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FDA Recommends Gardasil Recipients Sit, Lie Down After Receiving Vaccination
In a posting aimed at health care professionals, FDA on its Web site on Wednesday said that recipients of Merck"s human papillomavirus vaccine, Gardasil, should be closely observed afterward for 15 minutes while they remain seated or lying down to avoid the possibility of fainting, the Wall Street Journal reports. FDA said that since October 2007, Gardasil"s labeling for both health care providers and patients has included a discussion about fainting. The agency said the strengthened recommendation comes in response to reports of "traumatic injuries" among some recipients who experienced fainting (Corbett Dooren, Wall Street Journal, 6/10). Gardasil protects against the strains of HPV that cause most cases of cervical cancer and genital warts. The Centers for Disease Control and Prevention recommends that girls ages 11 and 12 receive the three-dose vaccine before they are sexually active. Girls and women ages 13 to 26 who have not been vaccinated or completed the vaccine series also should receive the vaccine (CDC fact sheet, June 2008). On Wednesday, FDA also approved changes to Gardasil materials that place warnings about fainting in a more prominent place on drug labels and handouts. The agency said that the new recommendations are intended to "prevent falls and injuries" (Wall Street Journal, 6/10).
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Family Of Murdered Abortion Provider Tiller Announces Permanent Closure Of Clinic
The family of murdered Kansas abortion provider George Tiller announced on Tuesday that his Wichita clinic will not re-open, leading some abortion-rights advocates to voice concern about access to the procedure, the New York Times reports. Tiller was one of a handful of abortion providers who performed the procedure in the second and third trimesters of pregnancy, and women for decades have traveled to the clinic from across the U.S. and other countries. The clinic, Women"s Health Care Services, also was Kansas" only clinic outside the Kansas City area (Davey, New York Times, 6/10). The Tiller family said in a statement that the clinic will be "permanently closed" effective immediately. The family also said it does not plan to be involved "in any similar clinic" but will "honor Dr. Tiller"s memory through private charitable activities" (Slevin/Stein, Washington Post, 6/10).While abortion-rights advocates expressed empathy for the family, some added that they also are concerned that the clinic"s closure could have devastating effects for women who learn of fatal health problems late in their pregnancies, the Times reports. Nancy Northup, president of the Center for Reproductive Rights, said, "It is unacceptable that antiabortion intimidation and violence has led to the closing of Dr. Tiller"s clinic." She added, "Not only have we lost a fearless defender of women"s fundamental health and rights in Dr. Tiller"s murder, but the closing of his clinic leaves an immediate and immense void in the availability of abortion" (New York Times, 6/10). Suzanne Poppema, board chair of Physicians for Reproductive Choice and Health and a retired ob-gyn who performed abortions, said that abortions later in pregnancy would still be available, including through university hospitals that do not advertise the service. The closing is "not going to stop people who want to provide the service, but it will slow them down," she said. Marla Patrick, Kansas coordinator for the National Organization for Women, said abortion-rights advocates are working to open another Wichita-based clinic that provides abortions later in pregnancy (Bello, USA Today, 6/10). The AP/Yahoo! News reports that Kansas state law permits abortion after 21 weeks" gestation only if continuing the pregnancy would endanger the woman"s life or cause a "substantial and irreversible impairment" of a major bodily function, which courts have interpreted to include the mental health of the woman (Hegman/Hanna, AP/Yahoo! News, 6/9).According to the Times, some abortion-rights advocates had hoped other abortion providers would take over Tiller"s work at the clinic. LeRoy Carhart, a Nebraska abortion provider who also worked with Tiller, said he is "currently exploring every option to be able to continue to make second- and early, medically indicated third-trimester abortions available." Warren Hern, a Colorado abortion provider who performs procedures later in pregnancy, said, "Where does it end? The antiabortion fanatics got exactly what they wanted" (New York Times, 6/10). According to the Wall Street Journal, abortion-rights opponents" response to the closure was "subdued." Some expressed concern that antiabortion-rights extremists would think that violence "gets results where legal protest doesn"t," the Journal reports (Simon, Wall Street Journal, 6/10). Troy Newman, president of Operation Rescue, said that while the group is "thankful" that the clinic is closed, they "wish it would have come through the peaceful, legal channels that we were pushing" (New York Times, 6/10).Broadcast CoverageMSNBC"s "The Rachel Maddow Show" on Tuesday reported on the clinic"s closure and included a discussion with Susan Hill, president of the National Women"s Health Organization, about violence against abortion providers and an increase in the hostility of protesters outside abortion clinics since Tiller"s murder (Maddow, "The Rachel Maddow Show," MSNBC, 6/9). NPR"s "All Things Considered" on Tuesday also reported on the clinic"s closure ("All Things
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Mean New MicroRNA Data Analysis Method Gives Sharper Results
Our understanding of the importance of microRNAs in regulating gene expression is expanding, and with it our requirement for robust methods to measure their expression levels. Now a new method published in BioMed Central"s open access journal Genome Biology helps researchers to better understand the delicate interplay between differences in microRNA expression levels and their target genes.
