to states and territories to strengthen and improve their rate review processes.

“Thanks to our Affordable Care Act grant funds, our rate reviews are more in-depth, and we recently proposed to use future grant funds to incorporate public hearings into our rate reviews,” Oregon Insurance Division Administrator Teresa Miller said. “We have already received valuable feedback from consumer groups and look forward to continuing to improve our rate review process"

Autism in Children

5-11-2011 Acording to NIH A 5-minute questionnaire completed by parents during well-baby checkups, the answers can spot subtle signs of autism and developmental delays in 1-year-olds, according to a new study. Early detection and treatment of these disorders may lead to better health outcomes for children.

Autism is a complex brain disorder characterized by difficulties with social interactions, poor verbal and nonverbal communication and repetitive behaviors. It’s often grouped with similar health disorders that range from mild to severe and are collectively referred to as autism spectrum disorders (ASD). ASD affects about 1 in 110 American children.

Although there’s no cure for ASD, most experts agree that early intervention can improve a child’s quality of life in later years. However, many studies show a significant time lag between a parent’s first reported concerns about a child’s behavior and an eventual diagnosis of ASD.

To see if a simple screening tool might aid early detection, Dr. Karen Pierce of the University of California, San Diego, and her colleagues enlisted the help of 137 pediatricians in San Diego County. They systematically screened all children who came in for a 1-year, well-baby check-up by asking parents or caregivers to complete a brief questionnaire. The 24-question survey asked about a child’s use of eye gaze, sounds, words, gestures, objects and other forms of age-appropriate communication. The physicians screened nearly 10,500 children. Their work was supported in part by NIH’s National Institute of Mental Health (NIMH) and other NIH components.

Text Version
ADHD Symptoms Widget

Alzheimers Update

4-26-2011 For the first time in 27 years, clinical diagnostic criteria for Alzheimer’s disease dementia have been revised, and research guidelines for earlier stages of the disease have been characterized to reflect a deeper understanding of this health disorder. The National Institute on Aging/Alzheimer’s Association Diagnostic Guidelines for Alzheimer’s Disease outline some new approaches for clinicians and provide scientists with more advanced guidelines for moving forward with research on diagnosis and health treatments. They mark a major change in how experts think about and study Alzheimer’s disease. Development of the new guidelines was led by the National Institutes of Health and the Alzheimer’s Association.

The original criteria were the first to address the disease and described only later stages, when symptoms of dementia are already evident. The updated guidelines announced today cover the full spectrum of the disease as it gradually changes over many years. They describe the earliest preclinical stages of the disease, mild cognitive impairment, and dementia due to Alzheimer’s pathology. Importantly, the guidelines now address the use of imaging and biomarkers in blood and spinal fluid that may help determine whether health changes in the brain and those in body fluids are due to Alzheimer’s disease. Biomarkers are increasingly employed in the research setting to detect onset of the disease and to track progression, but cannot yet be used routinely in clinical diagnosis without further testing and validation.

“Alzheimer’s research has greatly evolved over the past quarter of a century. Bringing the diagnostic guidelines up to speed with those advances is both a necessary and rewarding effort that will benefit patients and accelerate the pace of research,” said National Institute on Aging Director Richard J. Hodes, M.D.

“We believe that the publication of these articles is a major milestone for the field,” said William Thies, Ph.D., chief medical and scientific officer at the Alzheimer’s Association. “Our vision is that this process will result in improved health diagnosis and treatment of Alzheimer’s, and will drive research that ultimately will enable us to detect and treat the disease earlier and more effectively. This would allow more people to live full healthier, rich lives without—or with a minimum of—Alzheimer’s symptoms.”

No Smoking in Restaurants, It's Safer for Your Health

4-25-2011 If progress of past 10 years continue all states could be covered by 2020 or sooner, the entire nation could have health laws banning smoking in all indoor areas of private sector worksites to keep peoples health safer, restaurants and bars, a study by the Centers for Disease Control and Prevention has found. These places are major sources of dangerous secondhand smoke exposure.

