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Jun 20
Indian Medical Travel Association (IMTA) launched
Indian Hospitals, Wellness and Medical Tourism players join forces to make India the Global Healthcare Destination - Indian Medical Travel Association (IMTA) launched.

Leading Indian Hospitals, Healthcare providers (both Modern Medicine and Traditional Indian Medicine), Travel and Medical Tourism Industry providers have come together to form an industry association - Indian Medical Travel Association (IMTA) that aims to work together to make India the leading global healthcare destination.

The phenomenon now popularly known as Medical Tourism is often cited as the next big opportunity for India after the IT outsourcing to earn billions of dollars in forex earnings and create jobs in the healthcare sector. So far only a select group of Indian hospitals have been making valiant attempts to market their services in international arena. More than a million overseas patients already treated at top Indian corporate hospitals like Apollo, Fortis, Wockhardt, Max, Manipal and many others have already proved to the world that the clinical quality, technology and cost proposition offered by India is unmatched. The capacity in super specialty segment Indian hospitals is expanding fast and there is no waiting period for local or overseas patients.

CII Mc'Kinsey study first reported on medical tourism as the billion dollar opportunity for India way back in 2002 and the steady growth in overseas patient arrivals has validated the potential. With a large number of new private super specialty hospitals and even integrated health cities coming up in India's top ten cities, India has the potential to become the global leader in the Medical Travel/ Outsourcing industry. Indian doctors and professionals are world renowned for their skills and the country has abundance of all the inputs like talented young manpower, local high quality manufacturing base for pharmaceuticals, technology hardware and software that makes the Indian costs for high end surgical procedures so attractive. The challenge really is on the non medical side, primarily on the marketing front and also to create infrastructure and services to support the growth of medical tourism.

Indian Medical Travel Association (IMTA) - a non profit body and a unified voice of the Indian healthcare (modern medicine as well as traditional Indian medicine) and travel industry is aimed at preparing India for facing the challenges of global competition and actualise the tremendous opportunity for India to become a leading global healthcare destination. Modern medicine as well as India's 5000 year old traditional therapies like Ayurveda, Siddha and Yoga can offer to the world an unbeatable healing package.


"IMTA would strive to help its members reach out in a cost effective manner to millions of our potential global consumers who reside on the other side of the globe in a different time and cultural zone and make them aware of the tremendous value that Indian healthcare offers. The fact is that prior to choosing a hospital, the international patients first decide on the country or the destination. Therefore we all must join hands to aggressively promote INDIA as a preferred global healthcare destination," Says Pradeep Thukral, Executive Director, Indian Medical Travel Association (IMTA)

The Government of India and its various arms are actively supporting the growth of medical tourism to India. Two years ago the Government of India introduced a special category of Visa called M Visa for foreigners desirous of coming to India for medical treatment. India's Ministry of Tourism has achieved phenomenal success in last five years with its much acclaimed "Incredible India "campaign that has multiplied the arrival of foreign tourists to India. The current year 2009 is being promoted by Indian Ministry of Tourism as "Visit India'" year and the ministry is keen to promote Medical Tourism. It has recently notified the Market Development Assistance (MDA) Scheme to eligible Medical Tourism players which enables them to get financial support for participation in overseas promotional events.

About Indian Medical Travel Association. www.indianmedicaltravelassociation.com

A non profit body aimed at preparing India for facing the challenges of global competition in Medical Tourism space and actualise the tremendous opportunity for India to become a leading global healthcare destination. IMTA's membership has a diverse base of India's leading JCI, NABH accredited hospitals, Indian System of Medicine and Wellness service providers, travel industry, Insurance, Assistance and Medical Tourism facilitation companies.

For more details please contact :-

Mr Pradeep Thukral,

Executive Director,

Indian Medical Travel Association

Phone : 91 9810907151

Website : www.indianmedicaltravelassociation.com

Jun 18
Regular Exercise And A Healthy Diet Build Stronger Bones
June is National Osteoporosis Month and health experts from NHS Somerset are urging people to look after their bones by living well and eating well.

