Health Meaning

Panel Approves Limited therapy for menopause -

BETHESDA, MARYLAND - The best scientists in a 3-day consensus conference on the management of symptoms of menopause today concluded that, despite its risks, the short-term estrogen therapy is the best way to mitigate the debilitating problems like hot flashes. But the independent panel of 10 members, convened by the National Institutes of Health (NIH) also said that other problems traditionally attributed to menopause like depression and joint pain were more likely due to aging and should not treated with hormones.

Since it was approved in the US in the 1940s, estrogen and progestin early therapy has been widely used to relieve symptoms of menopause and to prevent many chronic diseases, such as osteoporosis and heart disease. Then, in 02, a study of 16,000 women-named Initiative on Women's Health (WHI) dropped a bombshell: the participants were more likely to suffer heart attacks and breast cancer if they took estrogen and combination progestin. Sales nosedived hormone replacement therapy, and many older women asked themselves how best to meet their symptoms.

A "state-of-the-science" statement issued by the group agrees with a number of professional societies, which, since the discovery WHI recommended that hormone therapy should be used to the lowest possible dose for the shortest time possible. But the panel recommends testing ethnically diverse women of treatment to help evaluate the course of time and a good deal for such therapies. It also urges the research on possible alternative treatments, including plants and some antidepressants.

in addition, "we have pruned the list" symptoms related to menopause, said panelist Lois Verbrugge, University of Michigan Ann Arbor, and currently a professor invited to the national University of Singapore. the depression, irritability, forgetfulness, joint pain, urinary incontinence, and changes in libido can not be easily associated with menopause the committee concluded, while hot flashes, vaginal dryness, and perhaps sleep disorders are more clearly triggered by the condition.

The Panel found that, in some cases, hormone therapy is appropriate, and does not give a very small increase in the absolute risk of disease for many middle-aged women. "I think we're too in our enthusiasm to avoid these drugs," said Deborah Grady presenter of the University of California, San Francisco - but also warned that women remain on hormone therapy for possible delay [

Related Sites
information about hormone therapy NIH
Initiative for women's health

Too much fluoride on Tap? -

WASHINGTON, DC -. Protecting the Environment Agency (EPA) should decrease the maximum amount of fluoride, it allows in drinking water, according to a National Academies report Sciences (NAS) released today. NAS group found compelling evidence of serious tooth decay in 10% of children exposed to the maximum legal limit - about 4 times higher than what is usually added to drinking water. Most of the group also found that adults exposed to these levels over a lifetime were likely to have a higher incidence of bone fractures.

Water suppliers have added fluoride to drinking water in the United States since the 1950s to fight against dental cavities. In 1962, the US Public Health Service has recommended a concentration of 0.7 to 1.2 parts per million (ppm), depending on the amount of water people in an area normally drink. Ironically, children who consume too much fluoride in their first 8 years of life may develop lasting problems with their teeth, including pitting of the enamel and tooth decay. Excess fluoride also weakens bones for decades. In addition, some studies have shown that fluoride causes cancer in laboratory animals.

In 1986, the EPA has set the maximum contaminant level for fluoride at 4 ppm. Seven years later, a NAS group agree with this standard, pending further research on uncertainties regarding exposure and toxicity. But the new panel, chaired by toxicologist John Doull of the University of Kansas Medical Center in Kansas City, came to a different conclusion.

Part of the reason is that the panelists a more refined look at the state of the tooth called enamel fluorosis. Previously, most researchers considered fluorosis an aesthetic problem rather than a health problem. But when the panel considered the most serious consequences - bites, bacterial contamination, and loss of the tooth - 10 of the 12 members decided that they were recorded as adverse health effects. And when panelist Charles Poole, an epidemiologist at the University of North Carolina, Chapel Hill, traced the prevalence of dental fluorosis in 94 studies, it was found that the prevalence dropped to near zero when fluoride levels in water were below 2 ppm. This and other evidence is sufficient to warrant a new standard, said Poole.

This is not to say that all questions concerning the health effects are set. The Panel found that the evidence of the effects of cancer is "tentative and mixed", but noted that a large enough study to be released this summer should help establish future research objectives. In addition, monitoring is required on preliminary results of endocrine effects in animals and IQ deficits in Chinese populations.

braces the report, which was 3 years in the making, is winning. "It is very comprehensive" says toxicologist Tim Kropp of the Environmental Working group, an advocacy group in Washington, DC

Related Sites

• CDC report on water fluoridation drinking
• review in 1991 of the public health Service of the benefits and risks of fluoridation
• fluoride Action Network, a group concerned about the toxicity and health impacts

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What's special about "Special K" -

A drug you. 'Re more likely to find at a rave at a veterinarian's office can be the next big antidepressant. A single dose of ketamine, a veterinary anesthetic that is also known as the recreational drug "Special K" improved the mood of patients with major depression in as little as 2 hours, with effects lasting up to a week, according to a new study.

For half a century the treatment of depression have largely targeted a class of neurotransmitters called monoamines. Newer drugs, such as Prozac and Paxil, for example, work by blocking the absorption of serotonin, which makes more of the neurotransmitter available to stimulate neurons typically understimulated in depressed people. The monoamines are limited to particular tasks in the brain, however. A more general communication system based on an amino acid called glutamate. The glutamate system is associated with learning and memory, but it has been increasingly involved in mood regulation ( Science NOW, April 24, 1998).

A team led by Carlos Zarate, a psychopharmacologist at the National Institute of Mental Health in Bethesda, Maryland, and colleagues identified a key player in the glutamate system, a receptor known to N-methyl d-aspartate (NMDA). Seventeen patients who had major depression and did not respond to traditional antidepressants, were injected with a placebo or ketamine, a known NMDA receptor blocker. Based on their reported moods and observations of the team, 12 responded to treatment with 5 of them meet the criteria for remission from depression, the team reports in this month's issue of Archives of General Psychiatry . In addition, 5 patients experienced relief for at least a week from the single injection. The placebo patients reported no improvement

The really exciting part, Zarate said, is the speed with which the treatment works. Just a day after receiving a shot of ketamine, patients reported improvements equivalent to those reported after 2 months of conventional antidepressants. This is a big deal, he says, because the time lag associated with standard antidepressant can be fatal in cases of major depression; Suicidal behavior has been noted particularly in the first 9 days of treatment.

This study adds significantly to the mounting body of evidence that the glutamate system is a more specific target for therapies of depression, said John Krystal, a psychopharmacologist at Yale University, who led a study in 00 alluding to antidepressant effects of ketamine.

Sites "We need to develop approaches that do not simply repeat treatment strategies already in place ... and glutamate history as it emerged is very promising." on

• NIMH website on depression
• ketamine Facts

Healthier With herpes? -

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the doctors consider them harmless hitchhikers at best and dangerous at worst pathogens. But a new study in mice shows that the herpes virus, which most of us relate to life, can have a surprising benefit: They provide protection against pathogenic bacteria, including the one that causes the plague. The effect is a rare example of a beneficial relationship between a virus and its host, the researchers say.

Eight human herpesviruses are known, and most people are infected with several of them at an early age. They can cause serious illness: Cytomegalovirus (CMV), for example, can blind people with weakened immune systems, and the Epstein-Barr virus (EBV) can cause tumors. But in most cases, herpes becomes latent: They just hang in the body, never leaving but never make trouble

A key player in maintaining this balance is a host molecule called interferon -γ (IFN. -γ). But not everything he does. IFN-γ also helps fight bacterial infection by activating macrophages, a type of white blood cell that engulfs microbes. So viral immunologist Herbert Virgin of Washington University School of Medicine in St. Louis, Missouri, said that mice latently infected may be more resistant to bacterial infection, because these mice had higher blood levels IFN-γ.

