Dose of measles virus destroys woman's incurable cancer

In what they describe as a proof of principle study, doctors in the US were able to keep a woman with deadly multiple myeloma - an incurable bone marrow cancer - free of all signs of living cancer cells for over 6 months by giving her just one high dose of measles virus.

Two patients received a single intravenous dose of measlesvirus that was engineered to kill myeloma plasma cells and not harm other cells.

The team, from the Mayo Clinic in Rochester, MN, says both patients responded to the treatment, showing reduced bone marrow cancer and levels of myeloma protein.

But one patient, a 49-year-old woman, experienced complete remission and remained disease-free for over 6 months.

A report on this first study to establish the feasibility of the treatment appears in the journal Mayo Clinic Proceedings.

Proof virotherapy works for disseminated cancer

First author Dr. Stephen Russell, hematologist and co-developer of the therapy, says:

"This is the first study to establish the feasibility of systemic oncolytic virotherapy for disseminated cancer. These patients were not responsive to other therapies and had experienced several recurrences of their disease."

The treatment is an example of oncolytic virotherapy - using engineered viruses to fight cancer - an approach that dates back to the 1950s. Thousands of patients have received this type of therapy, using oncolytic viruses from various families, including common cold viruses, herpes viruses and pox viruses.

But the authors say this is the first well-documented case of a patient with cancer that has spread experiencing complete remission at all disease sites after receiving oncolytic virus therapy.

Myeloma is a cancer that develops in plasma cells - a type of blood cell made in the bone marrow. According to the American Cancer Society, the disease is relatively uncommon, and in the US, there is a 1 in 149 risk of developing it.

Myeloma can arise in any part of the body where there is bone marrow, including the spine, rib cage and pelvis. Multiple myeloma means it is occurring in more than one place.

The disease, which also causes skeletal or soft tissue tumors, usually responds to drugs that stimulate the immune system, but it eventually overcomes them and is rarely cured.

First use of highest possible dose of engineered measles virus

Dr. Russell and colleagues explain in their article that they chose to report these two cases in particular because they were the first patients they had studied who had received the highest possible dose, and with limited previous exposure to measles, so their immune systems did not have many antibodies to the virus. They had also exhausted other treatment options.

Senior author Dr. Angela Dispenzieri, an expert in multiple myeloma, says in very simple terms, the measles virus makes the cancer cells join together and explode. The treatment also appears to trigger another lasting benefit:

"There's some suggestion that it may be stimulating the patient's immune system to further recognize the cancer cells or the myeloma cells and help mop that up more effectively than otherwise."

Having effectively completed a phase I clinical trial - to prove the concept that the measles virus can fight cancer - the team is now moving quickly into a phase II trial involving more patients.

They also intend to test the virus's effectiveness as a tool to fight other cancers, such as head and neck, brain and ovarian cancers and mesothelioma. And they are engineering other viruses that may be able to kill cancer cells.

Dr. Russell says they have recently started to think along the lines of "a single shot cure for cancer, and that's our goal with this therapy."

He and two other authors of the study, as well as the Mayo Clinic, have declared a financial interest in the methods used in the study, which was funded by the National Cancer Institute of the National Institutes of Health, Al and Mary Agnes McQuinn, The Harold W. Siebens Foundation and The Richard M. Schulze Family Foundation.

Medical News Today recently reported on a study in Nature Genetics, where scientists from The Institute of Cancer Research in the UK found a gene involved in aging is linked to multiple myeloma. The team said the discovery brings the total genetic variants linked to myeloma to seven and may help establish the genetic causes of the disease.

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New blood test 'could accurately predict heart attack risk'

According to The Heart Foundation, more than 920,000 Americans will suffer a heart attack this year, and many of these will occur without warning. But researchers from The Scripps Research Institute in California say they have created a blood test which may be able to predict whether patients are at high risk of heart attack.
The research team, led by Prof. Pete Kuhn, says that at present there is no test available that can predict the occurrence of a heart attack with good accuracy.
But they say their novel test, details of which have been recently published in the journal Physical Biology, has so far proved successful in identifying which patients are undergoing treatment for a recent heart attack and which patients are healthy.

