Clinical Trials News

Obama Set To Lift Restrictions On Stem Cell Research

2009-02-02T04:52:00.000-08:00

Researchers in Texas and throughout America are eagerly waiting to hear that President Barack Obama has lifted restrictions on using human embryonic stem cells in research, an event the US media is expecting to happen later this week.

According to a report in the Houston Chronicle, Baylor College of Medicine and the University of Texas Health Science Center at Houston are both centres of excellence in stem cell research, and while most of their work has been focusing on adult stem cells, they anticipate a huge expansion of activity when Obama overturns the policy of former President George W Bush.

Unlike adult stem cell research that uses cells harvested from tissue taken from people without harming them, embryonic stem cells are taken from 5- day old embryos that have to be destroyed in the process, putting the issue at the centre of a heated ethical and political debate.

Baylor Professor Bill Brinkley, a molecular and cellular biologist, told the Houston Chronicle that lifting the restriction will make embryonic stem cell research mainstream:

"Most every lab will take advantage of it," said Baylor.

Embryonic stem cells can become any of the 220 types of cell in the body. Scientists predict they will one day be used to make new tissue to replace old and diseased nerves, bones, muscles, heart tissue, and blood vessels. For example, animal studies have already shown it may be possible to create new brain cells, muscle tissue, and pancreatic cells, with potential for treating Parkinson's, muscular dsytrophy and diabetes, respectively.

In 2001, Bush put the brakes on embryonic stem cell research by restricting it to existing cell lines only (ie no more harvesting from embryos). There were only about 20 or so of these in existence at the time and their condition was said to be poor and not very useful for clinical work. Many scientists felt this severely hampered their ability to do serious research in the field.

During his election campaign, Obama promised to lift Bush's restriction to allow scientists to use stem cells harvested from embryos that would otherwise be discarded in fertility clinics. He is planning to do this after he has finished working on the plans to revive the economy, said the Chronicle. A legal bill would still be needed to ratify the policy.

Some say Bush wanted to slow down embryonic stem cell research to make scientists focus on adult stem cells.

Adult stem cells are not as versatile as embryonic stem cells: their potential tends to be restricted to the type of tissue they originated from, although some recent experiments have shown they may be more plastic than first thought and it might be possible to make them behave more like embryonic stem cells.

However, scientists are nervous about using the adult stem cell approach because it involves using genetically engineered viruses which can cause tumors.

Paul Simmons, an adult stem cell researcher and director of University of Texas Houston's Center for Stem Cell Research, told the Chronilce that the technique was far from perfect and doubts whether it will eventually be as good as using embryonic stem cells. Perhaps in the end, scientists will find that adult stem cells are good for some things and embryonic stem cells are better for others, he said.

Scientists at the University of California at Irvine have already developed a therapy using embryonic stem cells that made paralyzed rats walk again. Earlier this month they were given federal approval to go ahead and test their approach in humans, the first embryonic stem cell treatment to be tested in humans.

According to the Houston Chronicle, research centres in Texas are queueing up to put in grant applications to pursue research in using embryonic stem cells to treat Parkinson's, lung disease, and making cartilage to replace worn out joints. If the state legislature supports Obama's expected move, experts predict Texas will become a leader in the field of embryonic stem cell research, said the paper.

Antioxidants Offer Pain Relief In Patients With Chronic Pancreatitis

2009-01-06T13:26:00.000-08:00

Antioxidant supplementation was found to be effective in relieving pain and reducing levels of oxidative stress in patients with chronic pancreatitis (CP), reports a new study in Gastroenterology. CP is a progressive inflammatory disease of the pancreas in which patients experience abdominal pain (in early stage) and diabetes and maldigestion (in late stage). Pain is the major problem in 90 percent of patients with CP and currently, there is no effective medical therapy for pain relief. Gastroenterology is the official journal of the American Gastroenterological Association (AGA) Institute.

