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HICNet Medical News Digest Sat, 24 Sep 1994 Volume 07 : Issue 47 Today's Topics: Heart Disease in African-American Women Program: Strengthening Hospital Nursing Care CDC Issues New Report on Arthritis Prevalence Deprenyl - A Parkinson's Drug - 1994 Update AIDS Daily News Report +------------------------------------------------+ ! ! ! Health Info-Com Network ! ! Medical Newsletter ! +------------------------------------------------+ Editor: David Dodell, D.M.D. 10250 North 92nd Street, Suite 210, Scottsdale, Arizona 85258-4599 USA Telephone +1 (602) 860-1121 FAX +1 (602) 451-1165 Internet: mednews@stat.com Bitnet: ATW1H@ASUACAD Mosaic WWW: http://biomed.nus.sg/MEDNEWS/welcome.html Compilation Copyright 1994 by David Dodell, D.M.D. All rights Reserved. License is hereby granted to republish on electronic media for which no fees are charged, so long as the text of this copyright notice and license are attached intact to any and all republished portion or portions. The Health Info-Com Network Newsletter is distributed biweekly. Articles on a medical nature are welcomed. If you have an article, please contact the editor for information on how to submit it. If you are interested in joining the automated distribution system, please contact the editor. Associate Editors: E. Loren Buhle, Jr. Ph.D. Dept. of Radiation Oncology, Univ of Pennsylvania Tom Whalen, M.D., Robert Wood Johnson Medical School at Camden Douglas B. Hanson, Ph.D., Forsyth Dental Center, Boston, MA Lawrence Lee Miller, B.S. Biological Sciences, UCI Dr K C Lun, National University Hospital, Singapore W. Scott Erdley, MS, RN, SUNY@UB School of Nursing Jack E. Cross, B.S Health Care Admin, 882 Medical Trng Grp, USAF Albert Shar, Ph.D. CIO, Associate Prof, Univ of Penn School of Medicine Martin I. Herman, M.D., LeBonheur Children's Medical Center, Memphis TN Stephen Cristol, M.D., Dept of Ophthalmology, Emory Univ, Atlanta, GA Subscription Requests = mednews@stat.com anonymous ftp = vm1.nodak.edu; directory HICNEWS FAX Delivery = Contact Editor for information ---------------------------------------------------------------------- Date: Sat, 24 Sep 94 16:16:49 MST From: mednews@stat.com (HICNet Medical News) To: hicnews Subject: Heart Disease in African-American Women Message-ID: <quJ7sc4w165w@stat.com> Heart Disease in African-American Women American Heart Association Sept 17, 1994 The fact that women have not been represented in clinical studies of heart disease is well documented. However, "women" refers not to all women but usually to white women. That means that the lack of data about African-American women and heart disease is even more pronounced. It is well known that African-Americans in general have a higher rate of coronary heart disease than whites, so that places black women in double jeopardy -- first because they are black, and second, because they are women. Along with all women, they share the sex-specific risk factors of age, hormonal status, smoking, high levels of LDL, low levels of HDL, hypertriglyceridemia and psychosocial stress. As blacks, they are more likely to have more hypertension-related complications -- a higher death rate from stroke; more frequent enlargement of the left lower chamber of the heart, known as left ventricular hypertrophy; and strikingly more end-stage kidney disease. Why high blood pressure should manifest itself differently in blacks than whites is almost as poorly understood as the differences between men and women. Recent news reports from the Ninth International Interdisciplinary Conference on Hypertension in Blacks held in June 1994 shed light on a possible physiologic explanation. Pharmacologist Randall Tackett, Ph.D., and his colleagues have come up with direct evidence that African-Americans may have less flexible blood vessels than whites, which would increase blood pressure. This may explain why drugs like beta blockers, which regulate heart rate but do not relax blood vessels, are not very effective antihypertension drugs for African Americans. Beyond that, the complexity of the issue is revealed in a study of 1,719 consecutive black cardiac patients (780 men and 939 women) at an inner-city public hospital in Chicago. The research looked at three categories of patients: those who had cardiac catheterization for presumed coronary heart disease, hospitalization for heart attack or coronary bypass graft surgery (CABG). The findings show that black women -- even in comparison to black men, at least in this sample -- fare worse on a number of parameters. Diabetes was more common in the women patients in all three groups. High blood pressure was more prevalent except among those in the CABG subgroup. Women with CHD reported more angina than men, and the CHD-associated risk of cardiac death was higher for women than men. For reasons that are unclear, more