National Report Ranks Alaska No. 1 in Protecting Kids from Tobacco

  • Author: Health Informer
  • Filed under: Health News
  • Date: Nov 19,2008

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Ten Years After Tobacco Settlement, States Falling Short in Funding Tobacco Prevention

Ten years after the November 1998 state tobacco settlement, Alaska ranks No. 1 in the nation in funding programs to protect kids from tobacco, according to a national report released today by a coalition of public health organizations.

Alaska currently spends $9.2 million a year on tobacco prevention programs, which is 86 percent of the $10.7 million recommended by the U.S. Centers for Disease Control and Prevention (CDC). It is one of only nine states that are spending more than half of what the CDC recommends.

Other key findings for Alaska include:

  • The tobacco companies spend $28.1 million a year on marketing in Alaska. This is three times what the state spends on tobacco prevention.
  • Alaska this year will collect $103 million from the tobacco settlement and tobacco taxes and will spend about 9 percent of it on tobacco prevention.

The annual report on states’ funding of tobacco prevention programs, titled “A Decade of Broken Promises,” was released by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society Cancer Action Network, American Lung Association and the Robert Wood Johnson Foundation.

“Alaska has made a solid commitment and ranks first this year when it comes to protecting kids from tobacco,” said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. “On this 10th anniversary of the tobacco settlement, we call on Alaska’s leaders to build on their commitment to tobacco prevention by increasing funding to the CDC’s recommended amount. Tobacco prevention is a smart investment that reduces smoking, saves lives and saves money by reducing tobacco-related health care costs.”

On Nov. 23, 1998, 46 states settled their lawsuits against the nation’s major tobacco companies to recover tobacco-related health care costs, joining four states (Mississippi, Texas, Florida and Minnesota) that had reached earlier settlements. These settlements require the tobacco companies to make annual payments to the states in perpetuity, with total payments estimated at $246 billion over the first 25 years. The states also collect billions of dollars each year in tobacco taxes.

The new report finds that most states have broken their promise to use a significant portion of their tobacco money to fund programs to prevent kids from smoking and help smokers quit.

According to the report, the states in the last 10 years have received $203.5 billion in revenue from the tobacco settlement and tobacco taxes. But they have spent only 3.2 percent of this tobacco money - $6.5 billion - on tobacco prevention and cessation programs.

Other findings of the report include:

  • In the current year, no state is funding tobacco prevention at CDC-recommended levels, and only nine states fund their programs at even half of the CDC recommendation.
  • 41 states and the District of Columbia are funding tobacco prevention programs at less than half the CDC-recommended amount. These include 27 states that are providing less than a quarter of the recommended funding.
  • Total funding for state tobacco prevention programs this year, $718.1 million, amounts to less than three percent of the $24.6 billion the states will collect from the tobacco settlement and tobacco taxes. It would take just 15 percent of this tobacco revenue to fund tobacco prevention programs in every state at CDC-recommended levels.

The report warns that the nation faces two immediate challenges in the fight against tobacco use: complacency and looming state budget shortfalls. First, while the nation has made significant progress over the past decade in reducing smoking, progress has slowed and further progress is at risk without aggressive efforts at all levels of government. Second, the states are expected to face budget shortfalls in the coming year as a result of the weak economy. The last time the states faced significant budget shortfalls, they cut funding for tobacco prevention programs by 28 percent between 2002 and 2005. The cutbacks are a major reason why smoking declines subsequently stalled, and states should not make the same mistake again.

The report found that there is more evidence than ever that tobacco prevention programs work to reduce smoking, save lives and save money by reducing tobacco-related health care costs. Washington State, which has been a national leader in funding tobacco prevention, has reduced smoking by 60 percent among sixth graders and by 43 percent among 12th graders since the late 1990s. A recent study found that California’s tobacco control program saved $86 billion in health care costs in its first 15 years, compared to $1.8 billion spent on the program, for a return on investment of nearly 50:1.

In Alaska, 17.8 percent of high school students smoke, and 1,100 more kids become regular smokers every year. Each year, tobacco claims 500 lives and costs the state $169 million in health care bills.

More information, including the full report and state-specific information, can be obtained at www.tobaccofreekids.org/reports/settlements.

Source: Campaign for Tobacco-Free Kids



Study Finds Cost of Diabetes in the United States Exceeds $217 Billion

  • Author: Health Informer
  • Filed under: Health News
  • Date: Nov 18,2008

Current Cost Figures Only Include Diagnosed Patients

According to findings from a National Diabetes Economic Barometer study, undiagnosed, pre-diabetes and diabetes cost the United States an estimated $217.5 billion in 2007 due to higher medical expenditures and lost productivity.

The research shows that beyond the estimated $174 billion that is widely-accepted as the cost of diagnosed diabetes in 2007, an additional $18 billion was spent on 6.3 million people with undiagnosed diabetes; $25 billion for 57 million American adults with pre-diabetes; and $623 million for the 180,000 pregnancies where gestational diabetes is diagnosed.

The National Diabetes Economic Barometer research was conducted by The Lewin Group and commissioned by the National Changing Diabetes(R) Program (NCDP), an initiative created by Novo Nordisk to improve the lives of people with diabetes.

“In individuals with pre-diabetes, we observed a significant increase in ambulatory visits for a wide variety of medical conditions, including hypertension, endocrine, metabolic and kidney complications,” said Tim Dall, vice president at The Lewin Group. “Additionally, the data show that during the two years before diagnosis people exhibit an increase in ambulatory and hospital-based care for diabetes-related complications.”

As the leading source of health insurance, covering about 158 million non-elderly people in America(1), employers are beginning to feel the financial sting. However, businesses can take steps to help reduce these negative consequences by focusing efforts on diabetes prevention and detection.

