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Hospitals, White House Reach Accord On Cuts To Pay For Reform
Major hospital groups reached an agreement Monday with the White House and Senate Democrats to accept $155 billion in payment cuts over ten years, a concession that would help pay for proposed health care reforms, the Washington Post reports. Government savings would come mainly from lower Medicare and Medicaid payments to the hospitals, and smaller subsidies for providing care to the uninsured. Hospitals expect to make up some of the losses by increasing their volume as anticipated reforms bring health insurance to many of the 47 million Americans who don"t have coverage.
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Key To Improving Prognosis In Acute Heart Failure - Better Treatment Selection And Improved Therapies
Today, acute heart failure represents the most common reason for hospitalisation in the over-65 population. Although hospital care improves symptoms in the first 24 hours after admission in around 50% of these patients, acute heart failure events still remain associated with a more than 50% mortality and rehospitalisation rate at 6-12 months. "Indeed," says Professor Marco Metra from the Cardiology Department of the University of Brescia, Italy, "it is the very rapid onset of symptoms and the need for urgent therapy which characterise the condition."1,2
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Filling The Gap Between The ER And The Family Doctor: Urgent Care Centers
Urgent care centers (UCCs) are providing an alternative to emergency room treatment. A study published in the open access journal BMC Health Services Research has shown that UCCs tend to be open well outside of office hours and offer a wider range of services than primary care offices.
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Roche To Commence Phase III Trials With Innovative Treatment Designed To Lower Cardiovascular Risk In Diabetes Patients With Recent Heart Attack

Roche announced it will start Phase III clinical investigations for aleglitazar, its innovative PPAR co-agonist R1439 which is uniquely designed to reduce cardiovascular morbidity and mortality in high risk patients with type 2 diabetes. This decision is supported by data from the Phase II SYNCHRONY study published today in The Lancet(1) and announced at the American Diabetes Association meeting in New Orleans. The Phase III program is anticipated to start in the second half of 2009. SYNCHRONY, a placebo-controlled dose ranging study in type 2 diabetes patients, showed that aleglitazar had a balanced synergistic effect on both lipid and glucose control with a good safety and tolerability profile in patients with type 2 diabetes. Cardiovascular disease is currently the leading cause of death among those with type 2 diabetes, accounting for half of all deaths.(2) Despite guidelines recommending that cardiovascular risk in this patient group should be reduced by controlling factors such as dyslipidemia, blood pressure, body weight and hyperglycemia,(3,4) the majority of patients still do not achieve their treatment goals leaving them vulnerable to both initial and residual cardiovascular events.(3,5) Significantly, one in ten patients with an acute myocardial infarction died within a year.(6) "Roche is confident that aleglitazar has the potential to reduce cardiovascular morbidity and mortality in this high-risk patient group and is therefore committed to pursuing its rapid development," said Jean-Jacques Garaud, Global Head of Development Pharmaceuticals Division of Roche. The focused Phase III outcomes trial will investigate whether once daily 150 micrograms aleglitazar reduces the incidence of cardiovascular mortality, non-fatal myocardial infarction and stroke in patients with type 2 diabetes. The approach in this selected high-risk patient population will be unique as no drug has been demonstrated to reduce cardiovascular risk in type 2 diabetes patients following an ACS event. Professor Robert Henry, SYNCHRONY Clinical Investigator and Chief VA Endocrinology & Metabolism and Professor of Medicine in Residence at the University of California at San Diego, commented: "The favorable balance in the safety and efficacy profile of aleglitazar seen in the SYNCHRONY study represents encouraging short-term clinical data for this agent and provides good evidence to enter Phase III investigation." With the decision to move into Phase III, aleglitazar is Roche"s third Phase III clinical trial program in the area of metabolism. The new Phase III study is a cardiovascular outcomes trial designed to assess the potential of once-daily 150 micrograms aleglitazar to reduce cardiovascular mortality, non-fatal myocardial infarction and stroke in type 2 diabetes patients with a recent ACS. About the SYNCHRONY Study SYNCHRONY was a multicenter, randomized, double-blind, placebo-controlled dose ranging study among 332 type 2 diabetes patients (either drug-naive or pre-treated with less than or equal to 2 oral agents). Designed to determine the glucose-lowering and lipid-modifying effects, and safety profile of aleglitazar, the study confirmed the favorable safety and efficacy profile of the once daily 150 microgram aleglitazar dose and supported commencement of the Phase III clinical investigation. Patients underwent a single-blind 4- to 5-week placebo run-in period, then were randomized to receive 16 weeks treatment with either aleglitazar at one of four once daily doses (50, 150, 300 or 600 micrograms), placebo or 45 mg pioglitazone. The primary endpoint of dose-dependent reductions from baseline HbA1c versus placebo was met and a range of responses observed from -0.36% (95% CI:0.00 to -0.70, P=0.048) with 50 micrograms aleglitazar, to -1.35% (95% CI: -0.99 to -1.70, pAbout Aleglitazar Aleglitazar is an innovative treatment designed to reduce the incidence and impact of cardiovascular mortality, non-fatal myocardial infarction and stroke in patients with a recent ACS and type 2 diabetes. It is a rationally designed molecule providing balanced dual PPAR alpha/gamma activation. Specifically, it combines the improvements in peripheral insulin sensitivity (and therefore glycemic control) associated with PPAR gamma activation, with improved management of dyslipidemia, which is commonly associated with PPAR alpha activation. About Diabetes Diabetes is a disease characterized by excess blood glucose due to a deficiency in insulin availability and/or resistance to its action. Type 2 diabetes accounts for 90 percent of all diabetes cases worldwide. Complications from diabetes, such as coronary artery and peripheral vascular disease, stroke, diabetic neuropathy, amputations, renal failure and blindness, are resulting in increasing disability, reduced life expectancy and enormous health cost for virtually every society. According to current estimates by the World Health Organization, more than 180 million people worldwide have diabetes. This number is likely to more than double by 2030. About Roche Hoffmann-La Roche Inc. (Roche), based in Nutley, N.J., is the U.S. pharmaceuticals headquarters of the Roche Group, one of the world"s leading research-oriented healthcare groups with core businesses in pharmaceuticals and diagnostics. For more than 100 years in the U.S., Roche has been committed to developing innovative products and services that address prevention, diagnosis and treatment of diseases, thus enhancing people"s health and quality of life. All trademarks used or mentioned in this release are protected by law. References (1) Henry R et al. The dual peroxisome proliferator-activated receptor alpha/gamma: results from SYNCHRONY, a phase II, randomized, dose-ranging study in patients with type 2 diabetes. The Lancet, online edition, 8 June 2009 (2) World Health Organization. Diabetes Fact Sheet No 312, November 2008. (3) American Diabetes Association. Standard of medical care in diabetes - 2008. Diabetes Care 2008; 31 Suppl 1: S12-54 (4) Graham I et al. European Guidelines on cardiovascular disease prevention in clinical practice: executive summary. Eur heart J 2007; 28: 2375-414 (5) Saydah SH et al. poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA 2004; 291: 335-42 (6) Montalescot G and al. STEMI and NSTEMI: are they so different? 1 year outcomes in acute myocardial infarction as defined by the ESC/ACC definition (the OPERA registry). Eur Heart J 2007; 28: 1409-1417 Roche


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