Audio Journal of Fertility Circulating Markers Herald Onset of Preeclampsia REFERENCE: N Engl J Med 2006; 355:992 RICHARD LEVINE, National Institutes of Health, Bethesda In pregnant women circulating levels of the anti-angiogenic substances: soluble endoglin and soluble Flt-1 herald the onset of preeclampsia, according to a publication in the New England Journal of Medicine. Richard Levine told Peter Goodwin about his group?s findings from the Calcium for Preeclampsia Prevention Trial which give hope of designing molecularly targeted drugs to treat preeclampsia or of spotting the disease early.

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Audio Journal of Global Health Issues Circulating Markers Herald Onset of Preeclampsia REFERENCE: Lancet 2006; 368: 1973-83 CHARLOTTE WATTS, London School of Hygiene and Tropical Medicine A large and groundbreaking study has shown that microfinance, combined with a gender and HIV training scheme, can help reduce domestic violence among poor women living in rural South Africa. Charlotte Watts of the London School of Hygiene and Tropical Medicine told Derek Thorne about the IMAGE study.

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Audio Journal of Global Health Issues Three-Class Antiretroviral Therapy for HIV Not Appropriate: Results from the FIRST Study REFERENCE: Lancet 2006; 368: 2125-35 RODGER MacARTHUR, Wayne State University, Detroit A three-class HIV antiretroviral therapy is not necessary, according to data published in the Lancet. The FIRST study had three arms which included non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), or both, all in the presence of nucleoside reverse transcriptase inhibitors. Derek Thorne heard more from Rodger MacArthur of Wayne State University in Detroit.

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Audio Journal of Cardiovascular Medicine Telomere Length Predicts Coronary Heart Disease Risk and Statin Response REFERENCE: Lancet 2007; 369:107 NILESH SAMANI, Glenfield Hospital, Leicester A new genetic test could help predict which individuals will develop coronary heart disease among those with similar conventional risk factors. The length of the terminating structures of chromosomes, telomeres, can be used to predict cardiovascular mortality in middle-aged men, according to a study from Leicester in the UK which analysed blood samples collected for the West of Scotland Primary Prevention Study, (WOSCOPS). Nilesh Samani gave Helen Morant the details.

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Audio Journal of Global Health Issues, January 26th, 2007 Miscarriage Risk in Women with Low Body Mass Index REFERENCE: BJOG 2007 114:170 PAT DOYLE, London School of Hygiene and Tropical Medicine Underweight women were found to be at increased risk of miscarriage, according to a study published in the British Journal of Obstetrics and Gynaecology. A team from the London School of Hygiene and Tropical Medicine conducted a survey by questionnaire of 6 000 women among whom 600 had a first trimester miscarriage. Using a ?case-control? method of comparison it emerged that women with a body mass index below 18.5 had a 70 per cent increase in their risk of miscarriage. Peter Goodwin heard more about the study from Pat Doyle of the London School of Hygiene and Tropical Medicine.

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Audio Journal of Global Health Issues The Genetics of Obesity: Genetic Mutation, Possible Marker for Obesity? REFERENCE: N Engl J Med 2007;356:237-47 SADAF FAROOQI, Addenbrooke?s Hospital, Cambridge UK Gene defects and mutations could be markers for early onset obesity. This is according to a study published in the New England Journal of Medicine which concludes that the leptin receptor should be further explored as a cause of obesity, along with other genetic factors emerging from a multinational study called: the Genetics of Obesity Study. Sarah Maxwell heard the latest from Sadaf Farooqi in Cambridge, England.

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Audio Journal of Global Health Issues Folic Acid Supplement Improves Cognitive Function in Older Adults: FACIT Trial REFERENCE: Lancet 2007;369:208 JANE DURGA, Nestlé Research Centre, Lausanne A trial that randomised older adults to receive a folic acid supplement or placebo has shown that folic acid can significantly improve cognitive performance in older individuals. Jane Durga in Lausanne told Sarah Maxwell about the study findings and the hopes these may hold out.

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Audio Journal of Cardiovascular Medicine Aggressive Statin Therapy: Better than Endarterectomy for Patients with Carotid Stenosis? REFERENCE: Abstract No. 17 HENRIK SILLESEN, University of Copenhagen Patients with carotid artery stenosis run much lower risks of further events if treated aggressively with a statin, according to a study reported at the International Stroke Conference in San Francisco by Henrik Sillesen. Of 1,000 patients in the Stroke Prevention By Aggressive Reduction of Choleseterol Levels (SPARCL) study with documented carotid stenosis, those who received high-dose atorvastatin had a reduced need for endarterectomy in the follow up period. The aggressive statin treatment was as effective as endarterectomy at preventing future strokes. Helen Morant talked to Henrik Sillesen about the promise of this medical approach to treating such high-risk patients.

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Audio Journal of Cardiovascular Medicine MRI Scans Expand Therapeutic Window for Thrombolysis in Stroke REFERENCE: Abstract 2 PETER SCHELLINGER, University Clinic of Erlangen, Germany MRI scanning could make it possible to treat stroke patients safely and effectively with thrombolytics such as tPA beyond the recommended 3 hour window. The International Stroke Conference heard analysis of pooled data from five European Stroke Centers that compared CT and treatment within 3 hours with the use of MRI plus treatment either within 3 hours or longer than this. After his presentation in San Francisco Peter Schellinger explained the study to Helen Morant.

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Audio Journal of Cardiovascular Medicine "NIHSS-Plus": Improvement on National Institutes of Health Stroke Scale? REFERENCE: Poster 456 REBECCA GOTTESMAN, Johns Hopkins University, Baltimore Two simple bedside tests could be added to the NIHSS to make it more accurate, researchers claim. The team from Johns Hopkins University evaluated a range of cognitive tests for stroke patients and found that two corresponded particularly well to the size of the stroke on MRI scan. Rebecca Gottesman spoke to Helen Morant about why she thinks the NIHSS needs changing.

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Audio Journal of Cardiovascular Medicine Transthoracic Echo: A Wasted Test in Stroke Patients? REFERENCE: Poster 434 NICOLE PAGEAU, Trillium Health Centre, Ontario Stroke patients may be going through pointless tests, according to a poster presented by researchers at the Trillium Health Centre in Ottawa. The Stroke clinic there looked at whether routinely ordered tests, trans thoracic echo and 24 hour rhythm monitoring, actually changed patients' treatment, and found that generally, the results of these tests didn?t change a thing. Helen Morant talked to Nicole Pageau about their findings.

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Audio Journal of Cardiovascular Medicine The Wingspan Stent: Safe Intra-Cranial Angioplasty? REFERENCE: Abstract 102 FELIPE ALBUQUERQUE, Barrow Neurological Institute, Phoenix The Wingspan stent is a new approach to keeping open the atherosclerotic intracranial vessels of stroke and TIA patients. Early results presented to the San Francisco Conference suggest that it doesn?t harm patients, but that it seemed to block fairly quickly, Felipe Albuquerque talked to Helen Morant about these much anticipated results.

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Audio Journal of Cardiovascular Medicine Thrombectomy For Acute Stroke: Results of the Multi MERCI Trial REFERENCE: Abstract No. LB5 WADE SMITH, University of California, San Francisco Mechanical removal of the clot that?s causing an acute stroke is showing promising early signs, and is safe. The first of a new generation of the MERCI (Mechanical Embolus Removal in Cerebral Ischemia) devices for removing clots has compared favorably to its predecessors and can also be used in patients for whom the standard therapy, thrombolysis, has failed. Wade Smith on behalf of the MERCI investigators talked to Helen Morant about the results.

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Audio Journal of Cardiovascular Medicine GIST Trial: Treating Glucose Levels Acutely Doesn?t Help Survival, but Does Cause Hypotension REFERENCE: Abstract No. LB2 CHRISTOPHER GRAY, University of Newcastle Treating high blood sugar in the acute phases of stroke doesn?t reduce risk of death or severe disability, the GIST ? UK (Glucose Insulin in Stroke Trial) has found. This is despite other trials reporting that high glucose levels are associated with increase risk of stroke. Investigators also found that treating glucose levels aggressively also lowered blood pressure. To discuss this surprise result, and the background to the trial, Helen Morant talked to Chris Gray.

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Audio Journal of Global Health Issues Herpes Simplex Therapy Reduces HIV Activity in Co-Infected Patients REFERENCE: N Engl J Med 2007; 356: 790-9 PHILIPPE MAYAUD, London School of Hygiene and Tropical Medicine In patients who are infected with both HIV and herpes simplex type 2 the activity of the AIDS virus may be diminished by therapy with one of the established anti-herpes drugs, according to the findings of a study published in the New England Journal of Medicine by authors in France, England and Burkina Faso. Philippe Mayaud talked about his results with Peter Goodwin in which HIV concentrations in the blood and vagina of patients co-infected with both herpes and HIV were found to be reduced by continuous treatment with the anti-herpes agent valacyclovir.

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Audio Journal of Global Health Issues Growth Hormone Releasing Factor Analog: Slimming Aid for Patients Receiving HAART? REFERENCE: 14th Conference on Retroviruses and Opportunistic Infections, Los Angeles February 25-29, 2007 STEVEN GRINSPOON, Massachusetts General Hospital, Boston COMMENT: JUDITH CURRIER, University of California, Los Angeles Daily administration of an analog of growth hormone releasing factor to HIV patients receiving highly active antiretroviral therapy significantly decreased visceral fat and improved their lipid profiles. This development-stage drug, TH9507, was well tolerated and may help patients reduce central fat accumulation and abnormal lipid profiles, both of which are know cardiovascular risk factors. In addition, decreases in central fat may have a positive effect on patients' self-image. Steven Grinspoon gave Dan Keller details during the 14th Conference on Retroviruses and Opportunistic Infections in Los Angeles.

