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Friday, July 8, 2011

Indoor Air Pollution Linked to Cardiovascular Risk

ScienceDaily

Friday, July 8, 2011

ScienceDaily (July 8, 2011) — An estimated two billion people in the developing world heat and cook with a biomass fuel such as wood, but the practice exposes people -- especially women -- to large doses of small-particle air pollution, which can cause premature death and lung disease.

In a study just published online in the peer-reviewed journal Environmental Health Perspectives, researchers at the University of Wisconsin-Madison have associated indoor air pollution with increased blood pressure among older women.

In a remote area of Yunnan Province, China, 280 women in an ethnic minority called the Naxi wore a portable device that sampled the air they were breathing for 24 hours. The Naxi live in compounds including a central, free-standing kitchen that often has both a stove and a fire pit, says Jill Baumgartner, who performed the study with National Science Foundation funding while a Ph.D. student at UW-Madison.

"I spent a lot of time watching women cook in these unvented kitchens, and within seconds, my eyes would burn, it would get a little difficult to breathe. The women talk about these same discomforts, but they are viewed as just another hardship of rural life," Baumgartner says.

Most women are exposed to this smoke for several hours a day, and even if the cookstove is vented, a second fire is often burning for heat, says Baumgartner, who is now a global renewable energy leadership fellow at the Institute on the Environment at the University of Minnesota.

By correlating exposure over 24 hours with blood pressure, Baumgartner and colleagues associated higher levels of indoor air pollution with a significantly higher blood pressure among women aged 50 and over. Small-particle pollution raises blood pressure over the short term by stimulating the nervous system to constrict blood vessels. In the long term, the particles can cause oxidative stress, which likewise raises blood pressure.

Other studies have shown that improved stoves or cleaner fuels can cut indoor air pollution by 50 to 75 percent. In the Baumgartner study, that reduction in pollution level was linked to a four-point reduction in systolic blood pressure (the first number in a blood pressure reading). Such a change "may be of little consequence for an individual," says co-author Leonelo Baustista, an associate professor of population health sciences at UW-Madison. "However, changes of this magnitude in a population would have a significant, large impact on the risk of cardiovascular disease in the population."

In fact, the researchers concluded that this reduction would translate into an 18 percent decrease in coronary heart disease and a 22 percent decrease in stroke among Asian women aged 50 to 59. These benefits would save the lives of 230,900 Chinese women each year.

Because biomass fuels are also the primary source of energy for more than 2 billion people globally, cleaner fuels and better stoves would produce even greater cardiovascular benefits worldwide.

"This is the first study that links personal exposure to indoor air pollution to blood pressure changes; considering that a couple of billion people are exposed, this represents an extremely important public health discovery," says co-author Jonathan Patz, director of the UW Global Health Institute.

"We have known for years that unvented cooking indoors causes respiratory damage, but now that we have documented cardiovascular effects as well, the rationale for cleaner stoves and better fuels becomes that much stronger," adds Patz, a professor in the Nelson Institute for Environmental Studies.

Although China had a major program to promote cleaner stoves during the 1980s, indoor air pollution problem remains, Baumgartner says.

"Having a cleaner stove or fuel is important, but in these villages, the piece that is missing is education about the health implications. You can have a great stove, but if it is sitting right next to an open fire, the health benefit is lost," Baumgartner says.

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Wisconsin-Madison. The original article was written by David Tenenbaum.

Journal Reference:

Jill Baumgartner, James J. Schauer, Majid Ezzati, Lin Lu, Chun Cheng, Jonathan A. Patz, Leonelo E. Bautista. Indoor Air Pollution and Blood Pressure in Adult Women Living in Rural China. Environmental Health Perspectives, 2011; DOI: 10.1289/ehp.1003371

Vitamin D may improve pancreas function

By Eric Schultz

Reuters Health

Friday, July 8, 2011

NEW YORK (Reuters Health) - Vitamin D supplements reduced risk factors for type 2 diabetes by improving the function of insulin-producing cells in pre-diabetic volunteers, a new study has found.

"The results...suggest that vitamin D supplementation may help to improve the main defect in type 2 diabetes," co-author Dr. Anastassios Pittas, an endocrinologist at Tufts University Medical Center in Boston, told Reuters Health in an email.

Type 2 diabetes, the most common form of the disease, affects millions of Americans. The condition is characterized by high blood-sugar levels resulting from the body's poor response to insulin, a chemical that removes sugar from the bloodstream and stores it in the liver and muscles. Insulin is made by beta cells in the pancreas.

To see whether taking vitamin D would improve people's ability to handle blood sugar, researchers gave 92 pre-diabetic adults either vitamin D3 supplements, calcium supplements, both, or placebos. After four months, the participants' blood was tested for several known diabetes risk factors.

The measures included hemoglobin A1C, an indicator of blood-sugar levels over time, and beta-cell function, as reflected by how much insulin is being released and how well the body responds to it.

At the outset, participants were considered pre-diabetic if they were overweight and had blood-sugar levels that were above normal but not high enough to be classified as diabetic.

The researchers found that vitamin D significantly increased the beta-cell function of pre-diabetic adults, according to results published in the American Journal of Clinical Nutrition. The vitamin D group also had slightly more favorable hemoglobin A1C levels.

Calcium had no effect on beta-cell function, either alone or in combination with vitamin D.

The results don't necessarily indicate that vitamin D will reduce the likelihood of diabetes, since the study just measures blood test results. However, the important finding is that "supplementation affects biology," Dr. Ian De Boer, a nephrologist at the University of Washington in Seattle who was not involved in the study, told Reuters Health.

De Boer estimated that in the study vitamin D improved beta-cell function between 15 and 30 percent.

Previous research has explored the connection between vitamin D and diabetes, with mixed results. Several studies have shown that people with low levels of vitamin D may be at a higher risk for diabetes, but most have been unable to demonstrate that vitamin D supplementation can help prevent diabetes.

One recent study from Iran did show that vitamin D could help control blood sugar, which in itself may stave off diabetes.

"These findings are interesting but preliminary," cautioned Dr. Susan Kirkman of the American Diabetes Association.

"Vitamin D may have a role in delaying the progression to clinical diabetes in adults at high risk of Type 2 diabetes," wrote the authors of the new study, but they agree that role has not been adequately demonstrated.

"At this point, I would not recommend vitamin D based on the results of our study for prevention of diabetes," Pittas said. However, with larger and longer studies of vitamin D's connection to diabetes currently underway, he said, a more definitive answer could be forthcoming.

Source: http://bit.ly/qauWcN

American Journal of Clinical Nutrition, online June 29, 2011.

Discovery of Natural Antibody Brings a Universal Flu Vaccine a Step Closer

ScienceDaily

Friday, July 8, 2011 

ScienceDaily (July 8, 2011) — Annually changing flu vaccines with their hit-and-miss effectiveness may soon give way to a single, near-universal flu vaccine, according to a new report from scientists at The Scripps Research Institute and the Dutch biopharmaceutical company Crucell. They describe an antibody that, in animal tests, can prevent or cure infections with a broad variety of influenza viruses, including seasonal and potentially pandemic strains.

The finding, published in the journal Science Express on July 7, 2011, shows the influenza subtypes neutralized with the new antibody include H3N2, strains of which killed an estimated one million people in Asia in the late 1960s.

"Together this antibody and the one we reported in 2009 have the potential to protect people against most influenza viruses," said Ian Wilson, who is the Hansen Professor of Structural Biology and a member of the Skaggs Institute for Chemical Biology at Scripps Research, as well as senior author of the new paper with Crucell's chief scientific officer Jaap Goudsmit.

Tackling a Major Shortcoming

Wilson's laboratory has been working with Crucell scientists since 2008 to help them overcome the major shortcoming of current influenza vaccines: They work only against the narrow set of flu strains that the vaccine makers predict will dominate in a given year, so their effectiveness is temporary. In addition, current influenza vaccines provide little or no protection against unforeseen strains.

These shortcomings reflect a basic flu-virus defense mechanism. The viruses come packaged in spherical or filamentous envelopes that are studded with mushroom-shaped hemagglutinin (HA) proteins, whose more accessible outer structures effectively serve as decoys for a normal antibody response. "The outer loops on the HA head seem to draw most of the antibodies, but in a given strain these loops can mutate to evade an antibody response within months," said Wilson. Antiviral drugs aimed at these and other viral targets also lose effectiveness as flu virus populations evolve.

"The major goal of this research has been to find and attack relatively unvarying and functionally important structures on flu viruses," said Damian Ekiert, a graduate student in the Scripps Research Kellogg School of Science and Technology who is working in the Wilson laboratory. Ekiert and Crucell's Vice President for Antibody Discovery Robert H. E. Friesen are co-first authors of the Science Express report.

By sifting through the blood of people who had been immunized with flu vaccines, Goudsmit and his colleagues several years ago discovered an antibody that bound to one such vulnerable structure. In mice, an injection of the antibody, CR6261, could prevent or cure an otherwise-lethal infection by about half of flu viruses, including H1 viruses such as H1N1, strains of which caused deadly global pandemics in 1918 and 2009.

The Crucell researchers approached Wilson, whose structural biology lab has world-class expertise at characterizing antibodies and their viral targets. Ekiert, Wilson, and their colleagues soon determined the three-dimensional molecular structure of CR6261 and its binding site on HA, as they reported in Science in 2009. That binding site, or "epitope," turned out to be on HA's lower, less-accessible stalk portion. The binding of CR6261 to that region apparently interferes with flu viruses' ability to deliver their genetic material into host cells and start a new infection. That antibody is about to begin tests in human volunteers.

The Missing Piece

Crucell researchers subsequently searched for an antibody that could neutralize some or all of the remaining flu viruses unaffected by CR6261, and recently found one, CR8020, that fits this description. As the team now reports in the Science Express paper, CR8020 powerfully neutralizes a range of human-affecting flu viruses in lab-dish tests and in mice. The affected viruses include H3 and H7, two subtypes of great concern for human health that have already caused a pandemic (H3) or sporadic human infections (H7).

As with the CR6261 project, Ekiert and colleagues were able to grow crystals of the new antibody bound to an HA protein from a deadly strain of H3N2, and to use X-ray crystallography techniques to determine the antibody's structure and its precise epitope on the viral HA protein.

"It's even lower on the HA stalk than the CR6261 epitope; in fact it's closer to the viral envelope than any other influenza antibody epitope we've ever seen," said Ekiert.

Crucell is about to begin initial clinical trials of CR6261 in human volunteers, and the company expects eventually to begin similar trials of CR8020. If those trials succeed, aside from a vaccine the two antibodies could be combined and used in a "passive immunotherapy" approach. "This would mainly be useful as a fast-acting therapy against epidemic or pandemic influenza viruses," said Wilson. "The ultimate goal is an active vaccine that elicits a robust, long-term antibody response against those vulnerable epitopes; but developing that is going to be a challenging task."

The research was supported by the US National Institute of Allergy and Infectious Diseases, National Institutes of Health; the US Department of Energy; and by Crucell Holland BV.

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Scripps Research Institute.

Journal Reference:

Damian C. Ekiert, Robert H. E. Friesen, Gira Bhabha, Ted Kwaks, Mandy Jongeneelen, Wenli Yu, Carla Ophorst, Freek Cox, Hans J.W.M. Korse, Boerries Brandenburg, Ronald Vogels, Just P.J. Brakenhoff, Ronald Kompier, Martin H. Koldijk, Lisette A.H.M. Cornelissen, Leo L. M. Poon, Malik Peiris, Wouter Koudstaal, Ian A. Wilson, and Jaap Goudsmit. A Highly Conserved Neutralizing Epitope on Group 2 Influenza A Viruses. Science, July 7, 2011 DOI: 10.1126/science.1204839

Obesity May Increase Risk of Surgical Complications

HealthDay News

Friday, July 8, 2011

FRIDAY, July 8 (HealthDay News) -- Obese people who have elective surgery are nearly 12 times more likely to suffer from complications than those of normal weight, new research indicates.

Since data on surgical outcomes are often used by insurance companies, the Johns Hopkins researchers argued that the findings should change how doctors and hospitals are reimbursed for more complex procedures or penalized for higher complication rates.

Operations on obese patients are more demanding because they take longer and the operating fields are deeper, study leader Dr. Marty Makary, an associate professor of surgery, explained in a Hopkins news release. Obese patients who undergo surgery are also at greater risk for surgical site infection and slower healing because of reduced blood flow in fat tissue, Makary noted. Despite these added risks, Makary noted, "payments are based on the complexity of the procedure and are not adjusted for the complexity of the patient."

The study is published online in the journal Plastic and Reconstructive Surgery.

In conducting the study, researchers examined insurance claims, identifying 2,403 obese patients and 5,597 normal weight patients who underwent elective breast procedures, such as breast lifts, reductions and augmentations, between 2002 and 2006.

Within 30 days of surgery, 18.3 percent of the obese group experienced at least one complication, compared to 2.2 percent of non-obese patients. More specifically, obese patients were 22 times more likely to have inflammation, 13 times more likely to develop infection and 11 times more likely to experience pain.

The findings are significant, given that 34 percent of adults in the United States are estimated to be obese -- up from just 15 percent a decade ago. Meanwhile, the number of people having elective plastic surgery is also on the rise. Annual plastic surgery volume increased 725 percent between 1992 and 2005. Despite the trend, the study's authors concluded the increased risk of complications could deter some surgeons from taking on these higher-risk obese patients.

"It's more work, and it's a more complex surgery, as opposed to operating on a thin patient. And the payment is the same," Makary pointed out. "There are definitely incentives there for surgeons and institutions to select healthier patients. They're getting reimbursed less per unit of work for obese patients."

The researchers concluded that more research is needed to determine the role obesity plays in a wider range of surgeries so that new standards can be established to account for any differences, particularly increased risks.

More information

The American Heart Association details some of the cardiac risks associated with surgery in obese patients.

Brain Tumor Discovery Could Lead to New Treatment

ScienceDaily

Friday, July 8, 2011

ScienceDaily (July 8, 2011) — Cleveland Clinic researchers have identified a cellular pathway that cancer stem cells use to promote tumor growth in malignant glioma, an aggressive brain tumor. The research -- published in the July 8 issue of Cell -- also found that existing medications block this cancer-promoting pathway and delay glioma growth in animal models, suggesting a new treatment option for these often fatal brain tumors.

Malignant gliomas account for more than half of the 35,000-plus primary malignant brain tumors diagnosed each year in the United States. Unfortunately, the outlook for patients with malignant gliomas is poor. For patients with the most severe, aggressive form of malignant glioma (grade IV glioma or glioblastoma multiforme), median survival is 9 to 15 months with the best available therapies. These treatments include surgery followed by radiation therapy with the chemotherapy temozolomide followed by additional temozolomide treatment.

Although differences in tumors between people were known to exist, researchers have only recently begun to understand the importance of differences between cancer cells within the same patient. Groups of cells within a glioma which promote brain tumor formation in animal models -- called cancer stem cells -- have been identified. These cancer stem cells are often resistant to radiation and chemotherapy, making them an important target for developing new and effective disease treatments.

In a recently published manuscript, a team of Cleveland Clinic researchers -- led by Jeremy Rich, M.D., Chairman, and Anita Hjelmeland, Ph.D., of the Department of Stem Cell Biology and Regenerative Medicine of the Lerner Research Institute of Cleveland Clinic -- define a novel molecular pathway that cancer stem cells use to promote tumor growth. Cancer stem cells produce elevated nitric oxide, a molecule whose role in cancer is not well defined but which has been linked to therapeutic resistance, evasion of cell death, and enhanced proliferation. Nitric oxide is produced in cancer stem cells through increased levels of the enzyme nitric oxide synthase 2 (NOS2); decreasing the level or activity of this enzyme reduces cancer stem cell growth. When drugs inhibiting the NOS2 enzyme were given to mice with gliomas, the growth of the tumors was delayed. Using the National Institutes of Health supported database of glioma specimen data, they also found that increased levels of this enzyme are associated with decreased survival of glioma patients. Targeting this pathway could therefore provide benefits for glioma patients.

Current therapies for cancer have many side effects, because they rely on the increased sensitivity of the cancer cells to drugs which are toxic to normal cells. It is therefore important to consider the potential side effects of any new proposed cancer treatment. The current study did compare the levels of the enzyme NOS2 and the effects of its inhibitors in cancer stem cells and normal neural stem cells. Normal neural stem cells have some similar properties as cancer stem cells from gliomas but cannot form tumors. Only cancer stem cells were found to depend on the enzyme for their growth. Drugs inhibiting the NOS2 enzyme were evaluated in patients for the treatment of other diseases and had minimal toxicity. The authors suggest that these drugs may therefore be useful for enhancing the effects of current therapies without adding a lot of side effects. NOS2 inhibitors may thereby pose a potential therapeutic breakthrough for this lethal 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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Lerner Research Institute, via EurekAlert!, a service of AAAS.