women than men underwent catheterization, which is in contrast with the literature on white women cardiac patients. Also, the numbers of CHD cases confirmed by angiogram were similar between the sexes -- also in sharp contrast to the male predominance in most studies among whites. The excess risk of both cardiac and all causes of mortality in women with significant CHD was much greater than among men. The implication: Once overt CHD becomes clinically manifest, black women tend to lose their earlier coronary heart disease-free advantage over black men. Risk Factors Black women share with white women all the same risk factors for heart disease with the addition of several more: High blood pressure. High blood pressure, or hypertension, is more common among blacks than whites. Moreover, it develops earlier and complications are more severe. As a result of poorly controlled high blood pressure, blacks with coronary heart disease frequently have left ventricular hype trophy, an enlargement of the left lower chamber of the heart, which is an important predictor of mortality. This condition may affect both the incidence and the outcome of cardiac arrest, causing more frequent ventricular arrhythmias and more precipitous hypotension (low blood pressure) in response to irregular heart rhythms or ischemic events. Therefore, early diagnosis and treatment of hypertension is key for averting heart disease among black women. Although high blood pressure control has improved among African-Americans over the past 30 years, uncontrolled high blood pressure requiring emergency care is a grave condition that still occurs most commonly among black patients. Smoking. In 1990 about 417,000 Americans died of smoking- related illnesses. Among these nearly 20 percent of deaths from cardiovascular disease are attributable to smoking. Smokers' risk of heart attack is more than twice that of non-smokers, and 23 million women smoke. Virtually the same percentage of black women smoke as white women -- 23.9 percent and 25 percent, respectively. Women who smoke and young women who might consider smoking should know that cigarette smoking is the biggest risk factor for sudden cardiac death. Also smokers who have a heart attack are more likely to die and die suddenly (within an hour) than non-smokers. Smokers also affect the health of those around them. Nine million children under age five live with at least one smoker and are exposed to secondhand smoke almost the whole day. Each year this "passive smoke" causes up to 300,000 cases of respiratory infections such as pneumonia and bronchitis in babies less than 18 months old. Up to 15,000 of them must be hospitalized. Obesity. It is well known that obesity is a risk factor for heart disease and that it is more common among African-American women than white women. Genetics plays a role, as do diet and exercise patterns as well as different cultural standards of attractiveness. All women gain weight with the passage of years. But black women are on average heavier to begin with, gain more weight in general over the years and specifically with each pregnancy. A five-year heart study of several hundred women between the ages of 18 and 30 at the time of enrollment, found that black women with no children gained 12.8 pounds whereas comparable white women gained less than half -- 6.0 pounds. Those African-American women who had children during the study period incurred an additional seven-pound excess weight whereas white women put on only an extra four pounds. Both white and black women who had babies finished the study with larger waists in proportion to their hips -- usually referred to as the apple shape which is associated with a greater risk of both heart disease and diabetes. Marital Status. Surprisingly, being divorced or separated is a risk factor for heart disease for black women but not for white. In one study, being married decreased the risk for African-American women while being separated or divorced doubled the risk. According to a Census Bureau report, titled "Marital Status and Living Arrangements," published in July 1994, there is a trend toward delaying marriage, which is more pronounced in the black community with 22 percent of black women age 40 to 44 never having been married compared with only 7 percent of white women. Some of the possible explanations for the health benefits of marriage are tied to the economic benefits but also to the emotional support of a spouse, which may help one better adapt to stress. In addition, the relationship exercises some control over negative behaviors -- such as drinking, overeating and smoking -- and facilitates positive health-promoting behaviors such as getting enough sleep, eating regularly and seeking prompt medical attention when needed. Cholesterol Levels. The Framingham minority study found lower HDL cholesterol levels in blacks -- both men