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“Do not leave me. I live in despair. I live in darkness. My god Amon has left me. Bring me honey for my eyes and fat and genuine eye paint as soon as possible. Am I not your father? I wish to see with my eyes are deserting me.” (A letter written by the painter Poi to his son at the time of Ramses II (1504–1237 bc) translated in Thorwald J, Science and the Secrets of Medicine. New York: Harcourt Brace and World, 1963:82)

In February a vaccine manufactured by Elan referred to as AN-1792 was in the early investigative stages when a clinical trial was abruptly terminated. This was because 15 patients developed significant brain inflammation while on the therapy. Nevertheless, investigators still appear to be enthusiastic that by stimulating antibodies to β amyloid protein, the damage of Alzheimer's disease can be slowed or perhaps even reversed. A β amyloid nasal vaccine developed by Cynthia Lemare, a neuropathologist at the Center for Neurologic Diseases at Brigham and Women's Hospital in Boston, is set to go into clinical trials at the end of this year. (

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The National Eye Institute in Bethesda, Maryland, has just published a report titled Vision Problems in the United States. It suggests that the number of blind and visually impaired adults aged 40 years and older in the United States will double in the next 30 years. Today in the United States more than one million middle aged and older adults are blind and 2.4 million are visually impaired. The full report can be downloaded at http://www.nei.nih.gov/idata

Primary cryptococcal meningitis is a relatively uncommon disorder in immunologically competent individuals. Regrettably, it is a relatively common complication in adults with AIDS. In a study from Lusaka, Zambia, 230 patients with cryptococcal meningitis were studied. Cryptococcal meningitis was the first AIDS defining illness in 91% of these patients. Just over half of the patients had received treatment with fluconazole monotherapy. The fatality rate in this group was 100% by 7 weeks in the untreated group and by 6 months in the fluconazole treated group. Median survival from the time of diagnosis was 19 days for the fluconazole treated group and 10 days for the untreated group. (

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Over the past decade increased public awareness of the problem of osteoporosis has been encouraging. Perimenopausal and postmenopausal fractures are well recognised strong predictors of osteoporosis. Now, in a cross sectional study of 1284 women who were 10 years or more postmenopausal, evidence suggests that fractures between the ages of 20 and 50 years of age are also predictive of postmenopausal fractures. Patients who suffer fractures between the ages of 20 and 50 years of age have a 74% increase in the risk of fractures in the postmenopausal period. These data would seem to indicate that premenopausal fractures should be considered an independent risk factor for the development of osteoporosis. (

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The incidence of malignant gliomas has dramatically increased over the past two decades. Moreover, survival rates for this tumour remain depressingly low. Because of the wide dissemination of malignant glioma cells by the time the tumour is diagnosed anti-invasive strategies designed to limit further spread may be of little value. Investigators from the University Hospital Eppendorf in Hamburg, Germany, have determined that elevated thromboxane synthase gene expression and enzymatic activity are associated with a highly migratory phenotype of gliomas cells in vitro. Moreover, they have demonstrated that specific inhibitors for this enzyme block cell migration. These data suggest that thromboxane synthase may be involved in multiple signalling cascades that regulate motility and apoptosis in glioma cells. The authors hope that these observations will lead to more successful novel treatments for gliomas. (

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Heightened awareness of the benefit of routine aspirin ingestion to protect against heart disease is increasing. Regrettably, a recent study from the University of Western Australia, Royal Perth Hospital, may indicate that in some patients aspirin is ineffective. In this study the investigators found that patients taking aspirin but who had a high level of thromboxane in their urine were 3.5 times more likely to die of cardiovascular disease than patients taking aspirin who had low levels. These researchers suggested that in some patients aspirin does not effectively block thromboxane synthesis and in these patients the aspirin is ineffective. (

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Treatment of uveal human melanomas continues to advance. Nevertheless, enucleation remains a standard treatment for some patients. This may now be called into question by the findings of investigators from the University of Texas Southwestern Medical Center in Dallas, Texas. In this study of human uveal melanoma cell lines it was demonstrated that these cell lines significantly inhibited bovine endothelial cell proliferation and generated 38 kD angiostatin molecules. Enucleation of eyes containing cell line OCM3 in the posterior segment resulted in a higher number of metatstatic foci in a group compared with non-enucleated mice. The authors suggest that removing a source of angiostatin enucleation of melanoma containing eyes unwittingly exacerbates the metastatic potential. (

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The health benefits of a diet high in soybean protein and dietary fibre supplementation seems well established. Studies have suggested that soybean protein and dietary fibre supplementation reduce serum cholesterol. Now in a study from the Tulane University School of Public Health, it has been demonstrated that consumption of legumes, which are high in bean protein and water soluble fibre, may also be beneficial in preventing coronary heat disease. In a study of 9632 men and women over an average follow up of 19 years, legume consumption four times or more a week compared with less than once a week was associated with a 22% lower risk of coronary heart disease. (

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My darling Elinor, I have just read in the Saturday Review of your dreadful accident. There was a silly story in the papers early in the summer. I didn't see it but someone mentioned that you had tried to kill yourself or some such rot; naturally I paid no more attention to that than I paid the annual dribble of myself and Gene. Now it seems that you really did fall and were frightfully hurt. I can't tell you how I feel to realize that you have been ill and in pain for months and I haven't written you a word . . .. My dear I am so grieved to think of what happened to you this summer. I can see you coming down the stairs with your beautiful near-sighted eyes for whose sake long ago I made Myopia a goddess. (

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