Thursday, August 23, 2012

Most Effective Weight Loss Diet Revealed

Scientists at Aberdeen's Rowett Research Institute have shown that a high protein, low carbohydrate diet is most effective at reducing hunger and promoting weight loss, at least in the short term.

Healthy, obese men were given two different diets during their stay in the Rowett's specialised Human Nutrition Unit. Both diets had a high protein content (30% of total energy value of the diet) but they differed in the amount of carbohydrate: One diet was low in carbohydrate (4%) and the other contained a moderate amount of carbohydrate (35% total energy value).

"Our volunteers found both diets to be equally palatable, but they felt less hungry on the high-protein low-carbohydrate diet compared with the diet which contained high-protein but moderate amounts of carbohydrate," said Dr Alex Johnstone, the Rowett's weight-loss expert who led the study.

"Weight loss during the two four week study periods was greater on the high-protein low-carbohydrate diet, averaging 6.3 kg per person, compared with 4.3 kg on the moderate carbohydrate diet," said Dr Johnstone.

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Natural Viagra? "Horny Goat Weed" Shows Promise In Lab Studies

Move over, Viagra! Researchers in Italy report that an ancient Chinese herbal remedy known as "horny goat weed" shows potential in lab studies as source for new future drugs to treat erectile dysfunction (ED). The study, which provides scientific evidence supporting the herb's well-known use as a natural aphrodisiac, is scheduled for the October 24 issue of ACS' Journal of Natural Products, a monthly publication.

In the new study, Mario Dell'Agli and colleagues point out that Viagra (sildenafil) and several other prescription drugs are now available for ED, or male impotence. ED affects an estimated 18 million men in the United States alone. Studies show, however, that these drugs may cause side effects such as headache, facial flushing, stomach upset, and visual disturbances.

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SEROQUEL XR™ Improved Anxiety Symptoms By Day 4 In Generalised Anxiety Disorder - New Study Results Presented Today

AstraZeneca announced new SEROQUEL XR™ (extended release quetiapine fumarate) clinical study data in patients with Generalised Anxiety Disorder (GAD), presented at the 21st European College of Neuropsychopharmacology (ECNP) Congress in Barcelona. In this study, extended release quetiapine fumarate significantly improved symptoms of anxiety at Week 8 compared with placebo and this was observed as early as day 4. The active comparator arm, escitalopram 10mg/day, was also effective at improving symptoms of GAD at week 8 compared with placebo although improvement was not observed at day 4.

During their lifetimes, it is estimated between 2.7% and 5.4% of people in Europe will suffer from GAD.1 Characteristic symptoms include chronic anxiety, exaggerated worry and tension - it is often accompanied by depression or other anxiety disorders2,3 - and it has a substantial negative impact on Health-Related Quality of Life (HRQoL), productivity at work (including absenteeism) and healthcare costs1.

Antidepressants (SSRIs (selective-serotonin reuptake inhibitors) and SNRIs (serotonin and norepinephrine reuptake inhibitors)) are standard treatments that are generally effective but approximately 30 percent of patients treated with SSRIs or SNRIs will have an inadequate response4. Additionally, they may have a relatively slow onset of action, sometimes requiring combination with a short course of benzodiazepines (BZDs) to achieve initial symptom control - however, BZDs may have the potential for dependence and withdrawal symptoms5.

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Major Studies On Mulberry Leaf Show Its Significant Promise For Millions Of Americans Living With Type 2 Diabetes

Major clinical trials conducted by a team of researchers and doctors at the University of Minnesota (Minneapolis VA Hospital), demonstrate that mulberry leaf, the food source of silkworms, can help markedly stabilize blood sugar levels and inhibit carbohydrate absorption in Type 2 diabetics by providing additional support which enables them to make better dietary and lifestyle choices. In these studies, a proprietary mulberry leaf extract developed by Lee Zhong, M.D., Ph.D., a graduate and former researcher at University of California, Los Angeles (UCLA), was shown conclusively to:

-- Reduce body's absorption of sugars and other carbohydrates

-- Lower post-meal blood sugar spikes and stabilize blood sugar levels: One of these studies published in Diabetes Care , the most widely read diabetes journal, reported an average 44 percent reduction in peak post-meal blood sugar elevations (or spikes).

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Nagging Headache Often Linked To Dental Pain

Could that nagging headache and painful jaw be tied to your oral health? Many headache sufferers might want to consult their dentist as well as their doctor since headaches and dental pain have a lot in common, says Director of the Orofacial Pain and Oral Medicine Graduate Program at the USC School of Dentistry Glenn Clark.

Pain centered in the nerves and muscles running throughout the face and neck, as well as poor habits the discomfort may cause, can trap sufferers in a painful feedback loop, with head pain triggering jaw and neck pain and vice versa.

"Headaches and toothaches all transmit through the trigeminal nerve, the largest sensory nerve in the head that supplies the external face, scalp, jaw, teeth and much of the intra-oral structures," Clark says. "Pain in one branch of the nerve has the potential to activate other branches of the nerve, and when that pain is chronic and sustained, it is more likely to trigger a sequence of events that might lead to a headache. In people who have headaches, a continuous, sustained toothache can easily trigger one of the episodic headaches such as migraines."

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The Flexitarian Diet - The Mostly Vegetarian Way To Lose Weight, Lower Blood Pressure, Be Healthier & Add Years To Your Life - New Book

You're inclined toward eating vegetarian - you want to eat less meat and more vegetables, fruits, plant-foods and whole grains. Or maybe you're just more health-conscious than you used to be, but you're not ready to give up that occasional chicken breast or meatball. You want the health benefits of eating vegetarian, without having to give up meat altogether. That makes you part of a growing health movement which has been coined "Flexitarian."

According to registered dietitian Dawn Jackson Blatner, the creator of The Flexitarian Diet: The Mostly Vegetarian Way to Lose Weight, Be Healthier, Prevent Disease, and Add Years to Your Life (McGraw-Hill, October 2008), you can have the benefits of a vegetarian diet without having to follow all of the strict rules. Being a flexitarian is a more flexible, more realistic way to be a vegetarian.

The reality is that even vegetarians can't eat tempeh, tofu, soy and veggies 100% of the time. Studies have shown that nearly two out of three vegetarians don't, or can't, do it full-time.

But the health benefits of eating flexibly vegetarian are many. You'll reduce the likelihood of diseases and cancers.Your blood pressure, glucose, triglyceride, and cholesterol levels will plunge. Vegetarians live roughly 3.6 years longer than meat eaters - and you can reap those benefits simply by eating more plant-based meals, and less meat overall.

These changes will also reflect on your waistline. Vegetarians on average weigh 15% less than non-vegetarians. Think of it this way - six to twelve months of simply eating more plant-based, flexitarian meals could have you shed up to 30 pounds! Blatner's clients have seen these same results without having to follow all the vegetarian rules, but rather following a flexible vegetarian nutrition plan.

And the best part about Flexitarianism is there's no sacrificing taste! The book includes 100 delicious and easy recipes like pesto-style Portobello penne and pizza popcorn. Even grilled cheese sandwiches and barbecue Baja burgers are part of the Flex Diet. As an experienced cooking instructor, Blatner knows what tastes delicious!

All the foodies are in the know about Flexitarianism. Barbara Kingsolver's Animal, Vegetable, Miracle and Michael Pollan's In Defense of Food - even celebrated cookbook author and New York Times food writer Mark Bittman espouses the "less meat, more plants" philosophy. Flexible eating is ecologically sound (studies show eating less meat can also reduce greenhouse gas emissions), will put more plant-foods and variety into your meals, and help you lose weight, too.

