Less Than Half Of Medical Students Understand Health Care System
September 30, 2009
Less than half of graduating medical students in the U.S. say they received adequate training in understanding health care systems and the economics of practicing medicine, according to a study conducted by the University of Michigan Medical School.
The national survey of more than 58,000 medical students from 2003-2007 showed an overwhelming majority were confident about their clinical training. But when it came to understanding health economics, the health care system, managed care, managing a practice or medical record-keeping, 40 percent to 50 percent of students reported feeling inadequately prepared.
The findings were published this month in Academic Medicine.
U-M Diabetes Center Explores Use Of Arthritis Drug To Control Diabetes
September 30, 2009
Joslin Diabetes Center scientists will collaborate with the University of Michigan Comprehensive Diabetes Center to take groundbreaking research on the role of inflammation in type 2 diabetes to a new level.
A national clinical trial will investigate whether salsalate, an anti-inflammatory drug used for years to manage arthritis pain, can reduce blood glucose levels in people with type 2 diabetes. If successful, the trial could one day lead to an inexpensive way to treat the most common form of diabetes.
About 560 adults with poorly controlled blood glucose levels are being sought to participate for one year in the clinical research study, referred to as Targeting Inflammation with Salsalate in type 2 Diabetes (TINSAL-T2D).
Joslin researchers showed salsalate was effective at lowering blood sugars when given for three months, leading to the start of this larger trial of longer duration. The trial, led by Joslin, is being conducted there, the University of Michigan and 20 other medical institutions across the country.
Studies Point To Strategies for Reducing Painful Breast Cancer Drug Side Effects
September 29, 2009
Aromatase inhibitors, the same drugs that have buoyed long-term survival rates among breast cancer patients, also carry side effects including joint pain so severe that many patients discontinue these lifesaving medicines. New University of Pennsylvania School of Medicine research, however, has identified patterns that may help clinicians identify and help women at risk of these symptoms sooner in order to increase their chances of sticking with their treatment regimen. In a study published recently in the journal Cancer, researchers at Penn’s Abramson Cancer Center found that estrogen withdrawal may play a role in the onset of joint pain, also known as arthralgia, during treatment: Women who stopped getting their menstrual periods less than five years before starting breast cancer treatment were three times more likely to experience these pains than those who reached menopause more than a decade earlier.
In a separate study published in the journal Integrative Cancer Therapies, the Penn researchers found that among women experiencing these symptoms during treatment with aromatase inhibitors (AI), those who received electro-acupuncture – a technique that combines traditional acupuncture with electric stimulation – reported a reduction in joint pain severity and stiffness. Those women also said they suffered less fatigue and anxiety.
“We are fortunate today to have many effective treatments for breast cancer. Unfortunately, many of these treatments have troublesome and debilitating side effects that can last for months or years after treatment, and really harm the quality of life and productivity of women who receive them,” says lead author Jun J. Mao, MD, MSCE, an assistant Professor of Family Medicine and Community Health. “These findings are just a first step in our comprehensive research program aimed at understanding the nature of treatment-related symptoms, who is likely to get them, the mechanisms by which they occur, and how best to treat them.”
Mechanism for Potential Friedreich’s Ataxia Drug Uncovered
September 27, 2009
Using clever chemistry, a Scripps Research team has pinpointed the enzyme target of a drug group that stops the progression of the devastating disease Friedreich’s ataxia in mice and may do the same for humans. The findings, developed in collaboration with scientists from Repligen Corporation, help advance this treatment approach one step closer toward human clinical trials, which will be a welcome event for disease sufferers who currently have few treatment options.
The work, reported as the cover article of the September 25, 2009 issue of the journal Chemistry & Biology, could also lead to treatments for related conditions such as Huntington’s disease and the spinocerebellar ataxias.
“It will be very rewarding if our work actually leads to a therapy for Friedreich’s,” says Joel Gottesfeld, a professor in the Department of Molecular Biology and leader of the Scripps Research team that discovered the potential treatment. “This is a horrible disease.”
Researchers at University Hospitals Case Medical Center to Test Gammaglobulin Treatment for Alzheimer’s Disease
September 24, 2009
Researchers from the Memory and Cognition Center at University Hospitals Case Medical Center will begin testing an intriguing new approach to slowing down the progression of Alzheimer’s Disease (AD) using Intravenous Immune Globulin (IGIV), also known as gammaglobulin. IGIV is traditionally used to treat primary immunodeficiency disorders, but is not currently approved for treating AD, which is one of the leading causes of dementia in the elderly.
Initial research in experimental models and patients suggests that immunotherapy targeting beta amyloid (the protein that forms the core of plaques in the brain) may provide a more effective way to treat AD. Antibodies that bind to beta amyloid are present in IGIV, which is made from the blood of several thousand healthy adults.
One of the hallmarks of AD pathology is an abundance of beta-amyloid deposits in the brain. While it is not yet known if beta amyloid plaques cause AD or are a byproduct of the disease, scientists are interested in finding ways to reduce the toxic effects of beta amyloid on the brain. Antibodies against beta amyloid may do so by binding to toxic forms of beta amyloid, thereby neutralizing them and/or promoting their elimination.
