During the summer months, thousands of facial injuries occur to people of all ages. Dr. Anthony Brissett, facial plastic and reconstructive surgeon at The Methodist Hospital in Houston, says taking some basic precautions can minimize long lasting facial injuries, prevent costly medical problems and allow people to enjoy the summer injury-free.

Q: What are the main head and neck injuries you see?

A: I see a lot of patients with facial injuries, anything from lacerations to facial fractures such as broken cheek bones and noses. Whether the injuries are from baseball, basketball, bike riding, swimming or just outdoor fun, I’ve seen them all.

Q: How do you treat these kinds of facial injuries?

A: Treatment depends on the severity of the injury. If it’s a laceration, a topical anesthetic and suturing usually suffices. In some facial lacerations, in addition to suturing, I may also use botox injections in order to make the scar look as good as possible. If the injury is a broken bone, an x-ray or CT scan will assist in determining the extent of the break. Some type of X-ray can be very helpful when deciding whether surgery will be involved to repair the damage. For major injuries, I’ve had to reconstruct someone’s cheek or eye socket using bone from another part of their body and titanium plates. That’s an extreme case, but it was successful and that patient is now back in sports and headed to college.

Q: What tips would you provide people to prevent these kinds of facial injuries?

A: Definitely use the right equipment that fits the outdoor activity and be a rule-follower when it comes to sports.

– If you bike, wear a helmet. Don’t wear clothing that can interfere with your vision, but do wear a face mask or eye protection if needed.

– Do not dive in water less than 9 feet deep or in above-ground pools.

– Avoid uneven or unpaved surfaces when cycling, skateboarding or in-line skating.

– In baseball, try to not slide head-first.

– We also want to keep in mind the possibility of concussion. Subtle signs can include irritability, headache and drowsiness. I warn patients and family members to not dismiss or ignore these symptoms when seeking medical attention.

About The Methodist Hospital

The Methodist Hospital in Houston is one of the nation’s largest private, non-profit general hospitals. Dedicated to providing the highest level of patient care, Methodist has a 90 year legacy of medical breakthroughs, such as the world’s first multiple-organ transplant in the 1960s, gene therapy for prostate cancer, and the first islet cell transplants in Texas.

Methodist is ranked among the country’s top centers in 14 specialties in U.S News & World Report’s 2007 America’s Best Hospitals issue. The hospital ranked in more specialties than any other hospital in Texas. Methodist is also 10th on FORTUNE’s “100 Best Companies to Work For” in 2008.

Methodist is primarily affiliated with Weill Cornell Medical College and New York Presbyterian Hospital, two of the nation’s leading centers for patient care, medical education and research. Methodist also is affiliated with the University of Houston.

Methodist Hospital, Houston
6565 Fannin St.
Houston, TX 77030
United States
methodisthealth

View drug information on Botox.

An aneurysm occurs when part of a blood vessel (artery) or cardiac chamber swells, – either the blood vessel is damaged or there is a weakness in the wall of the blood vessel. As blood pressure builds up it balloons out at its weakest point. The swelling can be quite small or very large – when large it tends to extend along the blood vessel. As the aneurysm grows there is a greater risk of rupture – this can lead to severe hemorrhage, and other complications, including sudden death.

According to Medilexicon’s medical dictionary, an aneurysm is a “Circumscribed dilation of an artery or a cardiac chamber, in direct communication with the lumen, usually resulting from an acquired or congenital weakness of the wall of the artery or chamber.”

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An aneurysm can occur in any part of the body. They tend to most commonly occur on the wall of the aorta – the large trunk artery that carries blood from the left ventricle of the heart to branch arteries. The aorta goes down through the chest and into the abdomen, where it divides into the iliac arteries (two branches). There are two main types of aneurysms:

Aortic aneurysm – occurs in the aorta. Can be abdominal, or thoracic (higher up).
Cerebral aneurysm – occurs in an artery in the brain.

People of any age and either sex can have an aneurysm, although they are more common in men and people over 65 years of age.
What are the symptoms of an aneurysm?
Symptoms are linked to how big the aneurysm is, how fast it is growing and its location. Very small aneurysms which do not grow may go completely unnoticed. A large cerebral aneurysm (in the brain) may press on nerve tissue and trigger numbness in the face, or problems with the eyes.

Cerebral (brain) aneurysm symptoms

The following symptoms may be experienced before a cerebral aneurysm ruptures:

Very severe headache that occurs suddenly
Nausea
Vomiting
Eyesight problems
Seizures (fits)
Loss of consciousness
Confusion
A drooping eyelid
Stiff neck
Light sensitivity

If the cerebral aneurism bursts it will cause bleeding in the brain and a hemorrhagic stroke – it can also cause intracranial hematoma (blood leaks into the area surrounding the brain causing a blood clot in the skull).

Aortic aneurysm symptoms

The vast majority of aortic aneurysms occur in the patient’s abdominal aorta. It is not uncommon for a patient to have an aneurysm and experience no symptoms for several years. Many of them are difficult to detect because of this. Some aortic aneurysms will never rupture. It is hard to predict which ones will never grow, which grow slowly, and which ones grow rapidly.