and women -- than in whites. As with white women, high total cholesterol levels are a risk factor for black women as well as high LDL levels. Inactivity. Black women have a much lower rate of physical activity or exercise than do white women. A sedentary lifestyle puts one at a much higher risk for heart disease. Diabetes. The rates of both Type I and Type II diabetes are higher among blacks than whites. In fact, African-Americans are 1.6 times more likely to have diabetes than whites and experience higher rates of at least three of the serious complications of diabetes: blindness, amputation and kidney failure. Black women are more than twice as likely as white women (8 percent versus 3 percent) to have diabetes. Moreover, one study found that high blood sugar was more common among the 939 black women in the sample -- all of whom had coronary heart disease -- than the 780 black men. Lack of Access to Health Care. For a variety of reasons, including lack of access to medical care, black women may be more likely than whites to delay seeking care for potentially serious symptoms of heart disease such as chest pain. This may mean that coronary heart disease has already developed or is more advanced when black women are diagnosed. It also increases the likelihood of having a cardiac-related event such as cardiac arrest occur outside the hospital. Cardiac Arrest Perhaps the ultimate symptom of coronary heart disease is cardiac arrest. In a study published in The New England Journal of Medicine within the last year, out-of hospital cardiac arrests that occurred in Chicago over a year were tracked. Almost half of the cardiac arrests occurred in women -- 43 percent. Researchers found that the black community studied (2,910 people) was at significantly higher risk for cardiac arrest and subsequent death than the white community (3,207 people). The subsequent survival rate was 2.6 percent in whites, compared to 0.8 percent in blacks. The quality of EMS services did not explain the lower survival rates among blacks. In an editorial accompanying the New England Journal study, John Z. Ayanian, M.D., of Harvard Medical School and Brigham and Women's Hospital in Boston, pointed out that the striking differences between blacks and whites may be attributable to social factors. Higher socioeconomic status is strongly associated with better health, and those socioeconomic- factors transcend race. The route to improvement, according to Ayanian, requires substantial change in three areas: "first, a health care system that ensures access to effective medical care and educates patients to take full advantage of it; second, a commitment by physicians to eliminate racial bias, even in subtle forms, from clinical decision-making and communication with patients; and third, socioeconomic opportunities in American society that are not limited by race." Education Ongoing education for black women about their risk factors and how to modify them, their recognition of symptoms of heart disease, the value of early diagnosis and the availability of effective diagnostic techniques is crucial to reducing the numbers of deaths and disabilities among African-American women with heart disease. ------------------------------ Date: Sat, 24 Sep 94 16:19:34 MST From: mednews@stat.com (HICNet Medical News) To: hicnews Subject: Program: Strengthening Hospital Nursing Care Message-ID: <BZJ7sc5w165w@stat.com> THE STRENGTHENING HOSPITAL NURSING PROGRAM 1994 NATIONAL MEETINGS ATTN: Hospital Leaders, Nurse Executives, Medical Staff, Hospital Trustees and Health Care Providers ALL HEALTH CARE DISCIPLINES ARE INVITED! You are invited to attend one or more National Meetings this fall that bring together teams from 65 hospitals across the nation participating in Strengthening Hospital Nursing: A Program to Improve Patient Care. This national program, a collaborative initiative funded by The Robert Wood Johnson Foundation and The Pew Charitable Trusts, focuses on institutition-wide restructuring to improve patient care. After more than five years of planning and implementation, 18 project teams from 65 hospitals and health care institutions -- including small, rural institutions and large, urban medical centers, public and private hospitals, teaching and non-teaching institutions, and hospitals from 14 states and the District of Columbia -- will share their experiences and findings over the course of these meetings. Four different National Meetings will be held on t he following dates: October 3-4, 1994 Louisville, Kentucky October 16-18, 1994 Arlington, Virginia November 3-4, 1994 Portland, Oregon November 10-12, 1994 St. Louis, Missouri Registration will be limited to 350 participants at each meeting. The cost is $75 per person, with discounts for groups of three or more. To request a brochure, telephone 813/825-1154 or send a FAX to 813/823-7021. -- Les