Early Warnings = Less Dementia Meds

(American Health Newswire) -- As loved ones with dementia disappear into symptoms of aggression, agitation or delusions, families are left with few good medical solutions.

But a new study led by University of Michigan and VA Ann Arbor Healthcare System researchers shows the use of second-generation medications began to decline significantly in 2003, years ahead of a "black box" warning from the Food and Drug Administration in 2005 - the strongest type of warning issued by the FDA.

Prescriptions of the second-generation medications dropped off more steeply after the black box warning, which shows that it too had an impact, says Kales, the study's lead author.

"If you look at the history of black box warnings, sometimes they have an effect and sometimes they do not," Helen C. Kales, M.D., associate professor of psychiatry at the University of Michigan Medical School and researcher at the VA Ann Arbor Healthcare System was quoted as saying.  "When the warning was issued about children taking antidepressants, we saw a big drop in use, but in other cases there wasn't much change. In this case, providers appeared to be responsive."

While the number of dementia cases among VA patients 65 and older more than tripled from 30,000 in 1999 to 100,000 in 2007 as World War II and Korean War veterans aged, the study found the use of second-generation antipsychotic medications declined. Prescriptions fell from about 18 percent of patients to 12 percent.

Despite the drugs' increased risks and sometimes limited efficacy, doctors and desperate families find themselves with few good alternatives, Kales notes.

"The take-home message is that families need to take a measured approach and have a conversation with their doctor about the potential benefits and risks," she was quoted as saying.  "The behaviors associated with dementia can put a huge burden on families and unfortunately, there's no magic bullet."

SOURCE: Archives of General Psychiatry, February

Brain Tumor Vaccine

LOS ANGELES (American Health Newswire) -- Each year, 22,000 Americans are diagnosed with brain cancer. Glioblastomas are the most deadly types of brain tumors. Even with current treatments like chemo and radiation, most patients live less than two years. Now, a new vaccine is giving some the gift of time.

Michael Wulfe shouldn't even be alive -- much less running six miles uphill.

"Every time I do get to the top, I stop for just a second, and in my head, say a very short prayer that I am here on top of the hill, feeling like a normal, perfect, healthy person," Michael Wulfe, brain tumor survivor told American Health. Wulfe was diagnosed with a deadly brain tumor -- called glioblastoma -- nearly four years ago. Most patients only live 14 months doctors believe Wulfe is still alive thanks to an experimental vaccine that targets this difficult to treat cancer. 

"I think it's probably the most devastating cancer I know of," Keith L. Black, M.D., Chairman of the Department of Neurosurgery at Cedars-Sinai Medical Center in Los Angeles said.

With glioblastomas, surgeons can remove 99-percent of the tumor. The problem is what you can't see. Tiny, microscopic cells that are left behind multiply and resist treatments. Those cells are like roots of a weed -- the weed keeps growing if there's still a root.

"So, if that cell is left behind, then tumors can always grow from them," John S. Yu, M.D., Director of the Brain Tumor Center of Excellence at Cedars-Sinai Medical Center in Los Angeles said.

The vaccine targets the root. Doctors draw a patient's blood and isolate something called dendritic cells. They then place special proteins on those cells, and inject them back into the patient. The now "smart" cells ignite the immune system and tell it to attack the "bad" tumor cells.

"So, instead of going after the entire army, we're going after the general or the emperor," Dr. Yu said.

Three vaccines are given two weeks apart. In a phase one study, the survival of patients jumped from 26 percent to 80 percent.

Wulfe was one of the lucky ones. He's still cancer-free and enjoying the freedom of the outdoors.

 "You clear your head of everything. I'm a normal person, huffing to get air into lung and make it up the hill." Wulfe stated.

A man who continues to defy the odds with every hill he climbs.

Doctors say the vaccine has fewer side effects than traditional therapies because it activates the immune system and doesn't destroy it like chemotherapy.  More Information

Artificial Kidney: Medicine's Next Big Thing?

SAN FRANCISCO (American Health  Newswire) -- Half a million Americans suffer from chronic kidney failure each year, and that number keeps going up. The best available treatment is a transplant, but many have to wait years to get one if they get one at all. Now, an artificial kidney may be medicine's next big thing.  

It's a routine that's getting old for David Anderson. Sitting in this chair for hours on end is not how he'd prefer to spend his days.

"It's about five hours a day of coming and going, really, three times a week, " David Anderson, kidney failure patient, told American Health..

Anderson suffers from kidney failure and needs dialysis to survive. It's a process that cleans out blood but takes its toll on patients.

"It's uncomfortable to sit here for such a long time," Anderson said.

The therapy only replaces about 10 percent of kidney function. After five years, just 35 percent of patients are still alive.

"It's actually really sad. I have a lot of patients. I think all nephrologists have a lot of patients that die regularly," Lynda Frassetto, M.D., Nephrologist, Professor of Medicine at UCSF in San Francisco.

A kidney transplant is a better option. The problem? Last year, only 17 thousand of the 85 thousand patients on the waiting list received an organ.

But the artificial kidney could soon be a solution. Researchers at UC San Francisco hope to implant the device right in the body.

Thousands of microscopic filters mimic the filtering role of a real kidney. One side filters out toxins while the other re-absorbs salt and water and emits waste. The body's own blood pressure performs the filtration without the need for a power supply. 

"Because it's implanted and provides many of the same benefits of a transplant, the patient quality of life, the patient health, will be improved," Shuvo Roy, Ph.D.,

Bioengineer at the Department of Bioengineering and Therapeutic Sciences at UCSF in San Francisco said. 

The surgery will cost the same as a kidney transplant, but this device is designed to completely eliminate the 75 thousand per year spent on dialysis for each patient. A room-sized model of the artificial kidney has been used for over a decade. Now, engineers are trying to fit that into a device the size of a coffee cup. 

"I'd sign up now if I could," Anderson said.

Until then he'll wait, hoping medicine will soon get him out of this chair and onto more exciting adventures.

Another benefit is patients wouldn't need to take the immune-suppressant drugs like they do with a transplant. Researchers hope the artificial kidney will be in clinical trials in the next five years