Journal Reference:

Christine E. Eyler, Qiulian Wu, Kenneth Yan, Jennifer M. MacSwords, Devin Chandler-Militello, Katherine L. Misuraca, Justin D. Lathia, Michael T. Forrester, Jeongwu Lee, Jonathan S. Stamler et al. Glioma Stem Cell Proliferation and Tumor Growth Are Promoted by Nitric Oxide Synthase-2. Cell, Volume 146, Issue 1, 53-66, 8 July 2011 DOI: 10.1016/j.cell.2011.06.006

Lung cancer scans can be unreliable: study

By Frederik Joelving

Reuters Health

Friday, July 8, 2011

NEW YORK (Reuters Health) - CT scans to measure lung tumors can be unreliable, potentially leading patients and doctors to believe the cancer is growing when it's not, a new study suggests.

In principle, that could mean stopping a treatment that is actually keeping the tumor in check, researchers say.

"The patient and the doctor both need to understand that small changes don't necessarily mean much," Dr. Gregory Riely, a lung cancer specialist at Memorial Sloan-Kettering Cancer Center in New York, told Reuters Health.

"Changes of up to 10 percent can happen simply as a result of the inherent variability of CT imaging," he added.

Riely's study, published in the Journal of Clinical Oncology, is the first to test how reliable lung cancer scans are -- work that's long overdue, experts say, because CT scans have already become the gold standard for measuring cancer growth and treatment response.

"It's the sense of, 'Really? Is this first happening now?'" said Dr. Michael Maitland, an oncologist at the University of Chicago, who wrote an editorial about the findings.

"This is telling us scientifically how much noise is naturally there without any treatment or the cancer getting worse," he told Reuters Health. "It's an important thing to do whenever you are going to use any kind of marker for a disease."

For the study, the Sloan-Kettering team asked patients with late-stage lung cancer if they'd be willing to have two chest CT scans done within minutes -- 33 said yes.

Doctors normally scan such patients every few months to see if their tumor is growing, which might be a signal to try a new drug.

Then the researchers gave the images to three radiologists who had no idea the scans had been repeated before the tumors could have grown or shrunk appreciably.

According to the radiologists' measurements, however, many tumors had changed, ranging from 23-percent shrinkage to 31-percent growth.

Overall, three percent of the tumors appeared to have grown so much that doctors would diagnose disease progression according to common criteria. And the smaller the tumor, the bigger the variation.

Riely said some doctors will make treatment decisions based on tiny changes seen on scans, although that might be a costly mistake, according to the new findings.

"We begin to put more and more stock in the data without really understanding the true variability of those measurements," he said. "Small changes are not clinically meaningful and we should not alter clinical care based on them."

Riely stressed, however, that his results don't mean patients should get repeat scans, which would increase their radiation exposure.

Most likely, the results also apply outside of lung cancer, although patients' breathing could make the chest scans extra variable.

Maitland said the findings will also help drug developers, who look at increasingly small changes in tumor size during drug tests, forgetting that the scans might be unreliable at that scale.

"Many of the individuals analyzing data that way perhaps are not aware of that limitation," he explained.

With the new data, scientists can build better models of cancer progression that might save both time and money in clinical trials.

"There is a real opportunity here to update our systems and take advantage of the new technology," said Maitland.

Source:  http://bit.ly/puOY5x

Journal of Clinical Oncology, online July 5, 2011.

Male Smokers Less Likely to Need Joint Replacement Surgery of Hip or Knee

ScienceDaily

Friday, July 8, 2011

ScienceDaily (July 8, 2011) — Surprising results from a new study revealed that men who smoke had less risk of undergoing total joint replacement surgery than those who never smoked. Researchers also reported that men who were overweight, or who engaged in vigorous physical activity were more likely to need arthroplasty. Details of this study are now available in Arthritis & Rheumatism,a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR).

Research has shown that total hip and knee replacements, also known as arthroplasty, are among the most common elective surgeries performed in developed countries. According to data from the 2007 National Hospital Discharge Survey an estimated 230,000 Americans had hip replacement surgery and 543,000 received knee replacements, with severe osteoarthritis (OA) cited as the most frequent cause for undergoing the procedure. OA -- the most common form of arthritis -- causes pain and stiffness in the joints, with studies indicating that older age, female gender, and obesity increase disease risk.

In the current study, George Mnatzaganian, a PhD student from the University of Adelaide in Australia, and colleagues examined the associations of smoking, body mass index (BMI), and physical activity as they relate to risk of joint replacement surgery in men. Clinical data for the 11,388 male study participants, who were part of the Health in Men Study (HIMS), were integrated with hospital morbidity data and mortality records. During the initial health screening (1996-1999), HIMS subjects were surveyed regarding smoking history and physical activity.

Researchers analyzed clinical data from baseline through March 2007, identifying 857 men who had joint replacement surgery following the screening. Of those having surgery, 59% had total knee replacement and 41% had total hip replacement. Subjects were categorized into three age groups: 65-69 years, 70-74 years, and 75 or more years of age.

Analysis showed that being overweight independently increased total joint replacement risk, while smoking lowered the risk, which was most evident after 23 years of smoking exposure. In fact, men who smoked 48 years or more were up to 51% less likely to undergo total joint replacements than those who never smoked. The team also reported that vigorous exercise increased risk of joint replacement in men in the 70-74 year age group.

"Our study is the first to demonstrate a strong inverse correlation between smoking duration and risk of total joint replacement. The independent inverse associations of smoking with risk of total joint replacement were evident also after adjusting for major confounders and after accounting for the competing mortality risk in this elderly cohort of men," Mnatzaganian confirmed. "Further investigation is needed to determine how smoking impacts the development of OA."

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. 

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Wiley-Blackwell, via EurekAlert!, a service of AAAS.

Journal Reference:

George Mnatzaganian, Philip Ryan, Paul E. Norman, David C. Davidson, Janet E. Hiller. Smoking, Body Weight, Physical Exercise and Risk of Lower Limb Total Joint Replacement in a Population-Based Cohort of Men. Arthritis & Rheumatism, July 8, 2011 DOI: 10.1002/art.30400

Anxiety, Depression in Pregnancy May Raise Kids' Asthma Risk

HealthDay News

Friday, July 8, 2011

FRIDAY, July 8 (HealthDay News) -- Children of women who experience anxiety and depression during pregnancy may be at greater risk for asthma, according to new research.

The study of 279 inner-city black and Hispanic women adds weight to research previously conducted among white families that found children are particularly susceptible to asthma-related risks during the prenatal period.

The findings are published in the July issue of Annals of Allergy, Asthma & Immunology.

"Approximately 70 percent of mothers who said they experienced high levels of anxiety or depression while they were pregnant reported their child had wheezed before age 5," study lead author Marilyn Reyes, a researcher at the Columbia Center for Children's Environmental Health in New York City, said in a news release from the American College of Allergy, Asthma and Immunology.

"Understanding how maternal depression affects a child's respiratory health is important in developing effective interventions," Reyes added.

The research team said common asthma symptoms include:

Coughing, particularly during the night

Wheezing or whistling while breathing

Difficulty breathing that causes the skin around the ribs or neck to sink in

Frequent chest colds

The study authors noted that children who experience any of these symptoms on a regular basis could have asthma and should see an allergist.

"The symptoms of pediatric asthma can range from a nagging cough that lingers for days or weeks to sudden and scary breathing emergencies," allergist Dr. Rachel Miller, study senior author, said in the news release. "With the right treatment, your child can sleep through the night, avoid missing time from day care or preschool, and breathe easy."

More information

The U.S. National Institutes of Health provides more information on childhood asthma.

Nuts instead of carbs may aid diabetes control

By Amy Norton

Reuters Health

Friday, July 8, 2011

NEW YORK (Reuters Health) - Replacing that daily muffin with a handful or two of nuts may help people with diabetes better control their blood sugar and cholesterol levels, a new study suggests.

Researchers found that when people with type 2 diabetes replaced some of their usual carbohydrates with about a half-cup of mixed nuts each day, the study participants' blood sugar and "bad" cholesterol levels dipped slightly over three months.

In contrast, no such improvements were seen among people who swapped their normal carbs for a daily whole-wheat muffin.

The findings, published in the journal Diabetes Care, do not mean that nuts are the key to diabetes control, the authors say.

"We should be focusing on overall diet and lifestyle," Cyril W.C. Kendall of the University of Toronto in Canada, one of the researchers on the study, told Reuters Health.

The point, he said, is that "nuts can be part of a healthy diet."

"They have a lot of fat, but we now realize that those fats are healthy ones," Kendall added, referring to the unsaturated fats that have been linked to a lower risk of heart disease and other health benefits.

Still, nuts are high in calories, and people with diabetes should not simply add a handful to their usual diet, according to Kendall.

"They could use them instead to displace some of the less healthy snacks they usually have," he said.

For the study, Kendall and his colleagues randomly assigned 117 adults with type 2 diabetes to one of three groups: One group was given unsalted mixed nuts and told to eat them instead of some of their usual carbs; a second group replaced their normal carbs with "healthy" whole-wheat muffins with no added sugar.

The third group went on a half-nut/half-muffin regimen.

The "full-nut" group ate, on average, about 2 ounces (or a half-cup) of nuts per day, which totaled roughly 475 calories.

After three months, the researchers found, the full-nut group showed a 0.2 percent dip in their average hemoglobin A1C level -- a measure of long-term blood sugar control.

The change was small, and "just shy," Kendall said, of what is considered a "clinically significant" improvement in blood sugar control.

But, he added, people in the study were already on diabetes medication and typically had good blood sugar control. "So we're seeing a benefit over and above what they were achieving with medication," Kendall said.

As for cholesterol, the nut group's average LDL cholesterol -- the "bad" kind -- declined from about 97 milligrams per deciliter to 89 mg/dL. (An LDL count below 100 mg/dL is generally considered optimal.)

No similar improvements were seen in the other two groups.

It's not clear why the full-nut group showed better blood sugar and LDL numbers. Kendall said he suspects it is largely because of the monounsaturated fats in nuts.

"But," he added, "they also have protein, there's a little fiber, and some polyphenols." Polyphenols are antioxidant compounds found in a wide range of plant foods.

The bottom line for people with diabetes, Kendall said, is to remember that diet and other lifestyle habits, like regular exercise, matter. "Diet is very important, even if you are taking medication."

For people who are not crazy about nuts, there are other sources of monounsaturated fat, like olive oil and avocados. While this study did not look at those foods, Kendall said it would be a wise move to replace some carbs with those fats.

Another question is whether the blood sugar and cholesterol changes linked to eating nuts last over time -- and whether they translate into lower rates of heart disease or other diabetes complications.

Studying that is difficult, since very large groups of people would have to be followed over years -- a very expensive undertaking, Kendall noted.

"But," he said, "I think these long-term studies are important to do."

The current study was partially funded by the International Tree Nut Council Nutrition Research & Education Foundation and the Peanut Institute, both industry groups.

Source: http://bit.ly/pwmyBV

Diabetes Care, online June 29, 2011.

Thursday, July 7, 2011 

Older women who take vitamin D3 may live longer

By Amy Norton

Reuters Health

Thursday, July 7, 2011

NEW YORK (Reuters Health) - Elderly women who take vitamin D3 supplements may have a small survival advantage over those who don't, a new research review concludes, although they also raise their risk of kidney stones.

The review of 50 clinical trials involving more than 94,000 elderly adults found that those randomly assigned to take vitamin D3 were six percent less likely to die during study periods averaging two years than participants given inactive pills or no treatment.

That reduced risk of death, researchers say, translates into 200 elderly adults having to take vitamin D3 for about two years in order to save one additional life.

Many questions remain, however. For one, the trials included mostly women, so it's not clear if men would stand to gain the same benefit.

Moreover, it's not clear why women given vitamin D3 had better survival odds -- or what form or dose of the vitamin might be best.

Many of the studies focused on elderly adults living in nursing homes, who are likely to be deficient in vitamin D, frail and at risk of falls.

Vitamin D is needed for healthy bones, and a number of studies have suggested that supplements may lower elderly adults' risk of falls and fractures -- which can prove fatal.

"These preventive effects could likely explain some or all of the mortality reduction we observed," Dr. Christian Gluud, the senior researcher on the new study, told Reuters Health in an email.

However, he said, more research is needed to understand why women who took vitamin D3 had a lower death rate.

Although Gluud's team looked at studies involving four different forms of vitamin D, they found that better survival was specifically linked to vitamin D3 (cholecalciferol), which is more potent and readily absorbed than vitamin D2 (ergocalciferol), the form often found in multivitamins.

But it's not clear whether that's because only vitamin D3 is effective, or because too few trials have tested D2 or other forms of the vitamin, according to Gluud, who works with the Cochrane Collaboration, an international research organization that evaluates medical evidence and published the current findings.

As for the optimal dose of vitamin D for elderly people's health, that too remains to be seen, Gluud said.

In their review, he and his colleagues saw a reduced risk of death with vitamin D3 doses of 800 international units (IU) or less. But, Gluud noted, few trials have tested higher doses.

The benefit his team found is, however, in line with current recommendations.

Last year, the Institute of Medicine (IOM), a scientific advisory panel to the U.S. government, said that most people need 600 IU of vitamin D per day, while adults older than 70 should strive for 800 IU.

Older people are at increased risk of vitamin D deficiency because their bodies are less efficient at producing the vitamin after exposure to the sun, and because their kidneys are less able to convert vitamin D to its active form.

But in its recommendations, the IOM also sought to temper some of the enthusiasm over vitamin D in recent years.

A flurry of studies has linked higher vitamin D intake to lower risks of everything from diabetes, to severe asthma, heart disease, certain cancers and depression.

The problem with those studies is that they were observational -- which means that researchers looked at people's vitamin D intake, or their blood levels of the vitamin, and whether they developed a given health condition. Those studies cannot prove cause-and-effect.

And the IOM said that, other than benefits for bone health, there is insufficient evidence that vitamin D thwarts any specific health condition.

So what should older adults do about vitamin D? They can follow the IOM recommendations on intake levels, and choose food sources of the vitamin -- including fatty fish like salmon and mackerel, and fortified dairy products and cereals.

As for vitamin pills, Gluud said that older adults can talk with their own doctors about whether that's a good idea.

He added that vitamin supplements should be seen as medications that could potentially affect your life expectancy in a positive or negative way.

"Always discuss any medication with your physician," Gluud advised.

The IOM set an upper limit for vitamin D intake, at 4,000 IU per day. Taking too much can lead to vitamin D toxicity, which causes symptoms like nausea, vomiting, constipation and poor appetite. It can also lead to kidney stones and, by raising calcium levels in the blood, heart rhythm disturbances.

In this study, Gluud's team found that vitamin D3 taken along with calcium raised elderly adults' risk of kidney stones by 17 percent.

Gluud said that more clinical trials are needed to compare the effects of different doses of vitamin D, and to study the health effects in elderly men and younger people.

There's also little known about whether the cost of widespread vitamin D use would be worth the benefit. But the vitamin is cheap -- at about $10 for a two-month supply.

Source: http://bit.ly/qDuorP

Cochrane Library, July 2011.

Men Seem More Likely Than Women to Develop Hole in Knee Cartilage

By By Alan Mozes
HealthDay Reporter

HealthDay News

Thursday, July 7, 2011

THURSDAY, July 7 (HealthDay News) -- Men who undergo surgery for a torn or overstretched anterior cruciate ligament (ACL) appear to face a higher risk than women for developing a hole in their knee cartilage, new Norwegian research indicates.

Such holes can result from stress on the knee that strikes following an ACL injury, and these lesions can raise the chances of developing osteoarthritis, the study authors noted.

The identification of a gender risk factor stems from work involving nearly 16,000 Norwegian and Swedish patients that was conducted by a team led by Dr. Jan Harald Roetterud, from Akershus University Hospital in Lorenskog, Norway.

He and his colleagues are slated to present their findings Thursday at the American Orthopaedic Society for Sports Medicine annual meeting in San Diego.

According to the U.S. National Institutes of Health, the ACL is one of four principal ligaments that connect the end of the thigh bone (the femur) to the top of the shin bone (the tibia) in the knee. The ACL is situated in the middle of the knee, and its function is to stabilize the rotational movement of the knee and to keep the tibia from dislocating.

ACL injuries involving tears and overstretching are extremely common among both male and female athletes engaged in sports that entail a great deal of jumping or tackling.

Because recovery requires treatment, surgery is often called for to reconstruct the torn ligament.