Test identifies endothelial cells in blood

The new test uses a "fluid biopsy" technique. It works by identifying the presence of endothelial cells - which line the artery walls - in the bloodstream.
According to the researchers, endothelial cells that circulate in the bloodstream have been associated with ongoing heart attacks.

Researchers say the HD-CEC test can accurately detect circulating endothelial cells in patients, meaning the test could be used to predict heart attack risk.

They believe that endothelial cells enter the bloodstream as a result of diseased plaque building up, rupturing and ulcerating in the arteries, which triggers inflammation.
They add that this damage to the arteries can lead to the formation of blood clots. This stops the blood flowing through the arteries, which in turn can cause a heart attack.
Using a newly-created procedure called the High-Definition Circulating Endothelial Cell (HD-CEC) assay, the researchers were able to identify and differentiate endothelial cells in blood samples of 79 patients, all of whom had already suffered a heart attack when their samples were taken.
The researchers also used the HD-CEC assay on two groups of patients as a control measure. One group was made up of seven patients who were receiving treatment for cardiovascular disease, while the other group consisted of 25 healthy patients.

Blood test 'successfully identified heart attack patients'

The research team found that the HD-CEC assay was able to detect circulating endothelial cells in the blood of the patients through the cells' "morphological features and their reactions with specific antibodies."
Patients who suffered a heart attack had much higher levels of circulating endothelial cells in their blood, compared with healthy patients. And the researchers note that the cells were identified with "high sensitivity and high specificity."
To further confirm the accuracy of the HD-CEC assay, the researchers compared it with CellSearch - a test that has been approved by the US Food and Drug Administration (FDA) to identify circulating tumor cells in patients with cancer.
From this, the investigators found that the HD-CEC test was able to detect circulating endothelial cells more accurately than the CellSearch test.
The researchers say this is because the HD-CEC test "used a direct analysis method and was free of bias from an enrichment stage."
"Our assay effectively analyzes millions of cells, which is more work but guarantees that you are analyzing all of the potential cells," says Prof. Kuhn.
The investigators believe the technique is now ready to be tested on patients who show symptoms of increased risk of heart attack, but have not yet suffered one.
Prof. Kuhn adds:

"The goal of this paper was to establish evidence that these circulating endothelial cells can be detected reliably in patients following a heart attack and do not exist in healthy controls - which we have achieved.
Our results were so significant relative to the healthy controls that the obvious next step is to assess the usefulness of the test in identifying patients during the early stages of a heart attack."

This is not the only research to look at the possibility of predicting heart attack risk. In November last year, Medical News Today reported on a study from researchers at the University of Edinburgh in the UK, which detailed a new imaging technique that can light up dangerous fatty plaques in the arteries that are in danger of rupturing - therefore identifying heart attack risk.

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Pradaxa (Dabigatran) Bleeding Rates No Higher Than Warfarin, Says FDA

Bleeding rates linked to new use of Pradaxa (Dabigatran) are no higher than they are with new users of warfarin, says a new FDA Drug Safety communication report update (November 2, 2012).

The FDA (Food and Drug Administration) carried out an evaluation on Pradaxa after receiving several post-marketing reports of bleeding among new users.

The Agency says its investigation, which focused on bleeding occurring in the stomach and intestines, as well as bleeding in the brain (intracranial hemorrhage), among new Pradaxa versus warfarin users, found that Pradaxa's bleeding rates are no higher than warfarin's.

The FDA looked at data from insurance claims and the FDA's Mini-Sentinel pilot of the Sentinel Initiative. The results of the Mini-Sentinel assessment show that bleeding rates between the two medications are similar, and consistent with data from the clinical trials that were used during the approval process of Pradaxa (the RE-LY trial).

The Agency says it is continuing to monitor various data sources in the ongoing safety review of Pradaxa.

Medications for patients with non-valvular atrial fibrillation

Patients with non-valvular atrial fibrillation (AF) are at significantly higher risk of developing stroke and blood clots. AF is the most common heart rhythm abnormality, in which the upper chambers of the atria, in the heart, beat irregularly and rapidly.

The two most important medications prescribed to AF patients are warfarin and Pradaxa, to reduce the risk of stroke and blood clots.

