Seniors who neglect themselves, risking their own health and safety, tend to be individuals with limited social networks and little social engagement, according to a study by Rush University Medical Center.

The study, currently appearing online in the medical journal Gerontology, is the largest epidemiological study to date examining a wide range of sociodemographic, health-related and psychosocial characteristics associated with elder self-neglect.

“We need to better understand elder self-neglect who is at risk and why so that we can find solutions and establish appropriate policies,” said Dr. Xinqi Dong, a researcher and geriatrician at Rush University Medical Center and the study’s lead author. “This is particularly important because reports of self-neglect to social service agencies are rising.

“Moreover, as our aging population is rapidly increasing in size, elder self-neglect will likely become an even more pervasive public health issue.”

The study was based on records drawn from the Chicago Health and Aging Project, a longitudinal epidemiological study of a community-dwelling population of 9,056 individuals 65 years of age and older who live in three communities on Chicago’s South side.

Over the 12-year course of this population-based study, 1,812 of these seniors, or 20 percent, were reported to the Chicago Department of Aging because of concern about suspected self-neglect.

Elder self-neglect is defined by the National Centers on Elder Abuse as “the behavior of an elderly person that threatens his/her own health and safety.” It generally manifests as “a refusal or failure by the person to provide himself/herself with adequate food, water, clothing, shelter, personal hygiene, medication and safety precautions.”

Twice as many women as men and more than seven times the number of African Americans as whites were reported for self-neglect. Those reported, compared with those not reported, tended to be over the age of 80 and have a lower socioeconomic status. The individuals also tended to have nutritional deficiencies, medical conditions and cognitive, physical and psychological deficits.

However, independent of all these factors, lower levels of social well-being specifically, limited social networks and little social engagement were major risk factors for self-neglect.

The study has important implications for health and social service professionals, Dong said.

“Professionals who work with the elderly need to be mindful not just of their patients’ health profile, but also of their social well-being, a factor that may put them at risk of self-neglect,” Dong said. “With social services being cut, and community and city resources lacking to help seniors, the problems of isolation can only grow worse.”

Dong will be testifying before the City Council of Chicago on November 13 in support of a resolution seeking to identify measures to address the problem of elder self-neglect. The resolution has been submitted by Alderman Emma Mitts of the 37th Ward and is supported by 29 other Chicago aldermen.

Other researchers involved in the study were Dr. Denis Evans at Rush and Dr. Melissa Simon at Northwestern University.

The study was supported by the National Institute on Aging, a Paul B. Beeson Career Development Award in Aging, The Starr Foundation, the John A. Hartford Foundation and The Atlantic Philanthropies.

Rush University Medical Center includes a 674-bed (staffed) hospital; the Johnston R. Bowman Health Center; and Rush University (Rush Medical College, College of Nursing, College of Health Sciences and the Graduate College).

Rush is currently constructing a 14-floor, 806,000-square-foot hospital building at the corner of Ashland Avenue and Congress Parkway. The new hospital, scheduled to open in 2012, is the centerpiece of a $1-billion, 10-year campus redevelopment plan called the Rush Transformation, which also includes a new orthopedics building (to open in Fall 2009), a new parking garage and central power plant completed in June 2009, renovations of selected existing buildings and demolition of obsolete buildings. The new hospital is being designed and built to conserve energy and water, reduce waste and use sustainable building materials. Rush is seeking Leadership in Energy and Environmental Design (LEED) gold certification from the U.S. Green Building Council. It will be the first full-service “green” hospital in Chicago.

Rush’s mission is to provide the best possible care for our patients. Educating tomorrow’s health care professional, researching new and more advanced treatment options, transforming our facilities and investing in new technologies all are undertaken with the drive to improve patient care now, and for the future.

Source: Rush University Medical Center

Professor Fiona Watt gave the Anne McLaren Memorial Lecture at the UK National Stem Cell Network annual science meeting and detailed a new approach to screening for drugs that target stem cells. To begin with, this is being developed for adult skin stem cells, giving hope for new drugs to promote wound healing and aid the use of stem cells to, for example, treat severe burns. This technique can also be applied to a wide range of stem cells, opening up the possibilities for harnessing stem cells in regenerative medicine.

