Iphone 5

As  days gone by and we slide deeper and deeper in August, more and more rumors regarding the next generation of Apple iPhone continue to emerge and circulate, and many folks are now wondering if they should wait a little longer and get the new iPhone 5 or just get their hands on an already available Android device. According to the latest rumors, iPhone 5 could be released in just a month, on September 12. After looking at pictures that leaked on web a couple of days ago of what appears to be a fully assembled iPhone 5, we can draw two conclusions: iPhone 5 is the biggest Apple phone to date and its design team is responsible for lack of ideas.  Creating a next generation of Apple iPhone smartphone that resembles too much with its predecessor, iPhone 4S will certainly not please the consumers and this will reflect in the sales number.

iPhone 5

Photos provided by iLab Factory, a Chinese supplier of components, the fully assembled smartphone illustrates a smartphone that seems to be representative or even the next iPhone 5 prototype. In the absence of any official information from Apple it is very hard to tell whether this particular copy of the image is real or this is the case of another well done fake iPhone 5. The rumors seem to confirm the first hypothesis and these could be the actual first photos of the iPhone5.

In the picture we can also see the new dock connector, dropped to make way for a stronger set of speakers. The screen is “tall” and considerably bigger than the one iPhone 4S comes equipped with, and the back cover design keeps the new iphone 5 as flat as possible, replacing the glass surfaces with polished aluminum trim.

It remains to be seen whether the traditional design used for the 3.5 inch iPhones, will be able to convince also when adopted for a wider screen.

Iced Tea Consumption And Painful Kidney Stones Linked

According to clinicians, ice tea, when consumed in high amounts, can lead to kidney stones. During summer, people tend to drink  ice tea to hydrate, but this can damage the kidneys. The explanation is that iced tea contains oxalate, one of the constituents of kidney stones. Obviously, kidney stones contain, besides oxalate, other compounds such as calcium, uric acid, etc.. Dr. John Milner, assistant professor, Department of Urology, Loyola University Chicago Stritch School of Medicine, said that not only cold tea can lead to formation of kidney stones, but also hot tea, but people do not drink so much hot tea in summer so as to form kidney stones. Clinicians recommend that people drink water to hydrate, and not other beverages such as juices or alcohol etc. In fact, the effect of alcohol is dehydration. Natural lemonade (not powdered) is also recommended because of it contains high amounts of citrate that inhibits the formation of kidney stones . It is important to note that the intention is not to forbid ice tea intake, but to recommend a moderate intake.

Iced Tea

Renal calculi (kidney stones) occurs mainly in men over age 40. In the United States about 10% of men suffer from this disease. The causes of formation of kidney stones is dehydration or consumption of certain food or drinks ( animal protein, corn syrup, grapefruit juice, apple juice, etc.). The most common kidney stones symptoms is  pain in the back, flank, or lower abdomen, the so-called renal colic. Pain may be accompanied by vomiting, nausea or other urinary symptoms such as hematuria (blood in urine), pyuria (pus in the urine), painful urination. The pain occurs due to blockage of the urinary tract by kidney stones.

Depending on the location of kidney stones, it can lead to either ureterolithiasis, which occurs when a stone blocks the ureter,  or nephrolithiasis, when the calculus is blocked in the kidney, or cistolithiasis, which occurs when the calculus blocks the bladder. Pain can be relieved with NSAIDs or opioids.Regarding treatment, kidney stones can be treated with shockwave lithotripsy or different types of surgery. There are several dietary measures to be taken by patients who already have kidney stones. It is indicate that these patients  limit sodium intake, vitamin C and animal protein products that contain large amounts of oxalate (that is dark chocolate, spinach, blueberries, tea, nuts, etc). It is also recommended eating foods that contain citrate, such as lemon or orange. But the most important advice is that patients with kidney stones  drink 2 liters of water per day. Of course, this advice is appropriate for all people not just those with kidney stones.

Absence Epilepsy Seizures (Petit Mal Crisis) – Clinical Presentation

Absence seizures represent a type of generalized epilepsy seizures and were first described by Poupart in 1705, and later by Tissot in 1770, who named this crisis as petit accesses. In 1824, Calmeil used the term absence to describe this type of generalized epilepsy seizures and in 1935, Gibbs, Davis, and Lennox  have established a link between absence crisis and loss of consciousness.