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Audio Journal of Global Health Issues Entecavir Shows Activity Against HIV But Also Selects for an Antiretroviral Drug Resistance Mutation REFERENCE: Abstract: 136LB, 14th Conference on Retroviruses and Opportunistic Infections, Los Angeles February 25-29, 2007 CHLOE THIO, Johns Hopkins University School of Medicine Entecavir, used to treat hepatitis B virus infections, can lower levels of HIV in co-infected patients but also selects for a mutation that makes HIV resistant to entecavir as well as the antiretroviral drugs lamivudine and emtracitabine. These findings, derived from three case reports and associated laboratory studies, have important implications for the treatment of HBV in HIV-infected patients. Current guidelines, issued in October 2006 and which recommend entecavir as a first-line treatment of HBV in co-infected individuals who do not require anti-HIV therapy, need to be reconsidered. Chloe Thio discussed her study results and their implications with Dan Keller at the 14th Conference on Retroviruses and Opportunistic Infections in Los Angeles.

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Audio Journal of Global Health Issues Integrase Inhibitor Raltegravir Doubles Antiviral Response Rate in Treatment Experienced HIV-Infected Patients Compared to Optimised Background Therapy Alone REFERENCE: Abstract 105aLB, 105bLB, 14th Conference on Retroviruses and Opportunistic Infections, Los Angeles February 25-28, 2007 ROY STEIGBIGEL, State University of New York at Stony Brook JOHN W. MELLORS, University of Pittsburgh Raltegravir doubled the antiviral response rate and the increase in CD4 cells among treatment-experienced HIV-infected patients who were resistant to at least one drug in each of the nucleoside, non-nucleoside, and protease inhibitor classes. Two placebo controlled trials (BENCHMRK-1 and BENCHMRK-2) randomized a total of almost 700 subjects to either raltegravir 400 mg twice daily or to placebo, each on a background of optimized antiviral background therapy. Raltegravir is an integrase inhibitor and acts to block the enzyme that allows HIV?s nuclei acid to integrate into the DNA of host cells.

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Audio Journal of Global Health Issues Maraviroc: New Antiretroviral Drug Shows Efficacy and Safety REFERENCE: Abstract Number: 104aLB, 104bLB, 14th Conference on Retroviruses and Opportunistic Infections, Los Angeles February 25-28, 2007 HOWARD MAYER, Pfizer Global Research, New London CT MARK WAINBERG, McGill University, Montreal In a population of treatment-experienced HIV-infected subjects, maraviroc plus optimised background antiretroviral therapy provided significantly superior virologic control and increases in CD4 cell counts compared with placebo plus optimized background therapy. There were no clinically relevant differences in the safety profiles between the maraviroc and the placebo treatment groups. These drugs do not attack the virus itself but rather block host cells? CCR5 cell surface cytokine receptors that HIV interacts with to gain entry into the cell.

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Audio Journal of Global Health Issues 6 Months Exclusive Breast Feeding for Mothers with HIV Lowers Transmission Rates REFERENCE: Abstract 13, 14th Conference on Retroviruses and Opportunistic Infections, Los Angeles February 25-28, 2007 HOOSEN COOVADIA, University of KwaZulu-Natal, Durban In the developing world breastfeeding is the recommended infant feeding method, even for women infected with HIV. While early cessation of breastfeeding reduces HIV transmission to the baby, studies have shown that it increases morbidity and mortality in the infants. Exclusive breastfeeding for the first six months of life appears to reduce HIV transmission, as opposed to ?mixed? breastfeeding with supplementation with formula or solid foods. Dan Keller spoke with Hoosen Coovadia, who delivered a plenary talk on the subject at the14th Conference on Retroviruses and Opportunistic Infections in Los Angeles.

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Audio Journal of Cardiovascular Medicine Thrombin Receptor Antagonist: Advantages in Percutaneous Coronary Intervention? REFERENCE: ACC New Orleans, March 24th Late Breaking Trials DAVID MOLITERNO, University of Kentucky, Lexington An oral thrombin receptor antagonist, SCH 530348 has proved safe and effective, and may be better than conventional anti-coagulation treatments for patients receiving percutaneous coronary intervention. Results of the TRA-PCI study were presented at the ACC's New Orleans meeting by David Moliterno who discussed the new data with Peter Goodwin.

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Audio Journal of Cardiovascular Medicine Rapid Genotype Assay for Individualized Warfarin Dosing REFERENCE: Abstract 1020-89, American College of Cardiology New Orleans JEFFREY ANDERSON, University of Utah, Salt Lake City COMMENT: DOUGLAS ZIPES, University of Indiana, Indianapolis The hope of refining treatments for cardiovascular disease by genotyping patients to detect individual sensitivities to particular medical therapies was brought a step closer at the ACC meeting in New Orleans by results from a study using a rapid genothype test. Jeffrey Anderson told Peter Goodwin about the assay they've been investigating which indicates required dosing of warfarin.

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Audio Journal of Cardiovascular Medicine Increased Use of Recommended Drugs Explains Improved Trends in Prognosis after Myocardial Infarction REFERENCE: Abstract 1018-148, American College of Cardiology New Orleans SOKO SETOGUCHI, Brigham And Women?s Hospital, Boston COMMENT: DOUGLAS ZIPES, University of Indiana, Indianapolis The increased adherence to recommendations and guidelines for drug therapy after myocardial infarction during the last ten years has led to hoped-for improvements in outcomes and prognosis among patients treated. This is the finding of a study presented to the ACC meeting in New Orleans by Soko Setoguchi who discussed her group?s findings with Peter Goodwin.

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Audio Journal of Cardiovascular Medicine Bioabsorbable Everolimus-Eluting Stent: 6-Month Angiographic and IVUS Results REFERENCE: Abstract 2402-3, American College of Cardiology New Orleans PATRICK SERRUYS, Erasmus University, Rotterdam COMMENT: SPENCER KING, Piedmont Hospital, Atlanta Six-months follow-up of patients receiving a new bioabsorbable drug-eluting stent are favourable, according to Patrick Serruys whose group has been investigating the stent which elutes everolimus in a group of 30 patients. During the ACC Annual Meeting in New Orleans he discussed with Peter Goodwin the potential benefits the new device can bring to coronary patients.

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Audio Journal of Cardiovascular Medicine - COURAGE Trial: Optimal Medical Therapy Alone is Sufficient for Patients with Stable Angina: Adding PCI Does Not Help - ILLUSTRATE Study Shows Torcetrapib Raises HDL But Fails to Lower Coronary Risk REFERENCE: N Engl J Med 2007 356 Published: March 26th Reporting from: American College of Cardiology New Orleans STEVEN NISSEN, Cleveland Clinic, OH Two big studies published in the New England Journal of Medicine and presented simultaneously at the American College of Cardiology meeting in New Orleans have shown that two emerging therapies aimed at reducing risks in patients with coronary disease have failed to do so. The president of the ACC, Steven Nissen, talked with Peter Goodwin about the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) trial, in which patients with stable coronary artery disease were randomized to receive optimal medical therapy with or without PCI. He also discussed findings of the ILLUSTRATE (Investigation of Lipid Level Management Using Coronary Ultrasound to Assess Reduction of Atherosclerosis by CETP Inhibition and HDL Elevation) study in which the cholesteryl ester transfer protein inhibitor, torcetrapib was found to have adverse effects when used for modifying lipid profiles among coronary patients.

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Audio Journal of Cardiovascular Medicine Bioabsorbable Everolimus-Eluting Stent: 6-Month Angiographic and IVUS Results REFERENCE: Abstract 2402-3, American College of Cardiology New Orleans PATRICK SERRUYS, Erasmus University, Rotterdam COMMENT: SPENCER KING, Piedmont Hospital, Atlanta Six-months follow-up of patients receiving a new bioabsorbable drug-eluting stent are favourable, according to Patrick Serruys whose group has been investigating the stent which elutes everolimus in a group of 30 patients. During the ACC Annual Meeting in New Orleans he discussed with Peter Goodwin the potential benefits the new device can bring to coronary patients.

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Audio Journal of Cardiovascular Medicine "RADIANCE-1" Study: Cholesteryl Ester Transfer Protein Inhibitor Fails to Benefit Patients with Familial Hypercholesterolemia REFERENCE: Abstract 407-7, American College of Cardiology New Orleans JOHN KASTELEIN, Academic Medical Center, Amsterdam A drug which raises HDL and reduces circulating levels of LDL has nevertheless failed to reduce atherosclerotic progression in patients with familial hypercholesterolemia. This disappointing outcome of a study using the cholesteryl ester transfer protein inhibitor (CETP), torcetrapib, was announced at the American College of Cardiology meeting in New Orleans. John Kastelein discussed the findings, and their implications for therapies targeting HDL, with Peter Goodwin.

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Audio Journal of Cardiovascular Medicine Direct Renin Inhibitor Combined with Angiotensin Receptor Blockade Gives Additional Blood Pressure Lowering REFERENCE: Abstract 405-12, American College of Cardiology New Orleans SUZANNE OPARIL, University of Alabama, Birmingham A combination of two antihypertensive agents has given improved blood pressure control in a study with nearly 2000 patients reported to the ACC meeting in New Orleans by a group from the University of Alabama at Birmingham. Suzanne Oparil presented findings on the use of the direct rennin inhibitor, aliskiren, combined with the angiotensin receptor blocker, valsartan. She explained to Peter Goodwin how this ?dual renin system blockade? gave enhanced blood pressure lowering in patients with mild to moderate hypertension who were followed with ambulatory monitoring.

