joi, 15 decembrie 2011

Caffeine Study Shows Sport Performance Increase

Main Category: Sports Medicine / Fitness
Also Included In: Nutrition / Diet
Article Date: 15 Dec 2011 - 2:00 PST

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Caffeine combined with carbohydrate could be used to help athletes perform better on the field, according to new research by a sport nutrition expert.

Mayur Ranchordas, a senior lecturer and performance nutritionist at Sheffield Hallam University, carried out studies on footballers using caffeine and carbohydrates combined in a drink. Along with improvements in endurance caused by ingesting carbohydrate, the athletes' skill level improved after taking caffeine and carbohydrate together.

Mayur said: "There is already plenty of research that shows that caffeine and carbohydrate improve endurance, but this study shows that there is also a positive effect on skill and performance.

"We carried out three different soccer-specific match simulations of 90 minutes each two 45 minute sessions that tested agility, dribbling, heading and kicking accuracy. The test was designed to mimic a football game where the participants had to carry out multiple repeated sprints, dribble the ball around cones and shoot accurately.

"We found that the combination of carbohydrate and caffeine allowed players to sustain higher work intensity for the sprints, as well as improving shooting accuracy and dribbling during simulated soccer activity.

"These findings suggest that, for athletes competing in team sports where endurance and skill are important factors, ingesting a carbohydrate and caffeine drink, as opposed to just a carbohydrate drink, may significantly enhance performance. Our findings suggest that soccer players should choose a carbohydrate caffeine drink over a carbohydrate drink to consume before kick off and at half-time."

Article adapted by Medical News Today from original press release. Source: Sheffield Hallam University
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Biopsy Referral After PSA Screening Stays Consistent Over Time

Main Category: Prostate / Prostate Cancer
Article Date: 15 Dec 2011 - 0:00 PST

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After the US Prostate Cancer Prevention Trial found cancer in many men with low levels of prostate specific antigen (PSA), many debated which PSA level should lead to a biopsy recommendation. The US Preventive Screening Task Force (USPSTF) recently concluded, amid considerable controversy, that the evidence does not support recommending PSA screening for men under 75 years old at all, because the risks outweigh the benefits. Now, a study shows that physicians in a large Washington state health plan were being conservative in biopsy referral even before the USPSTF recommendation.

"Despite considerable recent debate about lowering the threshold for referring men to biopsy, we detected no change toward more aggressive biopsy referral practices in data spanning more than a decade for one integrated delivery system," says lead author Steven Zeliadt, PhD, of the Department of Veterans Affairs Medical Center in Seattle, Washington. "In fact, we observed an opposite pattern, with biopsies becoming slightly less common over the study period. This may reflect growing awareness of the problems of overdiagnosis and overtreatment - and the fact that many men die with prostate cancer but not from it."

Controversy is longstanding about what PSA threshold should be used to refer men for biopsy. The generally accepted standard is 4.0 ng/mL. However, some have urged lowering the level to 2.5 ng/mL, abandoning a specific cutoff altogether, or measuring the PSA velocity, or change over time, instead of absolute level. Dr. Zeliadt and his colleagues set out to determine if the actual biopsy referral practices in a community setting had changed in response to new recommendations, and to determine if PSA velocity is associated with follow-up biopsy.

The study examined PSA tests in members of Group Health, a health plan in Washington State and Northern Idaho, between 1997 and 2008. The final sample included 111,369 index tests among 54,831 subjects. For each test, the study evaluated the PSA level and velocity and the specific follow-up: receiving a biopsy within a year after the test date; attending a urology appointment within a year without biopsy; additional PSA testing within a year with no urology visit; and no PSA-related follow-up.

The researchers found that of tests with a PSA value greater than 4.0 ng/mL, 28% led to a biopsy within 12 months, and 38.6% were followed up by a urologist but did not result in a biopsy. Biopsies were slightly more common in the early years of the study, but biopsy rates did not differ over time for men with mild to moderate PSA levels. The threshold used for biopsy referral appeared not to change over time.