When symptoms occur, they tend to include:

A throbbing sensation in the abdomen
Back pain
Abdominal pain – this pain frequently spreads towards the back
If the aneurysm continues to grow and presses on the spine or chest organs the patient may experience:
Coughing
Loss of voice
Breathing difficulties
Problems swallowing

Sometimes an aortic aneurysm can be discovered by a GP (general practitioner, primary care physician) when performing a routine examination of the abdomen. He/she may detect a lump that pulses at the same rate as the patient’s heartbeat – it is often located high up in the abdomen, slightly to the right.
What causes an aneurysm?
Brain (cerebral) aneurysm causes:

Weakness in the artery wall (usually present since birth)
Hypertension (high blood pressure)
Arteriosclerosis (plaques of cholesterol, platelets, fibrin, and other substance form on the arterial wall)

Most cerebral aneurysms develop at the forks or branches in arteries because the walls in these sections are weaker. They most commonly form at the base of the brain – but can form anywhere in the brain.

Abdominal aortic aneurysm causes:

Atherosclerosis – accumulation of fatty deposits (cholesterol) on the artery walls.
Smoking – this is a major risk factor in the development of aortic aneurisms. Smoking contributes to atherosclerosis, hypertension and the acceleration of aneurysm growth. Compared to women who have quit smoking, women smokers are four times more likely to have an abdominal aortic aneurysm repair or ruptura, according to researchers at the VA Medical Center, Minneapolis.
Hypertension – especially if it is poorly controlled (not treated at all, or not treated properly).
Vasculitis (infection in the aorta) – this is an uncommon cause, and seems to run in families.
Cocaine use – Cocaine users in their mid-40s had more than four times the risk of coronary artery aneurysms as non-users, according to a study at Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital.

Thoracic aortic aneurysm causes:

About 1 in 4 aortic aneurysms occur in the thoracic area of the aorta (higher up in the chest). Causes are the same as with aortic aneurysms, plus the following below:

Marfan syndrome – this is a genetic disorder of the connective tissue; it is a much less common cause of aortic aneurysm.

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Previous aorta injury – people with a previous injury to the aorta, such as aortic dissection (tear in the wall of the aorta) have a higher risk of developing a thoracic aortic aneurysm.
Traumatic injury – this could be cause by a vehicle accident or a bad fall.

How is an aneurysm diagnosed?
Aortic aneurism diagnosis:

The majority of abdominal aortic aneurysms are discovered when doctors are examining a patient for some other reason, such as during a chest X-ray or ultrasound, according to this report by The Mayo Clinic. If an aortic aneurysm is suspected some specific tests will be ordered, they include:

Abdominal ultrasound – the patients lie on their back and some warm gel is applied to the skin of their abdomen prior to the examination. The gel reduces the chances of air pockets forming on the surface of the skin when the device (transducer) is placed on it. The transducer is moved along the surface of the abdominal skin and sends images to a monitor – from this monitor it is possible for a trained technician to detect a potential aneurysm.
CT (computerized tomography) scan – X-rays are used to create a 3-dimensional picture of the target area.
MRI (magnetic resonance imaging) scan – magnets and radio waves produce 2-dimensional and 3-dimensional pictures of the target area.
Regular screening for those at risk – as many aneurysms present no symptoms, people aged 60 or over and who are deemed to be at risk of developing an aortic aneurysm are advised to undergo regular screening. These may include men over 65 who have smoked regularly (even if they have given up), as well as men with a family history of abdominal aortic aneurysm. This report concluded that “The National Aortic Screening Programme” in the UK should, in due course, prevent about half of all aneurysm deaths in men over 65 and will be extremely cost effective for the NHS.

Cerebral aneurysm diagnosis:

Patients who suddenly have a very severe headache, or other symptoms which may indicate a ruptured cerebral aneurysm will most likely undergo some tests to find out whether there is any subarachnoid hemorrhage or some other type of stroke. If bleeding is detected, the emergency care team will determine whether an aneurysm was the cause. Patients who do not have a ruptured cerebral aneurysm, but have symptoms such as pain behind the eye, changes in vision, or paralysis on one side of their face, will also undergo tests. These tests may include:

A CT (computerized tomography) scan – X-rays are used to create a 3-dimensional picture of the target area. Multidetector computed tomography (MDCT) angiography is highly accurate in depicting intracranial aneurysms, according to a study carried out by researchers at the Department of Radiology at Klinikum Duisburg in Germany.
A cerebrospinal fluid test – anyone who had a subarachnoid hemorrhage will probably have red blood cells in the cerebrospinal fluid (the fluid surrounding the brain and spine). Patients who have symptoms of a ruptured aneurysm but had a CT scan which did not show any evidence of bleeding will undergo this cerebrospinal fluid test; called a lumbar puncture or spinal tap.
MRI (magnetic resonance imaging) scan – this test is better than a CT scan at detecting a ruptured aneurysm.
Cerebral arteriogram (cerebral angiogram) – a catheter is inserted into a large artery, usually entering the patient in his/her groin, and threads past the heart to the brain arteries. A special dye goes into the arteries via the catheter which shows up in X-ray images – the doctor can then see details about the conditions of the arteries and the site of a ruptured aneurysm. As this quite an invasive procedure, it is only generally used when other procedures have not provided enough data.