The projection is based on the rate at which states have been adopting comprehensive smoke-free laws. In just the past 10 years, 25 states and the District of Columbia have enacted these safe health laws, the CDC report said. The study, published in this week's Morbidity and Mortality Weekly Report, lists the smoke-free status of every state and the District of Columbia. In addition to listing the states with comprehensive smoke-free laws and years they went into effect, the report also lists the 10 states that have laws prohibiting smoking in one or two—but not all three—of the venues included in the study. It also identifies eight states that have less restrictive laws, such as those allowing smoking in designated areas or areas with separate ventilation. And the study details the seven states that have no statewide smoking restrictions in place for private worksites, restaurants or bars: Indiana, Kentucky, Mississippi, South Carolina, Texas, West Virginia, and Wyoming.

"Eliminating smoking from worksites, restaurants and bars is a low-cost, high-impact strategy that will protect nonsmokers and allow them to live healthier, longer, more productive lives while lowering health care costs associated with secondhand smoke," said CDC director Thomas R. Frieden, M.D., M.P.H. "While there has been a lot of progress over the past decade, far too many Americans continue to be exposed to secondhand smoke at their workplaces, increasing their risk of cancer and heart attacks."

Despite increased adoption of state and local smoke-free laws, approximately 88 million nonsmoking Americans aged 3 and older are still exposed to secondhand smoke each year. More than half of children over age 3 are exposed to secondhand smoke. The 2010 Surgeon General's report makes clear that there is no safe level of exposure to tobacco smoke—including secondhand smoke—and that any exposure can lead to immediate damage to the body's organs and DNA.

"Secondhand smoke is responsible for 46,000 heart disease deaths and 3,400 lung cancer deaths among nonsmokers each year," said Ursula Bauer, Ph.D., M.P.H., director of CDC's National Center for Chronic Disease Prevention and Health Promotion. "Completely prohibiting smoking in all public places and workplaces is the only way to fully protect nonsmokers from secondhand smoke exposure."

For a list of states and the types of smoke-free laws in each, view the full report at http://www.cdc.gov/mmwr. Additional information on secondhand smoke exposure and smoke-free laws is available by accessing CDC's State Tobacco Activities Tracking and Evaluation System at http://www.cdc.gov/tobacco/statesystem. Smokers can call 1-800-QUIT-NOW (1-800-784-8669) or visit http://www.smokefree.gov for quitting assistance.

NIH Study of Prostrate Tumors

3-24-2011 A new health study by NIH of prostate tumors has shown that a gene, FOXO3, suppresses activation of cells related to immunity and thus leads to a reduced immune response against a growing cancer. One of the main problems in treating cancer by vaccine or immunotherapy is that tumors often evade the body’s immune response — and one of their tricks is to create an environment where immunity is inhibited or suppressed. By identifying a gene that makes immune cells suppressive, the researchers may have found a new target for enhancing immune responses to cancer tumor cells. The health study, by scientists from the National Cancer Institute (NCI), part of the National Institutes of Health, appeared online March 23, 2011, in the Journal of Clinical Investigation.

The cells isolated and examined in this study were dendritic cells. These cells normally initiate an immune response to disease by presenting a foreign protein (or antigen) in a way that it is recognized by an invader-killing T cell. In tumor-associated dendritic cells, however, this stimulating immune response is often suppressed.

In this study, the scientists demonstrated not only that dendritic cells isolated from tumors were poor at initiating immune responses, but also that these cells were responsible for inducing T cell tolerance and converting them to suppressor T cells. Using microarray technology, a technique that allows scientists to examine the expression of thousands of genes simultaneously, they compared the genes expressed by the tumor-associated dendritic cells to those expressed by dendritic cells in normal tissue. Among the genes that were overexpressed in the tumor-associated dendritic cells, FOXO3 was an appealing candidate for an immune modulator because it was known to be a regulator associated with dendritic cell function. When FOXO3 gene expression was silenced in the tumor-associated dendritic cells, the scientists found that these cells no longer had an immune suppressive function but rather initiated appropriate immune responses.

