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Friday, June 3, 2011

Omega-3 fats linked to lower diabetes risk

By Amy Norton

Reuters Health

Friday, June 3, 2011

NEW YORK (Reuters Health) – People who get plenty of omega-3 fatty acids in their diets may have lowered odds of developing type 2 diabetes, two new reports suggest.

In one study, of more than 3,000 older U.S. adults, researchers found that those with the highest blood levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) -- two omega-3s found in fatty fish -- were about one-third less likely to develop diabetes over the next decade than their counterparts with the lowest levels.

In the other, researchers found that among 43,000 Singapore adults, those who got the most alpha-linolenic acid (ALA) in their diets had a decreased diabetes risk. ALA is an omega-3 fat found in certain plant foods, including flaxseed, canola oil and soy.

But before anyone runs out to buy fish oil pills, researchers caution that their findings do not prove that omega-3 fats, themselves, fight diabetes. The fats may, for instance, be markers for some other aspect of the participants' diet or lifestyle that influences diabetes risk.

People often hope there is a dietary "magic bullet" against disease, noted Andrew Odegaard of the University of Minnesota in Minneapolis, one of the researchers on the Singapore study.

He advised that people focus on getting plenty of healthy "whole foods" -- especially fruits, vegetables, fiber-rich grains, legumes, vegetable oils and fish -- instead of any single nutrient.

"Approaching your dietary intake with this 'big picture' approach should take care of the small things, like essential nutrients such as omega-3 fatty acids," Odegaard told Reuters Health in an email.

Neither of the new studies, which appear in the American Journal of Clinical Nutrition, proves that omega-3s directly lower diabetes risk.

In fact, studies up to now have come to conflicting conclusions on the connection between omega-3s and diabetes. A few have even found that people with a high intake of omega-3s, which are considered "good" fats, have an increased diabetes risk.

But the new U.S. study did something most previous ones have not: looked at people's actual blood levels of omega-3 fatty acids and their later risk of diabetes.

That type of study generally offers stronger evidence than those which ask people about their eating habits.

Researchers led by Dr. Luc Djousse of Harvard University used information on 3,088 older U.S. adults taking part in a heart-health study. At the outset, participants' blood levels of EPA, DHA and ALA were measured. Over the next decade, 204 were diagnosed with diabetes.

The researchers found that of the one-quarter of study participants with the highest EPA/DHA levels, 5 percent developed diabetes. That compared with 6.5 percent of the one-quarter with the lowest blood levels of the fatty acids.

The difference was greater when it came to ALA levels: just under 4 percent of people with the highest levels developed diabetes, versus 8.5 percent of those with the lowest.

When the researchers accounted for other factors -- like weight and exercise habits -- people's omega-3 levels, themselves, were still connected to a lower diabetes risk.

For the other study, Odegaard and his colleagues looked at records from 43,176 Singapore adults ages 45 to 74 who were interviewed about their diet habits, then followed over the next decade. During that time, 2,252 developed diabetes.

Overall, the 20 percent of participants with the highest ALA intake from food were less likely to develop diabetes than the 20 percent who ate the least: just under 5 percent did, versus 6 percent in the lowest-intake group.

After accounting for weight, exercise and other factors, the researchers found that high ALA intake was linked to a 22 percent dip in diabetes risk.

Omega-3s from fish, however, were not tied to diabetes risk.

It's not clear why ALA appeared to protect against diabetes, according to Odegaard. Some lab research, he said, has suggested that omega-3s -- and particularly ALA -- might improve body cells' sensitivity to insulin, the hormone that regulates blood sugar.

However, Odegaard also pointed out that people who consume a lot of ALA are likely to have a good diet overall -- and probably healthy lifestyle habits like regular exercise.

And while he and his colleagues tried to factor in those variables, it's still possible that it is not the ALA, specifically, that offers the anti-diabetes benefit.

As for why omega-3 from fish was not linked to diabetes risk, Odegaard said that a potential explanation might rest in how people prepare their fish. If it's fried and served with less-than-healthy side dishes, for example, any protective effect of omega-3s might be washed out.

"There are many things to consider," Odegaard said, "in this inherently complicated nutritional topic."

Source: http://bit.ly/maUxx9 and http://bit.ly/ksCC2b

American Journal of Clinical Nutrition, online May 18, 2011.

Concussions Tied to Verbal Memory Loss in Young Athletes

HealthDay News

Friday, June 3, 2011

FRIDAY, June 3 (HealthDay News) -- College athletes who suffer a concussion may experience poor verbal memory, researchers have found.

A concussion is a head injury that can cause headache, dizziness, irritability, mood changes, vomiting, changes in vision and hearing, as well as difficulty following instructions.

"This study corroborates the effect of concussion on brain functioning in student-athletes," study author Robert Gardner, a student at Elon University in North Carolina, said in a news release.

In examining 100 female and male college athletes who played football and soccer, the study authors found multiple signs of decreased brain function, or cognitive processing, among those who had sustained a concussion. Specifically, verbal memory was worse in those who suffered the head injury than those who did not.

More than 20 states have already passed legislation to ensure the safety of young athletes, and educate players, parents and coaches about the dangers of concussions. The researchers concluded, however, that even more research is needed to determine the full extent of a concussion's effects on cognition, particularly in the developing brains of children and teens.

The findings were scheduled for presentation this week at the annual meeting of the American College of Sports Medicine, held in conjunction with the World Congress on Exercise Is Medicine, in Denver. Experts note that research presented at meetings isn't subjected to the same type of scrutiny given to research published in peer-reviewed journals.

More information

The National Collegiate Athletic Association offers more information on concussion in sports.

Drifting Pesticides May Endanger People in Nearby Workplaces

HealthDay News

Friday, June 3, 2011

FRIDAY, June 3 (HealthDay News) -- People who work near fields sprayed with pesticides face an increased risk for Parkinson's disease, a new study has found.

Not just agricultural workers but teachers, firefighters, clerks and others whose workplaces are near fields in California's Central Valley are at greater risk for the degenerative disorder of the central nervous system, according to researchers from the University of California, Los Angeles.

"This stuff drifts," the study's senior author, Dr. Beate Ritz, an epidemiology professor at the UCLA School of Public Health, said in a university news release. "It's borne by the wind and can wind up on plants and animals, float into open doorways or kitchen windows -- up to several hundred meters from the fields."

The study focused on three pesticides used on the fields: the fungicides maneb and ziram and the herbicide paraquat. The researchers estimated the exposure of 703 people who lived or worked in the area over a 25-year span, taking into account how far they were from the fields sprayed with the chemicals. About half of the people in the study had Parkinson's.

The risk for Parkinson's rose threefold for those who worked near fields sprayed with the three pesticides, the study found. Exposure to just ziram and paraquat raised risk by 80 percent. Earlier analysis by the researchers had found a 75 percent jump in risk for people who lived near fields where maneb and paraquat were sprayed.

The findings suggest that the chemicals act together in increasing the risk for Parkinson's, according to the study, published online in the European Journal of Epidemiology.

"Our estimates of risk for ambient exposure in the workplaces were actually greater than for exposure at residences," said Ritz. "And, of course, people who both live and work near these fields experience the greatest ... risk. These workplace results give us independent confirmation of our earlier work that focused only on residences, and of the damage these chemicals are doing."

More information

The U.S. Environmental Protection Agency offers tips on reducing pesticide risk.

How High-Fat Diet During Pregnancy Increases Risk of Stillbirth

ScienceDaily

Friday, June 3, 2011

ScienceDaily (June 3, 2011) — Eating a high-fat diet during pregnancy increases the chance of stillbirth, according to new research at Oregon Health & Science University. The new data show eating a typical American diet, which is high in fat, decreases blood flow from the mother to the placenta, the temporary organ that nourishes the unborn fetus. Prior to this study, exactly how a fatty diet contributes to stillbirth was unclear.

The findings are published in the June edition of the journal Endocrinology.

The study was conducted at the OHSU Oregon National Primate Research Center. Because the placental structure of the Japanese macaque is very similar to that in humans, cause and effect can be better established. The researchers hope their work will inform expectant moms and their physicians about the inherent dangers of a high-calorie, high-fat diet.

"This study demonstrates that maternal diet during pregnancy has a profound influence on both placental and fetal development. The high-calorie, high-fat diet common in our society has negative effects on placental function and may be a significant contributor to adverse pregnancy outcomes, such as stillbirth," said Antonio Frias, M.D., principal investigator and assistant professor of obstetrics and gynecology (perinatology/maternal-fetal medicine) in the OHSU School of Medicine.

Previous studies have shown that nearly all adverse outcomes during pregnancy -- abnormal fetal growth, preeclampsia, preterm labor and stillbirth -- are in some way associated with an abnormally developed, or damaged, placenta, the temporary organ that nourishes the unborn fetus. In addition, maternal obesity has been associated with placental inflammation and dysfunction and an increased risk of stillbirth. Considering these findings, the researchers hypothesized that eating a diet high in fat during pregnancy also may increase the risk of placental inflammation and the risk of stillbirth.

Frias and colleagues observed 24 pregnant Japanese macaques that ate either a diet comprising 32 percent calories from fat or a control diet with 14 percent fat calories for at least four years.

The researchers found the monkeys that ate a high-fat diet experienced a significant decrease in blood flow from the uterus to the placenta, a reduction of 38 percent to 56 percent, and a rise in placental inflammation. This was the case regardless of whether the monkeys were obese or slender. The risk of stillbirth was further compounded, however, when the monkeys were obese with hyper-insulinemia, or pre-diabetes.

Additional studies are needed to determine exactly how a high-fat diet decreases placental blood flow, the researchers report.

Future studies also will investigate the impact of dietary changes and diet supplementation on improving outcomes in both monkeys and humans.

The National Institutes of Health funded the study. Technical assistance was provided by the Division of Animal Resources and veterinary staff at the OHSU Oregon National Primate Research Center. Researchers who contributed to the study include: Terry K. Morgan, M.D., Ph.D.; Anne E. Evans; Juha Rasane, M.D, Ph.D.; Karey Y. Oh, M.D.; Kent L. Thornburg, Ph.D.; and Kevin L. Grove, Ph.D.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

A. E. Frias, T. K. Morgan, A. E. Evans, J. Rasanen, K. Y. Oh, K. L. Thornburg, K. L. Grove. Maternal High-Fat Diet Disturbs Uteroplacental Hemodynamics and Increases the Frequency of Stillbirth in a Nonhuman Primate Model of Excess Nutrition. Endocrinology, 2011; 152 (6): 2456 DOI: 10.1210/en.2010-1332

Vegans may be at risk for low iodine: study

By Genevra Pittman

Reuters Health

Friday, June 3, 2011

NEW YORK (Reuters Health) – Some vegans may not be getting enough iodine in their diets, suggests a new study.

That finding is particularly relevant for women who are pregnant, researchers say, as that's a time when a mom's iodine levels are strained by her growing baby.

"It's an interesting observation that we ought to pay attention to," said Dr. Robert Smallridge, an endocrinologist at the Mayo Clinic in Jacksonville, Florida, who was not involved in the new research.

Though the study was small, the researchers "have identified a group that may be more likely to be iodine insufficient," Smallridge told Reuters Health. "That's an important thing for us to recognize and to counsel our patients about."

Iodine, which is present in iodized salt, seafood, eggs, dairy, and some breads, is used by the thyroid gland to help regulate metabolism and development, especially in babies and young kids.

Iodine deficiency during fetal and early-childhood development is a leading cause of brain impairments in much of the world.

Although researchers believe that most people in the U.S. get plenty of iodine in their diets, the American Thyroid Association recommends that pregnant and breastfeeding women take a vitamin with iodine because low iodine can increase the risk of miscarriage and thyroid problems in moms, in addition to mental disabilities in babies.

Dr. Angela Leung of Boston Medical Center, lead author of the new study, said that little research has been done on whether or not vegetarians and vegans may be more likely to have iodine deficiencies because of their dietary restrictions.

As a first stab at that question, she and her colleagues recruited 140 vegetarians and vegans -- mostly women -- and tested their urine for concentrations of iodine.

According to the World Health Organization, the general recommended range of iodine concentrations per liter of urine is between 100 and 199 micrograms, and between 150 and 249 micrograms per liter in pregnant women.

Leung and her colleagues calculated an average iodine level of 147 micrograms in vegetarians and 79 in vegans - those who avoid not just meat but eggs and dairy products as well.

Researchers also measured the participants' levels of thyroid hormones as a gauge of how well their thyroids were functioning, in addition to levels of a couple of chemicals - perchlorate and thiocyanate - known to interfere with iodine in the thyroid.

Thyroid hormone levels were similar in both vegetarians and vegans, and in the normal range, the authors report in The Journal of Clinical Endocrinology and Metabolism. Iodine concentrations were not linked to thyroid function in either group.

Leung said that's probably because the study was very small, which makes it harder for those associations to come out.

There was also no relationship between thyroid hormone levels and urine concentrations of perchlorate, a contaminant in food and water, or of thiocyanate, a chemical found in cabbage-like vegetables and in cigarette smoke.

One limitation of the study is that the urine test for iodine is only a window into recent iodine consumption, and can't get at how long-term iodine levels may be affecting the thyroid.

Leung said the purpose of this study was mainly to make the public aware of the issue of iodine deficiency, especially in women who forego some high-iodine foods, and to open the door for more research into this topic.

"In vulnerable populations, especially women that are pregnant or lactating, we want those populations to be sufficient in iodine," Leung told Reuters Health.

"All women of childbearing age should be encouraged to take iodine supplements... to ensure that the fetus is exposed to additional iodine during development," Leung said. "In particular vegan women of childbearing age should be encouraged to do that."

Too much iodine can also cause thyroid problems. Sarah Bath, a PhD student studying iodine in women at the University of Surrey, UK, said that people starting supplements should stay away from kelp and seaweed supplements - which may have widely variable iodine levels. She also said they should have a doctor looking out for them while taking iodine.

Supplements in the form of potassium iodide can be bought for a few cents per capsule.

Smallridge said that this study tells doctors that they should be encouraging their vegan patients to get enough iodine, and possibly trying to identify vegetarian patients who may be at risk of iodine deficiency as well.

