Monday, November 29, 2010

Paracetamol links to allergy/asthma in young children, study suggests

Links between early paracetamol use and the development of allergies and asthma in five and six year old children have been confirmed by health researchers at the University of Otago, Wellington.

The report by Professor Julian Crane is based on the New Zealand Asthma and Allergy Cohort Study. It investigated the use of paracetamol by 505 infants in Christchurch, and 914 five and six year olds in Wellington and Christchurch to see if they developed any signs of asthma or allergic sensitivity. The study has recently been published in Clinical and Experimental Allergy.

“The major finding is that children who used paracetamol before the age of 15 months (90%) were more than three times as likely to become sensitized to allergens and twice as likely to develop symptoms of asthma at six years old than children not using paracetamol,” says Professor Crane.


“However at present we don’t know why this might be so. We need clinical trials to see whether these associations are causal or not, and to clarify the use of this common medication.”


The research also found that by six years 95% of the study sample were using paracetamol and there was a significant increased risk for current asthma and wheeze. However the findings depended on how much paracetamol was being used, with the risk greater for those with severe asthma symptoms.


“The results at this stage are supportive of a role for paracetamol in asthma and allergic disease,” says Professor Crane.


However there may be many different mechanisms operating in the links between paracetamol and allergy/asthma researchers say. For instance it has been shown that fever in infancy may reduce allergy in childhood, and that paracetamol may affect antigen processing in the immune system early in life, or may be linked to free radical damage and enhancement of allergic inflammation and bronchospasm.


The University of Otago study concludes that although direct causation between paracetamol and allergy/asthma has not been established, neither has paracetamol been shown to have a beneficial effect on disease outcomes when used against fever, and guidelines for its use are unclear.


Provided by University of Otago
READ MORE - Paracetamol links to allergy/asthma in young children, study suggests

Botox Shots Approved for Migraine

The Food and Drug Administration approved Botox, the anti-wrinkle shot from Allergan, as a treatment to prevent chronic migraines, a little more than a month after the company agreed to pay $600 million to settle allegations that it had illegally marketed the drug for unapproved uses like headaches for years.
Allergan says sales of Botox for chronic migraine and other medical uses will eclipse sales of the drug as a wrinkle smoother. The agency’s decision endorses doctors’ use of Botox to treat patients who suffer from a severe form of migraine involving headaches on at least 15 days a month. Britain’s drug agency approved Botox for the same use this summer.
Botox is already approved by the F.D.A. to treat uncontrolled blinking; crossed eyes; certain neck muscle spasms; excessive underarm sweating; and stiffness associated with muscle spasticity in the elbows and hands. It also is approved for cosmetic purposes — to smooth lines between the eyebrows.
Botox had worldwide sales last year of about $1.3 billion, divided equally between medical and cosmetic uses.
But Allergan said sales of Botox for chronic migraine and other medical uses would soon eclipse sales of the drug as a wrinkle smoother. Allergan is also studying the drug for a variety of new medical uses, including overactive bladder, said Dr. Scott M. Whitcup, the company’s executive vice president for research and development.
“For the business, Botox has been an incredible medication. We call it our pipeline in a vial,” Dr. Whitcup said. “People still think about it as a cosmetic product, but the therapeutic indications in the next five years will far surpass its cosmetic use.”
Industry analysts have forecast worldwide sales of the drug for the severe migraine condition at $250 million to more than $1 billion annually by 2015.
Unlike the occasional headache, the chronic migraine condition is often accompanied by nausea, vomiting, dizziness, intense sensitivity to light and noise, and moderate to severe pain.
The audience for Botox headache shots could be significant because some chronic migraine patients do not improve when they take the pills that are now the standard treatment, neurologists said. Treatments include pills like Topamax, taken daily to prevent migraine, and the triptan family of drugs, taken to ease an existing migraine.
Botox is a purified form of botulinum toxin, a nerve poison produced by the bacteria that causes botulism. Injections of Botox typically act to temporarily blunt nerve signals to certain muscles or glands. Researchers are still exploring how the drug works on migraines. Dr. Whitcup said one theory was that it blocked pain signals from reaching nerve endings.
A Botox migraine treatment generally involves a total of 31 injections in seven areas — including the forehead, temples, the back of the head, the neck and shoulders. To treat the chronic condition, injections are given about every three months.
Industry analysts estimated that the migraine treatment would cost $1,000 to $2,000, depending on the amount of the drug used and the physician’s fee. Some private insurers are likely to cover the migraine treatment now that it has received F.D.A. approval, analysts said, although patients may have to cover a significant co-payment.
“The cost is prohibitive for some,” Randall Stanicky, a vice president for global research at Goldman Sachs, said in an interview earlier this year. “But given the debilitating challenges of having migraines more than 15 days a month, if Botox can cut down on that, it’s clearly going to be a big opportunity.”
Other analysts have expressed skepticism that doctors and patients would embrace the drug, arguing that Botox has a marginal effect on headaches compared with a placebo.
“The true drug effect is minimal,” Corey Davis, an analyst at Jefferies & Company, said in an interview earlier this year.
Patients in one study financed by Allergan, for example, typically experienced about five fewer headache episodes a month than they had before the study — no matter whether they had injections of Botox or a placebo.
After Allergan reviewed the results of that first study, the company changed the primary end point — the scientific goal post — on a second study so that it would focus on the drug’s effect on the number of headache days rather than the number of headache episodes that a person experienced each month. Dr. Whitcup said it was easier for patients to remember how many headache days as opposed to how many headache episodes they had every month.
The second study reported that patients who received Botox injections typically experienced about 2.3 fewer headache days than the placebo group, a statistically significant difference. But the placebo group also experienced considerable improvement — a common feature in pain studies — raising questions among some doctors about the magnitude of the Botox effect.
Dr. Whitcup said Botox had consistently beaten the placebo at different time points in the study and that patients had reported an improvement in their daily functioning and quality of life.
Although the F.D.A. approved the drug for the chronic condition, the agency said in its statement Friday that Botox had not been shown to work for the occasional headache or migraine.
Common side effects were neck pain and headaches. But neurologists point to a more welcome side effect for some — fewer wrinkles.
READ MORE - Botox Shots Approved for Migraine

