Monday, March 17, 2008

New hope in fight against Alzheimer's

AUSTRALIAN researchers have discovered a drug that could delay the onset of Alzheimer's disease and improve quality of life for sufferers. A trial of 78 people conducted in Sydney, Melbourne and Sweden showed patients who took the drug for 12 weeks had a significant improvement in their ability to plan and carry out everyday activities. Professor Colin Masters, from the Mental Health Research Institute of Victoria at the University of Melbourne, said the drug could be the first to slow or reverse the early effects of Alzheimer's disease. "Disease modification, where you modify or slow down the rate of decline, is the holy grail because you can potentially delay the onset of the disease if you get in early," he said.

Dementia affects 220,000 Australians. That figure is expected to rise to 731,000 by 2050. Alzheimer's Australia executive director Glenn Rees said scientific modelling showed the ability to delay the progression of dementia by five years would halve the number of people with the disease by 2040. He said current medications could be used to treat the symptoms of dementia, such as memory loss, but they did not slow or stop the progression of the disease.

A survey of 1380 people released last month by Alzheimer's Australia and drug company Pfizer found three-quarters of those would take a test predicting their likelihood of developing the disease, if it was available. Mr Rees said a predictive test would only be useful if medication was available to treat those at risk.

The experimental drug, PBT2, reduced the amount of a protein associated with Alzheimer's in the cerebrospinal fluid, compared to the placebo. Melbourne University spin-off company Prana Biotechnology plans a larger clinical trial.

Israeli researchers last week said memory loss could be slowed significantly in mice by one of the 400 chemicals present in marijuana, called cannabidiol, which could have ramifications for Alzheimer's sufferers.


Blood clot pill approved in Britain

A daily pill that could help to prevent tens of thousands of deaths due to blood clots will be available to hospitals within weeks. The condition, venous thrombo-embolism (VTE), causes one in ten fatalities in hospital and kills at least 25,000 people in England every year, more than 20 times the number of deaths attributed to the superbug MRSA.

Pradaxa, the first new blood-thinning treatment in more than 50 years, is set to receive its licence next month. It will be used initially after hip and knee replacement surgery when the risk of blood clotting is high. But doctors hope that the anticoagulant pill could also be used to treat thousands of other patients at risk from heart conditions and strokes.

As many as half of all patients going into hospital risk developing VTE, which occurs when part of a deep-vein thrombosis or blood clot migrates to the lungs, heart or brain, with potentially deadly consequences. Such clotting is common after surgery, especially in the elderly, the overweight or those confined to bed for more than three days.

Last year the National Institute for Health and Clinical Excellence (NICE) issued guidelines recommending that all patients should be assessed on admission to hospital for their risk of developing VTE but an audit by the all-party parliamentary thrombosis group in November found that less than a third of hospitals were doing so. Of those who were screened, only half the patients deemed at risk were receiving preventive treatment, a study published in The Lancet last month suggested.

A report by Sir Liam Donaldson, the Chief Medical Officer, admitted that "there was no systematic approach to identifying and treating those patients at risk from blood clots in hospitals and that there was significant room for improvement". At present, many hospital patients at risk of blood clots are given warfarin, which was licensed in the 1950s. Warfarin is effective but can trigger excessive internal bleeding. An alternative drug, heparin, involves a lengthy course of injections.

Preliminary results from a trial involving 34,000 patients suggest that Pradaxa is as effective in preventing clotting as existing treatments but it should be cheaper and easier to take. It works by reversing and inhibiting the effects of thrombin, a protein that allows clots to form after surgery.

Produced by the German company Boehringer Ingelheim, the drug is being evaluated by NICE and if approved it could be available to NHS patients within weeks. Another anticoagulant, Xarelto, is in development by Bayer, with preliminary results suggesting that it could be even more effective than Pradaxa.

Simon Frostick, a specialist in orthopaedics at the University of Liverpool, said: "These new drugs will revolutionise the way we prevent and treat blood clots. "Given the new trend for shorter hospital stays following joint replacement surgery, it is becoming increasingly important to have anticoagulant treatments available which are well tolerated and easy to use."

Beverley Hunt, medical director of the UK thrombosis charity Lifeblood, said: "The number of deaths from VTE is nothing short of a public health emergency. "The development of new drugs to treat this problem is terribly exciting. The potential benefit to the NHS is enormous."

Between 1995 and 2003, the NHS Litigation Authority handled more than 450 claims of negligence after patients developed VTE in hospital. It paid out almost 19 million pounds in compensation to sufferers or their bereaved families.

Professor Frostick added: "If these drugs reduce the number of deaths, the requirement for injections and community nurses, as well as other burdens - and if the proper sums are done - they should work out to be cost-effective for the NHS."



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

9). And how odd it is that we never hear of the huge American study which showed that women who eat lots of veggies have an INCREASED risk of stomach cancer? So the official recommendation to eat five lots of veggies every day might just be creating lots of cancer for the future! It's as plausible (i.e. not very) as all the other dietary "wisdom" we read about fat etc.

10). And will "this generation of Western children be the first in history to lead shorter lives than their parents did"? This is another anti-fat scare that emanates from a much-cited editorial in a prominent medical journal that said so. Yet this editorial offered no statistical basis for its opinion -- an opinion that flies directly in the face of the available evidence.

Even statistical correlations far stronger than anything found in medical research may disappear if more data is used. A remarkable example from Sociology:
"The modern literature on hate crimes began with a remarkable 1933 book by Arthur Raper titled The Tragedy of Lynching. Raper assembled data on the number of lynchings each year in the South and on the price of an acre's yield of cotton. He calculated the correlation coefficient between the two series at -0.532. In other words, when the economy was doing well, the number of lynchings was lower.... In 2001, Donald Green, Laurence McFalls, and Jennifer Smith published a paper that demolished the alleged connection between economic conditions and lynchings in Raper's data. Raper had the misfortune of stopping his analysis in 1929. After the Great Depression hit, the price of cotton plummeted and economic conditions deteriorated, yet lynchings continued to fall. The correlation disappeared altogether when more years of data were added."
So we must be sure to base our conclusions on ALL the data. But in medical research, data selectivity and the "overlooking" of discordant research findings is epidemic.

"What we should be doing is monitoring children from birth so we can detect any deviations from the norm at an early stage and action can be taken". Who said that? Joe Stalin? Adolf Hitler? Orwell's "Big Brother"? The Spanish Inquisition? Generalissimo Francisco Franco Bahamonde? None of those. It was Dr Colin Waine, chairman of Britain's National Obesity Forum. What a fine fellow!


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