Based on science and grounded in choice, eating Flexitarian will bring you closer to the earth, closer to a healthy weight, closer to fresh, seasonal foods that have variety and flavor, and closer to a long, healthy life.
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'Tredaptive'® (Nicotinic Acid/Laropiprant) Authorised In The European Union: New Lipid-Modifying Therapy To Treat LDL-C, HDL-C And Triglycerides

Merck Sharp & Dohme Limited (MSD) announced recently that 'Tredaptive' (nicotinic acid/laropiprant) 1000 mg/20 mg modified-release tablets, a new lipid-modifying therapy for patients with dyslipidaemia and primary hypercholesterolaemia, has been authorised for marketing in the 27 member countries of the European Union (EU) and Iceland and Norway.1

'Tredaptive' combines nicotinic acid (niacin) and laropiprant, a novel flushing pathway inhibitor. Clinical studies have shown nicotinic acid/laropiprant to reduce LDL- cholesterol (LDL-C, or "bad" cholesterol) levels, raise HDL-cholesterol (HDL-C, or "good" cholesterol) and decrease triglycerides (a type of fat in the blood).1 High LDL-C, low HDL-C and elevated triglycerides are risk factors associated with heart attacks and strokes.2,3,4

Professor Ian Young, Consultant in Clinical Biochemistry, Queen's University, Belfast comments, "Lowering LDL-C is the cornerstone of lipid management but a number of studies indicate triglycerides and HDL also have a key role in cardiovascular disease risk. The JBS 2 guidelines recommend that HDL-C and triglyceride values should also be considered in overall lipid management and other lipid lowering drugs should be considered in addition to a statin if cholesterol targets have not been achieved or other lipid parameters need to be addressed. Nicotinic acid/laropiprant can address these key cardiovascular risk factors and therefore could be an important treatment option in combination with statins, when statin monotherapy alone is inadequate, particularly for high risk patients."

Nicotinic acid/laropiprant is indicated for the treatment of dyslipidaemia, particularly in patients with combined mixed dyslipidaemia (characterised by elevated levels of LDL-C and triglycerides and low HDL-C) and in patients with primary hypercholesterolaemia (heterozygous familial and non-familial).1

Nicotinic acid/laropiprant should be used in patients in combination with statins, when the cholesterol lowering effects of statin monotherapy is inadequate. It can be used as monotherapy only in patients in whom statins are considered inappropriate or not tolerated. Diet and other non-pharmacological treatments (e.g. exercise, weight reduction) should be continued during therapy.1

"The approval of nicotinic acid/laropiprant in the European Union further reinforces our long- standing commitment to the cardiovascular area by bringing novel and innovative therapies to patients. The product provides comprehensive management of all three lipid parameters - LDL-C, HDL-C and triglycerides - for many patients," said Stefan Oschmann, President, MSD, Europe, Middle East, Africa and Canada.

Nicotinic acid/laropiprant provided significant improvements in LDL-C, HDL-C and triglycerides

When added to ongoing statin therapy or alone, nicotinic acid/laropiprant 2000 mg/40 mg provided significant improvements in LDL-C, HDL-C and triglycerides when administered for a 24 week period. Nicotinic acid/laropiprant 1000 mg/20 mg daily tablet was initiated at the study start; at week 4 the daily dose was advanced to the maintenance dose of 2000 mg/40 mg (2 x 1000 mg/20 mg tablets) through the remaining 20 weeks of the study. Across weeks 12 to 24 of the study, placebo adjusted results showed that nicotinic acid/laropiprant significantly reduced LDL-C levels (-18 percent), increased HDL-C levels (20 percent) and reduced triglyceride levels (-25 percent).1

When nicotinic acid/laropiprant was co-administered with simvastatin (data pooled across 1000 mg/20 mg or 2000 mg/40 mg doses) LDL-C was reduced by 48 percent, HDL-C increased by 28 percent and triglycerides were reduced by 33 percent following 12 weeks of treatment.1

Flushing with nicotinic acid/laropiprant (modified-release tablet) was significantly less than with nicotinic acid (prolonged release formulation)

In clinical studies, patients taking nicotinic acid/laropiprant (modified-release tablet) experienced significantly less moderate-to-extreme flushing than with nicotinic acid (prolonged release formulation). Patients were initiated on either 1000 mg/20 mg of nicotinic acid/laropiprant or 1000 mg of nicotinic acid or placebo. After 4 weeks, patients were advanced to 2000 mg/40 mg or 2000 mg respectively.1

In patients who continued treatment with nicotinic acid/laropiprant after the dose advancement the weekly frequency of moderate or greater flushing decreased and approached that of patients receiving placebo. In patients treated with nicotinic acid alone, the weekly flushing frequency remained constant (after week 6).1

Fewer discontinuation rates due to flushing with nicotinic acid/laropiprant

In a pool of four active- or placebo-controlled clinical trials of more than 4,700 patients the percentage of patients taking nicotinic acid/laropiprant who discontinued due to any flushing related symptom was 7.2 percent compared to 16.6 percent for the pooled nicotinic acid (prolonged release formulation) alone groups.5

Important information about nicotinic acid/laropiprant

Nicotinic acid/laropiprant is generally well tolerated.5 Flushing is the most common side-effect and is most prominent in the head, neck and upper torso. Additional common clinical adverse reactions (≥ 1 percent to < 10 percent) reported by the investigators as possibly, probably, or definitely related to the product in ≥ 1 percent of patients treated with nicotinic acid acid/laropiprant alone or co-administered with a statin for up to one year included elevations in ALT or AST (consecutive ≥ 3X ULN), fasting glucose, uric acid, dizziness, headache, paraesthesia (a feeling of numbness, tingling, pricking, or burning of the skin), diarrhoea, dyspepsia, nausea, vomiting, erythema (redness of the skin), pruritus (itching), rash, urticaria and feeling hot.1

Nicotinic acid medicinal products have been associated with increases in fasting blood glucose levels.1,5 Diabetic or potentially diabetic patients should be observed closely. Adjustment of diet and/or hypoglycaemic therapy may be necessary.1

As with other nicotinic acid products, nicotinic acid/laropiprant is contra-indicated in patients with significant or unexplained hepatic dysfunction and should be used in caution in those with renal impairment.1


Impact of three major lipids on cardiovascular risk factors

Cardiovascular disease (CVD) is a general term referring to diseases that affect the heart or blood vessels. Coronary heart disease (CHD), also known as coronary artery disease (CAD), is one of the most common forms of CVD and is the leading cause of death globally.6 Major risk factors for CVD include abnormal blood lipids, meaning not only high LDL-C but also high levels of triglycerides and low levels of HDL-C.7,8

CVD is the main cause of death in Europe, accounting for over 4.3 million deaths (48% of all mortality).9 It is also the UK's number one killer with more than one in three people dying from a heart attack or stroke.10 Coronary Heart Disease by itself is the most common cause of death in the U.K. accounting for 101,000 deaths per year.10

About Merck Sharp & Dohme

Merck Sharp & Dohme Limited (MSD) is the UK subsidiary of Merck & Co., Inc., of Whitehouse Station, New Jersey, USA, a leading research-based pharmaceutical company that discovers, develops, manufactures and markets a wide range of innovative pharmaceutical products to improve human health.

Forward-Looking Statement

This press release contains "forward-looking statements" about product development, product potential or about financial performance based on current expectations of the management of Merck & Co., Inc. No forward-looking statement can be guaranteed, and actual results may differ materially from those projected. Merck & Co., Inc. undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events, or otherwise.
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Women With Aggressive HER2 Positive Breast Cancer May Miss Out On Chemotherapy And Trastuzumab (Herceptin®)

Women with a particularly aggressive form of early stage (primary) breast cancer may miss out on optimal treatment which may include chemotherapy and trastuzumab (Herceptin) as a result of untimely or missing HER2-status test results, according to doctors responding to the results from a North of England Cancer Network audit of HER2-testing today.

Women with early stage HER2-positive breast cancer are at double the risk of their cancer returning during the first few years after diagnosis, when they do not receive adjuvant trastuzumab with their chemotherapy, according to trials involving over 13,000 women.[i],[ii],[iii],[iv] This risk is even higher when women with HER2-positive cancer do not receive chemotherapy treatment.

Only one quarter (26%) of 200 clinicians said that HER2 test results were routinely available at the time when a decision is being made about whether a patient will benefit from chemotherapy together with the HER2-targeted treatment trastuzumab (i.e. greater than 75% of the time) - during what is called the 'multi-disciplinary team meeting' (MDTM)[v], according to the results of the North of England Cancer Network audit. The results were presented at the 2008 annual conference of the National Cancer Research Institute.

Dr Mark Verrill, Consultant Oncologist, Newcastle General Hospital said, "For women with early stage HER2-positive breast cancer, chemotherapy with trastuzumab offers patients the best chance of a cure. Without failsafe mechanisms in place to ensure that HER2 status is known, there is a chance that women who may benefit from this treatment will not receive it, putting them at significantly greater risk of their cancer coming back during the first few years after diagnosis.''

Dr Alison Jones, Consultant Oncologist, Royal Free Hospital, London adds, ''Clinicians and patients must have access to all the information about their cancer in a timely fashion so that the best decision about treatment can be made for the patient. We must have the infrastructure in place to do this."