“We encourage businesses to take action to reduce the devastating economic consequences of this disease by learning about their workforce, engaging their employees, and making purchasing decisions that will encourage better health choices,” said Dana Haza, senior director of the National Changing Diabetes(R) Program. “If companies can help their employees learn how to better manage their health, businesses can potentially cut down on their own healthcare spending while improving the quality of life of those who work for them.”

At a Forbes Innovation in Healthcare forum sponsored by Novo Nordisk’s National Changing Diabetes(R) Program today, top executives from large employers in the U.S. discussed the critical role of business in addressing the diabetes crisis and protecting the health of our nation’s current and future workforce.

“Novo Nordisk is committed to defeating diabetes, but we can’t do it alone. We started the National Changing Diabetes(R) Program to bring together the many different groups and organizations it will take to beat this disease,” said Jerzy Gruhn, president of Novo Nordisk Inc., the world leader in diabetes care. “As the leading source of healthcare for Americans, businesses have the ability to change the direction of diabetes by tailoring benefits toward prevention, education and access to treatment.”

The National Diabetes Economic Barometer is the second in a series of studies that comprise NCDP’s National Diabetes Triple Barometer, a research program to benchmark the current societal, economic and clinical state of diabetes in the United States.

More information about the National Diabetes Economic Barometer and the National Changing Diabetes(R) Program is available online at www.ncdp.com.

National Diabetes Triple Barometer

Diabetes is an escalating health crisis in the United States. More than 20 million Americans suffer from diabetes and that number is projected to double by 2025. In 2007, the National Changing Diabetes(R) Program undertook a multi-phase initiative — the National Diabetes Triple Barometer — designed to evaluate the current state of diabetes in America in three critical indicators: societal, economic and clinical. After all three barometers are complete, they will be packaged and serve as a comprehensive, authoritative national benchmark and measurement system to create behavior change, drive policy change and catalyze momentum for further strategic system improvements.

(1) Kaiser Family Foundation, Kaiser Commission on Medicaid and the Uninsured, Health insurance Coverage in America, 2005 Data Update, May 2007. Available at www.kff.org/uninsured/upload/2005dataupdate.pdf

Source: Novo Nordisk



New National Poll: Medicare Coverage Gap Confounds Majority of Seniors

  • Author: Health Informer
  • Filed under: Health News
  • Date: Nov 18,2008

Medco Launches National Campaign to Educate Enrollees About the Gap

Nearly two-thirds of enrollees don’t fully understand the Medicare Part D Coverage Gap

Millions of Medicare Part D beneficiaries may not understand a key part of their prescription plan, which can lead to unexpected prescription costs.

According to a new national poll titled “What’s Your Gap? Seniors Struggling with the Medicare Coverage Gap,” nearly two-thirds of enrollees don’t fully understand the Medicare Part D Coverage Gap — the portion of Part D plans in which beneficiaries must cover the full cost of their prescriptions.

In fact, even after three years since the introduction of the Medicare Part D program, and with 56 percent of the eligible population enrolled in the program, more than one in four beneficiaries either don’t understand the Coverage Gap at all, or simply don’t know what the Coverage Gap is. And in spite of the lack of knowledge, nearly one-third of survey respondents have not looked for information on the Coverage Gap to better understand it.

“Seniors are in the dark about the Coverage Gap,” says Dr. Richard Dupee, president of the Massachusetts Geriatric Society and chief of geriatrics at Tufts Medical Center. “Without knowing how the Coverage Gap works, it’s simply impossible to take steps to push off or prevent it.”

To address this issue, Medco unveiled today a multi-level initiative aimed at educating retirees about the Coverage Gap, and what steps they can take to stave off or even prevent them from falling into the “doughnut hole.” The program, “What’s Your Gap?” provides retirees with information about prescription drug savings opportunities, where to look for hidden savings, and clarifies many misconceptions about the Coverage Gap. For example, Part D beneficiaries can save up to 38 percent and delay entering the Coverage Gap by an average of two and a half months by choosing both generics and mail order.

As part of the initiative, Medco has developed a free consumer’s guide called “What’s Your Gap? Three simple steps to make the most of your Medicare Part D coverage and delay the Coverage Gap.” The free guide presents easy-to-understand information on savings tools that are largely unknown or underutilized by beneficiaries and how to track your drug costs against the Coverage Gap. The guide is available free to consumers in a downloadable version at www.whatsyourgap.com, or by sending a postcard requesting the guide to “What’s Your Gap?”, PO Box 8007 Parsippany, NJ 07054-8007.

The poll, a national survey of 1,000 Medicare Part D program participants conducted for Medco Health Solutions, Inc. by Directive Analytics, is one of the first national polls to attempt to uncover some of the underlying reasons that so many beneficiaries end up in the “doughnut hole.” Key findings include:

Gap Hits Those with Chronic Diseases: Among respondents who are already in the Coverage Gap in 2008, more than three out of four regularly take medications to treat more than one chronic condition; among respondents, 43 percent indicated they had reached the Coverage Gap before June of 2008.

Missing Out on Savings: Nearly 28 percent of survey respondents have not used any lower-cost options to reduce their prescription price tag to delay entering the gap. Furthermore, fewer than one in four (23 percent) enrollees have discussed ways to reduce their prescription drugs costs with their physicians. Only 19 percent of respondents indicated they have used a mail-order pharmacy to reduce their drug costs.

In 2008, once Medicare enrollees spend a total of more than $2,510 on prescription drugs in the initial phase of coverage, they enter the Coverage Gap and become responsible for the full cost of their medications. In 2009, the Coverage Gap shifts to total drug costs exceeding $2,700.

Beneficiaries Don’t Know What Costs Count Toward the Gap

According to the survey, one of the root causes of confusion is that Medicare beneficiaries simply don’t know what parts of a prescription’s price count towards the Coverage Gap. Only one-quarter of enrollees polled correctly stated that the total cost of a drug ? both their out-of-pocket cost and the health plan’s portion of the drug price ? count towards the Coverage Gap.

