- Email: [email protected]
Administration Proposes $28.4 Billion FY 2007 NIH Budget, Same as FY 2006
Gastroenterology and Hepatology News continued
holic cirrhosis, independent of several potential confounders. In contrast, there was no statistically significant relation of coffee drinking to risk of nonalcoholic cirrhosis,” the authors state. “The positive correlations of coffee drinking with traits related to increased cirrhosis risk, such as alcohol intake, smoking, and BMI, indicate that residual confounding for these traits would more likely result in a positive—not an inverse— coffee-cirrhosis relation.”
The authors point out that the observational nature of the data and the absence of an established mechanism limit a causal interpretation. “There are also no clear therapeutic implications; even if coffee is protective, the primary approach to reduction of alcoholic cirrhosis is avoidance or cessation of heavy alcohol drinking. Assuming causality, the data do suggest that coffee intake may partly explain the vari-
ability of cirrhosis risk in alcohol consumers. Basic research about hepatic coffee-ethanol interactions is warranted, but we should keep in mind that coffee might represent only one of a number of potential cirrhosis risk modulators.” For further details see “Coffee, Cirrhosis, and Transaminase Enzymes,” Archives of Internal Medicine 2006;166: 1190 –1195.
Colorectal Cancer Risk Jointly Associated With Smoking and NSAID Use
involved 3299 Seattle-area residents between the ages of 20 and 74 (mean age 60), of whom approximately half had a history of colon cancer and half did not (controls). Cancer cases were identified through the Puget Sound Surveillance, Epidemiology and End Results Program, a population-based registry. Controls were randomly selected to match the distribution of the cases in terms of age and gender. Participants were interviewed by telephone about their smoking history and use of aspirin and other NSAID use, among other risk factors. The researchers also examined the impact of NSAIDs on tumor microsatellite instability in 1202 patients. This genetic characteristic indicates defects in DNArepair machinery. Microsatellite instability, or MSI, occurs in approximately 15%– 20% of colon cancers. MSI, defined as MSI high (MSI-H) or MSI-low/microsatellite stable (MSI-L/MSS), was assessed in tumors of the 1202 cases. “Compared with nonsmokers, there was a stronger association within MSI-H tumors with current smoking than there was within MSI-L/MSS tumors. Smokers of long duration were at elevated risk of
MSI-H tumors even with NSAID use,” the authors state. “There seems to be a synergistic inverse association (implying protection) against colorectal cancer overall as a result of NSAID use and nonsmoking, but risk of MSI-H colorectal cancer remains elevated among smokers even when they have a history of NSAID use.” The study found a 2-fold increased risk of microsatellite-unstable colorectal tumors among long-term smokers who used NSAIDs—virtually the same risk as smokers who had not used NSAIDs. “Given the damage that smokers receive over their lifetime, even strong anti-progression agents, like NSAIDs, may be ineffective,” the authors state. “NSAIDs may not be able to counteract the longterm effects of smoking, as evidenced by our observation that long-term smokers are at increased risk of colorectal cancer, despite current NSAID use.” For further details, see “Risk of Microsatellite-Unstable Colorectal Cancer Is Associated Jointly With Smoking and Nonsteroidal Anti-inflammatory Drug Use,” Cancer Research 2006;66:6877– 6883.
tor Dr. Elias Zerhouni, MD, submitted a budget request for $28.4 billion in FY 2007, the same as fiscal year 2006. Zerhouni focused his testimony on the return on the public’s investment in NIH, providing specific examples of dollars invested per American citizen and discussed how discoveries fueled by this investment are transforming the practice of medicine, “and the importance of maintaining the momentum developed over the past several years to
reach our goals.” He noted that the estimated total cumulative investment at the NIH per American citizen over the past 30 years is about $1334 or about $44 per American per year. In return, he said, Americans have gained over 6 years of life expectancy and are aging healthier than ever before. “We can now clearly envision an era when the treatment paradigm of medicine will increasingly become more predictive, personalized, and preemptive. We will
I
t is widely known that the use of aspirin and other nonsteroidal anti-inflammatory drugs may reduce the risk of colorectal cancer by up to 40%, but this protective effect may not extend to longterm smokers, who already face an increased risk of the disease, according to a study led by researchers at Fred Hutchinson Cancer Research Center in Seattle, Washington. In a large, population-based study comparing risk factors in persons with and without colorectal cancer, the researchers found the highest risk of colon cancer to be among long-term smokers (ⱖ20 years) who had never used NSAIDs. The researchers also found that smokers who used NSAIDs were still at an approximate 30% higher risk of colon cancer than nonsmokers. The findings, which appear in the July 1, 2006 issue of Cancer Research, arise from the first study of its kind to examine the effects of NSAID use on colorectal-cancer risk among smokers. The study
Administration Proposes $28.4 Billion FY 2007 NIH Budget, Same as FY 2006
P
resident George W. Bush has proposed flat funding for the NIH in fiscal year (FY) 2007. Testifying before the House Subcommittee on LaborHHS-Education Appropriations in April and the U.S. Senate Committee on Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies in May, NIH Direc-
695
Gastroenterology and Hepatology News continued
