Many Children With Asthma Not Receiving Medication Due To Lack Of Insurance

Every year, 759,000 children with asthma may be at risk of a major asthma attack while they have no health insurance. About 30 percent of those families earn more than 200 percent of the federal poverty level, putting them above the threshold for the state children’s health insurance program in most states.

“Too many children with this chronic condition are without insurance at some point during the year,” said Jill Halterman, M.D., M.P.H., associate professor of Pediatrics at the University of Rochester and author of the study that appears in Ambulatory Pediatrics. “These children need to have ongoing treatment from a primary care provider to avoid serious health complications. Without that, they are at increased risk for ongoing symptoms and even hospitalization.”

About 13 percent of children with asthma were without insurance at some point during the year. That includes 2 percent – or 114,000 children – who were uninsured for the entire year. Those same children were 14 times more likely to have had an unmet need for medication than children with private insurance. Even those who gained insurance by the time of the survey were six times more likely to have missed out on needed medication.

The study, which is an analysis of data from the National Survey of Children’s Health (conducted by the Center for Disease Control’s National Center for Health Statistics between January 2003 and July 2004), also showed that many children with asthma were not seeing a regular physician often enough. Almost one-third of parents of uninsured children said they had no personal primary care doctor for their child. More than one-third of parents of children who had lost insurance and about half of parents of children with no insurance for a full year said their child hadn’t seen a personal doctor for preventive care in the past year.

“Healthy children should see a physician for preventive care at least once a year. Children with asthma need even more consistent care to prevent asthma attacks and other related illnesses. No year should go by for a child with asthma without at least one, if not more, visits to their regular physician to update treatment plans and address ongoing health issues,” Halterman said. “We, as physicians, have very clear guidelines about how to effectively manage a child’s asthma symptoms, but we can’t help these children if we don’t see them.”

No differences were found between children with private and public insurance, when it came to unmet needs, discontinuity in care or poor access. This suggests that consistency of coverage for children with asthma is more important than the source of insurance. Recent studies conducted by the University of Rochester Medical Center have shown that providing insurance to children with asthma through the State Child Health Insurance Program (SCHIP) reduces their unmet needs and reduces racial disparities in access to care.

“No child, especially one with a chronic health condition such as asthma, should go without health care because of situations over which they have no control. Insurance costs a lot to buy, and many people can’t get approved because of past health problems. There will always be families who earn too much to qualify for private insurance yet too little to afford private insurance. It is hard to see children suffer with conditions like asthma, where we know what to do and we know that it helps – just because they cannot get health insurance.” said Laura Shone, Ph.D., M.P.H., an assistant professor of pediatrics at the University of Rochester Medical Center and an author of this study and several others on children’s access to care.

Source: Heather Hare

University of Rochester Medical Center

Sun Pharma Announces USFDA Tentative Approval For Generic Namenda(R) Tablets

Sun Pharmaceutical Industries Ltd. (Reuters: SUN.BO, Bloomberg: SUNP IN, NSE:SUNPHARMA, BSE: 524715) announced that USFDA has granted its subsidiary a tentative approval for its Abbreviated New Drug Application (ANDA) to market a generic version of Forest Laboratories, Inc.’s Namenda 5 mg and 10 mg tablets.

These generic Memantine tablets are equivalent to Forest Laboratories, Inc’s Namenda® tablets and includes two strengths: 5 mg and 10 mg. These strengths of Memantine have a combined annual sale of approximately $1.2 billion in the US.

Memantine tablets are indicated for the treatment of moderate to severe Alzheimer’s Disease.

Namneda ® is a registered trademark of Forest Laboratories, Inc.

Licensed from Merz Pharmaceuticals GMBH.

Sun Pharmaceutical Industries Ltd.

View drug information on Namenda.

Way To Measure, Treat Autism Suggested By Brain Study

Researchers have pinpointed subtle deficits in the brains of people with autism spectrum disorder (ASD) that they say could aid more precise diagnoses and perhaps improve treatment of ASD. The researchers discovered characteristic patterns of brain activity in people with ASD that reflect an inability to perceive themselves as social creatures.

P. Read Montague and colleagues published their findings in the February 7, 2008, issue of the journal Neuron, published by Cell Press.

Their experiments involved asking groups of high-functioning people with ASD and normal people to play a “social trust” game as their brains were scanned using functional magnetic resonance imaging. In this widely used imaging technique, harmless magnetic fields and radio waves are used to map brain flow in brain regions, which reflects brain activity.

