Hay fever and asthma patients can expect a good surprise in the times to come if a new drug, RPL554, is able to live up to expectations of effectively treating respiratory diseases but without many of the side-effects most presently-available drugs produce.

The trial to check efficacy of RPL554 started in November 2009 and is expected to be completed by this summer.

From News-Medical.Net:

Current treatments for asthma and hay fever sufferers are beta-agonists, which open up the airways, and inhaled steroids, which dampen down the inflammation that causes irritation - they are either taken together or singly.

But they have serious side effects, including possible harm to the cardiovascular system and the ’shakes’ reported by many patients from excess use.

Experts say little progress has been made recently with alternative, effective and practical treatment options for a wide range of people with asthma and hay fever and by combining anti-inflammatory properties and the ability to overcome airway narrowing in a single long-lasting dose via the nose, RPL554 could offer real hope of a significant breakthrough.

According to Dr. Clive Page, chairman of Verona Pharma and a professor of pharmacology at King’s College London, RPL554 is the sole molecule expected to have a low side effect profile. Once-a-day treatment with it can provide significant relief to asthma and hay fever patients.

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According to data from a Phase II study of an oral investigational drug, eltrombopag, the compound is highly effective to increase platelet counts in patients with chronic Immune Thrombocytopenic Purpura (ITP).

ITP is a disorder that is characterized by episodes of frequent spontaneous bruising, mucosal bleeding, and intracranial hemorrhage, and acute episodes of severe bleeding in severe cases.

From News-Medical.Net:

In the current double-blind randomized study, 104 adult ITP patients who had failed one prior therapy and had a platelet count <30,000/µL, were randomly assigned to take oral eltrombopag 30 mg, 50 mg, 75 mg, or placebo once daily for six weeks. The study found that eltrombopag at doses of 50 mg and 75 mg was significantly better than placebo (P < 0.001) at increasing and maintaining platelet counts to a level that would reduce the risk of bleeding and bruising. The drug increased platelet levels quickly, with up to 87 percent of responders raising their counts by day 15. Response was defined as a platelet count of 50,000/µL. At the end of six weeks of dosing, there were no safety and tolerability events that would preclude the advancement to future studies.

“The results of this trial are very encouraging, given that there are currently no oral treatment options available for ITP that increase the platelet count in such a high percentage of often difficult patients with apparently so little toxicity,” said Dr. Bussel, who is the principal investigator of the study and professor of pediatrics at Weill Medical College of Cornell University. “Eltrombopag may offer physicians an effective and convenient treatment alternative because current therapies, such as steroids and platelet transfusions, can have unwanted side effects, must be given IV, or are not sustainable over the long-term.”

The data was presented by James B. Bussel, M.D. - director of the Platelet Disorders Center, Children’s Blood Foundation Division at NewYork-Presbyterian Hospital/Weill Cornell Medical Center - at the “Seventh Review of Immune Thrombocytopenic Purpura: Current Issues in Pathogenesis, Diagnosis and Management.”

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David Ortiz recently remarked that he was a frustrated soul after a numbing loss, hitless game, and another day filled with questions about steroids.

Ortiz said that he has been greatly distracted by the steroid circumstances enveloping him.

From NYTimes.com:

In Ortiz’s brief exchange with reporters Thursday, he was not too comfortable. He typically stands by his locker and jokes with reporters. But when reporters descended upon him, he remained seated and kept his back to them. Then he used the Soulja Boy song as his version of a bouncer.

Other than that, he tried hard to be the normally bubbly Big Papi. He posed for pictures in the dugout, he signed autographs behind the plate and he teased teammates.

Still, as beloved as Ortiz has been in helping the Red Sox win World Series titles in 2004 and 2007, his legacy changed once it was reported that he was on the list of players who had tested positive. When Major League Baseball began testing for steroids in 2003, the list of those who failed the tests that year was supposed to remain anonymous. But the results were never destroyed.

The court-sealed results are now the subject of litigation between the government and the union. Whatever may be the result, the spirit of baseball has been once again torn by its “once considered greatest sons”.

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According to a recent study, adolescents who have tried herbal products are six times more likely to try illicit drugs such as cocaine and as much as fifteen times more likely to use anabolic steroids when compared to children who have never tried herbal products.

Susan Yussman, M.D., M.P.H., assistant professor of pediatrics in the Division of Adolescent Medicine at the university’s Golisano Children’s Hospital at Strong and study author, remarked that children expressing a desire to experiment with herbal products are more likely to try illicit drugs.

