For the almost 8,000 conventioneers in attendance at the 145th annual American Veterinary Medical Association convention in New Orleans July 19-22, just about everyone heard two magic words-”Thank you.”

City officials, hotel employees, taxi drivers, local veterinarians, waiters, musicians, artists and New Orleans residents from every walk of life were open about thanking AVMA staff and members for bringing its convention to the Big Easy. After all, some neighborhoods are still rebuilding from Hurricane Katrina.

Richard Colar, who works at the Riverside Hilton, was one of the many locals who were eager to say thanks to every veterinarian he met during the convention. “Veterinarians are great people,” he says. “Veterinarians saved my dog.”

When Hurricane Katrina flooded Colar’s neighborhood with 13 feet of water in 2005, he was forced by authorities to flee without his Siberian husky, Princess. Veterinarians later relocated the dog to safety in Delaware, and a few weeks later Princess and Colar were reunited. Colar hopes to move back into his rebuilt home from a FEMA trailer later this year.

“It was so important to me to get my dog back, and I was so thankful,” he says. “I was really happy to see veterinarians come to New Orleans. It really helps. Every convention that comes helps a little bit. I never knew that there were so many animal lovers in the world.”

Some of the veterinarians attending the AVMA convention were part of the efforts in New Orleans following Katrina to help people like Colar. In the aftermath of the hurricane, veterinarians on the AVMA Veterinary Medical Assistance Teams served in New Orleans, treating rescued animals and providing public health assistance. For them, the convention-and the “Voluntourism” program entitled “Our Oath in Action”-meant returning to ground zero.

For two days prior to the convention, approximately 150 AVMA members and their families, along with veterinary technicians, students and industry employees volunteered their time to help rebuild animal shelter facilities affected by Hurricane Katrina, including the Plaquemines Parish Animal Control facility, the St. Charles Parish Animal Shelter, the Jefferson West Parish Animal Shelter and the St. John the Baptist Parish Animal Shelter.

“Our volunteers were extremely dedicated,” says Dr. Bruce Little, vice chair of the American Veterinary Medical Foundation, a veterinarian-directed charity that funds disaster-relief programs across the country. “It was a wonderful program run by the foundation. The improvements made to these facilities were immense, but I still believe that the people that got the most of out it were the volunteers themselves. They really enjoyed contributing their time and the efforts to help rebuild New Orleans.”

With the support of sponsors like Bayer Animal Health, which funded transportation, food, caps and t-shirts and supplies for the volunteers; Hills Pet Nutrition, which provided cooling shelters; and Sherwin Williams, which provided paint and paining supplies, volunteers cleaned, insulated, patched shelter walls, painted, rebuilt cages, and even helped prepare the animals for adoption. “We were able to complete more work than we expected, and the facilities looked so much better when we were finished,” Dr. Little explains.

Conventioneers helped New Orleans in other significant ways as well, pouring $9.3 million into the struggling economy of the city, according to the New Orleans Metropolitan Convention & Visitors Bureau (NOMCVB).

“The American Veterinary Medical Association generated over $9 million in economic impact by bringing their annual convention to New Orleans in the off-peak summer months, which not only fueled our city’s most important economic engine-tourism-but also supported our chefs, street performers, musicians, artists, etc. that make New Orleans the unique destination that it is,” says Stephen Perry, NOMCVB president and CEO. “Above and beyond, AVMA donated their time to assist in building new homes for our animal community. We can’t wait to welcome them back!”

Dr. James Creed, chair of the Convention Management and Program Committee, said that the city of New Orleans didn’t disappoint. The host city and convention programs were praised by conventioneers.

“People loved the Cajun food in wonderful restaurants, and they had to be surprised at seeing no effects from Katrina in the downtown area,” Dr. Creed says. “Many unsolicited comments related how impressed attendees were with quality of speakers, breadth and relevance of topics and excellence of educational opportunities.”

