Common Alzheimer’s Medication Helps Skills Necessary For Safe Driving

A promising study from Rhode Island Hospital demonstrated that cholinesterase inhibitors (ChEI), a type of medication often prescribed for Alzheimer’s disease (AD), improved some cognitive skills in patients with mild AD – skills that are necessary for driving. Findings from the study showed that after being treated with a ChEI, AD patients improved in some computerized tests of executive function and visual attention, including a simulated driving task. The study is published in the June 2010 edition of the Journal of Clinical Psychopharmacology.

The study was led by Lori Daiello, PharmD, a research associate at the Rhode Island Hospital Alzheimer’s Disease and Memory Disorders Center (ADMDC). Daiello says, “Because many patients receiving a diagnosis of AD continue to drive in its early stages, it is critical that we assess driving safety among this population and identify therapies that may improve driving abilities. ChEIs are commonly prescribed for AD, yet little is known about how their potential treatment effects might impact a driver’s skills.”

The researchers studied the performance of 24 outpatients with newly-diagnosed, untreated, early stage AD using tests that simulate typical situations encountered in on-road driving. The subjects participated in computerized tests of visual attention (visual search performed alone or in conjunction with simulated driving) and executive function (maze navigation) both prior to beginning treatment with a ChEI and again after three months of therapy. The primary analysis consisted of comparing the test performance of AD patients before starting ChEI treatment and after three months of therapy. In a secondary cross-sectional analysis, the subjects’ pre-ChEI computerized test performances were compared to the abilities of a matched group of AD patients who had performed the same computerized tests while receiving stable ChEI therapy (i.e., greater than three months) during a prior study of driving and dementia conducted at the Rhode Island Hospital ADMDC.

The researchers report that ChEI treatment demonstrated consistent effects in both the pre- and post-treatment comparison as well as the cross-sectional comparisons. There were three key findings:

* ChEI treatment was associated with improvement in the ability to accurately maintain lane position during the simulated driving task. This was noted in the pre- and post-ChEI treatment comparison. It was also noted as an effect of ChEI user status when the visual search task was performed without simulated driving in the cross-sectional comparisons.

* ChEI treatment was associated with improved target detection accuracy in the visual search task and quicker visual search response times in both the pre- and post-treatment comparison and cross-sectional comparisons.

* After ChEI treatment, subjects completed the computerized mazes faster, although accuracy of completion was not affected.

Daiello, who is also an assistant professor of neurology (research) at The Warren Alpert Medical School of Brown University, says, “This study is the first of its kind to investigate how treatment might impact cognitive domains critical to driving safety in AD patients.” While relatively little is known about how ChEIs affect cognitive functions in AD other than memory, these results indicate an improvement in either attention processes or executive control. The investigators note that while the results are encouraging, this study lacked a direct measure of on-road driving performance. These preliminary findings, however, warrant further investigation. As Daiello says, “The results show an improvement in the skills that will impact a patient’s ability to perform tasks associated with safe driving.”

The research was supported by grants from the National Institutes of Health and the National Institute on Aging. The research team also included Brian Ott, MD, director of the ADMDC, and Brown University cognitive neuroscientists, Elena Festa, PhD and William Heindel, PhD, all of whom have conducted previous studies on the effects of dementia on driving. Other researchers involved in the study Michael Friedman, MD and Lindsay A. Miller, BS, also of Rhode Island Hospital and Brown University.

Nancy Cawley Jean

Experts Urge Industry And International Donors To Prepare Pneumococcal Vaccines

London, UK- In today’s online edition of The Lancet, a group of leading global health experts have come together to call for vaccine manufacturers and international donors to negotiate affordable pricing of pneumococcal conjugate vaccines and for governments of developing world countries and their partners to establish disease surveillance networks and begin preparations for pneumococcal vaccine introduction.

The experts believe that urgent action to introduce routine childhood pneumococcal vaccination is needed because of the enormous burden of the disease – the World Health Organization (WHO) estimates that about 1.6 million people, including up to one million children under five years old, die every year of pneumococcal pneumonia, meningitis, and sepsis.1 In populations with high child mortality rates, pneumonia is the leading infectious cause of mortality and accounts for about 20-25% of all child deaths.