HER2-positive breast cancer is a distinct form of breast cancer that demands attention because HER2-positive tumours are fast growing and are associated with poor prognosis and a high chance of relapse. It is thought that about 1 in 5 women with breast cancer will have HER2-positive tumours.[vi]

The Department of Health estimates 1,000 patient lives will potentially be saved per year if all eligible patients with early stage (adjuvant) HER2-positive breast cancer are treated adjuvantly with trastuzumab.[vii]

It is almost three years to the day since former Health Secretary Patricia Hewitt announced that all women should receive a HER2 status test on diagnosis of breast cancer to identify in good time whether they are eligible for trastuzumab treatment. 7

Results from the North of England Cancer Network audit show that both oestrogen receptor (ER) and HER2 status of the tumour influence treatment decisions made by clinicians. 5

According to 79 percent of clinicians, ER status was routinely (i.e. greater than 75% of the time) available at the MDTM. 5 This compares to 26 per cent of clinicians reporting that HER2 status was routinely available.5

Thirty percent (30%) of clinicians said that HER2 status was rarely (less than 25% of the time) available and missing HER2 results led to extra out-patient visits in 46% of responses. 5

In 2005 more than 45,500 women were diagnosed with breast cancer in the UK.[viii] A recent update to recommendations for HER2 testing in the UK states that HER2 test results at diagnosis of breast cancer should be accurate, reliable, timely and available for the MDTM.[ix]

About treatment of early breast cancer

Women with early stage breast cancer are normally treated with surgery to remove the lump. Sometimes lymph notes in the armpit are also removed.

Radiotherapy is given to help prevent 'local recurrence' or the tumour coming back in the breast.

Chemotherapy (with trastuzumab for HER2-positive breast cancers) is recommended for all but the lowest risk patients to 'mop up' any cancer cells that may have already spread outside the breast.

About trastuzumab

Trastuzumab is the only HER2 targeted treatment with an overall survival benefit for women with HER2 positive breast cancer. Trastuzumab offers thousands of patients diagnosed each year with early stage HER2-positive breast cancer the best chance of a cure4 and enables women to live longer with secondary (metastatic) disease.[x] It has a licence and has been shown to be cost effective in both of these settings.[xi], [xii]

In trials, trastuzumab consistently reduced patient risk of death from early stage HER2- positive breast cancer by about one third4 and risk of the cancer coming back in women by up to a half.1,2,3,4

Like most treatments, trastuzumab is associated with side-effects, the most common of which are mild flu-like symptoms, such as chills and fever during its administration. A clinically important side-effect is the cardiac side-effect experienced by a small number (0.5-4.0%) of patients with early stage HER2 positive breast cancer. 1,3 In the majority of these patients, this effect is of short duration and reversible. Careful monitoring of heart function is recommended during treatment.

Trastuzumab is a humanised antibody, designed to target and block the function of HER2, a protein produced by a specific gene with cancer-causing potential. It has demonstrated efficacy in treating both early and advanced (metastatic) breast cancer. Given on its own as monotherapy as well as in combination with or following standard chemotherapy, trastuzumab has been shown to improve response rates, disease-free survival and overall survival while maintaining quality of life in women with HER2- positive breast cancer.

Trastuzumab received approval for use in the European Union for advanced (metastatic) HER2-positive breast cancer in 2000 and for early HER2-positive breast cancer in 2006. In advanced disease, trastuzumab is now approved for use as a first-line therapy in combination with paclitaxel where anthracyclines are unsuitable, as first-line therapy in combination with docetaxel, and as a single agent in third-line therapy. It is also approved for use in combination with an aromatase inhibitor for the treatment of postmenopausal patients with HER2 and hormone receptor co-positive metastatic breast cancer. In early use, trastuzumab is approved for use following standard (adjuvant) chemotherapy.

Trastuzumab is recommended as a cost-effective option as part of the foundation of care by the National Institute for Health and Clinical Excellence (NICE) in all eligible patients with HER2-positive disease.11,12

Trastuzumab extends survival across all stages of HER2-positive breast cancer by activating the immune system and suppressing the HER2 receptor and preventing HER2 positive cells from growing and dividing.

Trastuzumab is marketed in the United States by Genentech, in Japan by Chugai and internationally by Roche. Since 1998, trastuzumab has been used to treat more than 450,000 HER2-positive breast cancer patients worldwide.

About Roche in the UK

Roche aims to improve people's health and quality of life with innovative products and services for the early detection, prevention, diagnosis and treatment of disease. Part of one of the world's leading healthcare groups, Roche in the UK employs nearly 2,000 people in pharmaceuticals and diagnostics. Globally Roche is the leader in diagnostics, and a major supplier of medicines for the treatment of cancer, transplantation, virology, bone and rheumatology, obesity and renal anaemia. For a copy of the trastuzumab Summary of Product Characteristics or to find out more please visit
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Treximet (sumatriptan And Naproxen Sodium) Tablets Approved By FDA For Acute Treatment Of Migraine

GlaxoSmithKline (LSE & NYSE: GSK) and POZEN Inc. (NASDAQ: POZN) announced that the FDA has approved Treximet for the acute treatment of migraine attacks with or without aura in adults. Treximet is the first and only migraine product designed to target multiple mechanisms of migraine by combining a triptan, a class of migraine-specific medicines pioneered by GSK, and an anti-inflammatory pain reliever in a single tablet.

Treximet contains 85 mg sumatriptan, formulated with RT Technology™, and 500 mg naproxen sodium. Sumatriptan is the active ingredient in Imitrex® Tablets, available in 25 mg, 50 mg and 100 mg strengths. In clinical trials, Treximet provided a significantly greater percentage of patients migraine pain relief at two hours compared to sumatriptan 85 mg or naproxen sodium 500 mg alone. In addition, Treximet provided more patients sustained migraine pain relief from two to 24 hours compared to the individual components.

"Migraine patients want their medicine to work early, and to continue to provide relief," said Dr. Stephen Silberstein, professor of neurology and director of the Jefferson Headache Center at Thomas Jefferson University and an investigator who participated in clinical trials. "The FDA approval of Treximet is good news for migraine patients because clinical trials showed that Treximet produced sustained migraine pain relief for a significant number of patients." Further, Silberstein said, significantly fewer patients on Treximet required the use of a rescue medication to treat their migraine attack than those taking sumatriptan 85 mg.

Treximet is well studied, with more than 3,700 migraine sufferers treating nearly 30,000 migraine attacks in clinical studies. The product is expected to be available in U.S. pharmacies by mid-May.

Clinical trials demonstrated superior efficacy to individual components The approval of Treximet was based on data from two identical double-blind, randomized, placebo-controlled, parallel-group, multicenter studies of more than 2,900 migraine sufferers.

Findings from these pivotal studies demonstrated that Treximet provided more patients migraine pain relief at two and four hours compared to sumatriptan 85 mg, naproxen sodium 500 mg or placebo alone. Importantly, in these studies, Treximet was effective at relieving the pain of a migraine attack and maintaining that relief from two to 24 hours. In addition, Treximet effectively relieved migraine associated symptoms nausea and sensitivity to light and sound compared to placebo.

Treximet was generally well-tolerated in these pivotal studies The most common treatment-related adverse events reported within 24 hours of taking Treximet were dizziness; nausea; somnolence; chest discomfort and chest pain; neck, throat and jaw pain, tightness and pressure; numbness/tingling; upset stomach; and dry mouth.Treximet was also studied in a one-year open-label tolerability and safety study of 565 patients who treated nearly 24,500 migraine attacks with the active drug. Patients completing the one-year study treated an average of five migraine attacks per month with Treximet.

Migraines impact millions of Americans

Migraine headaches continue to be a significant problem for the estimated 29.5 million Americans, nearly half of which are undiagnosed. According to the International Headache Society's diagnostic criteria, migraine is characterized by recurrent headaches which, if untreated, typically last four to 72 hours, with symptoms including moderate to severe headache pain, throbbing head pain, head pain located on one side of the head, head pain aggravated by routine activity, nausea, vomiting, and sensitivity to light and sound.

In the past, many clinicians believed that migraine was a vascular condition, induced by blood vessel dilation alone.

Today, new insight suggests that migraine is much more complex, involving a chain of events that are both neurovascular and inflammatory. Treximet contains sumatriptan that mediates vasoconstriction, which correlates with the relief of migraine headache. It also contains naproxen, an anti-inflammatory agent. Therefore, sumatriptan and naproxen sodium contribute to the relief of migraine through pharmacologically different mechanisms of action.