The AVMA and its more than 76,000 member veterinarians are engaged in a wide variety of activities dedicated to advancing the science and art of animal, human and public health. Visit the AVMA Web site at avma for more information.

American Veterinary Medical Association

According to reports in the media today, drug company Eli Lilly has allegedly been promoting off-label use of antipsychotic drug olanzapine (branded as Zyprexa) to treat dementia. Olanzapine is approved by the FDA for the long term treatment of schizophrenia, maintenance treatment of bipolar disorder, as well as
treatment of certain types of acute episodes of bipolar disorder.

It has been reported that a US lawyer handling the lawsuits of mentally ill patients is in receipt of internal marketing documents belonging to Eli Lilly, that
allegedly contain evidence of a long standing campaign to influence doctors to prescribe Zyprexa for non-approved use, specifically to elderly patients with
dementia.

A representative of the company has denied the allegation stating that their sales training does not encourage reps to give doctors information
that is outside the FDA’s approved use of the drug.

While federal law makes it illegal for drug companies to promote drugs for non-approved use, doctors have the right to prescribe what they consider the best treatment
for their patients. This is where “off-label” use – that is using a drug approved for one condition to treat another – comes into practice.

In the UK,
according to the Medicines and Healthcare products Regulatory Agency (MHRA), in 2003 some 9,000 patients were prescribed olanzapine to treat dementia. They stated in a report on the drug in 2004 that: “Antipsychotics are licensed to treat acute psychosis and schizophrenia. However, they are also prescribed off-label to treat behavioural
problems in older people with dementia and clinical trials show some evidence of benefit to patients.”

The FDA information that accompanies the Zyprexa prescription warns that the drug can be fatal to elderly dementia sufferers, and in 2004, in the UK, the Committee for the Safety of Medicines (CSM) reported that olanzapine and risperidone (another antipsychotic) should not be given to elderly dementia sufferers because of the increased risk of strokes.

Sir Alasdair Breckenbridge, Chair of MHRA, said at the time of the 2004 CSM report that:

“Antipsychotics are not licensed for the treatment of behavioural problems in dementia but we know they are used in these patients outside their licensed
indications where prescribers make a judgement on their own responsibility that it is the right treatment for a particular patient”.

The FDA’s patient information on Zyprexa lists some of the potential side-effects of the drug which include increased chance of death in the elderly, a life threatening nervous system problem termed Neuroleptic Malignant Syndrome (NMS), a movement problem called Tardive Dyskinesia (TD), high blood sugar and diabetes, strokes, dizziness, dry mouth and constipation.

In a nutshell, the debate hinges on actively promoting off-label use versus making available information about off-label use. The regulators have to consider the safety of the average patient. But doctors need all the facts because they have a responsibility to give each patient the best care possible given their individual circumstances. And sometimes, in their professional opinion, the only drug that will alleviate the symptoms will be one that is approved for another condition, albeit with (known) risks.

Click here for patient information sheet on Zyprexa (FDA).

: Catharine Paddock
Writer: blog

View drug information on Zyprexa.

A protein molecule that ‘glues’ cells together and so has a key role in cancer is also responsible for many other important functions of cells, a new study has found.

University of Manchester scientists say their unexpected findings are important because they could lead to a better understanding of why some cancer cells are difficult to eradicate in patients and lead to new cancer treatments.

The research – published in PLoS One – looked at the role of the cell-adhesion molecule E-cadherin in embryonic stem (ES) cells. As well as the expected findings associated with changes in adhesion, the team found that the protein may also regulate up to 25% of the genes within cells.

“E-cadherin is a ‘glue’ that keeps cells together in the body – without it we would not develop beyond a bundle of cells a few days after conception,” said Dr Chris Ward, who led the study in the University’s School of Dentistry.

“E-cadherin is also important during cancer progression from benign to malignant states, with loss of this molecule leading to increased movement of the cells which can lead to secondary tumours within the body.

