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Esteban Delisio





    Imagine swallowing a camera in a capsule the size of a vitamin pill to help doctors identify gastrointestinal problems that might otherwise go undiagnosed. That's exactly what patients at the Mayo Clinic in Scottsdale, Arizona, are doing. The clinic is one of only three centers in the nation to feature this technology, and the only one west of New York State. The capsule includes a miniature color video camera, a light, a battery, and a transmitter. The video camera transmits images to sensors attached to the patient's torso, and a Walkman-like device the patient wears around his waist records them digitally. It takes about 8 hours for the camera to make its way through the digestive tract. The device can help doctors evaluate intestinal bleeding and conditions that cause pain, diarrhea, or weight loss, such as Crohn's disease. David Fleischer, M.D., chair of the clinic's gastroenterology department, calls the procedure "the medical equivalent of space ex! ploration of the moon."
    Doctors at the University of California, San Diego are trying to determine if subtle genetic variations among people with high blood pressure produce differences in response to treatment. The study is one of the first in the emerging field of "pharmacogenomics," in which drug therapy is tailored to a person's genetic profile. "Why some people respond to blood pressure medications and others don't has always puzzled physicians," says Daniel T. O'Connor, M.D., professor of medicine and the project's director. "We believe that a substantial part of that variability is the result of differences in genes that either metabolize drugs or are the target of drugs." Working with scientists at Celera Genomics, the company that recently sequenced the human genome, O'Connor and his colleagues will see if they can find an association between genetic variations and differences in individual responses to drugs. The next step will be animal studies to clarify the mechani! sms through which the genetic variants give rise to different drug responses.
    Doctors at the Rambam Medical Center in Israel have found that lamotrigine, a drug commonly used to treat epilepsy, may also relieve the pain of diabetic neuropathy, a potentially serious complication that often results in limb amputation. They compared 27 diabetics taking the drug to 26 patients who received a placebo. The people taking lamotrigine had had diabetes nearly 4 years longer than the placebo group. From the beginning of the study to its end 8 weeks later, patient-rated pain intensity scores dropped significantly in the lamotrigine group, and many patients were able to reduce their use of pain medication. The placebo group, on the other hand, continued to use pain medication throughout the treatment period. These findings "support preliminary research showing that [lamotrigine] may be effective for this serious pain syndrome," says Elon Eisenberg, M.D, the lead investigator.
    Despite the physical and emotional struggles cancer patients face, many survivors report good quality of life. In fact, often it is better than the general public or even their physicians would expect, say the authors of a new study conducted at King Edward Memorial Hospital in Western Australia. They had 202 survivors of gynecological cancers fill out questionnaires asking about quality of life. At the same time, each woman's doctor was asked to rate the patient's overall quality of life at the end of each consultation. The doctors' ratings were consistently lower than those of the patients themselves. Interestingly, of the patients who responded to questions about sexual function (25 percent did not), those who lived with a partner were more likely to report a worsening in that aspect of their lives. These findings are important because quality of life is key to the assessment of new cancer treatments, particularly when several kinds of treatments yiel! d similar survival rates.
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