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An American man who suffered from AIDS appears to have been cured of the disease 20 months after receiving a targeted bone marrow transplant normally used to fight leukemia, his doctors said.

While researchers — and the doctors themselves — caution that the case might be no more than a fluke, others say it may inspire a greater interest in gene therapy to fight the disease that claims 2 million lives each year. The virus has infected 33 million people worldwide.

Dr. Gero Huetter said Wedneday his 42-year-old patient, an American living in Berlin who was not identified, had been infected with the AIDS virus for more than a decade. But 20 months after undergoing a transplant of genetically selected bone marrow, he no longer shows signs of carrying the virus.

“We waited every day for a bad reading,” Huetter said.

It has not come. Researchers at Berlin’s Charite hospital and medical school say tests on his bone marrow, blood and other organ tissues have all been clean.

However, Dr. Andrew Badley, director of the HIV and immunology research lab at the Mayo Clinic in Rochester, Minn., said those tests have probably not been extensive enough.

“A lot more scrutiny from a lot of different biological samples would be required to say it’s not present,” Badley said.

This isn’t the first time marrow transplants have been attempted for treating AIDS or HIV infection. In 1999, an article in the journal Medical Hypotheses reviewed the results of 32 attempts reported between 1982 and 1996. In two cases, HIV was apparently eradicated, the review reported.

Huetter’s patient was under treatment at Charite for both AIDS and leukemia, which developed unrelated to HIV.

As Huetter — who is a hematologist, not an HIV specialist — prepared to treat the patient’s leukemia with a bone marrow transplant, he recalled that some people carry a genetic mutation that seems to make them resistant to HIV infection. If the mutation, called Delta 32, is inherited from both parents, it prevents HIV from attaching itself to cells by blocking CCR5, a receptor that acts as a kind of gateway.

“I read it in 1996, coincidentally,” Huetter told reporters at the medical school. “I remembered it and thought it might work.”

Roughly one in 1,000 Europeans and Americans have inherited the mutation from both parents, and Huetter set out to find one such person among donors that matched the patient’s marrow type. Out of a pool of 80 suitable donors, the 61st person tested carried the proper mutation.

Before the transplant, the patient endured powerful drugs and radiation to kill off his own infected bone marrow cells and disable his immune system — a treatment fatal to between 20 and 30 percent of recipients.

He was also taken off the potent drugs used to treat his AIDS. Huetter’s team feared that the drugs might interfere with the new marrow cells’ survival. They risked lowering his defenses in the hopes that the new, mutated cells would reject the virus on their own.

Anthony Fauci, director of the National Institute of Allergy and Infections Diseases in the U.S., said the procedure was too costly and too dangerous to employ as a firstline cure. But he said it could inspire researchers to pursue gene therapy as a means to block or suppress HIV.

“It helps prove the concept that if somehow you can block the expression of CCR5, maybe by gene therapy, you might be able to inhibit the ability of the virus to replicate,” Fauci said.

David Roth, a professor of epidemiology and international public health at the London School of Hygiene and Tropical Medicine, said gene therapy as cheap and effective as current drug treatments is in very early stages of development.

“That’s a long way down the line because there may be other negative things that go with that mutation that we don’t know about.”

Even for the patient in Berlin, the lack of a clear understanding of exactly why his AIDS has disappeared means his future is far from certain.

“The virus is wily,” Huetter said. “There could always be a resurgence.”

A large European study has confirmed that simple measurements of the waist and hips may offer a better way of predicting obesity-related death than a standard, but more complicated, system of relating weight to height.

The standard body mass index, or BMI, method does not work very well for some people, such as the elderly or body builders, and researchers have begun building a case that it is better to look at waist circumference or the ratio of waist size to hip size.

Among people with comparable BMIs, having an extra 2 inches around the waist increased the annual risk of death by 17 percent for men and 13 percent for women, according to the team led by Dr. Tobias Pischon of the German Institute of Human Nutrition Potsdam-Rehbruecke in Nuthetal, Germany.

When they calculated the waist-to-hip ratio by dividing a person’s waist size, measured at the navel, by the biggest part of their hips, the Pischon group found that the risk of death increased by 34 percent for men and 24 percent for women every time that ratio increased by 0.1.

