October 13, 2006, 4:54 AM CT

Studying Pediatric AIDS Vaccine

Scientists at Makerere University, in Kampala, Uganda, along with scientists from Johns Hopkins and other institutions worldwide, have begun the first clinical safety trial in Africa of a vaccine to prevent mother-to-child transmission of HIV through breastfeeding. Breast milk is a leading route of infection in the developing world, according to the United Nations World Health Organization, which estimates that each day 1,800 newborns are infected with the AIDS virus, 30 percent to 40 percent by virus carried in their mother's milk.

Enrollment of the first newborn took place at Mulago Hospital in Kampala. The so-called phase I study is designed to test the safety of injecting newborns with the vaccine, formally known as ALVAC-HIV (vCP1521). If the vaccine is found to be safe in this study, and if it is later shown to be effective in reducing the chance of infants' becoming infected during breastfeeding, researchers estimate that it could potentially stop up to 8,000 of Uganda's 22,000 infections a year in children. Initial results are expected by mid-2007.

"A vaccine is the easiest way to help prevent mother-to-child transmission of the disease, as healthy alternatives to breastfeeding, such as infant formula, are not available or affordable to most new mothers in the developing world, many of whom do not know they are HIV positive," says study protocol chair and pediatric infectious disease specialist Laura Guay, M.D., who will lead Hopkins' efforts.........

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October 12, 2006, 10:17 PM CT

Leading Reason For Corneal Transplants

Guided by families with an unusual number of cases, researchers at Johns Hopkins have discovered the genetic origins of at least one form of Fuchs corneal dystrophy, FCD, the leading reason for corneal transplantation in the United States.

In one form or another, FCD's trademark deterioration of the cells covering the clear, outermost lens of the eye affects more than 4 percent of the population over 40. Late in life, the dystrophy causes swelling of the cornea and can severely affect vision, making it impossible to see well even with glasses or contact lenses. It's believed that various forms of FCD are due to multiple gene mutations.

In a report in the recent issue of Investigative Ophthalmology, a team led by Hopkins ophthalmologist John Gottsch, M.D., says they were able to map a common form of Fuchs, found most often in women, to chromosome 18.

"Finding this chromosomal locus is putting us in the right neighborhood to find culprit genes," says Gottsch. "Now we have to start knocking on every door".

Gottsch is heartened by success with earlier Fuchs gene-hunting studies. The Hopkins group tracked down its first FCD-related gene in a Virginia family with multiple, early onset cases. That gene, labeled COL8A2, was mapped to chromosome 1.........

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October 12, 2006, 4:47 AM CT

Researchers Refocus Studies On Patients With HIV, Hepatitis

"People are living longer with HIV now, but then we see people developing complications from liver disease due to hepatitis," says Dr. Mamta Jain, assistant professor of internal medicine at UT Southwestern Medical Center. "Before we had effective HIV therapy, there was no interest in treating hepatitis C because the thought was the patient would die of AIDS. Well, they're not dying of AIDS, so we are making an effort to try to treat more patients for hepatitis C".

Other diseases, such as cirrhosis or hepatocellular cancers, progress faster in co-infected HIV and hepatitis patients. As a result, health-care providers are trying to intervene as early as possible, said Dr. Jain, who specializes in infectious diseases.

Dr. Jain oversees a co-infection clinic at Parkland Memorial Hospital where patients are evaluated for hepatitis and HIV and can participate in clinical trials. Generally, co-infection rates range from 10 percent to 33 percent of HIV patients. Rates run at about 25 percent at the clinic in Parkland, which is the teaching hospital for UT Southwestern.

UT Southwestern has several ongoing clinical trials for which doctors are recruiting potential patients. The latest study involves whether giving hepatitis C, or HCV, medications early on during HIV disease speeds recovery or improves hepatitis therapies.........

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October 11, 2006, 8:21 PM CT

Allergy Runs In The Family

Infants whose parents have allergies that produce symptoms like wheezing, asthma, hay fever or hives risk developing allergic sensitization much earlier in life than previously reported, as per a research studyby Cincinnati researchers.

The study suggests that the current practice of avoiding skin testing for airborne allergens before age 4 or 5 should be reconsidered, so children in this high-risk group can be detected early and monitored for the possibility of later allergic respiratory disease.