"Sometimes iodine gets overlooked with milk-free diets or vegan diets," Bath, who did not participate in the new study, told Reuters Health. "In countries that are iodine sufficient...iodine is not something that people are concerned with because of this overriding assumption that intakes are okay."

Bath cited another recent study, published yesterday in The Lancet, which found that half of female adolescents sampled in the UK had at least mild iodine deficiency.

Sources: http://bit.ly/jBZDXP

The Journal of Clinical Endocrinology and Metabolism, online May 25, 2011. http://bit.ly/ipDssd The Lancet, online June 2, 2011. 

Mental Illness Linked to Greater Risk of Death After Heart Attack

HealthDay News

Friday, June 3, 2011

FRIDAY, JUNE 3 (HealthDay News) -- People with mental illness are more likely to die following a heart attack or serious cardiac event, a new study finds.

One explanation for this increased risk is that people with mental illness are 14 percent less likely to receive lifesaving treatments for their heart condition, researchers found.

Those treatments included coronary artery bypass graft (bypass surgery) and angioplasty (a procedure to open blocked arteries using a stent), both of which have been shown to improve outcomes for heart patients, researchers said.

The study, published June 1 in the British Journal of Psychiatry, examined 22 published studies that compared the level of care given to those with and without serious mental disorders.

"In 10 studies that specifically addressed care for people with schizophrenia, those with the disease received only half the interventions offered to those without schizophrenia," lead researcher Alex J. Mitchell, of the University of Leicester and University Hospitals of Leicester NHS Trust, said in a news release from the university.

Six studies involving more than 800,000 people found that the risk of death was 11 percent higher in the year after a cardiac event in people with a history of serious mental illness than those without.

"People with known mental health conditions have higher background rates of cardiovascular risk factors such as smoking, inactivity and obesity. We already know that this is reflected in a higher rate of heart disease, but what we demonstrate here is that mortality is greater even after patients come under health care," Mitchell said. "We don't yet know the reason for these poorer outcomes but it is worrying that we also find such patients may receive less frequent lifesaving interventions."

The study authors concluded more research is needed to determine whether patients with severe mental illness are declining treatment or whether physicians are not offering the same level of care to the mentally ill that they offer to their patients without mental disorders.

More information

The U.S. National Institute of Mental Health offers statistics on the prevalence, treatment and costs of mental illness.

Thursday, June 2, 2011

Eating Dirt Can Be Good for the Belly, Researchers Find

ScienceDaily

Thursday, June 2, 2011

ScienceDaily (June 2, 2011) — Most of us never considered eating the mud pies we made as kids, but for many people all over the world, dining on dirt is nothing out of the ordinary. Now an extensive meta-analysis forthcoming in the June issue of The Quarterly Review of Biology helps explain why.

According to the research, the most probable explanation for human geophagy -- the eating of earth -- is that it protects the stomach against toxins, parasites, and pathogens.

The first written account of human geophagy comes from Hippocrates more than 2,000 years ago, says Sera Young, a researcher at Cornell University and the study's lead author. Since then, the eating of earth has been reported on every inhabited continent and in almost every country.

Despite its ubiquity, scientists up to now have been unable to definitively explain why people crave earth. Several hypotheses had been considered plausible. Some researchers think geophagy is simply a consequence of food shortage. In other words, people eat dirt to ease the pangs of hunger, even though it doesn't provide any nutritional value. Others have suggested that nutrition is exactly why dirt is consumed; perhaps people crave dirt because it provides nutrients they lack, such as iron, zinc, or calcium. Still others posit that earth has a protective effect, working as a shield against ingested parasites, pathogens, and plant toxins.

To sort through the possible explanations, Young and her colleagues analyzed reports from missionaries, plantation doctors, explorers, and anthropologists to put together a database of more than 480 cultural accounts of geophagy. The database includes as many details as possible about the circumstances under which earth was consumed, and by whom. The researchers could then use patterns in the data to evaluate each potential explanation.

They found the hunger hypothesis unlikely. Studies in the database indicate that geophagy is common even when food is plentiful. Moreover, when people eat dirt they tend to eat only small quantities that are unlikely to fill an empty stomach.

The nutrition hypothesis was also a poor fit to the data. The database shows that the kind of earth people eat most often is a type of clay that contains low amounts of nutrients like iron, zinc, and calcium. Plus, if calcium deficiency drove people to eat dirt, one would expect them to do it most often at life stages when they need calcium the most -- adolescence or old age. But that isn't the case, according to the database. Reports do indicate that geophagy is often associated with anemia, but several studies have shown that cravings for earth continue even after people are given iron supplements. What's more, some research suggests that clay can bind to nutrients in the stomach, making them hard to digest. If that's true, it's not a lack of nutrients that causes geophagy; rather it could be the other way around.

Overall, the protection hypothesis fits the data best, the Cornell researchers found. The database shows that geophagy is documented most commonly in women in the early stages of pregnancy and in pre-adolescent children. Both categories of people are especially sensitive to parasites and pathogens, according to Young and her colleagues. In addition, geophagy is most common in tropical climates where foodborne microbes are abundant. Finally, the database shows that people often eat earth during episodes of gastrointestinal stress. It's unlikely the intestinal problems are caused by the dirt itself because the type of clay people usually eat comes from deep in the ground, where pathogens and parasites are unlikely to contaminate it. Plus, people usually boil the clay before eating it.

More study would be helpful to confirm the protection hypothesis, the researchers say, but the available data at this point clearly support it over the other explanations.

"We hope this paper stimulates [more] research," Young and her colleagues write. "More importantly, we hope readers agree that it is time to stop regarding geophagy as a bizarre, non-adaptive gustatory mistake."

"With these data, it is clear that geophagy is a widespread behavior in humans … that occurs during both vulnerable life stages and when facing ecological conditions that require protection."

Young has also released a book on the subject called Craving Earth: Understanding Pica -- the Urge to Eat Clay, Starch, Ice, and Chalk.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Sera L. Young, Paul W. Sherman, Julius Beau Lucks, and Gretel H. Pelto. Why on Earth?: Evaluating Hypotheses about the Physiological Functions of Human Geophagy. The Quarterly Review of Biology, 2011; 86: 2

Saliva Test Spots Virus That Can Cause Hearing Loss in Newborns

HealthDay News

Thursday, June 2, 2011

THURSDAY, June 2 (HealthDay News) -- A new study finds that a saliva test in newborns can detect almost all cases of a virus that can cause birth defects and hearing loss.

The test could allow doctors to get a head start on preventing or treating deafness in children infected with the virus, known as cytomegalovirus.

The traditional "heel stick" blood test for newborns doesn't do a good job of detecting the infection, which is passed from mother to child and affects tens of thousands of babies each year, although most don't suffer any ill effects. The test misses 60 percent to 70 percent of cases.

Cytomegalovirus is "the epidemic that nobody's ever heard of," said Dr. Mark Schleiss, director of the University of Minnesota Medical School's division of pediatric infectious diseases and immunology. "This virus causes more birth defects in babies than any other infectious disease in the United States today."

In the new study, published in the June 2 issue of the New England Journal of Medicine, researchers at the University of Alabama at Birmingham and colleagues examined mouth swabs taken from almost 35,000 infants from seven U.S. hospitals. They were taken when babies were about a day old.

The researchers tested the samples and confirmed their results using a testing procedure that's too unwieldy for widespread screening use.

They found that the test correctly detected the virus in 97 percent to 100 percent of cases. Just 13 positive tests were incorrect, possibly because secretions from the mother made it into the mouths of the babies, the researchers said.

"We now know that we have a test with saliva that works," study co-author Dr. Suresh Boppana said in a news release from the National Institute on Deafness and Other Communication Disorders. "The challenge is, unlike the dried blood spot [heel stick], which is already used for newborn screening in hospitals across the country, we don't have a system in place for the collection of saliva. But we've shown that if you wanted to test a lot of babies for congenital CMV infection, it can be done."

Schleiss praised the study as "outstanding and meticulous." In regard to deafness, he said, the test could alert physicians to the potential for hearing loss in infected infants -- even if a newborn hearing test doesn't show any problems -- and allow doctors to give preventive drugs or provide hearing aids.

More information

For more on cytomegalovirus, try the U.S. National Library of Medicine.

Mechanism Discovered for Health Benefit of Green Tea, New Approach to Autoimmune Disease

ScienceDaily

Thursday, June 2, 2011

ScienceDaily (June 2, 2011) — One of the beneficial compounds found in green tea has a powerful ability to increase the number of "regulatory T cells" that play a key role in immune function and suppression of autoimmune disease, according to new research in the Linus Pauling Institute at Oregon State University.

This may be one of the underlying mechanisms for the health benefits of green tea, which has attracted wide interest for its ability to help control inflammation, improve immune function and prevent cancer.

Pharmaceutical drugs are available that perform similar roles and have been the subject of much research, scientists say, but they have problems with toxicity. A natural food product might provide a long-term, sustainable way to accomplish this same goal without toxicity, researchers said.

"This appears to be a natural, plant-derived compound that can affect the number of regulatory T cells, and in the process improve immune function," said Emily Ho, an LPI principal investigator and associate professor in the OSU Department of Nutrition and Exercise Sciences.

"When fully understood, this could provide an easy and safe way to help control autoimmune problems and address various diseases," Ho said.

The findings have been published in Immunology Letters.

There are many types of cells that have different roles in the immune system, which is a delicate balancing act of attacking unwanted invaders without damaging normal cells. In autoimmune diseases, which can range from simple allergies to juvenile diabetes or even terminal conditions such as Lou Gehrig's disease, this process goes awry and the body mistakenly attacks itself.

Some cells exist primarily to help control that problem and dampen or "turn off" the immune system, including regulatory T cells. The number and proper function of those regulatory T cells, in turn, is regulated by other biological processes such as transcription factors and DNA methylation.

In this study, OSU scientists did experiments with a compound in green tea, a polyphenol called EGCG, which is believed to be responsible for much of its health benefits and has both anti-inflammatory and anti-cancer characteristics. They found it could cause a higher production of regulatory T cells. Its effects were not as potent as some of those produced by prescription drugs, but it also had few concerns about long-term use or toxicity.

"EGCG may have health benefits through an epigenetic mechanism, meaning we aren't changing the underlying DNA codes, but just influencing what gets expressed, what cells get turned on," Ho said. "And we may be able to do this with a simple, whole-food approach."

Laboratory studies done with mice, Ho said, showed that treatment with EGCG significantly increased the numbers and frequencies of regulatory T cells found in spleen and lymph notes, and in the process helped to control the immune response.

"Epigenetic regulation can be potentially exploited in generating suppressive regulatory T cells for therapeutic purposes, and is of significant clinical importance for the suppression of autoimmune diseases," the researchers said in their study.

The research was done by scientists from OSU, the University of Connecticut, and Changwon National University in South Korea. The work was supported by the National Institute of Environmental Health Sciences and the Oregon Agricultural Experiment Station.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Carmen P. Wong, Linda P. Nguyen, Sang K. Noh, Tammy M. Bray, Richard S. Bruno, Emily Ho. Induction of regulatory T cells by green tea polyphenol EGCG. Immunology Letters, 2011; DOI: 10.1016/j.imlet.2011.04.009 

U.S. says no cancer risk from blood pressure drugs

Reuters

Thursday, June 2, 2011

WASHINGTON (Reuters) – U.S. health officials found on Thursday that a class of widely-used blood pressure drugs does not increase the risk of cancer.

Last year, a published study reported a small increase in the cancer risk for patients taking medicines called angiotensin receptor blockers (ARBs), and the U.S. Food and Drug Administration launched its own year-long safety review.

ARBs are used to treat high blood pressure and other heart-related conditions, and include Novartis's Diovan, Merck's Cozaar, and Avapro from Bristol-Myers Squibb and Sanofi.

"The FDA has completed its review of controlled trial data on more than 155,000 patients randomized to ARBs or other treatments - the largest evaluation of such data to date - and finds no evidence of an increased risk of cancer in patients who take an ARB," said Mary Ross Southworth, a deputy director for safety in the FDA's Division of Cardiovascular and Renal Drugs.

The FDA's conclusion may provide some relief to the big-name makers of ARBs, though they face a larger threat from generic rivals already beginning to flood the market.

A study published in June 2010 in the Lancet medical journal looked at data from more than 1,000 patients in several long-term clinical trials and found that the rate of new cancer cases was 7.2 percent for patients who took an ARB versus 6 percent for patients who did not.

An earlier analysis of data from several clinical trials showed patients who took ARBs were 1.2 percent more likely to be diagnosed with a new cancer over four years than those who did not.

In its study, the FDA evaluated 31 randomized clinical trials and said its analysis resolved all concerns about the relationship between ARBs and cancer.

ARBs work by blocking receptors for angiotensin II, a hormone that raises blood pressure. Sustained high blood pressure increases the risk of death, heart attacks, stroke, heart failure and kidney failure.

(Reporting by Anna Yukhananov; editing by )

Scientists Find Way to Block Stress-Related Cell Death: New Drug Target for Heart Attack, Stroke and Parkinson's Disease?

ScienceDaily

Thursday, June 2, 2011

ScienceDaily (June 2, 2011) — Scientists from the Florida campus of The Scripps Research Institute have uncovered a potentially important new therapeutic target that could prevent stress-related cell death, a characteristic of neurodegenerative diseases such as Parkinson's, as well as heart attack and stroke.

In the study, published recently in the journal ACS Chemical Biology, the scientists showed they could disrupt a specific interaction of a critical enzyme that would prevent cell death without harming other important enzyme functions.

The enzyme in question is c-jun-N-terminal kinase (JNK), pronounced "junk," which has been implicated in many processes in the body's response to stresses, such as oxidative stress, protein misfolding, and metabolic disorder. JNK also plays an important role in nerve cell survival and has become a target for drugs to treat neurodegenerative disorders such as Parkinson's disease.

In recent studies, JNK has been found to migrate to the mitochondria -- the part of the cell that generates chemical energy and that is involved in cell growth and death. That migration, coupled with JNK activation, is associated with a number of serious health issues, including apoptosis or programmed cell death, liver damage, neuronal cell death, stroke and heart attack.