Treatment for an aneurysm
Aortic aneurysm treatment:

The aim is to prevent the aneurysm from bursting. There are usually two choices – 1. Watch and wait. 2. Surgery. How big the aneurysm is, how fast it’s growing, and sometimes its location are vital factors in determining what treatment to use.

If the aneurysm is small – if the patient’s aneurysm is no bigger than 1.6 inches (about 4cm) in diameter, and there are no symptoms, it may be best to tack the approach of watching-and-waiting, instead of surgery. This is also known as “watchful waiting”. In most cases the risks caused by surgery are greater than the likely risks caused by a small aneurysm. Watchful waiting usually involves an ultrasound scan every 6 to 12 months. The patient will be asked to be alert for any signs or symptoms of dissection or rupture.

Small observational studies have suggested that statins can significantly reduce the growth rate of small abdominal aortic aneurysms, Janet T. Powell, M.D., Ph.D., Professor at Imperial College and Honorary Consultant for United Healthcare in London revealed.
If the aneurysm is medium-sized – a medium-sized aneurysm is no bigger than 2.2 inches (5.5 cm) in diameter and bigger than 1.6 inches (4 cm). It is more difficult now to weigh up the risks of surgery against the risks of a medium-sized aneurysm. The chances of both patient and doctor deciding on one or the other are pretty even.
Large-sized or rapidly-growing aneurysm – a large aneurysm is larger than 2.2 inches (5.5 cm) in diameter, while a rapidly growing one is expanding at more than 0.5 cm every six months. In most cases the patient will require surgery. The damaged section of the aorta will be removed and replaced with a graft (synthetic tube) which is sewn into place. This is major surgery – open-abdominal or open-chest surgery. The patient will take several months to recover completely.

Endovascular surgery – this is a less invasive procedure to repair an aneurysm. A graft is attached to the end of the catheter which is inserted through an artery and threaded up into the aorta. The graft – consisting of a woven tube covered by a metal mesh support – is placed at the site of the aneurysm and stuck there will pins or small hooks. This graft strengthens the weakened section of the aorta and prevents the aneurysm from rupturing. Patients recover much faster with this procedure, and seem to have fewer complications.

Long-term survival for patients undergoing surgical repair of intact abdominal aortic aneurysms has improved in recent decades, according to a Swedish study.

Thoracic aortic aneurysm treatment:

Surgery is usually required as soon as the aneurysm reaches a diameter of 2.2 inches (5.5 cm). Patients with Marfan syndrome, as well as those with close relative who had an aortic dissection may undergo surgery if the aneurysm is smaller. Beta blockers have been shown to slow down the growth of thoracic aortic aneurysms for patients with Marfan syndrome.

Cerebral (brain) aneurysm treatment:

Ruptured cerebral aneurysm treatment

Patients with brain aneurysms have two options if the aneurysm has ruptured: 1. Surgical clipping. 2. Endovascular coiling.

Surgical clipping – the aneurysm is closed off. The surgeon removes a section of the skull to get to the aneurysm and finds the blood vessel that feeds it. A tiny metal clip is placed on the neck of the aneurysm to block off the blood flow to it.
Endovascular coiling – a catheter is inserted, usually in the groin, and is threaded through the body to the brain where the aneurysm is located. A guide wire is used to push a soft platinum wire through the catheter and into the aneurysm. The wire coils up inside the aneurysm and disrupts the blood flow, making it clot. The clotting of the blood effectively seals off the aneurysm from the artery.
Endovascular, noninvasive thoracic aortic aneurysm repair (TEVAR) is safer than open aneurysm repair (OAR) as it is associated with fewer cardiac, respiratory, and hemorrhagic complications, as well as a shorter hospital stay, this study revealed.

Patients whose aneurysms are coiled instead of clipped have a better survival rate over five years, according to a long-term study of the International Subarachnoid Aneurysm Trial (ISAT). However, another study found that over time outcomes are similar.

Smokers who undergo coil embolization are at a high risk of having another aneurism elsewhere later on, this study revealed .

The following cerebral aneurysm treatments help relieve symptoms as well as managing complications:

Painkillers – usually for headaches.
Calcium channel blockers – these stop calcium for entering cells of the blood vessel walls. They reduce the amount of widening and narrowing of blood vessels; often a complication of a ruptured aneurysm.
A vassopressor – this is an injected drug which raises blood pressure; widens blood vessels which have remained stubbornly narrowed. The aim is to prevent stroke.
Anti-seizure drugs – seizures may occur after an aneurysm has ruptures. Examples include levetiracetam (Keppra), phenytoin (Dilantin, Phenytek, others) and valproic acid (Depakene).
A ventricular catheter – this can reduce the pressure on the brain caused by hydrocephalus (excess cerebrospinal fluid). The catheter, which is placed in the spaces filled with fluid inside the brain, drains the excess liquid into an external bag. It may be necessary to place a shunt system – a shunt (flexible silicone rubber tube) and a valve. The shunt system is a drainage channel that starts in the brain and ends in the patient’s abdominal cavity.
Rehabilitation therapy – sometimes a subarachnoid hemorrhage causes brain damage, resulting in impaired speech and bodily movements. Rehabilitation therapy helps the patient relearn vital skills.

