A leading cancer drug may increase the risk of death from treatment side effects in some patients, research has shown. This is one of the most economically successful cancer medicines in the world but seems to cause more fatal side effects than previously realized, says a new study.
Avastin, one of a new generation of antibody drugs, was found to increase the likelihood of patients dying when combined with certain chemotherapeutic agents, a blockbuster drug with more than $ 5.5 billion in global revenue, increases the rate of fatal side effects with almost 50% when added to traditional chemotherapy, compared with chemotherapy alone.
However, the overall incidence of fatal side effects (FAEs) associated with the drug low of 2.5%. About 2.5% of cancer patients, combining Avastin and chemotherapy died of treatment - instead of the disease, according to an analysis of 10 217 patients in the current Journal of the American Medical Association. In comparison, 1.7% died of cancer patients who received only conventional chemotherapy as a result of therapy.
Experts say patients who received Avastin - also known by its scientific name bevacizumab - should be monitored closely and a decision on whether the benefits outweighed risks. Researchers analyzed data from 16 studies with a total of 10 217 patients with a variety of advanced solid tumors.
The most common causes of death were bleeding, loss of infection-fighting white blood cells, and perforations in the stomach or intestine, says Shenhong Wu of Stony Brook University School of Medicine, co-author of the analysis of 10 217 patients.
Avastin works by blocking the growth of blood vessels that feed cancer, and oftentimes used in conjunction with standard forms of chemotherapy. The central dilemma of whether Avastin, however, is that doctors today have no way of knowing which patients will benefit, says Daniel Hayes of the University of Michigan Comprehensive Cancer Center, who wrote an accompanying editorial.
The study found that compared with chemotherapy alone, the addition of Avastin is associated with a 1.46 times increase in the risk of an FAE. Doctors tend to give it to all eligible patients, hoping for the best, but to know that Avastin can sometimes hasten a patient's death, says Hayes.
A more than three-fold increase in risk was seen in patients who received taxanes or platinum agents. Internal bleeding in the gut and the lungs were responsible for most deaths.
Patients' willingness to try the drug has benefited Avastin, the total costs of the drug can exceed $ 100,000 a year - it has become the best-selling cancer treatment in the United States, according to IMS Health. Genentech scientists are actively looking for tests to help predict how patients will respond to Avastin, said company spokeswoman Charlotte Arnold.
Researchers led by Dr Vishal Ranpura, from Stony Brook University Medical Center in New York, reported the findings in the Journal of the American Medical Association.
Australian researchers have discovered that changes in a gene involved in brain development may cord to testis formation and male genital organs in an otherwise female embryos.
Men usually have one Y chromosome and one X chromosome, while females have two X chromosomes.
Lead researcher Melbourne Professor Andrew Sinclair, of the Murdoch Childrens Research Institute and the University of Melbourne, said the breakthrough would improve diagnosis and clinical treatment of patients with disorders of sex development (DSD).
A single gene on the Y, called SRY triggers testis development in early embryos, and when these begin to form, the rest of the embryo is also male.
These conditions occur when the testes or ovaries do not develop in the embryo, causing genital abnormalities in one in 4,500 babies.
However, the Adelaide researchers have discovered a way to make a male mouse without a Y chromosome by activating a single gene called SOX3, in fetal life.
The gene, called SOX3, sits on the X chromosome, and are normally involved in the development of the central nervous system and brain pituitary gland.
SOX3 is known to be important for brain development, but has not previously been shown to trigger the male way.
However, researchers found that mutations that affect the SOX3 gene caused it to be abnormally turned on in embryonic gonads, leading to testis development in human DSD patients and mice.
In a large international collaborative study, they have also shown for the first time that changes in the human version of the same gene is present in some patients with disorders of sexual development.
In men, testicular development regulated by an identical gene on the Y chromosome called SRY.
The results of this work is published online today in the Journal of Clinical Investigation, and will be published in the magazines print version in January 2011.The Y chromosome contains a gene called SRY that acts as a genetic switch to activate the male under way embryonic development, said Professor Paul Thomas from the University of Adelaide School of Molecular&Biomedical Science.
Females have two X chromosomes and therefore does not have an SRY gene.
The SRY genetic switch is unique to mammals and is thought to have evolved from SOX3 gene in early mammalian evolution.
We were confused over how female fetuses may develop testes without SRY gene, Professor Sinclair.
Professor Thomas and his colleagues have generated male mice with two X chromosomes by artificially activating the SOX3 gene in the developing gonads.