“Whilst E-cadherin has been studied intensively there has been no research that has identified all of the genes that E-cadherin regulates. Our lab has carried out profiling of ES cells lacking E-cadherin and found this protein is responsible for regulating up to 25% of the genes within cells.

“As well as the expected findings associated with changes in cell adhesion, we found that E-cadherin exerts an effect on a diverse range of biological functions within the cell. This unexpected result demonstrates that E-cadherin, often viewed as no more than a cell ‘glue’, is an important part of regulating the biology of ES cells.”

The group found that E-cadherin regulates genes associated with, amongst other things, cell proliferation, cell death, metabolism of fats and sugars and the deciphering of messages received by cells from outside.

Since loss of E-cadherin is implicated in higher death rates in cancer patients and a more aggressive tumour type, the group has suggested that this molecule may have a much more important role to play in preventing tumour development.

Dr Ward added: “Essentially, abnormal regulation of E-cadherin can lead to a significant change in a cell and this may be one of the reasons why such cells are difficult to eradicate in cancer patients. Further investigation of specific changes in these cells may lead to the development of novel treatments for cancer.”

Source:
Aeron Haworth

University of Manchester

West Australian researchers have voiced concern in light of findings which reveal female veterinarians who fail to safeguard themselves from x-rays and anaesthetic gases face double the risk of miscarriage.

The research, published in the most recent edition of the journal Occupational and Environmental Medicine, was carried out by scientists at the Western Australian Institute for Medical Research (WAIMR) and The University of Western Australia’s School Of Population Health.

WAIMR Associate Professor Lin Fritschi said the study of more than 1,200 female graduates from Australian veterinary schools over a 40-year period showed that occupational dangers such as x-rays, anaesthetic gases and pesticides could have a devastating effect on pregnancy and fertility.

“The worrying findings showed that female veterinarians exposed to an hour or more of anaesthetic gases or exposed to pesticides during the course of their duties were twice as likely to miscarry during pregnancy,” she said.

“We also found that two out of three veterinarians surveyed spent five or more hours a week in an operating suite or recovery room area, and nearly a quarter of these vets did not take steps to reduce their exposure to anaesthetic gases.

“While eight in 10 vets were found to use lead aprons to protect themselves when taking x-rays, a great deal of them did not use other protective devices such as gloves, screens or film holders.”

A/Prof Fritschi said the study proved that avoiding unnecessary exposure to occupational hazards needed to become a higher priority for veterinarians, particularly those who were pregnant.

“Existing precautions such as properly ventilating the workplace and minimising the amount of exposure through radiation protection measures such as masks, shoes and gloves are of vital importance,” she said.

“It is also essential that the vets themselves take part in the planning of preventive measures, and in training and educating the profession about how and when to use protective devices at work.

“Vets most at risk of dangerous exposures include graduates, vets under 30 years of age, those working in a mixed animal practice and vets working more than 45 hours a week.”

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The ‘Health Risks of Australian Veterinarians’ project was carried out by scientists at WAIMR and The University of Western Australia’s School Of Population Health as part of Dr Adeleh Shirangi’s PhD.

Source: Sarah Hayward

Research Australia

Preserving organs on ice prior to transplantation, an approach known as cold storage or CS, has been the standard practice in liver transplant for 20 years. Now there is new evidence that a technique called hypothermic machine perfusion (HMP) may offer an improvement, according to the first-ever study comparing the impact of the two techniques on transplant outcomes.

The phase I study was carried out by Dr. James V. Guarrera and his colleagues at NewYork-Presbyterian Hospital/Columbia University Medical Center. The researchers found that HMP is at least as good as CS in preserving donor livers — and that it most likely constitutes an advance over the traditional method. Improving preservation, they emphasize, could expand the availability of organs for transplantation.

Unlike cold storage, which Dr. Guarrera describes as a static technique, HMP dynamically simulates “aliveness” by providing a continuous flow of oxygen and key nutrients to the liver while diluting and removing toxins and waste products.

