Face Of Transplant Woman Has Complete Feeling And Better Speech

Five months after her partial face transplant, Isabelle Dinoire has complete feeling on her face again. According to an interview Dinoire had with Le Journal du Dimanche, the physical recovery has been easier than coming to terms with her new look.

When asked whether she had accepted her new look, she said 'It is too difficult to explain'. She says that every day she thinks of the donor who made it possible for her to be visible again. She says she is forever grateful. Sometimes she says she looks at her photo album, sees pictures of her old self - before she was mauled, and is still amazed at how different she looks now.

She is able to move her facial muscles again, Dinoire says her speech has improved significantly.

Dinoire has to have an injection each week to stop her body from rejecting the new tissue, she also takes 10 pills each day. On a daily basis she has to look at a patch of the donor's skin, which has been attached to her stomach. Any change in the skin would be an indication that her body may be rejecting the donor's tissue.

Dinoire was the first person to receive a face transplant. The operation took place in November, 2005. She received new lips, a chin and a nose.

In her first news conference last year it was not easy to understand her as she had difficulty in moving her mouth. She had a large scar around her face - this scar is healing well, she said. Her operation lasted over 15 hours.

In May last year Isabelle's face was severely disfigured when her dog mauled her while she was asleep as a result of a medication overdose. Apparently, the dog was trying to revive her - which it apparently managed to do. The dog was later put down, against the family's wishes.

This year a man received a face transplant at the Xijing Military Hospital, Xian, China. Li Guoxing received a new upper lip, cheek and nose. Surgeons worked for 14 hours on his face. Guoxing was a hunter who suffered a bear attack two years ago, leaving his face severely disfigured.

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Novartis Unveils Further Impressive Efficacy Data For Galvus(R), An Investigational Oral Diabetes Compound, Showing Significant Blood Sugar Reductions

Galvus(R) (vildagliptin), seeking to become a new once-daily oral treatment option for type 2 diabetes, has demonstrated impressive efficacy, especially in patients with poor glycemic control, as well as weight loss benefits in obese patients.

These new findings from Phase III studies were presented today at a late-breaker session at the 66th Scientific Sessions of the American Diabetes Association (ADA) meeting in Washington, DC.

The combination of Galvus, a member of the DPP-4 inhibitor class, and pioglitazone led to an overall 1.9% reduction in HbA1c (a measure of blood sugar control also known as A1c). Pioglitazone is an insulin sensitizer known as a thiazolidinedione, or TZD. Two-thirds of people (65%) on Galvus and pioglitazone achieved the ADA-defined A1c goal of less than or equal to 7% versus 42% of those who achieved this goal on monotherapy (Galvus 42.5%, pioglitazone 42.9%).

More importantly, a reduction of up to 2.8% in A1c was seen among patients with poor glycemic control who had the highest mean baseline blood sugar levels (about 10%) as measured by A1c.

Also in this study, patients over age 65 who were given Galvus and pioglitazone showed an A1c drop of 2.3% from a mean A1c baseline of 8.4%. In obese patients, with a Body Mass Index (BMI) equal to or over 35, patients given Galvus and pioglitazone showed a decline of 2.2% from a mean A1c baseline of 8.6%.

In a separate head-to-head comparison with rosiglitazone, another insulin sensitizer, Galvus demonstrated comparable efficacy. Among severely obese Galvus-treated patients, there was a mean reduction of body weight greater than 1 kg, with an overall mean difference of 2.8 kg between the Galvus and rosiglitazone treatment groups.

"These new data underscore the significant efficacy and good tolerability that have been consistently observed in the robust Galvus clinical development program," said James Shannon, MD, Head of Development at Novartis Pharma AG.

"The magnitude of A1c reductions seen with the combination of Galvus and a TZD is encouraging for patients struggling to reach and maintain their blood sugar levels. The trial results for Galvus continue to reinforce the benefits of treating both islet dysfunction and insulin resistance in type 2 diabetes," Shannon said.

Throughout the Phase III program, Galvus has shown clinically significant and consistent A1c reductions both as monotherapy and in combination with other oral and injectable anti-diabetic agents. Galvus has demonstrated a good tolerability profile in these studies, with no weight gain overall and an incidence of hypoglycemia (excessively low blood sugar) and edema (fluid retention) similar to placebo in monotherapy trials.


"As the diabetes epidemic continues to grow worldwide, there is a very real and urgent need for new ways to help control blood sugar levels in people with type 2 diabetes," said Julio Rosenstock, MD, Director of Dallas Diabetes and Endocrine Center at Medical City, Clinical Professor of Medicine, University of Texas, Southwestern Medical School Dallas and a lead investigator in the Galvus/pioglitazone trial. "We were pleased to see the especially steep reductions of glucose in the sub-analysis of patients with the highest blood sugar levels. However, this high baseline population represents a difficult to treat group and these patients usually require a multi-drug strategy to reach glycemic goal."

Galvus was accepted for U.S. regulatory review earlier in 2006. The submission includes data from clinical trials involving more than 4,300 patients worldwide. Regulatory filings in the EU are planned to be completed later in 2006.

About the trials

The two trials were highlighted at the ADA late-breaker session as part of a broad overview of clinical data summarizing the development as well as overall efficacy and tolerability of Galvus.

The first was a six-month clinical trial evaluating the combination of Galvus and pioglitazone (Pio) in patients with type 2 diabetes. The study evaluated 592 patients who had never been previously treated for type 2 diabetes and who had a baseline A1c of between 7.5% and 11%. It involved four treatment groups: (1) Galvus 100 mg; (2) Pio 30 mg; (3) Galvus 100 mg + Pio 30 mg; (4) Galvus 50 mg + Pio 15 mg.

Among patients with baseline A1c of 9% or greater, the combination of Galvus and Pio produced a 2.8% reduction in A1c. In the overall population, patients receiving Galvus 100 mg + Pio 30 mg saw a statistically significant overall reduction in A1c compared to those on Pio alone (1.9% vs. 1.4%, p < 0.001).

