Story first appeared in the New York Times.
The days since President Obama won re-election have been marked by tension and angst in Republican-led states like Iowa, where Gov. Terry Branstad has waited until the last minute to decide whether to create a crucial tool for people to get medical coverage under Mr. Obama’s health care law.
“There has been a total blackout of information,” said State Senator Jack Hatch, a Democrat who vented his frustration at a news conference here this week. “We’re behind schedule, we’re at a disadvantage, and I don’t know what our governor’s plan is to reposition Iowa.”
States are supposed to tell the Obama administration by Friday whether they want to create their own health insurance exchange — a deadline that many had bet might never come to pass, choosing to sit on their hands for months in the hope that Mitt Romney would win the presidency and the health care law would be repealed.
On Wednesday, they dug in their heels a little more. Leaders of the Republican Governors Association, gathering in Las Vegas for their annual meeting, wrote a letter to Mr. Obama requesting more time, more guidance and a meeting where the president and governors could talk.
“States are struggling with many unanswered questions and are not able to make comprehensive, far-reaching decisions prudently,” Gov. Bob McDonnell of Virginia, the chairman of the association, and Gov. Bobby Jindal of Louisiana, its next chairman, wrote.
Insurance exchanges — basically online markets where the uninsured can shop for private health insurance, often with federal subsidies to help provide Prescription Drug Assistance pay — are considered critical to making the health care law work. So far, 17 states, most led by Democrats, and the District of Columbia have indicated they will create their own state-run exchanges.
The other options are setting up an exchange in partnership with the federal government, or simply letting the federal government do it.
Every state is supposed to have an exchange by Jan. 1, 2014, when the health care law will require most Americans to have insurance. The exchanges are supposed to be ready to start enrolling people in October 2013.
Despite the unhappiness, there are indications that some Republican governors may be softening their opposition to the law. Gov. Rick Scott of Florida, a Republican who had been one of its toughest critics, signaled this week that he would be open to compromising.
“The election is over, and President Obama won,” Mr. Scott told The Associated Press. “If I can get to yes, I want to get to yes.”
And Governor McDonnell of Virginia — like Florida, a state Mr. Obama carried — noted that while his state had been the first to file suit seeking to block the law, it would comply with it.
But he said that the complexity of the law, and the lack of details from Washington, meant that “my best experts in Virginia, my doctors and others that are advising me on what to do, say they still can’t make a prudent call between a state or federal exchange because we don’t have all the answers.”
Others are facing intense, sometimes conflicting pressures from state legislators and interest groups. In Wisconsin, health care providers and business groups are lobbying Gov. Scott Walker to create a state exchange, while Tea Party groups are warning him not to.
At the Republican governors meeting in Las Vegas, Mr. Walker said in an interview that he would prefer a state-based program, but that he doubted that the federal government would allow him to shape it as he saw fit.
“I’d much prefer control at the state level,” Mr. Walker said, “but the problem is, I don’t think they are really state-run.”
He said that he would not disclose his decision until Friday, but added, “Why do I want to take on the potential risk to my taxpayers if I don’t really have any true authority about what’s going to happen?”
Republicans who support state-run exchanges say they are embracing a fundamental conservative belief: that states should make their own decisions rather than cede control to the federal government. But others argue that deferring to the federal government is a shrewder move; that way, they say, it will not be their fault if anything goes wrong.
The Affordable Care Act is a federal program, it’s primarily designed to give federal premium tax subsidies, and it’s all tied up in federal regulations,” said Tony Keck, director of the Department of Health and Human Services in South Carolina, which has rejected the idea of running its own exchange. “So to ask states to get involved is like asking states to run the post office. It doesn’t make sense.”
Setting up an insurance exchange is no simple task. Among other things, states have to set up a governance board, decide what kinds of health plans to offer through the exchange and build sophisticated information technology systems.
lthough many Republican governors delayed planning, some have quietly prepared. Gov. Brian Sandoval of Nevada and Gov. Susana Martinez of New Mexico have spent months laying the groundwork for exchanges; so has Mike Chaney, the Mississippi insurance commissioner.
Creating a state-based exchange will “allow us to retain some flexibility,” said Matt Kennicott, a spokesman for the New Mexico Human Services Department, and allow people there to buy insurance in an exchange “developed by New Mexicans, for New Mexicans.”
Other states, like Alaska, South Carolina, South Dakota and Texas, had already decided to let the federal government run an insurance exchange for them instead of building one themselves. A handful of additional states — Alabama, Kansas, Ohio, Wyoming and Missouri, whose governor, Jay Nixon, is a Democrat — announced this week that they, too, would opt for a federally run exchange.
But most Republican-led states are somewhere in the middle — still vexing over whether to build an exchange on their own, do it in partnership with the federal government or let the federal government do it for them. In Iowa, Mr. Branstad has been consulting with officials from his administration on how to move forward and help consumers get Prescription Savings, his spokesman said.
But their discussions have been private, and unlike some other governors, Mr. Branstad has not held public hearings or meetings to gather opinions. A coalition of health care advocacy groups circulated a list of “principles for success” for a state-run exchange and sent e-mails to Mr. Branstad’s staff in the days after the election, pleading for clarity.
The best response they got was at a health care conference in Des Moines on Tuesday, when several state officials said they were trying their best to prepare but were hampered by a lack of guidance. Asked by an audience member about “the current thought in Iowa on the health exchange,” Jennifer Vermeer, the state’s Medicaid director, paused for several long seconds before saying state officials had been “focusing our energies” on planning a partnership exchange.
Even if Iowa opts for a partnership with the federal government, it will be “without a totally clear understanding of who needs to do what,” said Charles M. Palmer, director of the state’s Department of Human Services.
