Believe it or not you'll soon be able to breathe fresh, clean air in New York City. Well, for a few minutes anyway.
The Toronto-based O2 Spa Bar will make its U.S. debut in the Big Apple early this year. For $16, patrons will be able to inhale 20 minutes worth of 99 percent pure oxygen - plain or spiced with the flavor of the day - while they read or gaze at serene aquariums and listen to jazz. There will be no TVs or alcohol, but fresh juices will be on tap.
Owner Lissa Charron says the nine-month-old Toronto bar - the first of its kind in North America - is extremely popular, especially with visiting Americans. That's what prompted her to set up shop south of the border. The Canadian establishment includes the main bar and a smaller one that can be reserved by a group wishing to chat over oxygen. For a more intimate oxygen experience, there are semi-private spa rooms with ergonomic leather loungers. Double occupancy is $20. The bar also takes portable oxygen to corporate meetings so executives can take a breather.
Exactly what are the health benefits? Charron says she makes no claims that inhaling O2 improves health. "It's simply an alternative to the alcohol bar where people smoke and drink," she explains. "It's a beautiful place where you can do something nice for yourself."
William Clark, EdM, RRT, assistant professor of cardiopulmonary sciences at UMDNJ's School of Health Related Professions says no doubt a stop at the bar would be a refreshing break from a hectic, smog-filled lifestyle. "But you don't need the supplemental oxygen," he says. "Because oxygen is associated with hospitals, people assume it must be good for them. The truth is, for a healthy person it has no lasting benefits."
He adds that inhaling oxygen will "help clear the head" of a person suffering a headache or hangover, and gives the heart and lungs a bit of a rest. "But the amount they're probably going to offer won't do much," Clark notes. "And several minutes after you stop the oxygen, all the effects end."
For emphysema patients, a visit to the O2 Spa Bar could be dangerous. "If a person with the disease gets too much oxygen, he or she could stop breathing," Clark says. He recommends patients with respiratory problems and pregnant women check with their physicians before visiting the bar.
Charron says bar employees screen patrons carefully. "If they have a disease or medical condition, we tell them to get an okay from their doctor." She adds that the bar uses sterile techniques, disposable equipment, and a "patented oxygen safety regulatory system."
According to Clark, a physician's order is required before oxygen can be administered in the U.S. "I'm not sure how the owners plan to get around that, but if they do, there's no reason why a healthy person shouldn't visit the bar."
As Plain As the Nose on Your Face
In early October 1994, the folks at Breathe Right® nasal strips began a marketing blitz. They sent samples to trainers of the 28 National Football League teams. On October 30, Herschel Walker of the Eagles showed up with a cold. The trainer gave him one of the strips, Walker scored two touchdowns, and the Eagles beat Washington 31-29. Breathe Right® scored, too.
Walker was not the only professional player to sport the strip. By the end of the year, sales totaled $2.8 million. That's a lot of money for a little piece of adhesive that gets pasted across the bridge of your nose - particularly when you consider that it simply lifts soft tissue where the nostrils flare, widening the space for air to enter. The company got clearance from the Food and Drug Administration to market the strips as a temporary treatment for snoring, nasal congestion and a deviated septum.
The concept is the brain child of an engineer whose allergies and deviated septum caused him to lose sleep. He had tried many mechanical devices to keep his nostrils propped open before coming up with the winning design. His patented device consists of two thin pieces of plastic running the length of the strip. As soon as it adheres, the plastic attempts to spring back to its linear shape, widening the nostrils in the process.
Does it really improve your breathing and help to stop snoring? "The company provides abstracts making those claims," observes John
Oppenheimer, MD, assistant clinical professor of medicine at UMDNJ-New Jersey Medical School. "Papers have been presented at meetings of ear, nose and throat specialists, but until a clinical study is published in a peer-reviewed journal, it's hard to evaluate that claim."
An asthma and allergy specialist, Oppenheimer notes that allergic rhinitis and chronic sinusitis rank among the top 12 causes of visits to physicians. The National Center for Health Statistics reports they accounted for more than 20,000 visits in 1991.
The nasal strip may get you through a tough basketball game or a sleepless night, but if it seems to become a permanent accessory, it's probably time to get professional help.
New Sickle Cell Treatment
Results of a major international study have shown that bone marrow transplants can cure sickle cell disease in some children. The five-year trial, which involved 22 patients with advanced disease, reported a cure in 16, although two died following the procedure. All participants were under the age of 14. The results were reported in the August 15 issue of the New England Journal of Medicine.
In this inherited disorder, sickle-shaped red blood cells block small blood vessels, causing pain and depriving organs of oxygen. Hematologist/oncologist Andrew Pecora, an alumnus of UMDNJ-New Jersey Medical School, explains that "patients selected for the bone marrow transplant trial had vital organ damage, but it was not severe enough to prevent them from undergoing the procedure."