Professor Watt said “We are very interested in developing regenerative medicine as a way to heal our bodies when they can’t heal themselves – when the damage from an injury or disease is too severe, for example. For this type of approach to be successful it is important to have powerful ways of identifying the processes that stimulate stem cells to renew themselves or mature into the cells that are needed for healing. When we know what these processes are, we can use that knowledge to develop new treatments.

“An important part of developing new drug treatments in any field of medicine is being able to do early tests to see if the drug is likely to work. In regenerative medicine we are often looking for ways to test a drug to see if it has the desired effect on stem cells. What we’ve developed is a technique that allows us to examine individual stem cells in such a way as we can learn about their biology and also screen new drugs for their potential to encourage stem cells to repair damaged tissues.”

Professor Watt presenedt research funded by Cancer Research UK, the Medical Research Council and the Wellcome Trust that was published recently in Nature Cell Biology. This work has demonstrated how single stem cells can be encouraged to grow on finely-patterned surfaces in order to identify the biological messages that control their ability to divide and mature into any type of cell. Using this approach, Professor Watt’s team at the Wellcome Trust Centre for Stem Cell Research, University of Cambridge, are uncovering the biology of adult skin stem cells. The methodology can also be applied to stem cells from a wide range of embryonic and adult stem cells.

Professor Watt concluded “In living tissues stem cells receive so many different messages from around the body that it is hard to identify which ones are most important. Our new technique involves studying a single cell in isolation, and that really helps us to identify the messages that ultimately drive the stem cell to divide or mature. And, crucially, it also gives us a powerful way of screening drugs that encourage stem cells to repair damaged tissue”

Source:
Nancy Mendoza
Biotechnology and Biological Sciences Research Council

The U.S. Food and Drug
Administration (FDA) has approved DORIBAX(TM) (doripenem for injection) as
a new treatment for complicated intra-abdominal and complicated urinary
tract infections, including pyelonephritis. DORIBAX has demonstrated
activity against a wide range of Gram-positive(1) and Gram-negative(2)
bacteria — including Pseudomonas — that cause these serious infections.

DORIBAX belongs to a class of antibacterial agents called carbapenems,
which are important for treating serious infections caused by Gram-positive
and Gram-negative bacteria.

The approval of DORIBAX is based on results of clinical trials in
complicated intra-abdominal infections (cIAI) and complicated urinary tract
infections (cUTI). In two multi-center, prospective, randomized,
double-blind studies, DORIBAX was found to be effective and well tolerated
for the treatment of complicated intra-abdominal infections. In another
multi-center, randomized, double-blind study and an additional single-arm,
multi-center study, DORIBAX was found to be effective and well tolerated
for the treatment of complicated urinary tract infections.

DORIBAX was effective against major organisms that cause cIAI and cUTI,
including E. coli, B. fragilis, viridans group streptococci, Proteus
species, K. pneumoniae and Pseudomonas aeruginosa.

Pseudomonas aeruginosa, a Gram-negative bacterium with increasing
multi-drug resistance, is one of the leading causes of hospital-acquired
(nosocomial) infections. In general, there are few antibiotics available or
in development to treat these life-threatening Gram-negative infections.

“New agents are urgently needed to effectively treat Gram-negative and
Gram-positive bacterial infections,” said Joseph Solomkin, M.D., Professor
of Surgery and Director of Research, University of Cincinnati College of
Medicine. “The introduction of DORIBAX is important for the treatment of
these serious infections as fewer antibiotics appear to effectively
eradicate many troublesome bacteria, such as Pseudomonas.”

Approximately two million intra-abdominal procedures are performed in
the U.S. each year. Complicated intra-abdominal infections are infections
that extend beyond the hollow cavity of the abdomen into the peritoneal
space and are a common cause of hospitalization following these procedures.

Urinary tract infections (UTIs) account for at least 40% of all
hospital infections. Although many cases of UTI are uncomplicated, a
significant proportion of UTIs are classified as complicated because of
anatomical abnormalities in the urinary tract, which make clearance of
bacteria more difficult, or cause kidney infection (pyelonephritis).
Complicated UTIs can be caused by a broad range of bacteria, many of which
are resistant to multiple antibiotics.

DORIBAX will be marketed to U.S. hospitals and other healthcare
institutions by Ortho-McNeil, Inc. through its Institutional Franchise. The
use of doripenem in the treatment of hospital-acquired (nosocomial)
pneumonia, including ventilator-associated pneumonia, is under regulatory
review in the U.S., and the use of doripenem for complicated
intra-abdominal infections, complicated urinary tract infections and
nosocomial pneumonia, including ventilator-associated pneumonia, is under
regulatory review in Europe. Doripenem is licensed from Shionogi & Co.,
Ltd., which launched the product in Japan in September 2005 under the name,
FINIBAX.

