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A recent report in "The Lancet" has shown that retroviruses similar in structure and function to HIV may play important roles in the development of certain liver disorders. Several pieces of research support the notion of an infectious component as one cause of primary biliary cirrhosis, since clinical symptoms of the disorder resemble those observed in other diseases known to be linked to a retrovirus.
Dr. Andrew L. Mason, Alton Ochsner Medical Foundation, New Orleans, LA found that almost one third of patients with primary biliary cirrhosis had antibodies to HIV proteins.
Source: The Lancet 1998;351:1620-1624.
Reporting in Circulation, data from the Physician's Health Study show C-reactive protein adds significantly to the predictive value of cholesterol measurements in determining the risk of first myocardial infarction.
A team of researchers led by Dr. Paul M. Ridker, of Brigham and Women's Hospital in Boston, Massachusetts, collected baseline data on C-reactive protein and total and HDL cholesterol levels from close to 15,000 healthy men enrolled in the Physicians Health Study. During an average 9-year follow-up, 245 of the study subjects developed a first myocardial infarction. The study found that a high CRP level or total : HDL cholesterol ratio were associated with 1.5- and 2.3-fold increased risks of a first MI, respectively, the two characteristics together increased the risk of MI by 5-fold.
Source: Circulation 1998;97:2000-2002,2007-2011.
Free-PSA testing could eliminate the need for about one-fifth of all prostate biopsies performed in the United States each year, reported Dr. William J. Catalona, director of urologic surgery at Washington University School of Medicine, St. Louis, MO. At about $1,200 for a biopsy vs. $65 for a free-PSA test, the new procedure could save $136 million a year. The study found that when 25 percent or less of circulating PSA was chemically free, cancer was present 95 percent of the time. The lower the percentage of free PSA, the more aggressive the cancer. The study was paid for by Hybritech Inc., a subsidiary of Beckman Coulter of Fullerton, Calif.
Source: May 1998, Journal of the American Medical Association.
Northfield Laboratories Inc., Evanston, Ill is expecting to begin Phase III clinical trials of its oxygen carrying blood substitute, PolyHeme in Europe. Northfield is currently engaged in Phase III clinical trials of PolyHeme in the United States. "We are initiating European trials at this juncture to position PolyHeme for a worldwide product launch upon completion of our Phase III trials and FDA approval," said Richard DeWoskin, chairman and chief executive officer of Northfield, in a company press release. "Our earlier studies have demonstrated that PolyHeme reduces or eliminates the need for donated blood in trauma situations and we expect similar findings in these new clinical trials." Northfield's Phase III trials in the United States are focused on elective surgery which is a more controlled clinical trial setting than trauma and addresses a larger market need.
In a prospective study, US and Canadian investigators have uncovered a positive correlation between the circulating concentration of insulin-like growth factor-1 (IGF-1) in premenopausal women and risk of breast cancer. In a nested, case-control study, involving women in the Nurses' Health Study, the team discovered that premenopausal women with the highest circulating IGF-1 levels had a relative risk of breast cancer of 2.33 compared with premenopausal women with the lowest circulating IGF-1 levels. In a subgroup of women who were <50 years of age at the time of IGF-1 analysis, the relative risk of breast cancer was 4.58. There was no association between IGF-1 and breast cancer risk in postmenopausal women.
Source: Lancet 1998; 351:1373-1374,1393-1396.
Reporting in "Circulation", Dr. Vincenzo Pasceri, the Catholic University of the Sacred Heart, Rome, Italy has shown that infection with CagA-bearing H. pylori, normally associated with stomach ulcers, may increase the risk of heart disease. The research assessed the prevalence of CagA-bearing H. pylori in a group of 176 individuals. Half of the group consisted of patients with diagnosed heart disease, while the other half consisted of healthy controls. The study found that a total of 38 of 88 patients and 15 of 88 controls were infected by CagA-positive Helicobacter pylori (43% versus 17%). In contrast, they found that CagA-negative strains were clearly not related to the incidence of ischemic heart disease.
Source: Circulation (1998;97)
Researchers at the Centers for Disease Control and Prevention, Atlanta, GA, report that Salmonella enterica serotype typhimurium DT104 has become a widespread pathogen in the US. Dr. M. Kathleen Glynn analyzed salmonella isolates collected by public health officials during national antimicrobial-drug resistance surveys of salmonella carried out between 1979 and 1996. According to the study, strains of Typhimurium DT104 are now resistant to five major antibiotics: ampicillin, chloramphenicol, streptomycin, sulfonamides, and tetracycline and that the proportion of US isolates with the five-drug pattern of resistance has increased from less than 1% in 1979-1980 to 34% in 1996.
Source: New England Journal of Medicine, 1998;338:1333-1338,1376-1378.
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