Surprisingly, we found that the SOX3 gene could replace the SRY gene in XX female fetuses, resulting in the development of testes, male genitalia and a masculine appearance in these patients.
These reversed XX male mice are completely male in appearance, reproductive structures and behaviors, but are sterile because of an inability to produce sperm, he says.
Professor Sinclair says the discovery could explain one of five XX DSD undiagnosed cases, which will help provide a diagnosis and guide clinical management of patients in the future.
We have long suspected that SOX3 is the evolutionary precursor to SRY gene.
The discovery also gives scientists new insights into the evolution of SRY gene, which is thought to have evolved from SOX3 gene.
By showing that SOX3 activate the male way similar to SRY, we now believe that this is true.
It is believed that changes in gene SOX3 like those seen in these patients DSD must have happened millions of years ago, causing the SOX3 gene is switched on in the gonads and initiate testis development.
This work is a long-standing collaboration between Professor Thomas and Dr. Robin Lovell-Badge at the Medical Research Council National Institute for Medical Research in London, who discovered the SRY gene in mice more than 20 years ago.
This mutated gene SOX3 evolved into the Y-linked testis determining gene, SRY.
Dr Lovell-Badge says hes excited about the findings: SOX3 normally functions in the development of the nervous system, but it is now clear that a mutation that makes it active in the early gonad can turn it into the switch that makes the testes develop.
The study, published today by The Journal of Clinical Investigation, was conducted in collaboration with the University of Adelaide, Women and Childrens Hospital, Adelaide, Prince Henry's Institute for Medical Research, Melbourne, King Edward Memorial Hospital, Perth, University of California , USA, and National Institute for Medical Research, UK.
It is now very likely that something similar to what has happened in the XX male mice and humans, we describe also occurred in our early mammalian ancestors, and this led to the development not only in the SRY, but the X and Y chromosomes.
Just think of all the problems this little gene has caused! he says.
Further research with Professor Andrew Sinclair, the Murdoch Childrens Research Institute in Melbourne and Professor Eric Vilaine at UCLA (University of California Los Angeles) have also shown that changes in the human SOX3 gene is present in some individuals who are XX men.
From a genetic perspective, the cases of XX male sex reversal is particularly exciting, and is poorly understood, says Professor Thomas.
This discovery provides new insights into the genetic causes of disorders of sexual development, which is relatively common in the community.
For the future, will this finding impact on molecular diagnosis of these diseases and, ultimately, help us to develop therapies or technologies to improve clinical outcomes, he said.
According to the National Institutes of Health, about 12 million Americans suffer from sleep apnea, a potentially life-threatening condition.
If statistics from the National Institute of Health is to be believed, some 18 million Americans suffer from sleep apnea and nearly 80% of those suffering are not aware of their problem.
CPAP machines are prescribed for the majority to control the symptoms, but many think they are bulky and uncomfortable, leading many to be non-compliant with treatment.
Sleep apnea effects of routine life is unfortunate and potentially life threatening in some cases.
Inspire Medical Systems is testing an implanted device that stimulates nerves in the tongue, open the airway during sleep for better breathing.
The common type of sleep apnea (which affects 90%) is OSA or obstructive sleep apnea.
The most common type of sleep apnea is obstructive sleep apnea (OSA).
CPAP machine with the proper CPAP masks are probably the most effective treatment for OSA.
During sleep, causes the airway collapses and blocks any shallow breathing or breathing pauses.
CPAP or Continuous Positive Airflow Pressure is a system that is designed to help combat sleep apnea sufferers sleep problems.
A common cause is a relaxation of the tongue, causing it to cover the airway.
They provide positive pressure in the airways and prevent it from collapsing at the end of respiration.
Breathing pauses can last from seconds to minutes and oftentimes occurs 5-30 times or more an hour.
The mask is usually worn over the nose and is attached to the CPAP device.
OSA is more common in people who are overweight, but it can affect anyone, even children.
There are several types of CPAP mask that you can choose from.
Sleep Apnea Reduces the good cholesterol Levels. Untreated sleep apnea may increase risk of high blood pressure, arrhythmia, myocardial infarction, heart failure, stroke, obesity and diabetes.
A user can either select from a full face mask, nasal mask or nasal CPAP pillow, says Vincent of Your CPAP mask, a store that sells CPAP masks.
Because of lack of sleep, sleep apnea can also increase the chance of having a work-related or driving accident.
There are more opportunities for buyers to choose from.
Inspire Medical Systems, based in Minneapolis, MN, has developed a new device that works by stimulating the hypoglossal nerve in the tongue with a mild electric current, so the muscle together.
