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"In the wake of a widely publicized report advising against prostatespecific antigen PSA testing for prostate cancer a new study finds not screening would triple the number of U.S. men developing advanced cancer. Testing on the other hand might keep some men each year from receiving a diagnosis of latestage prostate cancer cancer that has spread and is far less curable the study finds. PSA testing for all its pluses and minuses and all that . . . permits you to catch the disease earlier said lead researcher Dr. Edward Messing chair of urology at the University of Rochester Medical Center in Rochester N.Y. These people are all going to die they are going to die incredibly expensively and die miserably he said referring to the many men whose diagnoses would be delayed by not testing. I dont know that all these people could be saved with PSA testing but many could he added. The report was published online July in the journal Cancer. Messing said the annual number of prostate cancer deaths dropped from about in the s to now. The only thing that can explain that is PSA early detection and treatment he said. Many cases of prostate cancer are not lifethreatening which is why testing is controversial. The U.S. Preventive Services Task Force USPSTF in May recommended against routine PSA screening saying too many nonlethal cancers were being treated aggressively exposing men who didnt need treatment to serious side effects such as impotence and urinary incontinence. But Messing disagreed with that advice. Condemning PSA testing wasnt a brilliant conclusion he said. For the new study Messings team compared information from the U.S. Surveillance Epidemiology and End Results database for the years to immediately before widespread PSA testing started to data from through . In the data cases of prostate cancer were diagnosed after the malignancy had spread to other parts of the body. Using these cases as a base the researchers constructed a model that used data of advanced cancer diagnosed in the s and predicted how many cases of advanced cancer would have been diagnosed in if PSA testing was not done. Their model showed instead of actual cases in about cases would have been diagnosed. But the USPSTF maintains the benefits of testing are overrated. The task force recommends against prostate cancer screening using the PSA test as the potential benefit does not outweigh the harms said Dr. Michael LeFevre covice chair of the task force and professor in the department of family and community medicine at the University of Missouri School of Medicine. As a result of treatments for PSAdetected prostate cancer one out of men screened in the United States develops a blood clot in his legs or lungs two will have a heart attack or stroke and up to are left impotent or with urinary incontinence LeFevre said. At best only one of these men who were screened avoids dying from prostate cancer for at least years LeFevre said. In addition about one in every men screened dies as a result of surgery to treat cancer detected by the PSA test. Still the task force recognizes that some men may continue requesting the PSA test and some physicians may continue offering it LeFevre said. Before getting this blood test which measures a protein in cells of the prostate gland men should learn about the pros and cons he said. The decision to start or continue screening should reflect an understanding of the possible benefits and known harms and should respect each individuals preferences. Messing advises men with a family history of prostate cancer or urinary symptoms to have a PSA test. Men with no family history or symptoms should discuss PSA testing with their doctor he added. Messing pointed out that screeningdetected cancer doesnt mean surgery chemotherapy or radiation treatment must follow. Most cases can be watched for some time he said. Dr. Otis Brawley chief medical officer for the American Cancer Society said over the past few years a number of studies have been published on the benefits and harms of PSA testing. None of these studies can be considered decisive other than in proving that there are some harms associated with treatment he said. The American Cancer Society still supports screening for certain men in consultation with a physician. Prostate cancer is the secondleading cause of cancer death among men in the United States. In more than new cases are expected to be diagnosed and men will die from the disease researchers say. More information For more information on prostate cancer visit the U.S. National Cancer Institute."

"Its a portable piece of technology providing seemingly bottomless access to a drug craved by more than billion people worldwide nicotine. That craving is caused by smoking tobacco but is now being increasingly satisfied by ecigarettes and the trend to vape instead of smoke. The selling point is the clean image ecigarettes purvey by removing the simultaneous exposure to the tar and thousands of chemicals found in the tobacco smoke of regular cigarettes removing the cause of lung diseases as well as other tobaccorelated conditions. Tobacco kills almost million people each year according to the World Health Organization WHO and a growing number of people are now vaping instead of smoking resulting in industry worth . billion worldwide. Since their introduction in ecigarettes have become commonplace among smokers trying to kick their habit with a third of smokers trying to quit in the United Kingdom turning to ecigarettes to aid them according to one study httpsedition.cnn.comhealthecigarettessmokingaddictionnicotine But some critics argue these electronic nicotine delivery systems ENDS are fueling a new addiction to nicotine particularly among young people experimenting with them. Allure for adolescents While ENDS may have the potential to benefit established adult smokers ... they should not be used by youth and adult nontobacco users because of the harmful effects of nicotine and other risk exposures says Tim McAfee director the Office on Smoking and Health at the U.S. Centers for Disease Control and Prevention. Exposure to nicotine can harm adolescent brain development. Read Contact lens with builtin telescope httpedition.cnn.comtechcontactlenstelescopeblindnessindex.html Studies conducted by the CDC through its Adult and Youth National Tobacco Surveys found increased experimentation by youth trying out ecigarettes but not conventional cigarettes. The gadgetry and flavors associated with the devices is suggested as a reason behind this with fears of them acting as a gateway into real tobacco smoking. Benan BarwickCNN But others in the field of tobacco control disagree stating that whilst people including youth may have tried ecigarettes the evidence is lacking for their regular use. Kids like new technology and just experiment or use it once or twice says JeanFrancois Etter professor of Public Health at the University of Geneva. Etter has been researching the use of ecigarettes since and believes they are much safer than conventional cigarettes. The most dangerous way of consuming nicotine is to smoke it he says. Etter argued this point last week at the World Conference of Tobacco or Health http in Abu Dhabi. Whilst Etter says that use among young people should be monitored he believes the role of ecigarettes in reducing global tobacco consumption is more important. They are a gateway out of smoking says Etter. The number of people using a combination of tobacco and ecigarettes is on the rise according to Etter resulting in smokers switching and consuming less tobacco each day. They have the same level of nicotine but people are less exposed to toxins ... nicotine is not a health problem he says. However further evidence on the longterm health effects of ecigarettes or nicotine is needed. Satisfying the craving Nicotine is the main substance keeping people addicted to smoking tobacco and consequently exposing them to the tar and toxins found in cigarettes. Whilst many people try to kick the habit cold turkey nicotine replacement through gums and patches has long been advocated as a helping hand. Nicotine withdrawal is a very unpleasant process says Linda Bauld professor of Health Policy at the University of Stirling whose recent report https_datafileEcigarette_uptake_and_marketing.pdf for Public Health England identified an extensive and growing market for ecigarettes worldwide. The vast number of people using ecigarettes are using them to stop smoking theyre about more effective than going cold turkey or buying nicotine replacement therapy over the counter. Baulds research hasnt identified a dependence on nicotine with ecigarettes in the same way as the addiction resulting from regular cigarettes. Ecigarettes are not the best nicotine delivery devices she says referring to the fact nicotine is not seen to enter the bloodstream as readily when using ecigarettes. Thats backed up by Etters research http as well as a recent study httpnews.psu.edustoryresearchecigaretteslessaddictivecigarettesby researchers at Penn State College of Medicine in which ecigarettes were found to be less addictive than tobacco cigarettes. Benan BarwickCNN They do however provide nicotine more effectively than aids such as patches or gums according to Bauld. Patches and gums are a very small market says Etter about the quitting devices which first came onto the market years ago. He fears too much restriction on ecigarettes will limit their impact in achieving a world free of tobacco. Both Bauld and Etter recognize the need to monitor the consumption of nicotine among teenagers but feel the value of ecigarettes among adult smokers and their potential to save lives by reducing tobacco consumption should not be underestimated a sentiment recognized by the World Health Organization. Ecigarettes could be a way to help people quit but we need more evidence and regulation says Armand Peruga program manager for the WHOs Tobacco Free Initiative http which has celebrated years of its Framework for Tobacco Control http at the conference in Abu Dhabi. Legislate and regulate The greatest impact to date in reducing the number of smokers worldwide has been the taxation and legislation restricting tobacco advertising and increasing prices. For every increase in tax you have reduction in tobacco consumption says Peruga. The growing fear is the increasing domination of big tobacco in the ecigarette market which was once seen as a competitor. Their ownerships of popular ecigarette brands could push out smaller companies in the field reminiscent of the original tobacco epidemic. The intent of big tobacco is to sell their product concludes Peruga. They may expand their market to other customers who didnt use cigarettes but might consider nicotine use. But as it seems ecigarettes are here to stay most calls are for informed regulation rather than prohibition. The majority of ecigarettes especially when they are well regulated are likely to be less toxic than cigarettes and that for smokers is an advantage says Peruga."

"A new form of therapy has for the first time been shown to improve the symptoms and behaviour of autistic children offering a potential breakthrough in care for millions of families. Six years after parents were trained to better understand and interact with their preschool children researchers found that the therapy had moderated the behaviour of those who had been severely autistic unresponsive or unable to speak. A child who might have run around a supermarket squealing heedless of their parent putting objects in their mouth and pushing past shoppers to try to press the buttons at checkout might instead wait in the queue and even help load the trolley the research found. The success of the preschool autism communication trial Pact has surprised even the researchers who designed it. There are no drugs to treat the condition which typically sets in around the age of two and many families have tried intensive training of their children by therapists with mixed results. Pact instead trained the parents to help their children. Prof Jonathan Green at the University of Manchester who led the study published in the Lancet medical journal http said they had not found the cure for autism but he and his team believed it had great potential and hoped it would be widely adopted. The advantage of this approach over a direct therapistchild intervention is that it has potential to affect the everyday life of the child he said. Our findings are encouraging as they represent an improvement in the core symptoms of autism https previously thought very resistant to change. This is not a cure in the sense that the children who demonstrated improvements will still show remaining symptoms to a variable extent but it does suggest that working with parents to interact with their children in this way can lead to improvements in symptoms over the long term. The trial involved children aged two to four. The families visited a clinic twice a week for six months where parents were videoed with their children and a box of toys. Autistic children might not interact with their parents at all but when eventually a child did offer a toy or made a noise that could be interpreted as a request the incident was rerun on video and the parent encouraged to respond. If the child offered a toy the parent reciprocated. If the child said a word the parent repeated it and added something. The practice was repeated at home every day. The therapy continued with the parents for the next six months with less intensity. At the end of the first year the researchers could see the children had improved but the most dramatic development was seen at the followup six years later. At the start of the trial of those in the control group who did not get the therapy and of those who did were assessed as severely autistic. The children in the intervention group though got better. The proportion assessed as severe in the control group was by the end of six years compared with in the intervention group. Uta Frith emeritus professor of cognitive development at UCL said called the study a remarkably positive story. Photograph Antonio Zazueta OlmosAntonio Olmos Other experts applauded the work. I can see why these researchers are excited said Dorothy Bishop professor of developmental neuropsychology at the University of Oxford. These results at followup are pretty consistent in showing the benefit of this early intervention for autism across a range of measures. My impression is that this is an intervention that reduces the severity of autistic symptoms rather than curing autism. Nevertheless for parents of children with autism even a modest reduction would be worthwhile. Dr Max Davie of the Royal College of Paediatrics and Child Health https said it offered a hugely cheering message for families while Uta Frith emeritus professor of cognitive development at University College London called it a remarkably positive story because the intervention itself was neither intensive nor invasive. The absence of any hope as well as the very sudden regression in childrens behaviour led many parents to believe in the discredited theory of Andrew Wakefield that the MMR https measles mumps and rubella vaccine was the cause of autism. Parents commonly tell us that they fight for a diagnosis but when they finally get it the cupboard is bare with little information or tailored support available to them said Dr James Cusack director of science at the charity Autistica. Too often parents fall victim to the false claims of charlatans who prey on desperate families. These results look promising for the many thousands of parents who want to find early interventions for their children based on solid science. The researchers said childrens communication with their parents was improved at the end of the six years. The parents said there were also improvements in relations with other children in social communication and in repetitive behaviours. But there was no change in child anxiety challenging behaviours or depression in the autistic children and they would still need a lot of support while growing up. About of children and young people are affected by autistic spectrum disorder which ranges from mild to severe. The lifetime costs to the UK which include health social care and education costs as well as productivity losses are estimated at m to .m per child and between .m and .m in the United States."

"Acupuncture can help alleviate the oftendebilitating hot flashes that afflict many breast cancer patients new Italian research says. Noting that hot flashes are a fact of life for many women with breast cancer the investigators found that pairing lifestyle advice with weekly acupuncture sessions dramatically improved the womens quality of life. Acupuncture together with enhanced selfcare for three months is effective in reducing hot flashes in women with breast cancer said study author Giorgia Razzini a clinical trial project manager in the oncology unit of Ospedale di Carpi Carpi Hospital in Bologna Italy. And because hormone treatment for breast cancer typically makes the hot flash experience even worse Razzini added acupuncture could be a useful tool for helping such patients stay on their therapy and improve their quality of life. Razzini and colleagues published their findings online March in the Journal of Clinical Oncology. In the study the Italian team focused on breast cancer patients who had reported moderate or worse hot flashes while undergoing treatment at five cancer hospitals and one primary health care center in northern Italy between and . The patients whose average age was were randomly split into two groups. One group of patients was offered a threemonth regimen of selfcare advice on diet exercise and psychological support. The second group of was offered the same advice in the same time frame along with halfhour weekly sessions of traditional acupuncture. All of the participants kept hot flash diaries. At the end of the threemonth period and for up to six months thereafter daily hot flash experiences were assessed for changing severity and frequency. The result by the end of the treatment period those in the acupuncture group were found to have hot flash scores that were percent lower than those in the nonacupuncture group. The finding continued to hold up for a halfyear after the acupuncture sessions ended. Those in the acupuncture group also seemed to have a generally higher overall quality of life in terms of both physical and mental health with no serious side effects the study authors said. So why does acupuncture seem to work Razzini cited several reasons including acupunctures ability to prompt blood vessel dilation in the patients nervous system while stimulating the release of endorphins a neurotransmitter that interacts with brain cells involved in the regulation of pain and emotion. It also triggers the release of the stress hormone norepinephrine as well as the mood regulator serotonin. Razzini didnt know how much American patients might have to pay for such treatment but added Compared to other effective treatments such as antidepressants acupuncture should be less expensive and for sure more safe and feasible. Dr. Courtney Vito a breast oncologic surgeon at the City of Hope Comprehensive Cancer Center in Duarte Calif. was pleased that a serious issue in breast cancer treatment is getting a closer look. Anyone who treats breast cancer struggles with this problem in their practice because the hot flashes that some women experience with antihormonal treatment can be profound she said. Almost all women experience them. For some its a moderate situation but for others its a really significant problem. Some women I would say probably about percent have such severe hot flashes that they even refuse to take medications that can cut their risk for cancer or cancer recurrence by percent simply because they cant handle the hot flashes Vito explained. And Ive actually had patients who have had acupuncture with good success so Im not surprised by the finding she added. But it is heartening that we now have scientific proof that this can work. Which in the end may help to encourage insurance companies to their expand coverage so this can become an affordable option for all patients in need. More information Theres more on cancer and hot flashes at the U.S. National Cancer Institute http SOURCES Courtney Vito M.D. breast oncologic surgeon and assistant clinical professor City of Hope Comprehensive Cancer Center Duarte Calif. Giorgia Razzini Ph.D. clinical trial project manager oncology unit Ospedale di Carpi Bologna Italy March Journal of Clinical Oncology"

"A drug already used safely to treat Parkinsons disease restless leg syndrome and other movement disorders also could delay or prevent the most common cause of blindness affecting more than million older Americans agerelated macular degeneration AMD. Researchers have discovered that patients who take the drug LDOPA are significantly less likely to develop AMD and if they do get AMD its at a significantly older age according to the study published online Nov. in the American Journal of Medicine. The retrospective study was led by researchers at Marshfield Clinic Research Foundation University of Arizona Medical College of Wisconsin University of Miami Essentia Health Stanford University and University of Southern California. Research points to this as a pathway to regulate and prevent this most common cause of blindness in adults said Murray Brilliant Ph.D. director Marshfield Clinic Research Foundation Center for Human Genetics Marshfield Wisconsin. Imagine telling patients we potentially have medication that will allow them to see and continue enjoying life their family and perform every day activities as they age. That is very powerful. AMD the No. cause of legal blindness in adults over is a progressive eye condition affecting as many as one in three adults. The disease attacks the macula of the eye where the sharpest central vision occurs causing central blindness. This vision is used to drive read recognize faces and perform daily tasks. AMD spares the peripheral vision leaving dim images or black holes at the center of vision. LDOPA is a natural byproduct of pigmentation and is made in a layer of cells in the back of the eye that functions to promote health and survival of retinal tissues. Researchers asked the question if people taking LDOPA as a medicine are protected from AMD. The obvious question was if the LDOPA no longer produced was supplemented via pill form does it have the potential to serve as a preventive medicine against AMD Brilliant said. We need more research but this first step is promising. Albinism research leads to hope This work grew out of research using albino mouse models. Mice as well as humans who have albinism or lack of pigmentation have profound vision loss and changes in the eye structure especially the macula the ovalshaped area near the center of the retina associated with a persons ability to see clearly. Race and ocular pigmentation are known risk factors for developing AMD indicating darker pigmentation may protect from the disease as it occurs much much more frequently in the white population than black or Hispanic populations. This led to the hypothesis that those with darker pigmentation may have greater LDOPA signaling in the RPE. To test this researchers examined health records of Marshfield Clinic patients looking for those with AMD those taking LDOPA and those with both LDOPA and AMD. They then determined the age patients developed AMD. According to national statistics the average age at which individuals are given LDOPA is the average age of AMD diagnosis is . In those people who got LDOPA before being diagnosed with AMD their AMD diagnosis occurred eight years later than those without LDOPA. These provocative results were then confirmed in a much larger data set of million patients where similar results were observed and the study expanded to include prevention and delay of wet AMD the most devastating form of the disease. In all the groups examined data suggests LDOPA may prevent or delay AMD. This study suggests an intriguing link between patients taking LDOPA and a lower incidence and delayed onset of AMD said Paul A. Sieving M.D. Ph.D. director of the National Eye Institute. Showing that LDOPA causes this protective effect will require further investigation but if confirmed could lead to new drugs or combination therapies for AMD that target DOPAresponsive cells in the retina. The next step in this research is to perform a clinical trial to determine the ability of this drug to prevent AMD. Results suggest a new path forward in our fight against AMD that may even include a strategy to prevent those at risk of the disease from ever developing it said Brian McKay Ph.D. associate professor Department of Ophthalmology and Vision Science University of Arizona. In the end LDOPA may not be the drug that ends the disease but the pathway identified is likely to be a key observation as the search for a cure continues. This research titled Mining Retrospective Data for Virtual Prospective Drug Repurposing LDOPA and Agerelated Macular Degeneration was supported by National Center for Advancing Translational Sciences National Human Genome Research Institute Research to Prevent Blindness Bright Focus Foundation The Edward N. Della L. Thome Memorial Foundation Wisconsin Genomics Initiative National Eye Institute Marshfield Clinic and University of Arizona. Marshfield Clinic provides patient care research and education with more than locations in northern central and western Wisconsin making it one of the largest comprehensive medical systems in the United States."