“Our research suggests that it may be possible to boost immune responses to tumors and prevent immune suppression if we target FOXO3, either directly or with prostate and other cancer vaccines. This might be achieved by using small molecule drugs or peptides that target FOXO3 in dendritic cells or by silencing FOXO3 expression in dendritic cell vaccines that already exist, making them more potent,” said Hurwitz. “We believe this finding could also be applied to treating autoimmune diseases, where therapies aimed at inducing immune suppression may benefit from enforcing expression of FOXO3.”

This work has led to the submission of a patent application by the NIH on behalf of Hurwitz and Watkins to target FOXO3 as a way to boost immune responses in cancer and to silence excessive immune responses in autoimmune diseases. While waiting for patent approval, the scientists will study how tumors, or the tumor microenvironment, induce FOXO3 expression as well as how FOXO3 induces this suppressive activity.

Expired Drugs in Your Medicine Cabinet

2-7-2011 Is your medicine cabinet filled with expired drugs or medications you no longer use? How should you dispose of them?

Most drugs can be thrown in the household trash, but consumers should take certain precautions before tossing them out, according to the Food and Drug Administration (FDA). A few drugs should be flushed down the toilet. And a growing number of community-based "take-back" programs offer another safe disposal alternative.

Guidelines for Drug Disposal:

FDA worked with the White House Office of National Drug Control Policy (ONDCP) to develop the first consumer guidance for proper disposal of prescription drugs. Issued by ONDCP in February 2007, the federal guidelines are summarized here:

Follow any specific disposal instructions on the drug label or patient information that accompanies the medication. Do not flush prescription drugs down the toilet unless this information specifically instructs you to do so.

If no instructions are given, throw the drugs in the household trash, but first:

Take them out of their original containers and mix them with an undesirable substance, such as used coffee grounds or kitty litter. The medication will be less appealing to children and pets, and unrecognizable to people who may intentionally go through your trash.

Put them in a sealable bag, empty can, or other container to prevent the medication from leaking or breaking out of a garbage bag.

Take advantage of community drug take-back programs that allow the public to bring unused drugs to a central location for proper disposal. Call your city or county government's household trash and recycling service (see blue pages in phone book) to see if a take-back program is available in your community.

FDA's Director of Pharmacy Affairs, Ilisa Bernstein, Pharm.D., J.D., offers some additional tips: Before throwing out a medicine container, scratch out all identifying information on the prescription label to make it unreadable. This will help protect your identity and the privacy of your personal health information.

Do not give medications to friends. Doctors prescribe drugs based on a person's specific symptoms and medical history. A drug that works for you could be dangerous for someone else.

When in doubt about proper disposal, talk to your pharmacist.

Bernstein says the same disposal methods for prescription drugs could apply to over-the-counter drugs as well.

Health Law Unconstitutional

2-2-2011 HERE IS THE LEGAL PAPERS FROM THE FLORIDA JUDGE WHO RULED THE HEALTH CARE LAW UNCONSTITUTIONAL TODAY.

From: Don McCanne

Sent: Monday, January 31, 2011 5:04 PM

Subject: qotd: Medicaid is constitutional; mandate isn't

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF FLORIDA PENSACOLA DIVISION

STATE OF FLORIDA, by and through Attorney General Pam Bondi, et al.;

Plaintiffs,v. UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, et al., Defendants.

ORDER GRANTING SUMMARY JUDGMENT

I. Medicaid Expansion (Count Four)

Accordingly, summary judgment must be granted in favor of the defendants on Count IV.

II. Individual Mandate (Count One)

The individual mandate is outside Congress’ Commerce Clause power, and it cannot be otherwise authorized by an assertion of power under the Necessary and Proper Clause. It is not Constitutional. Accordingly, summary judgment must be granted in favor of the plaintiffs on Count I.

I must conclude that the individual mandate and the remaining provisions are all inextricably bound together in purpose and must stand or fall as a single unit. The individual mandate cannot be severed.

Injunction

Thus, the award of declaratory relief is adequate and separate injunctive relief is not necessary.