Adverse events were consistent with the individual safety profiles of Galvus and TZDs. The patients treated with the combination of Galvus and Pio experienced no significant additional weight gain and less edema compared to patients taking Pio alone.

The second trial involved 700 patients in a six-month head-to-head comparison of Galvus (100 mg daily) and rosiglitazone (8 mg once/day). Galvus reduced blood sugar levels significantly (-1.1%) as measured by A1c, with no difference between treatment groups. Galvus treatment was not associated with weight gain overall, while people in the rosiglitazone group gained on average 1.6 kg. Galvus-treated patients also experienced a lower incidence of edema (2.5% vs. 4.9%).

The initial results from this trial were presented at an ADA poster session at 10:00 am EDT on Saturday, June 10 (abstract 557-P).

In an additional subgroup analysis of severely obese patients presented at the late-breaker session, there was a mean reduction of body weight greater than 1 kg in the Galvus group, with a mean difference between the Galvus and rosiglitazone groups of 2.8 kg.

About the "GLORIOUS" mega-trial program

Novartis is committed to developing therapies that will impact the progression of type 2 diabetes. This was confirmed through the announcement at the ADA meeting of the "GLORIOUS" mega-trial program, one of the largest series of outcomes-focused clinical programs conducted among people with type 2 diabetes. Novartis intends to provide additional details on the program later in 2006.

About Galvus

In clinical studies, Galvus has demonstrated significant reductions in blood sugar that were sustained at one year. Galvus is suitable for once-daily dosing and has been evaluated in clinical trials both as monotherapy and in combination with other anti-diabetes agents. Galvus is not associated with overall weight gain, a key benefit for people with diabetes who struggle to keep their weight under control. The overall incidence of side effects with Galvus including hypoglycemia and edema was similar to placebo in monotherapy trials. Overall, the most common side effects seen in the Galvus clinical trial program were cold/flu-like symptoms, headaches and dizziness. Galvus lowers blood sugar by targeting islet dysfunction: It improves the ability of the islet's alpha- and beta-cells to appropriately sense and respond to sugar in the blood.

About Diabetes

Diabetes currently affects about 195 million people worldwide and is estimated to grow to more than 330 million by 2025, according to the International Diabetes Federation.(1) The U.S. Centers for Disease Control estimates that about 20 million Americans have diabetes.

Type 2 diabetes is a progressive disease where control of blood sugar deteriorates over time. It is the sixth leading cause of death in the United States and a major contributor to heart disease, stroke, blindness, kidney disease and vascular or neurological problems that can result in amputation.

Islet dysfunction and insulin resistance both contribute to diabetes. Specifically, islet dysfunction can lead to excess sugar production (via glucagon from the alpha-cells) and reduced insulin production (from the beta-cells). Even among people receiving diabetes care, controlling blood sugar levels is difficult. More than half of those currently taking medication to manage their diabetes are still not reaching their blood sugar goals, according to data from the National Health and Nutrition Examination Survey (NHANES)(2).

The foregoing press release contains forward-looking statements that can be identified by the use of forward-looking terminology such as "to evaluate," "under development," "encouraging," "may be," "continue to," "planned" or similar expressions, or by express or implied discussions regarding potential future regulatory filings, approvals or future sales of Galvus. Such forward-looking statements involve known and unknown risks, uncertainties and other factors that may cause actual results to be materially different from any future results, performance or achievements expressed or implied by such statements. There can be no guarantee that Galvus will be approved for sale in any market, or that Galvus will reach any particular level of sales. In particular, management's expectations regarding the approval and commercialization of Galvus could be affected by, among other things, unexpected clinical trial results, including additional analysis of existing clinical data and new clinical data; unexpected regulatory actions or delays in government regulation generally; the company's ability to obtain or maintain patent or other proprietary intellectual property protection; competition in general; government, industry, and general public pricing pressures; as well as the additional factors discussed in Novartis AG's Form 20-F filed with the US Securities and Exchange Commission. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those described herein as anticipated, believed, estimated or expected. Novartis is providing this information as of this date and does not undertake any obligation to update any forward-looking statements contained in this document as a result of new information, future events or otherwise.

About Novartis

Novartis Pharmaceuticals Corporation researches, develops, manufactures and markets leading innovative prescription drugs used to treat a number of diseases and conditions, including those in the cardiovascular, metabolic, cancer, organ transplantation, central nervous system, dermatological, GI and respiratory areas. The company's mission is to improve people's lives by pioneering novel healthcare solutions.

Located in East Hanover, New Jersey, Novartis Pharmaceuticals Corporation is an affiliate of Novartis AG (NYSE: NVS) -- a world leader in offering medicines to protect health, treat disease and improve well-being. Our goal is to discover, develop and successfully market innovative products to treat patients, ease suffering and enhance the quality of life. Novartis is the only company with leadership positions in both patented and generic pharmaceuticals. We are strengthening our medicine-based portfolio, which is focused on strategic growth platforms in innovation-driven pharmaceuticals, high-quality and low-cost generics, human vaccines and leading self-medication OTC brands. In 2005, the Group's businesses achieved net sales of USD 32.2 billion and net income of USD 6.1 billion. Approximately USD 4.8 billion was invested in R&D. Headquartered in Basel, Switzerland; Novartis Group companies employ approximately 96,000 people and operate in over 140 countries around the world. For more information, please visit http://www.novartis.com.

-- The tradename Galvus(R) is currently pending regulatory, including FDA, Approval

(1) http://www.idf.org/home/index.cfm?node=37
(2) Saydah SH, Fradkin J, Cowie CC. Poor Control of Risk Factors for Vascular Disease Among Adults with Previously Diagnosed Diabetes. JAMA 2004; 291(3):335-342.

Novartis Pharmaceuticals Corporation
http://www.novartis.com

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Non-Alcoholic Fatty Liver Disease Long-term Effects

A new study found that patients with non-alcoholic fatty liver disease (NAFLD) had a significant risk of developing end-stage liver disease and a lower chance of survival if they had non-alcoholic steatohepatitis (NASH), a form of NAFLD that can lead to cirrhosis. The study also found that most NAFLD patients will eventually develop diabetes or impaired glucose tolerance, which can lead to cardiovascular complications.