In the game, an “investor” decides how much of a fund of money to send to a “trustee.” The amount is tripled on the way to the trustee, and the trustee then decides what fraction to repay to the investor. The interaction is repeated ten times in each session. Previous studies had shown that the social game produces in normal people characteristic patterns of neural activity in the cingulate cortex, a region involved in higher brain activity.

The researchers found that, while people with ASD played the game the same as normal controls, the pattern of activity in their cingulate cortex indicated a diminished perception of themselves in a social interaction. The abnormality arose at the so-called “self” point in the game, where they were deciding how much to invest, and their brains were thus representing the social intent of their own behaviors.

The activity pattern seen in people with ASD during the game resembled the pattern seen in normal people when they played against a computer, in the absence of a social partner, noted the researchers.

The researchers concluded that their ability to quantify brain activity in people with ASD “may serve as a diagnostic tool, identify subtypes of autism, or be used to seek covariates in genetic databases.” They wrote that “the present data suggest that a quantitative analysis of neural responses on tasks as simple as video watching may be of diagnostic and therapeutic utility.” They suggested that the measurements they developed could be used in therapy to increase the ability of people with ASD to represent themselves in social interactions.

In a preview in the same issue of Neuron, Chris and Uta Frith wrote, “This is an exciting result because it suggests that some mechanisms of social interaction are intact in these high-functioning cases. What is the critical difference between the self phase and the other phase? We believe that the simple distinction of self versus other is not adequate.

“It involves higher-order mentalizing: you care what another person thinks of you, and even further, you care that the other person trusts you. You would not do this when playing against a computer. In autism there is no difference,” wrote the Friths, who are at University College London.

The researchers include Pearl H. Chiu, Baylor College of Medicine, Houston, TX; M. Amin Kayali, Baylor College of Medicine, Houston, TX; Kenneth T. Kishida, Baylor College of Medicine, Houston, TX; Damon Tomlin, Baylor College of Medicine, Houston, TX; Laura G. Klinger, Department of Psychology, University of Alabama, Tuscaloosa, AL; Mark R. Klinger, Department of Psychology, University of Alabama, Tuscaloosa, AL; and P. Read Montague, Baylor College of Medicine, Houston, TX.

Source: Cathleen Genova

Cell Press

A Second Risk Factor For Alzheimer’s

Researchers led by Howard Hughes Medical Institute (HHMI) international research scholar Peter St George-Hyslop have identified a new genetic risk factor associated with the most common form of Alzheimer’s disease. The research implicates a gene called SORL1 in late-onset Alzheimer’s, which usually strikes after age 65.

In an advance online publication in Nature Genetics on January 14, 2007, St George-Hyslop and colleagues connected the gene to the disease in six different groups of people, although they did not pinpoint the exact genetic mutations in SORL1 responsible for Alzheimer’s. In their studies, the researchers used databases that include genetic information about people with and without Alzheimer’s disease. More than 6,800 individuals 45.8 percent of them affected with the disease were included in the analysis, which is considered a large data set in the field, said St George-Hyslop.

“We looked for variations of SORL1 in nine different groups of people and found those variations to be associated with an increased risk of Alzheimer’s in six of them,” St George-Hyslop said. “That implies that SORL1 is not the only cause of Alzheimer’s, but it’s one of several. Some people with the disease will have a SORL1-related cause, and some won’t.” St George-Hyslop is a professor in the department of medicine and director of the Center for Research in Neurodegenerative Disease at the University of Toronto and an HHMI international research scholar. Through its international research scholars program, HHMI supports leading scientists in 28 countries outside the United States.

The researchers studied several groups of Caucasians, one group of African Americans, one group of Hispanics from the Dominican Republic, and a group of Israeli Arabs. They tracked the SORL1 genes via single nucleotide polymorphisms, or SNPs, which are single-letter changes in a gene’s sequence. They found that the Caucasians with Alzheimer’s displayed a certain SNP signature at one end of the gene, while the African Americans, Hispanics, and Israeli Arabs with the disease displayed another SNP signature. “This implies that there are at least two, and possibly more, gene variants at work here,” said St George-Hyslop. “That’s not unusual in many diseases you see multiple variations that all impact a specific gene.”

