Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts

Flu? Malaria? Disease forecasters look to the sky






NEW YORK (AP) — Only a 10 percent chance of showers today, but a 70 percent chance of flu next month.


That’s the kind of forecasting health scientists are trying to move toward, as they increasingly include weather data in their attempts to predict disease outbreaks.






In one recent study, two scientists reported they could predict — more than seven weeks in advance — when flu season was going to peak in New York City. Theirs was just the latest in a growing wave of computer models that factor in rainfall, temperature or other weather conditions to forecast disease.


Health officials are excited by this kind of work and the idea that it could be used to fine-tune vaccination campaigns or other disease prevention efforts.


At the same time, experts note that outbreaks are influenced as much, or more, by human behavior and other factors as by the weather. Some argue weather-based outbreak predictions still have a long way to go. And when government health officials warned in early December that flu season seemed to be off to an early start, they said there was no evidence it was driven by the weather.


This disease-forecasting concept is not new: Scientists have been working on mathematical models to predict outbreaks for decades and have long factored in the weather. They have known, for example, that temperature and rainfall affect the breeding of mosquitoes that carry malaria, West Nile virus and other dangerous diseases.


Recent improvements in weather-tracking have helped, including satellite technology and more sophisticated computer data processing.


As a result, “in the last five years or so, there’s been quite an improvement and acceleration” in weather-focused disease modeling, said Ira Longini, a University of Florida biostatistician who’s worked on outbreak prediction projects.


Some models have been labeled successes.


In the United States, researchers at Johns Hopkins University and the University of New Mexico tried to predict outbreaks of hantavirus in the late 1990s. They used rain and snow data and other information to study patterns of plant growth that attract rodents. People catch the disease from the droppings of infected rodents.


“We predicted what would happen later that year,” said Gregory Glass, a Johns Hopkins researcher who worked on the project.


More recently, in east Africa, satellites have been used to predict rainfall by measuring sea-surface temperatures and cloud density. That’s been used to generate “risk maps” for Rift Valley fever — a virus that spreads from animals to people and in severe cases can cause blindness or death. Researchers have said the system in some cases has given two to six weeks advance warning.


Last year, other researchers using satellite data in east Africa said they found that a small change in average temperature was a warning sign cholera cases would double within four months.


“We are getting very close to developing a viable forecasting system” against cholera that can help health officials in African countries ramp up emergency vaccinations and other efforts, said a statement by one of the authors, Rita Reyburn of the International Vaccine Institute in Seoul, South Korea.


Some diseases are hard to forecast, such as West Nile virus. Last year, the U.S. suffered one of its worst years since the virus arrived in 1999. There were more than 2,600 serious illnesses and nearly 240 deaths.


Officials said the mild winter, early spring and very hot summer helped spur mosquito breeding and the spread of the virus. But the danger wasn’t spread uniformly. In Texas, the Dallas area was particularly hard-hit, while other places, including some with similar weather patterns and the same type of mosquitoes, were not as affected.


“Why Dallas, and not areas with similar ecological conditions? We don’t really know,” said Roger Nasci of the Centers for Disease Control and Prevention. He is chief of the CDC branch that tracks insect-borne viruses.


Some think flu lends itself to outbreak forecasting — there’s already a predictability to the annual winter flu season. But that’s been tricky, too.


Seasonal flu reports come from doctors’ offices, but those show the disease when it’s already spreading. Some researchers have studied tweets on Twitter and searches on Google, but their work has offered a jump of only a week or two on traditional methods.


In the study of New York City flu cases published last month in the Proceedings of the National Academy of Sciences, the authors said they could forecast, by up to seven weeks, the peak of flu season.


They designed a model based on weather and flu data from past years, 2003-09. In part, their design was based on earlier studies that found flu virus spreads better when the air is dry and turns colder. They made calculations based on humidity readings and on Google Flu Trends, which tracks how many people are searching each day for information on flu-related topics (often because they’re beginning to feel ill).


Using that model, they hope to try real-time predictions as early as next year, said Jeffrey Shaman of Columbia University, who led the work.


“It’s certainly exciting,” said Lyn Finelli, the CDC’s flu surveillance chief. She said the CDC supports Shaman’s work, but agency officials are eager to see follow-up studies showing the model can predict flu trends in places different from New York, like Miami.


Despite the optimism by some, Dr. Edward Ryan, a Harvard University professor of immunology and infectious diseases, is cautious about weather-based prediction models. “I’m not sure any of them are ready for prime time,” he said.


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Women Lose Half Their Weight: How They Did It






At 25 years old and 288 pounds, Ashley Donahoo was depressed.


“I was unhappy with my job, I was unhappy with the direction my life was going, and I had a hard time enjoying the little things that my kids wanted to do,” the 27-year-old mother of two from Pace, Fla., said. “My health was failing. My doctor told me that he didn’t think I was going to make it to 30 if I kept on [this way]. … It kept getting worse and worse.”






Donahoo was concerned, but it was her faithful husband, David, who pushed her on a path to health, starting with a walk around the block.


“His heart was breaking for me,” she said. “And he saw how unhappy I was, and he came to me and said, ‘We’re going to go for a walk.’  And I was, like, ‘No, we’re not.’”


Her husband won that battle, and on the walk, she started thinking about her own choices and future.


“The realization hit me that I made this choice.  I made this choice to get where I am right now.  So I’m going to start making a different choice,” she said.   ”I put my health and myself on back burner, and I think … it had all caught up to me.”


Jumpstart Your Weight Loss: CLICK HERE to Ask a Celebrity Trainer a Question!


Like Donahoo, Caroline Jhingory reached a similar eye-opening realization about her weight.


“I looked in the mirror one day and just realized I didn’t recognize the person that was staring back at me,” said Jhingory, 32, of Washington, D.C.


Jhingory’s struggles with her weight began early. At age 8, she weighed 120 pounds. Taunted by her peers, Jhingory was enrolled in a medical weight loss program, but it didn’t work because she would sneak junk food like candy bars.


“I found a way to be a food hustler and get whatever food I wanted,” she said. “Not only did I spend two decades of my life morbidly obese. I spent two decades of my life being taunted and teased in every environment. I never went to prom. I never had dates. I couldn’t ride a roller coaster because the safety bar wouldn’t go over my stomach.”


Jhingory remained heavy until college, when she tipped the scales at 303 pounds and started feeling self-conscious in her new environment.


“I felt like I had a moment when all these difficult experiences were a huge pause button on my life. I finally said to myself, ‘I’m tired of this. I want to have a normal life.’”


Jhingory started walking everywhere. Then, she took up a daily cardio regimen to shed the weight, and she rid her pantry of tempting snack foods she once binged on. Now 149 pounds, she has reclaimed her shape and kept off the weight.


Jhingory’s amazing transformation, along with Donahoo’s and other weight-loss success stories, were spotlighted in the “Half Their Size” feature in the latest issue of People magazine.


RELATED: Is Being Overweight Really Bad For You?


Donahoo cut out the late-night binges that brought her down and, thanks to her strong support system, lost 137 pounds. She credited her weight loss success to tracking her food and exercise on livestrong.com and running. She has run two 5Ks.


Leah Fernandez of Atlanta found herself at 251 pounds after two pregnancies. The baby weight stuck and she tended to eat emotionally.


“I wanted the food,” she said. “It made me feel good, and so I ate it.”


But it was the motivation to be there for her children that helped her turn it all around.


“Thinking about going out to the park with my kids felt like work to me, you know?  And at some point I realized that’s ridiculous. Not only am I cheating myself but I’m cheating my kids of me,” she said.


Fernandez turned to Jenny Craig in March 2011 and hasn’t looked back. Since then, she has lost half her weight by staying active with her kids and incorporating walking into her lifestyle.


“I’m getting my groove back.  Leah’s getting her groove back,” she said.


RELATED: Apps to Help With Weight-Loss Resolutions


RELATED: 329 Pound-Weight-Loss Trio Share Their Secrets


READ MORE: 138 Pound Weight Loss Changes Woman’s Life


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Could Trip to Mars Cause Alzheimer’s?






Space travel has always been portrayed as risky — no air or water, extreme temperatures — a place where even a small miscalculation can be fatal. It can also be hazardous to your brain health, particularly on a three-year-long mission to Mars, according to a study published this week in the scientific journal PLOS ONE.


The eight-year long study, conducted at the NASA Space Radiation Laboratory at Brookhaven National Laboratory on New York’s Long Island, found that the cosmic radiation on such a mission could accelerate the onset of Alzheimer’s disease.