“It’s one of the great Medicare myths ? that only copays or out-of-pocket costs count towards the doughnut hole,” says Dr. Dupee. “This misunderstanding gives many seniors a false sense of security that the Coverage Gap is months away, when in reality, it could hit them with their next refill.”

Bridging the Communication Gap

Recognizing the significance of educating enrollees about the specifics of the Coverage Gap, Medco has implemented an integrated Coverage Gap communications program that alerts its Prescription Drug Plan (PDP) members and specific health plan beneficiaries through mailings and outbound phone calls of their proximity to the Gap long before they reach it. Additionally, any time one of these members contacts a customer service representative for any reason, that member can be provided with a real-time Coverage Gap status update. To promote increased use of generics in order to help members delay entry into the Coverage Gap, Medco also offers members prescription forms that they can bring to their physician or will contact the doctor on their behalf to discuss generic alternatives that can lower the patient’s medication costs.

Source: Medco Health Solutions, Inc.



Is There Really Such a Thing as Hope in a Jar?

Dermatologists help consumers sort through the cosmeceutical conundrum

When it comes to cosmeceuticals, consumers are bombarded by marketing claims that often fail to live up to their hype. Banking on promises that a product can “reverse the aging process” or “deliver the results of a facelift” leads consumers to spend billions of dollars each year to try an array of anti-aging skin care products. Their hope is that one day they will find a product that actually lives up to its claims.

Speaking today at the American Academy of Dermatology’s SKIN academy (Academy), dermatologist Patricia K. Farris, MD, FAAD, clinical associate professor of dermatology at Tulane University School of Medicine in New Orleans, discussed how to separate fact from fiction when evaluating cosmeceuticals and tips for gauging the validity of product claims.

“When consulting with our patients, dermatologists can suggest skin care products that have strong science behind them and that have been proven to be safe and effective in human studies,” said Dr. Farris. “The biggest problem with cosmeceuticals is not that they don’t work, but that their benefits are greatly exaggerated.”

Cosmeceuticals can be divided into categories based on their active ingredients. Anti-oxidants represent the largest category. They are followed by peptides (small proteins that stimulate the production of collagen and thicken the skin) and growth factors (compounds that act as chemical messengers between cells and play a role in cell division, new cell and blood vessel growth, and the production and distribution of collagen and elastin). More recently, Dr. Farris noted that the new trend is toward combination products. For example, cosmeceuticals with multiple anti-oxidants, retinol plus anti-oxidants, growth factors plus vitamin C and other unique combinations that are now being mass marketed. Consumers tend to favor combination products, embracing the philosophy that if one ingredient is good, then two must be better.

“The important thing to understand about combination products is that often the individual ingredients have been studied, but the combination of active ingredients has not,” said Dr. Farris. “More rigorous scientific studies are necessary to assure that biologic activity is maintained when ingredients are formulated together, and clinical studies should be done to determine if combination products really offer any added benefit.”

Consumer demand is high for cosmeceuticals containing “natural” or “organic” ingredients. However, Dr. Farris advised that the notion that these ingredients are safer than synthetic ones is a common misconception. In reality, there is no data to support the notion that natural or organic ingredients — derived from the root, stem, leaves, flowers and fruit of plants — are safer or even more effective than their synthetic counterparts.

“The problem with cosmeceuticals labeled ‘natural’ is that the labels themselves don’t mean anything because these products are not regulated by the Food and Drug Administration (FDA),” said Dr. Farris. “In fact, ‘natural’ skin care products are less tested and scrutinized than synthetic products and pharmaceuticals.”

Dr. Farris noted that most compounds as they exist in their natural state cannot be formulated into skin care products. They must be chemically altered before they can be incorporated into cosmetics. For instance, compounds including retinol, vitamin C, and soy are among those that require chemical alteration — after which they are referred to as enhanced natural ingredients. Enhanced natural ingredients tend to be more stable, penetrate better and have more long-lasting effects on the skin than unaltered plant extracts, which is the reason why most cosmeceuticals contain chemically-altered ingredients.

“There are a number of cosmeceutical ingredients that are completely synthetic, such as collagen-boosting peptides and synthetic forms of vitamin A,” explained Dr. Farris. “These compounds are among the most potent anti-aging ingredients and have been used extensively by dermatologists. So, it’s important for consumers to understand that synthetic ingredients are not necessarily bad and, in fact, skin care products containing these ingredients are probably among the most effective in the marketplace.”

Dr. Farris explained that the key to evaluating the effectiveness of cosmeceuticals is understanding how they are tested. After an active ingredient has been identified, it is evaluated using polymerase chain reaction (PCR) testing, which is used to characterize biologic activity and determine if the ingredient is an anti-oxidant or anti-inflammatory. PCR testing also can tell if an ingredient increases collagen production or reduces collagen breakdown. Although PCR testing is a valuable part of the testing process, many of the claims made as a result of PCR testing are not substantiated by human studies.

“For dermatologists, the gold standard for confirming a product’s efficacy remains the double-blind, vehicle-controlled study,” said Dr. Farris. “In this type of objectively designed study, the product containing the key ingredients is tested against the vehicle, or the product formulation that is similar to the product being tested but without the key active ingredients.” Dr. Farris explained that even though a compound may stimulate collagen production in PCR testing, it does not mean that the ingredient will cause any visible improvement in fine lines and wrinkles.

“Since cosmeceuticals are not subject to the FDA’s rigorous approval process, most cosmetic manufacturers do not perform double-blind, vehicle-controlled studies,” said Dr. Farris. “Instead, they rely on what are called open-label user studies where subjects apply test creams for a few weeks and then assess their improvement over baseline. Unfortunately, these types of studies are of no real value in determining product efficacy because they do not assess the vehicle’s effect and there are no objective measures. People participating in these studies want to believe that they look better after using the product, but that does not necessarily mean it works.”