"Swallowing a daily multivitamin can reduce the risk of cancer by at least eight percent in middleaged and older men and appears to have no dangerous sideeffects according to the first largescale randomized study on the subject. The protective effect of the daily pill was described as modest by the trial investigators who emphasized that the primary use of vitamins was to prevent nutritional deficiencies. The findings were published in the Journal of the American Medical Association and presented on Wednesday at a meeting of the American Association for Cancer Research in Anaheim California. This is indeed a landmark study said Cory AbateShen a professor of urological oncology at Columbia University Medical Center who was not involved in the trial. It suggests that a balanced multivitamin approach is probably more beneficial than increasing to high levels any one vitamin. About half of U.S. adults take at least one daily dietary supplement the most popular being a multivitamin according to the U.S. Centers for Disease Control and Prevention. The U.S. Physicians Health Study II included nearly male doctors aged and older and spanned more than years. Participants were randomly assigned to a multivitamin Pfizer Incs Centrum Silver or a placebo. The research was sponsored by the National Institutes of Health. Several previous studies many relying on selfreported use of specific vitamins or supplements have generated mixed results in terms of cancer outcomes. There have been some other trials that have tested combinations often at high doses of certain vitamins and minerals said Dr. Howard Sesso one of the studys authors and an associate epidemiologist at Brigham and Womens Hospital in Boston. Our trial took a very commonly used multivitamin that has basically low levels of all the different essential vitamins and minerals. The findings suggest that the biggest health benefit may come from a broad combination of dietary supplements he said. EFFECT IS GREATER FOR NONPROSTATE CANCERS Last year the questionnairebased Iowa Womens Health Study found that older women who take multivitamins have slightly increased death rates compared to those who dont. A study examining whether vitamin E and selenium could reduce the risk of prostate cancer was stopped prematurely in after men taking international units IU of the vitamin showed an increased risk of developing the cancer. Overthecounter multivitamins typically contain to IU of vitamin E. The newlyreleased Physicians Health Study showed an percent reduction in total cancer occurrence for participants taking a multivitamin but no benefit was seen for rates of prostate cancer the most common cancer seen among the participants in the study. Excluding prostate cancer researchers found about a percent reduction in overall cancer occurrence and said the protective effect seemed to be greater in people who had previously battled cancer. They also saw a percent reduction in the risk of death from cancer although those findings also were not statistically significant. Researchers said they planned to continue to follow the study group to monitor the effect of vitamin intake over time and said additional studies would be needed to see if there were similar benefits for women or younger men. It doesnt seem like there is any particular risk associated with taking a vitamin and there might be a small benefit said Dr. David Weinberg chief of the department of medicine at Fox Chase Cancer Center in Philadelphia. He was not involved in the study."

"Brynne Henn leaned back onto a pristine white couch and settled whiteandred headphones over her ears. She picked up a handset grasping one buzzer in each hand closed her eyes and the session began. The room was quiet. Through the headphones Henn heard an alternating tone first in the right ear then the left back and forth. The handset buzzed in synchrony rightleftrightleft part of a trauma treatment that also involves recalling painful memories. She turned her thoughts to the day her brother Nate died. Nate Henn had been visiting relatives and working with Invisible Children a nonprofit in Kampala Uganda. On July he was at a sports complex with friends enjoying the broadcast of a World Cup soccer match when terrorists struck. Nate was only when shrapnel from a bomb ended his life. The years hadnt diminished Brynne Henns pain. Your brothers dead and you need to come home to take care of your mom she remembered her father saying. With those simple words her brother was gone and she felt compelled to take control in the ensuing chaos. Henn who had been visiting her boyfriend in Chapel Hill immediately returned home to Raleigh N.C. I didnt stop for the first week after Nate died she said. The ordeal didnt end with the news of Nates death. Her other brother Kyle rushed home from Delaware to be with the family. But the private plane carrying him crashed the next day in nearby Chapel Hill. The pilot was killed and the copilot was seriously injured but Kyle survived. And then the media storm went crazy Henn said. The family already had received inquiries from journalists about Nates death Kyles brush with death only intensified the interest of media outlets from Philadelphia to Raleigh. It made it so much worse Henn said. At age she began functioning as the family spokeswoman. I felt like I had to protect my family from all of it she said. She occupied herself with press inquiries and funeral arrangements. But after the whirlwind passed unaddressed grief remained with her. Complicated grief When a person experiences trauma the associated memories can remain as vivid and urgent as on the day the event happened. The brain perceives the trauma as happening in the present and reacts accordingly even in safe situations. When Henns traumatic memories of her brothers violent death were triggered they popped and glowed in her mind as if they were being shown on a projector screen. All these memories around me started playing like a video loop Henn said. Her body remembered the sensations vividly the heat and discomfort of the summer day the pain of her high heels as she delivered the eulogy at the funeral. Henn did cognitive behavioral therapy a form of conventional talk therapy for five years. It helped me realize feelings were normal she explained and that she was not weak for reeling from the tragedy. But I never felt like I was getting over it. Random memories could send her spiraling into panic and fear. Talk therapy helped her manage those attacks but it didnt address the root cause. Henn was initially diagnosed with a condition known as complicated grief she was diagnosed with posttraumatic stress disorder only last year. She was surprised. She had thought of PTSD as an affliction of soldiers and others directly involved in horrendous events not of people like her suffering from the ripple effects of a bombing in Uganda. It was Kyle Henn recovering from his own PTSD after surviving the plane crash who recommended eye movement desensitization and reprocessing therapy or EMDR. Psychologist Francine Shapiro developed EMDR http in . Three years later she founded the EMDR Institute which has trained more than practitioners. Some therapists use sounds from headphones during a session. Others use eye movement moving a finger or object back and forth as the patient follows eyes moving left to right and back again. Others employ a bar on which small bulbs light up from one side to another. Patients follow the light or object with their eyes or listen to the alternating tone while thinking about a specific traumatic memory or series of memories. They describe the memories to the therapist who gives guidance as needed. The idea is that reliving the memories helps remove the sting and that the urgency of the memories can be reduced as the brain begins to move them from shortterm to longterm memory. The sound or the eye movement is supposed to activate both sides of the brain in an imitation of REM sleep when the brain usually converts shortterm memories into longterm recollections. Studies have found benefits httpjournals.cambridge.orgactiondisplayAbstractfromPageonlineaidfileIdS to EMDR. But there is debate about whether the eye movement http makes a difference http Stephen Holland founder of the Capital Institute for Cognitive Therapy and coauthor of the textbook Treatment Plans and Interventions for Depression and Anxiety Disorders. The question is whether stimulation adds to it. He does not use it in his practice because he considers it no more effective than cognitive behavioral therapy. Brynne Henn who lives in the District began seeing a licensed clinical psychologist who practices EMDR last September. In Gail Kalins office nestled in a treeshaded apartment building in Northwest Washington Henn confronted the trauma that still haunted her. The techniques associated with EMDR may merely have a placebo effect some psychologists say. In early sessions Henn focused on the headphones and handset they helped distract her from the terror of reliving the traumatic events surrounding her brothers death she said. This distraction had a positive effect on her she said allowing her to dive deeply into the therapy without freezing in the face of fear. Some insurance plans cover EMDR. Henns does not she pays for the sessions out of pocket. Henn who is a communications associate at a Washington research institution was initially very skeptical of EMDR. It is so weird she said. When I first got there and she hands me these two paddles that vibrate in my hands and then I put on these giant headphones I was like What is this a hearing test What are we doing But Henn was encouraged by the progress she made. I started getting really interested in it she said. Why is my brain coming up with this What in the world are you doing to me that this is what I came up with Henn was surprised by the vivid memories some of which she hadnt known existed that resurfaced after so much time had passed. Reliving the memories It didnt matter to her whether research supported EMDR what mattered was whether it worked for her. Each time a particularly painful memory resurfaced Henn said you have to go through it again until it has no meaning. By confronting the trauma headon she added it became less powerful. Its integrating whats stuck in time explained Kalin the psychologist. Memories formed under the adrenaline of trauma are never put to rest she said. EMDR processing is untangling the knot. Once the memories are processed therapists say they are less vivid less like the film reel Henn would see in her mind. Henn was able to recall processed memories without feeling panic. EMDRs central appeal lies in the possibility of closure an end to PTSD and to therapy for it. Im going to come out equipped with tools to take care of myself Henn said. She already has put these tools to the test Two months after she started EMDR terrorists hit Paris killing at least people. Soon after that attack she heard reports that a video possibly from the Islamic State contained a threat to hit Washington next and she had a fullfledged panic attack she said. I was not sure where I was I was sweating profusely but also really cold she said. She stepped onto the thfloor terrace at work and looked down. The thought came into my head I just need to walk off and that will wake me up Henn remembered. And I had enough awareness that I sat myself down and was trying to think of calming breaths and going back and forth actions reminiscent of EMDR processing. It took a while and it was a little terrifying that I had that thought she said. But the process of being able to calm myself down was much better than anything I had been equipped with before. In a few weeks Henn mentioned to Kalin she would be marrying her college sweetheart. Beneath the excitement she felt a twinge of panic How would she react to her brothers absence from the wedding She asked a close friend to write a speech from Nates point of view as if he were speaking at the celebration. But Henn admitted she was worried that the speech would trigger an extreme emotional reaction a fear shared by many who suffer from PTSD. They never know when the trauma will reignite it can spread from the smallest spark even on the happiest day. Does EMDR deal with the future she asked Kalin. Kalin nodded and they began processing memories again. Among the painful recollections Henn encountered a happy memory friends who arrived at the funeral to support the family and a smile broke through the tears. It felt like a gift from Nate she said. EMDR Henn said allowed her to have a doover to be able to grieve properly and then to move beyond grief. She was finally able to remember the good times with her brother without being overwhelmed by pain. Im still sad but Im not hurt by it anymore she said. Its not opening up any fresh wounds. As Henn walked outside into a brisk April evening after her session there was a new easiness to her as though something had finally been freed."

"THE QUESTION Memory wanes as mild cognitive impairment or Alzheimers disease sets in. Might insulin a drug used for diabetes help THIS STUDY randomly assigned adults with mild cognitive impairment or mild to moderate Alzheimers disease to be given via nasal spray or milligram doses of insulin detemir Levemir a manmade insulin that is longer acting than natural insulin or a placebo daily for three weeks. Standardized tests given at the start and end of the study showed that working memory sometimes thought of as shortterm memory improved for those given milligrams of insulin but not for those given the smaller dose or the placebo. Also among those in the milligram group people carrying what is sometimes called the Alzheimers gene APOEe showed more improvement than noncarriers. WHO MAY BE AFFECTED People in the early stages of dementia. Some research has suggested a link between lower levels of insulin in cerebrospinal fluid and the formation of plaques often found in the brain tissue of people with Alzheimers. Memory loss is often the first sign of dementia which in later stages can interfere with such things as the ability to solve problems control emotions or do such daily tasks as eating and dressing. CAVEATS The study involved a relatively small number of participants and lasted a short time a larger and longer study would be needed to adequately test effectiveness and safety. FIND THIS STUDY February issue of the Journal of Alzheimers Disease For an early version of the study abstract click on Contents then Volume No. in press and search for insulin. LEARN MORE ABOUT dementia at ninds.nih.govdisorders and The research described in Quick Study comes from credible peerreviewed journals. Nonetheless conclusive evidence about a treatments effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind THE QUESTION Memory wanes as mild cognitive impairment or Alzheimers disease sets in. Might insulin a drug used for diabetes help THIS STUDY randomly assigned adults with mild cognitive impairment or mild to moderate Alzheimers disease to be given via nasal spray or milligram doses of insulin detemir Levemir a manmade insulin that is longer acting than natural insulin or a placebo daily for three weeks. Standardized tests given at the start and end of the study showed that working memory sometimes thought of as shortterm memory improved for those given milligrams of insulin but not for those given the smaller dose or the placebo. Also among those in the milligram group people carrying what is sometimes called the Alzheimers gene APOEe showed more improvement than noncarriers. WHO MAY BE AFFECTED People in the early stages of dementia. Some research has suggested a link between lower levels of insulin in cerebrospinal fluid and the formation of plaques often found in the brain tissue of people with Alzheimers. Memory loss is often the first sign of dementia which in later stages can interfere with such things as the ability to solve problems control emotions or do such daily tasks as eating and dressing. CAVEATS The study involved a relatively small number of participants and lasted a short time a larger and longer study would be needed to adequately test effectiveness and safety. FIND THIS STUDY February issue of the Journal of Alzheimers Disease http For an early version of the study abstract click on Contents then Volume No. in press and search for insulin. LEARN MORE ABOUT dementia at ninds.nih.govdisorders http and http The research described in Quick Study comes from credible peerreviewed journals. Nonetheless conclusive evidence about a treatments effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician."

"Scientists have developed a blood test that could identify which people with depression will respond to treatment so that patients can avoid spending months taking antidepressants that do not help them. The experts involved believe the breakthrough could lead to depressed patients receiving personalised treatments that are more likely to relieve their symptoms. The Royal College of Psychiatrists said that if it worked the test could prove to be a key moment in the quest for the holy grail of biological psychiatry. The scientists at Kings College London behind the development claim that their test accurately and reliably predicts whether depressed patients will respond to common antidepressants which could herald a new era of personalised treatment for people with depression. If the test proves effective it is hoped that by measuring patients level of blood inflammation it would identify which of them would benefit from receiving antidepressants soon after their diagnosis to stop their condition worsening. What does depression feel like Trust me you really dont want to know Tim Lott About half of all patients with depression get no benefit from antidepressants the first time they take them and they never work for one in three people. Currently it is impossible to establish who should or should not be given antidepressants or combinations of them. That means that patients are tried on a succession of different drugs for weeks or more and experience prolonged periods of ineffective treatment because their medication does not benefit them. One in six Britons will suffer depression at some point in their life. Last year .m prescriptions for antidepressants were issued in England. Researchers focused on two independent clinical groups of depressed patients on two biological markers that measure inflammation of the blood as heightened levels are associated with poor response to antidepressants. They found that blood test results above certain levels reliably predicted how well patients would respond to commonly prescribed antidepressants. Their findings have been reported in the International Journal of Neuropsychopharmacology. The identification of biomarkers that predict treatment response is crucial in reducing the social and economic burden of depression and improving quality of life for patients said Prof Carmine Pariante from KCLs institute of psychiatry psychology and neuroscience. This study provides a clinically suitable approach for personalising antidepressants therapy. Patients who have blood inflammation above a certain threshold could be directed towards earlier access to more assertive antidepressant strategies including the addition of other antidepressants or antiinflammatory drugs Pariante added. Dr Cosmo Hallstrom a spokesman for the Royal College of Psychiatrists said Finding biological markers for depression and other mental illnesses has been the holy grail of biological psychiatry. Such a finding and a test to back it up would be critical to advancing our understanding of the biological causes of depression. It would accelerate our therapeutic interventions and make them more tailored to the needs of the patient. But further clinical research is needed to see if the findings can be applied in a clinical setting Hallstrom added. Stephen Buckley head of information at the mental health charity Mind said We welcome research which adds to our understanding of treatments and medications that may work for people experiencing mental health problems. These initial findings are interesting but as with all areas of mental health there is still more research to be done. Mental health https problems including depression are estimated to cost bn a year in England. The World Health Organisation has predicted that by depression will be the second biggest cause of health problems in the world."