The results of this study appear in the October 2006 issue of Hepatology, the official journal of the American Association for the Study of Liver Diseases (AASLD). Published by John Wiley & Sons, Inc., Hepatology is available online via Wiley InterScience at http://www.interscience.wiley.com/journal/hepatology.

Patients with NAFLD, one of the most common causes of liver disease worldwide, often have elevated liver enzymes but no symptoms of the disease. Obesity has been established as a major risk factor for NAFLD and since it is reaching epidemic proportions worldwide, the number of people at risk for developing chronic liver disease is likely to increase in the future. Studies conducted on NAFLD to date have either had small numbers of patients or relatively short follow-up periods. The current study involved the largest reported number of NAFLD patients originally referred because of elevated liver enzymes and followed the patients for more than ten years.

Led by Stergios Kechagias, M.D. of the Division of Internal Medicine at University Hospital in Linkping, Sweden, the study involved 212 patients between 1988 and 1993 who had chronically elevated liver enzymes. All of the patients underwent liver biopsy, and only the 129 patients who had confirmed fatty liver without excessive alcohol consumption or other liver disease participated in the study. A total of 88 patients accepted follow-up at an average of almost 14 years from when they were diagnosed with NAFLD. Of these, 68 patients underwent repeat liver biopsy.

The results showed that NAFLD was found to be associated with a significant risk of developing end-stage liver disease and that death from liver-related causes and cardiovascular diseases was significantly more common in the 71 patients with NASH than in the general population. In addition, 78 percent of NAFLD patients were diagnosed with diabetes or impaired glucose tolerance at follow-up. "Given the strong association between insulin resistance and NAFLD it is reasonable to recommend lifestyle modifications in all patients with NAFLD," the authors state. "Not only do lifestyle modifications reduce the risk of developing type 2 diabetes, intense dietary intervention may also improve liver histology in NAFLD."

In an accompanying editorial in the same issue, Vlad Ratziu and Thierry Poynard of the Universite Pierre et Marie Curie and Assistance Publique-Hopitaux de Paris in Paris, highlight the widespread misconception that NAFLD in its various forms is largely considered to be a mild disease with a good prognosis. They note that NAFLD patients are usually not referred to hepatologists and the only way to accurately diagnose the disease (liver biopsy) is not practical as a screening tool for large populations. Nonetheless, NASH is an important cause of advanced liver disease and it is important to prevent its progression to cirrhosis because once liver failure occurs in these cases the outcome is often fatal. They note that the current study is important not only because of its long follow-up period, but because the authors were able to identify the outcome of different forms of NAFLD. "Remarkably, and possibly because of the longer follow-up, the authors were able to show that even patients without cirrhosis developed ESLD [end-stage liver disease], thus refuting the claim that non-cirrhotic NASH is 'benign.'" They add that the study, along with previously published data, points to the necessity of studying the risk of increased cardiovascular deaths in NASH patients. They conclude that treating NASH is a "major unmet medical need," and that strategies for screening patients with risk factors for liver disease, including obesity, diabetes and heart disease, should be developed.

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Pfizer's CHANTIX(TM) (Varenicline) Now Available To Help Smokers Quit

Pfizer Inc announced today that CHANTIX(TM) (varenicline) is now available in U.S. pharmacies. CHANTIX, the first new prescription aid to smoking cessation treatment approved by the U.S. Food and Drug Administration in nearly a decade, was approved in May 2006. Those who are prescribed CHANTIX will be offered the opportunity to enroll in a behavioral modification program called GETQUIT(TM) Support Plan at no additional cost. The plan was developed by Pfizer with input from smoking cessation experts.

"By developing CHANTIX to help people quit smoking, we hope to take a positive step toward improving the health of smokers, their families and friends, and society in general," said Karen Katen, Pfizer vice chairman and president of Pfizer Human Health. "Quitting smoking is challenging physiologically and psychologically. Oftentimes, smokers are very much on their own during the difficult quitting process. To help people break free from the powerful grip of smoking, we are offering CHANTIX with a personalized behavior modification program called GETQUIT Support Plan. It is our hope that this will help smokers achieve their goal of living smoke-free."

There are 45 million adult smokers in the U.S., but approximately 70 percent say they want to quit. CHANTIX offers an important advance in smoking cessation. When a smoker takes CHANTIX as part of their efforts to quit, it is believed that the medication binds to the same receptors to which nicotine would bind, but CHANTIX appears to activate the receptors to a much lesser extent. Also, if a person does smoke while taking CHANTIX, CHANTIX may block the nicotine from binding and lessen nicotine's effects.

Behavioral Support Available to Patients Prescribed CHANTIX

Nicotine addiction is a chronic medical condition that is difficult to overcome. According to a research report on nicotine addiction from The National Institute on Drug Abuse, less than 7 percent of smokers who try to quit achieve at least one year of abstinence. That same report says that most smokers relapse within a few days of attempting to quit. However, for individuals who are motivated to quit smoking, literature has shown that a combination of medication and behavior modification can increase successful quit rates.

The GETQUIT(TM) Support Plan was developed using principles of cognitive therapy with input from smoking cessation experts to help educate patients about managing cravings and behavioral triggers. It will be available at no additional cost to CHANTIX patients. The plan will feature extensive behavior modification support that patients can customize to their individual needs, including a "Habit Changer" to identify and address their personal triggers to smoke, and daily communications that help them track their progress. "The U.S. Public Health Service Clinical Practice Guidelines say that increased behavioral support is associated with significantly better chances of quitting. At this time, there are many initiatives being passed in various states, including clean air laws, as well as the adoption of smoke-free workplaces that are designed to discourage smoking and drive people to consider a quit attempt," said Dr. Scott Leischow, a behavioral specialist and professor in the Department of Family and Community Medicine at the University of Arizona. "It is critically important that, when smokers want to try to quit, they have access to behavioral support programs and treatment modalities to help them in their quit attempts."