Conclusion

For the reasons stated, I must reluctantly conclude that Congress exceeded the bounds of its authority in passing the Act with the individual mandate. That is not to say, of course, that Congress is without power to address the problems and inequities in our health care system. The health care market is more than one sixth of the national economy, and without doubt Congress has the power to reform and regulate this market. That has not been disputed in this case. The principal dispute has been about how Congress chose to exercise that power here.

Because the individual mandate is unconstitutional and not severable, the entire Act must be declared void.

For all the reasons stated above and pursuant to Rule 56 of the Federal Rules of Civil Procedure, the plaintiffs’ motion for summary judgment (doc. 80) is hereby GRANTED as to its request for declaratory relief on Count I of the Second Amended Complaint, and DENIED as to its request for injunctive relief; and the defendants’ motion for summary judgment (doc. 82) is hereby GRANTED on Count IV of the Second Amended Complaint.

In accordance with Rule 57 of the Federal Rules of Civil Procedure and Title 28, United States Code, Section 2201(a), a Declaratory Judgment shall be entered separately, declaring “The Patient Protection and Affordable Care Act” unconstitutional.

DONE and ORDERED this 31st day of January, 2011.

ROGER VINSON Senior United States District Judge

Comment:  Judge Roger Vinson has ruled that the individual mandate in the Patent Protection and Affordable Care Act is unconstitutional, as Judge Henry Hudson had ruled earlier. Judge Vinson went further and ruled that the individual mandate cannot be severed from the rest of the Act, and, therefore, the entire Patent Protection and Affordable Care Act is unconstitutional. 

He also ruled that "officials of the Executive Branch will adhere to the law as declared by the court. As a result, the declaratory judgment is the functional equivalent of an injunction."

There are two fundamental decisions in this summary judgement:

1) The individual mandate to purchase private health insurance is unconstitutional. Since he has ruled that the mandate cannot be separated from the rest of the Act, the entire Act is unconstitutional. 

2) Medicaid is constitutional. Summary judgement in support of Medicaid expansion was granted on behalf of the United States Department of Health and Human Services.

Forget the Supreme Court. Let's walk away from the unconstitutional Patient Protection and Affordable Care Act and instead enact the constitutional Expanded and Improved Medicare for All Act. It's less expensive, works better, and includes all of us.

As Judge Vinson stated, "That is not to say, of course, that Congress is without power to address the problems and inequities in our health care system."

IV Fluid Study

1-11-2011 Severely injured emergency patients who are routinely given IV fluids by paramedics before transport to the nearest trauma center are significantly more likely to die than similarly injured patients who don’t get the time-consuming IV treatment before hospitalization, new Johns Hopkins-led research suggests.

The emergency health research, currently available online in advance of the Feb. 2011 issue of Annals of Surgery, raises new questions about a medical health practice developed decades ago that continues to be the standard of care despite lack of scientific research into its validity.

The researchers say that mandating pre-hospital IV fluids for all emergency trauma patients — the case in many states, including Maryland — should be discouraged. Some groups are slowly considering changes to their guidelines.

“Giving IV fluids to emergency patients before they go to the hospital can delay transport,” says Elliott R. Haut, M.D., an associate professor of surgery, anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine and the study’s leader. “Our study suggests it may be better to get patients to the hospital faster. Starting fluids takes time and the IV fluids may cause harm on top of the timing issue.”

Intravenous fluids are typically given immediately to emergency trauma victims whose blood pressure has sharply decreased due to blood loss. The rationale has been that fluids quickly raise dangerously low blood pressure in order to keep the body’s systems working, a concept that makes intuitive sense, says Haut. But, he adds, there is some evidence that IV fluids may actually be making matters worse in those patients in whom very low blood pressure temporarily stops bleeding. Rapidly raising blood pressure in these individuals could “pop the clot,” causing them to start bleeding again before they can get definitive emergency care in the hospital.

For the study, Haut and his colleagues examined data from 776,734 trauma patients in the American College of Surgeons’ National Trauma Data Bank between 2001 and 2005. The patients were primarily male, white and under the age of 40. About half were given IV fluids at the scene. Patients who received pre-hospital fluids were 11 percent more likely to die than those who did not. The findings were especially marked in people who were shot or stabbed (25 percent more likely to die), had severe head injuries (35 percent more likely), and got emergency surgery once hospitalized (35 percent more likely).

