New treatment promising for Parkinsons
Fri, 22 Jun 2007 19:22:11 GMT
By MALCOLM RITTER, AP Science Writer
NEW YORK - An experimental treatment for Parkinson's disease seemed to improve symptoms — dramatically so, for one 59-year-old man — without causing side effects in an early study of a dozen patients.
The gene therapy treatment involved slipping billions of copies of a gene into the brain to calm overactive brain circuitry.
The small study focused on testing the safety of the procedure rather than its effectiveness, and experts cautioned it's too soon to draw conclusions about how well it works. But they called the results promising and said the approach merits further studies.
"We still have quite a bit more testing to do," said Dr. Michael Kaplitt of Weill Cornell Medical College in New York, an author of the study. Still, "the initial results are extremely encouraging."
Kaplitt and collaborators report their results in this week's issue of the British medical journal, The Lancet.
They're not alone in trying gene therapy for Parkinson's. In April, another team told a medical meeting that its experiments, which delivered a different kind of gene to a different part of the brain, also appeared safe and gave a preliminary hint of benefit.
More than half a million Americans have Parkinson's. They endure symptoms that include tremors, rigidity in their limbs, slowness of movement and impaired balance and coordination. Eventually they can become severely disabled.
Nathan Klein, a 59-year-old freelance television producer in Port Washington, N.Y., said the disease left him "pretty messed up." It weakened his voice, impaired his walking and made his hand tremble so badly he couldn't hold a glass of wine without spilling it all.
Klein was the first patient to be treated with Kaplitt's gene therapy procedure in 2003, and he said his symptoms gradually subsided afterward. Nowadays, he said, apart from freezing now and then when he wants to walk, the symptoms are basically gone.
"I'm elated," said Klein, who continues to take his regular pills for the disease. "It's unbelievable."
Kaplitt, who has a financial interest in Neurologix Inc., which paid for the research, noted that the 12 patients in the study still have Parkinson's symptoms. The amount of medication they were already taking for their symptoms didn't change significantly in the year after the surgery.
Current medicines can control symptoms, but can't stop the disease from getting worse over time, and they can produce troublesome side effects like uncontrollable movement.
Some patients gain relief from a surgical treatment called deep brain stimulation, in which electrodes are placed in the brain and connected to a programmable stimulator.
Kaplitt's procedure was aimed at achieving the same goal as that surgery, calming overactive circuitry in the brain. It gets overactive because it loses the normal supply of a chemical called GABA. The gene therapy was designed to make the brain produce more GABA.
For the gene therapy surgery, a tube about the width of a hair was threaded through a hole about the size of a quarter at the top of the skull. The tube delivered a dose of a virus engineered to ferry copies of a gene into cells of a brain region called the subthalamic nucleus. The gene copies enable the cells to pump out more GABA.
The Lancet paper reports that over a year, patients showed no side effects from the procedure. What's more, they showed improvements in an overall assessment of symptoms like tremors, stiffness and walking problems.
The improvements were evident at a checkup three months after the procedure and persisted to the end of the study, one year after the surgery, researchers reported. By that time, the overall amount of improvement from before surgery was about 24 percent when measured at times that patients were off their normal medication, and 27 percent at times when they were on medication.
Most of the effect appeared on just one side of the body. Because of concerns about safety with the untested procedure, the researchers treated only the brain circuitry controlling one side of the body.
Dr. Karl Kieburtz of the University of Rochester Medical Center, who didn't participate in Kaplitt's work, said the lack of any apparent side effects is itself significant.
But he urged caution in interpreting the evidence of benefits in symptoms. Other experimental therapies that looked good at such a preliminary stage have failed to pan out in more rigorous studies, he said, so more research is needed.
Future studies could include a head-to-head test against deep brain stimulation to see which relieves symptoms better, said neurosurgeon Dr. Guy M. McKhann of the Columbia University Medical Center in New York.
Dr. J. Timothy Greenamyre of the University of Pittsburgh, who was also familiar with the results, said the new study and prior research in animals leave him "very optimistic" about Kaplitt's approach.
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On the Net:
Lancet: http://www.thelancet.com
Information on Parkinson's disease:
http://www.ninds.nih.gov/disorders/parkinsons_disease/parkinsons_disease.htm
State moves against troubled LA hospital
Fri, 22 Jun 2007 03:58:24 GMT
By JEREMIAH MARQUEZ, Associated Press Writer
LOS ANGELES - State health regulators said Thursday they were moving to revoke the license of a hospital where a patient recently died on the emergency room floor while waiting for treatment.
The California Department of Health Services said in a letter to Los Angeles County officials that it was beginning the process to terminate the license for Martin Luther King Jr.-Harbor Hospital.
While the public hospital could not operate without a license, the process could take many months and is subject to appeal.
The move was part of a growing chorus of government agencies targeting the facility, which has a long history of providing substandard care to inner-city patients.