The team used the SNP databases to track the SORL1 gene in the populations studied, but did not actually pinpoint the precise changes in the gene that contribute to disease. “Now we need to go back and look in the regions around the clusters of SNPs that we tracked and see if we can find additional genetic changes that are either unique or enriched in the individuals with Alzheimer’s,” said St George-Hyslop. “Then we’ll have the actual genetic variations that lead to the disease.”

After linking SORL1 to late-onset Alzheimer’s, the team investigated the gene’s function. Using cell culture studies, they discovered that decreasing the amount of SORL1 increased cells’ production of amyloid-beta, a toxic fragment of another protein that destroys neurons. Production of amyloid-beta is the key event in the progression of Alzheimer’s disease.

Amyloid-beta is made when cells improperly break down a protein called amyloid precursor protein (APP). Previous research had revealed that APP is subjected to a sequence of cellular events that either properly recycles APP or shunts it into cellular structures called endosomes, where it is chopped into amyloid-beta. Researchers had identified several genes involved in this cellular sorting process. St George Hyslop and his team reasoned that inherited defects in some of these proteins might cause more APP to be shunted into endosomes, causing more amyloid-beta to be made, thereby increasing risk for Alzheimer’s. When the team investigated these genes, only SORL1 was associated with an increased risk of Alzheimer’s.

“What we have now are three independent sets of observations, all implicating the SORL1 gene in Alzheimer’s disease,” said St George-Hyslop. “We started with an observation from pathologists, showing reduced SORL1 protein levels in the brains of patients with Alzheimer’s. Then we have the observation by us and other groups that if you reduce SORL1 expression in either cell cultures or mice???”you get an increase in the production of amyloid-beta. Now we can add our new observation that variants of the SORL1 gene are associated with an increased risk of Alzheimer’s.”

St George Hyslop said that other researchers need to replicate the results in other groups. “Even though we’ve seen it in six different groups of people, seeing it in eight, nine, or ten is even better,” he explained. Three of the nine data sets that St George-Hyslop’s team studied did not reveal a significant association between SORL1 and Alzheimer’s. Non-SORL1 causes might have been overrepresented and SORL1-associated causes underrepresented in these data sets, St George-Hyslop explained. Alternatively, these data sets may have contained several different Alzheimer’s variants of SORL1, but each variant might have been associated with a different SNP pattern. That complexity would have obscured the SNP marker patterns that the researchers were tracking.

The importance of this work is that it identifies a new player among the mechanisms causing Alzheimer’s disease, St George-Hyslop said. “This will lead to the real endgame, which is to see how to exploit the findings as a new diagnostic or therapeutic target,” he said.

Howard Hughes Medical Institute (HHMI)
4000 Jones Bridge Rd.
Chevy Chase, MD 20815-6789
United States

Hebrew U. To Launch Biggest Center In Israel For Brain Research

Israel’s largest institute for brain research will be launched this week at the Hebrew University of Jerusalem. The new $130 million Edmond and Lily Safra Center for Brain Sciences (or ELSC), will be announced in the presence of Mrs. Lily Safra.

The Edmond J. Safra Philanthropic Foundation has made a lead donation of $50 million to the project, and the Hebrew University is seeking additional funding from its friends in Israel and around the world.

The decision to invest in a center for brain sciences is based on the findings of an international monitoring committee, whose members include two Nobel laureates, Prof. Bert Sakmann and Prof. Richard Axel. The committee determined that the level of research in the field of brain sciences at the Hebrew University is among the highest in the world and that a newly equipped center will enable the university to be ranked among the top five in the world in this field.

President of the Hebrew University Prof. Menachem Magidor said, “Thanks to the leadership of the Edmond J. Safra Philanthropic Foundation, the university will be able to help solve one of the key scientific questions of the 21st century — how the human brain works — by discovering new medical approaches for treating neurological disorders and applying new technologies that imitate the activity of the human brain.”

According to the acting director of the ELSC, Prof. Eilon Vaadia, “With an increasing aging population and a rise in the prevalence of neurological disorders in old age, brain research should be a key issue in modern society. In another 15 years or so, we as a society won’t have the financial capacity to support all the health problems for the growing ageing population, and so we must quickly find solutions.”