Important safety information about Treximet

Prescription Treximet is indicated for the acute treatment of migraine attacks, with or without aura, in adults. Treximet should only be used where a clear diagnosis of migraine headache has been established. Treximet may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk. Treximet contains a non-steroidal anti-inflammatory drug (NSAID). NSAID-containing products cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events. Treximet is contraindicated in patients with history, symptoms, or signs of ischemic cardiac, cerebrovascular, or peripheral vascular syndromes and in patients with other significant underlying cardiovascular diseases. Treximet should not be given to patients in whom unrecognized coronary artery disease is predicted by the presence of risk factors without a prior cardiovascular evaluation. Treximet should not be given to patients with uncontrolled hypertension because the components have been shown to increase blood pressure. Concurrent administration of MAO-A inhibitors or use of Treximet within two weeks of discontinuation of MAO-A inhibitor therapy is contraindicated. Treximet and any ergotamine-containing or ergot-type medication (like dihydroergotamine and mthysergide) should not be used within 24 hours of each other. Since Treximet contains sumatriptan, it should not be administered with another 5-HT1 agonist. Treximet is contraindicated in patients with hepatic impairment. Treximet is contraindicated in patients who have had allergic reactions to products containing naproxen. It is also contraindicated in patients in whom aspirin or other NSAIDs/analgesic drugs induce the syndrome of asthma, rhinitis, and nasal polyps. Both types of reactions have the potential of being fatal. Treximet is contraindicated in patients with hypersensitivity to sumatriptan, naproxen, or any other component of the product. Cerebrovascular events have been reported in patients treated with sumatriptan. In a number of cases, it appears possible that the cerebrovascular events were primary. It is important to advise patients not to administer Treximet if a headache being experienced is atypical. The development of a potentially life-threatening serotonin syndrome may occur with triptans, including treatment with Treximet, particularly during combined use with selective serotonin reuptake inhibitors (SSRIs) or selective norepinephrine reuptake inhibitors (SNRIs). NSAID-containing products, including Treximet, should be prescribed with extreme caution in those with a prior history of ulcer disease or gastrointestinal bleeding. Treximet should not be used in late pregnancy because NSAID-containing products have been shown to cause premature closure of the ductus arteriosus. Treximet should not be used during early pregnancy unless the potential benefit justifies the potential risk to the fetus.

For complete Prescribing Information please visit

About GlaxoSmithKline (LSE & NYSE: GSK)

GlaxoSmithKline - one of the world's leading research-based pharmaceutical and healthcare companies - is committed to improving the quality of human life by enabling people to do more, feel better and live longer. For detailed company information, see GlaxoSmithKline's website:

Cautionary statement regarding forward-looking statements

Under the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995, GSK cautions investors that any forward-looking statements or projections made by GSK, including those made in this announcement, are subject to risks and uncertainties that may cause actual results to differ materially from those projected. Factors that may affect GSK's operations are described under 'Risk Factors' in the 'Business Review' in the company's Annual Report on Form 20-F for 2007.


POZEN is a pharmaceutical company committed to developing therapeutic advancements for diseases with unmet medical needs where it can improve efficacy, safety, and/or patient convenience. Since its inception, POZEN has focused its efforts primarily on the development of pharmaceutical products for the treatment of acute and chronic pain, migraine and other pain related conditions. POZEN is also exploring the development of product candidates in other pain-related therapeutic areas. POZEN has a development and commercialization alliance with GlaxoSmithKline. The company's common stock is traded on The Nasdaq Stock Market under the symbol "POZN". For detailed company information, including copies of this and other press releases, see POZEN's website:

Safe harbor statement

Statements included in this press release that are not historical in nature are "forward-looking statements" within the meaning of the "safe harbor" provisions of the Private Securities Litigation Reform Act of 1995. You should be aware that our actual results could differ materially from those contained in the forward-looking statements, which are based on management's current expectations and are subject to a number of risks and uncertainties, including, but not limited to, our failure to successfully commercialize our product candidates; costs and delays in the development and/or FDA approval of our product candidates, including as a result of the need to conduct additional studies, or the failure to obtain such approval of our product candidates, including as a result of changes in regulatory standards or the regulatory environment during the development period of any of our product candidates; our inability to know with certainty what standards the FDA will use to evaluate drug candidates and how that may change or evolve over time; uncertainties in clinical trial results or the timing of such trials, resulting in, among other things, an extension in the period over which we recognize deferred revenue or our failure to achieve milestones that would have provided us with revenue; the receipt of future development, regulatory or sales milestones and royalty payments from our collaboration partners; our inability to maintain or enter into, and the risks resulting from our dependence upon, collaboration or contractual arrangements necessary for the development, manufacture, commercialization, marketing, sales and distribution of any products; competitive factors; our inability to protect our patents or proprietary rights and obtain necessary rights to third party patents and intellectual property to operate our business; our inability to operate our business without infringing the patents and proprietary rights of others; general economic conditions; the failure of any products to gain market acceptance; our inability to obtain any additional required financing; technological changes; government regulation; changes in industry practice; and one-time events, including those discussed herein and in our Annual Report on Form 10-K for the period ended December 31, 2007. We do not intend to update any of these factors or to publicly announce the results of any revisions to these forward-looking statements.

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"Lazy Eye" Treatment Shows Promise In Adults

New evidence from a laboratory study and a pilot clinical trial confirms the promise of a simple treatment for amblyopia, or "lazy eye," according to researchers from the U.S. and China.

The treatment was effective on 20-year-old subjects. Amblyopia was considered mostly irreversible after age eight.

Many amblyopes, especially in developing countries, are diagnosed too late for conventional treatment with an eye patch. The disorder affects about nine million people in the U.S. alone.

Results from the laboratory study will be published online the week of Mar. 3 in PNAS Early Edition.

Patients seeking treatment will need to wait for eye doctors to adopt the non-surgical procedure in their clinics, said Zhong-Lin Lu, the University of Southern California neuroscientist who led the research group.

"I would be very happy to have some clinicians use the procedure to treat patients. It will take some time for them to be convinced," Lu said.

"We also have a lot of research to do to make the procedure better."

In a pilot clinical trial at a Beijing hospital in 2007, 28 out of 30 patients showed dramatic gains after a 10-day course of treatment, Lu said.

"After training, they start to use both eyes. Some people got to 20/20. By clinical standards, they're completely normal. They're not amblyopes anymore."

The gains averaged two to three lines on a standard eye chart. Previous studies by Lu's group found that the improvement is long-lasting, with 90 percent of vision gain retained after at least a year.

"This is a brilliant study that addresses a very important issue," said Dennis Levi, dean of optometry at the University of California, Berkeley. Levi was not involved in the study.

"The results have important implications for the treatment of amblyopia and possibly other clinical conditions."

The PNAS study shows that the benefit of the training protocol which involves a very simple visual task goes far beyond the task itself. Amblyopes trained on just one task improved their overall vision, Lu said.

The improvement was much greater for amblyopes than for normal subjects, Lu added.

"For amblyopes, the neural wiring is messed up. Any improvement you can give to the system may have much larger impacts on the system than for normals," he said.

The Lu group's findings also have major theoretical implications. The assumption of incurability for amblyopia rested on the notion of "critical period": that the visual system loses its plasticity and ability to change after a certain age.

The theory of critical period arose in part from experiments on the visual system of animals by David Hubel and Torsten Wiesel of Harvard Medical School, who shared the 1981 Nobel Prize in Medicine with Roger Sperry of Caltech.

"This is a challenge to the idea of critical period," Lu said. "The system is much more plastic than the idea of critical period implies. The fact that we can drastically change people's vision at age 20 says something."

A critical period still exists for certain functions, Lu added, but it might be more limited than previously thought.

"Amblyopia is a great model to re-examine the notion of critical period," Lu said.

The first study by Lu's group on the plasticity of amblyopic brains was published in the journal Vision Research in 2006 and attracted wide media attention.

Since then, Lu has received hundreds of emails from adult amblyopes who had assumed they were beyond help.

Berkeley's Levi cautioned that the clinical usefulness of perceptual learning, as Lu calls his treatment, remains a "sixty-four thousand dollar question."

"It's clear that perceptual learning in a lab setting is effective," Levi said. "However, ultimately it needs to be adopted by clinicians and that will probably require multi-center clinical trials."

Lu is collecting patients' names for possible future clinical trials.

The researchers are also working to develop a home-based treatment program.