strike disease before it strikes us with the hope of greatly reducing overall costs to society. We expect to move away from the costly and predominantly curative model of today, which requires us to wait for the disease to occur before intervening,” Zerhouni said. According to Zerhouni, the proposed budget will increase the Biodefense research program by $110 million for Advanced Development. Support for the Pandemic Influenza Preparedness Plan will increase by $17 million. The NIH Roadmap will increase to $113 million. “We allocated $40 million to the Institutes and Centers to launch the Genes, Environment, and Health Initiative to
accelerate discovery of the major genetic and environmental factors for diseases that have a substantial public health impact,” he added. “We have also directed $15 million to the new “Pathway to Independence” program to increase our support of new investigators.” This program will support 150 to 200 recently trained scientists conducting independent, innovative research for each of the next 5 years. On Thursday, July 20th, the Senate Appropriations Committee voted 28-0 to approve a $606 billion fiscal year 2007 Labor-HHS-Education appropriations bill (HR 5647). The bill includes $142.8 billion in discretionary spend-
ing—$5 billion more than President Bush requested and $1.3 billion more than FY 2006 levels—with the remainder being allocated for Medicare, Medicaid, and other entitlement programs. The legislation includes $64.2 billion for HHS. Under the bill, NIH would receive $28.5 billion, $200 million more than Bush requested and $220 million more than FY 2006 levels, according to Congressional Quarterly Today, July 20th. In addition, the legislation includes more than $1.9 billion to expand community health centers.
Stories by Les Lang
Heister of the Spiral Valve of Heister
Lorenz Heister (1683–1758) was born at Frankfurt-am-Main. Following classical instruction, to which he took with zeal, he began medical studies at the universities of Giessen, Amsterdam, and Leyden; his MD degree was conferred at Hardewyk. At Amsterdam he taught anatomy and surgery in Latin, German, and English. Across the channel, he visited the academic centers of Cambridge, Oxford, and London. Called to the chair of surgery at Altorf near Nürnberg, he began work on his Compendium Anatomicum, in which he described the spiral valve in the cystic duct that still bears his name. Heister’s Compendium was a standard textbook of anatomy for over a century, especially prized for its vivid illustrations. In a companion textbook of surgery, he described construction of enteric fistula in treatment of abdominal wounds, “taking a hint from nature.” In that work, he introduced the term “tracheotomy.”
—Contributed by WILLIAM S. HAUBRICH, MD The Scripps Clinic, La Jolla, California
Lorenz Heister, MD. Copyright holder unknown.
696
holic cirrhosis, independent of several potential confounders. In contrast, there was no statistically significant relation of coffee drinking to risk of nonalcoholic cirrhosis,” the authors state. “The positive correlations of coffee drinking with traits related to increased cirrhosis risk, such as alcohol intake, smoking, and BMI, indicate that residual confounding for these traits would more likely result in a positive—not an inverse— coffee-cirrhosis relation.”
The authors point out that the observational nature of the data and the absence of an established mechanism limit a causal interpretation. “There are also no clear therapeutic implications; even if coffee is protective, the primary approach to reduction of alcoholic cirrhosis is avoidance or cessation of heavy alcohol drinking. Assuming causality, the data do suggest that coffee intake may partly explain the vari-
ability of cirrhosis risk in alcohol consumers. Basic research about hepatic coffee-ethanol interactions is warranted, but we should keep in mind that coffee might represent only one of a number of potential cirrhosis risk modulators.” For further details see “Coffee, Cirrhosis, and Transaminase Enzymes,” Archives of Internal Medicine 2006;166: 1190 –1195.
Colorectal Cancer Risk Jointly Associated With Smoking and NSAID Use
involved 3299 Seattle-area residents between the ages of 20 and 74 (mean age 60), of whom approximately half had a history of colon cancer and half did not (controls). Cancer cases were identified through the Puget Sound Surveillance, Epidemiology and End Results Program, a population-based registry. Controls were randomly selected to match the distribution of the cases in terms of age and gender. Participants were interviewed by telephone about their smoking history and use of aspirin and other NSAID use, among other risk factors. The researchers also examined the impact of NSAIDs on tumor microsatellite instability in 1202 patients. This genetic characteristic indicates defects in DNArepair machinery. Microsatellite instability, or MSI, occurs in approximately 15%– 20% of colon cancers. MSI, defined as MSI high (MSI-H) or MSI-low/microsatellite stable (MSI-L/MSS), was assessed in tumors of the 1202 cases. “Compared with nonsmokers, there was a stronger association within MSI-H tumors with current smoking than there was within MSI-L/MSS tumors. Smokers of long duration were at elevated risk of
MSI-H tumors even with NSAID use,” the authors state. “There seems to be a synergistic inverse association (implying protection) against colorectal cancer overall as a result of NSAID use and nonsmoking, but risk of MSI-H colorectal cancer remains elevated among smokers even when they have a history of NSAID use.” The study found a 2-fold increased risk of microsatellite-unstable colorectal tumors among long-term smokers who used NSAIDs—virtually the same risk as smokers who had not used NSAIDs. “Given the damage that smokers receive over their lifetime, even strong anti-progression agents, like NSAIDs, may be ineffective,” the authors state. “NSAIDs may not be able to counteract the longterm effects of smoking, as evidenced by our observation that long-term smokers are at increased risk of colorectal cancer, despite current NSAID use.” For further details, see “Risk of Microsatellite-Unstable Colorectal Cancer Is Associated Jointly With Smoking and Nonsteroidal Anti-inflammatory Drug Use,” Cancer Research 2006;66:6877– 6883.
