Huntington’s disease (HD) is a genetic neurological disorder characterized by abnormal body movements called chorea and a lack of coordination; it also affects a number of mental abilities and some aspects of behavior. In more advanced stages it can cause complications that significantly reduce life expectancy.
The disorder is named after George Huntington, the American physician who first described it in 1872. Just over 120 years later, the altered gene that causes HD was discovered, making it one of the first inherited genetic disorders for which an accurate test could be performed. Because of this, and because of the characteristics the disorder shares with some other neurological disorders, it has been extensively researched since then.
Now, you can count a drug for HD among the priorities of researchers. | LINK
In earlier times (throughout the last 15 years or so), the use of telemedicine was relegated to inferior analog video technologies. It was often seen as an “interesting” curiosity to those global thinkers in healthcare delivery as the Next Big Thing. Of course, that sentiment is not to detract from the effect that telemedical devices have shown both in the late 1990s and in the earlier part of this decade — as it bridged the treatment gap between patients in more remote areas with those in urban, tertiary care centers.
But all previous incarnations of telemedical communication will certainly take a backseat to the now-confirmed potential of telemedical conferencing via broadband Internet and intranet networks. The medical journal, Lancet, is out with a study involving the emergent treatment of stroke patients that will have medical device companies involved in its development salivating with the potential of their Next Big Thing. | LINK
You’ve got to be asking yourself if medical device companies are going to feel the effects of this finding: the utilization of coronary stents in the treatment of heart disease becomes less crucial the longer the patient survives this particular diagnosis; that is, the role of medical (non-surgical) therapy leads to — at the very least — equivalent outcomes in the long run. According to the NEJM:
The equivalent benefit seen after 36 months for optimal medical therapy alone, reported in the Aug. 14 issue of the New England Journal of Medicine, was the latest finding to emerge from the 2,287-patient COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) trial. It was designed to compare the efficacy of [stenting vs. optimal medical therapy].
[…]
In the stent group, patients who had the most severe angina at baseline received the greatest benefit….The incremental benefit for stenting was apparent for six to 24 months, and then the two groups began to converge because “there was significant and rapid improvement in Seattle Angina Questionnaire scores among patients in the medical therapy group,” wrote Dr. Weintraub and colleagues.
LINK
Although this data comes from a peer reviewed specialty journal whose catchment is not exactly in the medical mainstream, its findings are no less compelling.
The American Physical Therapy Association (APTA) concurs with findings from a recent study published in Spine (Volume 33, Number 16) demonstrating that active physical therapy for patients with acute low back pain is associated with better clinical outcomes, decreased use of prescription medications, MRI and epidural injections, and lower healthcare costs than passive physical therapy.
Physical therapist management is a low-cost, high-value alternative to medication and surgery to deal with certain musculoskeletal pain. According to Fritz, “Considering that low back pain will affect between sixty and eighty percent of Americans during their lifetime, the potential cost savings of an early, effective intervention to prevent individuals from progressing to chronic disability may be considerable.”
Can we bottle this? | LINK
- A case study in greed? Minute clinics saturate the healthcare marketplace.
- Minn.-based Allina hospital cited for safety violations.
A patient having heart pacemaker surgery at Abbott Northwestern Hospital was burned on her face, lips and shoulder when a fire burst out from under the sterile drapes covering her body. Doctors and nurses immediately doused the fire and completed the surgery, according to a state investigative report made public Monday.
State health investigators found that the hospital violated safety and procedural policies that contributed to the June 24 incident. The unidentified patient, who was lightly sedated, woke up when the fire ignited and “was very frightened,” according to the report. She suffered first- and second-degree burns, and was kept in the hospital for two days after the accident.
- Federal panel: stop prostate exams at 75 years of age.
Most oncologists already argue against treating most men in that age group for prostate cancer because they are more likely to die from some other cause than from their tumor. The new guidelines go one step further, saying, in effect, why test if the patient is unlikely to be treated? The guidelines, published in the Annals of Internal Medicine, are only recommendations, but they are relied on by many physicians in determining patient care. The recommendations could therefore trigger a decline in prostate cancer testing in the elderly. The recommendations provoked a backlash from some experts.
- So much for privacy concerns. Apparently more UCLA Medical Center employees helped themselves to celebrities’ medical records.
- Can estrogens relieve psychosis in women with schizophrenia?
