Brief fever common in kids given influenza, pneumococcal vaccines together

PUBLIC RELEASE DATE:
6-Jan-2014

– Parents should be made aware that their child might develop a fever following simultaneous influenza and pneumococcal vaccinations

– children who received simultaneous influenza and pneumococcal vaccines, about a third (37.6 percent) had a fever of 100.4 F (38 C) or higher on the day of or day after vaccination, compared with children who received only the pneumococcal (9.5 percent) or only the influenza (7.5 percent) vaccine.

Findings suggest utility of text messaging to monitor safety

NEW YORK, NY (Jan. 6, 2014) – Giving young children the influenza and pneumococcal vaccines together appears to increase their risk of fever, according to a study led by researchers from Columbia University Medical Center (CUMC) and the Centers for Disease Control and Prevention (CDC). However, the fever was brief, and medical care was sought for few children, supporting the routine immunization schedule for these vaccines, including the recommendation to administer them simultaneously. The study, which looked at children 6-23 months old, was published online on Jan. 6, 2014, in JAMA Pediatrics. Continue reading “Brief fever common in kids given influenza, pneumococcal vaccines together”

Half of psychiatrists reject private and federal insurance, preferring cash

Contact: Jen Gundersen jeg2034@med.cornell.edu 646-317-7402 Weill Cornell Medical College

Researchers warn that just when the need for mental health services is recognized on a national level, access to help is declining at an alarming rate Continue reading “Half of psychiatrists reject private and federal insurance, preferring cash”

Discovery of brain activity in severely brain injured patients who ‘wake up’ with sleep drug

Contact: Jennifer Gundersen jeg2034@med.cornell.edu 646-317-7402 Weill Cornell Medical College

Pattern of brain activity points to possible neural circuit switched on by drug and may identify other patients who could respond

NEW YORK (November 19, 2013) — George Melendez has been called a medical miracle. After a near drowning deprived his brain of oxygen, Melendez remained in a fitful, minimally conscious state until his mother, in 2002, decided to give him the sleep aid drug Ambien to quiet his moaning and writhing. The next thing she knew, her son was quietly looking at her and trying to talk. He has been using the drug ever since to maintain awareness, but no one could understand why Ambien led to such an awakening.

Continue reading “Discovery of brain activity in severely brain injured patients who ‘wake up’ with sleep drug”

Omega-3 lipid emulsions markedly protect brain after stroke in mouse study – DHA

Contact: Karin Eskenazi ket2116@columbia.edu 212-342-0508 Columbia University Medical Center

New York, NY (February 20, 2013) — Triglyceride lipid emulsions rich in an omega-3 fatty acid injected within a few hours of an ischemic stroke can decrease the amount of damaged brain tissue by 50 percent or more in mice, reports a new study by researchers at Columbia University Medical Center.

The results suggest that the emulsions may be able to reduce some of the long-term neurological and behavioral problems seen in human survivors of neonatal stroke and possibly of adult stroke, as well. The findings were published today in the journal PLoS One.

Currently, clot-busting tPA (recombinant tissue-type plasminogen activator) is the only treatment shown to improve recovery from ischemic stroke. If administered soon after stroke onset, the drug can restore blood flow to the brain but may not prevent injured, but potentially salvageable, neurons from dying.

Drugs with neuroprotective qualities that can prevent the death of brain cells damaged by stroke are needed, but even after 30 years of research and more than 1000 agents tested in animals, no neuroprotectant has been found effective in people.

Omega-3 fatty acids may have more potential as neuroprotectants because they affect multiple biochemical processes in the brain that are disturbed by stroke, said the study’s senior author, Richard Deckelbaum, MD, director of the Institute of Human Nutrition at Columbia’s College of Physicians & Surgeons. “The findings also may be applicable to other causes of ischemic brain injury in newborns and adults,” added co-investigator Vadim S. Ten, MD, PhD,  an associate professor of pediatrics from the Department of Pediatrics at Columbia.

The effects of the omega-3 fatty acids include increasing the production of natural neuroprotectants in the brain, reducing inflammation and cell death, and activating genes that may protect brain cells. Omega-3 fatty acids also markedly reduce the release of harmful oxidants into the brain after stroke. “In most clinical trials in the past, the compounds tested affected only one pathway. Omega-3 fatty acids, in contrast, are very bioactive molecules that target multiple mechanisms involved in brain death after stroke,” Dr. Deckelbaum said.