Unruptured cerebral aneurysm treatment

The unruptured cerebral aneurysm can be sealed off with surgical clipping or endovascular coiling. Deciding on this is not easy as the risks are often equal, and sometimes higher than the potential benefits. The following will help the surgeon determine what to do:

Exactly where the aneurysm is.
How big the aneurysm is.
The patient’s age.
The patient’s general state of health
Whether the patient has a family history of ruptured aneurysms.
Whether the patient has any congenital conditions which may raise the risk of the aneurysm rupturing.

Patients with hypertension (high blood pressure) need to have their condition carefully monitored – proper control of hypertension significantly reduces the likelihood of a rupture.
Complications
A ruptured aneurysm is a major problem. An abdominal aneurysm rupture will cause mass bleeding leading to shock, and even death.

A cerebral aneurysm rupture causes serious bleeding into the fluid surrounding the brain. The patient will have an extremely painful headache, which is usually followed by loss of consciousness. A cerebral aneurysm rupture is a life threatening emergency.

Occasionally, a piece from inside an aneurysm may become dislodged and travel into the artery – the clot is known as a thrombosis. If it lodges into a small artery it will block blood flow. The blocked blood flow can be very serious, especially if it happens in an artery to a major organ, such as the heart, lungs or brain.
Prevention
A large percentage of aneurysms are caused by arteriosclerosis – a vascular disease. The following steps will help prevent the development of arteriosclerosis and aneurysms:

Quit smoking
Keep your blood pressure under control
Keep your blood cholesterol levels under control
Eat a healthy, well balanced diet, rich in fruit and vegetables, unrefined carbohydrates, dietary fiber, good quality fats, and lean protein
Keep your bodyweight within the ideal limits for your height
Get at least 7 hours of good quality sleep each night
Keep yourself physically active (check with your doctor that this is OK for you)

View drug information on Keppra.

Contrary to conventional wisdom, patients with chronic fatigue syndrome respond to placebos at a lower rate than people
with many other illnesses, according to the first systematic review of the topic.

According to the new analysis by Dr. Hyong Jin Cho of King’s College London and colleagues, 19.6 percent of patients with
chronic fatigue syndrome improved after receiving inactive treatments, compared with a widely accepted figure of about 30
percent for other conditions.

Because the placebo effect seems to be strongest in diseases with highly subjective symptoms, some medical professionals
believed it could be as high as 50 percent among CFS patients.

The review, reported in the current issue of Psychosomatic Medicine, pooled data from 29 studies in which 1,016 people with
CFS received various placebos.

CFS is a complex illness that has no known cause or cure. Myriad symptoms include severe malaise, muscle and joint pain,
sleep and mood disturbances and headache. The symptoms continue for at least six months and cannot be explained by any other
medical conditions. The Centers for Disease Control and Prevention estimate that as many as 500,000 Americans may have CFS or
related conditions.

With so many mysteries surrounding CFS, a great deal of controversy exists among both doctors and patients as to whether its
origins are primarily psychological or physiological. Current evidence suggests that emotional or social stresses such as
bereavement or problems at work, combined with other triggers such as common viral infections, contribute to the disorder.
Additional factors, such as avoidance of physical activity, may cause the symptoms to become chronic, says Cho.

The authors propose several possible explanations for the surprisingly low placebo response revealed in the analysis. Perhaps
patients have low expectations due to the reality that CFS is very difficult to treat and often persists for many years.
Alternatively, disconnects between how patients and doctors view the illness “may impede development of a collaborative
therapeutic relationship,” reviewers suggest.

The study also showed that the placebo response is 24 percent for medical interventions but only 14 percent for
psychiatric/psychological treatments. The authors say the reason may be that many CFS sufferers seen in specialist settings
or self-help groups “have a firm conviction that their illness is of physical origin” and thus would have little faith in
psychiatric/psychological treatments. This finding supports the idea that the placebo response is greatly influenced by
patients’ expectations of improvement.

According to the review, behavioral therapy and graded exercise therapy have benefits, and if patients were more aware of
them, says Cho, they might be “more open, more optimistic, and more collaborative with the professionals, and the overall
outcome of the treatments could be enhanced.”

Dr. Lucinda Bateman, an internist who specializes in CFS and fibromyalgia and serves on the board of the American Association
for Chronic Fatigue Syndrome, has worked with about 500 CFS patients over the past 15 years.

“In my clinical experience, I have found that CFS is among the most difficult conditions to improve at all, with either
physical or psychological interventions.” This is true in part, she says, because there is a great deal of variation among
patients diagnosed with CFS, and Bateman believes that ultimately CFS may be found to involve more than one disease.