PSA velocity was strongly associated with biopsy. Among men whose PSA tests exceeded 4.0 ng/mL, those with a rapidly rising velocity were more likely to undergo biopsy. This rate was also consistent across the years of the study. "PSA velocity has been promoted for many years as having value for predicting death from prostate cancer, although several recent studies and evidence from screening trials have demonstrated that in practice, velocity adds little value. This is not surprising given that PSA is a continuous marker, and a rapid rise may be likely to trigger follow-up, thus reducing rates of death from prostate cancer," notes Dr. Zeliadt.

"Even small changes in the PSA threshold can substantially alter the potential harms and benefits of screening. However, providers have limited evidence to help them discuss this with patients," concludes Dr. Zeliadt, who is also affiliated with Group Health Research Institute and the University of Washington. "This study highlights the importance of acknowledging that how aggressively patients are referred for biopsy is an important component of the PSA screening discussion."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our prostate / prostate cancer section for the latest news on this subject. The article is "Biopsy Follow-Up of Prostate-Specific Antigen Tests," by S.B. Zeliadt, D.S. Buist, R.J. Reid, D.C. Grossman, J. Ma, and R. Etzioni (doi: 10.1016/j.amepre.2011.08.024). The article appears in the American Journal of Preventive Medicine, Volume 42, Issue 1 (January 2012), published by Elsevier.
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Biochemical Signature Predicts Progression To Alzheimer's Disease

Main Category: Alzheimer's / Dementia
Also Included In: Biology / Biochemistry
Article Date: 15 Dec 2011 - 1:00 PST

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A study led by Research Professor Matej Oresic from VTT Technical Research Centre of Finland suggests that Alzheimer's disease is preceded by a molecular signature indicative of hypoxia and up-regulated pentose phosphate pathway. This indicator can be analysed as a simple biochemical assay from a serum sample months or even years before the first symptoms of the disease occur. In a healthcare setting, the application of such an assay could therefore complement the neurocognitive assessment by the medical doctor and could be applied to identify the at-risk patients in need of further comprehensive follow-up.

Alzheimer's disease (AD) is a growing challenge to the health care systems and economies of developed countries with millions of patients suffering from this disease and increasing numbers of new cases diagnosed annually with the increasing ageing of populations.

The progression of Alzheimer's disease (AD) is gradual, with the subclinical stage of illness believed to span several decades. The pre-dementia stage, also termed mild cognitive impairment (MCI), is characterised by subtle symptoms that may affect complex daily activities. MCI is considered as a transition phase between normal aging and AD. MCI confers an increased risk of developing AD, although the state is heterogeneous with several possible outcomes, including even improvement back to normal cognition.

What are the molecular changes and processes which define those MCI patients who are at high risk of developing AD? The teams led by Matej Orešic from VTT and Hilkka Soininen from the University of Eastern Finland set out to address this question, and the results were published on 13th Dec. 2011 in Translational Psychiatry.

The team used metabolomics, a high-throughput method for detecting small metabolites, to produce profiles of the serum metabolites associated with progression to AD. Serum samples were collected at baseline when the patients were diagnosed with AD, MCI, or identified as healthy controls. 52 out of 143 MCI patients progressed to AD during the follow-up period of 27 months on average. A molecular signature comprising three metabolites measured at baseline was derived which was predictive of progression to AD. Furthermore, analysis of data in the context of metabolic pathways revealed that pentose phosphate pathway was associated with progression to AD, also implicating the role of hypoxia and oxidative stress as early disease processes.

The unique study setting allowed the researchers to identify the patients diagnosed with MCI at baseline who later progressed to AD and to derive the molecular signature which can identify such patients at baseline.

Though there is no current therapy to prevent AD, early disease detection is vital both for delaying the onset of the disease through pharmacological treatment and/or lifestyle changes and for assessing the efficacy of potential AD therapeutic agents. The elucidation of early metabolic pathways associated with progression to Alzheimer's disease may also help in identifying new therapeutic avenues.