"A new low dose three in one pill to treat hypertension could transform the way high blood pressure is treated around the world. A trial led by The George Institute for Global Health revealed that most patients per cent reached blood pressure targets with the Triple Pill compared to just over half receiving normal care. With high blood pressure the leading cause of disease burden worldwide its expected the findings published in JAMA will change guidelines globally. Dr Ruth Webster of The George Institute for Global Health said this was a major advance by showing that the Triple Pill was not only more effective than standard care it was also safe. Its estimated more than a billion people globally suffer from high blood pressure with the vast majority having poorly controlled blood pressure. Our results could help millions of people globally reduce their blood pressure and reduce their risk of heart attack or stroke. The researchers tested an entirely new way of treating hypertension by giving patients three drugs each at half dose in a single pill for early treatment of high blood pressure. Traditionally patients begin treatment with one drug at a very low dose which is increased over time with additional drugs added and increased in dosage to try to reach target. Dr Webster added Patients are brought back at frequent intervals to see if they are meeting their targets with multiple visits required to tailor their treatments and dosage. This is not only time inefficient its costly. We also know that many doctors and patients find it too complicated and often dont stick to the process. This new approach is much simpler and it works. The trial which was conducted in Sri Lanka enrolled patients with an average age of and blood pressure of mm Hg. Patients were randomly assigned to receive either the combination pill or usual care their doctors choice of blood pressure lowering medication. The Triple Pill consisted of the blood pressure medications telmisartan mg amlodipine . mg and chlorthalidone . mg. Compared with patients receiving usual care a significantly higher proportion of patients receiving the Triple Pill achieved their target blood pressure of or less with lower targets of for patients with diabetes or chronic kidney disease. At six months percent of participants in the Triple Pill group were still receiving the combination pill compared to the majority of patients in the usualcare group still receiving only one and only one third receiving two or more bloodpressurelowering drugs. Professor Anushka Patel Principal Investigator of the trial and Chief Scientist at The George Institute said this was big improvement. The World Heart Federation has set an ambitious goal that by there will be a per cent reduction in blood pressure levels globally. The Triple Pill could be a low cost way of helping countries around the world to meet this target. This study has global relevance. While the most pressing need from the perspective of the global burden of disease is lowand middleincome countries its equally relevant in a country like Australia where were still achieving only control rates for high blood pressure. The George Institute is now looking at strategies to maximise uptake of the study results. This includes examining the acceptability of the Triple Pill approach to patients and their doctors as well as costeffectiveness which will be important for governments and other payers to consider. The study was funded by the National Health and Medical Research Council of Australia as part of the Global Alliance for Chronic Disease. Video interview with Professor Anushka Patel httpsyoutu.beFIntpSVHM"

"The immune checkpoint blockade drug nivolumab reduced tumor burden in . percent of patients with metastatic bladder cancer regardless of whether their tumors had a biomarker related to the drugs target according to clinical trial results from The University of Texas MD Anderson Cancer Center. The study will be presented Sunday June at the American Society of Clinical Oncology Annual Meeting. The response rate is better than weve seen for other potential secondline treatments and nivolumab is really welltolerated which is important because bladder cancer patients are a fragile group after frontline treatment with platinum chemotherapy said Padmanee Sharma M.D. Ph.D. professor of Genitourinary Medical Oncology at MD Anderson. Nivolumab unleashes an immune system attack on cancer by blocking activation of a protein called PD on T cells white blood cells that find and attack cells viruses or bacteria that have specific targets. PD acts as a brake or checkpoint to shut down activated T cells. PD is turned on by a ligand called PDL which is often found on cancer cells and other types of cells. The presence of PDL on a patients tumor has been considered a potential biomarker to guide treatment. The study found no significant difference in response rates between those with little to no PDL on their tumors percent and those with greater PDL expression percent. We can get good results without choosing to treat patients based on PDL status said Sharma who also is scientific director of MD Andersons immunotherapy platform and an investigator with the Parker Institute for Cancer Immunotherapy at MD Anderson. The platform is part of MD Andersons Moon Shots Program launched in to reduce cancer deaths by accelerating development of therapies prevention efforts and early detection from scientific discoveries. This Phase III clinical trial treated patients five . percent had complete responses percent had partial responses in which tumor burden shrinks by at least percent and . percent had stable disease. Thirty percent patients had disease progression. Treatmentrelated side effects included mainly lowgrade fatigue itching elevated lipase rash nausea joint pain and anemia. Grade or side effects occurred in . percent of patients. Two patients discontinued therapy because of adverse events related to the drug. At a median follow up of days . percent remained on treatment and . percent of patients survived for at least one year which Sharma noted is better than anything weve seen in the past. Overall survival will be analyzed in conjunction with the Phase II portion of this clinical trial which provides nivolumab or a combination of nivolumab plus the immune checkpoint inhibitor ipilimumab. The trial allows patients to cross over to the combination if nivolumab alone fails. Initial results from the Phase II portion of the trial will be presented later this year. Both nivolumab known as Opdivo and ipilimumab known as Yervoy were developed and marketed by BristolMyers Squibb which funded the clinical trial. Ipilimumab targets the CTLA checkpoint on T cells and was the first immune checkpoint inhibitor. It was based on the research of Jim Allison Ph.D. chair of Immunology executive director of the immunotherapy platform and director of the Parker Institute for Cancer Immunotherapy at MD Anderson. Ipilimumab was the first drug ever shown to extend the survival of patients with metastatic melanoma. Longterm follow up shows percent of those treated with the drug survive years or longer. Nivolumab has been approved by the U.S. Food and Drug Administration for advanced melanoma lung cancer kidney cancer and Hodgkin lymphoma. The fiveyear survival rate for those with metastatic melanoma treated with nivolumab is percent. The twoyear survival rate of patients treated with both drugs in combination is percent. Until May there were no drugs approved for secondline treatment of metastatic bladder cancer. The U.S. FDA approved atezolizumab which blocks PDL for these patients. Coauthors with Sharma who presented the data at ASCO are Petri Bono Helsinki University Hospital Helsinki Finland Joseph Kim Yale Cancer Center Pavlina Spiliopoulou Beatson West of Scotland Cancer Centre Glasgow Emiliano Calvo Centro Integral Oncolgico Clara Campal MadridSpain Rathi Pillai Emory Winship Cancer Institute Atlanta Patrick Ott Dana Farber Cancer Institute Boston Filippo DeBraud Istituto Nazionale dei Tumori Milan Italy Michael Morse Duke University Medical Center Durham N.C. Dung Le Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Baltimore Dirk Jaeger Heidelberg University Hospital Heidelberg Germany Emily Chan Vanderbilt University Nashville Tenn. Chris Harbison ChenSheng Lin Marina Tschaika Alex Azrilevich of BristolMyers Squibb and Jonathan Rosenberg of Memorial Sloan Kettering Cancer Center."

"Sleep deprivation typically administered in controlled inpatient settings rapidly reduces symptoms of depression in roughly half of depression patients according the first metaanalysis on the subject in nearly years from researchers at the Perelman School of Medicine at the University of Pennsylvania. Partial sleep deprivation sleep for three to four hours followed by forced wakefulness for hours was equally as effective as total sleep deprivation being deprived of sleep for hours and medication did not appear to significantly influence these results. The results are published today in the Journal of Clinical Psychiatry. Although total sleep deprivation or partial sleep deprivation can produce clinical improvement in depression symptoms within hours antidepressants are the most common treatment for depression. Such drugs typically take weeks or longer to experience results yet . percent of million U.S. adults filled one or more prescriptions for psychiatric drugs in . The findings of this metaanalysis hope to provide relief for the estimated . million adults who experienced a major depressive episode in . Previous studies have shown rapid antidepressant effects from sleep deprivation for roughly percent of individuals yet this response rate has not been analyzed to obtain a more precise percentage since despite more than studies since then on the subject. More than years since the discovery of the antidepressant effects of sleep deprivation we still do not have an effective grasp on precisely how effective the treatment is and how to achieve the best clinical results said study senior author Philip Gehrman PhD an associate professor of Psychiatry and member of the Penn Sleep Center who also treats patients at the Cpl. Michael J. Crescenz VA Medical Center. Our analysis precisely reports how effective sleep deprivation is and in which populations it should be administered. Reviewing more than studies the team pulled data from a final group of studies executed over a year period to determine how response may be affected by the type and timing of sleep deprivation performed total vs early or late partial sleep deprivation the clinical sample having depressive or manic episodes or a combination of both medication status and age and gender of the sample. They also explored how response to sleep deprivation may differ across studies according to how response is defined in each study. These studies in our analysis show that sleep deprivation is effective for many populations said lead author Elaine Boland PhD a clinical associate and research psychologist at the Cpl. Michael J. Crescenz VA Medical Center. Regardless of how the response was quantified how the sleep deprivation was delivered or the type of depression the subject was experiencing we found a nearly equivalent response rate. The authors note that further research is needed to identify precisely how sleep deprivation causes rapid and significant reductions in depression severity. Also future studies are needed to include a more comprehensive assessment of potential predictors of treatment outcome to identify those patients most likely to benefit from sleep deprivation. This research was funded by National Institutes of Health grants R HL P NS RMH RMH P EB R MH National Aeronautics and Space Administration grants NNXAKA NBPF NNXAYG NBPF NBPF NNXAMG NXAIG National Heart Lung and Brain Institute U HL National Institute on Drug Abuse R DAA the Office of Naval Research N the National Aeronautics and Space Administration NNXANG National Space Biomedical Research Institute through NASA NCC and grant support from Merck and Philips HealthcareRespironics. In addition to Gehrman and Boland additional authors include Rachel V. Smith from the Cpl. Michael J. Crescenz VA Medical Center and Hengyi Rao David F. Dinges Namni Goel John A. Detre Mathias Basner Yvette I. Sheline and Michael E. Thase all from Penn. Penn Medicine is one of the worlds leading academic medical centers dedicated to the related missions of medical education biomedical research and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvaniafounded in as the nations first medical school and the University of Pennsylvania Health System which together form a . billion enterprise. The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past years according to U.S. News World Reports survey of researchoriented medical schools. The School is consistently among the nations top recipients of funding from the National Institutes of Health with million awarded in the fiscal year. The University of Pennsylvania Health Systems patient care facilities include The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center which are recognized as one of the nations top Honor Roll hospitals by U.S. News World Report Chester County Hospital Lancaster General Health Penn Wissahickon Hospice and Pennsylvania Hospital the nations first hospital founded in . Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners a partnership between Good Shepherd Rehabilitation Network and Penn Medicine. Penn Medicine is committed to improving lives and health through a variety of communitybased programs and activities. In fiscal year Penn Medicine provided . million to benefit our community."

"A new study says yoga may be as good a treatment for back pain as physical therapy. One person who might agree is yearold Judith Zaborowski who took up yoga https more than years ago to help with her aching back. Im much more comfortable with movement she told CBS News. Yoga makes me think about my back and how Im standing and if Im standing properly then I can function better. New guidelines outline how to handle back pain https In the study adults with moderate to severe back pain received one of three approaches over weeks Weekly yoga classes physical therapy visits Education about how to cope with back pain Yoga was just as effective as physical therapy and both groups were about percent less likely to use pain medication than patients receiving education alone. Yoga classes started with relaxation exercises warm up then gentle yoga poses like wall dog and chair twist. Dr. Robert Saper at Boston Medical Center is one of the authors. He explained the results. Yoga was as effective as physical therapy for reducing pain intensity Saper said. Perhaps most importantly reducing pain medication use. Saper says yoga likely works by strengthening core and lower back muscles and helping with mindbody relaxation. I feel the more that one can do for ones self and not depend on medication the healthier it is for your body Zaborowski said. Opiate overdoses https are now the leading cause of death https for adults under age an especially compelling reason to find approaches to chronic pain that dont involve narcotics https"

"For concussion sufferers even those who never lost consciousness physicians may now be able to predict early on who is more likely to continue experiencing symptoms months or years after the headjarring event using a new noninvasive magnetic resonance imaging MRI method devised by a consortium of researchers led by UC San Francisco scientists. In their new study published online January in the Journal of Neurotrauma the researchers used a technique called functional MRI fMRI coupled with sophisticated statistical analysis to track activity in the brain networks of patients aged to within the first two weeks of their having experienced concussions. The study revealed telltale patterns of brain activity that six months later were associated with worse performance on behavioral and cognitive tests and were different from patterns seen in healthy control subjects. The fMRI method and analysis developed for the study highlighted abnormal patterns of brain activity that pointed to a higher risk for longterm postconcussive symptoms even among the study participants who had no evidence of bleeding or bruising in the brain in the immediate aftermath of brain trauma on computed tomography CT or ordinary MRI scans. This is an exploratory proofofconcept study showing that we can identify patients soon after mild brain trauma who may have more persistent symptoms despite no other evidence of injury within the brain said Pratik Mukherjee MD PhD professor of radiology and biomedical imaging at UCSF and the senior author of the study. We may be able to use this information to help guide treatment decisions and counseling of patients early on when it may be more effective. Only subjects who had lost consciousness for less than minutes were eligible for the study and many study subjects never lost consciousness during their injury. Scientists refer to concussion as mild traumatic brain injury mTBI but for some patients the harmful sometimes insidious effects are long lasting. Common symptoms in the aftermath of concussion include confusion headache changes in vision or hearing thinking or memory problems fatigue sleep changes and mood changes. Previously there has not been a way to predict whose symptoms will fade or persist following mTBI. Although effective drug treatments for mTBI await discovery rest and counseling are known to be helpful for patients Mukherjee said. In the new study the researchers focused on wellknown networks of activity that are observed when the brain is in a resting state. We asked subjects to close their eyes to relax and to not focus their attention on anything specific but also to not fall asleep Mukherjee said. In comparison to the control subjects who had never experienced TBI mTBI patients displayed less connectivity in frontal areas of the default mode network a set of brain regions that are particularly active in the resting brain. They also exhibited less connectivity within several other networks including those known as the executive control network the frontoparietal network the dorsal attentional network and the orbitofrontal network they showed an increase in connectivity in the visual network. Several of these differences were associated with worse performance months later in cognitive and behavioral tests. UCSF radiologist Esther Yuh MD PhD associate professor of radiology served as the lead neuroradiologist and also contributed to the analysis for the new study. Postdoctoral fellow and first author Eva Palacios PhD led the data analysis for the fMRI experiments. The study was part of the ongoing Transforming Research and Clinical Knowledge in Traumatic Brain Injury TRACKTBI project through which Mukherjee and study coauthor Geoffrey Manley MD PhD vice chairman of neurological surgery at UCSF and chief of neurosurgery at Zuckerberg San Francisco General Hospital along with collaborators from many other research institutions are leading studies and gathering common data across research sites to more quickly advance TBI research. Additional coauthors include researchers from UCSF the University of Texas at Austin the University of Pittsburgh Medical Center Virginia Commonwealth University the Icahn School of Medicine at Mount Sinai and University Hospital Antwerp Belgium. The research was funded through project grants from the National Institutes of Health and the Department of Defense. UC San Francisco UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research graduatelevel education in the life sciences and health professions and excellence in patient care. It includes topranked graduate schools of dentistry medicine nursing and pharmacy a graduate division with nationally renowned programs in basic biomedical translational and population sciences and a preeminent biomedical research enterprise. It also includes UCSF Health which comprises topranked hospitals UCSF Medical Center and UCSF Benioff Childrens Hospitals in San Francisco and Oakland and other partner and affiliated hospitals and healthcare providers throughout the Bay Area."

"If you think losing a meaningful amount of weight is so monumentally difficult that hardly anyone succeeds think again. About percent of patients lose percent or more of their weight enough to improve blood pressure and risk factors for diabetes within six months of the triedandtrue approach of diet exercise and counseling according to a review of obesity research published Wednesday in the New England Journal of Medicine. The counseling piece is crucial and should include at least sessions over six months with a trained professional such as a dietitian or exercise specialist. That kind of handholding is readily available the review said not only at medical centers but through YMCA diabetesprevention programs commercial weightloss plans such as Weight Watchers or Jenny Craig and even through call centers that provide tailored guidance. With intensive counseling patients get a lot of instruction but equally important they get a lot of support said psychologist Thomas Wadden director of the Center for Weight and Eating Disorders at the University of Pennsylvania. Partly its the accountability that makes the difference. If youre reviewing your progress every week with a counselor youre going to try harder than if youre just recording your weight on a phone app. For the paper Wadden teamed with Steven B. Heymsfield an obesity researcher at Louisiana State University to sum up what is known about the causes of the obesity epidemic and how to battle it. Some parts of their scholarly review come as no surprise. Twothirds of the U.S. adult population http is overweight a Body Mass Index of to . or obese a BMI of or more a result of increasingly sedentary lifestyles and eating too much highcalorie food in supersize portions. The girth of the nation has led to soaring rates of diabetes heart disease and other chronic illnesses. But less wellknown is the fact that research has uncovered uncommon genetic forms of obesity including a type that is found in about percent of severely obese children. Moreover studies suggest that when fat people slim down they continue to suffer metabolic and psychological effects such as increased appetite and a preoccupation with food. The implication is that persons who are no longer obese may not be physiologically identical to their counterparts who were never obese the authors wrote. If obesity permanently changes how the body functions then that helps explain why so many who lose weight regain it. The authors say it also supports the concept of obesity as a chronic disease that requires longterm vigilance and management. Because of the chronic nature of the problem professional guidelines httponlinelibrary.wiley.comdoi.oby.full recommend that antiobesity medications be considered to supplement intensive counseling and lifestyle changes. Six drugs have been approved http_Will_new_diet_drug_prove_safe__effective__and_affordable_.html for short or longterm use and research by Wadden and others has shown that adding a medication leads to greater weight loss and better maintenance. Nonetheless studies suggest the medications are underused given the scale of the obesity epidemic. Wadden and his coauthor cite the reasons Diet drugs have a history of being barely effective or unsafe insurance usually doesnt cover them and patients are often disappointed that pills are no panacea their losses are modest. Its clear that these medications are beneficial said Wadden who has been a paid consultant to pharmaceutical companies as well as Weight Watchers. Unfortunately theres a sense that they must not work if you have to take them indefinitely. But I think obesity medications should be used on a longterm basis for chronic weight management just as I take a cholesterollowering statin and a bloodpressure medication for the long term."