In the absence of a cure, Bateman has found that the most effective treatment for CFS combines improving symptoms with
medication, helping patients retain physical conditioning when possible and using psychological and psychiatric interventions
to help patients adapt to living with chronic illness.

She doesn’t discount the placebo effect, however. “When you say to people, ‘I believe you, I will help you manage your
symptoms, I will advocate for you,’ that hope and feeling of control over their disease could be considered placebo effect,
but it’s an important part of delivering medical care.”

Interviews: Contact Steven Reid at steve.reidnhs.
Psychosomatic Medicine: Contact Victoria White at 352-376-1611, ext. 5300, or
psychosomaticmedicine.ufl.edu. Online,
visit psychosomaticmedicine.

By Becky Ham, Science Writer
Health Behavior News Service

Contact: Dr. Hyong Jin Cho
h.chocop.kcl.ac
Center for the Advancement of Health
cfah

EPA has established an official reference dose (RfD) of 0.0007 mg/kg/day of perchlorate. This level is consistent with
the recommended reference dose included in the National Academy of Science’s January 2005 report. A reference dose is a
scientific estimate of a daily exposure level that is not expected to cause adverse health effects in humans.

EPA’s reference dose, which assumes total intake from both water and food sources, is appropriate and protective for all
populations, including the most sensitive subgroups. The selected reference dose contains a full ten-fold uncertainty factor
to protect the most sensitive population, the fetuses of pregnant women who might have hypothyroidism or iodide deficiency.
This uncertainty factor also covers variability among other human life stages, gender and individual sensitivities,
protecting not only adults, but also other sensitive subpopulations such as premature neonates, infants and developing
children.

Perchlorate exposure has the potential of blocking iodide uptake to the thyroid gland. NAS identified the non-adverse effect
of the inhibition of iodine uptake as the key biochemical event that precedes the occurrence of all potential adverse effects
of perchlorate exposure. EPA’s RfD is conservative and health protective because it is designed to prevent the occurrence of
any biochemical changes that could lead to adverse health effects.

EPA’s reference dose for perchlorate will be posted on the agency’s online IRIS database, which contains risk information on
possible human health effects from exposure to chemical substances in the environment.

EPA’s new RfD translates to a Drinking Water Equivalent Level (DWEL) of 24.5 ppb. A Drinking Water Equivalent Level, which
assumes that all of a contaminant comes from drinking water, is the concentration of a contaminant in drinking water that
will have no adverse effect with a margin of safety. Because there is a margin of safety built into the RfD and the DWEL,
exposures above the DWEL are not necessarily considered unsafe.

EPA’s Superfund cleanup program plans to issue guidance based on the new RfD.

Perchlorate has been used in various items, including missile and rocket propellants, munitions and fireworks, flares,
automobile airbags and pharmaceuticals. It may also occur naturally and has been found in some fertilizer. Perchlorate has
been detected in drinking water in some systems around the country, as well as in certain foods.

The perchlorate summary is available on the IRIS web site at:
epa/iris and at: epa/perchlorate

This is a press release from the EPA (USA)

Contact: Cynthia Bergman 202-564-9828 / bergman.cynthiaepa

A survey of high-school children in Scotland has shown that pupils who experience positive and inclusive social environments in schools are less likely to take up smoking. New research published in the open access journal BMC Public Health reveals that teachers who succeed in creating a positive environment in school may be responsible for their pupils staying smoke-free.

Marion Henderson of the Medical Research Council Social and Public Health Sciences Unit, Glasgow, led the study of 5092 pupils from 24 Scottish schools. She explains “The social environment of schools, in particular the quality of teacher-pupil relationships, pupil’s attitude to school and the school’s focus on caring and inclusiveness, all influence both boys’ and girls’ smoking habits”.

This research is especially important because the decreases in adult smoking seen in recent years have not, as yet, been matched in adolescent smokers. Dr. Henderson and colleagues found that, on average, 25% of males and 39% of females aged 15-16, reported that they either regularly or occasionally smoked. Henderson describes how current school-based anti-smoking interventions are largely ineffective “Most focus on individual characteristics rather than the environment in which adolescents smoke. Our research has shown that this environment acts to either encourage or discourage smoking”.

‘School effects’ refer to school-level variations in smoking that remain once other individual influences have been taken into account, such as whether pupils smoke before joining, whether they live with both parents and their amount of personal spending money. The research team found there were clear school effects that could be explained by pupils’ attitudes towards school, quality of teacher-pupil relationships and school-level affluence.

Henderson says: “Our results suggest that investing in the social environment of schools and endeavouring to make school a positive experience even for less academically able pupils may have the potential to reduce smoking rates, particularly for boys. This provides some of the strongest evidence to date to support the Health Promoting School concept, and for the first time looks at how this differs by gender.”