NASA is working on sending astronauts to a passing asteroid in the 2020s, and talks of a trip to Mars in the 2030s. It would take three years, with current technology, to get there and back. Current spacecraft are not heavily shielded from the cosmic radiation crew members would encounter beyond Earth’s protective magnetic field.


Researchers used mice that were genetically engineered to be predisposed to Alzheimer’s disease. They exposed them to cosmic radiation that was simulated in the lab.


“Galactic cosmic radiation poses a significant threat to future astronauts,” said Dr. M. Kerry O’Banion, senior author and professor of neurobiology and anatomy at the University of Rochester Medical Center.


The study team wanted to see if radiation had the potential to accelerate Alzheimer’s in those who were genetically vulnerable. Mouse models have been used extensively in this type of research and the rate at which they develop the disease is well understood.


Scientists have long worried about the potential dangers of working and living in deep space. Cosmic radiation beyond low Earth orbit, researchers say, could lead to cancer, cardiovascular disease, even cataracts.


Radiation exposure can cause acute effects such as nausea, vomiting, fatigue, skin injury and changes to white blood cell counts and the immune system, according to the National Space Biomedical Research Institute. Longer-term radiation effects include damage to the eyes, gastrointestinal system, lungs and central nervous system.


On Earth, humans are protected by the planet’s atmosphere and magnetic field. Crew members on the International Space Station, at an altitude of 200 miles, are still within the magnetic sheath that surrounds us. The 24 Apollo astronauts who flew to the moon between 1969 and 1972 were not protected, but the longest missions lasted less than two weeks.


Once out of low orbit, astronauts are exposed to showers of different radioactive particles. Though engineers say they can protect themselves from the radiation associated with solar flares, so far, they cannot block other forms of cosmic radiation.


The longer astronauts are in deep space, the greater the exposure to this low-level radiation.


This is the first such study to explore effects of radiation on the nervous system, a phenomenon known as neurodegeneration, according to the authors.


“The possibility that radiation exposure in space may give rise to health problems such as cancer has long been recognized,” said O’Banion. “However, this study shows for the first time that exposure to radiation levels equivalent to a mission to Mars could produce cognitive problems and speed up changes in the brain that are associated with Alzheimer’s disease.”


O’Banion has spent the last 20 years studying Alzheimer’s disease.


He and his fellow researchers studied a form of radiation from so-called high-mass, high-charged particles, which come in various forms and fly through space at high speeds. Some come from distant stars that have exploded.


At Brookhaven, where a portion of the research was conducted, particle accelerators were able to recreate some of the radioactive particles found in space.


“It is extremely difficult from an engineering perspective to effectively shield against them,” said O’Banion. “One would have to essentially wrap a spacecraft in a six-foot block of lead or concrete.”


For the study, researchers used mice that had been engineered to have two human gene mutations associated with familial Alzheimer’s.


“Essentially, they were healthy mice with nasty genes,” said O’Banion. Under natural conditions, mice do not get the disease.


The mice were exposed to the radiation for several minutes. Six months later, researchers evaluated the exposure to see if it had any effect.


“A minute or two [of exposure] is like three years in human life,” O’Banion said. “It’s apples and oranges, a very different kind of exposure, but the total dose is equivalent to what an astronaut would receive [on a three-year Mars mission].”


Cosmic radiation is unlike anything on earth, according to O’Banion, similar only to what might be experienced in a nuclear accident.


“The big problem NASA faces is that shielding is not effective, and a spacecraft is not bulky enough to protect them over long periods of travel,” said O’Banion. “At least not now. In scenarios I have heard of sending people to Mars, they would then build an underground shelter on a long-term mission in order to protect them from radiation.”


While the research does not solve the problem of radiation in space or explain why humans develop Alzheimer’s disease, it is important, according to O’Banion.


“My own bias is this,” he said. “It’s just another example of how the environment can influence diseases. The mice had a genetic predisposition and you have added an environmental injury — an insult to their system. And now they show exacerbation of the disease.”


There may even be parallels with the development of the disease after brain injuries in football players, he said.


Jeff Chancellor, a scientist in radiation physics at the National Space Biomedical Research Institute, said the Rochester team’s study is solid.


“I know most of the authors and they are very well respected, and I have full confidence in their results,” he said. . “The main benefit of their research is being able to further enhance the field and perhaps provide justification for more research.”


“Any time you identify a mechanism for how a disease or a condition is induced, you further the ability to mitigate it,” he said. “It provides more tools for the researchers and for M.D.s … There are great benefits to all these studies.”


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La terapia prostática con protones no provoca menos efectos adversos






NUEVA YORK (Reuters Health) – Un costoso tratamiento para el


cáncer de próstata, conocido como terapia con haz de protones,






provoca tantos efectos adversos como las radioterapias más


comunes y económicas.


“En el largo plazo, realmente no existen diferencias entre


los resultados de la terapia con protones y la radioterapia de


intensidad modulada (IMRT, por su sigla en inglés) en los


hombres con cáncer prostático”, dijo el autor principal del


estudio, el doctor James Yu, radiólogo y oncólogo de la Facultad


de Medicina de la Universidad de Yale.


Los defensores de la terapia con protones sostienen que el


haz de protones irradia directamente al tumor y, así, evita los


efectos adversos. La IMRT, que es más común, deja expuestos a la


radiación a tejidos sanos, lo que para los investigadores


aumentaría los efectos adversos y el riesgo de nuevos tumores.


Pero, en un año, los autores del nuevo estudio hallaron la


misma cantidad de efectos adversos en pacientes tratados con


ambos métodos.


El cáncer de próstata es el cáncer masculino más común; cada


año, causa 28.000 muertes en Estados Unidos. Aun así, muchos


hombres mueren por otras causas porque este cáncer avanza


lentamente. Los tratamientos incluyen la quimioterapia, la


hormonoterapia, la cirugía y la espera vigilada.


Aunque los investigadores aún debaten cuál de los dos


tratamientos (haz de protones e IMRT) son la mejor opción para


los pacientes que optan por la radioterapia, eso no impidió que


proliferaran los centros que ofrecen la terapia con protones. La


Asociación Nacional de Terapia con Protones estima que en


Estados Unidos existen 10 centros y ocho en desarrollo o


construcción.


Cada centro cuesta más de 125 millones de dólares y Medicare


reintegra el doble de eso a cambio de sus servicios.


En el estudio publicado en Journal of the National Cancer


Institute, los autores revisaron los reintegros de Medicare del


2008 y el 2009 debido a complicaciones asociadas con el


tratamiento en casi 28.000 hombres con cáncer de próstata desde


hacía un año. Sólo el 2 por ciento de esos pacientes había


recibido terapia con protones; el resto, IMRT.


A los seis meses, casi el 10 por ciento de los pacientes


tratados con IMRT y el 6 por ciento de aquellos tratados con haz


de protones tuvieron efectos adversos, como incontinencia,


sensación de quemazón al orinar o problemas de erección.


Y las diferencias desaparecieron al año del tratamiento,


cuando casi uno de cada cinco pacientes padecía efectos adversos


independientemente del tratamiento recibido.


El equipo de Yu determinó que la terapia con protones cuesta


dos veces más que la IMRT: 32.428 dólares por ronda, versus


18.575 dólares, algo que coincide con estudios previos.


“Ahora, son los defensores de la terapia con protones los


que deberían probar los beneficios”, dijo Yu.


Los autores se concentraron en los efectos adversos, no en


comparar la efectividad de los tratamientos, lo que para los


promotores del uso del haz de protones es una gran debilidad.


FUENTE: Journal of the National Cancer Institute, online 14


de diciembre del 2012.


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Republican Senator: chances for “fiscal cliff” deal “exceedingly good”






WASHINGTON (Reuters) – Republican Senator Lindsey Graham said on Sunday that chances for a small “fiscal Cliff” deal in the next 48 hours were “exceedingly good” and that President Barack Obama had won.


“I think people don’t want to go over the cliff if we can avoid it,” Graham said on Fox News Sunday.






“This deal won’t affect the debt situation, it will be a political victory for the president and I hope we’ll have the courage of our convictions when it comes time to raise the debt ceiling to fight for what we believe as Republicans, but hats off to the president, he won,” Graham said.


(Reporting By Tabassum Zakaria; Editing by David Brunnstrom)


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MSF warns Kenya not to send more refugees to stricken camp






LONDON (Reuters) – Conditions in a camp for Somali refugees in Kenya are deplorable and a government plan to send in thousands more would pose a major risk to health, medical charity Medecins Sans Frontieres (MSF) said on Friday.