Article adapted by Medical News Today from original press release. Source: Technical Research Centre of Finland
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Using A Restrictive Approach In Post-Surgical Blood Transfusions Is Safe And Saves Blood

Main Category: Transplants / Organ Donations
Also Included In: Blood / Hematology
Article Date: 15 Dec 2011 - 2:00 PST

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New research published online in advance of print in the New England Journal of Medicine could refine the way that post-operative patients are cared for while preserving blood supply levels, an essential resource that is difficult to maintain at necessary quantities throughout the year. The study, led by researchers at UMDNJ-Robert Wood Johnson Medical School, shows that using a liberal blood transfusion strategy in post-operative hip-surgery patients did not appear to improve patients' recoveries or reduce the rate of death, suggesting therefore, that utilizing a restrictive transfusion approach would be appropriate patient care and conserve blood.

"The need for, and the quantity of, transfusion of red blood cells in post-operative patients is controversial, but has not previously been evaluated in a large study," said Jeffrey L. Carson, MD, the Richard C. Reynolds Professor of Medicine and study chair of the Transfusion Trigger Trial for Functional Outcomes in Cardiovascular Patients Undergoing Surgical Hip Fracture Repair, known as the FOCUS trial. "Our research shows that using a more restrictive transfusion approach could become the standard of care for post-orthopedic surgical, high-risk patients with underlying cardiovascular disease and save blood a precious resource."

The study examined more than 2,000 high-risk patients, with a mean age of 82, with underlying cardiovascular disease or risk factors, and hemoglobin levels below 10 grams per deciliter, after hip surgery. Hemoglobin (Hb or Hgb) is the main component of red blood cells that carries oxygen throughout the body and is normally greater than 12 to 13 grams per deciliter. Patients commonly have a low hemoglobin level after surgery that results from bleeding and often receive red blood cell transfusion as treatment. However, the optimal level of hemoglobin at which blood transfusion should be administered has been unknown.

"This clinical trial is unique in that all patients were considered very high risk due to age and prior history of cardiovascular disease, including myocardial infarction (heart attack), or risk factors for heart disease," said Dr. Carson.

Patients were randomly assigned a liberal transfusion strategy (transfusion if hemoglobin was less than 10 grams per deciliter) or a restrictive transfusion strategy (transfusion if hemoglobin was less than 8 grams per deciliter). Patients in the restrictive group also received a transfusion if they exhibited symptoms of anemia including chest pain, congestive heart failure or unexplained excessive heart rate. At 30 and 60 days post-surgery, there was no difference between the groups in the patients' inability to walk without assistance nor was there a significant difference in the rate of death or heart attacks. Because the liberal transfusion strategy did not provide a benefit to patient outcomes as compared with the restrictive strategy, the study suggests that less blood transfusion may be appropriate and does not detrimentally affect patients' recovery after surgery.

The FOCUS Trial was funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health. The study results, "Liberal or Restrictive Transfusion in High-risk Patients after Hip Surgery", were published online today. Dr. Carson's team of researchers at Robert Wood Johnson Medical School included: Helaine Noveck, MPH, deputy director, Clinical Coordinating Center; George G. Rhoads, MD, MPH, interim dean and professor at UMDNJ-School of Public Health; and Karen Dragert, RN, lead research nurse. He was assisted by investigators at the University of Maryland School of Medicine (Michael L. Terrin, MD, MPH, principal investigator, Data Coordinating Center, and Jay Magaziner, PhD, MSHyg) and from 47 hospitals in the United States and Canada.

Article adapted by Medical News Today from original press release. Source: Springer Science+Business Media
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Pharmaceutical Portfolio & Product Lifecycle Management Conference, 18-19 April 2012

Main Category: Conferences
Also Included In: Pharma Industry / Biotech Industry
Article Date: 15 Dec 2011 - 1:00 PST

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With declining R&D costs, prioritizing a portfolio of successful projects has become essential within the pharmaceutical industry. Lifecycle management approaches must be implemented throughout a products developmental and market period to ensure an increase in profit. Ultimately, the success of pharmaceutical companies relies on crucial project portfolio decisions and understanding of a product's lifecycle.

