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Desert Sun Publishes Series On HIV/AIDS Amid Proposed Funding Cuts In California State Budget
The Desert Sun published a series of articles related to HIV/AIDS. The articles include a feature profiling people living with the virus and others looking at efforts by advocates to offer culturally appropriate information on HIV to Hispanics, blacks and other minorities; the efficacy of antiretrovirals, and how the drugs are enabling people to live longer; and the potential effects of proposed state budget cuts on HIV/AIDS programs in Riverside County (Brambila, Desert Sun, 6/10).
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Crohn's Disease: Case Western Reserve Researchers Identify Links Between Inflammatory Disease Genes
Researchers from Case Western Reserve University School of Medicine identified a novel link between ITCH, a gene known to regulate inflammation in the body and NOD2, a gene which causes the majority of genetic Crohn"s Disease diagnoses. ITCH, when malfunctioning, causes widespread inflammatory diseases, including inflammatory bowel disease, gastritis, uncontrolled skin inflammation, and pulmonary pneumonitis. Derek Abbott, M.D., Ph.D., and his team of researchers found that ITCH also influences NOD2-induced inflammation. These findings, published in the August 11th issue of Current Biology, suggest a common pathophysiology exists between multiple inflammatory diseases. The unexpected finding of the interaction between these genes offers the possibility of a new drug target, which would be effective in treating Crohn"s disease - a chronic disorder causing inflammation of the gastrointestinal tract.
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Blogs Comment On World Population Day, Health Care Reform, Other Topics
The following summarizes selected women"s health-related blog entries. ~ "World Population Day 2009 -- Time To Finally Make Maternal Health a Priority," Sharon Camp, Huffington Post blogs: World Population Day on Saturday "serves as an urgent reminder that ... governments around the world must boost investments in global health," especially maternal health, despite the global economic recession, Camp, president and CEO of the Guttmacher Institute, writes. Efforts "have fallen short" to date as the "financial res and political will needed to promote maternal health have been lagging," Camp writes. She notes that the nations are "hardly any closer" to achieving the United Nations" Millennium Development Goals of reducing maternal deaths by 75% and achieving universal access to reproductive health services by 2015. A "critical shortcoming" of recent efforts to achieve the MDGs has been the "reluctance of some governments and advocates to accept that better maternal health cannot be achieved without acknowledging, committing and fully funding sexual and reproductive health services," Camp writes. In particular, "this includes contraceptive services to help women time and space pregnancies as well as treatment of septic or incomplete abortions," and "providing safe abortion services consistent with individual country law," according to Camp. However, there is "some good news," she writes, noting that "[n]ew momentum behind worldwide advocacy efforts may yield the res and political commitment needed to make a difference." Camp concludes, "It is precisely because res are scarce that they must be used wisely and efficiently in a way that serves both humanitarian and economic development goals. Investing in saving women"s lives fits this bill" (Camp, Huffington Post blogs, 7/9).~ "Proposed Amendments Would Deny Health Care to Women," Lois Uttley, RH Reality Check: In a blog post addressed to "Gentlemen of the Congress," Uttley asks if they have "forgotten about the women" in their lives as they work on crafting health care reform legislation. Uttley writes,"[S]ome of you are wasting valuable time and taxpayer dollars proposing amendments that would deny health care" to several groups of people, including women. She writes that Republican Sens. Mike Enzi (Wyo.), Orrin Hatch (Utah) and Tom Coburn (Okla.) this week submitted amendments to the Senate Health, Education, Labor and Pensions Committee that would ban coverage for abortion services; protect health care providers and insurers from ""discrimination" for refusing to provide health care requested by their patients," including abortion and emergency contraception; allow federally qualified health centers to "not provide abortions and still get government grants"; and require that "[a]ny independent medical board appointed to determine the benefits that would be included in national health reform coverage would have to include "professional ethicists ... with specialty in rights of the life of the unborn."" Meanwhile, Democrats "are spending far too much time trying to win over colleagues who are never going to vote for health reform, no matter if you offer them abortion exclusions or new provider "conscience" laws or other provisions that would hobble health reform," Uttley writes. She continues, "Don"t forget that women are among the strongest supporters of moving quickly on health reform this year" because they are "grassroots experts on what is broken in the current health system," such as insurers" labeling of pregnancy as a "pre-existing condition," using "gender rating" in individual policies and excluding contraception coverage. She asks, "So what do women want?" Uttley provides a "list we"ve been compiling at Raising Women"s Voices for the Health Care We Need." Among the priorities, the list stresses that lawmakers should keep "moral values" out of the debate and that health insurance must be affordable, more simple to understand, fair, portable and universal (Uttley, RH Reality Check, 7/9).~ "Reports
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Hyperion Therapeutics Announces Results Of Phase I Study In Patients With Liver Cirrhosis