Kenya has more than half a million refugees from Somalia, which has lacked an effective central government since the outbreak of civil war in 1991.






A series of bombings, shootings and hand-grenade attacks blamed on Somali militants prompted the government on December 18 to stop registering asylum seekers and refugees in urban areas.


A Kenyan official said more than 100,000 refugees must now head to the remote Dadaab camp in the country’s remote north. Amnesty International said the order breached international law.


Dadaab camp was set up 20 years ago and already houses four times the population it was built for. Hunger and disease outbreaks are common.


MSF says its inhabitants suffer from overcrowding and poor sanitation that recent floods had worsened.


“The assistance provided here in Dadaab is already completely overstretched and is not meeting the current needs,” said Elena Velilla, MSF’s head of mission in Kenya.


In the last month, the number of children admitted to Dadaab’s hospital for severe acute malnutrition has doubled to around 300, MSF said. Sixty-three of those were taken to intensive care this week after developing serious complications.


Most of the sick are also suffering from acute watery diarrhea or severe respiratory tract infections, MSF said.


(Reporting by Kate Kelland; Editing by Tom Pfeiffer)


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Obama heads back to Washington as “cliff” deadline nears






WASHINGTON (Reuters) – President Barack Obama was flying back to Washington on Thursday and the top Republican in Congress planned to speak with House of Representatives lawmakers as the clock ticked toward a year-end deadline for action to avert the looming “fiscal cliff” tax hikes and spending cuts.


Markets around the world awaited action in Washington to prevent tax hikes on nearly all Americans and the deep automatic government spending cuts due to kick in at the beginning of next month that could push the U.S. economy back into recession.






Such action, however, remained far from certain, with Republicans and Democrats each insisting the other side move first amid continuing partisan gridlock.


Air Force One carrying Obama from Hawaii took off at about 3 a.m. EST for a journey that can take nearly half a day.


The U.S. Senate was scheduled to meet later on Thursday but on matters unrelated to the “fiscal cliff.” The Democrats control the Senate and the Republicans control the House.


Senate Majority Leader Harry Reid on Wednesday said through a spokesman that the Senate was ready to consider any bills coming from the House but would take no action on its own.


Speaker John Boehner and other House Republican leaders, who said on Wednesday they were willing to take up a “fiscal cliff” measure only after the Senate acts on one, planned a conference call with Republican House members on Thursday.


The expectation for the call was that lawmakers would be told to get back to Washington within 48 hours to consider anything the Senate might pass.


Weather permitting, that would bring them to Washington with perhaps three days left before the deadline for action. Storms affecting the Midwest, the South and the Northeast played havoc with airline schedules.


“This isn’t a one party or one house problem. This is (that) leaders in both parties in all branches of the government are not willing to make the deal that they know they have to make. Everybody wants their stuff but doesn’t want to give up what they don’t want to give up,” Republican U.S. Representative Steven LaTourette told CNN on Thursday.


The House and Senate passed bills months ago reflecting their own sharply divergent positions on the expiring low tax rates, which went into effect during the administration of Republican former President George W. Bush.


‘ALL TOO SLOWLY’


Democrats want to allow the tax cuts to expire on the wealthiest Americans. Republicans want to extend the tax cuts for everyone.


“We’re in an economy now that is fragile – still recovering, all too slowly. These tax cuts must be extended for the middle class. We need to protect the middle class from that huge tax increase,” Democratic Senator Richard Blumenthal told CNN.


While Obama and congressional leaders have said that they are willing to negotiate, no substantive discussions are known to have taken place over the holidays and the gap between them appears to remain.


A senior Obama administration official told reporters traveling with Obama that Republican leaders in Congress should step up to head off the looming tax and spending hit.


Congress has proven that it can act swiftly once an agreement is reached. Hope persisted that Republicans and Democrats might come up with a resolution before New Year’s Day that might at least postpone the impact of the tax hikes and spending cuts while further discussions take place.


On that basis, world shares and the euro edged higher on Thursday.


“There is still hope for a last-minute deal, otherwise we’re in for a correction in January. People have already priced in an agreement. Without it, the market can’t stay at these levels,” a Paris-based trader said.


Another battle is just over the horizon in late January or early February over raising the debt ceiling, which puts a limit on the amount of money the U.S. government can borrow to pay its debts and can be raised only with the approval of Congress.


Republican leaders have said they will insist on more budget cuts as a condition of raising the ceiling. Without any action, the U.S. Treasury said on Wednesday the government is set to reach its $ 16.4 trillion debt ceiling on December 31.


The Treasury Department said in a statement it would begin “extraordinary measures” to buy time. Many analysts believe the government can stave the default date off into late February.


(Additional reporting by Doina Chiacu and Alina Selyukh; Editing by Will Dunham)


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Light Therapy Helps Ease Winter Blues






Every October as the clocks are turned back, Jose Balido notices that his mood changes, almost as if his body were going into hibernation.


His limbs are heavy and he has trouble moving around. Simple household chores like loading the dishwasher seem “insurmountable,” he said. But when spring arrives, the lethargy lifts.






“It took me a while to realize what it was,” said Balido, owner of a travel social network site, Tripatini. “I was cranky, short-tempered, depressed, feeling hopeless and having difficulty concentrating.”


Balido, 51, was diagnosed a decade ago with seasonal affective disorder or SAD. The condition affects 62 million Americans, according to Michael Terman, director of the Center for Light Treatment and Biological Rhythms at Columbia University and a leader in the field.


About 5 percent of the population experiences the most severe symptoms of SAD — depression and hopelessness — while another 15 percent have the so-called “winter blues” or “winter doldrums.”


The vast majority never fall into full depression, according to Terman, but “plod through winters with slowness and gloominess that takes effort to hide from others.”


Two decades ago, SAD was identified as a legitimate disorder by the National Institute of Mental Health. Since then, the treatment of choice has been light therapy.


Balido, who lives in Miami, sought help from Terman and now undergoes light therapy. He sits in front of a daylight simulator for a half an hour each morning before 10 a.m.


“Within two or three days, the difference was mind-blowing,” he said.


The standard treatment for SAD is 30 minutes of 10,000-lux, diffused, white fluorescent light, used early in the morning. About half the patients are helped quickly — and when treatment is tailored to a person’s individual wake-sleep cycle, remission can climb to 80 percent, according to Terman.


This year, a utility company in the northern Swedish town of Umea installed ultraviolet lights at 30 bus stops to combat the effects of SAD.


“We wanted to celebrate the fact that all our electricity comes from green sources and we wanted to do this in a way that contributed to the citizens in one way or another,” said Umea Energi marketing chief Anna Norrgard in an email to ABCNews.com.


“As it is very dark where we live this time of year, a lot of us are longing for the daylight,” she said. “A lot of us are also a bit more tired this time of year and I would also say we sleep a little bit more. …We wanted to give the citizens of Umea a little energy boost, to be more alert.”


The town is located about 400 miles north of Stockholm. In December, the sun rises at about 10 a.m. and sets around 2:30 p.m. Some towns north of the Arctic Circle have no daylight for several weeks in the winter.


Geography has a strong influence on the prevalence of SAD symptoms, according to Terman.


“The common wisdom is that it’s worse the farther north you live, because winter days are so much shorter,” he said. “Not so simple.”


Columbia research shows that in North America, the incidence of SAD rises from the southern to the middle states, but levels off and stays bad from about 38 degrees North latitude (near such cities as San Francisco, St. Louis and Washington, D.C.) up through the northernmost states and Canada, according to Terman.


But the problem becomes “more severe” at the western edges of the northern states and provinces.


“This important finding reveals the underlying trigger for relapses into winter depression, since the sun rises an hour more later at the western edge of a zone,” said Terman, whose book, “Chronotherapy,” looks at the phenomenon.


Esther Kane, a clinical counselor from Vancouver, Canada, said her practice is filled with patients as the long days descend on British Columbia.


Seasonal Affective Disorder Hits Hard in Canada


“On the West Coast where we live it’s so rampant, I can’t even tell you how many people have it,” said Kane. “Everyone is feeling it with the gray skies and rain. It’s like nighttime all the time here.”


Doctors there routinely prescribe fish oil and vitamin D, as well as light therapy to balance out the sleep hormone melatonin and “boost” the feel-good hormone serotonin, according to Kane. Many are also on antidepressants.


“A lot of people depend on alcohol and drugs all of a sudden,” she said. “They are stuffing themselves with carbs and their food intake is up. They have depression symptoms — what’s the point of getting out of bed in the morning when they feel no energy and there is dark all over them?”


