* A new report concludes that the clot-dissolving drug tPA, if
administered more than three hours after the onset of a stroke,
drug can be ineffective or even harmful to patients.
- note: tPA, which was approved in 1996, significantly
improves the chance of complete survival from stroke
if given within three hours of stroke onset.
- researchers at the Oregon Health Sciences University
studied tPA use and patient outcomes in 542 stroke
victims to collect data.
- found no evidence of any benefit from the use of tPA
when the drug was administered after the three-hour
window, and that there was a measurable increase in the
risk of stroke worsening (7%) when the drug was used
late, including a 3% risk of early death.
- authors note that the study showed that late use of
tPA can cause dangerous bleeding in the brain.
- the report was presented by Oregon Health Sciences
University's Wayne Clark, M.D at the annual Stroke
Conference of the American Heart Association in
Nashville, Tennessee (February 4, 1999).
* A new study suggests that women treated for ovarian cancer
with platinum-based chemotherapy are at significantly increased
risk of developing leukemia.
- note: platinum-based chemotherapies are also used to treat
testicular, bladder, lung, endometrial and head and neck
cancers.
- researchers at the National Cancer Institute studied the
cases of more than 28,000 women worldwide diagnosed with
ovarian cancer between 1980 and 1993; 96 women later
developed leukemia, and these patients, along with 272
controls were studied further.
- found that women treated for ovarian cancer with platinum-
based chemotherapy were at between 2- and 8-times the
risk of developing leukemia, compared to women not so
treated; increased risk levels were correlated with
cumulative doses of platinum agents.
- authors note that other types of chemotherapy agents have
been linked to increase leukemia risk previously and
that it is still clear that the benefits of platinum-
based chemotherapy in this patient population far
outweigh the increased risk of leukemia.
- the study is in The New England Journal of Medicine
(1999;340:351-357).
*** Recall of clot-busting drug urged
WASHINGTON (AP) - Consumer advocates urged the government Wednesday
to immediately recall a clot-busting drug called Abbokinase because
it could be contaminated with such infections as hepatitis. The FDA
already has warned of the potential infection risk. Last month, the
agency urged doctors to use the numerous other clot-busters sold
instead, and to consider Abbokinase a last resort. The FDA had
suspended sales of Abbokinase in November to investigate whether
there were safety violations in manufacturing. But extensive sampling
of suspect Abbokinase failed to prove any contamination. See
http://www.infobeat.com/stories/cgi/story.cgi?id=2558402443-673
*** EKG abnormalities can mean trouble
CHICAGO (AP) - Seemingly minor abnormalities in electrocardiogram
readings may be an important predictor of death from heart disease, a
study found. Electrocardiograms measure the electrical impulses of
the heart. Men with repeated small abnormalities in a portion of
their EKG results called the ST-T wave segment were found to have an
increased risk of dying of heart trouble, researchers reported in
Wednesday's Journal of the American Medical Association. Doctors have
long been unsure what to make of such abnormalities in patients with
no other signs of heart disease. The researchers studied 1,673 men
who were 40 to 55 in 1957, when they became part of a long-term
heart-disease study. See
http://www.infobeat.com/stories/cgi/story.cgi?id=2558392305-184
* A recent study concludes that seemingly insignificant abnormal
readings from electrocardiograms may be indicators of increased
risk of death from heart disease.
- researchers at Chicago's Northwestern University Medical School
analyzed electrocardiogram (ECG) results from four consecutive
annual ECGs of 1,673 men to collect data.
- found that those men who had three or more occurrences
of abnormalities in the ST-T wave segment of their ECG
readings were at 2.5-times the risk of death due to heart
attack, coronary heart disease, or other types of cardiovascular
disease, compared to men with normal ECG tests.
- authors say the findings suggest that recurrent ST-T
abnormalities in middle-aged men indicate increased
mortality risk from coronary-related causes and may be
used to identify those patients who could benefit from
vigorous preventive management against the occurrence of
clinical coronary heart disease.
- the study is in The Journal of the American Medical
Association (1999;281:524-529).
* A recent study concludes that consuming high daily levels of
beta-carotene from fruits and vegetables appears to be associated
with a reduced risk of heart attack among the elderly.
- researchers at Erasmus University Medical School, the Netherlands,
studied the dietary and medical histories of 4,802 Dutch
persons, ages 55-95, over four years to collect data; 124
participants suffered a heart attack during the study period.
- found that those participants who consumed the highest daily
amounts of beta-carotene had a 45% reduced risk of heart
attack, compared to those with the lowest intake levels.
- authors further note that neither vitamins C nor vitamin E
were associated with a reduced risk of heart attack and
suggest that beta-carotene may protect against heart attack
by reducing levels of free radicals and inhibiting the
breakdown of fats.