Hyperion Therapeutics, Inc. announced top-line results from a phase I study of HPN-100 in patients with liver cirrhosis. The data were presented as part of the 2009 Digestive Disease Week meeting. The abstract is titled "Pharmacokinetic (PK) and Safety Analyses of a Novel Ammonia-Reducing Agent in Healthy Adults and Patients with Cirrhosis." This open-label study was designed to determine the safety, tolerability, and PK and pharmacodynamic (PD) profiles of HPN-100 administered orally to subjects with hepatic impairment and cirrhosis and to subjects with normal hepatic function. A total of thirty-two subjects were enrolled, including twenty four with cirrhosis (eight each Child-Pugh score A, B, and C), and eight age- and gender-matched healthy subjects with normal hepatic function. Subjects received a single oral dose (100mg/kg/d) of HPN-100 on day 1, two doses of 100mg/kg on each of days 8-14 (total of 200mg/kg/d), and a single dose on day 15 (100mg/kg/d). In order to assess the effects of food on HPN-100 PK, the dose was given fasting on Day 1 and with a meal on Day 8. HPN-100 was metabolized via the expected major pathway, from phenylbutyrate (PBA) to phenylacetic acid (PAA) and then to phenylacetylglutamine (PAGN). PAGN mediates waste nitrogen excretion and ammonia removal. The extent of plasma exposure to PAA significantly correlated with MELD score (r2= 0.15; p= 0.03), but did not correlate significantly with glomerular filtration rate (r2= 0.01; p= 0.54) or Child-Pugh score (r2= 0.10; p= 0.08). No consistent differences between cirrhotic subjects and healthy volunteers were seen for the plasma PK variables on days 1 or 15. There were no statistically significant differences in the PK characteristics when HPN-100 was given fasting on day 1 or with a meal on day 8. Excretion of the main metabolite PAGN was similar between healthy adults and cirrhotic subjects. Urinary PAGN after the first dose on Day 1 ranged from 42-49% of the administered dose, and the mean total excretion of PAGN after the last dose in the study (day 15) ranged from 25,152 to 31,431 umol in the four treatment groups There were no SAEs or AEs leading to withdrawal during the study. The most common system organ class was "investigations" (32 events in 18 subjects), and of these the most frequent individual AEs were increased body temperature, which was reported in 10 subjects (all from Child-Pugh groups A, B, and C), and decreased platelet count, which was reported in 4 subjects in Child-Pugh group A and 1 subject in the healthy volunteer group. There were no overall consistent patterns across all subject groups in changes in mean hematology, biochemistry, and coagulation variables. "Hepatic encephalopathy (HE) is a significant clinical problem," said Brendan M. McGuire, M.D. Medical Director of Liver Transplantation at the University of Alabama. "I am encouraged by the phase I study results and look forward to further clinical studies." About HPN-100 HPN-100 is an investigational product that is a pre-pro-drug of phenylacetic acid, the active moiety of BUPHENYL(R), the only therapy currently FDA-approved as adjunctive therapy for the chronic management of patients with the most prevalent urea cycle disorders: carbamylphosphate synthetase (CPS), ornithine transcarbamylase (OTC) and argininosuccinic acid synthetase (AS) deficiencies. HPN-100, which is dosed orally in liquid form, is under clinical investigation as providing a potential alternative pathway to the urea cycle for the disposal of waste nitrogen through the renal excretion of phenylacetylglutamine (PAGN), which is formed from phenylacetic acid (PAA) and glutamine. Hyperion has initiated a phase III clinical program for the use of HPN-100 in the treatment of urea cycle disorders and plans to initiate a phase II program for the use of HPN-100 in treating hepatic encephalopathy later this year. About Hepatic Encephalopathy Hepatic encephalopathy (HE) is a serious but potentially reversible neurological disorder that can occur in patients with acute liver failure and, most commonly, in patients with cirrhosis of any etiology. It comprises a spectrum of neurological signs and symptoms ranging from mild (e.g. minimal disorientation) to severe (e.g. coma, death) and is believed to occur when the brain is exposed to gut-derived toxins such as ammonia that are normally removed from the blood by a healthy liver. There are no therapies currently FDA-approved for the treatment of HE. About Urea Cycle Disorders Urea cycle disorders are inherited, inborn errors of metabolism present in an estimated 1 in 10,000 births in the United States. Patients with urea cycle disorders are deficient in one of the key enzymes that comprise the urea cycle, the body"s primary vehicle for removing ammonia, a potent neurotoxin, from the bloodstream. Onset may occur at any age depending on the severity of the disorder. Left untreated, urea cycle disorders can cause dangerously heightened levels of ammonia in the bloodstream (hyperammonemia) resulting in brain damage, coma, and/or death. About BUPHENYL BUPHENYL is indicated as adjunctive therapy in the chronic management of patients with urea cycle disorders involving deficiencies of CPS, OTC, or AS. BUPHENYL should not be administered to patients with known hypersensitivity to sodium phenylbutyrate or any component of this preparation. The most common adverse reactions associated with BUPHENYL were amenorrhea dysfunction, decreased appetite, body odor (probably caused by its metabolite phenylacetate) and bad taste or taste aversion. Patients with urea cycle disorders should not take valproic acid, haloperidol, or steroids as these drugs have been reported to increase blood ammonia levels, and probenecid may affect the kidneys" excretion. Use with great care, if at all, in patients with congestive heart failure or severe renal insufficiency, and in clinical states where there is sodium retention with edema. Use caution when administering to patients with hepatic or renal insufficiency or inborn errors of beta oxidation. The safety or efficacy of doses in excess of 20 grams (40 tablets) per day has not been established. About Hyperion Therapeutics Hyperion Therapeutics is a privately held specialty pharmaceutical company focused on the development of therapies that address critical unmet needs in the areas of gastroenterology and hepatology. Hyperion and Ucyclyd Pharma, Inc., a subsidiary of Medicis Pharmaceutical Corporation, entered into a collaboration agreement for HPN-100 in August 2007. Under the terms of the agreement, Hyperion is conducting ongoing research and development of HPN-100 for urea cycle disorders, hepatic encephalopathy, and other forms of hyperammonemia. Hyperion is headquartered in South San Francisco, CA. BUPHENYL is a registered trademark of Ucyclyd Pharma, Inc. Hyperion Therapeutics, Inc


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