"A new treatment might open the door for more patients with advanced kidney disease to get a transplant a preliminary study suggests. Of the plus Americans waiting for a donor kidney about onethird are sensitized said Dr. Robert Montgomery director of the Transplant Institute at NYU Langone in New York City. Those patients face a tough situation They harbor immune system antibodies that are primed to attack a donor organ. The antibodies can form when a person is exposed to foreign tissue Montgomery explained. So a patient whos had a prior kidney transplant may be highly sensitized meaning they have a large number of the offending antibodies. It can also happen to patients whove had blood transfusion or ever been pregnant Montgomery said. Its almost impossible to find a compatible donor for those patients. But they might be able to receive a kidney from an incompatible donor if they first undergo an extensive desensitization process. That involves various treatments including IV drugs called immune globulin and rituximab that try to quash the antibodies that would attack the donor organ. Now the new research suggests a simple approach an infusion of a particular enzyme hours before the transplant could offer a better alternative. Researchers found that the treatment dubbed IdeS quickly wiped out the dangerous antibodies allowing all but one of patients to have a successful transplant. The findings were published in the Aug. issue of the New England Journal of Medicine. Funding for the study came from the company developing IdeS Hansa Medical. Montgomery who was not involved in the study said hes never seen anything like it. When you give this all of the antibodies are gone Montgomery said. Im hopeful that this will turn out to be a gamechanger. However he stressed many questions remain. Critically the enzyme does not banish the antibodies forever. They come back Montgomery said and the results of that comeback vary from patient to patient. In the study patients had an episode of antibodymediated rejection anywhere from two weeks to five months after their transplant. That means antibodies started to attack the new kidney. Those patients were all successfully treated with standard antirejection drugs according to the researchers. Still its not yet clear how the patients will fare in the long term said Dr. Julie Ingelfinger a professor at Harvard Medical School in Boston. Ingelfinger who wrote an editorial published with the study echoed Montgomerys cautious optimism. If larger longer studies bolster the current findings she said this could potentially be practicechanging. But Ingelfinger stressed only time will tell. Lead researcher Dr. Stanley Jordan agreed that more work is necessary. But the findings mark another step forward for patients like these according to Jordan who is medical director of the kidney transplant program at CedarsSinai in Los Angeles. Traditionally highly sensitized patients in need of a kidney have languished on waiting lists because its so hard to find a compatible donor. But in the past years or so desensitization has emerged as an alternative. Last year a landmark study proved that patients who receive transplants after desensitization live significantly longer than those who stay on dialysis. The outcomes have been good Jordan said. But he added theres clearly room for improvement. Ingelfinger agreed. The desensitization protocols now in use are timeconsuming and they dont always work she said noting that they can leave dangerous antibodies behind. Desensitization adds about to to the cost of the transplant according to the University of Wisconsins transplant center. The new approach is quite different Ingelfinger said. Patients receive one infusion of an enzyme called IdeS four to six hours before the transplant. The enzyme is derived from a strain of Streptococcus bacteria and it essentially chops up the antibodies that would attack the organ. Jordan acknowledged that the source sounds scary but stressed that patients do not receive the bacteria itself but an engineered version of the enzyme. In all U.S. and Swedish patients received an infusion of IdeS before their kidney transplant. All but one had a successful transplant and none had detectable antibodies immediately afterward. IdeS patients still received additional treatment including a week of immune globulin and rituximab infusions. And as with all transplants they needed standard antirejection drugs. Because IdeS so readily banishes the offending antibodies it might make transplants feasible for even the most highly sensitized patients Montgomery said. But the question remains he said Can it extend the survival of the donor kidney and ultimately patients lives IdeS is still experimental and the only way patients could receive it is through a clinical trial. It will be a few years before it could be more widely available Montgomery said. More information The National Kidney Foundation has more on kidney transplantation. https SOURCES Stanley Jordan M.D. medical director kidney transplant program CedarsSinai Medical Center Los Angeles Robert Montgomery M.D. director Transplant Institute and professor transplant surgery NYU Langone Medical Center New York City Julie R. Ingelfinger M.D. professor pediatrics Harvard Medical School Boston and deputy editor New England Journal of Medicine Aug. New England Journal of Medicine"

"An experimental drug for treating Alzheimers disease that previously showed troubling side effects may actually be safe in the long run researchers report. The keys to the safety of the drug bapineuzumab may be lowering the dose and not giving it to patients with ApoE a gene mutation linked to Alzheimers according to two studies scheduled for presentation Wednesday at the Alzheimers Association International Conference on Alzheimers Disease in Paris. The data from the openlabel trial are encouraging. Patients were able to tolerate bapineuzumab for two to four additional years without the emergence of any new safety concerns said Dr. Stephen Salloway author of one of the studies. This is important because we are conceptualizing this drug as a longterm treatment for Alzheimers disease. Encouraging does not translate into certainty however another expert pointed out. I think it is too early to tell from the data from this small Phase safety trial said Ian Murray an assistant professor of neuroscience and experimental therapeutics at Texas AM Health Science Center College of Medicine in College Station. We will have to wait for larger trials to comment on this as a potential therapy. The studies were funded by Pfizer Inc. and Janssen Alzheimer Immunotherapy. Although bapineuzumab has shown promise in certain Alzheimers patients other research found that patients taking a higher dose of the drug had an increased risk of brain inflammation from water retention. This resulted in headache memory loss hallucinations reduced coordination or other symptoms. But no problems were seen with lower doses. Bapineuzumab is a humanized monoclonal antibody which binds to and might be able to eliminate beta amyloid peptide in the brains of people with Alzheimers. Most experts believe that the build up of beta amyloid proteins which accumulate as plaque is responsible for Alzheimers. Salloways study looked at the drugs safety in Alzheimers patients most of whom had mild tomoderate Alzheimers and participated in a longterm weeks or longer study. Some of the participants were followed for four years or more. Ninetyone percent of participants had side effects about a quarter of which were attributable to bapineuzumab. Of these percent were mild or moderate. The overall rate of vasogenic edema water on the brain was . percent a number that decreased over time said Salloway a professor of neurology and psychiatry at Alpert Medical School of Brown University and director of the Butler Hospital Memory and Aging Program in Providence R.I. The edema was symptomless in most cases he said. The other study which involved looking at more than MRI scans from patients found cases of amyloidrelated imaging abnormalities ARIA may have been linked to the bapineuzumab. These imaging abnormalities may indicate inflammation of the brain caused by water retention. But only of those cases involved symptoms and they were more likely to be found in patients with APOEe who were taking higher doses of the drug. The likelihood of these effects diminished with additional infusions of lowerdose bapineuzumab. There is a growing sense that VE vasogenic edema or ARIA amyloidrelated imaging abnormalities is a manageable side effect and may actually be a sign that the drug is clearing amyloid from the brain and the blood vessels said Salloway. Treatment will require ongoing monitoring with MRI. The researchers who said monitoring of bapineuzumab will continue are now awaiting the results of a larger Phase III trial on the drug. Because this study was presented at a medical meeting the data and conclusions should be viewed as preliminary until published in a peerreviewed journal. More information The Alzheimers Association http has more on this condition. SOURCES Stephen Salloway M.D. professor neurology and psychiatry Alpert Medical School of Brown University and director Butler Hospital Memory and Aging Program Providence R.I. Ian Murray Ph.D. assistant professor neuroscience and experimental therapeutics Texas AM Health Science Center College of Medicine College Station July presentation Alzheimers Association International Conference on Alzheimers Disease Paris"

"Changes can be detected and measured while older people are still healthy researchers say En Espaol httpsconsumer.healthday.comespanolcognitivehealthinformationalzheimersnewsmedirlasplacasdelcerebropodriacuteaofrecerpistassobreelriesgodealzheimer.html MONDAY Oct. HealthDay News A large amount of beta amyloid or plaques in the brain may trigger more significant memory loss in healthy older people than the genetic risk factor associated with Alzheimers disease known as the APOE allele according to new research from Australia. Our finding that brainplaquerelated memory decline can occur while people still have normal memory and thinking shows that these plaquerelated brain changes can be detected and measured while older people are still healthy said study author Yen Ying Lim of the University of Melbourne. This provides an enormous opportunity for understanding the development of early Alzheimers disease and even a sound basis for the assessment of plaquetargeting therapies. The researchers had nearly older adults with no thinking or memory problems undergo a PET brain scan. The participants who were an average age of also were tested for the APOE gene. The groups brain function was monitored for months using computerbased tests card games and having the participants memorize word lists. The study results are published in the Oct. issue of the journal Neurology. Over the course of the study the people who began with more brain plaques had up to percent greater decline on the computerbased assessments of memory than the people who had fewer brain plaques. The researchers also found the participants who carried the APOE gene had greater memory loss than those who did not have this genetic risk factor. They noted however that carrying the gene did not affect memory decline associated with the plaques. Our results show that plaques may be a more important factor in determining which people are at greater risk for cognitive impairment or other memory diseases such as Alzheimers disease Lim said in a journal news release. Unfortunately testing for the APOE genotype is easier and much less costly than conducting amyloid imaging. Although the researchers discovered an association between plaques and increased memory loss they did not prove a causeandeffect relationship. More information The U.S. National Institute on Aging provides more information on Alzheimers disease http SOURCE American Academy of Neurology news release Oct."

"Researchers from Hebrew SeniorLifes Institute for Aging Research University of Western Australia University of Sydney and Edith Cowan University have discovered that bone density scans typically used to determine fracture risk could also be an aid in identifying cardiovascular disease. The study was recently published in the Journal of Bone and Mineral Research. Researchers analyzed the bone density scans of over older women from Australia for the presence of calcium deposits in the large artery in the abdomen called the aorta. They graded the severity of these calcium deposits using scans done for osteoporosis screening. They then followed the women for almost years to determine the occurrence of cardiovascular disease within the cohort. We found that that the presence of calcifications increased the likelihood of having cardiovascular disease such as heart attacks and even the likelihood of cardiovascular deaths and mortality in general. Said Coauthor Douglas P. Kiel M.D. M.P.H. Director Musculoskeletal Research Center at Hebrew SeniorLifes Institute for Aging Research. Our study highlights the fact that having a bone density test not only tells women about their risk of fracture but also their long term risk for cardiovascular disease. This makes bone density testing even more useful in screening. About Institute for Aging Research Scientists at the Institute for Aging Research seek to transform the human experience of aging by conducting research that will ensure a life of health dignity and productivity into advanced age. The Institute carries out rigorous studies that discover the mechanisms of agerelated disease and disability lead to the prevention treatment and cure of disease advance the standard of care for older people and inform public decisionmaking. The Musculoskeletal Center within IFAR studies conditions affecting bone muscle and joint health with aging. About Hebrew SeniorLife Hebrew SeniorLife an affiliate of Harvard Medical School is a national senior services leader uniquely dedicated to rethinking researching and redefining the possibilities of aging. Based in Boston the nonprofit nonsectarian organization has provided communities and health care for seniors research into aging and education for geriatric care providers since . For more information about Hebrew SeniorLife visit http follow us on Twitter H_SeniorLife like us on Facebook or read our blog."

"Low doses of the antidepressant Lexapro escitalopram cooled off hot flashes better than placebo in about menopausal women according to a new study. We believe escitalopram provides an option for treating moderate to severe hot flashes that are disrupting peoples lives and quality of life says study researcher Ellen Freeman PhD a research professor in the department of obstetricsgynecology and psychiatry at the University of Pennsylvania School of Medicine Philadelphia. In the study Freeman found the antidepressant reduced both the number and severity of hot flashes compared to placebo. Previous studies of other antidepressants have yielded mixed results according to Freeman. The new study findings suggest Lexapro can provide an option for women reluctant to take hormone therapy. The findings are published in TheJournal of the American Medical Association. Antidepressants for Hot Flashes Lexapro Study Freeman and colleagues assigned women who were experiencing hot flashes either to a group which took to milligrams a day of Lexapro or a placebo for eight weeks. The women on average about age did not know whether they were taking the drug or the placebo. The women were asked to keep daily diaries noting the frequency and severity of their hot flashes. At the study start the average frequency of hot flashes was nearly per day. When Freemans team looked at the sevenday average of hot flash frequency at week eight in those who kept the daily diaries they found Those taking the antidepressant reported . hot flashes a day a decline of or about four and fewer a day. Those taking the placebo reported . hot flashes a day a decline of or about three fewer a day. The severity of the hot flashes went down more in the Lexaprotreated women than those on placebo. On a point scale the average overall hot flash severity score at the study start was .. At week eight those on Lexapro reported an average severity score of . termed mild to moderate. Those on placebo by week eight had a severity score of .. While of the women in the Lexapro group had a decrease of at least in hot flash frequency at the eightweek mark of those in the placebo group did. A reduction is pretty good Freeman says. The researchers followed up three weeks after the study ended and the women had stopped taking the drug or placebo. They found those in the drug group reported a bigger increase in hot flashes than did those in the placebo group. No serious adverse events were reported in either group Freeman says. The study was funded by the National Institute on Aging and other sources. Freeman reports having received research support from Forest Laboratories Inc. and other pharmaceutical companies that make antidepressants. For this study Forest which makes escitalopram provided the drug and placebo pills but no funding. Exactly how the drug relieves hot flashes is not known Freeman says. The cause of hot flashes is not really known she says. It is thought that the antidepressant works by providing more of the hormone serotonin to the brain she says. Lexapro is approved for depression in adults and teens to and for anxiety disorder in adults. Its use for hot flashes is considered offlabel. Offlabel drugs are prescribed for uses that have not been approved by the FDA. Second Opinion The new study findings are no surprise to Amanda Richards MD assistant professor of obstetrics and gynecology at the University of Miami Medical School who reviewed the study for WebMD. She has prescribed antidepressants for hot flashes for some of her patients including some who had cancer and went into surgical menopause after ovary removal with generally good success she says. Its not that it takes them away completely she says of the drugs effects on menopausal symptoms. But she finds as did the study researchers that the antidepressants do reduce the number and severity of the hot flashes. A typical patient prescribed an antidepressant for hot flashes she says will come back a couple weeks later thanking me saying they can now work they can manage their hot flashes. There could be a decline in libido she tells patients on antidepressants. But some will take that side effect she says in return for hot flash relief."

"When a suspicious lesion shows up in the lungs on a CT scan the first thing your doctor wants to know is whether its cancerous. A specialist will pass a long thin bronchoscope http into your airway in the hope of grabbing a few cells of the growth so they can be examined under a microscope. But some of these lesions or nodules are deep in the small branches of the lungs out of reach of the bronchoscope which is about the diameter of a pen. Other times the results are inconclusive. That has left only two ways to determine whether the abnormality is cancerous inserting a needle through the chest wall and into the tumor or surgically opening a patients chest to find it and remove it if necessary. The first procedure carries a percent risk of collapsing a lung pneumothorax as well as infection. The second is serious surgery that requires general anesthesia and results in the loss of lung tissue. Both are inpatient procedures that carry the cost and other risks of hospitalizations. In about a third of the surgeries the growth turns out to be benign meaning the surgery was unnecessary. But now according to a study published Sunday in the New England Journal of Medicine http_home there appears to be a new much less invasive way of determining whether a growth is malignant. Researchers at Boston University have discovered that the thin epithelial cells that line the entire airway show changes that indicate whether a growth is malignant. With small brushes on the bronchoscope they can take some of those cells and using genomic testing that has been available only in recent years reach a conclusion. Breast cancers predicted to rise by percent by http The study released Sunday showed that the tests were about percent accurate on subjects. A private company has purchased the technology and is making it available to hospitals across the country. Even though lung cancer tends to develop deep in your lung all the cells that line your airway are exposed said Avrum Spira a professor of medicine at Boston University who led the research. They have changes in their genome. Spiras test focuses on messenger RNA the molecules that express genes instructions to cells. He called the technology a canary in the coal mine for lung cancer which kills about people in the United States each year. If the test is negative its accuracy will allow doctors to wait and watch a lesion. If it shows a malignancy a biopsy still would be needed to confirm the cancer. There will still be a small number of biopsies Spira said. But were going to reduce them significantly. Other research is being conducted to find markers for lung cancer though much of it focuses on substances that can be found in the blood Spira said. With the vast majority of lung cancer victims being smokers the epithelial cells show changes that could be tracked once the technology became available he said. The next logical question is whether those changes might be detected early enough to predict and prevent lung cancer. Spira said his team already is working on research to determine whether thats possible. Woman denied bank transaction after chemotherapy erases her fingerprints http The current advance was a long time in coming and shows the difficulty of bringing research from the lab to the consumer. Spira said the initial discovery was made years ago but he couldnt find any private group willing to put up the millions of dollars needed to conduct studies work through the government and academic regulatory process and bring his idea to market. Seven years ago he formed his own company raised venture capital and eventually proved that his idea worked. Now his company has been purchased by Veracyte which will take over the production and marketing of the Bronchial Genomic Classifier. We were adding seconds to a minute to the length of a bronchoscopy Spira said. . . . Even then the regulatory hurdles were significant. We got over them all but they were significant. Correction The original version of this post incorrectly named the company that is distributing the Bronchial Genomic Classifier. This version has been corrected."

"A drug used outside the U.S. to treat osteoporosis https may not only lessen the everyday pain associated with knee https osteoarthritis https but may even slow down the progression of osteoarthritis https researchers say. The drug is called strontium ranelate. In a threeyear study of more than people with knee osteoarthritis httpsarthritis.webmd.comstayingactivearthritisdefault.htmvidvdhzim digital Xrays revealed substantially less loss of cartilage in the joint space in those who took strontium ranelate every day compared with people who took a placebo https daily. In people with osteoarthritis https the cartilage in a joint wears away in some areas. The function of cartilage is to reduce friction in the joints and serve as a shock absorber. The wearing away of cartilage leads to pain and other symptoms. Nearly one in people have evidence of knee https osteoarthritis on an Xray. And nearly of women and of men age and older have joint pain https stiffness and other symptoms of knee osteoarthritis according to a large study. Study head JeanYves Reginster MD PhD presented the findings today at the American College of Rheumatology ACR Annual Meeting in Washington D.C. He is president and chair of the department of public health sciences at the University of Lige in Belgium. Strontium is a trace element found in seawater and soil. Its main dietary sources are Seafood Whole milk Wheat bran Meat Poultry Root vegetables In several European countries and Australia a form of strontium called Protelos strontium ranelate is available as a prescription drug for osteoporosis treatment https_treatment_care. Protelos is not approved in the U.S. But forms of the element such as strontium citrate are widely available as nutritional supplements https_AssetsscopemapsWebMDConsumerPagesVitaminsandSupplementsLifestyleGuide_ecedpage_VitaminsandSupplementsLifestyleGuide_eced.xml in supermarkets health food stores and online. But strontium supplements https cant just be substituted for Protelos says ACR spokesman Stanley Cohen MD a rheumatologist https at the University of Texas Southwestern Medical School in Dallas. They would have to be tested in another study. Strontium in Perspective Cohen notes that there are a variety of arthritis https medications https called diseasemodifying antirheumatic drugs DMARDs that work by curbing the underlying processes that cause certain forms of inflammatory arthritis https including rheumatoid arthritis https ankylosing spondylitis https and psoriatic arthritis https But finding a drug that can actually delay the progression of knee osteoarthritis is difficult he says. Several large trials of drugs that looked promising in early research failed to pan out. That makes this study potentially very exciting he says. But until the research has been reviewed by other doctors and published in a medical journal it is too soon to draw firm conclusions Cohen says. With no approved treatment to delay the progression of the disease current osteoarthritis treatments https focus on improving disease symptoms through a combination of medication physical therapy https and other nonpharmaceutical therapy. Strontium vs. Placebo The study involved people with knee osteoarthritis whose average age was . They were given a or gram dose of strontium or placebo daily. The people who took either dose of strontium had less cartilage loss compared to the placebo group. Both doses worked at a level that could significantly lower their risk of surgery within five years Reginster says. What we saw in this study is that to fewer patients taking strontium reached this surgery threshold compared with placebo he says. As for symptoms people taking the gram dose scored substantially higher than either of the other groups on pain related to everyday activities. Because the drug can raise the risk for deep vein thrombosis https when given in osteoporosis https patients with a history of DVT https were excluded from the study. As always people should talk to their doctors before taking a supplement to prevent or treat any disorder Cohen stresses. Several researchers reported financial ties to drug companies including Servier Laboratories a manufacturer of strontium ranelate. These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the peer review process in which outside experts scrutinize the data prior to publication in a medical journal."