INDICATIONS

DORIBAX is indicated as a single agent for the treatment of:
complicated intra-abdominal infections caused by susceptible strains of E.
coli, K. pneumoniae, P. aeruginosa, B. caccae, B. fragilis, B.
thetaiotaomicron, B. uniformis, B. vulgatus, S. intermedius, S.
constellatus or P. micros and for the treatment of complicated urinary
tract infections, including pyelonephritis, caused by susceptible strains
of E. coli, including cases with concurrent bacteremia, K. pneumoniae, P.
mirabilis, P. aeruginosa, or A. baumannii.

To reduce the development of drug-resistant bacteria and maintain the
effectiveness of DORIBAX and other antibacterial drugs, DORIBAX should be
used only to treat infections that are proven or strongly suspected to be
caused by susceptible bacteria. When culture and susceptibility information
are available, they should be considered in selecting and modifying
antibacterial therapy. In the absence of such data, local epidemiology and
susceptibility patterns may contribute to the empiric selection of therapy.

IMPORTANT SAFETY INFORMATION

DORIBAX is contraindicated in patients with known serious
hypersensitivity to doripenem or other carbapenems or in patients who have
demonstrated anaphylactic reactions to beta-lactams.

Serious and occasionally fatal hypersensitivity (anaphylactic) and
serious skin reactions have been reported in patients receiving beta-lactam
antibiotics. These reactions are more likely to occur in individuals with a
history of sensitivity to multiple allergens. If an allergic reaction to
DORIBAX occurs, discontinue the drug. Serious acute anaphylactic reactions
require emergency treatment with epinephrine and other emergency measures,
including oxygen, IV fluids, IV antihistamines, corticosteroids, pressor
amines and airway management, as clinically indicated.

Carbapenems may reduce serum valproic acid concentrations to
subtherapeutic levels, resulting in loss of seizure control. Serum valproic
acid concentrations should be monitored frequently after initiating
carbapenem therapy. Alternative antibacterial or anticonvulsant therapy
should be considered if serum valproic acid concentrations cannot be
maintained in the therapeutic range or seizures occur.

Clostridium difficile-associated diarrhea (CDAD) has been reported with
use of nearly all antibacterial agents and may range in severity from mild
diarrhea to fatal colitis. CDAD must be considered in all patients who
present with diarrhea following antibiotic use. Careful medical history is
necessary since CDAD has been reported to occur over two months after
administration of antibacterial agents. If CDAD is suspected or confirmed,
ongoing antibiotic use not directed against C. difficile may need to be
discontinued.

When doripenem has been used investigationally via inhalation,
pneumonitis has occurred. DORIBAX should not be administered by this route.

Safety and effectiveness in pediatric patients have not been
established.

The most common adverse reactions (greater than or equal to 5%)
observed in clinical trials were headache, nausea, diarrhea, rash and
phlebitis.

Ortho-McNeil, Inc.

Ortho-McNeil, Inc., is committed to providing innovative, high-quality
prescription medicines, education and resources for patients, healthcare
providers, and other members of the healthcare community in primary care,
specialty and hospital settings. Headquartered in Raritan, N.J., the
company markets products for infectious diseases, gastrointestinal
disorders, pain management, women’s healthcare and urology. For more
information, visit ortho-mcneil.

[This press release contains "forward-looking statements" as defined in
the Private Securities Litigation Reform Act of 1995. These statements are
based on current expectations of future events. If underlying assumptions
prove inaccurate or unknown risks or uncertainties materialize, actual
results could vary materially from the Company's expectations and
projections. Risks and uncertainties include general industry conditions
and competition; economic conditions, such as interest rate and currency
exchange rate fluctuations; technological advances and patents attained by
competitors; challenges inherent in new product development, including
obtaining regulatory approvals; domestic and foreign health care reforms
and governmental laws and regulations; and trends toward health care cost
containment. A further list and description of these risks, uncertainties
and other factors can be found in Exhibit 99 of Johnson & Johnson's Annual
Report on Form 10-K for the fiscal year ended December 31, 2006. Copies of
this Form 10-K, as well as subsequent filings, are available online at
sec or on request from Johnson & Johnson. The Company does not
undertake to update any forward-looking statements as a result of new
information or future events or developments.]