This call to action comes on the eve of a meeting of G8 ministers to discuss funding vaccines. This seems to be the latest step in major changes over the last five years in financing of immunization, including the creation of the GAVI Alliance (Global Alliance for Vaccines and Immunization) Fund. Dr Orin Levine, the lead author of the article and Executive Director of PneumoADIP – a non-governmental organization that aims to shorten the time between use of a vaccine in industrialized nations and their introduction in the developing world – commented: “We hope that with such mechanisms in place, all developing countries will begin to consider that millions of children can now be saved by the simple addition of this vaccine to existing immunization programs.”

Dr Thomas Cherian, Co-ordinator, Ad Interim, EPI, WHO, and co-author of the article added: “Pneumococcal disease is a major global health issue; what is promising is that a seven-valent vaccine that is effective against seven common strains of the disease is already licensed and in use in over 60 countries and that formulations containing additional serotypes of the organism that are also relevant for developing countries are under development. The WHO considers pneumococcal vaccines to be a priority and recognizes the urgency to make these vaccines available for children in developing countries.”

There are other pneumococcal vaccines in development, which contain additional serotypes targeting strains of the disease that commonly cause death and disability in the developing world; however, these will not be available for several years. Introducing the seven-valent vaccine now means that lives can start to be saved immediately. This vaccine, manufactured by Wyeth, is effective, well-tolerated and can be delivered through existing immunization systems. Surveillance data from the U.S.indicate that the herd immunity* effect from routine childhood pneumococcal vaccination prevents twice as many cases as the direct effects of vaccination alone – protecting vulnerable adults as well as children.

Responding to The Lancet paper, Julian Lob-Levyt, Executive Secretary, GAVI Alliance, said, “There is convincing evidence of the benefits of vaccines for major child killers, especially when such a simple health intervention could help in meeting UN Millennium Development Goal no. 4: to reduce child mortality by two thirds by 2015. GAVI will be looking closely at how best to assist countries where pneumococcal disease represents a significant burden on public health.”

Jean St?phenne, President of GlaxoSmithKline Biologicals, the vaccines division of GlaxoSmithKline PLC, also welcomed the call to action in The Lancet and said, “GSK Bio has invested many years in the development of a vaccine that protects against the 10 most important strains of pneumococcus serotypes worldwide, and our candidate is now being studied in a global clinical program. We have a long history of supplying vaccines in developing countries and are committed to working to make our pneumococcal vaccine available worldwide at sustainable prices. We hope that our partners in governments, donor agencies, charities, and international organizations will step up with a firm purchase commitment that will allow us to save as many lives as possible.”

James Connolly, Executive Vice President and General Manager of Wyeth Pharmaceuticals vaccine’s business unit, concurred with the call to action and stated, “Prevnar has been launched in 60 countries, and has had a significant impact on the health of children where it is in use. In the U.S., three years after the routine use of Prevnar, there has been a 94 percent reduction in invasive pneumococcal disease caused by the disease serotypes included in the vaccine. We are actively working with international agencies to help provide access to Prevnar for children in the developing world.

Meanwhile, Wyeth researchers are continuing to work on new versions of Prevnar, including a version that will address 13 of the most prevalent serotypes of invasive pneumococcal disease, which will expand its usefulness globally for both children and adults.”

Herd immunity is the resistance of a population to spread of an infectious organism due to the immunity of a high proportion of the population – the US study suggests that the herd immunity effect of pneumococcal vaccination may be particularly strong.


1. WHO. Pneumococcal vaccines. Wkly Epidemiol Record 2003; 14: 110-19

2. Williams BG, Gouws E, Boschi-Pinto C et al. Estimates of worldwide distribution of child deaths from acute respiratory infections. Lancet Infect Dis 2002; 2: 25-32

3. Cutts FT, Zaman SM, Enwere G et al. Efficacy of nine-valent pneumococcal conjugate vaccine against pneumonia and invasive pneumococcal disease in The Gambia: randomised, double blind, placebo-controlled trial. Lancet 2005; 365:1139-46

Pneumococcal disease is an infection caused by Streptococcus pneumoniae. When these bacteria invade the lungs, they cause the most common kind of bacterial pneumonia. The bacteria can also invade the bloodstream (bacteremia) and/or the tissues and fluids surrounding the brain and spinal cord (meningitis).

According to WHO, pneumococcal pneumonia and meningitis are responsible for 800,000 to one million child deaths each year and more than 90 percent of pneumococcal pneumonia deaths in children occur in developing countries.