"It takes up to years and billion for a new drug to make it through testing and earn approval from the U.S. Food and Drug Administration FDA. Before researchers try a compound on humans its tested at labs in petri dishes and on animals such as mice and monkeys. More often than not these studies produce mixed data that dont tell researchers much about whether it is safe and effective for humans. For some time scientists have been searching for ways to cut down on the cost and failure rate of drug testing. Researchers at the Wyss Institute for Biologically Inspired Engineering at Harvard University have developed a beautiful solution httpwyss.harvard.eduviewpage OrgansOnChips. The clear and flexible polymer microchips are lined with human cells. Each one represents a different human organ system such as lungs heart and intestines. The institutes goal is to create different organ systems that can be joined together by blood vessel channels to simulate human physiology on a microscale and provide a cheaper more reliable way to test new drugs. The sophisticated architecture of these organsonchipswhich are about the size of a thumb drivehas also earned the Wyss Institute recognition in the art world with a Design of the Year award from the Design Museum and placement in the Museum of Modern Arts permanent collection. The real power of this approach is that you have a window to the inner workings of life says Don Ingber founding director of the Wyss Institute and a professor of Vascular Biology and of Bioengineering at Harvard University. Anything you can ask at the molecular level we could do in our chips. In the team built and tested its first organoid chip to mimic the mechanical function of human lungs. It contains tiny channels separated by a porous membrane to create two distinct hollow passagewaysone lined with human lung cells and the other with capillary blood vessel cells. Air is suctioned through the side channels to emulate breathing. Ingber and his team introduced bacteria into the chips lung channel and white blood cells into the capillary channel. They observed that the white blood cells permeated the membrane and attacked the bacteria in the lung cell channelexactly what would happen in human lungs fighting off an infection. In another experiment the team at Wyss filled a chips lung cell channel with interleukin a chemotherapy drug known to cause pulmonary edema an accumulation of fluid in the lungs. When air entered the lung cell channel the channel filled with fluid and then blood clotsexactly what happens in the lungs of patients who develop this lifethreatening condition. This proved the chips could provide real world information to scientists studying the effects of new drug compounds. The project has received support from the National Institutes of Health and the FDA. The Defense Advanced Research Projects Agency also recently awarded the institute a million grant to create chips representing nearly all systems in the body. Ingber says some scientists are interested in using the chips to conduct research that would be unethical if performed on people such as studying the effects of gamma radiation on the human body. Of course the chips have limitations. We cant mimic consciousness we cant mimic compression on a joint says Ingber. Danilo Tagle associate director for special initiatives at the National Center for Advancing Translational Sciences a division of the NIH is spearheading a similar organonchip project. He suspects that in the beginning the chips will be used to complement and supplement animal studies but will eventually become routine practice. The chips will also provide researchers with information on dosing at a much earlier stage in drug studiesparticularly helpful because animals metabolize chemical substances at a different rate than humans. You can go forward with a candidate drug with greater assurance and confidence that it will have the desired effect on humans says Tagle. Biology is very complex. Incorporating the chips into drug testing could save millions of dollars and years of time on research. Some companies are already trying out the concept. Janssen Pharmaceuticals Company a subsidiary of Johnson Johnson is using a version of the chips to understand how blood clots in the lungs. The information is essential to reduce the risk for this side effect of oncology drugs. Though there still arent enough data to prove the chips are reliable enough to put rodents out of a job Ingber says its only a matter of time they hope to have them tested and ready for market in two years. The FDA has been very supportive he says. Theyve told us if they are as good as animals that they would consider accepting data provided by a drug company from one of these models rather than an animal model."

"Its the person who wakes up at the crack of dawn on the weekend puts on shiny spandex and disappears with a mountain bike for hours at a time. Its the guy who heads to the pool one night a week and endures a workout that might make Michael Phelps gasp for air. Its the weekly rock climbers and double spin classtakers schvitzing their Sunday away. These weekend warriors cram the recommended amount of exercise into one or two days while the rest of us faithfully head to the gym multiple times a week for a halfhour hamster run on the treadmill. A paper published January in JAMA Internal Medicine httpjamanetwork.comjournalsjamainternalmedicinefullarticle.jamainternmed.. suggests these warriors may be onto something. In a study based on nearly adults researchers in the U.K. found that weekend exercise appears to be just as effective at preventing heart disease and cancer as exercise done more frequently. This is great news for anyone who feels too busy on weekdays to work out but enjoys outdoor activity on the weekend. I think that the weekend warrior physical activity pattern is beneficial because they are actually doing a large proportion of vigorous intensity activity. And vigorous activity makes you fit and fitness reduces your risk of disease and death says Gary ODonovan a researcher in physical activity and sedentary behavior at Englands Loughborough University and lead author of the paper. ODonovan and fellow researchers looked at data on middleaged adults who responded to a governmentsponsored household survey conducted from to . The survey included questions about health history and fitness habits. The researchers then crossreferenced this information with health department death records. They found the risk of death from all causes was about percent lower for weekend warriors compared with adults who maintained a sedentary lifestyle. And the warriors had a percent lower risk of cardiovascular death and an percent lower risk for cancerrelated death. The mortality rates of weekend warriors were roughly the same as those who claimed to exercise more than two days a week but for shorter durations. However there are also some limitations to this study the researchers say. More than percent of the subjects were white. The information about physical activity was reported by the participants and its likely that many were too generous in their estimates of how much time they spent at the gym. Unfortunately taking minutes in locker room to put on your sneakers doesnt count as a workout. Its recommended that people get minutes or two and half hours of exercise each week based on guidelines from the American Heart Association http_UCM__Article.jsp the U.S. Centers for Disease Control and Prevention https and other medical authorities. This could be something as simple as a brisk walk or other lowimpact options for vigorous exercise about minutes a day. Experts often encourage recreational athletes to not exercise more than an hour a day. In theory someone who did one bout of minutes of moderate exercise is a weekend warrior says ODonovan. This study shows that it doesnt matter how you decide to split up the recommended weekly amount of exercise. You just need to do it. However experts caution that it is possible to overdo it and more exercise than two and a half hours a week can actually be unhelpful and even harmful. One study published in in the journal Heart httpheart.bmj.comcontentearlyheartjnl.abstract suggests that in people with existing heart disease the risk for cardiac arrest and stroke was the same for people who exercised more than an hour a day compared with those who didnt exercise at all. The coronary heart disease patients who stuck with the recommended minutes a week had the lowest risk for heart attack and stroke. There are risks that come with a weekend warrior exercise schedule especially for people who arent used to being active. I would be more concerned about whats happening at the point of exercisenot the longterm benefits says Dr. Howard Andrew Selinger chair of family medicine at Quinnipiac University. He says someone who is not in good shape is at risk for sudden cardiac arrest or acute injury such as spraining muscles or putting too much stress on joints. ODonovan encourages aspiring weekend warriors to start slowly to avoid any health problems. He says middleaged adults should exercise moderately during the first weeks and then slowly build up to more vigorous activity."

"Multiple myeloma is the second most common type of blood cancer in the United States impacting more than people each year and disproportionatly affecting AfricanAmerican men. While patients have access to more quality treatment therapies than ever before the disease is still regarded as an incurable condition that often leads to death for those affected. However researchers at the University of Alabama at Birmingham httpuab.edu Division of Hematology and Oncology https are leading and currently recruiting for a Phase II clinical trial that intends to provide newly diagonosed multiple myeloma patients an innovative treatment plan. The hope is that the therapies will eradicate the disease in a significant proportion of patients and measure disease response more accurately than ever before. The clinical trial Monoclonal Antibody Sequential Therapy for Deep Remission in Multiple Myeloma also known as MASTER utilizes next generation sequencing technology to detect minimal residual disease down to a level of one cancer cell in or to fold more sensitive than traditional methods to evaluate response. With a goal of enrolling patients those in the trial will be treated with a combination of antimyeloma agents and immunotherapy that have a proven record of eliminating minimal residual disease including the drug carfilzomib and the monoclonal antibody daratumumab agents that are currently only approved to treat patients whose disease has returned. I believe for the first time that we have treatments that are effective enough to make it possible to eradicate multiple myeloma definitively in a substantial proportion of patients along with having the technology to detect that the disease has been targeted and that treatment can be stopped said Luciano Costa M.D. Ph.D. scientist at the UAB Comprehensive Cancer Center httpcancercenter.uab.edu lead of the HematologicMalignancy Working Group and principal investigator of the MASTER study. That is what patients want after all a treatment that gives them the possibility of eliminating any trace of the myeloma without having to be on therapy for the rest of their lives. It is a bold move but bold moves are what our patients deserve. Multiple myeloma is the second most common type of blood cancer in the U.S. impacting more than people each year and disproportionatly affecting AfricanAmerican men. This is one of the first trials in multiple myeloma to use minimal residual disease as primary endpoint and the very first one to modify therapy based on achievement of minimal residual disease eradication. Up until now existing therapies have been developed on trials that assigned treatment for a defined duration of time irrespective of depth or speed of response often followed by maintenance therapy for indefinite duration and with potentially adverse impact on risk of complications and cost. As it stands patients with billions of cancer cells in their bodies and patients with true disease eradication will both appear to be in complete remission using current methods to measure disease response to therapy. More than improving the results of the initial treatment the MASTER study will treat patients for the necessary time to confirm elimination of minimal residual disease and then discontinue therapy. Patients will be monitored for relapse at the molecular level before disease becomes again symptomatic. In addition to UABs study leadership Vanderbilt University Medical Center httpsww.mc.vanderbilt.edu Duke University https Medical College of Wisconsin https University of Wisconsin https and Oregon Health and Science University https are recruiting for the trial as well. The MASTER trial is supported by Amgen and Janseen both with drug and finaincial suppor"

"A new study published in the American Journal of Clinical Nutrition found that consuming tree nuts such as walnuts may lower the risk of cardiovascular disease. After conducting a systematic review and metaanalysis of controlled trials one of the authors Michael Falk PhD Life Sciences Research Organization found that consuming tree nuts lowers total cholesterol triglycerides LDL cholesterol and ApoB the primary protein found in LDL cholesterol. These are key factors that are used to evaluate a persons risk of cardiovascular disease. Walnuts were investigated in of the trials more than any other nut reviewed in this study. Our study results further support the growing body of research that tree nuts such as walnuts can reduce the risk of cardiovascular diseases said Dr. Falk. Tree nuts contain important nutrients such as unsaturated fats protein vitamins and minerals. Walnuts are the only nut that provide a significant amount . grams per one ounce serving of alphalinolenic acid ALA the plantbased form of omegas. Beyond finding that tree nuts lower total cholesterol triglycerides LDL cholesterol and ApoB researchers also found that consuming at least two servings two ounces per day of tree nuts such as walnuts has stronger effects on total cholesterol and LDL. Additionally results showed that tree nut consumption may be particularly important for lowering the risk of heart disease in individuals with type diabetes. Of articles surveyed trials met eligibility criteria for this systematic review and metaanalysis totaling unique participants. Trials directly provided nuts to the intervention group rather than relying solely on dietary advice to consume nuts. The dose of nuts varied from to gday and most participants followed their typical diet. More than two decades of research has shown that walnuts may help lower cardiovascular risk factors by decreasing LDL bad cholesterol by and diastolic blood pressure by mmHg as well as reducing total cholesterol raising HDL cholesterol reducing inflammation as measured by Creactive protein and improving arterial function. These factors are major contributors to heart disease risk and reducing them is a critical step toward a healthier heart. In addition to providing omegas walnuts also deliver a convenient source of fiber grams per ounce and protein grams per ounce. Coauthors with Dr. Falk are Liana C. Del Gobbo PhD Robin Feldman MBA Kara Lewis PhD and Dariush Mozaffarian MD PhD. This study was supported in part by funds from The International Tree Nut Council Nutrition Research and Education Foundation. About California Walnut Commission The California Walnut Commission established in is funded by mandatory assessments of the growers. The Commission is an agency of the State of California that works in concurrence with the Secretary of the California Department of Food and Agriculture CDFA. The CWC is mainly involved in health research and export market development activities. For more industry information health research and recipe ideas visit http NonDiscrimination Statement The California Walnut Commission CWC prohibits discrimination in all programs and activities on the basis of race color national origin age disability sex marital status familial status parental status religion sexual orientation genetic information political beliefs reprisal or because all or part of an individuals income is derived from any public assistance programs. Persons with disabilities who require alternative means for communication of program information Braille large print audiotape etc. should contact the CWC offices at . To file a complaint of discrimination write to USDA Director Office of Civil Rights Independence Avenue S.W. Washington D.C. or call voice or TDD. CWC is an equal opportunity employer and provider. The California Walnut Commission offices are located at Parkshore Dr. Ste. Folsom CA Del Gobbo L. Falk M.C. Feldman R. Lewis K. Mozaffarian D. Effects of tree nuts on blood lipids apolipoproteins and blood pressure systematic review metaanalysis and doseresponse of controlled intervention trials. Am J Clin Nutr. doi .ajcn... KrisEtherton P. Walnuts decrease risk of cardiovascular disease a summary of efficacy and biologic mechanisms. J Nutr. .SS. Sabat J Fraser GE Burke K Knutsen SF Bennett H Lindsted KD. Effects of walnuts on serum lipid levels and blood pressure in normal men.N Engl J Med. . Banel HK Hu FB. Effects of walnut consumption on blood lipids and other cardiovascular risk factors a metaanalysis and systematic review. Am J ClinNutr. Jul. Zhao G Etherton TD Martin KR et al. Dietary alphalinolenic acid reduces inflammatory and lipid cardiovascular risk factors in hypercholesterolemic men and women. J Nutr ."

"Cancer experts said Tuesday that the actress and filmmaker Angelina Jolie Pitt was wise to have had her ovaries and fallopian tubes removed last week because she carries a genetic mutation BRCA that significantly increases the risk of ovarian cancer a disease so difficult to detect that it is often found only at an advanced untreatable stage. They also said Ms. Jolie Pitts decision to discuss her own choices so frankly will encourage women in similar situations to consider their own options. BRCA mutations cause about to percent of breast cancers and to percent of ovarian cancers among white women in the United States. It is unclear how common the mutations are in other racial and ethnic groups. Prophylactic removal of ovaries and fallopian tubes is strongly recommended in women before age in BRCA and BRCA mutation carriers said Dr. Susan Domchek executive director of the University of Pennsylvanias Basser Research Center which specializes in BRCA mutations. There is no effective screening for ovarian cancer and too many women with advanced stage ovarian cancer die of their disease. Writing for The New York Timess OpEd page http_rmoduleinline Ms. Jolie Pitt said she had expected to have her ovaries and fallopian tubes removed a procedure called a laparoscopic bilateral salpingooophorectomy but that a cancer scare made her decide to undergo the procedure sooner. Her mother aunt and grandmother died of cancer. To my relief I still had the option of removing my ovaries and fallopian tubes and I chose to do it she wrote. Two years ago she ignited a worldwide discussion about options for women at high risk for breast cancer when she wrote that she had had both breasts removed because BRCA the same genetic mutation that prompted her surgery last week increased her risk of breast cancer. Several doctors said that for women in similar situations they generally recommend that ovaries be removed before breasts but the cost is that women who do so go into early menopause and can no longer bear children. However removing the ovaries substantially decreases a womans risk of developing breast cancer. Also breast cancer is generally more detectable and treatable than ovarian cancer. Were really quite pushy about oophorectomy Dr. Domchek said. And we talk about mastectomy as an option. Experts said that some details mentioned by Ms. Jolie Pitt might not apply to all women with such mutations or might be characterized differently by doctors. For example Ms. Jolie Pitt wrote that she was advised to have the surgery about years before the age at which her mother was first diagnosed which was . But doctors said a better rule of thumb is between ages and ideally after a woman has finished having children but before her cancer risk rises sharply. https_idactionclickmoduleeditorContentpgtypeArticleregionCompanionColumncontentCollectionTrending Ms. Jolie Pitt also said she had a yearly test for the CA protein to monitor the possibility of ovarian cancer. She noted that her doctor said the test missed a high percentage of cancers. Some experts said they had stopped such tests because they miss so many cancers and have not been shown to improve survival rates. Weve basically said theres no data to support it and were recommending the surgery said Dr. Kenneth Offit chief of the clinical genetics service at Memorial Sloan Kettering Cancer Center. He added In the end what she did is fine. She got to the right place. She had ovarian surgery done within the window of time. Ms. Jolie Pitts decision not to remove her uterus was consistent with what experts recommended. There is no research showing that having a BRCA mutation puts women at risk for uterine cancer said Dr. Jamie BakkumGamez a gynecologic oncologist at the Mayo Clinic. Dr. Jamie BakkumGamez and other experts endorsed her decision to take hormone replacement therapy an estrogen patch and a progesterone intrauterine device to counteract symptoms of surgeryinduced menopause. Ms. Jolie Pitt who has six children three adopted wrote that she knows these decisions are far harder for women who still want to get pregnant and that she had learned they might have options to remove their fallopian tubes but keep their ovaries. Experts cautioned that the evidence is still slim on whether fallopian tube removal is effective at preventing ovarian cancer. Shira Krance who has a BRCA mutation had a double mastectomy two years ago and said she has considered whether to have the fallopian tubes removed before her ovaries. Doctors will give you a lot of options but nobody will tell you what to do said Ms. Krance who lives in Valley Cottage N.Y. and has two young children. Its scary the idea of not being around when your children grow up. Thats the worst thing and Im going to do everything I can to avoid that. Ethel Zelenske a BRCA carrier who lives in Baltimore had her tubes and ovaries removed in . A few years later she was diagnosed with peritoneal cancer a condition that Dr. Offit said each year occurs in about half of a percent of women who have had their ovaries removed. Ms. Zelenske was treated but had a recurrence of the peritoneal cancer two years ago. My doctors have told me that I will always be in treatment said Ms. Zelenske who like many other women welcomed Ms. Jolie Pitts public disclosure. I really love that she said knowledge is power because I say that all the time."

