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stress quick treatment for H1N1

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stress quick treatment for H1N1

Patients who have flu-like symptoms and are having trouble breathing should get quick treatment with the antiviral drugs Tamiflu or Relenza, even before getting a flu test, U.S. officials said on Tuesday.

And doctors should consider setting up a system so that patients most likely to become severely ill from H1N1 swine flu have a prescription on hand so they can just call up to get the go-ahead to take the drugs if they develop symptoms, the U.S. Centers for Disease Control and Prevention said.

“Treatment should not wait for laboratory confirmation of influenza because laboratory testing can delay treatment and because a negative rapid test for influenza does not rule out influenza,” the CDC says in updated guidelines, available here

“The very young and very old, people with chronic medical conditions and pregnant women in general ought to be treated with antivirals when they have an influenza-like illness,” the CDC’s Dr. Anne Schuchat told reporters.

But most people will not need any treatment at all for H1N1 because most of those infected so far have recovered on their own. “They can be cared for with mom’s chicken soup at home, lots of fluids and rest,” Schuchat said.

The latest guidance suggests officials are keen to make sure people who need it get very quick treatment, while making sure people who do not need the drugs do not abuse them.

Both GlaxoSmithKline’s Relenza and Roche AG’s Tamiflu can help save the lives of patients severely ill with any influenza, if given within a day or so of symptoms starting. They can also ease the misery of milder cases and even prevent flu if people take it just after exposure.

But supplies are not infinite and health officials worry that the more people take them, the quicker the virus will evolve resistance, rendering them useless. Two older flu drugs, amantadine and rimantadine, are already useless against seasonal flu.

The CDC is clear that some people should take the drugs prophylactically — to prevent infection. That includes some healthcare workers and people with high-risk conditions such as asthma who know they were in close contact with an infected person.

But the new guidance adds an option to watch and see if the person gets a fever. “Instead of the preventive use of antivirals, clinicians may consider watchful waiting,” Schuchat said.

A vaccine against H1N1 swine flu is being tested but will not be available until mid-October. The CDC recommends that about 160 million people line up for the first doses starting then.

“Virtually all the influenza circulating now in the United States is the 2009 H1N1 strain,” Schuchat said. It has not mutated and the vaccine is still a good match, she said.

She said only a handful of cases of resistance to Tamiflu, known generically as oseltamivir, have been reported.

In the United States, 24 elementary, middle or high schools closed because of H1N1 outbreaks last week, letting 25,000 students out of class. The CDC advises against closing schools unless so many students or staff become ill that the school is overwhelmed.

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Researchers find prostate cancer stem cell

in.reuters.com

Researchers find prostate cancer stem cell

Cancer stem cells (CSCs) are cancer cells (found within tumors or hematological cancers) that possess characteristics associated with normal stem cells, specifically the ability to give rise to all cell types found in a particular cancer sample. CSCs are therefore tumorigenic (tumor-forming), perhaps in contrast to other non-tumorigenic cancer cells. CSCs may generate tumors through the stem cell processes of self-renewal and differentiation into multiple cell types. Such cells are proposed to persist in tumors as a distinct population and cause relapse and metastasis by giving rise to new tumors. Therefore, development of specific therapies targeted at CSCs holds hope for improvement of survival and quality of life of cancer patients, especially for sufferers of metastatic disease.

Existing cancer treatments have mostly been developed based on animal models, where therapies able to promote tumor shrinkage were deemed effective. However, animals could not provide a complete model of human disease. In particular, in mice, whose life spans do not exceed two years, tumor relapse is exceptionally difficult to study.

The efficacy of cancer treatments is, in the initial stages of testing, often measured by the ablation fraction of tumor mass (fractional kill). As CSCs would form a very small proportion of the tumor, this may not necessarily select for drugs that act specifically on the stem cells. The theory suggests that conventional chemotherapies kill differentiated or differentiating cells, which form the bulk of the tumor but are unable to generate new cells. A population of CSCs, which gave rise to it, could remain untouched and cause a relapse of the disease.