While Pradaxa and warfarin are effective, they can cause potentially serious and sometimes fatal bleeding. All anticoagulant medications have this risk.

Recommendations regarding Pradaxa remain unchanged

The FDA emphasizes that Pradaxa "provides an important health benefit when used as directed." It has not altered its recommendations regarding the medication.

Doctors who prescribe Pradaxa must follow the dosing recommendations in the drug label carefully, especially if the patient has renal impairment (improperly functioning kidneys), to minimize the risk of bleeding.

If you have atrial fibrillation and are on Pradaxa, do not stop taking it before discussing with your doctor. If you stop taking the drug suddenly, your risk of stroke will increase. Strokes are potentially serious, permanently disabling and fatal events.

The FDA says it is conducting two planned, protocol-based observational assessments of Pradaxa, which assess patients and evaluate reports of bleeding. Any relevant data that becomes available on bleeding risks related to Pradaxa will be reported immediately, the Agency added.

About Pradaxa (Dabigatran)

Pradaxa (Dabigatran) was approved by the US FDA in October 2010, in capsule form for the prevention of strokes and blood clots in patients with atrial fibrillation. Pradaxa was approved the following year by EMA (European Medicines Agency), in August 2011, for AF patients who are at risk of stroke.

It was the first stroke prevention medication to be approved in 50 years for individuals with AF, according to Pradaxa markers, Boehringer Ingelheim.

Pradaxa (Dabigatran) is a thrombin inhibitor anticoagulant - it inhibits thrombin. Thrombin is a blood enzyme involved in the blood clotting process. Experts believe that it will eventually replace warfarin as the preferred anticoagulant in the majority of cases, because it does not require frequent blood tests for international normalized ratio monitoring, and offers similar efficacy results.

Pradaxa competes with Johnson & Johnson's and Bayer's Xarelto

Bristol-Myers Squibb and Pfizer Inc. have submitted Eliquis (Apixaban) to the FDA for approval. According to many Wall Street analysts, Eliquis is the most impressive of the new generation of oral anticoagulants to replace warfarin.

A Phase III clinical trial (ARISTOTLE) found that patients on Eliquis had better stroke or systemic embolism protection and less bleeding than those on warfarin. Eliquis was shown to reduce stroke or systemic embolism risk by 21%, major bleeding risk by 31%; mortality was reduced by 11%.

Some facts about atrial fibrillation

• 5 million people are thought to suffer from atrial fibrillation in the USA, and 6 million in the European Union


• Atrial fibrillation is the most common cardiac arrhythmia (irregular heart condition)


• Approximately 1 in every 4 people age 40+ years in the USA and Europe are expected to develop AF


• An AF patient has a five times greater risk of stroke than people without the condition


• In the USA, 15% of all strokes are thought to be caused by AF


• Half of all AF patients who have a stroke die within 12 months of the stroke. This figure is considerably higher than stroke cases among non-AF patients. 24% of AF patients die within 30 days of having a stroke

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Blood Group Important Information

Did You Know?

Blood type and Rh How many people have it? O + 40 % O - 7 % A + 34 % A - 6 % B + 8 % B - 1 % AB + 3 % AB - 1 %

Does Your Blood Type Reveal Your Personality?
According to a Japanese institute that does research on blood types, there are certain personality traits that seem to match up with certain blood types. How do you rate?

TYPE O	You want to be a leader, and when you see something you want, you keep striving until you achieve your goal. You are a trend-setter, loyal, passionate, and self-confident. Your weaknesses include vanity and jealously and a tendency to be too competitive.
TYPE A	You like harmony, peace and organization. You work well with others, and are sensitive, patient and affectionate. Among your weaknesses are stubbornness and an inability to relax.
TYPE B	You're a rugged individualist, who's straightforward and likes to do things your own way. Creative and flexible, you adapt easily to any situation. But your insistence on being independent can sometimes go too far and become a weakne ss.
TYPE AB	Cool and controlled, you're generally well liked and always put people at ease You're a natural entertainer who's tactful and fair. But you're standoffish, blunt, and have difficulty making decisions.