The World Health Organization (WHO) is the United Nations specialized agency for health. It was established on 7 April 1948. WHO’s objective, as set out in its Constitution, is the attainment by all peoples of the highest possible level of health. Health is defined in WHO’s Constitution as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

The goal of the Pneumococcal Vaccines Accelerated Development and Introduction Plan (PneumoADIP) is to shorten the time between the use of a new vaccine in industrialized countries and its introduction in developing countries by reducing demand uncertainty and achieving an affordable, sustainable supply of vaccines. This novel approach is funded by the Global Alliance for Vaccines and Immunization (GAVI) through its partner the Vaccine Fund. PneumoADIP is located at the Johns Hopkins Bloomberg School of Public Health. The mission of PneumoADIP is to improve child survival and health by accelerating the evaluation of and access to new life saving pneumococcal vaccines for the world’s children. For more information, please visit:preventpneumo/

The GAVI Alliance (The Global Alliance for Vaccines and Immunization) was launched in 2000 to increase immunization rates and reverse widening global disparities in access to vaccines. Governments in industrialized and developing countries, UNICEF, WHO, the World Bank, non-governmental organizations, foundations, vaccine manufacturers, and public health and research institutions work together as partners in the Alliance, to achieve common immunization goals, in the recognition that only through a strong and united effort can much higher levels of support for global immunization be generated. Funds channelled through GAVI’s financing arm, The GAVI Fund (formerly The Vaccine Fund), are used to help strengthen health and immunization services, accelerate access to selected vaccines and new vaccine technologies – especially vaccines that are new or under-used, and improve injection safety. In addition to substantial funding from the Bill & Melinda Gates Foundation, The Vaccine Fund has been financed by ten governments to date-Canada, Denmark, France, Ireland, Luxembourg, the Netherlands, Norway, Sweden, the United Kingdom, and the United States- as well as the European Union and private contributors.

Hans Kvist
Strategic Communications


View drug information on Prevnar 13.

New Insights Into Lung Cancer Revealed By Tumor Genome Analysis

An international consortium of scientists in an advanced online publication in the journal Nature revealed a comprehensive view of the altered genetic background of the type of lung cancer that is the most common cause of cancer deaths in humans.

Of particular interest was a specific proto-oncogene called NKX2-1 that appears involved in as many as 12 percent of lung adenocarcinomas — the most common cause of cancer deaths worldwide, said the group, whose work was in part financed by the National Human Genome Research Institute (NHGRI). The group noted, however, that analysis indicates that many of the genes that play a role in the disease remain to be discovered.

“This view of the lung cancer genome is unprecedented, both in its breadth and depth,” said senior author Dr. Matthew Meyerson, a senior associate member of the Broad Institute of MIT and Harvard in Cambridge, Mass., and an associate professor at Dana-Farber Cancer Institute and Harvard Medical School in Boston. “It lays an essential foundation, and has already pinpointed an important gene that controls the growth of lung cells. This information offers crucial inroads to the biology of lung cancer and will help shape new strategies for cancer diagnosis and therapy

The report is the first to emerge from the Tumor Sequencing Project that involves three genome centers: Baylor College of Medicine Human Genome Sequencing Center in Houston, The Broad Institute of Harvard and MIT in Cambridge, Mass., and Washington University in St. Louis, Mo.; and five cancer centers: Dana-Farber Cancer Institute in Boston, The University of Texas M. D. Anderson Cancer Center in Houston, Memorial Sloan-Kettering Cancer Center in New York, the University of Michigan and Washington University.

Each year, more than 1 million people worldwide die of lung cancer. In the United States, the annual death toll is 150,000. Lung adenocarcinoma, the topic of this study, is the most common cause of lung cancer.

“This study illustrates the value in using high through-put sequencing and microarray analysis to understand the fundamental properties of tumors at the molecular level,” said Dr. Richard Gibbs, director of the BCM Human Genome Sequencing Center, and one of the paper’s co-authors. “The identification of this gene demonstrates the power of copy number analysis using arrays (or gene chips).”

The authors wrote: “This study represents a step toward comprehensive genomic characterization for one of the most common lung cancers, lung adenocarcinoma??¦. Recent advances in massively parallel DNA sequencing technology may soon make it feasible to undertake similar comprehensive studies to identify all translocations, point mutations and epigenomic changes in cancer and thus point the way to an integrated picture of the cancer genome.” Dr. Barbara A. Weir of Dana-Farber and the Broad Institute, Michele S. Woo of Dana-Farber and Gad Getz of the Broad Institute are first authors on the paper and contributed equally to the work.