Produced by researchers in UC's departments of environmental health and internal medicine and at Cincinnati Children's Hospital Medical Center, the study is published in the October 2006 edition of The Journal of Pediatrics.

The Cincinnati scientists collected data on 680 children being reviewed for enrollment in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS), sponsored by the National Institute of Environmental Health Sciences (NIEHS), and compared their results with findings in a 2004 Swedish study.

Using the skin-prick allergy test, the Swedish group observed that in their general population-which included children whose parents did not suffer from allergies-7 percent had allergic sensitivity at age 1. The Swedes tested five allergens, two of which were food allergens.........

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October 11, 2006, 5:22 AM CT

Innovative Surgery Corrects Vision

Children with cerebral palsy and other neurological problems often have extremely poor eyesight. Their ability to read, pick up objects and "see" the world is so impaired and complicated to treat that many go untreated, even though they may be legally blind.

Janice Brunstrom, M.D., assistant professor of neurology and pediatrics at Washington University School of Medicine in St. Loius and a neurologist at St. Louis Children's Hospital, saw firsthand how her patients' poor vision interfered with every aspect of their daily lives. Having cerebral palsy herself and wanting to help reverse the isolation that many of these children endure because of their poor vision, she approached pediatric ophthalmologist Lawrence Tychsen, M.D., to help devise some solutions.

He did. Tychsen, professor of ophthalmology and visual sciences, of pediatrics and of neurobiology and ophthalmologist in chief at St. Louis Children's Hospital, developed specialized testing and now does vision correction, or refractive surgery, on children with cerebral palsy, Down syndrome and neurobehavioral disorders such as autism. To date, St. Louis Children's Hospital is one of the only U.S. medical centers performing refractive surgery on these children and has the highest volume, operating on about 60 special-needs children a year.........

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October 10, 2006, 10:18 PM CT

New Hope For Borderline Personality Disorder

For the first time, a major outcome study has shown that a high percentage of patients with Borderline Personality Disorder can achieve full recovery across the complete range of symptoms. The controlled study, appearing in a recent issue of the Archives of General Psychiatry published by the American Medical Association, shows that a new approach -- Schema Therapy -- is more than twice as effective as a widely practiced psychodynamic approach, Transference Focused Psychotherapy (TFP). Schema Therapy was also found to be less costly and to have a much lower drop out rate. Borderline Personality Disorder (BPD) has until recent years been considered untreatable, with little scientific justification for longer-term treatment.

This study demonstrates that schema treatment leads to complete recovery in about 50% of the patients, and to significant improvement in two-thirds. The success of the treatment is strongly correlation to its duration and intensity (two sessions a week for 3 years). The results clearly contradict the prevailing opinion that BPD cannot be fully cured, and that longer-term psychotherapy is ineffective.

As per the National Institute of Mental Health, Borderline Personality Disorder is found in about 1 to 2.5 percent of the general population--about 5.8 to 8.7 million Americans, most of whom are young women. Patients with the disorder live life on the edge: they're typically impulsive, unstable, exquisitely sensitive to rejection, have regular outbursts of anger, and live daily with extreme emotional pain. They often self-mutilate and make repeated suicide attempts. Identity problems, low stress tolerance, and fears of abandonment also make the disorder difficult for patients and for those who live with them. A number of with BPD either cannot work or do not function at levels that could be expected in light of their intellectual capacities. As a result, the disorder carries high medical and societal costs, accounting for more than one in every five inpatient psychiatric admissions.........

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October 9, 2006, 9:14 PM CT

Progress In HIV Research

How a harmless virus called GB Virus type C (GBV-C) protects against HIV infection is now better understood. Researchers at the Department of Veterans Affairs (VA) Iowa City Health Care System and the University of Iowa have identified a protein segment that strongly inhibits HIV from growing in cell models.

The team found that an 85-amino acid segment within a GBV-C viral protein called NS5A greatly slows down HIV from replicating in cells grown in labs. The study results will appear online this week in the Proceedings of the National Academy of Sciences.

The finding builds on earlier VA and UI work showing that people with HIV who also are infected GBV-C live longer than those infected only with HIV, said Jinhua Xiang, M.D., a VA research health scientific specialist, UI researcher and the current study's principal author.