"Activated JNK migrates to the mitochondria in reaction to a stress signal," said Philip LoGrasso, professor in the Department of Molecular Therapeutics and senior director for drug discovery at Scripps Florida who led the study. "Once there, it amplifies the effects of reactive oxygen species that cause significant damage to the cell. We developed a small peptide that intervenes in JNK migration and blocks those harmful effects -- specifically cell death."

LoGrasso noted that the team was able to block JNK mitochondrial interaction without harming any other important enzyme processes, such as JNK's impact on gene expression. These findings, LoGrasso said, suggest that this interaction could be exploited in the development of a new drug.

"The peptide we developed will never be a drug, but it is an important new investigative tool that we can use to selectively probe mitochondrial biology," he said. "Our hope is to produce a small molecule that can mimic the inhibitory effect of this peptide. If we can do that, we might be able to selectively inhibit JNK mitochondrial interaction and use it to treat a number of diseases."

The study was supported by National Institutes of Health and the Saul and Theresa Esman Foundation.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Jeremy W. Chambers, Lisa Cherry, John D. Laughlin, Mariana Figuera-Losada, Philip V. LoGrasso. Selective Inhibition of Mitochondrial JNK Signaling Achieved Using Peptide Mimicry of the Sab Kinase Interacting Motif-1 (KIM1). ACS Chemical Biology, 2011; : 110524104023011 DOI: 10.1021/cb200062a

Pyramid tossed, dinner plate is new U.S. meals plan

By Emily Stephenson

Reuters

Thursday, June 2, 2011

WASHINGTON (Reuters) – The pyramid guide to healthy eating that many Americans grew up with has been scrapped, and in its place the Obama administration is serving a dinner plate icon sliced up by food groups.

The new guide, MyPlate, encourages Americans to make half of their meals fruit and vegetables as part of a balanced diet.

"When it comes to eating, what's more useful than a plate? What's more simple than a plate?" first lady Michelle Obama said on Thursday at the unveiling at the Department of Agriculture.

"This is a quick, simple reminder for all of us to be more mindful of the foods that we're eating," she said.

MyPlate, which includes colored sections for grains and proteins and a dairy cup beside it, is part of the administration's push to encourage healthy habits.

Dietary guidelines released in January told Americans to eat more produce and cut salt and fat, and the first lady has led a push to tackle obesity with her "Let's Move" initiative.

Food industry groups rushed to praise the new guide, which will replace the well-known food pyramid in classrooms, and will be used as part of federal food programs as well as by doctors and nurses.

The National Cattlemen's Beef Association said in a statement that lean beef could meet the protein recommendation. Grains groups praised suggestions that Americans eat more whole grains.

"This easy-to-understand illustration will help people remember what their own plate should look like," Margo Wootan, nutrition policy director at the Center for Science in the Public Interest, said in a statement.

"It likely will shock most people into recognizing that they need to eat a heck of a lot more vegetables and fruits."

Replacing The Pyramid

The well-known pyramid -- which was first introduced in 1992 and stacked foods by suggested number of servings -- was widely criticized. Nutritionists said it encouraged too many servings of grains, and producers said the bottom-up ranking discouraged Americans from buying foods at the top of the pyramid.

The 2005 MyPyramid replaced the hierarchy with vertical stripes correlating to recommended servings and an online program that let users develop a food plan. Health professionals found that complicated and difficult to teach.

MyPlate keeps the online tools for personal eating plans, now located at www.choosemyplate.gov, replacing the pyramid with a visual similar to those used by the American Diabetes Association and the Physicians Committee for Responsible Medicine.

"I'm supposed to be able to grab that pyramid and go into a lecture and teach a group of people how to eat. In the past, it's not been very effective," said Kathryn Strong, a dietitian with the physicians group.

"If you're looking at a plate, that's something you can directly translate to whatever you're about to eat."

(Reporting by Emily Stephenson, editing by Maureen Bavdek)

Diabetes risk in pregnancy tied to weight change

By Kerry Grens Kerry

Reuters Health

Thursday, June 2, 2011

NEW YORK (Reuters Health) – Overweight moms who lose weight after their first baby are less likely to develop diabetes during their second pregnancy, a new study shows.

The researchers found the reverse was also true: all women - overweight or not -- who gained weight between pregnancies had a better chance of developing diabetes during their second pregnancy than women whose weight remained stable.

Samantha Ehrlich, the research project manager at the Division of Research at Kaiser Permanente and the lead author on the study, said she was not surprised by the results.

"A lot of people have shown that lifestyle intervention to help people lose weight can delay the onset of type 2 diabetes" in adults who are not pregnant, Ehrlich told Reuters Health.

Being overweight is a risk factor for developing pregnancy-related diabetes, called gestational diabetes, which affects four percent of pregnant women.

Babies whose mothers have gestational diabetes tend to be larger, and mothers are at greater risk for high blood pressure.

Ehrlich and her colleagues examined medical records covering a 10-year period for more than 22,000 women who had their first and second babies using Kaiser Permanente Northern California facilities.

Forty-six out of every 1,000 women had gestational diabetes during their first pregnancies, 52 out of every 1,000 had it during their second pregnancies, and 18 out of every 1,000 mothers developed diabetes during both pregnancies.

The risk of developing diabetes during the second pregnancy among all the women increased with the amount of weight gained after the first baby.

For example, a 5'4'' woman who starts out at a normal weight (up to 145 pounds) and gains six to 12 pounds between pregnancies is almost twice as likely to develop gestational diabetes during her second pregnancy than a similar woman who has not gained weight.

If that same mom gains more than 18 pounds between pregnancies, her risk of gestational diabetes quadruples for her second pregnancy.

The increased risk associated with weight gain between pregnancies was also evident for women who were overweight or obese during their first pregnancy, but the rise was not as steep as for women who were of normal weight.

Dr. Eduardo Villamor at the University of Michigan, who was not involved in the study, has found previously that the risk of gestational diabetes during a second pregnancy increased with the amount of weight women gained after the first one.

"The message is that women should maintain a healthy weight before and after pregnancy," Villamor told Reuters Health in an email.

The current study, which is published in the journal Obstetrics and Gynecology, adds new information about the effect of weight loss on the risk of gestational diabetes.

Losing weight between pregnancies was tied to a reduced risk of diabetes for the second pregnancy, but only among overweight women.

A 5'4'' tall woman who is, for instance, 160 pounds during her first pregnancy, then loses six pounds, cuts her diabetes risk by 38 percent for her second pregnancy.

Is she loses more than 12 pounds, her gestational diabetes risk during the second pregnancy is 75 percent smaller than if her weight had remained the same.

"We thought that these findings indicated for all women that they should get back to their pre-pregnancy weight or lose weight if they were overweight or obese pre-pregnancy," Ehrlich said.

Ehrlich and her colleagues have reported success with a pilot program to help women lose weight after having a baby, but she says she understands the challenge some moms face in getting back the pre-baby body.

"It's easy to say, OK, go lose the baby weight. It's a lot harder to do."

Source: http://bit.ly/mGgZYv

Obstetrics and Gynecology, June 2011.

Baked goods may improve milk allergy symptoms

By Eric Schultz

Reuters Health

Thursday, June 2, 2011

NEW YORK (Reuters Health) – Eating baked goods that contain milk may help children get over milk allergies, a new study suggests.

Allergic children given cooked milk, baked into muffins, over the course of months or years saw their symptoms disappear faster than children who simply avoided milk products.

The researchers say their results have the potential to change how kids are treated for milk allergies -- which affect as many as three percent of young children, according to the National Institute of Allergy and Infectious Disease.

Milk allergy is not the same as lactose intolerance, which is an inability to digest milk products. Kids with allergies can react to the proteins in milk and cheese with symptoms ranging from mild itching to potentially deadly anaphylactic shock.

In the study, milk-allergic kids who were able to tolerate the muffins from the start were also much more likely to eventually grow out of their milk allergies - hinting at the possibility of a muffin test to distinguish transient allergies from more severe ones.

The study is "a step in the direction of...providing a more personalized approach for treating food allergies," co-author Dr. Anna Nowak-Wegrzyn, of the Mount Sinai Medical Center in New York told Reuters Health.

"One approach is not right for all children with milk allergy," she said in an email. "The majority does not need to and should not strictly avoid milk."

In the study, researchers gave 88 milk-allergic children between 2 and 17 years old baked goods that included milk, and compared them to a group of 60 allergic children who followed the standard treatment, which is strict avoidance of milk products.

Just under half of children in the experimental group were able to consume dairy products such as skim milk or yogurt without having allergic reactions by the end of the study period.

That compared to less than a quarter of the group that avoided milk products, the authors report in The Journal of Allergy and Clinical Immunology.

The idea behind the muffin experiment is that heating milk changes the shape of the proteins in it, and lessens the chance that the immune system will react to them.

Among children who eventually outgrew their milk allergies, the ones who received the muffin therapy did so faster than the kids who avoided milk - suggesting that the exposure also helped to hasten the process.

The findings "run contrary to what we thought several years ago" about how childhood milk allergies are treated, and will help "challenge older dogma," Dr. Wesley Burks, chief of pediatric allergy and immunology at Duke University Hospital in Durham, North Carolina, told Reuters Health.

While he is excited by the results of the study, Burks notes that more research is necessary to determine how this therapy will work best in the clinical setting.

Nowak-Wegrzyn agreed, and cautioned that parents of milk-allergic kids should only try the muffin treatment under a doctor's supervision.

Source: http://bit.ly/iHEA9w

The Journal of Allergy and Clinical Immunology, online May 23, 2011. 

Many ways food can get tainted from farm to fork

By Stephanie Nano

The Associated Press

Thursday, June 2, 2011

NEW YORK – On the path from farm-to-fork, there are many ways that foods can pick up nasty germs like the E. coli bug sickening more than 1,600 people across Europe. But there are steps consumers can take to avoid getting infected.

Health officials haven't pinpointed the source of the food poisoning outbreak that has hit Germany the hardest, but they're focusing on lettuce, tomatoes and cucumbers.

E. coli lives in the guts of people and animals and ends up in fecal matter. Those germs can end up in the water that irrigates fields or is used to wash just-picked crops. Or it winds up on the equipment used to harvest and pack up produce, said Jeffrey T. LeJeune of Ohio State University's Ohio Agricultural Research and Development Center in Wooster.

Other sources are animal waste used as fertilizer or from wildlife in the fields. And people are also a major source of contamination, said LeJeune, a veterinarian who has studied E. coli.

"And not just the chef at the greasy spoon who doesn't wash his hands," said LeJeune. "It can happen anywhere along the chain."

Many large farms avoid using manure because of the risk, he said. Manure is typically treated and dried before it is applied to a field, but "there's nobody standing over a farmer's shoulder all the time."

Organic farmers tend to use more manure and natural fertilizers than non-organic producers. Hilde Kruse, a food safety expert at the World Health Organization, said organic food producers were under the same obligations as any other farmers to ensure their practices meet proper hygiene standards.

"It's very difficult to guarantee that compost is sterile and if you can't do that, you are essentially spreading contaminated feces on food intended for human consumption" said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

The European outbreak, which involves a super-toxic E. coli bug, was initially linked to organic cucumbers from Spain, but tests didn't back that up. Based on what patients said they ate before getting sick, health investigators are still focused on cucumbers, tomatoes and lettuce. Greens like lettuce and spinach make it easy for bacteria to hide within leafy folds.

LeJeune says washing fruits and vegetables helps remove E. coli but "you're not going to get rid of it all." He suggests removing "hot spots" — damaged or dead parts like the brown edges on lettuce.

Other advice: Wash your hands before preparing or eating food — especially after using the bathroom or changing a diaper; keep raw meat separate from other foods; and thoroughly cook food.

He also recommends just making better food choices — skipping things like an undercooked hamburger or unpasteurized apple juice to avoid getting sick.

AP Medical Writer Maria Cheng in London contributed to this report.

Online:

http://www.foodsafety.gov

Male Heart Disease May Be Linked to Mom's Lifetime Nutrition

HealthDay News

Thursday, June 2, 2011

THURSDAY, June 2 (HealthDay News) -- A man's heart disease risk after the age of 40 may be linked, at least in part, to his mother's body size and placenta size when he was born, a new study suggests.

"Chronic disease is the product of a mother's lifetime nutrition and the early growth of her child," study lead author Dr. David Barker, a professor of clinical epidemiology at the University of Southampton in the United Kingdom, said in a news release from the European Society of Cardiology. "It is not simply a consequence of poor lifestyles in later life. Rather, it is a result of variations in the normal processes of human development."

The finding is reported online June 1 in the European Heart Journal by Barker, who is also a professor in cardiovascular medicine at Oregon Health and Science University, and colleagues.

Indications of the maternal influence on the heart disease risk of male offspring stem from an analysis involving nearly 7,000 Finnish men who were born in Helsinki between 1934 and 1944.

At that time, birth records included notations on the baby's size, the placental surface size, and other information on the mother's weight, height and age, and previous pregnancies. (The placenta -- a temporary organ that lines the uterus and feeds the baby in the womb -- is expelled at birth.)

The investigators found that male heart disease risk in late adulthood appeared to rise among:

Men whose mothers were short, pregnant for the first time and had relatively oval placentas (indicating that the placental development had been disrupted).

Men whose mothers were tall and heavy and had relatively small placentas (which might have restricted the infants' growth mid-gestation).

Men whose mothers were tall with a lower-than-normal body mass index and whose placentas were heavy relative to birth weight (the mothers' BMIs suggest that their nutrition was poor during pregnancy, Barker explained).

Regardless of which combination was in play, those men with the greatest likelihood for developing heart disease as adults had tended to be relatively thin at birth. This fact, the authors suggested, was an indication that malnourishment was a factor at the time of birth.

"We have been able to show for the first time that a combination of the mother's body size and the shape and size of the placental surface predicts later heart disease," Barker said.

Going forward, the research team intends to study abnormal development of the heart by examining pregnant women's nutritional habits and body characteristics alongside prenatal growth patterns and placenta sizes at birth.

More information

For more on heart disease risk, visit the American Heart Association.

Wednesday, June 1, 2011

Deadly Bacteria May Mimic Human Proteins to Evolve Antibiotic Resistance

ScienceDaily

Wednesday, June 1, 2011

ScienceDaily (June 1, 2011) — Deadly bacteria may be evolving antibiotic resistance by mimicking human proteins, according to a new study by the Translational Genomics Research Institute (TGen).