The team found 57 frequent genomic changes in their analysis of the genetics of tumors taken from lung cancer patients. Of these, 15 are linked to genes known to be involved in lung cancer. The rest remain to be discovered.

The gene NKX2-1 is essential in the development of cells that line the alveoli of the lungs. Mice lacking the gene die at birth because they cannot breathe. However, it is a proto-oncogene, which means that it can mutate into a gene that promotes development of cancer.

Lung adenocarcinoma is the leading cause of cancer death worldwide. Using gene chip or microarrays, researchers compared the genomes of 371 lung adenocarcinomas to 242 normal lung samples using special gene chips to analyze approximately 250,000 genetic markers. Their analyses identified areas of genetic material that has been repeated or deleted in the tumors. Among these were six areas currently associated with known mutations in lung cancers.

The most common event was an increase in genetic information on one arm of chromosome 14, where NKX2-1 is found in that area of the chromosome. Using a variety of techniques, including RNA interference, they determined that NKX2-1 is essential for the survival of lung cancer cell lines that express the gene.

Funding for the research came from the Ruth L. Kirschstein National Research Service Award of the National Institutes of Health, the National Cancer Institute, the Canadian Cancer Society/National Cancer Institute of Canada, the American Lung Association, Joan’s Legacy Foundation, the American Cancer Society, the International Association for the Study of Lung Cancer, the U.S. Department of Defense and the Carmel Hill Fund.

Researchers from The Brigham and Women’s Hospital, Nagoya City University Hospital in Japan and the University Health Network in Toronto, Canada, also contributed samples to this work. Researchers from the University of Ulm in Germany, UT Southwestern Medical Center in Dallas, Max-Planck Institute for Neurological Research in Germany, the University of Cologne in German, Harvard Medical School, and Princess Margaret Hospital in Toronto were also members of the consortium.

The paper is available at nature/.

Source: Glenna Picton

Baylor College of Medicine

2.8 Million Pound Grant To Raise Standards In Maternal And Newborn Health

The Royal College of Obstetricians and Gynaecologists (RCOG) and the Liverpool School of Tropical Medicine (LSTM) have been awarded ??2.8m to improve maternal and newborn health in five target countries Zimbabwe, Kenya, Bangladesh, India and Sierra Leone.

Each year more than half a million women and four million babies worldwide die from complications during pregnancy and childbirth, nearly all in developing countries in Asia and sub-Saharan Africa.

The three year programme ‘Making it Happen’, funded by the UK’s Department for International Development (DFID), will evaluate how training and supportive supervision of health care providers in developing countries improves the quality and uptake of care that will save the lives of mothers and their babies.

Dr Nynke van den Broek, Head of the Maternal and Newborn Health Unit at LSTM, explained that the reasons why women and babies die are largely known and there is now international agreement for what needs to be in place: “A skilled birth attendant a doctor or midwife and the availability of essential obstetric and newborn care are critical to reducing maternal and newborn deaths. RCOG and LSTM will be working in partnership with the Ministry of Health and sister professional associations in each country to improve national capacity to deliver good quality care. Put simply, increasing the provision of skilled birth attendance and appropriate obstetric and newborn care will reduce the numbers of women and children dying in childbirth.”

RCOG Vice President (International) Dr Tony Falconer said: “This is very good news for women in under-resourced countries. Mothers are dying needlessly in many countries due to a lack of access to the very basic care that we take for granted in the West.”

The programme will demonstrate and evaluate a new intervention model which will be adapted to specific conditions in each country. The five target countries in Asia and Africa will also work together to ‘share lessons learnt’.

Dr van den Broek added: “With this grant we will be able to increase the number of skilled health professionals providing high quality maternal and neonatal care and generate more demand for these services amongst women, as well as improving data on maternal and newborn health to influence policy at national and international levels.”

Source: Liverpool School of Tropical Medicine

Somalia: No Safety In Mogadishu

While thousands of people flee the Somali capital Mogadishu, the medical humanitarian organization Doctors Without Borders/Medecins Sans Frontieres (MSF), is gravely concerned about the remaining population as violence intensifies in the city.

MSF is one of the only international organizations providing health services in Mogadishu and is witnessing increasing violence in the areas near one of its clinics. Those who are able have left the city, but many more are trapped, cannot afford to flee, or are too afraid to leave Mogadishu. People are fleeing into other areas of the city but are increasingly left with no safe place to seek refuge.