tor Dr. Elias Zerhouni, MD, submitted a budget request for $28.4 billion in FY 2007, the same as fiscal year 2006. Zerhouni focused his testimony on the return on the public’s investment in NIH, providing specific examples of dollars invested per American citizen and discussed how discoveries fueled by this investment are transforming the practice of medicine, “and the importance of maintaining the momentum developed over the past several years to
reach our goals.” He noted that the estimated total cumulative investment at the NIH per American citizen over the past 30 years is about $1334 or about $44 per American per year. In return, he said, Americans have gained over 6 years of life expectancy and are aging healthier than ever before. “We can now clearly envision an era when the treatment paradigm of medicine will increasingly become more predictive, personalized, and preemptive. We will
I
t is widely known that the use of aspirin and other nonsteroidal anti-inflammatory drugs may reduce the risk of colorectal cancer by up to 40%, but this protective effect may not extend to longterm smokers, who already face an increased risk of the disease, according to a study led by researchers at Fred Hutchinson Cancer Research Center in Seattle, Washington. In a large, population-based study comparing risk factors in persons with and without colorectal cancer, the researchers found the highest risk of colon cancer to be among long-term smokers (ⱖ20 years) who had never used NSAIDs. The researchers also found that smokers who used NSAIDs were still at an approximate 30% higher risk of colon cancer than nonsmokers. The findings, which appear in the July 1, 2006 issue of Cancer Research, arise from the first study of its kind to examine the effects of NSAID use on colorectal-cancer risk among smokers. The study
Administration Proposes $28.4 Billion FY 2007 NIH Budget, Same as FY 2006
P
resident George W. Bush has proposed flat funding for the NIH in fiscal year (FY) 2007. Testifying before the House Subcommittee on LaborHHS-Education Appropriations in April and the U.S. Senate Committee on Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies in May, NIH Direc-
695
Gastroenterology and Hepatology News continued
strike disease before it strikes us with the hope of greatly reducing overall costs to society. We expect to move away from the costly and predominantly curative model of today, which requires us to wait for the disease to occur before intervening,” Zerhouni said. According to Zerhouni, the proposed budget will increase the Biodefense research program by $110 million for Advanced Development. Support for the Pandemic Influenza Preparedness Plan will increase by $17 million. The NIH Roadmap will increase to $113 million. “We allocated $40 million to the Institutes and Centers to launch the Genes, Environment, and Health Initiative to
accelerate discovery of the major genetic and environmental factors for diseases that have a substantial public health impact,” he added. “We have also directed $15 million to the new “Pathway to Independence” program to increase our support of new investigators.” This program will support 150 to 200 recently trained scientists conducting independent, innovative research for each of the next 5 years. On Thursday, July 20th, the Senate Appropriations Committee voted 28-0 to approve a $606 billion fiscal year 2007 Labor-HHS-Education appropriations bill (HR 5647). The bill includes $142.8 billion in discretionary spend-
ing—$5 billion more than President Bush requested and $1.3 billion more than FY 2006 levels—with the remainder being allocated for Medicare, Medicaid, and other entitlement programs. The legislation includes $64.2 billion for HHS. Under the bill, NIH would receive $28.5 billion, $200 million more than Bush requested and $220 million more than FY 2006 levels, according to Congressional Quarterly Today, July 20th. In addition, the legislation includes more than $1.9 billion to expand community health centers.
Stories by Les Lang
Heister of the Spiral Valve of Heister
Lorenz Heister (1683–1758) was born at Frankfurt-am-Main. Following classical instruction, to which he took with zeal, he began medical studies at the universities of Giessen, Amsterdam, and Leyden; his MD degree was conferred at Hardewyk. At Amsterdam he taught anatomy and surgery in Latin, German, and English. Across the channel, he visited the academic centers of Cambridge, Oxford, and London. Called to the chair of surgery at Altorf near Nürnberg, he began work on his Compendium Anatomicum, in which he described the spiral valve in the cystic duct that still bears his name. Heister’s Compendium was a standard textbook of anatomy for over a century, especially prized for its vivid illustrations. In a companion textbook of surgery, he described construction of enteric fistula in treatment of abdominal wounds, “taking a hint from nature.” In that work, he introduced the term “tracheotomy.”
—Contributed by WILLIAM S. HAUBRICH, MD The Scripps Clinic, La Jolla, California
Lorenz Heister, MD. Copyright holder unknown.
696