- the study is in the American Journal of Clinical Nutrition
(1999;69:261-266).
[Like the studies with smokers, get your Vitamin A from food sources, not
beta-carotene]
* A recent study sought to examine the effectiveness of various
drug therapies for the control of heart rate in patients with
atrial fibrillation (AF).
- note: AF is characterized by the improper functioning of the
upper chambers of the heart and is known to be associated
with an increased risk of stroke.
- researchers at the VA Medical Center of West Los Angeles
treated 12 AF patients with each of five different drug
regimens for two weeks each to collect data; the regimens
were: digoxin alone, the beta-blocker atenolol, the calcium
channel blocker diltiazem; digoxin and atenolol; and digoxin
and diltiazem.
- found that the most commonly used therapy for controlling
heart rate in AF patients, digoxin alone, was among the
least effective therapies, and that the most effective
single-agent therapy was the beta-blocker atenolol.
- it was further found that treatment with a combination
of atenolol and digoxin "achieved almost ideal control of
the heart rate."
- the study is in the Journal of the American College of
Cardiology (1999;33).
"Transmission of Mycobacterium Tuberculosis From Patients
Smear-Negative for Acid-Fast Bacilli"
Lancet (02/06/99) Vol. 353, No. 9151, P. 444;
Behr, M.A.; Warren, S.A.; Salamon, H.; et al.
Data from an ongoing study of the molecular epidemiology of
tuberculosis in San Francisco indicates that TB transmission in
the city is due to patients with smear-negative, culture-positive
TB about 17 percent of the time. The researchers, led by M. A.
Behr of McGill University Health Center in Montreal, Canada,
analyzed data from DNA fingerprinting and microscopic examination
of acid-fast bacilli among 1,359 patients. The data showed that
the relative transmission rate of smear-negative patients was
0.22 compared with smear-positive patients. The authors note
that "while the use of sputum smear does identify the most
infectious patients, those with negative smears should not be
considered non-infectious."
* A recent study concludes that a significant percentage of infectious
tuberculosis patients are not detected using the current standard test.
- researchers at Stanford University studied data on 1,359 patients
diagnosed with tuberculosis (TB) in San Francisco since 1991
to collect data; patients were sorted into 71 disease clusters
according bacterial DNA fingerprints from their disease strain.
- analysis showed that at least 17% of cases studied were
contracted from a person who had tested negative for TB
infectious status.
- authors say the findings suggest that smear-negative patients
are being overlooked as a major source of TB infection and
could have significant implications for TB control procedures
worldwide.
- the study is in The Lancet (February 5, 1999).
*** Study links scars to breast cancer
(AP) - A microscopic change in breast tissue can help doctors predict
whether a woman whose biopsy is benign may develop cancer later. If
the tissue has an abnormality called a radial scar, the woman is
almost twice as likely to develop cancer, researchers in Boston
found. Under a microscope, normal breast tissue shows random clusters
of ducts. Radial scars have a core of what appears to be scarred
tissue surrounded by a cluster of ducts radiating outward. Some
studies found a link between radial scars and breast cancer; others
were inconclusive. The latest study looked at 1,396 women with benign
breast biopsies. Ninety-nine had radial scars. See
http://www.infobeat.com/stories/cgi/story.cgi?id=2558404750-84b
* A recent report concludes that a regimen of two treatments of
radiation daily, combined with chemotherapy, for small-cell lung
cancer is significantly more effective that standard therapy
that used one dose of radiation per day.
- researchers at the Medical University of South Carolina
randomized 417 small-cell lung cancer patients to either
one or two daily radiation treatments in combination with
the chemotherapy agents cisplatin plus etoposide to
collect data.
- found that 47% of patients treated with radiation twice
daily survived for two year and that 26% were still
alive at five years; those patients treated with
one dose of radiation daily had survival rates of
41% and 16% at two and five years, respectively.
- authors say the findings show that twice-daily
radiation in this patient population represents a
considerable improvement in survival rates over
previous results.
- the report is in The New England Journal of Medicine
(February 4, 1999).
* A recent report suggests that a test for the enzyme telomerase
may be the most reliable method for detecting bladder cancer.
- researchers at the Mayo Graduate School of Medicine in
Rochester, Minnesotta, compared the effectiveness of
the telomerase with the BTA stat test, which looks for
another cancer marker, in 57 bladder cancer patients
to collect data.
- found that, while BTA stat had a higher detection rate
than the telomerase test (74% vs. 70%, respectively),
analysis of false-positive readings found the telomerase
test to have an accuracy rate of 99%, compared to an accuracy
rate of 73% with the BTA stat test.
