In a retrospective study, Saint Louis University researchers have found that patients with melanoma brain metastases can be treated with large doses of interleukin-2 (HD IL-2), a therapy that triggers the body’s own immune system to destroy the cancer cells.
John Richart, M.D., associate professor of internal medicine at SLU and principal investigator of the study, first treated a patient with the disease using the HD IL-2 treatment in 1999.
‘Traditionally, melanoma patients with brain metastases have not been considered for HD IL-2 because treatment was thought to be futile,’ Richart said. ‘Our study shows that having this condition does not exclude a patient from getting this treatment and can in fact improve the length of their life.’
Melanoma is the most dangerous form of skin cancer that begins in the melanin-producing cells called melanocytes. In some melanoma patients, the cancer spreads to the brain, causing multiple tumours that are difficult to treat. According to the CDC, melanoma is the third most common cancer causing brain metastases in the U.S. Richart said the median overall survival of patients with melanoma brain metastases is approximately four months whereas in the study, the median overall survival for patients was 8.7 months.
During the treatment, patients are given an IV medication – a chemical the body naturally makes that stimulates the immune system to recognise and destroy melanoma cells – for a period of six days while they are admitted to the hospital and are closely monitored by doctors and nurses. A patient requires four such six-day admission cycles in order to complete the course of the treatment.
To be eligible for HD IL-2 treatment, melanoma patients with brain metastases have to be in healthy shape with good brain function – that is they cannot have brain lesions that are growing rapidly or show any symptoms of brain lesions. In the past, melanoma patients with brain metastases have been considered ineligible for this treatment because doctors thought that the treatment would cause life-threatening cerebral oedema, a complication that causes excess accumulation of fluids in the brain, and neurotoxicity, or irreversible damage to the brain or the nervous system.
‘In this review, we found that there were no episodes of treatment-related mortality. Our findings demonstrate that HD IL-2 can be considered as an option for patients with melanoma brain metastases,’ said Melinda Chu, M.D., a first year dermatology resident at SLU and first author of the study. St Louis Hospital

The Echocardiography Guided Cardiac Resynchronization Therapy (EchoCRT) study showed CRT, a standard of care in heart failure patients with a wide QRS, is not beneficial in patients with heart failure and a narrow QRS complex, below 130 milliseconds (msec).
The results reaffirm current guidelines excluding patients with a narrow QRS for CRT, and expand the body of evidence that simple electrocardiographic determination of QRS duration remains the most important predictor of the clinical benefits of CRT, rather than measures of mechanical dyssynchrony by echocardiography. Based on the results of EchoCRT, the identification of patients who will obtain the benefit of CRT can be done most easily by a 12 lead-ECG.

‘Results from previous smaller trials had suggested a potential for CRT in heart failure patients with narrow QRS. EchoCRT now provides evidence from a definite outcome trial that patients with symptomatic heart failure with QRS width less than 130msec do not benefit from CRT,’ said co-lead investigator Frank Ruschitzka, MD, from the University Hospital in Zurich, Switzerland.
‘The EchoCRT trial evaluated an important question for daily clinical practice. The results will help to guide physicians

New research from the University of Southampton shows that copper and copper alloys will rapidly destroy norovirus

Nausea is one of the most debilitating symptoms of migraine and affects 80 percent of migraine suffers in the United States. Leading headache physician, Dr. Zoltan Medgyessy of the Berolina Clinic in Lohne, Germany demonstrated in a trial that pressure to the P6 antiemetic point on the inner wrist with an acupressure wristband is an effective and quick therapy for relieving nausea of migraine sufferers.
Migraine can be a disabling neurological disorder. It affects 36 million Americans, according to the American Migraine Foundation, and is considered by the World Health Organization as the 19th leading cause of all years lived with disability for both males and females.
Dr. Medgyessy’s acupressure study with the Department of Headache / Department of Psychosomatic at the Berolina Clinic included 41 patients who experienced an average of 33.1 migraine days during the previous three months with an average nausea intensity of 6.2 out of 10. Patients were given Sea-Band acupressure wristbands instead of antiemetic drugs during a migraine attack and 83 percent of patients noticed reduction of nausea. Reported nausea after therapy was rated a 2.9 out of 10 and relief was reported after an average of 28 minutes. Nearly all participants (98 percent) said they would use Sea-Band again for migraine nausea.
‘Acupressure wristbands are drug-free and that is an important advantage in using this therapy for migraine nausea as they have no risks for interaction with migraine drugs or the side effects commonly experienced with antiemetics, such as dizziness or tiredness,’ commented Dr. Medgyessy. ‘There are still many unknowns about migraine, making findings such as these an important stride toward improving the quality of life for those who suffer from the condition. I’m grateful that the International Headache Congress has given me a platform to share the results of my team’s study and look forward to discussing it with my colleagues.’ EurekAlert

A new study suggests that CPAP (continuos positive air passage) therapy reduces nightmares in veterans with post-traumatic stress disorder (PTSD) and obstructive sleep apnea (OSA). Results show that the mean number of nightmares per week fell significantly with CPAP use, and reduced nightmare frequency aft er starting CPAP was best predicted by CPAP compliance.