A gene mutation in Dalmatian dogs causing high levels of uric acid that can lead to bladder stones has been identified by a team of researchers in the
School of Veterinary Medicine at the University of California, Davis.

The discovery equips dog breeders with the tools to eliminate the harmful trait from the Dalmatian breed, and yields clues to the cause of similar
problems in humans. The findings are published November 7 in the open-access journal PLoS Genetics.

All mammals excrete waste products in their urine, but only humans, great apes and Dalmatian dogs produce elevated levels of uric acid in their urine
and blood. Other dog breeds do not usually produce uric acid.

In humans, this can result in kidney stones, hypertension and gout, a painful inflammation of the joints. In Dalmatians, high uric acid levels result
in the formation of bladder stones that often have to be removed surgically.

“This defect has been reported for nearly a century and was probably unintentionally introduced as breeders worked to select more distinctive
spotting patterns,” said veterinary geneticist and lead author Danika Bannasch. The gene responsible, however, has remained elusive until now.

“This trait can now be removed from the breed by crossing Dalmatians with the normal offspring of the original Dalmatian-pointer breeding that
occurred in the early 1970s,” Bannasch said. “The result is a healthy dog that looks like a Dalmatian, maintains the Dalmatian breed
characteristics and is genetically almost identical.”

The researchers collected DNA and urine samples from hundreds of dogs to identify the gene responsible for high levels of uric acid.
Genetic analysis of dogs that are a cross between pointers and Dalmatians revealed that gene to be SLC2A9, a gene that recently has been reported to
be important in regulating uric acid levels in humans. DNA analysis showed that mutations in the SLC2A9 gene were responsible for the elevated uric
acid in the Dalmatians.

Although humans also carry the SLC2A9 gene, scientists have not yet identified the exact mechanism that causes humans and great apes to have elevated
uric acid levels. The recent identification of the responsible gene mutation in dogs may help scientists better understand the related problem in
humans.

The study was partially supported by a fellowship from the Morris Animal Foundation and the National Institute of Diabetes and Digestive and Kidney
Diseases within the National Institutes of Health.

By Dec. 1, the Veterinary Genetics Laboratory in UC DavisВ№ School of Veterinary Medicine will begin offering DNA testing for the mutation in dogs to
allow breeders to eliminate the trait. Information on the testing program will be available online at vgl.ucdavis.edu/.

“Mutations in the SLC2A9 Gene Cause Hyperuricosuria and Hyperuricemia in the Dog.”
Bannasch D, Safra N, Young A, Karmi N, Schaible RS, et al. (2008)
PLoS Genet 4(11): e1000246. doi:10.1371/journal.pgen.1000246
Click here to view article online.

About PLoS Genetics

PLoS Genetics reflects the full breadth and interdisciplinary nature of genetics and genomics research by publishing
outstanding original contributions in all areas of biology. All works published in PLoS Genetics are open access. Everything is immediately and freely
available online throughout the world subject only to the condition that the original authorship and source are properly attributed. Copyright is
retained by the authors. The Public Library of Science uses the Creative Commons Attribution License.

PLoS Genetics

About the Public Library of Science

The Public Library of Science (PLoS) is a non-profit organization of scientists and physicians committed to making the world’s scientific and medical
literature a freely available public resource.

Public Library of Science

Patients with severe acute respiratory failure (ARF) should be referred for
treatment using extracorporeal membrane `oxygenation (ECMO), rather than
using conventional ventilator management, to improve their chances of
survival without disability. ECMO would be cost-effective in the UK and
other countries with similar health care costs. These are the conclusions of
an Article published Online First and in a forthcoming edition of The
Lancet, Dr Giles Peek, Department of Cardiothoracic Surgery and
Extracorporeal Membrane Oxygenation, Glenfield Hospital, Leicester, UK,
Professor Miranda Mugford, University of East Anglia, UK, and Professor
Diana Elbourne of the London School of Hygiene and Tropical Medicine, UK,
and colleagues. ECMO has already been a vital tool for battling swine flu
and will be essential during the northern hemisphere winter when cases could
rise dramatically again.