"The benefits for the heart of eating strawberries and blueberries can build up over a lifetime according to the latest research. Brightcolored berries have long been a part of any healthy diet owing mainly to the anthocyanins httphealthland.time.comcanblueberryjuiceboostyourmemory that give them their vibrant color and act as antioxidants to fight off damage to cells. Now a study published in the journal Circulation confirms and quantifies that benefit women who ate three or more servings of blueberries and strawberries per week reduced their risk of heart attack by up to one third. In the study researchers from the Harvard School of Public Health and the University of East Anglia in the U.K. analyzed data from women ages to enrolled in the Nurses Health Study II. For years the women filled out surveys detailing their diets at fouryear intervals. MORE Study Flavonoids May Help Protect Against Parkinsons httphealthland.time.comstudyflavonoidsmayhelpprotectagainstparkinsons During the study the women experienced heart attacks httptopics.time.comheartattacks. But women who consumed the most blueberries and strawberries had a reduced risk of heart attack compared with the women who ate berries once a month or less. The women who ate more berries also tended to eat healthier overall consuming more vegetables and fruits than those who didnt eat as many berries but when the scientists broke down the womens diets they found that the highest consumers httptopics.time.comconsumers of berries even had a lower risk of heart attack compared with women who still ate plenty of fruits and vegetables but fewer berries. The effect remained even after the researchers adjusted for other things that can influence heartdisease risk such as obesity high blood pressure smoking httptopics.time.comsmoking low levels of physical activity and a family history of heart disease. These foods can be readily incorporated into diets and simple dietary changes could have an impact in reducing risk of heart disease in younger women says study author Aedin Cassidy from the University of East Anglia. This supports growing lab data showing that these compounds can help keep arteries healthy and flexible. So what is it about berries that help the heart The researchers focused on blueberries httphealthland.time.comcanblueberrieshelpfightfat and strawberries httphealthland.time.comcaneatingstrawberriespreventcancer because these are the most widely consumed varieties in the U.S. Both berries contain high levels of anthocyanins as well as other flavonoids which fight the effects of stress and freeradical damage to cells as they age. They can also keep heart vessels more elastic and flexible which helps combat the growth of plaques that can build up and rupture causing heart attacks. MORE Can Eating Fruits and Veggies Outwit Bad Heart Genes httphealthland.time.comeatingfruitsandveggiesmayoutwitbadheartgenes The results are particularly encouraging because they showed that a change in diet could affect heartdisease risk for relatively young women. That means that regular consumption of berries might be a relatively easy way to lower a womans risk of having a heart attack later in life possibly even insulating her from heart problems. Although we know about the effects of antioxidants httphealthland.time.comstudyveggiesstillreallygoodforyou and flavonoids httphealthland.time.comstudyflavonoidsmayhelpprotectagainstparkinsons and their effects in wine httphealthland.time.comcheersladiesadrinkadaymaymeangoodhealthinolderage and chocolate httphealthland.time.comsweetalittlechocolateadaymayhelplowerbloodpressure it is interesting to look at their effects in such a large group of women over a long period of time says Dr. Suzanne Steinbaum director of women and heart disease at Lenox Hill Hospital in New York City who was not involved in the study. The takehome lesson is that even if you are eating these early in life youre getting benefits that last for life. When were making choices in our s we may think that a burger and fries is great but the message is that there are alternatives that make a difference for the rest of your life. It is a powerful message that we can prevent cardiovascular disease by what we eat. Something worth remembering the next time youre in the produce aisle."

"The inexpensive tests that look for hidden blood in a persons stool are effective for colon cancer screening a study out Tuesday confirms. The findings reported in the Canadian Medical Association Journal give some extra weight to fecal occult blood testing FOBT as a valid option for early detection of colon cancer. Experts generally recommend that people at average risk of colon cancer start screening tests for the disease at age . And they can pick from a number of tests that have all been found to cut the risk of dying from colon cancer. Along with stool tests done once a year at home the choices include two invasive procedures colonoscopy done every years and flexible sigmoidoscopy done every five years. The U.S. Preventive Services Task Force a federally supported expert panel recommends that people at average risk of colon cancer choose any of the three methods. FOBT detects hidden blood in the stool which can be a sign of colon cancer or precancerous growths called polyps. Positive results on the screen prompt a followup colonoscopy to investigate the source of the blood. Advances in the stool tests in recent years have made them more effective. A newer version called immunochemical FOBT iFOBT is supposed to zero in on colon growths better than an older version known as guaiac FOBT which often picked up bleeding originating in the upper digestive tract such as from a stomach ulcer. Immunochemical FOBT is now largely replacing the older test. But theres been surprisingly little evidence that it really is highly specific to colon cancer according to Dr. YiChia Lee of National Taiwan University Hospital one of the researchers on the new study. So for their study the researchers followed nearly adults who all volunteered to have iFOBT a colonoscopy and an upper endoscopy to check for problems in the upper digestive tract. They found that of people confirmed to have colon tumors after a colonoscopy all but one had also a positive iFOBT result. It means that almost every case with colon cancer can be identified by iFOBT Lee told Reuters Health in an email. It is a strong support to iFOBT as an effective screening tool. The researchers also found that iFOBT had specificity for colon cancer of close to percent meaning the test would accurately give a negative result to almost percent of people who did not have colon cancer. Of three study participants who were found to have cancers of the stomach or esophagus for instance none had a positive result on the iFOBT test. Like any screening test iFOBT does have a risk of falsepositive results which leads to unnecessary invasive testing in some people. In this study about percent of all participants had a falsepositive finding on the stool test. Among the risk factors for falsepositives the authors identified were the use of anticlotting drugs and low levels of the ironrich molecule hemoglobin in the blood. In practice a positive iFOBT result would be followed by colonoscopy in which a scope is used to investigate the interior of the colon. Whether used for firstline screening or as a followup colonoscopy has the advantage of allowing doctors to spot and remove precancerous growths called polyps which means the test can prevent cases of colon cancer. But as far as cutting the risk of death from colon cancer stool testing is similarly effective according to the U.S. Preventive Services Task Force. And its much cheaper iFOBT is more expensive than the older stool tests but it is still roughly . A screening colonoscopy averages around . The downside of iFOBT being specific to colon tumors is that it is not useful for catching cancers of the stomach or throat. Thats particularly important in Asia where those cancers are common. Lee said researchers there are looking into whether combining iFOBT with the older guaiac test is useful for catching cancers in the lower and upper digestive tract and whether adding a third stool test which looks for the ulcercausing bacteria H. pylori can help as well. Infection with H. pylori is associated with increased risks of stomach and throat cancers. In the U.S. cancers of the upper digestive tract are relatively uncommon. The average American has a one in chance of developing esophageal cancer while the risk of stomach cancer is one in . In contrast Americans lifetime risk of colon cancer is about one in according to the American Cancer Society. More than Americans died of the disease in . SOURCE bit.lymUOj httpbit.lymUOj Canadian Medical Association Journal online August . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Lovers of Indian food give yourselves a second helping Daily consumption of a certain form of curcumin the substance that gives Indian curry its bright color improved memory and mood in people with mild agerelated memory loss according to the results of a study conducted by UCLA researchers. The research httpsdoi.org.j.jagp... published online Jan. in the American Journal of Geriatric Psychiatry examined the effects of an easily absorbed curcumin supplement on memory performance in people without dementia as well as curcumins potential impact on the microscopic plaques and tangles in the brains of people with Alzheimers disease. Found in turmeric curcumin has previously been shown to have antiinflammatory and antioxidant properties in lab studies. It also has been suggested as a possible reason that senior citizens in India where curcumin is a dietary staple have a lower prevalence of Alzheimers disease and better cognitive performance. Exactly how curcumin exerts its effects is not certain but it may be due to its ability to reduce brain inammation which has been linked to both Alzheimers disease and major depression said Dr. Gary Small director of geriatric psychiatry at UCLAs Longevity Center and of the geriatric psychiatry division at the Semel Institute for Neuroscience and Human Behavior at UCLA https and the studys first author. The doubleblind placebocontrolled study involved adults between the ages of and years who had mild memory complaints. Participants were randomly assigned to receive either a placebo or milligrams of curcumin twice daily for months. All subjects received standardized cognitive assessments at the start of the study and at sixmonth intervals and monitoring of curcumin levels in their blood at the start of the study and after months. Thirty of the volunteers underwent positron emission tomography or PET scans to determine the levels of amyloid and tau in their brains at the start of the study and after months. The people who took curcumin experienced significant improvements in their memory and attention abilities while the subjects who received placebo did not Small said. In memory tests the people taking curcumin improved by percent over the months. Those taking curcumin also had mild improvements in mood and their brain PET scans showed significantly less amyloid and tau signals in the amygdala and hypothalamus than those who took placebos. The amygdala and hypothalamus are regions of the brain that control several memory and emotional functions. Four people taking curcumin and two taking placebos experienced mild side effects such as abdominal pain and nausea. The researchers plan to conduct a followup study with a larger number of people. That study will include some people with mild depression so the scientists can explore whether curcumin also has antidepressant effects. The larger sample also would allow them to analyze whether curcumins memoryenhancing effects vary according to peoples genetic risk for Alzheimers their age or the extent of their cognitive problems. These results suggest that taking this relatively safe form of curcumin could provide meaningful cognitive benefits over the years said Small UCLAs ParlowSolomon Professor on Aging. The papers authors in addition to Small are Prabha Siddarth Dr. Zhaoping Li Karen Miller Linda Ercoli Natacha Emerson Jacqueline Martinez KoonPong Wong Jie Liu Dr. David Merrill Dr. Stephen Chen Susanne Henning Nagichettiar Satyamurthy SungCheng Huang Dr. David Heber and Jorge Barrio all of UCLA. The study was supported by the Ahmanson Foundation the Marshall and Margherite McComb Foundation the McMahan Foundation Bob and Marion Wilson the Fran and Ray Stark Foundation Fund for Alzheimers Disease Research the U.S. Department of Energy and the National Institutes of Health. Theravalues Corp. provided the curcumin and placebos for the trial as well as funds for laboratory testing and for Smalls travel to present preliminary findings at the Alzheimers Association International Conference. SEE ORIGINAL STUDY http"

"Janet Jay is a cyborg. No shes not RoboCop or Darth Vader. But she shares a similarity with those characters Her alltoohuman body has been upgraded with a machine. A nextgeneration implant deep in Jays back stimulates her spinal cord overriding her bodys pain signals to give her some relief from the back pain that has plagued her for years. In an article https on Popular Sciences website Jay writes about her experience with pain and the nextgeneration way shes finding relief. She is hardly alone in her suffering. According to the National Center for Health Statistics httpsnccih.nih.govnewspress an estimated . million Americans or . percent of U.S. adults experience chronic pain. It can interfere with work and home life and leave patients debilitated disabled and depressed. So it makes sense that Jay jumped at the chance to experience longterm pain relief with the help of a spinalcord stimulator. Jay lays out the hows and whys of spinal stimulation and she paints a vivid picture of a life in agony a journey that has included skeptical doctors plenty of painkillers and unanswered questions about the future. She also describes her path to spinal stimulation how the device works with the body to shortcircuit pain and the many roadblocks to relief that patients face. Even for me the battle is not over Jay writes. Since this surgery Ive actually had another disc herniate complicating everything. My spine isnt cured and I still hurt all the time. But the pain is far more controlled and I can function much better at my current level of discomfort. As the human and financial costs of the opioid crisis rise spinal stimulation may become more popular even though its expensive. Jay says she was lucky Her insurance covered much of the sixfigure bill for the procedure."

"People with diets short on omega fatty acids the kind found in fish oil were more likely to experience accelerated brain aging a new study found. People with lower levels of omega fatty acids had lower brain volumes that were equivalent to about two years of brain aging said Dr. Zaldy S. Tan http a member of the UCLA Easton Center for Alzheimers Disease Research in the Department of Neurology. The study http published Tuesday in the print edition of the journal Neurology. Tan and his colleagues compared blood levels of two nutrients in omega fatty acids with MRI brain scans and cognitive tests. They found people in the bottom scored lower on such mental tests as problem solving multitasking and abstract thinking. Tan said the MRI images showed those with lower levels of omega fatty acids were also more likely to have minute but significant structural changes in the brain. The MRIs showed higher white matter hyperintensity volume tiny lesions in the brain raising the risk for death stroke and dementia for the low omega fatty acids group. Tan said the results were consistent with signs of damage to the intricate network of blood vessels in the brain. A third of the brain by volume is composed of blood vessels. Tans team studied people with an average age of who were free of dementia. They controlled for such risk factors as age smoking gender body mass index physical activity and APOE httpghr.nlm.nih.govgeneAPOE the one known gene linked to dementia risk. Tan said the next step in the research is to follow these people to see if the risk factors they observed translates into a higher rate of cognitive deterioration. Fatty fish like salmon offer a concentrated source of the omega fatty acid nutrients Tan and his colleagues looked at eicosapentaenoic acid EPA and docosahexaenoic acid DHA. Vegetable and canola oils soybeans flaxseed walnuts and vegetables including spinach kale and salad greens are also a source of omega fatty acids. These contain alphalinolenic acid ALA which the body partially converts to EPA and DHA. Both types are thought to be beneficial. The typical American diet doesnt contain enough of either. Choose My Plate http the governments dietary guidelines recommends eating seafood twice a week. This is an important new finding that supports omega for brain health and brain size said Dr. Majid Fotuhi http chairman of the Neurology Institute for Brain Health and Fitness and assistant professor of neurology at Johns Hopkins University School of Medicine. Fotuhi recommends his patients get mg per day of DHA a nutrient that increases blood flow in the brain reduces inflammation in the brain heart and elsewhere and reduces the toxic aggregation of amyloid in the brain. DHA has the added benefit of improving mood and reducing symptoms of depression he said. The only people who should avoid DHA are patients on a blood thinner like Cumadin he added. Neurology http published weekly is the official journal of the American Academy of Neurology."

"Both men and women have utilized many resources to combat baldness but now a former NASA scientist is using lasers to regrow hair. Dr. Tamim Hamid is the CEO and inventor of Theradome a helmet that he said uses cold lasers to promote hair growth by stimulating the base of the hair follicle. He based his helmet off the findings of Endre Mester a Hungarian physician who accidentally discovered that lasers can grow hair in mice in . This has been sitting dormant for many many years until about . We discovered that the same wavelength of nanometers was able to stimulate hair on humans as well Hamid told FoxNews.com. To further explain how light grows hair Hamid said the laser light stimulates the mitochondria at the base of the hair follicle which is where the stem cells that grow hair are located. Once the hair follicle is reactivated using light energy the hair reverses the miniaturization process which was induced by the hormone DHT. The challenge that Hamid faced was putting this technology into something that was wearable and easy to use. Board certified dermatologist Dr. Eric Schweiger who has not worked on Theradome told FoxNews.com that there have been other products that use low level laser technology to grow hair but Theradome is the first of its kind to be wearable. It doesnt require anything from the patient apart from wearing the helmet for minutes two times a week. The major benefit of therdome is you wear it as a cap and you dont have to hold it up to your scalp. I think that will increase compliance Schweiger said. Hamid said that Theradome has helped tens of thousands of people. One of those is Sabra Hardy who suffers from alopecia areata an autoimmune disease that left her with huge bald spots on either side of her head. I was using creams that were developed for the coats of animals when they had problems with their coat. I was using oils developed for animals that were dangerous to use and smelled really bad Hardy said. Her hair loss was costly and painful. She spent hundreds of dollars on wigs and was getting steroid injections in her scalp for nearly two years with no signs of progress until she started using Theradome. According to the Theradome website percent of subjects saw positive results after weeks of treatment and they reported a percent increase in hair growth. Schweiger said that Theradome is safe for someone who wants another option in conjunction with other conventional baldness remedies and that its effectiveness should be studied more over time. For patients who are looking for an additional therapy its not unreasonable to use. I think well know more as time goes on Schweiger said. As far as the products safety Schweiger said that since the lights are low energy and are not UV he is confident that Theradome is safe. Theradome is FDA cleared and costs . Patients should always see their physician before trying any new treatments."