Hip circumference alone did not predict death any better than BMI, which is a person’s weight in kilograms divided by the square of the height in meters, the researchers found.

They used data from the European Prospective Investigation into Cancer and Nutrition database, involving 359,387 people in nine countries.

Even among people of normal weight, men with the biggest bellies had more than twice the death rate of the slimmest. For women, the rate was 79 percent higher if their weight was in the normal range yet their bellies were big.

The findings, published in the New England Journal of Medicine, “underscore the importance of assessing the distribution of body fat even among persons of normal weight and challenge the use of cutoff points to define abdominal obesity, at least when they are used to predict the risk of death,” the researches wrote.

Earlier research had suggested that men should not have a waist-to-hip ratio above 0.95, and in women it should be no higher than 0.8.

Organized exercise designed to increase strength, flexibility, mobility and coordination may improve overall physical function among nursing home patients with Alzheimer’s disease, researchers report.

Alzheimer’s disease patients who have physically deteriorated are less able to perform activities of daily life, which, in turn, affects their quality of life. Despite the well-known physical benefits obtained from exercise, Professor Alejandro Lucia and colleagues in Spain found comparatively little research has focused on exercise training among patients with Alzheimer’s disease.

To address this, Lucia, of the Universidad Europea De Madrid, and collaborators compared the outcomes of 16 Alzheimer’s disease patients who were randomly assigned to receive normal care involving no programed exercise or to a12-week exercise program as part of their nursing home care.

Each group consisted of five women and three men of similar functional capacity at the start of the study. Participants’ average age was 73 years in the normal care group and 76 years in the exercise group, the investigators report in the International Journal of Sports Medicine.

Exercise sessions, held 3 days each week, included 75 minutes of warm-up and cool-down stretching, inside walking, joint mobility activities, elastic exercise-band resistance training, and coordination exercises using foam balls.

Lucia’s team reports the exercise group had significant improvements in measures of upper and lower body strength and flexibility; agility and balance; walking abilities; and endurance. Exercise participants also showed greater ability to independently perform activities of daily living such as rising from a chair, transferring from bed to chair, bathing, or dressing.

By contrast, the normal care group showed no changes over the 12-week period.

These findings show that shorter duration exercise programs “are sufficient to induce significant improvements in patients’ functional performance and independence,” the investigators state. Adherence to the training program was nearly 100 percent, they add.

While more evidence of efficacy is needed from larger study populations, Lucia and colleagues suggest similar programs could be included in the overall nursing home care of Alzheimer’s disease patients.

Twelve students fell ill and had to be taken to the nearest health centre after consuming iron tablets given by the health staff of their school in an Uttar Pradesh village, officials said Friday.

‘The incident took place Thursday at the government-run Dayanand Primary School in Mishran village in Jaunpur district, some 150 km from Lucknow,’ Deputy Chief Medical Officer Rajeev Yadav told IANS.

After consuming the iron tablets, nearly a dozen students complained of severe stomach ache and vomiting, following which they were taken to a community health centre, officials said.

‘Now all the students are doing fine,’ Yadav said.

According to Yadav, an inquiry into the matter has been initiated.

‘We still need to confirm what made the students ill. The stock of iron tablets has been seized and has been sent to the lab for testing,’ Yadav said.

Scientists have discovered a cellular mechanism behind traumatic memories, activated by a stress hormone, which may be linked with our long-term survival.

University of Queensland Brain Institute’s (QBI) Louise Faber and her colleagues have demonstrated how noradrenaline, the brain’s equivalent of adrenaline, affects the amygdala (almond-shaped part of the brain, associated with processing emotions by controlling chemical and electrical pathways).

“This is a new way of understanding how neurons form long-term memories in the amygdala,” Faber said.

“Our strongest and most vivid human memories are usually associated with strong emotional events such as those associated with extreme fear, love and rage. For many of us, our deepest memories are mental snapshots taken during times of high emotional impact or involvement,” she said.

“Some aspects of memory formation are incredibly robust - and the mechanism we’ve discovered opens another door in terms of understanding how these memories are formed,” reported a QBI press release.

Faber said her team’s discovery could help other scientists to elucidate new targets, leading to better treatment for conditions such as anxiety disorders and post-traumatic stress disorder.