Severe ARF causes high mortality in adults despite improvements in
ventilation techniques and other treatments (eg, steroids, inhaled nitric
oxide). Conventional management is by intermittent positive-pressure
ventilation where oxygen-enriched air is blown into the lungs at high
pressure, this in turn causes oxygen toxicity and pressure injury to the
lung tissue on top of the underlying lung disease, delaying or preventing
recovery. ECMO is an alternative which uses heart-lung bypass technology to
provide gas exchange outside the body, allowing time for the lung treatment
and recovery. Heparin is also given to prevent the blood clotting when it
passes through the ECMO system. In this study, the authors compared
treatment by a specialised ECMO team with care from specialist intensive
care unit teams using conventional ventilation, and also assessed the
cost-effectiveness of referral for ECMO care. In this UK-based randomised
controlled trial, 180 adults were randomly assigned to receive continued
conventional management (90) or ECMO (90). Eligible patients were aged 18-65
years and had severe but potentially reversible respiratory failure. The
primary outcome was death or severe disability at 6 months after
randomisation. Data about resource use and economic outcomes
(quality-adjusted life-years [QALYs]) were collected.

The researchers found that 68 of the 90 patients (75%) assigned to
consideration of ECMO actually received it. Of those referred for
consideration of ECMO, 63% survived to 6 months without disability compared
to 47% of those who were assigned to conventional management. This is
equivalent to 1 extra survivor without disability for every 6 patients
treated. Consideration of ECMO treatment led to a gain of 0.03 QALYs at
6-month follow-up. Use of modelling, making assumptions about life
expectancy, costs and quality of life after 6 months, predicted that the
cost per QALY of ECMO referral as ВЈ19,252. The cost per case was twice that
for conventional treatment, but the cost-effectiveness was still well within
the range regarded as cost-effective by health technology assessment
organisations such as the UK’s National Institute for Health and Clinical
Excellence (NICE).

The authors say: “This study shows a significant improvement in survival
without severe disability at 6 months in patients transferred to a
specialist centre for consideration for ECMO treatment compared with
continued conventional ventilation.”

They conclude: “The cost-effectiveness of ECMO would be improved if costs of
both transport and provision of the technique could be reduced…We are
confident that ECMO is a clinically effective treatment for acute
respiratory distress syndrome, which also promises to be cost effective in
comparison with other techniques competing for health resources.”

Dr Peek adds*: “Swine flu causes a viral pneumonia which can result in
severe respiratory failure in young adults, we have already used ECMO during
the first wave of the pandemic with good effect and we are expecting ECMO to
prove an invaluable weapon in the fight against the winter resurgence of the
infection, as has already been seen during the Australasian winter.”

In an accompanying Comment, Dr Joseph B Zwischenberger, University of
Kentucky College of Medicine, Lexington, KY, USA, and James E Lynch, ECMO
programme director, University of Texas Medical Branch, Galveston, TX, USA,
conclude: “The CESAR group should be congratulated on completion of such a
complex and large trial. The debate that will surround this study reflects
the difficulty of this type of research in the critically ill patient. This
study will likely provide ammunition for both those in favour and those
against the use of ECMO in the adult population.”

Source
The Lancet

KAI Pharmaceuticals, Inc., a privately held drug discovery and development company, announced enrollment of the first patients in a Phase 2 study of KAI-4169, a novel pharmaceutical agent being tested for the treatment of secondary hyperparathyroidism (SHPT), which is a frequent and serious complication of end-stage renal disease (ESRD). The Phase 2 study is a double-blind, randomized, placebo-controlled, multiple ascending dose study to assess the safety, tolerability and efficacy of multiple intravenous (IV) doses of KAI-4169 administered during hemodialysis in patients with SHPT.

Results obtained in the study will be used to select the appropriate dosing regimen for further development of KAI-4169 for the chronic management of SHPT in ESRD patients. Previous Phase 1 data demonstrated that single IV doses of KAI-4169 were safe and well-tolerated and resulted in sustained reductions in serum levels of parathyroid hormone (PTH) in both healthy male subjects and ESRD patients with SHPT.