From News-Medical.Net:

The study found that teens who have ever used herbal products are:

* 4.4 times more likely to have ever used inhalants

* 4.4 times more likely to have ever used LSD, PCP, ecstasy, mushrooms, and other illegal drugs

* 5.9 times more likely to have ever used cocaine

* 6.8 times more likely to have ever used methamphetamines

* 8.1 times more likely to have ever used IV drugs

* 8.8 times more likely to have ever used heroin

* 14.5 times more likely to have ever used steroids

than teens who have never used herbal products.

“Those numbers could go higher with a survey that includes students who don’t attend school regularly or who have dropped out. Those teens are considered at higher risk for drug use,” Yussman said.

The study was based on the 1999 Monroe County, N.Y., Youth Risk Behavior Survey which provided data on a random sample of 2,006 high school students. Herbal product use was defined by lifetime use of “herbal or other natural products–to feel better, or perform better in sports or school.”

The cross-sectional study may prompt the need for further studies to determine which all herbal products can be associated with use of which certain drugs.

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A nationwide survey of more than 10,000 adolescents that appeared in an issue of Child Health News has reported that body image is a concern among both boys and girls. It was noted that this image may prompt them to use hormones and dietary supplements to improve their physique.

The survey also reported that the adolescent supplement users appear to be deeply influenced by the media.

It was noted that some of the most popular products for improving body image were creatine, amino acids, the amino-acid metabolite HMB, the hormone dehydroepiandrosterone (DHEA), growth hormone, and anabolic steroids.

From News-Medical.Net:

Anabolic steroids have the most serious health effects, including testicular atrophy, impotence, liver and kidney damage, an increased risk for heart disease, and the widely reported “‘roid rage” (uncontrolled aggression). The safety of creatine, DHEA, and other products purported to increase muscle mass and tone has been questioned and isn’t well known.

“Most of us in adolescent medicine think it’s best to stay away from these products altogether,” Field says.

The survey, of adolescents aged 12 to 18, was done in 1999 as part of the Growing Up Today Study (GUTS), which involves children of nurses enrolled in the Nurses’ Health Study based at Brigham and Women’s Hospital. GUTS was co-founded by Field and Dr. Graham Colditz and colleagues of Harvard Medical School and the Harvard School of Public Health.

Dr. Alison Field, an epidemiologist in the Division of Adolescent Medicine and the Department of Psychiatry at Children’s Hospital Boston and the study’s first author, said that protein powders may be relatively safe but steroids have known side effects.

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According to a new review of studies about the use of anti-inflammatory steroids for traumatic head injuries such as car crashes, the risk of death is increased due to such usage.

This analysis that was published by the British-based Cochrane Library draws heavily from a study of corticosteroid treatment for brain injury involving more than 10,000 patients.

Dr. Phil Alderson, lead author of the Cochrane study, said that the considerable increase in death with steroids found participating in the trial suggests that steroids are no longer to be routinely used in patients with traumatic head injury.

From News-Medical.Net:

Corticosteroids are “widely used in medicine to treat inflammation,” Alderson explains. “It is thought that some of the damage after a brain injury results from inflammation following the initial injury and that reducing inflammation might reduce this secondary injury.”

In the case of severe head injuries, the inflammation leads to swelling of the brain and its surrounding tissues, which in turns creates pressure in the skull that may lead to complications or death.

The 17 studies on steroid use and the risk of death examined by Alderson and colleagues included a total of 12,083 patients of all ages with clinically diagnosed traumatic brain injury, some of whom received steroid treatment within seven days of their injury.

The cause of death in patients who received steroid treatment in the new large trial was unclear, according the study’s authors. Some researchers have suggested that corticosteroids increase the likelihood of death by interfering with adrenal gland function.

This review appeared in the January issue of The Cochrane Library, a publication of the Cochrane Collaboration that evaluates medical research.

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Steroids can have a long-lasting effect on brains of teenagers and may even flip the brain switch of adolescents for aggression that may last as much as two years, as per a U.S. study.

It was suggested by the study researchers that anabolic steroids may result in brain changes on a permanent basis, a fact that was based on results noticed in hamsters.

In the recent past, neuroscientists have shown a great concern about the rising adolescent abuse of anabolic-androgenic steroids (AASs).

From News-Medical.Net:

According to the researchers even after the drug was withdrawn, the newly vicious hamsters attacked, bit and chased the intruders, and the level of aggressiveness was 10 times greater than that of other hamsters which were only injected with oil.

Apparently the effects lasted for almost two weeks, which is the equivalent of half their adolescence.

After this period, the animals reverted to their normal playful defensiveness, but postmortems on the hamsters found there had been also been changes in their brain activity.

While they were being given steroids, a part of their brains called the anterior hypothalamus, which regulates aggression and social behaviour, pumped out more of a neurotransmitter called vasopressin.