Don't miss out on this fantastic opportunity to network with experts in the field that includes:

Tony Ellery, Managing Director, Ellery Pharma Consulting, Former Global Head LCM in Portfolio Management, Novartis?

Kimber Hardy, Head of Valuation and Analysis, Merck Serono

Tim Harris, Director, Respiratory & Immuno-inflammation Portfolio Management, GlaxoSmithKline?

Shafique Virani, Global Head CNS Business Development, F. Hoffman La Roche?

Sakir Mutevelic, Head of Global Project Management Biopharmaceuticals Hemophilia A/WD, Baxter?

Christiano Pereira Silva, Global Product Manager for Pradaxa, Boehringer-Ingelheim?

Julie Barrett-Major, Director of Intellectual Property, Norgine

Alan S. Harris, Senior Vice President, Global Projects & Portfolio Management, Ferring Pharmaceuticals?

Christine Deuschel, Vice President Portfolio & Project Management, Debiopharm

Boris Kreye, Lawyer, Bird & Bird

There will also be a two interactive pre-conference workshops held on the 17th April, hosted by Keith Rodgers, Director, Inspirexe Ltd and Vladimir Shnaydman, President, ORBee consulting

For more information and to book your place visit http://www.smi-online.co.uk/pharma-portfolio20.asp alternatively, contact Fateja Begum at Tel: +44 (0)20 7827 6184 or Email: fbegum@smi-online.co.uk

About SMi Group

The SMi Group is a world leader in business to business information. With nearly two decades in the business, thousands of senior executives from blue chip companies have already benefitted from SMi's highly targeted conferences, workshops and publications. For more information visit http://www.smi-online.co.uk

Article adapted by Medical News Today from original press release. Source: SMi
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Seizure Damage Reversed In Rats By Inhibitory Drug Targeting Neurologic Pathways

Main Category: Autism
Also Included In: Epilepsy;  Pediatrics / Children's Health
Article Date: 15 Dec 2011 - 0:00 PST

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About half of newborns who have seizures go on to have long-term intellectual and memory deficits and cognitive disorders such as autism, but why this occurs has been unknown. In the December 14 Journal of Neuroscience, researchers at Children's Hospital Boston detail how early-life seizures disrupt normal brain development, and show in a rat model that it might be possible to reverse this pathology by giving certain drugs soon after the seizure.

A research team led by Frances Jensen, MD, in the Department of Neurology and Division of Neuroscience at Children's, studied seizures in a rat model to see how they affected brain development at the cellular and molecular level, and whether these effects could be countered. They were particularly interested in the effect of seizures on synapses, the connections between neurons through which the brain is wired, since infancy is a time of rapid synapse development.

Examination of tissue from the hippocampus, a part of the brain important in learning and memory, showed that after seizures, the newborn rats had a far smaller pool of inactive or "silent" synapses, which normally predominate soon after birth. Instead, more synapses than normal had been converted to an excitable form by acquiring more so-called AMPA receptors. (AMPA stands for alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid.)

While an excitatory brain state and strengthening of synaptic connections are normal and necessary for cognitive development, Jensen's team found that seizures exaggerated excitation and synaptic strengthening too soon, to the point where synapses lost their flexibility to change in response to input from the environment, a quality known as plasticity. All these changes were evident within 2-3 days after the seizure.

"Our results show that once a seizure occurs, brain tissue has less synaptic plasticity," says Jensen. "Seizures have 'fixed' the synapses so they have much less potential to respond to experience." Since early-life seizures can lead to epilepsy, Jensen believes the results may help explain the cognitive impairments seen in many people with epilepsy.

After a seizure, the rats' brain tissue also showed a decrease in long-term potentiation (LTP), a change in the strength of synaptic connections that is critical in learning and memory, indicated by reduced electrical responses to stimulation of neurons. LTP is a widely accepted molecular measure of learning.

These effects appear to be reversible, however. When the rats were given a drug that blocks AMPA receptors, known as NBQX, immediately to 48 hours after seizures, these problems were reversed: Inactive synapses and LTP were preserved, and the protective effects lasted into adulthood.