"Electroencephalogram EEG a test that shows the electrical activity of the brain might be used to spot autism in children a new study suggests. The study conducted by researchers at Harvard University Medical School looked at the synchronization of brain activity across different brain regions as measured by EEG. These scientists used sensors to record electrical brain activity across many different regions on the scalp explained Geraldine Dawson chief science officer at the advocacy group Autism Speaks. They then looked at the extent to which brain activity from one region was synchronized with brain activity from another region a phenomenon known as EEG coherence said Dawson who was not involved in the research. Synchronization between different brain regions indicates that those regions are functioning in a coordinated rather than independent fashion in other words they are functionally connected and communicating with each other she said. In the new study Dr. Frank Duffy and Dr. Heidelise Als compared EEG measurements of nearly children with and without autism. They found that the two groups had widespread differences in terms of brain connectivity. EEG revealed that the children with autism had a reduced short range connectivity indicating poor function of local brain networks. This was especially true in the left hemisphere regions of the brain responsible for language. The children with autism also had increased connectivity between brain regions that were farther apart which might be a mechanism developed to compensate for reduced short range connectivity the researchers said. The research was conducted at Boston Childrens Hospital and was published online June in the journal BMC Medicine. The use of EEGbased testing may help diagnose autism in children and may improve early detection in infants leading to more effective treatments and coping strategies the researchers said. What was unique about this study is the very large number of children studied Dawson noted. Consistent with many previous studies using EEG and functional MRI with both children and adults with autism these investigators found that overall children with autism show reduced coordination coherence across brain regions. She said the findings are important because they help us understand why individuals with autism have difficulty with complex behaviors such as social interaction and language. As childrens brains develop the different brain regions become increasingly connected allowing for the acquisition of complex behaviors that require coordination across different brain regions. Language for example requires coordination across the auditory visual and motor brain regions as well as the participation of the prefrontal cortex she said. This reduced functional connectivity in the brain helps us understand impairments associated with autism she added. The hope is that early behavioral intervention can help mitigate these functional impairments helping to form the connections that natural develop in typical children. Another expert agreed. Although autism is still principally a clinical diagnosis this study ... may allow for a new approach to classifying children with autism and may even assist in the early identification of affected children at a younger age said Dr. Andrew Adesman chief of developmental and behavioral pediatrics at the Steven Alexandra Cohen Childrens Medical Center of New York in New Hyde Park NY. The number of children diagnosed with autism in the United States has recently increased to one in . More information The U.S. National Institute of Neurological Disorders and Stroke has more about autism http_autism.htm. SOURCES Geraldine Dawson Ph.D. chief science officer Autism Speaks Andrew Adesman MD chief of developmental behavioral pediatrics Steven Alexandra Cohen Childrens Medical Center of New York New Hyde Park NY BMC Medicine news release June"

"Multiple sclerosis patients may eventually benefit from a novel treatment that takes aim at the abnormal behavior of a specific type of immune cell preliminary research suggests. The errant behavior of the cells in question known as B cells is viewed as key to the development of this chronic and disabling nervous system disease commonly called MS. The new therapys potential is only in the early stages of exploration cautions an international study team comprised of researchers from the United States Canada Switzerland and the Netherlands in the report published in the Nov. online edition of The Lancet. But initial indications suggest that the new antibody drug called ocrelizumab successfully targets these renegade cells with hopeful results a significant reduction in diseaserelated inflammatory brain lesions. Our findings show that ocrelizumab rapidly suppresses inflammatory activity noted the study authors led by Dr. Ludwig Kappos from the University Hospital Basel Switzerland in a journal news release. Describing the targeting of B cells as an innovative therapeutic approach Kappos and his colleagues reported that in testing among patients the drugs impact on lesions was rapid and pronounced. Whats more to date the treatment appears to be safe. The study authors noted that MS is a progressively debilitating disease that attacks an individuals central nervous system disrupting the normal brain spinal cord and optic nerve function. A classic characteristic of the disease is inflammation which takes the form of brain lesions. The immune systems T cells have long been implicated in disease progression but the notion that B cells may also play a major role is relatively new. With this new potential target in mind researchers configured ocrelizumab to specifically focus on a protein CD found on the surface of certain B cells. To test the drug Kappos and his team recruited patients aged to seeking MS treatment in centers in countries. The patients were divided into four groups treated with a low dose of ocrelizumab milligrams a high dose of ocrelizumab mg a wellknown MS inflammation treatment known as intramuscular interferon betaa or a sugar pill placebo. After weeks some of the doses were adjusted. The result at week all of the patients receiving either dose of ocrelizumab fared better in terms of lesion count than either the placebo or standard treatment groups. The number of active lesions had dropped percent more among the mg group compared with those getting a placebo. Similarly those in the mg group experienced a percent bigger drop in lesions. Whats more relapse rates were much lower among those taking the new drug in contrast to those taking a placebo. The investigators further noted that even eight months after treatment launch no serious adverse effects were directly attributable to the new drug. That said Dr. Moses Rodriguez a professor of neurology and immunology at the Mayo Clinic in Rochester Minn. disputed the premise that ocrelizumab is shaping up as anything new and innovative. In fact theres nothing novel about this at all he said. There is another drug called rituximab thats been in early trials for MS for years. And all this new drug is attempting to do is replicate the same that rituximab already does. And I see no major advantage of this drug versus that older drug. Its not better or worse. Its the same Rodriguez noted. So bottomline I would not sell this as a major breakthrough in MS cautioned Rodriguez. Its not. Funding for the study was provided by F. HoffmannLa Roche and Biogen Idec. Inc. More information For more on multiple sclerosis visit the U.S. National Library of Medicine http SOURCES The Lancet news release Oct. Moses Rodriguez M.D. professor neurology and immunology Mayo Clinic Rochester Minn."

"Patients undergoing cancer treatment confront a number of welldocumented side effects. Chemotherapy and other cancer therapies can wreak havoc on the taste buds and olfactory senses depriving recipients of the intricate interplay between taste and smell that is critical to grasping flavors and enjoying foods. Over time taste and smell abnormalities TSA can lead to a loss of appetite and anorexic behaviors compromising patients ability to recuperate from the disease. In a new paper published in the journal Food Function httppubs.rsc.orgencontentarticlepdfFOCFOB Virginia Tech College of Agriculture and Life Sciences researchers Susan Duncan and Aili Wang investigated the feasibility of lactoferrin a highly bioactive protein found in saliva and milk as a treatment for TSA. Their findings could bring relief to millions of patients undergoing cancer treatment. The underlying molecular mechanisms of TSA are not wellunderstood said Duncan associate director of the Virginia Agricultural Experiment Station and a professor in the Department of Food Science and Technology. The prevailing symptom described by patients undergoing chemotherapy is a persistent metallic flavor or aftertaste with or without food intake. This can last for hours weeks or even months after the completion of treatments. As a consequence cancer patients suffer poor appetite weight loss depression and diminished nutrition all of which are detrimental to recovery. Although TSA is widespread and a frequent complaint of cancer patients until now there have been no established therapies that reliably prevent or treat this problem. Our research shows that daily lactoferrin supplementation elicits changes in the salivary protein profiles in cancer patients changes that may be influential in helping to protect taste buds and odor perception said Duncan. By suggesting lactoferrin as a dietary supplement we can reduce TSA for many patients restoring their ability to enjoy foods during a time in which nutrition can play a key role in their recovery. This research could help us develop TSAtargeted biomarkers and strategies for improving quality of life during chemotherapy. Cancer patients and their supporting family and friends may again find comfort in enjoying a meal together. The transdisciplinary team including William Ray Department of Biochemistry Andrea Dietrich of the Charles E. Via Jr. Department of Civil and Environmental Engineering in the College of Engineering and Glenn Lesser from Wake Forest Baptist Medical Center previously identified the role of lactoferrin a specific milk protein in diminishing the metallic flavor stimulated by chemotherapy medications. The substance is wellknown as a firstline defense aiding the bodys immune response but little is known about its ability to impact salivary proteins. Their most recent study builds on the previous body of work through the application of lactoferrin supplements in treating taste and smell abnormalities. The teams findings will make it possible for cancer patients to taste foods properly and to enjoy a healthier appetite enabling more optimal nutrition during a critical period of recovery. Lactoferrin supplementation also enhances the expression of salivary immune proteins which may help reduce oxidative stress and resulting side effects. Oral infections such as thrush also may be diminished."

"Treating stroke patients who have lost control and awareness of one side of their body with magnetic stimulation to the brain may improve their symptoms researchers said today. In a new small study published in the journal Neurology patients who were given quick bursts of stimulation over a couple of weeks improved by about percent on tests of vision and attention while those who got a fake stimulation treatment didnt improve significantly. But researchers said its still unclear what types of patients might benefit from the treatment and by how much. About half of people who have a stroke end up with difficulty processing or reacting to things on one side of their body most often on the left side after a stroke in the right side of the brain said Dr. Anna Barrett director of stroke rehabilitation research at the Kessler Foundation in West Orange New Jersey who wasnt involved in the new study. That poststroke condition is known as neglect. People that have that tend to do much worse in their eventual recovery Barrett said. Theyre less likely to become completely independent. Most of those patients can improve with therapy and exercises she said but the process is often slow and keeping people in the hospital during it is costly. She said that because of that the new findings are promising but added that brain stimulation is still an experimental technique and not ready to be used as part of normal stroke rehabilitation. For the study Italian researchers randomly assigned patients with neglect to get real or fake magnetic stimulation in ten sessions over two weeks in addition to their conventional rehab program. The treatment involved an electromagnetic coil placed over the left side of the brain that transmitted pulses of electrical currents. Similar types of stimulation treatment are used in some patients with depression or during spinal surgery according to Barrett. The device costs about . Nine people in each group completed all the treatment sessions. Before treatment right after and another two weeks later stroke patients were given tests to measure their visualspatial skills as well as attention and concentration. Those including drawing and shapecopying tests as well as menu reading and map navigating tasks. Patients in both groups started out with an average mark of about on the tests which are scored from to combined. The real magnetic stimulation group improved by about percent right after the treatment and percent at the later time point while there was no significant benefit seen in patients given the fake stimulation. The researchers said that its not clear what the amount of improvement they observed would mean for patients in their daily lives. But lead author Dr. Giacomo Koch said What we found is that the improvement was more marked in those patients that were more impaired. Koch from the Santa Lucia Foundation in Rome told Reuters Health he thinks those patients with more severe problems would likely see a benefit outside of just test results. He said that larger studies at multiple treatment sites are needed to determine how helpful magnetic stimulation can be in stroke recovery. But he was optimistic about the treatments future. I think in a few years this could become another tool that could be used systematically in the neurorehabilitation wards Koch said. He added that the treatment isnt painful and only takes a few minutes for each session. Close to people in the U.S. suffer a stroke each year mostly older adults. For those with neglect doctors typically prescribe cognitive rehabilitation in which therapists teach skills and help the patient become more aware of the affected side of the body. Barrett also from the University of Medicine Dentistry of New Jersey said that she wonders whether stimulation could help patients achieve the goals that are most important to regaining independence after a stroke such as using the bathroom. Its also not clear if the treatment might help most neglect patients or if the findings only apply to certain groups she told Reuters Health. The ideal option might end up being a combination treatment that involves stimulation in certain patients and other therapies that address a range of skills important for regaining function Barrett added. But she said That all remains to be investigated. SOURCE bit.lylUcacJ httpbit.lylUcacJ Neurology online December . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"A daily supplement of pharmaceutical grade chondroitin is as good as celecoxib Celebrex at relieving arthritic knee pain and doesnt have dangerous side effects researchers say. Dr. JeanYves Reginster of Liege State University in Belgium and colleagues recruited people over age with knee osteoarthritis from five European countries and randomly assigned them to take mg of the extrapure chondroitin sulfate Chondrosulf mg of celecoxib Celebrex or a placebo every day for six months. Those who took chondroitin sulfate or celecoxib had similar levels of pain relief at the end of the study and in both groups the improvement was greater than for those taking just a placebo according to the report in Annals of the Rheumatic Diseases. Reginster told Reuters Health the findings are in line with earlier studies showing pharmaceuticalgrade chondroitin sulfate could significantly decrease the progression of knee osteoarthritis over a period of three years. He stressed that pharmaceuticalgrade chondroitin is not the same as overthecounter supplements which are made differently and cant get into the joint in high enough concentrations to combat the causes of cartilage degradation and pain. European regulatory bodies recommend pharmaceuticalgrade chondroitin sulfate as well as pharmaceuticalgrade glucosamine sulfate as firstline treatments for osteoarthritis Reginster said by email because of the side effects associated with celecoxib and other nonsteroidal inflammatory drugs NSAIDs including stomach ulcers bleeding liver and kidney problems. Dr. Michael Shepard of Hoag Orthopedic Institute in Orange California noted that the study had a relatively low number of participants and that most U.S. studies of this type would run two years rather than six months. In addition U.S.based studies of chondroitin have had mixed results said Shepard who wasnt involved in the study. Some have found the supplements to be as effective as ibuprofen also an NSAID and some have found that chondroitin sulfate is no more effective than placebo he told Reuters Health. I tell my patients buyer beware Shepard said in an email. I tell them about the mixed results of chondroitin in the literature. I tell them to try chondroitin for one month as a trial and if they like it and feel better with it then keep taking it. If chondroitin doesnt work for them he suggests taking an NSAID periodically and to be aware of the side effects. If you are going to stay on an NSAID for a prolonged period then you need regular follow up with your doctor Shepard cautioned. Dr. Rachel Wolfe of Wake Forest Baptist Medical Center in WinstonSalem North Carolina agreed that chondroitin is reasonable to try for some people especially those with contraindications to NSAIDs. However it should not replace other therapy such as quad strengthening exercises and weight loss which we know will provide benefit. It should be used in conjunction with these measures said Wolfe who wasnt involved in the study. Chondroitin is not a miracle pill but if it allows people to feel less pain and be more active thereby losing weight and strengthening muscles then I think there may benefit Wolfe told Reuters Health by email. Studies like this highlight that medicine is still an art we do not have perfect answers and we have to individualize for each patient. The study was sponsored by IBSA Institut Biochimique SA a pharmaceutical company based in Lugano Switzerland that makes the chondroitin sulfate supplements used in the test. SOURCE bit.lyrcPLh httpbit.lyrcPLh Annals of the Rheumatic Diseases online May ."

"Heterosexuals who are HIV negative can significantly reduce their risk of infection by taking a daily dose of an antiviral drug according to a new study by the Centers for Disease Control and Prevention. The study called TDF httpthechart.blogs.cnn.comtakingmedsbeforeexposurecutshivriskforheterosexualsPreexposuredrugsreducesriskofHIVinfectioninHeterosexuals followed uninfected heterosexual men and women between the ages of and years in Botswana Africa. Study participants took a tablet containing tenofovir disoproxil fumarate and emitricitabine TDFFTC whose brand name is Truvada http or a placebo. On average patients were followed for a year although some were followed for about three and a half years. The risk of infection was reduced overall but for participants who actually got the drugs that risk decreased by . Giving daily antiretroviral drugs to uninfected individuals to prevent the disease is called preexposure prophylaxis or PrEP http Previous studies have shown PrEP to be effective in reducing infection rates among the uninfected. Dr. Kevin Fenton director of the CDCs national Center for HIVAIDS Viral Hepatitis STD and TB Prevention called the news a milestone. It is clear we are not going to find one magic pill to solve the issue of HIV but by combining this approach with others we are beginning to get a better handle on combination packages. There is reason to be excited. The news comes at the same time a second study looking at PrEP in heterosexual couples in Kenya and Uganda also found significant reductions in infection rates. The Partners PrEP study http participants took either TDFFTC the drug tenofovirbrand name Viread or a placebo. Preliminary results showed both treatments significantly reduced transmission in couples where one partner was already infected with the virus. Patients who took tenofovir had fewer infections while those taking the combination drug had fewer infections than those who got the placebo. Just a few years ago the tool kit for HIV prevention was not very large says Dr. Jared Baeten the principal investigator of the Partners PrEP study at the University of Washington. Now we have a nice collection of really powerful strategies that work for the population at greatest risk in the world. This is really a game changer. We now have findings from two studies showing that PrEP can work for heterosexuals the population hardest hit by HIV worldwide Fenton said. Taken together these studies provide strong evidence the power of this prevention strategy. In fact an interim review of the Partners data on effectiveness was so compelling that the trial was stopped early and the placebo arm was discontinued. Clear evidence Baeten said that PrEP substantially reduces infection risk. At the same time he says there was no evidence of safety concerns. Patients taking the placebo will be put on one of the drugs. In the TDF study those taking the drug reported nausea vomiting and dizziness. An earlier PrEP trial the iPrEx study http looked at treatment in men who have sex with men. Infection rates dropped by in patients who consistently used PrEP. We are in a critical moment in HIV prevention research said Robert Grant M.D. M.P.H of the Gladstone Institutes and the University of California at San Francisco. He is the iPrEx protocol chair. iPrEx provided the first proof of an important new method of HIV prevention that can help slow the global toll of . million new HIV infections each year. Partners PrEP and the TDF study have now expanded that finding by demonstrating the effectiveness of PrEP in heterosexual women and men. Developing and deploying proven HIV prevention methods including PrEP microbicides vaginal gels clean needles medical male circumcision early treatment counseling testing condoms and suppressive therapy for pregnant women will all be key to slowing the global epidemic he said. The CDC says the next step is to fully review all the data and begin to develop guidelines for the use of these drugs in heterosexual men and women here in the U.S."

