Personal Health


Friday, July 30, 2010


For blood pressure, can you be fit but fat?


By Genevra Pittman

Reuters Health

Friday, July 30, 2010

NEW YORK (Reuters Health) – If you're trying to bring your blood pressure to healthy levels, a new study suggests that how much you weigh is more important than how fit you are.

As expected, the study found that overweight or obese people were more likely to have a high systolic blood pressure - the top number in a blood pressure reading. But for those with a high body mass index (BMI) - a measure of weight versus height -- how in shape they were only had a small impact on their blood pressure.

The results suggest that people who are trying to decrease their risk for high blood pressure should focus on losing weight however they can most effectively do that, the authors say, and that increasing physical fitness should be a secondary goal.

"Obesity is such a strong predictor of blood pressure or hypertension risk that having a normal body weight is really what's going to drive your blood pressure" rather than your fitness level, Dr. Susan Lakoski, a cardiologist at the University of Texas Southwestern Medical Center and one of the study's authors, told Reuters Health.

At least in terms of lowering your risk for high blood pressure, she said, "it's not realistic to be fit and fat."

One in three American adults has high blood pressure - above 140/90 - including more than half of those over 55. Having high blood pressure puts a person at greater risk for stroke, heart attack, and kidney disease.

The Centers for Disease Control and Prevention reports that high blood pressure will cost the U.S. more than $75 billion in 2010 - from hospital stays and doctors' appointments, drugs, and lost time at work. Doctors often recommend medication and lifestyle changes, including exercise, for patients with high blood pressure.

In the study, published in the American Heart Journal, Lakoski and her colleagues analyzed data from approximately 35,000 patients, mostly white men, collected over the last 20 years at the Cooper Clinic in Dallas, Texas. When patients came into the clinic, doctors measured their body composition, blood pressure, and fitness levels.

To determine how fit patients were, the doctors timed how long they could keep up a comfortable walking pace on a treadmill at varying inclines and speeds.

Using this data, the authors compared BMI, fitness levels, and systolic blood pressure of all patients to see if the three measurements were linked. Among all participants, having a higher BMI was associated with having a higher systolic blood pressure, a correlation that has been found many times in the past.

But being fit had less of an effect on systolic blood pressure readings than BMI, and when the authors looked at people of the same age and gender, fitness didn't seem to have any effect on blood pressure.

Only people of normal weight seemed to get much of a blood pressure benefit from having better fitness levels - possibly because fitness alone couldn't overcome the negative effects of being obese, Lakoski said.

That doesn't mean that people who are overweight shouldn't try to improve their fitness, said Dr. Paul McAuley, who teaches health education at Winston-Salem State University in North Carolina. McAuley pointed out that the study is only a snapshot of one group of people at one time. The study doesn't show how the participants fared over the long term.

His research has shown that people who are obese but fit aren't any more likely to die from heart disease and stroke - or any cause - than people who are thinner and fit.

"We've got to back off and say, 'what is blood pressure measuring?'" McAuley told Reuters Health. "It's an indicator just like a weatherman would use. It's not the disease itself."

Whether or not being in better shape affects a person's blood pressure, McAuley said, "fitness does something to prevent disease and mortality."

Lakoski agreed that for overall health and mortality risk, fitness is an important part of the picture. "The ultimate thing we'd like to see is people obtain a lean body weight and start improving their fitness in the real world," she said.

Dr. Tim Church, the former head of medical research at The Cooper Institute who now studies exercise and disease at Louisiana State University's Pennington Biomedical Research Center, told Reuters Health that the findings don't change the current thinking on exercise and long-term health.

"Being overweight is bad for you (and) being sedentary is bad for you," he said.


American Heart Journal, July 2010.

What prevents falls after strokes? Study: Not much


By Lynne Peeples

Reuters Health

Friday, July 30, 2010


NEW YORK (Reuters Health) – While most stroke survivors will suffer falls, strategies to prevent these dangerous events continue to fall short, suggests a new study out of Australia.

Up to three in four stroke survivors fall within six months of their stroke, and these falls can lead to serious injuries, including broken bones.

"Although research has shown that fall prevention programs including exercise are effective for older people, it was unclear whether these, or any other interventions, work for people with stroke," lead researcher Dr. Francis Batchelor of the University of Melbourne, in Australia, told Reuters Health by email.

So Batchelor and his colleagues carefully reviewed the relevant research to date and pooled together the results of 13 studies that enlisted a total of nearly 1,500 people.

The studies analyzed a wide range of interventions to prevent falls after strokes, from strength training to medications, report the researchers in the journal Stroke.

However, the only strategy their review found to be effective was vitamin D supplementation, and even that only worked for women in nursing homes and other institutions at least two years after they had suffered a stroke.

"The effectiveness of vitamin D in fall prevention in all people with stroke has not yet been determined," noted Batchelor.

Overall, the team was surprised to find so few quality trials addressing the common problem. Most of the studies were primarily designed to look at an outcome other than falls, and the majority used stand-alone interventions that may not have been effective enough for this high-risk group.

Batchelor noted that future trials should evaluate a multifaceted fall-reducing program for people with stroke.

He also recommended looking closer at the potential benefit of vitamin D supplementation on falls for both men and women, and in earlier stages after stroke.

For now, Batchelor's best advice for stroke survivors is to "consult a health professional who can assess and address their individual fall risk factors."


Stroke, online July 8, 2010.

Thursday, July 29, 2010


Aging and Longevity Tied to Specific Brain Region in Mice



Thursday, July 29, 2010


ScienceDaily (July 29, 2010) — Researchers watched two groups of mice, both nearing the end of a two-day fast. One group was quietly huddled together, but the other group was active and alert. The difference? The second set of mice had been engineered so their brains produced more SIRT1, a protein known to play a role in aging and longevity.


"This result surprised us," says the study's senior author Shin-ichiro Imai, MD, PhD, an expert in aging research at Washington University School of Medicine in St. Louis. "It demonstrates that SIRT1 in the brain is tied into a mechanism that allows animals to survive when food is scarce. And this might be involved with the lifespan-increasing effect of low-calorie diets."


Imai explains that the mice with increased brain SIRT1 have internal mechanisms that make them use energy more efficiently, which helps them move around in search of food even after a long fast. This increased energy-efficiency could help delay aging and extend lifespan.


The research findings are published in the July 28 issue of the Journal of Neuroscience.


Imai's past research demonstrated that SIRT1 is at the center of a network that connects metabolism and aging. A form of the gene is found in every organism on earth. The gene coordinates metabolic reactions throughout the body and manages the body's response to nutrition. SIRT1 is activated under low-calorie conditions, which have been shown to extend the life spans of laboratory animals.


The researchers found that the key to the mice's extra activity lies in a small region of the brain called the hypothalamus, which controls basic life functions such as hunger, body temperature, stress response and sleep-wake cycles.


At the start of the research project, the study's lead author Akiko Satoh, PhD, a postdoctoral research associate in developmental biology, saw that mice on low-calorie diets had increased amounts of SIRT1 in specific regions of the hypothalamus and that neurons in the same regions were activated.


So the research team developed mice that continually produced higher amounts of SIRT1 in their brains to see what the effect would be. That's when Satoh observed the mice's unusual level of activity under fasting conditions.


"This is the first time that it has been demonstrated that SIRT1 is a central mediator for behavior adaptation to low-calorie conditions," Satoh says.


Interestingly, these mice, called BRASTO (brain-specific SIRT1-overexpressing) mice, also maintained higher body temperatures after a 48-hour fast than ordinary mice, which experience a drop in body temperature during fasting.


"The BRASTO mice have a better capability to come up with energy to achieve a higher body temperature and increased activity level when food is restricted," says Imai, associate professor of developmental biology and of medicine.


The team also examined mice that had no ability to produce SIRT1 in their brains. During diet-restricting conditions, these mice did not increase their activity, and their body temperature dropped more than normal, giving further evidence that SIRT1 was essential for high-activity, high-temperature responses.


As the researchers looked further into the role of SIRT1 in the hypothalamus, they found that during diet restriction, SIRT1 enhanced the production of a specific neural receptor in the hypothalamus involved in regulating metabolic rate, food intake and insulin sensitivity. Furthermore, mice with increased brain SIRT1 had a higher neural response to the gut hormone, ghrelin, which is known to stimulate the hypothalamus during low-calorie conditions. Both findings add weight to a significant role for SIRT1 in the hypothalamic response to a restricted diet.


The scientists are continuing to study the BRASTO mice to see if they live longer than ordinary mice.

Their work suggests that the brain, and particularly the hypothalamus, might play a dominant role in governing the pace of aging. They believe their studies could eventually provide clues for increasing productive aging in people.


"If we can enhance the function of the human hypothalamus by manipulating SIRT1, we could potentially overcome some health problems associated with aging," Imai says. "One example is anorexia of aging in which elderly people lose the drive to eat. It is possible that enhancing SIRT1 could alleviate behavioral problems like this."


Journal Reference:

Satoh A, Brace CS, Ben-Josef G, West T, Wozniak DF, Holtzman DM, Herzog ED, Imai S. SIRT1 promotes the central adaptive response to diet restriction through activation of the dorsomedial and lateral nuclei of the hypothalamus. Journal of Neuroscience, July 28, 2010

Damp house linked to kids' risk of nasal allergies


By Amy Norton

Reuters Health

Thursday, July 29, 2010

NEW YORK (Reuters Health) – Children who live in damp, water-damaged homes may be more likely than other kids to develop nasal allergies, a new study suggests.

Researchers found that of nearly 1,900 Finnish children they followed for six years, those who lived in homes with dampness or mold problems were more likely to develop allergic rhinitis during the study period.

Allergic rhinitis refers to symptoms of congestion, sneezing and runny nose caused by allergens such as pollen, dust, animal dander or mold.

In this study, published in the American Journal of Epidemiology, 16 percent of children whose parents reported dampness in the home went on to be diagnosed with allergic rhinitis over the next six years. That compared with just under 12 percent of children whose parents reported no dampness problems -- that is, no visible signs of water damage to the ceilings, walls or floors, and no visible mold or mold odor in the home.

The researchers weighed a number of factors that might help account for the connection, including families' socioeconomic status (asthma and allergies tend to be common in lower income children) and whether children were also exposed to second-hand smoke.

However, damp, moldy conditions in the home remained linked to an increased risk of children's nasal allergies. Children whose parents reported any mold or water damage in the home at the outset were 55 percent more likely than other children to develop allergic rhinitis -- connected to any allergen, and not just mold.

"Our study strengthens the evidence that exposure to indoor dampness increases the risk of developing allergic rhinitis," lead researcher Dr. Jouni Jaakkola, of the Institute of Health Sciences in Oulu, Finland, told Reuters Health in an email.

Previous studies, he said, had measured children's exposure to dampness and mold, and their rates of nasal allergies, all at one time -- making it impossible to tell whether the exposure preceded the allergies' development.