“Cold storage is the easy way to preserve vital organs for transplant. Generally, it has been a fairly effective way to keep a liver healthy en route to transplant surgery. But today, we have the technology to do better,” says Dr. Guarrera, surgical director of adult liver transplantation at NewYork-Presbyterian Hospital/Columbia University Medical Center and assistant professor of surgery at Columbia University College of Physicians and Surgeons. “And by better preserving donor livers and reducing preservation-related injury, we may be able to expand the pool of available organs, making liver transplantation available to more patients who need it.”

The study compared 20 transplant patients who received HMP-preserved livers with 20 patients with CS-preserved livers, finding the first group experienced shorter hospital stays and fewer long-term complications. The HMP group also had lower levels of blood markers indicating injury to the liver that may have occurred during the preservation interval.

The findings are currently reported online in The American Journal of Transplantation and will be featured in the journal’s February issue. The study was supported by a grant from the Health Resources and Services Administration, Division of Transplantation. A second grant is funding a phase II study.

Expanding Availability of Livers for Transplant

Improving organ preservation is especially important in light of major changes in the transplantation landscape, says Dr. Guarrera, and could broaden the availability of donor organs.

In the early days of liver transplantation, high-quality organs were plentiful for two reasons: First, liver transplantation had not yet become widespread, so demand was relatively low; and second, there was a greater supply of livers from young trauma victims. Thanks to a significant drop in violent crime and to public safety measures such as mandatory seat-belt use, the pool of young donors has shrunk — and that’s obviously a good thing, Dr. Guarrera notes. But there is no denying the stark fact that the age of the average liver donor is higher today, which means that the quality of available organs has deteriorated.

Dr. Guarrera goes on to describe the history and context of his interest in HMP, a technique that dates back to the 1960s, when it was introduced for kidney preservation. It was soon dropped in favor of cold storage, deemed the simpler way to go. But then, in the 1990s, HMP made a comeback in kidney transplantation, coinciding with greater reliance on “imperfect” kidneys from older donors.

“We strongly suspected that HMP could be adapted to the liver transplantation setting,” he says. “Our first challenge was to work with a manufacturer to make an HMP device more portable and more specific to the liver, an organ that is inherently more vulnerable to injury than the kidney. We’ve been using a pump produced by Medtronic, originally designed for use in cardiopulmonary bypass, combined with a preservation solution called Vasosol.

“Thus far, our results have been extremely encouraging. We just received FDA approval for a phase II study, focusing specifically on the effects of HMP in livers from ‘extended criteria donors,’ a group that makes up a growing proportion of the total number of donors today. Organs from these older, sicker donors are the ones most likely to benefit from machine perfusion.”

Molecular and mechanistic studies also are under way. Establishing the benefits of HMP over CS will depend on the results of larger clinical studies, says Dr. Guarrera, but it is equally important to clarify the way the two techniques play out at a cellular and molecular level.

“We aim to show that even imperfect livers can be maintained in peak condition via HMP during the critical period when they are in transit from donor to recipient. It’s the kind of ‘quality improvement’ that will translate into long-term benefits for patients.”

NewYork Presbyterian Hospital

NewYork-Presbyterian Hospital, based in New York City, is the nation’s largest not-for-profit, non-sectarian hospital, with 2,242 beds. The Hospital has nearly 2 million inpatient and outpatient visits in a year, including more than 230,000 visits to its emergency departments — more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian Morgan Stanley Children’s Hospital, NewYork-Presbyterian Hospital/The Allen Hospital and NewYork-Presbyterian Hospital/Westchester Division. One of the largest and most comprehensive health care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. The Hospital has academic affiliations with two of the nation’s leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.

Columbia University Medical Center

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The Medical Center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians and Surgeons was the first institution in the country to grant the M.D. degree and is now among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and state and one of the largest in the United States.

