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Dr. Scott C Isaacs will also be among the speakers. Dr. Isaacs' topic will be "Coping With Cushing's Through Diet and Lifestyle". More info here »
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Room Availability:
Nashville Mariott @ Vanderbilt University
Rate: $99.00 per night plus appropriate taxes
Call for Reservations: 1-615-321-1300
Room Reference is: Cushing's Disease Conference

Please Note: There is a limited number of rooms with two beds so if you plan to share your room, please reserve early. There is a $17.00 fee for parking. Carpooling is recommended.

For more information on the Marriott and the area check the following: The Marriott at Vanderbilt

Agenda:
Thursday October 21, 2004
9:00 AM: CUSH Officers Meeting, Crescent Room @ Marriott
11:00 AM - 5:00 PM: Open Forum Cushing's Patient Meeting,
Crescent Room @ Marriott

**Usually when we get together we try to come to a decision about where we all can dine together.

Friday October 22, 2004
8:30 AM - 5:00 PM: CUSH Conference at
Vanderbilt Ingram Cancer Center
Preston Research Building
8th Floor Conference Room

Please include your name, phone, and the number of people
that will be attending.

		Office of Research on Women's Health Symposium on Family Hormonal Health CONFERENCE GOALS Pituitary tumors are not rare and occur in nearly 20% of adults, worldwide. Although clinically significant, many of these tumors go undiagnosed for years. The abnormal hormone production caused by these tumors has severe and debilitating effects on growth, reproductive and sexual function, and neuroimmune function. Therefore, the purpose of this symposium is to increase awareness and scientific understanding of the all-encompassing nature of pituitary disorders in order to increase earlier diagnosis, disseminate knowledge of state of the art treatments, and pique interest in novel scientific study of the pathophysiology of these disorders and their many ramifications. MEETING LOCATION & TIME The Symposium will be held from 8:30 a.m. - 6:00 p.m. on Friday, October 29, 2004. The Symposium will take place in the Lipsett auditorium of the NIH Clinical Center, on the NIH Campus in Bethesda, Maryland. For driving directions and information on getting to the meeting using METRO, please visit the travel page. CONFERENCE OBJECTIVES Participants attending the conference should be able to: 1. Describe the structure of the pituitary gland and its central importance in normal functioning and disease. 2. Improve diagnostic skills for earlier detection of disease across the lifespan in men and women. 3. Discuss current treatment options for pituitary tumors. 4. Recognize the neuroendocrine effects resulting from pituitary tumors on the patient’s psychological state and psychosocial interactions and recommend appropriate intervention. 5. Develop a novel testable hypothesis to further continued scientific investigation in the understanding of pituitary disorders. This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the National Institutes of Health/Foundation for Advanced Education in the Sciences (NIH/FAES) and the Pituitary Network Association. The NIH/FAES is accredited by the ACME to provide continuing medical education for physicians Agenda 7:30 - 8:30 Registration & Continental Breakfast (sponsored by PNA) 8:30 - 9:15 OPENING REMARKS 8:30 - 8:40 Introduction & Welcome Vivian W. Pinn, M.D. Associate Director for Research on Women's Health, NIH Director, Office of Research on Women's Health 8:40 - 9:00 Family Hormonal Health: the Broader Picture Yvonne Maddox, Ph.D. Deputy Director National Institute of Child Health and Human Development 9:00 - 9:15 Hormonal Disease is no Apparent Impediment to Good Health Captain Mohamed K. Shakir, M.D., F.A.C.P., F.R.C.P. Director, Department of Endocrinology National Naval Medical Center Professor of Medicine Uniformed Services University of the Health Sciences 9:20 - 1:00 MORNING SESSION 9:20 - 9:30  Session chair: Ian McCutcheon, M.D. Professor of Neuosurgery University of Texas M.D. Anderson Cancer Center 9:30 - 10:05 The Pituitary Gland in Health and Disease Sylvia Asa , M.D., Ph.D. Professor, Department of Laboratory Medicine and Pathobiology University of Toronto Pathologist-in-Chief University Health Network and Toronto Medical Laboratories 10:05 - 10:35 Impact of Hormonal Disorders in Childhood George P. Chrousos, M.D. Chief, Pediatric and Reproductive Endocrinology Branch National Institute of Child Health and Human Development 10:35-11:00 Break 11:00 - 11:30 The Transition Years: Neither Child nor Adult Alan Rogol , M.D., Ph.D. Professor of Pediatrics University of Virginia 11:30-12:00  The Endocrinology of the Stress Response and Its Relevance to Depression, Anxiety, and Other States Phil Gold, M.D. Chief, Clinical Neuroendocrinology Branch National Institute of Mental Health 12:00 -1:00  Three Personal Perspectives on Living with Hormonal Disorders Sharmyn McGraw, Bram Levy and Robert Knutzen 1:00 - 2:00 Lunch 2:00 - 5:30 AFTERNOON SESSION 2:00 - 2:10  Session chair: Edward Oldfield, M.D. Chief, Surgical Neurology Branch, National Institute of Neurological Diseases and Stroke 2:10 - 2:40  The Young Male: What are his Options and Choices? Marc R. Blackman, M.D Chief, Endocrinology National Center for Complimentary and