Absence epilepsy seizures occur mainly in generalized epilepsy with onset in childhood and may be associated with tonic, clonic or atonic component, with automatisms or autonomic signs.This type of seizures are brief, are lasting just a few seconds (pyknoleptic) and for this reason some children can experience many such seizures per day. In other cases of epilepsy, particularly those with an older age of onset, absence seizures last several seconds up to minutes, patients may experience only a few number of seizures per day (nonpyknoleptic or spanioleptic absence seizures).

According to The International League Against Epilepsy (ILAE), absence epilepsy seizure are classified in:

• Absence seizures – typical or atypical;
• Absence with special features – myoclonic absence and eyelid myoclonia.

Absence Epilepsy Seizures (Petit Mal Crisis)

Absence epilepsy seizures usually occur in childhood, around the age of 2 years old, until the age of 13-14 years, when are replaced by generalized tonic-clonic epilepsy seizures.

Absence crisis have a sudden onset and interfere with normal activity, patient having no warning or postictal phase as in the case of grand mal crisis. If the patient is engaged in a motor activity such as walking, he may stop and remain motionless or he may continue walking. Typical, during an absence seizure the child or teenager abruptly ceases his activity and remain motionless, the gaze is fixed straight ahead and occasionally the eyelids may slightly flicker. This events lasts several seconds, after this episode patient resume his previous activity. If the crisis occur while the child is walking or playing, he stops and sometimes may drop objects from his hands and after several seconds will return to his previous activity. Children are not responsive during the seizure and have no memory of what happened during the crisis, they are generally unaware that the seizure has occurred. In most cases, absence crisis occur frequently in the morning.

Absence crisis usually lasts between 5 and 15 seconds, sometimes may last longer, and because it has a short duration may remain unnoticed by other family members, such a crisis may be observed on the electroencephalogram (EEG) examination.

Absence Seizures

In most cases of generalized epilepsy in children, physical and neurological examination are normal, but having the child hyperventilate for 3-5 minutes can often provoke absence seizures. This procedure can easily be performed and can represent a useful diagnostic maneuver.

Children with generalized epilepsy may have a medical history of staring spells or behavioral problems, but often absence seizures  remain undiagnosed until a generalized tonic-clonic seizure has occurred, but decline in school performance may be an indication of the onset or breakthrough of absence seizures. Atypical absence seizure may lead to intellectual development delay or mental retardation.

Absence Epilepsy Seizures (Petit Mal Crisis) Clinical Forms

In medical practice, particular variants of absence epilepsy seizures are encountered, such as:

1. Myoclonic absence, beside the absence crisis, the patient presents muscle contractions (myoclonic jerks);
2. Akinetic absence, in which absence crisis may be associated with loss of axial muscle tone and head nodding. If crisis lasts long enough, forward flexion of the trunk may occur.

New Study Findings Could Lead To New Anti-HIV Drug Therapies

Researchers at the University of Washington could find why the body can not fight against HIV infection. Scientists discovered that during HIV infection is produced a viral protein, called vpu, that interfere directly with the immune system, making it unable to fight infections. Normally, innate immune system helps  human body to prevent and to fight infections fight against infections (bacteria, viruses, parasites). HIV, in turn, through various mechanisms manages to trick the immune system,  in order to multiply and infect the body.

In AIDS, virus targets and infects CD 4+ lymphocytes, cells that are directly involved in fighting infection. Therefore, AIDS manifestations vary according to the number of  CD4 + lymphocytes. Normally, CD4+ lymphocytes number is about 750/microliter. When  CD4 + lymphocytes count reaches 200/microliter, human body immunity is severely impaired.  It is know that in people infected with HIV,  death occurs after infections and cancers that appear due to poor immunity. The most common infections occurring in AIDS include Pneumocystis jiroveci infection, Mycobacterium and Cryptoccocus neoformans. Among cancers, the most common are Kaposi sarcoma and B cell lymphomas.

HIV Cell

Human immunodeficiency virus (HIV) is a lentivirus, belonging to the retrovirus family. Like all retroviruses, HIV posses a replication mechanism based on the activity of an enzyme called reverse transcriptase. This enzyme produces DNA copies of the viral genome, which are then inserted into the host cell genome. The virus contains a viral envelope composed of phospholipids in which are embedded host cell proteins and a specific protein called Env, formed of  several glycoproteins, such as gp 120 and gp 41. This complex of glycoproteins has a very important role in the attaching process of the virus to the cells that will be infected. HIV genome contains several genes (gag, pol, env, tat, nef, vif, vpu, and rev) that encodes 19 proteins.  VPU gene, which encodes vpu protein,  is a regulatory gene that coordinate replication and the ability to infect cells.