“People are terrified but most have little choice except to wait and hope that the violence does not come to them,” said Colin McIlreavy, MSF head of mission for Somalia. “In Mogadishu now there is no safe place to go.”

The high levels of insecurity often prevent wounded civilians from receiving medical assistance. MSF staff have been unable to help individuals who have been wounded by shrapnel or bullets during fighting at night. Some have bled to death as it was too dangerous to move them to hospitals. Former residents of a densely populated suburb near MSF’s clinic described armed men marching through the streets emptying houses, in some cases shooting unarmed people.

Displaced people living in Mogadishu are particularly vulnerable. Makeshift camps are found throughout the city. Residents of these camps usually have little more than ripped cloth and plastic sheeting for shelter, which provide no protection from bullets, mortars, and shells. There are few men in these camps, leaving women to struggle to feed and care for their children, and remain vulnerable to violence and looting. Last week, MSF treated three women who had been raped in their home the previous night by armed men.

In the past weeks, MSF staff in Mogadishu have reported fighting coming increasingly closer to the clinic. Some staff are not able to travel to work because of roads closed due to the violence.

“We’ve seen a massive reduction in numbers of people coming to our clinic from some neighborhoods where fighting has been heaviest,” said Dr. Fuad, an MSF doctor in the Mogadishu clinic. “This is consistent with the stories we hear of people fleeing these neighborhoods to go to other parts of Mogadishu.”

Many who can afford to flee the city are doing so, but at high risk.

“The checkpoints between Mogadishu and Galcayo are unlike any I have seen in my life,” said one man interviewed by MSF team members in Galcayo, north of Mogadishu. “I managed to count 86 over 300 kilometers where they demanded money. Halfway through our journey, money was not enough and they took everything.”

MSF is struggling to provide a measure of healthcare and humanitarian assistance to the people of Mogadishu. But Mogadishu’s residents need more than medical care – they need safety. MSF calls upon all warring factions to refrain from indiscriminate attacks on civilians and to respect International Humanitarian Law.


Alzheimer’s Society Response To Adult Social Care Workforce Strategy

As the population ages, this strategy is an important first step in ensuring the social care workforce is able to cope with the rising numbers of people living with dementia.

‘There will be over a million people living with dementia in the UK in just 15 years.

But more is still needed if we are to rescue the UK from its position in the bottom third of Europe for dementia care. Over two thirds of people in care homes have dementia and over 400, 000 people with dementia live in the community. All social care staff must have dementia training if we are to pull dementia out of the dark ages.’

Neil Hunt
Chief Executive
Alzheimer’s Society


Alzheimer’s Society is the leading care and research charity for people with all forms of dementia and their carers. It provides information and education, support for carers, and quality day and home care. It funds medical and scientific research and campaigns for improved health and social services and greater public understanding of dementia.

The Alzheimer’s Society provides a national help line on 0845 3000 336 and website alzheimers. Please include this information in any publication that uses these comments.

Alzheimer’s Society

Avastin Filed In US For Treatment Of Most Common Form Of Lung Cancer

Roche and Genentech announced today that they have filed Avastin in the US for the treatment of the most common form of lung cancer – non-squamous non-small cell lung cancer. Lung cancer is the leading cause of cancer death worldwide.

The supplemental Biologics License Application (sBLA) has been submitted to the US Food and Drug Administration (FDA) for use of Avastin (bevacizumab) in combination with a platinum-based chemotherapy (carboplatin plus paclitaxel) for previously untreated patients suffering from advanced non-squamous non-small cell lung cancer (NSCLC).a In the US, NSCLC accounts for 87 percent of all lung cancers cases.

Avastin is the first and only treatment in more than a decade to have shown a survival benefit in this patient population. The sBLA submission is based on Genentech’s analysis of the results of the pivotal E4599 trial which were presented at ASCO last year1.

“The filing of Avastin in the USA is a critical step forward. The benefits seen in the Avastin study are significant and we look forward to the potential of bringing new hope to the patients who are diagnosed with this specific type of lung cancer” said Ed Holdener, Head of Roche Pharmaceuticals Development. “We are committed to working with regulatory authorities around the world in order to make it available to patients suffering from lung cancer as soon as possible.”

Roche has initiated a further study, the AVAiL trial, which is exploring the combination of Avastin with another platinum- based chemotherapy (cisplatin/gemcitabine). Interim data from this study will be used together with the E4599 data to file a Marketing Authorisation Application (MAA) with the European health authorities later this year.

