Reduce pain without causing numbness Combination of capsaisin and QX-314 .
In a front-page story, the Boston Globe (10/4, Nickerson) reported, "Scientists at Harvard Medical School and Massachusetts General Hospital yesterday described a new targeted approach to anesthesia that uses the active ingredient in chili peppers as part of an ingenious recipe for blocking sensation only from pain neurons," according to research findings published in Nature. "In time," the researchers said, "the process...might even be employed for major surgery on the heart and other organs."
The researchers "found that the chili pepper ingredient (capsaicin) generated heat that opened the gate to pain neurons, but had no similar effect on other nerve cells." Dr. Clifford Woolf, senior author of the study and a researcher in anesthesia and pain management at Mass. General, said, "Patients could remain alert without suffering pain. But they also wouldn't have to cope with numbness or paralysis."
And, WebMD (10/4, Warner) pointed out that during this study, rats which were injected with the experimental "anesthetic near the sciatic nerve" had "their paws [pricked] with nylon probes." The researchers found that "[t]he animals seemed to ignore the painful prick, but continued to move normally and responded to other stimuli."
Increase HDL without raising blood pressure. Bloomberg (10/5, Pettypiece) reports, "An experimental drug from Merck & Co. boosted good cholesterol levels without raising blood pressure, a side effect of a similar pill from Pfizer Inc. that was found to increase death rates a year ago," according to research presented by Merck at the International Symposium on Drugs Affecting Lipid Metabolism in New York. The company reported that the drug "raised patient's HDL...by as much as 139 percent, more than...Pfizer['s]...torcetrapib," a similar drug.
For the study, researchers followed 589 patients and found that "the highest blood pressure increase was in patients" who received a placebo. Furthermore, when anacetrapib "was combined with Pfizer's Lipitor (atorvastatin), it" reduced LDL levels "by as much as 27 percent more than Lipitor alone." Bloomberg notes that an increase in blood pressure was a "side effect of" torcetrapib. Pfizer ceased studies on torcetrapib last year "after 82 patients taking it with...Lipitor died."
Virtual colonoscopy Vs traditional colonoscopy. HealthDay (10/4, Dotinga) reported that "'virtual colonoscopy' is just as effective" in identifying potentially malignant polyps as traditional colonoscopy, according to a study published in the in the Oct. 4th issue of the New England Journal of Medicine.
In the study, researchers from the University of Wisconsin Medical School examined the virtual colonoscopy, which is also known as CT colonography, and the traditional colonoscopy results of more than 6,000 patients. Of those, 3,120 underwent a virtual colonoscopy and 3,163 underwent the tradition exam. The researchers "found that the two approaches were about equal in terms of detecting potentially dangerous polyps -- 123 were detected by virtual colonoscopy and 121 through the traditional approach."
MedPage Today (10/4, Groch) noted that in the study, "Advanced neoplasia of the colon consisted of both adenocarcinomas and a subgroup of benign neoplasms referred to as advanced adenomas, but associated with a relatively high risk of progression to cancer. ... An advanced adenoma was defined as an adenoma that meets one or more of the following criteria: at least 10 mm in size, a substantial villous component, and high-grade dysplasia." Of the 123 neoplasms found in the CT colonography group, 14 were "invasive," while four were "invasive" in the colonoscopy group. In addition, "Advanced neoplasia was confirmed in 100...patients in the CT group (3.2%) and in 107 of the...patients in the primary colonoscopy group (3.4%)."
In addition to the NEJM study, the AP (10/4, Nano) also covered a second study by the American College of Radiology Imaging Network in which 2,000 study participants underwent "a virtual colonoscopy followed by a traditional one the same day and the outcomes were compared." Once presented with the preliminary results, the group said that "virtual colonoscopy is 'highly accurate.'" The results of that study are expected to be published "around the end of the year." The AP also called CT colongraphy "quicker and cheaper than colonoscopy."
Made in China Medicine in USAChinese drugmaker first to obtain FDA approval to export pills to U.S. "When a small drugmaker [in the U.S.] got...[FDA] approval for an AIDS drug this past summer, the Chinese pharmaceutical industry quietly passed an important milestone.
As far as the agency can tell, it is the first time a Chinese company has won permission to export finished pills to the U.S."
"Even as Chinese products are drawing increased scrutiny, the nation's generic-drug industry is gearing up for the export of finished medicines."
Currently, China is "the world's largest producer of raw materials for drugs, and manufacturing those raw materials is a steppingstone to making the completed product." Something similar occurred with India's pharmaceutical industry.
Today, just one company, Ranbaxy Laboratories Ltd., has annual sales of $391 million in the U.S.
"Zhejiang Huahai Pharmaceutical Co., the Chinese drugmaker that won FDA approval this summer," will only begin marketing "the AIDS drug nevirapine (viramune)" in the U.S. in 2012 "when a U.S. patent held by Boehringer Ingelheim GmbH" expires. However, the Journal notes, "the FDA imprimatur will make it easier for Huahai to get other approvals and attract American drug partners."