“Some suffer so bad, they can’t function,” said Kane. “Everyone here who can afford to get away for two weeks in the winter, go to Hawaii.”


Even those who live south of the Mason-Dixon Line in the United States can be affected.


Tina Saratsiotis, who works for a faith-based nonprofit group in Towson, Md., was surprised to develop SAD several years ago.


“I used to be a night person and like the dark. Then something changed,” she said. “By fall when it gets darker and the fatigue and sadness comes and by Christmas, it’s difficult to function.”


“It creeps in slowly — I eat more and have trouble concentrating,” she said. “I am more irritable and weeping, like a prolonged version of PMS. It makes it hard to get things done and to enjoy things.”


Columbia’s Terman said there may be genetic influences in who gets SAD — a vulnerability to depression and to insufficient light exposure.


SAD sufferers say it’s especially hard on their relationships when their winter moods kick in.


“Now, he’s very understanding,” said Saratsiotis, who uses both light therapy and antidepressants to deal with the condition. “But before, when I didn’t feel up to going out, I couldn’t explain not feeling great. People wonder, ‘Why doesn’t she like me?’ and, ‘She’s no fun.’”


But when spring rolls around, so does her old self.


“I love the solstice — thank you, Lord, for the solstice,” she said. “I really need [the medication] now, but I may not in the spring and summer.”


But now, in when the days are their shortest, SAD puts a crimp on the holidays.


“It kills Christmas,” said Saratsiotis. “I sit in the middle of the department store with that particular song about the sleigh bells ringing, and I am sobbing. I burst into tears and think, ‘Just kill that song.’”


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Ethanol Shot to the Heart Saves Man






A cardiologist in England gained international attention when he used an unconventional procedure — a shot of basic alcohol to the heart — to stop an unusual cardio rhythm in an elderly patient.


Dr. Tom Johnson, who carried out the procedure at the Bristol Heart Institute Hospital in Bristol, England, said Ronald Aldom, 77, was doing “fantastically well” after Johnson and his team used pure ethanol to treat Aldom’s rapid heartbeat, a condition called ventricular tachycardia, or VT, about six weeks ago. VT, which starts in the lower two chambers of the heart — the ventricles — can be life-threatening if it goes untreated.






“He’s got a lot of life to live,” Johnson said.


It may seem like a story lifted out of “Pulp Fiction,” but treating VT with ethanol, though rare, is an accepted method that has been used for years. What was noteworthy about Johnson’s procedure was that he had never used ethanol to treat VT before, nor had it ever been done in that part of the United Kingdom.


“[Aldom] was at a point where he felt he had no other option and was kind of facing death,” Johnson said. “While it sounds like a very barbaric treatment, it was a very rewarding one, [but] very high risk.”


Typically, a radio frequency catheter ablation is the treatment choice for someone with VT. A radio frequency catheter is an electrical probe that is threaded into the heart and uses low-voltage electricity to kill the heart tissue around the area causing the arrhythmia. This prevents the tissue from continuing to produce the abnormal rhythm. 




California Man Undergoes ‘Breathing Lung’ Transplant Watch Video



But Johnson said his colleagues had already tried that technique on Aldom, who had also previously endured heart attacks, without success — scar tissue that forms after heart attacks can reject the electrical treatment.


“It was complicated by the fact that [Aldom] had severe damage to his heart already,” Johnson said. “It got to the point where this poor man was like, ‘please shut it off and let me die.’”


Ethanol ablation works in the same way in that it also selectively destroys heart tissue, but it is more commonly used to treat hypertrophic cardiomyopathy, a condition in which the heart muscle is thick or “bulky,” Johnson said. While he had used ethanol to treat hypertrophic cardiomyopathy before, to use it on Aldom was a last resort.


“This guy had no other option, which is why we were able to do something we had never done before,” Johnson said.


The first step, Johnson said, was for him and his team to electronically map the heart to find and isolate the tissue that was causing the abnormal rhythm. Once the problem artery was located, Johnson’s team fed a wire into the vein graph and inflated a balloon to block the artery. Through that balloon, Johnson said they injected the ethanol while the patient was under anesthetic, killing off the problem tissue.


Destroying the tissue creates a controlled, “selective” heart attack, which can be painful, Johnson said, but it allows the heartbeat to return to normal. 


Using ethanol can have risky complications, Johnson said, because not only does it kill tissue, it can also kill some of the electrical function of the heart — Aldom was already using a pace maker. Another risk, Johnson said, was that the balloon could shift, killing more tissue than intended. But his procedure came through successfully.


Dr. Richard Page, the chairman of the department of medicine at the University of Wisconsin School of Medicine and Public Health and a past-president of the Heart Rhythm Society in the United States, agreed that using ethanol to treat VT was “not a routine procedure at all.”


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FDA warns doctors of counterfeit Botox






WASHINGTON (AP) — Federal regulators have warned more than 350 medical practices that Botox they may have received from a Canadian supplier is unapproved and could be counterfeit or unsafe.


The Food and Drug Administration said in a letter sent last month, a letter released publicly last week, that batches of the wrinkle treatment shipped by suppliers owned by pharmacy Canada Drugs have not been approved by the FDA and that the agency cannot assure their effectiveness or their safety.






The FDA said Canada Drugs was previously tied to shipping unapproved and counterfeit cancer drugs.


The agency warned doctors about buying drugs from sources other than licensed U.S. pharmacies. It is the fifth warning the agency has made this year about foreign suppliers providing unapproved drugs.


In February, the agency warned 19 medical practices that they had received a counterfeit version of the cancer drug Avastin. On three more occasions the FDA issued similar warnings about counterfeit Avastin and Altuzan, another brand name for the same drug. The alerts were also primarily targeted at drugs distributed by Canada Drugs.


A request for comment from the drug distributor was not immediately returned.


Drug shortages increased the financial incentives for some pharmacies to provide counterfeit or illegally imported drugs. The drugs subject to warnings have all been injectable treatments typically distributed through medical practices and not directly to patients.


In October, the FDA ordered operators of about 4,100 websites to immediately stop selling unapproved medications to U.S. consumers. The vast majority of those sites were operated by Canada Drugs. The site was still operating Friday.


Genuine Botox is made by Allergan Inc., based in Irvine, Calif. Avastin is made by Roche Holding AG’s Genentech unit.


___


Online:


The FDA’s warning letter, plus a list of doctors who received it: http://1.usa.gov/R7jKiR


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Cancer Immunotherapy Where Are We Going?






The compelling concept of utilizing the patient’s own immune system for a stronger and more effective way to attack cancer cells is not a new one. William Coley observed in 1891 that infections produced in patients with inoperable cancer following an injection of streptococcal organisms (Gram-positive bacteria) led to tumor shrinkage especially when the patients developed fever and other signs of a full-blown infection.1 Since then, research has embraced approaches to “train” the patient’s own immune system to recognize certain biomarkers or proteins that are mainly found on cancer cells and to destroy the cells.