The intuition was vindicated, at least two of the three herpesvirus subfamilies. The mice latently infected with a so-called b -herpesviruses or gammaherpesvirus were highly resistant to infection Listeria monocytogenes , a food-borne microbe, and with Yersinia pestis , the plague bacteria, Virgin and his colleagues found. (The control animals developed a severe infection after exposure to either bug.) Latent infection with the third subfamily - alphaherpesvirus -. Do not offer such protection, reports the team tomorrow Nature

determine whether the same is true in humans will be a challenge, says Virgin, if only because it will be difficult to find enough people who have never been infected with beta- or gammaherpesvirus. But if the virus also protect humans, researchers would need to look in a new way, says Virgin. After coevolving with their hosts for 100 million years, "one could say they are part of our normal flora," he said, as the microbes living in our guts. And vaccines being developed against CMV and EBV can be studied more carefully, he notes, as they may increase the long-term risk of bacterial infections.

There are some other examples of a pathogen avert another says Jacob Koella, which studies host-parasite evolution at Imperial College London. for instance, schistosomiasis, a parasitic disease, appears to protect the host against malaria. But this is the first example of a do-good virus, he said . Yet many more of these evolutionary compromise may exist Koella predicted ". It is something that not enough people think "

Related site

• An introduction to the eight human herpesvirus known

Solving the Paradox Antidepressant -

Two genes involved in chemical signaling in the brain may help explain why antidepressants increase the risk of suicide in some people, according to a new study.

concerns about antidepressant safety arose a few years ago when studies began to indicate that the drug increased the risk of suicide in some adolescents and children. responsible for UK regulation in 03 prohibited the use of minors in several drugs called selective reuptake inhibitors of serotonin (SSRIs), and in 04 the Food and Drug Administration of the United States concluded that all classes antidepressants must carry a warning about the risk in children, adolescents, and young adults ( science NOW, February 3, 04). Although suicide link is well established, it is not clear how antidepressants trigger suicidal behavior or thoughts in some people.

Seeking to shed light on this issue, a team of researchers led by Francis McMahon of the National Institute of Mental Health (NIMH) in Bethesda, Maryland, looked at 68 genes in 1915 adults with major depression who have been treated with SSRI citalopram. The researchers were looking for genetic variations that might be associated with suicidal thoughts, and they may have hit the jackpot.

The reports of the McMahon team in the October issue of The American Journal of Psychiatry he identified two markers, or short sequences of DNA, in two genes GRIA3 and GRIK2 , which corresponds to a significantly increased risk of suicidal thoughts while taking citalopram. GRIA3 and GRIK2 code for receptors for glutamate, a chemical in the brain involved in learning and memory. A small variation in the DNA marker region of these genes appear to be all that separates those who develop suicidal thoughts while taking the drug to those who do not.

Participants with GRIA3 change was a risk almost doubled develop suicidal thoughts, and participants in the GRIK2 variation showed increased eightfold risk. Participants carrying both markers - an extremely rare phenomenon - showed an increase of 15 times the risk

"The findings suggest some of the tendency to develop this type of response to antidepressants could be genetically determined, and that. could be used in the future to develop genetic tests to identify people who might be at risk, "said McMahon. However, he noted that the work should be replicated and says at this stage we do not know why these particular genetic variations contribute to suicidal thinking in people taking antidepressants.

Elliot Gershon, researcher in psychiatric genetics at the University of Chicago in Illinois, who wrote an accompanying editorial in the study, called the results promising. "They head field in the potential of tailoring treatments to differences in individual genes and new general objectives for the treatment of depression," he said.

Related Sites

• The study
• NIMH overview of antidepressants in children

Obesity is Little Helper - bacteria

Fat mouse should consider flossing. Although not the exact conclusion of a new report, the study indicates that - at least in rodents - obesity weakens the immune system's ability to fight against the bacteria that cause gum disease. The discovery helps explain why obese people are more likely to develop oral disease and suggests they may be more vulnerable to other bacterial infections as well.

Obesity increases the risk of developing many serious illnesses, including heart disease, diabetes and some cancers, and a growing body of evidence indicates that it also impairs the immune system. Earlier this year, a study in mice has found that obese animals had more trouble against viruses and previous research in people suggests that obesity suppresses the key elements of the immune system that help to kill germs . Now a team led by oral biologist Salomon Amar of Boston University showed for the first time that obesity also appears to reduce the immune system's ability to thwart bacteria.

The first thing the researchers needed to do was to plump up some mice. Five mice fed a calorie, rich fat diet for 16 weeks inflated to 42 grams, or 1.5 times the weight of the animals to eat on standard mouse chow. Next, the researchers wrapped a silk soaked in a solution containing bacteria Porphyromonas gingivalis , that cause gingivitis, around a tooth of each mouse to cause disease gum infection. Compared to lean animals, the obese mice had 40% bone loss around the roots of their teeth within 10 days after infection and have higher levels of bacteria in dental plaque.

Further experiments showed that obese mice was sluggish immune system. When the researchers injected the gingivalis bacteria in the animals' tails, lean mice struck components of the immune system that respond to infections, including tumor necrosis factor-α and interleukin-6. This response was blunted in obese mice. The researchers report their results online this week in the Proceedings of the National Academy of Sciences .

How obesity affects the immune system is not yet clear, but the researcher in infectious diseases Herbert Tanowitz of Albert Einstein College of Medicine of Yeshiva University in New York suggests that chronic inflammation low level that occurs as a result of obesity can somehow be at fault.

Periodontist microbiologist Robert Genco of the University of Buffalo in New York state says the findings raise the possibility that another component of the immune system, neutrophils, is also removed from obesity. Neutrophils, which are not tracked in this study, to kill bacteria, so if these cells are compromised, more serious illnesses may develop, he said.

Tanowitz says that obese people probably have the same impaired immune response, a serious concern because gum disease can lead to tooth loss and increase the risk of heart disease and stroke. "There is evidence that people who are obese have more problems, at least in the hospital with bacterial infections," he said.

Related Sites

• Overview of obesity
• Information from the World Health Organization on obesity

Cholesterol crisis? -

A new study shows that a drug widely prescribed drug lowers cholesterol, but can not be beneficial for heart health, a paradoxical result that physicians discuss how the drug works and if it is. effective

The study found that the combination of a drug effective cholesterol-old, simvastatin, ezetimibe with the drug was no better than simvastatin alone in preventing arterial plaques - one the objectives of lowering cholesterol. The study was funded by Merck and Schering-Plough drug manufacturers. The results were a surprise. On the surface, the combination of two drugs had the upper air, reducing the blood concentration of the plate inducing low-density lipoprotein (LDL) about 15% more than the old one drug, doctors reported online March 30 in the New England Journal of Medicine and the annual meeting of the American College of Cardiology in Chicago, Illinois. The results contradict the notion established that lowering LDL reduces plaque buildup and slows the development of heart disease as well.

The reason for these results, some researchers think that, maybe, although both lower cholesterol drugs, they do it in different ways, and it can be more beneficial than the other. Simvastatin is a statin that blocks a liver enzyme needed to manufacture cholesterol, and thus stimulates the liver to draw more cholesterol from the blood stream. Ezetimibe, on the contrary, works by slowing the absorption of cholesterol from food by blocking a protein called scavenger receptor in the small intestine. Allen Taylor, a cardiologist at Walter Reed Army Medical Center in Washington, said it may be the problem. "This scavenger receptor also works throughout your body to clear cholesterol that you want to get rid of," Taylor said. "It's like not to take something new in your home, but you can not put no more garbage . "While LDL levels in the blood drop, he said, the body may have trouble getting rid of that little cholesterol, it absorbs.

Eric de Groot, a vascular-imaging specialist at university medical Center in Amsterdam, the Netherlands, and author of the study, defends ezetimibe. He said most of the nearly 700 patients in the study had been treated with statins for 7 10 years, so their arteries were healthy enough, leaving little room for improvement due to the addition of the new drug. "I read in the press sometimes it is ... a useless drug," dit- he. "I totally disagree with that. This design does not prove that. "People without a history of statin use, he said, could see more benefits of ezetimibe.