Alternative Medicine 2:40 - 3:10  A Young Woman's Hormonal World James Segars, M.D. Staff Clinician National Institute of Child Health and Human Development 3:10 - 3:40  Hormonal Needs and Disorders in the Mature Female Janet A. Schlecte, M.D. Endocrinologist University of Iowa 3:40 - 4:00  Break 4:00 -4:30  Surgical Treatment of Pituitary Disorders Edward Laws, M.D., Ph.D. Professor of Neurosurgery & Medicine University of Virginia 4:30 - 5:00  Difficult Pituitary Problems: Options and Solution Ian McCutcheon, M.D. Professor of Neurosurgery University of Texas M.D. Anderson Cancer Center 5:00 - 5:45 PANEL DISCUSSION Moderator: Shereen Ezzat, M.D. Professor of Medicine and Oncology Head, Endocine Oncology University of Toronto What do we Know, Where do we Go from Here and What is the Future Role of Research? Drs. McCutcheon, Asa, Chrousos, Rogol, Laws, Oldfield and Schlechte 5:45 - 6:00 CLOSING REMARKS, ADJOURNMENT Travel information HOTEL ACCOMMODATIONS For your convenience, a block of sleeping rooms has been reserved at the: Bethesda Marriott 5151 Pooks Hill Road Bethesda, MD 20814 301.897.9400 In order to receive the government rate of $150 per night (plus tax) single/double, you must call Marriott reservations directly at 800.228.9290 and reference the group name "NIH-ORWH Joint Hormonal Symposium". You must make your hotel reservation by October 7, 2004 in order to receive the group rate. Rates and availability after that date will be cannot be guaranteed. Shuttle service departs from the Bethesda Marriott for the NIH campus every 30 minutes, on the half-hour. Please inquire at the front desk for details. GETTING TO NIH We strongly encourage you to take METRO to the Natcher Conference Center, particularly in light of increased security measures recently instituted at NIH to ensure the safety of NIH employees and property. The Natcher Conference Center is a five-minute walk from the Medical Center station on METRO's Red Line. The Natcher Building is located on Center Drive directly behind the Medical Center stop. NIH Campus Map - Washington Metrorail Map If you must drive, take the Wisconsin Avenue exit from the Capital Beltway (I-495) and travel south on Wisconsin Avenue toward Bethesda. Drive approximately 1.5 miles on Wisconsin Avenue, then enter the NIH campus by turning right onto South Drive. At the bottom of the hill, turn left onto Center Drive. The Natcher Building is at 45 Center Drive and is located across from the Library of Medicine. Please note that all visitor vehicles, including taxicabs, hotel and airport shuttles, delivery trucks and vans will be inspected before being allowed on campus. Visitors will be asked to show a photo ID and state the purpose of their visit. Be sure to allow extra time for this vehicle inspection procedure. An alternative to driving onto the NIH campus is to drive to Bethesda and park in a public lot. From Bethesda you can either take the METRO (stop is located at East West Highway and Wisconsin Avenue) to the Medical Center stop or walk up Wisconsin Avenue to Center Drive (about a 10-15 minute walk). You may also drive and park at other METRO Stops on the Red Line that have public parking and take the Metro to the Medical Center station. Convenient stops include Rockville, White Flint, and Grovesnor. TRAVEL INFORMATION Participants are responsible for their own travel expenses; however, ESI Travel is available to assist you in making your travel arrangements for this meeting if you wish. Please be aware ESI Travel charges a $45 service fee with all ticket reservations. If you wish to use this service, please contact our travel agent, Bridget Hanafin, by e-mail at bhanafin@esitravel-dc.com. Please have the following information available when you call or email: Event name: ORWH Symposium Your arrival and departure dates and departure city Your seating preference (aisle, window) and preferred time frame for traveling Your email address and/or fax number Payment information (major credit card) If you are planning to travel by air, remember that heightened security has been implemented at all airports. Please be prepared to furnish e-ticket itineraries and receipts, along with government-issued photo identification, upon check-in. Travelers are advised to arrive at the airport at least two hours prior to their scheduled departure to ensure ample time to clear security. Also, please keep in mind that check-in procedures and policies vary according to each airport and airline. Upon arrival at the airport, we suggest that you ask airline personnel whether you are permitted to check in at the gate, as opposed to the main ticket Registration Online registration for this meeting is now open. Registration is open to the public and there is no fee. To register for the meeting, please click on the link below Register now! If you encounter any problems with the registration page, please contact us.
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Presented by the Office of Research on Women's Health, Office of the Director, National Institutes of Health; the Pediatric and Reproductive Endocrinology Branch, the National Institute of Child Health and Human Development, National Institutes of Health; the Department of Endocrinology, United States Naval Medical Center, Department of Defense; and the Pituitary Network Association.