Since drugs similar to NBQX are already FDA-approved for other indications, Jensen believes these results might eventually lead to a clinical trial in newborns who have had seizures.

"Because we can reverse the strengthening of synapses, we might be able to modify the disease after the fact, which is one step in the right direction toward thinking about potential strategies for cures," she says. "Epilepsy has many mechanisms and potential therapeutic targets, but this is one that may be important in undoing the cognitive effects that epilepsy may have."

Some 80-120 newborns per 100,000 births each year in the U.S. suffer seizures, often caused by brain damage from a shortage of oxygen around the time of birth.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our autism section for the latest news on this subject. Chengwen Zhou, PhD, Jocelyn Lippman Bell, and Hongyu Sun, PhD, of the Department of Neurology and Division of Neuroscience at Children's Hospital Boston were co-first authors on the paper. The study was funded by the National Institutes of Health, the National Institute of Child Health and Human Development, and the National Institute of Neurological Disorders and Stroke.
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Further Study Necessary To Better Utilize Nature's Medicine Cabinet

Main Category: Pharma Industry / Biotech Industry
Also Included In: Cancer / Oncology
Article Date: 15 Dec 2011 - 0:00 PST

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There are probably at least 500 medically useful chemicals awaiting discovery in plant species whose chemical constituents have not yet been evaluated for their potential to cure or treat disease, according to a new analysis by a New York Botanical Garden scientist who has more than 15 years of experience in collecting plants for natural-products discovery programs.

Currently, 135 drugs on the market are derived directly from plants; the analysis indicates that at least three times as many disease-fighting substances have yet to be found that could be developed into drugs or used as the basis for further drug research.

"Clearly, plant diversity has not been exhausted, and there is still great potential in the plant world," said James S. Miller, Ph.D., Dean and Vice President for Science at the Botanical Garden.

Dr. Miller's analysis, "The Discovery of Medicines from Plants: A Current Biological Perspective," is published in the December issue of the peer-reviewed journal Economic Botany.

To arrive at his estimate, Dr. Miller used a formula based on the ratio of the number of drugs that have been developed from plants to the number of plants that were screened to find those drugs. He then applied that ratio to the number of plant species that have not yet been screened.

Because of uncertainties in some of those numbers, the formula yields a range of potential drug discoveries. While there is no general agreement among botanists about the number of plant species that are likely to exist, Dr. Miller concluded that there are 300,000 to 350,000 species of plants. Of those, he determined that the chemistry of only 2,000 species has been thoroughly studied, and perhaps only 60,000 species have been evaluated even partially for medicinally useful chemicals.

Working with those numbers, Dr. Miller calculated that there are likely to be a minimum of 540 to 653 new drugs waiting to be discovered from plants; the actual number could be much greater.

"These calculations indicate that there is significant value in continuing to screen plants for the discovery of novel bioactive medicinally useful compounds," concludes Dr. Miller, who has run natural-products discovery programs that have collected specimens in North America, Central and Southeast Asia, and Africa for government agencies, pharmaceutical companies, and academic programs.

As part of his Economic Botany paper, Dr. Miller reviews the disappointing history of past plant-screening efforts and evaluates the potential for future programs.

Technological advances in the 1970s and 1980s gave medical researchers the capacity to evaluate large numbers of plant samples. That prompted the federal government and large pharmaceutical companies to institute aggressive plant collecting and screening programs. Those programs led to the development of several important drugs such as Taxol from Taxus brevifolia (used in cancer treatment) and Camptothecin from Camptotheca acuminata (derivatives of which are used to treat cancer). Other drugs indirectly trace their discovery to natural-products research, including the anti-viral Oseltamivir, which derives from Illicium anisatum and is marketed in the United States as Tamiflu.

The number of drug discoveries, however, was substantially less than anticipated. By the early 2000s, many of the large pharmaceutical companies had abandoned their efforts.

Dr. Miller argues that one possible explanation for the low yield is the relatively crude way in which plant extracts were tested for their pharmaceutical potential. Plants may contain as many as 500 to 800 different chemical compounds, but the screening programs of the late 20th century used extracts made from a whole plant or at best extracts that contained many hundreds of compounds.