Another study will be published in 2012 following the effects long-term health of ezetimibe on patients with heart disease. "This will be the big news," says Cynthia Jackevicius, an expert in the practice of pharmacy at the University of Western of health sciences in Pomona , California. "We're kind of in limbo until more information comes out."

Related Sites

• American Heart Association page on atherosclerosis
• Page American Heart Association on cholesterol
• science NOW on other benefits of statins

Mutation Spell Bad News for Breast Cancer Patients -

breast cancer patients with a mutation makes breast cancer cells more difficult to treat and more likely to spread. in both copies of the NQO1 gene have a survival rate of 20% less than 5 years after treatment than do patients without mutation, according to a new study of more than 2,000 Finnish women. Those with the mutation were also four times less likely to respond to a common type of chemotherapy.

NQO1 encodes an enzyme that protects cells against oxidative stress, damage to the cell and its DNA caused by reactive by-products of metabolism. The NQO1 enzyme also helps stabilize p53, sometimes called protein "guardian angel" for his crucial role in the prevention of tumors. Because NQO1 protects the DNA of a cell and its anti-cancer proteins, mutations that compromise the NQO1 enzyme are pernicious. A mutation, called NQO1 * 2, increases the risk of cancer or relapse of cancer, particularly leukemia.

A group of researchers from the University of Helsinki in Finland thought NQO1 could also be a promising predictor of survival of women with breast cancer. The team followed up the cases of 1,005 women who visited the Helsinki University Hospital for treatment of breast cancer between 1997 and 04. They tested the women for NQO1 * 2 mutation and compared their survival rate an average of nearly 6 years of follow-up visits. Only 65% ​​of women who carried two defective copies of the gene were alive 5 years after treatment, 85% against and 87% survival for women with one and two good copies, reports the team today in Nature Genetics . The mutation also increases the risk that cancer will spread. Moreover, the mutation seemed to make breast tumors resistant to a common form of chemotherapy, epirubicin. Women with two copies of NQO1 * 2 mutation only had a survival rate of 17% at 5 years after treatment, compared to a survival rate of 75% for women with at least one good copy of the gene. For radiotherapy or hormone therapy, the NQO1 * 2 mutation seemed to make no difference.

To confirm their findings, the researchers studied a second group of 1,162 women treated in two other Finnish hospitals. Again, they found reduced survival: Over 10 years, 46% of women with two copies of NQO1 * 2 survived, against 75% of women with at least one NQO1 normal gene. As in the previous group, the effect was more pronounced in patients who received chemotherapy rather than radiation - but most women in the second group received an older type of chemotherapy, so that researchers could not confirm the effect of NQO1 * 2 mutation on the now common epirubicin therapy.

However, "the results are quite dramatic," says Carl Blomqvist, a cancer clinician and author of the study. "The immediate thing to do," he adds, is to launch a new clinical trial designed not only to detect the association between NQO1 * and prognosis, but to really test the predictive power of NQO1 * 2 on cancer prognosis in women randomly assigned to epirubicin and other therapies. If the connection holds, it could give doctors another information to help them choose the right treatment for a patient.

"it is an important discovery," says David Ross, a toxicologist at the University of Colorado, Denver. He also emphasizes the need for a new clinical trial to confirm the link between NQO1 * 2 and prognosis, adding that the cause of the effect is uncertain. "Always be certain t crossed and i dotted," he said.

Related site

• More information about cancer within the National cancer Institute

Personal Trainer in a pill -

You want to run a marathon, but too lazy to form? Maybe you can take a pill one day. Scientists have found compounds that, when taken orally, significantly increase endurance in mice, including one that works without any exercise.

The traditional way to build endurance is aerobic exercise, which increases the ability of skeletal muscle to burn fat effectively. A key protein in this process is PPAR & # 948. When activated, it triggers a key network of genes that burn fat and endurance hoist. Last year, a research team led by Ronald Evans of the Salk Institute for Biological Studies in San Diego, California, genetically mice with increased PPAR & # 948 engineering activity; they discovered that these "marathon mice" had almost twice the endurance race normal mice.

Although trained athletes could consider gene therapy, casual jocks would probably prefer a pill. Yet when Evans and his colleagues recently gave a PPAR & # 948 drugs to stimulate normal adult mice, the rodents developed no greater endurance than their counterparts undoped - until researchers had the animals combine drugs with a workout routine. Then endurance drugged shot through the roof mice: They ran 70% further than the trained mice given a placebo, and their running times were similarly increased, the group reports online today Evans in cell

given that the exercise was necessary. to start the PPAR & # 948 drugs in high gear, the research team wondered what would happen if they tricked the body into thinking that it was exercised. They gave mice a drug - AICAR, which has been used in clinical trials for various diseases - that upped AMP-activated protein kinase (AMPK), an enzyme that becomes active during a workout. These mice "couch potato" got an instant boost of endurance up to 44% - without any form of exercise training. "We did not expect, you can create exercise in a pill," Evans said. But after four weeks on the drug, the mice behaved as if they had exercised every day.

Either exercise or one of its direct products, AMPK activates a pathway that stimulates endurance promoting genes in muscles, Evans concludes. And now that the path can be manipulated - or exploited. "It's a little scary," says Mark Tarnopolsky, Director of the Clinic for neuromuscular and neurometabolic disorders at the Medical Center of McMaster University in Ontario, Canada. "Unfortunately, many athletes will think they can use drugs to improve performance." But he adds that for people of "sedentary diseases" such as obesity or diabetes, medication is an exciting development.

Until now, no drug has been tested to increase endurance in people. But even if they did work in humans, they would only strengthen your ability run faster or farther - not your desire to do so, said Sebastian Jorgenson, an exercise physiologist at the University of Copenhagen in Denmark "Even if you have such a capacity if it is not used. what does it matter? "he said. Jorgenson and notes that drugs are not really necessary. "The remedy is there for millions of years," he said. "He called a balanced diet and exercise."

blood test for Mom Picks Up Down Syndrome in Fetus -

A technology guru may have solved a problem that has long vexed the Obstetricians: how to test for Down syndrome, without poking a needle into the uterus. By sequencing the floating fetal DNA in maternal blood, bioengineer Stephen Quake's team at Stanford University in Palo Alto, California, has detected new cases of the disease with 100% accuracy. If this small study is in larger trials, the test could become routine for pregnant women.

Down syndrome is caused by an extra copy of chromosome 21. This results in mental retardation and other health problems, and some women choose to abort fetuses with Down syndrome. Although there is a noninvasive screening test that indicates the likelihood of a fetus has Down syndrome, pregnant women who want a definite answer now have two choices: amniocentesis, which involves inserting a needle into the uterus to remove the fluid, or another procedure that extracts a piece of placental tissue. These tests, performed at about 10 to 16 weeks, are 99% accurate, but cost about $ 1000 and, in rare cases, can cause miscarriage. Therefore, usually only women over 35 who are at higher risk for carrying a baby down to get tested.

In the last decade, researchers have developed tests for prenatal sex and Rh blood group based on tests for mutations in fragments of fetal DNA circulating in the blood of pregnant women ( science , September 2, 05, p. 1476). But the detection of disorders such as Down syndrome using maternal blood was more difficult because the test is to identify an extra chromosome, and DNA from the mother swamps on the DNA of the fetus. In the most advanced approach, the Sequenom, based in San Diego, California, uses the messenger RNA produced by the placenta to detect Down. However, the test is only a screen because it relies on DNA markers on chromosome 21, which vary according to ancestry, and missing about 7% of the population in the United States.

Quake team tried a brute force approach to work around this problem: They put samples of maternal blood through a DNA sequencing machine. Although the researchers sequenced about 2% of the genome of the mother and the fetus, it was enough data to distinguish the levels of chromosome 21 in mothers carrying a baby syndrome down to those with normal fetuses from 14 weeks. In all nine cases of Down syndrome tested but not six normal cases, this ratio was greater than one - which indicates that the condition was present. The technique also detected three cases of other chromosomal disorders that lead to abnormal development, the group says Quake online today in the Proceedings of the National Academy of Sciences .