After several setbacks the first cellular immunotherapy, Dendreon’s Sipuleucel-T (Provenge(R)), was approved for the treatment of prostate cancer in 2010. Today, new promising cancer immunotherapy approaches are in clinical trials. Most recently, researchers at the 54th American Society of Hematology (ASH) meeting reported early success with a developmental-stage cell-based cancer vaccine for the treatment of leukemia and have shown remission in several patients 2,3, including a 7-year old girl who relapsed twice after chemotherapy.Cancer immunotherapy can be thought of as either active or passive immunotherapy. The most prominent passive immunotherapies, which have revolutionized cancer therapy, are monoclonal antibodies that either target tumor-specific antigens and receptors or block important pathways central to tumor growth and survival. Therapeutic monoclonal antibodies are the market leader in the targeted cancer therapy space and include blockbusters such as trastuzumab (Herceptin(R)) or rituximab (Rituxan(R)).In general, antibodies are significant elements of the body’s adaptive immune system. They play a dominant role in the recognition of foreign antigens and the stimulation of the immune response. Therapeutic antibodies target and bind to antigens, usually proteins that are mainly expressed on diseased cells such as cancer cells. After binding, cancer cells can be destroyed by different mechanisms such as antibody-dependent cellular cytotoxicity, the activation of the complement system — an important part of the immune system — and triggering cell death.Although very successful, especially in oncology, therapeutic antibodies have a significant limitation: they don’t generate a memory response by the immune system, and thus, repeated antibody infusions are required. Further, monoclonal antibodies are only able to recognize specific proteins present of the cell surface. Monoclonal antibodies are mostly produced in cell culture systems which are often costly. Humanization of murine monoclonal antibodies by replacing of certain parts of the antibody with human sequences has improved the tolerability of antibodies and made them less immunogenic, but even fully human sequence-derived antibodies can carry some immunological risk.Novel approaches in the passive immunization strategy include antibody drug conjugates, a combination of targeting antibody with a very potent drug such as the recently approved brentuximab vedotin (ADCETRIS(TM)) for Hodgkin lymphoma and anaplastic large cell lymphoma (ALCL). ADCETRIS comprises an anti-CD30 monoclonal antibodyanti-CD30 monoclonal antibody and a cytotoxic (cell-killing) agent that is released upon internalization into CD30-expressing tumor cells. Currently, the development of next generations of ADCs is underway.Alternatively, specific and durable cancer immunotherapies designed to actively “train” or stimulate the patient’s intrinsic immune response have been more problematic; however, recent success stories, such as the cell-based immunotherapy Provenge, have revitalized this field. Dendreon’s approach modifies the patients’ own dendritic cells to present a protein specific to prostate cancer cells.Dendritic cells are the most potent, “professional” antigen-presenting cells. They process the antigen material and present it on their surface to other cells of the immune system. Once activated, the dendritic cells migrate to the lymphoid tissues where they interact with T-cells and B-cells — white blood cells and important components of the immune system — to initiate and shape the adaptive immune response. To develop Provenge, each patient’s own dendritic cells are harvested and then loaded ex vivo with the tumor-associated antigen. Now “presenting” the antigen, the dendritic cells are administered back into the patient to induce a potent, cell-mediated anticancer immune response resulting in tumor shrinkage and clinical benefit.In another experimental approach for the treatment of leukemia, patients’ own modified T-cells were infused back into the patients. Prior to this, the T-cells were transduced with a lentivirus to express the CD19-specific chimeric antigen receptor. CD19 is an antigen which is found on B-cell neoplasms, cancerous B-cells, and the lentivirus was the vehicle to transfer the genetic material for CD19 into the cells. A case report published in the New England Journal of Medicine stated that a patient with chronic lymphocytic leukemia (CLL) was in ongoing remission 10 months after treatment.3These promising results have spurred continued research for new and safe ways to achieve effective tumor vaccination, and drug developers have explored many cancer immunotherapy strategies. To generate an effective antitumor immunity, therapeutic intervention should drive several functions; specifically, it should promote the antigen presentation functions of dendritic cells, promote the production of protective T-cell responses, stimulate B-cells and overcome immunosuppression characteristics that are common to tumor cells.4Cell-based therapeutic vaccines are most frequently produced outside the patient’s body and involve isolation of the specific cells, such as dendritic cells, and the introduction of preselected antigens, often with the use of specific vehicle, into the cells. The antigens can be encoded in viral vectors (frequently DNA) or administered as peptides or proteins in a suitable adjuvant and carrier through a long and cumbersome process.During my doctoral thesis, I conducted immunization experiments using RNA as a negative control, assuming that the RNA would be degraded during the experiment thus making it impossible to use as a vaccine. The physiological role of messenger (m) RNA is to transfer genetic information from the nucleus to the cytoplasm where this information is translated into the corresponding protein. mRNA is known to be very unstable and has a relatively short half-life. But astonishingly, we were able to measure a solid T-cell immune response. We repeated the experiment and confirmed that the RNA we had produced had the potential to be used as a vaccine. Importantly, we didn’t need to isolate the patients’ cells: mRNA-based vaccines can be injected directly into the skin (intradermal). The mRNA-based vaccines are then taken up by antigen-presenting cells, such as dendritic cells, and are then able to induce an immune response. Importantly, mRNA-vaccines can also be synthesized quickly for any antigen sequence identified.5The first mRNA-based vaccines (RNActive(R)) are now in the clinic for the treatment of prostate cancer and lung cancer and have demonstrated that they do what they are supposed to do – induce a balanced humoral, as well as T cell-mediated, immune response that is entirely HLA independent. The HLA (human leukocyte antigen) system is used to differentiate the body’s own cells (self) and non-self cells. Additionally, RNA-vaccines do not need a vehicle such as a virus for delivery to the cells, nor do they contain virus-derived elements that are often found in DNA-vaccines. These attributes make RNActive a very safe therapeutic.The risk of integration of the RNA into the host-genome is minimized (RNA would have been transcribed first to DNA, and then it has to be transported to the nucleus), as is the residual risk of DNA-based vaccines for inactivating or activating genes or affecting cellular regulatory elements, which can induce oncogenesis. Thus, the favorable safety profile of mRNA-based therapies broadens their potential use not only for the treatment of diseases but for use as prophylactic vaccinations. A recent proof-of-concept study using mRNA-based vaccines (RNActive) in animal models for influenza was published in Nature Biotechnology.6Therapeutic cancer immunotherapies and vaccines have come a long way, and novel, promising approaches give hope for safe and effective treatment options. This may one day lead to the treatment of all cancers as chronic diseases.Literature1Kirkwood JM, Butterfield LH, Tarhini AA, Zarour H, Kalinski P, Ferrone S: Immunotherapy of cancer in 2012. CA Cancer J Clin. 20122June CH, Blazar BR: T-Cell Infusions: A New Tool for Transfusion Medicine That Has Come of Age. Presentation at 54th ASH Annual Meeting 20133Porter DL, Levine BL, Kalos M, Bagg A, and June CH: Chimeric Antigen Receptor-Modified T Cells in Chronic Lymphoid Leukemia. N Engl J Med 20114Mellman I, Coukos G, Dranoff G: Cancer immunotherapy comes of age. Nature. 2011Petsch B, Schnee M, Vogel AB, Lange E, Hoffmann B, Voss D, Schlake T, Thess A, Kallen KJ,5Hoerr I, Obst R, Rammensee HG, Jung G: In vivo application of RNA leads to induction of specific cytotoxic T lymphocytes and antibodies. Eur J Immunol. 20006Petsch B, Schnee M, Vogel AB, Lange E, Hoffmann B, Voss D, Schlake T, Thess A, Kallen KJ, Stitz L, Kramps T: Protective efficacy of in vitro synthesized, specific mRNA vaccines against influenza A virus infection. Nat Biotechnol. 2012 






Follow Scientific American on Twitter @SciAm and @SciamBlogs.Visit ScientificAmerican.com for the latest in science, health and technology news.
© 2012 ScientificAmerican.com. All rights reserved.
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Cliff poses many risks to U.S. public sector, few severe: Moody’s






WASHINGTON (Reuters) – The “fiscal cliff” of impending federal spending cuts and tax increases set for the beginning of the year poses a wide variety of risks to the public sector, but many of the threats hanging over state and local governments are not severe or direct, Moody’s Investors Service said on Thursday.


President Barack Obama and Congressional leaders are in the middle of tough negotiations to avert the cliff before the start of the new year. Economists have warned the combination of tax hikes and across-the-board spending cuts, often referred to as sequestration, could plunge the country back into recession.






A downturn or a downgrade in the U.S. debt rating resulting from the federal budget battles would threaten the credit quality of the public sector, Moody’s said.


“Rating changes could ensue for public finance credits that have direct, or in some cases indirect, linkages to the rating and credit standing of the U.S. government,” it said.


“These rating changes would occur if Moody’s lowers the U.S. government’s rating as a result of the fiscal cliff, or a federal budget agreement is reached that fails to reduce the ratio of federal debt-to-GDP over the medium term,” it added.


Sequestration would mostly impact states indirectly as federal grants to people shrink and they spend less money. Currently, Medicaid, the healthcare program for the poor that states administer with federal reimbursements, is safe from sequestration. Moody’s warned that if Obama and Congress were to decide to cut it in their agreement, “the credit impact would be more severe.”


“The largest component of the sequester is an approximately 9.4 percent, $ 30 billion across-the-board cut to discretionary defense programs,” Moody’s added. “If it is implemented, the economic impact will be most heavily felt in states with high concentrations of defense procurement contracting such as Maryland, New Mexico and Virginia.”


Local governments only receive 5 percent of their revenues from direct federal payments, on average, meaning they too will only be affected by sequestration as lower spending hurts their revenues, Moody’s said. Cities dominated by the federal government and military could be hit harder.


While Medicaid is off limits in sequestration, Medicare, the health insurance program for the elderly, would have to reduce reimbursements for services by 2 percent. That would hit non-profit hospitals.


Sequestration would also cut agencies that fund research at universities, but will likely only impact new grants, while the availability of federal financial aid may shrink, hurting higher education, Moody’s said


The agency also said defense spending cuts will hurt military housing and could negatively impact revenue bonds for it.


