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[Info-congress. Insulin therapy for preventing type 1 diabetes in high-risk relatives: negative results of the "Diabetes Prevention Trial-Type 1"].

The results of the American multicentre "Diabetes Prevention Trial-Type 1" were presented by J. Skyler during the last congress of the American Diabetes Association in Philadelphia on June 23, 2001. The prophylactic subcutaneous administration of low-dose insulin was not able to prevent the development of type 1 diabetes nor to preserve residual insulin secretion in young relatives at very high-risk of diabetes (> 50% in the next 5 years), selected upon genetic, immunological and metabolic criteria.

Adolescent↗

[Report from the congress on andrology in Montreal. Diagnosis and treatment of the "andropause"].

As reflected by the proceedings of the recent VIIth International Congress of Andrology in Montreal, Canada, modern andrology takes a wider responsibility for men's health than previously. The area has expanded not only into the fields of basal and clinical endocrinology but also into paediatrics and geriatrics. These changes also put pressure on laboratories of clinical chemistry to provide new and clinically more relevant endocrinological investigations such as lutropin assays which detect the biologically active isoforms, and assays of "bioavailable" testosterone, as well as of inhibin B and anti-Müllerian hormone.

Aging↗

Rising healthcare spending gives pause to Congress and the public.

A recent Centers for Medicare and Medicaid Services (CMS) report announced that the nation's overall rate of growth in healthcare spending rose for the second consecutive year in 2000. The increase occurred in both private and public sectors of the healthcare industry, affecting areas such as prescription drugs, hospitals (including both inpatient and outpatient services), and freestanding nursing homes and home health agencies. CMS's findings may signal the beginning of a new period of healthcare inflation, accompanied by calls from Congress and the public for greater cost controls on the part of providers.

Centers for Medicare and Medicaid Services, U.S.↗

Clinical management and evidence based treatment of chronic hepatitis C--12th European Congress of Clinical Microbiology and Infectious Diseases, Milan, Italy, 21-24 April 2002.

As in totally 1% of the worldwide population is afflicted by hepatitis C virus with most of the 200 Mio carriers not diagnosed or treated, the clinical management of chronic hepatitis C remains an urgent demand for global health. The 12th European Congress of Clinical Microbiology and Infectious Diseases (12th ECCMID) held in Milan, Italy, from 21 to 24 April 2002, focussed on viral hepatitis in a keynote lecture as well as a session on evidence based treatment of chronic infection and various poster presentations.

Antiviral Agents↗

[Sournia as president of the International Society for History of Medicine and chairman of the International Congress in Paris].

During the last quarter of the century, Sournia took an active part in the life of the International Society for History of Medicine as he introduced English as a second official language and he modernised some procedures. In 1982 he organized an international congress in Paris about two themes close to his heart: the history of public health and of communication in medical area. So the I.S.H.M. became well known all around the world and Sournia remained a wise advise until his death.

France↗

[Info-congress. Prevention of type 2 diabetes in obese patients: first results with orlistat in the XENDOS study].

The results of the XENDOS study were presented by Professor Lars Sjöström (Gothenburg, Sweden), on August 26, 2002, at the 9th International Congress on Obesity in Sao Paulo, Brazil. XENDOS (XENical in the prevention of Diabetes in Obese Subjects) is a multicentre, randomised, double-blind, placebo-controlled, parallel-group prospective study performed in Sweden over a period of 4 years. The aim of XENDOS was to investigate the use of a weight loss agent (orlistat, Xenical) compared with lifestyle changes for the prevention of type 2 diabetes in obese patients (body mass index > or = 30 kg/m2). Weight loss was greater in the orlistat group (-6.9 kg; n = 1.640) than in the placebo group (-4.1 kg; n = 1.637; p < 0.001). Such a difference in weight reduction was sufficient to significantly reduce the cumulative incidence of type 2 diabetes (6.2% versus 9.0%; p = 0.0032; relative risk reduction of 37.3%). The difference was especially remarkable in obese patients with impaired glucose tolerance (21% of the cohort), with a reduction of conversion to diabetes from 28.8% in the placebo group to 18.8% in the orlistat group (p < 0.005) and a number needed to treat to avoid one event of 11 only. Significant and sustained reductions in cardiovascular risk factors such as arterial blood pressure and lipid levels were also observed in the orlistat group as compared to the placebo group. XENDOS is the first study demonstrating that an antiobesity agent, like orlistat, is able to reduce the progression to diabetes in obese subjects as compared with lifestyle changes alone.

Adult↗

Calling in the feds. IOM's new report says government must take lead in quality, but can Congress, hospitals find the money and support?

A new report by the Institute of Medicine calls for the federal government to "take the lead" in healthcare quality. Janet Corrigan, director of the IOM's Board of Health Care Services, and other members of the IOM say only the nation's largest provider and payer has what it takes to build a safer environment for patients. Can Congress come up with the money and support necessary to sustain such an undertaking?