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Audio Journal of Cardiovascular Medicine ?EXACT? Study: Carotid Stenting Benefits Are Maintained in the Real World REFERENCE: Abstract 2409-5, American College of Cardiology New Orleans WILLIAM GRAY, Columbia University, New York The benefits of carotid stenting as compared with surgery have been maintained in real-world settings since USA-approval of the technique in 2004, according to William Gray who reported findings from the EXACT study of 1500 patients to the annual meeting of the American College of Cardiology. He discussed his conclusions and recommendations with Peter Goodwin.

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Audio Journal of Cardiovascular Medicine Reporting from American College of Cardiology, New Orleans, March 24-27, 2007 "COURAGE" Trial Assessed: New Guidelines for Patients with Stable Coronary Disease? REFERENCE: ACC 2007 & N Engl J Med 356: March 2007 HARVEY WHITE, Auckland City Hospital The finding from the COURAGE trial: that angioplasty adds no benefits to optimal medical therapy alone for patients with stable coronary disease, should give pause for thought among clinicians all over the world, according to Harvey White, who discussed the new data with Peter Goodwin.

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Audio Journal of Global Health Issues Once-And-For-All TB Assay Brings Cheap, Sensitive, Specific, Seven-Day Diagnosis and Drug-Susceptibility Testing REFERENCE: N Engl J Med 355: 1539-50 DAVID MOORE, Imperial College, London and Lima A new test for TB, trialled in Peru, has proved more powerful and yet faster and cheaper than alternatives, making it especially suitable for use in resource-limited settings where tuberculosis is becoming more rampant, partly through the world-wide advance of HIV. David Moore and his colleagues have published results in the New England Journal of Medicine of a massive investigation conducted in Lima with nearly 4 000 samples of the sputum test called: Microscopic-Observation Drug-Susceptibility (MODS) Assay. Their findings promise not only to improve diagnosis and save lives in developing countries and other settings with limited health-care resources, but also out-perform costly gold-standard technology-intensive TB diagnosis methods currently used where cash is not a problem. The MODS test, David Moore told Peter Goodwin during a visit to Peru, gives sensitive and specific diagnosis in as little as seven days, and concurrently yields drug susceptibility data which helps combat multi-drug resistant TB.

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Audio Journal of Global Health Issues Rural to Urban Migration: Cardiovascular Health Risks Assessed in Lima, Peru JAIME MIRANDA, London School of Hygiene and Tropical Medicine, Peru The consequences of migration from rural to urban areas in Peru has provided an opportunity for studying the impact of a radically altered lifestyle and diet upon health. Jaime Miranda is investigating the disease patterns among migrants from the Andes Mountains and the Amazon Jungle regions of Peru in the capital, Lima. He discussed his group's investigation with Peter Goodwin.

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Audio Journal of Global Health Issues reporting from American College of Physicians Annual Meeting: Internal Medicine 2007; San Diego April 19-21 Study on Longevity Genes And Aging Raises Prospects for Therapy REFERENCE: ABSTRACT ERA 001 ACP 2007, San Diego NIR BARZILAI, Albert Einstein College of Medicine, New York The prospect of modulating the activity of "longevity genes" to extend life was held out at a special session of the ACP Internal Medicine annual meeting in San Diego. Nir Barzilai, Director of the Institute for Aging Research in New York, presented data from his group's study of patients up to 100 years old and over which have shown that specific genes are related to longevity and freedom from physical illness. Afterwards he talked about his findings and the clinical opportunities they present with Peter Goodwin.

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Audio Journal of Global Health Issues reporting from American College of Physicians Annual Meeting: Internal Medicine 2007; San Diego April 19-21 Patient Power Best to Manage Diabetes REFERENCE: ABSTRACT Press Release, San Diego ACP 2007 HILARY SELIGMAN, University of California, San Francisco Doctors can best help their patients with diabetes by taking particular care to put management into the hands of the patients themselves, rather than asking them to slavishly follow the doctors' instructions, conference-goers in San Diego heard. A new ACP guide booklet for diabetes management called "Living with Diabetes", designed to be used by patients in consultation with their doctors, has made concrete improvements in diabetic management, according to results from a study released during the American College of Physicians annual meeting. Peter Goodwin talked with one of the authors of the new initiative, Hilary Seligman.

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Audio Journal of Global Health Issues reporting from American College of Physicians Annual Meeting: Internal Medicine 2007; San Diego April 19-21 Drug Eluting Stents, PFO Closure: Indications Not Obvious REFERENCE: ABSTRACT ACP Internal Medicine 2007, ERA 002 MARK REISMAN, Swedish Medical Center, Seattle Drug eluting stents may not always be the automatic choice over the bare metal variety for patients requiring intervention, despite the important clinical advantages that have been emerging from their introduction recently. This is according to Mark Reisman who gave the Internal Medicine 2007 conference in San Diego his latest insights from the rapidly changing world of interventional cardiology. At this (recently renamed) annual meeting of the American College of Physicians he also discussed the difficult question of which patients are candidates for PFO closure, and what the clinical objectives of this might be: including the possible reduction of migraine headaches. After his session he talked with Peter Goodwin.

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Audio Journal of Cardiovascular Medicine Reporting from ACC 2007 Fewer Major Bleeding Events with Bivalirudin For Patients with Acute Coronary Syndromes: The ACUITY Study REFERENCE: ACUITY Trial, ACC.07 Scientific Session and i2 Innovations Summit. Presentation Number: 2414-5 Patients with acute coronary syndromes who take bivalirudin have fewer major bleeding events and a lower incidence of late stent thrombosis? compared with those who receive standard heparin therapy. This is the finding of one year results from the ACUITY Study announced by Gregg Stone of Columbia University, New York during the American College of Cardiology annual meeting that took place in New Orleans. Sarah Maxwell asked Harvey White at the Auckland City Hospital in New Zealand to comment about the ACUITY investigation.

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Audio Journal of Global Health Issues Can Road-Side Tranexamic Acid Therapy Reduce Mortality and Blood Transfusions after Trauma? The CRASH Trial. JAIME MIRANDA, London School of Hygiene and Tropical Medicine, Lima An antifibrinolytic agent, tranexamic acid (commonly used to reduce bleeding during surgery) is being investigated as first-aid to cut mortality and the need for blood transfusion immediately after trauma or injury. The CRASH trial, still in its early phases in a worldwide adult population, aims to bring particular benefit to developing countries, many of which are blighted by trauma with few measures, if any, having been available up to now to reduce the death toll. In Lima, Peru, Jaime Miranda discussed his group's ongoing investigation with Peter Goodwin.

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Audio Journal of Cardiovascular Medicine Reporting from ACC 2007 Reduced Mortality and Repeat MI with Enoxaparin for Patients with ST Elevation Myocardial Infarction HARVEY WHITE, Auckland City Hospital, New Zealand REFERENCE: European Heart Journal Advanced On-Line Publication April 24th, 2007 Enoxaparin could be the new standard anti-thrombotic therapy for patients receiving fibrinolysis for ST elevation myocardial infarction. This finding is from the double-blind EXTRACT-TIMI 25 Trial which compared the low molecular weight heparin with unfractionated heparin and saw a consistent treatment superiority from enoxaparin with a reduction in repeat myocardial infarction and mortality. Sarah Maxwell spoke with the principal investigator Harvey White at the Auckland City Hospital in New Zealand.

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Audio Journal of Global Health Issues Type 1 Polio Vaccine Could Help Finally Eradicate Polio REFERENCE: Lancet 2007; 369:1356-62 NICHOLAS GRASSLY, Imperial College London A case-control study performed in India has provided hope that polio could finally be eradicated. India is one of six countries in which polio transmission has not yet been interrupted and, specifically, it is the type 1 poliovirus that persists there. Nicholas Grassly of Imperial College London told Derek Thorne about his team?s study, published in the Lancet.

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Audio Journal of Global Health Issues Non-Perfect HIV Vaccine Could Still Have Major Benefits REFERENCE: N Engl J Med 2007;356:2073-81 ANTHONY FAUCI, National Institutes of Health, Bethesda Is there any hope for an HIV vaccine? According to Anthony Fauci, of the National Institutes of Health in Bethesda, there is ? but it might not be a perfect vaccine. He believes that even a vaccine that does not confer total immunity could still be of use, because it may slow disease progression and also reduce the spread of the disease. He talked with Derek Thorne about his co-authored paper in the New England Journal of Medicine.

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Audio Journal of Global Health Issues Pneumonia in Children Under One Year: Current Guidelines Not Sufficient REFERENCE: The Lancet 2007; 369:1440-1451 Lisa McNally, Institute of Child Health, London, and University of KwaZulu-Natal, Durban A new study suggests that current guidelines for the treatment of severe pneumonia in children under one year should change. The investigation, which took place in South Africa, found that HIV status and polymicrobial disease were among the predictors for treatment failure, and these findings have implications for the guidelines drawn up by the WHO. Derek Thorne heard more from Lisa McNally, who worked with the Institute of Child Health in London, and the University of KwaZulu-Natal in Durban.

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Audio Journal of Global Health Issues Simple Intervention Could Significantly Improve TB Detection in Women REFERENCE: The Lancet 2007; 369:1955-1960 MISHAL KHAN, London School of Hygiene and Tropical Medicine Giving comprehensive instructions to women before they produce a sputum sample can make tuberculosis detection more effective ? that?s the conclusion of a study published in the Lancet. A team from the UK and Pakistan carried out a large randomised trial in both men and women, and Derek Thorne got the details from Mishal Khan, of the London School of Hygiene and Tropical Medicine.