“The KAI-4169 program continues to advance as planned, and we expect to report data from the Phase 2 study in the second half of this year,” commented Steven James, President and CEO of KAI. “The results to date have been encouraging in these hard-to-treat patients. The unmet medical need is compelling – elevated PTH exacerbates mineral imbalances (particularly calcium and phosphorus) in ESRD patients, and is linked to severe pathological effects such as osteodystrophy, vascular calcification, and increased risk for cardiovascular events, all of which contribute to morbidity and mortality in these patients.”

About Secondary Hyperparathyroidism

SHPT develops early in chronic kidney disease (CKD) and worsens as renal function declines and progresses to ESRD. SHPT, which affects the vast majority of patients with ESRD, is associated with bone disease (high-turnover renal osteodystrophy) and cardiovascular disease (vascular calcification) and can lead to significant morbidity. In the U.S., there are roughly 350,000 and eight million patients with ESRD and CKD, respectively.

Source:

KAI Pharmaceuticals

The United States District Court for the District of Puerto Rico issued an Order of Permanent Injunction against J.M. Dairy Inc. and Las Martas Inc., and Juan Manuel Barreto Ginorio, the owner of the dairies, after illegal drug residues were found in cows.

The U.S. Food and Drug Administration is concerned about the sale of animals for human food that may contain illegal levels of animal drugs because of the potential for adverse effects on human health. FDA approves new animal drugs with requirements, including a specified time period to withdraw an animal from treatment prior to slaughter, to assure that a drug has been depleted from edible tissue to a level safe for humans. The order also prohibits the sale of milk until compliance is met.

The court order follows a civil complaint filed against the defendants on Sept. 19, 2006, based upon FDA’s investigations into the dairies and their practices. The dairies produce milk for human consumption and sell dairy cows for slaughter for human consumption.

The injunction is based, in part, on five illegal residues in the edible tissue of three dairy cows sampled by the U.S. Department of Agriculture’s Food Safety Inspection Service (FSIS) between August 2003 and September 2005. The drug residues found by FSIS included antibiotics such as sulfamethazine, sulfathiazole, sulfadimethoxine, and penicillin at levels not permitted by FDA. More recent FDA inspections confirmed that the dairies continued to use animal drugs in a manner contrary to the label directions, without the benefit of a veterinarian’s oversight, and failed to maintain record-keeping systems to ensure that they did not sell milk or animals for slaughter for human food with illegal new drug residues.

Under the terms of the Aug. 8, 2007 order, the defendants must implement record-keeping systems to ensure that their use of drugs conforms to FDA regulations and that no milk or animals for slaughter for human food enters into interstate commerce with illegal new drug residues.

The defendants may only resume selling or delivering food-milk or animals for slaughter for human food-in interstate commerce after they are notified by FDA that they are in compliance with the terms of the order.

fda

Officials from the journal Nature on Thursday said they plan to change a paper published in the journal’s Aug. 24 edition describing a technique that could derive human embryonic stem cells without destroying the embryo to further clarify that none of the embryos used in this particular study survived the experiment, the Chicago Tribune reports (Manier, Chicago Tribune, 9/1). Robert Lanza, medical director of Worcester, Mass.-based Advanced Cell Technology, and colleagues described the technique as removing a single cell — known as a blastomere — from a three-day-old embryo with eight to 10 cells and using a biochemical process to create embryonic stem cells from the blastomere. Researchers removed 91 blastomeres from 16 thawed embryos donated by fertility clinic patients and found that more than half of the blastomeres began to multiply and that in two cases the blastomeres became embryonic stem cells. The method of removing a cell from the embryo is based on preimplantation genetic diagnosis, or PGD, which usually is used to test the cell for genetic deficiencies. At the time the Nature article was published, Lanza said the research destroyed some of the embryos used but single-cell extractions that leave the embryo unharmed should be feasible in the future. In addition, the researchers wrote that single cells taken from three-day-old embryos “have never been shown to have the intrinsic capacity to generate a complete organism in any mammalian species.” Nature last week corrected wording in a news release it had distributed in advance of the study’s release after Richard Doerflinger of the United States Conference of Catholic Bishops in an e-mail wrote that the results presented in the release were misleading. According to Doerflinger, the release did not make it clear that the embryos used in the research did not survive in the experiments (Kaiser Daily Women’s Health Policy Report, 8/24). “We feel it necessary to explain that … the embryos that were used for these experiments did not remain intact,” Ruth Francis, Nature senior press officer, said in an e-mail (McCullough, Philadelphia Inquirer, 8/311). A Nature spokesperson on Thursday said that the “fate of the embryos isn’t obvious” in the study and that the journal might change part of the study’s abstract and a diagram that accompanied the study. She added the study’s findings remain uncontested. Lanza said the clarification “doesn’t change the scientific point of the paper” (Chicago Tribune, 9/1).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Therapies that can keep us younger longer might also push back the clock on Alzheimer’s disease, suggests a new study of mice in the December 11th issue of the journal Cell, a Cell Press publication.