Before getting transplants, patients have chemotherapy and radiation to destroy damaged blood cells. The rigors of the pre-transplant therapy and the delay in the immune system's reconstituting itself make the procedure risky, Pecora notes. Still, he calls it "a wonderful breakthrough for a small percentage of children and young adults."
Pecora, chief of the adult stem cell transplant program at Hackensack University Medical Center, an affiliate of The Cancer Institute of New Jersey and of UMDNJ, says Hackensack will begin offering bone marrow transplants to children with sickle cell sometime in January and to young adults three or four months later. He adds that stem cell transplants will probably also start soon. In this procedure, stem cells are harvested from donor blood and transfused. Prospective patients must be referred by specialists.
About a year ago another sickle cell milestone was announced: Results of a nationwide trial of the drug hydroxyurea were so promising the study was stopped early. "It has dramatically improved the lives of a large percentage of patients," says Pedro Gascon, MD, director of hematology at New Jersey Medical School, who conducted a trial of the drug.
"Some are now able to hold jobs, they take less pain medication so their appetites have improved, and they have more of a social life." If the drug does not work alone, he adds, "in selected patients we also give erythropoietin, which stimulates production of red cells."
Because hydroxyurea has toxic side effects, it was approved only for patients who had three or four painful crises a year, and the trial did not include children. But Gascon, who heads the school's sickle cell program in Newark, reports that about two years ago, several centers began giving the drug to certain children: "Physicians offer it in cases where the disease has already caused major problems, such as a stroke or repeated respiratory infections."
He notes that the National Institutes of Health, which sponsored the nationwide study, has provided funds to follow those patients for the next five years to see not only how they do, but also what effects there might be on their offspring.
Get a Move On
Just when the thought of hibernation seems particularly appealing comes a voice warning us to beware the sloth of March. You may think you've heard all you want to hear about getting off the couch and onto the treadmill or stationary bike, but Kristeen Caravela, program director of UMDNJ's Fitness Center, offers advice that's hard to refuse. "Just get moving," she says.
What? No StairMaster®, no CardioGlide®? No Jack LaLanne membership at those oh-so-low mid-winter rates?
"Not necessary," she says, "just start walking." Yes, even when it's 10 degrees outside. Bundle up your kids and your mate, or call up a neighbor and discuss the events of your day while sauntering through town. "You have everything to gain," she says, "and nothing to lose but 30 minutes of sitcom time. If you must watch your program, record it and play it back later."
Or walk with your colleagues at lunch time, she advises. You'll benefit in many ways - less time to eat, you'll get energized for the afternoon, and you'll always be up on the latest news. Exercising as a group may provide the incentive you need to continue the program on those days when all you want to do is order in a meatball sub and rest your weary head.
"Walking is a definite pick-me-up," the fitness expert states. "If you feel you have low energy, then a 20-minute hike will increase your productivity."
Just getting started is the hardest part, Caravela says. Make it easy for yourself. If you're a morning person, exercise early. If you're a night person, start your routine after sundown. But whatever time of day you choose, make a one month commitment. After that it gets easier, and you won't want to give it up, she predicts, because you'll start feeling the benefits.
If walking is not appealing, then buy a videotape - a financial investment of $15 or $20 - and move your body with Cathy Smith or Donna Richardson, recommends the fitness coach. If the routines become too easy, incorporate one pound weights into the workout (soup cans are okay), or move on to a more advanced routine.
Other alternatives include some of the old standbys - push-ups, sit-ups, leg lifts, calf raises (stand on tips of toes, then relax) and manual squats (sit lightly on edge of chair, then slowly get up) as excellent tools for toning and increasing overall fitness and muscle mass. Develop your own routine, starting with 5 to 10 minutes every other day, and increase the time gradually until you are exercising at least 20 minutes, three times each week.
"This is something you have to do for yourself," she says. "If your vision is blurred or your cough doesn't clear up, you would consider that important and take action. This is important, too - it's just a matter of getting started and not being overwhelmed by the thought of exercising."
And for those who discover the hidden fitness buff in all of us, exercise physiologists at the Fitness Center stand ready to help.
Of Mice and Chen
Suzie Chen, PhD, a member of The Cancer Institute of New Jersey, was attempting to develop a particular strain of mice when she discovered a gene that may be linked to melanoma, a virulent skin cancer.
Chen was researching the signals necessary for fibroblasts (cells that produce connective tissue) to become adipocytes (fat cells). These studies began during her postdoctoral work at Columbia University, where she helped to isolate and identify a small piece of DNA that was the necessary signal for development of fat cells.
Now an assistant professor at Rutgers University's College of Pharmacy, Chen has extended this research: "We wanted to find out what information this fragment contained so we put it into mouse eggs at the earliest stage of development - when it could go anywhere in the genome. We were looking for it to go into reproductive cells."