Source: NewYork Presbyterian Hospital

Daily events are minted into memories in the hippocampus, one of the oldest parts of the brain. For long-term storage, scientists believe that memories move to the neocortex, or “new bark,” the gray matter covering the hippocampus. This transfer process occurs during sleep, especially during deep, dreamless sleep.

Many neuroscientists have embraced and built upon this theory of memory storage, or consolidation, for a generation. But the theory is difficult to test. New research led by Brown University neuroscientist Mayank Mehta, conducted with Nobel Prize-winning physiologist Bert Sakmann, shows the best evidence yet of the sleep dialogue between the old brain and the new.

Their work, published in Nature Neuroscience, also shows that this interaction occurs in a startling way. Instead of the hippocampus uploading information to the neocortex in a burst of brain cell communication, Mehta found the opposite: the neocortex seems to drive the dialogue with the hippocampus.

The findings may give scientists a new understanding of how the brain manages memories in health and during dementia, offering up a fresh look at the causes of diseases such as Alzheimer’s, as well as potential treatments.

“Long-term memory making may be a very different process than we previously thought,” said Mehta, an assistant professor in the Department of Neuroscience at Brown. “Either this reversed dialogue is, somehow, a part of memory storage or this transfer of information from the old to the new brain may not occur during sleep. Either way, the results call into question commonly held theories about the role of cortico-hippocampal dialogue in sleep.”

Edvard Moser, a professor at the Norwegian University of Science and Technology and director of the Centre for the Biology of Memory, is a leading expert on memory processes in the hippocampus. Moser said of the new research, “This technically sophisticated study may significantly influence our view of hippocampal-neocortical interactions during sleep-related memory consolidation processes.”

To study this dialogue, Mehta recorded electrical activity in rat brains. To mimic the deepest sleep states, the rats were anesthetized then fitted with two electrodes. One electrode measured the electrical activity of thousands of cells in the neocortex. These cells were excitatory, meaning that they spark communication between nerve cells. The other electrode recorded the activity of a single inhibitory cell in the hippocampus. These inhibitory cells shut down dialogue between nerve cells.

Using this groundbreaking single-cell recording technique, honed in Sakmann’s laboratory at the Max Planck Institute for Medical Research, researchers made an important finding: During deepest sleep, in both the hippocampus and neocortex, the patterns of neural activity are both regular and highly related. The cells in the old and new brains fired nearly in synch, evidenced by similar peaks and troughs shown on electroencephalographs.

This is surprising; Previous studies showed that during deep sleep, when the excitatory cells in the neocortex showed rhythmic activity, excitatory neurons in the hippocampus showed erratic activity. This stumped Mehta and his colleagues: If these two parts of the brain talk during deep sleep, why didn’t they appear to be speaking the same language? They are, Mehta and his team discovered, if you listen to inhibitory, not excitatory, cells in the hippocampus. Mehta and his team also showed that the activity of the cells is related. The timing of activity, or talk, was the same in both brain regions, with a small delay in the hippocampus – as if those cells were echoing the speech in the neocortex.

This discovery of synchronized communication between the old and the new brain – a phenomenon known as “phase-locking” – has two key implications. It suggests that the neocortex, not the hippocampus, drives the discussion between these brain systems during deep sleep. It also suggests that the inhibitory neurons control the conversation.

Mehta says the findings may change the way neuroscientists look at past experimental data and the way they conduct future research.

“We now have a way, experimentally and theoretically, to see how the two parts of the brain talk to each other,” he said. “This will help us better understand the mechanisms behind learning and memory. But what is really exciting is that this method – simultaneously studying two different cell types in two different brain areas – could be used to study other aspects of brain function, such as perception, emotion, movement. It could open important new avenues for basic and applied research.”

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Along with Mehta and Sakmann, Thomas Hahn, a graduate student in the Department of Cell Physiology at the Max Planck Institute for Medical Research, helped conduct the research and also served as lead author of the journal article.