“There’s something about being youthful that protects us from Alzheimer’s disease,” said Andrew Dillin of The Salk Institute for Biological Studies. “People say that if you live long enough, you get Alzheimer’s. But if that were true, mice that live longer should get the disease at the same rate. That’s not what we found.”

The researchers show that mice carrying human genes that cause them to develop Alzheimer’s can be protected from that disease by turning down a pathway that is well known for its effects on aging. Surprisingly, the brains of the mice who were spared the cognitive, inflammatory and neural effects of Alzheimer’s by reducing the so-called insulin/IGF signaling pathway were still riddled with amyloid plaques. However, those plaques were more tightly packed into larger clusters than they would otherwise have been.

“We expected to see less plaque in the protected mice,” Dillin said. “Instead we saw the same number of plaques, but there was a qualitative difference in how they looked. They were condensed so that they took up less area in the brain.” Those larger structures are apparently also less toxic.

The new findings confirm an earlier report by the Salk team in worms engineered to produce the human beta amyloid protein in their body wall muscles.

Dillin said they don’t yet completely understand how the lowered IGF signal protects the mice, but the pathway is known to negatively control two transcription factors (FOXO and HSF-1). Those transcription factors in turn control other genes encoding molecular chaperones, whose job it is to protect all of a cell’s proteins.

“To maintain youth, you have to protect the proteome, not just the genome,” he said. That may be particularly critical in long-lived cells like neurons, heart and muscle, which do not often divide and replace themselves. He points out that those who are genetically predisposed to develop early onset Alzheimer’s carry the gene their whole lives, but don’t develop the disease until they reach their 50s.

He thinks that youth-extending drugs aimed at increasing the activity of the FOXO and HSF-1 transcription factors may be the better bet for staving off Alzheimer’s disease since the IGF pathway plays so many varied roles in the body. He plans to test in further studies whether a similar mechanism can also yield benefits for other neurodegenerative diseases that tend to come on with age, including Parkinson’s and Huntington’s diseases.

Dillin emphasizes that the ultimate aim is to improve the quality of life, not the quantity. “The goal is not to make people live to be 250 years old; it is to delay the onset of sickness,” he said. “I want to find ways to extend health span, not necessarily life span.”

The researchers include Ehud Cohen, Howard Hughes Medical Institute, The Salk Institute for Biological Studies, La Jolla, CA, The Hebrew University Medical School, Jerusalem, Israel; Johan F. Paulsson, The Scripps Research Institute, La Jolla, CA; Pablo Blinder, University of California, San Diego, La Jolla, CA; Tal Burstyn-Cohen, University of California, San Diego, La Jolla, CA; Deguo Du, The Scripps Research Institute, La Jolla, CA; Gabriela Estepa, Howard Hughes Medical Institute, The Salk Institute for Biological Studies, La Jolla, CA; Anthony Adame, University of California, San Diego, La Jolla, CA; Hang M. Pham, University of California, San Diego, La Jolla, CA; Martin Holzenberger, INSERM and UniversiteВґ Pierre-et-Marie-Curie, UMRS 938, Hopital Saint-Antoine, Paris, France; Jeffery W. Kelly, The Scripps Research Institute, La Jolla, CA; Eliezer Masliah, University of California, San Diego, La Jolla, CA; and Andrew Dillin, Howard Hughes Medical Institute, The Salk Institute for Biological Studies, La Jolla, CA.