Transgenic mice are created this way: The fertilized eggs - each carrying a snippet of added DNA - are implanted into females. Each mother has the potential of producing a separate line, but Chen explains the DNA is not always integrated.
Her experiments resulted in five different lines of transgenic mice, but also took an unexpected turn. The offspring of one line developed dark bands on the ears, snout and perianal region by the time they were 3 to 4 months old. The bands were found to be lesions containing melanin, the pigment that gives color to hair, skin and eyes.
"The propensity for the lesions to develop gets worse with succeeding generations," says Chen. "As this line was bred, you could see dark spots about 15 days after birth, and tumors started appearing at 4 weeks. This is very early." Some of these mice died at 2 months - their normal life span is 2 to 3 years.
"We don't yet know exactly where in the gene the DNA is integrated," she explains, "but we do know that it affects both growth and differentiation of the cells that carry melanin."
Chen notes that three major factors have been identified as leading to melanoma: the degree of skin pigmentation - the less pigmentation the greater the risk; cumulative exposure to sunlight; and genetic predisposition. The American Cancer Society estimates that there were more than 34,000 new cases of this type of skin cancer in 1995.
Chen's finding, which was reported in the May 1996 issue of the Journal of Investigative Dermatology, should prove useful in determining the development and progression of both benign and malignant melanin-containing tumors.
The Dope on Chocolate
Why is it that after you nosh some chocolate you feel so good? Is it simply the rich flavor and creamy texture that promote that soothing feeling of well being? Perhaps. But it may be more than that. Researchers have found that the popular sweet may actually have the same effect on the brain as marijuana.
Pharmacologists at the Neurosciences Institute in San Diego recently isolated an anandamide - a lipid naturally produced in the brain - from cocoa and three brands of chocolate. It stimulates the same receptors in the brain as does THC, the active ingredient in marijuana. Researchers believe that when someone ingests the anandamide or smokes marijuana, the compound binds to those receptors and induces a feeling of euphoria.
They also uncovered a pair of related chemicals - found in higher quantities than the anandamide - that they believe may prolong the sense of well being the anandamide induces.
Philip Babcock, PhD, an associate professor of pharmacognosy (the study of drugs of natural origin) at the College of Pharmacy at Rutgers, says although the anandamides in chocolate are structurally different from those in marijuana, "it appears they do have the molecular requirements necessary to bind to and activate the brain's receptors, but a great deal of work still needs to be done."
Riva Touger-Decker, PhD, RD, director of the Master of Science in Clinical Nutrition Program at UMDNJ's School of Health Related Professions, says in vitro studies are not conclusive in predicting chocolate's effects on humans. She explains that chocolate contains several compounds that might affect the brain's chemistry. One is tryptophan, which is a precursor to serotonin, a neurotransmitter known for its relaxing effect. Another is phenylethylamine - which is similar in structure to amphetamine - known to improve mood in some depressed patients.
There is no proof, however, that these chemical compounds are the reason chocolate is craved by many. Touger-Decker, who is also a clinical assistant professor at UMDNJ-New Jersey Dental School, cites a study published in Physiological Behavior (Vol.56, 1994).
Chocolate cravers were given either a milk chocolate bar; a white chocolate bar (containing cocoa butter but no cocoa, thus providing the sweetness and texture of chocolate without the chemical compounds); or a capsule containing either cocoa or white flour as a placebo. None of the capsules contained the flavor in chocolate.
"Only those who ate the white chocolate or milk chocolate bar said their cravings were satisfied," she says. "That strongly suggests that chocolate is craved for its sensory properties like aroma, taste and texture, rather then its chemical effects.
Who's Spanking the Kids?
The idea of spanking may be passé, but the reality is that most parents do resort to physical punishment - at least in certain circumstances. But while paddling a child was once a private matter, it has now become a legal issue - one that sometimes has punishing consequences for parents as well.
"The State says you can physically punish your child, that is you can spank him, as long as you don't abuse him," says Michael Lewis, PhD, director of the Institute for the Study of Child Development at UMDNJ-Robert Wood Johnson Medical School. "But where is the line drawn? That's not really clear.
"A smack on the bottom is obviously not abuse," he says. "But what if you use a board to deliver the smack? Or dislocate a child's arm by twisting it? Or hit a child in the face? Or what if you say in a cool, cold manner, 'This transgression deserves 15 whacks with a belt?' and then carry that out?"
The line between physical abuse and that oh-so necessary spanking is determined by the presence or absence of visible signs of bodily injury, he says. But how does a parent know if and when a spanking could cause mental trauma?
"Psychological literature says that in general any form of punishment is not as good as praising," observes Lewis, "but we know that positive reinforcement doesn't always work." He gives the example of his own child, who at the age of 2 often jumped off the curb into the street.