Sandra Shewry, director of the state health agency, said the goal is to improve the quality of King-Harbor care, not close the facility. She said the agency's move comes as a response "to the egregious incidents that have come to light in the last six weeks."
"We hope this will be the final rallying cry where the hospital and the county will make that push to improve patient care," Shewry said.
Last month, a woman died after writhing untreated for 45 minutes on the floor of the emergency room lobby. In February, a brain tumor patient allegedly languished in the ER for four days before his family drove him to another hospital for emergency surgery.
Dr. Bruce Chernof, director the county's health agency, stressed that King-Harbor would continue to operate. "What this does not mean is that the state is pulling the license immediately and the hospital will close," Chernof said.
The federal government has threatened to pull Medicare and Medi-Cal funding, and an upcoming inspection could decide the matter. The county Board of Supervisors has also sharply criticized health officials about conditions at the hospital, and ordered them to come up with a contingency plan should it be closed.
King-Harbor was built several years after the 1965 Watts riot to bring health care to poor, minority communities in South Los Angeles.
Portugal adopts law allowing abortion
Fri, 22 Jun 2007 03:49:20 GMT
By BARRY HATTON, Associated Press Writer
LISBON, Portugal - Portugal introduced a new law Thursday that allows abortion up to the 10th week of pregnancy, but imposes a three-day reflection period for women seeking the procedure and grants doctors the right to opt out on moral grounds.
The law was published in official government records and takes effect July 15.
Parliament voted overwhelmingly in March to scrap previous tight restrictions on abortion, bringing Portugal more in line with most of its European neighbors. The Health Ministry has spent months drawing up medical guidelines annexed to the law.
Under the law, women seeking an abortion will meet first with doctors who are to warn them of possible dangers. After a three-day reflection period, women can obtain an abortion free at a public hospital or go to a licensed private clinic.
Within two weeks of the procedure women must attend a family planning session where they will be informed about contraception methods.
Doctors can refuse to carry out abortions. The law stipulates that if no doctor is available to perform an abortion at a woman's local hospital she must be given access to a doctor elsewhere.
The old law allowed the procedure in the first 12 weeks of pregnancy only if a mother's health was at risk. In cases of rape, it was permitted through the 16th week. Only if abortion was the only way to save a woman's life was there no time restriction.
The center-left Socialist government hopes the new law will end dangerous backstreet abortions. Women's rights groups say about 10,000 women in the mostly Roman Catholic country are hospitalized every year with complications arising from botched, illegal abortions.
Hitachi Move the train with your brain
Fri, 22 Jun 2007 19:01:45 GMT
By HIROKO TABUCHI, Associated Press Writer
HATOYAMA, Japan - Forget the clicker: A new technology in Japan could let you control electronic devices without lifting a finger simply by reading brain activity.
The "brain-machine interface" developed by Hitachi Inc. analyzes slight changes in the brain's blood flow and translates brain motion into electric signals.
A cap connects by optical fibers to a mapping device, which links, in turn, to a toy train set via a control computer and motor during one recent demonstration at Hitachi's Advanced Research Laboratory in Hatoyama, just outside Tokyo.
"Take a deep breath and relax," said Kei Utsugi, a researcher, while demonstrating the device on Wednesday.
At his prompting, a reporter did simple calculations in her head, and the train sprang forward — apparently indicating activity in the brain's frontal cortex, which handles problem solving.
Activating that region of the brain — by doing sums or singing a song — is what makes the train run, according to Utsugi. When one stops the calculations, the train stops, too.
Underlying Hitachi's brain-machine interface is a technology called optical topography, which sends a small amount of infrared light through the brain's surface to map out changes in blood flow.
Although brain-machine interface technology has traditionally focused on medical uses, makers like Hitachi and Japanese automaker Honda Motor Co. have been racing to refine the technology for commercial application.
Hitachi's scientists are set to develop a brain TV remote controller letting users turn a TV on and off or switch channels by only thinking.
Honda, whose interface monitors the brain with an MRI machine like those used in hospitals, is keen to apply the interface to intelligent, next-generation automobiles.
The technology could one day replace remote controls and keyboards and perhaps help disabled people operate electric wheelchairs, beds or artificial limbs.
Initial uses would be helping people with paralyzing diseases communicate even after they have lost all control of their muscles.
Since 2005, Hitachi has sold a device based on optical topography that monitors brain activity in paralyzed patients so they can answer simple questions — for example, by doing mental calculations to indicate "yes" or thinking of nothing in particular to indicate "no."
"We are thinking of various kinds of applications," project leader Hideaki Koizumi said. "Locked-in patients can speak to other people by using this kind of brain machine interface."
A key advantage to Hitachi's technology is that sensors don't have to physically enter the brain. Earlier technologies developed by U.S. companies like Neural Signals Inc. required implanting a chip under the skull.
Still, major stumbling blocks remain.
Size is one issue, though Hitachi has developed a prototype compact headband and mapping machine that together weigh only about two pounds.
Another would be to tweak the interface to more accurately pick up on the correct signals while ignoring background brain activity.