For more information on Johnson & Johnson, please visit jnj.

References

(1) Gram-negative indicates a group of bacteria that become red when the
bacterial cells are treated using the Gram stain method. This response
is based on the chemical and physical properties of their cell walls
and is used to identify the type of bacteria. Some Gram-negative
bacteria may cause serious infections.

(2) Gram-positive indicates a group of bacteria that become blue when the
bacterial cells are treated with the Gram stain. This response is
based on the chemical and physical properties of their cell walls and
is used to identify the type of bacteria. Some Gram-positive bacteria
may cause serious infections.

Ortho-McNeil, Inc.
ortho-mcneil

View drug information on Doribax.

A common herbal extract available in health food stores can greatly reduce urinary tract infections and could potentially enhance the ability of antibiotics to kill the bacteria that cause 90 percent of infections in the bladder.

Researchers at Duke University Medical Center, in a series of experiments in mice, believe they have also discovered why many urinary tract infections in the bladder return even after treatment with antibiotics. They found that some bacteria hide in cells lining the bladder, where they cannot be reached by antibiotics. But they also found that forskolin, an extract from the Indian coleus plant, flushes out hiding colonies of bacteria, making them susceptible to antibiotic treatment.

About 90 percent of urinary tract infections in the bladder are caused by E. coli bacteria. These infections afflict women four times as often as men, and in a large number of cases, the infection returns within weeks of antibiotic treatment.

The research was led by Duke microbiologist Soman Abraham, Ph.D., who published the results online April 8, 2007, in the journal Nature Medicine. The research was supported by the National Institutes of Health.

The lining of the bladder is a highly impenetrable surface, Abraham said. Special pouchlike structures within the lining enable the bladder to stretch as it fills with urine. However, when infected, the pouches can create tiny niches that some opportunistic E. coli can slip into and hide.

“After customary antibiotic treatment, the vast majority of the bacteria are either killed by the antibiotics or eliminated during urination,” Abraham said. “However, there are small numbers of bacteria that survive antibiotic treatment because they sneak into the lining of the bladder, waiting for the opportunity, after antibiotic treatment, to come out and start multiplying again.”

The researchers found that forskalin has the ability to force the bacteria out of their niches and into the urine, where they can be killed by antibiotics.

Abraham said that forskalin’s action makes intuitive sense, since the herb is known to rev up certain cellular activity. This heightened activity in the bladder causes the specialized pouches to “flush out” their contents — in this case, the hiding E. coli.

“This herb has been used in Asia for centuries for a wide variety of ailments,” Abraham said. “However, one of its constant uses has been for treating painful urination.”

Today, forskalin is added to bodybuilding products and marketed for its ability to increase lean body and bone mass, as well as to increase testosterone levels. The herb also has been claimed to be an effective weight-loss aid. Herbal extracts such as forskalin are not tested nor regulated by the Food and Drug Administration. Abraham recommends that anyone with a urinary tract infection should contact their physician before trying forskalin.

In the latest experiments, the researchers injected forskalin directly into the bladder or administered it intravenously. The herb appeared to expel more than 75 percent of the hiding E. coli. The researchers next will determine whether or not the herb is effective when mice receive it orally, since that is how it would be used in humans. The experiments also will combine the use of forskalin and antibiotics.

“This type of treatment strategy may prove to be beneficial for patients with recurrent urinary tract infections,” Abraham said. “Ideally, use of this herb would expel the bacteria, where it would then be hit with antibiotics. With the reservoir of hiding bacteria cleared out, the infection should not recur.”

Abraham said that a new and effective approach for treating urinary tract infections is needed, because constant antibiotic use has many drawbacks, including high expense, possible liver and kidney damage and the potential for creating strains of antibiotic-resistant bacteria.

###

Other Duke members of the team were Brian Bishop, Mather Duncan, Jeongmin Song, Guojie Li and David Zaas.

Contact: Richard Merritt
Duke University Medical Center

Overweight aged male mice whose high calorie (fat) diet was supplemented by resveratrol, a natural compound found in common foods like grapes, wines and nuts, had better health and survival than aged overweight mice who did not receive it, according to a study published online in the Nov. 1 issue of Nature. The study was conducted and supported in part by the National Institute on Aging (NIA) of the National Institutes of Health (NIH).