Lung cancer is the leading cause of cancer death worldwide, accounting for 1 in 3 and 1 in 4 cancer-related deaths in men and women, respectively. In the US, NSCLC accounts for 87 percent of all lung cancers. The majority of NSCLC cases are diagnosed at an advanced stage2 when the cancer is inoperable or has already spread to another part of the body. In spite of the use of chemotherapy as the first-line treatment option, less than five percent of advanced NSCLC patients survive for five years and most die within twelve months2.

In Europe, Avastin was approved early 2005 for the first-line treatment of patients with metastatic carcinoma of the colon or rectum in combination with intravenous 5-fluorouracil/folinic acid or intravenous 5-fluorouracil/folinic acid/irinotecan. Avastin received approval by the US Food and Drug Administration (FDA) and was launched in the US in February 2004. Avastin is the first and only anti-angiogenic agent to have demonstrated improved survival in the three major causes of cancer death: colorectal cancer, NSCLC and breast cancer.

About the pivotal (E4599) study

The submission is based on results from a randomised, controlled, multicenter Phase III trial (E4599) that enrolled 878 patients with locally advanced, metastatic or recurrent NSCLC with histology other than predominant squamous cell. The results showed that patients receiving Avastin at a dose of 15mg/kg every three weeks plus paclitaxel and carboplatin had a 25 percent improvement in overall survival, the trial’s primary endpoint, compared to patients who received chemotherapy alone (based on a hazard ratio of 0.80, which is equivalent to a 20 percent reduction in the risk of death). In median, the survival of patients treated with Avastin plus chemotherapy was 12.3 months, compared to 10.3 months for patients treated with chemotherapy alone1.

The study also showed a 54 percent improvement in progression-free survival (or a hazard ratio of 0.65 which can also be referred to as a 35 percent reduction in the risk of progression). The response rate in patients with measurable disease was 29 percent in the group receiving Avastin plus chemotherapy, compared to 13 percent in the group receiving chemotherapy alone. Pulmonary haemorrhage (haemoptysis) cases were observed in 2.3% of the patients receiving Avastin plus chemotherapy.

About AVAiL

AVAiL is a randomised, controlled, multicenter international Phase III trial planning to enrol 1,050 patients with previously untreated advanced NSCLC and to explore two doses of Avastin (7.5 or 15 mg/kg every 3 weeks) in combination with a platinum doublet (gemcitabine/cisplatin) chemotherapy. The primary objective of the study is to demonstrate superiority in progression-free survival of both Avastin containing treatment arms versus control. Interim data from this study will be used to support the Roche filing of E4599 in Europe later this year. The final AVAiL data is expected in 2007 and will only then enable definitive conclusions on the efficacy of the two doses of Avastin.

About Avastin

Avastin is the first treatment that inhibits angiogenesis – the growth of a network of blood vessels that supply nutrients and oxygen to cancerous tissues. Avastin targets a naturally occurring protein called VEGF (Vascular Endothelial Growth Factor), a key mediator of angiogenesis, thus choking off the blood supply that is essential for the growth of the tumour and its spread throughout the body (metastasis).

Roche and Genentech are pursuing a comprehensive clinical programme investigating the use of Avastin in various tumour types (including colorectal, breast, lung, pancreatic cancer, ovarian cancer, renal cell carcinoma and others) and different settings (advanced and adjuvant ie post-operation). The total development programme is expected to include over 25,000 patients worldwide.

About Roche

Headquartered in Basel, Switzerland, Roche is one of the world’s leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As a supplier of innovative products and services for the early detection, prevention, diagnosis and treatment of disease, the Group contributes on a broad range of fronts to improving people’s health and quality of life. Roche is a world leader in diagnostics, the leading supplier of medicines for cancer and transplantation and a market leader in virology. In 2005 sales by the Pharmaceuticals Division totalled 27.3 billion Swiss francs, and the Diagnostics Division posted sales of 8.2 billion Swiss francs. Roche employs roughly 70,000 people in 150 countries and has R&D agreements and strategic alliances with numerous partners, including majority ownership interests in Genentech and Chugai. Additional information about the Roche Group is available on the Internet (roche).

a Regarding characterisation of lung cancer please refer to the respective backgrounder at the end of this release

All trademarks used or mentioned in this release are protected by law.