The test costs $ 700 per sample, but the price should drop with the latest sequencing technologies, says Quake, who hopes the approach commercialized. "I think it's going better and better," agrees Department of Medical Genetics of Energy Edward Rubin, who said the newspaper Quake was the speech of a meeting of the genome recently in Boston

experts fetal testing are also impressed. "the results are amazing," says molecular biologist Sinuhe Hahn Basel university hospital in Switzerland. Hahn and others say it is too early to tell, however, if the test will prove greater than of Sequenom. It must be studied on a much larger scale to be sure he can pick up all the 1000 births of Down syndrome in the general population, says Diana Bianchi of Tufts University in Boston. Although she says the study is "a significant step forward."

Lyme disease: Shoot at Shots -

Congress is floundering in trouble whether people with Lyme disease should receive long-term antibiotic or if the drugs affect more help. This question, which has been an inexhaustible source of friction among biomedical researchers between researchers and patient-advocates get congressional hearings next year.

If there was a Nobel prize for disease-causes extreme controversy, Lyme disease is a serious contender. For years, the disease transmitted by ticks has been the subject of vicious battles between scientists and patient advocates about whether long-term antibiotics can help. Many affected by the disease that yes, citing the decline of symptoms after treatment; Many scientists say no, and several clinical trials save.

Now enter the fray Lyme is representative Frank Wolf (R-VA), who used to oversee the funding from the National Science Foundation of the United States and other scientific bodies as a powerful President of Committee expenses when Republicans controlled the House of representatives. In September, he sent a letter to the Ministry of Health and Social Services of the United States, demanding it investigate the guidelines of the Infectious Diseases Society of America (IDSA), which avoids long-term antibiotics treatment. He also requested that Congress hearings as soon as possible keeping subcommittee, and the office of Frank Pallone, Jr. (D-NJ), who chairs the House energy panel and the Subcommittee on Commerce Health said they will occur next year. "We want an independent assessment" of treatment guidelines, Wolf said in an interview with Science . Patients' lost the confidence of people travel for miles to get treatment. "

"I do not think" the IDSA guidelines should be used, he continued, "but I'm not a scientist. "IDSA, no stranger to tumult, said he is happy to cooperate with all audiences, but maintains its recommendations. In fact, IDSA has recently begun to assemble an independent group of eight to 12 people to review its guidelines for . treatment Lyme A spokesman said Science Insider "We have taken that extra step to say," Okay [if] you do not believe us, we will put it for review. "

Note: Commenter swampcrawler stresses that the decision of IDSA to conduct a review of its guidelines was part of an agreement with the Attorney General of Connecticut in May

(corrected Point 15/12/08)

IOM to Obama: Get Your Act Together on Global Health -

A new Institute of Medicine report released today by a large group of scientists and former officials in a committee global health has a message for President-elect Barack Obama, Give us of this change you promised

committee, co-chaired by Harold Varmus, head of the cancer Center Memorial Sloan-Kettering and Thomas Pickering, Under took his retirement. Secretary of State for Political Affairs, urges Obama to make "an important speech at the beginning of its mandate" which states that the United States consider global health as "an essential component of US foreign policy." In the eyes of the committee, more investment in global health will provide diplomatic security and economic returns. specifically, they call on the administration to double its commitment of $ 7.5 billion to $ 15 billion by 2012. they suggest that 13 billion $ should go towards the Millennium development goals related to health development, and another $ 2 billion for noncommunicable diseases and injuries.

While the Committee commended the United States to make "dramatic increases" in global health over the past decade, he noted that the United States "does not come close" to the spending of development aid made by most other rich countries. Denmark, one of the most generous countries, Password $ 1.07 per day per person, while US public and private contributions make up only 35 ¢, for example. In terms of gross national income, the United States goes to 0.16%, while several Scandinavian countries contribute more than 0.8% (see chart). "Overall, in percentage, we are still dealing with Greece at the bottom of the pile," Varmus, who is also on Obama's transition team, said Science Insider. "We need to get the level up."

But is it realistic to expect a doubling of funding during the current economic crisis? "We talk about spending lots of money on the stimulus plan, but a relatively small investment in health care, "said Varmus, Nobel laureate who once led the US National Institutes of health. "We must recognize that we have a lot at stake here."

More of the commission, including a blistering passage, after the jump.

In addition to calling for increased funding, Committee wants the US government to evaluate more carefully the way it spends money and what it buys. funding was "highly biased" towards HIV / AIDS, the Committee emphasized, noting that he received 70% of aid in the overall health of the country in 08. the Obama administration and Congress should "create a balance in the traditional portfolio of global health aid," the report recommends.

in one of his most blistering passages, the committee complained that the government does not have a good handle on who does what. "to date, the committee is not aware of all efforts to quantify the overall coordination and US equities in global health through even large government agencies, "the report said. "The tools available to follow US funding for the Government of global health are limited, and their results are often fragmented, subject to double counting, and do not include the work of all agencies. Therefore, the total commitment of the US Government to global health is not known with certainty, the United States can neither measure the positive impacts, nor justify the level of investment in global health "

to better coordinate the global health efforts of the US government, the report recommends that Obama create a white House. -level interagency committee chaired by a senior white House "to direct, plan, prioritize and coordinate "budgeting. the report also urges Congress and the White House to demand a more rigorous assessment of global health funding.

in April, the committee plans to publish a more complete report that said Varmus will "dot all the i's and cross all the t of" dealing with these complex issues such as helping developing countries strengthen their provision of health care and the role of non-governmental organizations, academia and the private sector environment. "This is a" letter report to attract the interest of the new administration and hopefully set them up in no time, "he said. Varmus would not discuss whether he could have a role in Obama administration or the reaction of the transition team report.

Next Chapter for Zerhouni -

Elias Zerhouni, the researcher-radiologist who led the National Institutes of Health for six years until he resigned in October, joined the Bill and Melinda Gates Foundation as principal investigator in its global health program. Although generally well regarded for his leadership by scientists, it has not been particularly involved in battles involving international birth control policy, abortion, and travel to meetings is the AIDS rumbled in the early years George W. Bush Administration.

And win the war against cancer, as -

In addition to saving banks, strengthen the housing market cratered, and capping greenhouse gas emissions, President Barack Obama had another ambitious goal for the stimulus plan in his speech to Congress last night: the treatment of cancer. Presumably this is a reference to $ 10 billion head for the National Institutes of Health.

Our recovery plan will invest in electronic health records and new technology that will reduce errors, reduce costs, ensure privacy, and save lives. It will launch a new effort to conquer a disease that has touched the lives of nearly every American by seeking a cure for cancer in our time. And it makes the largest investment ever in preventive care, because that is one of the best ways to keep our people healthy and our costs under control.

Also a noble goal as it is, the treatment of cancer in the coming decades is a far cry from the ambitions of Andrew von Eschenbach, who led the National Cancer Institute until 05. He often mentioned his plan to "eliminate death and suffering" of cancer by 2015, then passing the lens until 2010- a generally considered unrealistic plan (and unlikely to be reached in the next 10 months).

Extremist animal rights Target UCLA neuroscientist -

animal rights extremists are not let in their attacks against the California biomedical researchers. According to Los Angeles Times , the FBI investigation into a bombing that destroyed the car of the University of California, Los Angeles (UCLA), neuroscientist at the weekend.

The incident on March 7th involving an incendiary device home took place outside the house of a faculty member and caused no injuries, according to FBI spokeswoman Laura Eimiller. The UCLA professor who does research treatments for schizophrenia, drug addiction and other disorders, has not been identified.

The bombing is the latest in a series of incidents at UCLA and other UC campuses from 06. Yesterday, UCLA Chancellor Gene Block issued a statement condemning the bombing. The university, as well as local and federal authorities, offering a reward of up to $ 445,000 for information leading to the arrest and conviction of those responsible for five separate attacks for researchers from UCLA.