The findings are the first to demonstrate that resveratrol, an activator of a family of enzymes called sirtuins, could affect the health and survival of mammals. The findings build upon previous research on resveratrol, a small molecule produced by certain plants in response to stress. Studies over the last few years have found that resveratrol can extend lifespan in yeast, worms, flies and fish.

The study was a collaborative effort between the laboratories of Rafael de Cabo, Ph.D., at the NIA, David A. Sinclair, Ph.D., at Harvard Medical School and an international group of researchers.

“There is currently intense interest in identifying interventions that can be applied to improve health and survival, especially as our society ages. Today’s basic science findings are a notable step in this effort,” notes Richard J. Hodes, M.D., director of the NIA. “At the same time, it should be cautioned that this is a study of male mice, and we still have much to learn about resveratrol’s safety and effectiveness in humans.”

The report describes the result of studies of year-old (middle-aged) mice placed on three different diets for six months: a standard mouse diet, a high calorie (fat) diet and a high calorie (fat) diet supplemented with resveratrol. After six months, the scientists observed a clear trend toward increased survival and insulin sensitivity (important for the body’s efficient processing of glucose into energy) in the high calorie diet supplemented with resveratrol relative to that seen on the high fat diet without resveratrol supplementation. In the study, resveratrol shifted the physiology of middle-aged mice on a high calorie diet towards that of mice on a standard diet and increased their survival.

The scientists reported that:

* At 60 weeks of age, the survival curves of the high calorie and the high calorie/resveratrol groups began to diverge, when the resveratrol group began to show a 3-4 month advantage in survival. As the mice aged, the trend continued.

*
At 114 weeks, when the mice reached old age, more than half of the high calorie mice died compared to less than a third of the high calorie mice receiving resveratrol. The overweight resveratrol-treated aged mice were healthier than the overweight mice that were not given resveratrol on a number of measures. For example, the untreated high calorie mice had increased plasma levels of insulin, glucose and insulin-like growth factor (IGF) 1 — markers that in humans predict the onset of diabetes — when compared with their overweight counterparts who did receive resveratrol.

* Some of the health-related findings were most evident in the liver of the high calorie mice. At 18 months of age (six months into the study), the livers of the high calorie, untreated mice were twice the size and weight of those of the high calorie/resveratrol animals, whose livers were comparable to the mice on standard diets. The livers of the high calorie, resveratrol-treated mice were more normal on a cellular level as well. They had considerably more mitochondria (cell structures that metabolize glucose and other sugars) than those of the untreated high calorie group and resembled the levels of mice on the standard diet.

*
Gene expression analysis in livers of these aged and overweight mice indicated that resveratrol modified some of the known metabolic pathways that are also affected by caloric restriction. Pathways are a series of chemical reactions that take place in living tissue.

*
A test of motor function determined the effect of resveratrol on physical performance with age. Tests on a rotating device to measure balance and motor coordination showed that the resveratrol-fed overweight mice maintained their performance on one laboratory measure of motor skills.

“After six months, resveratrol essentially prevented most of the negative effects of the high calorie diet,” de Cabo concludes. “There is a lot of work ahead that will help us better understand resveratrol’s roles and the best applications for it.”

De Cabo and Sinclair did not observe toxic effects of resveratrol on the mice at the doses studied. However, de Cabo emphasized, the safety and effectiveness of the substance for humans to address aging and age- or obesity-related conditions is far from demonstrated. Some contraindications are already known, including evidence from earlier animal studies that have shown high doses of resveratrol to affect blood platelets, which could increase the risk of bleeding when taken with anticoagulant, anti-platelet or nonsteroidal anti-inflammatory drugs.

###

In addition to scientists from the NIA and Harvard Medical School, researchers from the following institutions collaborated in this study: Pennington Biomedical Research Center in Baton Rouge, La., Harvard Medical School in Boston, Mass., the University of Sydney in Australia, Johns Hopkins University in Baltimore, Md., Universidad Pablo de Olavide in Sevilla, Spain, the Salk Institute in La Jolla, Calif., and Sirtris Pharmaceuticals of Cambridge, Mass., which is developing therapeutics to modulate sirtuins. Sirtris Pharmaceuticals was founded by Harvard University co-lead author David A. Sinclair.