– Lung Cancer (pdf)
– Roche in Oncology (pdf)
– Roche Health Kiosk, Cancer


1. Sandler AB, Gray R, Bhramer J, et al. Randomized phase II/III Trial of paclitaxel (P) plus carboplatin (C) with or without bevacizumab (NSC # 704865) in patients with advanced non-squamous non-small cell lung cancer (NSCLC): An Eastern Cooperative Oncology Group (ECOG) Trial – E4599. ASCO 2005, Abstract LBA4.

2. Wilking N and Jonsson B. A Pan-European comparison regarding patient access to cancer drugs. Karolinska Institute in collaboration with Stockholm School of Economics, Stockholm, Sweden, 2005.

View drug information on Avastin.

Haiti: Survivors In Flooded Village Stranded With No Help

A month after the last tropical storms and hurricanes hit Haiti, Doctors Without Borders/M?©decins Sans Fronti??res (MSF) medical teams have found a whole village partially submerged and its 2,400 remaining inhabitants stranded with no help.

On Tuesday, September 30, MSF teams managed to reach Mamont, a town southeast of Gona??ves in the Artibonite region, which was heavily affected by the series of storms that struck Haiti in late August and last month. The town, with an original population of roughly 17,000 people, had been totally isolated for the last four weeks. The teams found the village partially submerged with water spilling over from a lake formed by the storm. The remaining population is cut off from all major towns since the road is also submerged. The survivors have been without clean water, sufficient food, or medical care for weeks.

The MSF teams are currently providing assistance to those who remained in Mamont and is calling on other organizations to assist as quickly as possible. Although international attention has largely moved on from the emergency in Haiti, the example of Mamont shows that emergency assistance remains critical for some parts of the country.

In the Gona??ves area, concrete measures for getting the victims of the storms back on their feet are slow to materialize; there remains a lack of access to clean water, problems with sanitation, and a shortage of the most basic goods.

There is the risk of disease spreading and MSF is worried about the repeated expulsions of displaced people from places where they found temporary shelter. For several days the authorities have been pushing for the evacuation of classrooms before the start of the new school term on Monday, October 6. The situation is similar in churches, where congregations want to resume their worship and are pushing those sheltering inside to leave.

The cathedral in Gona??ves, where more then 200 people found refuge, was emptied two weeks ago; some of the displaced moved to a camp of 65 tents in Praville, where conditions are unacceptable. In the area of K-Soleil, more than 800 people were evicted from their shelter and had no option than to camp in their ravaged houses or sleep under a piece of cardboard. People who were asked to leave the Church of the Christian Union, numbering some 500 following the floods, had to relocate to the university, where now over 200 of them remain without even minimal hygiene facilities. And while the Parc Vincent area, heavily affected by the disaster, is gradually being cleaned up, large numbers of families there find themselves with no choice but to sleep in the street after being forced out of shelters.

Today, hundreds of families are left without a place to stay and without any means to rebuild their lives, as neither the authorities nor international organizations present in Gona??ves have provided alternative shelter.

MSF Emergency Intervention in Haiti

MSF has recently opened an 80-bed hospital in the north of Gona??ves in collaboration with the Health and Population Ministry. This structure is the only one in the region that can respond to emergencies and provide obstetric and pediatric services in this town of 300,000 inhabitants, devastated by the recent hurricanes and tropical storms.

During the first five days, this structure has already received 108 patients in the emergency room and performed 19 deliveries as well as eight minor and one major surgery interventions. In total, 40 people have been hospitalized

In parallel with its activities in the hospital, MSF continues to provide drinking water to the population, but the situation remains precarious in Gona??ves. Every three days, the team chlorinates 1 million liters of water, and, together with other organizations, they truck 350,000 liters daily for distribution to the communities. In total, since September 8, MSF has distributed more than 3.3 million liters of water. This represents the largest percentage of the water that has so far been distributed. MSF aims at having a capacity of 1 million liters of water per day.

Mobile medical teams continue to travel by car around Gona??ves and by helicopter to its environs to provide assistance to the most vulnerable people in temporary shelters or in nearby isolated villages. Since September 12, MSF teams have performed more than 1,150 consultations in mobile clinics.

After performing 2,326 consultations in 20 days, MSF teams left the health center of Rabouteau in Gonaives last week; it is now fully managed by the Health and Population Ministry.

MSF teams have also assessed needs in the northwest of Haiti, in the central Artibonite region, and in the south of the country. While interventions are not currently required in the areas visited, the teams have provided some health structures with drugs and materials and have carried out medical consultations. A nutritional surveillance system has also been established in the northwest region and assessments have been carried out in the northeast and southeast areas of the country in relation to food insecurity.