The study, conducted by researchers from the University of Washington, found that HIV escapes the immune system defenses through viral protein vpu. It seems that viral protein vpu directly interfere with IRF3 (Interferon Regulatory transcription factor), a protein involved in innate immune response. VPU protein binds to this specific protein, thus blocking its action.  In this way, HIV manages to escape immune response. This findings have been demonstrated by studies on HIV strains that do not posses vpu protein, being unable to block the immune system response. Researchers hope that by improving protein IRF3 function may improve treatment and prolong survival of patients infected with HIV.

“We have effectively identified a new Achilles heel in the arsenal that HIV uses to overcome the defenses present in the body’s immune system. This knowledge can be used to design new HIV antiviral therapeutics that prevent vpu from interacting with IRF3 and targeting it for destruction, thus enhancing immunity.”, stated Dr. Gale, leader of the study.

Guillain-Barre Syndrome – Causes, Symptoms,Diagnosis, Treatment And Prognosis

Guillain-Barre syndrome is a unique pathological condition that manifests as an acute inflammatory polyradiculoneuropathy with resultant weakness and diminished reflexes, being the most important cause of acute flaccid paralysis. Also known as polyradiculonevritis, the disease can rapidly and severely damage, within a few days,  a previously healthy patient and can evolve either to death or to complete remission.

The annual incidence of the disease is 2 cases per 100,000 inhabitants. Affects all age groups, with an average onset at the age of  40 years and a slight preponderance in males. Although seasonal variations are not evident, however, some studies shown a high frequency of Guillian-Barre syndrom in fall and winter.

Guillain-Barre Syndrome Causes

In 50% -60% of cases,  Guillain-Barre syndrome debuted after respiratory or gastrointestinal infections with viruses and bacteria or vaccinations to prevent them.

Among systemic infections that are associated with Guillain-Barre syndrome, have been reported infections with adenoviruses, hepatitis B virus, hepers simplex virus, varicella-zoster virus and  cytomegal virus. The association between acquired immunodeficiency syndrome (AIDS) and Guillain-Barre syndrome is well known.

Guillain-Barre syndrome is most commonly associated with bacterial infection with Campylobacter jejuni. Syndrome occurs in 10% -50% cases of infections caused by this bacterium. Polyradiculonevritis seems to be caused by an immune cross-response against Campylobacter jejuni, because it was observed that the disease occurs at 1-3 weeks after initial infection.

Guillain Barre Syndrome

The disease is considered an acquired immunological disorder, in which in the perivascular infiltrates with monocytes and macrophages are associated with neuronal segmental demyelination. Immunological studies have shown that in the disease development are involved both cellular and humoral immunity.

After an infectious process, most commonly with Campylobacter jejuni,  is induced the production of antibodies that cross react with gangliosides and glycolipide such as GM1 and GD1b, which are components of the myelin.

Guillain-Barre Syndrome Symptoms

Paralysis represent the predominant symptom of the disease. At the onset, the patient is not feverish, but is complaining by paresthesias and spontaneous muscle weakness in the limbs affected by the disease.

Paralysis are relatively symmetrical and rapidly progressive, affect manly proximal muscles of the limb muscles and can reach a maximum intensity within a few days to 4 weeks. Onset is usually in the legs and may take an ascending evolution, to the upper limbs, patient presenting a peripheral quadriplegia with muscle weakness and diminished reflexes. If paralysis are persistent, then muscular atrophies will develop. Trunk and neck muscles, intercostal nerves and cranial nerves are affected later in the evolution of the disease.

Respiratory crisis  represents a major life threatening complication and is  caused by respiratory muscles paralysis. Respiratory crisis is an emergency and require assisted mechanical ventilation. As disease progression is faster, within hours or days, the faster respiratory crisis can install. Respiratory impairment is present in 50% of patients with Guillain-Barre syndrome, and 25% of them developed respiratory failure.

Guillain Barre Syndrome

Were reported cases with onset in the upper limbs, in the neck muscles, with or without extension to the legs, cases in which respiratory muscles were constantly affected.