For patients who can travel, the Chinese hospital that hosted the pilot trial may be able to provide treatment.

The other members of Lu's group are Chang-Bing Huang and Yifeng Zhou of the Vision Research Lab at the University of Science and Technology of China, in Hefei, Anhui province (Huang is currently a postdoc in Lu's lab at USC).

Funding for the research came from the Chinese National Natural Science Foundation and the U.S. National Eye Institute.


Amblyopia affects about 3 percent of the population and cannot be rectified with glasses. People with the disorder suffer a range of symptoms: poor vision in one eye, poor depth perception, difficulty seeing three-dimensional objects, and poor motion sensitivity.

Also known as lazy eye, the disorder is caused by poor transmission of images from the eye to the brain during early childhood, leading to abnormal brain development. Lazy eye is actually a misnomer because in many cases the structure of the eye is normal.
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CDC Recommends ZOSTAVAX®, Merck's Shingles Vaccine, For All Appropriate Adults Aged 60 And Older

The U.S. Centers for Disease Control and Prevention (CDC) has adopted the unanimous recommendation of its Advisory Committee on Immunization Practices (ACIP) for the use of ZOSTAVAX® (Zoster Vaccine Live) for the prevention of shingles in adults aged 60 and older. ZOSTAVAX is the only vaccine to prevent shingles, a frequently painful disease marked by a blistering rash that is caused by the reactivation of the chickenpox virus. These final vaccination guidelines were published online today in the CDC's Morbidity and Mortality Weekly Report (MMWR) and are now available to health care providers.

ZOSTAVAX is indicated for the prevention of herpes zoster (shingles) in people 60 years of age and older. The ACIP recommendations call for routine vaccination of all appropriate people 60 years of age and older with a single dose of ZOSTAVAX (referred to in the guidelines as zoster vaccine). According to the recommendations, people who report a previous episode of shingles and people with chronic medical conditions (e.g., chronic renal failure, diabetes mellitus, rheumatoid arthritis, chronic pulmonary disease) can be vaccinated unless those conditions or other conditions the person may have are contraindications or precautions. ZOSTAVAX is not indicated for the treatment of shingles or the persistent nerve pain that can follow shingles in some people, called postherpetic neuralgia, or PHN. The recommendations also specify that ZOSTAVAX should not be used to prevent people who have shingles from developing PHN. According to the recommendations, before routine administration of ZOSTAVAX, it is not necessary to ask patients about their history of varicella (chickenpox) or to conduct serologic (blood) tests for varicella immunity. Shingles vaccination is also included on the CDC's 2007-2008 Recommended Adult Immunization Schedule.

"Many adults do not realize that shingles is caused by the same virus that causes chickenpox. Therefore, anyone who has had chickenpox and more than 90 percent of adults in America have is at risk for shingles," said William Schaffner, MD, professor and chairman, Department of Preventive Medicine and professor, Division of Infectious Diseases, Vanderbilt University School of Medicine, and vice president, National Foundation for Infectious Diseases (NFID). "Shingles can be painful. For most people, the pain associated with the shingles rash lessens as the rash heals, but for some adults shingles may lead to pain that can last for months or even years. Health care providers should review this recommendation and discuss the use of ZOSTAVAX for the prevention of shingles with their appropriate patients aged 60 and older."

More than 43 million adults over the age of 60 in the U.S. are estimated to be at risk for shingles. One out of two people who live to age 85 will have had the disease. Yet, according to results from the CDC's 2007 National Immunization Survey, relatively few adults are getting vaccinated against shingles and other potentially serious infectious diseases. Also, earlier this year, the National Foundation of Infectious Diseases (NFID) released a survey showing that, aside from the flu, most adults have trouble naming diseases that they might be able to prevent by getting vaccinated. This NFID survey found that only four percent of adults surveyed were aware that a vaccine can help prevent shingles.

ZOSTAVAX is contraindicated in persons with a history of anaphylactic/anaphylactoid reaction to gelatin, neomycin, or any other component of the vaccine; with a history of primary or acquired immunodeficiency states including leukemia; lymphomas of any type, or other malignant neoplasms affecting the bone marrow or lymphatic system; or with AIDS or other clinical manifestations of infection with human immunodeficiency viruses. ZOSTAVAX is a live attenuated varicella-zoster vaccine and administration may result in disseminated disease in individuals who are immunosuppressed. ZOSTAVAX is also contraindicated in persons on immunosuppressive therapy. ZOSTAVAX is not indicated in women of childbearing age and should not be administered to pregnant females.

Vaccination with ZOSTAVAX may not result in protection of all vaccine recipients.

Health care providers should question vaccine recipients about reactions to previous vaccines. Health care providers should also inform vaccine recipients of the benefits and risks of ZOSTAVAX. Patients should be provided with a copy of the Patient Information about ZOSTAVAX, and be given an opportunity to discuss any questions or concerns.

Vaccinees should be informed of the potential risk of transmitting the vaccine virus to varicella-susceptible individuals, including pregnant women who have not had chickenpox.

About Shingles

In people who have had chickenpox, shingles can occur at any time, without warning. The risk for shingles increases as people get older. The first signs of shingles are often felt and may not be seen, and may include itching, tingling, or burning. A few days later, a rash of fluid-filled blisters appears, usually on one side of the body or face. The blisters may take two to four weeks to heal. The rash can be painful, with the pain ranging from mild to severe. For most people, the pain from the shingles rash lessens as it heals. But for some people, shingles can cause long-term nerve pain, called postherpetic neuralgia, or PHN. This persistent nerve pain has been described as burning, stabbing, throbbing, or shooting pain. Other problems that may result from shingles include skin infection, muscle weakness, scarring, and decrease or loss of vision or hearing. There are approximately one million cases of shingles in the U.S. each year an estimated half of which occur in people 60 years and older.

Access and Reimbursement for ZOSTAVAX

Over 50,000 physicians' offices, pharmacies and public health clinics have ordered ZOSTAVAX since FDA approval. Approximately 3,000 pharmacies are currently participating in the Merck Adult Vaccination Program. This program, designed to help expand access to adult vaccines, including ZOSTAVAX, assists health care providers who want to refer patients to a pharmacy or vaccine service provider location that provides adult vaccinations.

Health plans covering approximately 94 percent of privately-insured lives in the U.S. have approved reimbursement for ZOSTAVAX. Additionally, ZOSTAVAX is eligible for reimbursement under the Medicare Part D prescription drug benefit, and plans covering more than 90 percent of Part D enrollees are reimbursing for ZOSTAVAX. However, individual coverage and reimbursement for privately insured lives and Part D enrollees are subject to the individual's benefit design, including any applicable co-pays, co-insurance and/or deductibles. People 60 and older are encouraged to contact their insurance provider to inquire about their coverage for ZOSTAVAX.

The U.S. Veterans Health Administration makes ZOSTAVAX available to veterans who are patients at VA medical facilities nationwide. Also, TRICARE, the health care plan for the U.S. Department of Defense Military Health System, made ZOSTAVAX a covered medical benefit for plan beneficiaries ages 60 and older. TRICARE administers the health care plan for the uniformed services, retirees and their families.

ZOSTAVAX is part of Merck's Vaccine Patient Assistance Program in the U.S. Through this program, currently available in private physicians' offices and private clinics, Merck makes available, free of charge, ZOSTAVAX and other Merck vaccines indicated for use in eligible individuals ages 19 and older, to people who are uninsured and who are unable to afford vaccines. For more information on the Merck Vaccine Patient Assistance Program, go to

Selected Important Information about ZOSTAVAX

ZOSTAVAX is a live attenuated virus vaccine indicated for prevention of herpes zoster (shingles) in individuals 60 years of age and older. ZOSTAVAX is not indicated for the treatment of zoster or PHN.

ZOSTAVAX is contraindicated in persons with a history of anaphylactic/anaphylactoid reaction to gelatin, neomycin, or any other component of the vaccine; with a history of primary or acquired immunodeficiency states including leukemia; lymphomas of any type, or other malignant neoplasms affecting the bone marrow or lymphatic system; or with AIDS or other clinical manifestations of infection with human immunodeficiency viruses. ZOSTAVAX is a live attenuated varicella-zoster vaccine and administration may result in disseminated disease in individuals who are immunosuppressed. ZOSTAVAX is also contraindicated in persons on immunosuppressive therapy. ZOSTAVAX is not indicated in women of childbearing age and should not be administered to pregnant females.