"Merck NYSEMRK known as MSD outside the United States and Canada today announced that the U.S. Food and Drug Administration FDA has approved ZEPATIER elbasvir and grazoprevir for the treatment of adult patients with chronic hepatitis C virus HCV genotype GT or GT infection with or without ribavirin RBV following priority review by the FDA. ZEPATIER pronounced ZEPahteer is a oncedaily fixeddose combination tablet containing the NSA inhibitor elbasvir mg and the NSA protease inhibitor grazoprevir mg. The FDA previously granted two Breakthrough Therapy designations to ZEPATIER for the treatment of chronic HCV GT infection in patients with end stage renal disease on hemodialysis and for the treatment of patients with chronic HCV GT infection. Breakthrough Therapy designation is given to investigational medicines for serious or lifethreatening conditions that may offer substantial improvement over existing therapies. Across multiple clinical studies ZEPATIER achieved high rates of sustained virologic response ranging from to percent in GTinfected patients and to percent in GTinfected patients. Sustained virologic response is defined as HCV RNA levels measuring less than the lower limit of quantification at weeks after the cessation of treatment SVR indicating that a patients HCV infection has been cured. ZEPATIER is not for use in patients with moderate or severe hepatic impairment ChildPugh B or C. ZEPATIER also is not for use with organic anion transporting polypeptides B OATPB inhibitors e.g. atazanavir darunavir lopinavir saquinavir tipranavir cyclosporine strong cytochrome P A CYPA inducers e.g. carbamazepine phenytoin rifampin St. Johns Wort and efavirenz. If ZEPATIER is administered with RBV healthcare professionals should refer to the prescribing information for RBV as the contraindications warnings and precautions adverse reactions and dosing for RBV also apply to this combination regimen. Continued innovation is needed to help address the worldwide epidemic of chronic hepatitis C virus infection said Dr. Roger M. Perlmutter president Merck Research Laboratories. Our clinical program was designed to study a broad range of patients infected with the hepatitis C virus including difficulttotreat patients such as those with stage or chronic kidney disease. The approval of ZEPATIER is a testament to Mercks unwavering commitment to improving therapy for patients with hepatitis C virus infection and we are eager to bring this innovation to patients and physicians in the United States. ZEPATIER was approved with a treatment duration of or weeks depending on HCV genotype prior treatment history and for patients with GTa infection the presence of certain baseline NSA polymorphisms. A week oncedaily regimen is recommended for the vast majority of patients for whom ZEPATIER is indicated. Mercks broad clinical trial program supporting the efficacy of ZEPATIER included six studies in patients with chronic HCV GT or GT infection. These studies assessed the rate of sustained virologic response weeks after the completion of treatment with ZEPATIER SVR. The clinical development program for ZEPATIER enrolled diverse groups of HCV GT and GTinfected patients including treatmentnave patients and those who had failed prior therapy with peginterferon alfa PegIFN and RBV as well as patients suffering with meaningful comorbidities and health complications such as compensated cirrhosis and HIV coinfection. GTinfected patients with severe renal impairment on hemodialysis and those who previously failed therapy with PegIFN and RBV in combination with an HCV NSA protease inhibitor boceprevir simeprevir or telaprevir also were studied. The following table provides a summary of clinical data that contributed to the efficacy assessment of ZEPATIER. The primary endpoint in each study was SVR. Please see section entitled Summary of Study Designs below for additional study design information including treatment arms and baseline characteristics. Clinical Studies Supporting Efficacy of ZEPATIER elbasvir and grazoprevir Clinical Trials Population SVR nN Treatment Regimen and Duration GT CEDGE TN double blind placebo controlled TN cirrhosis ZEPATIER weeks CEDGE COINFXN openlabel single arm TN cirrhosis HIV coinfection CSURFER double blind placebo controlled TNTEa cirrhosis severe renal impairment CEDGE TEd openlabel comparative TEb cirrhosis HIV coinfection ZEPATIER weeks ZEPATIER RBV weeks CSALVAGE openlabel single arm TEc cirrhosis ZEPATIER RBV weeks GT CSCAPE openlabel CEDGE TN CEDGE COINFXN TN without cirrhosis TN cirrhosis TN cirrhosis HIV coinfection ZEPATIER weeks CEDGE TE TEb cirrhosis ZEPATIER RBV weeks TE treatmentexperienced TN treatmentnave. a Failed prior IFN or PegIFN RBV. b Failed prior PegIFN RBV. c Failed prior PegIFN RBV HCV NSA protease inhibitor PI boceprevir simeprevir or telaprevir. d CEDGE TE treatment outcomes for ZEPATIER with RBV for weeks n or without RBV for weeks n not shown because these regimens are not recommended in PegIFN RBVexperienced GT patients. Selected Safety Information about ZEPATIER elbasvir and grazoprevir Elevations of alanine transaminase ALT to greater than times the upper limit of normal ULN occurred in of subjects generally at or after treatment week . These late ALT elevations were typically asymptomatic and most resolved with ongoing or completion of therapy. Healthcare professionals should perform hepatic lab testing on patients prior to therapy at treatment week and as clinically indicated. For patients receiving weeks of therapy additional hepatic lab testing should be performed at treatment week . Patients should be instructed to consult their healthcare professional without delay if they have onset of fatigue weakness lack of appetite nausea and vomiting jaundice or discolored feces. Healthcare providers should consider discontinuing ZEPATIER if ALT levels remain persistently greater than times ULN. ZEPATIER should be discontinued if ALT elevation is accompanied by signs or symptoms of liver inflammation or increasing conjugated bilirubin alkaline phosphatase or international normalized ratio. Recommended Dosage Regimens and Durations for ZEPATIER elbasvir and grazoprevir The dosing regimens and durations for treatment with oncedaily ZEPATIER for chronic HCV GT or GT infection in patients with or without cirrhosis HIV coinfection or renal impairment are as follows Patient Population Treatment Duration GTa Treatmentnave or PegIFNRBVexperienced without baseline NSA polymorphisms ZEPATIER weeks GTa Treatmentnave or PegIFNRBVexperienced with baseline NSA polymorphisms ZEPATIER with RBV weeks GTb Treatmentnave or PegIFNRBVexperienced ZEPATIER weeks GTa or GTb PegIFNRBVPIexperienced ZEPATIER with RBV weeks GT Treatmentnave ZEPATIER weeks GT PegIFNRBVexperienced ZEPATIER with RBV weeks Patients who have failed treatment with PegIFN RBV. NSA resistanceassociated polymorphisms at amino acid positions or . Patients who have failed treatment with PegIFNRBV HCV NSA PI boceprevir simeprevir or telaprevir. For GTainfected PegIFNRBVPIexperienced patients with one or more baseline NSA resistanceassociated polymorphisms positions or the optimal ZEPATIERbased treatment regimen and duration of therapy has not been established. In patients with GTa infection some hepatitis C viruses may contain mutations that can confer resistance to treatment. These are called resistanceassociated polymorphisms also referred to as resistanceassociated variants RAVs. GTa infection accounts for percent of U.S. HCV cases. To help as many patients as possible to achieve SVR testing for NSA resistanceassociated polymorphisms positions or is recommended for GTainfected patients prior to starting treatment with ZEPATIER to determine the optimal dosage regimen and duration. In clinical trials of ZEPATIER percent of GTainfected U.S. study participants had these NSA resistanceassociated polymorphisms at baseline. A week regimen of ZEPATIER with RBV is recommended for GTainfected patients with these baseline NSA polymorphisms as described in the above table. This approval provides patients and physicians with an additional treatment option that has the potential to cure many patients with chronic hepatitis C in the United States said Dr. Ira Jacobson site chair department of medicine Mount Sinai Beth Israel New York. ZEPATIER is a oncedaily singletablet directacting antiviral that has demonstrated high cure rates in genotype and in genotype including treatmentnave and treatmentexperienced patients with or without compensated cirrhosis and those with chronic kidney disease. The company anticipates that ZEPATIER will be available for shipping to wholesalers within seven business days. Chronic hepatitis C is a potentially devastating illness that can cause serious longterm health consequences for patients including reduced liver function liver failure or liver cancer said Michael Ninburg executive director Hepatitis Education Project Seattle. Today chronic hepatitis C is a curable condition for many patients and we are fortunate to have multiple therapeutic tools that can mitigate its impact. Selected Safety Information about ZEPATIER elbasvir and grazoprevir continued The concomitant use of ZEPATIER with certain drugs may lead to possible clinically significant adverse reactions from greater exposure to ZEPATIER or concomitant drugs. Coadministration of ZEPATIER is not recommended with certain strong CYPA inhibitors e.g. ketoconazole or the cobicistatcontaining regimens of elvitegravircobicistatemtricitabinetenofovir disoproxil fumarate or alafenamide. Healthcare professionals should not exceed atorvastatin mgdaily or rosuvastatin mgdaily when given with ZEPATIER. If ZEPATIER is given with fluvastatin lovastatin or simvastatin healthcare professionals should give the lowest statin dose necessary and closely monitor for statinassociated adverse events. If ZEPATIER and tacrolimus are coadministered frequent monitoring of tacrolimus whole blood concentrations changes in renal function and tacrolimusassociated adverse events is recommended. The concomitant use of ZEPATIER and certain drugs may cause significant decrease of elbasvir and grazoprevir plasma concentrations which may lead to reduced therapeutic effect of ZEPATIER and possible development of resistance. Coadministration of ZEPATIER is not recommended with moderate CYPA inducers e.g. nafcillin bosentan etravirine modafinil. In subjects receiving ZEPATIER for weeks the most commonly reported adverse reactions of all intensity greater than or equal to in placebocontrolled trials were fatigue headache and nausea. In subjects receiving ZEPATIER with RBV for weeks the most commonly reported adverse reactions of moderate or severe intensity greater than or equal to were anemia and headache. Pricing Designed to Enable Broad Patient Access to ZEPATIER elbasvir and grazoprevir The latest innovations in chronic HCV treatment that have become available over the past three years now including ZEPATIER provide the U.S. with an unprecedented opportunity to significantly reduce the burden of HCV. The scientific community believes that control of HCV infection may be possible and is actively working to achieve that goal by . A significant medical need remains it is estimated that less than one in five patients with chronic HCV infection are currently treated with thousands of new cases each year. ZEPATIER which received two Breakthrough Therapy designations for GT patients with end stage renal disease on hemodialysis and for GT patients and was thereafter approved by the FDA following priority review offers a highly effective option for a broad range of adult patients with chronic HCV GT or GT infection. Public reports indicate that net prices for the most commonly used directacting antiviral regimens are substantially lower than the list prices. However the majority of patients with chronic HCV have not yet been treated in some cases due to cost constraints. After considering these factors Merck has established a list price of for a week regimen which the company believes to be in the range of net prices for other commonly used HCV directacting antiviral regimens at weeks of therapy. Merck anticipates that this price as well as our comprehensive access strategy to seek broad coverage across commercial and public segments will help broaden and accelerate patient access to treatment and move us closer to our shared goal of reducing the burden of chronic HCV in the U.S. Mercks decadeslong commitment in chronic hepatitis C and infectious diseases overall has been to both scientific innovation and access said Robert McMahon president U.S. Market Global Human Health Merck. We are embracing this opportunity to partner with payers and physicians to enable as many appropriate patients to be treated as possible as quickly as possible. Financial Assistance Programs for Those Who Need Help With the Cost of Their Medicine Merck also anticipates that the list price of ZEPATIER will result in lower outofpocket medication costs for some patients. Lower outofpocket costs alone do not necessarily reflect a cost advantage in the outcome of the condition treated because there are other variables that affect relative costs. The direct outofpocket costs to patients will vary depending on an individuals insurance plan. Privately insured patients who have difficulty affording the copay set by their insurance plan may be eligible for significant copay assistance and may pay as little as for each prescription. Maximum savings are limited and terms and conditions apply. Information is available at http Merck anticipates that the website for ZEPATIER will be accessible within hours of FDA approval. Merck also offers assistance to patients who cannot afford ZEPATIER through Mercks yearold Patient Assistance Program. The Merck PAP provides certain Merck medicines free of charge to eligible patients. The Merck PAP for ZEPATIER is designed primarily for the uninsured who without our assistance could not afford their medication. Additionally for those patients whose insurance plan covers ZEPATIER but who still cannot afford their medication a request for an exception may be made if they meet certain financial medical andor insurance criteria. For more information about the Merck PAP please visit http or call the Merck Patient Assistance Program at . Summary of Study Designs Clinical Trials for GT HCV CEDGE TN was a randomized doubleblind placebocontrolled trial in treatmentnave patients with GT or GT infection with or without cirrhosis. Patients were randomized in a ratio to ZEPATIER for weeks immediate treatment group N or placebo for weeks followed by openlabel treatment with ZEPATIER for weeks deferred treatment group N. Among patients with GT infection randomized to the immediate treatment group the median age was years range to of the patients were male were white were black or African American were Hispanic or Latino mean body mass index was kgm had baseline HCV RNA levels greater than IU per mL had cirrhosis had nonCC ILB alleles CT or TT and had GTa and had GTb chronic HCV infection. CEDGE COINFECTION COINFXN was an openlabel singlearm trial in treatmentnave HIVHCV coinfected patients with GT or GT infection with or without cirrhosis. Patients received ZEPATIER for weeks N. Among patients with GT infection the median age was years range to of the patients were male were white were black or African American were Hispanic or Latino mean body mass index was kg per m had baseline HCV RNA levels greater than IU per mL had cirrhosis had nonCC ILB alleles CT or TT and had GTa had GTb and had GTOther chronic HCV infection. CSURFER was a randomized doubleblind placebocontrolled trial in patients with GT infection with or without cirrhosis with chronic kidney disease CKD Stage eGFR mLmin. m or CKD Stage eGFR mLmin. m including patients on hemodialysis who were treatmentnave or who had failed prior therapy with IFN or PegIFN RBV therapy. Patients were randomized in a ratio to one of the following treatment groups elbasvir mg once daily grazoprevir mg once daily for weeks N immediate treatment group or placebo for weeks followed by openlabel treatment with elbasvir grazoprevir for weeks N deferred treatment group. In addition patients received openlabel elbasvir grazoprevir for weeks intensive pharmacokinetic PK group. Patients randomized to the immediate treatment group and intensive PK group had a median age of years range to of the patients were male were white were black or African American were Hispanic or Latino had baseline HCV RNA levels greater than IUmL had cirrhosis and had nonCC ILB alleles CT or TT. CEDGE TE was a randomized openlabel comparative trial in patients with GT or GT infection with or without cirrhosis with or without HCVHIV coinfection who had failed prior therapy with PegIFN RBV therapy. Patients were randomized in a ratio to one of the following treatment groups ZEPATIER for weeks N ZEPATIER RBV for weeks N ZEPATIER for weeks N or ZEPATIER RBV for weeks N. Among patients with GT infection the median age was years range to of the patients were male were white were black or African American were Hispanic or Latino mean body mass index was kgm had baseline HCV RNA levels greater than IUmL had cirrhosis had nonCC ILB alleles CT or TT and had GTa had GTb and had GTOther chronic HCV infection. CSALVAGE was an openlabel singlearm trial in patients with GT infection with or without cirrhosis who had failed prior treatment with boceprevir simeprevir or telaprevir in combination with PegIFN RBV. Patients received elbasvir mg once daily grazoprevir mg once daily RBV for weeks N. Patients had a median age of years range to of the patients were male were white were black or African American were Hispanic or Latino mean body mass index was kgm had baseline HCV RNA levels greater than IUmL had cirrhosis and had nonCC ILB alleles CT or TT had baseline NS resistanceassociated substitutions. Clinical Trials for GT HCV The efficacy of ZEPATIER in patients with GT chronic HCV infection was demonstrated in CEDGE TN CEDGE COINFXN CEDGE TE and CSCAPE. CSCAPE was a randomized openlabel trial which included treatmentnave patients with GT infection without cirrhosis. Patients were randomized in a ratio to elbasvir mg once daily grazoprevir mg once daily for weeks N or elbasvir mg once daily grazoprevir mg once daily RBV for weeks N. In these combined studies in patients with GT infection were treatmentnave of the patients were male were white were black or African American had cirrhosis and had HIVHCV coinfection. About Merck Todays Merck is a global health care leader working to help the world be well. Merck is known as MSD outside the United States and Canada. Through our prescription medicines vaccines biologic therapies and animal health products we work with customers and operate in more than countries to deliver innovative health solutions. We also demonstrate our commitment to increasing access to health care through farreaching policies programs and partnerships. For more information visit http and connect with us on Twitter httpstwitter.comMerck Facebook http YouTube http and LinkedIn https ForwardLooking Statement of Merck Co. Inc. Kenilworth NJ USA This news release of Merck Co. Inc. Kenilworth NJ USA the company includes forwardlooking statements within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of . These statements are based upon the current beliefs and expectations of the companys management and are subject to significant risks and uncertainties. There can be no guarantees with respect to pipeline products that the products will receive the necessary regulatory approvals or that they will prove to be commercially successful. If underlying assumptions prove inaccurate or risks or uncertainties materialize actual results may differ materially from those set forth in the forwardlooking statements. Risks and uncertainties include but are not limited to general industry conditions and competition general economic factors including interest rate and currency exchange rate fluctuations the impact of pharmaceutical industry regulation and health care legislation in the United States and internationally global trends toward health care cost containment technological advances new products and patents attained by competitors challenges inherent in new product development including obtaining regulatory approval the companys ability to accurately predict future market conditions manufacturing difficulties or delays financial instability of international economies and sovereign risk dependence on the effectiveness of the companys patents and other protections for innovative products and the exposure to litigation including patent litigation andor regulatory actions. The company undertakes no obligation to publicly update any forwardlooking statement whether as a result of new information future events or otherwise. Additional factors that could cause results to differ materially from those described in the forwardlooking statements can be found in the companys Annual Report on Form K and the companys other filings with the Securities and Exchange Commission SEC available at the SECs Internet site http Please see Prescribing Information for ZEPATIER elbasvir and grazoprevir at http_circularszzepatierzepatier_pi.pdf and the Patient Information for ZEPATIER at http_circularszzepatierzepatier_ppi.pdf"

"Credit Hiroaki Shimokawa Ultrasound waves applied to the whole brain improve cognitive dysfunction in mice with conditions simulating vascular dementia and Alzheimers disease. The research conducted by scientists at Tohoku University in Japan suggests that this type of therapy may also benefit humans. The team led by cardiologist Hiroaki Shimokawa found that applying lowintensity pulsed ultrasound LIPUS to the whole brain of the mice improved blood vessel formation and nerve cell regeneration without having obvious side effects. The LIPUS therapy is a noninvasive physiotherapy that could apply to highrisk elderly patients without the need for surgery or anaesthesia and could be used repeatedly says Shimokawa. Dementia affects about million people worldwide with million new cases occurring every year. But there are currently no curative treatments available for vascular dementia or Alzheimers disease the most common causes of dementia. Also the cells lining the brains blood vessels are tightly packed forming a bloodbrain barrier that prevents large molecules from crossing into the brain tissue. This limits the types of drugs and cell therapies that could be made available to treat dementia. Shimokawa and his team had conducted previous studies showing that LIPUS improved blood vessel formation in pigs with myocardial ischemia a condition where there is reduced blood flow to the heart. Other studies have reported that LIPUS increases the production of proteins involved in nerve cell survival and growth in addition to a role in promoting nerve regeneration. Focusing LIPUS treatment on a region in the brain called the hippocampus which is involved in memory has also been found to improve dementia in mice but the details of how it does this need to be more fully investigated. The Tohoku University team wanted to find out if wholebrain rather than focused LIPUS is effective in treating mouse models of dementia and if it was what was happening at the molecular levels to achieve this. They found that cognitive impairment markedly improved in mice with conditions similar to vascular dementia and Alzheimers disease when LIPUS was applied to the whole brain three times a day for minutes each time. The mice with vascular dementia received the treatment on the first third and fifth days following a surgical procedure that limited the brains blood supply. The mice with a condition simulating Alzheimers disease in humans received LIPUS treatments over a period of three months. At the molecular level genes related to the cells lining blood vessels were turned on. Also there was increased expression of an enzyme involved in blood vessel formation and a protein involved in nerve cell survival and growth. The researchers conclude that their study recently published in the journal Brain Stimulation provides the first experimental evidence that wholebrain LIPUS therapy markedly improves cognitive dysfunctions without serious side effects by enhancing specific cells related to dementias pathology. The first clinical trials to evaluate the effectiveness and safety of the LIPUS treatment are already underway."