Autonomic nervous system impairment is present in 20% of patients and represents an important cause of death. Autonomic nervous system impairment may be mild, causing variations in blood pressure and in heart rate or may be severe, causing hypotension, supraventricular tachycardia, cardiac arrest or sudden cardiac death. Urinary retention is present in 15% of patients with Guillain-Barre syndrome. Hyponatremia and transient diabetes insipidus can occur through inappropriate secretion of antidiuretic hormone. Other autonomic nervous system impairments are facial redness, sudoration abnormalities (anhidrosis or diaphoresis).

Cranial nerves are commonly affected in this syndrome. Typically occurs facial diplegia (bilateral facial nerve paralysis), which is less common other neuropathies. Bilateral facial paralysis occurs in more than 50% of patients and has a transient character. Sometimes occur bulbar paralysis with glosopharyngeal and vagus nerve impairment.

Oculomotor nerves are affected in less than 10% of cases, oftalmo-paresis being the most common ocular sign seen in Guillain-Barre syndrome. It may be complete or incomplete and it may be accompanied by pupillary changes. Cranial nerve VI is most commonly affected, alone or associated cranial nerves IV and III impairment. It is assumed that oculomotor disturbances occur due to a type of IgG antibody directed against GQ1b gangliosides. Unilateral or bilateral ptosis may be present. The main pupillary disturbances are the reduction of pupillary reaction to light and accommodation disorders.

Paiplar edema was reported in a small percentage of cases and may be correlate with increased protein concentration in the cerebrospinal fluid.

Optic neuritis was also detected and is most often bilateral. Vision loss may be mild or severe, and in cases with favorable evolution, vision recovery may be partial or complete.

Guillain-Barre Syndrome Diagnosis

Guillain-Barre syndrome is diagnosed based on clinical and laboratory examinations, the most important investigations are represented by cerbrospinal fluid examination and electrophysiological study.

Lumbar puncture reveals a cerebrospinal fluid with normal pressure and acellular in 90% of cases. The most important anomaly is represented by an increased protein concentration over 400 mg / dl, but without a high cellularity. This anomaly is characteristic for the disease and is called albuminocytological dissociation, being present in over 90% of patients.

Guillain Barre Syndrome- Lumbar Puncture

Electrophysiological tests of peripheral nerves and muscles are often normal, demonstrating the proximal nature of the disease. The most frequent modification is represented by decreased nerve conduction velocity in proximal nerve segments, with over 60% of normal nerve conduction velocity.

Serum autoantibodies are not routinely used in the diagnosis of Guillain-Barre syndrome, but may be helpful in patients with a questionable diagnosis. Glycolipids antibodies are present in 60-70% of patients with Guillain-Barre syndrome during the acute phase.

Guillain-Barre Syndrome Treatment

ECG and blood pressure monitoring are required and sometimes a pacemaker implantation is required to prevent the occurrence of fatal arrhythmias. Respiratory dysfunction can lead to respiratory failure and respiratory infections and often require intubation, assisted ventilation and sustained antibiotic treatment of respiratory infections. Urinary tract infections require also supported antibiotic treatment.

Periodic repositioning of the patient is recommended in order to prevent pressure sores and nerve paresis by compression. Passive movements of the limbs and joints  should be made, in order to decrease the risk of thrombophlebitis. Low-doses of heparin are recommended to prevent deep vein thrombosis and pulmonary embolism.

Physiokinetotherapy should be started early in the recovery period in order to reduce functional deficits, impairments and disabilities resulting from Guillain-Barre syndrome.

Plasmapheresis has beneficial effects, especially if is performed in the first 14 days of onset. Are performed 4-6 procedures. Potential complications are the emergence of bleeding (decreased fibrinogen), cardiac arrhythmias and hypotension.

Immunoglobulins. Studies have shown that administration of intravenous gammaglobulins are more effective than plasmapheresis. Potential complications are represented by heart attack and stroke.

Corticosteroid therapy has not proved its effectiveness in the treatment of Guillain-Barre syndrome.

Guillain-Barre Syndrome Prognosis

Despite sustained therapy, between 3% -8% of patients die in the acute phase of disease by various complications such as respiratory failure or pulmonary embolism. Between 5% -10% of patients remain with motor disabilities, paresis or sensitive disorders. Between 10% -15% of patients present a complete recovery. Disease recurrence was detected in 5% -33% of patients.

Higgs Boson God particle discovered by the Large Hadron Collider scientists

European physicists have found evidence of a new particle on Wednesday, which might be Higgs Boson God particle. The Large Hadron Collider physicists at CERN have been cheering today, convinced that they have a discovery, though it’s not yet clear if it’s the Higgs Boson particle or not.