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Audio Journal of Medicine Reporting from European Society of Human Reproduction and Embryology (ESHRE) 23rd Annual Meeting, Lyon, July 1-4, 2007 Elective Single Embryo Transfer in IVF: 13 Year Data From Sweden REFERENCE: ABSTRACT Oral 005 Per-Olof Karlström, Academic Hospital Uppsala COMMENT: Richard Kennedy, University Hospital, Coventry Elective single embryo transfer, now the norm in Sweden for in-vitro fertilisation, has greatly reduced rates of multiple pregnancy and the risks that go with it. And there are other benefits, according to Per-Olof Karlström from Uppsala who talked with Peter Goodwin during the ESHRE conference on fertility held in Lyon. The evidence from Sweden was put in perspective during the conference by Richard Kennedy from Coventry.

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Audio Journal of Medicine Reporting from European Society of Human Reproduction and Embryology (ESHRE) 23rd Annual Meeting, Lyon, July 1-4, 2007 1. Eggs From Young Patients Before Chemotherapy: New Hope for Future Fertility REFERENCE: ABSTRACT O-107 Ariel Revel, Hadassah University Hospital, Jerusalem Harvesting eggs from young girls before they undergo aggressive chemotherapy can now be done to give the hope of pregnancy in the future, according to fertility experts from Jerusalem reporting to the European conference on fertility being held in Lyon. The investigators have obtained oocytes from girls as young as five years. Lead author Ariel Revel talked about his group's findings with Sarah Maxwell. 2. First Baby Born From Thawed, Frozen, In-Vitro Matured Oocytes REFERENCE: ABSTRACT Oral 018 Hananel Holzer, McGill University, Montreal The results of a study that has produced the first live birth by maturing oocytes in vitro which have been collected from unstimulated ovaries, freezing them, and subsequently thawing them for fertilization were presented to the ESHRE meeting in Lyon. This is the first time oocytes collected without hormonal stimulation have resulted in pregnancies. For some women potentially facing sterility, such as those with breast cancer who do not have time for hormonal stimulation, this technique provides the hope of pregnancy which could otherwise be denied. Sarah Maxwell interviewed Hananel Holzer about the findings. 3. Ovarian Stimulation: Menotrophin Gives More Live Births than Follicle-Stimulating Hormone for Assisted Reproduction REFERENCE: ABSTRACT Oral 098 Masoud Afnan, Birmingham Women's Hospital Of two types of gonadotrophins currently used for ovarian stimulation in assisted reproduction one has now clearly demonstrated superiority in a meta-analysis presenteted to the fertility conference in Lyon. Human menotrophin (hGH) gave more live births than recombinant follicle-stimulating hormone (rFSH) whether reproduction was by in-vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). Peter Goodwin talked with Masoud Afnan from Birmingham after his presentation of the study which he co-authored with Madelon van Wely and Julko van der Veen. 4. Single Embryo Transfer Recommended For Most Patients Receiving Donated Oocytes REFERENCE: ABSTRACT O-007 Viveca So?derstro?m-Anttila, Väestoliitto Fertility Clinics, Helsinki When oocytes are donated to achieve a pregnancy, single embryo transfer should generally be recommended over double transfer, according to the findings of a study from Helsinki. Sarah Maxwell discussed the data with Viveka Söderström.

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Audio Journal of Medicine Reporting from European Society of Human Reproduction and Embryology (ESHRE) 23rd Annual Meeting, Lyon, July 1-4, 2007 Elective Single Embryo Transfer in IVF: 13 Year Data From Sweden REFERENCE: ABSTRACT Oral 278 also N Engl J Med 2007;357:9-17 SJOERD REPPING, University of Amsterdam Genetic screening of embryos before implantation for in-vitro fertilisation caused a big reduction in the number of live births as compared with no screening, contrary to expectations. That's the finding of a study announced at the fertility conference in Lyon and simultaneously published in the New England Journal of Medicine. Sjoerd Repping of investigating team from the University of Amsterdam discussed the study findings and its clinical implications with Peter Goodwin.

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Audio Journal of Medicine Intensive Care: Prophylactic Steroids Prevent Postextubation Laryngeal Oedema REFERENCE: Lancet 2007;369:1083-89 Editorial page 1061 RUPERT PEARSE, Barts and The London School of Medicine A big step forwards in the management of patients in the emergency room who need artificial ventilation has been reported in the Lancet. An effective way to prevent postextubation laryngeal oedema has been reported. A study carried out by Bruno François of the Dupuytren Teaching Hospital in Limoges at 15 intensive-care units of the Association des Réanimateurs du Centre-Ouest, has found that giving patients prednisolone therapy 24hrs before a planned extubation can substantially reduce the incidence of laryngeal oedema and the need for reintubation. Karen Regester spoke to Rupert Pearse who wrote the commentary on the article in the Lancet.

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Audio Journal of Medicine, July 16th 2007 Rosiglitazone for Patients with Diabetes: Cardiovascular Outcomes Trial Findings REFERENCE: N Engl J Med 2007; 357: 28-38 STUART POCOCK, London School of Hygiene and Tropical Medicine Reassuring findings about the safety of the anti-diabetic drug rosiglitazone have been published in the New England Journal of Medicine following an interim analysis of the Rosiglitazone Evaluated for Cardiac Outcomes and Regulation of Glycaemia in Diabetes (RECORD) study. This latest publication follows a meta-analysis in June 2007 by Nissen and Wolski which raised doubt about the safety of the drug. Nicola Solomon spoke with the RECORD trial?s statistician, Stuart Pocock, to get the latest data from this largest study specifically designed to look at cardiovascular outcomes.

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Audio Journal of Medicine, August 2nd 2007 Best Evidence Yet that Folic Acid Fortification Reduces Neural-Tube Defects REFERENCE: N Engl J Med 2007;357:135-42 PHILIPPE DE WALS, Laval University, Quebec Compulsory food fortification with folic acid has been given new impetus following findings from a Canadian study published in The New England Journal of Medicine. Fifty per cent fewer neural?tube defects were detected in the Canadian population after compulsory fortification of cereals as compared with before. Nicola Solomon spoke to Philippe De Wals to get details about his group's study.

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Audio Journal of Medicine, August 2nd 2007 Shorter Anti-Viral Treatment for Hepatitis C: Less Effective Than Standard Regimen REFERENCE: N Engl J Med 2007;357:124-34 MITCHELL SHIFFMAN, Virginia Commonwealth University, Richmond Standard anti-viral therapy for Hepatitis C needs to be used to the full duration according to a publication in the New England Journal of Medicine. Following provocative evidence from previous smaller studies, suggesting that anti viral therapy can be shortened, the ACCELERATE trial (the largest international study with genotypes 2 and 3) was set up to resolve whether shortening the duration of therapy for patients would give the same virologic response rates as with the standard regimen. It found that full-dose, full-duration therapy with interferon and ribavirin needs to be adhered to. Nicola Solomon interviewed Mitchell Shiffman to find out more.

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Audio Journal of Medicine, August 2nd 2007 Reporting from: 23rd Annual Conference of the European Society of Human Reproduction and Embryology, 1-4 July 2007, Lyon, France Ovarian Stimulation Does Not Affect Fetal Birth Weight REFERENCE: O-103 GEORG GRIESINGER, University Clinic of Schleswig-Holstein, Luebeck, Germany Although low fetal birth weight is associated with singleton babies born after in-vitro fertilisation, a new prospective study has demonstrated that this is not a result of ovarian stimulation. Correspondent Sarah Maxwell interviewed Georg Griesinger at the ESHRE meeting in Lyon to get more details.

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Audio Journal of Medicine, August 2nd 2007 Reporting from: 23RD Annual Conference of the European Society of Human Reproduction and Embryology, 1-4 July 2007, Lyon, France GnRH Antagonist Protects of Ovarian Function During Chemotherapy REFERENCE: O-144 KATE STERN, Royal Women's Hospital, Melbourne A potential new way of preserving ovarian function during chemotherapy for cancer could be treatment with an antagonist of gonadotropin-releasing hormone: GnRH. A pilot study from Melbourne looked at 18 young women with cancer or auto immune disease due to receive cyclophosphamide therapy. Sarah Maxwell spoke with Kate Stern and heard more about the study.

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Audio Journal of Medicine, August 8th 2007 Visual Cervix Cancer Screening Test: Cheap and Effective in the Developing World REFERENCE: Lancet 2007;370:398-406 RENGASWAMY SANKARANARAYANAN, International Agency for Research on Cancer, Lyon An inexpensive visual cervix cancer-screening test has proved its worth in India according to a publication in the Lancet. Inspecting the cervix visually after applying 4% acetic acid can reduce the incidence and mortality from cervical cancer in developing countries. Nicola Solomon interviewed Rengaswamy Sankaranarayanan.

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Audio Journal of Medicine, August 9th 2007 Etravirine for HIV-1-infected Patients Failing Antiretroviral Therapy REFERENCE: Lancet 2007; 370:39-48 MARGARET JOHNSON, Royal Free Hospital, London A new non-nucleoside reverse-transcriptase inhibitor has demonstrated its activity in patients infected with HIV-1. TMC125, or etravirine, was compared with placebo in over 500 treatment-experienced patients in the DUET-2 trial, and Derek Thorne heard more from Margaret Johnson of the Royal Free Hospital in London.