These findings were published in the Journal of Neuroscience.

A new study suggests that people with advanced colon cancer who have a particular gene mutation won’t benefit from the medication cetuximab (Erbitux).

While the drug can add months to the lives of people without a mutation in a gene called K-ras, those who have the mutation won’t see any benefit from this additional therapy, reports the study, which is published in the Oct. 23 issue of the New England Journal of Medicine.

“We believe that, in the context of pre-treated advanced bowel cancer, the K-ras mutation status of the cancer should be determined before using cetuximab, and cetuximab should only be given to patients with tumors that do not have the mutation,” said study author Dr. Christos S. Karapetis, a senior consultant medical oncologist and director of clinical research in the department of medical oncology at Flinders Medical Centre in Australia.

Karapetis said that about four in 10 people with colon cancer have the K-ras mutation.

Erbitux works by interrupting cell growth and division. It does this by binding to a receptor known as epidermal growth factor receptor (EGFR). A mutation in the K-ras gene is believed to interfere with cetuximab’s ability to disrupt EGFR, according to the study.

For the study, 572 people with advanced colorectal cancer were randomly assigned to receive either weekly treatment with cetuximab and supportive care (287 people) or supportive care alone (285 people). All had undergone other treatment options without success.

Almost 400 tumor specimens from the study volunteers were tested for K-ras mutations (198 from the cetuximab group and 196 from the supportive care group). Just over 42 percent of the tumors evaluated were found to have mutations in the K-ras gene.

Even with cetuximab treatment, people with K-ras mutations had no significant changes in overall survival or in progression-free survival. Those without the mutations, on the other hand, appeared to benefit significantly from the therapy.

People with no K-ras mutations who were treated with cetuximab had nearly twice the overall survival rate compared to the supportive care group — 9.5 months versus 4.8 months. And, the time of progression-free survival was also nearly doubled for those treated with cetuximab — 3.7 months versus 1.9 months in the supportive care group.

“Patients with a colorectal tumor bearing mutated K-ras did not benefit from cetuximab,” the researchers concluded.

“This study suggests that if someone has this particular mutation, they won’t respond to this drug,” said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society. “The bottom line is that this study is important and really has the potential to impact how we treat patients with colorectal cancer with this very expensive drug.”

He added that other researchers have noted similar results for K-ras mutations in earlier-stage colorectal cancer.

“This is one more refinement on personalized medicine, and we’re moving into an age of molecular markers that eventually will guide treatment. If someone has a cancer in the future, that cancer will be analyzed for what kind of cancer it is, and then we’ll know what the best treatments are for that cancer,” Lichtenfeld said.

Another important molecular marker that guides treatment is already in use for breast cancer treatment, according to Lichtenfeld. Breast cancers are tested for HER2, a type of estrogen and progesterone receptor. Those with this molecular marker are likely to have a more aggressive type cancer, but also a type of cancer that responds to treatment with the drug trastuzumab (Herceptin).

“I’m excited about the future, and this study shows we can be more targeted with our targeted therapies,” said Lichtenfeld.

A consumer court has asked a leading government-run hospital here to pay Rs.500,000 in compensation to the widow of a man who underwent incorrect radiotherapy as a result of which he died.

“Taking an overall view of the matter, we find the hospital alone guilty for deficiency in service and in our view a lumpsum compensation of Rs. 500,000 shall meet the ends of justice,” Justice J.D. Kapoor, president of the Delhi Consumer Disputes Redressal Commission said in his order.

The ruling came on an appeal of the Lok Nayak Jai Prakash (LNJP) Hospital against an order of the district consumer commission asking it to pay Rs.800,000 in compensation.

Ramveer Singh had been admitted to the G.B. Pant Hospital here Dec 16, 1997 and was operated upon Dec 19 for removing a tumor. He was discharged Dec 26.

However, he suffered a relapse and was again admitted to the hospital April 25, 1998, was operated upon May 1 and was discharged a week later.

Singh was then referred to the LNJP Hospital for radiotherapy for removing tumor tissues that had developed in his body. The treatment commenced May 25.

