Archive for June 23rd, 2006
By Kathleen Doheny
(HealthDay News) — A hand-held imaging device designed for use at home appears effective in detecting breast cancer in its early stages, according to a University of Pennsylvania researcher who hopes the device might be available commercially to women in a year or two.
If so, the new device, tentatively called “iFind,” will make early detection of breast cancer more likely, said creator Britton Chance, professor emeritus of radiology, biophysics and biochemistry at the university’s medical school.
Another expert, Dr. Juri Gelovani of the University of Texas M.D. Anderson Cancer Center in Houston, called the new technology “encouraging,” but cautioned that a larger trial must be conducted before it could be recommended for wider use.
The finding was presented Thursday at the “Era of Hope” Department of Defense Breast Cancer Research Program meeting, in Philadelphia.
About the size of a deck of cards, iFind uses near-infrared light to measure how much blood is flowing in different locations in the breast, Chance said. The logic behind the device is that tumors require new blood vessels to grow, so those areas will have more blood.
iFind monitors differences in blood oxygen ratios in growing cancer tissue compared to normal tissues, he added. In this way, it detects “hypermetabolism” — the more rapid growth rate of malignant cells. When a certain threshold is passed, the device emits a light, tone or beep.
That’s an indication a woman needs to go to her doctor for further breast screening, he said.
Chance’s team tested the device on 116 women who came into two clinic testing sites from 1998 to 2003. “We had nurse practitioners demonstrate it,” Chance said.
In all, 44 of the women had cancers, also diagnosed by standard methods, and the device had a 96 percent sensitivity rate in detecting those 44 cancers. It takes just five minutes to use, Chance said.
“The object of this device is to get the women to go to the doctor if something is wrong,” Chance said. “It records what it finds on a chip when she scans it across her breasts.”
iFind is not meant as a substitute for mammograms or biopsies, Chance said, but might supplement those detection methods.
Chance estimates the device would cost a couple hundred dollars to make and said it could be on the market within two years, if all goes well. Doctors might recommend it to specific patients, just as some physicians recommend certain patients use home glucose-monitoring devices, he said.
“The results of this initial study are very encouraging,” said Gelovani, professor and chair of the department of experimental diagnostic imaging at M.D. Anderson Cancer Center. “Yet, large population-based studies are required to reproduce the findings to validate the technology.”
If the device’s effectiveness bears out in additional studies, he said, it would be especially valuable for women with a predisposition to cancer, including those with a family history or those with the so-called breast cancer genes, BRCA 1 and BRCA 2.
In another study presented at the meeting, other researchers used tiny particles called nanoshells — gold-wrapped bits of silica 20 times smaller than the average blood cell — to search out and destroy a protein, HER2. Aggressive breast cancers typically contain high levels of the protein.
Researchers from Rice University in Houston looked at two breast cancer cell lines. One overexpressed the HER2 protein, which signals aggressive disease. The other cell line did not. One set of the nanoshells was joined to the HER2 protein so it would seek it out, lighting up other malignant cells with high HER2. Next, laser-directed heat was used to kill these invasive breast cancer cells. The researchers believe the same technique could prove effective against most soft-tissue cancers.
June 23rd, 2006
By: JAMA
Acne is a common, recurring disease, according to background information in the article. Acne treatment can be complex, often requiring aggressive combination therapy of oral antibiotics and medication applied directly to the skin (topical), as well as a long-term strategy.
Because acne can return after successful treatment, maintenance therapy is necessary for many patients. However, due to reduced sensitivity of acne to some antibiotics, it has been recommended that antibiotic use be limited to three months. Topical retinoids, medications derived from vitamin A, have been identified as a choice for maintenance therapy.
Diane M. Thiboutot, M.D., of the Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, and colleagues studied the efficacy of a gel containing adapalene, a retinoid-like compound, in maintaining the effects of successful acne treatment. Patients from a previous study were included if they had shown at least moderate improvement in their acne when treated with either adapalene gel and 100 mg of doxycycline (an oral antibiotic) or doxycycline and an unmedicated gel. A total of 253 patients aged 12 to 30 years were randomly assigned to receive either adapalene gel or unmedicated gel once daily for 16 weeks. Patients’ acne was evaluated at the beginning of the study and after four, eight, 12 and 16 weeks.
The group that continued treatment with adapalene gel had significantly higher rates of maintaining previous treatment success, defined as at least 50 percent improvement since beginning therapy, than the unmedicated gel group, 75 percent vs. 54 percent. During the study, the number of breakouts gradually increased in the unmedicated gel group, while remaining stable or decreasing in the adapalene gel group. In a survey, a significantly larger percentage of patients treated with adapalene gel were “very satisfied” or “satisfied” with the overall treatment, compared with patients treated with unmedicated gel (75 percent vs. 58 percent).