As it turns out, many surgical patients are women, mostly because anatomical and muscular gender differences appear to raise the risk for an ACL injury more among women than men.

To see whether the same gender dynamic is at play with regard to ACL-associated cartilage issues, Roetterud and his team focused on a large pool of ACL reconstructive surgery patients who underwent the treatment between 2005 and 2008.

The authors found that 6.4 percent of roughly 15,800 patients between the ages of 8 and 69 had cartilage lesions. Among this subgroup of approximately 1,000 patients, 5.6 percent were women, while 7 percent were men.

The team suggested that gender be added to a list of known risk factors for such lesions, which include older age, history of prior surgery and a waiting period between an ACL injury and reconstructive surgery that is greater than a year.

Dr. Matthew Matava, an associate professor of orthopaedic surgery at Washington University School of Medicine in St. Louis, noted that the latest finding runs somewhat contrary to typical assumptions.

"It has been long known that girls have eight times the risk for an ACL injury than boys," he noted, "due to the way they fire their quads and hamstrings in response to a sprain in the knee joint. So, in terms of cartilage injury risk, it's been assumed to be kind of the same situation in terms of gender," Matava said.

"But men do tend to be bigger and somewhat faster, and put more stress on their body," he added. "So this makes some common sense. But does it change anything we would do as orthopaedic surgeons? Not really, other than to counsel our patients as to what their risks are once they already have this kind of injury."

Dr. C. David Geier Jr., director of the Medical University of South Carolina Sports Medicine Program, suggested that while the gender finding was intriguing, the emphasis should be placed on the need to get ACL patients of either gender into surgery sooner rather than later, to reduce their overall risk for associated cartilage damage.

"ACL tears are much more common in females than males," said Geier, who is also an assistant professor of orthopaedic surgery. "So, some doctors might find it interesting that males with these injuries are more likely to have cartilage damage," he noted.

"Active people who are worried about doing more harm to their knee might consider surgery early after the injury, and not wait months or years," he stressed. "As orthopaedic surgeons, we have few reliable options for reversing cartilage damage, and finding cartilage defects can potentially suggest poorer outcomes from ACL surgeries and long-term problems for those patients."

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

For more on ACL injuries, visit the U.S. National Library of Medicine. 

Wednesday, July 6, 2011

Green tea lowers cholesterol, but only a little

By Eric Schultz

Reuters Health

Wednesday, July 6, 2011

NEW YORK (Reuters Health) - Drinking green tea seems to cut "bad" cholesterol, according to a fresh look at the medical evidence.

The finding may help explain why green tea has been linked to a lower risk of heart disease, the leading killer worldwide, Xin-Xin Zheng and colleagues from Peking Union Medical College in Beijing report.

Because few people in the U.S. drink green tea, encouraging Americans to down more of the brew could have significant health benefits, the researchers write in the American Journal of Clinical Nutrition.

Still, one U.S. expert cautioned the drink shouldn't be used as medicine for high cholesterol, as the effect found in the Chinese study was small.

The new report pools the results of 14 previous trials. In each of those studies, researchers randomly divided participants into two groups: one that drank green tea or took an extract for periods ranging from three weeks to three months, and one that got an inactive preparation.

On average, those who got green tea ended up with total cholesterol levels that were 7.2 milligrams per deciliter (mg/dL) lower than in the comparison group. Their LDL, or "bad," cholesterol dropped 2.2 mg/dL -- a decrease of slightly less than two percent.

There was no difference in HDL, or "good," cholesterol between the two groups.

The cholesterol-lowering effects of green tea may be due to chemicals known as catechins, which decrease the absorption of cholesterol in the gut, according to the researcher.

However, the cholesterol reduction with green tea is pretty small, cautioned Nathan Wong, who runs the heart disease prevention program at the University of California, Irvine.

He told Reuters Health the drink "should not be recommended in place of well-proven cholesterol-lowering medicines for people with high cholesterol."

Some researchers have raised concerns over possible side effects from heavy consumption of green tea or green tea extracts. For instance, there have been a few dozen reports of liver damage, and green tea may also interact with certain medications to reduce their effectiveness.

Still, Wong said smaller doses of the brew "could be a useful component of a heart-healthy diet," with benefits that may go beyond its effect on cholesterol.

Source: http://bit.ly/kPFJLS

American Journal of Clinical Nutrition, online June 29, 2011.

Metabolic Shift May Offer Early Cancer Clue

ScienceDaily

Wednesday, July 6, 2011

ScienceDaily (July 6, 2011) — Cancer cells are well known for their altered metabolisms, which may help them generate the energy they need for rapid growth. Using an emerging imaging technology, researchers reporting in the July Cell Metabolism, have discovered that those metabolic shifts actually develop even before detectable tumors form. By the same token, the studies in mice with liver cancer show that the altered tumor metabolism shifts back before established tumors shrink.

"This may be an early diagnostic in liver cancer and a way to assess tumor response to treatment," said Andrei Goga of the University of California, San Francisco.

The increased conversion of glucose into lactate had been observed in tumor cells in culture before, Goga explained. But there hadn't been a good way to see those dynamic changes in glycolysis (the metabolic pathway that converts glucose into pyruvate to release energy) in a living animal.

His team sought to change that using hyperpolarized 13C-pyruvate magnetic resonance spectroscopic imaging (MRSI) in mice whose cancer could be turned on and off via a single cancer-causing oncogene known as Myc. The imaging method made it possible to see the real-time conversion of pyruvate, a key product of glycolysis, into other metabolites as tumors began to grow and then to shrink.

"The model allowed us to see what happens before a tumor forms," Goga said.

What they saw was that the conversion of pyruvate to lactate increased as tumors developed, with the conversion of pyruvate into alanine predominating very early in precancerous tissues.

"We were surprised to see that very early shift," he said. They aren't yet sure exactly what it means, but Goga suggests it may lead to new strategies to tackle cancer in those earliest stages.

When the oncogene was switched off in mice with liver tumors, changes in metabolism were apparent three days later. "The metabolism falls apart before there is any discernible regression," Goga said. "It suggests metabolic changes precede tumor formation and regression."

The findings could lead to new ways to diagnose liver cancer in its early stages. Better therapies and new imaging methods to monitor their effectiveness are also sorely needed in liver cancer. That's because the disease most often develops in patients with cirrhosis and the fibrous connective tissue typically found in their livers can prevent tumors from visibly shrinking even as they die. Hyperpolarized 13C-pyruvate MRSI may offer a way to assess drugs' effectiveness in such cases by visualizing changes in tumor metabolism.

"What excites us is that this is a new insight into tumor biology in a way that was not possible before," Goga says. "It also has real potential for application in patients."

In fact, the imaging technology they used is already being tested in an early clinical trial for use in patients with prostate cancer, another condition that can't be assessed well by current imaging methods.

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Cell Press, via EurekAlert!, a service of AAAS.

Journal Reference:

Simon Hu, Asha Balakrishnan, Robert A. Bok, Brittany Anderton, Peder E.Z. Larson, Sarah J. Nelson, John Kurhanewicz, Daniel B. Vigneron, Andrei Goga. 13C-Pyruvate Imaging Reveals Alterations in Glycolysis that Precede c-Myc-Induced Tumor Formation and Regression. Cell Metabolism, 6 July 2011; 14(1) pp. 131 - 142 DOI: 10.1016/j.cmet.2011.04.012

Breastfeeding may not stop MS flare-ups: study

By Amy Norton

Reuters Health

Wednesday, July 6, 2011

NEW YORK (Reuters Health) - Some studies have suggested that breastfeeding might offer women with multiple sclerosis a way to prevent symptom flare-ups after childbirth. But new findings refute that idea, researchers reported Wednesday.

In a study of nearly 300 pregnant women with MS, Italian researchers found no evidence that breastfeeding lowered a woman's odds of having worsening symptoms in the months after giving birth.

The study, experts say, means that women with MS should not make breastfeeding decisions based on the hope it will prevent symptom flare-ups -- also known as relapses.

In fact, breastfeeding could increase the risk of worsening symptoms, since breastfeeding mothers are advised against taking the so-called disease-modifying drugs used to control MS.

Researchers suggest that nursing mothers avoid these drugs -- which include brand-names like Avonex, Betaseron and Rebif - because it's possible they're passed to the baby through breast milk.

"It appears, based on the best available evidence, that the decision to breastfeed or not should not be based on the idea that breastfeeding is somehow protective against relapses," said Dr. Nicholas LaRocca of the National Multiple Sclerosis Society, who was not involved in the study.

Some small studies had suggested that women who breastfeed have fewer MS relapses than those who bottle-feed.

However, LaRocca said in an interview, those studies were subject to a key bias: Women who suffer symptom flare-ups right before they become pregnant, or during pregnancy, are also at increased risk of post-pregnancy relapses -- so they may choose not to breastfeed so that they can go back on their MS medication. (The disease-modifying drugs are not approved for use during pregnancy, either.)

In that case, breastfeeding would only appear to have a protective effect against relapses.

MS is a nervous system disorder thought to arise when a person's immune system mistakenly attacks the body's own nerve fibers. MS leads to symptoms like muscle weakness, numbness, vision problems and difficulty with coordination and balance; in most cases, those symptoms come and go -- worsening for a period of time, followed by a period of milder symptoms, or none at all.

Years ago, women with MS were advised to avoid pregnancy, partly out of concern that it could make their disease worse.

But studies in recent decades have shown that the opposite is true; many women see their symptoms improve or even disappear during pregnancy -- possibly because immune system activity naturally declines and levels of anti-inflammatory hormones called corticosteroids naturally rise during pregnancy.

On the other hand, women commonly have symptom relapses in the months after giving birth. It's estimated that 20 percent to 40 percent of women have a flare-up in the first six months after delivery.

Some small studies have linked breastfeeding to a lower risk of those post-pregnancy relapses. Others have found no such connection. This latest study, reported in the journal Neurology, is in line with those.

Of 298 women researchers followed, 37 percent had a symptom relapse in the year after giving birth. Just under seven percent had two or more relapses.

There was no evidence that women who breastfed had a lower risk. Instead, the only factor that seemed to predict post-pregnancy relapse was a woman's symptom history: if she'd had a relatively higher number of relapses in the year before pregnancy, or during pregnancy, her risk of post-childbirth relapse was higher.

"Our findings actually suggest that the choice to breastfeed can be biased by disease activity before and during pregnancy," lead researcher Dr. Emilio Portaccio, of the University of Florence, told Reuters Health in an email.

He said that women with MS should be aware that symptoms may flare up after childbirth, and that the risk is even greater if they have had relapses in the year before or during pregnancy.

"In such a patient, breastfeeding may not be feasible and early post-partum treatment should be an option," Portaccio said.

In general, breast milk is considered the best nutrition for infants, and experts recommend that mothers try to breastfeed exclusively for their baby's first six months.

LaRocca said that, like any new mother, women with MS have to weigh the benefits of breastfeeding against any potential downsides -- but with the added question of how their disease might be affected.

Unfortunately, there is no way to predict which women will have a relapse after giving birth. Even if a woman has been symptom-free before and during pregnancy, that's no guarantee against a post-pregnancy flare-up.

"MS is nothing if not unpredictable," LaRocca said. "(Breastfeeding) is a tough decision because of that unpredictability."

He suggested that each woman discuss the pros and cons with her own doctor.

Portaccio agreed. "The final decision on 'breastfeeding dilemma' is up to the patient," he said. "In my opinion, it is of crucial importance that the decision is made after receiving and understanding all information on possible drawbacks."

Portaccio and his co-researchers on the study have received research funding or have other financial connections to several manufacturers of MS drugs.

Source: http://bit.ly/Q5TNl

Neurology, online July 6, 2011.

Dietary Leucine May Fight Pre-Diabetes, Metabolic Syndrome: Study Shows Improvements in Animals With Amino Acid in Diet

ScienceDaily

Wednesday, July 6, 2011

ScienceDaily (July 6, 2011) — A study led by researchers at the Joslin Diabetes Center suggests that adding the amino acid leucine to their diets may help those with pre-diabetes or metabolic syndrome.

In an animal study, published in the journal PLoS ONE, mice who had been on a high-fat diet and who also received twice the usual intake of leucine, an amino acid found in protein, showed reductions in their prediabetic conditions with lower blood sugars and less fat in their livers, two of the collection of medical problems associated with insulin resistance that make up what is known as metabolic syndrome.

"The impact on the animals on the high-fat diet, even though it didn't change how fat they got, was that their bodies were able to handle glucose better," said C. Ronald Kahn, M.D., Head of the Joslin Section on Integrative Physiology and Metabolism and the Mary K. Iacocca Professor of Medicine at Harvard Medical School. Kahn led the team of researchers from Joslin and Metabolon Inc. of Durham, N.C.

"Their glucose tolerance tests improved," he said. "Their bodies responded to insulin better than they would have before they got the leucine. It improved their ability to metabolize sugar and fats. It markedly improved their pre-diabetic condition. Their metabolic syndrome also improved."

Mice who were fed a normal diet and given leucine showed no significant effects from taking the dietary supplement.

Kahn said the study sought to see what effect just a small change in their environment -- in this case in just one small component of the diet -- might have on animals with prediabetes or metabolic syndrome.

"We found that adding just this one amino acid to the diet changed the metabolism in a lot of different pathways," he said. "It had effects that improved insulin sensitivity, improved their ability to metabolize sugar and fats and their overall metabolism improved."

Kahn said the study, funded by the National Institutes of Health, shows that even small changes in how we interact with our environment can make a big difference. Such changes can be positive or negative. In this case, they were positive.

He said it is too soon to recommend that those with prediabetes or metabolic syndrome add leucine to their diets, but said the next step should be a study in humans.

Leucine is one of 22 amino acids that serve as building blocks of proteins. It was chosen to be tested because in vitro studies had previously shown that it has effects on insulin signaling, Kahn said. Leucine is found in all protein food sources. It is often taken in supplements by those involved in body building in order to increase muscle mass.

In addition to Kahn, others from Joslin listed as co-authors of the study were Yazmin Macotela, Brice Emanuelli, Anneli M. Bang, Daniel O. Espinosa and Jeremie Boucher. Kirk Beebe and Walter Gall of Metabolon were also listed as co-authors.

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Joslin Diabetes Center.

Journal Reference:

Yazmin Macotela, Brice Emanuelli, Anneli M. Bång, Daniel O. Espinoza, Jeremie Boucher, Kirk Beebe, Walter Gall, C. Ronald Kahn. Dietary Leucine - An Environmental Modifier of Insulin Resistance Acting on Multiple Levels of Metabolism. PLoS ONE, 2011; 6 (6): e21187 DOI: 10.1371/journal.pone.0021187

Tuesday, July 5, 2011

Eggs' Antioxidant Properties May Help Prevent Heart Disease and Cancer, Study Suggests

ScienceDaily

Tuesday, July 5, 2011

ScienceDaily (July 5, 2011) — One of nature's most perfect foods may be even better for us than previously thought.

While eggs are well known to be an excellent source of proteins, lipids, vitamins and minerals, researchers at the University of Alberta recently discovered they also contain antioxidant properties, which helps in the prevention of cardiovascular disease and cancer.

Jianping Wu, Andreas Schieber and graduate students Chamila Nimalaratne and Daise Lopes-Lutz of the U of A Department of Agricultural Food and Nutritional Science examined egg yolks produced by hens fed typical diets of either primarily wheat or corn. They found the yolks contained two amino acids, tryptophan and tyrosine, which have high antioxidant properties.

After analyzing the properties, the researchers determined that two egg yolks in their raw state have almost twice as many antioxidant properties as an apple and about the same as half a serving (25 grams) of cranberries.

However, when the eggs were fried or boiled, antioxidant properties were reduced by about half, and a little more than half if the eggs were cooked in a microwave.

"It's a big reduction but it still leaves eggs equal to apples in their antioxidant value," said Wu.

The findings were published in the peer-reviewed journal Food Chemistry.

The discovery of these two amino acids, while important, may only signify the beginning of finding antioxidant properties in egg yolks, said Wu, an associate professor of agricultural, food and nutritional science.

"Ultimately, we're trying to map antioxidants in egg yolks so we have to look at all of the properties in the yolks that could contain antioxidants, as well as how the eggs are ingested," said Wu, adding that he and his team will examine the other type of antioxidant already known to be in eggs, carotenoids, the yellow pigment in egg yolk, as well as peptides.

In previous research, Wu found that egg proteins were converted by enzymes in the stomach and small intestines and produced peptides that act the same way as ACE inhibitors, prescriptions drugs that are used to lower high blood pressure.

That finding defied common wisdom and contradicted the public perception that eggs increased high blood pressure because of their high cholesterol content. Additional research by Wu suggests the peptides can be formulated to help prevent and treat hypertension.