Smoking Cessation Benefits and CHANTIX Coverage

Smoking is the leading preventable cause of disease and premature death in the U.S. Smoking is also financially costly. Smokers spend an average of $700 per year on cigarettes and according to the American Lung Association, the economic cost of smoking on an annual basis is approximately $167 billion in the U.S.

Currently, however, many smokers do not have access to smoking cessation benefits. According to the Centers for Disease Control (CDC), although 66 percent of Americans under the age of 65 are insured through an employer, only 24 percent of employers offer coverage for treatment of tobacco use. Last month, the CDC released a new guide, Save Lives, Save Money: Make Your Business Smoke-Free, which recommends that employers, among other actions, check with their HMOs to see if their policies cover smoking cessation services. If they do not, the CDC recommends that they consider the addition of coverage for cessation services.

Patients who have insurance programs that cover the cost of prescription medicine should check with their insurance carrier and employer to see if they cover CHANTIX. Pfizer is working with third party payers to facilitate reimbursement of CHANTIX. The price of CHANTIX will vary depending on what a retail pharmacy charges for the product.

For those without insurance for prescription medicines, CHANTIX may be available through Pfizer Helpful Answers -- a family of programs that helps people without prescription coverage save on many Pfizer medicines, no matter their age or income. People with limited incomes may even qualify to get their Pfizer medicines for free. For more information call toll free 1-866-706-2400 or visit http://www.PfizerHelpfulAnswers.com.

CHANTIX Shown Effective in Clinical Trials

In two identically designed clinical trials, approximately 44 percent of patients who took CHANTIX (1 mg twice a day) quit smoking by the end of the 12-week treatment period versus approximately 30 percent who used buproprion SR (150 mg twice a day) and approximately 18 percent who used placebo. In a separate study, patients who quit with 12 weeks of treatment with CHANTIX were randomized to receive an additional 12 weeks of treatment with CHANTIX or placebo. At the end of a total of 24 weeks of therapy, 70.5 percent of patients who continued on CHANTIX remained smoke-free compared to 50 percent who switched to placebo.

CHANTIX Dosing Information

After a one week titration, the recommended dosing of CHANTIX is 1 mg twice a day. CHANTIX comes in user-friendly packaging. Each monthly package contains four weekly dosing packs.

Safety Information

CHANTIX is indicated as an aid to smoking cessation treatment in adults. The most frequently reported adverse events (>10 percent) with CHANTIX were nausea, headache, insomnia, and abnormal dreams.

Nausea was reported by approximately 30 percent of patients treated with CHANTIX (1 mg twice a day), with approximately a 3 percent discontinuation rate during 12 weeks of treatment. Nausea was generally described as mild or moderate and often transient. For some subjects, it was persistent over the course of treatment. Dose adjustment with CHANTIX is recommended in subjects with severe renal impairment. Patients who cannot tolerate adverse effects of CHANTIX may have the dose lowered temporarily or permanently.

In November 2005, Pfizer submitted a European marketing authorization application for varenicline for smoking cessation.

Patients and health care providers can visit http://www.chantix.com or call 1-877-CHANTIX to receive more information about CHANTIX.

To preview and request free broadcast-standard video about this announcement digitally or by tape please log onto http://www.thenewsmarket.com/pfizer.

Pfizer Inc
http://www.pfizer.com

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Aortic Dissection: High Survival Seen For Patients With Condition That Killed John Ritter

Nearly three years ago, actor John Ritter collapsed on the set of his sitcom, the victim of a rare but often deadly condition called aortic dissection -- a tear in the largest blood vessel in the body. His death brought international attention to the catastrophic condition, which strikes 10,000 Americans a year and is often linked to high blood pressure and genetic disorders.

Now, researchers have published some rare good news about aortic dissection, showing that 90 percent of patients who survive emergency surgery and hospitalization for its most serious form will still be alive three years later. Those without pre-existing heart and blood vessel problems were even more likely to survive. The findings are published in a supplement to the journal Circulation.

The study, performed by an international team led by specialists at the University of Michigan Cardiovascular Center, involved data from 303 patients. All were treated in the late 1990s and early 2000s for the most serious form of aortic dissection, called Type A, which occurs in the upper part of the aorta near the heart.

It's a unique study looking at survival among Type A aortic dissection patients who live through their initial crisis. The authors say the results offer hope that with proper rapid diagnosis and successful surgery, more patients can survive.

However, because aortic dissection is rare and its symptoms can mimic those of a heart attack, it is often not diagnosed or treated quickly -- contributing to a 30 percent in-hospital death rate that includes a 25 percent risk of death during surgery. But less is known about the fate of those who survive long enough to leave the hospital.

"Clearly, this is one of those diseases where if you catch it early you can save lives in the hospital, and with successful surgery your outlook after discharge can look quite good," says lead author Thomas Tsai, M.D., a cardiovascular research fellow at the U-M Medical School. "Of course, those who do survive will have a diagnosis for life of aortic disease, and will need medication and aggressive monitoring of their aorta."

Tsai and senior author Kim Eagle, M.D., co-director of the U-M CVC, conducted the research with colleagues from the International Registry of Aortic Dissection, or IRAD, using data on patients treated at 21 medical centers in 11 countries. U-M is the coordinating center for IRAD.

"Aortic dissection is still very much a lethal health crisis, with mortality approaching 2 percent per hour. But these results show we're doing a pretty good job in helping patients after they weather the storm of diagnosis and surgery," says Eagle.

The new study drew its patients from a group of 885 Type A aortic dissection patients who came or were transferred to IRAD centers. Nearly 30 percent of the Type A patients died before leaving the hospital, and long-term follow-up data were available on many of the 617 who left the hospital after surgical or non-surgical treatment. The patients included in the final analysis were treated at eight IRAD centers that compiled long-term follow-up data on most of their patients.


Ninety percent of the 303 patients in the study had surgery; the rest received medical treatment because of advanced age, pre-existing conditions that made surgery too risky, or patients' refusal to have surgery. Death rates were much higher among the non-surgical patients.