Any brain-machine interface device for widespread use would be "a little further down the road," Koizumi said.
He added, however, that the technology is entertaining in itself and could easily be applied to toys.
"It's really fun to move a model train just by thinking," he said.
Canada39s first ambulance for obese patients on call
Fri, 22 Jun 2007 16:37:48 GMT
By Natalie Armstrong
TORONTO -
Obese patients in Calgary, Alberta, are
the first in Canada to have a new ambulance on call specially
modified to move them in a dignified and safe way while
protecting paramedics from injury.
The so-called &;bariatric response team&; is called in when
the patient weighs between 400 pounds and 1,000
pounds .
&;There's a high risk of injury for our staff... obviously,
the larger the patient, the higher the probability is,&; Paul
Lapointe, public education officer at Calgary's emergency
medical services, said on Thursday.
&;Dignity of the patients was a big thing for us as well.&;
The ambulance has C$30,000 worth of modifications
by a California-based company, including a hydraulic lift.
It also has an air mattress with tiny holes that blow air
out causing patients to be lifted slightly off the mattress,
making it easier to move them around.
Lapointe says he hopes Calgary's new ambulance will ensure
that there will never be shocking images of obese patients
being transported by trucks, as in the United States.
&;I don't think that's a very dignified way to go but there
was no other option in the past,&; said Lapointe, who once had
to create a make-shift ramp for an obese patient.
Statistics Canada says almost one-quarter of Canadians are
obese.
&;I do have a number of patients who are 500 pounds and up
and they normally cannot be transferred anywhere,&; Dr. David
Lau, a University of Calgary endocrinologist and president of
Obesity Canada, told the Globe and Mail newspaper.
&;It's important to let people know that overweight people
are no longer second-class citizens.&;
Calgary EMS has 16 trained paramedics to work on the new
ambulance and four to six of them are needed for each call.
Lapointe said there are no plans to have dispatchers asking
911 callers how much a patient weighs but acknowledged that not
knowing could &;most definitely&; cost time and lives.
&;There are a couple of patients that we do have on a
reoccurring basis that are about 600 pounds,&; Lapointe said.
Four percent of American adults never had sex
Fri, 22 Jun 2007 15:52:44 GMT
MIAMI -
Four percent of US adults have never had sex in their lives, and the figure climbs to 12 percent in the case of Mexican-Americans, according to an official survey out on Friday.
&;Approximately 96 percent of adults age 20-59 years have had sex, with the age group 20-29 having the lowest percent ,&; the Center for Disease Control and Prevention said in a report.
Eighty-eight percent of Mexican-American adults have had sex, a lower percentage than any other ethnic group.
The report also said 16 percent of adults first had sex before the age of 15, while 15 percent abstained from sex until age 21 or older.
The data was compiled between 1999 and 2002, the Atlanta-based CDC said.
Study links autism with growth hormones big heads
Fri, 22 Jun 2007 20:03:07 GMT
WASHINGTON -
Boys with autism and related
disorders had higher levels of growth hormones than other boys,
which may explain why children with the condition often have
larger heads, researchers reported on Friday.
Boys with autism and autism spectrum disorders were also
heavier than boys without these conditions, the teams at the
National Institutes of Health, the Centers for Disease Control
and Prevention and the Cincinnati Children's Hospital reported.
Other studies had already shown that children with autism
have very rapid head growth in early life.
&;The study authors have uncovered a promising new lead in
the quest to understand autism,&; said Dr. Duane Alexander,
Director of the National Institute of Child Health and Human
Development.
&;Future research will determine whether the higher hormone
levels the researchers observed are related to abnormal head
growth as well as to other features of autism,&; Alexander said
in a statement.
No one knows what causes autism, a complex developmental
disorder that includes problems with social interaction and
communication.
Symptoms range from mild awkwardness seen in Asperger's
syndrome, to severe disability and mental retardation. A recent
CDC survey found that 1 in every 150 U.S. children has autism
or an autism spectrum disorder, a less severe condition related
to autism, such as Asperger's.
Writing in the journal Clinical Endocrinology, Dr. James
Mills of the NICHD and colleagues said they compared the
height, weight, head circumference and levels of growth-related
hormones to growth and maturation in 71 boys with autism to a
group of 59 healthy boys.
The boys with autism had higher levels of two hormones that
directly regulate growth -- insulin-like growth factor-1 and
IGF-2. The boys also had higher levels of hormones that
indirectly affect growth.
The researchers did not measure the boys' levels of human
growth hormone, which for technical reasons is difficult to
evaluate.
The boys with autism and those with autism spectrum
disorders had a greater head circumference on average, weighed
more and had a higher body mass index than the other boys,
although there was no difference in height between the two
groups of boys.
Girls are much less likely to develop autism than boys, and
the researchers were unable to recruit enough girls with autism
to participate in the study.
Several genes have been linked with autism, but
environmental factors may also play a role, experts say.