The fact that this study followed children's rates of allergy development over time strengthens the case that household dampness is a risk factor for nasal allergies -- though the findings alone do not prove cause-and-effect. It is still possible that there are other factors that explain the link.

However, Jaakkola said that based on other research, it is plausible that damp conditions in the house contribute to nasal allergies. Such conditions, he noted, encourage the growth of dust mites and fungi, and attract cockroaches -- all of which can serve as allergy triggers. Moisture may also boost the emission of chemicals from building materials, according to Jaakkola, and those chemicals could potentially create inflammation in the airways.

The bottom line for parents, Jaakkola said, is that they would be wise to look out for signs of water damage at home.

"In general, we should try to avoid dampness problems in homes and repair (damage) as soon as the problems appear," he noted, adding that parents of children who already have any form of allergy should be particularly careful to do so.


American Journal of Epidemiology, online July 16, 2010.

Molecular Mechanism Triggering Parkinson's Disease Identified


ScienceDaily (July 29, 2010) — Scientists at the Stanford University School of Medicine have identified a molecular pathway responsible for the death of key nerve cells whose loss causes Parkinson's disease. This discovery not only may explain how a genetic mutation linked to Parkinson's causes the cells' death, but could also open the door to new therapeutic approaches for the malady.


In a study to be published July 29 in Nature, investigators used an animal model, the common fruit fly, to show that the mutation results in impaired activity of recently discovered molecules called microRNAs, which fine-tune protein production in cells. This impairment, in turn, leads to the premature death of nerve cells specifically involved in the secretion of the brain chemical dopamine. The degeneration of these so-called dopaminergic nerve cells in the brain is a hallmark of Parkinson's.


"MicroRNA, whose role in the body has only recently begun to be figured out, has been implicated in cancer, cardiac dysfunction and faulty immune response," said Bingwei Lu, PhD, associate professor of pathology and the study's senior author. "But this is the first time it has been identified as a key player in a neurodegenerative disease."


Parkinson's is a movement disorder characterized outwardly by tremor, difficulty in initiating movement, and postural imbalance and, in the brain, by a massive loss of the dopaminergic nerve cells in areas that fine-tune motor activity. It affects an estimated 1 million people in the United States. The incidence of Parkinson's, rare in younger people, increases dramatically with age, although nobody is sure why. Nor is it known why the most common mutation implicated in Parkinson's -- LRRK2 G2019S, found in about one-third of all Parkinson's cases occurring among North African Arabs and North American Ashkenazi Jews -- increases the likelihood of contracting the disease.


The new findings show that the LRRK2 mutation trips up the normal activity of microRNAs, resulting in the overproduction of at least two proteins that can cause certain cells, like brain cells, to die.


Understanding how microRNA can go wrong requires an understanding of its relationship to its much longer and better-known cousins, "messenger RNA" (or mRNA) molecules. The latter carry genetic recipes from a cell's DNA to specialized molecular machines that translate the instructions into the proteins that make up a cell. In contrast, a microRNA molecule is a very short string of RNA that doesn't contain instructions for making proteins but that can bind to parts of messenger RNA sequences that complement its own. As a result, the messenger RNA's sequence can no longer be read by the cell's protein-manufacturing apparatus, gumming up assembly of the protein it encodes.


It's only recently that scientists have started to understand microRNA's critical role.


The researchers in Lu's lab conducted their experiments in Drosophila, the fruit fly, which has previously proved itself a useful model for several neurodegenerative disorders, yielding substantial insights into Parkinson's, Alzheimer's and Huntington's diseases. They observed that certain proteins were being produced at higher-than-normal levels in the fly LRRK2 model of Parkinson's disease. What particularly drew their attention were two proteins that are important in regulating cell division. Mature nerve cells, which no longer divide, should not have high levels of these proteins; when they do, they are prone to premature cell death.


The researchers looked at the mRNAs containing the genetic recipes for the two overproduced proteins, and predicted that they would be bound by two specific microRNAs: let-7 and miR-184. When they then manipulated the activities of those two microRNA species in flies' brains, they had results consistent with the damage associated with Parkinson's. Diminishing the activity of let-7 in dopaminergic nerve cells, for example, caused both the increased production of one of the suspect proteins and degeneration of the cells.


The researchers showed that toning down the levels of these two proteins, in itself, prevented dopaminergic nerve cell death in the flies. "The flies no longer got symptoms of Parkinson's," said Lu. "This alone has immediate therapeutic implications. Many pharmaceutical companies are already making compounds that act on these two proteins, which in previous studies have been shown to be associated with cancer. It may be possible to take these compounds off the shelf or quickly adapt them for use in non-cancer indications such as Parkinson's."


The researchers then went a step further, showing how the genetic mutation of LRRK2 caused interference of microRNA molecules' ability to inhibit their target mRNAs. It leads to the disruption of a huge complex of molecular machinery that must operate smoothly in order for microRNA to do its job. This link between the common Parkinson's-producing mutation and consequent microRNA malfunction is a new finding.


"The clinical impact of our findings may be five to 10 years down the road," Lu said. "But their impact on our understanding of the disease process is immediate. We can now start testing compounds in mammals and cultured human dopaminergic cells to see if they can inhibit overproduction of these proteins and stave off dopaminergic cell death." Currently available drugs for Parkinson's disease temporarily alleviate its symptoms but can have undesirable side effects, and they don't prevent dopaminergic cells from dying.


The study's first author is Stephan Gehrke, PhD, a postdoctoral researcher in Lu's laboratory. Second author Yuzuru Imai, PhD, a former postdoctoral scientist in Lu's lab, is now an associate professor at Tohoku University in Sendai, Japan. The study received financial support from the National Institutes of Health and the McKnight, Beckman and Sloan foundations.


Journal Reference:

Gehrke et al. Pathogenic LRRK2 negatively regulates microRNA-mediated translational repression. Nature, 2010; 466 (7306): 637 DOI: 10.1038/nature09191


Damp house linked to kids' risk of nasal allergies


By Amy Norton

Reuters Health

Thursday, July 29, 2010

NEW YORK (Reuters Health) – Children who live in damp, water-damaged homes may be more likely than other kids to develop nasal allergies, a new study suggests.

Researchers found that of nearly 1,900 Finnish children they followed for six years, those who lived in homes with dampness or mold problems were more likely to develop allergic rhinitis during the study period.

Allergic rhinitis refers to symptoms of congestion, sneezing and runny nose caused by allergens such as pollen, dust, animal dander or mold.

In this study, published in the American Journal of Epidemiology, 16 percent of children whose parents reported dampness in the home went on to be diagnosed with allergic rhinitis over the next six years. That compared with just under 12 percent of children whose parents reported no dampness problems -- that is, no visible signs of water damage to the ceilings, walls or floors, and no visible mold or mold odor in the home.

The researchers weighed a number of factors that might help account for the connection, including families' socioeconomic status (asthma and allergies tend to be common in lower income children) and whether children were also exposed to second-hand smoke.

However, damp, moldy conditions in the home remained linked to an increased risk of children's nasal allergies. Children whose parents reported any mold or water damage in the home at the outset were 55 percent more likely than other children to develop allergic rhinitis -- connected to any allergen, and not just mold.

"Our study strengthens the evidence that exposure to indoor dampness increases the risk of developing allergic rhinitis," lead researcher Dr. Jouni Jaakkola, of the Institute of Health Sciences in Oulu, Finland, told Reuters Health in an email.

Previous studies, he said, had measured children's exposure to dampness and mold, and their rates of nasal allergies, all at one time -- making it impossible to tell whether the exposure preceded the allergies' development.

The fact that this study followed children's rates of allergy development over time strengthens the case that household dampness is a risk factor for nasal allergies -- though the findings alone do not prove cause-and-effect. It is still possible that there are other factors that explain the link.

However, Jaakkola said that based on other research, it is plausible that damp conditions in the house contribute to nasal allergies. Such conditions, he noted, encourage the growth of dust mites and fungi, and attract cockroaches -- all of which can serve as allergy triggers. Moisture may also boost the emission of chemicals from building materials, according to Jaakkola, and those chemicals could potentially create inflammation in the airways.

The bottom line for parents, Jaakkola said, is that they would be wise to look out for signs of water damage at home.

"In general, we should try to avoid dampness problems in homes and repair (damage) as soon as the problems appear," he noted, adding that parents of children who already have any form of allergy should be particularly careful to do so.


American Journal of Epidemiology, online July 16, 2010.

Western Diet Link to ADHD, Australian Study Finds


ScienceDaily (July 29, 2010) — A new study from Perth's Telethon Institute for Child Health Research shows an association between ADHD and a 'Western-style' diet in adolescents.


The research findings have just been published online in the international Journal of Attention Disorders.

Leader of Nutrition studies at the Institute, Associate Professor Wendy Oddy, said the study examined the dietary patterns of 1800 adolescents from the long-term Raine Study and classified diets into 'Healthy' or 'Western' patterns.


"We found a diet high in the Western pattern of foods was associated with more than double the risk of having an ADHD diagnosis compared with a diet low in the Western pattern, after adjusting for numerous other social and family influences," Dr Oddy said.


"We looked at the dietary patterns amongst the adolescents and compared the diet information against whether or not the adolescent had received a diagnosis of ADHD by the age of 14 years. In our study, 115 adolescents had been diagnosed with ADHD, 91 boys and 24 girls."


A "healthy" pattern is a diet high in fresh fruit and vegetables, whole grains and fish. It tends to be higher in omega-3 fatty acids, folate and fibre. A "Western" pattern is a diet with a trend towards takeaway foods, confectionary, processed, fried and refined foods. These diets tend to be higher in total fat, saturated fat, refined sugar and sodium.


"When we looked at specific foods, having an ADHD diagnosis was associated with a diet high in takeaway foods, processed meats, red meat, high fat dairy products and confectionary," Dr Oddy said.


"We suggest that a Western dietary pattern may indicate the adolescent has a less optimal fatty acid profile, whereas a diet higher in omega-3 fatty acids is thought to hold benefits for mental health and optimal brain function.


"It also may be that the Western dietary pattern doesn't provide enough essential micronutrients that are needed for brain function, particularly attention and concentration, or that a Western diet might contain more colours, flavours and additives that have been linked to an increase in ADHD symptoms. It may also be that impulsivity, which is a characteristic of ADHD, leads to poor dietary choices such as quick snacks when hungry."


Dr Oddy said that whilst this study suggests that diet may be implicated in ADHD, more research is needed to determine the nature of the relationship.


"This is a cross-sectional study so we cannot be sure whether a poor diet leads to ADHD or whether ADHD leads to poor dietary choices and cravings," Dr Oddy said.


ADHD is the most commonly diagnosed childhood mental health disorder and has a prevalence of approximately 5%. ADHD is known to be more common in boys.