This process of "molecular mimicry" may help explain why bacterial human pathogens, many of which were at one time easily treatable with antibiotics, have re-emerged in recent years as highly infectious public health threats, according to the study appearing in the online journal PLoS ONE, published by the Public Library of Science.

"This mimicry allows the bacteria to evade its host's defense responses, side-stepping our immune system," said Dr. Mia Champion, an Assistant Professor in TGen's Pathogen Genomics Division, and the study's author.

Using genomic sequencing, the spelling out of billions of genetic instructions stored in DNA, the study identified several methyltransferase protein families that are very similar in otherwise very distantly related human bacterial pathogens. These proteins also were found in hosts such as humans, mouse and rat.

Researchers found methyltransferase in the pathogen Francisella tularensis subspecies tularensis, the most virulent form of Francisella. Just one cell can be lethal. Methyltransferase is a potential virulence factor in this pathogen, which causes Tularemia, an infection common in wild rodents, especially rabbits, that can be transmitted to humans though bites, touch, eating or drinking contaminated food or water, or even breathing in the bacteria. It is severely debilitating and even fatal, if not treated.

Similar methyltransferase proteins are found in other highly infectious bacteria, including the pathogen Mycobacterium tuberculosis that causes Tuberculosis, a disease that results in more than 1 million deaths annually. The study also identified distinct methyltransferase subtypes in human pathogens such as Coxiella, Legionella, and Pseudomonas.

In general, these bacterial pathogens are considered "highly clonal," meaning that the overall gene content of each species is very similar. However, the study said, "The evolution of pathogenic bacterial species from nonpathogenic ancestors is … marked by relatively small changes in the overall gene content."

Genomic comparisons were made with several strains of the bacteria, as well as with plants and animals, including humans. The methyltransferase protein also was found to have an ortholog, or similar counterpart, in human DNA. Although the overall sequence of the orthologs is highly similar, the study identifies a protein domain carrying distinct amino acid variations present in the different organisms.

"Altogether, evidence suggests a role of the Francisella tularensis protein in a mechanism of molecular mimicry. Upon infection, bacterial pathogens dump more than 200 proteins into human macrophage cells called 'effector proteins.' Because these proteins are so similar to the human proteins, it mimics them and enables them to interfere with the body's immunity response, thereby protecting the pathogen,'' Dr. Champion said.

"These findings not only provide insights into the evolution of virulence in Francisella, but have broader implications regarding the molecular mechanisms that mediate host-pathogen relationships," she added.

Identifying small differences between the pathogen and human proteins through Next Generation genome-wide datasets could help develop molecular targets in the development of new drug treatments, she said.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Mia D. Champion. Host-Pathogen O-Methyltransferase Similarity and Its Specific Presence in Highly Virulent Strains of Francisella tularensis Suggests Molecular Mimicry. PLoS ONE, 2011; 6 (5): e20295 DOI: 10.1371/journal.pone.0020295 

ERs Frequented by Kids With Behavioral Problems: Report

HealthDay News

Wednesday, June 1, 2011

WEDNESDAY, June 1 (HealthDay News) -- Regular outpatient care has not kept children and teenagers with mental health issues and behavioral problems from making repeat visits to the emergency room (ER), according to a new study.

Researchers from Johns Hopkins Children's Center found that more often than not, children who repeatedly end up in the ER do not actually have life-threatening emergencies.

The study, published in the June 1 issue of Psychiatric Services, examined the medical records of more than 2,900 children, ranging in age from 3 to 17 years, who were treated at the center's ER for mental health crises over the course of eight years. The analysis revealed that 12 percent of these children had a repeat trip to the ER within six months of their first visit.

The researchers also found that most of the children went to the ER seeking medical attention for behavioral problems or minor psychiatric problems, such as disruptive classroom behavior, verbal disputes and running away. Only 3 percent of the visits involved severe psychotic episodes and 10 percent were suicide attempts, the study authors noted.

Among the 338 patients who had at least two visits to the ER, about two-thirds of them reported having an outpatient mental health provider at both ER visits. Moreover, 85 percent stated during their second trip to the ER that they had a regular mental health provider. The investigators concluded that this could be a sign that patients are not receiving the care they need on an outpatient basis.

The findings are even more troubling given the fact that most ERs are not designed or staffed to provide mental health care, the study authors noted.

"We think of the ER as a 'front door to care,' but our findings suggest otherwise as a significant number of patients repeatedly seek care in the ER despite being connected to an outpatient provider," the study's lead author, Dr. Emily Frosch, a pediatric psychiatrist at Hopkins Children's, said in a news release from the center.

The researchers suggested there could be several possible explanations for the repeat ER visits, including:

Limited office hours may be an obstacle to effective regular outpatient care.

Children and their families may gravitate to ERs following prior positive experiences there.

Some families may see ER care as less stigmatizing than outpatient mental health services.

Outpatient providers may lack sufficient resources and so send patients to the ER.

Frosch and colleagues noted that more research is needed to determine the exact reasons behind these recurrent ER visits for non-emergency psychiatric problems. "We need to understand why families who are already connected to outpatient providers continue to seek ER care, why providers send patients to the ER and what role, if any, ERs may play in the continuum of care for non-psychotic, non-suicidal patients," said Frosch. "It is possible that ERs fulfill an important function in that continuum for some patients."

More information

The U.S. National Institute of Mental Health provides more information on child and adolescent mental health.

Low-Carb, Higher-Fat Diets Add No Arterial Health Risks to Obese People Seeking to Lose Weight, Studies Suggest

ScienceDaily

Wednesday, June 1, 2011

ScienceDaily (June 1, 2011) — Overweight and obese people looking to drop some pounds and considering one of the popular low-carbohydrate diets, along with moderate exercise, need not worry that the higher proportion of fat in such a program compared to a low-fat, high-carb diet may harm their arteries, suggests a pair of new studies by heart and vascular researchers at Johns Hopkins.

"Overweight and obese people appear to really have options when choosing a weight-loss program, including a low-carb diet, and even if it means eating more fat," says the studies' lead investigator exercise physiologist Kerry Stewart, Ed.D.

Stewart, a professor of medicine and director of clinical and research exercise physiology at the Johns Hopkins University School of Medicine and its Heart and Vascular Institute, says his team's latest analysis is believed to be the first direct comparison of either kind of diet on the effects to vascular health, using the real-life context of 46 people trying to lose weight through diet and moderate exercise. The research was prompted by concerns from people who wanted to include one of the low-carb, high-fat diets, such as Atkins, South Beach and Zone, as part of their weight-loss program, but were wary of the diets' higher fat content.

In the first study, scheduled to be presented June 3 at the annual meeting of the American College of Sports Medicine in Denver, the Hopkins team studied 23 men and women, weighing on average 218 pounds and participating in a six-month weight-loss program that consisted of moderate aerobic exercise and lifting weights, plus a diet made up of no more than 30 percent of calories from carbs, such as pastas, breads and sugary fruits. As much as 40 percent of their diet was made up of fats coming from meat, dairy products and nuts. This low-carb group showed no change after shedding 10 pounds in two key measures of vascular health: finger tip tests of how fast the inner vessel lining in the arteries in the lower arm relaxes after blood flow has been constrained and restored in the upper arm (the so-called reactive hyperemia index of endothelial function), and the augmentation index, a pulse-wave analysis of arterial stiffness.

Low-carb dieters showed no harmful vascular changes, but also on average dropped 10 pounds in 45 days, compared to an equal number of study participants randomly assigned to a low-fat diet. The low-fat group, whose diets consisted of no more than 30 percent from fat and 55 percent from carbs, took on average nearly a month longer, or 70 days, to lose the same amount of weight.

"Our study should help allay the concerns that many people who need to lose weight have about choosing a low-carb diet instead of a low-fat one, and provide re-assurance that both types of diet are effective at weight loss and that a low-carb approach does not seem to pose any immediate risk to vascular health," says Stewart. "More people should be considering a low-carb diet as a good option," he adds.

Because the study findings were obtained within three months, Stewart says the effects of eating low-carb, higher-fat diets versus low-fat, high-carb options over a longer period of time remain unknown.

However, Stewart does contend that an over-emphasis on low-fat diets has likely contributed to the obesity epidemic in the United States by encouraging an over-consumption of foods high in carbohydrates. He says high-carb foods are, in general, less filling, and people tend to get carried away with how much low-fat food they can eat. More than half of all American adults are estimated to be overweight, with a body mass index, or BMI, of 26 or higher; a third are considered to be obese, with a BMI of 30 or higher.

Stewart says the key to maintaining healthy blood vessels and vascular function seems -- in particular, when moderate exercise is included -- less about the type of diet and more about maintaining a healthy body weight without an excessive amount of body fat.

Among the researchers' other key study findings, to be presented separately at the conference, was that consuming an extremely high-fat McDonald's breakfast meal, consisting of two English muffin sandwiches, one with egg and another with sausage, along with hash browns and a decaffeinated beverage, had no immediate or short-term impact on vascular health. Study participants' blood vessels were actually less stiff when tested four hours after the meal, while endothelial or blood vessel lining function remained normal.

Researchers added the McDonald's meal challenge immediately before the start of the six-month investigation to separate any immediate vascular effects from those to be observed in the longer study. They also wanted to see what happened when people ate a higher amount of fat in a single meal than recommended in national guidelines. Previous research had suggested that such a meal was harmful, but its negative findings could not be confirmed in the Johns Hopkins' analysis. The same meal challenge will be repeated at the end of the study, when it is expected that its participants will still have lost considerable weight, despite having eaten more than the recommended amount of fat.

"Even consuming a high-fat meal now and then does not seem to cause any immediate harm to the blood vessels," says Stewart. However, he strongly cautions against eating too many such meals because of their high salt and caloric content. He says this single meal -- at over 900 calories and 50 grams of fat -- is at least half the maximum daily fat intake recommended by the American Heart Association and nearly half the recommended average daily intake of about 2,000 calories for most adults.

All study participants were between the age of 30 and 65, and healthy, aside from being overweight or obese. Researchers say that in the first study, because people were monitored for the period they lost the same amount of weight, any observed vascular differences would be due to what they ate.

Funding for the study was provided by the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health (NIH), with additional assistance from the Johns Hopkins Bayview Institute for Clinical Translational Research, also funded by the NIH. Besides Stewart, other Johns Hopkins researchers who took part in the studies were Sameer Chaudri, M.D.; Devon Dobrosielski, Ph.D.; Harry Silber, M.D., Ph.D.; Sammy Zakaria, M.D., M.P.H.; Edward Shapiro, M.D.; and Pamela Ouyang, M.B.B.S.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Diabetics show higher risk of pancreas disease

By Amy Norton

Reuters Health

Wednesday, June 1, 2011

NEW YORK (Reuters Health) – People with type 2 diabetes may have a heightened risk of a painful condition known as acute pancreatitis, but those odds are curbed in people on diabetes drugs, a new study suggests.

Acute pancreatitis is a sudden inflammation of the pancreas that causes upper abdominal pain - often worse after eating - as well as nausea and vomiting. Mild cases may go away without treatment, but acute pancreatitis can have serious, life-threatening complications like heart, lung or kidney failure.

The disease sends about 200,000 Americans to the hospital each year.

In the new study, researchers found that among more than 97,000 Taiwanese adults followed for up to eight years, those with type 2 diabetes had twice the rate of acute pancreatitis -- almost 28 cases per 10,000 people each year, versus 14 cases for every 10,000 people without diabetes.

People with diabetes were more likely to have a number of risk factors for acute pancreatitis. Those included gallstones and heavy drinking -- two of the most common causes of pancreas inflammation -- as well as high triglycerides (a type of blood fat) and a history of the liver infections hepatitis B or C.

But even when those conditions were taken into account, diabetes itself was linked to an 89 percent increase in the risk of acute pancreatitis.

The findings back up earlier studies that have linked type 2 diabetes to acute pancreatitis, according to senior researcher Dr. Pei-Chun Chen, of China Medical University College of Public Health in Taiwan.

But they also add something new, Chen told Reuters Health in an email.

Among people with diabetes, the study found, those on diabetes medications had a lower risk of acute pancreatitis. And the more medications they were using, the lower the risk.

The potential benefit was seen with a range of diabetes drugs -- including metformin (Glucophage); sulfonylureas, which include drugs like glimepiride (Amaryl) and glipizide (Glucotrol); thiazolidinediones, including rosiglitazone (Avandia) and pioglitazone (Actos); and alpha-glucosidase inhibitors, like miglitol (Glyset) and acarbose (Precose).

In recent years, certain other diabetes drugs -- including the brand names Januvia and Byetta -- have been linked to cases of pancreatitis, and warnings are included in the drugs' prescribing information.

However, it has not been clear whether the drugs themselves cause the pancreas inflammation. The medications were not specifically analyzed in the current study.

Chen said that these latest findings cannot prove that any diabetes medication protects against acute pancreatitis. Nor do they prove that diabetes, itself, causes pancreatitis in some people, the researcher said.

It's possible, according to Chen, that something else about people with diabetes -- such as high rates of obesity -- account for the connection.

The researchers also lacked information on study participants' smoking habits, and smoking is linked to an increased risk of pancreatitis.

More studies are needed, according to Chen's team, to confirm that diabetes does contribute to pancreatitis, and that medications -- or at least certain medications -- are protective.

For now, Chen advised that people with diabetes be aware of the symptoms of acute pancreatitis, and call their doctor immediately if they experience them. That may be especially important, Chen noted, for diabetics with alcohol problems or hepatitis C infection.

In this study, alcoholism and hepatitis C were each stronger risk factors than diabetes for pancreatitis. And both appeared to further boost the risk linked to diabetes.

The study was funded by the Taiwanese government and China Medical University. None of the researchers reports any financial conflicts of interest.

Source: http://bit.ly/j0Lioh

American Journal of Gastroenterology, online May 17, 2011.