A new tool to fight against prostate cancer -

For the unlucky 10% of men diagnosed with prostate cancer who have the most aggressive form, the prognosis is poor. The drugs available against prostate cancer can first reduce their tumors, but the remaining cancer cells usually grow out of control again after some years. These cases resistant to drugs account for most of the nearly 29,000 annual deaths in the US from prostate cancer.

Researchers led by Charles Sawyers at Memorial Sloan Kettering Cancer Center in New York have now developed a compound that could prevent some deaths. This Thursday they will report online Science that in mice the compound decreased tumor implanted human prostate untreatable with existing drugs and that he had evidence to arrest tumor growth in the men with a similar drug resistant cancer. Although more clinical studies are required, cancer researchers are excited about the potential drug, which treats prostate cancer by a different mechanism than existing drugs. "It may be a new and better way to treat prostate cancer," said oncologist Philip Kantoff of the Dana-Farber Cancer Institute in Boston.

In prostate cancer, genetic changes in cells allow testosterone and similar hormones, called androgens, to feed the rampant cell growth. most patients receive drugs to limit the production of androgen body. If the tumor continues to grow, doctors prescribe other drugs which bind to the androgen receptor in the cytoplasm of the cell of the prostate, so that the hormone can not land on the receptor and activate it. But these drugs usually fail after a time.

This problem intrigued Sawyers, who had previously worked on resistance to Gleevec, a drug against leukemia powerful, he helped to develop. in 03, the team of Sawyers showed why tumor cells advanced prostate possibly counteract the standard drugs: the cells produce high levels of androgen receptor, which makes them so sensitive that even androgen drugs blocking the receptors can stimulate cells to grow. Next Sawyers joined forces with chemist Michael Jung, whose group at the University of California, Los Angeles, synthesized nearly 0 androgen-like compounds. The researchers selected molecules, selecting those that bind tightly to the androgen receptor but does not activate. The group of Jung then twisted two promising candidates for potential drugs.

In addition to binding to the androgen receptor, the new compounds appear to prevent it from entering the nucleus of the cell, the DNA binding, and initiation of gene expression, the The team reports. "It's a great story," says pharmacologist at Duke University's Donald McDonnell cancer in Durham, North Carolina

In a clinical study with one of the compounds, dubbed MDV3100, levels of prostate specific antigen -. a marker for the tumor growth of prostate - decreased by at least 50% in 13 of 30 patients with advanced disease for whom other treatments have failed "in this group. of patients, this result is very impressive, "said Sawyers. Medivation Inc. in San Francisco, California, who collaborated on this work is currently testing the drug at higher doses on more patients. (Sawyers is a consultant for the company and is a co-inventor on a patent for MDV3100.)

Although MDV3100 extends the life of men with advanced prostate cancer, their tumors are likely to become resistant to him too . But researchers hope that the compound may be combined with another drug candidate, developed by a different team, but in the tests, which stops cancer cells from making their own supply of androgens. "A very exciting possibility" is that a cocktail of these drugs will prevent men with cancer of early prostate never reach the stage drug resistant, says Kantoff, who heads one of the many centers that test MDV3100.

A Nose for Disease -

In 1989, The Lancet was a curious report on a dog kept licking a mole on her leg owner. The mole turned out to be a malignant melanoma. Since then, scientists have observed "disease sniffing" capabilities similar in mice and rats, which tend to prevent the sick members of their own species. Now researchers think they have understood how these animals do.

Scientists have already identified a number of mouse smell receptors, cell surface proteins in animal noses that pick up any scent of food to the smell of fear ( science NOW, August 21, 08). Neurogeneticist Ivan Rodriguez of the University of Geneva in Switzerland, and his colleagues wondered if there could be such additional receptors that respond to a disease "perfume", perhaps by detecting chemicals associated with bacteria and inflammation.

The researchers traveled the already deciphered mouse genome, looking for genes that may encode proteins of additional receptors in the olfactory system, sensory cells that connect the nose to the brain. They found the genes of five new receptors, which belong to a known family of proteins called formyl peptide receptors (HRPF).

The known HRPF include two immune system receptors that detect chemicals given off by pathogens in the blood, helping immune cells track and attack foreign bodies. Could those newly identified on olfactory cells do the same, pathogen detection, but those outside the body on another animal? Rodriguez's team exposed olfactory mouse neurons in the laboratory to pathogenic bacteria and urine of sick mice. Indeed, some of the chemicals sparked a "smell response" in neurons, as demonstrated by electrical changes in cells, the researchers report online today in Nature .

neurons with the newfound FPR receptors reside in a part of the olfactory system at the base of the brain that also sniffs sexual signaling chemicals called pheromones This zone. - the vomeronasal organ - is directly related to brain emotional center , the amygdala. "This makes a lot of sense," Rodriguez said. When a mouse detects a nearby mate, or danger in the form of the disease, he needs to trigger a quick reaction, either an attempt to reproduce or to avoid an animal nearby ill, he said .

Rodriguez team also found the smell receptors in disease gerbils and rats, but thought it unlikely that they will be discovered in the human nose. There is no evidence that we HRPF elsewhere than in our immune system, he said.

The results are "very exciting, if not a major breakthrough," says neuroscientist and expert on odor Pierre Marie Lledo of the Pasteur Institute in Paris. The discovery will open "new field" in the molecular basis of sniff out the disease, said Marie-Christine Broillet, specialist in olfaction of the University of Lausanne in Switzerland.

Breaking News on the swine flu -

Since news of swine flu in the United States erupted last week Science journalists have been keeping an eye on the latest developments. Virus expert Jon Cohen is on the scene of some of the first cases in San Diego, California, then based in Paris, Martin Enserink, a pandemic expert, followed by the last of the biology of the virus. We have a cover, you will not find anywhere else, including an interview with an infectious disease specialist Edwin Kilbourne, who was at the center of the latest warning to swine flu in the United States, and an analysis into question the official word on the genetic makeup of the virus.

For our complete coverage and breaking updates, see science Insider.

Your Top Flu Primer Award Goes To ... -

... Washington post graphic Brenna Maloney and Laura Stanton, who now explain and elucidate how flu viruses work, and specifically what scientists learn about it.

Exclusive: Interview with the head of the High Swine Flu Lab Mexico -

Microbiologist Celia Alpuche heads the laboratory in Mexico that has become ground zero of the outbreak of the country's swine flu. Alpuche spoke to Science yesterday from his office at the Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE) in Mexico City.

Many people have raised questions about whether Mexico could have detected the outbreak earlier and contained before it spreads elsewhere. But as Alpuche explains InDRE was a confusing situation because the virus has surfaced in the middle of the flu season - and it may not have originated in Mexico anyway. Alpuche also sets out the facts about why it took several weeks to link the epidemic with symptoms first case, a 4 year old boy from La Gloria in Veracruz state. And she frankly described the limits of its own laboratory.

InDRE worked closely with the Public Health Agency of Canada and the US Centers for Disease Control and Prevention (CDC) to identify the virus as the cause of the epidemic, and Mexico continues collaborate to test suspected samples. May 1, Mexico had 156 confirmed cases and nine deaths, more than any other country in the world. Mexico has identified another 1,918 suspected cases, as described in the years CDC Morbidity and Mortality Weekly Report ( MMWR ) yesterday and InDRE rushes to sort how many are actually swine flu .

flu is caused by two strains A and B, as well as several different subtypes that are designated by the two proteins that mark the viral surface, hemagglutinin and neuraminidase, followed by a number. The epidemic is caused by an influenza A virus subtype H1N1

The interview follows after the jump ...

Science :. There have been many questions about the origin and timing. When is it an indication that there was an unusual number of cases of respiratory disease

Alpuche :? April 7, we learned that the National Institute of Respiratory Diseases was particularly serious cases of pneumonia in young adults who were previously healthy. Immediately, we started to get the data around this cluster. We also started doing a retrospective analysis of influenza data we had.

We looked at all the data we had on the detection of influenza since January until this month and also compared to the last flu season. In addition to SARS, we started having rumors there were other cases that are not pneumonia, it was like a respiratory disease, flu-like illness.

