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New in Physiology (page 58 of 63)
Many patients with moderate to severe chronic psoriasis showed significant improvement after treatment with Humira (adalimumab), according to a study presented at the recent annual meeting of the American Academy of Dermatology in Washington, D.C.
The REVEAL (Randomized Controlled EValuation of Adalimumab Every Other Week Dosing in Moderate to Severe Psoriasis TriAL) included 1,200 patients. After 16 weeks, 71 percent of the patients who took the drug showed a 75 percent improvement in skin clearance, compared to 6.5 percent of patients who received a placebo.
The study also found that patients who took the drug continuously were much less likely to experience a worsening of their psoriasis symptoms.
Upper respiratory tract infection, headache and nasopharyngitis were the most common side effects reported by patients in the study.
The REVEAL results will be submitted by drug maker Abbott in its applications to have Humira approved for treatment of psoriasis in the United States and Europe.
Psoriasis is an autoimmune disease that causes raised, inflamed, scaly, red skin lesions that can crack and bleed. There is no cure for psoriasis, which affects about 125 million people worldwide. Of those, about 25 percent have moderate to severe psoriasis. The disease can occur at any age but typically appears between the ages of 15 and 35.
HealthDay News, February 13, 2007
Human skin is crawling with bacteria, say U.S. researchers who identified more than 200 species -- 8 percent of which were previously unknown -- on samples collected from the forearms of six people.
The New York Medical School team used genetic analysis to detect the types of bacteria present on the volunteers' skin, BBC News reported.
An initial analysis detected 182 species of bacteria. Another test was conducted eight to 10 months later to see if there had been any changes. That second analysis revealed 65 more kinds of bacteria.
About half the species were already known to be common skin dwellers, but 8 percent had not been previously described in scientific literature. The researchers also found that about 75 percent of the bacteria species were unique to individuals, which suggests the skin is "highly diversified," BBC News reported.
The findings were published online in the journal Proceedings of the National Academy of Sciences.
"Over the years maybe about 50 different organisms have been found in human skin but we knew there were more organisms present" that couldn't be detected, study leader Martin Blaser, professor of microbiology, said in a prepared statement.
"We have now gone up five-fold from what's been known before," he said.
Experts say that bacteria plays an important role in keeping skin healthy, BBC News reported.
HealthDay News, February 6, 2007
Women are three times more likely than men to die of genital nonmelanoma skin cancer, new U.S. research shows.
Genital nonmelanoma skin cancer can be caused by sexually transmitted human papillomavirus (HPV), which is also associated with cervical cancer.
In this study, researchers found that almost 30,000 people -- 22,000 women and 8,000 men -- died of genital nonmelanoma skin cancers in the United States from 1969 to 2000.
The older a person is, the greater their risk of genital nonmelanoma skin cancer (NMSC). The findings were scheduled for presentation Sunday at the annual meeting of the American Academy of Dermatology, in Washington, D.C.
"As dermatologists, we expect to see skin cancers induced by ultraviolet light, because sunlight is one of the primary risk factors for the disease," researcher Dr. Martin A. Weinstock, professor of dermatology and community health at Brown University in Providence, R.I., said in a prepared statement.
"But some of the most dangerous types of skin cancers are those that are not sun-induced, such as skin cancers that occur on genital skin -- a place that is not exposed to intense sun and is not routinely examined by dermatologists. That's why there needs to be an increased awareness of this issue, so patients and physicians can be better prepared to detect these cancers early before they become fatal," said Weinstock, who is also chief dermatologist at Veterans Affairs Medical Center in Providence.
Because they're not always readily visible and may not cause any noticeable symptoms, genital skin cancers can be difficult to diagnose.
"The number of deaths attributed to genital NMSCs was higher than expected, and we believe HPV was a major cause of these cancers," Weinstock said.
"The availability of the new HPV vaccine offers the potential for a substantial reduction in the development of these skin cancers for future generations," he noted.
In addition, since "HPV is a sexually transmitted disease, both men and women can practice preventive measures that could lead to a decline in mortality rates from genital NMSCs and heed the warning signs of the disease, including new growths or sores that don't heal, to detect it early."