"We tried to reason with her," he says, "but she was too little. So every time she ran out into the street, we smacked her bottom - and she associated that with a little pain. The cost of her jumping into traffic was just too great."
He points out that corporal punishment often does not work with children because the punishment itself becomes the focus of a parent's and child's attention, rather than the child's behavior. A youngster needs to learn to make choices, explains the psychologist, comprehending which choice will get praised and which punished.
Knowing full well that spanking- at least as a last resort - is not going away, Dr. Lewis advises that if you need to spank, do so sparingly. "Physical abuse and prolonged and intense punishment rarely work to change children's behavior," he concludes. "In fact, they may be counterproductive."
Lilliputian Liver Transplants
Jaundice is not uncommon among newborns, but for Jasmine Dominique of Newark it signaled a congenital liver disease called biliary atresia, lack of bile ducts. She was 1 month old when the diagnosis was made. Last July, at age 2 1/2, Jasmine received a new liver at UMDNJ-University Hospital. It was a milestone for her and the hospital: She was the transplant program's 200th patient, as well as its youngest. And for Jasmine, it had been a saga.
Biliary atresia is the leading indication for pediatric liver transplant in the United States, explains Baburao Koneru, MD, chief of the hospital's division of transplantation. Since there is no way for bile to get out of the liver, it builds up, leading to scarring and eventually to cirrhosis.
Koneru says the first option in these cases - called a Kasai procedure - is to create an outlet by taking a piece of intestine, fashioning a tube and attaching it to the liver. This had been done for Jasmine, but it works only in 33 to 50 percent of patients. When the procedure isn't successful, it at least postpones the onset of cirrhosis, and that's what it did for her.
Jasmine was taken to the University of Pittsburgh, where the procedure was pioneered, for a consult. She remained on a waiting list for more than a year. When a donor organ was found, surgeons harvesting it discovered that the liver was not healthy enough to be transplanted. So Jasmine returned home.
Her doctor then arranged for the transplant to be done at University Hospital. That in itself was good news to Jasmine's mother, Jeanne Joseph, who says, "I prayed to have it done in New Jersey so I could have friends and family around me."
By the time of the transplant, Koneru notes, "Jasmine was very jaundiced. She was retaining fluids, and her liver was failing to make the blood clot."
Pediatric organs are hard to get. With Jasmine's condition deteriorating and no pediatric liver available, the transplant team decided to do the surgery using an adult organ - trimming it to fit. In adult transplants this is not unusual, but in this case it had to be reduced to a third of its size. The transplant failed - the new liver didn't function. It happens between 5 and 10 percent of the time, Koneru says.
Two days later a pediatric liver was found, and Jasmine underwent a second transplant. This one succeeded. She went home in early October, and her mother reports that "she is walking, talking and doing wonderfully. It's a miracle because she had not been developing."
A second pediatric transplant, done at the hospital in August, involved a 6-year-old with a rare condition called progressive familial intrahepatic cholestasis. The child is now at home and doing well.
The liver transplant program is the only one in the state. The opening of the hospital's Whitney Houston Pediatric Special Care Unit in November 1995, and the hiring of a pediatric intensivist - a specialist board-certified in both pediatrics and intensive care - have been major factors in taking on these very small children.
Dog bites - an unrecognized epidemic - ranks among the top 12 causes of nonfatal injury in this country, according to Jeffrey Sacks, MD, MPH, an expert in unintentional injuries at the Centers for Disease Control and Prevention in Atlanta. He reports that in 1994, 4.7 million Americans were bitten by dogs. Each year about 20 people are killed by dogs and some 800,000 seek medical treatment. Victims often carry lifelong scars, both physical and psychological.
Nearly 25 percent of those who are bitten are children. Kids suffer five times more dog bites than they do injuries on playground equipment, and they account for almost three-quarters of dog-bite fatalities. Some infants were asleep in carriages and cribs when attacked.
Sacks says some breeds are more likely to be aggressive than others: pit bulls, Rottweilers and German shepherds account for a disproportionate number of attacks. Males are more likely to bite than females; so are dogs that have not been neutered or spayed. And, contrary to popular notion, not all perpetrators are mean strays; some belong to neighbors or friends.
But the news isn't all bad. Victims bitten by strays or dogs that weren't inoculated no longer need to fear a series of painful abdominal injections to prevent rabies. "That treatment is not the nightmare it once was," says Chitra Reddy, MD, director of pediatric ambulatory services at UMDNJ-University Hospital. "We now give only five injections of vaccine in the arm, and they are no more painful than any other shot."
Vaccines of the past were less potent, Reddy explains, so it wasn't uncommon for a patient to need as many as 20 injections. "We would give them in the arms and legs until we ran out of room, then we'd move to the abdomen," she says. "The older vaccines also contained much higher levels of protein, which often caused inflammatory responses. Some patients developed huge welts at each injection site, but that no longer happens either."
