Doctor accused in drug case accepts plea
A California-based doctor accused of offering Major League Baseball players with performance-enhancing drugs has pleaded guilty to the accusations.
Ramon Scruggs, the doctor, made the confession after being accused of illegally writing prescriptions to patients.
The plea agreement came from federal prosecutors at the United States District Court in San Jose.
From NYTimes.com:
The New York Times reported in April that the players Troy Glaus and Todd Greene testified before a federal grand jury investigating Scruggs that their agents — Mike Nicotera and Gene Casaleggio — referred them to Scruggs.
Two other players, Scott Schoeneweis and Ismael Valdez, said that Scruggs provided them with steroids.
In an interview with The Times in April, Scruggs said that he provided patients with substances because they pressured him.
Scruggs was accused of distributing steroids and human growth hormone to people who did not had legal medical reasons for using the substances.
Worm hormone discovery may assist fight against parasitic disease
Nematodes, hormone-like molecules in tiny worms, work on the same line as certain human hormones - a finding that may one day prove to be useful to eliminate worm infections that tend to affect a third of the world population.
Researchers from the UT Southwestern discovered a molecule, which can be termed responsible to activate the genes involved in developing and reproducing Caenorhabditis elegans, a common research worm.
From UTSouthwestern.edu:
The experiments by Dr. Mangelsdorf’s team are related to how hormone-replacement therapy works in humans. For example, in patients with Addison’s disease, the adrenal glands do not produce enough of the steroids cortisol and aldosterone; in some cases, these glands produce none at all. Replacing the missing hormones through replacement therapy can relieve the symptoms of the disease, much as providing the missing ligand to the worms restored their normality.
“The conservation of this pathway is remarkable,” said Dr. Mangelsdorf, an investigator in UT Southwestern’s Howard Hughes Medical Institute (HHMI). “This line of investigation has been much sought-after in terms of how the DAF-12 protein works and whether it had a hormonal regulator. Mother Nature has used this system from the very simplest nematode worms up to humans, not only employing the same types of proteins to do the job, but also the same types of hormones.”
The dauer diapause occurs naturally in C. elegans when the worm senses from its environment that conditions are not favorable for maturing, such as when food is scarce. Dr. Mangelsdorf said cholesterol and other signals derived from the worm’s food source are required to launch the series of biochemical events leading to the production of the hormonal ligand and continued development. Without these environmental signals and the ligand to activate DAF-12, the worm’s life remains suspended.
The research was funded by HHMI, the Welch Foundation, the National Institutes of Health, the Jay and Betty Van Andel Foundation, the Department of Defense and the Glenn/AFAR Breakthroughs in Gerontology.
Blood test can simplify GVHD cure
The first biomarker of graft-versus-host disease (GVHD) of the skin for allowing a simple blood test to solve a treatment dilemma has been identified by researchers at the University of Michigan.
This biomarker will help doctors to treat patients who usually develop rashes after bone marrow transplantation.
From Sciencedaily.com:
Rashes are very common in patients after bone marrow transplants. They may signal the onset of acute GVHD. But until now, a skin biopsy was the only reliable way for doctors to determine whether the rash is caused by antibiotics commonly used to treat bone marrow transplant patients, or is instead GVHD of the skin, where the disease appears in about half of cases.
Because a firm diagnosis is not easy and the threat of GVHD is grave, many doctors who suspect a rash is due to GVHD prescribe systemic high-dose steroids to suppress GVHD, which further weaken a patient’s already compromised immune system.
James Ferrara, M.D., Ruth Heyn Endowed Professor of Pediatrics and Communicable Diseases and director of the bone marrow transplant program at U-M and senior author of the study, remarked that the test would be soon made available to the clinicians.
Effects of steroid use under the scanner
Steroids have always been linked with the world of professional sports but recent studies examining the effects of steroid use have highlighted that such use is not limited to professional sports alone and also extends to school sports.
It was estimated by the National Institute on Drug Abuse (NIDA) that more than half million eighth- and tenth-grade students have already used steroids. Moreover, 60 percent of them have the mindset that steroids are not dangerous.
As part of a community outreach effort, Penn State Worthington Scranton would be hosting a special presentation, “The Effects of Steroid Use” by Dr. P. Christopher Metzger on Wednesday, March 3, 2010 at 7 p.m. in The View cafeteria in the campus’ Study Learning Center.
From Timesleader.com:
According to some reports, students as young as those in junior high school have used steroids. The National Institute on Drug Abuse (NIDA) has estimated that more than a half million eighth- and tenth-grade students have used these drugs, and the mindset among high school seniors shows that almost 60 percent of them don’t think of these drugs as dangerous.
As a community outreach effort, Penn State Worthington Scranton will host a special presentation, “The Effects of Steroid Use” by Dr. P. Christopher Metzger on Wednesday, March 3 at 7 p.m. in The View cafeteria in the campus’ Study Learning Center.
Dr. Metzger is the author of many published medical articles and had been a guest lecturer at local universities.