P. Weber, B.S., B.S.E.E. Adventure is not outside Weber Engineering Associates, Inc. a man; it is within. "Software & System Crafters" -David Grayson ** Internet - weber@ic.mankato.mn.us AppleLink - WEBERENG Voice - 507-345-1694 ------------------------------ Date: Sat, 24 Sep 94 16:20:47 MST From: mednews@stat.com (HICNet Medical News) To: hicnews Subject: CDC Issues New Report on Arthritis Prevalence Message-ID: <c2J7sc6w165w@stat.com> ARTHRITIS FOUNDATION WARNS OF FUTURE EPIDEMIC: CDC ISSUES NEW REPORT ON ARTHRITIS PREVALENCE ATLANTA "News from the Arthritis Foundation" The Arthritis Foundation today warned that arthritis will be the epidemic of the future unless appropriate actions are taken now to limit its impact. The warning comes amid new projections released today by the Centers for Disease Control and Prevention (CDC) that show the number of people with arthritis shooting upward to more than 59 million Americans in the coming years, a 57 percent increase from 1990 estimates. The CDC estimates that 38 million Americans were affected by arthritis in 1990,15 percent of the population. Today, arthritis affects nearly 40 million Americans. And projections developed for the first time show that by the year 2020 the number of people with arthritis will increase to 59.4 million Americans, fully 18.2 percent of the population or more than one in six people. The dramatic increase is due in large part to the aging of the baby boom generation, which is now entering the prime years of arthritis onset. "Arthritis already is taking a heavy toll on our nation's health. The aging baby boomers will make arthritis an even more pervasive disease extracting a devastating toll in the future unless we take action now to limit its impact," said Don Riggin, president of the Arthritis Foundation. "This is an alarming report. But by planning for the future, funding more research to find preventions for arthritis, and taking the steps we already know can prevent or limit the impact of arthritis, we can greatly reduce the human suffering and economic drain caused by arthritis in the future," Riggin said. Because arthritis prevalence increases rapidly after age 45, the Arthritis Foundation cautions that the leading edge of the baby boomers, those born in 1949 or earlier, are already at increased risk. The Arthritis Foundation suggests people avoid excess weight gain, or lose excess weight, especially during middle age, to reduce the risk of developing knee osteoarthritis. Also, taking precautions to avoid joint injuries or repeated overuse of a joint can lower the risk for arthritis later in life. In addition, the foundation recommends that leading edge baby boomers begin checking for initial signs of arthritis. These signs include pain, swelling, and limited movement that lasts for more than two weeks. Knowing the early warning signs of arthritis and seeking early treatment can make a difference. "Unfortunately, six million Americans say they have arthritis but have never seen a doctor for help. Yet early treatment is essential if you hope to avoid future limits on your daily activities," Riggin said. The CDC report shows that arthritis now limits major activities, such as working or keeping house, for 6.7 million Americans. For people already affected by arthritis, the Arthritis ------------------------------ Date: Sat, 24 Sep 94 16:22:00 MST From: mednews@stat.com (HICNet Medical News) To: hicnews Subject: Deprenyl - A Parkinson's Drug - 1994 Update Message-ID: <D4J7sc7w165w@stat.com> Deprenyl - A 1994 Update The American Parkinson Disease Association Summer 1994 Newsletter Copyright 1994, Reproduced with Permission EDITOR'S NOTE: In 1989 APDA published "Deprenyl Update" an educational supplement authored by A. Lieberman, M.D., Chairman of the APDA Medical Advisory Board. At that time Deprenyl had just been approved by the FDA for use in this country. A short time ago an article on Selegiline (Eldepryl-Deprenyl) authored by E. Brunt, M.D., appeared in Parkinson Magazine highlighting the presentations made at a June 1993 neurologists meeting in Budapest, the city where Prof. Knoll developed this drug 30 years earlier. APDA is grateful to both Dr. Brunt and to Parkinson Magazine for sharing this article with our readers. Originally developed as a "psychic energizer" selegiline, also known as I-deprenyl or Eldepryl, appeared to be an irreversible inhibitor of the MAO-B enzyme. The MAO-B enzyme constitutes the main degrading pathway for dopamine, the transmitter which is deficient in the brain in Parkinson's disease (PD). An important advantage of selegiline compared with other MAO inhibitors was its lack of the "cheese effect". This effect is caused by the uptake of a food constituent, tyramine, which is present in high concentrations in cheese and Chianti wine, and causes the sudden, marked elevation of blood pressure in patients treated with