Viagra Cure for Erectile Dysfunction

Researchers at the University of Kentucky found that patients who had negative thinking patterns, such as thoughts about not being able to justify their own existence, were at higher risk for developing depression.

Heart patients with depression have been shown to have more complications, including a higher risk of death.

Rebecca Dekker, a research nurse, noted the findings suggest that heading off negative thoughts could help reduce depression in heart failure patients.

"Because of these findings, we have developed an intervention that is designed to reduce negative thinking in hospitalized patients with heart failure, and we will be testing this intervention in a randomized, controlled trial. In the meantime, health care professionals and family members who work with patients with heart failure need to realize that when a person with heart failure expresses negative thoughts, they should be screened and possibly treated for depression," Dekker said.

These results are being presented this week at the American Heart Association Scientific Sessions in New Orleans.

http://www.uky.edu/

Patients with locally advanced lung cancer who receive chemotherapy and proton therapy, a specialized form a radiation therapy only available in a few centers in the United States, have fewer instances of a serious side effect called bone marrow toxicity than patients who receive chemotherapy and another type of radiation therapy called intensity modulated radiation therapy (IMRT), according to a study presented at the 2008 Chicago Multidisciplinary Symposium in Thoracic Oncology, sponsored by ASTRO, ASCO, IASLC and the University of Chicago.

The standard of care for patients with locally advanced non-small-cell lung cancer is chemotherapy and radiation therapy. Unfortunately, these aggressive treatments can put patients at risk of a serious side effect called bone marrow toxicity that can lead to delayed or missed treatments, hospitalizations and growth problems.

To try to alleviate this side effect, doctors at M.D. Anderson Cancer Center examined 142 patients with locally advanced non-small cell lung cancer. Of those, 75 patients received chemotherapy plus a type of targeted photon (X-ray) radiation therapy called intensity modulated radiation therapy (IMRT). The remaining 67 patients received chemotherapy and proton beam therapy. Proton beam therapy is a type of external beam therapy that uses protons rather than photons to kill fast growing cancer cells.

"Because proton therapy allows us to control the radiation differently than other types of external beam radiation therapy, we were hopeful that we could keep radiation away from critical structures, like the bones to avoid bone marrow toxicity," said Ritsuko Komaki, M.D., FASTRO, a radiation oncologist at M.D. Anderson Cancer Center in Houston.

After a follow-up time of 17 months, researchers found patients who received proton therapy with chemotherapy had a significant reduction in bone marrow toxicity compared to patients who received IMRT and chemotherapy. These findings suggest that using proton therapy over other types of radiation may allow doctors to give a higher dose of radiation without compromising the chemotherapy schedule to the lung tumor while avoiding some debilitating side effects, like bone marrow toxicity.

"These results are very promising for people with locally advanced lung cancer," said Dr. Komaki. "However, we need to now confirm these findings with a randomized trial."

http://www.astro.org/

As testing for high-risk types of the human papillomavirus (HPV) emerges as the gold standard in cervical cancer prevention, scientists are already researching how to determine even more precisely who is most likely to develop the disease and thus are in need of more immediate intervention.

Speaking at the EUROGIN (European Research Organization on Genital Infection and Neoplasia) conference THIS WEEK, experts presented data suggesting that the most effective strategy would be to introduce a second test to determine if women who test positive for high-risk HPV have one of three types of the virus that are associated with the highest mortality from cervical cancer: 16, 18 and 45.

About 30 HPV types are spread through genital contact, and about 18 of these can potentially cause cervical cancer. Each is "named" with a number, in the order of their discovery. Much attention has been paid to types 16 and 18, which account for 70 percent of all cervical cancers and against which the new HPV vaccines protect. However, experts say that medical evidence shows that type 45 should be a priority concern as well.