BIOMED CENTRAL LIMITED
Middlesex House
34-42 Cleveland Street
London
W1T 4LB
biomedcentral

Nabi Biopharmaceuticals
(Nasdaq: NABI) today announced that NicVAX(R) (Nicotine Conjugate Vaccine),
the company’s novel, innovative and proprietary investigational vaccine being
developed to treat nicotine addiction and prevent smoking relapse, has
received Fast Track Designation from the U.S. Food and Drug Administration
(FDA).

Under the FDA Modernization Act of 1997, Fast Track regulations facilitate
the development of products that treat serious diseases where an unmet medical
need exists. Fast Track regulations are also designed to expedite the review
process for designated products, including the potential for companies to ask
for priority review.

“We believe this is the first Fast Track Designation for a smoking
cessation product candidate, which is unprecedented, and provides further
validation for our unique approach to addressing nicotine addiction,” stated
Henrik S. Rasmussen, M.D., Ph.D., senior vice president, clinical, medical and
regulatory affairs, Nabi Biopharmaceuticals. “Smoking is the number one
preventable cause of death in the western world, yet current smoking cessation
therapies do not effectively treat the root cause of the addiction. We
believe the vaccine approach inherent to NicVAX will provide clear patient
advantages and a strong differentiation from currently marketed and
development-stage products.”

How NicVAX is Designed to Work

NicVAX is designed to cause the immune system to produce antibodies that
bind to nicotine and prevent it from entering the brain. It is believed that
these nicotine antibodies will act like a “sponge” soaking up nicotine as it
circulates in the bloodstream and preventing it from reaching the brain. The
positive stimulus in the brain that is normally caused by nicotine is no
longer present, thereby eliminating the addictive properties of smoking and,
consequently, helping people to quit. Unlike current therapies, such as
nicotine patches and gums, smokers will not be able to eliminate the effects
of NicVAX by stopping their treatment. In addition, because these antibodies
are expected to be long lasting, it is believed NicVAX will also be effective
in preventing smoking relapse, a significant challenge with existing smoking
cessation therapies.

Progress to Date and Next Steps

Nabi Biopharmaceuticals has completed four Phase I/II studies, totaling
close to 200 patients, for NicVAX. These studies demonstrated that NicVAX is
well tolerated, highly immunogenic, produced dose-dependent increases in
antibody titers, and showed a good indication of efficacy at the 200 ug dose
with a 33 to 40 percent quit rate versus nine percent for smokers dosed with a
placebo.

In September 2005, Nabi Biopharmaceuticals announced that it had received
a $4.1 million grant by the U.S. National Institute on Drug Abuse (NIDA), part
of the National Institutes of Health, for partial funding of the development
program for NicVAX. Partnering remains Nabi Biopharmaceuticals’ strategic goal
for NicVAX.

Nabi Biopharmaceuticals will next conduct a Phase II “proof-of-concept”
study for NicVAX, which is expected to commence during the second quarter of
2006. The study will be comprised of approximately 300 patients, a large
enough sample size to establish both proof-of-concept and optimal dose
identification for the company’s Phase III program. The study results are
anticipated in the second half of 2007.

Importantly, the vaccine manufactured for this Phase II study has been
manufactured at commercial scale in an optimized formulation at the company’s
vaccine manufacturing facility in Boca Raton, Florida. This further
demonstrates the significant advancements that have already been achieved in
the development of Nabi Biopharmaceuticals’ nicotine addiction program. The
study design will incorporate recommendations from a newly formed scientific
advisory panel. The panel is comprised of scientific and clinical experts in
smoking cessation. The panel will also provide input to the company on other
aspects of the NicVAX development program.

Nabi Biopharmaceuticals has also met with the FDA, as well as the European
Medicines Agency (EMEA), to ensure all key regulatory requirements are built
into the NicVAX Phase II trial design and overall development program.

Cigarette Smoking: A Growing Global Health Challenge

Smoking is a global healthcare problem, and The World Health Organization
estimates that there are 1.3 billion smokers worldwide and nearly five million
tobacco-related deaths each year. According to the U.S. Centers for Disease
Control and Prevention (CDC), tobacco use is the single leading preventable
cause of death in the United States and is responsible for more than 440,000
deaths each year. They estimate that approximately 70 – 80 percent of smokers
in the U.S. want to quit, but less than five percent of those who try to quit
remain smoke-free at 12 months. In addition, they estimate that tobacco use
causes $75.5 billion in excess medical costs and $81.9 billion in illness-
related productivity losses each year in the U.S. To learn more about NicVAX
and how it works, please visit our website at:
nabi/pipeline/pipeline.php?id=3.

About Nabi Biopharmaceuticals

Nabi Biopharmaceuticals leverages its experience and knowledge in powering
the immune system to develop and market products that fight serious medical
conditions. The company has three products on the market today: PhosLo(R)
(calcium acetate), Nabi-HB(R) [Hepatitis B Immune Globulin (Human)], and
Aloprim(TM) (allopurinol sodium) for Injection. Nabi Biopharmaceuticals is
focused on developing products that address unmet medical needs and offer
commercial opportunities in our core business areas: Gram-positive bacterial
infections, hepatitis, kidney disease (nephrology) and nicotine addiction.
For a complete list of pipeline products, please go to
nabi/pipeline/index.php. The company is headquartered in Boca
Raton, Florida. For additional information about Nabi Biopharmaceuticals,
please visit our website at nabi.