Schizophrenic women who get an estrogen patch along with their regular antipsychotic medications have fewer symptoms than women who get inactive placebo patches. The finding, from a four-week study of 102 women of childbearing age with schizophrenia, comes from Jayashri Kulkarni, MBBS, PhD, and colleagues at Monash University in Melbourne, Australia. During her psychiatric training, Kulkarni spoke with many schizophrenic women who kept telling her, “It’s my hormones, Doc.” They also told her, “No one takes any notice when I say that it’s to do with my hormones.” Kulkarni took notice. She and her colleagues have now completed a series of small studies showing that estrogen can be very effective in reducing symptoms such as delusions, hallucinations, and disordered thinking.
- What to the Democrats think of Obama’s message of healthcare reform? Why, they’re all for it.
- Since 2000, the World Bank has spent over $1.6B to combat AIDS-related illness in Africa. But is it enough?
On the heels of a call to arms by various organizations and think tanks to meet the HIV/AIDS crisis head on in the African-American community, comes news from the CDC that, overall, almost 60 000 people become infected with the virus annually in this country. As methods for detection of the virus have become more rapid and precise, the sobering realization that the epidemic is worse than previously thought is starting to set in for epidemiologists and activists alike. | LINK
- There’s a new technique for culturing neurons, the functional units of the nervous system; it may shed light on the origins of amyotrophic lateral sclerosis (Lou Gehrig’s disease).
The new cells were derived from 3-millimeter patches of skin removed from the arm of an 82-year-old woman and her 89-year-old sister, who share a rare genetic mutation that causes about 2% of ALS cases.
The scientists from Harvard University and Columbia University focused on the rare form of ALS in part to test whether cells from elderly patients could be reprogrammed, said biologist Kevin Eggan of the Harvard Stem Cell Institute.
“This opens the door to being able to make patient-specific stem cell lines from diseases which affect people very late in life, like Parkinson’s disease or Alzheimer’s disease,” said Eggan, the study’s senior author.
- The race to the finish line for anti-Alzheimer drug development may prove to be a risky proposition for pharma and its research.
- The House of Representatives moves to give the FDA power to regulate tobacco products. Great news.
- CMS: Medicare payment rates to long term care facilities to increase by over three quarters of a billion dollars next year.
Medicare payment rates to nursing homes will increase by $780 million next year, the Centers for Medicare & Medicaid Services (CMS) announced.
The boost in payments is the result of a 3.4 percent increase in the annual market basket calculation of the cost of goods and services included in a skilled nursing facility stay.
- Michigan physicians are upset over EPA’s decision to allow the state to use a certain antibiotic to “treat” diseased apples.
Explaining that the findings represent “just the tip of the iceberg,” biochemical researchers detailing results in a schizophrenia study note that some of that mental illness’s most devastating effects may come from three discrete deletions in the human genome. Genetic changes in the DNA of schizophrenics were compared to the DNA of normal controls. The genetic mutations apparently occurred in approximately 1% of study subjects, a figure roughly equal to the prevalence of the disorder in the general population. | LINK
Ready for prime time by 2012? That’s what some researchers are saying about the anti-Alzheimer drug in the second stage of its development. The investigational drug is the first to attack the chronic degenerative disease at its core: the formation of proteinaceous neurotoxins (tau proteins) which are pathognomonic for the disorder. Early data show absolutely no decline in patients’ cognitive functioning over six months while on the drug — something not possible by the current crop of FDA approved agents for dementia (as cognitive decline is slowed, but not absolutely halted). | LINK
Early news from another trial involving former blockbuster drug Vytorin will not be good for investors and its parent Pharma company.
The combination was significantly more effective than placebo in reducing the risk of ischemic events, a secondary composite end point of nonfatal MI, coronary artery bypass graft (CABG) surgery, PCI, hospitalization for unstable angina, nonhemorrhagic stroke, and cardiovascular death. Vytorin failed to meet a secondary goal of improving aortic-valve disease events, which included valve-replacement surgery, hospitalization because of heart failure, and cardiovascular mortality.
“The SEAS study has given a clear-cut answer to the question of whether intensive lipid lowering will influence the course of aortic-stenosis disease. I think we can conclude that it does not,” announced Dr Terje Pedersen (Ulleval University Hospital, Oslo, Norway), chair of the steering committee, during a conference call today with the media. “We have also shown there is benefit in treating such patients with the study drug combination, as we saw a reduction in the risk of coronary artery disease.”
You may recall that Vytorin encountered hot water (and its market share took a big hit) when a previous scientific trial showed no difference between this combination drug and simvastatin (one of Vytorin’s component agents) alone in the treatment of coronary artery disease and prevention of its adverse outcomes. | LINK | Previous Doctor Pundit coverage here.
Here they are. Quick and dirty as I have a BBQ to attend!
