jueves, 29 de septiembre de 2011

DOV 21,947 Demonstrates Significant Body Weight And BMI Reductions In Drug Compliant Subjects In Phase Ib Clinical Study

DOV Pharmaceutical,
Inc. ("DOV", or the "Company") (OTCBB and Pink Sheets: DOVP) announced additional Phase Ib results for DOV 21,947, its lead triple reuptake inhibitor ("TRIP") for the treatment of depression and obesity. A preliminary analysis of the study results demonstrated that DOV 21,947 was
safe and well tolerated at the doses examined, and produced a statistically
significant reduction in plasma triglyceride levels, as described more
fully below. Further analyses of these data demonstrate that DOV 21,947
significantly reduces body weight and Body Mass Index ("BMI") in
drug compliant subjects compared to placebo. The Company intends to
initiate a Phase II study of DOV 21,947 for the treatment of depression in
the first quarter of 2008.



This double-blind, placebo-controlled Phase Ib study enrolled 46 male
and female volunteers. Following a one-week placebo run-in, subjects
received either escalating daily doses of 50 mg, 100 mg and 150 mg of DOV
21,947 (31 subjects) or placebo (15 subjects), for a total of eight weeks.
Those subjects with detectable blood levels of DOV 21,947 or its principal
metabolite during at least three of four bimonthly visits (approximately
70% of the drug-treated subjects) were classified as drug compliant.



At the end of this eight-week study, the mean difference in body weight
change from baseline between the drug-compliant and placebo groups was 4.6
pounds (p








"The delay in the initiation of the Phase II study of DOV 21,947 to the
first quarter of 2008 has enabled us to further evaluate the protocol
design to ensure that we are capturing potential effects of DOV 21,947's
effects on body weight and appropriately capture drug-compliance in our
analyses. This delay, along with other cost containment measures, also
serves to provide us with sufficient capital through April 2008 as we
explore our financing and collaborative options," said Barbara Duncan,
Chief Executive Officer of DOV. The double-blind, Phase II study now
scheduled for initiation in the first quarter of 2008 will compare up to
100 mg per day of DOV 21,947 versus placebo in approximately 200 patients
with major depressive disorder over a six-week treatment period. The
Company expects the results from this Phase II study to be available at the
end of 2008.



About DOV 21,947



Clinical research indicates that co-administrating drugs that, in
combination, inhibit reuptake of the three neurotransmitters most closely
linked to depression - serotonin, norepinephrine and dopamine - can produce
greater overall efficacy than currently marketed antidepressants. This
novel combination of properties in a single antidepressant could provide a
breakthrough in the treatment of depression. DOV 21,947, a TRIP, is
structurally related to DOV 216,303. In a Phase II clinical trial with DOV
216,303 for the treatment of depression, patients who completed two weeks
of treatment in both the DOV 216,303 and citalopram groups demonstrated
reductions from baseline (p

Links to our partners:


•   Buy Spiriva Without Prescription
•   Buy Female Pink Viagra Without Prescription
•   Buy Zithromax Without Prescription

Archimedes Pharma Announces Ground Breaking Phase III Data Showing NasalFent To Be Superior To The Standard Of Care For Breakthrough Cancer Pain

Archimedes Pharma Limited, the UK based, pan-European
specialty pharmaceutical company, announces new positive headline
phase
III results for NasalFent(R), the Company's innovative and highly
differentiated fentanyl citrate nasal spray, developed for the rapid
relief
of breakthrough cancer pain. The ground breaking phase III study compared
NasalFent to immediate release morphine sulphate, the most commonly
prescribed medicine for breakthrough cancer pain.





Breakthrough cancer pain affects up to 95% of all cancer
patients and is characterised by sudden, unpredictable episodes of intense
pain that occur despite background pain medication. This pain is rapid in
onset, often reaching maximum intensity in 5 minutes with a duration of
30-60
minutes.





NasalFent met the primary efficacy endpoint in the phase III
study 044. Patients treated with NasalFent showed a statistically
significant
improvement in Pain Intensity Difference within 15 minutes (PID15)
compared
to immediate release morphine sulphate (p < 0.04), meaning a greater
reduction in pain.