Wu is convinced the peptides also have some antioxidant properties, which leads him to suggest that when he completes the next step in his research, the result will likely be that eggs have more antioxidant properties than we currently know.

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Alberta, via EurekAlert!, a service of AAAS.

Journal Reference:

Chamila Nimalaratne, Daise Lopes-Lutz, Andreas Schieber, Jianping Wu. Free aromatic amino acids in egg yolk show antioxidant properties. Food Chemistry, 2011; 129 (1): 155 DOI: 10.1016/j.foodchem.2011.04.058

Study Finds Most Urgent Angioplasties Warranted

By By Denise Mann
HealthDay Reporter

HealthDay News

Tuesday, July 5, 2011

TUESDAY, July 5 (HealthDay News) -- New research shows that most urgent angioplasty procedures performed in the United States are warranted, but the same can't be said for those done on a non-emergency basis.

Reviewing data on more than a half million angioplasty procedures, researchers deemed the artery-opening procedure appropriate when performed for "acute indications," such as heart attacks or unstable angina (crushing chest pain) with certain high-risk features such as progressive pain with no known cause. By contrast, stable angina occurs only with activity such as a stress test and is not considered an appropriate indication for angioplasty.

"We found that the appropriateness of angioplasty depended upon whether the patient presented as acute or non-acute," said study author Dr. Paul S. Chan, of Saint Luke's Mid-America Heart and Vascular Institute in Kansas City, Mo.

"In elective, non-acute settings, angioplasty does not save lives and does not prevent heart attacks," he said. "The only role for angioplasty in elective setting is improving the quality of life in patients burdened by angina."

The study, published July 6 in the Journal of the American Medical Association, included data on patients in the National Cardiovascular Data Registry who underwent angioplasty between July 2009 and September 2010 at 1,091 U.S. hospitals. Of 500,154 procedures included, almost 99 percent of those performed for acute indications were appropriate, but just 50.4 percent of those performed in non-acute situations were classified as appropriate, according to criteria recently developed by six professional organizations.

Appropriate means that the procedures provided definite or probable benefit to patients, whereas inappropriate means that there was no established benefit and unlikely to be one.

Angioplasty involves inserting a balloon-tipped catheter into a blocked heart artery to open it and improve blood flow, relieve chest pain and/or prevent a heart attack. Physicians usually insert a device called a stent to keep the artery open. About 600,000 angioplasty procedures are done in the United States each year, according to the study.

Overall, about 71 percent of the procedures reviewed were for acute indications and about 29 percent were for non-acute indications. Heart attack comprised about 59 percent of all acute procedures, while high-risk unstable angina accounted for slightly more than 41 percent.

In the non-acute setting, half of all angioplasties are considered appropriate, one-third may confer a possible benefit, and one in eight was of no benefit, the study showed.

Unnecessary procedures increase risks as well as health-care costs, the study authors said. The annual cost of angioplasty is more than $12 billion a year, they said.

There was no variability among hospitals when it came to angioplasty procedures for acute indications. But hospitals did vary in their proportion of inappropriate angioplasty procedures for non-acute indications. Hospitals in the lowest quartile had inappropriate angioplasty rates of 6 percent or lower, compared with 16 percent or higher in hospitals in the highest quartile, the study showed.

Taken together, the findings suggest a need to better identify patients undergoing angioplasty in elective situations, the authors said.

Dr. William O'Neill, cardiologist and executive dean of clinical affairs at the University of Miami Miller School of Medicine, said that "the take-home message is that if you come into the hospital for an urgent procedure, it is extremely likely that you will get appropriate care."

If your physician recommends angioplasty for mild symptoms during a routine check-up, ask if there are alternatives, he said. "In people with stable angina, angioplasty doesn't prevent heart attack."

Dr. Barry Kaplan, vice chairman of cardiology for North Shore University Hospital in Manhasset, N.Y. and Long Island Jewish Medical Center in New Hyde Park, N.Y., urged caution in interpreting the findings.

"These are just recommendations and it is very difficult to apply them to each and every patient," he said.

"There is no doubt that inappropriate angioplasties are performed in this country," he added. "This study is not to say you should not have an angioplasty, just that the indications should be understood."

More information

For more on angioplasty, visit the American Heart Association.

People Who Suffer from Antibiotic-Resistant Bacteria Must Be Better Addressed in Health Care, Experts Urge

ScienceDaily

Tuesday, July 5, 2011

ScienceDaily (July 5, 2011) — Fear and confusion surrounding the diagnosis is often the result of suffering from an infection by antibiotic-resistant bacteria. Accurate information is crucial for these patients in order for them to handle their situation, yet that is the area where health care is lacking, new research suggests. This is shown in Infection Control Nurse Susanne Wiklund's master's thesis at NHV on patients with ESBL-producing bacteria.

Extended-Spectrum Beta-Lactamase (ESBL) is an enzyme which conveys resistance to most beta-lactam antibiotics. Infections are often difficult to treat due to general multiresistance and hospital care may be necessary even for non-serious infections.

"To suffer from an infectious disease can be stressful for the individual, both physically and mentally," says Susanne Wiklund, whose study deepens the understanding of what it means for individuals to suffer from ESBL-producing intestinal bacteria.

The results show that patients with these bacteria are exposed to an information culture in health care which in some cases is poor, despite legislation. "This results in fear and confusion around the diagnosis," says Susanne Wiklund.

In order to manage their life situation, it is important that those who have been infected of an ESBL-producing bacteria receive good information from the attending doctor, she explains further. All those interviewed felt they had received either insufficient no information about the diagnosis from the physician. The route of information was either by phone or a letter in the mail. Both the approach and content of the information affected the participants emotionally.

The interviewees had many thoughts and reflections after the interviews, including the question of how they had been infected; through medical care or something they had done themselves? Ignorance within health care was perceived as stigmatizing.

The discrepancy in how patients were treated was significant, from extreme hygiene measures consisting of protective gear to lacking hygiene. In addition, the study revealed perceived attitude problems among the personnel, carelessness, lack of understanding as well as no willingness or time to answer questions.

Patients instead tried to obtain information themselves; the Internet was used by everyone. The fear of infecting others resulted in the women introducing their own measures, e.g. instructing others about hand hygiene, using their own disinfectants during health care visits, avoiding public transportation, socializing with others and also self-informing others about their infection.

The male participants in the study continued to live life as they had before; no one wanted to cause worry for their family members/significant others. Some of the participants had not informed their children about the diagnosis, and the uncertainty surrounding what to say was great as they felt that they have not been properly informed.

The study approach was qualitative and materials from seven interviews were analyzed with Grounded theory.

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Nordic School of Public Health.

Many U.S. heart stents inappropriate: study

By Frederik Joelving

Reuters Health

Tuesday, July 5, 2011

NEW YORK (Reuters Health) - One in eight U.S. patients who have non-emergency stenting procedures to clear blocked arteries in the heart are likely to see more harm than good from the procedure, researchers said Tuesday.

The findings stoke concern about overuse of the invasive treatment, which costs the nation some $12 billion a year and offers few benefits over drug therapy unless the patient has suffered a heart attack.

"More than half of the inappropriate cases were in patients who didn't have any symptoms at all," said Dr. Paul Chan, whose results appear in the Journal of the American Medical Association.

"If they are not benefiting, that's a problem," Chan, a cardiologist at Saint Luke's Health System in Kansas City, Missouri, told Reuters Health.

Each year in the U.S., about 600,000 stents -- small metal mesh tubes -- are inserted into ailing hearts to prop open blocked arteries, according to the new report.

While they are live-saving for patients with heart attacks and for some patients with severe chest pain even at rest, stents are no better than drugs at preventing new heart attacks or death in patients with stable heart disease.

Apart from a hefty price tag of about $20,000, the stenting procedure carries risks of complications like major bleeding or tears. And after leaving the hospital, people need to take clot-buster medications, which also increase the chance of bleeding.

Chan and his colleagues used data from more than 1,000 hospitals across the country. They checked that data against guidelines developed by several medical groups in 2009 to judge whether the hospitals' stent use was appropriate or not -- that is, whether the benefits were likely to outweigh the harms.

Of about half a million stenting procedures, about 71 percent were done during emergencies such as heart attacks.

Nearly 99 percent of those were deemed appropriate, although the researchers had to exclude more than 100,000 cases that didn't include sufficient information.

"In the acute setting, we are doing a very good job," Chan told Reuters Health.

But when patients had stents inserted for less-pressing reasons, the picture was not as pretty.

Almost 55,000 of those procedures, or 38 percent, were of uncertain benefit and 16,838, or 12 percent, were inappropriate. That's consistent with earlier research suggesting doctors in the U.S. are quicker than others to use stents in patients with stable heart disease.

In just over half of the inappropriate cases, the patients didn't have any symptoms of heart disease at all, and Chan speculated that a doctor might have sent them to get a stent based on screening results.

That makes little sense, however, because the only proven benefit of stents over drugs in stable heart disease is pain relief.

The researchers also found a lot of variation between hospitals. In one quarter of them, less than six percent of stenting cases were inappropriate, whereas in another quarter of the hospitals, more than 16 percent of stenting procedures were unwarranted.

"This represents an opportunity for those hospital to look at how they perform" stenting, said Dr. William B. Borden, of the Weill Cornell Medical Center in New York, who was not involved in the new work.

However, he said, not all of the cases deemed inappropriate will necessarily do more harm than good. It's possible, for instance, that a patient might have had a lot of pain even with all the guideline-recommended drugs -- beta-blockers and calcium-channel blockers, among others -- and would have been a candidate for stenting.

But another expert, Dr. William Boden of Kaleida Health in Buffalo, New York, said the number of inappropriate cases might actually be an underestimate.

Twelve percent "is a low estimate," he told Reuters Health by email, "because it uses a liberal (American College of Cardiology) definition of what is 'appropriate.'"

Source: http://bit.ly/nHTYOj

Journal of the American Medical Association, July 5, 2011.

Research in Fish Provides New Clues About Deadly Form of Liver Cancer

ScienceDaily

Tuesday, July 5, 2011

ScienceDaily (July 5, 2011) — Hepatocellular carcinoma (HCC), the most common type of liver cancer, is a leading cause of cancer-related deaths worldwide. Although there are several treatment options available, they are largely unsuccessful because the disease is so poorly understood. Clinical studies of patients with HCC, combined with studies using mice and other animal models, have provided some clues, but many questions about how to diagnose and treat this deadly form of cancer remain.

Zhiyuan Gong and Serguei Parinov from the National University of Singapore decided to pursue these questions using zebrafish as a model system.

Their study uncovers new information that might help to diagnose and treat HCC in humans, and shows that zebrafish are a powerful and cost-effective model to study liver cancer. Gong and Parinov publish their results in Disease Models & Mechanisms on July 5th, 2011.

Previous work indicated that cancer cells from patients with HCC always have abnormally high activation of a cellular pathway called Ras. However, whether and how the Ras pathway actually causes liver cancer was not clear. To focus in on this issue, Gong and Parinov generated zebrafish that are genetically engineered to express a cancer-causing form of Ras (krasV12) in the liver. Fish that had the highest expression of krasV12 all died rapidly of malignant liver cancer (mostly within 30 days), whereas fish with lower krasV12 expression survived for longer and did not develop full-blown liver cancer. These results suggest that only very high levels of Ras pathway activation can cause HCC.

The researchers also uncovered abnormalities in several other cellular pathways in zebrafish that developed liver cancer, and genetic studies confirmed that the progression of disease happens similarly in zebrafish and humans. This allowed the researchers to establish a 'genetic signature' for HCC, which could potentially be translated into a method for diagnosing the disease in humans. In addition, the stage of cancer is an important factor in determining how patients should be treated. In this study, the researchers determined genetic signatures that were specific to early- and late-stage liver cancer, which might help in planning treatment regimes for patients with HCC.

These new findings using a zebrafish model of HCC should help to guide studies of this complex cancer in humans. Although validation studies in patients with HCC are required, this work provides new evidence that drugs targeting the Ras pathway are a promising avenue for therapy.

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by The Company of Biologists, via EurekAlert!, a service of AAAS.

Journal Reference:

Nguyen, A. T., Emelyanov, A., Koh, C. H. V., Spitsbergen, J. M., Lam, S. H., Mathavan, S., Parinov, S. and Gong, Z. A high level of liver-specific expression of oncogenic KrasV12 drives robust liver tumorigenesis in transgenic zebrafish. Disease Models & Mechanisms, July 4, 2011 DOI: 10.1242/dmm.007831

Eating Disorders Appear to Raise Risk of Death

HealthDay News

Tuesday, July 5, 2011

TUESDAY, July 5 (HealthDay News) -- People with eating disorders, especially those with anorexia nervosa, have an increased risk of death, a new study indicates.

English researchers analyzed 36 English-language studies -- published between January 2006 and September 2010 -- that looked at anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified.

Anorexics mistakenly believe they are fat and deny themselves food. Bulimics overeat and purge, usually by vomiting or using laxatives.

There were a total of 17,272 patients in the studies, which reported 755 deaths. The meta-analysis revealed that for each 1,000 person-years, 5.1 deaths occurred among anorexia patients (1.3 of which were suicide), 1.7 deaths among bulimia patients, and 3.3 deaths among patients with other eating disorders. (A meta-analysis pools and analyzes statistical data from different studies investigating similar questions.)

The standardized mortality ratio (the number of actual deaths compared with the number of expected deaths) was 5.86 for anorexia, 1.93 for bulimia, and 1.92 for other eating disorders.

Among anorexia patients, those in their late teens and 20s had a higher death rate than younger patients or those in their 30s, said Jon Arcelus of Leicester General Hospital and colleagues.

The study is published in the July issue of the journal Archives of General Psychiatry.

While noting that some of the deaths might be attributable to other causes, the authors said that death rates for eating disorders, especially anorexia, are higher than for schizophrenia and depression.

More research is needed to identify the factors that raise risk of death in people with eating disorders, the authors said.

More information

The U.S. National Institute of Mental Health has more about eating disorders.

Air Pollution Linked to Learning and Memory Problems, Depression

ScienceDaily

Tuesday, July 5, 2011

ScienceDaily (July 5, 2011) — Long-term exposure to air pollution can lead to physical changes in the brain, as well as learning and memory problems and even depression, new research in mice suggests.

While other studies have shown the damaging effects of polluted air on the heart and lungs, this is one of the first long-term studies to show the negative impact on the brain, said Laura Fonken, lead author of the study and a doctoral student in neuroscience at Ohio State University.

"The results suggest prolonged exposure to polluted air can have visible, negative effects on the brain, which can lead to a variety of health problems," Fonken said.

"This could have important and troubling implications for people who live and work in polluted urban areas around the world."

The study appears online this week in the journal Molecular Psychiatry.

For this study, Fonken and colleagues in Ohio State's Department of Neuroscience collaborated with researchers in the university's Davis Heart and Lung Research Institute.

In previous studies in mice, the Davis research group -- including Qinghua Sun, associate professor of environmental health sciences, and Sanjay Rajagopalan, professor of cardiovascular medicine -- found that fine air particulate matter causes widespread inflammation in the body, and can be linked to high blood pressure, diabetes and obesity. This new study aimed to extend their research on air pollution to the brain.

"The more we learn about the health effects of prolonged exposure to air pollution, the more reasons there are to be concerned," said Randy Nelson, co-author of the study and professor of neuroscience and psychology at Ohio State.

"This study adds more evidence of pollution's negative effects on health."

In the new study, mice were exposed to either filtered air or polluted air for six hours a day, five days a week for 10 months -- nearly half the lifespan of the mice.

The polluted air contained fine particulate matter, the kind of pollution created by cars, factories and natural dust. The fine particulates are tiny -- about 2.5 micrometers in diameter, or about 1/30th of the average width of a human hair. These particles can reach deep areas of the lungs and other organs of the body.

The concentration of particulate matter that the mice were exposed to was equivalent to what people may be exposed to in some polluted urban areas, according to the researchers.

After 10 months of exposure to the polluted or filtered air, the researchers performed a variety of behavioral tests on the animals.

In a learning and memory test, mice were placed in the middle of a brightly lit arena and given two minutes to find an escape hole leading to a dark box where they feel more comfortable. They were given five days of training to locate the escape hole, but the mice who breathed the polluted air took longer to learn where the escape hole was located. The mice exposed to polluted air also were less likely to remember where the escape hole was when tested later.

In another experiment, mice exposed to the polluted air showed more depressive-like behaviors than did the mice that breathed the filtered air. The polluted-air mice showed signs of higher levels of anxiety-like behaviors in one test, but not in another.

But how does air pollution lead to these changes in learning, memory and mood? The researchers did tests on the hippocampal area of the mice brains to find the answers.