“The present 16-week and previous 12-week studies provide data to support regimens, such as those recommended in the recent acne treatment guidelines, wherein oral antibiotics can be used initially in combination with topical retinoids to gain control over the acne, and maintenance with adapalene can delay the recurrence of acne,” the authors write. (Arch Dermatol. 2006;142:597-602)
June 23rd, 2006
By: Blackwell Publishing
A study in the July issue of The Journal of Sexual Medicine reports that bremelanotide, originally developed for the treatment of erectile dysfunction, has the potential to positively affect desire and arousal in women with female sexual arousal disorder (FSAD).
Additionally, researchers encourage further evaluation of the drug in an at-home study.
Bremelanotide (PT-141), administered nasally, is the first in a new class of therapies called melanocortin agonists and is novel in that it works through the brain’s functions, rather than through the body’s blood system as do currently available treatments.
Researchers conducted this study on 18 pre-menopausal women between the ages of 22 and 44 years to see what effects would result in women with female sexual arousal disorder after a single dose of the drug. Female sexual disorder (FSD) is defined by the American Foundation for Urologic Disease as: “The persistent or recurrent inability to attain or maintain sufficient sexual excitement, causing personal distress. It may be expressed as a lack of subjective excitement or a lack of genital or other somatic responses.” FSAD is one of the female sexual disorder categories.
Each subject was randomly assigned to receive a single dose (20 mg) of bremelanotide or matching placebo during an initial in-clinic session, and then the alternate medication in a second session. During the sessions, each subject viewed 20 minutes of a neutral video, followed by 20 minutes of a sexually explicit video. Vaginal pulse amplitude (VPA) was monitored continuously through a probe beginning 20 minutes before the dosing until 60 minutes afterwards.
The difference between the mean maximum amplitude change in VPA after placebo and bremelanotide treatment was not significant. However, among individuals, data showed a marked variability with percent changes in VPA ranging from negative 11 percent to 49 percent after placebo treatment and from 13 percent to 35 percent after bremelanotide treatment.
In analyzing the at-home experience 24 hours after dosing, the subjects were also asked to fill out a satisfaction survey. Seventy-two percent of the women reported feelings of genital arousal after bremelanotide compared with 39 percent after placebo treatment. Sixty-seven percent of the women reported experiencing sexual desire after bremelanotide with only 22 percent of women responding similarly after placebo treatment. Among those women who attempted sexual intercourse within 24 hours after the dose was administered, significantly more were satisfied with their level of sexual arousal following bremelanotide compared with placebo treatment.
“These preliminary data suggest a synthetic peptide melancortin analog, acting in the brain, may increase self-reported experiences of desire and arousal in women with sexual arousal problems, more likely women 34 and older,” states Dr. Julia R. Heiman, Director of the Kinsey Institute for Research in Sex, Gender and Reproduction in Indiana. “While the sample size is small and the effects are modest, these data are interesting in that they suggest an effect of PT-141 not in the lab to sexual stimuli, but where it most matters, in the sexual lives of some women.”
According to the study, despite the prevalence of female sexual disorder and its impact on women’s quality of life, there is a lack of data on the treatment of it. In fact, few medical treatments have been evaluated for female sexual disorder, thus marking this research an important step in more understanding and eventually having new treatments in women’s sexual health.
“Clinical and pre-clinical data, taken collectively, evoke a cautious optimism leading me to strongly encourage the sponsor to continue evaluation of bremelanotide for the treatment of female sexual disorder,” states Dr. Michael A. Perelman, Co-Director of the Human Sexuality Program at The NYWeill Cornell Medical Center, in Manhattan. “The potential use of this centrally acting compound to treat female sexual disorder is the most interesting development in sexual medicine research in years. Once concluded, I look forward to reviewing data from the larger at-home trial, currently underway.”
June 23rd, 2006
By Amanda Gardner
THURSDAY, June 22 (HealthDay News) — A magnetic device that seems to help depression and seizures may also short-circuit migraine headaches in their earliest stages, a new study finds.
The transcranial magnetic stimulation (TMS) device, about the size of a hair dryer, was able to interrupt the development of migraines, according to data to be presented Thursday at the American Headache Society’s annual meeting, in Los Angeles.
The study was funded by the device’s maker, NeuraLieve, of Sunnyvale, Calif.
About 28 million Americans suffer migraine headaches and about 20 percent experience migraine with aura, characterized by changes in vision before the actual pain begins.
Scientists now believe that migraine attacks start because of nerve cell hyper-excitability, which is followed by fatigue and malfunction of the nerve cells, or neurons. These phases seem to correlate with the aura.