Journal Reference:

Amber L. Howard, Monique Robinson, Grant J. Smith, Gina L. Ambrosini, Jan P. Piek, and Wendy H. Oddy. ADHD Is Associated With a 'Western' Dietary Pattern in Adolescents. Journal of Attention Disorders, 2010; DOI: 10.1177/1087054710365990

Pregnancy-related diabetes likely to recur: study


By Lynne Peeples

Reuters Health

Thursday, July 29, 2010

NEW YORK (Reuters Health) – Pregnant women with a history of pregnancy-related diabetes, also called gestational diabetes, have a good chance of developing the condition again, suggests a large new study.

Researchers found that the risk of having gestational diabetes during a future pregnancy increases with each previously affected one -- from 41 percent after the first to 57 percent after two pregnancies complicated by gestational diabetes.

Gestational diabetes typically strikes during late pregnancy and is characterized by high blood sugar that results from the body's impaired use of insulin. While it rarely causes birth defects, complications can arise that threaten the health of both mom and baby.

"Because of the silent nature of gestational diabetes, it is important to identify early those who are at risk and watch them closely during their prenatal care," lead researcher Dr. Darios Getahun of Kaiser Permanente Southern California Medical Group, in Pasadena, told Reuters Health in an email.

In an attempt to distinguish factors that put women at risk, Getahun and his colleagues studied the first two pregnancies of about 65,000 women and the first three pregnancies of about 13,000 women who sought care at their health center between 1991 and 2008.

Approximately 4 percent of the women developed gestational diabetes during their first pregnancy, they report in the American Journal of Obstetrics and Gynecology. This matches the U.S. rate estimated by the American Diabetes Association.

The team found that these women were about 13 times more likely to develop it again in their second pregnancy, compared to women without previous gestational diabetes. Among third pregnancies, the risk of diabetes for women who had two previous cases rose to 26 times that of women without any history of gestational diabetes.

Looking more closely at the data, it appeared that the most recent case of gestational diabetes was the most influential: About 44 percent of women with a diagnosis in their second but not first pregnancy developed gestational diabetes, compared to 23 percent of those with the condition in their first but not second pregnancy.

Hispanics, Asians and Pacific Islanders had approximately double the risk of gestational diabetes compared with white women, after taking into account factors such as age and education. The researchers guess that the relatively high consumption of rice in the latter two groups may cause elevated sugar and insulin levels, potentially triggering the condition.

The study, which was supported by funds from Kaiser Permanente, did not take into account lifestyle factors such as weight. This, the researchers say, limits the findings' applicability given that overweight and obesity -- now affecting approximately one out of every three women of childbearing age -- is thought to contribute to the recurrence of gestational diabetes.

The American College of Obstetrics and Gynecology and the American Diabetes Association both recommend that women at risk of type 2 diabetes be counseled on the benefits of modifying their diet, exercising and weight loss. This group includes those with a history of gestational diabetes.

"Early identification of at-risk populations and the timely initiation of a (post-delivery) lifestyle intervention may help to prevent gestational diabetes and related adverse pregnancy outcomes," Getahun told Reuters Health.


American Journal of Obstetrics and Gynecology, online July 14, 2010.

Vitamin D Deficiency Linked to Arterial Stiffness in Black Teens



Thursday, July 29, 2010


ScienceDaily (July 29, 2010) — Vitamin D deficiency is associated with arterial stiffness, a risk factor for heart disease and stroke, in black teens, according to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM). Black teens taking vitamin D supplementation of 2,000 international units (IU) per day had a decrease in central arterial stiffness.


"While we think of the sun as providing humans with most of our body's requirement of vitamin D, 95 percent of the 44 black teenagers living in sunny Georgia who took part in this study were classified as vitamin D deficient," said Yanbin Dong, MD, PhD, of the Medical College of Georgia in Augusta and lead author of the study. "Our study shows that vitamin D supplementation may improve cardiovascular health in black teens who don't get enough vitamin D from their diet and sun exposure."


In this study, 44 black teenagers (male and female) were randomly assigned to receive either 400 IU of vitamin D per day as recommended by the American Academy of Pediatrics or 2,000 IU of vitamin D per day. Study subjects taking 400 IU of vitamin D per day did not achieve vitamin D sufficiency, while their peers who took 2,000 IU of vitamin D per day on average became vitamin D sufficient.


Researchers measured arterial stiffness in study subjects using pulse wave velocity (PWV), a non-invasive procedure where a pulse is emitted at two arterial sites. The pulse's transit time and distance travelled help researchers reliably calculate arterial stiffness. Results from the study showed that vitamin D may protect vascular systems and that sufficient supplementation of vitamin D could elicit favorable alterations in the arterial system and in cardiovascular function in general.


"Our study is the first clinical trial of vitamin D intervention to use 2,000 IU in black subjects and to include cardiovascular risk factors as outcomes in youth," said Dong. "Our study indicates that the current recommendations for vitamin D intake in black teenagers may need to be revised upward."


Other researchers working on the study include: Inger Stallmann-Jorgensen, Norman Pollock, Ryan Harris, Daniel Keeton, Ying Huang, Ke Li, Reda Bassali, Dehuang Guo, Jeffrey Thomas, Gary Pierce, Jennifer White and Haidong Zhu of the Medical College of Georgia in Augusta; and Michael Holick of Boston University Medical Center in Mass.


The article, "A 16-week randomized clinical trial of 2,000 IU daily vitamin D3 supplementation in black youth: 25-hydroxyvitamin D, adiposity, and arterial stiffness," will appear in the October 2010 issue of JCEM.


Meth use in pregnancy endangers mom and baby


By Anne Harding

Reuters Health

Thursday, July 29, 2010

NEW YORK (Reuters Health) – New research shows that babies born to methamphetamine-using moms face much higher risks of serious complications, compared to babies not exposed in the womb to this illegal street drug.

Life-threatening pregnancy complications, such as uncontrolled high blood pressure, are also more common among women who use methamphetamine while pregnant, the researchers found.

Methamphetamine, also called meth, is a highly addictive stimulant that users inject, snort, smoke or swallow. A form called crystal meth looks like fragments of glass and is smoked using a glass pipe like those used to smoke crack cocaine.

Methamphetamine use among U.S. women continues to be a serious problem. A recent study found that over the last 15 years, methamphetamine abuse has become the most common reason for pregnant women to seek drug counseling.

Dr. Ido Solt of Cedars-Sinai Medical Center in Los Angeles and colleagues decided to look into meth use in pregnant women after treating three pregnant patients admitted to the intensive care unit with uncontrolled high blood pressure. "The common denominator was methamphetamine use," Solt told Reuters Health.

To better characterize the risks of meth use in pregnancy, he and his colleagues compared 276 meth-using women who delivered babies at a Phoenix hospital from 2000 through 2006 to 34,055 "control" women who delivered babies during the same time period at the same hospital. The meth users had either admitted to using meth while pregnant, or tested positive for the drug.

During the study period, the number of pregnant meth users the researchers identified steadily rose: from 22 in 2001, to 43 in 2004, to 77 in 2005.

On pretty much every measure Solt and his team looked at, the methamphetamine users and their babies fared worse.

Half of the meth users delivered their babies preterm, compared to 17 percent of the control population of women. Twenty-nine percent of meth users had C-sections, compared to 23 percent of control women.

Nearly 20 percent of pregnant meth users had uncontrolled high blood pressure, while nearly 10 percent suffered placental abruption, in which the placenta separates from the uterus before delivery. While the researchers didn't have data on rates of these two complications for the non-meth-users in the study, both are rare; for example, recent research suggests that placental abruption occurs in less than 1 percent of births in the US.

Solt's team also found that more than two-thirds of the women who had used meth reported fewer than five prenatal care visits, compared to 10 percent of the control women.

Six percent of the babies of meth users had low scores on a test designed to measure newborn health, compared to 1 percent of the control group babies. Four percent of the babies exposed to meth died soon after birth, compared to 1 percent of the control group babies.

Solt and his colleagues also found that nearly a quarter of the meth-using women reported being victims of domestic violence while pregnant. Forty percent of the meth-exposed babies were taken from their mothers at least temporarily, to be adopted, placed in Child Protective Services or foster care, or cared for by another person.

Meth users were older, and more likely to be white and English-speaking, than the control population. Only 12 percent were married, compared to 46 percent of control women.

These demographic characteristics might help doctors spot women at risk for using meth while pregnant, Solt noted. One might think that it would be easy to identify a pregnant meth user, but the researchers found otherwise. While the stereotypical meth addict has bad teeth, a gaunt body, and skin sores, many of the meth-using women didn't fit this profile.

"We were surprised to encounter a significant proportion of the methamphetamine users that did not look like the typical user, and they were discovered through the toxicity screen," the researcher said. Because urine tests can only identify the drug within three days of use, he added, screening might have missed some women who had used meth in their pregnancy.

While meth exposure is clearly dangerous to the developing baby, the researcher added, much remains unknown about how the drug hurts the fetus, or whether meth-exposed babies will experience lasting consequences.

"We have many black holes in our knowledge about the mechanism of harm," he said.


 Obstetrics & Gynecology, August 2010.

Plant Compound Resveratrol Shown to Suppresses Inflammation, Free Radicals in Humans



Thursday, July 29, 2010


ScienceDaily (July 29, 2010) — Resveratrol, a popular plant extract shown to prolong life in yeast and lower animals due to its anti-inflammatory and antioxidant properties, appears also to suppress inflammation in humans, based on results from the first prospective human trial of the extract conducted by University at Buffalo endocrinologists.


Results of the study appear as a rapid electronic publication on the Journal of Clinical Endocrinology & Metabolism website and will be published in an upcoming print issue of the journal.


The paper also has been selected for inclusion in Translational Research in Endocrinology & Metabolism, a new online anthology that highlights the latest clinical applications of cutting-edge research from the journals of the Endocrine Society.


Resveratrol is a compound produced naturally by several plants when under attack by pathogens such as bacteria or fungi, and is found in the skin of red grapes and red wine. It also is produced by chemical synthesis derived primarily from Japanese knotweed and is sold as a nutritional supplement.


Husam Ghanim, PhD, UB research assistant professor of medicine and first author on the study, notes that resveratrol has been shown to prolong life and to reduce the rate of aging in yeast, roundworms and fruit flies, actions thought to be affected by increased expression of a particular gene associated with longevity.

The compound also is thought to play a role in insulin resistance as well, a condition related to oxidative stress, which has a significant detrimental effect on overall health.


"Since there are no data demonstrating the effect of resveratrol on oxidative and inflammatory stress in humans," says Paresh Dandona, MD, PhD, UB distinguished professor of medicine and senior author on the study, "we decided to determine if the compound reduces the level of oxidative and inflammatory stress in humans.


"Several of the key mediators of insulin resistance also are pro-inflammatory, so we investigated the effect of resveratrol on their expression as well."


The study was conducted at Kaleida Health's Diabetes-Endocrinology Center of Western New York, which Dandona directs.