Walking down a hallway during the Republican governors meeting on Wednesday, Mr. Branstad said that Iowa was working on its letter to send the administration by the Friday deadline, but that officials did not feel they had gotten all the information they needed from the federal government.
“There’s a whole lot of questions we have,” he said. “We have a whole lot of questions.”
15 November 2012
02 November 2012
Tigers' Pitcher Doug Fister Appears to Avoid Concussion
story first appeared in Detroit Free Press
The line drive Tigers pitcher Doug Fister took to the head in Thursday’s World Series game certainly looked painful. But how badly was he injured?
Dr. Daniel B. Michael, a neurosurgeon and Chief of Neurotrauma at Beaumont Hospital in Royal Oak said a hit like that would obviously be painful.
Both Michael and Dr. Sadiq Haque, a sports medicine specialist at the Detroit Medical Center, watched the game on TV Thursday night. They said it didn’t appear that Fister suffered a concussion.
The line drive Tigers pitcher Doug Fister took to the head in Thursday’s World Series game certainly looked painful. But how badly was he injured?
Dr. Daniel B. Michael, a neurosurgeon and Chief of Neurotrauma at Beaumont Hospital in Royal Oak said a hit like that would obviously be painful.
Both Michael and Dr. Sadiq Haque, a sports medicine specialist at the Detroit Medical Center, watched the game on TV Thursday night. They said it didn’t appear that Fister suffered a concussion.
Michael said it it was good to see the ball hit him at a glancing blow, and the energy with which it went from his skull was a good sign, because that energy wasn't imparted to Fister's head.
Tigers Manager Jim Leyland, a pitching coach and a trainer immediately went to check on Fister. Michael noted that Fister was asked various questions, including where he was and which inning the game was in. Short term memory problems are among the symptoms of a concussion, an injury to the brain that results in a transient deficit in function.
Fister was able to answer the questions correctly. He went back in the game.
Tigers Manager Jim Leyland, a pitching coach and a trainer immediately went to check on Fister. Michael noted that Fister was asked various questions, including where he was and which inning the game was in. Short term memory problems are among the symptoms of a concussion, an injury to the brain that results in a transient deficit in function.
Fister was able to answer the questions correctly. He went back in the game.
Dr. Sadiq Haque said the impact looked serious, but the trainer would have done the appropriate evaluations to make sure it wasn't a concussion and that Fister could safely return to play.
Michael said if Fister has any memory problems, headaches or other concerning symptoms Friday, he should get checked out again, because sometimes in a moment like that the adrenaline will compensate for a mild concussion. If Doug demonstrated symptoms of a concussion within a few days of the game, he should be taken out of harm's way and watched closely. According to Michael, a head injury can be lethal even within a week or two.
Michael said he is in favor of having additional protective headgear for pitchers. He said even more protection built into the pitcher's cap could help prevent a serious head injury.
Michael said if Fister has any memory problems, headaches or other concerning symptoms Friday, he should get checked out again, because sometimes in a moment like that the adrenaline will compensate for a mild concussion. If Doug demonstrated symptoms of a concussion within a few days of the game, he should be taken out of harm's way and watched closely. According to Michael, a head injury can be lethal even within a week or two.
Michael said he is in favor of having additional protective headgear for pitchers. He said even more protection built into the pitcher's cap could help prevent a serious head injury.
01 November 2012
Hundreds of Patients Evacuated from New York Hospital for Hurricane Sandy
story first appeared on apnews.com
A backup generator failed at a New York City hospital Monday night, forcing it to move out more than 200 patients, including 20 babies from neonatal intensive care.
Dozens of ambulances lined up around the block outside New York University Tisch Hospital as doctors and nurses began the slow process of evacuation. They started with the sickest and youngest. Some were on respirators operating on battery power.
NYU Medical Dean Robert Grossman told WCBS-TV said this challenging situation is the kind of thing they drill for all the time.
Much of New York was plunged into darkness by superstorm Sandy, a monstrous hybrid system that swept across a huge swath of the East.
Most of the power outages in lower Manhattan, where Tisch is located, were due to an explosion at an electrical substation, officials at Consolidated Edison said. It wasn't clear whether flooding or flying debris caused the explosion, said John Miksad, senior vice president for electric operations at Con Edison.
Without power, there are no elevators, meaning patients - some of whom are being treated for cancer and other serious illnesses - must be carefully carried down staircases, Grossman said.
As the patients were evacuated, gusts of wind blew their blankets. Nurses and staff huddled around the patients, some holding IVs and other equipment.
Ambulances came from around the city to help transport the sick. Patients will be taken to other hospitals including Mount Sinai and the Memorial Sloan-Kettering Cancer.
A backup generator failed at a New York City hospital Monday night, forcing it to move out more than 200 patients, including 20 babies from neonatal intensive care.
Dozens of ambulances lined up around the block outside New York University Tisch Hospital as doctors and nurses began the slow process of evacuation. They started with the sickest and youngest. Some were on respirators operating on battery power.
NYU Medical Dean Robert Grossman told WCBS-TV said this challenging situation is the kind of thing they drill for all the time.
Much of New York was plunged into darkness by superstorm Sandy, a monstrous hybrid system that swept across a huge swath of the East.
Most of the power outages in lower Manhattan, where Tisch is located, were due to an explosion at an electrical substation, officials at Consolidated Edison said. It wasn't clear whether flooding or flying debris caused the explosion, said John Miksad, senior vice president for electric operations at Con Edison.
Without power, there are no elevators, meaning patients - some of whom are being treated for cancer and other serious illnesses - must be carefully carried down staircases, Grossman said.