It’s been nearly 50 years since physicists have believed the Higgs Boson particle exists, though no evidence showed up until now. The God particle is considered the final piece of particle physics and scientists have been working hard on getting more information and evidence about it.

The supposedly Higgs Boson particle has been recorder in the Large Hadron Collider ( LHC ) at CERN and the data is still being processed. Physicists managed to get an excess of collision events at a 125 gigaelectronvolts mass.

Unfortunately the physicist who reported this information wants to remain anonymous and all we know is that he works for ATLAS.

According to the physicists, an official announcement of the Higgs Boson God particle will not be made until the signal reaches 5 sigma, while until now the signal has been between 4.5 and 5 sigma, so they are actually very close. But a 5 sigma signal doesn’t mean anything sure, because it’s still weak, though chances would be higher.

François Englert, Carl Hagen, Peter Higgs and Gerald Guralnik, four of the physicists that have researched the Higgs Boson particle in 1960 attented the seminar on Wednesday.

Right now the physicists are struggling to understand this particle better as they want to learn if it behaves accordingly with Higgs’ theory. Measuring the ways this particle is produced is also crucial, considering that it could be affected by the exotic new particles.

Duchenne Muscular Dystrophy

Duchenne muscular dystrophy is the most common muscular dystrophy with onset in children, affecting 1 in 3,300 male newborns, with a prevalence of 63 cases per 1 million.

The disease is genetically transmitted, recessive, X-linked, thus the disease is transmitted to male newborns by mothers who do not develop clinical signs of disease. A third of patients do not have positive family history of disease, suggesting that the disease also occurs by spontaneous mutations. Duchenne disease and Becker phenotype affects almost exclusively males.

Duchenne Muscular Dystrophy Diagnosis

Duchenne muscular dystrophy was first described by Charles Bell in 1830, but Duchenne in 1868 is the one who established diagnostic criteria that are valid today:

• Weakness with onset in the legs;
• Hyperlordosis with wide-based gait;
• Hypertrophy of weak muscles;
• Progressive course over time;
• Reduced muscle contractility on electrical stimulation in advanced stages of the disease;
• Absence of bladder or bowel dysfunction, sensory disturbance, or febrile illness.

Paraclinical examinations:

Serum creatine phosphokinase(CPK) is dramatically increased in this disease, 50-100 times the normal amount. This value is very high from childhood, probably from birth, when the disease is not clinically apparent. Normal or slightly elevated creatine phosphokinase values do not match the diagnosis. Creatine phosphokinase may be elevated in amniotic fluid. The enzyme decreases when the muscle is atrophied.

Electrocardiogram is abnormal in 80% of patients. Most often appear arrhythmias. Dystrophic cardiomyopathy occurs by affecting the cardiac dystrophin. Echocardiography reveals small ventricles and prolonged diastolic relaxation.

DNA and immunoassay analysis of dystrophin in Duchenne muscular dystrophy, ease the diagnosis. Only one third of male patients do not present detectable deletions in DNA testing. Gene amplification by PCR (polymerase chain reaction) detects dystrophin gene deletions in two thirds of patients with Duchenne disease. PCR allows diagnosis of asymptomatic carriers and antenatal diagnosis in the eighth week of gestation. In cases where  dystrophin gene mutations or duplications are absent, muscle biopsy is required.

Duchenne Muscular Dystrophy – Genetic Analysis

Electromyography (EMG) narrows the diagnostic area, excluding diseases of neurogenic origin. EMG should be performed on more muscle, obvious changes are present especially in the proximal muscle of lumbo-pelvic belt. Usually, EMG reveals no spontaneous activity, early positive waves, moderate and high fibrillation potentials. Motor unit potentials are of short duration and variable amplitude, either normal and low. Typically occur polyphasic waves due to variability in size of muscle fibers.

Nerve conduction velocity is normal.

Muscle biopsy is characteristic for muscle diseases with excessive variations in the diameter of muscle fibers, muscle fibers are hypertrophied, central nuclei,  excessive interstitial fibrosis and necrotic muscle fibers undergoing regeneration. However muscle biopsy should be correlated with clinical data.