They could either choose from a ResMed mask, a Mirage mask or a Respironics mask.
The small pacemaker-like device is implanted under the skin at the collarbone and a wire attached to the hypoglossal nerve.
The problem with the CPAP mask but using the device.
A sensor in the diaphragm senses when a patient takes a breath, signalling the implant to transmit a stream.
Although technological breakthroughs have made these devices use there is still a general unease at the use of a CPAP mask.
The force of the current will be adjusted so that the nerve is stimulated just enough to keep the tongue from falling back during sleep, thereby blocking the airways, but not too much as to cause the tongue to protrude.
Most of the problems can be solved with proper consultation from a health worker, he adds.
Patients can switch the device at bedtime with a remote control and preset the device to turn on and off of at certain times.
A CPAP mask is undoubtedly the most effective way to deal with sleep apnea.
Read: Sleep Apnea Causes Memory LossInspire plans to begin to enroll 100 sleep apnea patients in January for a key study to see if their hypoglossal nerve stimulation implant device will work.
But, as Vincent says it is important that these masks should be purchased with guidance from a doctor or a sleep specialist who is the best person to decide a mask that is comfortable for the user.
Thurs the 2nd U.S. competitors have also announced small-scale testing.
About CPAP Mask: Mr. Vincent is an online retailer of CPAP masks and sell almost all brands straight from ResMed, Respironics and Fisher and Paykel.
Potential patients will be needed to undergo a special examination to determine whether tongue collapse is the real cause of the apnea.
Until approved for use, patients with obstructive sleep apnea work with their healthcare provider or a sleep specialist to find the best CPAP machine for their individual needs.
Continuous Positive Airway Pressure machines are today's undisputed best treatment, but as many as 30% of patients discontinue use because of the masks that fit poorly or other causes, such as a sense of claustrophobia.
Medical experts are concerned because the return of the swine flu has coincided with a decline in the number of people taking free vaccinations - down by 15 percent in October.
About a million people in the North-East have the right to vaccination, which protects against swine flu.
Although last year's swine flu pandemic is officially over, H1N1 continues to circulate in the population, along with other flu viruses.
Some of the victims are fighting for their lives in the north-east have existing medical conditions and could have avoided the virus if they had been vaccinated.
Last night, says North-East health officials it was important that all exposed patients received the vaccine as soon as possible.
So far, 14 of the 17 British deaths this flu series has involved the swine flu.
All were under 65 and six were under 18.
Last year's pandemic claimed seven lives in the north-east.
Some experts have called for the reintroduction of swine influenza intensive care planning groups, set up at the height of the pandemic in the last year, to handle the latest crisis.
Dr George Rae, chairman of the British Medical Association (BMA) in the north-east, says: It looks like it could be worse than last year.
It happens again and things can start to get out of control.
He said the flu jab was a hundred percent sure and urged people in high risk groups to contact their GPs.
The BMA said it was deeply concerned that a major flu crisis is brewing.
Dr Lawrence Buckman, chairman of the BMA's GPs Committee, has written to the government urging it to step up public awareness campaign for seasonal influenza vaccination.
Two of the 11 critically ill North-East patients are kept alive by an advanced artificial lung machine known as ECMO (Extra corporeal Membrane Oxygenation).
Newcastle's Freeman's Hospital ECMO unit, which is one of a handful in the country, is normally used to treat children with pulmonary failure.
But because of the increased number of seriously ill patients flu in Newcastle Hospitals Trust has adapted to the pediatric unit so that it can treat adults.
ECMO treatment involves artificial oxygenation of the blood for an average of 17 days to allow the patient's lungs to recover from illness.
A spokesman for the trust said they were treated two adult influenza patients in the unit.
Earlier this week, said Dr Richard Firmin, director of Britain's most important ECMO center in Leicester, they were very busy, busier than last year with 15 ECMO beds open in the UK, compared with 12 on top of last year's pandemic.
Health Protection Agency figures show that so far this season, has 17 patients required ECMO therapy.
All of them were adults under 65 and four were pregnant.
Dr Tricia Cresswell, deputy medical director of NHS North East, said: We are very concerned about the number of people being admitted to hospital with serious complications from influenza, which is critically ill.
Reasonable, levels of influenza in the general community still quite low and most people recover well.
But, for those with chronic health problems and for pregnant women, there is a risk of more serious disease.
We encourage everyone in danger - particularly pregnant women and young people with long-term health conditions - to get vaccinated against flu as a matter of urgency - you need not be complacent.