Osteoporosis is a disease where the inner honeycomb structure inside each bone becomes thinner and more fragile. It can affect any part of our body but the wrist, hip and spine are the most common areas.

Every bone in your body is alive - new cells are being created all the time to replace older ones - but when we are young this process tends to work faster enabling the skeleton to increase in density and strength.

The best way to build up your bones is by doing exercise and eating a healthy diet. During childhood, adolescence and early adulthood, when the skeleton is growing, you can 'bank' plenty of bone which puts the skeleton in a better position to hold out against the natural bone loss that occurs later in life.

Rachel Levenson, Associate Director of Nursing and Patient Safety for NHS Somerset said: "Your skeleton will grow stronger if you do regular weight-bearing exercise such as jogging, aerobics, tennis, dancing and brisk walking.

"As you get older, you may need to be careful of vigorous, high impact exercise but it's still very important to stay active and find something you enjoy doing. Swimming, gardening, walking or golf can all help reduce your risk of falling and breaking a bone," said Ms Levenson.

She added: "Eating a normal varied diet of bread, potatoes, fruit and vegetables, milk, meat, fish and foods containing fat and sugar will provide all you need to maintain a healthy skeleton. Our bodies contain 1kg of calcium, 99% of which is stored in our bones so we need to make sure our diet includes calcium-rich foods as well as other vitamins and minerals.

"If you can, try to give up smoking and reduce your alcohol intake. Don't let your weight drop too low - being overweight is not good for general health but being underweight increases the risk of broken bones when you fall.

Ms Levenson said: "Many older people fall in the home, so it is important to try and reduce the hazards that could cause you to trip and fall. Make sure you take your time using stairs and hold onto the rail. Tidy up any loose rugs or carpets, trailing wires, slippery floor surfaces and anything else that might cause you to fall over."

As you get older ask for help if feel you are at risk of falling or falling frequently. A referral to a physiotherapist may be helpful for advice about exercises to help with balance and co-ordination.

Jun 18
What Is Swine Flu? How Is Swine Flu Treated?
Swine flu (swine influenza) is a disease of pigs. It is a highly contagious respiratory disease caused by one of many Influenza A viruses. Approximately 1% to 4% of pigs that get swine flu die from it. It is spread among pigs by direct and indirect contact, aerosols, and from pigs that are infected but do not have symptoms. In many parts of the world pigs are vaccinated against swine flu.

Most commonly, swine flu is of the H1N1 influenza subtype. However, they can sometimes come from the other types, such as H1N2, H3N1, and H3N2.

The current outbreak of swine flu that has infected humans is of the H1N1 type - this type is not as dangerous as some others.
Avian Influenza (Bird Flu) can also infect pigs
Avian flu and human seasonal flu viruses can infect pigs, as well as swine influenza. The H3N2 influenza virus subtype, a virulent one, is thought to have come from pigs - it went on to infect humans.

It is possible for pigs to be infected with more than one flu virus subtype simultaneously. When this happens the genes of the viruses have the opportunity to mingle. When different flu subtypes mix they can create a new virus which contains the genes from several sources - a reassortant virus.

Although swine influenza tends to just infect pigs, they can, and sometimes do, jump the species barrier and infect humans.
What is the risk for human health?
Outbreaks of human infection from a virus which came from pigs (swine influenza) do happen and are sometimes reported. Symptoms will generally be similar to seasonal human influenzas - this can range from mild or no symptoms at all, to severe and possibly fatal pneumonia.

As swine flu symptoms are similar to typical human seasonal flu symptoms, and other upper respiratory tract infections, detection of swine flu in humans often does not happen, and when it does it is usually purely by chance through seasonal influenza surveillance. If symptoms are mild it is extremely unlikely that any connection to swine influenza is found - even if it is there. In other words, unless the doctors and experts are specifically looking for swine flu, it is rarely detected. Because of this, we really do not know what the true human infection rate is.
Examples of known swine flu infecting humans
Since the World Health Organization's (WHO's) implementation of IHR (2005) in 2007, they have been notified of swine influenza cases from the USA and Spain.