Asthma symptoms can be effectively managed with corticosteroids
Efficacy of inhaled corticosteroids is better than that of cromolyn for managing symptoms of asthma, according to a review of recent studies comparing the two treatments.
Patients suffering from asthma and treated with inhaled corticosteroids tend to make less use of life-saving inhalers and displayed improved breathing signs than their counterparts treated with cromolyn.
From News-Medical.Net:
Adult asthma patients using inhaled steroids such as the brand names Beclovent, Pulmicort and Flovent had on average three fewer severe asthma flare-ups each year compared to patients using inhaled cromolyn, sold under the brand name Intal.
Patients taking the steroids also scored significantly higher on tests of lung function and used their “rescue” inhalers less often than those taking cromolyn, say James Guevara, M.D., of the University of Pennsylvania School of Medicine and colleagues.
The findings were similar for children, Guevara and colleagues add, saying that their review supports recent consensus in the medical community that favors inhaled corticosteroids as a first-choice treatment for asthma.
“To our knowledge, this is the first systematic review comparing the effects of cromolyn to the gold standard, inhaled steroids,” Guevara said.
It was remarked by William Storms, M.D., an allergist at the University of Colorado Health Sciences Center and director of the William Storms Allergy Clinic in Colorado Springs that the results do not suggest that there is no scope for cromolyn treatment, a fact that was supported by NIH asthma guideline advocating for cromolyn and other drugs as alternative therapies.
Sport doping may now be prevented
A new technique for identifying doping and sport cheaters has been developed by scientists from Imperial College London and the University of Nottingham.
The finding was revealed in a research published in the journal Rapid Communications in Mass Spectrometry.
From News-Medical.Net:
The new approach, developed by scientists from Imperial College London and the University of Nottingham, allows easy analysis of the carbon ratio. It uses a catalytic reaction to strip steroids of their more aggressive parts whilst leaving the carbon ’skeleton’ intact. This technique, called hydropyrolysis, is commonly used to aid oil exploration by freeing small fragments of organic matter from petroleum rock sources.
Dr Mark Sephton, from Imperial’s Department of Earth Science and Engineering and lead author of the research, explained: “The type of carbon in the body’s molecules reflects the carbon ingested as part of an athlete’s diet, and if you can work out the carbon ratio in the molecules you can determine the source of the carbon.
“Drug cheats should beware. The carbon-based secrets of steroids are now apparent to the analyst. Thanks to our technique, in the future it will be much more difficult to escape detection when using performance-enhancing steroids“, he added.
This technique is expected to have the potential of examining the presence of naturally occurring and synthetically manufactured steroids in the human body.
Allergic reaction symptoms from Clopidogrel use may be effectively treated with steroids and antihistamines
According to a study of cardiac patients who have suffered allergic reactions to clopidogrel, also known as Plavix, a combination therapy involving steroids and antihistamines may prove to be a highly effective treatment option to alleviate allergic reaction symptoms.
The study findings were presented at the American College of Cardiology’s Annual Scientific Session by Primary investigator Michael P. Savage, M.D., director, Cardiac Catheterization Laboratory at Thomas Jefferson University Hospital and Kimberly L. Campbell, M.D.
From News-Medical.Net:
“This is a very important study for many cardiac patients but especially those with stents,” said Savage. “Every patient who receives a stent must take Plavix to help prevent stent thrombosis which is clotting of the stent. This obviously poses major problems if the patient suffers an allergic reaction to the medication. To discontinue taking the drug can lead to a heart attack which may be fatal. Those with a drug eluting stent are required to be on the drug for at least one year. Our patients with drug eluting stents actually averaged 17 months on Plavix versus the minimum of one year. That’s a very long time to not be on a medication that may save your life.”
Plavix is one of the most prescribed drugs world-wide. Data from 2007 shows Plavix is the fourth most sold drug in the United States with almost four billion dollars in sales, according to IMS Health, a leading pharmaceutical industry monitoring company. It is estimated that about six percent of those taking the drug showed some signs of an allergic reaction.
John R. Cohn, M.D., chief of Adult Allergy at Thomas Jefferson University and Hospitals and a key contributor to the study noted, “Previously, when patients had an allergic reaction to Plavix we would give an alternative drug but they can have their own side effects. Rather than giving the secondary drug we concentrated on suppressing the patient’s allergic symptoms they were having to Plavix by administering low doses of steroids and antihistamines while continuing the drug. What we found was that most of our patients became tolerant to Plavix, essentially becoming ‘desensitized’ to the drug enabling them to continue treatment. Once this occurred we were able to discontinue the steroids and even the antihistamines.”
Doctors from the Thomas Jefferson University Hospital said that patients suffering from allergic symptoms can continue to remain on the drug after being treated with a combination of steroids and antihistamines.
Hormone may prove effective for inhibiting joint injuries from resulting in osteoarthritis
An existing osteoporosis drug has been found effective for inhibiting cartilage loss from osteoarthritis post joint injury besides being effective in regeneration of a part of lost cartilage that happened because of osteoarthritis.