NasalFent is the only one of the new generation of fentanyl
products to have demonstrated statistically significant improvements over
immediate release morphine sulphate. Significantly better improvements in
pain scores for NasalFent versus immediate release morphine sulphate were
seen at all subsequent time points indicating that superiority of
NasalFent
was maintained for 60 minutes after dosing.





NasalFent showed both consistent effectiveness and high
acceptability; 94% of patients completed the double-blind part of the
study
and 70% of patients elected to continue therapy with NasalFent in the long
term Phase III safety study.





Professor Marie Fallon, St Columba's Hospice Chair of
Palliative Medicine, University of Edinburgh, Edinburgh Cancer Research
Centre (CRUK) Western General Hospital Edinburgh, UK stated: "These data
are
hugely exciting. This is the first time a simple-to-use fentanyl product
has
been shown to be superior to the standard treatment for breakthrough
cancer
pain. NasalFent offers the prospect of greatly improving the management of
this distressing and common complication of cancer".





Study 044 was conducted in all major western European
countries and in India, involving 35 expert investigational sites. A total
of
135 patients were screened and 110 (82%) entered the open dose titration
phase. 84 (76%) patients participated in the double-blind,
placebo-controlled
portion of the study. It is planned that data from study 044 will be
presented at scientific meetings later in 2009.





Richard de Souza, CEO of Archimedes, commented, "We are
delighted with these results from another innovative study of NasalFent in
what is the largest and most comprehensive clinical programme for any
breakthrough cancer pain product. These data clearly show that NasalFent
is
superior to the benchmark product for this condition and fully supports
the
results from study 043 which demonstrate that NasalFent offers pain relief
within 5 minutes of dosing and is highly acceptable to patients. Data from
our third phase III study, 045, a long-term safety study, including over
500
patients, will be available shortly."


















Phase III data on NasalFent confirming best-in-class profile
to be presented at major scientific congresses





Data from the phase III study 043 on NasalFent are to be
presented at the American Pain Society (APS) on 7 and 8 May by Professor
Allen Burton, Professor and Chair at the University of Texas and MD
Anderson
Cancer Centre in Houston, Texas, and at the European Association of
Palliative Care (EAPC) on 9 and 10 May by Dr Russell Portenoy, Chairman,
Department of Pain Medicine and Palliative Care, Beth Israel Medical
Center,
New York and Dr Donald Taylor, Medical Director and Anesthesiologist,
Georgia
Center for Cancer Pain Management & Palliative Medicine, Georgia.





Results covering both primary and secondary outcomes show
statistical superiority for NasalFent over placebo and provide robust
evidence for NasalFent as the first product to have demonstrated both
rapid
onset of pain relief within five minutes of dosing, and early clinically
meaningful pain relief within 10 minutes of dosing. Use of rescue
medication
was low confirming that NasalFent was also consistently effective.
Additional
data presented showed that NasalFent produced highly significant
improvements
across a range of pain assessments. Nasal tolerability was excellent and
side
effects were generally mild to moderate in intensity and importantly were
typical of fentanyl use in this patient population.





Professor Allen Burton, Professor and Chair at the University
of Texas and MD Anderson Cancer Centre in Houston, Texas, who participated
in
the study and is presenting the data at the APS, said: "Breakthrough
cancer
pain is a significant clinical issue and these data illustrate the
potential
for NasalFent to offer ultra-rapid, consistent pain relief to the many
patients who suffer from this unpredictable and extremely debilitating
pain."










NasalFent





NasalFent is an innovative and highly differentiated aqueous
fentanyl citrate nasal spray utilising Archimedes' proprietary PecSys(TM)
technology. NasalFent has a low viscosity and is easily delivered in a low
volume of 100mcl using a conventional nasal spray pump. The pump produces
a
fine mist of similarly sized spray droplets which are deposited into the
front of the nostril. The calcium ions present in nasal mucosal fluid
cause
the pectin to form a thin gel layer resulting in modulated drug
absorption,
allowing rapid but controlled absorption into the systemic circulation and
an
increased duration of action. PecSys technology avoids problems associated
with simple solutions used as nasal sprays such as supratherapeutic levels
of
drugs and dripping or swallowing of drug solution. NasalFent is in
development for rapid relief of breakthrough cancer pain.