In March/April 2009 human cases of influenza A swine fever (H1N1) were first reported in California and Texas. Later other states also reported cases. A significant number of human cases during the same period have also been reported in Mexico - starting just in Mexico City, but now throughout various parts of the country. More cases are being reported in Canada, Europe, and New Zealand - mainly from people who have been in Mexico.
How does a human catch swine influenza?

* From contact with infected pigs (most common way)
* From contact with infected humans (much less common way)

In cases when humans have infected other humans close contact was necessary with the infected person, and they nearly always occurred in closed groups of people.
Can I eat pork meat and pork products?
If the pork meat and pork food products have been handled properly transmission of swine influenza to humans is not possible. Cooking pork meats to a temperature of 70C (160F) kills the virus. So the answer is YES, pork meat and pork food products are safe to eat.
Where have pigs been infected?
As swine influenza infection among pigs is not an internationally notifiable disease we cannot be completely sure. Swine influenza infection among pigs is known to be endemic in the USA. Outbreaks have also occurred in other parts of North America, South American, Europe, Africa, China, Japan, and other parts of Asia.
Is there a pandemic risk?
People who are not in close contact with pigs generally have no immunity to the swine influenza viruses - they are less likely to be able to prevent a virus infection. If the virus infects enough people in a given area, the risk of an influenza pandemic is significantly greater. Experts say it is very hard to predict what impact a flu pandemic caused by a swine influenza virus would have on the global human population. This would depend on how virulent the virus is, what existing immunity among humans there already is, plus several other factors.
Do we have a specific swine flu vaccine?
No - not for humans.
Will current human flu vaccines help protect people from swine influenza infection?
We really don't know. Influenza viruses are adapting and changing all the time. If a vaccine was made, it would have to be specifically for a current strain that is circulating for it to be effective. The WHO says it needs access to as many viruses as possible so that it can isolate the most appropriate candidate vaccine.
What are the signs and symptoms of swine influenza in humans?
They are similar to those of regular flu, and include:

* Body aches
* Chills
* Cough
* Diarrhea (less common)
* Headache
* Sore throat
* Temperature (fever)
* Tiredness (fatigue)
* Vomiting (less common)

What medications are there?
There are some drugs around that can effectively treat swine flu infection in humans - and many types of flu infections in humans. There are two main types:

* adamantanes (amantadine and remantadine)
* inhibitors of influenza neuraminidase (oseltamivir and zanamivir)

Most previous swine influenza human cases recovered completely without the need for medical attention.
What can I do to protect myself?

* Wash your hands regularly with soap
* Try to stay healthy
* Get plenty of sleep
* Do plenty of exercise
* Try to manage your stress
* Drink plenty of liquids
* Eat a well balanced diet
* Refrain from touching surfaces which may have the virus
* Do not get close to people who are sick
* Stay away from crowded areas if there is a swine flu outbreak in your area

If I am infected, how can I stop others from becoming infected?

* Limit your contact with other people
* Do not go to work or school
* When you cough or sneeze cover your mouth with a tissue. If you do not have a tissue, cover your mouth and nose.
* Put your used tissues in a waste basket
* Wash your hands and face regularly
* Keep all surfaces you have touched clean
* Follow your doctor's instructions

Jun 18
Cooking Carrots Whole Preserves More Anti-Cancer Properties
A new study by UK scientists showed that cooking carrots whole preserves their anti-cancer properties better than cooking them sliced or diced.

The study was the work Dr Kirsten Brandt and researcher Ahlam Rashed at the University of Newcastle Upon Tyne and is being presented today at the NutrEvent nutrition and health conference that is taking place in Lille, France.

Brandt and colleagues found that carrots boiled before cutting had 25 per cent more of the anti-cancer chemical falcarinol than those that were cut up before boiling.