As the patients were evacuated, gusts of wind blew their blankets. Nurses and staff huddled around the patients, some holding IVs and other equipment.
Ambulances came from around the city to help transport the sick. Patients will be taken to other hospitals including Mount Sinai and the Memorial Sloan-Kettering Cancer.
Quality of Heath Care Varies by Region According to Study
story first appeared on usatoday.com
Where you live – and where your doctors did their training – has a lot to do with whether you'll be operated on, get an infection or have other potentially risky medical tests, a report out Tuesday said.
And we're not talking about small-town vs. big-city medicine. The report by Dartmouth Medical School's Atlas Project looked closely at 23 medical centers, including many of the top-rated hospitals for clinical excellence by U.S. News and World Report and other leading hospitals affiliated with universities. New Atlas data that include nearly all the teaching hospitals in the U.S. were also released.
The study was done to help medical students decide where to do their residencies, but it also helps consumers better understand how their local hospitals differ from the norm.
Among the findings: If you're in Salt Lake City, you're twice as likely to get knee-replacement surgery than if you're in New York City. Lubbock, Texas, had the highest rate of knee replacements -- 13.2 per 1,000 Medicare beneficiaries.
Arthritis in the knee is "not a dependably progressive disorder" that nearly always requires surgery, says David Goodman, a doctor who is co-principal investigator for the Atlas Project.
The report uses new 2010 Medicare data to update previous reports on regional variations in the treatment of patients at the end of life, trends in surgical procedures and trends in quality of care as it relates to patient experience and safety.
There is an emphasis on more aggressive treatment over preventive care at some hospitals, Goodman says. The report includes a "hospital care intensity index" when it comes to treatment of people at the "end of life."
Goodman says some hospitals may have a lot of capacity in their intensive care units and not enough in primary care.
Patients at NYU Langone Medical Center were 47 times less likely to get an infection from a urinary catheter than patients at the University of Michigan Health System, for example. Mount Sinai Medical Center had the second lowest. Goodman says such infections are "largely preventable."
David Muller, dean for medical education at the Mount Sinai School of Medicine, says the population of patients a hospital treats -- that is, whether they are low income and already in poor health -- can have a lot to do with whether a patient contracts an infection and can recover fully from it. The report's rates were adjusted for age, race and gender using the U.S. Medicare population as the standard.
Muller says the Dartmouth report can be valuable for both medical students and patients, but he notes that the Atlas Project's research is sometimes practically considered a bible, but he says any measures of quality of care in hospitals, varies widely and the subject is controversial.
This list ranks 23 teaching hospitals by the Hospital Care Intensity (HCI) index, which is a measure that combines the number of days patients spent in the hospital and the average number of inpatient physician visits during the last two years of life.
Hospital (ranked by Hospital Care Intensity (HCI) index):
Patients at NYU Langone Medical Center were 47 times less likely to get an infection from a urinary catheter than patients at the University of Michigan Health System, for example. Mount Sinai Medical Center had the second lowest. Goodman says such infections are "largely preventable."
David Muller, dean for medical education at the Mount Sinai School of Medicine, says the population of patients a hospital treats -- that is, whether they are low income and already in poor health -- can have a lot to do with whether a patient contracts an infection and can recover fully from it. The report's rates were adjusted for age, race and gender using the U.S. Medicare population as the standard.
Muller says the Dartmouth report can be valuable for both medical students and patients, but he notes that the Atlas Project's research is sometimes practically considered a bible, but he says any measures of quality of care in hospitals, varies widely and the subject is controversial.
This list ranks 23 teaching hospitals by the Hospital Care Intensity (HCI) index, which is a measure that combines the number of days patients spent in the hospital and the average number of inpatient physician visits during the last two years of life.
Hospital (ranked by Hospital Care Intensity (HCI) index):
- Cedars-Sinai Medical Center 2.06
- NYU Langone Medical Center 1.73
- Mount Sinai Medical Center 1.50
- Ronald Reagan UCLA Medical Center 1.48
- New York-Presbyterian Hospital 1.37
- University of Pittsburgh Medical Center 1.28
- Northwestern Memorial Hospital 1.28
- Massachusetts General Hospital 1.19
- Cleveland Clinic 1.12
- Hospital of the Univ. of Pennsylvania 1.08
- University of Michigan Health System 1.07
- Brigham and Women's Hospital 1.06
- Johns Hopkins Hospital 1.01
- United States average 1.00
- Indiana Univ. Health (Clarian Health) 0.96
- Barnes-Jewish Hospital/Washington Univ. 0.95
- UCSF Medical Center 0.92
- Duke University Medical Center 0.87
- Vanderbilt Univ. Medical Center 0.80
- University of Washington Medical Center 0.78
- Stanford Hospital and Clinics 0.78
- St. Mary's Hospital, Mayo Clinic 0.70
- Scott & White Memorial Hospital 0.62
- University of Utah Health Care 0.62
23 October 2012
Studies Show No Health Benefits of Organic Food for Kids
story first appeared on nbcnews.com
If you’re buying organic foods for your kids because you think they’re more nutritious, you might want to think again. The nation’s pediatricians have weighed in on the issue for the first time, and they say that when it comes to nutritional value, organics are virtually indistinguishable from conventionally produced foods.
Dr. Janet Silverstein, a professor of pediatric endocrinology at the University of Florida said studies show no nutritional difference. She’s a co-author of the report published Monday by the American Academy of Pediatrics.
Silverstein and her colleagues reviewed the available studies on organic and conventionally produced foods, including produce, dairy products and meat. They considered research about issues including nutrition, hormones, antibiotics and synthetic chemical exposure, plus factors such as environmental impact and price.