"We wanted to look carefully at the hippocampus because it is associated with learning, memory and depression," said Fonken, who, along with Nelson, are also members of Ohio State's Institute for Behavioral Medicine Research.

Results showed clear physical differences in the hippocampi of the mice who were exposed to polluted air compared to those who weren't.

The researchers looked specifically at branches that grow off of nerve cells (or neurons) called dendrites. The dendrites have small projections growing off them called spines, which transmit signals from one neuron to another.

Mice exposed to polluted air had fewer spines in parts of the hippocampus, shorter dendrites and overall reduced cell complexity.

"Previous research has shown that these types of changes are linked to decreased learning and memory abilities," said Nelson.

In other studies, several of the co-authors of this study from the Davis research center found that chronic exposure to polluted air leads to widespread inflammation in the body, which is linked to a variety of health problems in humans, including depression. This new study found evidence that this low-grade inflammation is evident in the hippocampus.

In mice that breathed the polluted air, chemical messengers that cause inflammation -- called pro-inflammatory cytokines -- were more active in the hippocampus than they were in mice who breathed the filtered air.

"The hippocampus is particularly sensitive to damage caused by inflammation," Fonken said.

"We suspect that the systemic inflammation caused by breathing polluted air is being communicated to the central nervous system."

The research was supported by grants from the National Institutes of Health.

Other co-authors, all from Ohio State, included Qinghua Sun, associate professor of environmental health sciences; Sanjay Rajagopalan, professor of cardiovascular medicine; Xiaohua Xu, in environmental health sciences; Zachary Weil, in neuroscience and psychology; and Guohua Chen, in the Davis Heart and Lung Research Institute.

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Ohio State University, via EurekAlert!, a service of AAAS.

Journal Reference:

L K Fonken, X Xu, Z M Weil, G Chen, Q Sun, S Rajagopalan, R J Nelson. Air pollution impairs cognition, provokes depressive-like behaviors and alters hippocampal cytokine expression and morphology. Molecular Psychiatry, 2011; DOI: 10.1038/mp.2011.76

Fewer Americans developing and dying from colon cancer

By David Beasley

Reuters

Tuesday, July 5, 2011

ATLANTA (Reuters) - Screening for colon cancer has increased in the United States and deaths are down, but even more lives could be saved with expanded testing, a federal report released on Tuesday said.

The rate of new colorectal cancer cases in the U.S. dropped to 45.4 per 100,000 people in 2007 from 52.3 per 100,000 people in 2003, representing nearly 66,000 fewer cancers, according to a study by the Centers for Disease Control and Prevention.

There were 32,000 fewer deaths from the disease during that time, the report said.

About half the decline in the number of cases and deaths was due to increased screening, CDC Director Thomas R. Frieden told reporters in a telephone conference call on Tuesday.

"One thing we know is that screening works," Frieden said.

Colon cancer remains the nation's second most deadly cancer, killing more than 53,000 people per year, the CDC said. Only lung cancer is deadlier.

Screening for colorectal cancer, which is recommended for men and women beginning at age 50, has increased to 65 percent in 2010 from 52 percent in 2002, the CDC report said.

But about a third of those between the ages of 50 and 75 -- or 22 million people -- are not up to date with their screenings, the CDC said.

Screening is designed to detect precancerous polyps that can be removed before they turn into cancer. Frieden told reporters that he recently had four non-cancerous polyps removed after testing.

"Colon cancer is largely preventable," he said. "If you find it early enough, you can prevent cancer."

Frieden expressed concern that screening, after steadily increasing in recent years, may be leveling off. He said the largest single reason patients do not get screened is that their doctors do not suggest it.

Death rates from colorectal cancer decreased in 49 states and Washington, D.C., with the largest declines in states with the most screening, the CDC said. Only Mississippi had no change in its death rate.

In 2007, Washington D.C. reported the highest number of colorectal cancer deaths per 100,000 people, and Montana and Colorado reported the lowest.

North Dakota had the highest number of cases per 100,000 people, and Utah had the lowest.

(Editing by Colleen Jenkins and Greg McCune)

Rose-Colored Beer Goggles: Some Drinkers Believe Social Benefits of Heavy Drinking Outweigh Harms

ScienceDaily

Tuesday, July 5, 2011

ScienceDaily (July 5, 2011) — A study by University of Washington psychologists shows some people continue to drink heavily because of perceived positive effects, despite experiencing negative effects such as hangovers, fights and regrettable sexual situations.

According to participants in the study, boosts of courage, chattiness and other social benefits of drinking outweigh its harms, which they generally did not consider as strong deterrents.

The findings offer a new direction for programs targeting binge drinking, which tend to limit their focus to avoiding alcohol's ill effects rather than considering its rewards.

"This study suggest why some people can experience a lot of bad consequences of drinking but not change their behavior," said Kevin King, co-author and UW assistant professor of psychology.

"People think, 'It's not going to happen to me' or 'I'll never drink that much again.' They do not seem to associate their own heavy drinking with negative consequences," he said.

The paper was published online May 30 in Psychology of Addictive Behaviors.

Nearly 500 college students completed an online survey measuring their drinking habits during the previous year. The survey assessed how often the participants had experienced 35 different negative consequences of drinking, such as blackouts, fights, hangovers, missed classes and work, and lost or stolen belongings, as well as 14 positive effects of drinking, including better conversational and joke-telling abilities, improved sexual encounters and more energy to stay up late partying and dancing.

The researchers also measured the participants' beliefs about how likely all of these drinking consequences would happen again and how positive or negative they were.

Participants rated the upsides to drinking as more positive and likely to happen in the future, a finding the researchers call "rose-colored beer goggles."

"It's as though they think that the good effects of drinking keep getting better and more likely to happen again," said Diane Logan, lead author and a UW clinical psychology graduate student.

Respondents' perceptions of drinking's negative consequences differed according to how many bad experiences they had had. Those who experienced a small to moderate number of ill effects of drinking did not consider the experiences to be not so bad and did not think that they were any more likely to experience them again compared with students who hadn't experienced them.

The researchers call this cognitive-dissonance reasoning. It leads to people, on the morning after a night of heavy partying, telling themselves "I'll never drink that much again" or "I threw up that one time, but that's not me; I won't do it again." Or, it may be that once a bad consequence of drinking happens, people think that it wasn't really as bad as they initially thought, the researchers speculated.

But the participants reporting the most bad experiences rated the episodes as more negative and more likely to happen again. "Until high levels of negative consequences are experienced, participants aren't deterred by the ill effects of drinking," Logan said.

The findings have implications for alcohol intervention programs for college students, which tend to focus on how to avoid the negative consequences of drinking. "We should take into account how people don't think of negative consequences as all that bad or likely to happen again," Logan said, adding that factoring in how people view alcohol's positive effects "might have a bigger impact" on drinking habits.

She suggests a risk reduction approach by helping people reduce their drinking such that they still get some of the positive effects while avoiding many of the negative and recommends training exercises to increase social skills in the absence of alcohol.

The National Institute on Alcohol Abuse and Alcoholism funded the study. Co-authors are Teague Henry, a UW psychology undergraduate student; Matthew Vaughn, a former UW psychology undergraduate student; and Jeremy Luk, a UW psychology graduate student.

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Washington, via EurekAlert!, a service of AAAS.

Journal Reference:

Diane E. Logan, Teague Henry, Matthew Vaughn, Jeremy W. Luk, Kevin M. King. Rose-colored beer goggles: The relation between experiencing alcohol consequences and perceived likelihood and valence.. Psychology of Addictive Behaviors, 2011; DOI: 10.1037/a0024126

Too Much Sitting May Double Women's Risk of Blood Clots

HealthDay News

Tuesday, July 5, 2011

TUESDAY, July 5 (HealthDay News) -- Women who sit for long periods of time on a regular basis have a two- to threefold increased risk of developing a potentially deadly blood clot in their lungs, a new study finds.

The researchers said their study is the first to prove that an inactive lifestyle increases the risk of developing a pulmonary embolism, which occurs when part or all of a blood clot that forms in the deep veins of the legs travels through the bloodstream to the lungs.

Sudden shortness of breath, severe chest pain and coughing that may produce blood are among the symptoms of pulmonary embolism, in addition to excessive sweating, fainting and weak pulse.

The new study included 69,950 female nurses who were followed for 18 years and every two years provided details about their lifestyle habits. Women who spent most of their time sitting (more than 41 hours a week outside of work) were two times more likely to develop a pulmonary embolism than those who spent the least time sitting (less than 10 hours a week outside of work).

The link between levels of physical activity and pulmonary embolism risk remained conclusive after accounting for such factors as age, smoking and body mass index (a measurement based on height and weight), the researchers said.

The investigators also found an association between physical inactivity and high blood pressure and heart disease, which suggests that physical inactivity could be one of the hidden mechanisms that connect arterial disease and venous disease.

Public health campaigns that encourage people to be physically active could reduce the incidence of pulmonary embolism, concluded study author Dr. Christopher Kabrhel, attending physician in the emergency medicine department at Massachusetts General Hospital, and colleagues, in a statement.

Their study was published online July 4 in the BMJ.

The findings reinforce "the notion that prolonged inactivity increases the risk of venous thromboembolism [pulmonary embolism or deep-vein thrombosis], and it shows how this occurs in everyday life," Dr. James Douketis, director of vascular medicine at McMaster University in Hamilton, Ontario, Canada, and colleagues wrote in an accompanying editorial.

Although the risk is small -- equal to seven extra cases per 10,000 person-years -- the results could have major public health ramifications, the editorialists noted.

The study offers "additional evidence to prove what we've already seen in other contexts," Dr. Furqan Tejani, director of advanced cardiovascular imaging the State University of New York Downstate Medical Center in New York City, said in an e-mailed statement.

"For instance, Olympic athletes who took trips from Europe to Australia were found to have deep venous thrombosis and pulmonary embolism. Recently, in fact, one of the Williams sisters [tennis star Serena Williams] also had pulmonary embolism," Tejani noted.

"Whether travel and prolonged sitting had anything to do with it is not clear, but because a mounting body of evidence pointing to the fact that it may be, it is recommended that one take a baby aspirin before long-haul travels described as lasting more than eight hours," Tejani added. "Certainly it is recommended to at least get up and walk around the aircraft cabin and do calf muscle exercises on a regular basis while en route."

More information

The U.S. National Heart, Lung and Blood Institute has more about pulmonary embolism.

Higher Daily Dose of Aspirin Could Play Key Role in Preventing Heart Attacks for Those With Diabetes

ScienceDaily

Tuesday, July 5, 2011

ScienceDaily (July 5, 2011) — In some cases, an apple a day may keep the doctor away, but for people with diabetes, regular, over-the-counter Aspirin may also do the job.

A new study by University of Alberta researcher Scot Simpson has shed light on the use of Aspirin as a preventative measure for cardiovascular disease and reoccurrence in patients with diabetes.

The study collected data from clinical trials that looked at whether taking Aspirin as a course of treatment would prevent a first or recurrent heart attack or stroke.

Using information from diabetic patients in these studies, Simpson discovered that patients with previous cardiac episodes who were taking a low dose of Aspirin daily had very little benefit in terms of prevention of a second heart attack or a decreased risk of mortality. However, in patients taking higher doses of Aspirin, the risk of a repeat heart attack and/or death was significantly lower.

"We took all of the data from 21 studies and focused specifically on diabetic patients who had suffered a previous heart attack or stroke to measure the ability of Aspirin to prevent a second event. We found that, if those patients took up to 325 milligrams of Aspirin per day, they had a 23 percent lower risk of death," said Simpson.

Simpson, an associate professor in the Faculty of Pharmacy and Pharmaceutical Sciences, says that people with diabetes are at an increased risk of cardiovascular disease, adding there is evidence that suggests as much as 60 per cent of deaths in diabetics are attributable to heart disease. Simpson says he always suspected the Aspirin dosage could play a role in treating cardiovascular disease in diabetics and felt because Aspirin was an over-the-counter medication, it's something that pharmacists could have an active role in administering.

"The pharmacists' best role for chronic disease management is working proactively with physicians and patients," said Simpson. "Whether that means working directly with the physician, and consulting about prescribed medications, or when the patient is deciding about whether or not to take Aspirin as part of a treatment plan, pharmacists can have a significant, positive impact."

Simpson's study was recently published in the Journal of General Internal Medicine. Other researchers from the U of A include John-Michael Gamble, in the School of Public Health; Laurie Mereu, in the Faculty of Medicine & Dentistry, and Thane Chambers, in Library Services.

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Alberta, via EurekAlert!, a service of AAAS.

Journal Reference:

Scot H. Simpson, John-Michael Gamble, Laurie Mereu, Thane Chambers. Effect of Aspirin Dose on Mortality and Cardiovascular Events in People with Diabetes: A Meta-Analysis. Journal of General Internal Medicine, 2011; DOI: 10.1007/s11606-011-1757-y

Massage may ease chronic back pain short-term

By Frederik Joelving

Reuters Health

Tuesday, July 5, 2011

NEW YORK (Reuters Health) - A new study shows massage therapy may help people who suffer from chronic back pain.

After 10 weeks, patients who got weekly massage sessions used less pain medicine and spent less time in bed than those who didn't get any special care -- although the effects had disappeared after a year.

"If we look at patients who seemed to have some substantial improvement, that was about two-thirds in the massage group compared to about one-third among patients getting usual care," said Dr. Richard A. Deyo of the Oregon Health and Science University, who led the study.

He said some degree of lower back pain is a common ailment in the population, with about 10 percent of sufferers experiencing long-lasting symptoms.

"We have a whole lot of treatments, and when you see a whole lot of treatments, it usually means that none of them is clearly effective and superior," he told Reuters Health.

While pain medications are the go-to treatment, many people now also use alternative treatments like acupuncture, massage or even talk therapy, which recent work suggests is effective.

In the new study, published in the Annals of Internal Medicine, 401 people were randomly assigned to usual care or one of two kinds of massage therapy: either so-called structural massage, or relaxation massage (also called Swedish massage).

After 10 weeks the massage group had improved considerably compared to the other patients.

For instance, about 30 percent of those getting massages had used painkillers in the past week, compared to 40 percent of those getting usual care. And twice as many in the usual care group -- seven percent -- had stayed in bed at least one day in the past month.

However, some of the apparent benefits of massage had vanished after half a year, and all the gains were gone after a full year had passed.

There weren't any substantial difference between the two kinds of massage, the researchers say, adding that the Swedish version is widely available for about $60 per session.

Deyo said the new results compare to what is seen with other kinds of treatment, although the cost-effectiveness is still unclear.

One caveat, he added, is that patients knew which kind of treatment they got in the study, and some might have been disappointed that they didn't get massages, which could have affected the results.

Deyo said acute back pain can usually be taken care of with over-the-counter painkillers or heat pads, as long as there aren't any other symptoms like numbness or tingling in the legs.

For chronic sufferers, what works best will depend on the individual.

"Many of us believe that for truly chronic pain problems, exercise programs are actually one of the mainstay treatments that will help people function better on a daily basis," Deyo said.

Source: http://bit.ly/lvnjiD

Annals of INternal Medicine, July 5, 2011.

High Folate Intake May Reduce Risk of Colorectal Cancer

ScienceDaily

Tuesday, July 5, 2011

ScienceDaily (July 5, 2011) — Intake of high levels of folate may reduce colorectal cancer risk, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute. Folate is a water-soluble B vitamin that occurs naturally in food.

"We found that all forms and sources of folate were associated with lower risk of colorectal cancer," said Victoria Stevens, PhD, of the American Cancer Society and lead author of this study. "The strongest association was with total folate, which suggests that total folate intake is the best measure to define exposure to this nutrient because it encompasses all forms and sources." Total folate includes naturally occurring food folate and folic acid from fortified foods and dietary supplements.

A research team investigated the association between folate intake and colorectal cancer among 99,523 participants in the Cancer Prevention Study II Nutrition Cohort; a total of 1,023 participants were diagnosed with colorectal cancer between 1999 and 2007, a period entirely after folate fortification began. Neither higher nor lower risk was observed during the first two years of follow-up (1999 to 2001), while associations were statistically significantly inverse for the subsequent years (2002 to 2007).

The findings of this study add to the epidemiologic evidence that high folate intake reduces colorectal cancer incidence. Further, one important difference between the current study and previous studies was the separate assessment of natural folates and folic acid. Previous studies that discriminated between folates considered only the source (i.e., diet versus supplement) and not the chemical form.

The study also addressed concerns that the intake of high levels of folate frequently consumed in the U.S. -- as a result of the recent increase in the use of folate-containing supplements and mandatory folate fortification of food -- may actually increase risk of cancer. No increased risk of colorectal cancer was found for the highest intake levels, suggesting that the high levels of this vitamin consumed by significant numbers of Americans should not lead to increased incidence rates of this cancer in the population.