(Reporting By Lisa Lambert; Editing by Leslie Adler)


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Resolve to Get Clearer Skin in the New Year– Tips From the Paula’s Choice Research Team






It’s frustrating, but true: Acne, to one degree or another, can occur at any age. The Paula’s Choice Research Team behind the best-selling book, Don’t Go to the Cosmetics Counter Without Me, share the facts and products they’ve uncovered to have acne-free skin at any age.


Seattle, Washington (PRWEB) December 21, 2012






Let 2013 be a year where skin is beautiful and clear—because, while it’s frustrating, it is true: Acne can strike at any age and at any time. Whether it’s during the teen years or in the middle of menopause, acne affects up to 95% of the population at various stages of life. It’s a struggle that the Paula’s Choice Research Team, writers of the best-selling book, Don’t Go to the Cosmetics Counter Without Me, know all too well.


Through their investigative work evaluating and reviewing all kinds of skin-care products, as well as published research on acne and its treatments, they developed this essential guide to having clear skin at any age.



  •     Cleanse Twice Daily: Use a gentle, water-soluble cleanser to remove excess oil and makeup that lead to clogged pores and dull-looking skin. Drying cleansers will cause irritation, making acne worse. Try Paula’s Choice CLEAR Normalizing Cleanser, a face wash that’s tough on blemishes but gentle on skin.



  •     Leave-On Exfoliant is a Must: Daily use of a well-formulated, leave-on product with salicylic acid (also known as beta hydroxy acid, or BHA) works beautifully to unclog pores that cause breakouts. Salicylic acid also reduces the redness and red marks from acne and provides an additional antibacterial punch. Truly, BHA is an anti-acne miracle! Find the top-rated salicylic acid products on CosmeticsCop.com.

  •     Eradicate Acne-Causing Bacteria: After exfoliating, apply a lightweight, nonirritating anti-acne product that’s medicated with benzoyl peroxide. This well-researched topical disinfectant works to quickly eliminate acne-causing bacteria. Apply it to all breakout-prone areas as a preventive measure—don’t just spot-treat current pimples.

  •     Avoid Heavy Moisturizers: Those with oily skin and breakouts should not use traditional cream moisturizers, even if they claim to be oil-free, because the ingredients in cream moisturizers can clog pores. Instead, if dry areas are a concern, apply a lightweight, gel-textured moisturizer for soothing relief or opt for a serum, which is especially great to prep skin for makeup.

  •     Remove Surface Pimples: Beauty magazines and even some dermatologists say one should never pop a pimple, but let’s get real—sometimes, it’s just plain necessary. In reality, popping a pimple the right way reduces inflammation, scarring, and healing time, and gets rid of the ugly white bump. Follow this step-by-step guide to safely and effectively pop, treat, and conceal a blemish.

These basic tips for clear skin are the first step in the battle against blemishes. For information on how to treat, conceal, and prevent acne visit CosmeticsCop.com.


###



Led by best-selling author and beauty expert Paula Begoun, the Paula’s Choice Research Team evaluates and reviews hundreds of skin-care and makeup products, in books such as Don’t Go to the Cosmetics Counter Without Me, and online at CosmeticsCop.com. Combining cosmetics industry knowledge and expertise, Paula and her team have developed the Paula’s Choice line of state-of-the-art formulations based on reliable, published skin-care research. Products include skin-care, makeup, body, and hair-care products, beauty tools, and accessories. All products are fragrance-free, cruelty free, and environmentally friendly, and they perform beautifully without false promises.


Tanya Wayne
[email protected]
212-243-1431
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Texas governor asks cancer agency to halt grants






AUSTIN, Texas (AP) — A $ 3 billion cancer-fighting effort that’s already under criminal investigation received yet more humiliation Wednesday when Texas Gov. Rick Perry called for a moratorium on new grants until confidence is restored in a once-celebrated agency that has plunged into turmoil in just three years.


Leaders of the Cancer Prevention and Research Institute of Texas quickly embraced the request from Perry, who unveiled the unprecedented state-run cancer fight in 2009 with promises of medical breakthroughs. But the effort has unraveled into one of Texas‘ biggest tempests involving a state agency in Perry’s 12 years as governor.






A key Republican lawmaker who filed the original bill creating CPRIT piled on Wednesday by introducing new legislation, this time calling for new polices to bolster agency oversight and accountability. The agency also faces another round of scrutiny Thursday in front of a key state budget-writing committee.


“The mission of defeating cancer is too important to be derailed by inadequate processes and a lack of oversight,” Perry said in a letter to CPRIT’s oversight committee. That panel includes members appointed by Perry and some of his top political donors.


The governor added, “It is important that we restore the confidence of the Texas taxpayers who approved this important initiative before new funds are dispersed.”


The letter was co-signed by Lt. Gov. David Dewhurst and state House Speaker Joe Straus, who also appoints members of the agency’s governing board.


CPRIT controls the nation’s second-largest pot of cancer research dollars, behind the National Institutes of Health. That federal department’s cancer-research arm, the National Cancer Institute, also has said it is reviewing the troubles surrounding the Texas agency.


NCI confers on CPRIT prestigious status as an approved funding entity and losing that designation would be another blow for the beleaguered agency. It’s already under a criminal investigation, is the target of widespread rebuke from scientists and has seen its leadership purged by resignations, including its executive director last week.


In a statement, oversight committee Chairman Jimmy Mansour and Vice Chairman Joseph Bailes said they agreed with Perry’s call to cooperate with current reviews, implement recommended changes, enact reforms and fill key positions.


“These issues need to be resolved to restore public confidence in CPRIT,” they said in a joint statement.


The reviews began after CPRIT disclosed that an $ 11 million grant to a private company had bypassed review.


The award to Dallas-based Peloton Therapeutics, a biomedical startup, marked the second time this year that a lucrative taxpayer-funded grant authorized by CPRIT instigated backlash and raised questions about oversight.


The first involved a $ 20 million grant to M.D. Anderson Cancer Center in Houston that CPRIT’s former chief science officer, Nobel laureate Dr. Alfred Gilman, described as a thin proposal that should have first been scrutinized by an outside panel of scientific peer-reviewers, even though none was required under the agency’s rules.


Dozens of the nation’s top scientists agreed. They resigned en masse from the agency’s peer-review panels along with Gilman. Some accused the agency of “hucksterism” and charting a politically-driven path that was putting commercial product-development above science.


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Russia fund in consortium to back U.S. pharma firms






MOSCOW (Reuters) – Russian state technology firm Rusnano, alongside a group of investors, is investing $ 93 million in three U.S.-based pharmaceutical firms to develop drugs to treat illnesses such as epilepsy, the investors said on Wednesday.


Rusnano is making the investment with U.S. venture capital fund Domain Associates and other investors. Rusnano partnered with Domain in March with plans to invest around $ 760 million in U.S. healthcare and pharmaceutical firms to bring new drugs to the Russian market.






The three companies receiving investments – Marinus Pharmaceuticals, Lithera and Regado Biosciences – are portfolio companies of Domain and the investments will be used to register medications and undertake further clinical trials in the U.S. and Russia, the companies said.


Marinus is developing a drug for the treatment of epilepsy, Lithera works on products for aesthetic medicine and ophthalmology and Regado is developing antithrombotic products.


(Reporting by Megan Davies; Editing by Douglas Busvine)


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“Fiscal cliff” deal closer, but gaps remain






WASHINGTON (Reuters) – After making major concessions on long-held “fiscal cliff” positions, President Barack Obama and House of Representatives Speaker John Boehner will test the reaction Tuesday of their respective parties in the U.S. Congress and continue talks aimed at further narrowing their differences.


The effort is designed to avert the steep tax hikes and across the board spending cuts set to take effect unless a deal is enacted into law before December 31. Enactment would require a buy-in by the full U.S. Senate and House on whatever Obama and Boehner present to them. Neither Obama or Boehner can be certain yet on how much resistance they might meet.






Though much work remains, the progress contrasted dramatically with previous movement so slow that as recently as Sunday, some Washington insiders saw a 50-50 chance of going over the cliff – which the Congressional Budget Office says would bring on a new recession.


In rapid developments Monday, the two sides came significantly closer to bridging gaps on critical issues such as tax hikes for the wealthy and cuts in Social Security cost-of-living benefits. Those issues have the potential to cause problems politically for both leaders, as Republicans and Democrats start to study them.


