Personal Health


Friday, February 4, 2011

Want More Efficient Muscles? Eat Your Spinach


Friday, February 4, 2011

ScienceDaily (Feb. 4, 2011) — After taking a small dose of inorganic nitrate for three days, healthy people consume less oxygen while riding an exercise bike. A new study in the February issue of Cell Metabolism traces that improved performance to increased efficiency of the mitochondria that power our cells.

The researchers aren't recommending anyone begin taking inorganic nitrate supplements based on the new findings. Rather, they say that the results may offer one explanation for the well-known health benefits of fruits and vegetables, and leafy green vegetables in particular.

"We're talking about an amount of nitrate equivalent to what is found in two or three red beets or a plate of spinach," said Eddie Weitzberg of the Karolinska Institutet in Sweden. "We know that diets rich in fruits and vegetables can help prevent cardiovascular disease and diabetes but the active nutrients haven't been clear. This shows inorganic nitrate as a candidate to explain those benefits."

In fact, up until recently nitrate wasn't thought to have any nutritional value at all. It has even been suggested that this component of vegetables might be toxic. But Weitzberg and his colleague Jon Lundberg earlier showed that dietary nitrate feeds into a pathway that produces nitric oxide with the help of friendly bacteria found in our mouths. Nitric oxide has been known for two decades as a physiologically important molecule. It opens up our blood vessels to lower blood pressure, for instance.

The new study offers yet another benefit of nitrate and the nitric oxides that stem from them. It appears that the increased mitochondrial efficiency is owed to lower levels of proteins that normally make the cellular powerhouses leaky. "Mitochondria normally aren't fully efficient," Weitzberg explained. "No machine is."

Questions do remain. The new results show that increased dietary nitrate can have a rather immediate effect. But it's not yet clear what might happen in people who consume higher levels of inorganic nitrate over longer periods of time. Weitzberg says it will be a natural next step to repeat the experiment in people with conditions linked to mitochondrial dysfunction, including diabetes and cardiovascular disease, to see if they too enjoy the benefits of nitrates.

"Among the more consistent findings from nutritional research are the beneficial effects of a high intake of fruit and vegetables in protection against major disorders such as cardiovascular disease and diabetes," the researchers concluded. "However, the underlying mechanism(s) responsible for these effects is still unclear, and trials with single nutrients have generally failed. It is tempting to speculate that boosting of the nitrate-nitrite-NO pathway may be one mechanism by which vegetables exert their protective effects."

As an interesting aside, Weitzberg says that the benefits of dietary nitrates suggest that powerful mouthwashes may have a downside. "We need oral bacteria for the first step in nitrate reduction," he says. "You could block the effects of inorganic nitrate if you use a strong mouthwash or spit [instead of swallowing your saliva]. In our view, strong mouthwashes are not good if you want this system to work."

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

Journal Reference:

Filip J. Larsen, Tomas A. Schiffer, Sara Borniquel, Kent Sahlin, Bjφrn Ekblom, Jon O. Lundberg, Eddie Weitzberg. Dietary Inorganic Nitrate Improves Mitochondrial Efficiency in Humans. Cell Metabolism, 2011; 13 (2): 149-159 DOI: 10.1016/j.cmet.2011.01.004

Many get antidepressants for no psychiatric reason

By Frederik Joelving

Reuters Health

Friday, February 4, 2011

NEW YORK (Reuters Health) – More than a quarter of Americans taking antidepressants have never been diagnosed with any of the conditions the drugs are typically used to treat, according to new research.

That means millions could be exposed to side effects from the medicines without proven health benefits, researchers say.

"We cannot be sure that the risks and side effects of antidepressants are worth the benefit of taking them for people who do not meet criteria for major depression," said Jina Pagura, a psychologist and currently a medical student at the University of Manitoba in Canada, who worked on the study.

"These individuals are likely approaching their physicians with concerns that may be related to depression, and could include symptoms like trouble sleeping, poor mood, difficulties in relationships, etc.," she added in an e-mail to Reuters Health. "Although an antidepressant might help with these issues, the problems may also go away on their own with time, or might be more amenable to counseling or psychotherapy."

The researchers tapped into data from the Collaborative Psychiatric Epidemiologic Surveys, which include a nationally representative sample of more than 20,000 U.S. adults interviewed between 2001 and 2003.

Roughly one in ten people told interviewers they had been taking antidepressants during the past year. Yet a quarter of those people had never been diagnosed with any of the conditions that doctors usually treat with the medication, such as major depression and anxiety disorder.

According to The National Institute of Mental Health, nearly 15 million American adults suffer from major depression, and 40 million more have anxiety disorders.

Although the survey didn't include all mental illnesses that might have led doctors to prescribe an antidepressant -- say, obsessive-compulsive disorder or to help quit smoking -- other experts said the new findings are not exaggerated.

"Reviews of claims records, which are diagnoses actually given by health care professionals, suggest that only about 50% of patients who are prescribed antidepressants receive a psychiatric diagnosis," said Dr. Mark Olfson, a psychiatrist at Columbia University in New York.

"These findings raise questions about the clinical appropriateness of antidepressant treatment selection for many primary care patients," he added in an e-mail to Reuters Health.

With sales of $9.9 billion in 2009, up three percent since the previous year, antidepressants rank fourth among prescription drugs in the U.S., according to IMS Health, a company that analyzes the pharmaceutical industry.

Popular brand names include Pfizer's Zoloft, Forest Laboratories' Lexapro and Eli Lilly's Prozac.

While studies have shown the drugs may help some people with depression, they come with a price tag -- and not only the $100 or more that a month's supply can cost. Some users experience sexual problems or gain weight, for instance.

"Nearly all medication has side effects, so there are undoubtedly a large number of Americans who are taking antidepressants that may not be effective at treating their conditions, yet they suffer from the side effects," said Jeffrey S. Harman, an expert in health services at the University of Florida in Gainesville, who was not involved in the new study.

"Not to mention inappropriate use of our health care dollars that comes along with inappropriate prescribing," he added in an e-mail.

Still, Harman said the findings, published in the Journal of Clinical Psychiatry, didn't necessarily mean doctors are prescribing more antidepressants than they should.

"As far as overprescribing, I don't think you can say that it is occurring as a blanket statement," he explained. "There are undoubtedly many people being prescribed antidepressants that may not be effective for them, but there are also millions of Americans suffering from depression who are not being prescribed antidepressants or are being prescribed them at a suboptimal dose."

Pfizer did not comment directly on the new findings, but told Reuters Health it was dedicated to ensuring "that patients and their doctors have the most up to date medical information on which to base their treatment decisions."


Journal of Clinical Psychiatry, online January 25, 2011.