Transmission of vaccine virus may occur rarely between vaccinees and susceptible contacts. ZOSTAVAX is not indicated for prevention of primary varicella infection (chickenpox). Vaccination with ZOSTAVAX may not result in protection of all vaccine recipients.

Vaccine-related, injection-site and systemic adverse experiences in >1 percent of individuals in the Adverse Event Monitoring Substudy (AEMS), a subgroup of individuals from the Shingles Prevention Study (SPS) who received ZOSTAVAX (n=3,345), included headache (1.4 percent) and the following injection-site reactions: erythema (33.7 percent), pain/tenderness (33.4 percent), swelling (24.9 percent), hematoma (1.4 percent), pruritus (6.6 percent), and warmth (1.5 percent). Most of these adverse experiences were reported as mild in intensity.

From Day zero to 42 post vaccination, in the overall study population, serious adverse experiences (SAEs) occurred at a similar rate (1.4 percent) in subjects vaccinated with ZOSTAVAX or placebo. In the AEMS, the rate of SAEs was increased in the group who received ZOSTAVAX (1.9 percent) as compared to the placebo group (1.3 percent) from Day zero to 42 post vaccination. Over the course of the entire study, in the overall study population, investigator-determined, vaccine-related serious adverse experiences were reported for two subjects vaccinated with ZOSTAVAX (asthma exacerbation and polymyalgia rheumatica) and three subjects who received placebo (Goodpasture's syndrome, anaphylactic reaction, and polymyalgia rheumatica).

Among reported serious adverse events in the SPS (Days 0-42 post vaccination), serious cardiovascular events occurred more frequently in subjects who received ZOSTAVAX (20 [0.6 percent]) than in subjects who received placebo (12 [0.4 percent]) in the AEMS. The frequencies of serious cardiovascular events were similar in subjects who received ZOSTAVAX (81 [0.4 percent]) and in subjects who received placebo (72 [0.4 percent]) in the entire SPS study cohort (Days 0 - 42 post vaccination).

About Merck

Merck & Co., Inc. is a global research-driven pharmaceutical company dedicated to putting patients first. Established in 1891, Merck currently discovers, develops, manufactures and markets vaccines and medicines to address unmet medical needs. The Company devotes extensive efforts to increase access to medicines through far-reaching programs that not only donate Merck medicines but help deliver them to the people who need them. Merck also publishes unbiased health information as a not-for-profit service. For more information, visit

Forward Looking Statement

This press release contains "forward-looking statements" as that term is defined in the Private Securities Litigation Reform Act of 1995. These statements are based on management's current expectations and involve risks and uncertainties, which may cause results to differ materially from those set forth in the statements. The forward-looking statements may include statements regarding product development, product potential or financial performance. No forward-looking statement can be guaranteed and actual results may differ materially from those projected. Merck undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events, or otherwise. Forward-looking statements in this press release should be evaluated together with the many uncertainties that affect Merck's business, particularly those mentioned in the risk factors and cautionary statements in Item 1A of Merck's Form 10-K for the year ended Dec. 31, 2007, and in any risk factors or cautionary statements contained in the Company's periodic reports on Form 10-Q or current reports on Form 8-K, which the Company incorporates by reference.

ZOSTAVAX® is a registered trademark of Merck & Co., Inc., Whitehouse Station, N.J., U.S.A.
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New Emollient Cream Dexeryl(R) Preferred By Patients With Ichthyosis And Eczema

Dexeryl® cream, a new topical emollient and moisturising cream from Pierre Fabre Dermatologie is launched today. It has been shown to be effective but, importantly, patients significantly prefer using Dexeryl (p < 0.001).1 Dry skin conditions like ichthyosis and eczema are hugely prevalent in the UK with atopic eczema affecting a fifth of school-age children.2 In many cases, atopic eczema is associated with ichthyosis;3,4 a distressing condition involving continual widespread scaling of the skin.5

The impact of atopic eczema and ichthyosis on quality of life can be considerable; leading to time lost from work or school; impacting social relationships and also increasing anxiety, depression and other psychological problems.2,6 For the majority of people with atopic eczema and ichthyosis, their mainstay treatment will involve regular daily application of emollient.2 An emollient works by moisturising the skin, which is important to maintain the skin's natural barrier; reducing skin perspiration; keeping irritants or disease out and preventing painful cracking.2

"One of the key skin treatments in looking after eczema and ichthyosis is to use emollients as often as possible; they are the foundation on which all additional treatment is based. However, the most important consideration is whether the patient finds the emollient recommended by their physician acceptable to use. The most greasy that is tolerated should be used and this may vary during the day so that a lighter cream may be more appropriate for daytime use and a greasier one at night. Sticky, messy or difficult-to-apply emollients will simply not be used as often as they should be so the patient's skin condition can easily get out of control," comments Dr David Paige, Chairman of the Medical Advisory Board to the Ichthyosis Support Group.

"Ichthyosis varies enormously across and within the different types; it is therefore very important for sufferers to have a choice of emollients which are appropriate to the severity of their condition." Ichthyosis Support Group.

Bao-Tam Phan, a pharmacist and UK Marketing & Training Manager at Pierre Fabre Dermatologie, the manufacturers of Dexeryl comments on Dexeryl's formulation: "The combination of glycerol, which improves the stratum corneum elasticity and white, soft paraffin and liquid paraffin in Dexeryl offers a highly acceptable non-sticky and non-greasy formulation, which patients in our trials significantly prefer."

Dexeryl is available in 250g tubes and is fully reimbursed and available on prescription; the NHS price is £3.16. Product is available through Unichem, Phoenix, Mawdsley Brookes and K Waterhouse wholesalers.

About ichthyosis

Ichthyosis is the term used to describe continual and widespread scaling of the skin. It may be inherited (genetic) or acquired during life. The inherited forms are rare and are generally present from infancy and are usually lifelong conditions. Ichthyosis vulgaris is the commonest form of inherited ichthyosis affecting one in every 250 people. It is usually quite mild and develops in early childhood with fine, light grey scales and roughness on the arms and legs. It may be more widespread and is more obvious in the winter time and in temperate climates. It is sometimes associated with atopic or childhood allergic eczema and may cause an increased wrinkling of the palms and soles. It can be improved with regular application of moisturisers.3

About atopic eczema

Atopic eczema is a dry, itchy inflammation of the skin. The words 'eczema' and 'dermatitis' are interchangeable Atopic eczema can affect any part of the skin, including the face, but the areas most commonly affected are the bends of the elbows, around the knees, and around the wrists and neck. These are known as 'flexural' areas. It affects both sexes equally and usually starts in the first weeks or months of life. It is most common in children, affecting at least 10% of infants, although it can carry on into adult life or come back in the teenage or early adult years. The treatments used most often are moisturisers, and topical steroid creams or ointments.7

About Dexeryl®

Dexeryl combines Glycerol, which improves the stratum corneum elasticity, with white soft paraffin and liquid paraffin, which act as an emollient and helps restore the skin barrier. This combination helps to reduce skin perspiration, enhances moisturising and improves the skin barrier function helping therefore to help to reduce irritating itching and pruritus phenomena. Patient should apply a thin layer of cream to the skin once or twice daily, or more if needed. The safety, efficacy, and acceptability of Dexeryl®, was evaluated compared to gelified glycerol, a reference French National Formulary preparation for the symptomatic treatment of moderate ichthyosis. This randomised single-blind study was conducted on 70 patients with ichthyosis. Evaluation criteria were based on the progression and outcome of symptoms of ichthyosis (presence of scales, rough skin, thickness of the skin). The investigator's and each subject's overall opinions were collected. The statistically significant efficacy of the two products at the end of four weeks was demonstrated (p = 0.001). There was no significant difference between the two products of the following criteria: outcome of rough skin, skin thickness, and the investigator's overall opinion. The subject's opinion demonstrated a statistically significant difference in favor of Dexeryl® (p < 0.001), corresponding to a preference for use (ease of spreading and penetration of product, skin appearance, skin comfort).1


1. Single blinded randomised comparative study on Dexeryl efficacy and tolerance in the symptomatic treatment of ichthyosis. C. Blanchet, L. Parmentier, JM Pibourdin, P. Dupu Nouv. Dermatol. 2000 664-668



4. Prevalent and rare mutations in the gene encoding filaggrin cause ichthyosis vulgaris and predispose individuals to atopic dermatitis. Sandilands A, O'Regan GM, Liao H, et al. J Invest Dermatol. 2006 Aug;126(8):1770-5




Pierre Fabre Dermatologie

Pierre Fabre Laboratories is a leading French independent pharmaceutical company re-investing 13% of its turnover in R&D in 5 area of excellence: oncology, central nervous system, cardiovascular, immunology and dermatology. Pierre Fabre is organised in 3 divisions: ethical, OTC and dermatology-based cosmetics and hair care.