De Cabo is a scientist in the NIA’s Intramural Research Program. In addition, the work was funded by grants from the NIA, the primary supporter of the work, as well as grants from the National Institute of General Medical Sciences and the National Institute of Diabetes and Digestive and Kidney Diseases at the NIH. The Ellison Medical Research Foundation, the American Heart Foundation, the Australian and Spanish governments, the American Diabetes Association and Paul F. Glenn and The Paul F. Glenn Laboratories for the Biological Mechanisms of Aging also provided support to members of the research team.

The NIA leads the federal effort supporting and conducting research on aging and the medical, social and behavioral issues of older people. For more information on research and aging, go to nia.nih/. Publications on research and on a variety of topics of interest on health and aging can be viewed and ordered by visiting the NIA Web site.

The NIH — the nation’s medical research agency — includes 27 institutes and centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments and cures for both common and rare diseases. For more information about NIH and its programs, visit nih/.

Reference: Baur, J., Pearson, K et al. Resveratrol improves health and increases survival of mice on a high-calorie diet Nature 2006. DOI 10.1038/nature05354

Contact: Jeannine Mjoseth

NIH/National Institute on Aging

Children of smokers who don’t show any signs of respiratory problems may still be experiencing damaging changes in their airways that could lead to lung disease later in life, according to a new study presented at the American Thoracic Society 2007 International Conference, on Sunday, May 20.

“Everyone knows that children of smokers have more respiratory problems-more puffing, wheezing, cases of pneumonia-but until now we haven’t known if lung function is impaired in children of smokers who don’t have any respiratory complaints or diagnosed lung problems,” says researcher Bert Arets, M.D., Ph.D., of University Medical Center Utrecht in the Netherlands.

The study included 244 children ages 4 to 12 without any history of lung or airway disease. They were divided into four groups according to the smoking pattern of their parents: never smokers, smoking after birth but not during pregnancy, during pregnancy but not after birth, and both before and after birth.

The researchers found that children of smoking parents had significantly reduced lung function similar to that seen in smokers. Smoking after birth appeared to be more harmful than smoking during pregnancy alone. The researchers have now expanded their study to include 2,000 healthy children of smokers.

Dr. Arets speculated that in the future, the growing number of smoking bans in public places might cause parents to smoke more in their own homes, thereby increasing the harm to the developing lungs of children. “We may see an increase in diminished lung function in children of smokers because of this trend,” he said.

– “Healthy Children with Smoking Parents? Are They Really Healthy?”(Session A105; Abstract # 309; Poster Board # 901) To read this abstract in full, click here.

American Thoracic Society
61 Broadway, 4th Floor
New York, NY 10006-2755
thoracic

1. Excess Risk for Death Following Hip Fracture Persists Over Time, Especially for Men

While almost all studies report an increased risk for death in the first three to six months following hip fracture, it is unclear whether this risk continues over the longer-term. Researchers identified and reviewed studies that followed people after hip fracture and compared their survival to that of age- and sex-matched control groups. The researchers found 22 studies that included 578,436 women and 17 studies that included 154,276 men with hip fracture. Their analysis found a five- to eight-fold increased risk for death during the first three months after hip fracture. While this excess mortality decreases significantly during the first two years, it does not return to the mortality rate seen in the control participants even after 10 years of follow-up. At any given age, excess mortality after hip fracture is higher in men than in women.

2. Empirical Study Explores Concerns About The Ethics of Payment to Live Kidney Donors

People who need kidney transplants outnumber available kidneys and many patients become sicker or die before a kidney is available. Paying donors might increase the number of available kidneys, but payment could result in the following ethical problems: 1) payment could dull a person’s sensitivity to the risks of donation; 2) poor or disadvantaged persons may be more enticed to donate than more economically advantaged people; and 3) payment could dissuade donation for altruistic reasons. Researchers surveyed 409 persons riding the regional rail and urban trolley lines in Philadelphia to determine whether payment for kidney donation might lead to these problems. Responses suggested that payment would not create undue or unjust incentives for donation or alter a person’s willingness to donate altruistically. However, the authors of a related editorial argue that empirical research should be examined with caution. For example, even though the study authors found no association between change of price and change of willingness to donate across income level, at any given price, lower income respondents were almost twice as likely to give in to the inducements. “We must scrutinize conclusions for their soundness, and we must be vigilant that we do not inadvertently use empirical findings to justify practices that are morally objectionable,” the editorialist writes.