Abuse of Children Down

1-5-2011 “We are pleased to see a steady decrease in the rate of abused and neglected children, however we also know even one child abused is one too many,” said David A. Hansell, HHS acting assistant secretary for children and families. “The more we support and implement evidenced-based programs and services to prevent child maltreatment and promote healthy families and communities, the sooner we can ensure children are able to have the safe, happy and healthy childhood they deserve.”

ACF has been implementing major initiatives aimed at bringing down the rate of child abuse and neglect, including the recently funded Family Violence Prevention and Services Act grants geared toward domestic violence victims and organizations, as well as grants to reduce long-term foster care and develop innovative intervention strategies to help move children into permanent safe homes. ACF also awarded $3 million in Affordable Care Act funds for the Tribal Maternal, Infant and Early Childhood Home Visiting Grant program, which addresses the diverse needs of at-risk American Indian and Alaska Native children and families and assures effective coordination and delivery of child abuse and neglect prevention.

Moreover, President Obama’s 2011 budget reflects a further commitment to reducing child maltreatment by requesting $107 million for child abuse prevention programs through child abuse state grants, community-based child abuse prevention and child abuse discretionary activities. This includes a $10 million increase in funding for a new competitive grant program to encourage states to use evidence-based practices for preventing child abuse and neglect. The budget also requests $145 million for family violence prevention and service programs, $11 million more than FY 2010 funding. The increase would assist in expanding shelter capacity and support services and provide help to children who witness domestic violence.

This release comes four months earlier than it has in prior years, when publication coincided with Child Abuse Prevention Month. From now on, the report will be released in December with a mid-year update published in April.

Cigarette Warnings

9-11-2010 The Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act) requires that cigarette packages and advertisements have larger and more visible graphic health warnings.

FDA issued a proposed rule, Required Warnings for Cigarette Packages and Advertisements, proposing to modify the required warnings that appear on cigarette packages and in cigarette advertisements. These new required warnings would consist of nine new textual warning statements accompanied by color graphics depicting the negative health consequences of smoking.

Timeline for Final Regulations

The Tobacco Control Act requires FDA to issue final regulations requiring these color graphics by June 22, 2011. It also specifies that the requirement for the new health warnings on cigarette packages and advertisements will take effect 15 months after issuance of this final rule.

Proposed Graphic Health Warnings for Cigarette Packages and Advertisements

WARNING: Cigarettes are addictive.

WARNING: Tobacco smoke can harm your children.

WARNING: Cigarettes cause fatal lung disease.

WARNING: Cigarettes cause cancer.

WARNING: Cigarettes cause strokes and heart disease.

WARNING: Smoking during pregnancy can harm your baby.

WARNING: Smoking can kill you.

WARNING: Tobacco smoke causes fatal lung disease in nonsmokers.

WARNING: Quitting smoking now greatly reduces serious risks to your health.

911 Insurance Costs

11-22-2010 Today, many insurance companies spend a substantial portion of consumers’ premium dollars on administrative costs and profits, including executive salaries, overhead, and marketing. Thanks to the Affordable Care Act, consumers will receive more value for their premium dollar because insurance companies will be required to spend 80 to 85 percent of premium dollars on medical care and health care quality improvement, rather than on administrative costs, starting in 2011. If they don’t, the insurance companies will be required to provide a rebate to their customers starting in 2012.

In 2011, the new rules will protect up to 74.8 million insured Americans and estimates indicate that up to 9 million Americans could be eligible for rebates starting in 2012 worth up to $1.4 billion. Average rebates per person could total $164 in the individual market. Important details regarding the new regulation are included below.

The medical loss ratio regulation outlines disclosure and reporting requirements, how insurance companies will calculate their medical loss ratio and provide rebates, and how adjustments could be made to the medical loss ratio standard to guard against market destabilization.