Benefits of Outdoor Exercise Confirmed


Friday, February 4, 2011

ScienceDaily (Feb. 4, 2011) — A systematic review carried out by a team at the Peninsula College of Medicine and Dentistry has analysed existing studies and concluded that there are benefits to mental and physical well-being from taking exercise in the natural environment. Their findings are published in the research journal Environmental Science and Technology on February 4th 2011.

The research team, supported by the NIHR Peninsula Collaboration in Leadership for Applied Health Research and Care (PenCLAHRC, part of the NIHR family of health and research initiatives) in collaboration with the European Centre for the Environment and Human Health (ECEHH), analysed data from a number of sources including 11 randomised and non-randomised control trials incorporating information from 833 adults.

Eligible trials were those that compared the effects of outdoor exercise initiatives with those conducted indoors and which reported at least one physical or mental well-being outcome in adults or children.

The study found that most trials showed an improvement in mental well-being: compared with exercising indoors, exercising in natural environments was associated with greater feelings of revitalisation, increased energy and positive engagement, together with decreases in tension, confusion, anger and depression. Participants also reported greater enjoyment and satisfaction with outdoor activity and stated that they were more likely to repeat the activity at a later date.

However, none of the identified studies measured the effects of physical activity on physical well-being, or the effect of natural environments on sticking to exercise.

On balance this review has identified some promising effects on self-reported mental well-being immediately following exercise in the natural environment, as opposed to those reported following exercise indoors. This is a first step towards vindicating the positive effects of programmes such as the Green Gym and Blue Gym, and innovative interventions by medical practitioners that include exercise outdoors as part of holistic treatments for those suffering from depression and similar psychological ailments.

At present research analysts are working with a paucity of high quality evidence, and one significant outcome from this study is the urgent need for there to be further research in this area. Large, well-designed longer-term trials in populations who might benefit most from the potential advantages of outdoor exercise are needed to fully analyse the effects of outdoor exercise on mental and physical well-being. Studies are also required that measure the influence of such effects on the sustainability of physical activity.

Dr. Jo Thompson-Coon, PenCLAHRC Research Fellow, commented: "The hypothesis that there are added beneficial effects to be gained from exercising in the natural environment is very appealing and has generated considerable interest. By using the data currently available to us we have added strength to the link between mental and physical well-being and outdoor exercise, but further research and longer, tailor-made and focused trials are needed to better understand this link."

The senior author of the study, Professor Michael Depledge, Chair of Environment and Human Health at the ECEHH, added: "Some 75 per cent of the European population now live in urban environments, so that increasing efforts need to be made to re-connect people with nature via programmes such as the Green Gym and Blue Gym. Our research, which brings together data from a wide variety of sources, adds significant weight to the case for spending more time in the natural environment as members of the public and their clinicians fight to counteract the negative outcomes of modern living, such as obesity and depression. We look forward to conducting the further research and trials required to establish the evidence-base for introduction of outdoor activity into general lifestyle to complement therapeutic intervention."

Professor Stuart Logan, Director -- Institute of Health Service Research and Director -- PenCLAHRC, at the Peninsula College of Medicine & Dentistry, said: "This is just the sort of project that PenCLAHRC is designed to support. It reflects the aim of the National Institute for Health Research in establishing CLAHRCs around the UK -- locally identified and undertaken research that translates to improved health and well-being and that both benefits the local community and contributes to the production of research evidence. This is an exciting project with immense potential."

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

Journal Reference:

J. Thompson Coon, K. Boddy, K. Stein, R. Whear, J. Barton, M. H. Depledge. Does Participating in Physical Activity in Outdoor Natural Environments Have a Greater Effect on Physical and Mental Wellbeing than Physical Activity Indoors? A Systematic Review. Environmental Science & Technology, 2011; : 110203115102046 DOI: 10.1021/es102947t

Simple life changes could stop millions of cancers

By Kate Kelland


Friday, February 4, 2011

LONDON (Reuters) – About a third of all common cancers in the United States, China and Britain could be prevented each year if people ate healthier food, drank less alcohol and exercised more, health experts said on Friday.

Estimates from the American Institute for Cancer Research (AICR) and the World Cancer Research Fund (WCRF) suggest that making simple lifestyle changes could prevent some 40 percent of breast cancers alone in Britain and the United States, as well as tens of thousands of colon, stomach and prostate cancers.

"It is distressing that even in 2011, people are dying unnecessarily from cancers that could be prevented through maintaining a healthy weight, diet, physical activity and other lifestyle factors," Martin Wiseman, a WCRF medical and scientific adviser, said in statement.

In China, 620,000 cases, or 27 percent are preventable, the WCRF said, as are about 35 percent, or 340,000, in the United States and 37 percent in Britain. Healthier lifestyles could prevent 61,000 cancers in Brazil and 79,000 in Britain.

The WCRF findings are backed by World Health Organisation (WHO) recommendations, which say regular exercise can prevent many diseases such as cancers, heart diseases and diabetes.

Cancer is a leading cause of death around the world and its incidence is rising. Each year around 12.7 million people discover they have cancer and 7.6 million people die from some form of the disease. There are about 200 known types of cancer.

According to the International Agency for Research on Cancer (IARC), cancer will kill more than 13.2 million people a year by 2030, almost double the number it killed in 2008 -- and the vast majority of deaths will be in poorer countries.

In a separate statement, the Geneva-based WHO said low levels of physical activity are the main cause of an estimated 21 to 25 percent of breast and colon cancers, 27 percent of diabetes cases and 30 percent of heart disease cases worldwide.

Rachel Thompson, the WCRF's deputy head of science, said that while the message was simple -- that not smoking, eating good food and being a healthy weight can help ward off many cancers -- it was still a difficult one to get across.

"It's all very well us saying 'this is what you need to eat and this is how much physical activity you need to do', but we need to make it easier for people to make those changes," she said. "Everybody has a role in that -- from international organizations, to governments, to people themselves."

The WHO says adults should do at least 150 minutes of moderate exercise a week. This could be done by walking for 30 minutes five times per week or by cycling to work every day.

Peter Baldini, head of the World Lung Foundation, also called on all governments to introduce smoke-free laws and raise the price of cigarettes.

Tobacco kills millions of smokers every year, and tobacco-related lung cancers also kill hundreds of thousands of people who don't smoke but have been exposed to it second-hand.

"There isn't a magic bullet to cure all forms of cancer, but we have the opportunity and the obligation to protect people from developing cancer wherever possible," Baldini said.

(Additional reporting by Stephanie Nebehay in Geneva, editing by Matthew Jones) 

Ruptured appendix more common in rural U.S

By Amy Norton

Reuters Health

Friday, February 4, 2011

NEW YORK (Reuters Health) – People in rural areas are more likely than city-dwellers to have appendicitis progress to a full-blown ruptured appendix, a U.S. study finds.