A nutritional supplement containing 40 milligrams of resveratrol was used as the active product. Twenty participants were randomized into two groups of 10: one group received the supplement, while the other group received an identical pill containing no active ingredient. Participants took the pill once a day for six weeks. Fasting blood samples were collected as the start of the trial and at weeks one, three and six.


Results showed that resveratrol suppressed the generation of free radicals, or reactive oxygen species, unstable molecules known to cause oxidative stress and release proinflammatory factors into the blood stream, resulting in damage to the blood vessel lining.


Blood samples from persons taking resveratrol also showed suppression of the inflammatory protein tumor necrosis factor (TNF) and other similar compounds that increase inflammation in blood vessels and interfere with insulin action, causing insulin resistance and the risk of developing diabetes.


These inflammatory factors, in the long term, have an impact on the development of type 2 diabetes, aging, heart disease and stroke, noted Dandona.


Blood samples from the participants who received the placebo showed no change in these pro-inflammatory markers.


While these results are promising, Dandona added a caveat: The study didn't eliminate the possibility that something in the extract other than resveratrol was responsible for the anti-inflammatory effects.

"The product we used has only 20 percent resveratrol, so it is possible that something else in the preparation is responsible for the positive effects. These agents could be even more potent than resveratrol. Purer preparations now are available and we intend to test those."


Additional contributors to the study, all from Dandona's laboratory, are Chang Ling Sia, Sanaa Abuaysheh, Kelly Korzeniewski, Priyanka Patniak, MD, Anuritha Marumganti, MD, and Ajay Chaudhuri, MD.

The study was supported in part by grants to Dandona from the National Institutes of Health and the American Diabetes Association.


Wednesday, July 28, 2010


One Molecule, Many More Insulin-Producing Cells to Treat Diabetes


ScienceDaily (July 28, 2010)

Wednesday, July 28, 2010


ScienceDaily (July 28, 2010) — With a single stimulatory molecule, human insulin-producing beta cell replication can be sustained for at least four weeks in a mouse model of diabetes, according to researchers at the University of Pittsburgh School of Medicine in Diabetes, a journal of the American Diabetes Association.

They also found several cocktails of molecules that drive human beta cells to replicate, as well as important differences between mouse and human beta cells that could influence how these approaches are best used to treat diabetes, which is caused by insufficient insulin production leading to abnormal blood sugar levels.

"Our team was the first to show that adult human beta cells can be induced to proliferate or grow at substantial rates, which no one thought possible before," said senior author Andrew F. Stewart, M.D., professor of medicine and chief of the Division of Endocrinology and Metabolism, Pitt School of Medicine. "Now our effort has been to unravel these regulatory pathways to find the most effective strategy that will allow us to treat -- and perhaps cure -- diabetes by making new insulin-producing cells."


In a series of experiments, lead author Nathalie M. Fiaschi-Taesch, Ph.D., assistant professor of endocrinology, and the team discovered that combining elevated amounts of the regulatory molecules cdk4 or cdk6 with a variety of D-cyclin proteins, particularly cyclin D3, stimulates human beta cell replication in test tubes.


"We didn't expect cyclin D3 to ramp up beta cell replication so strongly when it was used with either cdk4 or cdk6," Dr. Fiaschi-Taesch said. "There was no known role for cyclin D3 in human beta cell physiology."

Cyclin D2 is present in and essential for rodent beta cell replication and function, but the team showed that molecule is barely detectable in human cells, and beta cell replication could be sustained for at least four weeks in a model in which mice were transplanted with human beta cells engineered to overproduce cdk6. Blood sugar normalized in the diabetic mice transplanted with surprisingly small numbers of human beta cells, indicating that the cells functioned properly to produce needed insulin.


Mice don't appear to make cdk6 naturally, but they do have cdk4 and cyclins D1 and D2, so standard rodent studies of beta replication might have led scientists to pursue the wrong molecules in their quest to stimulate human beta cell replication, Dr. Stewart noted.


He and his colleagues continue to explore many other regulatory proteins that could play a role in encouraging or thwarting beta cell replication.


Other authors of the paper include Fatimah Salim, Jeffrey Kleinberger, Ronnie Troxell, Karen Selk, Edward Cherok, Karen K. Takane, Ph.D., and Donald K. Scott, Ph.D., all of the Division of Endocrinology and Metabolism, Department of Medicine, Pitt School of Medicine; and Irene Cozar-Castellano, Ph.D., Unidad de Investigacion, Hospital Universitario Puerta del Mar, Cadiz, Spain.


The research was funded by grants from the National Institute of Diabetes and Digestive and Kidney Diseases, the Juvenile Diabetes Research Foundation, the Spanish Ministry of Science and Innovation, and the Pam and Scott Kroh and the Don and Arleen Wagner family foundations.



Mom's pregnancy diet not tied to wheezing risk


By Amy Norton

Reuters Health

Wednesday, July 28, 2010

NEW YORK (Reuters Health) – A woman's overall diet during pregnancy may not be related to her child's risk of developing wheezing problems by preschool age, a new study suggests.

Wheezing refers to a high-pitched whistling sound, most obvious while exhaling, that is usually caused by blockages in the small breathing tubes in the chest.

Occasional wheezing is common in infancy and early childhood, and is often related to viral infections. But young children with recurrent wheezing episodes are more likely than other children to develop asthma, particularly if they have risk factors such as family history of allergies and asthma.

Several studies have found connections between a pregnant woman's intake of specific foods or nutrients and her child's risk of developing recurrent wheezing or asthma.

Women who eat more fish, apples, omega-3 fatty acids and vitamins D and E, for example, seem to have relatively lower risks of the breathing problems. However, those studies do not prove that the foods and nutrients themselves bring the benefit.

One of the questions has been whether women who consume more of those foods simply have a healthier diet overall, and it's the overall diet pattern that matters.

So for the new study, reported in the Journal of Allergy and Clinical Immunology, researchers looked at the relationship between diet patterns during pregnancy and wheezing risk among 1,376 mother-child pairs. Mothers completed detailed dietary questionnaires during their first and second trimesters, and their children's rates of recurrent wheezing were followed to the age of 3.

Overall, 18 percent of the children developed repeat bouts of wheezing, based on parents' questionnaire responses.

In general, the researchers found no differences in the children's risk of wheezing, whether their mothers' diet during pregnancy fit a generally healthful pattern or less-than-optimal one.

Healthy patterns included a "Mediterranean"-style diet -- typically high in fish, fruits and vegetables, olive oil, nuts and whole grains -- and a "prudent" diet, rich in fruits and vegetables, whole grains, fish, poultry and eggs.

The less-than-healthful diet -- called the "Western" pattern -- included relatively high amounts of red and processed meats, high-fat dairy, sweets and refined grains like white bread.

The researchers stress, however, that the lack of a link between these eating patterns and wheezing risk does not diminish the importance of a healthy diet during pregnancy.

"For many reasons, both for the mother and child, it is important for mothers to eat a healthy diet," said lead researcher Dr. Nancy M. Lange, of Brigham and Women's Hospital and Harvard Medical School in Boston.

Nor do the current findings mean that nutrition during pregnancy has no role in the risk of childhood asthma, according to Lange.

Instead, she told Reuters Health in an email, they suggest that future studies should continue to investigate the links between specific nutrients during pregnancy and children's wheezing and asthma risk.

For now, Lange said, no recommendations on specific foods or nutrients can be made.

She explained that the existing evidence linking benefits to certain vitamins and foods come from observational studies -- where researchers asked women about their nutrition during pregnancy, then looked at the rates of wheezing or asthma among their children.

Such studies cannot prove cause-and-effect.

"It would be premature to recommend that women with a history of asthma, or without this history, take anything specific for the purposes of preventing asthma in their children," Lange said.

Clinical trials to confirm any benefit of specific nutrients have yet to be done, she noted.

They are, however, in the works. One ongoing trial, for example, is testing whether giving pregnant women extra vitamin D has any effect on their children's risk of recurrent wheezing by the age of 3.


 Journal of Allergy and Clinical Immunology, online June 28, 2010.

Why Fad Diets Work Well for Some, but Not Others



Wednesday, July 28, 2010


ScienceDaily (July 28, 2010) — Ever notice some people seem to eat anything they want and never gain a pound, while others seem to gain weight just by looking at fattening foods? You may be seeing things correctly after all. According to research published in the July 2010 issue of Genetics,  this may have a biological cause. Using fruit flies, researchers have found that genes interacting with diet, rather than diet alone, are the main cause of variation in metabolic traits, such as body weight. This helps explain why some diets work better for some people than others, and suggests that future diets should be tailored to an individual's genes rather than to physical appearance.


"There is no one-size-fits all solution to the diseases of obesity and type-2 diabetes," said Laura K. Reed, Ph.D, a researcher from the Department of Genetics at North Carolina State University, the lead investigator in the work. "Each person has a unique set of genetic and environmental factors contributing to his or her metabolic health, and as a society, we should stop looking for a panacea and start accepting that this is a complex problem that may have a different solution for each individual."


To make this discovery, the scientists studied 146 different genetic lines of fruit flies that were fed four different diets (nutritionally balanced, low calorie, high sugar, and high fat). Researchers then measured a variety of metabolic traits, including body weight, in each group. Flies in some of the genetic lines were highly sensitive to their diets, as reflected by changes in body weight, while flies of other lines showed no change in weight across diets. The scientists were able to ascertain what portion of the total variation in the metabolic traits was determined by genetics alone, by diet alone, or by the interaction between genotype and diet. Results showed that diet alone made a small contribution to the total variation, while genotype and genotype interactions with diet made very large contributions. This study strongly suggests that some individuals can achieve benefits from altering their dietary habits, while the same changes for others will have virtually no effect.


"The summer beach season often serves as a 'gut check' for many in terms of their weight," said Mark Johnston, Editor-in-Chief of the journal Genetics. "This research explains why the one-size-fits-all approach offered by many diet programs can have dramatically different effects for people who try them."


Hands-only CPR, pushy dispatchers are lifesavers


By Mike Stobbe

AP Medical Writer

The Associated Press

Wednesday, July 28, 2010

ATLANTA – More bystanders are willing to attempt CPR if an emergency dispatcher gives them firm and direct instructions — especially if they can just press on the chest and skip the mouth-to-mouth, according to new research.

The two new studies conclude that "hands-only" chest compression is enough to save a life. They are the largest and most rigorous yet to suggest that breathing into a victim's mouth isn't needed in most cases.

The American Heart Association has been promoting hands-only CPR for two years, though it's not clear how much it's caught on. The new studies should encourage dispatchers and bystanders to be more aggressive about using the simpler technique.

"That could translate into hundreds if not thousands of additional lives saved each year. What are we waiting for?" said Dr. Arthur Kellermann, a RAND Corporation expert on emergency medicine.

An estimated 310,000 Americans die each year of cardiac arrest outside hospitals or in emergency rooms. Only about 6 percent of those who are stricken outside a hospital survive.