Evaluation Studies as Topic↗

An epidemiological assessment of problematic contacts to members of Congress.

In order to assess the nature of threat assessment activity pertaining to members of Congress, 4387 cases involving threatening and other problematic contact were analyzed. The cases were studied regarding subject characteristics, articulated motives, as well as several aspects of contact behavior in relation to approach behavior. Approachers were significantly less likely to have articulated threat language prior to or during their contacts and were also less likely to have stated a policy grievance (foreign or domestic) as the source of their concern. Further, approachers were substantially more likely to have expressed help seeking requests as part of their prior and approach-related contacts and were less likely to have had racial or sexualized content within their contacts. Approachers were also significantly more likely to have had a criminal record as well as displayed symptoms suggestive of major mental illness. Subjects engaging in approach behavior were also less likely to have used an alias, were less likely to be a direct constituent of the target and were more likely to have contacted multiple congressional targets. The implications for threat assessment activity are discussed.

Adult↗

Is aging a disease? A review of the Serono Symposia Workshop held under the auspices of the 3rd World Congress on the Aging Male. February 9, 2002, Berlin, Germany.

On February 9, 2002, Serono Symposia sponsored a workshop at The 3rd World Congress on The Aging Male that was held in Berlin, Germany at the Hotel Inter-Continental. The title of the workshop 'Is aging a disease?', was intended to convey recent interest in the subject of aging as a clinically relevant entity and to discuss causes and approaches to its management. The Workshop was co-chaired by Drs Viktor Büber and Richard F. Walker. Speakers included Drs George R. Merriam, Heinrich M. Schulte, Felice Strollo and Richard F. Walker. Topics were arranged to proceed from a general overview of fundamental aspects of the aging process and their clinical consequences to specific aspects of the diagnosis and treatment of age-related disorders that could be associated with neuroendocrine dysfunction. F. Strollo initiated the series of lectures by reviewing some of the biological theories of aging and suggesting that maladaptive changes within the central nervous and endocrine systems play a major role in contributing to the cascade of events defined as senescence. R. Walker expanded upon this background by differentiating aging and disease. He suggested that while the process of aging is not a disease, it is directly responsible for the development of functional decrements causal of the intrinsic disease, frailty and general morbidity that occur in direct relation to advancing chronological age. From this generalized approach of linking age and disease, G. Merriam discussed a specific example in which age-related decrements in neuroendocrine dysfunction could contribute, at least in part, to senescent changes in body composition and physiological function. Specifically, he provided evidence that the gradual decline in growth hormone (GH) and testosterone secretion during aging is accompanied by anatomical and functional changes resembling pathogenic hormone deficiency. He went on to discuss possible interventions into this process, specifically showing data to support the view that a combination of GH secretagogues and sex hormones may be of value in sustaining health and vitality in the elderly. As an extension of this discussion, H. M. Schulte compared and contrasted age changes in sex hormone secretion between genders, and also stressed that the diagnosis and management of endocrine changes during life has become a serious challenge to those physicians intending to intervene in the aging process. Because the relationship of reduced hormone secretion to disease in the elderly is presently unclear, the Workshop concluded on a note of caution that guidelines for the replacement of endocrine substances as a prophylactic approach to aging have yet to be defined.

Aged↗

[Info-congress. Study of the prevention of type 1 diabetes with nicotinamide: positive lessons of a negative clinical trial (ENDIT)].

ENDIT ("European Nicotinamide Diabetes Intervention Trial") is a large placebo-controlled randomised clinical trial that aimed at studying the efficacy of nicotinamide in the prevention of type 1 diabetes mellitus among first-degree relatives of type 1 diabetic patients with positive islet cell antibodies (ICA). The results presented at the last congress of the European Association for the Study of Diabetes (EASD) in Budapest do not evidence any significant difference in the risk of developing overt diabetes mellitus in the patients treated with nicotinamide (n = 274) as compared to those receiving placebo (n = 275) after 5 years of follow-up. Despite these negative results, positive lessons could be drawn from ENDIT: 1) the feasibility of a large long-standing multicentre European trial in a difficult research area; 2) the importance of large randomised controlled clinical trials to bring the evidence requested by "Evidence-Based Medicine"; 3) the predictive value of various risk markers to progress toward type 1 diabetes in first-degree relatives, especially the number of positive auto-antibodies; and 4) the urgent need to continue intensive research in this important field of preventive medicine.

Diabetes Mellitus, Type 1↗

[Report from the XXVIII Congress of ERA-EDTA, Vienna, June, 2001].