Singh underwent two sessions of radiotherapy. In the first, lead blocks were placed around the affected area of the spinal cord but in the second, but in the second, wet cotton gauze was used instead. This resulted in Singh being paralysed from the waist downwards. He ultimately died Oct 20, 2004.

Singh had first approached the district consumer forum, alleging that the LNJP doctor who conducted the radiotherapy was a trainee and did not check the focus of the heat on the affected portion of his body, thus causing his paralysis.

The district forum awarded Singh’s widow Rs.800,000 but the LNJP Hospital contested this, saying there had been no medical negligence on its part. No complications had occurred due to any error in conducting the radiotherapy, the hospital said in its appeal to the state consumer commission.

In his order, Kapoor said: “Whenever a patient lands himself in a hospital, private or government, his direct contract is with the hospital and not with the attending staff or the doctors as there is no consideration paid to those doctors or staff individually.”

He further noted the direct relationship was between the patient and the hospital. Therefore, no individual doctor can be held liable.

“The consumer does not avail services of such doctors individually by paying fees or consideration to those doctors directly. It is only those persons whose services are hired or availed that come within the net of a service provider,” the commission ruled.

Doctors baffled by an unexplained rash on people’s ears or cheeks should be on alert for a skin allergy caused by too much mobile phone use, the British Association of Dermatologists said on Thursday.Citing published studies, the group said a red or itchy rash, known as ‘mobile phone dermatitis’, affects people who develop an allergic reaction to the nickel surface on mobile phones after spending long periods of time on the devices.

“It is worth doctors bearing this condition in mind if they see a patient with a rash on the cheek or ear that cannot otherwise be explained,” it said.

The British group said many doctors were unaware mobile phones could cause the condition.

Safety concerns over mobile phones has grown as more people rely on them for everyday communication, although the evidence to date has given the technology a clean bill of health when it comes to serious conditions like brain cancer.”In mobile phone dermatitis, the rash would typically occur on the cheek or ear, depending on where the metal part of the phone comes into contact with the skin,” the group said in a statement.

“In theory it could even occur on the fingers if you spend a lot of time texting on metal menu buttons.”

Nickel is a metal found in products, ranging from mobile phones to jewellery to belt buckles and is one of the most common causes of allergic contact dermatitis, according to the Mayo Clinic in the United States.

Earlier in 2008, Lionel Bercovitch of Brown University in Providence, Rhode Island and colleagues tested 22 popular handsets from eight different manufacturers and found nickel in 10 of the devices.

A Web site meant to help parents understand medical research in children was launched recently by the U.S. National Institutes of Health (NIH).

The Children and Clinical Studies site explains why and how clinical studies in children are conducted, and outlines measures taken to protect participants’ safety and privacy. The site also features videos of children, parents and health-care providers discussing the rewards and challenges of taking part in this kind of research.

“Clinical studies are essential to improving our understanding of how to diagnose, prevent and treat disease — as well as how to stay healthy — and this is true of children as well as adults,” Dr. Elizabeth G. Nabel, director of the NIH’s Heart, Lung, and Blood Institute (NHLBI), said in a government news release.

“We hope this new resource will help parents and others learn more about how clinical studies are conducted in children, so they can make well-informed decisions about whether to enroll their child in a study,” Nabel said.

“Children are not little adults — their bodies and their brains are still developing,” Dr. Renee R. Jenkins, president of the American Academy of Pediatrics and a professor in the department of pediatrics and child health at Howard University College of Medicine, said in the news release. “A good example of their unique research needs is understanding how medications affect the developing child and adolescent, and clinical trials are the best way to do that.”

The Web site, developed by NHLBI in collaboration with New England Research Institutes and other groups, includes a list of questions for parents to ask researchers when deciding whether to enroll their child in a study. Other topics covered on the Web site include: how institutional review boards monitor studies for safety; important terms to know, such as informed consent and assent; the rights of families enrolled in clinical studies; and how a child’s participation in a research study can affect the entire family.

“It’s perfectly natural for parents to be concerned about the risks and benefits of enrolling their child in a research study,” Dr. Gail Pearson, an NHLBI pediatric cardiologist who oversees the Pediatric Heart Network, said in the news release. “They should know that there is almost no other time in a child’s life that they will have as many safeguards brought to bear on their well-being than when they are in a clinical trial.”

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