Sacks says knowing dog-safe behavior can significantly reduce the risk of an attack. Here are his suggestions. Never leave an infant or small child alone with a dog; a jealous dog may take the opportunity to become aggressive. Never approach or pet an unfamiliar dog, unless the owner gives the okay; then let the dog sniff you for about 40 seconds and extend a fist, not an open hand. Don't stare directly into a dog's eyes - your action may be interpreted as an aggressive challenge. If a dog knocks you over, roll up in a ball, place your hands over your ears and lie still until the animal walks away. If you are approached by a strange dog, stay still and quiet; never scream and run, as this may prompt the animal to chase or attack you.
While it's wise to be on the lookout for potential dog danger, it's important to remember there are 52 million dogs in America that never bite anyone. It's only the highly visible minority that makes news.
Many years of work by faculty members of the Department of Neurology at UMDNJ-Robert Wood Johnson Medical School recently culminated in a breakthrough in Parkinson's disease research. They identified a small region on chromosome 4 as the site of the gene mutation that caused the disease in 60 members of a large multi- generational family. The finding was reported in the November 15th issue of the journal Science.
Roger Duvoisin, MD, recently retired chair of the department and now Lovett professor emeritus, spent most of his career wrestling with the roles of heredity and environment in Parkinson's disease. Earlier epidemiological surveys and studies of twins proved inconclusive, but in 1980 he began studying patterns of inheritance in familial clusters of the disease. Working with Lawrence Golbe, MD, Margery Mark, MD, and later William Johnson, MD, he collected a number of multi-case families. Johnson, director of the Lovett Laboratory of Neurogenetics, stored DNA collected from these families and initiated a search for a DNA marker linked to the disease.
One family of Italian origin identified 10 years ago by Golbe in the medical school's neurology clinic was eventually found to comprise over 400 individuals. So far, at least 60 cases of Parkinson's disease have been identified in the last five generations in this family.
With the aid of colleagues at the University of Naples, Italy, Golbe was able to establish the full genealogy of this family through 12 generations to an ancestral couple who lived in the village of Contursi in southern Italy in the early 18th century. His examination confirmed that the family disease was in fact Parkinson's, and showed for the first time that Parkinson's disease could occur on a genetic basis.
Meanwhile, Alice Lazzarini, PhD, assistant professor of clinical neurology, carried out a study of familial aggregation in Duvoisin's personal patients and established that a large subset of Parkinson's disease cases are familial. Her analysis of 80 multi-case families drawn from the medical school's neurology clinic defined the pattern of inheritance as autosomal dominant.
In October 1995, Duvoisin, Johnson, Golbe and Lazzarini began a collaborative effort with Robert Nussbaum, MD, and Mihael Polymeropoulos, MD, at the National Center for Human Genome Research and Joseph Higgins, MD, at the National Institutes of Neurological Disorders and Stroke, to locate the gene mutation in the Contursi kindred. In less than a year, they had linked the disease to DNA markers for a small region of chromosome 4.
The discovery not only confirmed that Parkinson's disease can occur on a genetic basis, but also showed that a mutation in a single gene is sufficient to cause the disease. "The next step is to isolate the specific gene and identify the mutation," says Duvoisin. "Then we can learn how the mutation causes the disease and ultimately develop methods of prevention and even of cure."
The research group anticipates that clarifying the molecular genetic mechanism of the disease in the large extended Contursi family will yield invaluable insights into the biological mechanisms underlying all cases of Parkinson's disease, whether sporadic or due to mutations in another gene.
The Center for Vascular Disease at UMDNJ-New Jersey Medical School is one of 15 national sites to receive funding from the NIH's National Heart, Lung and Blood Institute. The $585,106 grant is to advance treatment through new clinical care, research and educational initiatives. Vascular disease includes stroke, circulatory problems, non-healing ulcers, aneurysms and kidney failure.
New initiatives in coordinating care for patients, organizing postgraduate study programs for physicians and nurses, and creating a fellowship in vascular medicine are being planned. As part of its services for physicians not directly affiliated with the center, it publishes a quarterly newsletter on recent research findings and case studies. The center also operates a toll-free line (1-800-827-2362) to provide information to practitioners and patients.