Under those circumstances, one compound may interfere with the action of another, or the amount of one compound may be too small to register in a mix of hundreds of chemicals.

To correct this problem, new technologies now allow researchers to separate complex mixtures of natural products into a "library" of relatively pure compounds that can be tested individually. A 2002 study demonstrated that testing such libraries dramatically improves discovery rates.

Bringing these advances together with refinements in collecting strategies could lead to what Dr. Miller calls a "second renaissance" of natural-products discovery.

Miller undertook his analysis to highlight the fact that despite past collecting programs, the plant world represents a poorly explored source of potentially lifesaving drugs. That adds urgency, he said, to efforts to conserve natural habitats so that species are not driven to extinction before they can be studied.

"The natural world has a great and diverse array of interesting chemicals that have been only minimally studied and still hold considerable potential," he writes.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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European Commission Grants Marketing Authorization For Astellas Pharma Europe Ltd.'s DIFICLIR™ For Use In The EU

Editor's Choice
Main Category: Infectious Diseases / Bacteria / Viruses
Also Included In: GastroIntestinal / Gastroenterology;  Regulatory Affairs / Drug Approvals
Article Date: 14 Dec 2011 - 9:00 PST

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The European Commission has granted a marketing authorization for DIFICLIR™ (fidaxomicin) tablets to treat adults with Clostridium difficile infections (CDI), also known as C. difficile-associated diarrhea (CDAD), in the European Union. The announcement was made by Astellas Pharma Europe Ltd., a European subsidiary of Tokyo-based Astellas Pharma Inc. and Optimer Pharmaceuticals, Inc.

Ken Jones, President and CEO of Astellas Pharma Europe Ltd commented:

"Treatment for CDI has changed little in the past 20 years, even though the disease has a major impact on patients' health and quality of life and is potentially fatal. The EU approval of DIFICLIR, a novel macrocyclic antibiotic that specifically targets C. difficile bacteria, is therefore an important advance for patients suffering from CDI."

CDI, one of the most common causes of diarrhea linked to antibiotics, can lead to bowel surgery and even death in severe cases. In hospitals, nursing homes and other long-term care facilities, CDI represents a substantial problem, with recurrence rates of up to 25% in patients within 30 days of initial treatment with current therapies.

DIFICLIR's EU approval was granted based on two Phase III clinical studies, which compared the efficacy and safety of 400mg/day oral DIFICLIR with the only approved treatment of CDI, 500mg/day oral vancomycin, for a 10-day duration of treatment in adults with CDI in Europe and North America.

DIFICLIRs primary endpoint was determined as non-inferiority to vancomycin, which was met by achieving clinical cure in similar proportions of participants in a comparison of both drugs. In both trials, researchers determined clinical cure as patients who no longer needed further CDI therapy two days after completion of study medication.

The researchers also observed potential advantages of DIFICLIR over vancomycin; DIFICLIR reduced the rate of CDI recurrence substantially in comparison with vancomycin. Patients who received DIFICLIR had a substantially higher chance of their diarrhea to resolve without recurrence within 30 days of completing the therapy compared with those patients who received vancomycin. The researchers also reported that the disruption of the normal intestinal flora was minimal in patients treated with DIFICLIR and that the drug caused only few systemic adverse events compared with vancomycin.

Professor Mark Wilcox, Professor of Medical Microbiology at the Leeds Teaching Hospitals & University of Leeds commented:

"The high rate of disease recurrence is the greatest limitation of current treatments for CDI. The significant reduction in disease recurrence by DIFICLIR compared with vancomycin is a key step to reducing the morbidity associated with CDI, and this new treatment option is a welcome addition that has the potential to improve the patient experience".

DIFICLIR, known as DIFICID™ in the U.S. was discovered and developed by Optimer and gained the US FDA approval (US Food and Drug Administration in May 2011 to treat CDAD in adults aged 18 years and above. Optimer's exclusive licensee for DIFICLIRs development and commercialization in Europe, the Middle East, Africa and the Commonwealth of Independent States is a company called Astellas Pharma Europe Ltd.