Scientists identify gene linked to common birth defect in male genitalia

King's College London, in collaboration with Radboud University Nijmegen Medical Centre in The Netherlands, has discovered a new gene associated with Hypospadias, the congenital malformation of the male genitalia. The research was published today in Nature Genetics.

It was previously known that genetics play a part in developing the condition, with five percent of patients having an affected male relative, but the genes involved were unknown. This study shows for the first time that a gene inherited from the mother is likely to be important in development of the condition.

Hypospadias is a common congenital condition which affects around 1 in 375 boys. In these infants the urethral opening is not located at the tip of the penis, but somewhere halfway, at the base of the penis, or in the scrotum. Children with the condition typically undergo surgery between six and 18 months of age, but the malformation may have medical, psychological and sexual consequences later in life.

Dr Jo Knight, based at the Comprehensive Biomedical Research Centre at King's, assisted in the analysis of a genome-wide association study on 436 boys with hypospadias and 494 without the condition, which was undertaken by Loes van der Zanden and colleagues at Radboud University Nijmegen Medical Centre in The Netherlands.

The study revealed a strong association between changes in the DGKK gene and hypospadias. A boy with a modified DGKK gene has 2.5 times increased risk of being born with the condition compared to other boys. The DGKK gene is located on the X chromosome and is therefore inherited from the mother.

Dr Jo Knight said: 'Until now we knew very little about hypospadias and why some boys are born with the condition. We already knew that there was a greater chance of boys being born with hypospadias if a male relative has the condition, but this study shows that changes in the DGKK gene, found on the X chromosome and inherited from the mother, plays a major role in the development of the condition.

'But we still don't know exactly how this causes the condition, so there is more research to be done to look at other combinations of genes and environmental factors that might trigger the malformation.'