The study revealed that an emulsion containing only DHA (docosahexaenoic acid), but not EPA (eicosapentaenoic acid), in a triglyceride molecule reduced the area of dead brain tissue by about 50 percent or more even when administered up to two hours after the stroke. Dr. Deckelbaum noted, “Since mice have a much faster metabolism than humans, longer windows of time for therapeutic effect after stroke are likely in humans.” Eight weeks after the stroke, much of the “saved” mouse brain tissue was still healthy, and no toxic effects were detected.

Studies are currently under way to test the emulsion in older mice and in mice with different types of stroke. The researchers are also conducting additional studies to identify more precisely how the omega-3 emulsion works and to optimize the emulsion in order to improve functional recovery after stroke.

After animal studies on dosages and timing, and if the emulsions continue to show promising results, Dr. Deckelbaum said, clinical trials could begin quickly, as such emulsions have already been shown to be safe in people. Similar emulsions are used in European ICUs for nutrition support, and in the US they have been found to be safe when tested in babies for their nutritive and anti-inflammatory effects.

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The title of the paper is “n-3 Fatty Acid Rich Triglyceride Emulsions are Neuroprotective after Cerebral Hypoxic-Ischemic Injury in Neonatal Mice.” The other contributors are Jill J. Williams, Korapat Mayurasakorn, Susan J. Vannucci (Weill Cornell); Christopher Mastropietro (Wayne State); Nicolas G. Bazan (Louisiana State); and Vadim S. Ten CUMC).

The study was supported by the National Institutes of Health (RO1 HL040404, RO1 NS056146, and RO1 NS046741).

A U.S. patent application filed by Columbia University and naming RD as an inventor, for the therapeutic use of omega-3 diglyceride emulsions, has been allowed by the U.S. Patent and Trademark Office. The other authors declare no financial or other conflicts of interest.

Columbia University Medical Center provides international leadership in basic, pre-clinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians and Surgeons was the first institution in the country to grant the MD degree and is among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest in the United States. Its physicians treat patients at multiple locations throughout the tri-state area, including the NewYork-Presbyterian/Columbia campus in Washington Heights, the new ColumbiaDoctors Midtown location at 51 W. 51st St. in Manhattan, and the new ColumbiaDoctors Riverdale practice. For more information, visit www.cumc.columbia.edu or columbiadoctors.org.

Vitamin E effective for ‘silent’ liver disease

2010 study posted for filing

Contact: Jennifer Homa jeh9057@nyp.org 212-305-5587 New York- Presbyterian Hospital/Columbia University Medical Center

NIH-funded, NEJM study is largest ever to look at nonalcoholic steatohepatitis, an obesity-related condition

NEW YORK (April 29, 2010) — Vitamin E has been shown effective in treating nonalcoholic steatohepatitis (NASH), an obesity-associated chronic liver disease that can lead to cirrhosis, liver cancer, and death. NASH also is related to or a part of type 2 diabetes, lipid disorders and cardiovascular disease.

The often asymptomatic condition affects 2 to 5 percent of Americans, although an additional 10 to 20 percent of the population has fat in their liver, but no inflammation or liver damage, a condition called “fatty liver” that is a precursor to NASH. There is no established treatment.

The government-funded multicenter study was organized by the Nonalcoholic Steatohepatitis Clinical Research Network of the National Institute of Diabetes and Digestive and Kidney Diseases, and is the largest ever placebo-controlled randomized trial of treatment for NASH. Results are published in the April 28 online edition of the New England Journal of Medicine.

Beginning in the late 1990s, study of vitamin E for NASH was pioneered in pilot trials by Dr. Joel Lavine, now a faculty member in the Department of Pediatrics at Columbia University College of Physicians and Surgeons and chief of gastroenterology, hepatology and nutrition at NewYork-Presbyterian/Morgan Stanley Children’s Hospital. Researchers followed patients at nine centers, including the University of California, San Diego, where Dr. Lavine was previously on faculty.

“There is an increasing prevalence of nonalcoholic steatohepatitis in this country, something that is directly related to the obesity epidemic,” says Dr. Lavine, co-chair of the Network’s steering committee and a co-author of the study. “The good news is that this study showed that cheap and readily available vitamin E can help many of those with the condition. We also looked at the drug pioglitazone, which showed some benefits, although not as dramatic as with vitamin E.”