Dr. Farris offered these tips when purchasing cosmeceuticals:

  • Ask yourself what the product claims to do and what kinds of studies have been performed.
  • Trust your instincts. If it sounds too good to be true, then it probably is.
  • Stick with products and brands that you know to be reputable. Well-known manufacturers have more money behind their active ingredients and product testing.
  • Beware of Web site claims, as many are biased even if they say they are objective.
  • For day, use products containing anti-oxidants, as they have sun-protection properties. At night, use products containing retinoids, peptides or growth factors for their repair properties.
  • Talk to your dermatologist about the best options for your skin care needs.

For more information on aging skin, go to the “AgingSkinNet” section of http://www.skincarephysicians.com/, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of disorders of the skin, hair and nails.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or http://www.aad.org/.



New Data, New Directions in the Management of Mood and Anxiety Disorders

  • Author: Health Informer
  • Filed under: Health News
  • Date: Nov 17,2008

8th International Forum for Mood and Anxiety Disorders Congress Roundup

Clinicians and researchers from around the world attended this week’s 8th International Forum on Mood and Anxiety disorders in Vienna, Austria to discuss the latest advances in the treatment of mood disorders.

A wide range of topics were included in this year’s programme, highlighting the position of IFMAD in the congress calendar as a forum for breaking news, original thinking and debate.

Highlights from the meeting included the latest new treatments for depression and anxiety disorders. There was the first comprehensive presentation of data demonstrating that quetiapine has clear cut efficacy in major depressive disorder (MDD), including a study in the elderly, a difficult to treat and under-researched patient population. It is also the first time that an antidepressant has shown consistent early efficacy at one week in both MDD and bipolar depression. Delegates were excited at the announcement at IFMAD of the first EU licence within the EU for a treatment for bipolar depression.

This year’s IFMAD reflected the rapid pace in which new discoveries are being made to improve our understanding of the mechanisms of mood disorders, the underlying neurobiology and the role of antidepressant treatment. Data evaluating a wide range of potential treatment directions were presented, including studies on the antidepressant agomelatine which targets melatonin and serotonin receptors in the brain. Other new data were presented showing that as much as 30 percent of unipolar depression has genetic or symptomatic predictors for the development of bipolar disorder and the delegates agreed that this was an important area for further research and the targeting of new treatments.

“We are living in exciting times for the treatment of mood disorders with new approaches and new targets being discovered and explored all of the time,” said Professor Siegfried Kasper, IFMAD Chairman and Professor of Psychiatry, Head of the Department of Psychiatry and Psychotherapy at the Medical University of Vienna, Austria. “The breadth of data presented at this year’s IFMAD has really demonstrated this, providing delegates with a comprehensive update of cutting edge advances in the field.”

Other elements of the meeting included an important debate on the relationships between pain, anxiety and depression and the continuing problem of under-diagnosis of GAD despite its prevalence and significant burden to society. The vital need to ensure patient concordance in the treatment of depression and anxiety was discussed, including the roles of patient education, monitoring and the selection of treatments with minimal side effects.

“The format of IFMAD allows informal debate and brings together leaders in the field of mood and anxiety disorders to discuss the most pressing topics and issues of the moment,” said Professor Stuart Montgomery, IFMAD Co-Chairman and Emeritus Professor of Psychiatry, Imperial College of Medicine, University of London, UK. “What sets IFMAD apart is that the meeting is friendly and small enough to allow that informal exchange of new and emerging data from around the world.”

This year’s meeting also marked the launch of the new IFMAD website, providing an online forum to ensure that clinicians and researchers can access the latest developments in mood disorders throughout the year. A full roundup of the 8th IFMAD meeting, including the final abstract book, will be available shortly on the new website, http://www.ifmad.org.

Source: IFMAD



US-Specific DAWN Youth WebTalk Survey Data Released on World Diabetes Day at Youth Forum

Data from a new global survey released on World Diabetes Day finds that many teens and young adults with type 1 diabetes are optimistic about their future, but report a lack of support from school staff. The poll highlights the importance of family and peer-to-peer support.

The DAWN Youth WebTalk Survey was conducted in partnership with the International Diabetes Federation and the International Society for Pediatric and Adolescent Diabetes as part of DAWN Youth, Novo Nordisk’s major global leadership initiative to understand and address the attitudes, wishes and needs of children and young people with or at risk of developing diabetes, and their families.

“The DAWN Youth WebTalk Survey demonstrates the serious issues faced by young people living with type 1 diabetes and their desire for peer-to-peer support and improved care and education during the school day,” said Barbara Anderson, Ph.D., DAWN Youth Advisor and professor at the Department of Pediatrics at Baylor College of Medicine and Texas Children’s Hospital in Houston. “These findings can help shape diabetes initiatives for teens and young adults living with type 1 diabetes.”

In an effort to bring the Dawn Youth WebTalk Survey results to life and further explore what teens and young adults living with type 1 diabetes want and need to better their lives, Novo Nordisk, the Juvenile Diabetes Research Foundation (JDRF), Discovery Health and Discovery Education, are hosting an interactive youth forum in New York City on World Diabetes Day, entitled, “Young Voices: Life With Diabetes.” Event ambassadors affected by type 1 diabetes include ESPN reporter Brian Kenny, Formula 3 racecar driver Charlie Kimball, Miss Black USA 2007 Kalilah Harris, former Mets player Todd Zeile, and country music star Steve Wariner among others, who will be present to lend their support. At the forum, JDRF will launch a first-of-its-kind, user-generated online community - Juvenation - for teens and young adults living with type 1 diabetes (www.juvenation.org).