The reasons for the rural-urban divide are not clear, but researchers suspect that a lack of surgeons in rural areas is the prime factor.

"I think this does show that there's a gap that needs to be filled," lead researcher Dr. Ian M. Paquette, a surgeon at the University of Minnesota in Minneapolis, told Reuters Health.

The study, published in the Annals of Surgery, found that among 123,000 Americans treated for acute appendicitis over one year, rural patients were more likely to arrive at the hospital with a ruptured appendix. Just under 36 percent had a rupture, compared to about 32 percent of urban patients.

Appendicitis refers to inflammation of the appendix, a small pouch attached to the colon in the lower right abdomen that has no known function. The inflammation develops because of a blockage and infection in the appendix. Treatment involves surgery to remove the appendix to prevent it from rupturing.

A ruptured appendix causes infectious material to spill into the abdomen, where it can lead to complications and boost patients' time in the hospital and medical costs.

It's likely that rural patients in the current study had less access to quick surgical care, according to Paquette.

Rural hospitals may not be able to afford, or may not have enough surgical cases, to justify having a full-time general surgeon on staff, Paquette said.

He pointed to one study that found only 36 percent of hospitals in the most sparsely populated U.S. rural areas had a full-time general surgeon, and just two-thirds had a full-time anesthesiologist.

When a hospital has no surgeon and anesthesiologist available, Paquette said, a patient with appendicitis would have to be transferred to another center. That delay could raise the odds of a rupture.

Another recent study that looked just at ruptured appendixes in kids also found higher rates of the problem in rural versus urban children, and that study too blamed a shortage of doctors-but the researchers pointed to a lack of pediatricians rather than surgeons.

The author of that study suggested that "children in specific counties that had easier access to pediatricians were more quickly fast-tracked into the emergency room or hospital where a surgeon was then able to treat them." (See Reuters Health story of December 22, 2010.)

In Paquette's study, patients who suffered a rupture spent an average of almost six days in the hospital, at a cost of $20,700. That compared with an average of two days and $15,000 for patients without a rupture.

The difference between rural and urban patients in the rate of appendix rupture "might sound small," Paquette said.

But, he added, the gap is significant considering how common appendicitis is -- about one in 15 Americans will develop it -- and the consequences of a rupture.

"There are there are the added costs to the healthcare system," Paquette said, "plus the added time for patients to return to normal health."

Efforts to encourage more surgeons to work in rural areas are needed, Paquette said. He noted that some are already underway, including "loan forgiveness" programs that help doctors repay medical school loans in exchange for working in underserved areas.

Paquette said that some general surgery programs have also developed specific "rural surgeon tracks," which train general surgeons in a broader range of simple procedures so that patients in rural areas will not have to be transferred as often.


 Annals of Surgery, online January 4, 2011. 

Thursday, February 3, 2011

Kids' Rising Obesity Rates Due to Bad Habits, Not Genes: Study

HealthDay News

Thursday, February 3, 2011

THURSDAY, Feb. 3 (HealthDay News) -- Poor eating and activity habits, not genetics, are the underlying causes for most cases of adolescent obesity, new research suggests.

The finding stems from an analysis involving more than 1,000 Michigan sixth-grade students who participated in the Project Healthy Schools program, which is in place in 13 middle schools across the state.

"For the extremely overweight child, genetic screening may be a consideration," study senior author Dr. Kim A. Eagle, a cardiologist and a director of the University of Michigan Cardiovascular Center in Ann Arbor, said in a center news release.

"For the rest, increasing physical activity, reducing recreational screen time and improving the nutritional value of school lunches offers great promise to begin a reversal of current childhood obesity trends."

The study findings were published in a recent issue of the American Heart Journal.

The authors noted that, in 1980, just 6.5 percent of U.S. children aged 6 to 11 years were considered obese, but that percentage rose to nearly 20 percent by 2008.

The recent study found that 15 percent of the participants were obese. And almost all had poor eating habits.

Nearly one-third of all the students said they drank a soda the day before, while fewer than half said they could recall having eaten two portions of fruits and vegetables in the same time frame.

And while 34 percent of non-obese kids consumed lunches provided by their school, that figure rose to 45 percent among obese students.

Only one-third of all the kids reported exercising a half hour for five days during the previous week. Obese children were much less likely than non-obese kids to participate in regular exercise and/or physical education classes, and less likely to be a part of a sports team.

Among obese children, 58 percent reported watching two hours of TV in the past day. That compared with 41 percent of non-obese kids.

The finding comes against the backdrop of the recent enactment of the federal government's new "Healthy, Hunger-Free Kids Act of 2010," which is designed to foster healthier school menus for the nation's 31 million children currently receiving lunch through school-based programs.

More information

For more on the Healthy, Hunger-Free Kids Act of 2010, visit the White House Web site.

Study supports restricted diet for kids with ADHD

By Kate Kelland


Thursday, February 3, 2011

LONDON (Reuters) – Children with attention-deficit hyperactivity disorder (ADHD) should be fed a special diet to help their carers determine whether certain foods are making their condition worse, Dutch scientists said on Friday.

In a study of 100 children with ADHD -- one of the world's most common child mental disorders -- scientists from Radboud University and the ADHD Research Center in the Netherlands found that a restricted diet led to significant improvements in the symptoms of some ADHD sufferers.

"Dietary intervention should be considered in all children with ADHD, provided parents are willing to follow a diagnostic restricted elimination diet for a five-week period, and provided expert supervision is available," the scientists said in their study in The Lancet medical journal.

ADHD is estimated to affect around 3 to 5 percent of children worldwide. Children with ADHD are excessively restless, impulsive and distracted, and often have difficulties at home and in school. There is no cure, but the symptoms can be kept in check by a combination of drugs and behavioral therapy.

Previous studies have suggested that in some children, ADHD might be an allergic or hypersensitivity disorder that could be triggered by any type of food that can cause allergic reactions.

In this study, children aged four to eight years diagnosed with ADHD were divided into two groups and given either an elimination diet or a general healthy diet for five weeks.

Jan Buitelaar of Radboud University, who led the study, said in a telephone interview that the elimination diet was restricted to rice, water, white meat such as turkey, and some fruits and vegetables that are generally considered as unlikely to cause allergies.

Foods such as wheat, tomatoes, oranges, eggs and dairy products were kept out of the diet as they are often linked with allergies or food intolerances.

After five weeks, children who reacted well to the restricted diet went into a second phase in which different groups of foods were gradually added to their diet and their symptoms monitored to see if they worsened. The foods were different for each child, based on blood results.

In the first phase, 64 percent of children in the diet group had significant improvements in their ADHD symptoms, Buitelaar said, and showed a decrease in "oppositional defiant disorder symptoms" such as challenging behavior.