Science : Have you seen anything from your analysis of influenza trends that tell you anything

Alpuche : the first thing he told us we were still detect flu in the country, not only in Mexico city. It was about the same as we see every year, except that it was an extension of the flu season. Then we analyzed the subtypes of influenza strains, and one of the unusual things we saw was that in this season, we had the first peak in the latter part of November and December and another in February. During the season, we started to have more influenza B that we had last year.

Science :. This has nothing to do with this epidemic

Alpuche nothing to do with it. He was very confused. We found that 37% were B and the year before, we find up to 15% were B. Then, we examined the data they have the flu to CDC surveillance system to see if anything unusual occurring. We also saw in the United States something kind of similar - a prolonged period of influenza and increasing the strain B. So, we thought we had something related to the flu, and we were still concerned by pneumonia. We returned immediately to look all influenza outbreaks we had in the country since the season started to see if it was more related to the prolonged flu or there was something else we see. We had small outbreaks in some states in the central part of Mexico, Tlaxcala, and the last outbreak we had was in the state of Veracruz, in the town of La Gloria, near Perote. It was during the last 2 weeks of March

Science :. Why did not it trigger concern in the last 2 weeks of March

Alpuche : There was a flu-like illness, no deaths and no cases of pneumonia. This outbreak has been deeply studied with epidemiologists from the state. The Secretary of Health of Veracruz did a great job during the epidemic in the last 2 weeks of March

Science :. What capacity do they have to type subtypes?

Alpuche : influenza, laboratory surveillance network in Mexico using immunofluorescence - which is the screening test, and uses antibodies against A and B. This is what the laboratory public health is doing.

Science : So they do not have the subtype tests and had to send the samples to you

Alpuche : Yes. Not now, because if there is anything unusual, they expect to get accumulated cases and then send to the national reference center. One of the interesting things in this epidemic is that they were testing, but the onset of symptoms was after 4 or 5 days. The sensitivity of the immunofluorescence test is low after 72 hours. Most of the tests, which were nasopharyngeal samples were negative

Scienc e :. You made later sampling over La Gloria, right?

Alpuche : In the last part of the outbreak in La Gloria, the children began to have symptoms April 1. They took samples April 3. They sent samples the laboratory of the state of public health, and they were treated 4. April they arrived in my laboratory on April 8.

science :? What were the positive aspects

Alpuche : They have identified three influenza strains at the end of the period. A proven to be H3N2. The other was, but it was not encouraging. Here in our lab, we considered that this could be H1, but she seemed indeterminate. To be honest, we are not able to enter it. And then we got a B.

Science : The one that you are not able to type, have you sent anywhere else? Did you fear that you can not type

Alpuch e:. At this point, we have no information about the A nontypable they have seen in the children of California

science . in the monitoring program here in California, if you can not type, you send it to CDC

Alpuche : That's what we do. Our collaboration center is CDC. We have three different time to the accumulation of samples sent to the CDC during the season. When we had the first permanent strain of La Gloria, we were not worried. Right now, the epidemic has been controlled.

Science : On April 12, Mexico notified the Pan American Health Organization, in accordance with the International Health Regulations regarding the outbreak of influenza Veracruz. First, do you have that these cases resemble flu

Alpuche :? Our initial thinking, as we reported in accordance with International Health Regulations, was that we were in the process of intensification and extension of the influenza period. We thought outbreaks of Tlaxcala and Perote were nothing unusual in terms of pneumonia. It is later, then we started to consider that there was anything unusual

Science :. On April 17, Mexico began to increase its surveillance of influenza. What triggered the switch to improve active surveillance

Alpuche : We had a notification of an isolated case, a 37-year-old diabetic who is death due to respiratory disease and pneumonia in Oaxaca. The woman had onset of symptoms April 4. There was no connection to Perote. We obtained samples, and it was a lung biopsy because the parents did not allow an autopsy. They studied intensively contacts around the deaths. They found some with respiratory diseases, but no deaths. Nothing unusual, right? They were tested and all were negative for influenza and other viruses.

Science :? When did you first contact Frank Plummer, head of Canada's Public Health Agency National Microbiology Laboratory

Alpuche : I contacted April 17 by e- mail and he replied immediately. He wanted to know more about it, and we had a long conversation Saturday, April 18.

Science Frank told me he not originally thought flu. He thought it would be an unknown pathogen

Alpuche :. Exactly. And we discussed with Dr. Plummer. In fact, I'm the one who called him because I am the person laboratory. I met him through the Action Group for global health security. And we talked about different collaborations, and immediately when we started discussing it and epidemiology, we wanted to exclude all we could

Science .: Why did you contact him?

Alpuche : Canada has a lot of experience with the screening of severe acute respiratory syndrome, SARS, of unknown pathogenesis.

Science : When did you learn of the first two cases of swine flu in California that have been reported in MMWR April 21

Alpuche : CDC sent me a preprint. I do not know exactly when

Science .? When you have samples sent to Canada and CDC

Alpuche : April 21. We have asked for help both simultaneously. The CDC is my collaborating center in the WHO network. They always help us make the quality assessment for us, giving us the reagents, do training, technology transfer. But to do the shipping for each of them, it was a bit difficult. It was a bit delayed to get all the US authorities

Science : Was your decision to send him to Canada also because the US authorities held your samples?

Alpuche : No, not at all. I sent these samples to the CDC because they are my collaboration center. Here's how to do it. We get all the help we need the CDC

Science :. But I think it's important for the United States to learn from that. How long your samples were held in place and why

Alpuche : It was just a difference of 1 day. I can not tell you if it is because it is more difficult to send things from Mexico to the United States rather than Canada. To be honest, I can not explain.

Science : I guess you were frustrated by the delay

Alpuche :. Yeah, but we knew we were going to get the help we needed, and we got it. He was just a little difference

Science .? When have you heard back from Frank Plummer on your samples

Alpuche : We got the preliminary results April 22. Dr. Plummer received the samples at 3:00 in the afternoon and at midnight he called me to say that we had influenza A. Some of the samples that I sent him, we knew they were swine flu this week, we started to see the A and we have started to change our mind that influenza B prolongation of seasonal flu.

Science : When did you know they were positive for a new virus of swine flu?

Alpuche : I learned that it was swine Frank Plummer; that was in the afternoon of April 23. And later that night Dr. Nancy Cox [of CDC] on a conference we had with Mexican experts, we discussed it and she gave us the preliminary results we have some pig strains, those who just arrived that day at CDC

science :. what do you think of the criticism that Mexico has not made early enough to catch it? It comes from the Mexican press and the international press

Alpuche . There will always be to be something to find fault in everything. This is a new unknown virus. We have grown both in terms of diagnosis and epidemiological surveillance recently. We still have limitations, for sure. We really have to accept. And we work very hard to overcome these limitations. We, and all health authorities, has done everything possible to try to define as soon as possible.

We work so hard to try to control it. And we were very open from the beginning. When I received the confirmation of Dr. Frank Plummer, I was immediately in contact with my superior Dr. Mauricio Hernández, and he spoke immediately with Secretary Córdova and was essentially open.

Science : Many laboratories in Mexico that I have visited are very sophisticated. What are the limits that have prevented your lab to identify the new H1N1 virus? What CDC and Canada only you do not have

Alpuche : The only place in Mexico doing subtyping is this lab here. We are able to sequence and subtype, but we are overwhelmed by samples of the flu and other things around the country. It is a bit slower than in the US or Canada

Science .? But what are the limits of your laboratory for virus isolation and sequencing

Alpuche Since this week, we have experts from CDC and Canada helping us develop a PCR live [polymerase chain reaction] technology to test swine H1N1 directly.

Science : Is your lab the only lab in the country at this point who can do the confirmatory test with the real-time PCR machine

[?

Alpuche : at this point, yes, but we work with the CDC and Canada to form molecular biologists in different institutions in six different states in Mexico. We have two PCR machines in real time, we were able to immediately - we borrowed from each company. And now, we purchased 10 more machines. We are working full-time to accelerate diagnostics

Science .? How many samples do you have waiting to be tested

Alpuche : right now we have a backlog of about 1,000 tests that we will rush to make it in time . We will have three quarters of people who work in the morning, afternoon and night

Science :. You have 1000 samples waiting to be tested, but there are almost 2,000 suspected cases.