Mrs. Lily Safra, president of the Edmond J. Safra Foundation, said, “Understanding the brain is the premier challenge of our time, and I am confident that the Hebrew University’s investigators and students will make a profound impact. My husband Edmond would have been so proud that his name is linked to an initiative that brings new hope to families around the world suffering from Parkinson’s, Alzheimer’s and other devastating brain diseases.”

The Edmond and Lily Safra Center will pursue five different inter-cooperative fields of brain research. The first will focus on genes, molecules and nerve cells in the brain; the second will focus on research of structure and function of local neuronal circuits; the third will focus on research of electrical activity and the communication between brain areas, with the aim of understanding how senses, movement and thoughts are created; the fourth will research cognitive processes and will focus mainly on aspects of human brain function; while the fifth will focus on theoretical fields, computational aspects and building models of the nervous system, proposing new experiments and predicting their results. The ELSC will recruit an additional 15 members of staff to undertake the research.

To mark the launch of the Edmond and Lily Safra Center, a series of events involving leading researchers from the Hebrew University and overseas will be held as part of the 72nd meeting of the Hebrew University’s Board of Governors:
Symposium on June 8, “From brain research to brain repair,” will address advances in basic research in neuroscience and their consequences for treatment of neurodegenerative diseases. Lectures include “Genetics and neuroscience of autism;” “Deep brain stimulations for Parkinson’s disease;” “‘Prospects and challenges of stem cell research;” and “Advances in treatment of Alzheimer’s disease.” Speakers include Nobel laureate Prof. Bert Sakmann, Prof. Menachem Magidor, Prof. Gerald Fishbach, Prof. Nissim Benvenisty, Prof. Eilon Vaadia, Prof. Marta Weinstock-Rosin and Prof. Hagai Bergmann.

Roundtable discussion on June 9, “Brain, Art and Creativity,” will bring together artists and scientists to discuss the process of creativity and the potential for bridging the divide between art and science. Speakers include Prof. Idan Segev, artist Michal Rovner and Prof. Hanoch Gutfreund.

Roundtable discussion on June 10, “Neuroscience and Society,”| will highlight the far-reaching ethical, philosophical and psychological consequences of brain research. Speakers include Prof. Haim Sompolinsky, Prof. Hermona Soreq, Dr. Amir Amedi and Prof. Naftaly Tishby.

Jerry Barach

The Hebrew University of Jerusalem

MedImmune Announces Phase 2 Safety Data For Anti RSV Antibody And National RSV Surveillance Results

MedImmune, Inc. announced
results from two important studies presented at the 2007 Infectious
Diseases Society of America (IDSA) 45th Annual Meeting adding to the body
of knowledge about respiratory syncytial virus (RSV). RSV is a viral
pathogen that produces annual outbreaks usually between fall and spring.
While RSV typically manifests cold-like symptoms in healthy children, it
can prove to be a very serious respiratory illness for premature infants
and is the leading cause of respiratory infections for newborns each year.
MedImmune has long been committed to developing and improving products for
prevention of RSV disease and to enhancing the body of knowledge about RSV

“MedImmune continues to forge ahead with its aggressive strategy to
help combat RSV disease,” said Edward M. Connor, M.D., executive vice
president and chief medical officer. “We are pleased to present new Phase 2
data at IDSA regarding motavizumab, a key investigational monoclonal
antibody (MAb) within our product development portfolio that we are
currently preparing for regulatory submission in the United States.”

Connor added, “We will also present data regarding RSV surveillance at
IDSA. These data show regional variability of RSV in the community,
particularly in the southernmost United States. We believe that a better
understanding of the regional variation in the timing of RSV may help
inform decisions about timing of RSV prophylaxis for children at risk for
serious RSV disease.”

Data pertaining to MedImmune’s anti-RSV initiatives that will be
presented during the IDSA meeting include:

Safety, Tolerability, and Immunogenicity of Motavizumab in Young
Children After a Second Season of RSV Prophylaxis (Poster Presentation
#233) – Katia G. Abarca, M.D., Infectious Diseases and Molecular Virology
Laboratory, Universidad Catolica de Chile,

– Friday, October 5, 2007; 12:30 – 2:00 p.m. in Poster Halls G-H.

– This study assessed the safety and immunogenicity of
motavizumab, an investigational anti-RSV MAb, in young children
with a history of prematurity who received two sequential
seasons of the antibody.