The finding was presented on September 12, 2009 at the annual meeting of the American Society for Bone and Mineral Research in Denver.
From Sciencedaily.com:
Cartilage can become damaged by many kinds of injury and by mechanical stresses that come with age. Over time, damaged cartilage deteriorates to cause osteoarthritis (OA), with its attendant joint inflammation and pain. Currently available drugs like steroids or non-steroidal anti-inflammatory agents (e.g. Advil, Aleve) reduce pain but do not address the loss of cartilage behind the osteoarthritis, which is projected to afflict more than 50 million Americans by 2020.
Cartilage forms the sponge-like, shock-absorbing layers that keep the impact of running and jumping and lifting from grinding bones against each other in joints. The cell type at the heart of osteoarthritis is the chondrocyte, the cartilage-producing cell responsible for maintaining the integrity of joint cartilage.
It was remarked by Randy Rosier, M.D., Ph.D., professor within the Department of Orthopedics and Rehabilitation at the University of Rochester Medical Center, that physicians are currently left with no option for restoring cartilage in their patients who have lost it because of osteoarthritis. The results of this study suggested that cartilage degeneration can be prevented and the volume of cartilage in diseased joints be improved, at least in mice.
Monitoring of nitric oxide of no use
There are no significant improvements in context of calibrating medications based on daily monitoring of the fractional exhaled nitric oxide (FENO) and symptoms in asthmatic children over medicating based on daily symptom monitoring alone, as per a multi-center prospective study.
The results appeared in an issue of the American Journal of Respiratory and Critical Care Medicine, which is a publication of the American Thoracic Society.
From News-Medical.Net:
Still, in light of these findings, it is clear that FENO monitoring should only be applied to those who stand to gain the most. “There can be no doubt that adding frequent assessments of FENO to management plans of most children and adults with asthma will add unjustifiable costs without providing clinical benefit. Whether there is a role for monitoring FENO to aid management of severe asthma is untested,” wrote Stephen Stick, Ph.D., of the Princess Margaret Hospital for Children in Perth, Australia and Peter Franklin, Ph.D., of the Centre for Asthma, Allergy and Respiratory Research at the University of Western Australia in Perth in an editorial that accompanied the article.
“We did not address other possible applications of frequent FENO monitoring, such as prediction of steroid effect. Loss of control, prediction and prevention of exacerbations, and tapering of steroids in symptom-free children who wheezed in the past,” noted Dr. de Jongste. “We think there is good reason to study these potential applications.”
Furthermore, as D. Robin Taylor, M.D., of the Dunedin School of Medicine at the University of Otago, in New Zealand, pointed out in separate editorial, “FENO measurements shed complementary light on the underlying inflammatory phenotype and, more importantly, on the potential response to anti-inflammatory treatment. Historically, this has been assessed either by empiric “trials of steroid” or, even more imperfectly. With reference to before/after changes in spirometry, serial or repeated FENO measurements in individual patients may provide additional diagnostic as well as prognostic insights.”
This randomized study involved 151 children from 15 academic centers and hospitals with mild to moderate asthma to a 30-week monitoring course and was led by Johan C. de Jongste, M.D., Ph.D., at the Erasmus University Medical Center-Sophia Children’s Hospital in the Netherlands, and colleagues.
Asthma attacks among preschoolers can be reduced with inhaled corticosteroids
The largest study of its kind on preschoolers has highlighted the fact that high dosages of inhaled corticosteroids can be used as preventive treatment for reducing the severity and time duration of asthma attacks, which are triggered by colds.
The study was published in the New England Journal of Medicine and led by Dr. Francine Ducharme, assistant director of clinical research at the Sainte-Justine Hospital Research Center and a pediatrics professor at the Université de Montréal.
From News-Medical.Net:
The breakthrough is all the more important, since this age group represents more than half (60 percent) of children that go to emergency departments or are admitted to hospital for asthma attacks. Although viral-induced asthma is frequent in preschool-aged children, optimal management of this disease remains elusive. That’s why Dr. Ducharme has focused her research on improving treatment for asthmatic children, particularly those of preschool age.
The basic treatment for asthma, which consists of administering weak doses of inhaled steroids such as fluticasone on a daily basis, has not proven to be effective in children with viral-induced asthma. For the purposes of the study, 2243 children were screened. Some 17 percent met the criteria for having asthma that was triggered solely by colds, no signs of allergy and had not experienced moderate to severe asthma attacks or symptoms between colds.
The new therapeutic approach was tested in 129 children aged 12 months to six years. By increasing the usual pediatric dose six-fold over a maximum of 10 days and beginning administration as soon as colds started, the team noted a 50 percent decrease in asthma attacks that required oral steroids in children.
It was found by the research team that high doses of corticosteroids (fluticasone), when administered in an inhaled form up to ten days at the onset of a cold can considerably reduce the numbers of moderate or severe asthma attacks that require emergency oral steroids.