CDI is caused by an infection of the internal lining of the colon through C. difficile bacteria and is a serious disease. The bacteria produce toxins, which cause inflammation of the colon as well as diarrhea. In severe cases, CDI can lead to death. Patients commonly develop CDI after using broad-spectrum antibiotics. These disrupt the normal gastrointestinal flora and enable C. difficile bacteria to flourish. Patients aged 65 years or older are at a particularly high risk of developing or recurring CDI.

CDI incidents are a substantial financial burden to healthcare systems, particularly in cases where extended hospitalization is required.

Written by Petra Rattue


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15 Dec. 2011. APA

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Epilepsy In Children - Adverse Events of Invasive EEG, Study

Editor's Choice
Academic Journal
Main Category: Epilepsy
Also Included In: Pediatrics / Children's Health
Article Date: 15 Dec 2011 - 8:00 PST

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According to an investigation led by Dr. Thomas Blauwblomme and his team of Great Ormond Street Hospital, London, in the December issue of Operative Neurosurgery, a quarterly supplement to Neurosurgery, official journal of the Congress of Neurological Surgeons, almost half of all children suffering with severe epilepsy who receive invasive electroencephalography (EEG) recordings, experience some type of side effect.

The study reveals that no other method can obtain the vital information needed for planning complicated epilepsy procedures that EEG recordings provide.

The team examined side effects associated to invasive EEG recordings in 95 children between 1994 and 2009. The majority of epilepsy cases in children can be controlled with drugs, although surgery is highly effective when medications are not successful. In order to plan the surgery, surgeons need accurate information on the region of the brain which controls seizure activity.

EEG recordings are required in some complex cases to gather this information. EEG recordings use electrodes placed on the brain surface or into the brain tissues. The novel investigation set out to obtain detailed information regarding the risks connected with EEG recordings. In the study the children had extremely severe epilepsy, averaging over 200 seizures per month. The average age of the children was around 11 years.

The researchers discovered that in total, nearly half of the children (49%) experienced some form of side effect. Approximately 30% of children had more severe events that increased the time they were hospitalized. None of the adverse events caused permanent neurological damage or death.

Side effects included: Infection - 15%Brain swelling - 6%Bleeding - 17%Cerebrospinal fluid leakage - 11%In most of the children who experienced bleeding and in some of those with infection, further surgery was required. After surgeons began using a novel type of graft material in 2002, no further problems with CSF leakage were reported.

Brain swelling was more prevalent among older children, while the complication rate was lower (20%) in children under the age of 2. Length of EEG recording, or if recordings used electrodes on the surface or implanted in the brain, was not associated with the risk of side effects.

In 69% of patients, EEG recordings successfully recorded the location of the seizure zone in brain activity during seizures. In total, 89% of children received surgery for epilepsy. The success rate of surgery was highest the more precise the invasive EEG recordings were in localizing the seizure zone.

The investigation notes the considerable risk of side effects associated to EEG recordings in children with the condition. Although the EEG is invasive, it provides "invaluable information" for locating the source of seizure activity within the brain.

The team highlight the relatively low risk of adverse events in children under 2 years - which adds to recent evidence backing early surgery for children with epilepsy that doesn't respond to drugs.

Dr. Blauwblomme and coauthors explain:

"For all children undergoing invasive EEG recordings, parents should receive detailed information on the risks and benefits of the procedure."

In addition, the researchers stress that the surgery should be performed at a treatment center with experience in invasive EEG recording, with cautious planning prior to the procedure and close patient follow-up afterward.

Written by Grace Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our epilepsy section for the latest news on this subject. Operative Neurosurgery, published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health. Please use one of the following formats to cite this article in your essay, paper or report:

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Grace Rattue. "Epilepsy In Children - Adverse Events of Invasive EEG, Study." Medical News Today. MediLexicon, Intl., 15 Dec. 2011. Web.
15 Dec. 2011. APA

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