Preserving The Usefulness Of Antibiotics

The historical scourge known as the bubonic plague killed up to one-third of Europe's population in the 1300s. But in modern times, it has been controlled handily with the help of antibiotic drugs such as streptomycin, gentamicin and chloramphenical.

That is, until 1995, when a plague infection in a 16-year-old boy from Madagascar failed to respond to the usual antibiotic treatments.

In the United States and globally, many other infectious germs, including those that cause pneumonia, ear infections, acne, gonorrhea, urinary tract infections, meningitis, and tuberculosis, can now outwit some of the most commonly used antibiotics and their synthetic counterparts, antimicrobials. According to the Mayo Clinic in Rochester, Minn., drug resistance may have contributed to the 58 percent rise in infectious disease deaths among Americans between 1980 and 1992.

Antibiotic resistance isn't a new problem; resistant disease strains began emerging not long after the discovery of antibiotics more than 50 years ago. Penicillin and other antibiotics, which were initially viewed as miracle drugs for their ability to cure such serious and often life-threatening diseases as bacterial meningitis, typhoid fever, and rheumatic fever, soon were challenged by some defiant strains.

"What's different now," explains David Bell, M.D., an expert on antimicrobial resistance with the national Centers for Disease Control and Prevention, "is that we've reached a situation where it's no longer an isolated problem of this bug or that bug; virtually all important human pathogens treatable with antibiotics have developed some resistance."

Despite the frightening trend, most people aren't likely to encounter a "superbug" that can outsmart all antibiotics, says Mark Goldberger, M.D., director of the Food and Drug Administration's division of special pathogen and immunologic drug products. "For the average person walking around on the street, the risk at the moment remains low."

Still, as one antibiotic's effectiveness wanes, doctors are forced in many cases to rely on more expensive and toxic drugs. Resistance is "a big problem and growing," says Linda Tollefson, director of surveillance and compliance in FDA's Center for Veterinary Medicine. "You're dealing with living microbes that have shown an incredible ability to accommodate antibiotics and come out winning. We have no idea what they are going to do next. Our fear is that we're seeing the tip of the iceberg."

To stop infectious germs from gaining ground, experts the world over, including doctors and scientists from FDA, CDC, and the World Health Organization, have been focusing since 1995 on finding ways to prolong the lives of antibiotics and to encourage drug companies to develop new "miracle drugs."

Herpes treatment helps infected women also fight HIV

Levels of HIV come down in HIV-positive women who are also infected with herpes simplex and are being treated for it with the antiviral drug valacyclovir.

These are the findings of a study published in today's New England Journal of Medicine.The research was conducted in Burkina-Faso in Africa and took the form of a randomized, double-blind placebo-controlled trial.Valocyclovir is marketed by GlaxoSmithKline as Valtrex.

Dr Nicolas Nagot of the London School of Hygiene and Tropical Medicine and colleagues found that treating herpes simplex 2 (HSV-2) infections with valocyclovir reduced levels of HIV-1 RNA in both the blood plasma and the genital mucosa, with the latter being more significant.And this effect seemed to get stronger over the three months of the study.Once a woman has herpes, the risk of getting HIV is increased and other research studies have shown that when HSV-2 is present it increases the amount of HIV-1 in plasma and genital mucosa.

The study enrolled 140 women who were tested positive for HIV-1 and HSV-2 and were not eligible for highly active antiretroviral therapy.The participants' levels of HIV and herpes were monitored for 24 weeks; 12 before and 12 after being randomly assigned to either the placebo or the valocyclovir treatment group.

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Vertigo pill is new obesity wonderdrug

A new pill for obesity helps overweight people shed more than 4lb a week. The drug, Betahistine, is currently used to treat the dizziness disorder vertigo.

But an obesity expert in Israel stumbled on the alternative use while looking for a new treatment for his overweight patients.

Now drug company Eli Lilly has become involved and is backing trials being carried out in Canada and America. In the first human trial in Tel Aviv, volunteers shed excess weight at a rate of almost 4lb a week for three months.

Because Betahistine is an existing drug, it is expected to be fast-tracked by British and American drug safety regulators and should become available worldwide for treating obesity in 2009.

About 40 per cent of adults in the UK are overweight, and 20 per cent are obese. This figure is rising, particularly among young adults.

"This drug is significantly more effective at helping people to lose weight then anything else on the market at present," says Dr Ami Eyal, medical director of Obecure, the company developing the pill.