External experts commenting on the research said it offered "excellent evidence" that dietary changes might be very beneficial for some children with ADHD, but they questioned whether it would be cost-effective in time and resources.

"We need to know more about how expensive the intervention is, how motivated parents need to be to make it work, and how easy it is for parents to get their ADHD child to stick to the diet," said David Daley, professor of psychological intervention and behavior change at Britain's Nottingham University.

Professor Jim Stevenson of Southampton University said it was good for parents to explore alternative treatment options.

"Many parents are reluctant to use a drug treatment and it is important that alternatives such as the few foods approach can be shown to be effective," he said.

(Editing by Paul Casciato) 

Narrowed Leg Arteries Disable Women Faster Than Men: Study

By Alan Mozes
HealthDay Reporter
HealthDay News

Thursday, February 3, 2011

THURSDAY, Feb. 3 (HealthDay News) -- Women coping with peripheral arterial disease (PAD) in the legs appear to lose mobility faster than men, new research reveals.

PAD is marked by narrowing and blockages of the peripheral arteries, usually those in the legs and pelvis. The most common symptoms are pain, cramping and tiredness in the leg or hip muscles when walking or climbing stairs -- symptoms that go away during rest.

"The bottom line is that among those with lower extremity PAD, women have faster declines in mobility and functional performance compared to men," said study author Mary M. McDermott, a professor of medicine in the department of medicine at the Northwestern University Feinberg School of Medicine in Chicago.

"This may be related to gender differences in calf muscle, as women tend to have less calf muscle compared to men," McDermott added.

She and her colleagues report their findinsg in the Feb. 8 issue of the Journal of the American College of Cardiology.

Both the researchers and the American Heart Association note that an estimated 8 million American men and women are affected by lower extremity PAD, with disease prevalence being split about equally across genders.

To examine whether disease progression differs among men and women, between 2002 and 2009 McDermott and her team tracked the progress of 380 male and female patients with PAD of the legs in the Chicago area.

All the participants were 59 and older. Over a four-year period, annual mobility assessments were conducted during which each patient was asked to complete a quarter mile, six-minute walk, as well as a four-minute speed test, to observe the development of disability. Changes in calf muscle measurements and characteristics were also noted, alongside knee extension strength.

Overall, the research team determined that after adjusting for age, women fared more poorly than men over the course of the study.

As the study period unfolded, they noted that women ended up walking less per week and had more difficulty walking the quarter-mile. Specifically, female PAD patients who had initially been able to complete a continuous six-minute quarter-mile walk were 2.3 times as likely as men to lose that ability by year four.

Women were also more likely to undergo a decline in unassisted mobility at a faster rate, year-to-year, than men, and were 1.9 times as likely to develop mobility disability (defined as being unable to continuously walk a quarter mile or ascend and descend a single flight of stairs without help).

Women also experienced a faster drop than men in the speed with which they could walk unassisted. And although women experienced less of an annual decline in calf muscle area and isometric knee extension strength than men, they also had generally smaller calf muscles, lower calf muscle density, and less overall knee extension strength to begin with.

The authors concluded that female PAD patients suffer faster rates of functional decline than their male counterparts.

They noted, however, that women generally started out the study with worse mobility than men, and that their faster loss of mobility might in the end be traced to the initial disadvantage women have in terms of weaker calf muscles and poorer leg strength. Viewed in reverse, the greater lower extremity "muscle reserves" typical of men may actually help protect them against the mobility ravages of PAD.

"This has not been reported before in people with PAD," McDermott noted. "So I was somewhat surprised. But there is some data in people without PAD that also shows this gender phenomenon. So it may be that because women live longer, they have more opportunity to experience these declines than men."

Regardless, McDermott stressed that the observations could have important implications for treatment protocols. Further research will help determine whether interventions to increase calf muscle area and leg strength in women with PAD in the legs can help slow a decline in mobility, she and her colleagues noted.

The researchers did not report any conflicts of interest.

For his part, Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, said that the findings underscore the importance of timely intervention among PAD patients, regardless of gender.

"Men or women with peripheral arterial disease have four to five times the risk of heart attack or stroke," he noted. "Left untreated, peripheral arterial disease can lead to amputation."

"Treatment of peripheral artery disease," he added, "focuses on preventing further progression of the disease, including lifestyle changes, exercise programs, and specific medications to reduce the risk of heart attacks and stroke as well as to slow the progression or even reverse symptoms of peripheral artery disease."

This study, he concluded, "highlights the need for aggressive treatment of peripheral artery disease in both women and men".

More information

For more on PAD, visit the American Heart Association.

Coffee, Energy Drinkers Beware: Many Mega-Sized Drinks Loaded With Sugar, Nutrition Expert Says


Thursday, February 3, 2011

ScienceDaily (Feb. 3, 2011) — Starbucks recently announced a new-sized 31-ounce drink, the "Trenta," which will be in stores this spring. The mega-sized coffee joins the ranks of other energy drinks that can pack plenty of caffeine and calories. Ellen Schuster, a University of Missouri nutrition expert, says that Americans should be wary of extra calories and sugar in the quest for bigger, bolder drinks.

"The sheer size of new coffee and energy drinks increases consumers' potential for unhealthy calorie and sugar consumption," said Schuster, state specialist for MU Extension and the College of Human Environmental Sciences. "A 'Trenta'-sized Starbuck's lemonade could include 21 teaspoons of sugar -- much more than should be consumed at one time, or in one day."

Excess sugar is common in many prepared beverages. According to the U.S. Department of Health and Human Services, people who consume drinks with added sugars consume more total calories, and studies have found that drinking sweetened beverages is related to weight gain.

Health experts at the Mayo Clinic note that moderate consumption of coffee and other caffeinated beverages is unlikely to cause harm, but large quantities in excess of 500 mg, or more than four cups of coffee, can cause difficulty sleeping, irritability, restlessness, stomach problems and irregular heartbeat. Especially of concern is caffeine consumption among children and adolescents.

"Energy and coffee beverages are subject to the same nutrition rules as other foods and drinks; it's all about moderation," Schuster said. "Ideally, it's best to avoid drinking calories, because drinks leave you less full than solid foods. By eating calories in the form of high-calorie, high-sugar drinks, people crowd out other nutritious foods. However, like any indulgence, it's fine to order a 'Trenta' drink as an occasional treat."

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. 

Rare Form of Stroke Strikes More Often Than Thought: Report

HealthDay News

Thursday, February 3, 2011

THURSDAY, Feb. 3 (HealthDay News) -- A rare form of stroke that involves veins instead of arteries occurs more often than thought, according to a new American Heart Association/American Stroke Association scientific statement.

This type of stroke -- cerebral venous thrombosis (CVT) -- is caused by a clot in the dural venous sinuses, which are veins that drain blood from the brain toward the heart. It is most common in women who are pregnant or taking oral contraceptives, and in people age 45 and younger.