If you’re buying organic foods for your kids because you think they’re more nutritious, you might want to think again. The nation’s pediatricians have weighed in on the issue for the first time, and they say that when it comes to nutritional value, organics are virtually indistinguishable from conventionally produced foods.
Dr. Janet Silverstein, a professor of pediatric endocrinology at the University of Florida said studies show no nutritional difference. She’s a co-author of the report published Monday by the American Academy of Pediatrics.
Silverstein and her colleagues reviewed the available studies on organic and conventionally produced foods, including produce, dairy products and meat. They considered research about issues including nutrition, hormones, antibiotics and synthetic chemical exposure, plus factors such as environmental impact and price.
Overall, the docs came to a conclusion that may surprise some parents who believe organic is best for their kids
“In the long term, there is currently no direct evidence that consuming an organic diet leads to improved health or lower risk of disease,” AAP officials said in a statement.
No large studies been conducted that address the differences, they said. That largely echoes the findings of a Stanford University review last month that analyzed 237 studies and concluded that organic foods were no more nutritious than conventional -- and ignited huge debates online and on talk shows.
When it comes to the pesky issue of pesticides, hormones and other contaminants, the pediatricians came to a similar conclusion.
No one knows yet whether those substances make foods from conventional sources less safe for growing kids, Silverstein said.
While there’s no question that conventionally grown foods have more pesticides than organic foods, the effect isn’t certain.
Lowers are level than federal governement cutoffs, Silverstein said. But she also said they have no way of knowing how these low levels effect children during the vulnerable period of time when brain growth is occurring: in utero and through the first few years of life.
Studies evaluating the long-term effects of pesticides on child development need to be conducted, she said.
One clear difference between organics and conventionally produced food is price. Organics are typically more expensive, in some cases priced 50 percent higher than the same conventionally grown foods.
Parents should recognize the importance of providing kids with lots of fruits and vegetables whether it comes from organic or conventional farms.
Parents with limited resources should know it is important to give children a healthy diet of fruits and vegetables, whether or not they can afford organic foods.
“In the long term, there is currently no direct evidence that consuming an organic diet leads to improved health or lower risk of disease,” AAP officials said in a statement.
No large studies been conducted that address the differences, they said. That largely echoes the findings of a Stanford University review last month that analyzed 237 studies and concluded that organic foods were no more nutritious than conventional -- and ignited huge debates online and on talk shows.
When it comes to the pesky issue of pesticides, hormones and other contaminants, the pediatricians came to a similar conclusion.
No one knows yet whether those substances make foods from conventional sources less safe for growing kids, Silverstein said.
While there’s no question that conventionally grown foods have more pesticides than organic foods, the effect isn’t certain.
Lowers are level than federal governement cutoffs, Silverstein said. But she also said they have no way of knowing how these low levels effect children during the vulnerable period of time when brain growth is occurring: in utero and through the first few years of life.
Studies evaluating the long-term effects of pesticides on child development need to be conducted, she said.
One clear difference between organics and conventionally produced food is price. Organics are typically more expensive, in some cases priced 50 percent higher than the same conventionally grown foods.
Parents should recognize the importance of providing kids with lots of fruits and vegetables whether it comes from organic or conventional farms.
Parents with limited resources should know it is important to give children a healthy diet of fruits and vegetables, whether or not they can afford organic foods.
If cost is a factor, families can be selective in choosing organic foods, Silverstein said. Some conventionally grown fruits and vegetables tend to have lower pesticide residues. The AAP cites organic shopper's guides like those provided by Consumer Reports and the Environmental Working Group as references for consumers.
If moms interviewed by NBC News are typical, the new report isn’t likely to dissuade any parents from buying organic.
For Diana Lovett, 34, of Larchmont, N.Y., the most important issue was avoiding pesticides in the foods she gives her son, Noam, 4 ½ months.
Lovett says she’d make her own baby food if she couldn’t find an organic product at the supermarket.
Gigi Lee Chang, 45, of New York, has been feeding her son, Cato, mostly organic foods since he was a baby. Now that he’s 8, she’s planning on packing organic fruits and vegetables to supplement school lunches.
“I don’t think from a mom’s perspective it was ever about the nutrition,” said Chang, chief executive of Healthy Child, Healthy World, an advocacy group that works to help parents protect children from harmful chemicals.
As far as Chang is concerned, the science just hasn’t had a chance to catch up on this issue. Chang points to the situation with bisphenol A, the estrogen-mimicking chemical known as BPA. Several years ago there wasn’t enough evidence on the impact of BPA, she said. And now it’s been banned from baby bottles and sippy cups.
That makes sense to Rachel Blumenthal, 32, of New York. She chooses organic foods for 18-month-old Griffin’s meals because she’s worried about chemicals in conventional foods.
Blumenthal figures it’s just a matter of time before scientists prove what she suspects.
If moms interviewed by NBC News are typical, the new report isn’t likely to dissuade any parents from buying organic.
For Diana Lovett, 34, of Larchmont, N.Y., the most important issue was avoiding pesticides in the foods she gives her son, Noam, 4 ½ months.
Lovett says she’d make her own baby food if she couldn’t find an organic product at the supermarket.
Gigi Lee Chang, 45, of New York, has been feeding her son, Cato, mostly organic foods since he was a baby. Now that he’s 8, she’s planning on packing organic fruits and vegetables to supplement school lunches.
“I don’t think from a mom’s perspective it was ever about the nutrition,” said Chang, chief executive of Healthy Child, Healthy World, an advocacy group that works to help parents protect children from harmful chemicals.
As far as Chang is concerned, the science just hasn’t had a chance to catch up on this issue. Chang points to the situation with bisphenol A, the estrogen-mimicking chemical known as BPA. Several years ago there wasn’t enough evidence on the impact of BPA, she said. And now it’s been banned from baby bottles and sippy cups.