Alpuche had not all cases that have been tested in hospitals samples that were submitted to us. . And not all the 1000 samples we have are suspected cases

Science : Are you always send samples to the CDC and Canada

Alpuche : Yes, we sent several samples to Canada this week, and we just organize one here with the CDC to send more samples to the CDC. We want to exclude all these samples into us so that we can continue with the new

Science :. Many Mexican press and now press outside of Mexico wrote about the Gloria and the large pig farm near Perote, Granjas Carroll. There are all these allegations and even conspiracy theories.

Alpuche :. I do not know, there are so many rumors

Science : What about the boy in La Gloria, which has received much attention

Alpuche :. It was a mild disease, no problem

science : Is it correct that it is the index case

Alpuche :? We're not sure. By the onset of symptoms, it is the first that we see in our database, which is all

Science : .. What is the start for him

Alpuche : April 1.

science : There were all these stories as Perote the epicenter, or sender. Do you believe that

Alpuche : We asked the agriculture authorities, and they have assured us that they do not detect any problems with outbreaks with animals on these farms near Perote. And the farm is located 80 kilometers from La Gloria.

Science : So, it is very far

Alpuche :. Even away to someone who works there to make the trip. But we are studying it. We epidemiological surveillance. And we asked other authorities, and there was virtually nothing wrong

Science .? Is there a confirmed case any employee of Granjas Carroll

Alpuche :. Not that I know to date

science : One of the theories is that this origin in the US or elsewhere and a human being came to Mexico, may -being a migrant. The assumption that he was a big pig could be very misleading

Alpuche :. Perhaps. This is the same thought that we have. We need more data to prove it. One of the interesting things is we see these isolated cases in Oaxaca and Perote, they are well known for migration. And also the other state that we see many cases today when active outbreak is San Luis Potosi, and it is like the migration corridor. It is hard to believe that it will be associated to this farm, but I know that the authorities thoroughly investigated, it

Science :. Do you think if it resurfaces elsewhere that Mexico would have been contained, or the flu just go too fast anyway

Alpuche : Considering it was the end of the season, maybe confused done a little something else might grow, but probably the flu moves too fast anyway.

Science The US cases detected early, and the US has not been able to contain it. He said that the virus is smarter

Alpuche : Yes, for sure

Science :. One. last thing. How many hours a night do you sleep

Alpuche : .. [laughter] At the two

Science . This has been going on for 2 weeks now

Alpuche : Yeah, so some days we get 2 hours and then a nap half an hour. And there Latte. double strokes. . Espresso

Science : Anything you need, anything at present the international community

Alpuche : We 're all right now in the way we work and our employees. But at some point, if we need it so I'll ask. But now, we agree.

The growing number - on the swine flu

May 8 Morbidity and Mortality Weekly Report published today reports new details on outbreaks of swine flu in Mexico and the United States, revealing a much larger number of suspected and confirmed cases reported above. Highlights: Mexico May 6 had nearly 12,000 suspected cases, more than 1,000 others confirmed; the United States had more than 0 confirmed and 800 probable and tests showed that over 99% of probable cases were found to be positive for influenza A (H1N1) virus. Both countries show a "similar age distribution" in their cases, and the report notes that "the percentage of patients requiring hospitalization appears to be higher than would be expected during a normal flu season."

Microbiologist arrested for smuggling materials -

A Canadian researcher is held US after attempting to pass 22 vials of biological materials in the United States. Konan Michel Yao was arrested at the border between North Dakota and the Canadian province of Manitoba, on May 5, according to this AFP story.

Yao worked until recently at Canada's National Microbiology Laboratory, doing research on vaccines for the Ebola virus and HIV. He said US border guards that he was carrying the vials to his new job at the National Institutes of Health. Although the materials in its possession are not infectious, and the authorities do not believe this is a case of attempted terrorism, the case is likely to add to concerns about the safety of laboratories that harbor dangerous pathogens. Yao could face smuggling charges.

When the vaccine against the flu Get ready? -

Despite recent news report to the contrary, the US Centers for Disease Control and Prevention (CDC) provides Science Insider efforts to make a vaccine against the virus causing the swine flu outbreak have not encountered unexpected delays.

Confusion about the chronology of the vaccine from a report by the World Health Organisation (WHO) yesterday, who told a meeting organized by a scientific working group which studied closely production problems. The Advisory Working Group concluded that manufacturers would not be able to begin "large scale production" of a vaccine against the new H1N1 virus until mid-July. The report did not describe these as delays, but many media accounts did, noting that Marie-Paule Kieny, WHO, the director of the WHO's initiative for vaccine research, earlier predicted that production could begin two months earlier and suggested that a vaccine could be ready as soon as September.

Tom Skinner, spokesman for the CDC, assured science Insider that everything is on track. "We hope we can have a loan late autumn vaccine; However, we know that the manufacturing process is complicated, and we must be ready in case we encounter glitches with vaccine production, "said Skinner. The time, of course, depends on the specific steps in the manufacturing process, and the CDC and the WHO working group seem to have different estimates on some key points.

the vaccine process begins with viral isolate being converted into "seed stock." CDC has already five isolates sent to seven laboratories to make the starting material. a key property of the seed bank is that it is a weakened or attenuated version of the original virus, making it a safer production process and reduces the risk of an accidental release.

Skinner said CDC expects the seed stock in hand next week. According to the WHO report, it will then take 1 to 2 weeks of testing animals to ensure that the seed stock is attenuated. But Skinner said CDC simultaneously perform these tests on animals and send the seed stock for some manufacturers who biosafety level laboratories 3-plus (BSL-3 and more), which are specially designed to work with dangerous pathogens. "Those who have BSL-3 laboratories as well, and some will begin immediately," said Skinner, who points out that the United States, it all depends on the government to decide to get the vaccine, which does has not happened yet.

the WHO report says that manufacturers must then typically 1 to 2 months "to isolate rapid growing strains for maximum efficiency." Skinner said no. "They to do some more work on it to get in the condition they need for the vaccine, and I thought that takes a few weeks, so that the middle of June to the end of June, they could start to produce a lot of drivers, "he said. These pilot batches are used in small clinical trials to make sure the vaccine is safe and triggers the appropriate immune responses, a process that takes about 8 weeks Skinner said.

But Skinner points out that manufacturers are not normally put the production of commercial batches of vaccines waiting until they have the results of the batch of pilot tests. "They will not wait until everything is done to start producing the vaccine than the rest of us might need in the fall and winter," said Skinner. "These two processes are parallel. "

As to exactly when this vaccine can be ready, Skinner says this is a question for manufacturers. A spokesman for GlaxoSmithKline, a major manufacturer of vaccine against influenza, said, "We expect the first doses of H1N1 vaccine would be available 4 to 6 months after receipt of the seed strain, pending regulatory approval." this means that the vaccine would be available in mid-October to mid-December and that is assuming there are no unforeseen manufacturing problems or regulatory issues surface. wHO Kieny May 1 estimated that it would take only 4 to 6 months to produce a vaccine from the time of virus isolation, which means September 1 availability.

is CDC concerned that the vaccine may not be ready in time? "It is safe to say that we are considering several scenarios in mind when a vaccine could be available, "Skinner said.