Researchers have found a stem cell, a kind of master cell, that may cause at least some types of prostate cancer.

Their findings are only experimental — the stem cells were found in mice — but could explain at least some types of prostate cancer and eventually offer new ways to treat it, they reported on Wednesday in the journal Nature.

The findings also show a potential new source for prostate tumors — so-called luminal cells, which secrete various compounds used in the prostate.

“The role of stem cells in the development of prostate cancer has been a focus of speculation for many years,” Dr. Helen Rippon of Britain’s Prostate Cancer Charity said in a statement.

“Importantly, this new stem cell does not rely on androgens — the male sex hormones that control prostate growth — to survive and grow. This may give a clue as to why prostate cancer often becomes resistant to treatments designed to regulate these androgens in the later stages of the disease,” added Rippon, who was not involved in the research.

“This improved knowledge will also be a step forward in learning how we might help to prevent the disease from developing in men in the first place.”

Michael Shen of Columbia University Medical Center and colleagues named the new stem cells CARNs, for castration-resistant Nkx3.1-expressing cells.

They normally regenerate part of the tissue that lines the inside of the gland, which produces semen. But the cells can also form tumors if certain genes meant to stop out-of-control growth get turned off.

Shen said researchers had believed that tumors arise from a different layer of cells in the prostate, called basal cells.

“Previous research suggested that prostate cancer originates from basal stem cells, and that during cancer formation these cells differentiate into luminal cells,” Shen said in a statement. “Instead, CARNs may represent a luminal origin for prostate cancer.”

Prostate cancer is the second most common cancer in men worldwide after lung cancer, killing 254,000 men a year globally.

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Beyond the Brain

Electrodes measure a Tibetan monk’s brain activity.

The ancient Egyptians thought so little of brain matter they made a practice of scooping it out through the nose of a dead leader before packing the skull with cloth before burial. They believed consciousness resided in the heart, a view shared by Aristotle and a legacy of medieval thinkers. Even when consensus for the locus of thought moved northward into the head, it was not the brain that was believed to be the sine qua non, but the empty spaces within it, called ventricles, where ephemeral spirits swirled about. As late as 1662, philosopher Henry More scoffed that the brain showed “no more capacity for thought than a cake of suet, or a bowl of curds.”

Around the same time, French philosopher René Descartes codified the separation of conscious thought from the physical flesh of the brain. Cartesian “dualism” exerted a powerful influence over Western science for centuries, and while dismissed by most neuroscientists today, still feeds the popular belief in mind as a magical, transcendent quality.

A contemporary of Descartes named Thomas Willis—often referred to as the father of neurology—was the first to suggest that not only was the brain itself the locus of the mind, but that different parts of the brain give rise to specific cognitive functions. Early 19th-century phrenologists pushed this notion in a quaint direction, proposing that personality proclivities could be deduced by feeling the bumps on a person’s skull, which were caused by the brain “pushing out” in places where it was particularly well developed. Plaster casts of the heads of executed criminals were examined and compared to a reference head to determine whether any particular protuberances could be reliably associated with criminal behavior.

Though absurdly unscientific even for its time, phrenology was remarkably prescient—up to a point. In the past decade especially, advanced technologies for capturing a snapshot of the brain in action have confirmed that discrete functions occur in specific locations. The neural “address” where you remember a phone number, for instance, is different from the one where you remember a face, and recalling a famous face involves different circuits than remembering your best friend’s.

Yet it is increasingly clear that cognitive functions cannot be pinned to spots on the brain like towns on a map. A given mental task may involve a complicated web of circuits, which interact in varying degrees with others throughout the brain—not like the parts in a machine, but like the instruments in a symphony orchestra combining their tenor, volume, and resonance to create a particular musical effect.

Corina’s brain all she is…is here

Corina Alamillo is lying on her right side in an operating room in the UCLA Medical Center. There is a pillow tucked beneath her cheek and a steel scaffold screwed into her forehead to keep her head perfectly still. A medical assistant in her late 20s, she has dark brown eyes, full eyebrows, and a round, open face.