Source: Cathleen Genova

Cell Press

A randomized trial compared three ways to deliver a behavioral smoking cessation program using varenicline (Chantix®): by phone, Web, or both. Although phone counseling had greater treatment advantage for early cessation and appeared to increase medication adherence, abstinence outcomes did not differ at six months. The findings suggest the three programs are all effective treatment options when combined with varenicline. Nonprofit scientific research institute SRI International, Group Health Research Institute, and Free & Clear, Inc. conducted the trial, published in the May 2010 American Journal of Preventive Medicine.

Proactive telephone behavioral counseling and Web-based services are popular tools for smoking cessation. Although both phone- and Web-based services are known to be effective, previous studies have not examined whether combining these services improves outcomes over either method alone. The trial aimed to determine the relative effectiveness of a widely used smoking cessation program (Free & Clear Quit For Life® Program) delivered in three ways: standard proactive telephone behavioral counseling, Web-based delivery, and a program that combined the two.

The trial was among the first “real-world” examinations of varenicline use since the original phase III studies that the manufacturer sponsored. The researchers tracked more than 1,200 Group Health adult patients who received behavioral therapy and varenicline to quit smoking. All participants received 12 weeks of varenicline, printed guides, a 5у€ќ¶ minute orientation call, and access to a toll-free phone number for support as needed.

“Our findings provide important data regarding the real-world use of varenicline and show that a supportive treatment philosophy along with individualized information matter most for long-term smoking cessation success,” said Gary Swan, PhD, director of the Center for Health Sciences at SRI International and lead author of the study. “Any of the programs shows promise as a counseling tool when used in combination with varenicline.”

Varenicline is a non-nicotine prescription medicine specifically developed to help adults 18 and older quit smoking. It targets nicotine receptors in the brain, attaches to them, and blocks nicotine from reaching them. Based on the observed smoking abstinence outcomes, researchers found that data obtained in real-world behavioral therapy settings are comparable to those from the varenicline phase III clinical trials. Gastrointestinal disturbances and abnormal dreams were the most common varenicline side effects, similar to the proportion of study participants reporting side effects in the phase III trials. No serious neuro-psychiatric incidents attributable to varenicline use occurred during the trial.

Notes:
Co-authors were Group Health Research Institute Senior Investigator Jennifer B. McClure, PhD, and Associate Investigator Sheryl L. Catz, PhD; Project Manager Julie Richards, MPH; and Affiliate Investigators Susan M. Zbikowski, PhD, and Timothy A. McAfee, MD, MPH, both of Free & Clear; Mona Deprey, MS, of Free & Clear; and Lisa M. Jack, MA, and Harold S. Javitz, PhD, of SRI International.


The project described is registered at clinicaltrials (NCT00301145). It was 97.85 percent funded ($3.3 million) by the National Cancer Institute (Grant R01CA071358). Pfizer Inc. provided study medication and nominal support (2.15%) for recruiting participants ($72,000).

Source:
Rebecca Hughes
Group Health Research Institute

View drug information on Chantix.

Australia’s regenerative medicine company, Mesoblast Limited (ASX:MSB)(PINK:MBLTY), announced today that the thirteenth patient enrolled in the ongoing Phase 2 clinical trial for congestive heart failure had been safely implanted with the proprietary adult stem cells during a live case at the American Heart Association’s annual conference, currently underway in New Orleans.

The procedure was performed by cardiologists from the Texas Heart Institute and broadcast during a satellite symposium titled ‘Future Direction of Stem Cells in Cardiovascular Disease’. The annual American Heart Association conference is the premier symposium for American cardiologists.