Breakthrough cancer pain affects up to 95% of all cancer
patients and is characterised by sudden, unpredictable episodes of intense
pain typically lasting 30-60 minutes and which occur despite background
opioid pain medication. Initial Phase III data illustrates that NasalFent
has
a potential best-in-class profile among fentanyl products for breakthrough
cancer pain and is the first product to demonstrate onset of pain relief
within five minutes of dosing. NasalFent will be filed for regulatory
approvals from Q2 2009 and is targeted for launch from mid-2010.


Source
Archimedes Pharma Limited

Links to our partners:


•   Buy Female Pink Viagra Without Prescription
•   Buy Nolvadex Without Prescription
•   Buy Antabuse Without Prescription
•   Buy Erythromycin Without Prescription
•   Buy Lumigan Without Prescription

British Doctors To Scale Everest For Intensive Care Breakthrough

What's the similarity between high altitude climbing and intensive care? A great deal, according to a team of extreme athletes who also happen to be qualified physicians and scientists. Next spring, they will conduct experiments at high altitude and at Everest's summit - such as blood oxygen readings and brain function tests - that will be brought back ultimately to the bedsides of critically ill patients.



Many in the team are based at the Institute of Human Health and Performance at University College London and are members of the Centre for Aviation, Space and Extreme Environment Medicine, (CASE Medicine) where the team leader, Dr Mike Grocott and his fellow medics conceived the idea for the 'world first' expedition.



Expedition research leader, Dr Hugh Montgomery, who today (June 6) talks at the Knowledge Two conference at The Institute of Electrical Engineers, London said, "At the 8,850m summit of Everest, there's so little oxygen getting into the lungs that the body quickly starts shutting down and mountaineers risk slipping into a coma. These extreme conditions mimic what it's like for patients in intensive care and studying the human body in this environment will teach us invaluable lessons in the science of survival.



"One in six Britons will spend time in an Intensive Care Unit and, shocking as it may sound, statistics show that up to three in ten people admitted do not pull through, causing devastation to families.



"We know that mountaineers survive on low oxygen levels that would take the lives of intensive care patients in a matter of minutes. Our Everest ascent will involve creating the world's highest medical laboratory, taking field science to a new level."



Dr Montgomery's genetic work has identified a gene associated with improved performance at high altitude and subsequently demonstrated that the same gene was associated with improved outcome in a variety of conditions found on intensive care units, including the severe lung disease, Acute Respiratory Distress Syndrome (ARDS).



Peak practice



While any Everest expedition has risks, the team of climbers have a wealth of extreme sports experience at their disposal. Dr Montgomery, aged 45 from Southampton is a qualified skydiver who also dived in the Solent to help raise Henry VIII's sunken Mary Rose. Climbing leader Dr Sundeep Dhillon, aged 36 from London in 1998 became the youngest person in the world to conquer the Seven Summits. Dr Kevin Fong, aged 35 from London specialises in the medical conditions experienced by astronauts while Dr Denny Levett, aged 35 from Kent is a qualified Divemaster. Dr Levett is married to the expedition leader, Dr Mike Grocott, aged 40, from Manchester.



Dr Grocott lectures in high altitude physiology and is a Consultant Intensive Care Physician.



He said, "If we chose to, we could simulate our experiments in a special laboratory but this would in fact cost a lot more than going to Everest and the results would be no more accurate.



"Low oxygen levels (hypoxia) in the blood and cells are a critical factor in Intensive Care patients. The summit of Everest is by extraordinary coincidence exactly at the limit of human tolerance for hypoxia. For many years, doctors and scientists believed that it would be impossible to climb Everest without supplementary oxygen. In 1978 Reinhold Messner proved them wrong and since then more than 100 individuals have ascended the mountain without supplemental oxygen. It is clear that were the mountain even a few meters higher this would be impossible. The summit of Everest is a wonderful natural laboratory for the study of the effects of critical hypoxia in humans."



The physicians hope that their findings will result in better intensive care recovery rates throughout Britain and the rest of the world plus increased quality of life for people with conditions ranging from Cystic Fibrosis to severe infections and lung disease.



xtreme-everest

case.ucl.ac




The team, that is currently seeking sponsors, leaves for Everest in March 2007. They will climb the South Col route.