Folates are essential nutrients needed to make components used for functions required for normal cell growth, including DNA synthesis and repair. Because these processes are critical for cell growth and differentiation, the relationship between folate intake and cancer development has been investigated in several cancers, and most extensively in colorectal cancer.

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by American Gastroenterological Association, via EurekAlert!, a service of AAAS.

Journal Reference:

Victoria L. Stevens, Marjorie L. McCullough, Juzhong Sun, Eric J. Jacobs, Peter T. Campbell, Susan M. Gapstur. High Levels of Folate From Supplements and Fortification Are Not Associated With Increased Risk of Colorectal Cancer. Gastroenterology, 2011; DOI: 10.1053/j.gastro.2011.04.004

Painkillers May Raise Risk of Dangerous Heart Flutter

HealthDay News

Tuesday, July 5, 2011

TUESDAY, July 5 (HealthDay News) -- A new study finds that painkillers widely used to treat inflammation are associated with an increased risk of atrial fibrillation, a heart rhythm disorder connected with a raised risk of stroke, heart failure and death.

Previous research has linked non-steroidal anti-inflammatory drugs (NSAIDs) and newer anti-inflammatory medications known as cox-2 inhibitors to an increased risk for heart attacks and strokes, but this is the first study to link the painkillers with atrial fibrillation.

Danish researchers looked at 32,602 patients who had a first diagnosis of atrial fibrillation between 1999 and 2008. Each of those patients was compared with 10 age and gender-matched controls from the general population in Denmark.

The results showed that use of these medications was associated with an increased risk of atrial fibrillation. The link was strongest among new users of the drugs, with a 70 percent increased risk for cox-2 inhibitors and a 40 percent increase in risk for non-selective NSAIDs.

The increased risk is equal to about seven extra cases of atrial fibrillation per 1,000 new users of cox-2 inhibitors and about four extra cases per 1,000 new users of non-selective NSAIDs, according to the researchers at Aarhus University Hospital.

They also found that the risk when starting treatment with cox-2 inhibitors seemed highest in older people and patients with chronic kidney disease or rheumatoid arthritis.

"Our study thus adds evidence that atrial fibrillation or flutter need to be added to the cardiovascular risks under consideration when prescribing NSAIDs," the researchers concluded.

"There is evidence that these medicines affected the heart, but [we] did not have evidence that it affected the rhythm of the heart. This study sheds light on another problem that we did not know with these medicines," Dr. Furqan Tejani, director of advanced cardiovascular imaging at SUNY Downstate Medical Center in New York City, said in a statement.

The study is published online in the July 4 issue of the BMJ.

The drugs do, indeed, have a checkered history.

In 2004, the blockbuster cox-2 inhibitor called Vioxx was pulled from the market because of its link to an increased risk of heart attack. In 2007, the American Heart Association warned doctors about the risk of giving NSAIDs to heart patients and recommended that these patients receive only the lowest dose and take the drugs for the shortest possible time.

In addition, a study published in the July 2010 issue of Circulation: Cardiovascular Quality and Outcomes found that healthy people who take NSAIDs to relieve minor aches and pains may be at increased risk of death from heart problems.

And a review of existing research this year found that NSAIDs taken to treat inflammation can boost the risk of heart attack, stroke or death. The researchers said their finding from the analysis of 31 clinical trials of NSAIDs suggest that a patient's cardiovascular risk needs to be assessed before being prescribed NSAIDs. That study appeared in the January issue of the BMJ.

More information

The American Academy of Family Physicians has more about atrial fibrillation.

'Gifted' Natural Vitamin E Tocotrienol Protects Brain Against Stroke in 3 Ways

ScienceDaily

Tuesday, July 5, 2011

ScienceDaily (July 5, 2011) — A natural form of vitamin E called alpha-tocotrienol can trigger production of a protein in the brain that clears toxins from nerve cells, preventing those cells from dying after a stroke, new research shows.

This process is one of three mechanisms identified so far that this form of vitamin E uses to protect brain cells after a stroke, meaning that this natural substance might be more potent than drugs targeting single mechanisms for preventing stroke damage, according to Ohio State University scientists who have studied the nutrient for more than a decade.

These researchers previously reported that the tocotrienol form of vitamin E protects the brain after a stroke by blocking an enzyme from releasing toxic fatty acids and inhibiting activity of a gene that can lead to neuron death.

Vitamin E occurs naturally in eight different forms, and all of this work is focused on the tocotrienol form, also known as TCT. The commonly known form of vitamin E belongs to a variety called tocopherols. TCT is not abundant in the American diet but is available as a nutritional supplement. It is a common component of a typical Southeast Asian diet.

In this new study, the researchers first clarified the role of a protein called MRP1, or multidrug resistance-associated protein 1. This protein clears away a compound that can cause toxicity and cell death when it builds up in neurons as a result of the trauma of blocked blood flow associated with a stroke.

They then determined that TCT taken orally influences production of this protein by elevating the activity of genes that make MRP1. This appears to occur at the microRNA level; a microRNA is a small segment of RNA that influences a gene's protein-building function.

This is one of the first studies to provide evidence that a safe nutrient - a vitamin - can alter microRNA biology to produce a favorable disease outcome," said Chandan Sen, professor and vice chair for research in Ohio State's Department of Surgery and senior author of the study. "Here, a natural nutritional product is simultaneously acting on multiple targets to help prevent stroke-induced brain damage. That is a gifted molecule."

The research appears online and is scheduled for later print publication in the journal Stroke.

Over the past decade, Sen has led numerous studies on how the TCT form of vitamin E protects the brain against stroke damage in animal and cell models, and intends to eventually pursue tests of its potential to both prevent and treat strokes in humans. Approximately 795,000 Americans suffer new or recurrent strokes each year, and stroke is the third-leading cause of death in the United States, according to the American Stroke Association.

These latest research findings in mice follow a recent Food and Drug Administration certification of TCT as "Generally Recognized as Safe." The scientists conclude in the paper that even before clinical trials can take place, "TCT may be considered as a preventive nutritional countermeasure for people at high risk for stroke."

To determine the role of MRP1 in protecting brain cells, the researchers compared the effects of an induced stroke in two groups of mice: normal mice and animals that were genetically modified to be deficient in the MRP1 protein.

Both groups of mice showed comparably decreased blood flow in the area of the stroke, but the mice deficient in MRP1 had a larger volume of tissue death than did normal mice.

The mice with the protein deficiency also had a 1.6-fold higher level of a toxin that is cleared by MRP1. This toxin is called GSSG, or glutathione disulfide, and these researchers have previously shown that a failure to clear this toxin appears to trigger neuron death in the brain after stroke.

"The protein has the effect of dredging out the toxin," said Sen, who is also a deputy director of Ohio State's Davis Heart and Lung Research Institute. "A significant finding in this work is the recognition that MRP1 is a protective factor against stroke. Thanks to tocotrienol, we were able to identify that path."

The presence of GSSG is linked to an excessive amount of glutamate that is released in the brain after a stroke. Glutamate is a neurotransmitter that, in tiny amounts, has important roles in learning and memory. Too much of it triggers a sequence of reactions that lead to the death of brain cells - the most damaging effects of a stroke.

This experiment showed for the first time that the loss of MRP1 function impairs the clearance of GSSG, and that MRP1 cells were recruited to the site of the stroke in normal mice, indicating this protein has a protective role in the brain after a stroke.

The researchers searched databases containing genomic data for a microRNA that appeared to have potential to influence production of MRP1. MicroRNAs bind to messenger RNA, which contains the actual set of instructions for building proteins. When that connection is made, however, the microRNA inhibits the building of protein from messenger RNA. So an inverse relationship exists between a microRNA and a protein it controls.

The researchers saw this very relationship in the cell study in which they manipulated the candidate microRNA levels and observed the effects of changing those levels on the presence of the MRP1 protein.

Finally, the researchers compared mice that were treated with TCT supplements or corn oil as a control for 13 weeks before a stroke was induced. The amount of damaged brain tissue was smaller in the mice that received TCT supplementation than in the mice receiving corn oil. In addition, TCT supplementation was associated with a lower level of the candidate microRNA in the damaged brain tissue, as well as an increase in the abundance of MRP1 cells at the stroke site.

"Essentially what we are showing with mechanistic explanation is that tocotrienol protects neural cells. It is anti-neurodegenerative," Sen said. "This form of vitamin E helped us identify three major checkpoints in stroke-related neurodegeneration that were not known before we began testing tocotrienols against neurodegeneration"

This research was supported by the National Institutes of Health.

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Ohio State University, via EurekAlert!, a service of AAAS.

Journal Reference:

H.-A. Park, N. Kubicki, S. Gnyawali, Y. C. Chan, S. Roy, S. Khanna, C. K. Sen. Natural Vitamin E  -Tocotrienol Protects Against Ischemic Stroke by Induction of Multidrug Resistance-Associated Protein 1. Stroke, 2011; DOI: 10.1161/STROKEAHA.110.608547

Lifestyle may affect sudden cardiac death risk

By Kerry Grens

Reuters Health

Tuesday, July 5, 2011

NEW YORK (Reuters Health) - Researchers have identified one more reason for women to stay fit, eat healthy, abstain from smoking, and maintain their weight: those who do so might be less likely to die from sudden cardiac death.

The new study, published in the Journal of the American Medical Association, found that each positive lifestyle choice -- a Mediterranean-style diet, a healthy weight, not smoking, and exercise -- was linked to a smaller chance of sudden cardiac death, and added together, the factors were tied to a 92 percent reduced risk.

"The more you adhere to this healthy lifestyle, the better you are in terms of your risk of sudden cardiac death," said Dr. Stephanie Chiuve from Brigham and Women's Hospital in Boston and the lead author of the study.

Sudden cardiac death is responsible for half of all cardiac deaths, with about 250,000 to 310,000 cases occurring annually in the U.S., the authors write.

Chiuve's study, which was funded by the National Institutes of Health and the American Heart Association, did not look at how long women stuck to each of the healthier lifestyle factors, nor was it able to prove that healthy living is actually responsible for the drop in sudden cardiac death risk.

Unlike a heart attack, which is caused by a blood vessel blockage, sudden cardiac death is related to a malfunctioning of the electrical rhythm of the heart.

Chiuve and her colleagues looked at results from the Nurses' Health Study, in which more than 81,000 women periodically answered surveys about health and lifestyle.

During the 26 years of the study, 321 women suffered sudden cardiac death at an average age of 72.

Women who ate a diet closest to the Mediterranean diet, which has a high proportion of vegetables, fruits, nuts, omega-3 fats, and fish, along with moderate amounts of alcohol and small amounts of red meat, had the lowest risk of sudden cardiac death -- 40 percent less than women whose diets least resembled the Mediterranean diet.

Weight was tied to a similar effect on risk. Normal-weight women were 56 percent less likely to suffer sudden cardiac death compared to obese women.

Exercise was also linked with a smaller chance of sudden cardiac death, and the more the women exercised, the smaller their risk. At least 30 minutes a day of exercise brought the risk of sudden cardiac death down by 28 percent.

Smoking was the biggest risk factor. Women who had never smoked were 75 percent less likely to suffer sudden cardiac death than women who smoked at least 25 cigarettes per day.

The researchers concluded that 81 percent of cases of sudden cardiac death were due to unhealthy lifestyles.

Chiuve said the results are important for understanding who is at risk for sudden cardiac death. Most people are flagged as being at high risk because of other health problems, such as having had a heart attack in the past.

"But with sudden cardiac death, the majority (of cases) occur in the general population," Chiuve told Reuters Health. "Lifestyle is not something that's generally focused on in sudden cardiac death research."

Sudden cardiac death is a rare event, but Chiuve points out that lifestyle-based efforts to prevent it can also impact the risks for more common health problems, such as diabetes, stroke and coronary disease.

Source: http://bit.ly/f2xHnI

Journal of the American Medical Association, July 6, 2011.

Prenatal Exposure to Certain Antidepressants May Modestly Increase Risk of Autism Spectrum Disorders, Study Suggests

ScienceDaily

Tuesday, July 5, 2011

ScienceDaily (July 5, 2011) — Prenatal exposure to selective serotonin reuptake inhibitors, especially during the first trimester, is associated with a modest increase the risk of developing an autism spectrum disorder, according to a report published Online First in the Archives of General Psychiatry, one of the JAMA/Archives journals.

"The prevalence of autism spectrum disorders (ASDs) has increased over recent years," the authors write as background information in the article. "Use of antidepressant medications during pregnancy also shows a secular increase in recent decades, prompting concerns that prenatal exposure may contribute to increased risk of ASD."

To evaluate if prenatal exposure to antidepressants, including selective serotonin reuptake inhibitors (SSRIs), is associated with an increase in ASD, Lisa A. Croen, Ph.D., of Kaiser Permanente Northern California, Oakland, and colleagues examined medical records for children drawn from the Childhood Autism Perinatal Study conducted by Kaiser Permanente Medical Care Program in Northern California. The authors included 298 children with ASD (case group) and their mothers, and 1,507 control children and their mothers in the study.

Twenty mothers of children in the case group (6.7 percent) and 50 mothers of children in the control group (3.3 percent) had at least one prescription for an antidepressant in the year prior to the birth of the study child. Of the 20 case mothers who were prescribed antidepressants, 13 (65 percent) were prescribed SSRIs only, two (10 percent) were prescribed an SSRI in combination with another antidepressant and five (25 percent) were prescribed one or more non-SSRI antidepressants only. Of the 50 control mothers who were prescribed an antidepressant, 25 (50 percent) were prescribed SSRIs only, nine (18 percent) were prescribed an SSRI in combination with another antidepressant and 16 (32 percent) were prescribed one or more non-SSRI antidepressants only.

After adjusting for maternal and birth factors, mothers of children with ASD were twice as likely to have at least one antidepressant prescription in the year prior to delivery. When compared with women with no antidepressant prescription during the study period, those with a prescription for a SSRI were more than twice as likely to have a child later diagnosed with ASD. This association was not seen for the small group of women who were prescribed a non-SSRI antidepressant only.

Additionally, after adjustment for a history of depression during the year prior to delivery, SSRI exposure during the first trimester remained significantly associated with risk of ASD, as was a history of SSRI exposure at any point during the year prior to delivery. Conversely, no association was seen between risk of ASD and the indication for treatment (mother having a history of depression or any mental health disorder) for the year prior to delivery.

"Although the number of children exposed prenatally to selective serotonin reuptake inhibitors in this population was low, results suggest that exposure, especially during the first trimester, may modestly increase the risk of ASD," the authors conclude. "We recommend that our findings be considered as preliminary and treated with caution, pending results from further studies designed to address the very complex question of whether prenatal exposure to SSRIs may be etiologically linked to later diagnoses of ASDs in offspring."

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by JAMA and Archives Journals.

Journal Reference:

Lisa A. Croen; Judith K. Grether; Cathleen K. Yoshida; Roxana Odouli; Victoria Hendrick. Antidepressant Use During Pregnancy and Childhood Autism Spectrum Disorders. Archives of General Psychiatry, 2011; DOI: 10.1001/archgenpsychiatry.2011.73

Healthy Lifestyle May Ward Off Sudden Cardiac Death in Women

HealthDay News

Tuesday, July 5, 2011

TUESDAY, July 5 (HealthDay News) -- Healthy living significantly reduces a woman's risk of sudden cardiac death, a new study says.

Researchers analyzed data from about 82,000 women who participated in the Nurses' Health Study from 1984 to 2010. During those 26 years, there were 321 cases of sudden cardiac death among the women. The average age of women who died was 72.

Four low-risk lifestyle factors were significantly and independently associated with a lower risk of sudden cardiac death: not smoking; having a body mass index lower than 25; exercising at least 30 minutes per day; and consuming a Mediterranean-style diet that included plenty of vegetables, fruits, nuts, legumes, whole grains and fish, with moderate alcohol intake.

Women who adhered to all four low-risk lifestyle factors had a 92 percent lower risk of SCD than those who didn't have any of the low-risk factors, said Stephanie Chiuve, of Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues.

Their study appears in the July 6 issue of the Journal of the American Medical Association.

Each year in the United States, there are 250,000 to 310,000 cases of sudden cardiac death, which accounts for more than half of all cardiac deaths, according to the researchers.

More information

The U.S. National Heart, Lung, and Blood Institute has more about sudden cardiac arrest/death.

Findings in Mice Have Potential to Curb Obesity and Type 2 Diabetes

ScienceDaily

Tuesday, July 5, 2011

ScienceDaily (July 5, 2011) — Scientists at the National Institutes of Health have uncovered a pathway in mice that allows white fat -- a contributor to obesity and type 2 diabetes -- to burn calories in a way that's normally found in brown fat and muscle. The findings are in the July 6 edition of Cell Metabolism.