Two-Thirds of Newly Diagnosed U.S. Cancer Patients Unable to Obtain Oncology Appointments, Study Suggests

ScienceDaily

Wednesday, June 1, 2011

ScienceDaily (June 1, 2011) — Newly diagnosed cancer patients frequently face hurdles in obtaining an appointment for care with an oncologist, according to new research from the Perelman School of Medicine at the University of Pennnsylvania that will be presented on June 4 at the 2011 annual meeting of American Society of Clinical Oncology. Even callers with private health insurance had difficulty scheduling an appointment, with just 22 percent of them obtaining a slot, compared to 29 percent of uninsured patients and 17 percent of patients on Medicaid, according to results of a study in which research assistants posed as patients seeking an initial evaluation.

"Although healthcare reform is likely to expand health insurance coverage to more Americans, our research shows that even with insurance, patients face barriers when they try to access cancer care," says lead author Keerthi Gogineni, MD, an instructor in the division of Hematology-Oncology at Penn's Abramson Cancer Center. "Given the typical pre-appointment expectations for new patients -- which typically involve referral requirements, paperwork and routing of medical records and test results -- both insured and uninsured patients must contend with many challenges that delay care with a specialty cancer provider."

In the study, research assistants attempted to call 160 U.S. hospitals under three different circumstances each, varying only their insurance status as they explained their scripted patient situation, which involved a new diagnosis of an inoperable liver cancer. Callers reached a scheduler 79 percent of the time, but only 29 percent of those callers received appointments. Of the appointments ultimately scheduled, 35 percent required multiple calls to complete the process. In nearly a quarter of cases, callers failed to reach staff even after three attempts. Among reasons for denial of appointments or inability to schedule: Demand for medical records (39 percent), not being able to reach appropriate schedulers (24 percent), and referral requirements (18 percent).

The authors note that the access problems revealed in the study may become more urgent in the coming years, given Institute of Medicine and ASCO projections showing a widening gap between the number of people living with cancer and the number of practicing oncologists available to care for them.

Gogineni and her co-author, Katrina Armstrong, MD, MSCE, chief of the division of General Internal Medicine and associate director of Outcomes and Delivery in the Abramson Cancer Center, suggest that more patient navigator programs could play a critical role at coaching patients through this initial phase of their care. Since literacy issues or lack of guidance from a referring physician may impede patients' ability to locate the proper number to call for help at some hospitals, they also urge centers to train staff at locations other than appointment hotlines or intake centers to point new patients to the proper location.

"Patients who are newly diagnosed with cancer may be confused or frightened," Armstrong says. "Asking them to find their way through the complex process of obtaining imaging studies and other tests or collecting records from another doctor prior to scheduling an appointment may pose an undue burden, and cancer centers should be prepared to provide help with those preliminary steps."

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Earpieces Can Minimize Possible Risks From Cellphones, Experts Say

By Steven Reinberg
HealthDay Reporter

HealthDay News

Wednesday, June 1, 2011

WEDNESDAY, June, 1 (HealthDay News) -- Can using a cellphone increase the risk of cancer?

The World Health Organization (WHO) says that it might.

After a group of scientists from 14 countries, including the United States, analyzed peer-reviewed studies on cellphones, the team announced Tuesday that there was enough evidence to categorize personal exposure as "possibly carcinogenic to humans."

This puts cellphones in the same category as lead and auto exhaust. The WHO report noted that there wasn't enough evidence to prove the radiation from cellphones is linked to cancer, but enough to alert consumers to a possible connection.

Dr. Michael Schulder, vice chairman of neurosurgery and director of the brain tumor institute at North Shore Long Island Jewish School of Medicine in Hempstead, N.Y., said the category into which WHO is putting cellphones is one that asserts there may be a concern. "That's fairly weak as a concern goes," he addded.

According to the U.S. Federal Communications Commission (FCC), which regulates radiation from cellphones, "there is no scientific evidence to date that proves that wireless phone usage can lead to cancer or a variety of other health effects, including headaches, dizziness or memory loss."

But, Schulder said, "commonsense would tell you that since a cellphone is a microwave generator and emits radiation, it has the potential to alter DNA. And it should be used in moderation."

Proving a causal relation between cellphone use and brain tumors is very hard to do, Schulder added. "It [would] take following many patients over many years to try to draw a connection," he said. "Even if a connection exists, it will be very hard to prove."

That's partly because the radiation emitted by cellphone includes very low level microwave radiation, a type of non-ionizing radiation which is absorbed near the skin. It's not ionizing radiation such as that emitted by an X-ray or CT scan. So-called ionizing radiation -- a known cause of cancer -- has enough energy to break down chemical bonds by knocking electrons off atoms or molecules (thus "ionizing" them and making them unstable).

However, to be on the safe side, Schulder recommends not speaking for long periods with the phone held to the ear. In addition, he suggests using an earpiece or speaker whenever possible. Both will keep the phone away from your head, he pointed out.

"If you use these methods, then any risk of brain tumor formation from the phone will be essentially eliminated," Schulder said.

Dr. Otis Brawley, chief medical officer for the American Cancer Society, added: "Given that the evidence remains uncertain, it is up to each individual to determine what changes they wish to make, if any, after weighing the potential benefits and risks of using a cellphone."

If some feel the potential risk outweighs the benefit, they can take actions, including limiting cellphone use or using a headset, he said. "Limiting use among children also seems reasonable in light of this uncertainty," Brawley said.

"On the other hand," Brawley said, "if someone is of the opinion that the absence of strong scientific evidence on the harms of cellphone use is reassuring, they may take different actions, and it would be hard to criticize that," he said.

Brawley also noted that many common exposures -- even coffee drinking --are classified by WHO as potentially concerning.

For those who want to know how much radiation their phone emits, the FCC recommends contacting the manufacturer.

The FCC noted that earpieces will indeed "significantly reduce the rate of energy absorption" in a user's head, but that if the phone is attached to the waist or another part of the body, "then that part of the body will absorb [radiofrequency] energy."

Besides ear pieces, there are other devices (such as metal cellphone shields) that claim to protect users from cellphone radiation or reduce it, but the FCC is skeptical of them.

"Studies have shown that these devices generally do not work as advertised," an FCC official statement cautioned. "In fact, they may actually increase radio frequency absorption in the head due to their potential to interfere with proper operation of the phone, thus forcing it to increase power to compensate," the agency stated.

Another expert, Dr. Roberto Heros, a professor of neurological surgery at the University of Miami Miller School of Medicine, has a different take on cellphone safety.

"Our culture has become a slave to the cellphone," he said. "We feel we cannot be out of touch for one minute, and we have to be connected by the cellphone."

Heros thinks people should limit the time they spend on the devices. But, he said, "they should use it when necessary. They should not [hesitate to] make calls that are necessary, because of any fear or panic about radiation," he said.

"If you really want to save lives, then don't use the cellphone while you're driving," Heros said. "Not because of brain cancer, but because of immediate death from an accident."

More information

For more information on cell phone safety, visit the U.S. Food and Drug Administration.

How Vitamins and Minerals May Prevent Age-Related Diseases

ScienceDaily

Wednesday, June 1, 2011

ScienceDaily (June 1, 2011) — Severe deficiency of the vitamins and minerals required for life is relatively uncommon in developed nations, but modest deficiency is very common and often not taken seriously. A new research published online in the FASEB Journal, however, may change this thinking as it examines moderate selenium and vitamin K deficiency to show how damage accumulates over time as a result of vitamin and mineral loss, leading to age-related diseases.

"Understanding how best to define and measure optimum nutrition will make the application of new technologies to allow each person to optimize their own nutrition a much more realistic possibility than it is today." said Joyce C. McCann, Ph.D., a co-author of the study from the Nutrition and Metabolism Center at Children's Hospital Oakland Research Institute in Oakland, California. "If the principles of the theory, as demonstrated for vitamin K and selenium, can be generalized to other vitamins and minerals, this may provide the foundation needed."

McCann and colleagues reached their conclusions by compiling and assessing several general types of scientific evidence. They tested whether selenium-dependent proteins that are essential from an evolutionary perspective are more resistant to selenium deficiency than those that are less essential. They discovered a highly sophisticated array of mechanisms at cellular and tissue levels that, when selenium is limited, protect essential selenium-dependent proteins at the expense of those that are nonessential. They also found that mutations in selenium-dependent proteins that are lost on modest selenium deficiency result in characteristics shared by age-related diseases including cancer, heart disease, and loss of immune or brain function. Results should inform attempts to locate mechanistic linkages between vitamin or mineral deficiencies and age-related diseases by focusing attention on the vitamin and mineral-dependent proteins that are nonessential from an evolutionary perspective. Such mechanistic linkages are likely to present opportunities for treatment.

"This paper should settle any debate about the importance of taking a good, complete, multivitamin every day," said Gerald Weissmann, M.D., Editor-in-Chief of the FASEB Journal. "As this report shows, taking a multivitamin that contains selenium is a good way to prevent deficiencies that, over time, can cause harm in ways that we are just beginning to understand." 

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

J. C. McCann, B. N. Ames. Adaptive dysfunction of selenoproteins from the perspective of the triage theory: why modest selenium deficiency may increase risk of diseases of aging. The FASEB Journal, 2011; DOI: 10.1096/fj.11-180885

Can Removing Tonsils, Appendix Boost Early Heart Attack Risk?

HealthDay News

Wednesday, June 1, 2011

WEDNESDAY, June 1 (HealthDay News) -- Although the tonsils and appendix are not considered vital to the body, Swedish researchers have found that people who had them taken out before the age of 20 may be at a slightly greater risk of an early heart attack.

The new study linked the role of the appendix and the tonsils in the body's immune system with the increased risk for heart disease.

"Given the strong biological and epidemiological evidence linking inflammation with coronary heart disease [CHD], one might anticipate that surgical removal of the tonsils and appendix, with their consequent effects on immunity, might also have a long-term effect on CHD," investigator Dr. Imre Janszky, from the department of public health science of the Karolinska Institute in Stockholm, said in a news release from the European Society of Cardiology.

"However, we were aware of no studies evaluating the potential effects of appendectomy or tonsillectomy on atherosclerosis or CHD risk," Janszky added.

Persistent infections force roughly 10 percent to 20 percent of young people to have their tonsils or appendix removed, the researchers noted.

In conducting the study, published online June 1 in the European Heart Journal, the researchers identified 54,449 appendectomies and 27,284 tonsillectomies performed on Swedish residents under the age of 20 years. The patients were followed for an average of 23.5 years to determine how many would suffer fatal or non-fatal heart attacks.

Within the follow-up period, a total of 89 of the participants who had had appendectomies and 47 of those who had had tonsillectomies experienced a heart attack, the investigators found.

The study authors concluded that tonsillectomy increased the relative risk of a heart attack by 44 percent, and appendectomy increased the relative risk by 33 percent. The risk was slightly higher for those who had both their tonsils and appendix removed, the results showed.

Janszky noted, however, that the absolute numbers of heart attack cases in the study were small, with slightly more than 400 and 200 total cases of heart attack in more than 7.5 million and nearly 4 million person-years of follow-up, respectively.

"As expected from the young age of the population," he said, "the observed moderate increases in relative risk actually corresponded to very small risk increases in absolute terms."

And because the study was limited to childhood procedures and participants were still relatively young during the follow-up period, the findings may not apply to older people at greater risk for heart disease, the researchers added.

The researchers also pointed out that appendectomies or tonsillectomies could have other "complex" and long-term side effects on the immune system, including decreased production of immunoglobulins.

More information

The American Heart Association has more about risk factors for heart attack.

Blueberry's Effects on Cholesterol Examined in Lab Animal Study

ScienceDaily

Wednesday, June 1, 2011

ScienceDaily (June 1, 2011) — Laboratory hamsters that were fed rations spiked with blueberry peels and other blueberry-juice-processing leftovers had better cholesterol health than hamsters whose rations weren't enhanced with blueberries. That's according to a study led by U.S. Department of Agriculture (USDA) chemist Wallace H. Yokoyama.

Yokoyama pointed out that further research is needed to confirm whether the effects observed in hamsters hold true for humans. He works at the Western Regional Research Center operated in Albany Calif., by the Agricultural Research Service (ARS), the principal scientific research agency of USDA.

In the investigation, hamsters were fed high-fat rations. For some animals, those rations were supplemented with one of three different kinds of juice byproducts: blueberry skins-that is, peels leftover when berries are pressed to make juice; fiber extracted from the peels; or natural compounds known as polyphenols, also extracted from the peels. Blueberry polyphenols give the fruit its purple, blue, and red coloration.

In an article published in the Journal of Agricultural and Food Chemistry in 2010, Yokoyama and his coinvestigators reported that all the hamsters that were fed blueberry-enhanced rations had from 22 to 27 percent lower total plasma cholesterol than hamsters fed rations that didn't contain blueberry juice byproducts.

Levels of VLDL (very low density lipoprotein-a form of "bad" cholesterol) were about 44 percent lower in the blueberry-fed hamsters.

Yokoyama and his coinvestigators used a procedure known as real-time reverse transcription polymerase chain reaction, or RT-PCR, to learn about the genes responsible for these effects. This approach allowed the scientists to pinpoint differences in the level of activity of certain liver genes.

In hamsters-and in humans-the liver both makes cholesterol and helps get rid of excessive levels of it. Results suggest that activity of some liver genes that either produce or use cholesterol resulted in the lower blood cholesterol levels.

The study is apparently the first published account of cholesterol-lowering effects in laboratory hamsters fed blueberry peels or fiber or polyphenols extracted from those peels.

Of course, some pieces of the cholesterol puzzle are not yet in place. For example, the researchers don't know which berry compound or compounds activated the liver genes, or which parts of the berry have the highest levels of these compounds.

Yokoyama collaborated in the study with former Albany postdoctoral research associate Hyunsook Kim and ARS research chemist Agnes M. Rimando, who is based at Oxford, Miss.

More details about this study are available in the May/June 2011 issue of Agricultural Research magazine. http://www.ars.usda.gov/is/AR/archive/may11/fruit0511.htm

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Hyunsook Kim, Glenn E. Bartley, Agnes M. Rimando, Wallace Yokoyama. Hepatic Gene Expression Related to Lower Plasma Cholesterol in Hamsters Fed High-Fat Diets Supplemented with Blueberry Peels and Peel Extract†. Journal of Agricultural and Food Chemistry, 2010; 58 (7): 3984 DOI: 10.1021/jf903230s 

Tuesday, May 31, 2011

Dangerous Bacteria Found on Cell Phones of Hospital Patients

ScienceDaily

Tuesday, May 31, 2011

ScienceDaily (May 31, 2011) — Cell phones used by patients and their visitors were twice as likely to contain potentially dangerous bacteria as those of healthcare workers (HCW), according to a study published in the June issue of the American Journal of Infection Control, the official publication of APIC -- the Association for Professionals in Infection Control and Epidemiology.