STATEMENT BY TOMMY G. THOMPSON, Secretary of Health and Human Services
Urging Americans To Get Influenza Vaccine

A flu vaccination will protect the health of millions of Americans this flu season. That's why we have worked with manufacturers to ensure that there is more vaccine available in the United States this year than ever before.

We are urging people to visit a health professional and get vaccinated to protect themselves and their loved ones from the flu. Among those we recommend get vaccinated are people 50 years and older, women who will be pregnant during the flu season, and all children six to 23 months of age.

A full list of people who should get vaccinated is available at http://www.cdc.gov/flu/

Date: October 5, 2004
For Release: Immediately
Contact: HHS Press Office
(202) 690-6343

STATEMENT FROM THE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Regarding Chiron Flu Vaccine

Clearly, the loss of the Chiron flu vaccine poses a serious challenge to our vaccine supply for the upcoming flu season. Chiron was to produce between 46-48 million doses of influenza vaccine for the United States. The Department has begun pursuing contingencies for this loss of supply.

We currently anticipate having approximately 54 million doses of influenza vaccine from Aventis and about another 1-2 million doses of FluMist nasal spray. HHS had planned for a vaccine supply of about 100 million doses this season, after a demand of about 87 million doses last flu season.

Our immediate focus will be on making sure that the supply we do have reaches those who are most vulnerable. The Centers for Disease Control and Prevention is convening its Advisory Committee on Immunization Practices to prioritize its recommendations on who should get the flu vaccine for this season based on the new vaccine supply information.

We will need the help of the public, the public health community and the medical community to make sure that the vaccine goes to those who truly need it most.

We are in the process of learning more detailed information about why the UK regulatory authority suspended Chiron's license for three months and whether anything can be done to address the issues involved. The Department of Health and Human Services, including its Food and Drug Administration, Centers for Disease Control and Prevention, and National Institutes for Health, are working with their counterparts in the British government as well as Chiron regarding this matter.

The Department also has begun exploring whether more flu vaccine can be manufactured for this flu season. This includes working with Aventis on its ability to provide more vaccine. At this point, however, it is not known whether it's possible to get more vaccine.

HHS and its agencies will make more information available regarding the influenza vaccine supply as it becomes available.

Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.

Some Questions and Answers About Flu
.c The Associated Press

ATLANTA (AP) - Health officials say this year's flu outbreak, which has spread faster and earlier than usual, appears to be the worst in at least three years. Here are answers to some common flu season questions:

Q: What's the difference between a cold and flu?