They also found uncut cooked carrots had higher concentrations of the naturally occurring sugars that give them their distinctive flavour.

Brandt, who is based at the School of Agriculture, Food and Rural Development and the Human Nutrition Research Centre at Newcastle University said that:

"Chopping up your carrots increases the surface area so more of the nutrients leach out into the water while they are being cooked."

"By cooking them whole and chopping them up afterwards you are locking in both taste and nutrients so the carrot is better for you all round," she added.

Working with colleagues at the University of Southern Denmark, Brandt and her team at Newcastle discovered the health properites of falcarinol in carrots four years ago.

They showed that feeding rats a diet containing either raw carrots or isolated falcarinol reduced their risk of developing tumors by one third compared with rats in a control group.

Since then the researchers have been looking at the health benefits of raw and cooked carrots, comparing different varieties of the vegetable, and how their properties change with heat.

They found that cooking a carrot kills its cells so they can't hold water and this increases the concentration of falcarinol. But heat also softens the walls of the cells so sugar, vitamin C and other compounds such as falcarinol leach out more readily.

Cutting the carrot into pieces before boiling increases the surface area which allows more of the nutrients to leach out of the cell walls into the boiling water.

The scientists also asked 100 people to wear a blindfold and compare the taste of carrots that had been cut before cooking and carrots that had been cut after cooking. More than 80 per cent said the carrots that were cut after cooking tasted better.

Jun 15
Physicians To Discuss Health Consequences Of Climate Change
Physician representatives will gather in Copenhagen in September to discuss the health consequences of climate change to ensure that the medical profession's voice is heard when a new global climate treaty to replace the Kyoto accord is considered two months later.

The seminar will be held by the World Medical Association on September 1, when physician leaders and climate change experts will highlight the health impact of climate change and suggest the role physicians can play in alerting the world to the increased risks of disease.

Dr. Otmar Kloiber, Secretary General of the WMA, said: 'It is vital that health is fully considered in current global debates and that physicians are provided with accurate information and awareness raising tools to advocate action at a national level.

'The WMA is preparing major new policy for physicians in areas such as advocacy, capacity building and collaboration. We hope to adopt this at our annual General Assembly in New Delhi in October so that it can be fed into the United Nations climate change conference being held in Copenhagen in December'.

Jun 15
Cancer May Be Stopped In Its Tracks By MicroRNA Replacement Therapy
A new study suggests that delivering small RNAs, known as microRNAs, to cancer cells could help to stop the disease in its tracks. microRNAs control gene expression and are commonly lost in cancerous tumors. Researchers have shown that replacement of a single microRNA in mice with an extremely aggressive form of liver cancer can be enough to halt their disease, according to a report in the June 12 issue of the journal Cell, a Cell Press publication.

They delivered the microRNA to the mice using a virus that has been applied in other forms of gene therapy. That so-called adeno-associated virus (AAV) is particularly good at targeting new genetic material to the liver.

"Mice given the control virus showed no change in the growth rate of their tumors and within three weeks, the cancer had taken over," said Joshua Mendell of Johns Hopkins University School of Medicine. "When we gave them the microRNA-carrying virus, some animals showed essentially complete regression of their tumors." In other cases, he said, the tumors were much smaller and far fewer.

Mendell said his team, which included his father Jerry Mendell at The Research Institute at Nationwide Children's Hospital, was hopeful the strategy would work based on previous evidence. Nonetheless, he added, "it is always surprising to see results this striking."

They were also amazed by how specifically the microRNA affected cancer cells, while leaving normal cells unscathed. "We found that the tumor cells are exquisitely sensitive [to microRNA replacement]--they not only stopped proliferating, but they actually died," he said. Meanwhile, the mice showed no evidence of any damage to their normal liver tissue.

MicroRNAs are important regulators of gene activity, the researchers explained, and a single microRNA can have far-reaching effects. That's because an individual microRNA can influence hundreds of gene transcripts to coordinate complex programs of gene expression and affect global changes in the physiology of a cell. A growing body of evidence shows that microRNAs are essential for normal development and to keep cells in balance. By the same token, when microRNAs get out of whack, they can lead to disease.