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Audio Journal of Medicine, August 9th 2007 Tuberculosis: Non-Adherence to Treatment is a Major Obstacle to Therapy Success REFERENCE: PLoS Med 4(7):e238. doi:10.1371/journal.pmed.0040238 SIMON LEWIN, London School of Hygiene and Tropical Medicine Non-adherence is a big factor reducing the efficacy of tuberculosis treatment according to a review of research released by the Public Library of Science's online medical journal, PLoS Medicine. The article suggests that more needs to be done to resolve barriers to therapy compliance in order to help reduce the global burden of tuberculosis. Nicola Solomon interviewed Simon Lewin.

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Audio Journal of Medicine, August 2nd 2007 Reporting from: 23rd Annual Conference of the European Society of Human Reproduction and Embryology, 1-4 July 2007, Lyon, France Single Embryo Transfer: Just as High Live Birth Rates as Double Transfer, But Without Risks REFERENCE: O-004 KERSTI LUNDIN, Sahlgrenska University Hospital, Göteborg, Sweden The same birth rates following in-vitro fertilisation can be achieved with single embryo transfer as with double transfer, according to the findings of a study from Sweden. A retrospective investigation looked at whether multiple births, and other risk factors associated with double embryo transfer, can be avoided when single transfer is used whilst still achieving the same live delivery rates. Sarah Maxwell talked with study author Kersti Lundin during the European fertility conference in Lyon.

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Audio Journal of Medicine, August 2nd 2007 Reporting from: 23rd Annual Conference of the European Society of Human Reproduction and Embryology, 1-4 July 2007, Lyon, France Lapraroscopic Ovarian Diathermy Or Clomifene as First Line Treatment for Polycystic Ovarian Syndrome? REFERENCE: O-148 SAAD AMER, The Derby Medical School, Nottingham University More reassurance about the use of clomifene for treating anovulatory women with polycystic ovarian syndrome has emerged from a randomised study from Nottingham reported to the fertility conference held in Lyon. Laparoscopic ovarian diathermy, normally used as second line treatment (after clomifene), was found to be equivalent for inducing ovulation and pregnancy in a study with over sixty women. But Saad Amer explained to Sarah Maxwell why he still favours clomifene.

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Audio Journal of Medicine, August 2nd 2007 Reporting from: 23rd Annual Conference of the European Society of Human Reproduction and Embryology, 1-4 July 2007, Lyon, France Cortical Grafting Or Intact Ovary Transplantation for Preserving Fertility? REFERENCE: O-149 SHERMAN SILBER, St Luke's Hospital, St Louis MO A study from Missouri has shown that transplanting intact ovaries using microvascular surgical techniques is superior in the long term for restoring or preserving fertility to the simpler technique known as cortical grafting. Sarah Maxwell heard about the findings from Sherman Silber during the fertility conference held in Lyon.

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Audio Journal of Medicine, August 15th 2007 Earlier Interferon Reduces Disability in Patients With Multiple Sclerosis REFERENCE: Lancet 2007; 370: 389-97 LUDWIG KAPPOS, University Hospital, Basel Earlier treatment can reduce the risk of confirmed disability in patients with multiple sclerosis, according to a new study published in the Lancet. Three-year follow-up of the BENEFIT study showed favourable results among patients who began treatment with interferon beta-1b after a first event suggestive of multiple sclerosis, rather than waiting for further confirmatory events. Nicola Solomon interviewed Ludwig Kappos.

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Audio Journal of Medicine, August 23rd 2007 Vaginal Progesterone Reduced Risk of Preterm Birth in Women with Short Cervix REFERENCE: N Engl J Med 2007; 357: 426-9 KYPROS NICOLAIDES, Kings College Hospital, London The risk of giving birth prematurely was reduced among pregnant women with short cervices by treatment with vaginally administered progesterone: whether or not they had a history of preterm delivery. Investigators from London have reported in the New England Journal of Medicine that progesterone therapy significantly reduced the risk of spontaneous delivery before 34 weeks: from a one in three chance with a placebo to one in five with progesterone. Kypros Nicolaides discussed the results with Anna Lacey.

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Audio Journal of Medicine, August 29th 2007 Gene Study Identifies Heart Disease Risk REFERENCE: N Engl J Med 2007; 357: 443-53 NILESH SAMANI, University of Leicester UK Previously unrecognised DNA segments in human genes have been found to significantly increase the risk of coronary artery disease. That's according to a publication just out in the New England Journal of Medicine. Nilesh Samani from the University of Leicester explained how this will help identify new high-risk groups and target prevention before the disease develops in at risk individuals.

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Sunday, September 2nd - European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria 1. Blood Pressure Drugs Reduce Mortality in Patients with Diabetes: The ADVANCE Study REFERENCE: Abstract 312 Hot Line 1 Sunday STEPHEN MACMAHON, The George Institute, University of Sydney COMMENT: RAYMOND GIBBONS, Mayo Clinic, Rochester MN The randomised placebo controlled ADVANCE study of 11000 patients with diabetes has demonstrated that a combination of the ACE inhibitor, perindopril, with the diuretic indapamide can lower blood pressure and mortality. The investigators saw an impact even in patients who did not have high blood pressure. Lead study author Stephen MacMahon said this approach should be included in current practise guidelines. Sarah Maxwell spoke with him at the meeting in Vienna. Commented on Stephen McMahon's presentation of the ADVANCE study looking at the use of perindopril plus indapamide among patients with diabetes: a study with 11 000 patients divided between active and placebo in which a 14 per cent improvement in all-cause mortality, an 18 per cent reduction of cardiovascular deaths, was achieved together with reductions of the incidence of both renal and coronary disease. 2. Lifestyle and Heart Disease in Europe: A Growing Problem REFERENCE: Abstract 316 DAVID WOOD, Charing Cross Hospital, London Among 8000 coronary patients in 9 European countries, smoking prevalence hasn?t changed over the last 12 years, and obesity is going up ? that?s according to the combined EUROASPIRE surveys, which were presented at the ESC congress. Derek Thorne got more from David Wood, of Charing Cross Hospital in London. 3. Drug Eluting Stents, Bare Metal Stents: No Survival Difference REFERENCE: Hot Line 1 Sunday 11:00 2 Sept/ESC Congress 2007 Vienna 1-5 September STEFAN JAMES, Uppsala Clinical Research Centre, Sweden COMMENT: RAYMOND GIBBONS, Mayo Clinic, Rochester MN Another year?s results of the long term outcome of using drug-eluting stents as compared with bare-metal stents from Sweden reveal that there is no longer an increased risk of late mortality when using drug-eluting stents according to Stefan James of Uppsala Clinical Research Centre. He suggested that improvements in technique have helped reduce the risk of death or myocardial infarction associated with using drug-eluting stents nevertheless the risk of blood clots still remains. Overall survival of patients was found to be the similar for both categories of stent.

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Monday, September 3rd - European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria 1. Chronic Stable Angina: Should ESC Guidelines on Clopidogrel as Pre-Treatment to Planned Coronary Angiography be Changed? PETR WIDIMSKY, Charles University, Prague COMMENT: ECKART FLECK, Deutsches Herzzentrum Berlin REFERENCE: Hot Line II Monday 3rd Sept The ESC guideline suggesting all patients with chronic stable angina having coronary angiography should have clopidogrel pre-treatment is now being questioned following findings of the PRAGUE-8 Study, which randomized patients to receive the anti-platelet agent either non selectively before angiography, or selectively after angiography in those considered to need PCI. The PRAGUE investigators concluded that the ESC guideline was unjustified for the treatment of elective angiography in chronic stable angina, and that the previous practice of selective administration of clopidogrel should be resumed. Nicola Solomon talked with Petr Widimsky at the ESC Congress in Vienna. Derek Thorne heard comments on the findings from Eckart Fleck. 2. Enoxaparin Superior to Unfractionated Heparin for STEMI at 12 months Follow Up: ExTRACT-TIMI 25 Trial DAVID MORROW, Brigham and Women?s Hospital, Boston REFERENCE: 1027, Clinical Trial Update I Further data to support the use of enoxaparin has come out of the latest update from the ExTRACT-TIMI 25 study. It shows at 12 months follow up, that the benefits of enoxaparin are durable and still superior to unfractionated heparin for patients with ST elevation myocardial infarction undergoing fibrinolytic therapy. Sarah Maxwell interviewed David Morrow at the Vienna meeting. 3. Drug Eluting Stent Shows Great Benefit in Chronic Total Occlusions GERALD WERNER, Klinikum Darmstadt, Germany REFERENCE: Abstract 925 The ESC congress in Vienna heard that drug eluting stents are highly effective in chronically occluded arteries, when compared with bare metal stents. Derek Thorne got more on this German study from Gerald Werner, of Klinikum Darmstadt in Germany.

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Tuesday, September 4th - European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria 1. Drug Eluting Stents: Higher Late Mortality in STEMI Patients Than Bare Metal: GRACE Registry Findings GABRIEL STEG, Hôpital Bichat, Paris COMMENT: FREEK VERHEUGT, Radboud University Nijmegen Medical Centre, Nijmegen REFERENCE: Hotline III, number 709 The GRACE registry looking at over 60 000 patients with ST elevation myocardial infarction has shown that patients live longer if they receive bare metal stents than if they get drug eluting stents. Gabriel Steg presented these latest data at the ESC meeting in Vienna. Sarah Maxwell discussed the findings with him. 2. Looking for Atherosclerosis in the Legs Could Save Lives CURT DIEHM, University of Heidelberg COMMENT: FREEK VERHEUGT, Radboud University Nijmegen Medical Centre, Nijmegen Peripheral arterial disease (PAD) can be diagnosed easily by a test using the ankle brachial index (ABI) and its presence can indicate a high risk of myocardial infarction. Curt Diehm explained his findings to Derek Thorne, while Peter Goodwin got expert comment from Freek Verheugt. 2. Heart Attacks Drop After Smoking Ban in Ireland EDMOND CRONIN, Cork University Hospital REFERENCE: Abstract 3506, European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria Study data that support banning smoking in public places were unveiled at the ESC congress by a team from Ireland. After the smoking ban in 2004, admissions for acute coronary syndromes dropped, and lead author Edmond Cronin explained the significance of his findings to Derek Thorne.

