Day: 07/25/2010

Olanzapine Combats Chemo-Induced Nausea, Vomiting

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CHICAGO (EGMN) – Olanzapine, an atypical antipsychotic used in the treatment of schizophrenia and other psychiatric disorders, may also have a role in the management of chemotherapy-induced nausea and vomiting, a randomized phase III trial found.The 61 patients receiving highly emetogenic chemotherapy were about twice as likely not to experience any delayed nausea with an olanzapine (Zyprexa) regimen compared with a standard aprepitant (Emend) regimen (68% vs. 37%), investigators reported

HPV Vaccine Provides Protection for 42 Months, Manufacturer Reports

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Recipients of a quadrivalent vaccine against human papillomavirus (HPV) show sustained protection against low-grade lesions associated with viral types included in the vaccine, according to a BMJ study.

The trial, conducted by the vaccine’s manufacturer, examined outcomes in some 18,000 young women who were randomized to vaccine or placebo. After a mean of 42 months, the vaccine was over 95% effective in preventing condyloma as well as low-grade cervical, vulvar, and vaginal intraepithelial neoplasia related to viral types included in the vaccine (6, 11, 16, and 18).

Its efficacy in preventing any lesion regardless of HPV type was lower — for example, only 30% against low-grade cervical intraepithelial neoplasia.

Vaginal Anti-HIV Gel: Confirmation Needed

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Vaginal Gel May Prevent HIV

Study Shows Gel Halves Women’s HIV Risk
By Daniel J. DeNoon
WebMD Health News

July 19, 2010 – AIDS researchers have finally found a vaginal gel that halves a woman’s risk of getting HIV from an infected sex partner.

The announcement, made at the outset of the 18th International AIDS Conference in Vienna, Austria, marks the beginning of the end of a 20-year search. Those years saw the failure of 11 clinical trials of six different agents intended to help women avoid HIV infection.

Now a vaginal gel containing tenofovir, an anti-HIV drug sold as Viread by Gilead Sciences Inc., is the first shown to protect against infection with the AIDS virus.

The announcement was made by husband/wife researchers Quarraisha Abdool Karim, PhD, and Salim S. Abdool Karim, MD, PHD, of the Center for the AIDS Program of Research in South Africa (CAPRISA) and Columbia University.

“We now have a product that can potentially alter the epidemic … and save millions of lives by averting HIV infection,” Quarraisha Abdool Karim said at a news teleconference.

She asked reporters to imagine a young woman in rural South Africa whose partner is a migrant worker who refuses to use a condom and will not allow her to use the female condom.

“Picture [that woman] asking what I have to offer to prevent her from getting infected with HIV,” Abdool Karim said. “Until today I had nothing to offer. Today that changes. I can now offer tenofovir gel that offers 39% protection. And if she is highly adherent, it can be up to 54% protection.”

That’s far from full protection. But given that about 10% of the population in the area where the gel was tested are infected with HIV, such protection would have a profound effect.

“Without the gel, for every 100 women, 10 will be infected in a year. With this gel, only six women will be infected,” Quarraisha Abdool Karim said. “For an individual woman, we say, ‘If you use it consistently, you cut your chance of infection in half.”

If one in three South African women at risk of infection use the gel, she estimated, over 20 years there would be 1.3 million fewer HIV infections — and 820,000 lives would be saved.

The gel is applied 12 hours before sex and again 12 hours later. Salim Abdool Karim said that while this should be done only once every 24 hours, the gel should theoretically offer protection to women who have sex more than once during that time.

As welcome as the findings are, the study by the Abdool Karims and colleagues must be confirmed. The study gave the gel to 445 sexually active women in rural and urban South Africa, while 444 women received identical, inactive placebo gel.

Over the course of the study, 38 women who got the gel and 60 women who got the placebo became HIV infected. Overall, that’s 39% effectiveness. But women who used the gel in at least 80% of sexual encounters had a 54% prevention rate.

If the gel truly works, however, Salim Abdool Karim believes that women will be much more likely to use it than they were in the study, during which they were warned not to rely on it and that it’s safety was unproven.

In terms of safety, the gel did not have negative side effects. Virus in women who became infected with HIV despite gel use was not resistant to Viread.

While the Abdool Karims’ study must be confirmed, the findings suggest that they used the right approach. By spiking the gel with a drug that enters cells and repels HIV when it tries to enter them, they took a different tack than previous gels which used general microbicides to kill HIV on vaginal surfaces.

The U.S. National Institute of Allergy and Infectious Diseases (NIAID) already has launched a study to confirm the efficacy of tenofovir gel.

“The NIAID-sponsored VOICE study, which launched last fall and is expected to enroll 5,000 women in four south African countries, will provide additional safety and effectiveness data for a tenofovir-based vaginal gel as an HIV prevention method,” NIAID director Anthony Fauci, MD, says in a news release. “The study also will offer some insight as to the gel’s acceptability as a product used once a day rather than one that is used before and after sexual intercourse.”