Extensive trials are being conducted in advance of the Everest expedition. In July they will train in the Alps and in September will become further prepared on Cho Oyu, the world's sixth highest peak.



Dr Mike Grocott is also a co-director for CASE - the Centre for Aviation, Space and Extreme Environment Medicine based at the Institute of Human Health and Performance, Ground Floor, Charterhouse Building, Archway Campus, Highgate Hill, London N19 5LW, Tel: +44 (0)20 7323 9911, email: infoxtreme-everest

Links to our partners:


•   Buy Glucophage Without Prescription
•   Buy Chantix Without Prescription
•   Buy Lumigan Without Prescription
•   Buy Zyban Without Prescription
•   Buy Suprax Without Prescription
•   Buy Robaxin Without Prescription
•   Buy Nexium Without Prescription
•   Buy Synthroid Without Prescription
•   Buy Antabuse Without Prescription
•   Buy Spiriva Without Prescription

Fight Off Aches & Pains This Winter With Extra Vitamin D

It's no wonder many people feel achy and sore, and sometimes tired and depressed, during winter months they're often not getting enough vitamin D. The body makes vitamin D from the sun's ultraviolet rays, so it's known as the sunshine vitamin, but this source is in short supply throughout late fall and winter.


According to an extensive review of clinical research in a report from Pain Treatment Topics (Pain-Topics), inadequate vitamin D has been linked to a long list of painful maladies, including bone and joint pain, muscle aches, fibromyalgia syndrome, rheumatic disorders, osteoarthritis, and other complaints. Lack of vitamin D also has been implicated in the mood disturbances of chronic fatigue syndrome and seasonal affective disorder, or SAD, which are more common during winter.


Author of the report and editor of Pain Treatment Topics, Stewart B. Leavitt, MA, PhD, notes that for many people sunshine is not an ample source of vitamin D during most of the year and the few foods containing the vitamin do not provide enough of it. "In our review of 22 clinical research studies persons with various pain and fatigue syndromes almost always lacked vitamin D, especially during winter months. When sufficient vitamin D supplementation was provided, the aches, pains, weakness, and related problems in most sufferers either vanished or were at least helped to a significant degree."


The report mentions the following important points:


-- Vitamin D is a complex nutrient that actually functions as a hormone to benefit numerous body tissues and organs, including bones, muscles, and nerves.


-- A surprising majority of persons in many parts of the world, including the United States, do not get enough vitamin D from sunshine or foods.


-- The currently recommended adequate intake of vitamin D up to 400 IU per day in children and 600 IU per day in adults is outdated and too low. According to the research, most children and adults need at least 1000 IU per day, and persons with bone or muscle aches and pains could benefit from 2000 IU or more per day of supplemental vitamin D3 (also called cholecalciferol), especially during winter months.


-- Vitamin D supplements are generally safe if taken as directed. They interact with very few drugs or other agents, and are usually not harmful unless very high daily doses such as, 50,000 IU or more are taken for an extended period of time.


-- Vitamin D supplements are easy to take, usually have no side effects, and typically cost as little as 7 to 10 cents per day.


Besides the comprehensive Research Report (50-pages, 170 references) -- titled "Vitamin D A Neglected 'Analgesic' for Chronic Musculoskeletal Pain" -- there is available a shorter Practitioner Briefing (7-pages) that summarizes the report and provides guidance for healthcare providers. Additionally, a special Patient Brochure (6-pages) explains what vitamin D is, how it works, and how it can help in relieving aches and pains.


All 3 documents are available for free access at:
pain-topics/vitamind


In conclusion, Leavitt stresses that vitamin D should not be viewed as a cure for all pain conditions, and it is not necessarily a replacement for other pain-relief treatments. "While further research would be helpful," he says, "extra vitamin D should be considered for all persons in late fall or early winter, and especially for those who have developed aches and pains, or fatigue and mood disorders."


