VIRUS MAY BE A FACTOR
IN LOU GEHRIG'S DISEASE
A specific virus has been found in the spinal cords of victims of the neuromuscular disorder known as Lou Gehrig's disease, leading researchers to suggest the virus may play a role in bringing on the disease.
A team at Rockefeller University in Lyon, France, found that 15 of 17 deceased victims of the disorder, amyotrophic lateral sclerosis (ALS), showed evidence of the virus in the motor nerve cells of their spinal cords. The virus was found in only one of 29 people who died of other causes.
"Many researchers have suspected a viral link to ALS, but in this study we were able to identify a virus known for nerve damage in the exact areas of the nervous system that are affected by this disease," said Martina Berger, lead researcher with the team and now with the University of California, Irvine. The results were published in the current issue of the journal Neurology.
The virus that was found was similar to echovirus-7, which is known to cause meningitis and rare cases of encephalitis.
ALS gradually weakens the muscles of the body, generally leading to death from respiratory paralysis. About 4,600 Americans are diagnosed annually with the disorder, which is well known for striking Yankees baseball great Gehrig, who died from it in 1941. Current treatments relieve some symptoms but cannot reverse or control the disorder.
In the Neurology study, researchers reported that while they found a close correlation between the virus and ALS, they could not say there was a direct cause-and-effect connection. They speculated that the virus could be a byproduct of the disorder or could be one of a cascade of problems caused by something else and leading to ALS.
"We have detected the virus, but we still do not understand how it affects the disease. That is what we are trying to do now," said Berger.
If researchers find a viral cause for ALS, then drugs might be developed that could prevent or control the disease.
HOSPITALS FAILING TO TEST
FOR ANTIBIOTIC RESISTANCE
Patients in U.S. hospitals are increasingly at risk of becoming infected with bacteria that resist treatment with antibiotics. But a new government survey has found that many hospital and clinic laboratories aren't routinely performing tests to identify some of the most dangerous drug-resistant strains.
Last week, the federal Centers for Disease Control and Prevention (CDC) reported the fourth confirmed U.S. case of infection with a strain of Staphylococcus aureus bacteria with partial resistance to vancomycin, an antibiotic that doctors have relied on to treat serious "staph" infections. Although the strain was promptly identified, the patient--a 63-year-old woman with kidney failure--died despite appropriate treatment with vancomycin and two other antibiotics.
When preliminary laboratory testing suggests that a strain of staph may be vancomycin-resistant, additional tests are needed to confirm resistance. But a CDC survey of 369 laboratories in eight states last year found that 41 percent of the labs were not performing such confirmatory tests on suspicious strains. And 68 percent of labs reported that they did not perform tests to identify bacteria with another type of drug resistance known as extended-spectrum beta-lactamases production, or ESBLs. Bacteria with ESBLs produce high levels of enzymes that can break down powerful antibiotics often held in reserve for the sickest patients.
"If you don't test for this resistance, it means that in the intensive care units . . . where you have sick patients, the physician will just assume that these antibiotics are going to be effective," said Fred Tenover, chief of the CDC's nosocomial pathogens laboratory. If ESBLs resistance exists, "a number of those patients will fail therapy."
In the CDC survey, labs at hospitals with more than 200 beds were more likely than those at smaller facilities to do both types of tests. On the other hand, laboratories operated by managed-care programs were significantly less likely than others to perform confirmatory tests for vancomycin resistance.
"All laboratories need to have the capacity to detect these problems when they exist," said Julie Gerberding, director of the CDC's hospital infections program.
The survey results were published in the January 7 issue of the CDC's Morbidity and Mortality Weekly Report.
BRAIN PACEMAKER EASES
The first small study where doctors implanted a pacemaker-like device in the brain helped lift the moods of about 40 percent of severely depressed patients, doctors reported last month. But the 30-patient pilot study does not prove this unusual brain-stimulating treatment really helps depression, researchers cautioned.
Still, sufferers of severe depression have clamored to try the experimental treatment since press reports of the preliminary research last fall. The pacemaker's manufacturer, Cyberonics Inc., received several hundred phone calls from patients.
Researchers reported last month on an Internet version of the medical journal Biological Psychiatry that this "vagus nerve stimulation" seemed to help 40 percent of study participants.
The stimulator is essentially a brain pacemaker.
A generator the size of a pocket watch is implanted into the chest. Wires snake up the neck to the vagus nerve, which runs from the neck into a brain region thought important for regulating mood. Every few minutes, the stimulator sends tiny electric shocks to that nerve and thus on to the brain.
The stimulator already is sold as a treatment for epilepsy.
For depression, it is "extremely encouraging as a potential treatment," but more study is needed to prove the effect, said the lead investigator, John Rush of the University of Texas Southwestern Medical Center.