"Most of the focus has been on HPV types 16 and 18, because they are the most prevalent carcinogenic HPV types and are targeted by the new HPV vaccines," comments Attila Lorincz, PhD, one of the originators of the HPV test and Professor at Barts and The London School of Medicine. "However, type 45 also is highly associated with risk, particularly for adenocarcinoma, a very aggressive type of cervical cancer with a mortality rate of 52% after five years -- twice the rate of squamous-cell cancers. The incidence of invasive cervical adenocarcinoma, which used to account for 10-15 percent of all cervical cancers, has been steadily increasing -- in part because it develops inside the cervical canal and thus is difficult to detect early using a Pap smear."

Currently, there is one HPV test, developed by QIAGEN (Nasdaq: QGEN; Frankfurt, Prime Standard: QIA) and marketed as the digene HPV Test, which is approved by the U.S. Food and Drug Administration and is CE-marked in Europe. When used for screening, it is given to women over the age of 30 along with a Pap test, which can find abnormal cells but cannot detect HPV directly. And now, QIAGEN is developing two types of follow-up tests that will identify specifically which types of the virus are carried by HPV-positive women. At EUROGIN this week, QIAGEN scientists are presenting the results of research showing the accuracy of the company's digene HPV Genotyping PS Test, which specifically identifies the presence of types 16, 18 and 45. This assay is based on the technology used in QIAGEN's front-line HPV screening test, hybrid capture 2 (hc2) -- currently the gold standard in the field. In addition, data are being presented for a second QIAGEN assay, the digene HPV Genotyping RH Test, which identifies 18 types of potentially carcinogenic HPV. Prior to receiving CE marking in Europe, the genotyping tests will be made available for research use by laboratories and physicians exploring their potential clinical benefits. First to be available will be the digene HPV Genotyping RH Test, which is expected to be launched by the end of this year.

Currently, women who screen positive for high-risk HPV, but have normal Paps, are brought back for re-testing 12 months later, since it is only persistent infections that cause cancer. However, Dr. Lorincz explains that genotyping would allow women with HPV 16, 18 or 45 -- who are at highest risk of cervical cancer -- to be immediately examined further for the presence of pre-cancerous or cancerous cells.

http://www.qiagen.com/

The four drug-combination of carboplatin and paclitaxel, with the targeted therapies bevacizumab (Avastin) and cetuximab (Erbitux), is safe and may improve survival for patients with advanced lung cancer, according to a cooperative group study led by The University of Texas M. D. Anderson Cancer Center.

Presented today on the press program of the 2008 Chicago Multidisciplinary Symposium in Thoracic Oncology, sponsored by ASTRO, ASCO, IASLC and the University of Chicago, the study is the first to investigate in lung cancer a four-drug regimen of two standard chemotherapies and targeted therapies.

The Southwest Oncology Group (SWOG) Phase II study was led by Edward S. Kim, M.D., assistant professor in M. D. Anderson's Department of Thoracic Head and Neck Medical Oncology. Until now, the SWOG standard regimen for lung cancer has been carboplatin, paclitaxel and Erbitux, explained Kim; with the addition of Avastin, this study looked to increase efficacy without compromising safety.

"We could not conduct a study with four chemotherapeutic agents in patients due to toxicity concerns," said Kim, the study's principal investigator. "The rationale behind the study was the finding that Avastin enhances the efficacy of existing therapy, thereby possibly improving the carboplatin-paclitaxel-Erbitux regimen."

Data in lung cancer has also suggested there's a "synergistic effect" of pairing the epidermal growth factor (EGFR) inhibitor compounds with the vascular endothelial growth factor (VEGF) inhibitor, explained Kim.

Interestingly, explained Kim, the SWOG's study came at a crossroads for lung cancer - soon after a study was presented showing the benefits of adding Avastin to standard chemotherapy, and prior to a study showing a modest survival benefit when Erbitux is combined with chemotherapy.

Between August 2006 and September 2007, the large Phase II study enrolled 110 Stage IIIB or IV non-small cell lung cancer patients, 99 of whom were able to be evaluated. Patients received six cycles of the four-drug regimen, and as maintenance, continued receiving both Avastin and Erbitux. It's unique for a trial to feature a two-drug maintenance biologic therapy combination, explained Kim.

