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A Novel Approach For Treating Cognitive Impairments Identified By Animal Model For Schizophrenia
Researchers have been seeking a safe and effective way to treat cognitive impairments associated with schizophrenia by enhancing N-methyl-D-aspartate (NMDA) glutamate receptors. Functional deficits in NMDA receptors may contribute to the underlying neurobiology of this disorder. The first generation of studies trying to stimulate NMDA receptors administered large amounts of substances, like glycine or D-serine, which indirectly enhance NMDA receptor function. While there were some positive reports of efficacy, findings across studies were more inconsistent than was hoped.

Reducing Medical Residents' Hours Would Cost $2.5B Annually, Study Says
Implementing proposed reductions in the number of hours medical residents work could cost as much as $2.5 billion annually, according to a recent study published in the New England Journal of Medicine, the Baltimore Sun reports. The study follows an Institute of Medicine report that proposed reducing the maximum hours that residents can work without sleep from 30 to 16, increasing the number of days they must take off and improving their supervision (Desmon, Baltimore Sun, 5/21). In 2003, the Accreditation Council for Graduate Medical Education reduced the number of hours residents at teaching hospitals could work weekly from more than 100 hours to 80 hours. In the recent study, which was partially funded by IOM, researchers examined post-2003 literature on resident work hours and patient harm and evaluated it against additional labor costs. The authors concluded that the IOM recommendations "would be costly, and their effectiveness is unknown" (Shishkin, Wall Street Journal, 5/21). Teryl Nuckols, the lead author of the study, said that teaching hospitals would most likely need to hire more residents and experienced physicians to take care of patients, which would likely cost each teaching hospital $3.2 million annually (Baltimore Sun, 5/21). The study was accompanied by an NEJM editorial in which the authors "strongly disagree" with the IOM recommendations, claiming that reducing resident work hours "leads to an increase in the number of handoffs in care, and this increase outweighs the potential benefits of reducing residents" fatigue." The accreditation council said that more research is needed before it decides whether to adopt the IOM recommendations. The council"s decision will be announced in February 2010 (Wall Street Journal, 5/21).
News of the day
Immediate Tendonitis Relief Following Rotator Cuff Treatment
A minimally invasive procedure to treat tendonitis in the rotator cuff of the shoulder provides immediate symptom relief to the patient, according to a study published in the July issue of Radiology. The study found that ultrasound-guided nonsurgical therapy significantly reduces pain from calcific tendonitis of the rotator cuff and restores lasting mobility after treatment.
Endocrinology

Thalidomide Does Not Improve Survival In Small Cell Lung Cancer: Journal Of The National Cancer Institute News Brief

Treating patients with thalidomide in combination with chemotherapy for small cell lung cancer (SCLC) did not improve their survival but did increase their risk of blood clots, according to a new study published online July 16 in the Journal of the National Cancer Institute. Siow Ming Lee, M.D., of the Department of Oncology, University Hospital in London, and colleagues randomly assigned 724 SCLC patients to take either a placebo or thalidomide. Used in treating some other cancers, thalidomide is an anti-angiogenic drug, i.e., it targets and suppresses the formation of new blood vessels that tumors need to survive and grow. In this randomized double-blind trial, patients received 100-200 milligrams daily for up to two years. The researchers found no evidence of a survival difference between the two groups. The median overall survival for patients who received the placebo was 10.5 months. For patients who took thalidomide capsules, it was 10.1 months. Patients treated with thalidomide, however, had higher risk of thrombotic events. "Together, these results suggest that targeting anti-angiogenesis in SCLC may not work as well as in multiple myeloma or colorectal cancer, perhaps because of differences in the angiogenic pathways involved in SCLC," the authors write. In an accompanying editorial, Curzio RÃøegg, M.D., of the Division of Experimental Oncology at the University of Lausanne in Switzerland, and Solange Peters, M.D., Ph.D., of the Clinical Oncology Service at the University of Lausanne, note that this study"s results, as well as similar, negative results from previous studies, should lead to a fresh look at the basic biology of SCLC and of the putative anti-angiogenic activity of thalidomide. "Rather than running from failure to failure, it may be more reasonable to go back to experimental work, including the development and analysis of transgenic SCLC models, to better understand SCLC biology and identify robust therapeutic targets," the editorialists write. Steve Graff Journal of the National Cancer Institute


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