Following are US data highlights from the DAWN Youth WebTalk Survey:

Peer Support and Networking

  • Sixty-one percent of young adults with diabetes said it was important to talk with other people their age who had diabetes, and 81% of parents felt it was important for their children to do so
  • Despite the availability of youth camps, local events in some areas, and networking sites on the Internet, 41% of young adults had not been involved with any diabetes-related youth activities (compared with 34% for all participating countries); 60% of those young adults who had not been involved with any diabetes-related youth activities would be interested in doing so
  • Both young adults and parents felt that youth camps for children with diabetes had been very helpful

Improved Support for Children in Schools

  • Most parents and young adults thought that schools should have teachers who are better informed about diabetes (80% and 73%, respectively), or who know how to deal with an emergency diabetes situation (80% and 69%, respectively)
  • Nine out of ten young adults with diabetes said that when they were in elementary and high school, they could not rely on a school nurse to assist them with their diabetes during school hours
  • About 75% of respondents felt that the three primary services schools should be able to provide are: teachers who are better informed about diabetes, nutritional information about food served at school, and healthy food and drink options

Survey Methodology

The DAWN Youth WebTalk Survey was an internationally coordinated series of online surveys of the views of young adults with diabetes who were between the ages of 18 to 25 years, parents/caregivers of at least 1 child with diabetes who was under the age of 18 years, and health care providers (HCPs).

Self-completion online surveys were conducted using a 25-30 minute structured questionnaire. Recruitment was supported by national DAWN Youth committees with the help of patient associations. Screening questions applied to ensure that only correct/eligible respondents were able to access the respective surveys.

The Survey polled over 9,200 respondents from around the world, including more than 1,600 parents and caregivers, more than 300 young adults with diabetes, and more than 100 healthcare professionals from the United States. This year marks the first time US-specific results from the survey have been released to the public.

Type 1 Diabetes

Type 1 diabetes often develops in children, adolescents, and young adults, so it’s sometimes called juvenile (meaning “young”) diabetes. About 5 to 10 percent of the as many as 30 million Americans who are diagnosed with diabetes have type 1 diabetes.(1) A healthy pancreas produces insulin, a hormone the body uses to change glucose in the blood into energy. Glucose in the blood comes from the food and drink a person consumes. A person with type 1 diabetes does not produce any insulin. Without insulin, the glucose builds up in the blood, causing hyperglycemia (high blood sugar). Since people with type 1 diabetes can’t produce their own insulin, they must put insulin into the blood stream through injections or an insulin pump.

(1) JDRF. Two Types of Diabetes. Juvenile Diabetes Research Foundation Kids Online Web site. (Due to the length of the URL, copy and paste into a browser window to view.) http://kids.jdrf.org/index.cfm?fuseaction=home.viewPage&page_id=4C3F66A1-5004- D739-A5DAF476C4930A5B. Accessed September 29, 2008.

Source: Novo Nordisk



Alzheimer’s Gene Slows Brain’s Ability to Export Toxic Protein

  • Author: Health Informer
  • Filed under: Health News
  • Date: Nov 16,2008

The only known genetic risk factor for Alzheimer’s disease slows down the brain’s ability to export a toxic protein known as amyloid-beta that is central to the damage the disease causes, scientists have found.

The research, published Nov. 13 by the Journal of Clinical Investigation, provides new clues into the workings of a protein known as apolipoprotein E4, or ApoE4. People who carry two copies of the gene have roughly eight to 10 times the risk of getting Alzheimer’s disease than people who do not.

The new results mark a step toward resolving a longstanding question that scientists have had about exactly how ApoE4 increases a person’s risk for the disease. The findings point to differences in the way that amyloid-beta is removed from the brain depending on which ApoE protein is involved.

Scientists found that when ApoE4 is present, the brain is less efficient at ridding itself of the toxic material, because a molecule that is much slower at removing the substance becomes much more involved.

The new results are in line with a body of research amassed over the last 15 years by the leader of the team, Berislav Zlokovic, M.D., Ph.D., of the University of Rochester Medical Center, that blood circulation plays a key role in the disease. His team has identified much of the molecular machinery that allows amyloid-beta to sidestep the body’s safeguards and enter the brain, and he has discovered molecules that falter when the toxic protein accumulates in the brain.

“Our latest findings help explain one of the major risk factors for Alzheimer’s disease,” said Zlokovic. “ApoE4 changes the brain’s ability to rid itself of amyloid-beta. It’s becoming more and more apparent that the brain’s ability to clear out amyloid-beta, through the vascular system and across the blood-brain barrier, is central to the development of Alzheimer’s disease.”

In the latest work the Rochester team, working with colleagues at Washington University School of Medicine in St. Louis, found that a molecule known as very low-density lipoprotein receptor, or VLDLR, is an active - but slow - player in the removal of amyloid-beta from the brain. That step is crucial: Once amyloid-beta gets out of the brain and into the body, it can be eliminated easily.

“It’s as if you have a pile of trash building up in the brain, and you need to move the trash away before it becomes toxic,” said Rashid Deane, Ph.D., one of the authors of the paper and research professor of Neurosurgery at the University of Rochester Medical Center.

“We’ve known that the brain uses a molecule called LRP1, which is extremely efficient and acts like a fast ferry to remove amyloid-beta. Now we’ve found that there is another molecule involved, which works much more slowly, and it’s especially active when amyloid is coupled to ApoE4,” Deane added.

The team showed that speedy LRP1 is central to removing amyloid-beta when ApoE2 or ApoE3 is involved, with the slower VLDLR picking up some of the slack. But when the form of the gene that puts people at risk, ApoE4, is involved, VLDLR nearly alone is responsible for hauling the amyloid-beta away.