When someone collapses and stops breathing, many people panic and believe that phoning 911 is the best they can do to help.

The larger of the two new studies reported survival rates of about 12 percent when bystanders did dispatcher-directed CPR, confirming earlier research that on-scene CPR can dramatically increase a victim's odds of survival.

The studies also spotlighted the importance of having forceful dispatchers coaching bystanders, said Dr. Michael Sayre, an Ohio State University emergency medicine specialist who helped update the Heart Association guidelines on CPR.

Previous research has suggested that adults who need CPR get it only about one-quarter to one-third of the time when bystanders are around.

One of the new studies found that when dispatchers told callers to start CPR, about 80 percent attempted it when given hands-only instructions, more than the 70 percent who tried the standard version.

Sayre and others credited the increase on dispatchers who immediately told callers what to do, instead of first asking them if they'd had CPR training or if they'd be willing to try it until medical help arrives.

"This study shows that with great training and motivation, the 911 call taker can make a big difference," Sayre said.

CPR, or cardiopulmonary resuscitation, is a technique that's been in use for about 50 years. The standard version now calls for alternating 30 hard pushes on a victim's chest with two quick breaths into their mouth.

The aim of CPR is to do some of the mechanical work of the heart by forcing at least some blood and oxygen to the brain and other vital organs.

Experts have come to believe that pumping is what's most important in most adult cases, and advise doing chest pushes continually at a rate of 100 per minute and skipping the mouth-to-mouth. Some suggest using the beat of the old disco song "Stayin' Alive" as a guide.

Cardiac patients do as good or better when they got hands-only CPR as compared to the traditional version, these and earlier studies have found.

One of the new studies, carried out in London and the Seattle area, involved more than 1,900 people who witnessed someone in cardiac arrest and called 911 or some other emergency number. Emergency dispatchers instructed callers to do either hands-only CPR or an older form of standard CPR that alternates 15 pushes with two quick breaths.

The second study was done in Sweden and included nearly 1,300

In both studies, there was no significant difference in the survival rates of people who got conventional CPR and those who got the hands-only version.

The studies are being published in Thursday's New England Journal of Medicine.

While there is no good national data on how often hands-only CPR is used, Dr. Ben Bobrow, who directs the Arizona Department of Health Services' emergency medical system, believes it is catching on.

"We've seen a huge trend in hands-only CPR in Arizona and I believe that trend is spreading across the country. I think these findings will further promote that," he said.

Many people think of traditional CPR as difficult, and to some extent it is. The victim's head has to be tilted back, the airway cleared, the nose pinched and the mouth completely covered with the rescuer's. A lot of people have trouble with it, said Don Pederson, a dispatcher in Seattle's King County, who participated in the U.S. study.

"A lot of the times they weren't getting air in there correctly," with oxygen escaping out the sides of the mouth, Pederson said.

Rea and his colleagues believe some bystanders perform mouth-to-mouth so poorly that the interruption reduces blood flow.

Worry about doing CPR correctly was the No. 2 reason many people don't attempt it, according to a Michigan study published in 2006. The No. 1 reason? People are too panicked.

The "ick" factor of putting lips to a stranger's mouth — and picking up the stranger's germs — was cited by only a tiny fraction of people in the study. However, it may be a more significant issue than the study showed, at least in some communities, experts say.

Traditional CPR is still the preferred form of resuscitation for children or adults who have stopped breathing because of choking, drowning or other respiratory problems.


New England Journal:

Many Knee and Hip Replacement Patients Experience Weight Decrease After Surgery



Wednesday, July 28, 2010


ScienceDaily (July 28, 2010) — A Mount Sinai School of Medicine study has found that patients often exhibit a significant decrease in weight and body mass index (BMI) after undergoing knee or hip replacement surgery (arthroplasty). The study is the first of its type to correct for the annual increase in BMI typically found in North Americans between the ages of 29 to 73 years. The study was recently published in Orthopedics.


A total of 196 Mount Sinai patients who had knee or hip replacement from 2005 -- 2007 to treat osteoarthritis were randomly selected for the study. Mean patient age at surgery was 67.56 years, with about 65 percent female and 35 percent male. Of this group, 19.9 percent demonstrated a clinically significant decrease in weight (defined as the loss of five percent or more of body weight) and BMI following knee or hip replacement. In addition, the mean weight of the group dropped from 79.59 kg (175.47 lbs) to 78.13 kg (172.24 lbs) after surgery.


Significant BMI decrease was found to be greater in knee replacement patients (21.5 percent) than hip replacement patients (16.9 percent). Patients who were obese prior to surgery, with BMI greater than 30, were the most likely to experience significant post-surgery weight reductions.


"Total joint arthroplasties are performed with the intent of relieving a patient's pain and disability," said the study's lead author Michael Bronson, MD, Chief of Joint Replacement Surgery at Mount Sinai School of Medicine. "Both total knee patients and total hip patients experienced a statistically significant and clinically significant corrected weight loss following surgery, which indicates a healthier overall lifestyle."


The incidence of overweight and obese adults has been steadily increasing over the past five decades in the U.S. Lifestyle modification, consisting of changes in patterns of dietary intake, exercise, and other behaviors, is considered the cornerstone of overweight and obesity management. Overweight patients often argue that their osteoarthritis limits their mobility and ability to exercise. Thus, patients may feel frustrated that they are unable to lose weight, and are often hopeful that losing weight would be easier postoperatively.


These results suggest that patients have improved weight parameters when compared to North American adults. Dr. Bronson and his joint replacement team at Mount Sinai believe that additional studies of total knee and total hip arthroplasty postoperative patients, which also incorporate nutritional guidance and long-term fitness goals, may show even more encouraging results.


Tuesday, July 27, 2010


MabCure's test detects ovarian tumors in blood



Tuesday, July 27, 2010

WASHINGTON (Reuters) – An experimental test that uses antibodies to detect ovarian tumor cells in the blood correctly identified 16 of 17 women who had the cancer, a Belgian company said on Tuesday.

MabCure Inc said its monoclonal antibodies threw up no false positives -- meaning none of them incorrectly identified the blood of healthy women as carrying tumors.

"The availability of a simple blood test with the ability to diagnose the presence of ovarian cancer early and to differentiate it from benign tumors has the potential to save thousands of lives and reduce the need for unnecessary surgery," Amnon Gonenne, CEO of MabCure, said in a statement.

"Our findings are an important step in that direction and also have significant implications for the future development of cancer-specific targeted therapies."

If detected early, ovarian cancer can be cured, but more than 70 percent of women have advanced disease by the time they are diagnosed. Ovarian cancer kills 15,000 U.S. women each year, and 140,000 globally.

Symptoms of ovarian cancer are vague and often missed. A protein called CA-125 is elevated in ovarian cancer cells but is not a good test to screen for early cancer.

MabCure has designed lab engineered monoclonal antibodies (MAbs), which are immune system proteins, that were designed to specifically home in on ovarian tumors.

They tested several different versions using blood samples from 17 patients with ovarian cancer, five patients with benign tumors of the ovaries, 24 healthy young females and eight males at UZ Hospital in Leuven, Belgium.

Each version correctly diagnosed 16 of the 17 ovarian cancers, a diagnostic sensitivity of 94 percent, the company said.

"MabCure is currently evaluating the diagnostic potential of its MAbs in detecting ovarian cancer in high-risk patients in a clinical study in Thailand," the company said in a statement.

(Reporting by Maggie Fox)


New Proteins That Regulate Blood Pressure, Flow Discovered



Tuesday, July 27, 2010


ScienceDaily (July 27, 2010) — Researchers at the University of Pittsburgh School of Medicine have identified key players in a little-known biochemical pathway that appears to regulate blood pressure. The findings, reported in the early online version of Cardiovascular Research, have evolved from studies conducted by Jeffrey S. Isenberg, M.D., Eileen M. Bauer, Ph.D., and their colleagues at Pitt's Vascular Medicine Institute.


"Identifying and unraveling this important pathway for blood pressure regulation could lead to a better understanding of who will get high blood pressure and why, as well as allow us to develop better drugs to treat these patients," Dr. Isenberg said. "Poorly controlled hypertension is a major risk factor for heart attacks and heart failure, stroke and kidney failure."


The pathway he and collaborator David D. Roberts, Ph.D., of the National Cancer Institute (NCI), National Institutes of Health (NIH), have been exploring involves nitric oxide (NO) signaling. The cells that line blood vessels, called the endothelium, produce NO in a few biochemical steps. NO promotes blood vessel dilation and increases blood flow. Conversely, endothelial dysfunction, along with loss of NO production, is known to be involved in the development of many forms of cardiovascular disease, including hypertension.


Through cell culture and mouse experiments, the researchers found that a protein called thrombospondin-1 (TSP1) and its receptor, CD47, inhibit activation of the endothelial-based enzyme called endothelial nitric oxide synthase (eNOS), which in turn limits the production of NO and thus prevents blood vessels from relaxing and blood pressure from dropping. Circulating TSP1, at levels consistent with those found in the blood stream, is capable of inhibiting activation of endothelial-based eNOS and thus blocking NO production.


"For some time now, it has not been clear what role TSP1 served in the blood. Experiments in cells told us TSP1 could alter NO signaling. But TSP1 is a protein too large to cross through the endothelial layer and into the blood vessel wall, so it was not obvious how it could alter the muscle tone of the arteries," Dr. Isenberg said. "We also knew that mice genetically engineered to not produce TSP1 or CD47 showed more NO-based blood flow and blood vessel dilation. This suggested to us that perhaps circulating TSP1 was altering the ability of the endothelium to make NO by acting on eNOS."


He and his team are now developing agents that can alter the activity of eNOS by "blocking" the inhibitory signal mediated by TSP1 and CD47, which have the potential to be novel blood pressure-regulating drugs.


Some cases of hypertension may arise from gene-based differences in these proteins, Dr. Isenberg noted.

"This work has identified a key pathway that effectively puts the brakes on nitric oxide production, which slows down blood flow," said Mark T. Gladwin, M.D., director of the Vascular Medicine Institute. "Furthermore, drugs that block this pathway have the potential to restore nitric oxide levels and may be useful for the treatment of high blood pressure and other vascular diseases."


The team included other researchers from the Pitt School of Medicine and NCI, as well as the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The work was funded by grants from NCI, NIDDK and NIH.


Brain Structure Changes Found in Irritable Bowel Patients


HealthDay News

Tuesday, July 27, 2010

TUESDAY, July 27 (HealthDay News) -- Women with irritable bowel syndrome have increases and decreases in gray matter density in areas of the brain that play a role in attention, emotion regulation, pain inhibition and the processing of information from the gut, new research suggests.

Similar brain structural changes have been noted in patients with pain disorders such as lower back pain, migraines and hip pain.