A team of researchers from the Department of Medical Microbiology at Inonu University in Malatya, Turkey collected swab samples from three parts of cell phones -- the keypad, microphone and ear piece. A total of 200 mobile phones (MPs) were cultured for the study, 67 of which belonged to medical employees and 133 to patients, patients' companions and visitors. The researchers found that 39.6 percent of the patient group phones and 20.6 percent of HCW phones tested positive for pathogens. Additionally, seven patient phones contained multidrug resistant (MDR) pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) and multiply resistant gram-negative organisms, while no HCW phones tested positive for MDR pathogens.

"The types of bacteria that were found on the patients' MPs and their resistance patterns were very worrisome," state the authors. "Some investigators have reported that MPs of medical personnel may be a potential source of bacterial pathogens in the hospital setting. Our findings suggest that mobile phones of patients, patients' companions and visitors represent higher risk for nosocomial pathogen colonization than those of HCWs. Specific infection control measures may be required for this threat."

Hospital-acquired infections affect more than 25 percent of admitted patients in developing countries. In U.S. hospitals, they cause 1.7 million infections a year and are associated with approximately 100,000 deaths. It is estimated that one third of these infections could be prevented by adhering to standard infection control guidelines.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Mehmet Sait Tekerekoǧlu, Yucel Duman, Ayfer Serindağ, Serpil Semiha Cuǧlan, Halim Kaysadu, Emine Tunc, Yusuf Yakupogullari et al. Do mobile phones of patients, companions and visitors carry multidrug-resistant hospital pathogens? AJIC: American Journal of Infection Control, Volume 39, Issue 5 , Pages 379-381, June 2011 DOI: 10.1016/j.ajic.2010.10.026

Hospitals hunt substitutes as drug shortages rise

By Lauran Neergaard

AP Medical Writer

The Associated Press

Tuesday, May 31, 2011

WASHINGTON – A growing shortage of medications for a host of illnesses — from cancer to cystic fibrosis to cardiac arrest — has hospitals scrambling for substitutes to avoid patient harm, and sometimes even delaying treatment.

"It's just a matter of time now before we call for a drug that we need to save a patient's life and we find out there isn't any," says Dr. Eric Lavonas of the American College of Emergency Physicians.

The problem of scarce supplies or even completely unavailable medications isn't a new one but it's getting markedly worse. The number listed in short supply has tripled over the past five years, to a record 211 medications last year. While some of those have been resolved, another 89 drug shortages have occurred in the first three months of this year, according to the University of Utah's Drug Information Service. It tracks shortages for the American Society of Health-System Pharmacists.

The vast majority involve injectable medications used mostly by medical centers — in emergency rooms, ICUs and cancer wards. Particular shortages can last for weeks or for many months, and there aren't always good alternatives. Nor is it just a U.S. problem, as other countries report some of the same supply disruptions.

It's frightening for families.

At Miami Children's Hospital, doctors had to postpone for a month the last round of chemotherapy for 14-year-old Caroline Pallidine, because of a months-long nationwide shortage of cytarabine, a drug considered key to curing a type of leukemia.

"There's always a fear, if she's going so long without chemo, is there a chance this cancer's going to come back?" says her mother, Marta Pallidine, who says she'll be nervous until Caroline finishes her final treatments scheduled for this week.

"In this day and age, we really shouldn't be having this kind of problem and putting our children's lives at risk," she adds.

There are lots of causes, from recalls of contaminated vials, to trouble importing raw ingredients, to spikes in demand, to factories that temporarily shut down for quality upgrades.

Some experts pointedly note that pricier brand-name drugs seldom are in short supply. The Food and Drug Administration agrees that the overarching problem is that fewer and fewer manufacturers produce these older, cheaper generic drugs, especially the harder-to-make injectable ones. So if one company has trouble — or decides to quit making a particular drug — there are few others able to ramp up their own production to fill the gap, says Valerie Jensen, who heads FDA's shortage office.

The shortage that's made the most headlines is a sedative used on death row. But on the health-care front, shortages are wide-ranging, including:

  • Thiotepa, used with bone marrow transplants.
  • A whole list of electrolytes, injectable nutrients crucial for certain premature infants and tube-feeding of the critically ill.
  • Norepinephrine injections for septic shock.

·        A cystic fibrosis drug named acetylcysteine.

·        Injections used in the ER for certain types of cardiac arrest.

·        Certain versions of pills for ADHD, attention deficit hyperactivity disorder.

·        Some leuprolide hormone injections used in fertility treatment.

No one is tracking patient harm. But last fall, the nonprofit Institute for Safe Medication Practices said it had two reports of people who died from the wrong dose of a substitute painkiller during a morphine shortage.

"Every pharmacist in every hospital across the country is working to make sure those things don't happen, but shortages create the perfect storm for a medication error to happen," says University of Utah pharmacist Erin Fox, who oversees the shortage-tracking program.

What can be done?

The FDA has taken an unusual step, asking some foreign companies to temporarily ship to the U.S. their own versions of some scarce drugs that aren't normally sold here. That eased shortages of propofol, a key anesthesia drug, and the transplant drug thiotepa.

Affected companies say they're working hard to eliminate backlogs. For instance, Hospira Inc., the largest maker of those injectable drugs, says it is increasing production capacity and working with FDA "to address shortage situations as quickly as possible and to help prevent recurrence."

But the Generic Pharmaceutical Association says some shortages are beyond industry control, such as FDA inspections or stockpiling that can exacerbate a shortage.

"Drug shortages of any kind are a complex problem that require broad-based solutions from all stakeholders," adds the Pharmaceutical Research and Manufacturers of America, a fellow trade group.

Lawmakers are getting involved. Sen. Herb Kohl, D-Wis., is urging the Federal Trade Commission to consider if any pending drug-company mergers would create or exacerbate shortages.

Also, pending legislation would require manufacturers to give FDA advance notice of problems such as manufacturing delays that might trigger a shortage. The FDA cannot force a company to make a drug, but was able to prevent 38 close calls from turning into shortages last year by speeding approval of manufacturing changes or urging competing companies to get ready to meet a shortfall.

"No patient's life should have to be at risk when there is a drug somewhere" that could be used, says Sen. Amy Klobuchar, D-Minn., who introduced the bill.

Editor’s Note: Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

Why Childhood Obesity? It's So Much More Than What Kids Eat

ScienceDaily

Tuesday, May 31, 2011

ScienceDaily (May 31, 2011) — University of Illinois scientists from a variety of disciplines have teamed up to examine the factors that contribute to childhood obesity. Why? Because individual researchers have found that the problem is too complicated for any of them to tackle alone.

"Our Strong Kids team members are looking at such diverse factors as genetic predisposition, the effect of breastfeeding, how much TV a child watches, and the neighborhood he lives in, among many others," said Kristen Harrison of the U of I's Division of Nutritional Sciences. "It seems like the answer should be simple, just eat less and exercise more, but when you look at the reasons that kids overeat and burn fewer calories, it turns out there are a lot of them."

Harrison and other Strong Kids team members received funding for a three-year longitudinal study and are applying for support to keep the research going. The scientists have collected and analyzed two generations of data on approximately 400 families, and they are beginning a third wave of data collection. Individual studies, including communication professor Harrison's own examination of preschoolers' television viewing and eating habits, are ongoing.

But the first step was developing a model for studying the problem. The team's Six Cs model will examine the problem of childhood obesity from the following angles: cell, child, clan (or family), community, country and culture. A paper detailing their approach appeared in a recent issue of Child Development Perspectives.

"From 30 to 40 percent of the population has a variety of genetic markers that puts them at greater risk for obesity," said professor of nutrition Margarita Teran-Garcia, who is approaching the problem at the cellular level. As a starting point, she is taking saliva samples from preschoolers in the study group to map their genetic susceptibility to obesity.

Child development professor Kelly Bost is looking at the quality of parent-child attachment. "There's evidence that insecure attachment predicts more TV exposure, more consumption of unhealthful foods, and other factors leading to greater obesity," she said.

Another kinesiology and community health professor, Diana Grigsby-Toussaint, is geomapping retail environments in the neighborhoods where the participating families live, looking in detail at what foods are available there. "She's also mapping how much green space is available and how that relates to outdoor play and activity," Harrison said.

Later work will add more puzzle pieces relating to the community and culture components. For example, what's the community BMI and do participants in the study believe that BMI is normal? What's the usual portion size in this culture? Are children urged to take second and third helpings at mealtime?

"Southern U.S. culture, Latin American culture, and the Sam's Club bulk-buying phenomenon are all elements of what we're trying to capture when we talk about culture," Harrison said.

And professor of applied family studies Angela Wiley is collecting data relating to childhood obesity prevention among Mexican immigrant families in the Abriendos-Caminos program so the researchers can compare parallel populations across countries.

"Childhood obesity is a puzzle, and at different stages, certain variables drop in or out of the picture. Breastfeeding versus formula feeding is a predictor, but it drops out of the model entirely when you get past babyhood. Vending machines in schools are important later in a child's life, but they weren't important before," she added.

There has been very little transdisciplinary effort to map out how all these factors work together, although research shows that no single factor is the most important, Harrison noted.

"We're each looking at different spheres in the model, but we're also looking at potential interactions. That's one of the exciting things we'll get to do as we move forward," she said.

Co-authors of the paper are Harrison, Kelly K. Bost, Brent A. McBride, Sharon M. Donovan, Diana S. Grigsby-Toussaint, Janet M. Liechty, Angela Wiley, Margarita Teran-Garcia, and Gwen Costa-Jacobsohn, all of the U of I.

Funding was provided by the State of Illinois Council for Food and Agricultural Research and the Illinois Department of Human Services via grants supporting the U of I Strong Kids program.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff

Journal Reference:

Kristen Harrison, Kelly K. Bost, Brent A. McBride, Sharon M. Donovan, Diana S. Grigsby-Toussaint, Juhee Kim, Janet M. Liechty, Angela Wiley, Margarita Teran-Garcia, Gwen Costa Jacobsohn. Toward a Developmental Conceptualization of Contributors to Overweight and Obesity in Childhood: The Six-Cs Model. Child Development Perspectives, 2011; 5 (1): 50 DOI: 10.1111/j.1750-8606.2010.00150.x

Kids with stubborn asthma may have food allergy

By Amy Norton

Reuters Health

Tuesday, May 31, 2011

NEW YORK (Reuters Health) – Inner-city children with poorly controlled asthma or skin allergies may be more likely to have food allergies, a new study hints.

Researchers found that among 228 inner-city New York children seen at their allergy clinic, 28 percent had a food allergy -- with eggs, peanuts and milk being the prime culprits. By contrast, the rate of food allergy among U.S. kids in general is only about four percent.

And a full 71 percent were "sensitized" to at least one food - meaning they had immune system antibodies in their blood against a particular food. In other words, their body was on the alert, and they were at increased risk of an allergic reaction. That rate too is much higher than average.

Some of the children were tested for food allergies because they had symptoms, such as hives or an itchy rash, breathing difficulty, or nausea, vomiting or diarrhea soon after eating a particular food.

But most -- 62 percent -- had never had any obvious reaction to food. Instead, they were tested because they had asthma or eczema (an allergic skin condition) that was not responding well to medication.

The children in this study were patients at an allergy clinic, so they are not representative of inner-city children in general.

Still, the findings suggest that doctors who treat inner-city children with stubborn asthma or eczema "should have a high degree of suspicion for food allergy," senior researcher Dr. Julie Wang told Reuters Health in an email.

In those cases, she said, doctors should get a detailed history of children's symptoms and refer families to an allergy specialist if necessary.

Wang and her colleagues at the Mount Sinai School of Medicine in New York report the findings in the Journal of Allergy & Clinical Immunology.

It's known that poor minority children, many of whom live in inner cities, have high rates of asthma and nasal allergies. An estimated 23 percent of Puerto Rican children from low-income families have asthma, as do 16 percent of poor African-American children, according to the U.S. Centers for Disease Control and Prevention.

That compares with a national average of just over nine percent.

Wang said she is not aware of any studies that have looked at the prevalence of food allergies among inner-city children.

The rates of food allergy and sensitization in this study were much higher than the national norm: About four percent of U.S. children younger than 18 have a food allergy, while food sensitization affects an estimated 28 percent of children age five and younger -- the age range where it is most common.

Nationally, food allergies are seen as a growing problem. In 2007, about three million school-aged children had a food allergy -- up 18 percent from a decade before. And there is some evidence that children's emergency room visits for severe food reactions are on the upswing as well.

No one is sure why the rate is rising.

One theory blames changes in children's diets. Another theory, known as the "hygiene hypothesis," holds that today's clean living -- creating less exposure to germs -- may actually make some people's immune system more prone to attacking normally harmless substances, like food proteins and pollen.

Regardless of what's behind the trend, the research team says that when inner city children have skin rashes or asthma that can't be controlled with standard medicines, doctors should consider the possibility of food allergy - even if the kids don't show any of the usual reactions to food.

Source: http://bit.ly/kAcHiP

Journal of Allergy & Clinical Immunology, online May 8, 2011.

Cellphones a 'possible' carcinogen — like coffee

By Maria Cheng

AP Medical Writer

The Associated Press

Tuesday, May 31, 2011

LONDON – A respected international panel of scientists says cellphones are possible cancer-causing agents, putting them in the same category as the pesticide DDT, gasoline engine exhaust and coffee.

The classification was issued Tuesday in Lyon, France, by the International Agency for Research on Cancer after a review of dozens of published studies. The agency is an arm of the World Health Organization and its assessment now goes to WHO and national health agencies for possible guidance on cellphone use.

Classifying agents as "possibly carcinogenic" doesn't mean they automatically cause cancer and some experts said the ruling shouldn't change people's cellphone habits.

"Anything is a possible carcinogen," said Donald Berry, a professor of biostatistics at the M.D. Anderson Cancer Center at the University of Texas. He was not involved in the WHO cancer group's assessment. "This is not something I worry about and it will not in any way change how I use my cellphone," he said — speaking from his cellphone.