Forward-Looking Statement

Statements in this press release about the company that are not strictly
historical are forward-looking statements and include statements about our
marketed products, products in development, demand for our products, clinical
trials and studies, licensure applications and approvals, assessment of the
StaphVAX Phase III trial results, and alliances and partnerships. You can
identify these forward-looking statements because they involve our
expectations, beliefs, projections, or other characterizations of future
events or circumstances. These forward-looking statements are not guarantees
of future performance and are subject to risks and uncertainties that may
cause actual results to differ materially from those in the forward-looking
statements as a result of any number of factors. These factors include, but
are not limited to, risks relating to the company’s ability to advance the
development of products currently in the pipeline or in clinical trials;
complete the assessment of the StaphVAX Phase III clinical trials during the
first half of 2006; maintain the human and financial resources to
commercialize current products and bring to market products in development;
obtain regulatory approval for its products in the U.S., Europe or other
markets; successfully develop, manufacture and market its products; realize
future sales growth for its biopharmaceutical products; prevail in patent
litigation; raise additional capital on acceptable terms; re-pay its
outstanding convertible senior notes when due. Many of these factors are more
fully discussed, as are other factors, in the company’s Annual Report on Form
10-K for the fiscal year ended December 31, 2005 filed with the Securities and
Exchange Commission.

Nabi Biopharmaceuticals
nabi.

The American College of Sports Medicine (ACSM) has published its Position Stand “Appropriate Physical Activity Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults,” updating its previous guidelines, particularly as it relates to the increased levels of physical activity that may be necessary for prevention of weight gain, for weight loss and for prevention of weight regain. The official ACSM pronouncement is published in the February 2009 issue of Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine.

The paper is a companion to “Weight Management,” a position paper published by the American Dietetic Association in the February issue Journal of the American Dietetic Association. Together, the statements provide a thorough, scientific overview of two of the most important components of a healthy lifestyle: exercise and nutrition.

Among its recommendations, the ACSM Position Stand emphasizes physical activity and its relation to weight loss and weight management. Its prominent points include:

- Weight management is an urgent public health issue, with more than 66 percent of U.S. adults either overweight or obese. Health improvements in chronic disease risk factors can be realized with as little as a 2- to 3-percent reduction in excess body weight.

- Greater amounts of physical activity are likely to be needed to achieve weight loss and prevent weight regain in adults. The panel recognized the amounts in these categories:

Prevent weight gain

150-250 minutes/week of moderate-intensity physical activity is associated with prevention of weight gain

More than 150 minutes/week of moderate-intensity physical activity is associated with modest weight loss.

Weight loss

150-250 minutes/week of moderate-intensity physical activity provides only modest weight loss. Greater amounts (ie. >250) provide clinically significant weight loss.

For weight maintenance after weight loss

There is some evidence that >250 minutes/week of moderate-intensity physical activity will prevent weight re-gain.

- Energy/diet restriction combined with physical activity will increase weight loss as compared to diet alone.

ACSM recommends that adults participate in at least 150 minutes/week of moderate-intensity physical activity to prevent significant weight gain and reduce associated chronic disease risk factors. For most adults, this amount of physical activity can be easily achieved in 30 minutes/day, five days a week. Overweight and obese individuals will most likely experience greater weight reduction and prevent weight regain with 250+ minutes/week of moderate-intensity physical activity. ACSM also recommends strength training as part of this health and fitness regimen, in order to increase fat-free mass and further reduce health risks.

“In the midst of a genuine crisis in Americans’ health related to what we eat and how little we move, these guidelines are meant to provide an understanding and clarification of the role of physical activity and its relationship to weight,” said Joseph E. Donnelly, Ed.D., FACSM, chair of the writing committee. “Now that we have the latest information on how much physical activity is part of the equation, we can continue the educational process to help people who struggle with their weight.”

“Appropriate Physical Activity Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults” replaces the 2001 Position Stand, “Appropriate Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults.” To access this Position Stand, visit acsm-msse.

The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 35,000 international, national, and regional members and certified professionals are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine.

NOTE: Medicine & Science in Sports & Exercise® is the official journal of the American College of Sports Medicine, and is available from Lippincott Williams & Wilkins at 1-800-638-6423. For a complete copy of the research paper (Vol. 41, No. 2, pages 459-471) or to speak with a leading sports medicine expert on the topic, contact the Department of Communications and Public Information at 317-637-9200 ext. 127 or 133. Visit ACSM online at acsm.

American College of Sports Medicine

ORLANDO, FL (UroToday) – A collection of 5 single-nucleotide polymorphisms (SNPs) at 8q24 (3 total), 17q12, and 17q24 has received much attention. A publication in NEJM in January of 2008 demonstrated that this combination of SNPs together with family history had a significant relationship with development of prostate cancer.