The Max Planck Institute for Medical Research, the National Science Foundation, the National Institutes of Health, NARSAD: The Mental Health Research Association, the Rhode Island Foundation and the Salomon Family Foundation supported the work.

Contact: Wendy Lawton

Brown University

In a study that appears in the current issue of Military Medicine, William C. Holmes, MD, MSCE, Assistant Professor of Medicine and Epidemiology, University of Pennsylvania School of Medicine, and lead author of the paper, assesses veterans’ tolerance for detainee abuse and variables associated with it.

In the study, three scenarios of detainee abuse, taken directly from Abu Ghraib prison in Iraq, were presented to veterans. After each scenario, zero tolerance — or the belief that abuse is “completely unacceptable” regardless of who the detainee is — was assessed for the described abuse. Holmes, who is also an investigator at the Center for Health Equity Resesarch and Promotion at the Philadelphia VA Medical Center, found that:

* Only 16% of veterans indicated zero tolerance for detainee exposure and deprivation

* Only 31% indicated zero tolerance for detainee exposure and sexualized humiliation

* Not even half (48%) indicated zero tolerance for detainee rape

“The level of tolerance exhibited by these findings is surprising, but may not be true for all veterans and certainly cannot be said to be representative of active-duty military,” says Holmes. He adds, “These findings do indicate, however, the value of assessing tolerance for abuse, and for using scenario-based assessment to do that; it provides an argument for similar work being done in active-duty military, particularly those who are heading to Iraq to become involved in sensitive, oversight positions.”

The study was completed by administering paper questionnaires to 351veteran volunteers at the Philadelphia VA Medical Center’s Mental Health Clinic, Primary Care Clinic, and Women’s Health Center. Participants were asked a number of sociodemographic questions (e.g., age, sex) and other questions (e.g., period of service, service in a war zone). Symptoms of depression and post traumatic stress disorder (PTSD) were also assessed.

Although every questionnaire administered the three increasingly-severe abuse scenarios, there were three questionnaire versions used: all scenarios of one version ended by stating that the abusing soldier was not ordered by a superior to treat the detainee in this way; all scenarios of the second version ended by stating that the abusing soldier was ordered by a superior to treat the detainee in this way; and all scenarios of the third version ended by stating that a second soldier stated, “This treatment is wrong,” and reported it.

In general, veterans’ tolerance for abuse was least when soldier-initiated, and greatest when superior-ordered. Tolerance for abuse also was high when a whistleblower was involved.

The strongest, most consistently significant variable related to tolerance was depression and co-morbid depression/posttraumatic stress disorder (PTSD). Those with depression alone and those with comorbid depression/PTSD exhibited odds that were approximately two and three times more tolerant of abuse than those with neither depression or PTSD. Sex of the respondent also was related to tolerance. Men exhibited odds that were ~4 to 20 times more tolerant of abuse than women.

Holmes notes that future studies using scenario-based questionnaire methods are warranted in generalizable war zone samples. “If our results are replicated in active-duty soldiers,” he challenges, “one could imagine the use of scenario-based questionnaires of this type to provide risk stratification of a soldiers’ likelihood for abuse upon entry into a sensitive oversight position. The frequent development of depression and PTSD in soldiers in Afghanistan and Iraq would suggest that completion of the questionnaire occur intermittently during their tour of duty as well.”

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PENN Medicine is a $2.9 billion enterprise dedicated to the related missions of medical education, biomedical research, and high-quality patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System.

Penn’s School of Medicine is ranked #2 in the nation for receipt of NIH research funds; and ranked #3 in the nation in U.S. News & World Report’s most recent ranking of top research-oriented medical schools. Supporting 1,400 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.