That makes sense to Rachel Blumenthal, 32, of New York. She chooses organic foods for 18-month-old Griffin’s meals because she’s worried about chemicals in conventional foods.
Blumenthal figures it’s just a matter of time before scientists prove what she suspects.
Brain Imaging could Detect Early Alzheimer's Signs
Story first appeared on Bloomberg News
Glaxo Fund Looks for Early-Stage Alzheimer’s Detectors
GlaxoSmithKline Plc (GSK)’s venture- capital fund is seeking to invest in a biotechnology company that has both a brain-imaging dye to detect warning signs for Alzheimer’s disease and a drug treatment for the ailment.
Jens Eckstein, president of the Cambridge, Massachusetts-based SR One fund, said big change will come with imaging agent.
Imaging agents detect proteins called amyloid that define the disease. The illness can be identified at an early stage through routine scanning if started when patients are still healthy, Eckstein said. Recent studies of treatments to slow or stop progression of Alzheimer’s were flawed as they recruited patients with advanced forms of the disease, where damage was already done.
The comments show Glaxo isn’t giving up on Alzheimer’s disease after recent high-profile failures of experimental treatments. Johnson & Johnson (JNJ) and Pfizer Inc. (PFE)’s bapineuzumab as well as Eli Lilly & Co. (LLY)’s solanezumab failed to help Alzheimer’s symptoms in people with advanced disease in separate study results announced over the past two months. Still, both target amyloid plaque and showed promise for use in early-stage patients.
Disease Growth
In a study of 141 healthy subjects, those with clumps of amyloid beta plaques in their brains at the start of the study had as much as a 20 percent greater decline in memory and thinking over an 18-month period than those with fewer plaques. The study, conducted by Australian researchers, was published in the journal Neurology on Oct. 16.
The number of Alzheimer’s cases globally is expected to double within 20 years as the world’s population ages, to as many as 65.7 million people in 2030 and 115 million by 2050, the Geneva- based World Health Organization said in April.
SR One invests in about 30 public and private companies, half of which have compounds in human testing, and invests $30 million to $50 million in five or six companies a year, according to Eckstein.
While Glaxo has “high interest in our portfolio,” the fund acts largely independent of the drugmaker, with a strict firewall between the two entities and no special product rights, he said.
The company’s investments include iPierian Inc., which is developing treatments for neurodegenerative diseases such as Alzheimer’s, Parkinson’s and Huntington’s diseases using induced pluripotent stem cells. Shinya Yamanaka, who won the Nobel Prize in medicine this month for his discovery of iPS cells, sits on iPierian’s scientific advisory board.
GlaxoSmithKline Plc (GSK)’s venture- capital fund is seeking to invest in a biotechnology company that has both a brain-imaging dye to detect warning signs for Alzheimer’s disease and a drug treatment for the ailment.
Jens Eckstein, president of the Cambridge, Massachusetts-based SR One fund, said big change will come with imaging agent.
Imaging agents detect proteins called amyloid that define the disease. The illness can be identified at an early stage through routine scanning if started when patients are still healthy, Eckstein said. Recent studies of treatments to slow or stop progression of Alzheimer’s were flawed as they recruited patients with advanced forms of the disease, where damage was already done.
The comments show Glaxo isn’t giving up on Alzheimer’s disease after recent high-profile failures of experimental treatments. Johnson & Johnson (JNJ) and Pfizer Inc. (PFE)’s bapineuzumab as well as Eli Lilly & Co. (LLY)’s solanezumab failed to help Alzheimer’s symptoms in people with advanced disease in separate study results announced over the past two months. Still, both target amyloid plaque and showed promise for use in early-stage patients.
Disease Growth
In a study of 141 healthy subjects, those with clumps of amyloid beta plaques in their brains at the start of the study had as much as a 20 percent greater decline in memory and thinking over an 18-month period than those with fewer plaques. The study, conducted by Australian researchers, was published in the journal Neurology on Oct. 16.
The number of Alzheimer’s cases globally is expected to double within 20 years as the world’s population ages, to as many as 65.7 million people in 2030 and 115 million by 2050, the Geneva- based World Health Organization said in April.
SR One invests in about 30 public and private companies, half of which have compounds in human testing, and invests $30 million to $50 million in five or six companies a year, according to Eckstein.
While Glaxo has “high interest in our portfolio,” the fund acts largely independent of the drugmaker, with a strict firewall between the two entities and no special product rights, he said.
The company’s investments include iPierian Inc., which is developing treatments for neurodegenerative diseases such as Alzheimer’s, Parkinson’s and Huntington’s diseases using induced pluripotent stem cells. Shinya Yamanaka, who won the Nobel Prize in medicine this month for his discovery of iPS cells, sits on iPierian’s scientific advisory board.
17 October 2012
Diet Drink Consumptin Increases Diabetes Risk
Story first appeared on usatoday.com
Diet drink consumption has increased over the past decade, a trend that reinforces other research showing intake of calories from sugar in regular soda has decreased, government statistics out today show.
"The data suggest that diet drinks may have replaced sugar drinks during this time," says the study's lead author Tala Fakhouri, an epidemiologist with the Centers for Disease Control and Prevention.
The new diet drink analysis shows that the change in diet drink consumption occurred for both women (up from 18% in 2000 to 21% in 2010) and men (up from 14% to 19% in the same period).
Still, only about 20% of people in the USA consume diet drinks on any given day with the majority (80%) not drinking them, the report finds. Diet drinks included calorie-free and low-calorie versions of soda, fruit drinks, energy drinks, sports drinks and carbonated water. Diet drinks did not include unsweetened teas or coffees or 100% fruit juice.