The Pain-Topics website, a project of Pain Treatment Topics, provides open and free access to noncommercial, evidence-based clinical news, information, research, and education on the causes and effective treatment of the many types of pain conditions. It is independently produced and currently supported by an unrestricted educational grant from Covidien/Mallinckrodt Inc., St. Louis, MO, a leading manufacturer of generic opioid analgesic products.


NOTE: Neither the author nor the sponsor has any financial interests in vitamin D products or the nutritional supplement field.


Pain Treatment Topics

Pain-Topics


Links to our partners:


•   Buy Zithromax Without Prescription
•   Buy Sterapred Without Prescription
•   Buy Biaxin Without Prescription
•   Buy Human Growth Hormone Without Prescription

Breast Cancer Could Be Reduced And Existing Sufferers Helped By Drugs Like Aspirin

Anti-inflammatory drugs like aspirin may reduce breast cancer by up to 20 per cent, according to an extensive review carried out by experts at London's Guy's Hospital and published in the March issue of IJCP, the International Journal of Clinical Practice.



But they stress that further research is needed to determine the best type, dose and duration and whether the benefits of regularly using non-steroidal anti-inflammatory drugs (NSAIDs) outweigh the side effects, especially for high-risk groups.



"Our review of research published over the last 27 years suggests that, in addition to possible prevention, there may also be a role for NSAIDs in the treatment of women with established breast cancer" says Professor Ian Fentiman from the Hedley Atkins Breast Unit at the hospital, part of Guy's and St Thomas' NHS Foundation Trust.



"NSAID use could be combined with hormone therapy or used to relieve symptoms in the commonest cause of cancer-related deaths in women."



Professor Fentiman and Mr Avi Agrawal reviewed 21 studies covering more than 37,000 women published between 1980 and 2007.



Their review included 11 studies of women with breast cancer and ten studies that compared women who did and did not have the disease.



"The purpose of a review like this is to look at a wide range of published studies and see if it is possible to pull together all the findings and come to any overarching conclusions" explains Professor Fentiman. "This includes looking at any conflicting results and exploring how the studies were carried out.



"For example some of the studies we looked at as part of this review found no links between NSAIDs and reduced levels of breast cancer, while others suggested that taking NSAIDs can reduce the breast cancer risk by about a fifth.



"Having weighed up the findings from over 20 studies, we have concluded that NSAIDs may well offer significant protection against developing breast cancer in the first place and may provide a useful addition to the treatment currently available to women who already have the disease.



"Recent studies of NSAIDs use have shown about a 20 per cent risk reduction in the incidence of breast cancer, but this benefit may be confined to aspirin use alone and not other NSAIDs."



Previous studies have suggested that NSAIDs like aspirin and ibuprofen, which have traditionally been used as mainstream non-prescription analgesics, may provide protection against coronary heart disease and some malignancies, such as colorectal cancer.



But Professor Fentiman is urging caution until further research fully weighs up the pros and cons of using NSAIDs to prevent and treat breast cancer.



"Our review did not look at the potential side effects of using NSAIDs on a regular basis" stresses Professor Fentiman "These can include gastrointestinal bleeding and perforation which can carry a significant risk of ill health and death.



"It would be essential to take these negative effects into account before we could justify routinely using NSAIDs like aspirin to prevent breast cancer.



"More research is clearly needed and we are not advocating that women take these non prescription drugs routinely until the benefits and risks are clearer.



"But our findings clearly indicate that these popular over-the-counter drugs could, if used correctly, play an important role in preventing and treating breast cancer."



###



* NSAIDS and breast cancer: possible prevention and treatment strategy. Agrawal A and Fentiman I S. IJCP, the International Journal of Clinical Practice. 62.3, 444-449. (March 2008)



* IJCP, the International Journal of Clinical Practice was established in 1946 and is edited by Dr Graham Jackson from Guy's and St Thomas' NHS Foundation Trust, London, UK. It provides its global audience of clinicians with high-calibre clinical papers, including original data from clinical investigations, evidence-based analysis and discussions on the latest clinical topics. The journal is published by Blackwell Publishing Ltd, part of the international Blackwell Publishing group. blackwellpublishing/ijcp



* About Wiley-Blackwell. Wiley-Blackwell was formed in February 2007 as a result of the acquisition of Blackwell Publishing Ltd. by John Wiley & Sons, Inc., and its merger with Wiley's Scientific, Technical, and Medical business. Together, the companies have created a global publishing business with deep strength in every major academic and professional field. Wiley-Blackwell publishes approximately 1,400 scholarly peer-reviewed journals and an extensive collection of books with global appeal. For more information on Wiley-Blackwell, please visit blackwellpublishing/ or interscience.wiley/



Source: Annette Whibley


Blackwell Publishing Ltd.