In the last five years, researchers have discovered a particularly important role for microRNAs in cancer. "Virtually all examined tumor types are characterized by globally abnormal microRNA expression patterns," Mendell said. Some microRNAs lead to cancer when they reach levels that are higher than normal. But in most instances, microRNA levels are found to decline in cancerous tumors compared to normal tissue.

Earlier studies have begun to suggest that methods to replace those lost microRNAs might hold particular promise for therapy. For one thing, reducing the level of microRNAs can actually drive the transformation of normal cells into cancerous ones. And, in the case of lymphoma, Mendell's group showed that a single microRNA could suppress the growth of cancer cells.

The new study is the first to show that the strategy might work in a living animal.

First, they showed that primary liver cancers, known as hepatocellular carcinomas (HCC), have a dramatic reduction in a specific microRNA designated as miR-26a. miR-26a is found at high levels in many tissues throughout the body. When they introduced the microRNA back into cancer cells, those cells stopped progressing through the cell cycle. Likewise, mice with the liver cancer that were given the virus-delivered microRNA therapy were protected from the disease as their cancer cells stopped proliferating and underwent a programmed cell death.

There is a dire need for new strategies to combat HCC, which the researchers said is the third leading cause of cancer deaths and the fifth most common malignancy worldwide. HCC is often diagnosed at an advanced and incurable stage. Even when it is caught earlier, other characteristics of the disease tend to make it a challenge to treat with currently available drugs.

The promising strategy for HCC is also likely to work in other cancers as well. The researchers chose mice with liver cancer as a test bed in part because the liver is readily targeted by AAV, but they said that they don't think there is anything special about liver cancer that makes it more sensitive to microRNA replacement therapy.

Jun 15
Risk For Premature Birth May Be Heightened By Pre-Pregnancy Depressed Mood
Researchers trying to uncover why premature birth is a growing problem in the United States and one that disproportionately affects black women have found that pre-pregnancy depressive mood appears to be a risk factor in preterm birth among both blacks and whites.

Black women, however, have nearly two times the odds of having a preterm birth compared to white women, according to Amelia Gavin, a University of Washington assistant professor of social work and lead author of a new study that appears online in the June issue of the Journal of Women's Health.

"Preterm births are one of the most significant health disparities in the United States and the overall number of these births increased from 10.6 percent in 2000 to 12.8 percent in 2005," she said.

While there appears to be some sort of link between giving birth prematurely and depressed mood, the study found no cause and effect, said Gavin, who studies health disparities. She believes the higher preterm birth rate among blacks may be the result of declining health over time among black women.

For this study, premature birth referred to any child born after less than 37 weeks of gestation. Normal gestation ranges from 38 to 42 weeks. Data for the study was drawn from a larger longitudinal investigation looking at the risks for cardiovascular disease among more than 5,000 young adults in four metropolitan areas. The Coronary Artery Risk Development in Young Adults Study also collected information about mental health and pregnancy outcomes. Between 1990 and 1996, 555 women in the larger study gave birth. These women were the subjects in the depression-premature birth study.

"At this point we can't say that pre-pregnancy depressive mood is a cause of preterm birth or how race effects this association," said Gavin. "But it seems to be a risk factor in giving birth prematurely and higher pre-pregnancy depressive mood among black women compared to white women may indirectly contribute to the greater odds of preterm birth found among black women."

In the study 18.1 percent of the black women had a preterm birth compared to 8.5 percent of the white women.

This difference may be the result of what she calls "weathering," or accelerated declines in health due to repeated socioeconomic and political factors.

"What some people experience by being black takes a toll on the physiological system, and over time wear and tear that occurs across neural, neuroendocrine and immune systems as a result of chronic exposure to stressors lead to health disparities for blacks. Some of this may manifest itself in premature birth and low-birth weight," Gavin said.