RSV Surveillance: Retrospective and Current Data on the Variance in
Season Onsets and Offsets (Poster Presentation #719) – Jessie R. Groothuis
M.D., MedImmune,

– Saturday, October 6, 2007; 12:15 – 1:45 p.m. in Poster Halls G-H.
— A nationwide active surveillance program was established to
evaluate the variability of the RSV season temporally and
geographically in the United States. Laboratory results from a
three-year period were analyzed by month and by geographic

Additional information regarding the IDSA 45TH Annual Meeting can be
found at idsociety/Meetingshome.aspx?id=238.

MedImmune’s Commitment to RSV Prevention

MedImmune is a world leader in the development of innovative
therapeutic biologic products to prevent RSV disease. In 1996, MedImmune
launched the first anti-RSV drug, RespiGam(R) (respiratory syncytial virus
immune globulin intravenous (human) (RSV-IGIV)), which was a polyclonal
antibody administered via four-hour intravenous infusion. In 1998,
MedImmune introduced Synagis(R) (palivizumab), which was the first MAb to
receive U.S. Food and Drug Administration (FDA) approval for an infectious
disease. With the development of motavizumab, MedImmune continues to
reinforce its commitment to developing anti-RSV products. In a head-to-head
comparative Phase 3 trial with Synagis, motavizumab met its primary
endpoint of reducing RSV-related hospitalizations in high-risk pediatric
patients and met a secondary endpoint of reducing medically attended,
outpatient respiratory tract infections in that patient group. MedImmune is
also developing a small-molecule product candidate to prevent RSV as well
as a vaccine against RSV, both of which are in Phase 1 clinical trials.

About RSV

Each year, up to 125,000 infants in the U.S. are hospitalized with
severe RSV infections, the leading cause of lower respiratory tract
infections in infants in the United States. RSV is the most common
respiratory infection in infancy or childhood. Approximately one-half of
all infants are infected with RSV during the first year of life, and nearly
all children have been infected at least once by the time they reach their
second birthday. Children born prematurely as well as those with chronic
lung disease (CLD) or congenital heart disease (CHD) are at highest risk
for severe disease and hospitalization due to RSV. The virus may also cause
severe illness in other high-risk groups such as the elderly, those with
underlying respiratory or cardiac disease, and those with compromised
immune systems (e.g., bone marrow transplant patients).

About Motavizumab

Motavizumab, formerly known as Numax(R), is an investigational
humanized MAb being evaluated for its potential to prevent serious lower
respiratory tract disease caused by RSV in pediatric patients at high risk
of RSV disease. Phase 1 and Phase 2 study data have been reported showing
that motavizumab appears to have a similar safety and pharmacokinetic
profile to Synagis (palivizumab) in infants. Additionally, in early phase
studies children treated with motavizumab had reduced RSV replication in
the upper respiratory tract. In its first pivotal trial, which was a
head-to-head comparative trial with Synagis (palivizumab), motavizumab met
its non-inferiority objective by demonstrating a 26-percent relative
reduction in RSV hospitalizations and also showed a statistically
significant 50-percent relative reduction in the incidence of RSV lower
respiratory tract infections requiring outpatient management, a secondary

About MedImmune

MedImmune strives to provide better medicines to patients, new medical
options for physicians and rewarding careers to employees. Dedicated to
advancing science and medicine to help people live better lives, the
company is focused on the areas of infectious diseases, cancer and
inflammatory diseases. With approximately 3,000 employees worldwide and
headquarters in Maryland, MedImmune is wholly owned by AstraZeneca plc
(LSE: AZN.L, NYSE: AZN). For more information, visit MedImmune’s website at

MedImmune, Inc.

View drug information on Synagis.

Cyclist Tackles Amazing Feat To Raise Money For The American Lung Association

It’s not every day one wakes up and decides to ride their bike from San Francisco to Washington, D.C., but if you are Shawne Camp, anything is possible. Camp suffers from an extremely painful and rare lung disease called spontaneous pneumothorax, which can cause a sudden collapse of the lung. After enduring chest tubes, surgery to essentially glue his right lung to his chest wall and countless hours of pulmonary rehabilitation, Shawne has since made a full recovery.

With his reclaimed health, Camp is cycling cross country to raise money and awareness to benefit the American Lung Association’s fight for clean air and healthy lungs. Camp will cover more than 3,900 miles and cross through nine states during his nearly 50 day journey. He will have a total elevation gain of over 96,000 feet, which is the equivalent of climbing Mt. Everest 3.4 times if you start at sea level.