The incidence of CVT among pregnant women and those who have recently given birth ranges from one in 2,500 to one in 10,000. The risk is greatest during the third trimester of pregnancy and in the first four weeks after giving birth. Up to 73 percent of CVT cases occur immediately after childbirth.

But women who've suffered CVT have a low risk of complications during future pregnancies, according to the scientific statement.

Patients with suspected CVT should have blood tests to determine if they have an inherited or acquired factor in the blood that increases the risk of blood clots (prothrombotic factor).

In addition, patients should be screened for conditions that increase the risk of CVT, such as the use of oral contraceptives, inflammatory disease and infection.

"The most common symptoms of patients with CVT include headaches that progress in severity over days or weeks, and seizures. Some patients may develop a focal neurological deficit (weakness affecting the extremities, double vision, etc.)," Dr. Gustavo Saposnik, chair of the statement writing group and an assistant professor of medicine at Saint Michael's Hospital, University of Toronto, said in an American Heart Association news release.

Diagnosis of CVT can be challenging. For example, 30 percent to 40 percent of patients with CVT may develop an intracranial hemorrhage (bleeding within the skull).

"It's important to distinguish a hemorrhage caused by a ruptured brain artery from those associated with CVT. The mechanisms -- and treatment -- of the bleeding are quite different," Saposnik said.

The statement outlined the approach doctors should take to diagnose and manage CVT:

Clinical suspicion of CVT.

MRI, or alternative imaging technique at hospitals/medical centers with fewer resources.

Confirm CVT.

Begin anticoagulation therapy (IV Heparin).

Continue anticoagulation therapy, lasting three to 12 months to a lifetime.

Other options may be considered in patients who continue to experience neurological deterioration despite medical treatment. These options include surgery to temporarily remove a section of skull to relieve pressure on the brain (hemicraniectomy), or minimally invasive surgery to remove clots in the affected veins (endovascular treatment).

The scientific statement, published in the Feb. 3 issue of Stroke, is endorsed by a number of organizations, including the American Academy of Neurology and the American Academy of Neurological Surgeons.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about stroke.

Potential Vaccine to Prevent Gastritis, Ulcer Disease, Gastric Cancer


Thursday, February 3, 2011

ScienceDaily (Feb. 3, 2011) — A new study led by researchers at Rhode Island Hospital in collaboration with the University of Rhode Island (URI) and EpiVax. Inc, a privately owned vaccine development company in Providence, RI, has identified a potential vaccine capable of reducing colonization of Helicobacter pylori (H. pylori) -- a known cause of gastritis, ulcer disease and cancer. Their findings appear online in advance of print in the journal Vaccine.

Because the colonization of H. pylori has far-reaching health consequences, it represents a significant public health challenge. Current treatments use multiple antibiotics in combination with acid suppression medications to eradicate it. Due to an increase in antibiotic resistance, it is now more difficult to eliminate, and the development of a vaccine as an alternative therapy is of increased interest.

Steven Moss, M.D., is a gastroenterologist at Rhode Island Hospital and lead author of the paper. Moss, who is also a professor of medicine at the Warren Alpert Medical School of Brown University, says, "Normal immune mechanisms fail to eradicate H.pylori, but some prophylactic and therapeutic vaccine strategies using a wide variety of H. pylori antigens have been reported to be successful. The literature, however, does not define the optimal choice of antigen or the best delivery method."

Through an animal model study, Moss and his colleagues utilized a gene-to-vaccine approach, incorporating multiple epitopes (a part of an antigen that is recognized by the immune system) and administered them both intranasally and intramuscularly. The results of the study suggest that when the vaccine was delivered intranasally it was more effective. Moss says, "We found that the multi-epitope vaccine induced a broad immune response that led to a significant reduction in H. pylori colonization."

Anne S. De Groot, M.D., initiated the HelicoVax research program in 2005 in her company, EpiVax, Inc., with funding from a National Institutes of Health small business research award. De Groot comments, "This project illustrates the power of persistence and collaboration between the biotech industry and academe, especially when it comes to emerging infectious disease vaccines."

Moss concludes, "These encouraging, though preliminary, results suggest that further development of an epitope-based mucosal vaccine against H. pylori can potentially lead to a novel approach to prevent H. pylori-associated diseases such as peptic ulcer disease and gastric cancer in humans. We are now receiving further NIH funding to continue this collaboration with URI and EpiVax and are starting to translate this approach from mice to human subjects."

Other researchers involved in the study with Moss include Dong Soo Lee, Woojin Kim, and Songhua Zhang of Rhode Island Hospital and Alpert Medical School; Anne S. De Groot (University of Rhode Island, EpiVax Inc. and Alpert Medical School), Leonard Moise (University of Rhode Island, and EpiVax Inc.) William Martin, of EpiVax, Inc.; Jinhee Lee of the University of Massachusetts Medical School; and Arlin Rogers of the University of North Carolina, Chapel Hill. EpiVax, Inc. is a privately owned vaccine development company in Providence, RI.

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

Journal Reference:

Steven F. Moss, Leonard Moise, Dong Soo Lee, Woojin Kim, Songhua Zhang, Jinhee Lee, Arlin B. Rogers, William Martin, Anne S. De Groot. HelicoVax: Epitope-based therapeutic Helicobacter pylori vaccination in a mouse model. Vaccine, 2011; DOI: 10.1016/j.vaccine.2010.12.130

Cold Viruses Appear Linked to Type 1 Diabetes

By Steven Reinberg
HealthDay Reporter by Steven Reinberg
HealthDay News

Thursday, February 3, 2011 

THURSDAY, Feb. 3 (HealthDay News) -- While the causes of type 1 diabetes aren't known for certain, a new analysis backs the possibility that cold-like viruses might trigger the disease.

Australian researchers looked at a number of studies, and concluded there is a strong association between enteroviruses and the development of type 1 diabetes. In fact, children with diabetes were 10 times more likely to have had an enterovirus infection than children without the disease.

"The finding implies that enterovirus infection is a very important cause of type 1 diabetes," said lead researcher Dr. Maria Craig, an associate professor at Children's Hospital at Westmead's Institute of Endocrinology and Diabetes in Sydney.

Craig noted that the idea that enteroviruses are involved in the development of type 1 diabetes is not new, but this study makes use of new data that makes the association more likely.

"It is time to look at how these viruses are involved in the disease process," Craig said. The goal would be to find a way to "stop these viruses from contributing to diabetes -- potentially leading to vaccination," she added.

The report is published in the Feb. 3 online edition of the BMJ.

For the study, Craig's team, using a type of research known as a meta-analysis, reviewed 24 papers and two abstracts involving 4,448 individuals to see if there was an association between type 1 diabetes and enterovirus infection.