Irritable bowel syndrome, or IBS -- which can cause pain and discomfort in the abdomen, along with constipation, diarrhea, or both -- affects about 15 percent of the U.S. population, mainly women. Among those in the medical field, IBS is currently considered a "functional" syndrome (the digestive tract is not working properly), rather than an "organic" disorder (which would involve structural organ changes).

"Discovering structural changes in the brain, whether they are primary or secondary to gastrointestinal symptoms, demonstrates an 'organic' component to IBS and supports the concept of a brain-gut disorder," study author Dr. Emeran Mayer, a professor of medicine, physiology, and psychiatry at the David Geffen School of Medicine, University of California, Los Angeles, said in a university news release.

"Also, the finding removes the idea once and for all that IBS symptoms are not real and are 'only psychological.' The findings will give us more insight into better understanding IBS," Mayer added.

In the study, American and Canadian researchers used medical imaging to analyze anatomical differences in the brains of 55 female IBS patients and 48 women without IBS. The IBS patients had increases and decreases of gray matter in specific cortical brain regions involved in cognitive and evaluative functions, the investigators found.

"We noticed that the structural brain changes varied between patients who characterized their symptoms primarily as pain, rather than non-painful discomfort. In contrast, the length of time a patient has had IBS was not related to these structural brain changes," Mayer said.

The study is published in the July issue of the journal Gastroenterology.

The next steps in this research will include trying to determine if certain genes are related to the structural brain changes in IBS patients.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about IBS.

Body Mass Index at Age 17 Within the Normal Range Can Predict Future Risk for Hypertension in Later Life



Tuesday, July 27, 2010


ScienceDaily (July 27, 2010) — Ben-Gurion University of the Negev (BGU) researchers reveal in a new, large-scale study that "normal" blood pressure at age 17 can still predict hypertension at early adulthood and that teenage boys are three to four times more likely to develop high blood pressure in early adulthood than girls.


According to the study published in Hypertension: Journal of the American Heart Association, the research team assessed how teenage boys and girls with normal blood pressure might progress into becoming young adults with hypertension. Currently, systolic blood pressures of 100 to 110 and even up to 120 are considered within the normal range for adolescents. Other traits like weight, height and body mass index (BMI) have a range of distribution that is considered "normal."


"Frequently called the 'silent killer,' hypertension is a major risk factor for heart disease and vascular diseases like stroke," explains researcher Dr. Assaf Rudich, an associate professor in the Department of Clinical Biochemistry at BGU. "It is increasing along with the obesity epidemic, but regrettably, young adults who are otherwise healthy frequently are not screened for becoming hypertensive."


The BGU researchers examined the development of blood pressure from adolescence to young adulthood in 23,191 boys and 3,789 girls from ages 17 to 42 by taking regular readings of their blood pressure and BMI of Israel Defense Forces personnel who were not hypertensive at age 17 in their initial evaluation before recruitment.


The study revealed two substantive findings:

*                   In boys, there is a strong correlation between blood pressure and BMI at age 17. This means that while the blood pressure reading may be in the "normal range," there is a greater risk for hypertension when BMI is also evaluated. The rate of progression to hypertension is higher in boys whose systolic blood pressure is 110 versus those whose blood pressure is 100.


*                   For girls, only the sub-group considered obese had substantially higher risk of high blood pressure. The researchers believe that estrogen may protect against hypertension.

The study also confirmed several known observations:

*                   Seventeen-year-old boys have higher blood pressure than their female counter parts.

*                   Boys are three to four times more likely to develop hypertension as young adults and the higher the blood pressure value, even within the normal range, the higher is the risk for becoming hypertensive adults.

During a follow-up period with these adolescents, 14 percent or 3,810 people developed hypertension.

"Collectively, the study suggests that pediatricians caring for adolescents and physicians caring for young adults should be more aware of the need to monitor weight and blood pressure even when they are considered "normal," explains Dr. Iris Shai, an associate professor in the Department of Epidemiology in the Faculty of Health and Sciences. "For the individual person, a 'normal value' may still be associated with a significant elevated risk of disease when the BMI and sex of the patient is also considered."


Participants were part of the Metabolic, Lifestyle and Nutrition Assessment in Young Adults (MELANY) Study conducted by the Israel Defense Forces.


The Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel-Hashomer Israel and the Israel Defense Forces Medical Corps funded the study.


Mom's Affection Helps Babies Grow Into Less Stressed Adults


HealthDay News

Tuesday, July 27, 2010

TUESDAY, July 27 (HealthDay News) -- The more a mother showers her infant child with warmth and affection, the less anxiety, hostility and general distress the child will ultimately grow up to harbor as an adult, new research indicates.

The finding is based on the tracking of 482 children from the age of 8 months all the way up to an average age of 34 years. The results suggest that maternal affection at a very young age can have a critical long-range impact on mental health and emotional coping skills.

Study author Joanna Maselko of Duke University and her colleagues report the observations in the July 27 online edition of the Journal of Epidemiology and Community Health.

All of the study participants were part of the National Collaborative Perinatal Project, which included people born in Providence, R.I. The researchers first assessed the children at 8 months of age in terms of their developmental progress. In turn, the mothers were assessed for their reaction to their child's test results and how well they reacted to their child's exam "performance."

At the same time, the degree of maternal affection and attention displayed toward the children was also assessed, and rated ranging from "negative" to "extravagant" levels, the study authors explained in a news release from the journal's publisher.

Ten percent of the mothers were deemed to have offered their children very low levels of affection, while 85 percent had offered a so-called "normal" degree of warmth. Six percent showered their child with what the investigators determined was a very high amount of maternal affection.

Flash forward a few decades, and the children -- now adults -- were assessed for feelings of anxiety, hostility and general distress levels.

When stacking up maternal affection during infancy against the emotional state of mind of the now fully grown adults, Maselko and her colleagues found that those children who had been exposed to the most affection had the lowest levels of anxiety, hostility and general distress.

By contrast, children who had been exposed to the least amount of affection as infants had the highest degree of those qualities, which can contribute to emotional instability and insecurity, the researchers said.

Maternal affection may enable and promote the healthy development of bonding and emotional attachments, which may help a child to develop social skills that are key to coping with general stress and anxiety, the study authors noted in the news release.

"These findings suggest that early nurturing and warmth have long-lasting positive effects on mental health well into adulthood," the researchers concluded in their report.

More information

For more on infant development, visit the National Network for Child Care.

ADHD, Conduct Disorder and Smoking Most Strongly Related to Dropping out of High School



Tuesday, July 27, 2010


ScienceDaily (July 27, 2010) — Teens with attention-deficit/hyperactivity disorder (ADHD) -- the most common childhood psychiatric condition in the United States -- are less likely to finish high school on time than students with other mental-health disorders that often are considered more serious, a large national study by researchers at the UC Davis School of Medicine has found. The study found that nearly one third of students with ADHD, twice the proportion as students with no psychiatric disorder, either drop out or delay high school graduation.


The study also examined the effects of substance use and abuse on high school graduation and found that among students who engage in substance use, including alcohol and other drugs, teens who smoke cigarettes are at greatest risk of dropping out.


There are three types of ADHD: the hyperactive type, the inattentive type and the combined type. Symptoms include not being able to pay attention, daydreaming, being easily distracted and being in constant motion or unable to remain seated.


"Most people think that the student who is acting out, who is lying and stealing, is most likely to drop out of school. But we found that students with the combined type of ADHD -- the most common type -- have a higher likelihood of dropping out than students with disciplinary problems," said Julie Schweitzer, an expert on ADHD at the UC Davis MIND Institute, an associate professor of psychiatry and behavioral sciences and the study's senior author. "This study shows that ADHD is a serious disorder that affects a child's ability to be successful in school and subsequently in a way that can limit success in life."


Published online in July in the Journal of Psychiatric Research, the study "Childhood and Adolescent-onset Psychiatric Disorders, Substance Use, and Failure to Graduate High School on Time" found that 32.3 percent of students with the combined type of ADHD -- which incorporates hyperactive and inattentive symptoms -- drop out of high school. Fifteen percent of teens with no psychiatric disorder drop out.


"Understanding the factors that contribute to dropping out of high school has major public-health implications, given that a third of youth in this country do not complete high school on time. Supporting mental-health interventions for students may have a significant impact on reducing high school dropout," said study author Elizabeth Miller, an assistant professor of pediatrics and an adolescent medicine specialist at UC Davis Children's Hospital.


In 2006 an estimated 4.5 million children in the United States between 5 and 17 years of age were diagnosed with attention-deficit/hyperactivity disorder, according to the Centers for Disease Control and Prevention. An estimated 9.5 percent of boys and 5.9 percent of girls are diagnosed with the condition.


The next most at-risk teens are students with conduct disorder, whose symptoms include aggression, lying, stealing, truancy, vandalism and a general pattern of rule-breaking. Thirty-one percent of students with conduct disorder drop out, said Joshua Breslau, associate professor of internal medicine and the study's lead author. Breslau said the research shows there are different pathways to poor high school performance.


"This study identifies multiple ways in which mental-health problems can affect education at the high school level. Attention-deficit/hyperactivity disorder impacts achievement because it affects how well students are able to perform basic classroom tasks from paying attention to turning in their homework," said Breslau. "Students with conduct disorder are able to do just as well as everyone else academically but disciplinary issues and dealing with the routines of school life may cause them to drop out."


For the study, the researchers examined the joint, predictive effects of childhood- and adolescent-onset psychiatric and substance-use disorders on failure to graduate high school on time, using data collected during 2001 and 2002 from the National Epidemiological Survey of Alcohol and Related Conditions. A total of approximately 43,000 racially diverse male and female participants over 18 from throughout the United States were interviewed by U.S. Census Bureau representatives about the age of onset of psychiatric diagnoses, substance use and high school graduation. Respondents were excluded if they had less than eight years of education or arrived in the U.S. after age 13. A total of 29,662 of the respondents were included in the UC Davis study.


Among childhood and adolescent psychiatric disorders, diagnosis with either the combined type of ADHD or the inattentive type -- at 28.6 percent -- resulted in the highest dropout rates. Students with mania, a mood disorder, and panic disorder dropped out at 26.6 and 24.9 percent respectively. Students with other mental-health disorders had dropout rates in the high teen- to low 20-percent range. The disorders included specific phobias (like fear of water), social phobia (fear of people), post-traumatic stress disorder, generalized anxiety disorder and depression.


But more predictive of dropping out than all other mental-health disorders except ADHD and conduct disorder was tobacco use. The study found that 29 percent of students who used tobacco failed to complete high school on time. Only 20 percent of teens who used alcohol and 24.6 percent of teens who used drugs dropped out. However, when the three substances were examined together, the effect of drinking and using drugs was no longer significant, Breslau said.


"Kids who smoke had a much higher risk of dropping out than kids who drink alcohol or use other drugs. When we looked at smoking in combination with other substances, drinking and using drugs did not increase one's risk of not completing high school on time. There's no additional increment of risk of dropping out once you account for smoking," Breslau said.