The multi-centre trial is testing the safety and effectiveness of Revascor(TM), the proprietary allogeneic, or “off-the-shelf”, stem cell product being developed for patients with congestive heart failure by Mesoblast’s United States-base! d sister company Angioblast Systems Inc.

Revascor! (TM) is delivered to damaged areas of the heart by a minimally invasive cardiac catheterisation procedure performed under local anaesthesia while the patient is awake. Patients undergoing the procedure are released from the hospital within 24 hours.

The placebo-controlled trial will randomise up to 60 patients suffering from congestive heart failure at various sites in the United States, including California, Arizona, Minnesota, and Texas. The first cohort of patients in the trial is expected to be completed by the end of December.

About Heart Failure

Almost six million Americans have congestive heart failure, a progressive form of cardiovascular disease that inhibits the heart from pumping blood throughout the body, with 550,000 new cases diagnosed each year. The extensive morbidity and mortality associated with this disease make it a principal health and economic burden in the Western world. Existing therapies do not result in repair or regenerat! ion of heart muscle. Revascor(TM), a trademark of Angioblast Systems Inc, is being developed to rebuild both blood vessels and heart muscle.

About Mesoblast Limited

Mesoblast Limited (ASX:MSB)(USOTC:MBLTY) is an Australian biotechnology company committed to the development of novel treatments for orthopaedic conditions, including the rapid commercialisation of a unique adult stem cell technology aimed at the regeneration and repair of bone and cartilage. Our focus is to progress through clinical trials and international regulatory processes necessary to commercialise the technology in as short a timeframe as possible.

Mesoblast has the worldwide exclusive rights for a series of patents and technologies that have been developed over more than 10 years and which relate to the identification, extraction and culture of adult Mesenchymal Precursor Cells (MPCs). The Company has also acquired a substantial interest in Angioblast Systems Inc, an A! merican company developing the platform MPC technology for the! treatme nt of cardiovascular diseases, including repair and regeneration of blood vessels and heart muscle. Mesoblast and Angioblast are jointly funding and progressing the core technology. Mesoblast’s strategy is to maximise shareholder value through both corporate partnerships and the rapid and successful completion of clinical milestones.

Mesoblast Limited

A form of TB, MRD-TB is resistant to the first line of drugs formulated to fight the disease. On World TB Day March 24th, The World Health Organization (WHO) the Global Fund to Fight AIDS, Tuberculosis and Malaria and the Stop TB Partnership are calling on world leaders to step up their commitment and contributions to meet the goal of diagnosing and treating one million people with multidrug-resistant tuberculosis between 2011 and 2015.

In 2009, WHO reported that 9.4 million people became ill with TB and 1.7 million died, including 380 000 people with HIV-associated TB. There were some 440 000 cases of MDR-TB and 150,000 deaths in 2008, the latest year for which estimates are available.

Professor Michel Kazatchkine, Executive Director of the Global Fund states:

“MDR-TB is a threat to all countries as it is difficult and expensive to treat. Unless we make an extraordinary effort to tackle this problem our ability to finance and secure continued progress against TB in general will be threatened.”

Leaving MDR-TB untreated increases the risk of spread of drug resistant strains of TB. WHO estimates there will be more than 2 million new cases of MDR-TB between 2011 and 2015.

Dr Margaret Chan, WHO Director-General continues:

“Many countries have made progress, but despite the recent scale up in efforts, the world needs to do much more to get care to all MDR-TB patients who need it. We cannot allow MDR-TB to spread unchecked.”

Tuberculosis, MTB or TB, is a common and in some cases deadly infectious disease caused by various strains of mycobacterium in humans. Tuberculosis usually attacks the lungs but can also affect other parts of the body. It is spread through the air when people who have active MTB infection cough, sneeze, or spit. Most infections in humans result in an asymptomatic, latent infection, and about one in ten latent infections eventually progresses to active disease, which, if left untreated, kills more than 50% of its victims.