"The great thing is that this drug has been around since the Sixties and there are no significant side-effects from taking it. It has already been used by 130 million people for vertigo - it is licensed in the UK for this - so we know it is safe.

"Some of the existing drugs for obesity have been linked with depression and suicidal tendencies, but there have never been any such reports with this drug.
"Our patients were absolutely amazed at how quickly they lost weight and they were quite disappointed when we had to stop the trial.

"Existing anti-obesity pills have proved to be slow in reducing weight in seriously obese people and they generally need to have surgery. But operations for the morbidly obese are risky."


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What Is Meningitis?

Meningitis is a relatively rare infection that affects the delicate membranes -- called meninges (men-in'-jeez) -- that cover the brain and spinal cord. Meningitis used to occur most commonly in infants, but because a vaccine is now given to infants, this infection now occurs mainly in adults. Many forms of meningitis can be contagious among people in close contact -- in classrooms and university dorms, for example.
Outbreaks of meningitis, particularly the bacterial form, are rare in the U.S. However, since 1991 such outbreaks have been increasing for reasons not yet understood. Viral meningitis tends to be less severe, and most people recover completely. Fungal meningitis is the most rare form and generally occurs only in people with weak immune systems, such as people with AIDS.

What Causes It?
Meningitis is almost always caused by another bacterial or viral infection that began elsewhere in the body, like the ears, sinuses or upper respiratory tract.
The bacterial form of meningitis is an extremely serious illness that requires immediate medical care. If not treated quickly, it can lead to death within hours or to permanent brain damage in about 30% of people.

Bacterial meningitis is caused by any one of several bacteria. The most common forms are Hemophilus influenzae type b (common form in infants until the vaccine was introduced), Neisseria meningitidis or "meningococcus" (primarily in young adults) and Streptococcus pneumoniae or "pneumococcus" (most common form in adults). Together, these three bacteria account for about 80% of bacterial meningitis cases in the U.S.
The bacteria can spread from person to person through coughing and sneezing. If you are around someone who has bacterial meningitis, you should contact your doctor to see if anything needs to be done so you don't become infected.

In most instances, bacterial meningitis develops when bacteria get into the bloodstream from an infection in the sinuses, ears or other part of the upper respiratory tract. The bacteria then travel through the bloodstream to the brain.

Viral meningitis is more common than the bacterial form and generally - but not always -- less serious. It can be triggered by a number of viruses, including several that can cause diarrhea. The flu virus can also lead to meningitis in rare instances. More recently, the West Nile virus transmitted to humans by mosquitoes carrying the virus, has been known to cause cases of meningitis. People with viral meningitis are much less likely to have permanent brain damage after the infection resolves.

Fungal meningitis is much less common. It is usually caused by a fungus called cryptococcus, found in pigeon droppings. Fungus-related meningitis is rare in healthy people. However, someone who has an impaired immune system, as happens with AIDS, is more likely to become infected with this form of meningitis.

Include herbs in your diet

According to Suzanna Zick, a naturopathic physician and researcher at the University of Michigan Health System , adding spices such as basil, oregano, garlic, curry, and rosemary to one’s diet can benefit health.

"Adding herbs and spices can help you maintain a healthy weight. Plus, they can help prevent certain cancers, and even lower blood pressure, control blood sugar and improve cardiovascular health," Zick said in a prepared statement.

Traditional seasonings like sugar, salt and fat when replaced with herbs and spices not only improve overall health but also improve the flavor of your food.

Herbs as medicine
Herbs such as oregano, thyme, rosemary, parsley and garlic bring out the natural flavors in a meal and can replace salts.

Garlic lowers B P and cholesterol. "For maximum benefit, you need to have about three medium cloves of garlic per day. Dry garlic, or garlic left out too long, loses its healthy benefits," said Zick.

Rosemary is an antioxidant that improves memory and possibly helps prevent cancer. Basil, oregano and rosemary fight colds.

Thyme treats chronic coughs. "The health benefits of thyme are unique. It has been traditionally used to treat coughs, even whooping cough," said Zick.

Turmeric cures back pain. A substance known as curcumin found in turmeric has anti-inflammatory properties.Turmeric can be used alone or added to curry. Curcumin also shrinks pre-cancerous colon polyps.

"Warming spices," including ginger, nutmeg, cinnamon, allspice, pepper, and cayenne pepper, decrease blood pressure. Ginger soothes stomach. Gingerols in ginger also control nausea.