- authors note that bladder cancer is the fourth most commonly
diagnosed cancer in men, with an estimated 54,400 new cases
annually in the U.S.
- the report is in The Journal of Urology (February, 1999).
* A new report says that current evidence suggests that supplements
containing glucosamine could be recommended for use to relieve
arthritis-related pain when nonsteroidal anti-inflammatory drugs
(NSAIDs), such as aspirin and ibuprofen, are either ineffective
or cannot be taken safely.
- Dr. Randy Rosier of the University of Rochester, New York,
says most placebo-controlled clinical trials of glucosamine
have reported beneficial effects from the compound in
arthritis patients.
- the report notes that glucosamine is a component of
cartilage and that it is not regulated by the U.S. Food
and Drug Administration.
- Rosier further notes that use of glucosamine may cause side-
effects, particularly in diabetics or persons with certain
heart conditions.
- the report was presented by Dr. Rosier at the 66th annual
meeting of the American Academy of Orthopaedic Surgeons
in New York (February 8, 1999).
*** Diet industry given new guidelines
WASHINGTON (AP) - Some of the biggest names in the weight loss
business have pledged to give consumers looking to shed excess pounds
better information about how much diet products and programs will
cost, the risks involved and the benefits of even moderate weight
loss. A set of voluntary guidelines, released Wednesday by a group of
government, industry and health representatives, don't reach a
consensus on one of the most pressing questions - how many pounds
consumers can expect to lose - but they do urge the diet industry to
disclose more information to clients. "We are very happy that we have
gotten this far," said Lynn McAfee of the Philadelphia-based Council
on Size & Weight Discrimination. See
http://www.infobeat.com/stories/cgi/story.cgi?id=2558397831-032
* The U.S. Food and Drug Administration has granted marketing
approval to Seragen, Inc.'s denileukin diftitox (Ontak) for the
treatment of a rare slow-growing form of non-Hodgkin's lymphoma
known as cutaneous t-cell lymphoma (CTCL).
- Ontak is a biotechnology product known as a fusion protein
that is produced by combining proteins from the diphtheria
toxin to interleukin-2, an immune system protein.
- trial results submitted in support of the drug's
application for approval are reported to have shown
that 30% of CTCL patients treated with Ontak showed at
least a 50% reduction in tumor mass, with responses
lasting an average of four months.
- developers note that 10% of patients treated with the drug
achieved a complete clinical remission that lasted an average
of nine months and that Ontak therapy also affects normal
lymphocytes, resulting in an increased risk among patients
of severe infections.
- data taken from an FDA release, a copy of which is available
at: http://www.fda.gov/opacom/hpnews.html (February 5, 1999).
*** Drug co. stops work on cancer drug
PRINCETON, N.J. (AP) - Drug giant Bristol-Myers Squibb Co. had
withdrawn its backing from a drug previously touted for its apparent
cancer-fighting qualities. Angiostatin, a naturally occurring human
protein, was thrust into the spotlight last May when it was featured
in a front-page New York Times article. According to research by Dr.
Judah Folkman of Children's Hospital in Boston, the combination of
angiostatin and the drug endostatin was able to shrink tumors in mice
by cutting off the tumor's blood supply. Neither of the drugs have
been tested on people, however. But in a statement Tuesday,
Bristol-Myers cast doubt on whether the drug's future. See
http://www.infobeat.com/stories/cgi/story.cgi?id=2558396808-018 ***
Also: EntreMed stock plunges on drug drop, see
http://www.infobeat.com/stories/cgi/story.cgi?id=2558401572-c08
*** Anti-cancer drug to be tested
BOSTON (AP) - Government scientists have finally been able to
reproduce a scientist's highly publicized results for an anti-cancer
drug and are now seeking to begin the first human tests, The Boston
Globe reported Thursday. The breakthrough using the drug endostatin
came only when National Cancer Institute scientists conducted the
experiment in the Children's Hospital laboratory of researcher Dr.
Judah Folkman, who discovered it and found that it reduced tumors in
mice. Last fall, NCI scientists said they could not match Folkman's
promising test results using a small quantity of the drug Folkman
sent them. Folkman attributed the failure to the drug's sensitivity
to handling, storage and the way it's administered. See
http://www.infobeat.com/stories/cgi/story.cgi?id=2558415902-fe8
* The U.S. Food and Drug Administration has granted marketing
approval to Ligand Pharmaceuticals Inc.'s Panretin(R) gel
(alitretinoin) 0.1% for the treatment of cutaneous Kaposi's
sarcoma (KS) lesions in AIDS patients.