Programs financed by the celebrity driven Global Fund and following WHO treatment standards are expected to diagnose and treat about 200,000 people for MDR-TB by 2015, a fourfold increase from those 50,000 patients who are currently undergoing treatment.

Dr. Jorge Sampaio, the UN Secretary-General’s Special Envoy to Stop TB adds:

“It is time for countries with rapidly growing economies and a heavy burden of MDR-TB to step up their commitment and financing for their own MDR-TB programs. Several have the capacity to show new leadership on south-south cooperation and aid to neighboring countries that are also affected.”

World TB Day is a campaign inspired by the ambitious new objectives and targets of the Global Plan to Stop TB 2011-2015: Transforming the Fight-Towards Elimination of Tuberculosis, which was launched by the Stop TB Partnership in October 2010. This new plan, for the first time, identifies all the research gaps that need to be filled to bring rapid TB tests, faster treatment regimens and a fully effective vaccine to market. It also shows public health programs how to drive universal access to TB care, including how to modernize diagnostic laboratories and adopt revolutionary TB tests that have recently become available.

The campaign will focus once again on individuals around the world who have found new ways to stop TB and can serve as an inspiration to others. The idea is to recognize people and organizations who have introduced a variety of innovations in a variety of settings.

Since 2009, the 23 countries most heavily affected by TB drug resistance have nearly doubled their budgets for MDR-TB. From 2002 through 2010, Global Fund-financed TB programs around the world have provided treatment to 7.7 million people and saved the lives of 4.1 million.

Dr. Lucica Ditiu, Executive Secretary of the Stop TB Partnership concludes:

“The Global Fund’s success can be measured in the number of lives that have been saved through care provided by the TB programs it finances. Every TB patient should have access to proper care. We advocate on behalf of millions of patients worldwide and our strong partners such as WHO and the Global Fund. To reach a million people with effective care for MDR-TB over the next five years, we will need to work closely with all partners, especially with affected communities.”

Source: The Stop TB Partnership

Sy Kraft, B.A.

UroToday- It is reported that 5-year biochemical-free survival (BFS) occurs in over 50% of men with a pre-operative PSA undergoing radical prostatectomy (RP). Dr. Magheli and colleagues investigated whether the zonal origin of the tumor in the radical prostatectomy specimen influences this outcome. This is based upon the hypothesis that transition zone tumors often had superior outcomes compared to peripheral zone tumors. Their report appears in the October 2007 issue of the Journal of Urology.

Between 1984 and 2005, 265 men were identified for having undergone an RP with a PSA >20ng/ml and having adequate data for followup. Anterior tumor location was defined as the primary component of the tumor being located anterior to the urethra. Post-operative PSA was followed and the clinical and pathological characteristics evaluated.

A total of 50 men (19%) were identified with anterior tumors and 215 (81%) with a posterior tumor. Patients with anterior prostate tumors had a lower clinical stage and less seminal vesicle involvement but no difference regarding extraprostatic extension, positive surgical margins, or lymph node involvement. There was no difference in biopsy and RP Gleason score between each group. Median followup was 6-7 years.

Multivariable analysis of preoperative clinical factors found tumor stage and biopsy Gleason score independently predictive of biochemical recurrence. Multivariable analysis of post-operative factors identified prostatectomy Gleason score, pathological stage, and positive surgical margins as predictive of biochemical recurrence. The 5- and 10-year BFS was 47% and 33% for patients undergoing RP with a PSA >20ng/ml. While patients with anterior tumors had 5- and 10-year BFS rates of 62% and 50% compared to 45% and 29% respectively for those with posterior tumors, anterior tumor location was not an independent predictor of biochemical recurrence on multivariable analyses.

Magheli A, Rais-Bahrami S, Peck HJ, Walsh PC, Epstein JI, Trock BJ, Gonzalgo ML

J Urol. 178(4): 1311- 1315, October 2007
doi:10.1016/j.juro.2007.05.143

Reported by UroToday Contributing Editor Christopher P. Evans, M.D

UroToday – the only urology website with original content global urology key opinion leaders actively engaged in clinical practice.

To access the latest urology news releases from UroToday, go to:
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