“I am doing this solo and trying to do this in the most cost effective and green way I can, so I will be camping most of the time,” said Camp. “I will be self-sufficient carrying a tent, small stove, small pot, sleeping bag, camera, phone, journal, a change of clothes, food, water and some spare bike parts.”

Camp departed San Francisco on May 2, 2009 and is expected to arrive at the American Lung Association in Washington, DC located at 530 7th Street, SE on Wednesday, June 17, 2009. Shawne’s arrival time is still being confirmed, but he is expected to arrive early in the afternoon. A special friend, four-year old Alexander Eller will ride the last 100 meters with Camp on his brand new two-wheel bike. Both cyclists will be greeted by a crowd of well-wishers who will gather for a celebration ceremony following his arrival.

“Shawne’s journey is truly an inspiration and a testament to the perseverance of the human spirit,” said Rolando A. Andrewn, American Lung Association in Washington, DC President and CEO. “We are truly honored by his dedication to take on such a massive challenge to support the work of the Lung Association.”

Washington area residents wanting to show their support for the American Lung Association but aren’t up for the challenge of a cross country bike trip are encouraged to participate in the Breathe DC Metro Walk on Saturday, June 27, 2009. This 5K walk commencing on the National Mall at 8:30 AM will raise money to fight lung disease and provide vital programs to those living and working in our nation’s capitol. For more information or to register for the Breathe DC Metro walk, please visit: breathedcmetrowalk.

American Lung Association

Clinical decision system helps reduce inappropriate antimicrobial prescribing

A clinical decision support system intervention reduced the overall use of antimicrobials for respiratory tract infections such as colds, bronchitis and sinusitis, according to a study in the November 9 issue of JAMA.

Antimicrobial resistance is a serious public threat that is exacerbated by the gradual withdrawal of the pharmaceutical industry from new antimicrobial agent development, according to background information in the article. Overuse of antimicrobial agents fosters the spread of antimicrobial-resistant organisms. Despite recent trends that demonstrate reduced outpatient use of antimicrobial agents, prescribing continues to significantly exceed prudent levels. Approximately 50 percent of courses of ambulatory antimicrobial drugs are prescribed for patients with viral respiratory infections and therefore, are not clinically indicated.

Matthew H. Samore, M.D., of the University of Utah, Salt Lake City, and colleagues evaluated the effectiveness of a direct intervention with primary care clinicians that was used to reduce the rate of inappropriate prescribing of antimicrobial drugs for acute respiratory infections. The intervention, the clinical decision support system (CDSS), incorporated stand-alone decision support tools on paper and a handheld personal digital assistant (PDA) to guide diagnosis and management of the acute respiratory tract infection. The researchers measured the added value of the CDSS when coupled with a community intervention.

The PDA-based CDSS generated diagnostic and therapeutic recommendations on the basis of patient-specific information that was input about the suspected diagnosis, such as the presence or absence of specific symptoms and signs. Therapeutic recommendations included over-the-counter medications for symptom control as well as prescription antimicrobials. In the study, antimicrobial agents were grouped into 4 classes: penicillins, macrolides, cephalosporins, and other.

The randomized trial included 407,460 inhabitants and 334 primary care clinicians in 12 rural communities in Utah and Idaho and a third group of 6 communities that served as nonstudy controls. The pre-intervention period was January to December 2001 and the postintervention period was January 2002 to September 2003. Six communities received a community intervention alone and 6 communities received community intervention plus CDSS that were targeted toward primary care clinicians. Community-wide antimicrobial usage was assessed using retail pharmacy data. Diagnosis-specific antimicrobial use was compared by chart review.

Within CDSS communities, 71 percent of primary care clinicians participated in the use of CDSS. The researchers found that during the second-intervention year, prescribing rates in CDSS communities decreased 10 percent from baseline, whereas in the community intervention?alone communities and nonstudy communities, prescribing rates in 2003 increased by 1 percent and 6 percent, respectively. The prescribing rate decreased from 84.1 to 75.3 per 100 person-years in the CDSS group vs. 84.3 to 85.2 in community intervention alone, and remained stable in the other communities. A total of 13,081 acute respiratory infection visits were documented for this study. The relative decrease in antimicrobial prescribing for visits in the antibiotics “never-indicated” category during the post-intervention period was 32 percent in CDSS communities and 5 percent in community intervention-alone communities. Use of macrolides decreased significantly in CDSS communities but not in community intervention-alone communities.