3. Salsalate May Help Type 2 Diabetics Control Blood Glucose Levels

In small studies, salsalate has been shown to reduce blood glucose concentration. Researchers conducted a study to compare the efficacy and safety of salsalate at different doses in patients with type 2 diabetes. Participants aged 18 to 75 were randomly assigned to receive placebo or salsalate in dosages of 3.0, 3.5, or 4.0 g/d (27 patients each) in addition to their regular therapy. After 14 weeks, patients receiving all doses of salsalate had lower HbA1c levels and improvements in other markers of glycemic control. However, due to the small study size and short duration, researchers conclude that additional research is needed to determine if salsalate may provide a new avenue for treatment for patients with type 2 diabetes.

4. Pay for Performance Compatible with Medical Professionalism, Finds ACP

Some experts have proposed a Pay for Performance (P4P) approach to improving the quality of health care in the United States. However, some argue that this method is at odds with medical professionalism. The American College of Physicians (ACP) convened an expert panel in clinical medicine, law, management, and health policy at six in-person meetings to discuss the relationship between medical professionalism and P4P incentive programs. The advisory board used the Medical Professionalism Charter as the framework for the analysis. The panel systematically considered the interaction between P4P and the following Charter themes – application of scientific evidence, ethical interaction, achieving equity, and commitment to professionalism. They concluded that properly designed P4P models can strengthen the relationship between the physician and the patient and increase the likelihood that all physicians will deliver the best possible care to every patient.

Source:
Angela Collom

American College of Physicians

Recent studies have linked sleep loss and sleep disorders to health problems such as depression, obesity, diabetes, high blood pressure and stroke. The latest findings in sleep research will be presented and discussed by more than 6,500 scientists and sleep specialists when the SLEEP 2009 23rd Annual Meeting of the Associated Professional Sleep Societies convenes at the Washington State Convention and Trade Center in Seattle, Wash. from June 8 to 11.

More than 1,300 research abstracts will be presented at SLEEP 2009. The scientific program also includes symposia, clinical workshops, and discussion groups on topics ranging from neuroscience and genetics to dreams, sleep deprivation and aging. Clinical sleep specialists will discuss current practices in the diagnosis and treatment of sleep disorders such as insomnia, narcolepsy, and sleep apnea.

During the plenary session on Monday morning, June 8, Howard P. Roffwarg, MD, will deliver the keynote address on “Participation of REM Sleep in the Development of the Brain: Starting Hypothesis, Unfolding Data, Current Perspective.”

After the plenary session the exhibit hall will open, featuring booth displays from more than 125 pharmaceutical companies, equipment manufacturers, medical publishers, software companies, professional organizations and schools.

The Associated Professional Sleep Societies LLC is a partnership of the American Academy of Sleep Medicine and the Sleep Research Society. In addition to organizing SLEEP 2009, the APSS also publishes SLEEP, a monthly peer-reviewed scientific journal.

SLEEP 2009 Highlights

Dates:
Monday, June 8, to Thursday, June 11

Location:
Washington State Convention and Trade Center, 800 Convention Place

Attendees:
More than 6,500 sleep scientists, sleep specialists, allied health professionals and students

Scientific Program:
More than 1,300 abstract presentations and 78 open sessions

Exhibit Hall:
More than 150 exhibits from industry leaders in pharmaceuticals, medical equipment, publications and software

Plenary Session:

Monday, June 8, from 8 a.m. to 10 a.m.

Keynote Address:


“Participation of REM Sleep in the Development of the Brain: Starting Hypothesis, Unfolding Data, Current Perspective” by Dr. Howard P. Roffwarg, professor of psychiatry and human behavior and director of the Departmental Division of Sleep Medicine at the University of Mississippi Medical Center.

Source:
Kelly Wagner

American Academy of Sleep Medicine

Expression of a toxic RNA that leads to Fragile X Tremor Ataxia Syndrome is modifiable by genetic or pharmacologic means, according to new research from U-M Medical School scientists.

In the study published online today in the journal Public Library Of Science Genetics, U-M’s Peter K. Todd, M.D., Ph.D., led a team of researchers who examined the expression of a toxic messenger RNA (mRNA) seen in the brains of those afflicted with the syndrome.