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New Heart Ultrasound Research Reveals Life-Saving Treatment Alternatives And Advancements For Heart Patients

The American Society of Echocardiography (ASE) welcomes the world"s leading researchers in cardiovascular medicine to present their most-recent findings at its 20th Annual Scientific Sessions, June 6-10, at the Gaylord National Convention Center in Washington, DC. This year, NBA basketball player and former heart patient, Ronny Turiaf will be in attendance to talk about how echocardiography, otherwise known as heart ultrasound, saved his life. Many of the studies revealed will have a significant impact on the diagnosis and treatment of heart disease and the application of echocardiograms. Studies detail the following: -- A nonsurgical option for common heart procedures -- Lack of adherence to guidelines leave symptoms unidentified and patients untreated -- Newer technology that can better predict survival chances for heart patients NONSURGICAL OPTION FOR COMMON HEART PROCEDURE OFFERS EFFECTIVE RESULTS WITH LESS RECOVERY TIME FOR PATIENTS Technique presents options to elderly patients who may not survive open-heart surgery This study found that patients unable to undergo open-heart surgery may be candidates for a new nonsurgical aortic valve replacement procedure. Transcatheter aortic valve replacement is a promising new treatment for patients with severe aortic stenosis who are considered high risk for conventional surgical aortic valve replacement. With this approach, echocardiography, or heart ultrasound, is used to guide interventional cardiologists through the procedure and to assess the effects of intervention after the procedure. "Some people with severe aortic stenosis, or narrowing of the aortic valve, are not good candidates for open-heart surgery because they may have other medical conditions that would classify them as high risk for surgery," said Dr. Linda D. Gillam of the Columbia University Medical Center in New York, a lead author on the study. "These findings are especially critical for elderly patients who could not survive open-heart surgery." The study concluded that transcatheter and surgical aortic valve replacement result in comparable improvements in radial strain, strain rate and left ventricular ejection fraction in elderly patients with severe symptomatic aortic stenosis. LACK OF ADHERENCE TO GUIDELINES FOR SEVERE AORTIC STENOSIS LEAVE SYMPTOMS UNIDENTIFIED AND PATIENTS WITH LIFE-THREATENING HEART CONDITIONS UNTREATED More than 75 percent of patients studied did not have aortic valve replacement surgery even though they met established criteria Symptoms of severe aortic stenosis are under-diagnosed, preventing patients from receiving potentially life-saving aortic valve replacement surgery, according to research unveiled at ASE"s Scientific Sessions. By using cardiovascular ultrasound and other objective tests, physicians can more accurately diagnose symptoms of severe aortic stenosis and help prevent the rapid progression of the disease. For this research, physicians examined 106 patients and found that only 25 percent with severe aortic stenosis (AS) were referred for surgery. The other 75 percent did not have valve replacement (AVR) surgery even though they met echocardiographic criteria. "Patients are not being referred for aortic valve replacement surgery because symptoms of aortic stenosis are not being identified or are not attributed to aortic stenosis. As a result, surgery in these patients is frequently delayed or not performed," said Dr. Benjamin H. Freed of the University of Chicago Medical Center, a lead author of the study. Patients with suspected aortic stenosis should talk to their doctors about whether they need an echocardiogram or other diagnostic tests. Patients with existing aortic stenosis should monitor their conditions carefully and if their conditions become severe, they should discuss their options for aortic valve replacement surgery with their doctors. STUDY SHOWS DOCTORS CAN BETTER PREDICT SURVIVAL CHANCE FOR HEART PATIENTS WITH NEWER IMAGING TECHNOLOGY Study finds 3-D echocardiography serves as a stronger predictor of patient outcomes than 2-D This study showed that physicians can better predict potentially life-threatening cardiac events with real-time, three-dimensional echocardiography technology. Physicians can use echocardiograms, or heart ultrasound, to view the heart"s left ventricular end systolic volume (this measurement refers to the volume of blood in the ventricle immediately after the contraction of the heart) and ejection fraction, (a measurement that determines how well the heart is pumping), which determines the severity of the patient"s heart condition. The study concluded that 3-D measurements could help guide management decisions on how to best treat the patient and therefore, better predict the patient"s chance of survival. The American Society of Echocardiography (ASE) is a professional organization of physicians, cardiac sonographers, nurses and scientists involved in echocardiography, the use of ultrasound to image the heart and cardiovascular system. The organization was founded in 1975 and has is the largest international organization for cardiac imaging. The American Society of Echocardiography


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