Meanwhile, the consumption of sugar found in regular soda has dropped from roughly 150 calories a day in 2000 to 91 calories a day in 2008.
But when it comes to calories from all sugary drinks, including sodas, fruit drinks, energy drinks, sports drinks and sweetened bottled waters, males consume an average of 178 calories a day; females consume 103 calories, according to other government data.
Overall, about half of the population, ages 2 and older, consume sugary drinks on any given day. Among boys 2 to 19, 70% consume these types of drinks while 40% of adult women consume them.
The statistics from the CDC's National Center for Health Statistics are based on interviews with thousands of people in the National Health and Nutrition Examination Survey. Food and beverage intake is based on in-person interviews about dietary habits.
Among the findings:
-- Diet drink consumption was similar for females and males in 2010, except among adolescents, ages 12 to 19, with 17% girls consuming them on a given day compared with only 9.5% of boys the same age.
-- 28% of white adults consume diet drinks compared with 10% of black adults and 14% of Hispanic adults.
"We know that Americans, mainly white Americans, are increasing significantly the consumption of low-calorie diet beverages," says Barry Popkin, a nutrition professor at the University of North Carolina-Chapel Hill and one of the nation's top experts on beverage consumption. Research suggests that an increased intake of these diet beverages in replacement of sugary beverages reduces weight, he says.
Kelly Brownell, director of Yale University's Rudd Center for Food Policy and Obesity, says, "Diet products are controversial because it is unclear whether they are safe and help people control weight.
"We do not recommend diet drinks, particularly for children, but one can make a case for them if they do in fact displace caloric beverages and do no harm."
Sugary drinks have been in the spotlight for years, and most recently because of news that they may magnify genetic risk of obesity and diabetes. To learn more about diabetes treatment and other research and other research that heavy teens who cut soft drink consumption slow weight gain and improve individual health characteristics.
New York City is putting a 16-ounce cap on sweetened bottled drinks and fountain beverages sold at city restaurants, delis, movie theaters, sports venues and street carts. The beverage ban, which goes into effect March 12, applies to drinks that have more than 25 calories per 8 ounces. It does not include 100% juice drinks or beverages with more than 50% milk.
Diet drink consumption has increased over the past decade, a trend that reinforces other research showing intake of calories from sugar in regular soda has decreased, government statistics out today show.
"The data suggest that diet drinks may have replaced sugar drinks during this time," says the study's lead author Tala Fakhouri, an epidemiologist with the Centers for Disease Control and Prevention.
The new diet drink analysis shows that the change in diet drink consumption occurred for both women (up from 18% in 2000 to 21% in 2010) and men (up from 14% to 19% in the same period).
Still, only about 20% of people in the USA consume diet drinks on any given day with the majority (80%) not drinking them, the report finds. Diet drinks included calorie-free and low-calorie versions of soda, fruit drinks, energy drinks, sports drinks and carbonated water. Diet drinks did not include unsweetened teas or coffees or 100% fruit juice.
Meanwhile, the consumption of sugar found in regular soda has dropped from roughly 150 calories a day in 2000 to 91 calories a day in 2008.
But when it comes to calories from all sugary drinks, including sodas, fruit drinks, energy drinks, sports drinks and sweetened bottled waters, males consume an average of 178 calories a day; females consume 103 calories, according to other government data.
Overall, about half of the population, ages 2 and older, consume sugary drinks on any given day. Among boys 2 to 19, 70% consume these types of drinks while 40% of adult women consume them.
The statistics from the CDC's National Center for Health Statistics are based on interviews with thousands of people in the National Health and Nutrition Examination Survey. Food and beverage intake is based on in-person interviews about dietary habits.
Among the findings:
-- Diet drink consumption was similar for females and males in 2010, except among adolescents, ages 12 to 19, with 17% girls consuming them on a given day compared with only 9.5% of boys the same age.
-- 28% of white adults consume diet drinks compared with 10% of black adults and 14% of Hispanic adults.
"We know that Americans, mainly white Americans, are increasing significantly the consumption of low-calorie diet beverages," says Barry Popkin, a nutrition professor at the University of North Carolina-Chapel Hill and one of the nation's top experts on beverage consumption. Research suggests that an increased intake of these diet beverages in replacement of sugary beverages reduces weight, he says.
Kelly Brownell, director of Yale University's Rudd Center for Food Policy and Obesity, says, "Diet products are controversial because it is unclear whether they are safe and help people control weight.
"We do not recommend diet drinks, particularly for children, but one can make a case for them if they do in fact displace caloric beverages and do no harm."
Sugary drinks have been in the spotlight for years, and most recently because of news that they may magnify genetic risk of obesity and diabetes. To learn more about diabetes treatment and other research and other research that heavy teens who cut soft drink consumption slow weight gain and improve individual health characteristics.
New York City is putting a 16-ounce cap on sweetened bottled drinks and fountain beverages sold at city restaurants, delis, movie theaters, sports venues and street carts. The beverage ban, which goes into effect March 12, applies to drinks that have more than 25 calories per 8 ounces. It does not include 100% juice drinks or beverages with more than 50% milk.
12 October 2012
Nobel Prize Goes to Stem-Cell Scientists
Story first appeared on wsj.com.
Two stem-cell researchers have won this year's Nobel Prize in Physiology or Medicine for their groundbreaking work in cellular reprogramming, a technique that unleashed a wave of advances in biology, from cloning to the possible treatment of diseases using a patient's own cells.
Experiments by John B. Gurdon of the United Kingdom and Shinya Yamanaka of Japan showed that mature cells taken from the body could be changed to an embryonic-like state in a laboratory dish, a head-spinning discovery that is the biological equivalent of turning back time.