GBV-C and its role in HIV infection have been studied for nearly a decade by Xiang, along with another study author Jack Stapleton, M.D., staff doctor and researcher at the VA Iowa City Health Care System and professor of internal medicine at the UI Roy J. and Lucille A. Carver College of Medicine.

"Identifying a specific protein made by GBV-C that inhibits HIV growth in cell culture strengthens the argument that GBV-C is responsible for the prolonged survival observed in several studies of HIV-positive people," Xiang said. "Understanding how the protein works may allow us to develop target-specific therapies that can mimic these effects and inhibit HIV.........

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October 9, 2006, 8:37 PM CT

About Antibiotic Resistance In Hospitals

In one of the first national studies on guidelines that control antibiotics and antibiotic resistance in hospitals, scientists from the Indiana University School of Medicine, the Regenstrief Institute, Inc. and the Richard Roudebush Veterans.

Administration Medical Center report that hospitals that follow national guidelines on controlling antibiotic use have lower rates of antibiotic resistance.

As per a research findings reported in the recent issue of Infection Control and Hospital Epidemiology, the scientists studied four major types of antibiotic resistance at almost 450 hospitals, looking at what each hospital did to control antibiotic use and how this affected the rate of antibiotic resistance.

"We saw in this study, as in other work we have done, that antibiotic resistance is increasing rapidly. This increase is seen in all types of hospitals across the country - large and small, teaching and non-teaching, VA and non-VA," said Bradley N. Doebbeling, M.D., M.Sc., who led the study. He directs the IU Center for Health Services and Outcomes Research at the Regenstrief Institute and the IU School of Medicine. He also directs the VA Center for Implementing Evidence-Based Practice.

The study looked at measures to prevent development of antibiotic resistance as well as ways to stop its spread. The scientists reported that if hospitals implemented specific measures to control the use of antibiotics they were more likely to have succeeded in controlling antibiotic resistance.........

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October 8, 2006, 6:27 PM CT

Maggot Therapy Without The Maggots

Researchers in the United Kingdom have developed a new wound dressing that could bring the benefits of maggot treatment to patients without putting live Greenbottle fly (blowfly) larvae into non-healing wounds. The joint research project of Stephen Britland from Bradford University and David Pritchard of Nottingham University included colleagues from the Bradford-based biotechnology company AGT Sciences Ltd. It describes development and preliminary testing in laboratory cell cultures of the new hydrogel dressing in a report scheduled for publication in the Oct. 6 issue of the ACS bimonthly journal Biotechnology Progress.

The scientists note resurgence in medical use of larval biotherapy -- intentionally introducing blowfly maggots into non-healing wounds to clean away dead tissue. Medical use of the technique led to observations suggesting that maggots' excretions and secretions (ESs) also may encourage regeneration of tissue and wound healing. Realizing that the ESs would have to be delivered in a controlled fashion, Britland's group developed the hydrogel dressing, which slowly releases maggot ESs.

"The present prototype hydrogel wound dressing could potentially be deployed as a device to deliver insect-derived active products to skin wounds in vivo to encourage tissue regeneration".........

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October 8, 2006, 5:12 PM CT

More Than Meets The Eye

Ever watch a jittery video made with a hand-held camera that made you almost ill? With our eyes constantly darting back and forth and our body hardly ever holding still, that is exactly what our brain is faced with. Yet despite the shaky video stream, we commonly perceive our environment according tofectly stable.

Not only does the brain find a way to compensate for our constantly flickering gaze, but scientists at the Salk Institute for Biological Studies have observed that it actually turns the tables and relies on eye movements to recognize partially hidden or moving objects. Their findings will be published in a forthcoming issue of Nature Neuroscience.

"You might expect that if you move your eyes, your perception of objects might get degraded," explains senior author Richard Krauzlis, Ph.D., an associate professor in the Systems Neurobiology Laboratory at the Salk Institute. "The striking thing is that moving your eyes can actually help resolve ambiguous visual inputs".

Our eyes move all the time, whether to follow a moving object or to scan our surroundings. On average, our eyes move several times a second in fact, in a lifetime, our eyes move more often than our heart beats. "Nevertheless, you don't have the sense that the world has just swept across or rotated around you. You sense that the world is stable," says Krauzlis.........

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