Fragile X Tremor Ataxia Syndrome (FXTAS) is usually found in older adults, who often have grandchildren afflicted with Fragile X. Those affected with the adult form of the syndrome have slow gait, tremors, dementia and balance problems. The symptoms are caused by overproduction of a toxic mRNA in the brain that causes neurodegeneration.

“We found that the expression of this toxic mRNA is dynamic and modifiable,” says Todd, who is an assistant professor in U-M’s Department of Neurology. “There is a potential for modifying the increased production of the toxic RNA with drugs that inhibit histone acetylation.”

FXTAS is an under-diagnosed syndrome that was only discovered about 10 years ago, when researchers discovered the grandfathers of children with Fragile X were displaying common symptoms. It is one of three known Fragile X disorders that result from changes in the Fragile X gene. The altered gene can be passed down through generations, affecting both genders at different stages in life.

About 1 in 3,000 men and about 1 in 5,200 women in the general population will develop symptoms of FXTAS, according to the National Fragile X Foundation. Current estimates suggest that about 30-40 percent of male Fragile X gene carriers over 50 years of age, within families already known to have someone with a Fragile X-associated disorder, will ultimately exhibit some features of FXTAS.

Fragile X is the most common cause of developmental delay in boys and is the most common known single gene cause of autism.

Using both fruit fly models and human cells, the U-M researchers found that drugs that inhibit histone acetyltransferases modify the brain changes associated with FXTAS and could provide the pathway to a therapeutic target.

“These drugs that we used are too toxic for use in patients but the important finding is that we have a better idea of what’s driving this syndrome and proof of principle that those brain changes can be modified,” says Todd.

“Our findings underscore the need for developing more specific modifiers of expression at the Fragile X gene, with the long-term goal of developing preventive therapy for FXTAS patients,” says Todd.

Todd stressed the need for more research into neurodegenerative diseases like FXTAS, which can be devastating to families.

“This should be a high priority. Neurodegeneration robs people of their humanity,” Todd says. “To lead a happy and fruitful life, you have to protect the brain.”

Journal reference: PLoS Genetics, 6(12): e1001240.

doi:10.1371/journal.pgen.1001240

Funding: AAN Foundation award, National Institutes of Health, Harris Professorship to Peter K. Todd.

Additional authors: Henry L. Paulson, professor U-M’s Department of Neurology; Seok Yoon Oh and Amy Krans, U-M Department of Neurology; Udai B. Pandey, Louisiana State University Health Sciences Center; Nicholas DiProspero, Johnson & Johnson; Kyung-Tai Min, University of Indiana; J. Paul Taylor, St. Jude’s Children’s Hospital.

Source: University of Michigan Health System

Liverpool Associates in Tropical Health (LATH), a consulting arm of Liverpool School of Tropical Medicine, has been awarded a ВЈ10 million contract to manage a programme of work supporting a new Health Research Capacity Strengthening (HCRS) initiative in Malawi.

Led by the National Research Council of Malawi (NRCM), the initiative is a 5 year programme supported by the Wellcome Trust, the UK Department for International Development (DfiD) and the International Development Research Centre (Canada) and was developed in consultation with the Ministry of Health and the Government of Malawi.

The initiative aims to strengthen the capacity for the generation of new health research knowledge within Malawi and improve its use in evidence-based decision making, policy formulation and implementation. In collaboration with national stakeholders, it aims to:
enhance institutional capacity for high quality multi-disciplinary health research;

promote the use of research in national health policy and programmes;

enhance dissemination of scientific knowledge in Malawi; and

strengthen the regulation and coordination of the research environment in Malawi.

A consortium led by LATH and comprising the Liverpool School of Tropical Medicine, Development Management Associates and Calcon will manage a programme of work in support of the initiative.

The consortium will source and manage expertise to develop the NRCM’s capacity to manage an enhanced and transparent grant-making process, providing management and financial oversight to strengthen NRCM to the point where external support is no longer required.

Malawi Programme Coordinator Margret Caffrey commented: “Developing capacity and providing appropriate support to NRCM and its implementing partners will focus on empowerment and individual and organisational transformation.

“The strengthening and transfer of key management and strategic planning skills will enable NRCM to more effectively coordinate and manage all health research activities in Malawi. Training and development will be aligned with organisational and institutional realities to ensure that skills and learning are effectively transferred and have the intended impact and results.”

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Source: Alan Hughes

Liverpool School of Tropical Medicine