Viagra Relatives Shrink Abnormally Large Hearts
September 24, 2009
Compounds related to Viagra, which is already in clinical trials to prevent heart failure, may also counter the disease in a different way, according to a study published online today in the journal Circulation Research. The results hold promise for the design of a new drug class and for its potential use in combination with Viagra or beta blockers.
In heart failure, which affects about 5.7 million Americans, the heart gradually loses the ability to pump with enough force to supply the body with blood. One reason for lost pumping strength is the mass death of heart muscle cells seen in many heart diseases (e.g. heart attack). Fewer remaining muscle cells must then push around the same amount of blood, and hard working muscles grow. Unlike the healthy bulging of an athlete’s bicep, abnormal muscle growth (pathogenic hypertrophy) in diseased hearts thickens chamber walls, slows the heartbeat and causes potentially fatal arrhythmias. Hypertrophy is a major risk factor for the development of heart failure as well.
Recent efforts to reverse hypertrophy include a clinical trial, sponsored by Viagra manufacturer Pfizer, and the National Heart, Lung, and Blood Institute (NHLBI), looking at whether Viagra (sildenafil) can treat moderate heart failure and reduce hypertrophy. Along with increasing blood flow in arteries, Viagra interferes with phosphodiesterases (PDEs). PDEs break down cyclic guanosine monophosphate (cGMP), the molecular messenger that otherwise “puts the brakes on” heart muscle cell growth. PDE inhibitors re-apply the brakes.
HIV Vaccine Regimen Demonstrates Modest Preventive Effect in Thailand Clinical Study
September 24, 2009
In an encouraging development, an investigational vaccine regimen has been shown to be well-tolerated and to have a modest effect in preventing HIV infection in a clinical trial involving more than 16,000 adult participants in Thailand. Following a final analysis of the trial data, the Surgeon General of the U.S. Army, the trial sponsor, announced today that the prime-boost investigational vaccine regimen was safe and 31 percent effective in preventing HIV infection.
“These new findings represent an important step forward in HIV vaccine research,” says Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH, which provided major funding and other support for the study. “For the first time, an investigational HIV vaccine has demonstrated some ability to prevent HIV infection among vaccinated individuals. Additional research is needed to better understand how this vaccine regimen reduced the risk of HIV infection, but certainly this is an encouraging advance for the HIV vaccine field.
“We thank the trial staff in Thailand and the United States for their years of effort in successfully conducting this study and the study participants and the people of Thailand for their long-standing support of HIV vaccine research,” Dr. Fauci adds.
Use of Toad Venom in Cancer Treatment
September 24, 2009
Huachansu, a Chinese medicine that comes from the dried venom secreted by the skin glands of toads, has tolerable toxicity levels, even at doses eight times those normally administered, and may slow disease progression in some cancer patients, say researchers from The University of Texas M. D. Anderson Cancer Center.
The results from the Phase I clinical study, a collaborative research project between M. D. Anderson and Fudan University Cancer Hospital in Shanghai, are reported in the online Early View feature of the journal Cancer. The study marks the first time a formal clinical trial has examined the relationship between huachansu dose and toxicity, although the drug is common in China and approved by the Chinese Food and Drug Administration.
Huachansu is widely used to treat patients with liver, lung, colon and pancreatic cancer at oncology clinics in China. Chinese clinical trials conducted since the 1970s have demonstrated the anti-cancer properties of huachansu, citing total response rates of 10% and 16% observed in patients with advanced hepatocellular carcinoma and lung cancer, respectively.
Marshall Research hows Safe Dosages Of Common Pain Reliever May Help Prevent Muscle Loss And Other Conditions Related To Aging
September 23, 2009
Recent studies conducted by Dr. Eric Blough and his colleagues at Marshall University have shown that use of the common pain reliever acetaminophen may help prevent age-associated muscle loss and other conditions.
Their study examined how acetaminophen may affect the regulation of protein kinase B (Akt), an enzyme known to play an important role in regulation of cellular survival, proliferation and metabolism.
The researchers’ data indicates that aging skeletal muscles experience a decrease in the proper functioning of the enzyme and that acetaminophen intervention in aged animals could be used to restore Akt activity to a level comparable to that seen in young animals. In turn, this improvement in Akt activity was associated with improvements in muscle cell size and decreased muscle cell death.
“Using a model that closely mimics many of the age-associated physiological changes observed in humans, we were able to demonstrate that chronic acetaminophen treatment in a recommended dosage is not only safe but might be beneficial for the treatment of the muscle dysfunction many people experience as they get older,” said Blough, an associate professor in the university’s Department of Biological Sciences.
High-Sugar Diet Increases Men’s Blood Pressure; Gout Drug Protective
September 23, 2009
A high-fructose diet raises blood pressure in men, while a drug used to treat gout seems to protect against the blood pressure increase, according to research reported at the American Heart Association’s 63rd High Blood Pressure Research Conference.
“This is the first evidence of a role of fructose in raising blood pressure and a role for lowering uric acid to protect against that blood pressure increase in people,” said Richard Johnson, M.D., co-author of the study and professor and head of the division of Renal Diseases and Hypertension at the University of Colorado–Denver medical campus in Aurora, Colo.
In the study, excessive fructose consumption seemed to increase new onset of metabolic syndrome, a cluster of risk factors associated with the development of cardiovascular disease and type 2 diabetes. On the other hand, the gout drug seemed to halt it — most likely by lowering uric acid, which affects blood pressure.