- note: KS is a type of skin cancer that commonly occurs
in AIDS patients.
- Panretin is the first patient-applied treatment for
AIDS-related KS.
- trial results submitted in support of the drug's
application for approval are reported to have shown
that 35% of patients treated with Panretin gel
experienced complete or partial responses.
- developers note that Panretin gel was generally
well tolerated in studies, but that skin toxicity,
swelling, and blistering led to 7% of patients
withdrawing from studies.
- data taken from a Ligand Pharmaceuticals release
(February 3, 1999).
* A recent report concludes that HIV can survive for more than
a month in used syringes at room temperature.
- researchers at Yale University used specialized assays to
study the small amount of blood that usually remains in
syringes after use by injection drug users.
- found that viable, proliferating HIV-1 was obtainable
from syringes that had been maintained at room temperature
in excess of four weeks.
- authors say the findings support the need for syringe
exchange programs and used syringe disposal schemes.
- the study is in the Journal of Acquired Immune Deficiency
Syndromes and Human Retrovirology (1999;20:73-80).
"Good News, Bad News for Patients With AIDS"
Washington Times (02/09/99) P. A1; Larson,
Ruth
The availability of potent anti-HIV drugs is allowing many AIDS
patients to live longer, but with that change also comes several
new problems. Statistics show that between 1996 and 1997, the
number of AIDS-related deaths fell 47 percent. Furthermore,
between 1995 and 1998, AIDS-related deaths among homosexual men
number of AIDS-related deaths fell 47 percent. Furthermore,
between 1995 and 1998, AIDS-related deaths among homosexual men
dropped by 81 percent, and by 60 percent among heterosexuals,
Johns Hopkins University researchers report. Dr. Anthony Fauci,
head of the National Institute of Allergy and Infectious
Diseases, notes that with the new drugs, "there is less
suppression of the immune response, or the immune system is able
to rebound to fight the virus." However, Fauci notes that the
drugs do not completely suppress HIV and that the AIDS cocktails
require patients to follow a complex regimen and special diets.
Some individuals have also been lulled into a sense of
complacency because of the drugs, especially sexually active
youths. New cases of HIV infection are on the rise, with half of
the 40,000 new cases each year reported among individuals under
age 25.
* A recent report discussed quantified long-term results from
triple-combination HIV/AIDS therapy consisting of Crixivan(R)
(indinavir), zidovudine(AZT), and 3TC.
- Cornell University researchers say a 148-week follow-up
study of 33 patients treated with the combination found
that 67% of treated patients maintained viral loads below the
level of detection, with a median increase in CD4 cell counts
of 198 cells/mm3.
- authors note that the baseline median HIV RNA count was
41,900 copies/ml and that those patients who maintained
viral loads below the level of detection had fewer than
500 copies/ml.
- the report says the data represent the longest-term
information available since the introduction of protease
inhibitors for HIV treatment in 1996.
- the report was presented by Cornell University's
Dr. Roy Gulick at the sixth conference on Retroviruses and
Opportunistic Infections in Chicago (February 8, 1999).
"Protease Inhibitors Linked With 'Dramatic' Increase in Oral
Warts"
Reuters Health Information Services (02/08/99)
University of California at San Francisco researchers have found
that, since the advent of protease inhibitors, oral warts have
become a growing problem among HIV-infected individuals. The
researchers, who presented their findings last week at the 6th
Conference on Retroviruses and Opportunistic Infections, noted an
overall decline in the incidence of most common oral lesions in
HIV-infected patients, including hairy leukoplakia and oral
candidiasis. However, the scientists also observed a substantial
increase in oral warts, primarily linked to protease inhibitor
use.
"Vits Help the Rits Go Down"
POZ (02/99) No. 44, P. 75;
Lands, Lark
Rhode Island researchers have found that taking vitamins in
conjunction with ritonavir may increase patient tolerance to the
drug. The protease inhibitor can cause gastrointestinal symptoms
that may lead to drug discontinuation. The scientists, who
studied 322 tolerant and intolerant patients, found that dosage
was a factor in drug tolerance. They also discovered that those
patients with pre-existing micronutrient deficiencies and lower
body fat were more likely to be intolerant of the drug.
Fifty-eight percent of the intolerant patients showed
micronutrient deficiency, compared to 27 percent of tolerant
patients. Additionally, only 32 percent of the intolerant group
took vitamin supplements, compared to 69 percent of drug-tolerant
patients. The researchers measured for vitamins C, E, B-12,
folic acid, and beta-carotene.
------------------------------------------------------------------------
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Datafellows http://www.datafellows.com/vir-info/
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* Evaluating Internet Research Sources at
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* Evaluation of Information Sources at
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