The average age of all the patients was 59, but a quarter of the patients were over age 70 -- reflecting the fact that aortic dissection can strike relatively young patients with genetic diseases such as Marfan syndrome that prematurely weaken the walls of their aorta, or can arise from a lifetime of high blood pressure that stresses the aorta and creates weak spots.

Seventy-two percent of the patients in the study had hypertension before their dissection. Nearly 25 percent had atherosclerosis (clogged, stiffened blood vessels often linked to high cholesterol and blood pressure) and just under 13 percent had had some sort of cardiovascular surgery in the past.

These underlying problems -- and not any aspect of their in-hospital complications -- appear to have made a big impact on patients' risk of dying after leaving the hospital. In fact, patients who had atherosclerosis or previous cardiovascular surgery had twice the risk of dying in the three-year follow-up period as patients without these characteristics. "What predicts an aortic dissection patient's death after hospitalization are the risk factors they came in with," says Tsai.

Tsai and Eagle note that the good news of the new result may have a lot to do with recent advances in emergency diagnosis, surgical and anesthesiology techniques, and intensive-care practices, as well as better post-hospital care of patients using drugs and regular medical imaging. Because IRAD has collected data on so many patients treated within a seven-year period, the authors say, the study reflects the modern treatment of the condition, compared with other studies that have compiled data from patients treated over several decades at one or two medical centers.

Now, the researchers are hopeful that early diagnosis and rapid treatment will increase as more hospitals use advanced medical imaging to determine what is causing chest pain in patients who come to emergency rooms. Advanced CT scanners, for example, can make a "triple rule-out" scan that can quickly tell if a patient is experiencing a heart attack, an aortic dissection, or a blood clot in the lung. But, says Tsai, doctors need to order the right kind of scan or a dissection can be missed.

A "swat team" approach that combines the talents of emergency room doctors and nurses, cardiologists, radiologists, surgeons and anesthesiologists to make rapid diagnostic and treatment decisions may also help, says Eagle. Such an approach is now in place at the U-M Health System.

The IRAD team is also working to improve the screening tools that might be used to determine who is at high risk of an aortic dissection. Currently, people with Marfan syndrome, connective tissue disorders and some other conditions are known to have an elevated risk, as are people with long-term blood pressure problems. It can also occur during pregnancy or childbirth, or in cocaine users.

IRAD researchers are currently developing tests that would examine DNA or blood to screen high-risk people or the relatives of dissection patients, to make a rapid diagnosis in the emergency room, or to add to long-term monitoring of survivors. Better screening for aneurysms in the aorta, which are involved in a large percentage of dissections, could also help nip more dissections in the bud.

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Academic Achievement Higher Among Most Active Kids - Vigorous Physical Activity Linked To Better Grades

Children who participate in vigorous physical activity, such as sports, perform better in school, according to a new study released today by the American College of Sports Medicine (ACSM). The examination of activity and physical education (PE) compared to academic achievement shows the most active kids more often have better grades. The study is published in the August issue of Medicine & Science in Sports & Exercise �, the official journal of ACSM.

The study was conducted to determine the effect of physical education class enrollment and overall physical activity on academic achievement. The link between activity and academic performance was most significant when kids met Healthy People 2010 (HP2010) guidelines for vigorous activity 20 minutes a day, at least three days a week. Grades were not affected among kids who were moderately active for 30 minutes at least five days a week.

Two hundred fourteen middle school-aged students participated, all of whom were randomly assigned to a PE course for either the first (August to mid-January) or second (mid-January to June) semester of the academic year. The research team measured students' physical activity in and outside school in 30-minute blocks, and compared their individual grades in core subjects, such as English, world studies, science and mathematics.

"Physical education and activity during the school day may reduce boredom and help keep kids attention in the classroom," said Dawn Podulka Coe, Ph.D., the study's lead author. "We were expecting to find that students enrolled in PE would have better grades because of the opportunity to be active during the school day. But, enrollment in PE alone did not influence grades. The students who performed better academically in this study were the most active, meaning those who participated in a sport or other vigorous activity at least three times a week."

Most of the vigorous activity was achieved outside the classroom, in sports such as soccer, football, basketball and baseball/softball. Since academic performance was favorably influenced by this level of activity, the researchers suggest incorporating vigorous activity in PE classes.

"This is a good tool for all of us-parents, teachers and researchers alike-to understand what motivates students and possibly coordinate their activity and academic needs," said Coe.

The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 20,000 international, national, and regional members are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine.

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. Visit ACSM online at http://www.acsm.org. The conclusions outlined in this news release are those of the researchers only, and should not be construed as an official statement of the American College of Sports Medicine.

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Humans And Chimpanzees, How Similar Are We?

The DNA sequences of humans and chimpanzees are 98.5 percent identical, but now Uppsala University researchers can show that parts of the genetic material are missing in one species or the other. This means in some cases that humans can produce a protein that the chimpanzee lacks and vice versa. The study, being published in the November issue of the Journal of Molecular Evolution, estimates that the total variation between humans and chimpanzees is rather 6-7 percent.

The chimpanzee, together with the pygmy chimpanzee (the bonobo), is the closest relative to humans still in existence. Even though the similarities between chimpanzees and human are obvious, there are clear differences in body structure, intellect, and behavior, etc. In the more than five million years that have passed since the developmental lines of humans and chimpanzees parted, mutations have altered the genes. A key issue for researchers studying the evolutionary history of humans and chimpanzees is to understand which of these differences have been crucial to the development of the species and their unique characteristics.

Tomas Bergstr�m and his research team at the Department of Genetics and Pathology have compared the DNA sequence from chromosome 21 in humans and chimpanzees to map where the genetic differences are found and what significance this might have. The findings corroborate other studies that indicate that in 1.5 percent of the genetic material a nucleotide (genetic letter) has been replaced by another nucleotide. But the findings also show that more than 5 percent of the genetic material occurs in only one of the species. In both species, DNA has been added or lost. In other words, the total difference is estimated at 6.5 percent. Even though most of the differences occur, as expected, in parts of the genetic material that do not contain genes, the research team has found that pieces of DNA have been added or lost in 13 percent of the genes. Some genes (5 percent) have undergone such major changes that certain proteins can probably not be produced by one of the species.