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Wednesday, September 5th - European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria 1. Better Criteria For Cardiac Resynchronisation Needed in Heart Failure: PROSPECT Trial Results STEFANO GHIO, San Matteo University Hospital, Italy COMMENT: CECILIA LINDE, Karolinska University Hospital, Stockholm REFERENCE: Hotline III, 3222 page 315 The standard echocardiographic criteria for selecting patients to receive cardiac resynchronisation are not adequate according to Stefano Ghio. During the ESC Congress in Vienna he presented results from the PROSPECT trial and afterwards he talked with Sarah Maxwell. Cecilia Linde gave Nicola Solomon her comments on the findings. 2. Selective Invasive Treatment Best for Women with Non-ST Elevation Acute Coronary Syndromes EVA SWAHN, University Hospital Linköping, Sweden COMMENT: ECKART FLECK, Deutsches Herzzentrum, Berlin REFERENCE: HOTLINE II, Monday 8am Women who undergo selective invasive treatment for non-ST elevation acute coronary syndromes do better than those who receive routine early invasive treatment. This is according to the OASIS 5 study from Sweden that randomised women to either of the two approaches. The findings suggest that females with non-ST elevation ACS should be approached differently from their male counterparts. Sarah Maxwell interviewed OASIS investigator Eva Swahn at the ESC meeting in Vienna. Eckart Fleck of the Deutsches Herzzentrum in Berlin gave his comments on her comments to Derek Thorne. 3Patients with High Restenosis Risk Benefit More from Drug Eluting Stents RAUL MORENO, University Hospital La Paz, Madrid REFERENCE: Abstract 3103 Results from a large meta analysis suggest that drug eluting stents have a greater benefit when the risk of restenosis increases. This could affect the ?off label? use of these stents. Raul Moreno, of the University Hospital La Paz, Madrid, discussed his findings with Derek Thorne.

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Audio Journal of Medicine, September 18th, 2007 Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007 MRSA: Fight Superbug Using Hydrogen Peroxide Vapour JON OTTER, Bioquell Ltd, Andover UK REFERENCE: Poster Session 033 K-464, ICAAC 2007 Chicago 17-20 September An investigation looking at hydrogen peroxide vapour for sterilisation in hospital areas at risk of an outbreak of MRSA revealed that it can significantly reduce environmental contamination. Nicola Solomon discussed this new technique with Jon Otter of Bioquell Ltd.

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Audio Journal of Global Health Issues, September 19th, 2007 Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007 Vancomycin: New Guidelines May Induce Kidney Damage MEGAN NGUYEN, Western University of Health Sciences, Pomona REFERENCE: Poster Session 104 K-1096/ICAAC Congress 2007 Chicago 16-20 September New vancomycin guidelines that recommend using higher doses may cause kidney damage according to a study presented at the 2007 ICAAC meeting. Nicola Solomon discussed this new finding with Megan Nguyen of Western University of Health Sciences.

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Audio Journal of Medicine, September 18th, 2007 Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007 Nosocomial Clostridrium Difficile: Reduce by Cleaning with Household Bleach DONNA HACEK, Evanston Hospital, Evanston IL REFERENCE: Slide Session 42 K-608 Thorough, all surface bleach cleaning helps to achieve a significant and sustained reduction in nosocomial C. difficile infections according to a study from Evanston Hospital. Nicola Solomon discussed the results of this simple technique with Donna Hacek.

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Audio Journal of Medicine, September 18th, 2007 Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007 Bortezomib for Multiple Myeloma Can Cause Reactivation of Viruses GEORG HÄRTER, University Hospital, Ulm REFERENCE: Interscience Conference on Antimicrobial Agents and Chemotherapy, 17 ? 20 September 2007, Chicago For patients with multiple myeloma being treated with the proteasome inhibitor bortezomib, doctor?s should be wary of viral reactivation ? and they should give antiviral prophylaxis in all cases. This finding was unveiled at ICAAC by Georg Härter from the University Hospital in Ulm, and he shared his data with Derek Thorne.

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Audio Journal of Medicine, September 18th, 2007 Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007 Starting Antiretroviral Therapy Can Trigger Leprosy DIANA LOCKWOOD, London School of Hygiene and Tropical Medicine REFERENCE: Interscience Conference on Antimicrobial Agents and Chemotherapy, 17 ? 20 September 2007, Chicago ICAAC delegates heard that ?hidden? leprosy can be triggered in some patients who are receiving HIV antiretroviral therapy. So what might this mean for the countries that are rolling out this therapy to large numbers of people? Derek Thorne discussed the issue with Diana Lockwood of the London School of Hygiene and Tropical Medicine.

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Audio Journal of Medicine, September 18th, 2007 Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007 Maraviroc for HIV: Responses at 48 Weeks JACOB LALEZARI, Quest Clinical Research, San Francisco REFERENCE: Interscience Conference on Antimicrobial Agents and Chemotherapy, 17 ? 20 September 2007, Chicago Maraviroc could be a useful new drug for the treatment of some HIV infections, according to Jacob Lalezari of Quest Clinical Research in San Francisco. He presented 48 week results from the MOTIVATE 1 study and Derek Thorne spoke to him at ICAAC in Chicago

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Audio Journal of Medicine, September 18th, 2007 Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007 Monoclonal Antibody to Help Treat HIV? JEFFREY JACOBSON, Drexel University College of Medicine, Philadelphia REFERENCE: Interscience Conference on Antimicrobial Agents and Chemotherapy, 17 ? 20 September 2007, Chicago Could a monoclonal antibody have a role to play in HIV treatment? Early data on the PRO 140 antibody, presented at ICAAC, show that it does give responses. Derek Thorne discussed this news approach with Jeffrey Jacobson of Drexel University College of Medicine, Philadelphia.

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Audio Journal of Medicine, September 18th, 2007 Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007 Entecavir for Hepatitis B Linked to HIV Resistance MOIRA MCMAHON, Johns Hopkins University, Baltimore REFERENCE: Interscience Conference on Antimicrobial Agents and Chemotherapy, 17 ? 20 September 2007, Chicago The hepatitis B drug entecavir appears to select for a drug resistant HIV mutation ? and this has implications for patients infected with both viruses. Derek Thorne got the details from Moira McMahon from Johns Hopkins University in Baltimore.

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Audio Journal of Medicine, September 21st, 2007 Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007 BORIS: A. baumanni Highly Resistant ?-Lactamase and Varying Susceptibility Patterns JANE HATA, bioMéríeux Inc, Durham REFERENCE: Slide Session C2-1360/ICAAC Congress 2007 Chicago 16-20 September Reports from the BORIS study call for ongoing surveillance of multi-drug resistant Acinetobacter Baumanii. Investigators found varying susceptibility and resistance patterns across the United States that highlight the organisms ability to adapt. Nicola Solomon spoke with Jane Hata of bioMéríeux.

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Audio Journal of Medicine, September 21st, 2007 Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007 Hospital Hand Hygiene Program Successfully Rolled Out LINDSAY GRAYSON, Austin Hospital, Victoria, Australia REFERENCE: Abstract K-1374/ICAAC Congress 2007 Chicago 16-20 September A hand hygiene campaign implemented in six hospitals in Victoria, Australia has saved lives from MRSA, and saved twice as much money as it cost. Lindsay Grayson from Austin Hospital explained his data to Derek Thorne.

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Audio Journal of Medicine, September 21st, 2007 Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007 DUET 1 and 2 Trials: TMC 125 has Superior Virologic and Immunologic Response Rates PEDRO CAHN, Juan A. Fernández Hospital, Buenos Aires REFERENCE: Abstract H-717/ICAAC Congress 2007 Chicago 16-20 September Etravirine provides a chance to rescue patients who are failing non-nucleoside regimens according to 24-week pooled results of the DUET-1 and -2 studies. Nicola Solomon discussed these major trials with Pedro Cahn, of Juan A. Fernández Hospital in Buenos Aires.

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Audio Journal of Medicine, September 21st, 2007 Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007 Broad Approach, Including Computer System, to Improve Hospital Hygiene YEHUDA CARMELI, Tel-Aviv Medical Center REFERENCE: Abstract K-1373/ICAAC Congress 2007 Chicago 16-20 September Hospitals can prevent significant numbers of infections by taking up a multi-faceted approach, including the use of a computer program to guide the isolation of patients. Derek Thorne spoke to Yehuda Carmeli of the Tel-Aviv Medical Center about his hospital?s experience.

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Audio Journal of Medicine, September 21st, 2007 Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007 Which HIV Treatment is Best for Patients with HIV and Hepatitis C? JUAN BERENGUER, Hospital Gregorio Marañón, Madrid REFERENCE: Abstract V-1385/ICAAC Congress 2007 Chicago 16-20 September A retrospective study has thrown doubt on the theory that protease inhibitors (PIs) are a preferable antiretroviral treatment for patients co-infected with HIV and Hepatitis C virus. Previous research had suggested that PIs had a more beneficial effect on liver fibrosis than NNRTIs, but a study based at the Hospital Gregorio Marañón in Madrid has found the opposite. Derek Thorne discussed the data with Juan Berenguer.