Dr. Lavine cautions that there are risks with any therapy, even vitamin E, and all treatment should be done under medical supervision. “Individuals who are overweight or have a family history of liver disease should ask their doctor to be tested for the condition. In addition, physicians should be aware that liver enzyme levels considered normal are actually elevated. Healthy levels are <30 U/L for a man and <20 for a woman.”

In the Pioglitazone or Vitamin E for NASH Study (PIVENS), investigators randomly assigned 247 nondiabetic adults with biopsy-confirmed NASH to receive vitamin E, pioglitazone or placebo. Vitamin E functions as an antioxidant while pioglitazone improves the sensitivity of cells to insulin, a hormone that controls both sugar and fat metabolism.

After 96 weeks of treatment, vitamin E improved all features of NASH with the exception of the amount of scar tissue in the liver; 43 percent of those treated with vitamin E met the primary endpoint of the trial, which was a composite of the scores for several features of NASH indicative of disease activity, compared with only 19 percent of those who received a placebo. Pioglitazone also improved many features of NASH and met the primary endpoint in 34 percent of individuals who received it but fell short of statistical significance. Pioglitazone treatment led to an average weight gain of 10 pounds over the 96-week duration of this study. Liver enzyme tests, which are commonly used to assess liver injury, also improved in those who received either pioglitazone or vitamin E. However, upon stopping the medications, the liver enzymes worsened again suggesting the need for long-term treatment.

The study was conducted in those with NASH who did not have diabetes, and the benefits of either drug for those with NASH who also have diabetes remain unknown. Also, the study lasted for two years only and the potential long-term benefits and risks of taking vitamin E or pioglitazone in these doses are uncertain.

Lead author of the study and the other NASH Clinical Research Network co-chair is Dr. Arun Sanyal, professor of medicine and chairman of the Division of Gastroenterology at Virginia Commonwealth University in Richmond.

Pioglitazone (trade name Actos) was provided by Takeda Pharmaceuticals North America, and vitamin E was provided by Pharmavite. Both also supplied placebos.

Dr. Lavine joined NewYork-Presbyterian/Columbia from the University of California San Diego in February and brought his NIH grant for the study of fatty liver to NewYork-Presbyterian/Columbia. He is currently preparing a report on a multicenter study he led of vitamin E and the diabetes drug metformin for NASH in children.

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NewYork-Presbyterian Hospital

NewYork-Presbyterian Hospital, based in New York City, is the nation’s largest not-for-profit, non-sectarian hospital, with 2,353 beds. The Hospital has more than 1 million inpatient and outpatient visits in a year, including more than 220,000 visits to its emergency departments — more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian/Morgan Stanley Children’s Hospital, NewYork-Presbyterian/The Allen Hospital and NewYork-Presbyterian Hospital/Westchester Division. One of the most comprehensive health care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. The Hospital has academic affiliations with two of the nation’s leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons. For more information, visit www.nyp.org.

Columbia University Medical Center

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians and Surgeons was the first institution in the country to grant the M.D. degree and is now among the most selective medical schools in the country. Columbia University Medical Center is home to the most comprehensive medical research enterprise in New York City and State and one of the largest in the United States. Columbia University Medical Center is affiliated with NewYork-Presbyterian Hospital, the nation’s largest not-for-profit, non-sectarian hospital provider. For more information, please visit www.cumc.columbia.edu.

Office of Public Affairs NewYork-Presbyterian Hospital/Columbia University Medical Center 627 West 165th Street New York, NY 10032
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Researchers explore new ways to prevent spinal cord damage using a vitamin B3 precursor: nicotinamide adenine dinucleotide ( NAD+ )

2009 study posted for filing

Contact: Andrew Klein
ank2017@med.cornell.edu
212-821-0560
New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College

Weill Cornell Medical College team receives $2.5 million New York State research grant to undertake laboratory study

NEW YORK (November 5, 2009) — Substances naturally produced by the human body may one day help prevent paralysis following a spinal cord injury, according to researchers at Weill Cornell Medical College. A recent $2.5 million grant from the New York State Spinal Cord Injury Research Board will fund their research investigating this possibility.

The Weill Cornell team believes that permanent nerve damage may be avoided by raising levels of a compound that converts to nicotinamide adenine dinucleotide (NAD+) — the active form of vitamin B3. The compound would potentially be administered immediately following spinal cord injury.