The study did not look at depressive mood or depression during pregnancy because the larger research project did not collect that data. She hopes to replicate and expand her findings by analyzing data from another study to look at depressive mood prior to pregnancy and childhood poverty to see if those two factors in part explain the black and white difference in preterm delivery. That study also will look at the role antidepressive medication plays in preterm birth.

Jun 15
Asymptomatic Perioperative Myocardial Injury Affects Vascular Outcomes
A new study reports that 75 percent of cardiac damage after vascular surgery is asymptomatic or patients' symptoms are concealed by postoperative complaints such as nausea and incision pain. This damage is associated with an increased risk for mortality. Researchers have found that screening for cardiac damage following surgery helps identify high-risk patients who might benefit from more aggressive medical therapy and follow-up after discharge. These findings are from a study presented today at the 63rd Annual Meeting of the Society for Vascular Surgery®.

"While the prognosis of symptomatic cardiac damage is known to be poor compared to patients without cardiac damage, the impact of asymptomatic cardiac damage is largely unknown," said Olaf Schouten, MD, Erasmus Medical Center of Rotterdam, The Netherlands. "Therefore, this study was performed to assess the long-term prognosis of vascular surgery patients who experience asymptomatic cardiac damage in the first week after major vascular surgery."

Dr. Schouten explained that appropriate screening consists of repeated measurement of cardiac troponin T (cTnT), a simple and sensitive laboratory marker for myocardial injury and cardiac damage after surgery. "However," he added, "the prognosis of cTnT elevations without clinical symptoms and/or new electrocardiographic changes (asymptomatic cTnT release) is unknown."

Initially 1,545 patients undergoing elective major vascular surgery were enrolled and baseline characteristics and medication were noted. Before surgery all patients were screened for the presence of cardiac risk factors such as a history of myocardial infarction, diabetes mellitus, and heart failure.

Routine sampling of cTnT and ECG recording was performed on days one, three, and seven after surgery and at the day of discharge. Elevated cTnT was defined as serum concentrations equal to or more than 0.01 ng/ml. Following surgery, cardiac damage occurred in 213 (14 percent) asymptomatic patients and in 71 (5 percent) symptomatic patients.

Patients were followed for a mean of 3.7 years after surgery. Asymptomatic cardiac damage in the perioperative period was associated with a poor long-term outcome compared to patients without cardiac damage. A total of 13 percent of patients without cardiac damage died during follow-up versus 40 percent of patients with asymptomatic cardiac damage. Also, after adjustment for risk factors and type and site of surgery asymptomatic cardiac damage was associated with a 2.3-fold increased risk for mortality during the first four years after vascular surgery, (adjusted HR 2.3; 95 percent; CI 1.8-3.0) and risk increased with higher cTnT levels (HR 1.64 for every 0.10 ng/ml increase, p=0.02). Elevated cTnT had prognostic value irrespective of baseline creatinine value or renal dysfunction after surgery.

"Asymptomatic cTnT release, without clinical symptoms or new ECG changes, is associated with an increased long-term mortality in patients undergoing vascular surgery," said Dr. Schouten. "Patients undergoing major arterial vascular surgery because of atherosclerotic disease are at high-risk for cardiac complications in the perioperative period. It is estimated that one out of five patients undergoing major vascular surgery suffers cardiac damage around the time of the operation if patients are appropriately screened in the first week after surgery. Screening is a valuable tool to determine how aggressive medical therapy should be for their long-term prognosis."

Jun 13
Vaporized Viral Vector Shows Promise In Anti-Cancer Gene Therapy
A new lung cancer therapy employing a vaporized viral vector to deliver a cancer-inhibiting molecule directly to lung tissue shows early promise in mouse trials, according to researchers at the Ministry of Education, Science and Technology in Korea.

Gene therapy is an area of great promise, but delivery mechanisms, which have included intravenous injection and intratracheal instillation, have proven problematic for effective delivery of genetic therapy to lung tissues.

