World's Sexiest Penthouses

It's the makings of a scene from Pretty Woman—the ultimate penthouse suite. City views to swoon over, outrageous bedrooms, sunken tubs begging for bubbles, and of course a glamorous couple ordering up a bottle of 1982 Dom Perignon Rosé. But even when it comes to big-dollar penthouses, there's an upper tier. We've scoured the world to find the sexiest summit suites, from high-design, high-tech pads in Vegas to lush high-rise living in New York City. All you need now is that right someone to join you in this alternative Mile-High Club.
—Mark Ellwood

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Stamp out common virus to beat brain cancer

New strategy could help beat tenacious brain tumours.

Matt Kaplan

Brain cancers could be treated by targeting the viruses that often lurk within.Getty

Cancer experts have suggested a new way to tackle particularly tenacious brain tumours known as glioblastomas. Attacking a common virus often found in these cancers may halt their growth, say researchers.

This technique might provide an alternative to current surgical treatments for glioblastoma, which, because of the tumours' position deep in the brain, carry a significant risk of brain damage.

This strategy may help doctors pursue their preferred tactic of allowing the body's own immune system to attack cancer cells, systematically eradicating them from the brain tissue without harming nearby healthy cells.

Until now it has been impossible for the immune system to distinguish brain tumour cells from healthy cells as they often have the same identifying marker proteins - called antigens - and because brain tumours often suppress immune function.

Delaying tactics

In the new study, oncologist Duane Mitchell at Duke University Medical Center and colleagues build on previous research showing the consistent presence of cytomegalovirus, a type of herpesvirus, in glioblastoma cells but not in surrounding healthy tissue.

Roughly 50-80% of healthy people in the United States are infected with cytomegalovirus, although in healthy people it remains latent. Virus particles multiply to high numbers only in those with compromised immune systems. So Mitchell and his team wondered if they could halt the cancer by guiding the immune system to attack the unique antigens of the virus in glioblastoma cells.

The team took white blood cells from 21 patients, exposed them to parts of the virus, and injected the cells back into the patients. Their preliminary results suggest that this technique is safe and effective.

“Because the immune system kills both the virus and the cell it resides in, we are hoping that we will be able use this vaccine to kill the tumour cells that standard therapy can't reach,” explains Mitchell.

Mitchell and his colleagues will unveil their findings¹ on 1 June at a meeting of the American Society of Clinical Oncology in Chicago. Although the results are preliminary, tumour progression for those in the trial was delayed by more than a year on average - and several patients had no sign of tumour growth after two years.

The delay in tumour growth using standard therapy is typically six to eight months compared with non-treatment, with average survival of less than 15 months.

Attack is the best form of defence

Nobody is certain whether the virus triggers the cancer or the cancer attracts the virus. But, “the fact that the brain tumour cells create an immunosuppressive environment where the virus can make its home makes a lot of sense,” explains Charles Cobbs at California Pacific Medical Center Research Institute in San Francisco, who first discovered the association between cytomegalovirus and the tumours.

If the virus is causing the cancer, then destroying it is all the more important. But even if it merely exists side by side with the cancer, “its unique antigens look like the perfect way for the immune system to go about attacking the tumour,” explains Cobbs.

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Docs list who would be allowed to die in a catastrophe

CHICAGO, Illinois (AP) -- Doctors know some patients needing lifesaving care won't get it in a flu pandemic or other disaster. The gut-wrenching dilemma will be deciding whom to let die.

In the event of a mass-casualty situation, medical resources woul be have to be rationed.

Now, an influential group of physicians has drafted a grimly specific list of recommendations for which patients wouldn't be treated. They include the very elderly, seriously hurt trauma victims, severely burned patients and those with severe dementia.

The suggested list was compiled by a task force whose members come from prestigious universities, medical groups, the military and government agencies. They include the Department of Homeland Security, the Centers for Disease Control and Prevention and the Department of Health and Human Services.

The proposed guidelines are designed to be a blueprint for hospitals "so that everybody will be thinking in the same way" when pandemic flu or another widespread health care disaster hits, said Dr. Asha Devereaux. She is a critical care specialist in San Diego, California, and lead writer of the task force report.

The idea is to try to make sure that scarce resources -- including ventilators, medicine and doctors and nurses -- are used in a uniform, objective way, task force members said.

Their recommendations appear in a report appearing Monday in the May edition of Chest, the medical journal of the American College of Chest Physicians.

"If a mass casualty critical care event were to occur tomorrow, many people with clinical conditions that are survivable under usual health care system conditions may have to forgo life-sustaining interventions owing to deficiencies in supply or staffing," the report states.

To prepare, hospitals should designate a triage team with the Godlike task of deciding who will and who won't get lifesaving care, the task force wrote. Those out of luck are the people at high risk of death and a slim chance of long-term survival. But the recommendations get much more specific, and include:

• People older than 85.

• Those with severe trauma, which could include critical injuries from car crashes and shootings.

• Severely burned patients older than 60.

• Those with severe mental impairment, which could include advanced Alzheimer's disease.

• Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.

Dr. Kevin Yeskey, director of the preparedness and emergency operations office at the Department of Health and Human Services, was on the task force. He said the report would be among many the agency reviews as part of preparedness efforts.

Public health law expert Lawrence Gostin of Georgetown University called the report an important initiative but also "a political minefield and a legal minefield."

The recommendations would probably violate federal laws against age discrimination and disability discrimination, said Gostin, who was not on the task force.

If followed to a tee, such rules could exclude care for the poorest, most disadvantaged citizens who suffer disproportionately from chronic disease and disability, he said. While health care rationing will be necessary in a mass disaster, "there are some real ethical concerns here."

James Bentley, a senior vice president at American Hospital Association, said the report will give guidance to hospitals in shaping their own preparedness plans even if they don't follow all the suggestions.

He said the proposals resemble a battlefield approach in which limited health care resources are reserved for those most likely to survive.

Bentley said it's not the first time this type of approach has been recommended for a catastrophic pandemic, but that "this is the most detailed one I have seen from a professional group."

While the notion of rationing health care is unpleasant, the report could help the public understand that it will be necessary, Bentley said.

Devereaux said compiling the list "was emotionally difficult for everyone."

That's partly because members believe it's just a matter of time before such a health care disaster hits, she said.

"You never know," Devereaux said. "SARS took a lot of folks by surprise. We didn't even know it existed."

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