“Boosting NAD+ after injury may prevent permanent nerve death,” explains Dr. Samie Jaffrey, associate professor of pharmacology at Weill Cornell Medical College. “Our study is aimed at synthesizing a molecule that, when given soon after injury, may augment the body’s production of NAD+ and rescue these cells before they are stressed beyond recovery.”

The compound, called nicotinamide riboside (NR) — a natural NAD+ precursor found in foods like milk — as well as other NR derivatives have already been proven to protect against cell death and axonal degeneration in cultured cells and in models of spinal cord injury. In 2007, the authors reported results of laboratory experiments finding that NR can increase NAD+ concentrations as high as 270 percent when compared with untreated control cells. No other known agent has been shown to achieve these types of increases in cells.

NAD+ is known to play a key role in human cells by activating proteins called sirtuins that help the cells survive under stress. Sirtuins, which can be activated by compounds like resveratrol (found in large concentrations in the skin of grapes used to make red wine) have been shown to possess anti-aging and healing properties. The researchers believe that quickly increasing the NAD+ levels may help to activate the sirtuin levels in the cells and prevent cell death. This is especially important because when cells and tissues experience extreme trauma, NAD+ levels drop quickly.

In the newly funded research, the Weill Cornell team will conduct a lab study to see how NR compounds can raise NAD+ levels in cells that are stressed to the point that they will die within three to four hours, and instead survive as a consequence of treatment. In a separate study, Dr. Brett Langley from the Burke Rehabilitation Center in Westchester, N.Y. — a hospital affiliated with Weill Cornell Medical College — will test the compounds in mice with spinal injuries, with the hope of observing physical recovery and improvement in behavioral testing.

“We hope to show that a natural compound that can be produced cheaply and efficiently could be the key to preventing permanent injury,” explains Dr. Anthony Sauve, associate professor of pharmacology at Weill Cornell Medical College. “We also believe that the compound would be perfectly safe to use in humans, since it is a vitamin that has not been shown to have negative effects on the body when artificially elevated.”

Dr. Sauve has patented and pioneered a way to produce compounds that regulate NAD+ and specializes in making an array of NAD derivatives to determine which one best augments NAD+ levels in neurons.

“If this study is successful in animal testing, we hope to study the compound clinically,” says Dr. Jaffrey.

 

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New York State Spinal Cord Injury Research Board

The New York State Spinal Cord Injury Research Board distributes research grants to find a cure for spinal cord injuries. More than 16,000 New Yorkers suffer with spinal cord injuries. In July 1998, landmark legislation was enacted to create the New York State Spinal Cord Injury Research Board and allocate funding to the Spinal Cord Injury Research Trust Fund. The purpose of the fund is to assist leading researchers with ongoing and new efforts to find a cure for spinal cord injuries. Since its inception, the Board has recommended more than $54 million in research awards to some of New York State’s finest research teams.

Weill Cornell Medical College

Weill Cornell Medical College, Cornell University’s medical school located in New York City, is committed to excellence in research, teaching, patient care and the advancement of the art and science of medicine, locally, nationally and globally. Weill Cornell, which is a principal academic affiliate of NewYork-Presbyterian Hospital, offers an innovative curriculum that integrates the teaching of basic and clinical sciences, problem-based learning, office-based preceptorships, and primary care and doctoring courses. Physicians and scientists of Weill Cornell Medical College are engaged in cutting-edge research in areas such as stem cells, genetics and gene therapy, geriatrics, neuroscience, structural biology, cardiovascular medicine, transplantation medicine, infectious disease, obesity, cancer, psychiatry and public health — and continue to delve ever deeper into the molecular basis of disease and social determinants of health in an effort to unlock the mysteries of the human body in health and sickness. In its commitment to global health and education, the Medical College has a strong presence in places such as Qatar, Tanzania, Haiti, Brazil, Austria and Turkey. Through the historic Weill Cornell Medical College in Qatar, the Medical College is the first in the U.S. to offer its M.D. degree overseas. Weill Cornell is the birthplace of many medical advances — including the development of the Pap test for cervical cancer, the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial of gene therapy for Parkinson’s disease, the first indication of bone marrow’s critical role in tumor growth, and most recently, the world’s first successful use of deep brain stimulation to treat a minimally conscious brain-injured patient. For more information, visit www.med.cornell.edu.