HealthDay News, Monday, February 5, 2007
Psoriasis Cure Now, a nonprofit patient advocacy group, today reported that biotech and pharmaceutical companies are investigating a record 70 potential new treatments for psoriasis and psoriatic arthritis. The data, culled from published reports and clinical trial recruitment Web sites, shows continued, strong business interest in the psoriasis market. A New York Times article last week called into question the profitability of the psoriasis sector, lighting up psoriasis message boards with concerns that the psoriasis drug pipeline could dry up. The full (and free) report of psoriasis treatments under clinical development is available on the Psoriasis Cure Now Web site: www.psoriasis-cure-now.org/hope.php.
The U.S. Food and Drug Administration has ruled that the oral contraceptive YAZ can also be used by women to control moderate acne, the Associated Press reported..
The decision means that YAZ, made by Bayer Schering Pharma AG, is the first oral contraceptive to be approved by the FDA for three distinct uses, the drug maker said in a statement released Monday.
Along with birth control and acne treatment, YAZ is also approved in the United States to treat the physical and emotional symptoms of premenstrual dysphoric disorder, the AP reported.
HealthDay News, January 30, 2007
It's a puzzle to scientists, but a new study suggests that the main cause of deadly skin cancer -- sunlight -- might also help protect against the disease.
The key could lie in the amount of ultraviolet B (UVB) light the skin absorbs -- enough to stimulate a healthy, vitamin D-linked immune response in the skin but not so much that it boosts skin cancer risk.
"I do think that a little bit of sunlight is good for people, but I think that one of the problems that the American Cancer Society and dermatologists have is, how do you define what a little bit is?" said skin cancer researcher Marianne Berwick, chief of epidemiology at the University of New Mexico's Cancer Research and Treatment Center. "How do you tell people that it's OK to have a little bit of sunlight but not too much?"
In 2005, Berwick's team published a controversial study that found that melanoma patients with higher levels of daily sun exposure actually had better survival than patients who spent less time in the sun.
"I've been searching for an explanation for that ever since," she said.
Now, findings from a group led by immunologists at Stanford University may provide an answer. The study, led by professor of pathology Eugene Butcher, is expected to be published in the March issue of Nature Immunology.
In its study, the Stanford team worked with cells in the lab and discovered a biochemical chain of events that appears to link sunlight exposure to the skin's own immune defenses.
The researchers started from the notion that an inactive precursor of vitamin D, called vitamin D3, "is generated in the skin in response to sun exposure." That's been known for years. Specifically, a short-wavelength form of UV light, called UVB, is responsible for D3 generation.
D3 is inert and powerless, however. Through contact with various enzymes in the liver and kidneys, the body turns D3 into an active compound called 1,25(OH)2D3.
And that's where the immune-system connection kicks in, the Stanford authors said.
In their experiments, they found that the new compound "signaled (immune) T-cells," pushing them to migrate back to specific sites in the skin's epidermis. Once there, these powerful immune system agents stand on guard against infection and even cancer, the researchers said.
"So, the same wavelengths of sunlight that are most potent in inducing skin cancer -- UVB -- are also the wavelengths that produce this vitamin D precursor, D3," said Dr. Martin Weinstock, chairman of the skin cancer advisory group at the American Cancer Society. And it's D3 that starts the whole chain of events rolling.
Weinstock stressed that the Stanford study is far from conclusive, however, and should not be seen as an excuse to bake in the sun.
"We know that the sun is the major avoidable cause of skin cancer," he said. "This study is interesting and points to a productive area of research, both to confirm this in other settings and to flush out the implications of the finding. But does it really relate to skin cancers in real live people? We don't know."
"So, avoiding intense sun, protecting yourself when you're out in intense sun -- that's still our [cancer society] recommendation, and this is not going to change that," said Weinstock, who is also professor of dermatology and community health at Brown University.
Kathleen Egan, a professor of epidemiology at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Fla., agreed that the study findings are "tantalizing" but need further study.
Especially since the release of Berwick's melanoma study, "there's been an awful lot of questions about how -- or if -- vitamin D has a part to play in potentially offering some [cancer] protection under some circumstances," she said. "But it's very difficult to tease out, because the main human source of vitamin D is, in fact, sunlight exposure, which is also the most important risk factor for melanoma."