Physicians flocking to Texas "Four years after Texas voters approved a constitutional amendment limiting awards in medical malpractice lawsuits, doctors are responding as supporters predicted, arriving from all parts of the country to swell the ranks of specialists at Texas hospitals and bring professional healthcare to some long-underserved rural areas."
"The influx, raising the state's abysmally low ranking in physicians per capita, has flooded the medical board's offices in Austin with applications for licenses, close to 2,500 at last count." According to Dr. Donald W. Patrick, executive director of the medical board and a neurosurgeon and lawyer, "Doctors are coming to Texas because they sense a friendlier malpractice climate."
However, "[s]ome experts say the picture may be more complicated and less positive. They question how big a role the cap on malpractice awards has played, arguing that awards in malpractice lawsuits showed little increase in the 12 years before the law changed." In addition, certain critics, "including liability lawyers, question whether the changes have left patients more vulnerable."
Smart Seniors of TodayToday's seniors may be smarter than those from the previous generation, study indicates. Elderly people are smarter today than they were less than a generation ago." In addition, "when it comes to mental acuity,
74 is the new 59," according to a study published in the current issue of the journal Psychology and Aging.
Elizabeth M. Zelinski, Ph.D., of the University of Southern California in Los Angeles, and colleagues, "compared performances on a battery of intelligence tests between a group of contemporary 74-year-olds and another group of people who took the tests 16 years earlier, when they were also 74."
The study team found that the "latter-day septuagenarians performed better on the tests across the board," having an average performance "closer to someone 15 years younger in the earlier testing group." Zelinski concluded,
"These findings have very interesting implications for the future, especially in terms of employment. ... As a group, older people are more mentally able to keep working beyond retirement age today."
Pocket Ultrasound for DoctorsPhysicians are using small ultrasound machines to screen for heart disease. "Miniature ultrasound machines are starting to make their way into ordinary doctors' offices, where they may someday be as common as stethoscopes and EKGs."
Some of the "new ultrasound machines offer a relatively cheap, painless way to screen people with no symptoms of heart problems for signs of hidden trouble." The "devices can make images of neck arteries, which offer a 'window' to heart arteries that cannot easily be seen."
Some physicians say the devices may be useful "because, for one-third of heart disease sufferers, the first symptom is dropping dead of a heart attack."
While the "American Heart Association says [that] testing with traditional ultrasound machines can help certain patients," the organization "does not endorse widespread screening with the small devices because proof of benefit is lacking."
The AP notes that a "pocket-sized" ultrasound machine "weighing less than 2 pounds hit the market last week."
Your Health Record ...... to be onlineMicrosoft launches website for consumer health records. "Microsoft announced a website called
HealthVault," which will provide "a central place for consumers to store their health-related data and share it with doctors and other medical professionals. The site also offers Internet search and a Web page for viewing and organizing articles and other information on health."
"From the consumer's point of view, Microsoft's HealthVault site is
part library, part filing cabinet and part fax machine for an individual or family's medical records and notes."
The free site "gives users a repository for health-related data such as
medical histories,
immunizations and
records from the doctor's office and hospital visits as well as measurements from devices like heart rate monitors."
"Microsoft may have a tough go of it," because patient health records "are about as resistant to information technology as the common cold is to a cure. Doctors with small practices haven't always been keen to make the investment in computer systems when the payoff seems so unclear."
In addition, "Few hospitals have bothered to set up systems to retrieve data from patients' electronic files."
"Getting doctors to participate in such services, experts said, would probably require more government regulation." According to Health and Human Services officials, over the past few years, the government has "worked on standards under which software vendors would store data the same way. They are still determining how to get data to transfer seamlessly from one program to another."
Many physicians have said that the biggest "barrier to digitizing...is the lack of federal standards for how the software should work."
"The personal information, Microsoft said, will be stored in a secure, encrypted database. Its privacy controls...are set entirely by the individual, including what information goes in and who gets to see it."
Cholesterol Mystery Drugs in ChaosWelcome to The Science Business, a blog focusing on how companies affect and are affected by research in biology, medicine, chemistry and physics.
Biotech and pharmaceutical firms, whose stocks trade on research results, will be a primary focus here, but I'll try to cast a wide net for other kinds of science as well.First, a look at one of the most puzzling mysteries in pharmaceutical science right now:
Why did Pfizer's drug to boost good cholesterol, torcetrapib, fail, and does that mean similar pills from Merck and Roche are goners as well?
New data on Merck's pill provides some clues.Torcetrapib was supposed to be Pfizer's savior when its Lipitor goes off patent three years from now. High levels of good cholesterol, also known as HDL or high-density lipoprotein, seem to protect the heart by carrying heart-attack-causing artery plaque out of the body, like a garbage truck. Torcetrapib boosted HDL 60% or more.But the torcetrapib actually seems to have caused deaths in a big clinical trial, and nobody knows why. This could be because torcetrapib boosted blood pressure, a known risk for heart attacks, but it could also be the HDL it produced, instead of preventing heart disease, actually caused it.How could that happen?