Pierre Fabre Dermatologie
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Embryonic Parasitic Twin Removed From 9-Year-Old Girl's Stomach

Doctors at the General Hospital in the Greek city of Larissa said yesterday, Thursday, that they had successfully removed an embryonic parasitic twin from the stomach of a 9-year-old girl.

The girl, whose family asked that she not be named, was suffering from stomach pains, which the doctors established were due to a tumour growing on the right side of her belly. She has since made a full recovery, said the hospital authorities.

Larissa General Hospital's director, Lakovos Brouskelis told the press:

"They could see on the right side that her belly was swollen, but they couldn't suspect that this tumor would hide an embryo."

On closer examination the doctors found that the growth concealed an embryo six centimeters (about two inches) long, fully formed with a head, hair and eyes but no brain and no umbilical cord, reported the Associated Press.

A parasitic twin results from the same biological process that produces conjoined twins and vanishing twins (where one twin "disappears" early in the pregnancy). The twin embryo grows in the uterus but it does not fully separate into two individuals: one stops developing and becomes "vestigial" inside the other fully formed and usually quite healthy twin.

The chance of developing a parasitic twin is very rare, and occurs in around one in 500,000 births. There have only been about 90 such recorded cases in the world.

Last year, Filipino television aired a programme about a Eljie Millapes, a baby girl whose parents were alarmed at how big her stomach was growing when she was two months old. Doctors later found she had a "fetus in fetu" lodged inside, which is a special type of parasitic twin that contiues to grow like a tumor, but it is still parasitic in that it is fully dependent on the "host" twin for its blood supply.

Perhaps the most famous case of fetus in fetu is that of 7-year-old Alamjan Nematilaev in Kazakhstan in 2003. A school doctor noticed the boy's enlarged stomach was showing movement inside, and referred him to a hospital where they removed what they thought was a cyst only to find a highly developed identical twin brother with hair, fingers, nails, genitals, limbs, head and almost a face.

Click here for more information on "parasitic twins" (wikipedia).

For a fuller layman's account of the genetics and biology of embryo development read "The Boy Who Gave Birth to His Twin", by Dr Martin Brookes, (, Dec 03)

Source: Associated Press, GMA News, Agence France-Presse, wikipedia.
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ICU Nursing-Nurse Interventions In Acute Exacerbations Of COPD

ICU Nursing

Intensive Care Unit (ICU) nursing is commonly referred to as critical care nursing. Critical care nursing deals specifically with the human response to life threatening conditions. Critical care nursing is challenging due to the life-threatening health situations in the ICU. Critical care nurses are often in highstress situations which demands complex assessments, highintensity therapies and interventions and continuous vigilance.

Acute Exacerbations of COPD

Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive lung disease (COLD), is a term used to describe progressive lung diseases, which include emphysema, chronic bronchitis and chronic asthma. The common symptoms of COPD are progressive limitations of the airflow into and out of the lungs and shortness of breath. Emphysema and chronic bronchitis are closely related and patients with COPD may have both, which affects lung function. Emphysema involves destruction of the alveoli in the lungs. Chronic bronchitis is characterized by chronic cough and mucus production.

Over a period of time the patient experiences abnormal ventilationperfusion, insufficient oxygenation of blood (hypoxemia), hypoventilation and right-sided heart failure. People with COPD have a variety of illnesses such as, atelectasis which occurs due to the collapse of part or all of a lung by blockage of the bronchus or bronchioles or by very shallow breathing; bronchiectasis, which is an acquired disorder of the large bronchi that become dilated due to destructive infections of the lungs; congestive heart failure (CHF),a disorder in which the heart loses its ability to pump and cor pulmonale ,where the right ventricle gets enlarged because of pulmonary hypertension from lung disorders. COPD symptoms, when ignored, usually lead to hospitalization in intensive care (ICU) units.

Nurse Interventions in Acute Exacerbations

People with chest deformities or neurologic conditions that cause shallow breathing benefit from mechanical devices that assist breathing, such as continuous positive airway pressure, which delivers oxygen through a nose or face mask that prevent airways collapse, even at the end of a breath. Additional respiratory support can be provided with a mechanical ventilator. The primary treatment for acute massive atelectasis, a common complication in COPD is removal of the underlying cause (Brooks-Brunn, 1995).

If the blockage cannot be removed by coughing or by suctioning the airways then it should be removed by bronchoscopy. Antibiotics are to be given for any detected infection as in chronic atelectasis, when infection is almost inevitable. Treatment of atelectasis due to deficient or ineffective surfactant is done by treating the low blood oxygen either with mechanical ventilation or positive end expiratory pressure. For cor pulmonale, supplemental oxygen can be administered to increase the level of oxygen in the blood. A low salt diet is recommended. Diuretics are given to remove excess fluid from the body. Calcium channel blockers, intravenous prostacyclin, or the oral medication bosentan are frequently used to treat pulmonary hypertension. Blood thinning anticoagulants are also useful. Oxygen administration relieves symptoms and prolongs survival. Careful intervention is essential because progressive pulmonary hypertension and cor pulmonale often leads to severe fluid retention, lifethreatening shortness of breath, shock, and death.

Benzodiazepines are not recommended to relieve anxiety in patients with COPD because they decrease respiratory drive and compromise lung function (Brooks-Brunn, 1995). An anxiolytic, buspirone, have been found to be safe in reducing anxiety in COPD patients. Dyspnea is common in individuals with chronic obstructive pulmonary disease. Respiratory assessment of the patient should include present level of dyspnea measured using a quantitative scale such as a visual analogue or numeric rating scale. Usual dyspnea is measured using a quantitative scale such as the Medical Research Council (MRC) Dyspnea Scale.

The other assessments include Vital signs, pulse oximetry, chest auscultation, chest wall movement and shape/abnormalities, presence of peripheral edema, accessory muscle use, presence of cough and/or sputum, ability to complete a full sentence and the level of consciousness. By doing so, nurses should be able to detect stable and unstable dyspnea and acute respiratory failure (American Thoracic Society, 1998). Nurses should also be able to offer interventions for all levels of dyspnea including acute episodes of respiratory distress which includes acceptance of patients' self-report of present level of dyspnea, medications, controlled oxygen therapy, secretion clearance strategies, noninvasive and invasive ventilation modalities, energy conserving strategies, relaxation techniques, nutritional strategies and breathing retraining strategies. It is important for the nurses to remain with patients during episodes of acute respiratory distress. Nurses have to assess patients for hypoxemia/hypoxia and administer appropriate oxygen therapy for individuals for all levels of dyspnea. Medications include bronchodilators, beta 2 agonists, anticholinergics and methylxanthines, corticosteroids, antibiotics, psychotropics and opioids (

Patient safety checks

Patient safety checks include circuit leaks; maintenance of positive pressure; adequate inspiratory air flow and not leaving the patient alone. Continuous Positive Airway Pressure Oxygen therapy is part of any ICU and requires absolute attention.

Managing the therapy involves maintenance of the desired FIO2; level of positive airway pressure and time period for CPAP therapy, attaching CPAP machine medical air and oxygen gas lines to wall sources, preparation of humidification source ,selection of prescribed FIO2 on oxygen blender, turning flow on to level above 25 litres / min., positioning of rubber securing band behind the patient's head, centred on occiput, positioning of face mask over the patient, adjusting the level of positive expiratory pressure to prescribed level, adjusting inspiratory gas flow so that minimal fluctuations are present on pressure gauge, observing and documenting respiratory rate; work of breathing and SpO2, increasing inspiratory flow if respiratory work is excessive or the patient complains of continuing dyspnea, maintaining continuous SpO2 monitoring with alarm function in place, maintaining humidification temperature at 36 degree C or at temperature tolerated by the patient (American Thoracic Society, 1998).

Patient observations include, visual check every half an hour, documentation of respiratory rate, SpO2, nausea and vomiting, monitoring pulse rate and rhythm; blood pressure; peripheral circulation and proper functioning of humidification system every hour, checking the condition of skin around and under mask and rubber securing band, documentation of condition and interventions, condition of conjunctivae every two hours, auscultation of lungs for equal air entry and palpitation of abdomen for distension every four hours (Vollman,1997). Ventilator-Associated Pneumonia is a common nosocomial infection in the ICU accounting for 13% to 18% of all nosocomial infections (Rello, 1996).