The same cancer research agency lists alcoholic drinks as a known carcinogen and night shift work as a probable carcinogen. Anyone's risk for cancer depends on many factors, from genetic makeup to the amount and length of time of an exposure.

After a weeklong meeting on the type of electromagnetic radiation found in cellphones, microwaves and radar, the expert panel said there was limited evidence cellphone use was linked to two types of brain tumors and inadequate evidence to draw conclusions for other cancers.

"We found some threads of evidence telling us how cancers might occur, but there were acknowledged gaps and uncertainties," said Jonathan Samet of the University of Southern California, the panel's chairman.

"The WHO's verdict means there is some evidence linking mobile phones to cancer but it is too weak to draw strong conclusions from," said Ed Yong, head of health information at Cancer Research U.K. "If such a link exists, it is unlikely to be a large one."

Last year, results of a large study found no clear link between cellphones and cancer. But some advocacy groups contend the study raised serious concerns because it showed a hint of a possible connection between very heavy phone use and glioma, a rare but often deadly form of brain tumor. However, the numbers in that subgroup weren't sufficient to make the case.

The study was controversial because it began with people who already had cancer and asked them to recall how often they used their cellphones more than a decade ago.

In about 30 other studies done in Europe, New Zealand and the U.S., patients with brain tumors have not reported using their cellphones more often than unaffected people.

Because cellphones are so popular, it may be impossible for experts to compare cellphone users who develop brain tumors with people who don't use the devices. According to a survey last year, the number of cellphone subscribers worldwide has hit 5 billion, or nearly three-quarters of the global population.

People's cellphone habits have also changed dramatically since the first studies began years ago and it's unclear if the results of previous research would still apply today.

Since many cancerous tumors take decades to develop, experts say it's impossible to conclude cellphones have no long-term health risks. The studies conducted so far haven't tracked people for longer than about a decade.

Cellphones send signals to nearby towers via radio frequency waves, a form of energy similar to FM radio waves and microwaves. But the radiation produced by cellphones cannot directly damage DNA and is different from stronger types of radiation like X-rays or ultraviolet light. At very high levels, radio frequency waves from cellphones can heat up body tissue, but that is not believed to damage human cells.

Some experts recommended people use a headset or earpiece if they are worried about the possible health dangers of cellphones. "If there is a risk, most of it goes away with a wireless earpiece," said Otis Brawley, chief medical officer of the American Cancer Society.

Brawley said people should focus on the real health hazards of cellphones. "Cellphones may cause brain tumors but they kill far more people through automobile accidents," he said. Brawley added it was also reasonable to limit children's use of cellphones since their brains are still developing.

Earlier this year, a U.S. National Institutes of Health study found that cellphone use can speed up brain activity, but it is unknown whether that has any dangerous health effects.

The cellphone industry trade group, CTIA-The Wireless Association, pointed to two U.S. agencies that have found no evidence cellphones are linked to cancer — the Food and Drug Administration and the Federal Communications Commission.

The WHO's cancer research agency has reviewed more than 900 occupational exposures, chemicals and other agents since 1971, classifying their link to cancer by labeling them from carcinogenic to probably not carcinogenic. The American Cancer Society has estimated that only about 6 percent of cancers are related to environmental causes and most of that is on-the-job occupational exposure.

Online:

http://www.iarc.fr

http://www.cancer.org

http://www.cancerresearchuk.org

Mouse virus doesn't cause chronic fatigue: reports

By Julie Steenhuysen

Reuters

Tuesday, May 31, 2011

CHICAGO (Reuters) – A mouse virus called XMRV, which has been fingered as a cause of chronic fatigue syndrome, is likely not responsible for the mysterious disease, according to two studies released on Tuesday.

The studies are the latest to refute a 2009 study that claimed to have found XMRV in the blood of patients with chronic fatigue syndrome, raising hope for a treatment for the debilitating condition that causes muscle pain, memory loss and overwhelming fatigue.

Science, which published the 2009 study, is running the two new reports along with an "editorial expression of concern," noting that the validity of the original chronic fatigue study by research teams Nevada and Maryland "is now in question."

The 2009 study raised hopes that patients with the baffling disease might benefit from a range of drugs designed to fight AIDS, cancer and inflammation.

XMRV was first reported in samples from a human prostate tumor in 2006, and has since been reported to be present in 6 to 27 percent of human prostate cancers.

Later research reported XMRV in the blood of 67 percent of people with chronic fatigue syndrome.

But several groups have challenged the claim that XMRV is circulating in people with studies that have failed to detect it in people with prostate cancer and chronic fatigue syndrome.

Last December, a team at University College London, the Wellcome Trust Sanger Institute and Oxford University said cell samples from patients in earlier studies were likely contaminated.

In one of the new studies, researchers the National Cancer Institute, one of the National Institutes of Health, suggest XMRV came about when two mouse leukemia viruses became mixed and contaminated lab experiments.

A second study by Konstance Knox and colleagues of the Wisconsin Virus Research Group in Milwaukee examined the blood of people whose tissue was used in the 2009 study and found no trace of the virus in any of the samples.

"Taken together, these results essentially close the door on XMRV as a cause of human disease," said John Coffin of Tufts University School of Medicine in Boston, who worked on one of the studies with Vinay Pathak of the National Cancer Institute.

To settle the debate, Pathak and colleagues studied human prostate cancer cells thought to contain XMRV, as well as tumors from these cells after they had been made to grow in mice, a common way to study new treatments that might not be safe to test in people.

A careful study of these showed that the while the initial prostate tumors grown in mice contained no XMRV, later tumors derived from this tissue did -- showing that the virus was not present in the original human tumor, as previously thought.

Instead, the virus appears to have infected tumor cells while they were in mice.

They also showed that the mice used in the study had two new viruses, and these viruses combined to form XMRV.

Pathak said the latest results are not what the team had expected, but they will likely allow researchers now to focus on the real causes of these diseases.

Meanwhile, Knox said people with chronic fatigue syndrome need to know that taking antiretroviral drugs such as those used to treat people with HIV/AIDS "will not benefit them, and may do them serious harm."

"Physicians should not be prescribing antiviral compounds used in the treatment of HIV/AIDS to patients on the basis of a chronic fatigue syndrome diagnosis or a XMRV test result," she said in a statement.

Chronic fatigue syndrome strikes an estimated 1 million to 4 million Americans.

(Editing by Cynthia Osterman)

In Diabetics, Good Scores on Bone Tests May Not Rule Out Risk

By Steven Reinberg
HealthDay Reporter

HealthDay News

Tuesday, May 31, 2011

TUESDAY, May 31 (HealthDay News) -- Although many older diabetics have good bone density scores, they are as prone to fractures as people with osteoporosis, a new study finds.

For people over 65, doctors usually recommend a bone density test to look for signs of bone loss and osteoporosis, but whether those tests are of use in older people with type 2 diabetes has been a question, according to the researchers.

"People with type 2 diabetes have a strange combination," said the study's lead researcher, Ann V. Schwartz, an associate adjunct professor in the epidemiology and biostatistics department at the University of California, San Francisco. "They have a higher fracture risk and they have a higher bone density."

However, she said, "we found that these tests work to predict fracture," though the interpretation of the results needs to be different.

To assess the value of bone density tests in predicting the risk for fractures among diabetics, the researchers looked at two tests of bone strength: bone mineral density, which produces what's called a T score, and the World Health Organization's fracture risk algorithm, called a FRAX score.

"A T score of minus 2.5 or lower is generally considered osteoporotic and at high risk of fracture," Schwartz said. "But if you have someone with type 2 diabetes who has a T score of minus 2, they have about the same fracture risk as a non-diabetic with a T score of minus 2.5," she said.

Doctors should use bone density to screen older adults with type 2 diabetes, Schwartz said, "but they have to realize that the threshold they use to indicate high risk has to be raised."

The report was published in the June 1 issue of the Journal of the American Medical Association.

For the study, Schwartz's team collected data on 9,449 women and 7,436 men who took part in one of three studies, the Study of Osteoporotic Fractures, the Osteoporotic Fractures in Men Study or the Health, Aging and Body Composition study. All participants were in their 70s when their study began.

During almost 13 years of follow-up, 84 hip fractures and 262 other fractures were recorded among the 770 women with diabetes. Among 1,199 men with diabetes, 32 had hip fractures and 133 had other fractures during about eight years of follow-up, the investigators found.

The researchers noted that, among diabetics, fractures were more likely to occur even when bone density tests indicated that there was only a small risk for fracture.

"For a given T score and age, those adults with DM [diabetes mellitus] had a higher risk of fracture than those without DM, consistent with previous studies," they wrote. "Participants with DM also experienced higher fracture rates at a given FRAX score than participants without DM."

Because of this, according to the researchers, doctors should consider people with type 2 diabetes at risk for fractures even when bone density tests indicate that they don't have osteoporosis and, therefore, have a lower risk for fractures.

In addition, Schwartz said that she would start treating diabetic patients for osteoporosis if they had T scores of minus 2.

She noted that standard treatments for osteoporosis have not been studied in diabetics but that they appear to work. "In general, the treatments seem to be as effective in diabetics as in non-diabetics," she said.

Commenting on the study, Dr. Robert R. Recker, president of the National Osteoporosis Foundation, said that "a lot of people with diabetes will be at risk for fracture, and many of them don't have low bone mass."

But he noted that the reasons that someone with diabetes has a fracture risk may not be the same as for a person without diabetes. "So the same treatments may not be appropriate -- and therein lies the rub," Recker said.

He does, however, recommend calcium and vitamin D.

The real problem, he said, is that little is known about why the risk for fracture is elevated among type 2 diabetics.

"Basically, we don't know anything about it," Recker said. "There may be something going on that interferes with bone cell function -- and it's not outrageous to think that because diabetes interferes with just about all cell function all over the body."

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more on diabetes.

Diabetes may shorten working life

By Amy Norton

Reuters Health

Tuesday, May 31, 2011

NEW YORK (Reuters Health) – People with diabetes may leave the workforce sooner than employees without diabetes -- suggesting, French researchers say, that the common disease could be taking a large economic toll.

Among more than 3,000 employees of France's national gas and electric company, diabetic workers were more likely to retire or go on disability in their 50s than workers of the same age who had similar jobs but no diabetes.

"Diabetes can impact individuals' ability to maintain employment through different pathways," said senior researcher Dr. Rosemary Dray-Spira, of the French national research institute INSERM.

For example, she told Reuters Health in an email, diabetes complications such as vision loss and nerve damage can lead to mobility problems or amputations that make it difficult or impossible for people to do their jobs. Diabetes is also often linked with medical conditions, like heart disease or kidney disease.

Then there is obesity, one of the major risk factors for developing diabetes.

Dray-Spira's team found that obesity seemed to explain much of the higher risk of work disability among people with diabetes.

The findings, reported in the journal Diabetes Care, echo those from a U.S. study that was reported in 2004.

In that study, adults with diabetes were less likely to be working in their 50s than similar adults without the disease. And researchers estimated that between 1992 and 2000, diabetes accounted for $4.4 billion in lost income due to earlier retirement and nearly $32 billion due to work disability.

These latest findings, Dray-Spira's team writes, underscore the point that diabetes "has major social and economic consequences for patients, employers, and society."

The results are based on data from a long-term health study of employees at the French national gas and electric company. Between 1989 and 2007, 506 workers developed diabetes.

Dray-Spira's team compared each of those workers with five diabetes-free co-workers the same age and in the same job type.

Overall, diabetics were less likely to still be working in their mid-50s. By age 55, 52 percent of workers with diabetes were still on the job, versus 66 percent of those without diabetes.

The gap narrowed by the time the workers were 60 years old, the official retirement age in France during the study period. At age 60, 10 percent of diabetic workers were still on the job, compared with 13 percent of their co-workers.

In addition, by age 60, roughly five of every 100 diabetics were on disability, compared to roughly one of every 100 non-diabetics.

Dray-Spira noted that France has both a relatively young retirement age and a universal healthcare system. The impact of diabetes on retirement and disability could be greater, she said, in a country where people typically work longer and lack universal healthcare -- like the U.S.

"The major implication of our results is that particular attention should be paid to help people with diabetes in maintaining employment," Dray-Spira said.

It's estimated that almost 26 million U.S. adults have diabetes. Most of them have type 2 diabetes -- the form of the disease closely associated with obesity.

A government study last year projected that up to one-third of the U.S. population could have diabetes by 2050, if Americans continue to avoid exercise, take in too many calories, and gain weight.

Source: http://bit.ly/muH2DU

Diabetes Care, online May 11, 2011.

Monday, May 30, 2011

Zeroing in on Alzheimer's Disease

ScienceDaily

Monday, May 30, 2011

ScienceDaily (May 31, 2011) — Recently the number of genes known to be associated with Alzheimer's disease has increased from four to eight, including the MS4A gene cluster on chromosome 11. New research published in BioMed Central's open access journal Genome Medicine has expanded on this using a genome-wide association study (GWAS) to find a novel location within the MS4A gene cluster which is associated with Alzheimer's disease.

Alzheimer's disease is the most common cause of dementia in the developed world. It irrevocably destroys cells in the brain that are responsible for intellectual ability and memory. Despite continued investigation, the causes of Alzheimer's disease are not yet fully understood but they are thought to be a mixture of genetic and environmental factors. Several studies have used GWAS to search the entire human genome for genes which are mutated in Alzheimer's sufferers in the hope of finding a way to treat or slow down the disease.

A team of researchers across Spain and USA sponsored by non-profit Fundación Alzheimur (Comunidad Autónoma de la Región de Murcia) and Fundació ACE Institut Català de Neurociències Aplicades performed their own GWAS study using patients with Alzheimer's disease, and non-affected controls, from Spain and then combined their results with four public GWAS data sets. Dr Agustín Ruiz said, "Combining these data sets allowed us to look more accurately at small genetic defects. Using this technique we were able to confirm the presence of mutations (SNP) known to be associated with Alzheimer's disease, including those within the MS4A cluster, and we also found a novel site."