Their full-blown aggression which was clearly drug-induced lasted for nearly two weeks of withdrawal.

Three weeks after withdrawal, vasopressin levels had subsided in line with the aggressive behaviour.

This study appeared in the current edition of Behavioral Neuroscience, Vol. 120, No. 1.

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A recent study has shown that Rituximab is an effective treatment option for Graves’ eye disease after steroids have failed to deliver expected results. It is worth noting here that rituximab is presently used for other autoimmune diseases.

Raymond S. Douglas, M.D., Ph.D., an oculoplastics specialist who recently joined the faculty of the U-M Kellogg Eye Center, noted on the drug potential in the online October issue of Ophthalmology.

From News-Medical.Net:

In the current study, Douglas observed improvement among the patients, four of whom were women, as early as four weeks following the first infusion of rituximab. Researchers also observed that the positive results were sustained 4 to 6 months after treatment.

“Treatment of the inflammatory component of Graves’ eye disease has not advanced appreciably over several decades,” says Douglas. High-dose steroids, sometimes in combination with orbital radiation, are still the first line treatment. But, says Douglas, “These are imperfect options because inflammation often recurs when the treatment ends.” He is hopeful that rituximab can offer sustained improvement. Douglas observes that the results from a small case series must be viewed with some caution. But given the substantial benefits for patients treated with rituximab, he sees good reason to proceed with a large-scale clinical trial to test this promising new drug.

It was suggested by the study that rituximab is an effective form of treatment when it comes to the most severe forms of Graves’ eye disease.

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According to a Saint Louis University study, sleep problems of 80-90 percent children suffering from obstructive sleep apnea (OSA) can be effectively treated with a tonsillectomy and adenoidectomy surgery.

This study was the largest to date and focused on potential factors such as age and ethnicity, which may have an effect on OSA diagnosis and surgery impact.

Ron Mitchell, M.D., professor of pediatric otolaryngology at Saint Louis University and the study’s author, said that OSA has a significant impact on life quality of children, much like chronic asthma or rheumatoid arthritis.

From News-Medical.Net:

“Even though OSA resolved in the overwhelming majority of children after the surgery, it is still crucial to identify and treat children with persistent OSA,” Mitchell says. “Otherwise these children will continue to experience the health, behavioral and learning problems associated with OSA.”

Several options for treating persistent OSA exist, including: nasal steroids, allergy treatment, additional surgery or continuous positive airway pressure (CPAP) mask. Over time, some children who did not experience immediate resolution will normalize, Mitchell says. Children who are overweight must lose weight in conjunction with the surgery for a successful outcome.

Obese children and children with Down’s syndrome or other genetic disorders that affect the craniofacial anatomy were excluded from the study because the rate of OSA is known to be higher.

It was emphasized by Dr. Mitchell that children scoring way outside normal parameters on behavioral measures were the greatest beneficiaries of the surgery.

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Women with naturally increased levels of DHEAs, the hormone precursor, were found to perform better in terms of cognitive function than their counterparts with reduced levels. This finding appeared in the March issue of the Journal of Clinical Endocrinology & Metabolism (JCEM).

This study revealed that cognitively intact women with increased circulating levels of DHEA (dehydroepiandrosterone) in the form of DHEA sulfate (DHEAS) fared better on executive function, concentration, and working memory tests.

From News-Medical.Net:

DHEA is a steroid precursor, which means that it is converted in the body to steroid hormones such as testosterone and estrogen. It is the most abundant circulating sex steroid in women.

Previous studies suggest that DHEA and DHEAS may have neuroprotective effects. These studies also suggest that the decline in the production of these steroids with healthy aging may contribute to neuronal dysfunction and degeneration, and thus cognitive decline.

Maintenance of cognitive function in elderly women is influenced by a number of health variables, including diabetes, hypertension, and smoking. Other studies have reported association between these factors and progression to dementia in elderly individuals. “In our study we were specifically interested in the associations between cognitive function and DHEAS, social circumstances, and leisure activities,” said Dr. Davis.

For this study, “Endogenous Androgen Levels in Women across the Adult Life Span,” 295 women, ages 21 to 77 (mean age 55), were recruited from an Australian community-based dataset. Each participant underwent a battery of tests known to measure a wide range of cognitive abilities, including verbal, visual, spatial and working memory, attention and concentration, speed, and accuracy. Women were excluded if they reported any health condition that might potentially adversely affect cognitive function.

Other researchers involved in the study were Sonal M. Shah, Dean P. McKenzie, Jayashri Kulkarni, Sonia L. Davison, and Robin J. Bell, all of the Monash University.

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