The data suggested a strong association, especially among children, Craig said.

Type 1 diabetes is caused by a combination of genetic factors, the immune system and environmental factors, the researchers explained. And enteroviruses are common viruses in infants and children. Enteroviruses can cause cold or flu symptoms, fever, muscle aches, rash or even meningitis, they noted.

Recently, there has been a worldwide increase in the incidence of childhood type 1 diabetes, especially in children under 5, which could be partially because of more exposure to these viruses, the researchers suggested.

Dr. Didier Hober, a professor of virology at University Lille in France and author of an accompanying journal editorial, said "the increased incidence rate of type 1 diabetes can be explained by a role of environmental factors, especially enteroviruses, like coxsackievirus B."

However, it is unclear whether enteroviruses are involved in all patients or just some, he added. "Enteroviruses could act as inducers of the disease or as accelerators of the progression of the disease. A persistent infection or consecutive infections could play a role," he said.

"The relationship between enteroviruses and type 1 diabetes opens up the possibility of developing new preventive and therapeutic strategies to fight the disease," Hober said.

Another expert, Dr. Joel Zonszein, a professor of clinical medicine at the Albert Einstein College of Medicine's Clinical Diabetes Center at Montefiore Medical Center in New York City, said for 40 to 50 years it has been proposed that these viruses may trigger type 1 diabetes.

"There is an association," he said. "It doesn't show a cause-and-effect; it shows an association. Maybe patients with type 1 diabetes are more susceptible to get these enteroviruses."

"It's a good reminder that we don't know the causes of type 1 diabetes," he added.

Type 1 diabetes occurs when the body cannot produce insulin, which is essential in metabolizing sugar. The resulting extra sugar in the blood can cause serious complications, such as heart disease, kidney disease, loss of sight or limbs and an early death. The condition is controlled with doses of insulin and a diet that keep blood sugar levels in normal ranges.

In Type 2 diabetes, which is far more common, the body produces insulin but doesn't utilize it properly. Unlike type 1 diabetes, type 2 is linked to overeating and under-exercising.

More information

For more on type 1 diabetes, visit the U.S. National Library of Medicine. 

Wednesday, February 2, 2011 

Why Folic Acid May Prevent a First Heart Attack, but Not a Second


Wednesday, February 2, 2011

ScienceDaily (Feb. 2, 2011) — A perplexing medical paradox now has an explanation according to research undertaken at Barts and The London School of Medicine and Dentistry and published in the current issue of the Public Library of Science. The paradox is that taking folic acid, a B vitamin, lowers homocysteine in the blood which, epidemiological evidence indicates, should lower the risk of heart attack, but clinical trials of folic acid have not shown the expected benefit.

The explanation is surprisingly simple; lowering homocysteine prevents platelets sticking, which stops blood clots…something aspirin also does, so if people in the trials were already taking aspirin there would be no extra benefit in lowering homocysteine with folic acid. Aspirin was in fact widely used by participants in the trials because they were mainly conducted in patients who had already had a heart attack or other cardiovascular diseases.

Research led by Dr David Wald at the Wolfson Institute of Preventive Medicine at Barts and The London School of Medicine and Dentistry showed that there was a difference in the reduction in heart disease events between the five trials with the lowest aspirin use (60 per cent of the participants took aspirin) and the five trials with the highest use (91 per cent took aspirin). The observed risk reduction was six per cent but it would have been 15 per cent if no one had been taking aspirin. Research was based on 75 epidemiological studies involving about 50,000 participants and clinical trials involving about 40,000 participants.

"The explanation has important implications," said Dr David Wald, the lead author of the paper. "The negative clinical trial evidence should not close the door on folic acid -- folic acid may still be of benefit in people who have not had a heart attack because they will generally not be taking aspirin." 

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

Journal Reference:

David S. Wald, Joan K. Morris, Nicholas J. Wald. Reconciling the Evidence on Serum Homocysteine and Ischaemic Heart Disease: A Meta-Analysis. PLoS ONE, 2011; 6 (2): e16473 DOI: 10.1371/journal.pone.0016473

Pregnancy high blood pressure tied to later stroke

By Leigh Krietsch Boerner

Reuters Health

Wednesday, February 2, 2011

NEW YORK (Reuters Health) – Having high blood pressure while you're pregnant may be linked to having a stroke within several years, a new study says.

This link is stronger if your baby was premature, said the study published in the journal Stroke.

"We know these women are at risk, but no one really knows if there (is) anything to do about it," said Dr. Baha Sibai, professor of obstetrics and gynecology at the University of Cincinnati College of Medicine in Ohio, and not affiliated with the study.

About one in 300 women aged 20 to 39 have strokes in the US each year, according to the American Heart Association.

The researchers found that women aged 15 to 40 had about a one in 150 chance of having a stroke within six years, if they had high blood pressure during pregnancy. If a woman had both high blood pressure and a premature delivery, this jumped to about a one in 110 chance.

There was also a one in 225 chance of having a stroke if the baby was premature, even if the mother didn't have high blood pressure while she was pregnant.

The researchers looked at two conditions that involve high blood pressure during pregnancy. One, gestational hypertension, is blood pressure greater than 140/90 after the 20th week of pregnancy, said study co-author Fung-Chang Sung, a professor of public health at the China Medical University in Taiwan.

Healthy blood pressure is 120/80 or lower, according to the National Heart Lung and Blood Institute (NHLBI).

About 20 percent of women go on to develop the second condition, preeclampsia. That life-threatening disorder involves high blood pressure during the second half of pregnancy and protein in the urine. It affects about five percent of pregnant women in the US, according to the NHLBI.

Doctors have known about the link between high blood pressure during pregnancy and stroke for about 30 years, said Sibai. These women should be followed more closely after they have their babies, to see if more attention to their health would reduce the risk of stroke later in life, he said.

What this study added was a look at the medical records of about 5800 Taiwanese women, about 1000 of whom had high blood pressure during pregnancy.

Within six years of having a baby, 21 of the women with high blood pressure had a stroke. In women who did not have high blood pressure while they were pregnant, 40 had a stroke in the same time period.

Not very many women of that age have strokes, said Dr. David Williams, an obstetric consultant at the University College London Hospital in England, and it may have been better to study older women.

"Sometime after menopause would be a good time to look at, because that's the time when risk increases," he said.

To reduce the risk of stroke, Williams suggests the usual advice of keeping fit, eat sensibly and don't smoke.

"Apart from indentifying women at an increased risk, we don't have any magic bullet" to stop this problem, he said.


Stroke, online January 13, 2011.