The New Jersey Commission on Sciences and Technology is funding a new center to be jointly operated by UMDNJ, Rutgers-Newark, New Jersey Institute of Technology and Princeton University. The goal of the New Jersey Center for Biomaterials and Medical Devices, which will be based at Rutgers-Newark, is to design and evaluate new biomaterials, improve existing medical devices and develop new medical implants. The commission's grant of $970,000 in the first year will be part of an overall budget of more than $25 million in cash and matching contributions over a five-year period. Major commitments from the four institutions will match the commission's support. In addition, seven New Jersey companies have committed almost $1 million in cash and in-kind support for the center's first year of research activity. They are ConvaTec (a Bristol-Myers Squibb Company), Hoechst Celanese Corp., Integra LifeSciences Corp., Johnson & Johnson, Johnson & Johnson Professional, Inc., Ortec International Inc., and PolyMedicus Technologies Inc. The proposal to establish the center grew from the Biomaterials Initiative, an effort begun in 1989 by UMDNJ President Stanley S. Bergen, Jr., MD. Since 1992, almost two dozen small pilot projects have also been funded with seed awards from UMDNJ, which have supported both basic science studies and development projects.
UMDNJ was awarded a $627,000 telemedicine grant from the U.S. Department of Commerce for a system to improve access to health care for residents of Camden and Newark. Initially, the project will involve one housing complex in each city. Kiosks at these locations will enable residents to communicate electronically with physicians and other health care professionals at five sites - three primary care offices and two community health centers - about their medical concerns. The kiosks, which are similar to ATM machines, will also be linked to the Newark Public Library and the state's department of health. Connections to UMDNJ facilities will allow the health care professionals involved to consult with specialists at its seven schools and The Cancer Institute of New Jersey.
The kiosks will also give residents access to information on health care topics 24 hours a day and enable them to participate in real-time health education seminars and classes. All kiosk services will be free, and information will be provided in English and Spanish. The system will be installed over the next 12 months by the University and its technical partners on the project: Apple, Bell Atlantic and IBM.
In mid-November, Governor Christine Todd Whitman signed legislation that regulates genetic testing and the retention and disclosure of information obtained from such tests. The bill also imposes criminal and civil sanctions for those who violate the provisions of the bill. The Genetic Privacy Act protects individuals seeking insurance coverage and employees from unauthorized genetic testing, unauthorized use of genetic testing information, and insurance and employment discrimination based on genetic information. In September, the Governor conditionally vetoed the original legislation. The amended bill deletes the provision that makes a person's genetic information his or her property as it would discourage research. In addition, it permits the Commissioner of Health and Senior Services to adopt federal guidelines when devising the rules on informed consent with regard to the disclosure of genetic information. "This legislation strikes an important balance between protecting privacy and preventing discrimination," said Governor Whitman. "It ensures that scientific and medical research are not unduly inhibited or burdened."
"As I get older, I find I rely more and more on
these sticky notes to remind me"
(DRAWING BY LEVIN; © 1996 THE NEW YORKER MAGAZINE, INC.)
Compiled by Merry Sue Baum, Eve Jacobs, Margaret Keenan and Carole Walker
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HEALTH CARE SERVICES
Chemical Dependency Institute, sponsored by the Department of Addiction Recovery Services at University Behavioral HealthCare in Piscataway, offers Addiction Training to Health Care Professionals. For information regarding 1997 spring and summer course offerings, contact Susan Kleber at 908-235-5730.
Have you fallen? Are you 65 or older? You may qualify for a study being conducted by the Falls Assessment and Prevention Program, run by the UMDNJ-School of Osteopathic Medicine's Center for the Aging in Stratford, N.J. Call 609-566-6843 for more information.
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Sleep Disorders in Midlife Women
Women between the ages of 42 and 54 who are experiencing hot flushes and difficulty sleeping are being sought for a sleep and memory research study at UMDNJ-New Jersey Medical School in Newark. All study-related tests are free, and participants will be paid $240 upon completion.
For more information call Cheryl Forst, RN, BSN, in the Department of Obstetrics and Gynecology, at 201-982-6573.
Diabetic Black Americans
UMDNJ-New Jersey Medical School in Newark is offering free eye exams and lab testing for black Americans of any age who began using insulin before age 30. In an effort to learn more about why diabetes affects this group, participants will be asked to answer a questionnaire. They will receive $50 for the one-time visit.
For more information, call Lisa Schoenherr at 201-982-2029.
The Department of Obstetrics, Gynecology and Reproductive Sciences at UMDNJ-Robert Wood Johnson Medical School in New Brunswick is conducting a five-month study of a contraceptive vaginal ring. To be eligible, women must be between the ages of 18 and 40, and not be using birth control pills, an IUD or have hormonal implants.
Participants will receive $400 reimbursement for completion of the study. For more information call program coordinator Jean Zebrowski at 908-235-7847 or project coordinator Mitzi Dolese, RNC, at 908-235-7925.
Gasoline Additive Study
The Environmental and Occupational Health Sciences Institute, ARCO Chemicals and the state Department of Environmental Protection are recruiting volunteers for the investigation of sensitivity to methyl-tertiary-butyl ether (MTBE). The study will evaluate the effects of exposure to a gasoline additive believed to cause health problems in some people while driving or refueling their vehicles. Volunteers who think they are MTBE-sensitive, as well as healthy people who display no signs of MTBE sensitivity, will be asked to complete a short questionnaire and visit the institute, located on the Busch campus in Piscataway, for five two-hour sessions.
