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Popular Articles

Recent Releases: Polio Eradication; Chagas Disease Discovery Anniversary; River Blindness; Malaria Tools; Childhood Malnutrition
MMWR Examines Polio Eradication In India

Society, Wildlife Disease And Wildlife Conservation: Oxymoron Or Evolutionary Siblings?
Over the past 50 years, the field of wildlife disease as an issue for concern has exploded in significance, mostly because of the increased realization that most emerging human diseases are "zoonotic," that is, diseases that can spread from people to other animals or vice-versa. USGS emeritus scientist Dr. Milton Friend, in an invited talk at the Wildlife Disease Association conference, will explore how and why the field of wildlife disease research has changed over the last 50 years.
News of the day
Boston Globe Examines Hospital's Attempt To Reduce Emergency Department Visits, Hospital Stays Among Elderly
Efforts by Massachusetts General Hospital to reduce health spending could be indicative of the difficulty the health industry faces in trying to reduce spending growth, the Boston Globe reports. Industry groups last week pledged to seek a 1.5% overall reduction in health care spending over the next 10 years.Massachusetts General"s program, which began in 2006, aims to reduce hospitalizations among the elderly by 15% to 20%, as well as to improve the quality of care the elderly receive. A study looking at 35 efforts to improve elderly care found that only six, including Massachusetts General"s program, saved money or covered their costs, the Globe reports. Massachusetts General"s program relies on nurses in primary care practices to be in regular contact with patients and provide assistance with nonmedical services. The program also uses electronic health records to coordinate care. The hospital spent $8 million to $9 million over the first three years of the program to provide enhanced services to patients. Hospital readmissions fell by 19%, admissions decreased by 17% and ED visits dropped by 15% between 2007 and 2008, according to preliminary research. The program saved enough by reducing hospital admissions and emergency department visits to cover its costs and also to generate savings of $7 million to $10 million. The overall cost for the program was about 5% less than for a group of other patients treated in a more traditional way.According to Harvard University health care economist David Cutler, improving care and reducing costs among the elderly is a necessary component of health reform. He said, "If we can"t do this, it doesn"t bode well for health reform." Eric Weil, a primary care physician and medical director of the program at Massachusetts General, said, "Medicare is looking for any and every way to save money," adding, "This is a population of patients who are sick and will get sicker over time. Any opportunity to demonstrate savings in this group of patients is good, and 5% is very good" (Kowalczyk, Boston Globe, 5/17).
Diagnostics

Promising New Treatment For Alzheimer's Suggested Based On Hebrew University Research

Research carried out at the Hebrew University of Jerusalem has resulted in a promising approach to help treat Alzheimer"s disease in a significant proportion of the population that suffers from a particularly rapid development of this disease. In the research at the Silberman Institute of Life Sciences of the Hebrew University, scientists solved a mystery as to why people who carried a mutated gene known as BChE-K were prone to more rapid development of Alzheimer"s than those who had a normal version of the gene. This mutation appears in about 20 percent of the American and Israeli populations. In theory, the carriers of the mutated gene should actually be more protected from the devastating effects of the disease, since the mutated protein (the enzyme that is the product of the gene) breaks down the neurotransmitter acetylcholine at a slower rate than in those who have the normal gene. The result is that the carriers maintain higher levels of this neurotransmitter, so they should in principle be protected from Alzheimer"s disease, in which acetylcholine levels decrease. Indeed, these carriers tend to develop the disease later than others, but when that happens, it progresses more rapidly and does not respond to medication. Therefore, the bottom line is that carriers of the mutated gene have a greater risk than others for disease progression. The reason for this anomalous situation has been a puzzle for a long time, but the studies by the Hebrew University scientists solved it by finding the explanation for this increased risk, thereby offering as well a possible new therapeutic solution. At the Wolfson Center for Structural Biology at the Hebrew University, the researchers found that the mutation in the BChE-K gene damages the very end, or tail, of the resultant mutant enzyme protein. This tail is the part of BChE which is important for protection from the Alzheimer"s disease plaques. It does this by interacting with the Alzheimer"s disease í²-amyloid protein and preventing it from precipitating and forming those brain plaques which are the neuropathological hallmark of this disease. To compare the normal protein to the K mutant, the researchers used synthetic tails of the normal and the K proteins, as well as engineered human BChE produced in the milk of transgenic goats at a U.S. company, Pharmathene. The goat- produced protein is prepared at Pharmathene for the U.S. military as protection from nerve gas poisoning (a result of earlier research at the Hebrew University). It was much more stable and efficient than the mutant protein, which suggests that the BChE-K carriers" susceptibility to Alzheimer"s could be substantially improved by treating them with the engineered normal protein that is produced in the milk of the transgenic goats. The current study was the last part in the Ph.D. work of Dr. Erez Podoly, now a post- doctoral fellow with the Nobel laureate Roger Kornberg at Stanford University. Podoly was the joint student of Prof Oded Livnah and Prof. Hermona Soreq and won a National Eshkol fellowship in Biotechnology to perform this work as well as a Kaye Innovation Award at the Hebrew University. Others who contributed to this study included Dr, Debbie Shalev and Dr. Ester Bennett from the Silberman Institute of Life Sciences, Harvey Wilgus from Pharmathene, and Dr Einor Ben-Assayag and Shani Shenhar- Tsarfati, a Ph.D. student, both from the Sourasky Medical Center in Tel aviv, where the Israeli carriers of BChE-K were identified. The project is patented and is available for licensing by the Yissum Research Development Company of the Hebrew University of Jerusalem. An article by the researchers on this work was recently selected as a Journal of Biological Chemistry (JBC) Paper of the Week and featured on the cover of the publication. Rebecca Zeffert The Hebrew University of Jerusalem


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