Most Important Information Now:

You Can Receive
If Your Type Is	O-	O+	B-	B+	A-	A+	AB-	AB+
AB+	YES	YES	YES	YES	YES	YES	YES	YES
AB-	YES		YES		YES	YES
A+	YES	YES			YES	YES
A-	YES				YES
B+	YES	YES	YES	YES
B-	YES		YES
O+	YES	YES
O-	YES

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Sepsis (Blood Infection) and Septic Shock

Sepsis is a serious medical condition caused by an overwhelming immune response to infection. Chemicals released into the blood to fight infection trigger widespread inflammation.
Inflammation may result in organ damage. Blood clotting during sepsis reduces blood flow to limbs and internal organs, depriving them of nutrients and oxygen. In severe cases, one or more organs fail. In the worst cases, infection leads to a life-threatening drop in blood pressure, called septic shock. This can quickly lead to the failure of several organs -- lungs, kidneys, and liver -- causing death.

Recommended Related to Infectious Diseases

Understanding Bladder Infections -- the Basics

Bladder infections are known as cystitis or inflammation of the bladder. They are common in women but very rare in men. More than half of all women get at least one bladder infection at some time in their lives. However, a man's chance of getting cystitis increases as he ages due to in part to an increase in prostate size. Doctors aren't sure exactly why women have many more bladder infections than men. They suspect it may be because women have a shorter urethra, the tube that carries urine...

Sepsis occurs in 1% to 2% of all hospitalizations in the U.S. It affects at least 750,000 people each year.
The term sepsis is often used interchangeably with septicemia, a serious, life-threatening infection that gets worse very quickly and is often fatal.

Sepsis Causes and Risk Factors

Bacterial infections are the most common cause of sepsis. However, sepsis can also be caused by other infections. The infection can begin anywhere bacteria or other infectious agents can enter the body. It can result from something as seemingly harmless as a scraped knee or nicked cuticle or from a more serious medical problem such as appendicitis, pneumonia, meningitis, or a urinary tract infection.
Sepsis may accompany infection of the bone, called osteomyelitis. In hospitalized patients, common sites of initial infection include IV lines, surgical incisions, urinary catheters, and bed sores.
Although anyone can get sepsis, certain groups of people are at greater risk. They include:

• People whose immune systems are not functioning well due to illnesses such as HIV/AIDS or cancer or use of drugs that suppress the immune system, such as those to prevent rejection of transplanted organs.
• Very young babies.
• The elderly, particularly if they have other health problems.
• People who have recently been hospitalized and/or had invasive medical procedures.
• People with diabetes.

Sepsis Symptoms

Because sepsis can begin in different parts of the body, it can have many different symptoms. Rapid breathing and a change in mental status, such as reduced alertness or confusion, may be the first signs that sepsis is starting. Other common symptoms include:

• fever and shaking chills or, alternatively, a very low body temperature
• decreased urination
• rapid pulse
• rapid breathing
• nausea and vomiting
• diarrhea

Sepsis Treatment

The first step to successful treatment for sepsis is quick diagnosis. If sepsis is suspected, the doctor will perform an exam and run tests to look for:

• Bacteria in the blood or other body fluids
• Source of the infection, using radiologic imaging such as X-ray, CT scan, or ultrasound
• A high or low white blood cell count
• A low platelet count
• Low blood pressure
• Too much acid in the blood (acidosis)
• Altered kidney or liver function 

Other tests of bodily fluids and radiologic tests, such as X-ray or CT scan, can help in diagnosing the cause of the infection. People diagnosed with severe sepsis are usually placed in the intensive care unit (ICU), where doctors try to stop the infection, keep vital organs functioning, and regulate blood pressure.

Sepsis treatment usually begins with:

• Broad-spectrum antibiotics, which kill many types of bacteria
• IV fluids to maintain blood pressure
• Oxygen to maintain normal blood oxygen

Once the infectious agent is identified, the doctor can switch to a drug that targets that particular agent. Depending on the severity and effects of sepsis, other types of treatment, such as a breathing machine or kidney dialysis, may be needed. Sometimes surgery is necessary to drain or clean an infection.
Often doctors prescribe other treatments, including vasopressors (drugs that cause the blood vessels to narrow) to improve blood pressure.
Permanent organ damage can occur in people who survive sepsis. Death rates are 20% for sepsis and over 60% for septic shock.

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