Obama and Boehner made the most headway on extending the reduced tax rates originally enacted in the administration of President George W. Bush. Both have agreed to keep the low rates for everyone but the wealthy, but they still differ on who qualifies as wealthy for tax purposes.


Obama, whose definition has for months been taxpayers above the $ 250,000 threshold, traveled to $ 400,000 in his latest offer. Boehner was at $ 1 million, but could move down to $ 500,000.


Obama also offered a “fast track” process for major tax and spending reforms in the year ahead. A Republican aide who asked not to be identified said that “conceptually,” there was agreement to make permanent changes in the tax code, with some of those changes taking effect at the start of 2013 and others at the beginning of 2014.


A comprehensive cliff-avoiding agreement would immediately substitute new and more targeted spending cuts for the indiscriminate slashing of defense and non-defense programs known as “sequestration.”


Possible plans to produce cuts in spending for Medicare and Medicaid, the government health insurance programs for seniors and low income Americans respectively, remain to be discussed.


Boehner and Obama have made headway on the politically explosive question of the president’s ability to avoid constant battles over raising the debt ceiling, which controls the level of borrowing by the government. Boehner is ready to give Obama a year of relative immunity from conservative strife over the debt ceiling, while Obama is pushing for two years.


Boehner is set to meet with Republicans in the House Tuesday morning and then speak to reporters. Also likely Tuesday is a White House briefing which could shed more light on the work ahead.


The reaction Tuesday from their party allies in Congress may help determine how much further each can go to finish off a deal and how much long it would require to do so.


(Reporting by Richard Cowan, Mark Felsenthal, David Lawder and Fred Barbash. Editing by Fred Barbash)


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In The Flesh: The Embedded Dangers of Untested Stem Cell Cosmetics






When cosmetic surgeon Allan Wu first heard the woman’s complaint, he wondered if she was imagining things or making it up. A resident of Los Angeles in her late sixties, she explained that she could not open her right eye without considerable pain and that every time she forced it open, she heard a strange click—a sharp sound, like a tiny castanet snapping shut. After examining her in person at The Morrow Institute in Rancho Mirage, Calif., Wu could see that something was wrong: Her eyelid drooped stubbornly, and the area around her eye was somewhat swollen. Six and a half hours of surgery later, he and his colleagues had dug out small chunks of bone from the woman’s eyelid and tissue surrounding her eye, which was scratched but largely intact. The clicks she heard were the bone fragments grinding against one another.

About three months earlier the woman had opted for a relatively new kind of cosmetic procedure at a different clinic in Beverly Hills—a face-lift that made use of her own adult stem cells. First, cosmetic surgeons had removed some the woman’s abdominal fat with liposuction and isolated the adult stem cells within—a family of cells that can make many copies of themselves in an immature state and can develop into several different kinds of mature tissue. In this case the doctors extracted mesenchymal stem cells—which can turn into bone, cartilage or fat, among other tissues—and injected those cells back into her face, especially around her eyes. The procedure cost her more than $ 20,000, Wu recollects. Such face-lifts supposedly rejuvenate the skin because stem cells turn into brand-new tissue and release chemicals that help heal aging cells and stimulate nearby cells to proliferate.


During the face-lift her clinicians had also injected some dermal filler, which plastic surgeons have safely used for more than 20 years to reduce the appearance of wrinkles. The principal component of such fillers is calcium hydroxylapatite, a mineral with which cell biologists encourage mesenchymal stem cells to turn into bone—a fact that escaped the woman’s clinicians. Wu thinks this unanticipated interaction explains her predicament. He successfully removed the pieces of bone from her eyelid in 2009 and says she is doing well today, but some living stem cells may linger in her face. These cells could turn into bone or other out-of-place tissues once again.






Dozens, perhaps hundreds, of clinics across the country offer a variety of similar, untested stem cell treatments for both cosmetic and medical purposes. Costing between $ 3,000 and $ 30,000, the treatments promise to alleviate everything from wrinkles to joint pain to autism. The U.S. Food and Drug Administration (FDA) has not approved any of these treatments and, with a limited budget, is struggling to keep track of all the unapproved therapies on the market. At the same time, pills, oils, creams and moisturizers that allegedly contain the right combination of ingredients to mobilize the body’s resident stem cells, or contain chemicals extracted from the stem cells in plants and animals, are popping up in pharmacies and online. There’s Stem Cell 100, for example, MEGA STEM and Apple Stem Cell Cloud Cream. Few of these cosmetics have been properly tested in published experiments, yet the companies that manufacture them say they may heal damaged organs, slow or reverse natural aging, restore youthful energy and revitalize the skin. Whether such cosmetics may also produce unintended and potentially harmful effects remains largely unexamined. The increasing number of untested and unauthorized stem cell treatments threaten both people who buy them and researchers hoping to conduct clinical trials for promising stem cell medicine.


When is a skin cream a drug?
So far, the FDA has only approved one stem cell treatment: a transplant of bone marrow stem cells for people with the blood cancer leukemia. Among the increasing number of unapproved stem cell treatments, some clearly violate the FDA’s regulations whereas others may technically be legal without its approval. In July 2012, for example, the U.S. District Court upheld an injunction brought by the FDA against Colorado-based Regenerative Sciences to regulate just one of the company’s several stem cell treatments for various joint injuries as an “unapproved biological drug product.” The decision hinged on what constitutes “minimal manipulation” of cells in the lab before they are injected into patients. In the treatment that the FDA won the right to regulate, stem cells are grown and modified in the lab for several weeks before they are returned to patients; in Regenerative Science’s other treatments, patients’ stem cells are extracted and injected within a day or two. Regenerative Sciences now offers the legally problematic treatment at a Cayman Island facility.


Many stem cell cosmetics reside in a legal gray area. Unlike drugs and “biologics” made from living cells and tissues, cosmetics do not require premarket approval from the FDA. But stem cell cosmetics often satisfy the FDA’s definitions for both cosmetics and drugs. In September 2012 the FDA posted a letter on its Web site warning Lancôme, a division of L’Oréal, that the way it describes its Genifique skin care products qualify the creams and serums as unapproved drugs: they are supposed to “boost the activity of genes,” for example, and “improve the condition of stem cells.” Other times the difference between needing or not needing FDA approval comes down to linguistic nuance—the difference between claiming that a product does something or appears to do something.


Personal Cell Sciences, in Eatontown, N.J., sells some of the more sophisticated stem cell–based cosmetics: an eye cream, moisturizer and serum infused with chemicals derived from a consumer’s own stem cells. According to its website and marketing materials, these products help “make skin more supple and radiant,” “reduce the appearance of fine lines and wrinkles around the eyes and lips,” “improve cellular renewal” and “stimulate cell turnover for renewed texture and tone.” In exchange for $ 3,000, Personal Cell Sciences will arrange for a participating physician to vacuum about 60 cubic centimeters (one quarter cup) of a customer’s fat from beneath his or her skin and ship it on ice to American CryoStem Corp. in Red Bank, N.J., where laboratory technicians isolate and grow the customer’s mesenchymal stem cells to around 30 million strong. Half these cells are frozen for storage; from the other half, technicians harvest hundreds of different kinds of exuded growth factors and cytokines—molecules that help heal damaged cells and encourage cells to divide, among other functions. These molecules are mixed with many other ingredients—including green tea extract, caffeine and vitamins—to create the company’s various “U Autologous” skin care products, which are then sold back to the consumer for between $ 400 and $ 800. When the customer wants a refill, technicians thaw some of the frozen cells, collect more cytokines and produce new bottles of cream.


In an unpublished safety trial sponsored by Personal Cell Sciences, Frederic Stern of the Stern Center for Aesthetic Surgery in Bellevue, Wash., and his colleagues monitored 19 patients for eight weeks as they used the U Autologous products on the left sides of their faces. A computer program meant to objectively analyze photos of the volunteers’ faces measured an average of 25.6 percent reduction in the volume of wrinkles on the treated side of the face. Analysis of tissue biopsies revealed increased levels of the protein elastin, which helps keep skin taut, and no signs of unusual or cancerous cell growth.


Only skin deep?
Supposedly, the primary active ingredients in the U Autologous skin care products are the hundreds of different kinds of cytokines they contain. Cytokines are a large and diverse family of proteins that cells release to communicate with and influence one another. Cytokines can stimulate cell division or halt it; they can suppress the immune system or provoke it; they can also change a cell’s shape, modulate its metabolism and force it to migrate from one location to another like a cowboy corralling cattle. Researchers have only named and characterized some of the many cytokines that stem cells secrete. Some of these molecules certainly help repair damaged cells and promote cell survival. Others seem to be involved in the development of tumors. In fact, some recent evidence suggests that the cytokines released by mesenchymal stem cells can trigger tumors by accelerating the growth of dormant cancer cells. Personal Cell Sciences does not pick and choose among the cytokines exuded by its customers’ stem cells—instead, it dumps them all into its skin care products.