Source: www.medical-health-care-information.com

Combination Of Drugs Should Be Used To Fight Flu Pandemic

A combination of antiviral drugs should be stockpiled for use in an influenza pandemic, say researchers in this week's BMJ.

We currently have two classes of drugs that are effective against influenza viruses: the ion channel inhibitors (amantadine and rimantadine) and the neuraminidase inhibitors (oseltamivir and zanamivir).

Although ion channel inhibitors are effective against several strains of influenza viruses, they are not being widely stockpiled for a future flu pandemic because they cause unacceptable side effects and their use is associated with a rapid emergence of resistance.

But researchers argue that combining the two types of drugs may reduce side effects and the risk of resistance, and could play an important role in our armoury against a future flu pandemic. In laboratory tests, the combination of ion channel and neuraminidase inhibitors reduced the emergence of resistance and even prevented the emergence of resistant strains of the highly pathogenic avian influenza H5N1 virus.

Ion channel inhibitors are also considerably cheaper than neuraminidase inhibitors, so the cost implications of maintaining stocks of both types of drug are therefore modest, say the authors. These drugs are also chemically stable, giving them a long shelf life.

The World Health Organisation recently recommended combined use of ion channel and neuraminidase inhibitors against the H5N1 strain, but this recommendation was deemed weak because of a lack of good evidence. Adequately sized trials of such combinations are therefore urgently needed, they add.

Several countries including the US, UK, and Greece are already stockpiling ion channel inhibitors. Other countries should consider following suit, say the authors. Failure to stockpile both types of antiviral drugs could prove costly.

An accompanying editorial discusses new guidelines on the clinical management of pandemic flu and says that the United Kingdom is well advanced in its preparations for a flu pandemic.


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Pain killer Helps Against Child Cancer

Neuroblastoma is a form of cancer that develops in the nervous system and it affects small children more commonly than any other tumour type. Now, however, scientists at Karolinska Institutet in Sweden can show that a common painkiller can inhibit the development of neuroblastoma and help make treatment of the disease more effective.

The results apply to celecoxib, an analgesic, anti-inflammatory substance that works by inhibiting the effect of the inflammatory enzyme, Cox-2. In a study presented in Clinical Cancer Research, the research group has shown that celecoxib is also active against neuroblastoma, a type of tumour that depends on Cox-2 for its growth and proliferation.

The scientists have shown that celecoxib has an inhibitory and preventative effect on tumour development in rats. The substance also proved able to reinforce the effect of different cytostatics currently in use in the treatment of neuroblastoma.

"The painkiller can check the rapid division and growth of the cancer cells and block the blood vessels that supply the tumour with oxygen and nutrients," says John Inge Johnsen, researcher in child cancer at Karolinska Institutet.

The researchers conclude that celecoxib is a potential anti-neuroblastoma drug, possibly in combination with other drugs.

"But it's a matter of finding the right combination, as celecoxib can also counteract the tumouricidal effects of certain cytostatics," says Per Kogner, Professor at Karolinska Institutet and paediatrician at the Astrid Lindgren Children's Hospital in Stockholm.

The results from cell cultures and animals were obtained at concentrations that the scientists had previously measured in children receiving the medicine. They now plan to proceed to clinical trials, which will determine the way in which celecoxib can be used to treat neuroblastoma in children.

The research was conducted with the support of the Children's Cancer Foundation and the Swedish Cancer Society.


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What Is a Cold?

What Is a Cold?

It's called common cold. The common part is right on: it's the most frequent infection across all U.S. age groups. Most adults have 2-4 colds per year and children have 3 to 8 per year.

What does happen is that you catch a virus from another person. This often happens by touching a contaminated surface and then touching your eyes, nose, or mouth. You can also catch a cold by encountering secretions sneezed into the air.

A cold begins when a cold virus enters the body. Your immune system sends white blood cells out to attack this germ. Unless you've encountered it before, the initial attack fails and your body sends in reinforcements. Your nose and throat get inflamed and produce lots of mucus. With so much of your energy directed at fighting the virus, you feel tired and miserable.

What Causes It?
There are approximately 200 viruses that can cause a cold. Rhinoviruses and there are more than 100 subtypes -- cause up to half of all colds.

while getting a chill does not cause a cold, there are factors that make a person more susceptible to attack by cold viruses. These include excessive fatigue, emotional distress, immature or compromised immune systems, and close contact with someone with a cold.