Anti-HIV Gel Protects Against Genital Herpes, Too

There’s an additional benefit to the tenofovir gel. Salim Abdool Karim reported that it also protects against genital herpes infection — which itself makes a woman more susceptible to HIV infection.

“We also show a 51% reduction in HSV-2 [genital herpes] infection,” he said. “Women who have HSV-2 have twice the risk of acquiring HIV. So this would have the benefit of reducing risk of HIV in women who otherwise would have acquired HSV-2 infection.”

Abdool Karim said that Gilead has promised him that it will allow South Africa to manufacture tenofovir gel without having to pay any royalties to the company.

Study Links Zinc Nose Sprays, Loss of Smell

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July 19, 2010 — Just over a year ago, the FDA warned that zinc-containing intranasal cold remedies might cause loss of sense of smell.

Now a researcher who has long argued that the sprays were harmful says he has scientific evidence to back up the claim.

Last summer, the FDA warned consumers to stop using three zinc-containing Zicam products: Zicam Cold Remedy Nasal Gel, Zicam Cold Remedy Swabs, and Zicam Cold Remedy Swabs for kids. The federal regulators cited 130 reports of loss of sense of smell among users of the products.

Zicam manufacturer Matrixx Initiatives pulled the three products from the shelves, but the company maintains that there is no link between their use and loss of smell.

In the newly reported analysis, researchers applied a statistical method used to establish a cause-and-effect link between an environmental exposure and development of a disease in an effort to confirm that zinc-containing nasal products can cause loss of sense of smell, known medically as anosmia.

University of California, San Diego professor Terence M. Davidson, MD, says the analysis supports the hypothesis.

He adds that the effectiveness of zinc-containing products for preventing or shortening the duration of colds has never been proven.

“Given that they do absolutely no good for colds and given that there is potential for harm, I see no point in putting any zinc gluconate products in the nose,” Davidson tells WebMD.

Zinc Sprays and Smell Loss

The analysis included 25 patients treated at the University of California, San Diego Nasal Dysfunction Clinic, which Davidson directs, who experienced loss of smell after using zinc nasal sprays or swabs to prevent or treat colds.

Along with colleague Wendy M. Smith, MD, Davidson applied the nine-point Bradford Hill causation environmental exposure statistical measure to assess the probability that the cold-remedy use caused the loss of sense of smell.

In lawsuits brought by Zicam users, Matrixx has maintained that loss of smell resulted from colds or sinus conditions and not use of the zinc-based nasal products.

Upper respiratory infections and nasal and sinus disease are major causes of both temporary and permanent loss of smell and diminished sense of smell.

Davidson says many of his patients and others with suspected zinc-induced smell loss reported intensely painful burning in the nose when they used the products. This was followed by loss of smell within several hours.

“This is a pain that brings people to their knees,” he says. “And soon after they get over the pain, they realize they can’t smell their coffee. This is very different from viral-induced anosmia.”

Courts Find Evidence Lacking

In an interview with WebMD, Matrixx CEO Bill Hemelt said there is no proven correlation between stinging and burning in people who used zinc nasal products and  loss of sense of smell.

He notes that Matrixx’s own studies showed both zinc nasal spray and placebo sprays containing no zinc can cause occasional burning.

In 2006, Matrixx settled a lawsuit brought by 340 zinc-containing Zicam users for $12 million, and Hemelt says the company has settled other cases over the years.

But he adds that 10 judges in 10 cases have found little scientific evidence to support the claim that zinc-containing Zicam nasal products caused loss of smell.

In one such case, Davidson was rejected as an expert witness when the judge ruled his opinions on specific causation to be “seriously flawed.”

More than a dozen Zicam products remain on the market, including several oral zinc-based lozenges.

But none of the company’s nasal products still contain zinc gluconate.

“The products at issue were removed voluntarily more than a year ago,” Hemelt says. “There is absolutely no new scientific information in this analysis.”

Neurologist Robert I. Henkin, MD who directs the Taste and Smell Clinic in Washington, D.C., believes zinc-based nasal remedies can cause loss of sense of smell.

But he agrees that little scientific evidence exists to prove it.

“The most frequent cause of smell loss is the common cold,” he tells WebMD. “The role these zinc-based products play in initiating or exacerbating this condition remains very difficult to ascertain.”

A Well-Preserved Meteor Impact

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At only 16 meters deep and 45 meters wide, you wouldn’t call the Kamil Crater in the southwest corner of Egypt “Deep Impact”. Indeed, there are much more massive and impressive meteor craters scarring the Earth. Yet this small but perfectly preserved depression, discovered in 2009 during a Google Earth survey, is a rare beauty. There are currently 176 known craters on Earth’s surface, of which only 15 are less than 300 meters wide—but all of these small craters have rapidly eroded and lost most of their original features. The Kamil Crater, however, has been well preserved, with the radial streaks of ejecta thrown out during impact still visible. And that’s giving scientists a unique opportunity to study the characteristics of small-scale meteor impacts, researchers report online today in Science. The crater is in such pristine condition because it is geologically young (current estimates put the age at less than 5000 years) and because it escaped significant weathering, as it formed when extremely arid conditions were already prevalent in this remote part of Egypt. Craters like this one are typically found on planetary bodies in the Solar System that don’t have atmospheres and therefore no weather systems to erode them.

rainbow warrior

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Our seas are in danger. Though BP (British Petroleum) claims to have temporarily stopped the oil spill in the Gulf of Mexico, the damage is already catastrophic. Greenpeace is sending one of its ships, the Arctic Sunrise, on a three month expedition to document the destruction.