In the current study, Helfand and colleagues set out to examine the interplay between these five chromosomal regions. Presence of the SNPs in question was assessed for 575 Caucasian male patients who underwent radical retropubic prostatectomy and consented to genetic testing. Statistical analysis was undertaken to evaluate the association between genetic characteristics and tumor features.

Greater than 99% of the study population were carriers for at least 1 of the 5 alleles with the two SNPs on 17q being the most prevalent. The investigators were able to show that carriers of a larger number of SNPs were more likely to harbor aggressive disease. For instance, if a patient had at least 3 of the 5 alleles they at a significantly higher risk for Gleason 7 or higher disease, positive surgical margins, and seminal vesicle invasion. The less frequent alleles at 8q24 as compared to SNPs at 17q had a stronger association with high risk CaP.

This study by a talented group of investigators is the first report to document a “complex multiplicative interaction” between the five SNPs at 8q24 and 17q.
Presented by Brian T Helfand, MD, et al., at the Annual Meeting of the American Urological Association (AUA) – May 17 – 22, 2008. Orange County Convention Center – Orlando, Florida, USA.

Reported by UroToday Contributing Editor Alexander Kutikov, MD

UroToday – the only urology website with original content global urology key opinion leaders actively engaged in clinical practice.

To access the latest urology news releases from UroToday, go to:
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Copyright © 2008 – UroToday

For nearly two decades, the medical world and the American public have grappled with the lightning-rod topic of stem cells, in particular the controversy surrounding cells from human embryos. But when researchers four years ago successfully “reprogrammed” adult body cells to become stem cells, some thought the ethical debate was nearly over. Those redirected cells, known as induced pluripotent cells, or iPS cells, show potential as therapy.

“The benefit is they require no destruction of human embryos,” says Mayo Clinic hematologist/oncologist C. Christopher Hook, M.D., an author reviewing the science and ethics of stem cell technologies in the July issue of Mayo Clinic Proceedings. “The hope is that these cells may make embryonic stem cells unnecessary, but, according to the stem cell scientists, we’re not there yet.”

Scientists who specialize in stem cells continue to regard embryo-derived cells as the gold standard among stem cells in pluripotency, the capacity to become any tissue in the body. Other stem cell technologies have benefits: Blood, bone marrow, and umbilical cord cells contain stem cells that treat leukemia and other blood cancers, but because they are adult stem cells lacking pluripotency, they’ve shown limitations as universal regenerative therapies. The newcomers on the scene, iPS cells, can be taken directly from each patient and genetically redirected to replace ailing cells, avoiding immune rejection or the need for existing embryos or eggs to create embryos.

Hook cautions that there are still challenges with iPS cells, and the public shouldn’t expect therapies to roll out in the next year or so.

“One of the problems with the history of stem cell technologies in general has been the unrealistic hype and promise of therapies far faster than the science could produce,” Hook says.

In an editorial in the same issue, medical geneticist Andre Terzic, M.D., Ph.D., the Marriott Family Professor of Cardiovascular Research at Mayo Clinic, states that iPS technology may not have reached fruition, but is invaluable for learning about diseases and testing new treatments.

“We need to accelerate the pace of this research, and speed discoveries in regenerative medicine to help patients,” Terzic says.

Worldwide, however, state-of-the-art research still depends on embryonic stem cells, at least in serving as a biological yardstick.

“This is a topic that remains charged and highly politicized,” Hook says. “Some claim the controversy about the need for embryonic stem cells should now be resolved. Hopefully, in time, with iPS’s the perceived need for and use of human embryonic stem cells will rapidly become obsolete, but, according to many in the scientific community, we’re far from being done with them. There may be another option in the use of these new cells, but it’s going to take time.”

Source: Mayo Clinic

Imaging utilization on stroke patients is affected by age and imaging capacity – the number of magnetic resonance imaging (MRI) and computed tomography (CT) machines at any given facility, according to a study in the June issue of the Journal of the American College of Radiology.

Advanced medical imaging is a component of health care expenditure growth. Although there are many potential reasons for imaging growth, including that scans have been directly linked to greater life expectancy, declines in cancer mortality rates, and are generally less expensive than the invasive procedures that they replace, one of the major drivers of utilization may be enhanced imaging capacity available in most major metropolitan areas.

“To better understand some of the determinants of imaging ordering behavior, we analyzed the effect of differential capacity on the imaging workup of patients with acute non-hemorrhagic stroke,” said Max P. Rosen, MD, MPH, lead author of the study. A “natural experiment” between the United States and Canada was performed.

Nine hundred eighteen patients at the U.S. hospital and 1,759 patients at the Canadian hospital were included in the study. We found that patient age and site (U.S. vs. Canada) were significant predictors of MRI use. Scanning utilization varied at hospitals with differential access to scanning technologies – there was less frequent use of MRI scanning at hospitals with limited access to this modality.

“Our study demonstrates that for patients presenting with symptoms of acute stroke, differences in scanning capacity (CT and MRI) may shape aspects of clinical management,” said Rosen.

Source:
Shawn Farley

American College of Radiology