The University of Pennsylvania Health System includes three hospitals, all of which have received numerous national patient-care honors [Hospital of the University of Pennsylvania; Pennsylvania Hospital, the nation's first hospital; and Penn Presbyterian Medical Center]; a faculty practice plan; a primary-care provider network; two multispecialty satellite facilities; and home care and hospice.

Contact: Kate Olderman

University of Pennsylvania School of Medicine

Mobile phones could hold the key to people giving up smoking after a programme involving sending motivational and supportive text messages to smokers doubled quit rates at six months.

The findings of the txt2stop trial, which was led by the London School of Hygiene & Tropical Medicine and funded by the Medical Research Council, are published in The Lancet today.

Text messaging is an innovative approach to the deadly problem of smoking, which is estimated to cause more than five million deaths each year worldwide. Putting cigarettes out for good has huge implications for health but although two out of three smokers would like to give up, they often fail. Almost 6,000 people took part in the txt2stop trial, which evaluated this new way of helping smokers beat their addiction.

The study examined the long-term effects of specially-designed text messages by testing the levels of cotinine (a chemical found in tobacco) found in participants’ saliva after they reported they had stopped smoking for six months.

A total of 5,800 smokers were randomly allocated to the txt2stop programme or a control group. The txt2stop group received five text messages a day for the first five weeks and then three per week for the next 26 weeks with a personalised system which also allowed people to receive instant messages at times of need by texting the word ‘crave’ or ‘Lapse’.

The messages, which were developed with input from smokers and smoking cessation professionals, encouraged participants to persevere and focused on their success so far. Examples of the messages include:

– “This is it! QUIT DAY, throw away all your fags. TODAY is the start of being QUIT forever, you can do it!”

– “Cravings last less than 5 minutes on average. To help distract yourself, try sipping a drink slowly until the craving is over”.

Control group participants received fortnightly text messages thanking them for taking part in the trial. The results showed that continuous abstinence verified by chemical tests at six months was significantly increased in the txt2stop group 10.7% success txt2stop versus 4.9% success control.

The study found txt2stop worked well for all ages and across all social groups, with the authors concluding: “Mobile phone text messaging smoking cessation support doubles quit rates at six months.”

LSHTM clinical lecturer and GP Dr Caroline Free, who led the research, says: “Text messages are a very convenient way for smokers to receive support to quit. People described txt2stop as being like having a ‘friend’ encouraging them or an ‘angel on their shoulder’. It helped people resist the temptation to smoke.”

Professor Max Parmar, director of the Medical Research Council clinical trials unit, says: “Smoking kills more than five million people each year, and two out of every three smokers have said at some point that they would like to give up. By carrying out a large scale trial like this to see whether text messages can help people truly free themselves of their addiction, this research has shown that texting could be a powerful tool to help people to walk away from cigarettes for good. The MRC has been tackling the problem of smoking for over half a century, and we’re committed to funding research that has the potential to change so many people’s lives.”

Glyn Mcintosh, Director of Development & Communications at QUIT, which helped develop the text messages and find volunteers for the study, says: “We are delighted with the results and hope that text motivation will now become a standard part of the quitting process.”

Sources: London School of Hygiene & Tropical Medicine (LSHTM), AlphaGalileo Foundation.

Discovery provides a tool to track brain cell metabolic changes related to aging and diseases such as Alzheimer’s, Parkinson’s and Huntington’s

A protein that causes coral to glow is helping researchers at the University of Maryland School of Medicine to light up brain cells that are critical for the proper functioning of the central nervous system. This fluorescent marker protein may shed light on brain cell defects believed to play a role in various neurological diseases. The researchers describe how this marker works in mice in the December 20, 2006, issue of The Journal of Neuroscience.