Dr Ruiz continued, "Several of the 16 genes within the MS4A cluster are implicated in the activities of the immune system and are probably involved in allergies and autoimmune disease. MS4A2 in particular has been linked to aspirin-intolerant asthma. Our research provides new evidence for a role of the immune system in the progression of Alzheimer's disease."

 

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Carmen Antunez, Mercè Boada, Antonio Gonzalez-Perez, Javier Gayan, Reposo Ramirez-Lorca, Juan Marín, Isabel Hernandez, Concha Moreno-Rey, Francisco J Morón, Jesús López-Arrieta, Ana Mauleón, Maitée Rosende Roca, Fuensanta Noguera-Perea, Agustina Legaz-García, Laura Vivancos-Moreau, Juan Velasco, José M Carrasco, Montserrat Alegret, Martirio Antequera-torres, Salvadora Manzanares, Alejandro Romo, Irene Blanca, Susana Ruiz, Anna Espinosa, Sandra Castaño, Blanca García, Begoña Martínez-Herrada, Georgina Vinyes, Asunción Lafuente, James T Becker, José J Galán, Manuel Serrano-Ríos, Lluis Tárraga, María E Sáez, Enrique Vázquez, Oscar L López, Luis M Real and Agustín Ruiz. The membrane-spanning 4-domains, subfamily A (MS4A) gene cluster contains a common variant associated with Alzheimer's disease. Genome Medicine, 2011

More evidence for PTSD, heart disease link

By Genevra Pittman

Reuters Health

Monday, May 30, 2011

NEW YORK (Reuters Health) – People with post-traumatic stress disorder may be at a higher risk for heart disease, according to researchers.

In a study of U.S. war veterans, they found that those with PTSD were more likely to have fatty buildup, or plaque, in the arteries leading to the heart, called coronary artery disease.

The disease had also progressed farther in the mentally troubled vets, and they were more likely to die of any cause over the next three and a half years than their peers.

Joseph Boscarino, an investigator at Geisinger Health System in Danville, Pennsylvania, told Reuters Health the new results confirm earlier findings.

Studies "keep showing this link between PTSD and various forms of cardiovascular disease," said Boscarino, who was not involved in the current work.

"Something needs to be done in terms of better interventions" for these individuals, he added.

The military has already been under pressure to better address PTSD in returning troops, as accounts of vets plagued by combat flashbacks, fearful and avoidant behavior, and depression have been piling up.

According to the National institute of Mental Health, about 1 in 30 adults in the U.S. suffer from PTSD in a given year -- and that risk is much higher in war vets.

The new results highlight the importance of integrating medical and psychological care in vets, and quickly identifying those who are at risk for PTSD and thus heart disease as well, the researchers write in The American Journal of Cardiology.

Dr. Ramin Ebrahimi of the Greater Los Angeles Veterans Administration Medical Center and colleagues screened a group of 637 vets suspected of having heart disease for PTSD and signs of coronary artery disease.

The vets were an average of about 60 years old, and most were men. Eighty-eight of them fit the criteria for PTSD.

Calcium scans of their hearts showed the majority of participants had some sort of plaque buildup in their arteries. More than three-quarters of the vets with PTSD had narrowed arteries, compared to 59 percent of those without PTSD.

After their initial tests, the researchers followed participants for an average of three and half years. Over that time, 17 percent of the vets with PTSD died, compared to 10 percent without PTSD.

Even among those with the same degree of plaque buildup, participants with PTSD died at a higher rate.

Although the study doesn't mean that PTSD necessarily causes heart disease, it does suggest that it's not enough to worry about the mental toll of the disorder.

"For the longest time (PTSD) was basically known as a psychological or psychiatric disorder," Ebrahimi told Reuters Health. "Little by little we understood that these patients actually do have a fair amount of other medical problems."

Boscarino said that it's still unclear what exactly is behind the link between mental and physical health.

It's possible that stress hormones related to PTSD could affect the chance of getting heart disease or that the behavior of people with PTSD -- such as higher rates of heavy alcohol use and smoking -- puts them more at risk, he explained.

It could also be that certain genes influence a person's risk for both PTSD and heart disease, rather than PTSD causing heart problems, he added.

Ebrahimi emphasized that PTSD strikes not only people involved in combat or other violence, but survivors of rape and natural disasters as well. Often, it can be treated successfully with psychotherapy.

According to Boscarino, screening for heart disease and trying to prevent it is key in people with PTSD. But addressing the psychological problems may be even more important.

"If you treat someone for PTSD early on...you should prevent not only the psychological problems, but you're also potentially preventing the medical problems" that may come later, he said.

Source: http://bit.ly/j0loTJ

The American Journal of Cardiology, online April 29, 2011.

Noncoding RNA May Promote Alzheimer's Disease

ScienceDaily

Monday, May 30, 2011

ScienceDaily (May 30, 2011) — Researchers pinpoint a small RNA that spurs cells to manufacture a particular splice variant of a key neuronal protein, potentially promoting Alzheimer's disease (AD) or other types of neurodegeneration. The study appears in the May 30 issue of The Journal of Cell Biology.

Like a movie with an alternate ending, a protein can come in more than one version. Although scientists have identified numerous proteins and RNAs that influence alternative splicing, they haven't deciphered how cells fine-tune the process to produce specific protein versions. Four years ago, researchers identified a set of 30 small, noncoding RNAs that they suspected help regulate gene expression.

Italian researchers have now determined the function of one of the RNA snippets, known as 38A, that hails from a noncoding part of the gene that encodes the protein KCNIP4. KCNIP4 helps ensure that neurons fire impulses in a characteristic slow, repeating pattern. The researchers found that 38A spurs cells to produce an alternative splice variant of KCNIP4, Var IV, that disrupts this current, potentially leading to neurodegeneration.

KCNIP4 normally interacts with gamma-secretase, the enzyme complex that helps generate beta-amyloid (Abeta), a protein that accumulates in the brains of AD patients. But Var IV can't make the connection, possibly disturbing Abeta processing. Supporting that notion, the researchers found that levels of 38A were more than 10 times higher in brain cells from AD patients than in controls and that 38A hiked output of the more dangerous Abeta isoform Abeta 1-42.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

S. Massone, I. Vassallo, M. Castelnuovo, G. Fiorino, E. Gatta, M. Robello, R. Borghi, M. Tabaton, C. Russo, G. Dieci, R. Cancedda, A. Pagano. RNA polymerase III drives alternative splicing of the potassium channel-interacting protein contributing to brain complexity and neurodegeneration. The Journal of Cell Biology, 2011; 193 (5): 851 DOI: 10.1083/jcb.201011053

Stay away from energy drinks, doctors say

By Frederik Joelving

Reuters Health

Monday, May 30, 2011

NEW YORK (Reuters Health) – In a new report, a large group of American doctors urge kids and teens to avoid energy drinks and only consume sports drinks in limited amount.

The recommendations come in the wake of a national debate over energy drinks, which experts fear may have side effects.

"Children never need energy drinks," said Dr. Holly Benjamin, of the American Academy of Pediatrics, who worked on the new report. "They contain caffeine and other stimulant substances that aren't nutritional, so you don't need them."

And kids might be more vulnerable to the contents of energy drinks than grownups.

"If you drink them on a regular basis, it stresses the body," Benjamin told Reuters Health. "You don't really want to stress the body of a person that's growing."

For the new recommendations, published in the journal Pediatrics, researchers went through earlier studies and reports on both energy drinks and sports drinks, which don't contain any stimulants.

They note that energy drinks contain a jumble of ingredients -- including vitamins and herbal extracts -- with possible side effects that aren't always well understood.

While there aren't many documented cases of harm directly linked to the beverages, stimulants can disturb the heart's rhythm and may lead to seizures in very rare cases, Benjamin said.

Recently, she saw a 15-year-old boy with attention deficit hyperactivity disorder who came into the hospital with a seizure after having drunk two 24-ounce bottles of Mountain Dew, a soft drink that contains caffeine.

The boy was already taking stimulant ADHD medication, and the extra caffeine in principle might have pushed him over the edge, according to Benjamin.

"You just never know," she said. "It's definitely a concern."

Earlier this year, Pediatrics published another review of the literature on energy drinks.

In it, Florida pediatricians described cases of seizures, delusions, heart problems and kidney or liver damage in people who had drunk one or more non-alcoholic energy drinks -- including brands like Red Bull, Spike Shooter and Redline.

While they acknowledged that such cases are very rare, and can't be conclusively linked to the drinks, they urged caution, especially in kids with medical conditions (see Reuters story of February 14, 2011).

U.S. sales of non-alcoholic energy drinks are expected to hit $9 billion this year, with children and young adults accounting for half the market.

Manufacturers claim their products will enhance both mental and physical performance, and were quick to downplay the February report.

"The effects of caffeine are well-known and as an 8.4 oz can of Red Bull contains about the same amount of caffeine as a cup of coffee (80 mg), it should be treated accordingly," Red Bull said in an emailed statement to Reuters Health.

Benjamin said that for most kids, water is the best thing to quench their thirst. If they happen to be young athletes training hard, a sports drink might be helpful, too, because it contains sugar.

But for kids who lead less-active lives, sports and energy drinks might just serve to pile on extra pounds, fueling the national obesity epidemic.

While she acknowledged that more research is needed, Benjamin said the safest thing to drink is water.

Source: http://bit.ly/cxXOG

Pediatrics, online May 30, 2011.

Aging: Peroxisomes Have Two Independent Proliferation Mechanisms

ScienceDaily

Monday, May 30, 2011

ScienceDaily (May 30, 2011) — Peroxisomes are cell organelles that can cause disease and aging processes if they do not function properly. For the first time ever, University of Groningen researchers have demonstrated that peroxisomes can be created by two independent processes, one of which serves as a kind of 'backup'. The study was published in the 23 May issue of the Journal of Cell Biology.

Lack of clarity

Two mechanisms by which peroxisomes proliferate are known: division of an existing peroxisome and creation of a new one by budding from another cell organelle, the endoplasmic reticulum (ER). There is a lack of clarity in scientific circles regarding the status of the two mechanisms.

Independent after all

In their Journal of Cell Biology article, the Groningen researchers are the first to describe the proteins which are essential in creating peroxisomes from the ER. This discovery was subsequently used to inhibit the formation of these proteins. It transpired that when ER peroxisome production ceased, this had little or no effect on the numbers of peroxisomes present in the cell. This proved that peroxisomes are indeed independent cell organelles capable of proliferation by division, just like other important cell organelles such as mitochondria.

Backup

Formation of organelles from the ER is probably an important backup mechanism when a cell has lost all its peroxisomes. In that case, peroxisomes can be created de novo in a cell. These results are a major contribution to the debate on the importance of the ER peroxisome formation process.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

R. Saraya, A. M. Krikken, M. Veenhuis, I. J. van der Klei. Peroxisome reintroduction in Hansenula polymorpha requires Pex25 and Rho1. The Journal of Cell Biology, 2011; DOI: 10.1083/jcb.201012083 

Stress doesn't raise risk of MS: study

By Genevra Pittman

Reuters Health

Monday, May 30, 2011

NEW YORK (Reuters Health) – Having a stressful home or work environment doesn't make a person more likely to develop multiple sclerosis, hints a large new study.

Previous research has suggested that in people who already have the chronic disease -- which affects the brain and spinal cord -- stressful events make flare-ups more likely. In the new study, the authors looked at whether stress raised a woman's risk of getting the disease, and couldn't find a link.

Despite studying more than 150,000 women, though, the researchers said they couldn't rule out a connection either because they couldn't account for all stressful life events and their impact on the body's disease-fighting systems.

"These results do not support a major role of stress in the development of the disease, but repeated and more focused measures of stress are needed to firmly exclude stress as a potential risk factor for MS," they report today in the journal Neurology.

The National Multiple Sclerosis Society estimates that about 400,000 people in the U.S. have MS. There is no cure for the disease, which occurs when the protective coating around nerve fibers begins to break down -- slowing the brain's communication to the rest of the body.

Symptoms include fatigue and problems with balance and muscle coordination, as well as memory loss and trouble with logical thinking in some people.

To determine if stress is linked to the onset of MS, researchers including Harvard Medical School's Dr. Alberto Ascherio analyzed data from two large nationwide studies of female nurses.

Starting in 1976 for one study and 1989 for the other, women were regularly asked about any new diseases they were diagnosed with, including MS, and diagnoses were confirmed by their doctors.

The first group of about 93,000 nurses was also given a questionnaire about their levels of stress at home and at work, six years after the study began. The second group of about 68,500 nurses filled out questionnaires about physical and sexual abuse during childhood and adolescence -- another possible cause of stress.

As of 2004 to 2005, 77 women in the first group and 292 in the second had been diagnosed with MS and responded to questionnaires about stress. The number in the second study was higher because researchers included women who had been diagnosed with MS before the study was initiated, and that group was younger.

MS is typically diagnosed between the ages of 20 and 40.

How much stress women reported both at home and work was not linked with their chance of having MS. For example, 44 percent of all women said in their questionnaire that they experienced moderate stress at work, compared to 39 percent of women with MS. Those numbers were similar for moderate stress at home.

Severe stress at work was reported by 11 percent of all women and 5 percent of the MS group in particular.

Nor did a history of physical abuse make women any more likely to get MS.

The researchers found a slight increase in MS in women who said they were touched multiple times in a sexual way as a child -- but they note that result is hard to interpret, especially because women who said they were touched once seemed to have a lowest risk of MS.

One limitation of the study was that it only included female nurses, so the findings may not apply to men, the authors say.

Another limitation was that the study only asked about stress at a single time point.

Dr. Thomas Mack, who studies MS at the University of Southern California, said that one question when considering stress is whether to ask people how they feel or to measure the body's stress response.

"The main difficulty in studying stress specifically is, what does the word mean?" said Mack, who was not involved in the current study.

"Does it have a specific physiologic meaning, or is it a very general term? Some people feel more stressed than others -- whether there's any physiologic meaning to that is very difficult to know," he told Reuters Health.

Researchers sometimes measure stress by looking at the presence of certain hormones in the blood.

Mack said this issue of stress as a possible cause of MS hasn't been studied much -- mostly because doctors who treat MS are more interested in what causes exacerbations in their patients than why they developed the disease in the first place.

Source: http://bit.ly/lUcacJ

Neurology, online May 30, 2011.