other, previously used MAO inhibitors. In the seventies, Prof. Birkmayer, Prof. Csanda and Dr. Lees were among the first to apply, in the medical treatment of PD patients, the concept of slowing down the dopamine degradation by selegiline. The addition of selegiline to levodopa therapy appeared to be successful, as patients with motor fluctuations showed improvement and levodopa dosage could be reduced. In 1985 Birkmayer reported a nine year retrospective study from which appeared that addition of selegiline to levodopa therapy in PD patients also lengthened their lifetime. Thus, selegiline not only improved the response to levodopa, but also appeared to have a protective action against deterioration in PD. Support for a possible protective role of selegiline came from studies on two animal models of PD. In the "MPTP model" and the "6- hydroxy-dopa model", simultaneous administration of selegiline appeared to prevent the development of parkinsonism. The MPTP animal model of PD originates from the discovery that this substance, methylphenytetrahydropyridine was responsible for the development of a PD-like disease in users of a synthetic heroine-like drug in California in the early eighties. MPTP was found to be oxidized in the brain by the MAO-B enzyme into MPP+, which could destroy dopamine producing cells after being taken up into these cells, causing a PD-like syndrome. In this model, blocking of MAO-B enzyme prevents death of dopaminergic cells by MPTP. In the 6-hydroxy-dopa model of PD, this substance is injected into the brain of rodents in the tract formed by the dopamine nerve cell fibers running from the brainstem to their target in the basal ganglia. After being taken up into the nerve endings, 6-hydroxy-dopa also causes death of these cells, again producing a PD-like syndrome. Also in this model, selegiline prevents the damage, by blocking the uptake of the substance into the nerve cells. Thus in the second half of the previous decade, both human and animal studies suggested a possible neuroprotective action of selegiline in PD. To evaluate the results of previous open studies and to investigate the supposed neuroprotective effect of selegiline, several controlled studies have been performed by the groups of Dr. Langston, the Parkinson Study Group in the United States, and by the groups of Dr. Myllyla in Finland and Dr. Allain in France. The largest and most important of these studies was a multicenter study called "DATATOP" (deprenyl and tocopherol antioxidant therapy of Parkinson). Over 800 newly diagnosed PD patients from 40 centers in the US and Canada were included in this study and randomized to treatment with selegiline, vitamin E (tocopherol) or placebo. This study showed a strongly significant delay of the need to add levodopa therapy in the selegiline treated group. However, the interpretation as to whether this effect was due to a symptomatic or protective effect remained controversial. In other words it could not be ascertained whether the delay was due to improvement of PD symptoms, or to slowing down of the progression of the disease. Critics argued that the one-month "wash-out" period following the withdrawal of selegiline, after which the groups of patients had been compared, was too short. Indeed, early this year, it was reported that the difference in favor of the selegiline treated group was no longer obvious after a prolonged wash-out period of 3 months. As the time needed for the restoration of MAO-B in humans is now estimated to be about 40 days, the current interpretation of the DATATOP study is that selegiline does have a symptomatic effect, and possibly a protective effect. A comparable conclusion on the action of selegiline was drawn by Dr. Myllyla in Finland from the interim analysis of a recently concluded study on the effect of selegiline in newly treated PD patients. Also in this study, the group treated with selegiline required introduction of levodopa at a later date. In addition, in the following years patients in the selegiline treated group needed less levodopa than those in the placebo treated group. In a recent report on the French selegiline multicenter trial, Dr. Allain also reported both an improvement of symptoms and a delay in progression in the selegiline treated group. As mentioned before, selegiline not only is being used in many countries in the treatment of PD, but also has had a major impact upon the research on PD and other neurodegenerative diseases. The exciting story of selegiline includes study on the possible role of MAO-B enzyme in the pathogenesis of PD and evidence for protective or even rescue effect of the drug upon endangered and damaged nerve cells. Investigations on the MAO enzymes have made clear that the two different types, A and B. have their own distribution both outside and inside the human brain, - and act upon different substances. The wide