“This trial demonstrated the feasibility, uptake, and benefit of stand-alone, portable CDSS tools for acute respiratory infections in rural primary care settings. The CDSS decreased unnecessary use of antimicrobial agents for viral respiratory tract infections and improved antimicrobial agent selection,” the authors write.

“An unresolved question is whether the modest decrease in total antimicrobial prescriptions and more substantial reduction in macrolide use induced by the CDSS intervention was sufficient to lessen selection of resistant pneumococci and other bacteria in community populations. Decreased prevalence of resistant organisms may not necessarily accompany lowered antimicrobial consumption, in part because resistant organisms have an ability to develop compensatory mutations that ameliorate the fitness costs of resistance. More potent interventions that sustain greater improvements in antimicrobial use may be needed to adequately control antimicrobial resistance,” the researchers conclude.

(JAMA.2005; 294:2305-2314.)

For funding/support information, please see the JAMA article.

Appropriate Use of Antimicrobial Drugs – A Better Prescription Needed

In an accompanying editorial, J. Todd Weber, M.D., of the Centers for Disease Control and Prevention, Atlanta, comments on the studies in this week’s JAMA on antimicrobial drugs.

“All interventions for improving appropriate use of antimicrobial drugs must be introduced and promoted in the context of efforts to improve awareness among the public and to further educate prescribers. Additional interventions can include formulary restrictions, practice measures such as those currently used and planned for the Health Plan Employer Data and Information Set, clinical decision support systems, and other measures indirectly related to prescribing. These interventions, as well as algorithms and guidelines to improve antimicrobial use, must be transparently evidence-based. Such interventions that improve quality of care for individual patients save time, reduce prescribing errors, and reduce costs and are those most likely to be acceptable, effective, and sustainable.”

“Increased use of an electronic health record may serve as the framework for some of these practice changes. The electronic health record also may help answer the need for better, more universal, readily available data for designing and evaluating interventions that include patient-linked microbiological testing and results, diagnoses, and prescriptions. Surveillance systems under development, such as the National Healthcare Safety Network, may also provide the data required for better study of antimicrobial use and resistance,” Dr. Weber writes.

(JAMA.2005; 294:2354-2356.)

Chantelle Turner
JAMA and Archives Journals

New National Director For NHS Flu Resilience Appointed

Ian Dalton has been appointed the new National Director for NHS Flu Resilience at the Department of Health, Health Secretary Alan Johnson announced today.

Mr Dalton, currently Chief Executive of NHS North East, will take up this newly created position with immediate effect, reporting to NHS Chief Executive David Nicholson.

The establishment of this new role follows the recent Swine Flu outbreak. Mr Dalton will be responsible for ensuring that all NHS organisations in England build on the robust planning that is already in place to deal with a flu pandemic, that NHS front line organisations are supplied with adequate equipment and drugs, and leading on appropriate vaccination programs.

Health Secretary Alan Johnson said:

“We have been preparing for the possibility of a pandemic for a number of years and the World Health Organisation says we are among the most prepared countries in the world.

“We already have robust arrangements in place that are continuing to ensure we are well-placed to deal with Swine Flu. The appointment of Ian Dalton will support the vital operational side of our plans by ensuring every NHS organisation in England is in the best possible position to protect the population.

“Ian Dalton is highly respected in the NHS and brings a wealth of skills and experience to this challenging role. I am extremely pleased to be welcoming him to the Department.”

NHS Chief Executive David Nicholson said:
“The NHS has done a good job so far handling the swine flu challenge and we have clear plans in place for responding to future developments. Ian’s many years of senior management experience mean he is well placed to ensure the NHS is prepared and can continue to protect and care for people.”

Ian Dalton said:
“Preparing for and dealing with the threat of pandemic flu is extremely
important. The NHS is well placed to deal with such an eventuality and I
am looking forward to working with colleagues throughout England to
ensure the NHS continues to respond appropriately to any developing

Mr Dalton will remain substantive in his current post as Chief Executive for NHS
North East and will return to this role in due course. David Stout, currently Director of Finance and Communications, will be appointed as Acting Chief Executive for NHS North East.


1. Ian Dalton will work for the Department on a full-time basis, working between London and Leeds.

2. Ian Dalton is seconded from his current role of Chief Executive for NHS North East. He takes up this post today and will be in post as long as is required on a full time basis.