Beginning in 2011, the law requires that insurance companies publicly report how they spend premium dollars, providing meaningful information to consumers. Also beginning in 2011, insurers are required to spend at least 80 percent of the premium dollars they collect on medical care and quality improvement activities. Insurance companies that are not meeting the medical loss ratio standard will be required to provide rebates to their consumers. Insurers will be required to make the first round of rebates to consumers in 2012.

“These rules were carefully developed through a transparent and fair process with significant input from the public, the States, and other key stakeholders,” said Jay Angoff, Director of the Office of Consumer Information and Insurance Oversight at HHS. “As we build a bridge to 2014, when better, more affordable options are available to consumers, these rules will help make health insurance fairer for consumers now.”

The Affordable Care Act required the National Association of Insurance Commissioners (NAIC) to develop uniform definitions and methodologies for calculating insurance companies’ medical loss ratios. Insurance commissioners in every State have a responsibility to protect the interests of the general public, policyholders, and enrollees within their respective States. Today’s regulation certifies and adopts the recommendations submitted to the Secretary of HHS on October 27, 2010 by the NAIC. It also incorporates recommendations from a letter sent to the Secretary by the NAIC on October 13, 2010.

8-11-2010 Master painter’s depiction of God contains neuroanatomical “oddities”. The odd depiction of God's neck in "Separation of Light From Darkness" bears a striking resemblance to a brainstem, seen in tissue from a cadaver and outlined in the painting.

Michelangelo, the 16th century master painter and accomplished anatomist, appears to have hidden an image of the brainstem and spinal cord in a depiction of God in the Sistine Chapel’s ceiling, a new study by Johns Hopkins researchers reports. These findings by a neurosurgeon and a medical illustrator, published in the May Neurosurgery, may explain long controversial and unusual features of one of the frescoes’ figures.

We did not realize how inerested in peoples health he really was.Michelangelo is known to have dissected numerous cadavers starting in his teenage years, these anatomic studies aiding him in creating extremely accurate depictions of the human figure in his sculptures and paintings, notably the statue of David in Florence and paintings of God and other figures from the Book of Genesis in the Vatican’s Sistine Chapel in Rome.

Although the vast majority of subjects in this painting are considered anatomically correct, art historians and scholars have long debated the meaning of some anatomical peculiarities seen on God’s neck in the part of the painting known as Separation of Light From Darkness. In this image, the neck appears lumpy, and God’s beard awkwardly curls upward around his jaw.

“Michelangelo definitely knew how to depict necks—he knew anatomy so well,” says Rafael Tamargo, M.D., a professor in the Department of Neurosurgery at the Johns Hopkins University School of Medicine. “That’s why it was such a mystery why this particular neck looked so odd.”

To investigate, Tamargo enlisted the help of his Hopkins colleague Ian Suk, B.Sc., B.M.C., a medical illustrator and associate professor in the Department of Neurosurgery. Together, the researchers realized that the unusual features in the neck strongly resemble a brainstem, the portion of tissue at the base of the brain that connects to the spinal cord.

“It’s an unusual view of the brainstem, from the bottom up. Most people wouldn’t recognize it unless they had extensively studied neuroanatomy,” says Suk.

Suk adds that the strategically placed brainstem might also explain another unusual feature of the painting. In this same image, God is depicted in a red robe with an odd tubular structure depicted in the chest. Although God wears the same red robe in other images in the fresco, this tubular structure is absent elsewhere. The structure has the right placement, shape, and size to be a spinal cord, say the researchers, suggesting another piece of hidden anatomy in the artwork.

Tamargo and Suk explain that, if their proposition is correct, it wouldn’t be the first time that such concealed anatomical depictions have been proposed to exist in the Sistine Chapel’s ceiling. In 1990, Frank Lynn Meshberger, an obstetrician based in Indiana, published a paper suggesting that the shroud surrounding the image known as the Creation of Adam strongly resembles an anatomically correct brain.

“It looks like the central nervous system may have been too good a motif to use only once,” Tamargo says.

The two researchers plan to continue searching for other hidden pieces of anatomy elsewhere in the Sistine Chapel painting.

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.

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 NIH Scientists Identify Maternal and Fetal Genes That Increase Preterm Birth Risk

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. 

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

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