Roasting Coffee Beans a Dark Brown Produces Valued Antioxidants, Scientists Find


Wednesday, February 2, 2011

ScienceDaily (Feb. 2, 2011) — Food scientists at the University of British Columbia have been able to pinpoint more of the complex chemistry behind coffee's much touted antioxidant benefits, tracing valuable compounds to the roasting process.

Lead author Yazheng Liu and co-author Prof. David Kitts found that the prevailing antioxidants present in dark roasted coffee brew extracts result from the green beans being browned under high temperatures.

Their findings will appear in a forthcoming issue of Food Research International.

Liu and Kitts analyzed the complex mixture of chemical compounds produced during the bean's browning process, called the "Maillard reaction." The term refers to the work by French chemist Louis-Camille Maillard who in the 1900s looked at how heat affects the carbohydrates, sugars and proteins in food, such as when grilling steaks or toasting bread.

Antioxidants aid in removing free radicals, the end products of metabolism which have been linked to the aging process.

"Previous studies suggested that antioxidants in coffee could be traced to caffeine or the chlorogenic acid found in green coffee beans, but our results clearly show that the Maillard reaction is the main source of antioxidants," says Liu, an MSc student in the Faculty of Land and Food Systems (LFS).

"We found, for example, that coffee beans lose 90 per cent of their chlorogenic acid during the roasting process," says Kitts, LFS food science professor and director of the Food, Nutrition and Health program.

The UBC study sheds light on an area of research that has yielded largely inconsistent findings. While some scientists report increased antioxidant activity in coffee made from dark roasted beans, others found a decrease. Yet other theories insist that medium roast coffees yield the highest level of antioxidant activity.

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

Journal Reference:

Yazheng Liu, David D. Kitts. Confirmation that the Maillard reaction is the principle contributor to the antioxidant capacity of coffee brews. Food Research International, 2011; DOI: 10.1016/j.foodres.2010.12.037

Gene test may help spot lethal prostate tumors

By Julie Steenhuysen


Wednesday, February 2, 2011


CHICAGO (Reuters) – Prostate tumors with a distinctive four-gene "signature" are far more lethal than others, laying the groundwork for a test to predict which tumors need aggressive treatment, U.S. researchers said on Wednesday.

Tests of this four-gene signature method alone accurately identified 83 percent of deadly prostate tumors from tissue samples taken in a national health study.

When they combined this method with a standard test of a prostate tumor's aggressiveness, the team accurately identified more than 90 percent of tumors that later killed patients.

"This would have 92 percent accuracy relative to what we currently have, which is at best 75 percent accuracy," said Dr. Ronald DePinho of Dana-Farber's Belfer Institute for Applied Cancer Science in Massachusetts.

"There is no question this will influence the practical management of these cases," DePinho, whose study appears in the journal Nature, said in telephone interview.

He said such a test would spare many men from unnecessary treatment for cancers that might never have killed them.

"The vast majority of prostate cancers would not become life-threatening, even if left untreated. But because we can't accurately forecast which are likely to spread and which aren't, there is a tendency to unnecessarily subject many men to draconian interventions," he said in a statement.

Currently, he said, about 48 men must be treated for prostate cancer to save one life, and the main forms of prostate cancer treatment - surgery and radiation therapy - can cause impotence and incontinence.

"This will clearly shift the numbers of individuals that are treated," DePinho said.

Aggressiveness Genes 

To find genes that drive the aggressiveness of prostate tumors, DePinho said, his team "ping-ponged" between mouse and human studies.

They started out with mice that lack a working copy of the Pten gene, which is involved with cell growth. These mice develop tumors, but the tumors do not spread.

They looked to see what genes kept those tumors from spreading and found a gene known as Smad4 that acts as a brake to cancer growth.

Blocking this gene in mice that also lacked a working copy of Pten appeared to flip a growth switch. Mice without working copies of both genes developed fast-growing tumors that spread to their lymph nodes and beyond.

Once they had narrowed down what kept the cancers from growing, DePinho's team conducted a series of experiments to find genes that were key to driving this growth. They found two: SPP1 and CyclinD1. Both genes play a role in cell division and both work closely with Smad4.

They tested this four-gene signature in human prostate tumor samples taken from the Physicians' Health Study, a 30-year study of U.S. physicians.

They found this four-gene signature was more accurate in predicting the ultimate course of the illness than a conventional test called a Gleason score, in which tumor cells are examined under a microscope.

DePinho said the results will make a big impact on how men are tested and treated for prostate cancer, the second most common cancer in men worldwide after lung cancer, killing 254,000 a year.

Dana-Farber has licensed the technology to Metamark Genetics Inc, a Massachusetts-based company that will commercialize the test.

"The goal is to do this within about a year or maybe a bit longer than that," said DePinho, who has a stake in the company.

On Tuesday, a team at the U.S. national Institutes of Health identified a compound that tumors make when they are most likely to spread and they hope to make a similar test.


Nature, February 2, 2011

U.S. "stroke belt" also hit by heart failure

By Amy Norton

Reuters Health

Wednesday, February 2, 2011

NEW YORK (Reuters Health) – People who live in the southeastern U.S., already dubbed the nation's "stroke belt," may have a higher-than-average rate of death from heart failure as well, a new study finds.

Researchers found that across the six contiguous southeastern states -- Alabama, Arkansas, Georgia, Louisiana, Mississippi and Oklahoma -- the rate of death from heart failure was 31 per 100,000 people.

That was 69 percent higher than the national average of 18 heart-failure deaths per 100,000 people, the researchers report in the American Journal of Cardiology. And the regional disparity was seen among both whites and African Americans.

The southeastern U.S. has long been known as the nation's "stroke belt" because stroke death rates are about 50 percent higher there compared with the rest of the country.

But the current study appears to be the first to I.D. the southeast as the nation's "heart failure belt," according to Marjan Mujib and colleagues at the University of Alabama at Birmingham.

Heart failure is a chronic condition in which the heart gradually loses its ability to efficiently pump blood to the body -- causing symptoms like breathlessness, fatigue and fluid build-up in the limbs. It arises from underlying conditions that damage the heart -- most often clogged arteries, a heart attack or uncontrolled high blood pressure.

Heart failure and stroke share some risk factors, including clogged arteries, high blood pressure and diabetes. But they are also two very distinct conditions, so the researchers were not sure what kind of geographical pattern they would find going into this study, said senior investigator Dr. Ali Ahmed.

Zeroing in on the southeast as the heart failure belt is a first step toward finding ways to change that pattern, according to Ahmed.

In an email, he pointed to ongoing research looking at the underlying reasons for the stroke belt. So far, researchers have found that "traditional" risk factors for stroke -- like high blood pressure, diabetes and African-American race -- seem to explain only half of the excess risk of stroke death in the southeast.

So now they're looking at non-traditional factors, like education and income, environmental exposures and specific diet habits.