Doctors Without Borders/M?©decins Sans Fronti??res

A molecular basis for selective therapeutic intervention in Alzheimer’s disease

Alzheimer’s disease, a complex neurological disorder, has as one of its hallmarks the presence of senile plaques in the brains of affected individuals. These senile plaques are rich in a toxic amyloid peptide termed A?.

The mechanisms underlying the production of A? are complex, but it is known that this peptide is derived from a larger precursor known as the amyloid precursor protein (A?PP). Interestingly, and of potential therapeutic significance,

A?PP can be processed within the cell via different pathways, some of which preclude the formation of the toxic peptide A?.

Cellular stress has been associated with the disease and may impact upon A?PP processing and, consequently, toxic amyloid peptide termed A? production. University of Aveiro researchers, in their recent article ‘Cellular stress affects phosphorylation dependent A?PP processing’ by A. G. Henriques et al, published in the Journal of Alzheimer’s Disease, Vol. 7, pp 201-212, addressed how the non-toxic amyloid precursor protein (A?PP) processing was affected by cellular stress.

The research was carried out in the recently established Neuroscience Laboratory of the University of Aveiro, headed by Prof. Odete A. B. da Cruz e Silva. The University of Aveiro was created in 1973 and is generally recognized as one of the most dynamic universities in Portugal, being a member of the European Consortium of Innovative Universities. The university prides itself in the quality of its research groups and, in addition to its traditional strength in areas such as Material Science, Signal Transduction, Environment and Marine Studies, Electronics and Telematics, Telecommunications and Telemedicine, it has recently promoted the development of internationally competitive research in Biomolecular and Health Sciences.

Odete Cruz e Silva
Universidade de Aveiro

Even If Brain Volume Is Already Reduced, Formal Education Lessens The Impact Of Alzheimer’s Disease

Researchers at the Department of Psychiatry, Klinikum rechts der Isar, Technische Universit?¤t M??nchen, investigated the effects of formal education on the symptoms of Alzheimer’s disease. They were able to show that education diminishes the impact of Alzheimer’s disease on cognition even if a manifest brain volume loss has already occurred. The results are published in the current issue of the Journal of Alzheimer’s Disease (“Education attenuates the effect of medial temporal lobe atrophy on cognitive function in Alzheimer’s disease: The MIRAGE Study,” Journal of Alzheimer’s Disease, August 2009).

Dr. Robert Perneczky, Department of Psychiatry at Klinikum rechts der Isar explains: “We know that there is not always a close association between brain damage due to Alzheimer’s disease and the resulting symptoms of dementia. In fact, there are individuals with severe brain pathology with almost no signs of dementia, whereas others with only minor brain lesions exhibit a considerable degree of clinical symptoms.” These phenomena are often ascribed to the theoretical concept of cognitive reserve. A high level of cognitive reserve results in a strong individual resilience against symptoms of brain damage; cognitive reserve can therefore be seen as protective against brain damage.

In support of this, previous studies demonstrated that duration of formal education is associated with cognitive reserve such that comparison of individuals with the same degree of brain damage shows that those with more years of formal education suffer from less severe symptoms of dementia.

Prior to the current study, brain damage was assessed after death using brain autopsy measures or using very sensitive functional imaging measures in live individuals. Perneczky comments: “Our study is the first to show that formal education also modifies the association between brain damage and clinical symptoms of dementia in Alzheimer’s disease if brain damage is defined as volume loss on magnetic resonance imaging scans. The relevance of our findings is strengthened by the large sample including 270 patients with Alzheimer’s disease. Furthermore, factors with a potential negative influence on cognition and brain volume loss, such as genetic characteristics, age, gender, and brain infarction were also considered.” These research results show for the first time that the modifying effect of formal education is robust enough to reduce the negative effects of structural brain damage on cognitive function. Further studies are planned that will include a larger patient cohort and more precise measurement of brain volume reduction.

Perneczky R, Wagenpfeil S, Lunetta KL, Cupples LA, Green RC, Decarli C, Farrer LA, Kurz A. Education Attenuates the Effect of Medial Temporal Lobe Atrophy on Cognitive Function in Alzheimer’s Disease: The MIRAGE Study.J Alzheimers Dis 17:4 (August 2009).

Esther Mateike

IOS Press