Nutritionists have known for decades that sunlight stimulates vitamin D production in the skin. In fact, this natural process is the body's major source of the nutrient. A proper amount of vitamin D is crucial to bone health, "and there's also a bunch of evidence that vitamin D may have a role in preventing colon cancer, although there's still some controversy about that," Weinstock said.
So, how much sunlight is enough to get the ideal amount of vitamin D?
Katharine Tallmadge, a Washington, D.C., dietitian and a spokeswoman for the American Dietetic Association, suggests that most people can probably get the U.S. Department of Agriculture's recommended 400 daily IUs of vitamin D by spending a half-hour to an hour outside per day.
Egan agreed. She said it's not difficult for people to soak up the sun's goodness without boosting their cancer risk. In response to even a moderate amount of sunlight, "the skin actually creates an amazing amount of vitamin D," Egan said. "It doesn't take much exposure to make enough of the vitamin D that's certainly needed to preserve bone health, for example."
By E. J. Mundell, HealthDay News, January 29, 2007
Two are better than one when it comes to performing a skin exam for melanoma and spotting it at the earliest, most treatable stage, a new study shows.
Men and women at high risk of developing melanoma who underwent skin self exam training with their live-in partner were more likely to perform the exams than those who trained solo, Dr. June K. Robinson of Northwestern University Feinberg School of Medicine in Chicago and colleagues found.
People trained to perform a skin self exam also seek treatment at an earlier stage of melanoma and are less likely to die from it, Robinson and her team note in the Archives of Dermatology. They hypothesized that training couples in skin self exams would be even more effective than training individuals because couples may encourage each other to do the exams and help each other another to perform them.
To investigate, Robinson's group randomly assigned 130 people to undergo a 10-minute training on skin self exams alone or with their live-in partner.
Four months after the training, 45 of the 65 people who underwent solo training had not examined their skin, compared with 23 of the 65 who trained with their partner. Of the paired learners, 19 checked their skin at least once and 13 checked it several times, compared with 9 and 4 of the solo learners, respectively.
The men and women who learned in pairs also were more likely to perceive the exams as important and to feel confident in their ability to perform the exams, the researchers found.
The study "affirms the role of partners in health care and extends it to promoting health behaviors," the researchers conclude.
Reuters Health, January 16, 2007
Older Americans taking shots of human growth hormone in an effort to turn back the clock will likely be disappointed.
As an anti-aging treatment, the hormones appear to offer few benefits but significant health risks, a review of the research finds.
Stanford University researchers came to this conclusion after analyzing 31 studies that included a total of more than 500 relatively healthy elderly people.
The only clearly positive effect found from taking the hormones was a slight improvement in lean body mass.
On the negative side, participants who took human growth hormones were significantly more likely to develop joint swelling and pain, and carpal tunnel syndrome.
There was also a suggestion of an increased risk of diabetes and prediabetes, but that association did not reach statistical significance.
Authors of the review say better studies are needed to understand the risks and benefits of human growth hormone as an anti-aging treatment.
But they say studies do not support the use of human growth hormones for this reason.
"If the benefits truly are minimal, and the risks are not, this is not a therapy that should be used for anti-aging purposes," Hau Liu, MD, MBA, MPH tells WebMD.
Use Growing Among Elderly
Growth hormone is naturally produced in the pituitary gland at the base of the brain, but its levels decline with age.
Promoters of synthetic growth hormone as an anti-aging treatment claim the hormones can do everything from firm sagging skin to boost a sagging libido.
According to government figures, between 25,000 and 30,000 Americans used growth hormones for aging purposes in 2004. That is a tenfold increase in about a decade, Thomas T. Perls, MD, tells WebMD.
"The cost of this treatment can be $12,000 a year or more, but even if you take the cost out of the equation, there is still a huge potential for causing harm," Perls says. "The people promoting this stuff have absolutely no idea what the long-term health effects are."
Because human growth hormone has not been approved for use as an anti-aging treatment by federal regulators, Perls argues that doctors who prescribe it for this purpose are breaking the law.