“This process spreads throughout the brain and the end result is the throbbing headache,” said Dr. Yousef Mohammad, principal investigator of the study and an assistant professor of neurology at Ohio State University Medical Center.
“If we can interrupt this with two pulses of magnetic stimulation, we can abort the headache,” he added.
The TMS device used in this study is approved by the U.S. Food and Drug Administration as an investigational device. It sends an electric current through a metal coil, creating a magnetic field that activates nerve cells in the brain.
The study involved 43 people who had migraines with aura and were randomly picked to receive either TMS or treatment with a placebo device. Participants were instructed to give themselves two pulses to the back of the head at the first sign of an aura.
Seventy-four percent of people in the TMS group said they had no or only a mild headache two hours after using the device, compared with 45 percent in the control group. Participants also reported a reduction in noise and light sensitivity: 74 percent of people in the TMS group experienced a reduction in light sensitivity while 75 percent experienced less noise sensitivity. In the placebo group, only 20 percent or so experienced such reductions.
A larger study of TMS involving nine medical centers and 200 patients will begin next month, Mohammad said.
Another study presented at the meeting found that the anti-seizure medication Topamax (generic name topiramate) provided relief to people who have migraine headaches virtually every day.
The drug is approved by the FDA for prevention of migraine headaches, but had not been specifically studied in migraine sufferers who also experienced chronic daily headaches.
About 4 percent of U.S. adults, or nearly 9 million people, have headaches 15 or more days a month, known as chronic daily headache.
For this study, more than 300 patients were randomly chosen to receive Topamax or a placebo for 16 weeks. The study was funded by the drug’s maker, Ortho McNeil Pharmaceutical.
At the end of the study period, 41.2 percent of people taking Topamax had fewer headaches or days with headaches, compared to 28.8 percent in the placebo group.
Half of the people in the Topamax group had a 40 percent or greater reduction in migraines or days with migraine. Headache severity was also reduced significantly in the Topamax group.
There were, however, side effects in the Topamax group: 29 percent of these patients experienced numbness or tingling in the hands or legs, compared to 7 percent of those in the placebo group.
“It’s extraordinarily important that not only headache frequency decreased, but also severity,” said Dr. Stephen Silberstein, study author and director of the Jefferson Headache Center at Thomas Jefferson University Hospital, in Philadelphia. “It’s important to have a medication that works for difficult-to-treat patients.”
June 23rd, 2006
By: UVA Health
Obese girls in the early stages of puberty are at risk for having high levels of androgens (sometimes called “male hormones”), a condition that may lead to health problems later, write a team of researchers from the University of Virginia Health System.
Dr. Christopher McCartney and colleagues, writing in the Journal of Clinical Endocrinology and Metabolism, found that free testosterone (T) was three times higher in obese girls than in normal-weight girls. These findings were especially prominent in the group of obese early pubertal (Tanner stage 1-3) girls, who had a mean free T that was 5 times as great as the group of normal-weight early pubertal girls. The obese group also demonstrated elevated fasting insulin compared with normal-weight girls, the researchers noted.
The study of 76 girls included 41 obese children, and an extension of this research involving 98 girls will be presented at the ENDO 2006 meeting in Boston on Sunday, June 25.
“We are still not certain why overweight girls tend to have elevated testosterone,” said Dr. McCartney, assistant professor of research in endocrinology and metabolism. “I suspect that the reasons for this association are very complex, but currently available data suggest that elevated insulin levels and abnormalities of LH secretion may play a role in many cases.”
The obese girls with higher testosterone may be at risk for adult polycystic ovary syndrome (PCOS), says co-author Dr. John C. Marshall, professor of internal medicine and director for the UVa Center for Research in Reproduction (CRR), one of 14 such centers in the country. This CRR work is funded by an NIH (NICHD) Center Grant.
The UVa team is currently investigating how obesity and hyperandrogenemia (high levels of male hormones) might contribute to the development of adolescent and adult PCOS. PCOS is a syndrome characterized by irregular menstrual cycles and elevated androgen levels, which may lead to reduced fertility, acne, and facial hair growth. It is also associated with metabolic problems that affect several body systems.
Previous studies have demonstrated an association between childhood/adolescent obesity with abnormal glucose metabolism, hypertension, and abnormal lipid metabolism, McCartney says. Additionally, obesity during childhood and adolescence is strongly associated with obesity during adulthood, which also suggests a higher risk for adult diabetes. It remains unclear whether or not the presence of high testosterone (in obese girls) independently impacts this risk, he said.
The Center for Research in Reproduction continues to need both normal weight and overweight research volunteers; call 243-6911.
June 23rd, 2006