In Duchenne muscular dystrophy to describe these aspects of muscle biopsy:

• Necrosis and degeneration of muscular fibers with phagocytosis and small regenerating basophilic fibers;
• Cellular infiltration with lymphocytes and macrophages in the necrotic fibers;
• Variations in size of muscle fibers, atrophies alternating with hypertrophies;
• Increased number of nuclei, with a central disposition.

Duchenne Muscular Dystrophy – Muscle Biopsy

In  female carriers, muscular biopsy shows changes in 30% of cases, even if serum creatine phosphokinase is normal.

Carriers detection

A minority of female carriers are symptomatic, but for the detection of this cases other tests are needed. Serum creatine phosphokinase is increased in two thirds of female carriers. Imunoflorescent assay for dystrophin is necessary and does not establish with certainty the diagnosis of carrier. Muscle biopsy is necessary to quantify the level of dystrophin.

Duchenne Muscular Dystrophy Treatment

Family support is essential for these children. Prophylaxis of immobilization effects is required because installation of vicious contractures andcifoscoliosis   should be delayed as much as possible.  Are required lung function monitoring, forced vital capacity and use of spirometry to prevent atelectasis and pneumonia. In the terminal stages of illness may be required tracheostomy and assisted ventilation. Surgery can prolong mobilization. Also, patients with Duchenne muscular dystrophy should avoid obesity. It was observed that administration of prednisone can produce a slight delay in disease progression.

Genetic counseling is the most effective prevention. Genetic testing can determine if the mother is a carrier, in which case there is a 50% risk of having a child with Duchenne muscular dystrophy. Analysis of chorionic villi and amniotic cells allow prenatal diagnosis.

Trying to transfer myoblasts in dystrophic muscle proved to be ineffective.

Diabetes And Certain Types Of Blood Cancer

Researchers from The Miriam Hospital have discovered, after a meta-analysis, that patients with diabetes type 2 are more likely to develop hematological cancers such as leukemia, myeloma or lymphoma.

Researchers reviewed 26 previously published studies aiming the relationship between type 2 diabetes and hematological cancers . It is known that type 2 diabetes mellitus may alter the health of the patient due to cardiovascular and renal complications. Also, diabetes mellitus was connected with certain types of cancers such as pancreatic cancer and liver cancer.

The study published recently in the American Society of Hematology Blood journal, diabetic patients have a 20% higher risk of developing lymphoma, leukemia or myeloma. Scientists also discovered that there is a link between the geographical area and the risk of developing these type of cancers. Thus, the incidence of non-Hodgkin lymphoma is higher in Asia and Europe, while for leukemia, the incidence is higher in America and Asia.

Diabetes

Further studies must be conducted as researchers have not yet found a clear explanation. Lead author Jorge Castillo, MD, a hematologist / oncologist with The Miriam Hospital, noted that next studies should  focus on risk factors of diabetes and cancer, such as obesity, smoking and physical inactivity.

One explanation given by scientists would be that diabetes alters the  immune function. Also, this disease is associated with chronic inflammation. Therefore, these disorders induced by diabetes could be involved in the development of lymphomas and leukemias. Diabetes mellitus type 2 is a polygenic disease. However  the most important feature is hyperglycemia (increased blood glucose level) due on the one hand to high intake of carbohydrates and on the other hand due to insulin deficiency, a hormone secreted by the pancreas. Therefore, type 2 diabetes correlates with insulin resistance. Insulin has an important role in regulating blood sugar, as it is a hypoglycemic hormone, that promotes entry of glucose into cells. When insulin deficiency occurs, there is an increase in blood glucose. Usually, diabetes occurs in people with pre-existing insulin deficiency. The 3 typical symptoms of diabetes are polyuria, polyphagia and polydipsia. Untreated, diabetes leads to vascular complications (favoring the process of atherosclerosis), renal complications and ocular complications (blindness). It should be noted that diabetes is a chronic condition, uncurable by modern medicine  and that these complications occur after many years of disease evolution. As it is a disease mostly connected with lifestyle, diabetes can be prevented. “So by preventing the onset of type 2 diabetes, we could also prevent blood cancer.”, said Dr. Castillo.

New Multiple Myeloma Treatment Scheme

Researchers at the University of Chicago Medical Center have found that triple therapy, carfilzomib-lenalidomide-dexamethasone  can double the survival rates of patients with multiple myeloma. Researchers said such patients had a durable response compared with those treated with standard therapy.