In this placebo-controlled, double blind trial, 127 patients, ages 30.5+/-10.5, were assigned to placebo or antioxidant groups. After six months, the reduction in the number of painful days/month was significantly higher in the antioxidant group, compared with the placebo group (7.4±6.8 versus 3.2±4, respectively). The reduction in the number of analgesic tablets/month was also higher in the antioxidant group (10.5±11.8 versus 4.4±5.8, respectively). Furthermore, 32 percent and 13 percent of patients became pain free in the antioxidant and placebo groups, respectively; the beneficial effect of antioxidants on pain relief was noted early at three months.

"Abdominal pain, the predominant symptom in patients with CP, is difficult to treat. The main reason for a largely ineffective medical treatment is that the mechanism of pain in CP is not well understood," said Pramod Kumar Garg, MD, DM, of the All India Institute of Medical Sciences, New Delhi and lead author of the study. "We are encouraged by our findings, as significant improvement was noted with antioxidants in respect to all the parameters of pain in this study. In addition, reduction in pain resulted in fewer man-days lost, thus providing functional employment gain to the patients. The findings should spur further research in this exciting area."

There are two important implications of this study - the fact that measures of oxidative stress were increased initially and decreased subsequently after supplementation with antioxidants suggests that there is a state of heightened free radical mediated injury in CP, and that injury is reversible. Second, with regard to pain management, this trial showed that antioxidant therapy is effective for pain relief in patients with CP. This assumes significance since no effective medical therapy exists for pain relief for such patients.

Pancreatitis is inflammation of the pancreas that usually begins as a sudden attack and is often caused by gallstones, alcohol abuse or genetic mutations. Symptoms of pancreatitis start with a gradual or sudden severe pain in the center part of the upper abdomen going through to the back. Treatment often focuses on the nutritional and metabolic needs of the patient and on relieving pain. Most people with chronic pancreatitis have a good prognosis if they follow their treatment regimen. "Aside from medication, abstaining from alcohol and smoking are most important and key to halt the progression of CP," added Dr. Garg.

California Health Insurance And Medicare

2008-09-29T14:33:00.000-07:00

Medicare (United States)

Medicare is the name given to a health insurance program administered by the United States government, covering people who are either age 65 and over, or who meet other special criteria. It was originally signed into law on July 30, 1965 by President Lyndon B. Johnson as amendments to Social Security legislation. At the bill-signing ceremony President Johnson enrolled former President Harry S. Truman as the first Medicare beneficiary and presented him with the first Medicare card.

Administration

The Centers for Medicare and Medicaid Services (CMS), a component of the Department of Health and Human Services (HHS), administers Medicare, Medicaid, the State Children's Health Insurance Program (SCHIP), and the Clinical Laboratory Improvement Amendments (CLIA). Along with the Departments of Labor and Treasury, CMS also implements the insurance reform provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The Social Security Administration is responsible for determining Medicare eligibility and processing premium payments for the Medicare program.

Since the beginning of the Medicare program, CMS has contracted to private companies to assist with administrating the program. These contractors are commonly already in the insurance or health care area. Contracted process include claims and payment processing, call center services, clinician enrollment, and fraud investigation.

Taxes imposed to finance Medicare

Medicare is partially financed by payroll taxes imposed by the Federal Insurance Contributions Act (FICA) and the Self-Employment Contributions Act of 1954. In the case of employees, the tax is equal to 2.9% (1.45% withheld from the worker and a matching 1.45% paid by the employer) of the wages, salaries and other compensation in connection with employment. Until December 31, 1993, the law provided a maximum amount of wages, etc., on which the Medicare tax could be imposed each year. Beginning January 1, 1994, the compensation limit was removed. In the case of self-employed individuals, the tax is 2.9% of net earnings from self-employment, and the entire amount is paid by the self-employed individual.

Cost

According to the 2004 "Green Book" of the House Ways and Means Committee, Medicare expenditures from the American government were $256.8 billion in fiscal year 2002. Beneficiary premiums are highly subsidized, and net outlays for the program, accounting for the premiums paid by subscribers, were $230.9 billion.

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