A British stem-cell pioneer stated that their work has changed the accepted dogma that mature cells are condemned to exist in a specialized state.
Cellular reprogramming triggered the rewriting of biology textbooks and spawned thousands of new experiments in labs around the world. It led to the first cloned animal—a frog—and to the first cloned mammal, Dolly the sheep. It also paved the way for deriving embryonic-like stem cells without destroying human embryos, sidestepping an ethically contentious approach.
Once cellular reprogramming is used to turn mature cells into embryonic-like ones, those cells can be further manipulated and turned into heart, nerve, muscle and virtually all other tissues types. This freshly made tissue—from an Alzheimer's patient, for example—could be inexpensively grown and studied in a lab dish.
Drug firms have already started to test drugs on human tissue made through reprogramming. Next year, fresh retinal cells derived in this way will be transplanted into people for the first time, in a Japanese trial for patients with an eye disease known as macular degeneration.
Scientists used to believe the fate of our cells was a one-way trip. We start as a fertilized egg; become an embryo consisting of immature, undifferentiated cells; then gradually develop into a body of specialist cells, including blood, bone, muscle and skin.
In 1962, Dr. Gurdon, while trying to understand how simple, undifferentiated cells became all the other cells in the body, performed an audacious experiment. He removed the DNA from a frog egg and replaced it with the DNA of a mature cell taken from a tadpole. The egg developed into a healthy, cloned tadpole. (The same approach would be used to create Dolly the sheep in 1996.)
The frog experiment was an effort to answer a pure scientific question about how we came to be formed. There was no foreseeable therapeutic benefit.
Dr. Yamanaka, 50, was born in the year Dr. Gurdon did his frog experiment. Dr. Yamanaka would eventually ponder a related question: Could the Gurdon reprogramming trick be done without using eggs—which, in human cases, can be hard to come by?
Dr. Yamanaka had the answer a few years later. He demonstrated that by adding just four genes to a mature cell, he could turn it into an embryonic-like state. He first achieved this with mouse cells, and in 2007 he reported the same result for human cells. He transformed those cells, in turn, into heart, nerve and other human tissue in a lab.
Dr. Yamanak commented that without [Dr. Gurdon's] work they would never have started this risky project 12 years ago.
Since Dr. Yamanaka's breakthrough, many labs have altered how they do stem-cell research. Some years ago, Ian Wilmut, the scientist who created Dolly the sheep, abandoned a cloning-based approach in favor of the Yamanaka method. Last week, Japanese scientists said they used the Yamanaka technique to make mouse eggs.
Tomatoes Lower Risk of Stroke
Study shows that you could lower the chance of a stroke by eating tomatoes. A new study shows that men who had the highest levels of lycopene—an antioxidant found in tomatoes—had fewer strokes than men who had the lowest level of lycopene in their blood. Overall, the risk of strokes was reduced by 55%.
Story first appeared on wsj.com.
The study, based in Finland, will be published in the Oct. 9 issue of the medical journal Neurology. Lycopene is found in the highest concentrations in cooked tomato products like paste, puree and sauce, according to the United States Department of Agriculture's national nutrient database.
A cup of ready-to-serve marinara sauce has more than 31,000 micrograms of lycopene while the average raw tomato has about 3,165 micrograms, according to USDA. A slice of fast food pizza has 2,074 micrograms of lycopene. A tablespoon of catsup has 2,146 micrograms of lycopene.
Lycopene is also found in watermelon, grapefruit, papaya and mango.
There are no government recommendations specific to lycopene consumption, but U.S. dietary guidelines have traditionally recommended Americans consume at least five to nine servings of fruits and vegetables per day. In 2010, the U.S. updated its dietary guidelines, stating Americans should "increase" fruit and vegetable intake, noting that at least 2½ cups of fruits and vegetables per day was associated with a reduced risk of heart attacks and strokes. There have also been some studies that suggest lycopene can cut the risk of prostate and other types of cancer.
Dr. Rafael Ortiz, director of the Center for Stroke and Neuro-Endovascular Surgery at Lenox Hill Hospital in New York, who wasn't involved in the lycopene study, said it shows diet is very important for cutting stroke risk along with exercising and not smoking. He said lycopene reduces inflammation and prevents blood clots from forming.
The Finnish study involved 1,031 men who were part of a larger study looking at risk factors for the development of cardiovascular disease.
The men were between ages 42 and 61 and living in and around the city of Kuopio in Eastern Finland when they first enrolled in the study in the early 1990s. Samples of blood were taken at the study's start and seven years later for most men. The men were followed an average of 12 years.
The main goal of the study was to look at whether other substances such as retinol, or vitamin A, and alpha-tocopherol, a type of vitamin E, impacted stroke rates.
They found no association with the levels of vitamin A or E, but instead found men who had the highest level of lycopene in their bodies were 55% less likely to have a stroke than men with the lowest amount of lyocopene. They were 59% less likely to have a type of stroke called an ischemic stroke, the most common type of stroke that is caused by a blood clot.
Overall, there were 67 strokes among the 1,031 men in the study. Of those, 50 were ischemic. There were 25 strokes among 258 men who were considered to have the lowest levels of lycopene while there were 11 strokes among men with the highest lycopene levels. The men were divided into four groups by lycopene levels.
08 October 2012
Four People Have Died And Twenty-Two More People Are Sick From Rare Meningitis Outbreak In The US
original article appeared in AP News
After sickening 26 people across five states, an outbreak of a rare from of meningitis is expected to grow. Four out of those 26 people have already died, according to health officials.