"It is probable that a species can compensate for this by producing a similar protein from another part of the gene, but some of these differences have clearly been crucial to the development of the species," says Tomas Bergstr�m.

About the UPPSALA UNIVERSITET

Uppsala University, founded in 1477, is the oldest university in Sweden with venerable traditions from Linnaeus, Celsius, Angstrom and at the same time the newest. The university rests on the stable ground of scientific and educational experience within the eight faculties of Theology, Law, Medicine, Pharmacy, History-Philosophy, Languages, Social Sciences, and Science and Technology. There is also a new virtual IT Faculty for research and education. Uppsala University has one of Sweden's largest faculties of science and technology and the only faculty of pharmacy. Today Uppsala University has 37 000 students and 5 500 employees.

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Alzheimer's Disease Discovered 100 Years Ago, November 4th

According to the Alzheimer's Association, Alzheimer's disease was discovered 100 years ago on Saturday, November 4, 1906. Currently 4.5 million people in America have Alzheimer's and that figure is expected to grow to as many as 16 million by 2050.

On November 4, 1906, German physician Alois Alzheimer presented the case of a 51-year-old woman who had shown severe memory, language and behavior problems to his medical colleagues. When Dr. Alzheimer performed the woman's autopsy, he found a dramatically shrunken brain and unusual abnormalities in and around cells. Not long afterward, the brain disease he described was named Alzheimer. Alzheimer's disease is a progressive brain disorder that gradually destroys a person's memory and ability to learn, reason, make judgments, communicate and carry out daily activities.

For more information on Alzheimer's disease contact the Alzheimer's Association, http://www.alz.org or call 800-272-3900.

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Study Takes Rare Look At How Materialism Develops In The Young

As Christmas approaches, many people blame advertising for stoking the desire among teenagers to own the latest and best in computers, clothes, toys, video games, jewelry, sports equipment and cosmetics.

Some groups have criticized advertisers for manipulating children to demand an endless array of consumer products, while others have decried the creeping placement of branded goods in public schools.

But despite the finger pointing, relatively little is known about how materialistic values develop in childhood and adolescence, a University of Illinois researcher says.

"Materialism has long been of interest to consumer researchers, but research has centered on adult consumers, not children or teens," says Lan Nguyen Chaplin, a professor of marketing in the U. of I. College of Business.

To get a better handle on the issue, Chaplin and co-investigator Deborah Roedder John, a professor of marketing at the University of Minnesota, looked at three age groups - 8-9 year olds (third- and fourth-graders), 12-13 year olds (seventh- and eighth-graders) and 16-18 year olds (11th- and 12th-graders).

The researchers used collages to chart the value placed on materialistic objects such as "stuffed animals," "money" and "nice sports equipment" compared with non-materialistic sentiments such as "being with "friends," "being good at sports" and "helping others," in making them happy. The researchers also asked the children open-ended questions about what made them happy.

The researchers found that materialistic values increased between 8-9 year olds and 12-13 year olds, but then dropped between the 12-13 age group and 16-18 age group.

In a second study, the researchers determined that self-esteem was a key factor in a child's level of materialism. Children with lower self-esteem valued possessions significantly more than children with higher self-esteem.

Moreover, the heightened materialistic values of early adolescents were directly related to "a severe drop in self-esteem that occurs around 12-13 years of age." By using a test that primed high self-esteem among the children, the researchers wrote that they "reversed the large drop in self-esteem experienced by early adolescents, thereby reducing the steep rise in materialism among this group."

As a result, the researchers wondered whether proposed bans on child advertising and other restrictions were the best approach to reduce overly materialistic values.

"Our results suggest that strategies aimed at influencing feelings of self-worth and self-esteem among 'tweens' (8-12 year olds) and adolescents would be effective,"

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Body Mass Index Misleading Indicator Of Health

Measuring somebody's Body Mass Index (BMI) is commonly used to decide whether that person is overweight. It is often used as an indicator of cardiovascular disease risk. However, BMI may not be such an accurate indicator as it lumps muscle and fat into one category, say researchers from the Mayo Clinic.

There are two ways you can calculate your BMI:

1. Metric system - Kilograms and Metres
[Your weight] divided by [Your height squared]

2. Imperial System - Pounds and Inches
[You weight] divided by [Your height squared] times 703

A person is healthy if his/her BMI is between 18.5 and 24.9.

The researchers looked at 40 studies involving 250,000 patients. Their analysis revealed that people with a BMI of 30-35 were at lower risk of cardiovascular disease than those whose BMI was below 20.

You can read about this study in the journal The Lancet, August 19 issue.

The team concluded "An explanation for the lack of a positive association with BMI and mortality in older ages is that, in older persons, BMI is a poor measure of body fat. The measurement of weight does not differentiate between fat and fat-free mass, and fat-free mass is progressively lost with increasing age." Most of fat-free mass consists of muscle.

Dr. Francisco Lopez-Jimenez, lead researcher, said he and his team had suspected BMI was not a good indicator for quite some time. Dr. Lopez-Jimenez added "We presented a report at an American Heart Association meeting a few months ago showing that BMI did not correlate with fat. A better way to distinguish between fat and muscle is to take a cross-sectional view of the abdomen, to focus on the waist-hip ratio."

A study carried out by researchers at the London School of Hygiene and Tropical Medicine concluded, after analyzing data on 15,000 patients, that BMI was not a good indicator of health risks for elderly people. They also favoured a calculation which looked at hip-waist ratio.

Hip-waist ratio gives a much better idea about how much fat a person has in the abdomen area (abdominal adiposity). If you have a 'beer-gut' the hip-waist ratio calculation will spot it more accurately than using BMI.

The Mayo Clinic team did find that BMI is a good calculator of risk for people with a BMI over 35. Dr. Lopez-Jimenez said "The group of people with BMI of 35 or higher had a bad outcome. Patients with BMIs of 35 to 40 naively believe that they have a lot of muscle. In extreme cases, fat determines the measurement."