differences found between individuals on the amounts of MAO-A and MAO-B present in skin and blood may be important in the study of diseases such as PD. Although preferably metabolized by MAO-B, dopamine is also degraded by MAO-A and auto-oxidation. In the brain about 60% of MAO is of B type and the amount of MAO-B increases after age 60. After its production and excretion from the nerve cell to act upon the receptors of other nerve cells, dopamine is re-uptaken and subsequently degraded. This degradation takes place mainly outside the nerve cells, possibly in the nearby support glial cells, which are known to contain the highest concentration of MAO-B enzyme. It appears that in the normal process of dopamine degradation by MAO enzymes, toxic compounds such as hydrogen peroxide are formed, which may react to form "free radicals". These "free radicals" are aggressive oxidative substances which can impair the energy production or damage the membrane of nerve cells, causing their death. At the Budapest meeting, Profs. Olanow, Jenner and Youdim presented data suggesting that in dopamine cells of PD patients the production of the oxidizing substances is increased, while at the same time the defense mechanisms against this "oxidative stress' is reduced. As selegiline reduces the turnover of dopamine by impeding its degradation and increases one of the defending enzymes, reduction of "oxidative stress" may be one way in which it may protect nerve cells. Evidence to support a protective role of selegiline was also provided by Prof. Knoll. He has found a reduction of age related changes in the dopamine nerve cells of the substantia nigra and increased longevity in rats treated with selegiline. Maybe the most exciting findings on the action of selegiline were discussed at this meeting by Prof. Tatton. Several experiments suggest an action of selegiline which differs from MAO-inhibition or protection from oxidative free radicals. The first example is the MPTP-mouse model in which low dose selegiline given following MPTP administration at a time when lethal damage to neurons has been completed, triples the number of surviving nerve cells. At this dosage selegiline causes less than 50% inhibition of the MAO-B enzyme, so this cannot explain the rescue. Another example is an experiment in which one facial nerve is cut in rats of two weeks of age. At this age the cells of the facial nerve are dependent on nurturing substances ('trophic" or "growth" factors) from the muscles with which they are connected. These trophic factors are transported via the nerve and cutting of the nerve normally results in death for most of the nerve cells. Selegiline given to these rats both in high and in low dosage, more than doubled the number of surviving cells, apparently providing a substitute for the trophic factors. The suggestion that selegiline provides a substitute for trophic factors is also supported by the observation that in cultures of brain cells, selegiline promotes the growth of these cells and increases the production of growth factors. These examples suggest that selegiline, used in low dosage, may have a "rescue" effect, comparable to the effect of trophic factors. Several of these neurotrophic factors have been identified and they play an important role both in the growth and in maintenance of nerve cells, and they have also been shown to be important in fetal cell transplantation. It can be concluded that selegiline has proven to be a fascinating drug for its use in the treatment of PD and for its inspiration of a vast area of research on neurodegeneration. Actions of selegiline at different dosages include; MAO-B inhibition, dopamine re-uptake inhibition, reinforcement of defense against "oxidative stress", and substitution for trophic factors. A symptomatic and levodopa sparing effect of selegiline in the treatment of PD patients has become evident, supporting its use in patients already treated with levodopa. A protective action in PD patients, by diminishing the rate of progression of the disease, awaits further clinical proof. Therefore, the decision to use selegiline as monotherapy in early stage PD and during its further course is currently based upon the suggestion of possible benefit rather than evidence. Its suggested rescue effect and substitution of trophic factors for nerve cells opens most exciting perspectives. Selegiline has now taken a place in the treatment of PD and experimental work has opened exciting perspectives. Whether these promises will become a reality for the patients depends on clinical results. In the end only these count. Much work needs to be done, but the hope for a better treatment of this disease is a good reason for doing it. ------------------------------ Date: Sat, 24 Sep 94 16:24:28 MST From: mednews@stat.com (HICNet Medical News) To: hicnews Subject: AIDS Daily News Report Message-ID: <H8J7sc1w165w@stat.com> AIDS Daily Summary The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC Clearinghouse should be cited as the source of this information. Copyright 1994, Information, Inc., Bethesda, MD In this issue: ******************************************************************* "Progenics Pharmaceuticals Awarded NIH Grant for Development of Imaging Agent for HIV Infection" "Swiss Red Cross Collaborating With HemaSure Inc." "$25 Million Committed by U.S. for Alternatives to AIDS Drug Therapy" "AIDS Vaccine Doubted" "Female Condom to Get Disease Trials in City" "CDC Says AIDS Case Remains Unsolved" "Sites Awarded, Renewed for Community-Based AIDS Trials" "Gladstone Institute Researchers Create Multi-Purpose Vaccine Capable of Generating Immune Response to HIV" "Study Adds to Fears of Blood Recipients" "U.S. AIDS Research Switches Focu[Position] x=961 y=471 [Width] cx=44 u╗╬jⁿσPLUS QAGç│╧j^σMPQWK INIδò jσEL QAG·û╤j*σCHEDULEINIπ╥j╫σHIPSOFTQAGUî╥j▌σLIPS QAGXî╥jÿσXIT QAGXî╥ jFσCONFETTQAGVî╥ j₧σAMAIN QAGRî╥j7σOUND QAG\î╥jΣσUPERST QAGWî╥jσMARTCANINIÑ┤╥j%σRLITE INI"YΘj£σROGMAN INIö╙jrädY═ç¿I3ZLBτφAô╩ƒîσÅ(╔>å½╤╝8xw4ƒXÇu;9╩π¡`fk├ë;Éj2═÷û₧▓╜╟Ωu╔N*╛a┐úkaBQ┐ÿ 18╨Æ>Qj÷ÄúÇ╩ùe²oà]«»n╟≤"░óE╕πvδH¢xE^â╢.+╫ÄüÇó%δ¢┬?σ╔èrßçó¬óD7uαiφ$5½k║╙₧XZhq▌~┌óè┴µO┤ÑδfX■`Çaå╤ò{⌠Xtç├åúó,GN╢αφ=╦╙╖-,░▐jz{'ñÄ√"0Ñ∙Äª░╥■⌐QsN£╫ΘB╡&Ω─½öñTH╒l┬J≥öJ&(╬&ço\¿Ä┼ä« T┬▌£÷φúÇ»τ█╜ZK_ÇNOÑ╤9∙è¥éW⌐M┤φp╪1q/tªD4∞o¬èV╗ûj-°εa]=b▒£¢9J$╦÷Zq╨√{û0Ü+A½╚#ù6╩ 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Transmission" "Yokohama Conference Overview" "Transmission of Zidovudine-Resistant HIV During a Bloody Fight" "Kaposi's Sarcoma--Major Overview Published" "Publicizing AIDS Data Early and Often" "Cocaine and HIV Prevalence in an Alcohol Treatment Center" "Human Growth Hormone Reverses Wasting in Clinical Trial" "Infectious Diseases in Competitive Sports" "Regulating Syringe Exchange Programs: A Cautionary Note" "HIV, TB Present Deadly Combination" "Directly Observed Therapy for Tuberculosis in New York City" "Shifting AIDS Research Back to Basics" Correction from AIDS Daily Summary, 09/09/94: "Blacks Far More Likely Than Whites to Have AIDS, Agency Says" ******************************************************************* "Progenics Pharmaceuticals Awarded NIH Grant for Development of Imaging Agent for HIV Infection" PRNewswire (08/30/94) The National Institutes of Health has awarded Progenics Pharmaceuticals Inc. an $80,000 grant under Phase I of its Small Business Innovation Research Program. The funding goes toward the development of ProScan-A, an imaging agent designed for the detection of the HIV in its asymptomatic period. It can also help doctors determine how well treatments and vaccines are working in HIV-infected patients. Progenics has signed a clinical trial agreement with Memorial Sloan-Kettering Cancer Center for a Phase I clinical trial on ProScan-A. "Swiss Red Cross Collaborating With HemaSure Inc." PRNewswire (08/30/94) HemaSure Inc. announced on Tuesday that it is teaming up with ZLB Central Laboratory, Blood Transfusion Service of the Swiss Red Cross, to develop the Leukovir Filter, which is designed to remove methylene blue from virally inactivated plasma. The methylene blue can then be transfused into patients to inactivate viruses which can contaminate plasma. This application of methylene blue was developed by the Blood Transfusion Service of the German Red Cross. Eugene J. Zurlo, President and Chief Executive Officer of HemaSure, said the collaboration will be "beneficial to the organizations involved, and most importantly, to the patients who will benefit from safer plasma." Currently there is no FDA approved viral inactivation process for plasma in the United States. "$25 Million Committed by U.S. for Alternatives to AIDS Drug Therapy" Washington Post (09/02/94) P. A19 The federal government has promised $25 million for the investigation of alternatives to drug therapy for the treatment of AIDS, to be split among the New England Medical Center, the University of Pennsylvania, the University of Michigan, the Fred Hutchinson Cancer Research Center in Seattle, Stanford University, and the University of California at San Diego. National Institutes of Health officials said on Friday that more money is expected to be approved for the studies next year. Director of the National Institute of Allergy and Infectious Diseases, Anthony S. Fauci, said, "This effort is crucial because currently available anti-HIV drugs only partially and temporarily suppress replication of the virus, and their use is hampered by toxicity and drug resistance." "AIDS Vaccine Doubted" Washington Post (09/02/94) P. A10 A study conducted by Sally M. Blower and Angela R. McLean of Oxford University and published in Friday's Science magazine showed it to be nearly impossible for a vaccine alone to conquer AIDS. Using the gay community in San Francisco as a model, Blower and