A: Colds usually begin slowly and last only two to seven days, although it can be two weeks. They start with a scratchy, sore throat, followed by sneezing and a runny nose. You may get a mild cough later. Infants and young children can sometimes run temperatures up to 102 F. with a cold.

Flu often begins with a sudden headache and dry cough, possibly a runny nose and sore throat; also achy muscles and extreme fatigue. You may run a fever up to 104. Most people feel better in a couple of days, but the tiredness and cough can last for two weeks or longer. Flu can cause severe illness and life-threatening complications in some people.

Children may have symptoms - nausea, vomiting or diarrhea - that are not common for adults.

Flu can be confirmed with a test if given within two to three days after symptoms begin, but getting it isn't always practical.

Q: What flu symptoms are dangerous?

A: A combination of symptoms - sustained fever and chills, chest pain that gets worse when taking a deep breath and sputum that's a yellow color - can indicate pneumonia and a doctor should be consulted.

Q: Can I get the flu even though I got a flu shot this year?

A: Yes, although it often lessens the severity of the virus and can prevent deadly complications. Typically, the flu shot protects between 70 percent and 90 percent of healthy people under age 65. The elderly are more susceptible.

The power of the flu shot also depends on how well it matches the flu virus in circulation. The current Fujian flu strain that is affecting most people is not the strain in this year's flu shot. But disease experts say it is a close enough match that considerable protection should be provided.

Q: What are complications from the flu?

A: They include bacterial pneumonia, dehydration and worsening of chronic medical conditions such as congestive heart failure, asthma or diabetes. Seniors and those with chronic medical conditions are at highest risk.

Q: How is flu spread?

A: It spreads when an infected person coughs, sneezes or talks and the virus is sent into the air.

Q: How soon can I get sick from the flu?

A: It takes one to four days - on average two days - for a person exposed to the flu virus to develop symptoms.

Q: How do I protect myself?

A: The best way for individuals, particularly those at high risk for its serious complications, is to get a flu shot. It is particularly recommended for the elderly and children 6 months to 23 months.

Q: How many people get sick or die from the flu?

A: It's estimated 10 percent to 20 percent of U.S. residents get the flu and 114,000 are hospitalized each season for flu-related complications. Typically, it kills about 36,000 people in the United States each year, but experts say this year could be worse.

Source: Centers for Disease Control and Prevention.

On the Net: http://www.cdc.gov/flu/about/qa/

CDC information: http://www.cdc.gov/ncidod/diseases/flu/facts.htm

Merck Pulls Arthritis Drug from Market

By Ransdell Pierson

NEW YORK (Reuters) - Merck & Co Inc. on Thursday pulled its arthritis drug Vioxx off the market because it increases the risk of heart attack and stroke, a move that sent the company's shares plunging, erasing $25 billion of its market value.

Vioxx, used by two million people around the world, accounts for 10 percent of Merck's annual sales.

The withdrawal of the drug casts a cloud over an entire class of widely used arthritis and pain drugs known as COX-2 inhibitors. "This has implications for all members of this class," said Dr. Garret FitzGerald, chairman of the Department of Pharmacology at the University of Pennsylvania.

Merck said that in a colon cancer trial, patients who took Vioxx for three years faced twice the risk of cardiovascular events, such as heart attack and stroke, as patients taking a placebo.

"Patients who are currently taking Vioxx should contact their health care providers to discuss discontinuing use of Vioxx and possible alternative treatments," it said.

Concerns over the drug's side effects have been building in recent years after several studies showed risks attached to it. Other drugs in the same class, including Pfizer Inc.'s Celebrex and Bextra and Novartis AG's Prexige, have so far not shown the same dangers.

However, the U.S. Food and Drug Administration (news - web sites) said it would closely watch other such drugs.

Worldwide sales of Vioxx totaled $2.55 billion last year. Since its introduction in 1999, 84 million people have used the medication. In the United States alone, 91 million Vioxx prescriptions have been written. The drug is sold in some countries under the name Ceoxx.

"This is a very significant negative for Merck. Not only is this a nearly $3 billion drug, but it calls into question the future of one the key drugs in its pipeline, Arcoxia," said Scott Henry, an analyst at Oppenheimer & Co.

