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Flu Shots For Young Children And Pregnant Moms

It may be summer, but next winter will be there and along with it the threat of flus.
Flu shots are offered in fall, and especially people with health problems (like asthma or diabetes, just to name a few) and seniors have been the primary target groups for public vaccination programs. U.S. health authorities now have also added young children under 2 to the program.

This step has been taken, as babies and young children are at a substantially increased risk for influenza-related hospitalizations.
The U.S. Centers for Disease Control has just release a new recommendation, that all women who are pregnant during the influenza season should get flu shots. Pregnant women who contract influenza frequently have an increased rate of complications, including pneumonia, tachycardia (rapid heart beat), and contractions.
Even though most pregnant women are young and healthy, their hospital admission rate during the flu season is similar to what you see in the elderly.
Statistics show that generally only 12% of women with uncomplicated pregnancies get vaccinated. With the threat of a severe strain of influenza A, which showed its aggressive and widespread activity last winter, it can be expected that there will be an increased demand for flu shots this year.

The Medical Post, May18, 2004, pg.8 and 9.

Insomnia Sufferers Will Get Help

People with chronic insomnia not only have difficulties to get a good rest at night. If they reach for the currently available sleeping medications, their days start with a drug-induced mild "hangover": they feel drowsy for a few hours, and once they discontinue the medication, withdrawal can be a problem.

A new medication by the name of indiplon to treat chronic insomnia will be a safer, more effective form of medicine for patients with sleep disorders, reports Dr. James Walsh (PhD). He is an executive director and senior scientist at St. Luke's Hospital and the Unity Sleep Medicine Center in St. Louis. Dr. Walsh reports that the new medication has a very short half-life, meaning, that it is out of the body, by the time the patient wakes up in the morning. A 35-day trial showed that it is not only safe and effective, but also suitable to treat patients who have trouble falling asleep and those who have trouble sleeping through the night.
More studies are needed, before the medication will be available in the U.S. and in Canada.

The Medical Post, May 25, 2004, pg. 16

New Asthma Drug Works Slowly But Surely

Patients with severe asthma will have a new treatment option. A new medication under the name omalizumab has been studied in clinical trials by Dr. Jean Bousquet of Arnaud de Villeneuve Hospital in Montpellier, France.

In the study it was also determined which patients would benefit most of the new drug. The results are very encouraging: those patients who had the least success with other asthma medications had the best response. However, it is not an instant response. 67 % of the patients showed a good response after 4 weeks of treatment. 87 % of patients showed a response only after having been on the medication for 12 weeks. As a result of this trial it was determined, that patients with asthma should be treated with omalizumab for at least 12 weeks. More clinical trials will be needed before the drug will be available. On the other hand, patience is also of essence: if the medication is only administered for a month, a lot of patients with difficult to treat asthma will miss out on the beneficial effects, as opposed to those who persist and reap significant improvement after 12 weeks.

National Review of Medicine, May 15, 2004, pg. 27

Beer A Red Flag For Gout

For centuries gout has been known as the affliction of the affluent. The Greek physician Hippocrates first described it as "the disease of the kings". In the meantime the illness has jumped social boundaries, as the over consumption of meats and alcohol will occur in all population groups.

In its April 17 issue the British medical paper"The Lancet" shows the first publication on the link between alcohol and gout. Dr. Hyon Choi of the rheumatology unit of the Massachusetts General Hospital, Harvard Medical School, headed a study that showed that moderate amounts of wine did not pose a risk for gout. It was the beer drinkers that were headed for trouble! Those who drank more than two 350 ml cans or bottles of beer per day had a 2.5 times higher risk of developing gout than nondrinkers. People who had 2 shots of liquor a day ran a risk that was 1.6 times higher than those who did not drink. Moderate wine drinkers had the same risk of developing gout as nondrinkers, as long as they did not overindulge: 1 to 2 glasses of wine per day were the limit! It is not clear at this point, which would be the noxious substance in beer and spirits that is responsible for attacks of gout, and moderation is still in order for all wine lovers!

National Review Of Medicine, May 15,2004, pg.10

Gene Therapy Can Repair Blood Vessels

When the first attempt of gene therapy were made, a concoction of LDL- receptor genes was infused into the portal vein of patients with a family trait of high cholesterol levels. This was back in 1989, and the results at that point were not encouraging.
In the meantime advances have been made in genetic research. Dr. Duncan Stewart of the cardiology department of St. Michael's Hospital in Toronto who is considered by many as the guru of cardiac gene therapy, reports that we are now "at a crucial stage of the field". He cautions, that having the gene on hand is only part of the answer. For good results it is also important to understand how the delivery system to the diseased organ works.

Gene therapy stands out from other treatment options, because instead of drugs, DNA is provided. DNA itself is not the therapeutic agent. It penetrates the cells where it sets up shop and produces proteins, which are needed for therapy. In the case of heart disease, where heart vessels are blocked or have been damaged, the idea is to send specific DNA sequences to the heart cells and stimulate the production of growth factors. These growth factors would trigger new heart vessels to grow and take over for damaged or blocked vessels. This is not just a dream of a research team: a gene therapy trial - the only one of its kind in Canada - is on its way under the leadership of Dr. Stewart. This ambitious project was launched in 2002. In seven sites across Canada 110 patients with heart disease are receiving the vascular endothelial growth factor gene (VEGF for short). The gene is being directly injected into the areas of the heart where blood vessels have become diseased or blocked. The placement is measured with a mapping system known as NOGA (details see link). At the end of the year the study enrolment will be finished. Patients will be followed up for results 6 months later. This therapy promises long lasting effects, but it is still a long way to go.

Dr. Robert Hegele from the Blackburn Cardiovascular Genetic Laboratory at the University of Western Ontario is credited with uncovering eight genes for human disease (four of them are related to cardiovascular illness) and 80 mutations in other genes that are contributing to premature heart disease and diabetes. Dr. Hegel's interest is to discover the villains that predispose people to illness, but at the same time he cautions that genes are not everything. Being genetically susceptible does not necessarily foretell one's destiny when it comes to developing heart disease. Dr. Hegele emphasizes that the longer he works in the genetic field, the more he respects environment and lifestyle and finds that most people can even overturn genetic susceptibility and he leaves us with the final remark: "Tell your patients to stay away from tobacco, eat wisely and get that needed exercise."

The Medical Post June 29, 2004 (Vol. 40, No.26): page 35.

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