Obesity Drug Helps Unlock Clues About Cancer

An approved drug for fighting obesity is helping scientists at Wake Forest University School of Medicine uncover clues about how to stop the growth of cancerous tumors.

"Our discovery makes an exciting treatment target because theoretically you don't have to worry about harming nearby healthy tissue," said senior researcher Steven J. Kridel, Ph.D., an assistant professor in the Department of Cancer Biology.

In the current issue of Cancer Research, Kridel and colleagues are the first to report that a tubular network within cells, known as the endoplasmic reticulum (ER), is regulated by an enzyme that is tightly linked to tumor growth and development.

"When the ER cannot do its job properly, there's a series of events that gets turned on that can lead to cell suicide or death," said Kridel.

The research showed that an enzyme known as fatty acid synthase is vital for the ER to do its job. Blocking this enzyme, which makes fat in cells, has been shown to prevent tumor cell growth and to promote cell death.

"No one had made connection before between fatty acid synthase and the function of the ER in tumor cells," said Kridel. "This is the first to show that fatty acid synthesis is important in maintaining ER function and keeping tumor cells alive."

The researchers started the work five years ago when they analyzed prostate cancer cells to see which proteins and enzymes were expressed at high levels. Their hope was that treatments that reduced those levels could also stop tumor growth.

"We found that fatty acid synthase is expressed at high levels in tumor cells, but is fairly absent in normal cells," said Kridel. "Other researchers had made similar findings in other types of cancer cells, so we decided to follow up because it looked promising.

"We then made the surprising finding that OrlistatTM, a drug approved by the FDA to treat obesity, can block the function of fatty acid synthase, prevent tumor cell growth and promote tumor cell death."

Finding out exactly how the drug worked was the next step, so that better treatments could be developed. While effective in mice, Olistat's current formulation cannot be given to humans as a cancer treatment because it acts only in the digestive tract.

In the current study, Kridel and colleagues treated prostate, colon and cervical cancer cells in the laboratory with Olistat and two other agents to understand why blocking fatty acid synthase induces cell death.

"Our goal was to understand how fatty acid synthase contributes to tumor growth," said Kridel. "This might provide an explanation for why this enzyme is expressed at high levels."

Now that the scientists understand that the ER is involved -- and that inhibiting fatty acid synthase can impair its function -- they are working to develop new treatments for cancer therapy.

They are exploring the possibility of using existing FDA-approved drugs, as well as developing new drugs. They've already determined that the structure of Orlistat bound to fatty acid synthase, which is the first step in developing similar agents that could be used in humans.

"Our latest findings that connect fatty acid synthase and ER function gives us a better understanding about how the drug kills tumor cells and give us clues to make better drugs," said Kridel. "For any drugs we develop, we'll need to show that they impair the function of the ER."

New Approach Could Lower Antibiotic Requirements By 50 Times

Antibiotic doses could be reduced by up to 50 times using a new approach based on bacteriophages.

Steven Hagens, previously at the University of Vienna, told Chemistry & Industry, the magazine of the SCI, that certain bacteriophages, a type of virus that infects bacteria, can boost the effectiveness of antibiotics gentamicin, gramacidin or tetracycline.

It is the phages' ability to channel through bacterial cell membranes that boosts antibiotic effectiveness. 'Pseudomonas bacteria for example are particularly multi-resistant to antibiotics because they have efflux pump mechanisms that enable them to throw out antibiotics. A pore in the cell wall would obviously cancel the efflux effect,' Hagens explains.

Pseudomonas bacteria cause pneumonia and are a common cause of hospital-acquired infections.

Experiments in mice revealed that 75% of those infected with a lethal dose of Pseudomonas survived if the antibiotic gentamicin was administered in the presence of bacteriophages.

The bacteriophage approach would also be particularly useful for treating cases of food poisoning, because the lower doses of antibiotic needed would not disrupt the friendly bacteria in the gut - a big problem with conventional antibiotic treatments.

'The prospect of using such treatments to prolong the life of existing agents and delay the onset of widespread resistance is to be welcomed,' said Jim Spencer a lecturer in microbial pathogenesis at the University of Bristol.

The overuse of antibiotics since the 1940s had slowly created a host of infections that are resistant to antibiotics. MRSA (Methicillin-resistant Staphylococcus aureus) for example is rapidly spreading through hospitals, affecting more than 8,000 people in the UK every year. MRSA infection can lead to septic shock and death.

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