McLean found that the number of HIV cases in that community could double every two to seven years. They further concluded that a vaccine might even contribute to the disease by creating a false sense of security and preventing changes in dangerous behavior. Several HIV vaccines are currently in development but none have been approved for widespread testing in the United States. Related Story: Philadelphia Inquirer (09/02) P. A17 "Female Condom to Get Disease Trials in City" Philadelphia Inquirer (09/02/94) P. A1 (Belluck, Pam; Collins, Huntly) On Tuesday a health department committee approved two tests on the female condom, to start in the fall, involving patients at the department's sexually transmitted disease clinic. The first study, funded by the condom's manufacturer, Female Health Co., would attempt to ascertain whether the female condom would protect women from sexually transmitted diseases. The second study, funded by the federal Centers for Disease Control and Protection, would try to determine what sort of contraceptive women will use if given a choice. The female condom gained FDA approval as a contraceptive last year and clinical trials have found it to be as effective in preventing pregnancy as the diaphragm, the sponge, and the cervical cap. "CDC Says AIDS Case Remains Unsolved" United Press International (09/01/94) Dr. Harold Jaffe, director of the U.S. Center for Disease Control and Prevention's division on HIV/AIDS, says the agency has no direct evidence of criminal intent concerning the dental practice of Florida Dr. David Acer. Officials linked six cases of HIV infection to Acer in 1990. According to investigators, transmission of the virus could have occurred in one of three ways. Dr. Acer could have accidentally cut himself and exposed patients to his blood, he could have used unsterilized equipment and unsterile procedures, or he could have intentionally transmitted the virus. A behavioral scientist has stated that results of a three-year study into the case show the late dentist's personality matches the profiles of 36 serial killers studied by the FBI. "Sites Awarded, Renewed for Community-Based AIDS Trials" PR Newswire (09/01/94) The National Institute of Allergy and Infectious Diseases (NIAID) has awarded funding to four new sites and 12 incumbent sites to study promising HIV therapies as part of the community-based clinical trials network. The first-year funding for the 16 five-year awards is approximately $12 million. Anthony S. Fauci, M.D., director of NIAID, says the awards "strengthen our capability and commitment to offer HIV-infected patients clinical trials of HIV therapies in community settings such as private practices and clinics as well as in health centers." The awards stem from the recompetition of NIAID's Terry Beim Community Programs for Clinical Research on AIDS. "Gladstone Institute Researchers Create Multi-Purpose Vaccine Capable of Generating Immune Response to HIV" Business Wire (09/01/94) Researchers from UC San Francisco have inserted two HIV genes into the poliovirus vaccine to create a new vaccine capable of generating in an immune response in animals to HIV. The decades-old Sabin polio vaccine was used as a vehicle to deliver key proteins to specific targets in the body, where they could generate an immune response to guard against infection. The proteins packed into the poliovirus included two important HIV proteins, Nef and Gag, a protein from influenza type A virus, and the highly toxic cholera toxin. "Study Adds to Fears of Blood Recipients" Toronto Globe and Mail (08/31/94) P. A3 (Picard, Andre) The Laboratory Centre for Disease Control in Canada estimates that 940 to 1,440 people may have been infected with HIV through transfusions between 1978 to 1985--two to three times the number of people originally thought to be infected. In addition, as many as 245 people may still be "unaware of their HIV-positive status." Although public officials in almost every province have urged transfusion recipients to be tested for the virus, hospitals have resisted demands that they locate each person who received blood because of the cost of such research and the poor condition of records. Scientists say that the risk of being infected by bad blood was nearly 25 times higher in 1985 than in 1978. They also estimate that the risk of HIV to surgery patients receiving between 30 and 50 units of blood had risen to 9.4 out of every 1,000 by the time mandatory blood screening for the virus was started in 1985. Public officials are concerned that those who didn't realize they were affected could have spread the disease through sexual encounters. The Canadian Red Cross Society reports that the risk of receiving contaminated blood during surgery in Canada today is estimated at one in 250,000. "U.S. AIDS Research Switches Focus to Boost Immune System" Washington Times (09/07/94) P. A6