Based on the available evidence so far, topical creams containing cytokines from stem cells pose far less risk of cancer than living stem cells injected beneath the skin. But scientists do not yet know enough about stem cell cytokines to reliably predict everything they will do when rubbed into the skin; they could interact with healthy skin cells in a completely unexpected way, just as the unintended interplay between calcium hydroxylapatite and stem cells produced bones in the Los Angeles woman’s eye. Stern acknowledges that unusual tissue growth is a concern for any treatment based on stem cells and the chemicals they release. “Down the line, we want to continue watching that,” he says. Unlike many other clinics, he and his colleagues have been keeping tabs on their patients through regular follow-ups. John Arnone, CEO of American CryoStem and founder of Personal Cell Sciences, says the fact that U Autologous skin care products contain such a diversity of cytokines does not bother him: “I’ve seen worse things out there. I’ve been putting this formulation for almost a year on myself prior to the study. I’m the best guinea pig here.”


Beyond the considerable risks to consumers, unapproved stem cell treatments also threaten the progress of basic research and clinical trials needed to establish safe stem cell therapies for serious illnesses. By harvesting stem cells, subsequently nourishing them in the lab and transplanting them back inside the human body, scientists hope to improve treatment for a variety of medical conditions, including heart failure, neurodegenerative disorders like Parkinson’s, and spinal cord injuries—essentially any condition in which the body needs new cells and tissues. Researchers are investigating many stem cell therapies in ongoing, carefully controlled clinical trials. Some of the principal questions entail which of the many kinds of stem cells to use; how to safely deliver stem cells to patients without stimulating tumors or the growth of unwanted tissues; and how to prevent the immune system from attacking stem cells provided by a donor. Securing funding for such research becomes all the more difficult if shortcuts taken by private clinics and cosmetic manufacturers—and the subsequent botched procedures and unanticipated consequences—imprint a stigma on stem cells.


“Many of us are super excited about stem cells, but at same time we have to be really careful,” says Paul Knoepfler, a cell biologist at the University of California, Davis, who regularly blogs about the regulation of stem cell treatments. “These aren’t your typical drugs. You can stop taking a pill and the chemicals go away. But if you get stem cells, most likely you will have some of those cells or their effects for the rest of your life. And we simply don’t know everything they are going to do.”Follow Scientific American on Twitter @SciAm and @SciamBlogs.Visit ScientificAmerican.com for the latest in science, health and technology news.
© 2012 ScientificAmerican.com. All rights reserved.


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Child deaths and bitter cold in Syrian refugee camps






ZAATARI, Jordan (Reuters) – One-year-old Ali Ghazawi, born with a heart defect, faced a battle for survival even before his family fled Syria‘s civil war. It was a struggle he lost two weeks ago in the bitter winter cold of a tented refugee camp in north Jordan.


Ali died two days after undergoing a heart operation in Zaatari camp, which houses at least 32,000 refugees who escaped fierce bombardment in Syria’s rebellious southern province of Deraa, cradle of the uprising against President Bashar al-Assad.






“I covered my son with two blankets, but he was not warming up, and he turned blue before he passed away in my hands,” said his sobbing 22-year-old mother, alone with a three-year-old daughter after she left her husband in Deraa and crossed the border in November.


Ali was the fourth baby to die in three weeks in the windswept camp. United Nations aid workers say none of the deaths were the direct result of conditions in Zaatari, yet they highlight the challenge facing relief agencies scrambling to provide basic shelter for half a million refugees in the region.


“These deaths are a result of cumulative factors, some related to shortage in needs and natural causes. But on top of that, the reality that conditions are harsh cannot be ignored,” said Saba Mobaslat, program director at Save the Children.


Jordan, Lebanon and Turkey each host more than 130,000 registered refugees, and relief workers predict the numbers will only increase as violence escalates around the capital Damascus.


Mirroring Syria’s youthful population, almost 65 percent of Jordan’s camp residents are newborns and young children.


“Every night we are getting children as young as four days old, six days old, one week, two weeks old, and it’s a real struggle to try to make sure that everyone survives,” said Andrew Harper, Jordan head of the United Nations High Commissioner for Refugees (UNHCR).


“Women are giving birth on the border, and people are coming across pregnant. It’s a situation where we just need to redouble efforts, particularly as we move into winter, because you have hundreds of pregnant women who cross the border,” Harper said.


Families often send the most vulnerable to safety, he added, so alongside the very young in Zaatari are many older refugees. “Last night we had a couple who were 97 years old,” he said.


“CHILDREN’S CAMP”


Along the main road in the middle of the camp’s muddy and gravel streets, children of all ages race around the makeshift market place that sprang up after the camp opened in July.


Many families join in, out of enterprise or necessity, selling everything from hot falafel to household goods, old clothing and fresh vegetables.


“It’s a children’s camp. You walk into it and there are children everywhere. It’s in your face. The male adults are staying behind, and a woman comes with 10 children without her bread earner,” Mobaslat added.


In one of several UNICEF-run playgrounds, among seesaws, swings and volunteers giving music lessons, the scars of war are fresh in the minds of most children.


“I long for my home, and I hope Bashar falls to get back to my home. It’s much better than here, where we are humiliated,” said Mohammad Ghazawi, 12, who came to play after a break from selling cheap cigarettes.


Their elders complain that two thin blankets per refugee distributed in recent weeks were not enough to warm them in tents that let in rain water despite zinc reinforcements and waterproof layers that have helped insulate them.


“Kids are dying from cold and lack of blankets. My kids shiver at night, and one has constant diarrhea,” said Mohammad Samara, 46, who fled heavy shelling in the southern Syrian town of Busr al-Sham in October with his wife and four children.


Carsten Hansen, country director for the Norwegian Refugee Council (NRC), which has set up a heated tent that receives families on arrival, says much progress has been made to help distribute aid.


“Everybody is trying to mobilize resources … in order to react to bigger numbers and a huge influx,” Hansen said, adding that 6,000 gas heaters had been airlifted to Jordan to help heat the tent camp.


FROM CRISIS TO DISASTER?


Harper said UNHCR was working to prevent “this humanitarian crisis becoming a major disaster”. But he said that while aid teams were racing to improve conditions at Zaatari, there were 100,000 other registered refugees living outside the camp and probably another 100,000 unregistered, whose living conditions were not improving.


In Lebanon, too, host to 154,000 refugees, many face a bleak winter, and aid workers expect their numbers to more than double by the middle of next year.


In the Bekaa Valley town of Bar Elias, a woman from the northern Syria province of Idlib says her home for the last year has been a wooden shack with only plastic sheeting to protect from the rain. Plastic bags are stuffed into the roof as extra insurance against leaks. “There is no water, no electricity, no school for my kids,” she said in a croaky voice.


“My husband is sick. The situation is very bad.”


Mads Almaas, NRC country director in Lebanon, said many more may flee Syria over the winter to escape worsening conditions there, putting even greater strain on relief efforts.


“The violence will not only continue but also get worse. And even in the increasingly likely event of the fall of Assad, we don’t think the violence will end,” he said.


Almaas said the United Nations would launch a regional response plan on Wednesday anticipating a total of 300,000 registered refugees in Lebanon by mid-2013. “At first we thought it was too high. Now we are concerned it is too low,” he said.


In Turkey, which hosts 136,000 refugees, camps for the most part have facilities such as portable electric heaters, and refugees receive three hot meals a day from the Red Crescent. But temperatures can plunge below freezing in the rugged terrain along the 900 kilometer (560 mile) border with Syria during the winter months, and rain can be torrential and cause flooding.


Overcrowding remains a concern, with extended families cramped in single tents and ever more refugees arriving as fighting across the border drags on.


Across the region, aid workers fear an explosion in violence could leave them seriously overstretched.


“Right now funds are sufficient. What is a challenge is if we get any shocks, something like 5,000-10,000 refugees arriving (in Lebanon) in a matter of hours,” Almaas said.


If fighting swept through the center of Damascus, thousands of Syrians could flee to the Lebanese border in a matter of hours. “For that, we are not prepared as the NRC. I also question the international community’s capacity.”


(Additional reporting by Oliver Holmes in Beirut and Nick Tattersall in Ankara; Editing by Dominic Evans and Will Waterman)


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