“It’s like having a choice between a fast ferry and a slow ferry,” said Deane. “For reasons we don’t yet understand, when ApoE4 is involved, the slow ferry is used almost exclusively. This means that the amyloid-beta isn’t removed as quickly as it otherwise would, potentially giving it a chance to accumulate, like we see in the brains of patients with Alzheimer’s disease.”

The team found that LRP1 is able to export amyloid from the brain about 20 times faster than VLDLR. Consequently, in mice with the more efficient versions of the ApoE protein, ApoE2 and ApoE3, amyloid is cleared out of the brain at a rate about twice or three times as fast as it is in mice with the ApoE4 protein. Amyloid deposits accumulate in the brains of mice with the ApoE4 protein in much higher amounts, about 10 to 15 times as much as in the brains of mice with either ApoE2 or ApoE3.

Not only do the ApoE proteins help determine how quickly amyloid-beta is removed from the brain; the proteins actually couple with amyloid-beta in the brain to form sticky complexes. This gunk gathers around cells and is much more difficult to remove from the brain than free-floating amyloid-beta. Companies are trying to develop drugs that would break up the relationship, freeing amyloid-beta and making it easier to remove from the brain.

The work described in the paper published in the Journal of Clinical Investigation was funded by a Senator Jacob Javits Award from the National Institute of Neurological Disorders and Stroke, and by the National Institute on Aging.

In addition to Zlokovic and Deane, other Rochester authors of the paper include instructor Abhay Sagare, Ph.D., who performed much of the research; technicians Katie Hamm, Margaret Parisi, and Steven Lane; and neuroscientist David Holtzman and graduate student Mary Beth Finn at Washington University School of Medicine.

Zlokovic is a founder of a company, Socratech, which is seeking to commercialize his team’s discoveries about how amyloid-beta collects in the brain and how it might be removed more efficiently. He is also the Dean’s Professor of Neurosurgery and Neurology and director of the Center for Neurodegenerative and Vascular Brain Disorders.

One of the nation’s top academic medical centers, the University of Rochester Medical Center (http://www.urmc.rochester.edu/) forms the centerpiece of the University’s health research, teaching, patient care, and community outreach missions. The Medical Center receives more than $230 million in external research funding per year, and the University of Rochester School of Medicine and Dentistry ranks in the top one-quarter of U.S. medical centers in federal research funding. The University’s health care delivery network is anchored by Strong Memorial Hospital - a 739-bed, University-owned teaching hospital. As upstate New York’s premier health care delivery network, patients benefit from the Medical Center’s robust teaching and biomedical research programs.

Source: University of Rochester Medical Center



Plastic Surgeons Warn of Malnutrition in Body Contouring Patients

ASPS Study Suggests Nutritional Supplements Prior to Surgery

Identifying malnutrition before surgery in massive weight loss patients seeking body contouring will significantly decrease surgical complications, accelerate wound healing, improve scar quality and boost patient energy levels, according to a study in the December issue of Plastic and Reconstructive Surgery(R), the official medical journal of the American Society of Plastic Surgeons (ASPS). Optimizing nutrition with the addition of supplements, such as powder drinks and multi-vitamin tablets formulated for massive weight loss patients, is vital to successful body contouring surgery, the study reveals.

“Body contouring procedures for massive weight loss patients are major operations with large incisions in many areas that demand a lot of the body during the healing process,” said ASPS Member Surgeon and study co-author Dennis Hurwitz, MD. “By carefully monitoring nutritional deficiencies preoperatively and supplementing the patient with the necessary nutrients, minerals and vitamins, I have seen a significant decrease in complications and improved postoperative healing. In my practice, I won’t do body contouring procedures on this patient population without a preoperative regimen of nutritional supplements.”

The study was performed in two parts; First, medical literature regarding nutrition’s effect on healing from the 1940s to the present was reviewed. The authors then compared healing and wound problems in 75 of their massive weight loss body contouring patients from 2001 to 2005 who did not receive supplementation, with 37 patients from 2006 to present, who participated in a uniquely designed nutritional supplement program prior to surgery. The study also noted the role of each nutrient in wound healing and immune response.

The study found that complications and wound problems occurred in 66 percent of the 75 patients who did not receive supplementation before 2006. In the 37 patients on the nutritional supplement regimen after 2006, major complication rates were reduced to 19 percent. The study found specifically that improving nutritional deficiencies in massive weight loss patients improved the healing process, wound tension, and scar quality, in addition to increasing patients’ energy levels.

Because of reduced calorie intake for massive weight loss patients, they are highly susceptible to malnutrition, the study observed. At one year after bariatric surgery, most patients’ food intake remains at about 1,000 calories per day, not even close to meeting standard recommendations regarding calories and protein intake. The study also noted the role various nutrients play in wound healing: Protein, vitamins A, B complex, C, arginine, glutamine, iron, zinc and selenium promote wound healing, collagen production and immune response; Vitamin B complex has also been associated with reducing the risk of deep vein thrombosis.

According to the ASPS, nearly 67,000 body contouring procedures after massive weight loss were performed in 2007.

The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 6,700 physician members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.

Source: American Society of Plastic Surgeons



Millions Mark World Diabetes Day

  • Author: Health Informer
  • Filed under: Health News
  • Date: Nov 13,2008

Diabetes Activists Worldwide Organize Events to Draw Attention to Growing Pandemic With the Focus on Diabetes in Children and Adolescents

November 14 is the most important day of the year for the over 250 million people with diabetes worldwide. World Diabetes Day draws attention to the global diabetes epidemic and the need for action to improve care, prevent the disease in those at risk and find a cure. People on every continent, from countries as far apart as Australia and Uruguay, have organized activities to mark the day.