Infection may be even due to improper hand washing, not changing the gloves from patient to patient, and contamination of respiratory devices like nebulizers, spirometers, oxygen sensors, bag-valve mask devices, and suction catheters (Shelby Hixson, 1998). Oral care includes brushing the patient's teeth, use of solutions and mouthwash to cleanse the mouth, and periodical suctioning of oral secretions. Nasal care and proper cleansing of the nasopharynx reduces bacterial infection.


The ICU setting demands stressful nursing interventions and constant monitoring of the patients especially with conditions like COPD. Nurse interventions should be based on assessment of dyspnea, vital signs, pulse oximetry, chest auscultation, chest wall movement and presence of peripheral edema, cough and/or sputum, ability to complete a full sentence and the level of consciousness. Proper oral and nasal care reduces lung infection.


-- American Thoracic Society (1998).Research Priorities in Respiratory Nursing. Am. J. Respir. Crit. Care Med.158 (6): 2006-2015.
-- Brooks-Brunn, J. A (1995). Postoperative atelectasis and pneumonia. Heart Lung 24: 94-115. Link.Nursing care of dyspnea: the 6th vital sign in individuals with chronic obstructive pulmonary disease (COPD).
-- Kingston GW, Phang PT and Leathley MJ (1991). Increased incidence of nosocomial pneumonia in mechanically ventilated patients with subclinical aspiration. Am J Surg 161: 589-593.
-- Metheny N (1993). Minimizing respiratory complications of nasoenteric tube feedings: State of the science. Heart Lung 22:213-223.
-- Rello J, Sonora R, Jubert P, Artigas A, Rue M, Valles J (1996). Pneumonia in intubated patients: Role of respiratory airway care. Am J Respir Crit Care Med 154:111-115.
-- Shelby Hixson, Tracey King, Nursing Strategies to Prevent Ventilator-Associated Pneumonia. AACN Clinical Issues: Advanced Practice in Acute and Critical Care 9 (1).
-- Vollman, KM (1997). Prone positioning for the ARDS patient. Dimens Crit Care Nurs 16: 184-193.
-- Zaloga GP (1991). Bedside method for placing small bowel feeding tubes in critically ill patients: A prospective study. Chest 100:1643-1646.

-- Journal of Nursing

-- Journals belonging to the American Society of Registered Nurses

The American Society of Registered Nurses (ASRN) was founded in May 2003 for the purpose of bringing together professional nurses interested in creating a nursing "society" which is defined as "A group of humans broadly distinguished from other groups by mutual interests, participation in characteristic relationships, shared institutions, and a common culture".

This new Society brings together nurses from all fields of inquiry, regions, and specializations both inside and outside academe in order to expand the study and practice of nursing, and offer support, resources, education, and distinction to its members. The Society serves nurses in all 50 states as well as across the globe. ASRN represents a community for all nursing voices. We invite registered nurses, international professionals, and new graduates to discover ASRN. Our goal is to advance nursing as a science and profession.

American Society of Registered Nurses (ASRN)
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New Findings On Mercury Content In Salmon

A new study published in Environmental Toxicology and Chemistry finds that although mercury levels in both wild and farmed salmon from British Columbia are substantially below human health consumption guidelines, the levels found in wild salmon were three times higher than in farmed salmon.

A large proportion of the farmed salmon consumed in the United States originates in British Columbia, Canada. Over the years, there have been health concerns because high levels of methylmercury have been found in long-lived fish species nearer to the top of the food chain - such as tuna and salmon. High mercury levels have been associated with an increase in the risk of cancer, and this has led many people to avoid consuming certain fishes.

This most recent study has determined that levels of mercury and other trace metals measured in both farmed and wild salmon were significantly below Health Canada's consumption guidelines. Compared to wild salmon, the researchers found that farmed salmon did not have significantly higher concentrations of metals such as arsenic, cobalt, copper, or cadmium. The threefold higher mercury concentration observed in the flesh of wild salmon than in farmed salmon is potentially explained by farmed salmon's low gastrointestinal absorption efficiency, its negligible transfer of metals to muscle tissue, and its rapid growth cycles (growth dilution). In farmed fish, there were no differences in metal levels found between pre- and post-processing.

For comparison to other parts of the human diet, the researchers indicate that total mercury levels were slightly higher in wild or farmed salmon than in chicken, beef, or pork and about the same as in fruit, vegetables, honey, and eggs. Compared to other foods, salmon contains lower levels of other trace elements. The average dietary intake of mercury and trace metals from salmon still remains a paltry 0.05% to 32% compared to the 68% to 99% that is absorbed from meat, poultry, fruit, and vegetables. Salmon also contains its own protection against mercury in the form of the element selenium. The moderate surplus of this metal can counteract mercury's toxicity.

"Estimates of human dietary exposure indicate that human health risks associated with trace metal exposure via consumption of farmed and wild British Columbia salmon are negligible," conclude the authors. "The current scientific evidence therefore supports the weekly consumption of oily fish species (including all British Columbia salmon sources) as recommended by the American Heart Association."

Mercury and Other Trace Elements in Farmed and Wild Salmon from British Columbia, Canada

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Baby's Gender Linked To Mother's Diet At Conception

New research from the UK suggests that a baby's sex is linked to his or her mother's diet around the time of conception and the finding may explain why fewer boys are born nowadays in the industrialized world, including the UK and the US.

The study is the work of researchers at the Universities of Exeter and Oxford and is published today in the Proceedings of the Royal Society B: Biological Sciences.

The researchers found a strong link between the consumption of a high energy diet around the time of conception and giving birth to sons.

Over the last four decades the birth rate for boys has been declining steadily in industrialized countries including the UK, the US and Canada. The decline is small but consistent, at around one in 1,000 births a year, said the researchers.

For the study, lead author Dr Fiona Mathews of the University of Exeter and colleagues investigated the diets of 740 first time mothers living in the UK who did not know the sex of their unborn child. The mothers to be gave information about their eating habits before and around conception and during the early months of their pregnancy.

The participants were grouped according to their daily calorie intake at around conception and the results compared with the sex of their baby.

The results showed that:
  • 56 per cent of the women in the highest energy intake group had sons.

  • This compared with only 45 per cent of the women in the lowest energy intake group.

  • Women who had sons not only had higher energy diets but they were also more likely to have eaten a wider range and higher amount of nutrients such as potassium, calcium, plus vitamins C, E and B12.

  • There was also a strong association between eating breakfast cereals and having sons.
The women were representative of the UK average according to weight, health and lifestyle, and there was no link between the mother's body mass index (BMI) and smoking and caffeine intake before pregnancy and the sex of the babies.

Other studies have found that average energy intake in the developed world has reduced, and that the obesity epidemic is driven by increased sedentary living and changes in food quality and eating habits. In the developed world many people now skip breakfast; in the US the percentage of adults who had breakfast fell from 86 per cent in 1965 to 75 per cent in 1991, said the authors.

Mathews suggested that:

"This research may help to explain why in developed countries, where many young women choose to have low calorie diets, the proportion of boys born is falling."

She said the discovery is evidence of a natural way where women are already using diet to determine the sex of their baby, which is interesting when contrasted with the current debate on whether legislation should be introduced to regulate gender clinics that allow parents to choose the sex of their baby, for non medical reasons.

Biologists have noticed that many animal species produce more sons when resources are abundant or the mother is high ranking (meaning she gets the best food). This is commonly observed in invertebrates and mammals as well, such as horses, some types of deer and cows. The phenomenon is often explained as an evolved survival strategy.

"Potentially, males of most species can father more offspring than females, but this can be strongly influenced by the size or social status of the male, with poor quality males failing to breed at all," said Mathews, adding that on the other hand, females tend to reproduce more consistently:

"If a mother has plentiful resources then it can make sense to invest in producing a son because he is likely to produce more grandchildren than would a daughter. However, in leaner times having a daughter is a safer bet," she explained.

Although the father, through sperm, determines the sex of the fetus, mothers appear to have influence too. While poorly understood in mammals, IVF research suggests that high levels of maternal blood glucose inhibit female embryos but encourage male embryos to grow.

Perhaps the increasing tendency for humans to skip breakfast, which depresses glucose levels, is giving the body the impression that resources are low and food is scarce, suggested the authors.

Click here for Proceedings of the Royal Society B: Biological Sciences.

Sources: University of Exeter press release.
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