White fat is used to store calories. However, too much white fat (obesity) increases the risk of type 2 diabetes and other diseases. Brown fat generates heat to maintain body temperature and, like muscle, has lots of iron-containing, calorie-burning mitochondria in its cells. Changing white fat into brown fat or muscle is a potential new approach to treating obesity and type 2 diabetes, although the research is a long way from being applicable to people.

The findings were exciting and unexpected, said Sushil Rane, Ph.D., a researcher at the NIH's National Institute of Diabetes and Digestive and Kidney Diseases and the paper's senior author. "We weren't looking to have white fat acquire the properties of brown fat, but that's what we found, with the fat getting browner from increased mitochondria and displaying genes typically expressed in muscle. It was a striking difference.

"Efforts to reduce obesity by dieting are mostly unsuccessful in the long term, so finding ways to prevent excess fat storage is an urgent medical need," Rane said. "Our discovery that white fat can be reduced by partially transforming it to brown fat and muscle opens up new avenues to combat the obesity epidemic."

Researchers made their discovery in mice by reducing the actions of a protein called TGF-beta in two ways: through genetic engineering and using an antibody -- a different protein that finds and blocks the TGF-beta protein. The TGF-beta proteins determine the capacity of cells to grow and function normally. Without the TGF-beta actions, the researchers saw that the mice's white fat was getting browner with more mitochondria. The increased metabolic activity due to the mitochondria led to burning calories, thus lessening obesity.

"The default function of white fat is to store energy. This discovery identifies a potential way for it to burn energy instead," said Marc Reitman, M.D., Ph.D., chief of the NIDDK Diabetes, Endocrinology, and Obesity Branch.

The TGF-beta blocking antibody is also being tested as a cancer treatment in people through a trial at the National Cancer Institute. Due to the potential side effects of the antibody, including compromising the immune system, it has not been tested or proven for treatment of human obesity or type 2 diabetes. The researchers next plan to design a more targeted approach to partially transform white fat of mice into the brown fat or muscle-like state without compromising the immune system.

"So many great discoveries are the result of hard work and an openness to being surprised by findings, and to follow where those surprises lead," said NIDDK Director Griffin P. Rodgers, M.D. "If continuing research supports current findings, this discovery has the potential to improve the treatment of obesity and the prevention of type 2 diabetes."

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by NIH/National Institute of Diabetes and Digestive and Kidney Diseases, via EurekAlert!, a service of AAAS.

Journal Reference:

Hariom Yadav, Celia Quijano, Anil K. Kamaraju, Oksana Gavrilova, Rana Malek, Weiping Chen, Patricia Zerfas, Duan Zhigang, Elizabeth C. Wright, Christina Stuelten et al. Protection from Obesity and Diabetes by Blockade of TGF-β/Smad3 Signaling. Cell Metabolism, 6 July 2011; 14(1) pp. 67 - 79 DOI: 10.1016/j.cmet.2011.04.013

Higher Daily Dose of Aspirin Could Play Key Role in Preventing Heart Attacks for Those With Diabetes

ScienceDaily

Tuesday, July 5, 2011

ScienceDaily (July 5, 2011) — In some cases, an apple a day may keep the doctor away, but for people with diabetes, regular, over-the-counter Aspirin may also do the job.

A new study by University of Alberta researcher Scot Simpson has shed light on the use of Aspirin as a preventative measure for cardiovascular disease and reoccurrence in patients with diabetes.

The study collected data from clinical trials that looked at whether taking Aspirin as a course of treatment would prevent a first or recurrent heart attack or stroke.

Using information from diabetic patients in these studies, Simpson discovered that patients with previous cardiac episodes who were taking a low dose of Aspirin daily had very little benefit in terms of prevention of a second heart attack or a decreased risk of mortality. However, in patients taking higher doses of Aspirin, the risk of a repeat heart attack and/or death was significantly lower.

"We took all of the data from 21 studies and focused specifically on diabetic patients who had suffered a previous heart attack or stroke to measure the ability of Aspirin to prevent a second event. We found that, if those patients took up to 325 milligrams of Aspirin per day, they had a 23 percent lower risk of death," said Simpson.

Simpson, an associate professor in the Faculty of Pharmacy and Pharmaceutical Sciences, says that people with diabetes are at an increased risk of cardiovascular disease, adding there is evidence that suggests as much as 60 per cent of deaths in diabetics are attributable to heart disease. Simpson says he always suspected the Aspirin dosage could play a role in treating cardiovascular disease in diabetics and felt because Aspirin was an over-the-counter medication, it's something that pharmacists could have an active role in administering.

"The pharmacists' best role for chronic disease management is working proactively with physicians and patients," said Simpson. "Whether that means working directly with the physician, and consulting about prescribed medications, or when the patient is deciding about whether or not to take Aspirin as part of a treatment plan, pharmacists can have a significant, positive impact."

Simpson's study was recently published in the Journal of General Internal Medicine. Other researchers from the U of A include John-Michael Gamble, in the School of Public Health; Laurie Mereu, in the Faculty of Medicine & Dentistry, and Thane Chambers, in Library Services.

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Alberta, via EurekAlert!, a service of AAAS.

Journal Reference:

Scot H. Simpson, John-Michael Gamble, Laurie Mereu, Thane Chambers. Effect of Aspirin Dose on Mortality and Cardiovascular Events in People with Diabetes: A Meta-Analysis. Journal of General Internal Medicine, 2011; DOI: 10.1007/s11606-011-1757-y

Monday, July 4, 2011

Pfizer's quit smoking drug raises heart risks: study

By Kate Kelland

Reuters

Monday, July 4, 2011

LONDON (Reuters) - Healthy, middle-aged smokers who take Pfizer's Chantix or Champix, one of the most popular quit-smoking drugs, have a higher risk of suffering heart attacks or other serious heart problems, a study found on Monday.

British and American scientists analyzed 14 clinical trials of Champix, sold as Chantix in the United States and known generically as varenicline, and found the likelihood of developing serious heart problems resulting in hospitalization, disability or death was 72 percent higher in patients taking the drug compared with those taking a placebo.

The researchers said U.S. drug regulators, who have already issued warnings about Chantix's safety in certain patient groups, should take note of their findings.

"Our new research shifts the risk-benefit profile of varenicline," said Sonal Singh of Johns Hopkins University School of Medicine, who led the research and published it in the Canadian Medical Association Journal.

"People should be concerned. They do not need Chantix to quit and this is another reason to consider avoiding Chantix altogether," he said in a statement. "People want to quit smoking to reduce the risk of cardiovascular disease, but in this case they are taking a drug that increases the risk for the very problems they are trying to avoid."

Pfizer, the world's largest drugmaker, said in a statement it disagreed with Singh's interpretation of the data. "The analysis contains several limitations -- most notably that it is based on a small number of events, which raises concerns about the reliability of the authors' conclusions."

Investors had high hopes for Chantix when Pfizer launched it in 2006. But reports of suicidal thoughts and other mental health problems in users led U.S. Food and Drug Administration (FDA) officials to order a so-called "black box" warning on the drug's label in 2009.

Chantix, which reduces both the craving for and pleasurable effects of cigarettes, is used by heavy smokers who find it difficult to quit. It is one of the biggest-selling stop-smoking drugs in the United States, and has more than 70,000 prescriptions every month in Britain. Annual sales of around $800 million make Chantix a moderate-sized product for Pfizer.

Life-Threatening

In the study, Singh's team reviewed and analyzed 14 trials involving more than 8,200 healthy people given either Champix or a placebo -- a dummy pill.

Whereas the number of people who died in each group was the same, at seven, the increased risk of a major harmful cardiovascular event requiring hospitalization was 72 percent among those taking Champix/Chantix. None of the studies followed people for longer than a year. The average age of study participants was less than 45 years and the majority were men.

Yoon Loke of Britain's University of East Anglia, who co-led the research, said while the number of serious heart problems was low, at around 1 percent, it was worth noting that most of the studies were carried out in healthy people.

"These are life-threatening diseases and so any increased risk should be carefully avoided -- particularly as heavy smokers are already susceptible to cardiovascular disease," Loke said in a statement.

He said the results suggested that in smokers who do have a history of heart disease, an estimated 1-in-28 would experience extra heart problems if they used Champix for a year.

Smoking, which kills up to half of those with the habit, has been predicted to claim up to 8 million lives a year by 2030 if current trends persist.

It causes lung cancer, which is often fatal, and other chronic respiratory diseases, and is also a major risk factor for cardiovascular diseases -- the world's number one killers.

The FDA said last month it was changing the Chantix label to make clear it carried an increased heart risk for people who already have cardiovascular disease.

In May, France said it was removing Champix from a register of reimbursable treatments on state social security funds after questions were raised about the drug.

Pfizer said it works with regulators a continual basis to review and monitor data for Chantix.

"In particular, we are working with FDA to conduct a combined analysis of clinical trial data (meta-analysis), which will help further evaluate the cardiovascular safety of Chantix," the drugmaker said.

(Reporting by Kate Kelland; Editing by Sophie Walker and Dan Lalor)

Body's Natural Marijuana-Like Chemicals Make Fatty Foods Hard to Resist

ScienceDaily

Monday, July 4, 2011

ScienceDaily (July 4, 2011) — Recent studies have revealed potato chips and french fries to be the worst contributors to weight gain -- and with good reason. Have you ever wondered why you can't eat just one chip or a single fry? It's not just the carbohydrates at fault.

UC Irvine researchers Daniele Piomelli, Nicholas DiPatrizio and colleagues found that fats in these foods make them nearly irresistible and trigger a surprising biological mechanism that likely drives our gluttonous behavior. The apparent culprit? Natural marijuana-like chemicals in the body called endocannabinoids.

In their study, the Piomelli team discovered that when rats tasted something fatty, cells in their upper gut started producing endocannabinoids. Sugars and proteins, the researchers noted, did not have this effect.

The process starts on the tongue, where fats in food generate a signal that travels first to the brain and then through a nerve bundle called the vagus to the intestines. There, the signal stimulates the production of endocannabinoids, which initiates a surge in cell signaling that prompts the wanton intake of fatty foods, Piomelli said, probably by initiating the release of digestive chemicals linked to hunger and satiety that compel us to eat more.

"This is the first demonstration that endocannabinoid signaling in the gut plays an important role in regulating fat intake," added the Louise Turner Arnold Chair in the Neurosciences and professor of pharmacology.

Study results appear in the online edition of Proceedings of the National Academy of Sciences.

Piomelli said that from an evolutionary standpoint, there's a compelling need for animals to consume fats, which are scarce in nature but crucial for proper cell functioning. In contemporary human society, however, fats are readily available, and the innate drive to eat fatty foods leads to obesity, diabetes and cancer.

The findings suggest it might be possible to curb this tendency by obstructing endocannabinoid activity -- for example, by using drugs that "clog" cannabinoid receptors. Since these drugs wouldn't need to enter the brain, they shouldn't cause the central side effects -- anxiety and depression -- seen when endocannabinoid signaling is blocked in the brain, Piomelli noted.

Director of the UCI School of Medicine's Center for Drug Discovery & Development, Piomelli is one of the world's leading researchers on endocannabinoids. His groundbreaking work is showing that this system can be targeted by new treatments for anxiety, depression and obesity.

Giuseppe Astarita of UCI and Gary Schwartz and Xiaosong Li of New York's Yeshiva University contributed to the study, which received support from the National Institute of Diabetes & Digestive & Kidney Diseases and the National Institute on Drug Abuse.

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of California - Irvine.

Journal Reference:

Nicholas V. Dipatrizio, Giuseppe Astarita, Gary Schwartz, Xiaosong Li, Daniele Piomelli. Endocannabinoid signal in the gut controls dietary fat intake. Proceedings of the National Academy of Sciences, 2011; DOI: 10.1073/pnas.1104675108

Moms' diet not tied to kids' heart health: study

By Genevra Pittman

Reuters Health

Monday, July 4, 2011

 

NEW YORK (Reuters Health) - A new study from West Africa suggests that supplementing pregnant women's diets with extra calories and protein doesn't protect their kids against risk factors for heart disease once they're teenagers.

But researchers unconnected to the new work suggest that it might take more time for those extra prenatal calories to show up in the form of lower cholesterol and blood pressure among adult children.

"There's still such a big question mark" as to how well these supplementation programs work, said Marie-Jo Brion, an epidemiologist at the University of Bristol in the UK not tied to the study. "It's been a really difficult area to investigate."

The general theory is that kids born to moms with poor nutrition are more likely to be small and underweight at birth, which could have long-term health consequences such as heart risks, explained Dr. Prakesh Shah, an epidemiologist at the University of Toronto not involved in the new research.

In the latest study, researchers led by Sophie Hawkesworth of the London School of Hygiene and Tropical Medicine measured some of the early risk factors for diabetes and heart disease in about 1,300 Gambian kids aged 11 to 17. Half of the kids were born to mothers who were given food supplements equal to about 1,000 calories per day starting at their 20th week of pregnancy, the other half to mothers who acted as a comparison group.

But there were no clear differences between the two groups of adolescents in body mass index (a measure of weight in relation to height), cholesterol or blood pressure levels, or in blood glucose and insulin levels -- two indicators that can warn of diabetes.

In a separate trial also presented in the American Journal of Clinical Nutrition, the researchers reported that giving moms calcium during pregnancy wasn't linked to blood pressure levels in their kids between ages 5 and 10.

Shah said that it's possible the researchers need to follow kids for many more years to see a difference from the supplements, or that starting extra nutrition for moms-to-be in week 20 may be too late to have an effect on their kids' heart health.

Either way, "extrapolating these findings to a developed country is going to be a big, big challenge," Shah told Reuters Health.

"The underlying nutritional status of these mothers is completely different" than in places like the U.S. and Canada -- meaning pregnant women there shouldn't take these findings to mean that proper prenatal nutrition isn't important, he explained.

Another limitation of this study, Shah mentioned, is that the researchers were only able to track down about 60 percent of kids whose moms had been in the original study -- leaving questions about the health of those who were not included.

But Keith West, a child nutrition researcher at the Johns Hopkins Bloomberg School of Public Health, says that's par for the course with long-term studies in poor countries, and the lack of findings doesn't mean the nutrition supplements didn't make a difference.

"The endowment that occurs early in life though good nutrition is undeniable," West told Reuters Health -- including for development and disease resistance.

"In nutrition trials, these nutrients have many different effects and we often don't measure them all," he added. Plus, it's hard to predict the influence of these supplement programs because every population of moms is different in terms of their normal diet and other baseline health factors.

"Pinpointing nutritionally what's going on is difficult," Brion agreed.

Still, she said, "we would expect a lot of the studies that come out of more deprived populations to be the ones where we might see the effects of supplementation. It's a much more extreme environment."

West emphasized the importance of keeping these studies going for many years to get a better picture of how prenatal programs help kids as they grow up.

"Some interventions are going to stand out and have very clear and impressive effects, and others, in other populations, are not," he said. "It's a story in the making."

Source: http://bit.ly/l1LCZw

American Journal of Clinical Nutrition, online June 15, 2011.

Could Ovarian Stimulation Cause an Increase in Oocyte Chromosome Abnormalities?

ScienceDaily

Monday, July 4, 2011

ScienceDaily (July 4, 2011) — Ovarian stimulation undertaken by women of advanced maternal age (over 35 years) receiving fertility treatment may be disrupting the normal pattern of meiosis -- a critical process of chromosome duplication followed by two specialised cell divisions in the production of oocytes and sperm -- and leading to abnormalities of chromosome copy numbers (aneuploidy) that result in IVF failure, pregnancy loss or, more rarely, the birth of affected children with conditions such as Down's syndrome, which is caused by the inheritance of three copies of chromosome 21 (trisomy 21).

Researchers involved in ESHRE's polar body screening study (launched in 2009) will tell the annual conference of the European Society of Human Reproduction and Embryology on July 4 that results from the study are leading to a new understanding about how such abnormalities are developing, and they believe that the ovarian stimulation a woman receives might be playing a part. Understanding the mechanisms involved could help older women who are trying to have a healthy baby with their own oocytes.

Professor Alan Handyside, Director of The London Bridge Fertility, Gynaecology and Genetics Centre, London, UK, and colleagues from eight countries undertook a proof of principle study of a novel method of screening polar bodies, small cells that are the by-product of oocyte development, using the new technology of microarray comparative genomic hybridisation (array CGH) in order to find whether this was a reliable method of analysing the chromosomal status of an oocyte. This is because many more chromosome copy number abnormalities arise in the oocyte than in sperm.