A medical evaluation by licensed, board-certified physicians will be conducted, and participants will be reimbursed for travel expenses. A stipend will be offered to those who participate in the study. For more information, contact Jean Bowman at 908-445-0157.
Nutrition Study for HIV Positive Patients
The Southern New Jersey AIDS Clinical Trials Unit at Cooper Hospital/University Medical Center in Camden is enrolling patients to participate in a comparative study of nutritional substances. Volunteers will be placed in one of three groups. The first will receive NuBasics and a daily multivitamin and mineral supplement; the second group will get Peptamen and a daily multivitamin and mineral supplement; and the third group will receive only the multivitamin and mineral supplement.
Eligible volunteers must be: HIV positive with a CD4 cell count of 200, or less; age 18 or older; and have a stable weight (no more than 5 percent weight loss as compared to weight three to six months ago). Supplements and multivitamins will be provided by the study. Patients will be followed for four months.
For more information contact: Lisa O'Leary, RN, CCRN, SNJACT in Camden at 609-963-6890; Jean Muratore, RN, Kennedy EIP Site in Voorhees at 609-596-3190; or Dawn McIntyre, RN, The A-Team in Neptune at 908-776-4709.
National Study of Protease Inhibitors for Treatment of AIDS
A nationwide study seeks to determine whether it is more beneficial to add a protease inhibitor early in the course of the disease, or later. Disease progression is based on CD4 cell count and viral load. Protease inhibitors are the newest class of drugs to be approved for the treatment of AIDS by the Food and Drug Administration. Indinavir (Crixivan) is the protease inhibitor being used in this study. It will be supplied, along with all necessary blood work.
The study hopes to enroll 1,900 volunteers. Those eligible to participate must be HIV positive, age 18 or older, have CD4 cell counts of 200-500/mm3, and have had no prior use of protease inhibitors except for Invirase (saquinavir) for two weeks or less.
For more information contact: Lisa O'Leary, RN, CCRN, SNJACT in Camden at 609-963-6890; Jean Muratore, RN, Kennedy EIP Site in Voorhees at 609-596-3190; or Dawn McIntyre, RN, The A-Team in Neptune at 908-776-4709.
Studies on Advanced Breast Cancer Therapies
Researchers at Cooper Hospital/University Medical Center in Camden are conducting two comparative studies on therapies for advanced breast cancer. The first will compare Taxotere and taxol. Volunteers must have metastatic/inoperable disease and have had previous treatment with chemotherapy. Those who have been treated with taxol are not eligible to participate.
A second research protocol will enroll postmenopausal women with advanced breast cancer in a study comparing tamoxifen with the new drug Anastrozole. Study medication is provided free of charge.
For more information on both studies, call 609-365-8941.
Comparative Study of Two Regimen Therapies for TB
Standard treatment for active tuberculosis is generally six months of therapy: two months of treatment with four drugs, followed by four months of daily therapy with two drugs. The National Tuberculosis Center at UMDNJ-New Jersey Medical School is conducting a clinical trial to compare the safety and efficacy of a once-a-week regimen of isoniazid and rifapentine to the twice-weekly doses of isoniazid and rifampin during the last four months of treatment. Rifapentine is taken only once a week because it remains in the system longer than rifampin.
All anti-TB drugs will be provided free of charge.
Following drug therapy, patients enrolled will be seen every three months during the first year, and then every six months during the second year. For more information contact Saundra Barnes, RN, at 201-982-4287.
New Medications for Diabetic Kidney Disease and High Blood Pressure
Hypertension specialists at UMDNJ-Robert Wood Johnson Medical School in New Brunswick are conducting a study to evaluate the effect of Irbesartan in hypertensive patients with Type II diabetes and diabetic nephropathy. The purpose of the investigation is to determine whether the drug will reduce the rate of progression of kidney disease and other problems associated with this type of adult onset diabetes.
Those eligible to participate must be between the ages of 30 and 70, have Type II diabetes, high blood pressure and protein in the urine. Participants will receive a chest x-ray, medication, frequent blood pressure assessments, laboratory tests, EKGs, physical examinations and prorated monetary compensation.
A second study, sponsored by the same group, is evaluating a new medication for high blood pressure. Volunteers must be 18 or older with high blood pressure; women must be surgically sterilized or at least two years postmenopausal. Participants will receive physical examinations, EKGs, laboratory tests, frequent blood pressure checks and medication at no cost. Volunteers must be available between 7 and 10 a.m. for bi-weekly and weekly visits.
For more information on both studies, contact Amelia Sherr, RN, at 908-235-7825.