The reasons why this is the case merits further investigation, he said. However, existing literature suggests that poor educational performance contributes to smoking. If this is true, then breaking the connection between smoking and education may be essential to further reduction in the prevalence of smoking, Breslau said.

The implication of the findings, according to Breslau, is that the impact of mental health on education is likely to arise from a small set of conditions.


"This study suggests that focusing on a relatively narrow and hopefully more manageable range of mental-health conditions may have a consequential impact on improving school performance in secondary education."

Schweitzer said that devising effective interventions to help students with ADHD graduate high school would have important long-term societal consequences.


"If you don't have your high school degree, you're going to have less income. You can't buy houses and cars. People who drop out of high school are more likely to be reliant on public assistance. This is a disorder that has serious long-term impacts on your ability to be successful and contribute to society, not just in school, but for the rest of your life," she said.


Are kids' ER visits for food allergies on the rise?


By Amy Norton

Reuters Health

Tuesday, July 27, 2010

NEW YORK (Reuters Health) – Children's visits to the emergency room for serious food-allergy reactions may be on the rise, if the experience of one major U.S. medical center is an indicator.

Researchers at Children's Hospital Boston found that the number of food-induced allergic reactions treated in their ER more than doubled over six years -- from 164 cases in 2001, to 391 in 2006.

There was an even sharper increase in the number of more serious, and sometimes life-threatening, reactions known as anaphylaxis. Signs and symptoms of anaphylaxis include skin reactions like hives and flushed or pale skin; nausea, vomiting or diarrhea; dizziness or fainting; difficulty breathing; and a sudden drop in blood pressure that can lead to shock.

In 2001, the current study found, there were 78 cases of food-induced anaphylaxis; in 2006, that number was 207.

That corresponded to a rate of 15 anaphylaxis cases for every 10,000 ER visits in 2001, and a rate of 38 per 10,000 in 2006, the researchers report in the Journal of Allergy and Clinical Immunology.

The reasons for the increases cannot be gleaned from the data. But the findings are in line with studies pointing to a general increase in food allergies among U.S. children in recent years, first author Dr. Susan A. Rudders told Reuters Health in an email.

According to the U.S. Centers for Disease Control and Prevention, 3 million school-aged children in the U.S. had a food allergy in 2007, which was up 18 percent from 10 years earlier.

Among the most common triggers of children's food allergies are peanuts and tree nuts -- such as almonds, walnuts and cashews -- milk and eggs.

No one is sure why food allergies are being increasingly diagnosed, Rudders said. One theory, she noted, is that changes in diet may be at work; another theory, known as the "hygiene hypothesis," holds that today's clean living -- creating less exposure to germs from early life on -- may in some people make the immune system more prone to attacking normally benign substances, like food proteins and pollen.

It is not yet clear whether the rise in ER visits for serious food reactions seen in this study points to a wider trend. Rudders said that this appears to be the first study looking specifically at ER visits for serious food reactions, and further research at other centers is needed.

A limitation of the current study is that it was a review of medical records, and the researchers could not test the children to confirm that they had a food allergy. Food-related allergies were defined as symptoms suggestive of an immune-system reaction after a child had reportedly been exposed to a food allergen.

Anaphylaxis was defined as a reaction involving at least two organ systems in the body, or a sudden drop in blood pressure alone.

If the current findings can be extrapolated to other U.S. medical centers, Rudders and her colleagues write, that would mean that the number of ER visits spurred by food allergies each year is actually much higher than has been estimated. An often-quoted statistic, they note, is that severe food reactions send 30,000 Americans to the emergency room every year.


Journal of Allergy and Clinical Immunology, online July 10, 2010.

Calcium Connections: Basic Pathway for Maintaining Cell's Fuel Stores



Tuesday, July 27, 2010


ScienceDaily (July 27, 2010) — University of Pennsylvania School of Medicine researchers have described a previously unknown biological mechanism in cells that prevents them from cannibalizing themselves for fuel. The mechanism involves the fuel used by cells under normal conditions and relies on an ongoing transfer of calcium between two cell components via an ion channel. Without this transfer, cells start consuming themselves as a way of to get enough energy.


"Altered metabolism is a feature of many diseases, as well as aging," says senior author J. Kevin Foskett, PhD, professor of Physiology. "The definition of this essential mechanism for regulating cell energy will have implications for a wide variety of physiological processes and diseases." The investigators describe their findings in the cover article in the most recent issue of Cell.


Most healthy cells in the body rely on a complicated process called oxidative phosphorylation to produce the fuel ATP. Knowledge about how ATP is produced by the cell's mitochondria, the energy storehouse, is important for understanding normal cell metabolism, which will provide insights into abnormal cell metabolism, as in the case of cancer.


Foskett and colleagues discovered that a fundamental control system regulating ATP is an ongoing shuttling of calcium to the mitochondria from another cell component called the endoplasmic reticulum.


The endoplasmic reticulum is the major reservoir of calcium in cells. The stored calcium is released to adjacent mitochondria through a calcium ion channel called the IP3 receptor. The researchers found that this calcium release occurs at a low level all the time.


When the researchers interfered with the calcium release using genetic or pharmacological methods, the mitochondria were unable to produce enough ATP to meet the needs of the cell. This indicates that mitochondria rely on the ongoing calcium transfer to make enough ATP to support normal cell metabolism. In the absence of this transfer, the mitochondria fail to make enough ATP, which triggers an extreme cell survival process called autophagy, or self eating.


"We discovered that this self consumption as a response to the lack of the calcium transfer appears to work in many types of cells, including hepatocytes from the liver, vascular smooth muscle cells, and various cultured cells lines," says Foskett.


Autophagy is important for clearing aggregated proteins from cells, for example in neurodegenerative diseases, and it plays a role in cancer and hypertension. The IP3 receptor plays important roles in the regulation of programmed cell death, a process that is subverted in many cancers, and in neurodegenerative diseases, including Alzheimer's and Huntington's diseases. Calcium release from the IP3 receptor may be at the nexus of neurodegeneration, cancer and the role of cell metabolism gone awry in these broad disease classes.


This research was funded by the National Institute of General Medical Sciences, the National Heart, Lung, and Blood Institute, and the National Institute of Diabetes and Digestive and Kidney Diseases.

Journal Reference:

Cιsar Cαrdenas, Russell A. Miller, Ian Smith, Thi Bui, Jordi Molgσ, Marioly Mόller, Horia Vais, King-Ho Cheung, Jun Yang, Ian Parker, Craig B. Thompson, Morris J. Birnbaum, Kenneth R. Hallows, J. Kevin Foskett. Essential Regulation of Cell Bioenergetics by Constitutive InsP3 Receptor Ca2 Transfer to Mitochondria. Cell, 2010; DOI: 10.1016/j.cell.2010.06.007


Monday, July 26, 2010


Educated people cope better with dementia


By Kate Kelland


Monday, July 26, 2010

LONDON (Reuters) – Educated people are better able to cope with the physical effects of dementia, and even one extra year of education can significantly cut the risk of developing the brain-wasting disease, scientists said on Monday.

The findings by scientists from Britain and Finland could have important implications for public health at a time when populations in many countries are rapidly aging and dementia numbers are expected to rise sharply.

The researchers found that people who go on to university or college after leaving school appear to be less affected by the brain changes, or pathology, associated with dementia than those who stop education earlier.

"More education is not associated with any differences in the damage to the brain, but people with higher education can cope with that damage better," Hanna Keage from Cambridge University, who worked on the study with an Anglo-Finnish team, said in a telephone interview.

Over the past decade, studies on dementia have shown that the more time you spend in education, the lower your risk of dementia -- but until now scientists had not known whether this was because education somehow protected the brain against damage, or because it made people better able to cope.

In this study, published in the journal Brain, post-mortem examinations showed that the pathology, or changes, in the brain, were similar in those who were educated for longer and those who were not, but the disease's affects on more educated people was mitigated by their greater ability to cope.

Psychological Strength

Keage said this may be due to psychological strength, which might allow those with more education to think around problems presented by their disease or find ways to overcome them.

It also found that for every extra year of education there was an 11 percent decrease in the risk of developing dementia.

Around 35 million people around the world have dementia. Its most common form is Alzheimer's disease, in which patients gradually lose their memory, their ability to understand the world and to look after themselves. Despite decades of research, doctors still have few effective weapons against it.

Developing ways of preventing dementia is becoming more and more important for governments worldwide as the number of dementia cases globally is expected to almost double every 20 years to 66 million in 2030 and over 115 million in 2050, and the cost of coping with the disease in aging populations is forecast to rise dramatically in the coming decades.

Keage's team said that in the United States for example, if the onset of dementia could be delayed by two years in those aged over 50, there would be nearly two million fewer cases of dementia over the next 40 years -- a reduction that would also dramatically cut the projected economic costs of the disease.

The scientists examined the brains of 872 people who were involved in three large European studies of aging and who, before their deaths, had completed questionnaires about their education, when they left school and if they went to university.

"Our study shows education in early life appears to enable some people to cope with a lot of changes in their brain before showing dementia symptoms," Keage said.

(Editing by Peter Millership)

Study Explores Links Between Obesity and Chronic Pain

HealthDay News

Monday, July 26, 2010

MONDAY, July 26 (HealthDay News) -- Obesity and chronic pain are both linked with family history and mood disorders, a new study suggests.

Previous research has shown that overweight people are at greater risk for chronic pain, mainly due to excessive weight placed on the joints. The most common pain disorders related to overweight and obesity are low back pain and osteoarthritis.

In this new study, Lisa Johnson Wright, of the University of California, San Diego, along with colleagues there and at the University of Washington in Seattle and the Veterans Affairs San Diego Healthcare System, examined data from 3,471 people in the University of Washington Twin Registry in order to determine how family history and psychological factors influence the relationship between obesity and chronic pain.

"Overall, overweight and obese twins were more likely to report low back pain, tension-type or migraine headache, fibromyalgia, abdominal pain, and chronic widespread pain than normal-weight twins after adjustment for age, gender and depression," Wright and colleagues wrote in the July issue of the Journal of Pain.

The study authors also concluded that depression and family history play a significant role linking obesity and pain.

In terms of depression, behavioral factors play a role in obesity and pain. Depressed people are often sedentary, which can lead to obesity and contribute to acute pain becoming chronic pain, the researchers explained in a news release from the American Pain Society.

Chronic pain and obesity are significant problems in the United States, the researchers noted, with costs related to obesity estimated at $118 billion annually. For chronic pain the estimate is $70 billion a year in health-care expenses and lost productivity.

More information

The American Academy of Family Physicians has more about chronic pain.

Medical device problems hurt 70,000+ kids annually

By Lindsey Tanner

AP Medical Writer

The Associated Press

Monday, July 26, 2010

CHICAGO – More than 70,000 children and teens go to the emergency room each year for injuries and complications from medical devices, and contact lenses are the leading culprit, the first detailed national estimate suggests.