"Aerosol delivery targets the lungs specifically and represents a noninvasive alternative for targeting genes to the lung," wrote Myung-Haing Cho, D.V.M., Ph.D., professor at Seoul National University and principal investigator of the study. "The delivery of genes via aerosol holds promise for the treatment of a broad spectrum of pulmonary disorders and offers numerous advantages over more invasive modes of delivery."

Lung cancer is the most common cause of cancer deaths worldwide, killing more people each year than breast, prostate and colon cancers combined. It costs the U.S. alone more than $9 billion a year, according to the Centers for Disease Control and Prevention. Most available therapies - surgery, radiation and chemotherapy - offer transient relief at best and are typically ineffective in advanced stages of the disease. For this reason, novel therapies for lung cancer are of great interest.

Dr. Cho and colleagues targeted the Akt signaling pathway, which has been shown to be an important regulator of cell proliferation and cancer progression. A recent report found that 90 percent of non-small cell lung carcinomas were associated with the activation of the Akt signaling pathway. They chose a lentiviral vector, derived from a retrovirus and known for its ability to infect nondividing cells and effect persistent genetic changes. They transfected the lentiviral vector with a negative regulator of Akt signaling, carboxyl-terminal modulator protein (CTMP), which would theoretically inhibit Akt signaling, thus suppressing cancer cell proliferation and tumor growth.

Using a mouse model of lung cancer, the researchers designed a double-control study, exposing one-third of the mice to the aerosolized CTMP vector, one-third to the vector alone and one third were untreated.

"In this study, our main purpose was to determine if viral delivery of CTMP can provide useful tool for designing lung tumor treatment," said Dr. Cho. "We would like to demonstrate that CTMP can suppress lung tumor mass in the lungs and lentivirus may act as an effective carrier of CTMP."

After four weeks of twice-weekly treatments, the researchers found exactly that: both pathological and histological examination of the mice revealed that CTMP delivery suppressed lung tumor mass in the lungs of the mice. Furthermore, the number and volume of tumors were significantly decreased in CTMP-treated mice.

The researchers also found that CTMP increased apoptosis, inhibited angiogenesis and suppressed production of several proteins, such as cyclin D1, CDK4 and CDK2, which are important in cancer cell growth.

Jun 13
Screening For Left Ventricular Dysfunction May Have Less Value Than Thought
The value and cost-effectiveness of screening for left ventricular (LV) dysfunction remains unclear, particularly since specific, evidence-based treatments are not available for the majority of patients with preserved systolic dysfunction, reports a study in the June issue of the Journal of Cardiac Failure, published by Elsevier.

In the study,1012 primary care patients with hypertension and/or diabetes without signs or symptoms of heart failure were screened for asymptomatic left ventricular dysfunction (ALVD), using measurements of NT-pro-BNP and echocardiography. Diastolic dysfunction was found in 368 subjects (36%) and was categorized as mild in 327 and moderate-severe in 41. Systolic dysfunction was present in only 11 (1.1%)l. NT-proBNP levels were 170±206 and 859±661 pg/mL respectively in diastolic and systolic dysfunction and 92±169 in normal subjects (p<.0001).

For the 52 subjects (5.1%) with moderate to severe diastolic dysfunction or systolic dysfunction, a NT-proBNP of < 125 pg/ml had a negative predictive value (NPV) >99% and a positive predictive value of 33% in patients < 67 years. For older patients, NPV was 100%, but PPV was somewhat lower in women (23%) than in men (33%).

This study suggests that the evaluation of NT-proBNP in asymptomatic patients with type 2 diabetes or hypertension may lead to very early exclusion of LV dysfunction. As a perspective of this study, general practitioners could use NT-proBNP determination to rule out heart failure (HF) in these patients, a much more cost effective measure than the use of an echocardiographic one. The study was partially supported by an unrestricted grant from Roche Diagnostics.

"This study demonstrates that low values of NT-proBNP usually exclude significant LV dysfunction, but elevated values are relatively non-specific, especially in a population where systolic dysfunction is rare.

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