The International Diabetes Federation (IDF) and the World Health Organization (WHO) introduced World Diabetes Day more than 15 years ago in response to the worrying rise of diabetes around the world. Today the picture is even more alarming, with the total number of people living with diabetes now estimated at over 250 million. The figure will continue to grow without significant action and investment to reverse the trend. One of only a handful of health days officially recognized by the United Nations, World Diabetes Day is celebrated every year on 14 November-a date chosen to mark the birthday of Frederick Banting, who is widely credited with the discovery of insulin in 1921.

On World Diabetes Day, local, national and international events are organized to educate the public and inform policy-makers about the need to respond to the diabetes threat. Each year, the campaign centres on a theme established by the International Diabetes Federation. This year, the theme is diabetes in children and adolescents.

Diabetes in Children

Diabetes is one of the most common chronic diseases of childhood. It can strike children at any age, including pre-school children and even toddlers. Over 200 children a day develop type 1 diabetes, an autoimmune disease that cannot be prevented. Type 2 diabetes, widely associated with weight gain and lack of exercise, was previously thought to be an adult-only disease. Type 2 is now affecting an increasing number of children worldwide.

Diabetes in children is often diagnosed late or is misdiagnosed as something else such as the flu. One of the campaign goals for World Diabetes Day 2008 is to make the public aware of the most obvious warning signs of type 1 diabetes: frequent urination, rapid weight loss, lack of energy and extreme thirst. Those closest to the child - family members, school staff, the family doctor - need to know these signs.

The global campaign, led by the International Diabetes Federation, calls on diabetes advocates around the world to bring diabetes to light. Campaign Director Phil Riley explained: “We want people to draw attention to diabetes. We encourage them to do fun things that involve family, friends and colleagues. We need people with diabetes everywhere to know that they are connected to a global community.”

Bring diabetes to light

On and around World diabetes Day, over 800 buildings and landmark sites will light in blue for diabetes. The buildings are all listed on the campaign website at http://www.worlddiabetesday.org/monuments and include the Pyramids in Egypt, Niagara Falls in Canada, the Tower of London in the UK, Christ the Redeemer in Brazil, the United Nations Headquarters in the United States, the Burj al Arab in the UAE, the Sagrada Familia in Spain and the Tokyo Tower in Japan. They are lighting in the blue colour of the diabetes circle, the global symbol of diabetes and logo of the World Diabetes Day campaign.

No child should die of diabetes

Dr Martin Silink, President of the International Diabetes Federation, highlighted the serious impact of diabetes that underlies the campaign. “While we want people to enjoy the celebrations, we don’t want them to lose sight of the serious global impact of diabetes. The stark truth is that many, children included, are dying in the developing world because they cannot access the medication, monitoring and education they need to survive. It’s been 87 years since Banting, Macleod and the team in Toronto discovered insulin, yet it still does not reach many of the world’s most vulnerable citizens.”

The World Diabetes Day campaign can be followed online at http://www.worlddiabetesday.org.

World Diabetes Day

World Diabetes Day (WDD) is the primary global awareness campaign of the diabetes world. Led by the International Diabetes Federation, the campaign is a multi-stakeholder partnership that involves a broad alliance of diabetes representative organizations, individuals and government agencies. Official World Diabetes Partners contribute support to help World Diabetes Day reach its goals. The 2008 Official World Diabetes Day Partners are: AstraZeneca, Boston Scientific, Bristol-Myers Squibb, Insulet Corporation, LifeScan, Eli Lilly, Medtronic, Merck Sharp & Dohme, Novo Nordisk, Novartis, Pfizer and Takeda. The theme for World Diabetes Day 2009-2013 is ‘diabetes prevention and education’.

Diabetes in children

Type 1 diabetes is growing by 3% per year in children and adolescents, and at an alarming 6% per year among pre-school children. It is estimated that 70,000 children under 15 develop type 1 diabetes each year (200 children a day). Of the estimated 440,000 cases of type 1 diabetes in children worldwide, more than a quarter live in South-East Asia, and more than a fifth in Europe. Type 2 diabetes was once seen as a disease of adults. Today, this type of diabetes is growing at alarming rates in children and adolescents. In the US, it is estimated that type 2 diabetes represents between 8 and 45% of new-onset diabetes cases in children depending on geographic location. Over a 20-year period, type 2 diabetes has doubled in children in Japan, so that it is now more common than type 1. In native and aboriginal children in North America and Australia, the prevalence of type 2 diabetes ranges from 1.3 to 5.3%. Source: Diabetes Atlas 3rd Edition, International Diabetes Federation, 2006.

International Diabetes Federation

The International Diabetes Federation (IDF) is an umbrella organization of over 200 member associations in more than 160 countries, advocating for the more than 250 million people with diabetes, their families, and their healthcare providers. Its mission is to promote diabetes care, prevention and a cure worldwide. The International Diabetes Federation is an NGO in official relations with the World Health Organization and an associated NGO with the United Nations Department of Public Information. The International Diabetes Federation leads the World Diabetes Day and Unite for Diabetes campaigns. Additional information is available at http://www.idf.org

Source: The International Diabetes Federation (IDF)



Sanofi Pasteur and Chumakov Institute Russian Academy Medical Sciences Providers of Inactivated Polio Vaccine (IPV) IMOVAX PolioTM for Russia National “Project Health”

Sanofi Pasteur, the vaccines division of sanofi-aventis Group, announced today that Russia has chosen inactivated polio vaccine (IPV) from Sanofi Pasteur for primary immunization of all infants. The IPV doses are provided by M.P. Chumakov Institute of Poliomyelitis and Virus Encephalitides through a manufacturing agreement with Sanofi Pasteur.

IPV vaccination started in the summer of 2008 as part of Russia National “Project Health.” Four-million doses of IPV IMOVAX PolioTM have been delivered to date, ensuring that a complete birth cohort (approximately 1.3 million babies are born every year in Russia) can receive the recommended three doses of IPV vaccine.