About one-fourth of the problems were things like infections and eye abrasions in contact lens wearers. These are sometimes preventable and can result from wearing contact lenses too long without cleaning them.

Other common problems found by researchers at the U.S. Food and Drug Administration include puncture wounds from hypodermic needles breaking off in the skin while injecting medicine or illegal drugs; infections in young children with ear tubes; and skin tears from pelvic devices used during gynecological exams in teen girls.

Malfunction and misuse are among possible reasons; the researchers are working to determine how and why the injuries occurred and also are examining the prevalence in adults. Those efforts might result in FDA device warnings, depending on what they find, said study co-author Dr. Brock Hefflin.

The most serious problems involved implanted devices such as brain shunts for kids with hydrocephalus (water on the brain); chest catheters for cancer patients receiving chemotherapy at home; and insulin pumps for diabetics. Infections and overdoses are among problems associated with these devices. Only 6 percent of patients overall had to be hospitalized.

Dr. Steven Krug, head of emergency medicine at Chicago's Children's Memorial Hospital, said the study highlights a trade-off linked with medical advances that have enabled chronically ill children to be treated at home and live more normal lives.

Home care can be challenging for families; Krug says he has seen children brought in because catheters were damaged or became infected.

"Health care providers need to be aware of these kids and their devices and how to recognize or diagnose" related problems, Krug said. He was not involved in the study.

The study appears in Pediatrics, published online Monday.

Hefflin and lead author Dr. Cunlin Wang work in the FDA's Center for Devices and Radiological Health. They note there has been recent concern about medical device safety in children, particularly since many devices intended for adults are used in children.

The researchers analyzed medical records from ER visits reported in a national injury surveillance system. Based on data from about 100 nationally representative hospitals, they estimated that 144,799 medical device-related complications occurred during 2004 and 2005, or more than 70,000 yearly.

Almost 34,000 problems were linked with contact lenses in the two-year period. The rest were scattered among 12 other categories including general medical devices such as needles and catheters, gynecology devices and heart devices.

Hefflin said the study is the first to evaluate device-related injuries in children only. It did not include device problems in already hospitalized children.



Link Between Depression, Cholesterol May Differ by Gender

HealthDay News

Monday, July 26, 2010

MONDAY, July 26 (HealthDay News) -- Gender-specific regulation of cholesterol levels may help prevent depression in the elderly, suggests a new study.

French researchers followed a large group of men and women aged 65 and older for seven years. They found that depression in women was associated with low levels of "good" high-density lipoprotein cholesterol (HDL-C), which puts them at higher risk for cardiovascular disease, including stroke.

Previous research has shown that certain types of stroke increase the risk of depression.

In contrast, depression in men was linked with low levels of "bad" low-density lipoprotein cholesterol (LDL-C). This association was strongest in men with a genetic vulnerability to depression related to a serotonin transporter gene.

The study appears in the July 15 issue of the journal Biological Psychiatry.

"Our results suggest that clinical management of abnormal lipid levels may reduce depression in the elderly, but different treatment will be required according to sex," corresponding author Dr. Marie-Laure Ancelin, of INSERM, Montpellier, France, said in a journal news release.

"LDL-C serum level seems to be an important biological marker in men, with a narrow range for normal functioning. Above this range, cardio- or cerebro-vascular risk increases, and below it, there is increased risk of depression," she added.

Therefore, proper regulation of HDL-C and LDL-C levels may help prevent depression in the elderly, the researchers concluded.

More information

The U.S. National Institute on Aging has more about depression.

Downing diet soda tied to risk of premature birth


By Anne Harding

Reuters Health

Monday, July 26, 2010

NEW YORK (Reuters Health) – New research suggests that drinking lots of artificially sweetened beverages may be linked with an increased risk of premature births.

"It may be non-optimal for pregnant women to have high consumption of these types of products," Dr. Thorhallur I. Halldorsson of the Statens Serum Institut in Copenhagen, one of the researchers on the study, told Reuters Health.

"Diet" drinks are widely promoted as a healthy alternative to sugary sodas and juices, but Halldorsson and his colleagues note that there's been little research on the safety of regular consumption of artificial sweeteners in humans.

Soft drinks -- both artificially sweetened and sugar sweetened -- were recently linked to high blood pressure, the researchers add, which increases the risk of premature delivery. To investigate whether there might be a direct link, the researchers looked at nearly 60,000 Danish women who reported on their diet, including how many soft drinks they had each day, at around 25 weeks of pregnancy.

Around 5 percent of women delivered their babies before 37 weeks.

Women who had at least one serving of artificially sweetened soda a day while they were pregnant were 38 percent more likely to deliver preterm than women who drank no diet soda at all, the researchers report in the American Journal of Clinical Nutrition.

Women who had at least four diet sodas a day were nearly 80 percent more likely to deliver preterm. The association was the same for normal-weight and overweight women.

The researchers did not report the actual risk of premature babies in each group. However, according to the March of Dimes, one in eight babies -- or around 13 percent -- is born too soon. This means that if drinking diet soda does indeed increase risk - which must first be confirmed by other research teams -- a woman who drank at least one diet soda daily would have a 17 percent risk, while her risk would be around 22 percent if she drank four or more diet sodas.

In a statement, the Calorie Control Council, a lobbying group for companies that make and distribute low-calorie foods, called the study "misleading."

"This study may unduly alarm pregnant women. While this study is counter to the weight of the scientific evidence demonstrating that low-calorie sweeteners are safe for use in pregnancy, research has shown that overweight and obesity can negatively affect pregnancy outcomes," Beth Hubrich, a dietitian with the council, said in the statement. "Further, low-calorie sweeteners can help pregnant women enjoy the taste of sweets without excess calories, leaving room for nutritious foods and beverages without excess weight gain - something that has been shown to be harmful to both the mother and developing baby."

Because only diet soda was linked to preterm delivery, not sugar-sweetened soda, the findings suggest that the artificial sweetener itself, not soda drinking, could account for the relationship, the researchers say. However, they add, other possible causes for the link can't be ruled out.

The researchers didn't look at specific artificial sweeteners, and Halldorsson noted that many beverages contain more than one of these chemicals. However, he and his colleagues say, there is indirect evidence linking the sweetener aspartame to preterm delivery in animals.

Aspartame breaks down into methanol and other substances in the body, which can in turn be converted to toxic substances such as formaldehyde and formic acid, the researchers explain. And studies in non-human primates have linked even very low exposure to methanol to shortened pregnancy and labor complications.

While pregnant women who consume soft drinks shouldn't be alarmed by the findings, Halldorsson said, "what we are seeing warrants further attention."

According to the American College of Obstetricians and Gynecologists, women who normally use the artificial sweeteners saccharin (Sweet n' Low), aspartame (NutraSweet), sucralose (Splenda) or acesulfame K (Sunett, Sweet One) can safely continue to do so "in moderation" during pregnancy.


American Journal of Clinical Nutrition, online June 30, 2010.

Most Men With Low-Risk Prostate Cancer Treated Aggressively, Study Shows


By Steven Reinberg
HealthDay Reporter

HealthDay News

Monday, July 26, 2010

MONDAY, July 26 (HealthDay News) -- Too many men with low-risk prostate cancers, those whose level of prostate-specific antigen (PSA) is normal or below normal, still receive aggressive treatment, a new study shows.

Recent evidence has shown that among older men with low-risk prostate cancer, it's not the cancer they die from, but another condition. For these men, watchful waiting is probably better than surgery or radiation therapy, the researchers noted.

"The difficulty we have right now is that we need further efforts in research to understand who is who, and individualize treatment in a better way," said lead researcher Dr. Robert S. DiPaola, director of the Cancer Institute of New Jersey and associate dean for oncology programs and professor of medicine at UMDNJ-Robert Wood Johnson Medical School in New Brunswick, N.J.

Understanding more about prostate cancer will enable doctors to make better use of the therapies available, he added. "Obviously, there is a large population, if we knew who they were, [that] would not need that therapy," he said.

But on an individual basis, the decision whether to have aggressive treatment or not is complex, DiPaola noted. Because the decision may be different "depending on age, aggressiveness of the tumor, the PSA level, this is a call to action that patients need a very informed discussion. They need all those things considered, and the approach needs to be individualized," he said.

The report is published in the July 26 issue of the Archives of Internal Medicine.

For the study, DiPaola's team collected data on 123,934 men with prostate cancer who were listed in the Surveillance, Epidemiology and End Results (SEER) system. Among these men, 14 percent had PSA levels at or below 4 nanograms per milliliter, which is normal or below normal. These patients were likely to have low-risk cancer, the researchers say.

Although the men had low-risk cancer, more than 75 percent of them underwent surgery to remove their prostate or had radiation therapy, DiPaola's group found.

More than 90 percent of prostate cancers are found before the disease has spread to other parts of the body, and these men have a five-year survival rate of almost 100 percent, the researchers say. Since 1975, the overall survival rate of men with prostate cancer has increased, from 69 percent to almost 99 percent in 2003, they added.

Dr. Anthony D'Amico, chief of radiation oncology at Brigham and Women's Hospital in Boston, said one problem with this study is that whether patients had another serious medical condition, other than prostate cancer, such as heart disease or diabetes, is not mentioned.

"What needs to be done is to look at people's risk profile, not just based on the PSA and the kind of cancer that was diagnosed, but also based on their overall health," he said. "There is no data, to date, to understand the natural history of untreated low-risk, low-PSA, prostate cancer in healthy men in their 60s and 70s whose life expectancy is exceeding 10 to 15 years," he said.

D'Amico thinks that healthy younger men with low-risk prostate cancer may opt for aggressive treatment, while older men in poorer health could benefit from active monitoring. "For men 60 and 65 in good health, I think, treatment is warranted," he said.

For another expert, the problem of overtreatment starts with over-screening.

Dr. Otis Brawley, chief medical officer of the American Cancer Society, said that "there are huge problems with PSA screening." Most men who have prostate cancer will die from some other condition and do not have to have their prostate cancer treated, he added.

"PSA screening is so good it diagnoses far too many men with prostate cancer, and is so bad it misses a lot of prostate cancer," he added.

There are a lot of uncertainties regarding prostate cancer and prostate cancer screening as to whether it save lives, as to whether it diagnoses the cancers that need to be treated or the cancers that simply need to be watched, Brawley said. "Unfortunately, over the last 20 years men have not been told that truth."

Brawley thinks men who are worried about prostate cancer should be screened. "It's okay to get prostate cancer screening, but realize that prostate cancer screening is not nearly as good, as clearly beneficial, as many people have said," he said.

The overdiagnosis of prostate cancer is leading to overtreatment, Brawley said. "Over the last 20 years, since we started screening, well over 2 million men were needlessly treated for prostate cancer," he said.

"At least 40 percent, or probably more than 60 percent of the men who we diagnose, don't need to be diagnosed," Brawley said.

More information

For more information on prostate cancer, visit the American Cancer Society.