If BMI were the only calculation ever made, the whole of the English national rugby team would be classed as very-overweight to obese and at high risk of cardiovascular disease. The conclusion would have been similar for a fit, heavyweight boxer when he was at his peak. There is no way a professional boxer who is 1.88 metres tall (6ft 2 ins), weighing in at 104 kilograms (228 pounds) has the same cardiovascular disease risk as a sedentary man of same height and weight - they would both have a BMI of 29.42. However, their hip-waist ratio would be completely different.

Calculate your Hip-to-Waist Ratio

Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease

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Almost Two Million Children Overweight In UK, 700,000 Are Obese

The number of overweight schoolchildren in the UK is almost two million, of which about 700,000 are obese, according to a study carried out by the International Obesity Taskforce. Over 25% of girls and 20% of boys are overweight.

The number of UK schoolchildren who have high blood pressure and cholesterol levels has reached 160,000.

If this trend towards more obese and overweight children continues, the UK could be facing a serious national health crisis in a decade's time, say researchers.

With fewer and fewer playing fields in the UK, in comparison to ten or twenty years ago, British children are becoming less physically active at scholl. Add to this the change in eating habits among young children, and the reasons for this growing childhood obesity problem becomes evident.

British children are eating more and more of the wrong foods and doing less and less exercise.

The number of hours children spend either watching TV or sitting in front of some kind of screen at home has increased.

You can read about this study in the International Journal of Pediatric Obesity.

According to the report, there are already over 4,000 British children with Type 2 Diabetes symptoms. 58,000 have bad glucose tolerance.

As children are not generally screened for blood pressure or indications of Diabetes Type 2 symptoms, it is hard to say exactly how many children are currently at risk. When these children become young adults and start to go to their doctors with complaints, perhaps the full extent of the problem will be known.

Health professionals throughout Britain are calling on authorities to ban the advertising of junk foods targeted at children.

-- Obesity Rates Worldwide

-- International Association for the Study of Obesity

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Stem Cell Therapy For Parkinson's Disease

High hopes have been pinned on the prospects of using stem cells to eventually be able to replace diseased or dead cells with new, healthy ones. In order to do this, the stem cells must be programmed to form cells with the exact speciality needed for the treatment of patients.

Parkinson's Disease is caused by the degeneration of dopamine-producing cells in a certain part of the brain. By studying the embryonic development of the central nervous system, research groups led by Johan Ericson and Thomas Perlmann at Karolinska Institutet have been able to show that two genes, Lmx1a and Msx1, play a critical part in the formation of cerebral dopamine cells.

They also demonstrate how these findings can be used to control the formation of dopamine-producing cells from stem cells in a highly effective manner. This represents an important step in the development of a stem-cell based treatment for Parkinson's Disease.

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Empire Blue Cross Blue Shield Joins Blue Plans Nationwide To Launch Largest Private Database Of Health Care Information

Empire Blue Cross Blue Shield announced today that it is collaborating with 19 other Blue Plans nationwide to launch Blue Health Intelligence (BHI), a unique resource that will help improve health care quality by providing the most detailed view available of health care trends, best practices and comparative costs through a claims database of 79 million people.

BHI, the premier health intelligence resource in the nation, will strengthen the movement toward greater health care transparency and informed decision-making by employers and, ultimately, providers and consumers.

A secure, HIPAA-compliant database, Blue Health Intelligence is significantly larger than existing health care databases. Access to the aggregate data -- containing no personal identifiers -- will be available to the Blue Cross and Blue Shield Plans currently participating in BHI.

"Our vision is for a health care system that is less complex and easier for consumers to navigate," said Larry C. Glasscock, chairman, president and chief executive officer of WellPoint, Inc., the parent company of Empire Blue Cross Blue Shield. "BHI will help transform the current health care system into a focused, knowledge-based system. Blue Health Intelligence is in direct response to employers and consumers who are interested in more precise information that is presented in a clear, understandable and useable way."

In the near term, BHI will support the efforts of employers to better manage the quality of benefits they offer their employees. In the future, BHI will provide consumers with greater access to information that will enable their ability to make informed health care decisions, and will heighten collaboration with providers as they deliver high-quality, evidence-based care to their patients.

Specifically, here are some examples of what BHI will ultimately provide:

-- information about the pros and cons of certain treatments. For example, a given medical condition could have more than one treatment option. In the long term, the database could provide consumers with information on the costs and outcomes of these options so they could have informed discussions with their physicians about which option is best for them.

-- data that would allow an employer to compare health care costs for its employees to national trends and costs for other employers in the same industry.

-- opportunities for health services research. With such a large database, BHI will be able to better track costs and outcomes for different clinical practice patterns and the experience of FDA-approved drugs and medical devices.

BHI is being pilot-tested and will be operational in 2007.

Blue Health Intelligence is part of Blue Distinction, an umbrella program for multiple initiatives that foster health information transparency by Blue Plans nationwide.

"As a leader in health care transparency, we are committed to collaborating with physicians, hospitals and other stakeholders to provide consumers with meaningful cost and quality data," Glasscock said. "We will continue to provide consumers with the information they need to make informed choices about their medical care."