Hereditary Causes of Breast and Ovarian Cancers
Specialists at the Center for Human and Molecular Genetics at UMDNJ-New Jersey Medical School in Newark and a team of psychologists from Rutgers University in New Brunswick are conducting a study on testing for BRCA1 and BRCA2 in the Ashkenazi Jewish population. BRCA1 and BRCA2 are genes that when mutated are associated with the risk of developing breast and/or ovarian cancer. The goal of the project is to determine how this population responds to the availability of genetic testing for an inherited susceptibility to breast and/or ovarian cancer and, if tested, how they respond to positive or negative results. Participants must be of Ashkenazi Jewish descent and have had either a personal history of breast and/or ovarian cancer at an early age, or a strong family history of these cancers.
For more information call Monica Magee, MS, at 201-982-3304.
Comprehensive Breast and Cervical Cancer Screening
The Women's Wellness Center in Newark is offering a comprehensive breast and cervical cancer screening program for 700 women over age 40 who live in Essex County. Services include mammograms, Pap tests, breast self-exam teaching, women's health education and follow-up of cases. To be eligible, a woman must be at least 40 years old, reside in Essex county, meet income eligibility guidelines and have limited or no health insurance. House calls are made to single locations such as apartment buildings, churches or senior centers for groups of 12 or more women who qualify. Portable mammography is available to provide service on site.
For more information contact co-investigator Mary Jane Tranzillo, RN, MSN, GNPC, at 201-982-2777.
Health Study for Women Over Age 50
The Women's Health Initiative in Newark and a second center at UMDNJ-Robert Wood Johnson Medical School in New Brunswick are conducting studies on strategies to prevent heart disease, breast and colon cancers, and osteoporosis - the major causes of poor health and death in women. Strategies being studied include hormone replacement therapy, low-fat dietary changes, and calcium and vitamin D supplementation. Participants will be given a medical examination and blood tests to determine whether they are eligible to participate.
For more information, call 1-800-WOMEN-10.
UMDNJ-Robert Wood Johnson Medical School in New Brunswick is one of a number of institutions in the country participating in a four-year study of a drug, Pimagedine, that prevents glycation, a cause of the debilitating complications of diabetes.
Stephen H. Schneider, MD, professor of medicine at the school, is seeking individuals with Type II diabetes who have diabetes-related eye disease of any severity, as well as protein in their urine. They must be between 30 and 70 years of age and have had the disease for at least one year. For more information call Shelley Greenhaus, RN, at 908-235-7751; those outside the area can call toll free, 1-800-413-6765.
Investigational Drug Studies
Researchers at UMDNJ-Robert Wood Johnson Medical School in New Brunswick are seeking volunteers for two drug studies. One is investigating Pimagedine as a possible therapy for people who have had a stroke. Those eligible will be asked to stay overnight at the school's Clinical Research Center for two nights, during which they will receive a single intravenous dose of the drug. Study subjects will be asked to complete up to three such visits and will receive up to $1,490 for their participation. To be eligible, women should be between 25 and 65 years of age, without significant medical conditions, and either be postmenopausal or surgically sterile.
A second study is evaluating a medication, SCH 39400, which is being developed as a possible treatment for autoimmune disorders, such as rheumatoid arthritis, lupus and some forms of diabetes. Volunteers will be asked to stay overnight at the Clinical Research Center for three nights, during which they will receive a single subcutaneous injection of the drug. Participants will receive $650. To be eligible, volunteers should be between 18 and 45 years of age and without significant medical conditions. Both men and women are eligible; however, women participants must be either postmenopausal or surgically sterile.
For further information on both studies, contact Helane Rosenberg at 908-418-8461.
Multiple Sclerosis Prevention Study
Neuroscientists at UMDNJ-New Jersey Medical School are participating in a nationwide study to determine whether a new medication can prevent the onset of multiple sclerosis in those who have a high risk of developing it. Those who have experienced a first demyelinating event and who have shown brain abnormalities on an MRI are considered to be at high risk for MS. The investigation is also designed to see if treatment reduces the rate of development of new brain abnormalities as shown on MRI.
Volunteers must meet these criteria: be between the ages of 18-50; have exhibited optic neuritis, spinal cord syndrome, or brain stem/cerebellar syndrome; have two or more clinically silent lesions on MRI brain scan; have started IV corticosteroid treatment within 14 days of the onset of symptoms; and must not have clinically significant pre-existing medical conditions.
This is a three-year randomized, double-blind trial. In this type of study, neither the subjects nor the physicians know who is receiving the drug and who is getting a placebo. The New Jersey Medical School study will be directed by Stuart D. Cook, MD, professor and chair of neurosciences. For further information call project coordinators Annette Jotkowitz, RN, or James Quinless, RN, at 201-982-5208 or 201-982-5209.
Compiled by Mamie Hargrove