Multiple myeloma is a cancer of blood cells, specifically white blood cells. Multiple myeloma is one of the most common hematological cancers, and the average survival ranges between 3 and 4 years from diagnosis for patients treated with conventional therapy. Multiple myeloma affects men more than women and the age at which it commonly occurs is 65-70 years. Recently it was found that multiple myeloma appears to affect increasingly younger ages. There are four specific paraclinical features of multiple myeloma:  high serum calcium levels, kidney failure, anemia and pathological bone fractures. These symptoms appear as a result of accumulation in the bone marrow of abnormal blood cells that interfere with normal production of blood cells.

Therapy consists of chemotherapy, stem cell transplantation and radiotherapy. Steroid durugs are also used, immunomodulatory drugs, proteasome inhibitors, etc. Radiation therapy is used for pain relief caused by the bone lesions, but it can also kill cancerous cells. Standard treatment includes bortezomib, a proteasome inhibitor, thalidomide, lenalidomide. As far as chemotherapeutic drugs are concerned, most commonly used are melphalan, cyclophosphamide, vincristine and doxorubicin. Stem cell transplantation is used to replace damaged bone marrow cells due to chemotherapy.

Multiple Myeloma

Recently, a team of researchers led by Andrzej J. Jakubowiak, MD, Ph.D., professor of medicine and director of the Multiple Myeloma Program at the University of Chicago Medical Center, found that multiple myeloma patients respond better to  carfilzomib – lenalidomide and low-dose dexamethasone combination. Carfilzomib is second generation proteasome inhibitor (it binds irreversibly to chymotrypsin-like activity of the 20S proteasome).

The study results were presented at the American Society of Clinical Oncology’s Annual Meeting in Chicago, IL, USA, included 53 patients recently diagnosed with multiple myeloma. Patients followed the treatment with all three drugs during the study and doses of carfilzomib were doubled. Of the 53  initially enrolled , only 36 patients remained. After at least eight 28-day cycles of treatment, 61% had a complete response. Regarding stagnation of disease, more than 90% of patients had no progression of disease. Dr. Jakubowiak, who led the team of researchers, noted that the patients response was faster and more durable than previous therapies. He added that patient tolerance was better because there were fewer cases of peripheral neuropathy.

Statins

A meta analysis published online in The Lancet confirms the beneficial role of statins in the prevention of vascular disease. Research has shown that statins may be beneficial even in patients without any history of vascular disease. This demonstrates again that the benefits of these drugs far outweigh their adverse effects.

Statins are drugs that reduce cholesterol by inhibiting HMG-CoA reductase, an enzyme with a role in the production of cholesterol in the liver. So far statins were recommended as secondary prevention in patients treated with other cardiovascular protective drugs (betablockers, etc.). Moreover, studies have shown that statins reduce mortality and morbidity in patients with cardiovascular disease. But use of these drugs as primary prevention has been so far controversial.

Statins

Researchers have conducted a survey in which they enrolled 175,000 individuals in 27 randomized trials. Scientists then observed the effect in patients treated with statins and those without statins. Results showed that for every 1 mmol / L reduction in LDL cholesterol, the risk of a cardiovascular event decreased by 21% in individuals with 5-year risk of major vascular events. This new finding will involve changing the current treatment guidelines for patients with cardiovascular disease risk.

Like any drug, statins have different side effects. These include rhabdomyolysis (breakdown of skeletal muscle), myalgia, hyperglycemia, cancer, neuropathy, increased levels of liver enzymes, etc.. The authors noted that administration of statins was not associated with risk of death from cancer or non-vascular causes. The conclusion was that although statins increase the risk of  hemorrhagic stroke and diabetes side effects do not outweigh the benefits.

The mechanism of action of statins is to block an enzyme involved in cholesterol production in the liver, ie the HMG-CoA reductase. There was some controversy regarding the administration method of statins, since cholesterol production takes place during the night. Therefore, since statins have a short half-life, it is recommended to administer them before sleeping to have maximum effect. However, it seems that this only applies for simvastatin. There is no difference in terms of administration for atorvastatin for example.

The major role of statins is to combat atherosclerosis, the leading cause of cardiovascular disease. Studies have shown that statins prolong the lives of patients through several mechanisms, such as improved endothelial function, modulation of inflammatory responses, maintain plaque stability and prevent thrombus formation. Moreover, it appears that statins have a beneficial role in other situations, such as lung cancer, prostate cancer, cataracts, dementia. Studies regarding the beneficial role of statins in these diseases are undergoing.