"In doing so, we obtained a lot of data at the individual chromosome and chromatid level," says Professor Joep Geraedts, co-ordinator of the ESHRE Task Force on preimplantation genetic screening (PGS). (A chromatid is one of the two identical copies of DNA making up a duplicated chromosome). "So we decided to analyse these data separately to see whether they could provide us with information that could be useful in determining better treatment strategies for the future."

"In this unique study, we were able to use the new technology of array CGH to examine the copy number of all 23 pairs of chromosomes, in all three products of female meiosis in over 100 oocytes with abnormal numbers of chromosomes," says Professor Handyside. "What happens in female meiosis is that the 23 pairs of chromosomes duplicate and each pair of duplicated chromosomes comes together and the four single chromosomes, or 'chromatids', become 'glued' together along the whole length of each chromosome. This actually occurs before the woman is born and is the stage at which DNA is swapped between the grandparents' chromosomes.

"Sometimes, decades later, just before ovulation, the glue 'dissolves' first between the two duplicated chromosomes and finally after fertilisation between the two individual chromosomes. This enables pairs of chromosomes to segregate in the first meiotic division producing the first polar body. In the second meiotic division the second polar body is produced, resulting in a single set of chromosomes in the fertilised oocyte or 'zygote', which, when combined with the single set in the fertilising sperm, restores the 23 pairs," he says.

The researchers believe that ovarian stimulation may be disturbing this process in older women because the chromosomes are becoming unglued prematurely, particularly the smaller ones like chromosome 21. Ovarian stimulation uses hormonal medication to stimulate the ovaries to release a larger number of oocytes than normal, in order to provide enough good quality oocytes for fertilisation in vitro.

Following natural conception in older mothers, Down's pregnancies are predominantly caused by errors in the first female meiotic division. "Our evidence demonstrates that, following IVF, there are multiple chromosome errors in both meiotic divisions, suggesting more extensive premature separation of single chromosomes resulting in more random segregation, which in turn results in multiple chromosome copy number changes in individual oocytes," says Professor Handyside.

"We need to look further into the incidence and pattern of meiotic errors following different stimulation regimes including mild stimulation and natural cycle IVF, where one oocyte per cycle is removed, fertilised and transferred back to the woman. The results of such research should enable us to identify better clinical strategies to reduce the incidence of chromosome errors in older women undergoing IVF."

"We also believe that our research will help identify women who want to have their own offspring but have practically no chance of doing so that we can advise them to use donor oocytes," says Professor Geraedts. "This in itself is already a big step forward that will aid couples hoping for a healthy pregnancy and birth to be able to achieve one."

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by European Society of Human Reproduction and Embryology, via EurekAlert!, a service of AAAS.

Burning coal indoors linked to birth defects

By Eric Schultz

Reuters Health

Monday, July 4, 2011

NEW YORK (Reuters Health) - Parents who inhale coal smoke at home may put their babies at increased risk of birth defects, Chinese researchers say.

Zhiwen Li and colleagues at the Peking University Health Science Center in Beijing found that the odds of having malformations of the brain and spine known as neural tube defects are 60 percent higher for children whose mothers inhaled coal smoke than for the children of unexposed mothers.

A 2004 report by the World Health Organization estimated that 90 percent of rural households worldwide use coal and biomass fuel (such as wood, charcoal and dung) for cooking and heating. While coal is relatively inexpensive compared to other energy sources, there are known health risks associated with breathing coal smoke, including lung cancer and other respiratory diseases.

"The indoor air pollution caused by coal and biomass burning at home is a major public health concern, especially given the very large numbers of households that rely on these fuels" said Dr. Beate Ritz, an epidemiologist at the University of California, Los Angeles, who was not involved in the new study.

Coal smoke contains many chemicals known to cause health problems, including arsenic, carbon monoxide and lead. Coal smoke has many similarities to cigarette smoke, explained Kirk Smith, a professor of global environmental health at the University of California, Berkeley.

Some 70 percent of Chinese households rely on coal or biomass fuels and coal use in particular has tripled in the past 20 years, note the Peking University researchers in the American Journal of Epidemiology.

They focused on four rural counties in Shanxi Province in China, where many residents use coal for cooking and heating their homes and where the rate of 10 to 20 cases of neural tube defects for every 1,000 births in some counties represents one of the highest in the world.

For comparison, the U.S. rate of neural tube defects -- which include spina bifida, a paralyzing deformation of the spine -- is about 1 in 1,000 births.

The researchers collected information on coal use and other exposures for parents of 610 infants with neural tube defects and 837 healthy infants. Overall, nearly 90 percent of infants with neural tube defects lived in a house that used coal for cooking, compared to just over 80 percent of infants without the defects.

Infants were also more likely to have neural tube defects the higher their mothers' exposure to coal smoke -- which is often a good indicator of a link between an apparent cause and an effect.

Nonetheless, the study does not prove that exposure to burning coal produced the birth defects, merely that there is some association between the two.

Smith said the results of the study do provide further evidence that coal causes significant health problems and should be replaced by other fuel sources. "Coal can't be burned cleanly...it should be banned from all household use," he told Reuters Health.

Advocating biomass fuel as an alternative, Smith pointed to the potential benefits of "taking a dirty non-renewable fuel and substituting a clean renewable fuel." Biomass can be burned cleanly in a special stove that costs as little as $80, Smith explained, which may prevent future health problems for millions of people.

Source: http://bit.ly/kZWWWb

American Journal of Epidemiology, online June 9, 2011.

Environment, not just genetics, at play in autism

By Julie Steenhuysen

Reuters

Monday, July 4, 2011

CHICAGO (Reuters) - Environmental factors may play a greater role in autism than previously thought, tipping the scale away from a strict focus on genetics, two studies released on Monday suggest.

In one, a team at Stanford University compared cases of autism in identical and fraternal twins and found that fraternal twins -- who share only half of the same genes -- have unusually high rates of autism, suggesting that factors other than genetics may be triggering the disease.

In another, researchers at health insurer Kaiser Permanente found mothers of children with autism were twice as likely to have been prescribed a common antidepressant during the year before their pregnancy than mothers of healthy children.

And the risk was even greater -- a threefold increase -- when the drug was taken in the first trimester of pregnancy.

The findings, released in the Archives of General Psychiatry, suggest that something in the birth environment -- drugs, chemicals or infections -- may be triggering autism in children who are already genetically predisposed to develop the disease.

"It has been well-established that genetic factors contribute to risk for autism," Clara Lajonchere, a study co-author and vice president of clinical programs for Autism Speaks, said in a statement.

"We now have strong evidence that, on top of genetic heritability, a shared prenatal environment may have a greater than previously realized role in the development of autism."

Autism is a spectrum of disorders ranging from a profound inability to communicate and mental retardation to relatively mild symptoms such as with Asperger's syndrome.

It affects one in every 150 children born today in the United States, or about 1 percent of the population.

Shared Environment

The Stanford study involved 54 pairs of identical twins, who share 100 percent of the same genes, and 138 pairs of fraternal twins, who share half of the same genes.

In each pair, at least one of the twins had been diagnosed with autism.

The researchers found the chances of both children having autism spectrum disorder was higher among identical twins than among fraternal twins. But fraternal twins were much more likely to develop autism than studies of children in families where a sibling has autism.

According to the study, environmental factors common to twins explain about 55 percent of the cases of autism, and while genetic factors still play a role, it is much lower than seen in other studies of twins and autism.

"Environmental factors play a bigger role than previously thought," said Dr. Joachim Hallmayer of Stanford University School of Medicine in California, who led the study.

Recent studies have suggested genetics played the biggest role in autism, but his findings suggest something different, he said in a telephone interview.

"We have to study both the genetics and the environment," Hallmayer said. "If we look only at one side, I don't think that will lead us to the right answer."

Could It Be Antidepressants?

In a separate study in the same journal, a team led by Lisa Croen, director of the Autism Research Program at the Kaiser Permanente Division of Research in Oakland, California, looked to see whether antidepressants known as selective serotonin reuptake inhibitors, or SSRIs, contributed to autism risk.

The team studied nearly 300 children with autism and 1,500 randomly selected children and then checked their mothers' medical records.

They found mothers of the children with autism were twice as likely to have taken an antidepressant in the year before delivery than children in the control group.

And the effect was strongest -- three times higher -- when the drugs were taken in the first trimester of pregnancy.

"Our results suggest a possible, albeit small, risk to the unborn child associated with in utero exposure to SSRIs," Croen said in a statement.

But she said this risk must be balanced with the risk to the mother of having untreated depression.

The team cautioned that the SSRI study was preliminary and said much more work was needed to understand the link between antidepressants and autism.

"There are real risks to not being treated for a serious illness like depression. You have to weigh the options," said Dr. Thomas Insel, director of the National Institute of Mental Health.

"A threefold increase in risk is not insignificant. It is worth taking that into account with other factors," Insel said in a telephone interview.

Insel, whose agency funded the twins study, said it is not yet clear what environmental factors may be triggering autism.

"It could be a range of things from infection to chemical exposures. We simply don't know."

What is becoming clear, he said, is that the exposure is likely occurring before childbirth.

"From all the studies that so far have concluded, that is where the evidence seems to be going," he said.

(Editing by Doina Chiacu)

Too many women get HPV tests: study

By Genevra Pittman

Reuters Health

Monday, July 4, 2011

NEW YORK (Reuters Health) - Doctors are testing women for human papillomavirus, or HPV, more often than guidelines recommend, suggests a new study.

Not only is that a waste of money, researchers say, it also means that women who test positive may be getting extra treatment that won't necessarily help them, but comes with a risk of complications and side effects.

Doctors use the HPV test in addition to Pap smears to screen women for signs of cervical cancer. But researchers say that in young women, a positive test gives doctors very little information, since HPV is common in women in their 20's and probably won't lead to cancer.

Still, "there's a much greater emphasis on avoiding a single cancer versus literally thousands of women being over-screened and over-treated," said Philip Castle, an HPV expert at the American Society for Clinical Pathology in Chicago, Illinois, who wrote a commentary on the new study in Obstetrics & Gynecology.

There are about 40 different kinds of sexually transmitted HPV, according to the Centers for Disease Control and Prevention -- and at least half of sexually active people will get HPV at some point. The virus can't be cured, but often goes away on its own without treatment.

Some types of HPV have been linked to cervical cancer in women, whereas other types cause genital warts.

HPV tests, which start at about $30 but can cost much more, look for HPV in cells taken from a swab of the cervix.

For the current study, Dr. Mona Saraiya of the CDC and her colleagues analyzed data from a national survey of doctors and clinics that used Pap tests. In total, 376 individual doctors and another 216 outpatient clinics responded to survey questions about whether and how they performed HPV testing.

Three-quarters of doctors and clinics had ordered an HPV test at least once. Of those, more than half said they used HPV testing regularly alongside Pap smears in women less than 30 years old -- a use not recommended by the American Cancer Society and other organizations.

The majority also reported using HPV tests as a follow-up to a questionable Pap smear when the tests may not have helped doctors with much more information.

Finally, almost one-third of doctors and clinics who did HPV testing used two different kinds of HPV tests, the so called "high-risk" and "low-risk" HPV tests, even though the low-risk test tells doctors nothing about cervical cancer, researchers said, because it screens for the types of HPV that don't cause cancer.

Doctors may be confused about which tests to order if they aren't keeping up with current evidence, Castle told Reuters Health. "The low-risk test really has no business being on the market at all," he added.

And with regard to testing in women less than 30, "cancer is really rare in that group," Castle said. Routine HPV testing at that age, he said, could lead to biopsies and cancer treatments that aren't really necessary -- along with a lot of stress and worry.

"There's a lot of HPV and very little disease" in women in their 20s, he said. "And the disease that's found there is generally about 10 to 15 years away from becoming invasive. There's no good justification for using" the HPV test routinely.

Castle said the findings are particularly troubling given how clear the guidelines are regarding use of the HPV test, and how united experts are about which instances call for the test and which don't.

"It's quite clear that HPV testing can be used in a very beneficial way," he said, including for routine cancer screening in older women and to clarify some types of "equivocal" Pap smears. "But misuses of it just have no place in medical practice," he said.

Saraiya said that women can do their homework -- including on the CDC website, http://www.cdc.gov/cancer-- and be aware of when they should or shouldn't get an HPV test and discuss that with their doctors.

"Doctors are all over the map right now in terms of the recommendations," she told Reuters Health.

Some questions women might want to consider and ask their physicians, Saraiya said, include: "What is the test they're going to be giving to me for screening? Is it a Pap test, an HPV test, or both?"

And for young women: "I've heard I do not need an HPV test for screening under age 30 -- why are you giving it to me?"

"The whole field of HPV and cervical cancer is a fast-changing field. For a clinician to be keeping up with the literature, especially outside of the OB/GYN field, is quite difficult," she said.

"A well informed patient does go a long way."

Source: http://bit.ly/jPDFUi

Obstetrics & Gynecology, online June 20, 2011.

Evidence "increasingly against" phone cancer risk

By Ben Hirschler

Reuters

Monday, July 4, 2011

LONDON (Reuters) - Despite a recent move to classify mobile phones as possibly carcinogenic, the scientific evidence increasingly points away from a link between their use and brain tumors, according to a new study on Saturday.

A major review of previously published research by a committee of experts from Britain, the United States and Sweden concluded there was no convincing evidence of any cancer connection.

It also found a lack of established biological mechanisms by which radio signals from mobile phones might trigger tumors.

"Although there remains some uncertainty, the trend in the accumulating evidence is increasingly against the hypothesis that mobile phone use can cause brain tumors in adults," the experts wrote in the journal Environmental Health Perspectives.

The latest paper comes just two months after the World Health Organisation's (WHO) International Agency for Research on Cancer (IARC) decided cellphone use should be classified as "possibly carcinogenic to humans."

Anthony Swerdlow of Britain's Institute of Cancer Research, who led the new review, told Reuters the two positions were not necessarily contradictory, since the IARC needed to put mobile phones into a pre-defined risk category.

"We are trying to say in plain English what we believe the relationship is. They (IARC) were trying to classify the risk according to a pre-set classification system," Swerdlow said.

Other things deemed by the IARC to be possibly carcinogenic include items as diverse as lead, pickled vegetables and coffee.

Mobile phone use has risen hugely since the early 1980s, with nearly 5 billion handsets in use today, and controversy about their potential link to the main types of brain tumor, glioma and meningioma, has never been far away.

The largest study to date, published last year, looked at almost 13,000 mobile phone users over 10 years.

Swerdlow and colleagues analyzed its results in detail but concluded it gave no clear answer and had several methodological problems, since it was based on interviews and asked subjects to recall phone use going back several years.

Significantly, other studies from several countries have shown no indication of increases in brain tumors up to 20 years after the introduction of mobile phones and 10 years after their use became widespread, they added.

Proving an absence of association is always far harder in science than finding one, and Swerdlow said it should become much clearer over the next few years whether or not there was any plausible link.

"This is a really difficult issue to research," said David Spiegelhalter, Winton Professor of the Public Understanding of Risk at the University of Cambridge, who was not involved in the study.

"But even given the limitations of the evidence, this report is clear that any risk appears to be so small that it is very hard to detect -- even in the masses of people now using mobile phones."

Swerdlow is chairman of the International Commission on Non-Ionizing Radiation Protection's Standing Committee on Epidemiology. The commission is the international body, recognized by the WHO, that constructs guidelines for exposure limits for non-ionizing radiation.

Since mobile phones have become such a key part of daily life -- used by many for websurfing as well as talking -- industry experts say a health threat is unlikely to stop people using them.

(Reporting by Ben Hirschler; Editing by Will Waterman)

Smoking Does Not Keep You Slim, Swedish Research Shows

ScienceDaily

Monday, July 4, 2011

ScienceDaily (July 4, 2011) — You might think that you will gain weight if you quit smoking. But it's not that simple. A master's thesis from the Nordic School of Public Health (NHV) in Sweden shows that smoking doesn't help you get thinner.

While cigarette smoking has decreased in western countries, obesity has increased. Recent studies have suggested that today's smokers may have less weight problems than non-smokers. "That's why I wanted to study whether the relationship between smoking and overweight has changed over time," said Lisa Webb, Master of Public Health at NHV.

Approximately 6,000 people have participated in a study on the relationship between smoking and obesity. Two measure of body fat have been used: BMI (body mass index) and WHR (waist hip ratio). The master's thesis "Smoking in the age of obesity: an investigation of secular trends in body fat and cigarette smoking" shows higher WHR for male and female smokers but lower BMI for female smokers, as compared with non-smokers.

A particularly noteworthy finding was that the difference between WHR among female smokers and never-smokers increased during the study.

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.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Nordic School of Public Health, via AlphaGalileo.