While the Sunrise gets to work, the legendary Rainbow Warrior ship is ready to enter its third avatar. The current Warrior is now over 50 years old and needs to be retired. The planet needs a new Warrior.

http://greenpeace.in/donate/help-build-rw.php

What Causes Fragile X Syndrome?

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Fragile X Syndrome

Fragile X is a group of genetic disorders that can affect individuals and their families in many ways because they are all caused by changes in the same gene, the Fragile X Mental Retardation 1 (FMR1) gene. The group of fragile X conditions includes:

  • Fragile X syndrome is the most common known cause of intellectual disability that can be inherited.
  • Fragile X-associated tremor/ataxia syndrome (FXTAS) involves tremors and problems with walking, balance, and memory. FXTAS occurs in some older men and women who carry certain changes in the FMR1 gene. (See people with a premutation.)
  • Fragile X-associated tremor/ataxia syndrome (FXTAS) can cause tremors and problems with walking, balance, and memory. FXTAS occurs in some older men who have changes in the FMR1 gene.

What is Fragile X Syndrome?

Fragile X syndrome is the most common known cause of intellectual disability, also known as mental retardation, that can be inherited (passed from one generation to the next).

Physical and behavioral signs that a child has fragile X syndrome include:

  • Not sitting, walking, or talking as early as other children (this is known as having developmental delays)
  • Learning disabilities
  • Speech and language delays
  • Behavioral problems such as attention-deficit/hyperactivity disorder (ADHD)

Children often have a typical facial appearance that gets more noticeable with age. These features include:

  • A large head
  • A long face
  • Prominent ears, chin, and forehead

Males who have fragile X syndrome usually have some degree of intellectual disability that can range from mild to severe. Females with fragile X syndrome can have normal intelligence or some degree of intellectual disability with or without learning disabilities.

Autism spectrum disorders also occur more frequently in children with fragile X syndrome.

How Many People Have Fragile X Syndrome?

The exact number of people who have fragile X syndrome is unknown, but it is estimated that about 1 in 4,000 males and 1 in 6,000 to 8,000 females have the disorder. Although fragile X syndrome occurs in both males and females, females usually have milder symptoms.

FXS is caused by a change (mutation) in a gene on the X chromosome. Genes contain codes, or recipes, for proteins. Proteins are very important biological components (parts) in all forms of life. The gene on the X chromosome that causes FXS is called the Fragile X Mental Retardation 1 (FMR1) gene. The FMR1 gene makes a protein that is needed for normal brain development. This protein is not made in individuals who have FXS.

How is Fragile X Syndrome Diagnosed?

Fragile X syndrome can be diagnosed by testing a person’s DNA from a blood sample. A physician or genetic counselor must order the test. Testing can also be done to detect changes in the FMR1 gene that can lead to the different conditions mentioned above.

What is CDC Doing about Fragile X Syndrome?

Since 2005, CDC and its partners have been working on several public health activities to find out more about fragile X syndrome.

These projects include:

  • Fragile X Clinic Consortium
    The fragile X community is linking together clinics that care for people with fragile X, FXTAS, and FXPOI. The purpose is to improve care, identify research projects, and develop a patient registry. CDC is providing support for this effort.
  • Fragile X Pilot Surveillance Projects
    CDC is supporting a project to estimate the prevalence of FXS in individuals who have autism and intellectual disability. Researchers at Johns Hopkins University and the Medical University of South Carolina are working on this project.
  • National Fragile X Survey
    CDC is working with researchers at Research Triangle Institute (RTI) on a national survey that will identify the needs of families with fragile X syndrome. A total of 1,221 families have enrolled in the survey. The results from this survey will help researchers find ways to better serve families with fragile X.
  • Fragile X syndrome cascade testing and genetic counseling protocols
    The 2005 National Society of Genetic Counselors guidelines for fragile X-related disorders were updated to include recent research on the different conditions that can affect people who have changes in the FMR1 gene. In addition, efforts were taken to help inform health care providers about these conditions.
  • Development of a newborn screening test for fragile X syndrome
    CDC has worked with researchers to develop a test to detect fragile X syndrome in newborns. This project will also find out how often fragile X syndrome occurs in newborns.
  • Single Gene Resource Center
    CDC is working with the Genetic Alliance to help people find quality information on single gene disorders, such as fragile X syndrome.