He first made that charge in a report published in The Journal of the American Medical Association in late 2005.
Perls' report prompted Liu and colleagues to conduct their review of the research on human growth hormone as an antiaging treatment.
No Fountain of Youth
The researchers limited their review to randomized, controlled clinical trials that included relatively healthy elderly people.
The participants used growth hormone for an average of about six months.
While growth hormone did appear to increase lean muscle mass and reduce body fat by an average of just over 4 pounds, it did not appear to have an effect on other measures of fitness, including bone density, cholesterol and lipid levels.
"From our review, there's not data to suggest that growth hormone prolongs life, and none of the studies make that claim," Liu says.
Liu tells WebMD he was surprised to find so little research has been done on the use of growth hormones in the elderly population—especially since so many claims have been made about the treatment's benefits.
But he says he understands why people believe the hype.
"Elderly people today are very health conscious and they are trying to do all they can to take care of themselves," Liu says. "But our conclusion is that growth hormone does not represent a magic bullet or the fountain of youth."
By Salynn Boyles, WebMD Medical News, January 16, 2007
"SunSafe in the Middle School Years" was a middle school research project conducted to improve awareness and educate teenagers about the prevention of skin cancer and the need for sun protection. The research study has been published in the January issue of Pediatrics.
The study provided a two-year follow-up period indicating that teens who participated in the program were much better about using sun protection devices than those teens who had not participated in the program.
The "SunSafe" project involved the cooperation of schools staff, recreational sports program coaches, parents and health care professionals. According to the study results, this may be the intervention needed to improve the behaviors of teens in protecting themselves better from the harmful ultraviolet rays of the sun.
The research took place within 10 communities in Vermont and New Hampshire. Funding was provided by the National Cancer Institute and was directed by pediatrician Ardis Olsen, MD and colleagues.
According to the "Primary Care Practice Manual" produced through the project, reducing sun exposure can eliminate 90 percent of skin cancers that currently occur in 1 of 5 Americans.
The middle school years were noted as being an especially important time to be sure that teenagers are given the important information regarding the risks and precautions of sun exposure. The project establishes that the teenage years are influential as a time when children begin to establish their own health habits. The hopes to influence these habits in a healthy way can prevent many individuals from having to suffer from future skin cancer.
Some of the findings from the study include that only about 30 percent of middle school students protect themselves from the sun. Seventy percent of the children surveyed had suffered from a sunburn during the previous summer.
Statistics indicate that one or more blistering sunburn before 20 years of age doubles the risk of getting skin cancer.
Children have three times as much exposure to the sun as adults. Therefore, statistically, the majority of lifetime sun exposure occurs by the age of 18 years.
Health care providers should take part in the responsibility to discuss sun exposure with the teenagers as well as parents, teachers and coaches. However, this study found that only one-third of physicians had spoken to their patients about this subject.
Pediatricians who incorporated the "SunSafe" information message into their visits with their patients resulted in nearly a 10 percent increase of informed teenagers.
The approach of the SunSafe project was not to simply use classroom instruction, but to include poster contests, buttons and other means of promoting the sun-safety message. A medical device was also used to allow children to see skin changes that are not visible to the naked eye in normal light.
According to the researchers, public health efforts for the different approaches as used by SunSafe seem to show promise for establishing changes in adolescent behaviors in order to reduce skin cancer risks.
By Patricia Shehan, All Headline News, January 11, 2007
The U.S. Food and Drug Administration has approved a new treatment for moderate-to-severe frown lines, medically called nasolabial folds.
BioForm Medical issued a statement describing its Radiesse as a longer-lasting alternative to existing wrinkle fillers. The company said its calcium-based microsphere technology not only fills in facial folds and depressions, but also stimulates the body to produce collagen, the fibrous protein that gives the face its structure and fullness.
The drug was also newly approved to improve the appearance of people with AIDS-causing HIV who have significant facial fat loss (lipoatrophy), the San Mateo, Calif.-based company said.
Radiesse was first FDA approved in 2002 for use in facial reconstructive surgery.
HealthDay News, December 28, 2006