More information: Nature Genetics paper: 'Common variants in DGKK are strongly associated with risk of hypospadias'

Provided by King's College London
READ MORE - Scientists identify gene linked to common birth defect in male genitalia

Accuray's CyberKnife VSI System recognized as Best New Radiology Device of 2010

Accuray Incorporated (Nasdaq: ARAY), a global leader in the field of radiosurgery, announced today that the company's CyberKnife® VSI™ System received the 2010 Minnie for Best New Radiology Device from AuntMinnie.com, the largest and most comprehensive community internet site for radiologists and related professionals in the medical imaging industry. Accuray will be presented with the award at the 2010 Radiological Society of North America (RSNA) annual meeting taking place in Chicago, Ill. from November 28 – December 3, 2010.

"The Minnies awards have been an important barometer of excellence in radiology for the past 11 years," said Brian Casey, editor in chief of AuntMinnie.com. "We're pleased to recognize Accuray's CyberKnife VSI System as the Best New Radiology Device of the year."

Through Accuray's R&D commitment to clinically-driven product enhancements that meet the needs of its customers and improve patient care, the company announced the CyberKnife VSI System in November 2009. The CyberKnife VSI System leverages the versatility, simplicity, and intelligence of the CyberKnife System to broaden the range of treatment options physicians can offer their patients - from radiosurgery to conventionally fractionated Robotic IMRT™. By supporting this full spectrum of fractionation schemes, the CyberKnife VSI System allows for more customized treatment plans based on patient-specific situations and conditions, such as patients requiring re-irradiation of previously treated areas, or patients requiring partial breast irradiation. Cutting-edge product enhancements, including a world-class 1,000 MU/minute X-band linear accelerator and auto-segmentation capabilities, make planning and delivery simple, convenient and fast for routine clinical use.

"We are honored to receive this designation from such an influential industry publication," said Euan S. Thomson, Ph.D., president and CEO of Accuray. "The team at Accuray is incredibly proud of the CyberKnife VSI System and the benefits it brings to helping patients win their fight against cancer."

SOURCE Accuray Incorporated
READ MORE - Accuray's CyberKnife VSI System recognized as Best New Radiology Device of 2010

Walking Slows Cognitive Decline In Alzheimer's Patients And Healthy People

Walking five miles per week may protect the brain and slow cognitive decline in people with mild cognitive impairment (MCI) and Alzheimer's disease, said researchers at a conference of medical imaging professionals in Chicago on Sunday; they also found that walking six miles a week did the same for healthy people.

Dr Cyrus Raji, from the Department of Radiology at the University of Pittsburgh in Pennsylvania, presented the findings of a study where he and his colleagues analyzed changes in brain volume among adults with varying degrees of congnitive impairment, including some with Alzheimer's, and also healthy adults, whose weekly physical activity had been monitored in a cardiovascular study over the previous 10 years.

Speaking at the 96th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA), being held this week in Chicago, Raji said:

"We found that walking five miles per week protects the brain structure over 10 years in people with Alzheimer's and MCI [mild cognitive impairment], especially in areas of the brain's key memory and learning centers."

"We also found that these people had a slower decline in memory loss over five years," he added.

MCI, short for Mild Cognitive Impairment, is where a person has more problems with memory and thinking skills than is typical for their age, but it is not as severe as that found in Alzheimer's disease. About 50 per cent of people diagnosed with MCI progress to Alzheimer's disease.

The numbers of Americans with MCI and Alzheimer's is set to increase significantly over the next decade, based on current population trends.

There is no cure for Alzheimer's, which is why researchers like Raji and colleagues are keen to find ways to alleviate the symptoms and slow the progression of the disease in people whose thinking and memory are already showing signs of decline.

Raji and colleagues recruited participants from the Cardiovascular Health Study, which is still ongoing, and has been collecting data for 20 years, and analyzed the relationship between their physical activity and brain structure.

Their study involved 426 participants in all, comprising 127 cognitively impaired adults of average age 81 years, and 299 healthy adults of average age 78. Of the cognitively impaired participants, 83 had MCI and 44 had Alzheimer's dementia.

The study data allowed the researchers to measure how far participants walked in a week. Then 10 years later they performed 3D MRI scans of their brains to look for changes in brain volume.

Raji explained that:

"Volume is a vital sign for the brain."

"When it decreases, that means brain cells are dying. But when it remains higher, brain health is being maintained," he said.
READ MORE - Walking Slows Cognitive Decline In Alzheimer's Patients And Healthy People