This paper refers to selected reports on nephrology and renal dialysis therapy presented on the XXXVIII Congress of European Renal Association--European Dialysis and Transplant Association (ERA-EDTA), held in 2001 in Vienna. Special attention was paid to diagnosis and therapy of renal anaemia, calcium-phosphate metabolism, Fabry's disease and vascular access in hemodialysed patients.

Anemia↗

Recent advances in breast cancer: the 27th ESMO Congress 2002.

Breast cancer was the focus of several presentations during the 27th European Society of Medical Oncology (ESMO) Congress held in Nice. Fulvestrant seems to be equally effective to tamoxifen as a first-line therapy in hormone-sensitive advanced breast cancer in postmenopausal women. However, it may be more effective than tamoxifen in ER- and PgR-positive disease. The addition of tamoxifen to epirubicin containing regimens was found to significantly increase PFS and OS in patients with MBC according to a multivariate analysis of 640 patients. BRCA-1 linked breast cancer was reported to be more sensitive to anthracycline-based CT than sporadic and BRCA-2 linked disease. VEGF was found to be an independent prognostic factor in patients with node-negative breast cancer. The implications and limitations of these findings are discussed.

Breast Neoplasms↗

German Cancer Society--12th International AEK Cancer Congress. 25-28 March 2003, Würzburg, Germany.

The 12th International AEK Cancer Congress was attended by approximately 500 oncologists, basic scientists and biotechnologists. The majority of the oral contributions were dedicated to the molecular mechanisms of oncogenesis and potential targets for cancer treatment; novel drugs and approaches for cancer therapy were presented in one of seven sessions, as well as in a series of posters. Antisense oligonucleotides, peptide aptamers and siRNA technology were disclosed at the meeting as novel approaches for cancer treatment. In addition, a number of anticancer drugs were discussed, including 17-allylamino demethoxygeldanamycin (17-AAG), treosulfan, sulfasalazine and U-0126, and also the receptor ligand TRAIL.

Animals↗

Meeting Report: 10 Years of Progress: Report from Selected Presentations at the 19th ECTRIMS Congress, 1720 September 2003, Milan, Italy.

The success of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) is notable, and Chris Polman (Amsterdam, the Netherlands), the new President of ECTRIMS, pointed out that the Congress had grown from an attendance of 50 delegates in 1982 to over 3000 at this 19th meeting. ECTRIMS 2003 provided an overview of recent achievements in clinical multiple sclerosis (MS) research, with sessions highlighting understanding and promoting functional and structural recovery, and the necessity and progress made in co-ordinating research efforts in MS. The impact of molecular biology, new perspectives in MRI and advances in treatment were covered in comprehensive reviews and original presentations. Five hundred stimulating posters from researchers around the world were also presented. Several satellite symposia, a young scientific investigators' session, an international workshop on remyelination in MS, a comprehensive exhibition and presentations of late-breaking research complemented the main programme.

Biomedical Research↗

Asthma issues from ERS Congress.

Asthma is an important topic for general practitioners and AFP has selected abstracts from papers on recent advances and issues in asthma management that were delivered at the European Respiratory Society Congress, held in Brussels in September 1991. The abstracts and reviews are reprinted with permission from 'Asthma Issues From ERS Brussels 91. An Australian Perspective', published by Allen and Hanbury.

Asthma↗

[Optimizing the managment of patients with diabetes mellitus: selected clinical trials from the 2004 Congress of the American Diabetes Association].

The 64th scientific congress of the American Diabetes Association had a special session devoted to the presentation of the results from three clinical trials: 1) the first multicentre international trial of pancreatic islet transplantation according to the so-called Edmonton protocol with the primary endpoint of restoring insulin independence in type 1 diabetic patients; 2) three pivotal studies of 30 weeks testing both the efficacy and safety of exenatide (exendin-4), a new insulin secretagogue that is a long-acting analogue of glucagon-like peptide-1, in patients with type 2 diabetes treated with either metformin, or a sulfonylurea, or a metformin-sulfonylurea combination; and 3) the "Collaborative AtoRvastatin Diabetes Study" (CARDS), a placebo-controlled primary prevention trial of cardiovascular complications using atorvastatin 10 mg in 2 838 at risk patients with type 2 diabetes. The main results and conclusions of these trials are briefly presented as they open new perspectives in the management of patients with type 1 or type 2 diabetes mellitus.

Anticholesteremic Agents↗

Anti-cancer treatment - 12th International Congress. 4-7 February 2002, Paris, France.

The 12th International Congress on Anti-Cancer Treatment (ICACT), endorsed by the American Society of Clinical Oncology, was held in Paris, France. Led by Gabriel Hortbagyi (MD Anderson Cancer Center, USA) and David Khayat (Hopital de la Pitie Salpetriere, France), the meeting was well organized and attended by several thousand participants from many countries. The list of members forming the Scientific Committee included well-known international experts whose involvement was reflected in the scientific excellence of the presentations.

Journal Article↗