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“Selling and marketing books in Italy has never been easy. The fault lies with the schools and the lack of libraries and the statistics have always been enough to make you blanch. Then there has always been that story about books being good for us, that they make us better people, and are even good for our health, a notion that publishers tend to imply even before they call in the marketing teams. In reality, reading takes time and effort and when we overdo things it leaves us blind, consumptive, scoliotic and dyspeptic, as Valerio Riva would put it.” (

Many investigators still hold out hope for immunotherapy in the treatment of certain tumours. However, tumours normally fend off attacks by the immune system. Now, however, scientists have found a way to give immune cells assistance. Investigators at the National Cancer Institute in Bethesda, Maryland, have incorporated chemotherapy and a select form of immunotherapy to treat patients with metastatic melanoma. The preliminary results are promising as 10 of 13 patients remain alive 6–24 months after treatment despite the fact they all had a grave prognosis. Side effects of the therapy still remain a problem. Four volunteers experienced loss of skin pigmentation and one suffered inflammation in the eye—signs that the therapy not only attacked the cancer cells but normal pigment producing cells as well. (www.Sciencemag.org/cgi/content/abstract/1076514)

Evidence continues to suggest that physical exercise and weight loss may be beneficial in the treatment of hypertension. A study from Duke University of 112 participants with unmedicated high normal or stage 1 or stage 2 hypertension reinforced this opinion. In this study, exercise, especially combined with weight loss, reduced blood pressure levels at rest and in situations that typically elevate blood pressure, such as intense physical activity and emotional distress. Many of the patients who were in early stage 1 or stage 2 hypertension returned to normotensive levels as a result of weight loss and exercise. (

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Recent evidence suggests that hypothermia may be an effective therapy for stroke victims. In a study from Denmark, 390 patients with acute stroke admitted within 6 hours from the onset of symptoms were studied. Patients with hyperthermia had more severe strokes and were more frequently diabetics. Low body temperature on admission was an independent predictor of a good short term outcome. This study supports the notion that admission body temperature is a major determinant even for long term mortality after stroke. Hypothermic therapy in the early stages of strokes may offer long lasting neuroprotective benefits. (

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Although primary open angle glaucoma is a leading cause of blindness throughout the world, some critics have suggested that reducing intraocular pressure has not been demonstrated to be effective in treating this disorder. A randomised, multicentre prospective trial (the Ocular Hypertensive Treatment Study) has now been completed. In this study 1636 participants with no evidence of glaucomatous damage (as defined by visual field loss or optic disc changes) and with an intraocular pressures between 24 and 32 mm Hg in one eye and 21 and 32 mm Hg in the other eye were randomised to observation or treatment. In this study topical ocular hypotensive drugs were effective in delaying or preventing optic nerve head damage and/or visual field loss in individuals with elevated intraocular pressure compared to the untreated control group. The authors do not advocate that all patients with borderline or elevated intraocular pressure receive medication although further studies will address this question. (

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There are currently 19 anti-HIV drugs approved for clinical use and some combinations lower the virus to undetectable levels in the blood although they do not eliminate it entirely. A new generation of antiviral drugs is now being developed. Roche has completed clinical trials of a promising new drug, the T-20 fusion inhibitor. T-20 is a synthetic peptide that blocks gp41, the protein that the virus uses to bind to the cell membrane. Twice daily injections of T-20 fusion inhibitor produced good results in reducing HIV with relatively few side effects. The drug has not yet been approved for use, however, and its $11 000 annual cost will preclude its use in many of the countries currently experiencing the worst effect of the AIDS epidemic. (

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In the presence of calcium, low density lipoprotein cholesterol binds with molecules secreted from the inner lining of artery walls, thus forming tiny plaques that can accumulate and become part of the pathology of atherosclerosis. High density lipoprotein cholesterol inhibits this process by absorbing excess plaque forming molecules. Researchers from the Free University of Berlin have now reported that garlic extract works exactly in the same way but is more potent. In concentrations relevant to humans, garlic extract was found to be 2.5 times more effective in inhibiting plaque formation than was high density lipoprotein cholesterol. (

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The importance of Helicobacter pylori in the pathophysiology of peptic ulcer disease is now well established. In a recent study from Greece 41 patients with glaucoma and 30 age matched anaemic controls underwent upper gastrointestinal endoscopic biopsies to detect the presence of H pylori infection. In this study, H pylori was detected in 88% of glaucoma cases and in 47% of controls. Eradication of H pylori with standard medication was successful in 83% of treated patients. After 2 years of follow up, H pylori eradication was shown to be positively correlated with control of intraocular pressure and prevention of visual field defect progression in the glaucoma group. The authors suggest that there may be a causal link between H pylori and glaucoma. (

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A small but vocal group of critics continue to imply that routine childhood vaccination carries with it significant medical risks. A few studies have suggested that childhood vaccines may increase the risk of childhood asthma. In a very large cohort study of 167 240 children in four large health maintenance organisations, investigators from the Center for Disease Control and Prevention in Atlanta, Georgia, have demonstrated that 11% of children will develop asthma at a median age of onset of 11 months. There was no increased risk of asthma associated with diphtheria-tetanus and whole cell pertussis vaccine, oral polio vaccine, or measles, mumps, and rubella vaccine. A weak association with the increased risk of asthma was seen with HIB and hepatitis B vaccines. (

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