Even if the uS government decides to buy the vaccine, Skinner acknowledges that the country can not eventually use the product if the spread of the new H1N1 virus does not justify. "We will be looking very closely what happens during the summer here in the United States, but especially what happens in the southern hemisphere regarding the new H1N1, to have this information to decide what, if anything, we're going to do regarding a vaccination campaign later this fall and winter, "said Skinner." But if we think we might need a vaccine, we must now to ensure that we have one, and what we do. "

The Rock-It Scientists -

by Geoffrey Beene advertising campaign in the June issue of GQ has 11 biomedical scientists (all men) posing with rock stars such that Seal and Sheryl Crow. Why? It seems that the clothing company has a foundation that funds medical research. The campaign aims to "honor researchers who save our lives, to rock science as a career choice for the next generation, and increase [stars'] platinum voice in the application for funding for future research," says the announcement. Soon on a website, visitors will be nominal measuring their favorite rock star of science or sign a petition asking Congress to increase funding for medical research. This plan offers Alzheimer's researcher Rudy Tanzi, Aerosmith guitarist Joe Perry, and geneticist Francis Collins, who seems to be everywhere these days as rumors grow louder it will soon be appointed as Director of the National Institutes of Health. (For details, see the blog scientific careers to take on the ad.)

Novartis Reports Advance in swine flu vaccine production -

Novartis announced in a press release today that it has made the first batch of vaccine against influenza A ( H1N1) flu causing the swine flu pandemic. The Swiss pharmaceutical company said it had 10 liters of vaccine that will be used in pre-clinical studies and clinical trials may be the beginning. The company uses cells to grow the vaccine virus and claims that this traditional overproduction with eggs "shows significant time savings." Thirty governments "requests" to the company for the ingredients of vaccines. If all goes well, the company expects to receive regulatory approval for its vaccine in the fall.

The New York Times on - Results Nerve cancer subsidies

Yesterday The New York Times featured a front-page story suggesting that the approach the government cancer research funding, particularly at the national Institutes of Health (NIH) scientists -pushes to "play it safe" and steer clear of bold ideas. The article, by Gina Kolata, addressed the scientific points have complained for years, and has generated a storm of comments mostly positive on Times website. More than 0 people have weighed in so far, many of them frustrated researchers, grant their authors, and others inside and outside the field of cancer.

A number of scientists, both those comments and those mentioned in the original article, said it was not always bad. They attribute some caution to years of tight budgets under the Bush administration. Several speakers defended the current system, especially at a time of difficult funding: "There is a limited amount of money VERY limited," wrote Rosa Ohio, who said she has reviewed grants. NIH for the last 8 years. "We can not finance all the wild ideas without any proof of the basic feasibility."

But from the sound of it, there is a desire among some at least, to the wildest studies over those tamed in the hope that they will actually make a difference.

Cancer does not discriminate -

For years, researchers know that race is a factor in cancer survival. Black women are less likely than whites to have breast cancer, for example, but much more likely to die from it ( Science , February 2, 07). How much of this difference stems from unequal access to health care, such as regular screening and aggressive treatment, and how much is rooted in biology? A new study looks back on dozens of clinical cancer trials finds that for some cancers, such as lung and leukemia, race makes no difference, while for others, such as breast, prostate and ovarian cancer, it does.

oncologist Kathy Albain of Loyola University of Chicago in Illinois found that one way to get a big-picture view of the link between race and cancer survival was combing through a vast clinical trials network. So she turned to the Southwest Oncology Group (SWOG), one of the many cooperative groups in the United States overseeing large multicenter trials for a variety of cancers in which all participants receive the same level of care, and many receive the same treatment. Albain and colleagues focused on 35 large SWOG trials that were running at some point between 1974 and 01, which included almost 20,000 adults. Trials were conducted on eight cancers: breast, lung, colon, ovarian, prostate, multiple myeloma, lymphoma and leukemia. Albain's team examined how African-American participants are doing, adjusting for potential confounding factors such as weight and socioeconomic status (estimated from zip codes).

For most cancers, the race made no difference in survival. But for three - breast, prostate and ovarian cancer - it mattered. In premenopausal cancer early breast, for example, the survival rate at 10 years was 68% for African Americans against 77% for all other patients (mostly Caucasian) in the tests. For advanced ovarian cancer, median survival was 1.3 years for African Americans and 2.3 years for the rest of the participants. And cancer advanced prostate, it was 2.2 years against 2.7 years, the group says online today in the Journal of the National Cancer Institute .

First, the results are reassuring because for many common cancers, race made no difference to the outcome, said Albain. She believes the answer to why there are differences in three cancers lies in an interaction between tumor biology, hormonal responses in the patient, and genes that may affect how medicines such as some chemotherapy, are metabolized .

One of the issues that dogged the study of racial disparities in cancer has been how much is due to access to care, notes Timothy Rebbeck, a cancer epidemiologist at the University of Pennsylvania . But here, "the disparities persist even with standard treatment." In addition, three specific cancers sex were fingers in other racial-disparity studies, he said.

One concern, said Peter B. Bach, a physician and epidemiologist at Cancer Center Memorial Sloan-Kettering in New York City, is whether the deaths in the trials were invariably due to cancer - as opposed to a disease unrelated to which African Americans are more susceptible, such as diabetes. But Albain noted that if that were the case, his group would have seen disparities in all cancers - not just some detected. She is now scrutinizing the expression profiles of genes and other characteristics of tumor bank for more tips.

Elimination of river blindness in view -

Cases of parasitic infection known as river blindness or onchocerciasis, fell dramatically in Africa in the 2 recent decades, thanks to large donations of a drug by the pharmaceutical company Merck. Now, a new study suggests that these programs can eventually eradicate the disease. "It's fantastic," said Uche Amazigo, Director of the African Programme against onchocerciasis, based in Ouagadougou, Burkina Faso. "For us in Africa, this is an important step."

onchocerciasis - often simply called "river blindness" - is caused by Onchocerca volvulus , a nematode worm that is transmitted from person to person by many species of Simulium black flies. The adult worms mate inside the human body, and the female produces a large number of microscopic larvae, called microfilariae. The larvae cause intense itching and a severe immune reaction when they die; when they colonize the eye can cause blindness.

initial control efforts have focused kill black flies around fast rivers where they prefer to breed. But after Merck has set up a donation program for ivermectin in 1987 - which is sold in the US as well and is active against many other parasites - annual or biannual treatment rounds with the drug proved more effective. Ivermectin paralyzes and kills the microfilariae; it also reduces the fertility of adult worms, but does not kill them. This works great to prevent blindness and other symptoms, but no one knew if the drug alone could completely stop onchocerciasis transmission

In the new study, researchers surveyed the places where treatment by ivermectin has been going on longer :. Three regions Mali and Senegal, which were distributed the drug for 15 to 17 years. The team verified nearly 18,000 people in 126 villages for O. volvulus less than 1% were tested positive. Of more than 150,000 black flies captured in the same areas, less than 0.05% have been able to transmit the worm. At these levels, the models suggest that the disease is linked to eventually peter says Hans Remme, parasitology World Health Organization retired who participated in the study as a consultant.

Next, the researchers stopped the treatment with ivermectin in five eight villages in each region. (Given the importance of whether the treatment can be stopped safely, it was considered ethical provided that the villages were monitored carefully for signs of resurgence, said Remme.) But the disease did not return. Among nearly 2,300 people were tested from 16 to 22 months later, no one had worms, while the number of infected flies remained extremely low, today reports the team in PloS Neglected Tropical Diseases . It is the first evidence, Remme said that stopping treatment with ivermectin is safe

In the next study phase, treatment was interrupted through two of the three regions. if the results are similar, Mali and Senegal ivermectin consider dropping altogether, said Remme. The chances of O. volvulus would stage a comeback are slim, he said, partly because men and women to need to meet within a single individual spread.

similar success may be more difficult in countries such as Cameroon and the Democratic Republic of Congo, which had higher transmission levels prior to treatment and are home to black fly species that spread them to more efficiently, said Remme. But a new drug called moxidectin, currently under study, could reduce the clearance time for it to target the long-term adult, in addition to their microscopic offspring. Nobody talks about eradication - the elimination of a disease of the entire planet - for now, but "we can really start to shrink the map onchocerciasis in Africa," said Amazigo

Merck, which already. given some 2.5 billion ivermectin tablets valued at $ 3.5 billion, said it will continue the program as long as necessary. "We dreamed that a step like this could be a day possible, "said CEO Richard Clarke in a statement released by the company today.