The study met its primary endpoint, safety, defined by frequency of pulmonary hemorrhage, or bleeding, a concern related to Avastin. There were four treatment-related deaths and two due to bleeding, which is consistent with prior Avastin studies, explained Kim. Adverse events such as low blood counts and neuropathy were reported in 40 patients, also consistent with standard chemotherapy.

Secondary endpoints included response rate, progression-free survival and overall survival. Of patients enrolled, 53 percent had shrinkage of their tumors and 24 percent had stable disease. The median progression-free survival rate was seven months and overall survival was 14 months. In contrast, previous SWOG studies showed an average progression-free survival rate of five-and-a-half months and overall survival of 12 months.

"These findings were certainly compelling, and are the best results ever for a SWOG-based study for advanced lung cancer. While early, this four-drug combination seems to show promising, yet modest improvement in efficacy without compromising patients' safety," said Kim. "Our next priority will be to analyze the tissue from this to study to help find appropriate biomarkers for the disease to best understand who might benefit from this drug regimen."

A biomarker analysis of this study is ongoing and a randomized Phase III study is planned, with the trial scheduled to open in 2009.

http://www.mdanderson.org/

Maybe you have an 85-year-old grandfather who still whips through the newspaper crossword puzzle every morning or a 94-year-old aunt who never forgets a name or a face.

They don't seem to suffer the ravages of memory that beset most people as they age.

Researchers at Northwestern University's Feinberg School of Medicine wondered if the brains of the elderly with still laser sharp memory -- called "super aged" -- were somehow different than everyone else's. So, instead of the usual approach in which scientists explore what goes wrong in a brain when older people lose their memory, they investigated what goes right in an aging brain that stays nimble.

Now they have a preliminary answer. Scientists examined the brains of five deceased people considered super aged because of their high performance on memory tests when they were more than 80 years old and compared them to the brains of elderly, non-demented individuals. Researchers found the super aged brains had many fewer fiber-like tangles than the brains of those who had aged normally. The tangles consist of a protein called tau that accumulates inside brain cells and is thought to eventually kill the cells. Tangles are found in moderate numbers in the brains of elderly and increase substantially in the brains of Alzheimer's disease patients.

"This new finding in super aged brains is very exciting," said Changiz Geula, principal investigator of the study and a research professor of neurology at the Cognitive Neurology and Alzheimer's Disease Center at Northwestern's Feinberg School. "It was always assumed that the accumulation of these tangles is a progressive phenomenon through the aging process. But we are seeing that some individuals are immune to tangle formation and that the presence of these tangles seems to influence cognitive performance." Individuals who have few tangles perform at superior levels, while those who have more tangles appear to be normal for their age, Geula noted.

Geula will present his findings Sunday, November 16, at the Society for Neuroscience annual meeting in Washington, D.C.

The number of plaques in the brains of the super aged was similar to that in the brains of the normally aging group. The plaque is an aggregation of protein called amyloid that becomes deposited outside the brain cell and disrupts communication between neurons. Like tangles, plaques also are found in modest numbers in the brains of aged individuals and show a dramatic increase in number in Alzheimer's disease.

Geula said the lower number of tangles in the super aged appears to be the critical difference in maintaining memory skills.

Some of the super aged in the study performed memory tasks at the level of people who were about 50 years old. For example, after being told a story, they were able to remember it immediately after and still accurately recall its details 30 minutes later. They also remembered a list of 15 words and recalled these words equally well when tested after 30 minutes.

Geula said new research will focus on what makes cells in super aged brains more resistant to tangle formation. "We want to see what protects the brains of these individuals against the ravages that cause memory loss," he said. " Understanding the specific genetic and molecular characteristics of the brains that makes them resistant, someday may lead to the ability to protect average brains from memory loss. "

Geula's research is part of a larger super aging study at Northwestern's Cognitive Neurology and Alzheimer's Disease Center (CNADC). The study's goal is to identify high functioning individuals over 80 and investigate what factors are important to maintain this ability into old age. A number of super aged individuals have been identified and are being followed up annually with tests of cognitive abilities. Recruitment continues for the study.

http://www.northwestern.edu/