The marker gives scientists the first-ever opportunity to distinguish between energy-producing structures, called mitochondria, in neurons, from mitochondria in other brain cells, called glia. Defects in mitochondria may be part of the process that leads to Alzheimer’s and Parkinson’s disease, as well as changes in the brain associated with stroke and aging.

v
“Prior to the development of this marker, we had no way to identify the mitochondria in neuronal cells from those in glial cells,” says the study’s principal investigator, Krish Chandrasekaran, Ph.D., an assistant professor in the Department of Anesthesiology at the University of Maryland School of Medicine. “Using this tool, we and other investigators can answer certain questions, such as to what extent does neuronal mitochondrial dysfunction contribute to Parkinson’s or Alzheimer’s. And, in a general way, we could look into whether there are changes in neuronal mitochondria as we age.”

Using advanced genetic techniques, the researchers have produced mice with fluorescent protein markers that identify only the mitochondria in neurons. These structures light up with a greenish-yellow glow when the scientists look at the brains of these mice through a fluorescent microscope. The researchers have determined that the expression of the fluorescent protein does not interfere with the normal functions of mitochondria.

Neurons conduct and generate electro-chemical impulses or nerve signals, which carry information from one part of the brain to another. Mitochondria in the neurons function like cellular powerhouses to produce those impulses through a metabolic process that combines oxygen with food calories. It is these nerve signals that cause muscles to move and thoughts to be processed. Dr. Chandrasekaran says the fluorescent marker system may make it possible to explore how neuronal activity and the mitochondrial energy-producing system are coordinated and how the interrelationship works.

The researchers say the establishment of the fluorescent marker in mice could unravel the mysteries of some of the most debilitating neurodegenerative diseases. The study’s senior author, Tibor Kristian, Ph.D., an assistant professor in the Department of Anesthesiology at the University of Maryland School of Medicine, says there are animal models for several of these diseases including Parkinson’s, Alzheimer’s, amyotrophic lateral sclerosis (also known as ALS) and Huntington’s disease. “The mice we have developed with the fluorescent protein could be bred with mouse models of various neurological diseases, so we could apply the ability to see mitochondria in neurons to the research of those diseases,” says Dr. Kristian.

This mouse model could also be used to study the role of neuronal mitochondria in stroke and traumatic brain injury, according to Dr. Kristian. He says his investigators are developing a similar marker for glial cells in the brain.

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The team included research assistants Julie Hazelton and Yu Wang, and Gary Fiskum, Ph.D., professor and vice chairman of research in the Department of Anesthesiology at the University of Maryland School of Medicine.

The National Institutes of Health supported this work with a two-year grant of $400,000.

Contact: Bill Seiler

University of Maryland Medical Center

Changes in brain density could be used to predict whether an individual who is at risk for schizophrenia is likely to develop the condition or not. A study published today in the open access journal BMC Medicine reveals that monitoring changes in grey matter density over time using brain scans could help early detection of individuals who are likely to develop schizophrenia, when used in combination with other prediction methods.

Dominic Job and colleagues from the University of Edinburgh in the UK analysed the brain scans of 65 individuals known to be at risk for schizophrenia because members of their family had suffered from it. The scans were generated using structural magnetic resonance imaging techniques (sMRI). Job et al. analysed changes in grey matter density in the scans, over a period of 18 months. Eight of the individuals studied went on to develop schizophrenia, on average 2.3 years after the brain scans were collected.

Job et al.’s results show that a reduction in grey matter density over time could be used as an indicator that an individual who is at risk will develop schizophrenia. Sixty percent of the individuals who according to Job et al.’s results were likely to develop schizophrenia, because they showed a reduction in grey matter in one part of their brain called the temporal gyrus, did develop the condition. Over 90% of the individuals who according to Job et al.’s predictions would not develop schizophrenia, did not develop it. Job et al.’s predictions could be used to assess possibilities for preventing schizophrenia.

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Article:
Grey matter changes can improve the prediction of schizophrenia in subjects at high risk
Dominic E Job, Heather C Whalley, Andrew M McIntosh, David GC Owens, Eve C Johnstone and Stephen M Lawrie
BMC Medicine 2006, (in press)

Contact: Juliette Savin

BioMed Central