Arcoxia, which is similar to Vioxx, is sold outside the United States but has not yet been approved by the FDA (news - web sites) because of concerns about heart and stroke risk. Some analysts had expected the agency to rule on Arcoxia by late October.

Merck is already struggling with slowing earnings growth and faces the loss of patent protection for its biggest-selling drug, cholesterol fighter Zocor, in 2006.

Despite the setback, Merck Chairman and Chief Executive Raymond Gilmartin said he had no intention of resigning.

Merck is already gearing up for lawsuits over Vioxx. "We have substantial defenses in these cases and will defend them vigorously," said Kenneth Frazier, Merck's general counsel.

Merck shares fell 25 percent on the New York Stock Exchange (news - web sites). Shares of Pfizer, which sells two rival arthritis drugs, edged higher.

Vioxx sales have been flat in recent years amid safety concerns. Clinical trial data have shown the drug increased the incidence of blood clots tied to strokes and heart attacks.

A recent study by the U.S. Food and Drug Administration suggested patients taking Vioxx faced a 50 percent greater risk of heart attack and sudden cardiac death than those taking Celebrex.

Sales of the Pfizer drugs Celebrex and Bextra have steadily grown as doctors have turned to those medications, which have not been linked to heart attack and stroke.

The colon cancer trial was designed to evaluate the effectiveness of the standard 25-milligram Vioxx dose in preventing recurrence of colon polyps. Such polyps sometimes become cancerous.

Vioxx was used in the trial because some researchers theorize that inflammation, present in arthritis, may be linked to colon cancer.

Merck said the heart attacks and strokes were not spotted during the first 18 months of the trial but became apparent later.

"Given the availability of alternative therapies, and the questions raised by the data, we concluded that a voluntary withdrawal (of Vioxx) is the responsible course to take," Merck chief Gilmartin said.

Merck said it expects the cost associated with the recall to reduce earnings by 50 cents to 60 cents per share in the second half of the year, and will give more financial details on Oct. 21.

Merck said it planned to cut costs and said it remains comfortable with its earnings forecast for full-year 2004 of $3.11 to $3.17 per share.

Vioxx and the two Pfizer arthritis drugs are designed to block inflammation and pain as effectively as standard nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen, while causing far fewer ulcers and gastrointestinal problems than the older treatments.

The newer medicines block a protein called COX-2 that has been linked to inflammation.

Merck said it would continue to market Arcoxia, which is sold in 47 countries. (Additional reporting by Toni Clarke and Edward Tobin)

RESEARCH STUDIES AVAILABLE

Your patients may qualify for research studies in the Neuroendocrine Clinical Center, Massachusetts General Hospital, Boston, MA 02114. We are currently accepting the following categories of patients for screening to determine study eligibility. Depending on the study, subjects may receive free testing, medication and/or stipends.

SUBJECTS	STUDIES	CONTACT 617-726-3870
Newly diagnosed acromegaly patients	Evaluating preoperative medical treatments	Dr. Laurence Katznelson
Patients with acromegaly requiring medical therapy	Evaluating two different medical therapies	Karen Szczesiul, R.N.
Patients with history of cured acromegaly and current hypopituitarism	Investigating GH effects in patients with history of cured acromegaly and GH deficiency	Dr. Catherine Beauregard Dr. Anne Klibanski
Patients with hypopituitarism (panhypopituitary or partial hypopituitarism)	GH deficiency/replacement studies	Dr. Beverly M.K. Biller Dr. Karen K. Miller
Women with anorexia nervosa	New hormonal therapies	Dr. Karen K. Miller Dr. Anne Klibanski
Adolescent girls with anorexia nervosa	Evaluating bone density and the effects of estrogen replacement	Dr. Anne Klibanski Dr. Madhu Misra
Women with hypopituitarism, ages 18-50	Testosterone replacement therapy study	Dr. Karen K. Miller
HIV positive women with weight loss or fat redistribution	Evaluating testosterone therapy Evaluation of bone loss Evaluation of cardiovascular risk markers	Dr. Steven Grinspoon
HIV positive men and women with fat redistribution	Novel treatments to redistribute fat Determination of growth hormone levels and efficacy of GH secretogogues Novel lipid lowering therapy	Dr. Steven Grinspoon Dr. Colleen Hadigan Dr. Polyxeni Koutkia

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