People who qualify for free NHS seasonal flu vaccine includes all frontline health care workers, pregnant women who were not previously protected against swine flu, all over 65 and anyone with a serious chronic disease or condition.
Colorectal cancer is the second most prevalent cancer in developed countries, with approximately 1 million new cases and 600,000 deaths each year.
Low doses of aspirin taken to reduce the risk of heart attack and stroke can also reduce the risk of colorectal cancer, British researchers reported Thursday. The study found that low doses of aspirin, when taken daily and long-term, can cut cases of colorectal cancer by 25% and the death toll from the disease with a third.
The findings might tip the balance in favour of using aspirin to prevent colorectal cancer, which is the second most common cancer in industrialized countries, after lung cancer. The study examined 20-year results from four studies involving over 14,000 people.
They found that aspirin reduced the incidence of colorectal cancer by a fourth and cut colorectal cancer deaths by a third. The participants were included in a study on the use of aspirin (ASA) to prevent strokes and heart attacks.
But their findings, published in the Lancet medical journal, is unlikely to decide a case that doctors consider controversial. In high doses over a long time, ASA can irritate the stomach, intestine and colon, causing damage and bleeding. But aspirin itself can be dangerous for many people, causing sometimes fatal bleeding in the stomach and intestines.
Aspirin has long been prescribed by doctors to patients who are at risk of heart attack or a stroke. Some experts hope to use cheap drugs like aspirin may be a way to prevent colon cancer in the population.
A new study has found that children of single parents more likely to have behavioural problems, the study analysed the effect of family patterns, economic status and parents' qualifications on the behaviour of children. Some 12 percent of the children who grew up with one parent displayed some sort of behavioural problems at age seven, it was revealed, compared with only six percent of the youths raised by both natural parents.
The disclosure is made as part of a larger study of about 14 000 children born in Britain between 2000 and 2002. The findings are a result of publicly funded Millennium Cohort studies involving 14 000 children born in Britain between 2000 and 2002. It found that the family makeup, parental education and income had a great effect on children's behaviour at a young age, that may have harmful long-term consequences.
The researchers analysed the impact of family factors on children's education and behavioural factors in a study, while in the second study were asked the 13 500 mothers to look at children's behaviour. In a separate analysis, The researchers also discovered that children with younger mothers had a much harder start in life than those with mothers of 30. They were far less likely to have married parents, and more than seven times as likely to have step-fathers, disclosed.
It it was discovered that 12% of children, that was taken care of by one parent and 15% of step-children had serious behavioural problems at age seven, compared with the 6% figure for adults brought up by both natural parents. As these experiences are particularly concentrated among children of young mothers, these findings provide support for policies aimed at reducing teenage pregnancy, researchers said. They also indicates that families with young parents can benefit from further targeted public sector support.
Scottish scientists have come up with a new treatment, which can be used to improve memory and mental performance in older people. Researchers at the University of Edinburgh say that a new experimental compound may improve memory and cognitive function in aging mice. Older mice with memories addled by age could remember as well as their younger counterparts after receiving a drug that blocks a brain enzyme. The finding could one day help people with memory impairment.
It shows that normal memory loss through aging is not irreversible as many assume, says Jonathan Seckl of the University of Edinburgh, UK, who carried out the study. A brain enzyme found in humans and mice, called 11-beta-hydroxysteroid dehydrogenase type 1 (HSD1), amplifies the effects of stress hormones called glucocorticoids in the brain. The team has identified a preclinical candidate who they hope to take into human trials within a year.
Many people find they become more forgetful as they get older, and it is generally accepted as a natural part of aging. Absent mind and a difficulty to concentrate are not uncommon, it takes longer to recall a person's name, and we can not remember where we left the car keys. Over a person's life, it weakens the ability to gain the hippocampus to store and recover the memories, so that older people have more problems with their memory, said Seckl. The drug works by blocking HSD1.
An enzyme known as 11beta-HSD1 is involved in making these hormones, and has proven to be more active in the brain during aging. In a study team reports the effect of a new synthetic drug that selectively blocks 11beta-HSD1 on the ability of mice to complete a task memory, called the Y maze. Professor Jonathan Seckl of the University of Edinburgh, who discovered the role of 11beta-HSD1 in the brain, described the findings: normal old mice normally have marked deficits in learning and memory just like some older people.
Seckl now hope to test the drug on humans for toxicology studies are completed. This also inhibits HSD1, but, as it also inhibits other enzymes, it has side effects including increased blood pressure. The effects were seen after just 10 days on this treatment. The study is published in the Journal of Neuroscience.