Torcetrapib -- and similar drugs from Roche and Merck -- raise HDL by blocking the cholesterol ester transfer protein (CETP). Doing this raises blood levels of HDL, but the HDL may actually be full of cholesterol. The result is kind of like having a lot of garbage trucks on the street, but they're all full.
If raising cholesterol by blocking CETP out of the water were a good thing, Merck's drug would have blown torcetrapib out of the water. Because their drug doesn't raise blood pressure, Merck scientists were able to boost good cholesterol 130%, and cut bad cholesterol, or LDL, by 40% -- as much as a low dose of Lipitor.So was this good cholesterol, well, good?
One marker of heart disease risk is a protein called lp-a; the Merck drug lowered that. But it didn't affect C-reactive protein, or CRP, which a measure of how inflamed artery plaque is. More inflammation means the plaque is more likely to burst and cause a heart attack. So maybe the cholesterol wasn't so good. More information on CETP-blocking drugs should emerge at the annual meeting of the American Heart Association in a month.
Alcohol Addiction: a need for new drugTopamax may help reduce alcohol addiction, study suggests. "A migraine [and epilepsy] pill seems to help alcoholics taper off their drinking without detox treatment,...offering a potential option for a hard-to-treat problem," according to a study published in today's issue of the
Journal of the American Medical Association.
The pill is called Topamax (topiramate), and may "appeal to heavy drinkers who would rather seek help from their own doctors, rather than enter a rehab clinic to dry out." Heavy drinkers consumed about "11 standard drinks daily," which translates into "two six-packs of beer each day, or two bottles of wine." While study participants noted some side effects, addiction specialist Dr. Mark Willenbring of the National Institute on Alcohol Abuse and Alcoholism, said, "The size of the treatment effect is larger than in most of the other medications we've seen. ... And all the drinking variables changed in the right direction." On average, Topamax would cost about $350 per month, in addition to physicians' fees.
HealthDay (10/10, Dotinga) adds that lead author Dr. Bankole Johnson, chairman of the University of Virginia's Department of Psychiatry and Neurobehavioral Sciences, and colleagues, "recruited 371 alcoholics between the ages of 18 and 65" from 2004 to 2006. "The subjects, both male and female, received daily doses of topiramate -- up to 300 milligrams -- or a placebo along with a brief weekly visit with a counselor." After 14 weeks, the researchers found that "the percentage of heavy-drinking days per week dropped from 81.9 percent to 43.8 percent among those who took topiramate, and from 82 percent to 51.8 percent among those who took a placebo." In addition, Topamax "led to a higher rate of achieving 28 or more days of continuous non-heavy drinking and 28 or more days of continuous abstinence." The research team plans to study the long-term effects of Topamax.
The
Wall Street Journal (10/10, D4, Dooren) quotes Dr. Johnson as saying that "current medications approved to treat alcohol dependence are given after a person has stopped drinking or gone through detox." His team wanted "to find treatments that can be used while people are still drinking." Therefore, Topamax was a good candidate for the study because it "is designed to inhibit dopamine, a neurotransmitter in the brain involved in several functions including regulating behavior, sleep and mood."
"Some adverse events were about five times more common in topiramate users than in the placebo group." These "included tingling of arms and legs, reported by half of topiramate users; strange tastes,...[experienced] by nearly a quarter on the drug; loss of appetite, reported by about a fifth of the topiramate patients; and difficulty with concentration in about 15% on the drug." But Sidney Wolfe, director of the Public Citizen Health Research Group, an advocacy group, "was not impressed by the 'modest' improvement in topiramate users."
In fact, the group wrote a letter to the FDA stating that "a press kit about the study from the University of Virginia promoted off-label use of topiramate for treating alcoholism, even though the drug's labeling states [that] users should avoid drinking alcohol." According to Wolfe, "The press kit says doctors can prescribe topiramate off-label for treating alcoholism." However, the University of Virginia has denied this charge. In response to the criticism about side effects,
AHN (10/10, Sharma) notes that "the effects were mild compared to the side effects reported with other treatments for alcoholism such as naltrexone or acamprosate," the researchers indicated.
"Alcoholism causes 85,000 deaths each year, according to Centers for Disease Control statistics." The Daily News continues, "While a handful of other drugs can help relapsing alcoholics, this one is 'for people who are drinking seriously and want help immediately,'" said Dr. Johnson. Dr. Petros Levounis, director of the Addiction Institute of New York at St. Luke's-Roosevelt Hospital, noted, "Anything that will get the patient to slow down damage to the body is welcome."
The comprehensive training provided by the St. Luke's Family Medicine Residency Program gives residents the skills necessary to deliver quality health care. Graduates of this residency are able to 