In addition to Empire Blue Cross Blue Shield, the company's participating units include:

-- Anthem National Accounts
-- Anthem Blue Cross and Blue Shield in Colorado
-- Anthem Blue Cross and Blue Shield in Connecticut
-- Anthem Blue Cross and Blue Shield in Indiana
-- Anthem Blue Cross and Blue Shield in Kentucky
-- Anthem Blue Cross and Blue Shield in Maine
-- Anthem Blue Cross and Blue Shield in Missouri
-- Anthem Blue Cross and Blue Shield in Nevada
-- Anthem Blue Cross and Blue Shield in New Hampshire
-- Anthem Blue Cross and Blue Shield in Ohio
-- Anthem Blue Cross and Blue Shield in Virginia
-- Anthem Blue Cross and Blue Shield in Wisconsin
-- Blue Cross Blue Shield of Georgia
-- Blue Cross of California

About Empire Blue Cross Blue Shield

Empire Blue Cross Blue Shield, the largest health insurer in New York State, based on PPO and HMO membership, is a subsidiary of WellPoint, Inc. (NYSE: WLP). WellPoint's mission is to improve the lives of the people it serves and the health of its communities. WellPoint, Inc. is the largest health benefits company in terms of commercial membership in the United States. Through its nationwide networks, the company delivers a number of leading health benefit solutions through a broad portfolio of integrated health care plans and related services, along with a wide range of specialty products such as life and disability insurance benefits, pharmacy benefit management, dental, vision, behavioral health benefit services, as well as long term care insurance and flexible spending accounts. Headquartered in Indianapolis, Indiana, WellPoint is an independent licensee of the Blue Cross and Blue Shield Association and serves its members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as Blue Cross Blue Shield in 10 New York City metropolitan and surrounding counties and as Blue Cross or Blue Cross Blue Shield in selected upstate counties only), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), Wisconsin; and through UniCare. Additional information about WellPoint is available at http://www.wellpoint.com.

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Small Weight Gain Linked To Acid Reflux (GERD)

GERD (gastroesophageal reflux disease) has been directly linked to even small gains in body weight, without the person having to be overweight, say researchers in a report published in the New England Journal of Medicine, June 1 issue.

One of the symptoms of GERD is heartburn.

Dr. B Jacobson, study author, from Boston University School of Medicine, USA, said that his study shows that any excess weight may have a negative effect on health, even small amounts which would not class the person as overweight. In other words, a person of normal weight who gains a bit of weight - and is still considered to be of normal weight - can become more prone to GERD.

GERD is the failure of the valve between the stomach and the esophagus to close properly. Stomach acids work their way up into the esophagus, which erodes. GERD can lead to cancer of the esophagus.

We have known for a while that obese/overweight people are prone to GERD. The association between GERD and BMI (body-mass index) was unclear. This study clearly showed a link.

10,545 women completed a questionnaire which asked them how often, how severely, and how long they suffered from GERD symptoms. They were categorized according to BMI, which was then referenced over to GERD data.

22% had GERD symptoms once a week or more. Of the women who had had GERD symptoms at some time, 55% described them as moderate.

Those with a BMI under 20 were 33% less likely to suffer from GERD than those with a BMI between 20-22.4.

Women with a BMI of 22.5-24.9 had a 38% higher chance of having GERD symptoms in comparison with the 20-22.4 BMI group.

Women with a BMI higher than 25 are classed as overweight.

The researchers found the increase in GERD risk correlated pretty much in parallel to the increase in the womens' BMI - the trend was linear.

The scientists stressed that they would not advise a person whose weight is ideal to lose weight if he/she is suffering from GERD symptoms.

However, if a person of ideal weight puts on a few pounds and notices his/her GERD symptoms become more severe, losing a few pounds may help alleviate the symptoms. They added that aiming for your ideal weight brings with it a host of other health benefits, including a lower risk of heart disease, cancer and diabetes, as well as reducing GERD symptoms.

GERD is more likely to get people to do something about it than worrying about the risk of diabetes or cancer is. This is because heartburn is an annoying problem that will make you think carefully about your weight. It hits you there and then - put an a few pounds and the annoyance immediately grows, lose a few and the bother immediately goes away.

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American Children Getting Too Fat For Car Safety Seats

Over 250,000 American children under the age of 6 are too heavy for car-safety seats designed for their age-group. Makers of car-safety seats are having to make sturdier models to ensure levels of safety for these seriously obese and overweight children are maintained.

As the American obesity epidemic gains pace and spreads through all age groups, the number of children under 6 who are obese is growing at an alarming rate.

Standard safety-seats are designed for children who weigh less than 40 pounds. Most of the children who were found to be over the limit were three years old. For a three-year-old to weigh over that amount he/she is either incredibly tall or seriously overweight.

Researchers at a Safety Center, John Hopkins Hospital, said if a child weighs more than the seat's weight limit the risks of injury during a car accident are much greater.

Lead researcher Lara Trifiletti said she and her colleagues began to notice that more and more children were very obese and their car-seat technicians were finding it hard to provide car seats to fit them.

(Although Lara Trifiletti worked at Johns Hopkins Hospital at the time of the research, she now works at The Children's Research Institute, Ohio University).

Of the children found to be too heavy for their car seats, 190,000 were 3 years old.

You can read about this study in the journal Pediatrics (April).

3-year-olds are not mature enough (or tall enough) for booster seats, which can be used for slightly older children (booster seats use the car's seat belts).

Five years ago 23% of American children between the ages of two and five were overweight, 10% were obese. The figures today are expected to be higher.

In the nineties, new diet movements blamed the introduction of high carb diets during the seventies for the growth in obesity and overweight in the USA.

Several options for weight control have been present in the USA for the last ten years. Different diets, such as Atkins, The Zone, The South Beach have been around for over a decade now. The increase in obesity over the last ten years has still been accelerating despite new diets being introduced and having had a while to prove themselves nationally.

Many write in to Medical News Today stressing that the focus in the USA has been too much on what people should eat, rather than how much exercise people do. What's the good of telling people to eat steaks and salads (low carb), or keep their total calories down, or eat less fat, or cut down on sugars, if they can't keep it up for more than a year or so.

As one lady from Kansas said:

'Our family, me, my husband and our two 10-year-old children, all used to be overweight. We tried every diet - low carb, high carb, low fat, high fat, everything. They all worked for a bit, then the weight came back on. We then decided to go for speedwalking. We have been speedwalking for 60 minutes a day, the whole family together, for one year now. The weight has come off, and stayed off. Diets work, but not for long. Exercise is easier to sustain if you choose something that is not too strenuous. We decided on walking as that was something we could all do - rather than anything too hard. And it has worked for us. If I had a three-year-old now I would take a stroller and have the child walk part of the way - we could all slow down for him.'

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