Links to our partners:


•   Buy Gleevec Without Prescription
•   Buy Savella Without Prescription
•   Buy Aciphex Without Prescription

Blocking Stress-Related Cell Death Could Provide New Drug Development Target For Heart Attack, Stroke And Parkinson's

Scientists from the Florida campus of The Scripps Research Institute have uncovered a potentially important new therapeutic target that could prevent stress-related cell death, a characteristic of neurodegenerative diseases such as Parkinson's, as well as heart attack and stroke.



In the study, published recently in the journal ACS Chemical Biology, the scientists showed they could disrupt a specific interaction of a critical enzyme that would prevent cell death without harming other important enzyme functions.



The enzyme in question is c-jun-N-terminal kinase (JNK), pronounced "junk," which has been implicated in many processes in the body's response to stresses, such as oxidative stress, protein misfolding, and metabolic disorder. JNK also plays an important role in nerve cell survival and has become a target for drugs to treat neurodegenerative disorders such as Parkinson's disease.



In recent studies, JNK has been found to migrate to the mitochondria - the part of the cell that generates chemical energy and that is involved in cell growth and death. That migration, coupled with JNK activation, is associated with a number of serious health issues, including apoptosis or programmed cell death, liver damage, neuronal cell death, stroke and heart attack.



"Activated JNK migrates to the mitochondria in reaction to a stress signal," said Philip LoGrasso, professor in the Department of Molecular Therapeutics and senior director for drug discovery at Scripps Florida who led the study. "Once there, it amplifies the effects of reactive oxygen species that cause significant damage to the cell. We developed a small peptide that intervenes in JNK migration and blocks those harmful effects - specifically cell death."



LoGrasso noted that the team was able to block JNK mitochondrial interaction without harming any other important enzyme processes, such as JNK's impact on gene expression. These findings, LoGrasso said, suggest that this interaction could be exploited in the development of a new drug.



"The peptide we developed will never be a drug, but it is an important new investigative tool that we can use to selectively probe mitochondrial biology," he said. "Our hope is to produce a small molecule that can mimic the inhibitory effect of this peptide. If we can do that, we might be able to selectively inhibit JNK mitochondrial interaction and use it to treat a number of diseases."


Notes:


The first author of the study, "Selective Inhibition of Mitochondrial JNK Signaling Achieved Using Peptide Mimicry of the Sab Kinase Interacting Motif-1 (KIM1)," is Jeremy W. Chambers of Scripps Research. Other authors include Lisa Cherry, John D. Laughlin, and Mariana Figuera-Losada, also of Scripps Research.



The study was supported by National Institutes of Health and the Saul and Theresa Esman Foundation.



Source:

Mika Ono


Scripps Research Institute

Links to our partners:


•   Buy Emla Without Prescription
•   Buy Biaxin Without Prescription
•   Buy Zyban Without Prescription
•   Buy Misoprostol Without Prescription
•   Buy Female Pink Viagra Without Prescription
•   Buy Clonidine Without Prescription
•   Buy Lumigan Without Prescription
•   Buy Super Antiox GSE Without Prescription

Coma, Vegetative State, Minimally Conscious State: Frequent Misdiagnoses And Inconsistent Standards In Europe Pose Ethical Problems

"Latest research raises important ethical issues concerning our care for patients with chronic consciousness disorders," said Professor Gustave Moonen (Liege, Belgium), past president of the European Neurological Society (ENS), at a press conference at the current ENS Congress. This major meeting in European neurology is gathering more than 2,900 experts from all over the world in Milan. "This is all the more important as studies have shown that more than a third of patients given an initial diagnosis of vegetative state or persistent vegetative state show minimal signs of consciousness under more detailed examination."