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Audio Journal of Medicine, September 21st, 2007 Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007 Colistin Use Linked to Outbreak of Rare Hospital Infection RAMON GUEVARA, Los Angeles County Department of Public Health REFERENCE: Abstract K-1942/ICAAC Congress 2007 Chicago 16-20 September A report on a hospital outbreak involving a rare pathogen, which was presented at ICAAC, may have an important message for the whole field of infection control. Elizabethkingia Meningoseptica was found in a Los Angles hospital outbreak in 2006 and its emergence was linked to the use of colistin. So was this antibiotic selecting for the pathogen? Derek Thorne spoke with Ramon Guevara of Los Angeles County Department of Public Health.

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Audio Journal of Cardiovascular Medicine, November 5th, 2007 Reporting from: American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida Stable Angina: Add PCI To Medical Therapy If Guided by SPECT-Detected Ischemia? COURAGE Nuclear Sub-Study Results LESLEE SHAW, Emory University, Atlanta COMMENT: DANIEL JONES, AHA President, University of Mississippi, Jackson REFERENCE: Late Breaking Clinical Trials, Session 1 Some patients with stable angina may be best treated by adding percutaneous intervention to optimal medical therapy. This is the finding of a "nuclear sub-study" of the COURAGE (Clinical Outcomes Using Revascularization and Aggressive Drug Evaluation) trial. Although the study found no benefit of adding angioplasty in most patients, the AHA conference heard from Leslee Shaw that if myocardial ischemia is monitored using Single Photon Emission Computed Tomography (SPECT), there could be a role for angioplasty in a subgroup of patients. Peter Goodwin talked with Dr Shaw after her presentation and then asked the American Heart Association President, Daniel Jones, for his assessment.

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Audio Journal of Cardiovascular Medicine, November 5th, 2007 Reporting from: American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida Long Term Outcomes of Drug Eluting and Bare Metal Stents in Patients Undergoing PCI LAURA MAURI, Brigham and Woman?s Hospital, Boston Massachusetts COMMENT: RAYMOND GIBBONS, Mayo Clinic, Rochester, Minnesota REFERENCE: Late Breaking Special Session, AHA 2007 The largest study to date looking at long-term outcomes of bare metal stents as compared with drug eluting stents in patients who have undergone PCI was presented to the American Heart Association annual meeting. There was no increased mortality for patients who received drug eluting stents in a Massachussets based population. Sarah Maxwell spoke with investigator to Laura Mauri at the Orlando meeting.

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Audio Journal of Cardiovascular Medicine, November 5th, 2007 Reporting from: American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida Eptifibatide After PCI: Brief Infusion Is Just As Good ANTHONY FUNG, University of British Columbia, Vancouver REFERENCE: Late Breaking Clinical Trials Session I, AHA 2007 Brief courses of antiplatelet therapy with the glycoprotein 2b 3a inhibitor are just as effective as longer infusions for patients receiving non-emergency percutaneous intervention. So said Anthony Fung at the first session of Late breaking Clinical Trials held at the American Heart Association's annual meeting in Orlando. He talked with Peter Goodwin about his findings.

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Audio Journal of Cardiovascular Medicine, November 5th, 2007 Reporting from: American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida TRITON-TIMI 38 Prasugrel Or Clopidogrel In Percutaneous Intevention? GORDON TOMASELLI, Johns Hopkins University, Baltimore COMMENT: DANIEL JONES, President, American Heart Association, University of Mississippi, Jackson REFERENCE: Late Breaking Clinical Trials 1, AHA 2007 A potential new option for patients with acute coronary syndromes receiving coronary intervention has emerged following a report on the comparison of prasugrel, a new anti-platelet agent, with clopidogrel. Elliott Antman from Brigham and Women?s Hospital in Boston gave the American Heart Association his findings and recommendations about when and in which patients prasugrel might be favored. Gordon Tomaselli discussed the findings with Sarah Maxwell.

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Audio Journal of Cardiovascular Medicine, November 6th, 2007 Reporting from: American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida Eptifibatide as Effective as Abciximab in Primary PCI for Acute ST Elevation Myocardial Infarction: EVA-AMI Study UWE ZEYMER, Herzzentrum Ludwigshafen, Germany REFERENCE: Late Breaking Clinical Trials Session 1 The glycoprotein 2B 3A antagonist eptifibatide has performed as well as standard abciximab therapy in patients receiving primary angioplasty for acute myocardial infarction. So according to Uwe Zeymer who presented findings on this it can be used in this setting just as it is already being used in elective PCI. Sarah Maxwell interviewed Dr Zeymer at the Orlando conference.

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Audio Journal of Cardiovascular Medicine, November 6th, 2007 Reporting from: American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida TAXUS DES Trials Results: How Long Should Thienopyridine Be Used After Drug Eluting Stent? GREGG STONE, Columbia University, New York REFERENCE: Abstract 2357 New light has been thrown on the use of thienopyridine therapy after percutaneous intervention using drug-eluting stents. Gregg Stone presented data from the TAXUS DES trials which looked at patients surviving more than a year after receiving either paclitaxel-eluting or bare metal stents. After his talk at the American Heart Association he discussed his findings with Sarah Maxwell.

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Audio Journal of Cardiovascular Medicine, November 6th, 2007 Reporting from: American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida Rosuvastatin: No Significant Benefit for Older Patients with Systolic Heart Failure: CORONA Study Results AKE HJALMARSON, Sahlgrenska University, Göteborg COMMENT: GORDON TOMASELLI, Johns Hopkins University, Baltmimore REFERENCE: Late Breaking Clinical Trials Session 2 & N Engl J Med 2007;357 The lipid lowering agent rosuvastatin did not bring a significant benefit to older patients with systolic heart failure, according to the findings of the CORONA study released at the American Heart Association sessions in Orlando. Ake Hjalmarson talked with Peter Goodwin about the implications this has for using statins in older patients with heart failure.

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Audio Journal of Cardiovascular Medicine, November 6th, 2007 Reporting from: American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida Torcetrapib in Patients at High Risk for Coronary Events: ILLUMINATE Trial Latest Results PHILIP BARTER, Heart Research Institute, Sydney, Australia COMMENT: GORDON TOMASELLI, Johns Hopkins University, Baltmimore REFERENCE: Late Breaking Clinical Trials Session 2 A randomized double-blind study involving over 15,000 patients at high cardiovascular risk which looked at the new agent torcetrapib (an inhibitor of cholesteryl ester transfer protein, CETP) resulted in higher mortality in the experimental arm. The study compared torcetrapib plus atorvastatin with atorvatstin alone. Inhibition of CETP increases HDL levels and reduces LDL levels and should combat atherosclerosis. Sarah Maxwell spoke with Philip Barter who presented data on the ILLUMINATE trial at the American Heart Association meeting in Orlando.

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Audio Journal of Cardiovascular Medicine, November 6th, 2007 Reporting from: American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida Protective Cardiovascular Benefit for Women on HRT For Natural Menopause GEORGE SOPKO, National Heart, Lung And Blood Institute, Bethesda, Maryland COMMENT: JENNIFER MIERES, New York University REFERENCE: Abstract 3771 A new study presented to the American Heart Association meeting found women taking hormone replacement therapy since the menopause had a protective cardiovascular benefit. This was greater the earlier HRT was initiated and the women who took HRT had lower rates of coronary artery disease. Chief study author George Sopko spoke with Sarah Maxwell at the Orlando meeting.

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Audio Journal of Cardiovascular Medicine, November 6th, 2007 Reporting from: American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida Oral Contraceptive Use: More Carotid and Femoral Atheroschlerosis Later in Life ERNST RIETZSCHEL, University of Ghent, Belgium COMMENT: JENNIFER MIERES, New York University REFERENCE: News Briefing Women who used the contraceptive pill had increases in atherosclerotic plaque in their carotid and femoral arteries of between 20 and 30 percent by the time they reached late middle age. This is the finding of the ASKLEPIOS study conducted by the University of Ghent in which plaque was measured by ultrasound in 2 500 healthy men and women. Ernst Rietzschel presented data from the study to the 2007 Sessions of the AHA, and afterwards discussed the findings with Peter Goodwin.

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Audio Journal of Medicine, December 8th, 2007 Reporting from: American Society of Hematology Annual Meeting, December 8-11 2007, Atlanta Large Risk Reduction For Rivaroxaban In Blood Clot Prevention BENGT ERIKSSON, Gothenburg University REFERENCE: Abstract 6 In a large phase III trial of patients having a hip replacement, the oral anticoagulant rivaroxaban has shown significant benefit when compared to enoxaparin. Derek Thorne heard more from Bengt Eriksson of Gothenburg University.

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Audio Journal of Global Health Issues, December 8th, 2007 Reporting from: American Society of Hematology Annual Meeting, December 8-11 2007, Atlanta No Use Of Hydroxyurea In Country With Most Sickle Cell Anemia ZAKARI ALIYU, Howard University, Washington DC REFERENCE: Late Breaking Special Session, AHA 2007 Nigeria has the highest incidence of sickle cell anemia in the world, with over 150,000 children being born each year with the disease. But a new study has shown that no one is using the standard therapy hydroxyurea to treat it. Derek Thorne got more from Zakari Aliyu of Howard University in Washington DC.