“The Chumakov Institute was the first to produce oral polio vaccine which was instrumental in eradicating poliomyelitis in Russia,” said Academician Sergey Drosdov, Senior Scientific Advisor of M.P. Chumakov Institute of Poliomyelitis and Viral Encephalitides Russian Academy Medical Sciences. “Today, IPV is the vaccine of choice for post-eradication polio immunization programs and the Institute is proud to bring this vaccine to Russian children.”

The Russian Federation was certified polio-free in 2002. Since 2006, children from certain at risk groups are vaccinated with IPV. Starting mid 2008, all children less than one year of age are vaccinated following a sequential schedule: three doses of IPV for primary immunization, followed by two doses of oral polio vaccine (OPV).

“Every year in Russia, over 1.3 million children will be vaccinated with IPV and will benefit from its enhanced safety profile,” said Dr. Vladimir Tatochenko, Professor of pediatrics, Head of Diagnostic Department of Scientific Center of Children Health, Russian Academy of Medical Sciences. “IPV fits perfectly with the Russian childhood immunization calendar. DTP (diphtheria, tetanus, pertussis) vaccine and IPV will be administered during the same pediatrician visit. The existing high DTP vaccination coverage will ensure the success of IPV vaccination.”

Over 50 polio-free countries are using IPV

An increasing number of polio-free countries are using IPV for their national immunization programs which is becoming the international health standard of care for polio vaccination. In 2007, Mexico was the first Latin American country to choose IPV in a national immunization program with sanofi pasteur’s IPV containing pediatric combination vaccine, Pentaxim(R) (Diphtheria, tetanus, acellular pertussis, inactivated poliomyelitis vaccine, Haemophilus influenzae type b conjugate vaccine). Turkey also chose to include Pentaxim(R) in its national immunization program.

In Indonesia the World Health Organization (WHO) is conducting a pilot program to evaluate the switch from OPV to IPV in a tropical setting, for which sanofi pasteur is donating 1.5 million doses of IPV over 5 years.

Committed to the Global Polio Eradication Initiative for 20 years

Sanofi Pasteur has been a partner of the Global Polio Eradication Initiative since its founding by WHO in 1988.

  • Since 1988, Sanofi Pasteur has been a leading provider of OPV, supplying over 600 million vaccine doses in 2007, helping to reduce the number of polio cases by 99% with an estimated five million people escaping paralysis(1).
  • Between 1997 and 2005 Sanofi Pasteur donated over 120 million doses of oral polio vaccine to help eradicate polio in Africa (Nigeria is the only remaining endemic country in Africa).
  • In 2005, Sanofi Pasteur developed a novel monovalent Oral Polio Vaccine ype 1 or mOPV1 following urgent requests from the WHO. Fifty million doses of mOPV 1 were used for the polio eradication campaign in Egypt. As a result, Egypt was declared polio-free by the WHO in February 2006.

About M.P. Chumakov Institute of Poliomyelitis and Viral Encephalitides

The Institute of Poliomyelitis Research was established in 1955 by Michael Chumakov who became its first Director.

In 1960, the Institute included several laboratories and research departments from other research organizations and became Institute of Poliomyelitis and Viral Encephalitides.

Inactivated polio Salk vaccine has been produced in the Institute from 1956 to 1958, and since 1959 live attenuated polio vaccine administered orally (OPV) manufactured by the Institute has been used for mass vaccination campaigns.

Production technology of oral polio vaccine created in the Institute was the first to be certified by WHO for production and control of polio vaccines.

In the 1980’s, new inactivated vaccine against tick-born encephalitis was developed by the Institute.

Now scientists are working on creation of human gamma immunoglobulin by new hybrid technology.

Vaccines against rabies and hepatitis A were also developed in research laboratories of M.P. Chumakov Institute and other Russian manufacturers produce those vaccines for mass vaccination.

The Institute has an exclusive advantage of close coordination between research and industrial operations. Scientists are involved in creating new vaccines and also new technologies for mass production.

The research department of M. P. Chumakov Institute includes 18 laboratories with 91 research scientists, including four academicians. The Institute produces live polio vaccine, vaccine against tick-born encephalitis, rabies, yellow fever, and measles.

About poliomyelitis

Poliomyelitis (polio) is a highly infectious disease caused by a virus that invades the nervous system and can cause severe paralysis. The virus enters the body through the mouth and multiplies in the intestine. Initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. One in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralyzed, 5-10% die when their breathing muscles become immobilized. Polio mainly affects children under five years of age. In 1994, the Region of the Americas was certified polio-free by the World Health Organization, followed by the Western Pacific Region in 2000 and the European Region in 2002; worldwide efforts are continuing towards global eradication of this contagious and devastating disease.

About sanofi-aventis

Sanofi-aventis, a leading global pharmaceutical company, discovers, develops and distributes therapeutic solutions to improve the lives of everyone. Sanofi-aventis is listed in Paris (EURONEXT: SAN) and in New York (NYSE: SNY).

Sanofi Pasteur, the vaccines division of sanofi-aventis Group, provided more than 1.6 billion doses of vaccine in 2007, making it possible to immunize more than 500 million people across the globe. A world leader in the vaccine industry, sanofi pasteur offers the broadest range of vaccines protecting against 20 infectious diseases. The company’s heritage, to create vaccines that protect life, dates back more than a century. Sanofi Pasteur is the largest company entirely dedicated to vaccines. Every day, the company invests more than EUR1 million in research and development. For more information, please visit: http://www.sanofipasteur.com or http://www.sanofipasteur.us

IMOVAX PolioTM is a trademark of Sanofi Pasteur.

(1) World Health Organization, Fact sheet 288 Immunization against diseases of public health importance

http://www.who.int/mediacentre/factsheets/fs288/en/index.html

http://www.sanofipasteur.com



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