All received steroid injections, mostly for back pain, a fairly typical treatment. The drug was made by a specialty pharmacy in Massachusetts that issued a recall last week and has shut down operations.
The type of meningitis involved is not contagious like the more common forms. This type is caused by a fungus often found in leaf mold and which health officials suspect may have been in the steroid.
Eighteen of the cases are in Tennessee, where a Nashville clinic received the largest shipment of the steroid. Investigators, though, say they are still trying to confirm the source of the infection.
Three cases have been reported in Virginia, two in Maryland, two in Florida and one in North Carolina. Two of the deaths were in Tennessee, and Virginia and Maryland had one each, said officials at the Centers for Disease Control and Prevention.
More new cases are almost certain to appear in the coming days, said Tennessee Department of Health Commissioner John Dreyzehner. Five new cases were confirmed over the past 24 hours, he said Wednesday.
But federal health officials weren't clear about whether new infections are occurring. They are looking for - and increasingly finding - illnesses that occurred in the past two or three months.
Meningitis is an inflammation of the lining of the brain and spinal cord. Symptoms include severe and worsening headache, nausea, dizziness and fever. Some of the patients also experienced slurred speech, and difficulty walking and urinating, Tennessee health officials said.
The incubation period is estimated at anywhere from two to 28 days, so some people may not have fallen ill yet, Tennessee health officials said. At three clinics in Tennessee, officials are contacting the more than 900 people who received the steroid in the past three months.
Investigators also have been looking into the antiseptic and anesthetic used during the injections. Neither has been ruled out. However, the primary suspicion is on the steroid medication. Steroid shots are common for back pain, often given together with an anesthetic.
The Food and Drug Administration identified the maker of the steroid as New England Compounding Center, a specialty pharmacy in Framingham, Mass. Last week, the company issued a recall of three lots of the steroid - methylprednisolone acetate. In a statement, the company said it had voluntarily suspended operations and was working with regulators to identify the source of the infection.
Compounding pharmacies mix ingredients for customized medicines that generally aren't commercially available. They are regulated by states.
The outbreak was discovered about two weeks ago when Vanderbilt University's Dr. April Pettit was treating a patient who was not doing well for reasons doctors did not understand.
When the lab found the fungus in the patient's spinal fluid, Pettit began asking questions and learned the patient recently had steroid injections in his spine, according to Dr. William Schaffner, who chairs Vanderbilt's Department of Preventive Medicine.
Federal officials did not release condition reports or details on all the patients in the five states. Fungal meningitis is treated with high-dose antifungal medications, usually given intravenously in a hospital.
Seventeen of the Tennessee cases were treated at the Saint Thomas Outpatient Neurosurgery Center in Nashville. It had 2,000 vials of the suspect lots, the largest number. To deal with the investigation, that clinic voluntarily closed last month.
After sickening 26 people across five states, an outbreak of a rare from of meningitis is expected to grow. Four out of those 26 people have already died, according to health officials.
All received steroid injections, mostly for back pain, a fairly typical treatment. The drug was made by a specialty pharmacy in Massachusetts that issued a recall last week and has shut down operations.
The type of meningitis involved is not contagious like the more common forms. This type is caused by a fungus often found in leaf mold and which health officials suspect may have been in the steroid.
Eighteen of the cases are in Tennessee, where a Nashville clinic received the largest shipment of the steroid. Investigators, though, say they are still trying to confirm the source of the infection.
Three cases have been reported in Virginia, two in Maryland, two in Florida and one in North Carolina. Two of the deaths were in Tennessee, and Virginia and Maryland had one each, said officials at the Centers for Disease Control and Prevention.
More new cases are almost certain to appear in the coming days, said Tennessee Department of Health Commissioner John Dreyzehner. Five new cases were confirmed over the past 24 hours, he said Wednesday.
But federal health officials weren't clear about whether new infections are occurring. They are looking for - and increasingly finding - illnesses that occurred in the past two or three months.
Meningitis is an inflammation of the lining of the brain and spinal cord. Symptoms include severe and worsening headache, nausea, dizziness and fever. Some of the patients also experienced slurred speech, and difficulty walking and urinating, Tennessee health officials said.
The incubation period is estimated at anywhere from two to 28 days, so some people may not have fallen ill yet, Tennessee health officials said. At three clinics in Tennessee, officials are contacting the more than 900 people who received the steroid in the past three months.
Investigators also have been looking into the antiseptic and anesthetic used during the injections. Neither has been ruled out. However, the primary suspicion is on the steroid medication. Steroid shots are common for back pain, often given together with an anesthetic.
The Food and Drug Administration identified the maker of the steroid as New England Compounding Center, a specialty pharmacy in Framingham, Mass. Last week, the company issued a recall of three lots of the steroid - methylprednisolone acetate. In a statement, the company said it had voluntarily suspended operations and was working with regulators to identify the source of the infection.
Compounding pharmacies mix ingredients for customized medicines that generally aren't commercially available. They are regulated by states.
The outbreak was discovered about two weeks ago when Vanderbilt University's Dr. April Pettit was treating a patient who was not doing well for reasons doctors did not understand.
When the lab found the fungus in the patient's spinal fluid, Pettit began asking questions and learned the patient recently had steroid injections in his spine, according to Dr. William Schaffner, who chairs Vanderbilt's Department of Preventive Medicine.
Federal officials did not release condition reports or details on all the patients in the five states. Fungal meningitis is treated with high-dose antifungal medications, usually given intravenously in a hospital.
Seventeen of the Tennessee cases were treated at the Saint Thomas Outpatient Neurosurgery Center in Nashville. It had 2,000 vials of the suspect lots, the largest number. To deal with the investigation, that clinic voluntarily closed last month.
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