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Audio Journal of Oncology, December 8th, 2007 Reporting from: American Society of Hematology Annual Meeting, December 8-11 2007, Atlanta New Drug AMG 531 Effective in Splenectomized Patients with Chronic Immune Thrombocytopenic Purpura TERRY GERNSHEIMER, University of Washington Medical Center, Seattle REFERENCE: ABSTRACT 2, ASH 2007 An investigational drug AMG 531 has increased and sustained platelet counts in splenectomized patients with chronic immune thrombocytopenia purpura or ITP. This was in a placebo controlled phase III trial that randomized patients to receive either the novel agent or a placebo. The new drug increased platelet counts and was also well tolerated. Sarah Maxwell spoke to study author Terry Gernsheimer from the University of Washington during the American Society of Hematology meeting in Atlanta.

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Audio Journal of Oncology, December 9th, 2007 Reporting from: American Society of Hematology Annual Meeting, December 8-11 2007, Atlanta Interleukin-2 For Acute Myeloid Leukemia In First Remission? JONATHAN KOLITZ, Monter Cancer Center, Lake Success, NY GEORGE CANELLOS, Dana-Farber Cancer Institute REFERENCE: ABSTRACT 157, ASH 2007 New data shows that dasatinib is giving durable responses in patients with chronic phase chronic myeloid leukemia who have failed, or who cannot tolerate imatinib. So where does dasatinib stand as an emerging CML therapy? Richard Stone of the Dana-Farber Cancer Institute in Boston explained all to Derek Thorne, while George Canellos, of the same institute, gave another perspective on the data.

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Audio Journal of Oncology, December 9th, 2007 Reporting from: American Society of Hematology Annual Meeting, December 8-11 2007, Atlanta Azacitidine ?New Standard? In High Risk Myelodysplastic Syndromes PIERRE FENAUX, Paris 13 University REFERENCE: ABSTRACT 817, ASH 2007 Results from a phase III study presented at ASH suggest that the hypomethylating agent azacitidine should be the new standard of care for patients with high-risk MDS. Pierre Fenaux of Paris 13 University gave the details to Derek Thorne.

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Audio Journal of Oncology, December 9th, 2007 Reporting from: American Society of Hematology Annual Meeting, December 8-11 2007, Atlanta Dasatinib Effective At Two Years? Follow Up in Chronic Phase CML RICHARD STONE, Dana-Farber Cancer Institute, Boston GEORGE CANELLOS, Dana-Farber Cancer Institute, Boston REFERENCE: ABSTRACT 734, ASH 2007 New data shows that dasatinib is giving durable responses in patients with chronic phase chronic myeloid leukemia who have failed, or who cannot tolerate imatinib. So where does dasatinib stand as an emerging CML therapy? Richard Stone of the Dana-Farber Cancer Institute in Boston explained all to Derek Thorne, while George Canellos, of the same institute, gave another perspective on the data.

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Audio Journal of Oncology, December 10th, 2007 Reporting from: American Society of Hematology Annual Meeting, December 8-11 2007, Atlanta Oblimersen Extends Survival in Chronic Lymphocytic Leukemia SUSAN O'BRIEN, MD Anderson Cancer Center, Houston REFERENCE: ASH 2007 For patients with relapsed or refractory CLL, oblimersen extends survival when added to standard fludarabine/cyclophosphamide chemotherapy. Susan O?Brien presented data from this phase III trial to the American Society of Hematology meeting in Atlanta. Sarah Maxwell reports.

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Audio Journal of Oncology, December 10th, 2007 Reporting from: American Society of Hematology Annual Meeting, December 8-11 2007, Atlanta Ibritumomab Provides Benefit in Patients with Follicular Lymphoma ANTON HAGENBEEK, University Medical Centre Utrecht REFERENCE: ABSTRACT 643, ASH 2007 For patients with advanced-stage follicular non-Hodgkin?s lymphoma, ibritumomab tiuxetan seems to prolong progression free survival by two years with favourable toxicity. Sarah Maxwell spoke to study author Anton Hagenbeek at the ASH meeting in Atlanta while George Canellos provided comment.

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Audio Journal of Oncology, December 11th, 2007 Reporting from: American Society of Hematology Annual Meeting, December 8-11 2007, Atlanta Can Intensive Immunochemotherapy Cure Mantle Cell Lymphoma? CHRISTIAN GEISLER, Rigshospitalet, Copenhagen REFERENCE: ABSTRACT LB1, ASH 2007 Mantle cell lymphoma, which was previously considered incurable, has apparently been cured in some patients on a phase II study. Derek Thorne got the details on the study ? which featured an intensive immunochemotherapy approach - from Christian Geisler of Rigshospitalet in Copenhagen.

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Reporting from: San Antonio Breast Cancer Symposium, 13-16 December, 2007 AACR In New Partnership For San Antonio Breast Cancer Symposium MARGARET FOTI, American Association for Cancer Research, Philadelphia The San Antonio Breast Cancer Symposium will, in the future, be presented jointly by the Cancer Therapy and Research Center at the University of Texas Health Science Center, Baylor College of Medicine, and the American Association for Cancer Research. Peter Goodwin found out more on this new collaboration from Margaret Foti, CEO of the American Association for Cancer Research in Philadelphia.

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Oncology, December 13th, 2007 Reporting from: San Antonio Breast Cancer Symposium, 13-16 December, 2007 Early Breast Cancer: Survival Benefit For Adjuvant Docetaxel/Cyclophosphamide STEPHEN JONES, US Oncology Research, Houston REFERENCE: ABSTRACT 12 Long term data from an early breast cancer trial involving cyclophosphamide combined with docetaxel or doxorubicin have shown a survival advantage for the taxane. As Stephen Jones of US Oncology Research explained to Derek Thorne, this advantage was also seen in patients over 65.

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Audio Journal of Oncology, December 15th, 2007 Reporting from: San Antonio Breast Cancer Symposium, 13-16 December, 2007 ATAC Trial: Anastrozole Still Superior At Over Eight Years? Follow Up JACK CUZICK, Wolfson Institute of Preventive Medicine, London REFERENCE: ABSTRACTS 41, 2069, 2071 New data from the ATAC trial, which is testing anastrozole and tamoxifen in early breast cancer, have demonstrated the continued superiority of the aromatase inhibitor. Among other things, the data now show a benefit in the time to distant recurrence. Derek Thorne heard more from Jack Cuzick, of the Wolfson Institute of Preventive Medicine in London.

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Audio Journal of Oncology, December 15th, 2007 Reporting from: San Antonio Breast Cancer Symposium, 13-16 December, 2007 New Drug RAD001 Plus Letrozole In Neoadjuvant Therapy For Breast Cancer JOSE BASELGA, Vall d?Hebron Hospital, Barcelona REFERENCE: ABSTRACT 2066 RAD001, a drug targeted at the mTor pathway, has been combined with letrozole in a randomised phase II trial in breast cancer. The investigators saw more responses in the experimental arm, and so Derek Thorne got the details from Jose Baselga of Vall d?Hebron Hospital in Barcelona.

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Audio Journal of Medicine, January 4th, 2008 Non Drug Intervention: Better Than Antipsychotic Drugs for Aggressive Challenging Behaviour in Intellectual Disability PETER TYRER, Imperial College, W6 8RP London REFERENCE: Lancet 371:57 January 5, 2008 A randomized study comparing treatment with risperidone, or haloperidol, or placebo to treat patients who have intellectual disability presenting with a syndrome commonly labelled as "aggressive challenging behaviour" has shown that the anti-psychotic medicines gave no benefit. Peter Goodwin met up with Professor Peter Tyrer at London's Imperial College to ask him about the study.

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Audio Journal of Medicine, January 11th, 2008 Meta-Analysis Proves Statins Help Patients With Diabetes COLIN BAIGENT, Oxford University REFERENCE: Lancet 371:117 January 11, 2008 Statins were foiund to cut cardiovascular event rates by a fifth among patients with both Type I and Type II diabetes in a meta-analysis of 18 000 patients from Oxford University in England and the University of Sydney in Australia. Peter Goodwin asked the lead UK investigator, Colin Baigent, about the findings and their implications.

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Audio Journal of Oncology, February 26th, 2008 Multiple Myeloma: Towards A Chronic Disease With Cure On The Horizon KENNETH ANDERSON, Dana-Farber Cancer Institute, Boston REFERENCE: 4th European Congress on Hematologic Malignancies, Paris 22-24 February, 2008 Multiple myeloma may soon be considered a chronic disease with cure on the horizon, thanks to an array of novel therapies which are turning prospects around for this malignancy. So said Kenneth Anderson at the European meeting in Paris. He explained to Peter Goodwin how a number of molecular and other therapies are changing the prospects for this disease.

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Audio Journal of Oncology, February 26th, 2008 "Total Therapy" Possible Cure For Multiple Myeloma? BART BARLOGIE, University of Arkansas, Little Rock REFERENCE: 4th European Congress on Hematologic Malignancies, Paris 22-24 February, 2008 A treatment known as "total therapy" could cure many patients with multiple myeloma, conference-goers have just heard. The targeted drugs thalidomide and bortezomib, coupled with tandem autologous transplants, are used by Arkansas-based Bart Barlogie. In Paris he told Peter Goodwin about their success.

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Audio Journal of Oncology, February 26th, 2008 Combinations and Targeted Agents: Better Survival in Mantle Cell Lymphoma MARTIN DREYLING, University Hospital Grosshaden, Munich REFERENCE: 4th European Congress on Hematologic Malignancies, Paris 22-24 February, 2008 Since the 1970s therapies for mantle cell lymphoma have greatly extended life, Martin Dreyling told conference delegates in Paris. He gave Peter Goodwin his latest data on combination therapy using the antibody, rituximab, and the emerging rôles of other targeted agents.

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