3. Ian has held a number of Chief Executive posts in the NHS and was previously seconded to the Foreign and Commonwealth Office to lead the reconstruction of the health service in Southern Iraq following the Second Gulf War.

Department of Health, UK
See our Map Of H1N1 Outbreaks
See our Mexico Swine Flu Blog

Memory Pharmaceuticals Completes Enrollment In Phase 2a MEM 1003 Alzheimer’s Disease Trial

Pharmaceuticals Corp. (Nasdaq: MEMY) today announced that it has completed
enrollment in its Phase 2a trial of MEM 1003 in Alzheimer’s disease. The
Company expects to report top-line results for this trial in the fourth
quarter of 2007.

“Completion of enrollment in this trial is a key milestone in our
Alzheimer’s disease programs,” said Stephen R. Murray, M.D., Ph.D., Vice
President of Clinical Development. “We are excited that the MEM 1003 Phase
2a trial is nearing completion and are focused on reporting top-line
results from both this trial, and our ongoing Phase 2a trial of MEM 3454
for Alzheimer’s disease, in the fourth quarter of this year.”

This Phase 2a clinical trial is a multi-center, randomized,
double-blind, placebo-controlled study to evaluate the safety and efficacy
of two dose levels of MEM 1003 in approximately 180 subjects with mild to
moderate Alzheimer’s disease at over 50 centers in the United States.
Subjects participating in the study were randomized at enrollment into one
of three treatment groups — 30 mg of MEM 1003 twice a day, 90 mg of MEM
1003 twice a day or placebo twice a day. During the double-blind treatment
segment of the study, subjects receive MEM 1003 or placebo for a period of
12 weeks, which is followed by a four week single-blind placebo treatment.
The primary outcome measure of the trial is a twelve-week change in the
Alzheimer’s Disease Assessment Scale — Cognitive subscale (ADAS – cog)
score. Secondary measures will assess changes in activities of daily
living, behavior and global function.

MEM 1003 is a neuronal L-type calcium channel modulator that Memory
Pharmaceuticals is developing for the treatment of Alzheimer’s disease. By
blocking L-type calcium channels, MEM 1003 may regulate the flow of calcium
and reestablish normal levels of calcium, which may help treat and prevent
the onset of Alzheimer’s disease.

About the Company

Memory Pharmaceuticals Corp., a biopharmaceutical company, is focused
on developing innovative drugs for the treatment of debilitating CNS
disorders such as Alzheimer’s disease, schizophrenia and depression. For
additional information, please visit our website at

Safe Harbor Statement

This press release contains forward-looking statements within the
meaning of the Private Securities Litigation Reform Act of 1995 that are
subject to risks and uncertainties. All statements, other than statements
of historical facts, regarding management’s expectations, beliefs, goals,
plans or Memory Pharmaceuticals’ prospects, future financial position,
future revenues and projected costs should be considered forward-looking.
Readers are cautioned that actual results may differ materially from
projections or estimates due to a variety of important factors, including
the risks and uncertainties associated with: obtaining additional financing
to support Memory Pharmaceuticals’ R&D and clinical activities and
operations; the outcome of clinical trials of Memory Pharmaceuticals’ drug
candidates and whether they demonstrate these candidates’ safety and
effectiveness; obtaining regulatory approvals to conduct clinical trials
and to commercialize Memory Pharmaceuticals’ drug candidates; Memory
Pharmaceuticals’ ability to enter into and maintain collaborations with
third parties for its drug development programs; Memory Pharmaceuticals’
dependence on its collaborations and its license relationship with Bayer;
achieving milestones under Memory Pharmaceuticals’ collaborations; Memory
Pharmaceuticals’ dependence on preclinical and clinical investigators,
preclinical and clinical research organizations, manufacturers and
consultants; and protecting the intellectual property developed by or
licensed to Memory Pharmaceuticals. These and other risks are described in
greater detail in Memory Pharmaceuticals’ filings with the Securities and
Exchange Commission. Memory Pharmaceuticals may not actually achieve the
goals or plans described in its forward-looking statements, and investors
should not place undue reliance on these statements. Memory Pharmaceuticals
disclaims any intent or obligation to update any forward-looking statements
as a result of developments occurring after the date of this press release.

Memory Pharmaceuticals Corp.