230,000 coma patients in Europe per year


The special challenge for neurologists and other professionals caring for coma patients will be just one of the topics under discussion at the congress in Milan. Modern medical progress leads to an increasing number of patients having survived injuries and illnesses but at the price of serious brain injuries. Experts estimate that there are around 230,000 coma patients in Europe each year and that around 30,000 remain in a persistent vegetative state. Many of the studies on coma and related issues are a result of the work done in Liege by the "Coma Science Group" headed by Professor Steven Laureys.


A particularly delicate issue: coma and other states of impaired consciousness are not always easy to differentiate, although the classification can have grave repercussions. Patients seldom remain longer than two to five weeks in a coma, a state of deep unconsciousness uninterrupted by exterior stimuli. The vegetative state is characterized by wakefulness without awareness. "In a chronic vegetative state of more than a year, medical guidelines consider the withdrawal of treatment such as artificial nutrition and hydration ethically justifiable," Prof. Moonen explains. "The minimally conscious state characterizes patients with more than reflex behavior, with an inconsistent but clearly discernible evidence of consciousness but a lack of interactive communication. There are no generally accepted standards for the care of these patients." European studies show varying standards for care and decision making involving passive assisted death.


In a current study being presented at the ENS Congress in Milan, Professors Moonen and Laureys and their team surveyed the attitudes of European doctors, paramedical professionals and non-medical professionals on end-of life decisions in these challenging patients. The investigation shows that that key questions are being evaluated with anything but uniformity. Some 65 % of all respondents considered it acceptable to stop artificial nutrition and hydration in patients in a chronic vegetative state, whereas only 29 % considered this measure justified in patients in chronically minimally conscious states. The majority (78%) of respondents considered that being in a permanent vegetative state is worse than death for the patient's family, but only 51 % think that it is worse than death for the patients themselves. Furthermore, half of the respondents (52 %) considered that being in a minimally conscious state is worse than a vegetative state for the patients. "There are quite different attitudes throughout Europe towards patients in a minimally conscious state and a vegetative state," Professor Moonen points out. "In light of the high rates of diagnostic error in these patients, the necessity for adapted standards of care for minimally conscious state as compared to vegetative state is warranted."


Children with "locked-in-syndrome"


Another new study being presented in Milan by the Coma Science Group identifies the particular problems entailed in the treatment of children with so-called "locked-in-syndrome" (LIS). Patients suffering this syndrome are fully conscious but are completely paralyzed and only able to communicate via small eye movements. "The development of intensive care has considerably increased the number of children surviving acute brainstem damage," Professor Moonen explains. "But LIS is still rare in children. As a result, the diagnosis is often missed or delayed." Researchers in Liege examined a series of five cases. "Two of the reported cases died, and three survived, one up to eleven years, remaining with a severely handicapped motricity but meaningful self-scored quality of life," Professor Laureys reports. "We also observed that most pediatric LIS patients show some motor recovery. Our reported and reviewed data stress the need for physicians to carefully interpret signs and symptoms of LIS." Results of this study are to appear in the journal "Pediatric Neurology".


Neural networks show significant differences between the vegetative state and brain death.


Still another study in Liege shows just how delicate the decision over life and death can be. Through magnetic resonance imaging, the connections among defined neuroanatomical networks in the brain were compared using healthy people, patients in a vegetative state and brain dead patients. "Our MRI data indeed showed not only significant remaining correlations between distant default network areas in a case of vegetative state. In the vegetative state patient, as in age-matched controls, anti-correlations could also be observed between specific cortical networks. Both correlations and anti-correlations were significantly reduced in vegetative state as compared to healthy persons. A similar approach in a brain dead patient did not show any such long-distance functional connectivity," Prof. Laureys explains. "Ongoing multi-centric studies are documenting the diagnostic and prognostic value of cerebral 'resting state' functional MRI studies in coma survivors." Results of this study are in press in the journal "Human Brain Mapping".



Source
European Neurological Society

Links to our partners:


•   Buy Biaxin Without Prescription
•   Buy Nexium Without Prescription
•   Buy Hangover Pills Without Prescription
•   Buy Chantix Without Prescription
•   Buy Inderal Without Prescription
•   Buy Boniva Without Prescription
•   Buy Gleevec Without Prescription