One recent finding, Ahmed said, is that certain diet patterns in the southeast -- like a high intake of fried fish -- might help explain the higher death rate from stroke.

As for heart failure, Ahmed said, the higher death rate could either mean that people in the southeast are more likely to develop heart failure than other Americans are, or that when they do they are more likely to die from it. Or it could be both.

It could be that higher rates of clogged arteries, high blood pressure and diabetes explain the heart failure belt, according to Ahmed. It could also be that people in the southeast are more likely to progress to severe heart failure, possibly related to differences in the quality of their healthcare.

More research, Ahmed's team says, is needed to weed out the reasons for their findings.


American Journal of Cardiology, online January 19, 2011.

Better Nutrition Seems to Help Preemies With Lung Disease

HealthDay News

Wednesday, February 2, 2011

WEDNESDAY, Feb. 2 (HealthDay News) -- Better nutrition and greater weight gain may help improve lung function in premature babies with a lung disease called bronchopulmonary dysplasia, finds a small new study.

The study included 18 premature infants (born before 37 weeks of gestation) with a history of moderate-to-severe bronchopulmonary dysplasia. The condition typically develops in children who are born preterm and need prolonged ventilation or oxygen therapy after birth.

After nearly one year of follow-up, the 18 infants showed little overall improvement in average airflow and lung volume. However, the nine infants who had above-average weight gain during their first year showed the most improvement, although it didn't match the airflow and lung volume of full-term infants, according to the University of Michigan Health System researchers.

"Consistent with animal studies that show the harmful effects of malnutrition on lung development, we showed improvements in lung function, such as forced vital [air] capacity and total lung capacity, in infants with above-average body growth," lead author Dr. Amy G. Filbrun, an assistant professor of pediatrics and communicable diseases and director of the University of Michigan Apnea and Bronchopulmonary Dysplasia Program, said in a university news release.

The study was released online in advance of publication in an upcoming print edition of the journal Pediatric Pulmonology.

Malnutrition and poor growth are common among infants with bronchopulmonary dysplasia. The study authors said further research is needed to examine how different feeding regimens affect lung growth.

More information

The U.S. National Heart, Lung, and Blood Institute has more about bronchopulmonary dysplasia.

Some vaccines tied to lower kids' leukemia risk

By Genevra Pittman


Wednesday, February 2, 2011 

NEW YORK (Reuters Health) – Kids who have had certain vaccines might be less likely to develop cancer, especially one type of leukemia, suggests a new study.

The findings, published in The Journal of Pediatrics, showed that kids born in counties where most children had been vaccinated for hepatitis B had about 20 percent lower odds of all types of childhood cancers than those born in counties where fewer were vaccinated.

Those born in counties with high use both of polio vaccines and of a vaccine series that included hepatitis B and polio, among other diseases, had 30 to 40 percent lower odds of getting acute lymphoblastic leukemia, a cancer that affects the white blood cells.

But despite the apparent relationship, which should become more clear with future research, "we don't think it's the end all be all," said Dr. Michael Scheurer, one of the study's authors from the Baylor College of Medicine in Houston, Texas. It's not "get your kids vaccinated and they won't get cancer."

Previous studies of the subject have shown mixed results. According to one theory, some common infections may increase a child's risk of leukemia, or blood cancer, because of the effect they have on the developing immune system.

Vaccinations, theoretically, should then cut down on that cancer risk - unless the vaccine itself closely enough mimics a natural infection.

According the National Cancer Institute, more than 10,000 kids are diagnosed with cancer each year. The most common childhood cancers are leukemia and brain and spinal cord cancers.

Childhood cancers "are so rare," Scheurer told Reuters Health. "But when they do happen, it's a really devastating event."

Scheurer and his colleagues wanted to see if kids born in areas of Texas where most children were vaccinated according to standard procedures were more or less likely to get cancer than those born in areas with lower vaccination rates. Using data on all cancer diagnoses in the state, they identified 2,800 cases of childhood cancer diagnosed in 1995-2006 among kids born in Texas.

The authors focused on kids who were diagnosed when they were at least 2 years old, as vaccinations have generally been completed by then.

For each child who had been diagnosed with cancer, the researchers found four others of the same age and gender who had not. Then, they compared how many of the kids with and without cancer had been born in counties with high vaccination rates.

While the authors did not have data on which individual children had been vaccinated, kids living in areas with high vaccination rates are generally considered safe from infection because of "herd immunity" - the idea that infection can't spread when only a few are susceptible.

According to Scheurer, the strongest finding was a decreased risk of leukemia in areas with high vaccination rates for hepatitis B and polio - which is also where most of the previous childhood cancer research has shown a benefit for vaccination.

This particular study is timely, Scheurer said, because it coincides with recent news that British researcher Andrew Wakefield faked some of the scientific evidence that supposedly showed a link between vaccines and autism (see Reuters story of January 6, 2011).

After that, "people can take a step back and really look at the benefit that vaccines provide," Scheurer said, "not just for the infectious diseases that they were intended to prevent. Now, there appears to be some other added benefit" to vaccines.


 The Journal of Pediatrics, online January 13, 2011.

If Mom Had a Stroke, Daughter May Be Prone to Heart Attack

By Kathleen Doheny
HealthDay Reporter

HealthDay News

Wednesday, February 2, 2011

WEDNESDAY, Feb. 2 (HealthDay News) -- A mother's history of stroke can help predict a daughter's chances of not only having a stroke but also her chances of having a heart attack, new research shows.

"Our new study shows that stroke in mothers is associated with heart attacks in daughters," said Dr. Amitava Banerjee, a clinical research associate at the Stroke Prevention Research Unit at the University of Oxford, in England.

In other words, a stroke in mothers or other first-degree relatives can help identify women at increased risk for heart attacks -- even if their mother has not had a heart attack.

The research, published in Circulation: Cardiovascular Genetics, shows an association, but a cause-and-effect relationship has yet to be determined, Banerjee said.

Putting the research in perspective, he said: "We know that, in men and women, stroke or heart attack in the parents increases the risk of heart attack. Previous studies have not looked at these issues by sex of the parent or sex of the patient and have not looked in a 'prospective' way -- that is, they have not followed up a population over time."

In the new study, Banerjee and his colleagues evaluated 2,210 men and women who had either heart attacks or other coronary syndromes or strokes. Complete family histories were not available for all of them. But the researchers found that more than 24 percent of those who'd had heart attacks and angina -- and about the same percentage of patients who had had strokes or transient ischemic attacks (called TIAs, or mini-strokes) -- had a history of stroke in one or more first-degree relatives, such as their parents or siblings.

This indicates that stroke history in parents and siblings is as important to a person's risk for a heart attack as it is to stroke risk, according to Banerjee.

Maternal stroke was more common than paternal stroke history in women with heart attacks or unstable angina. Women heart patients were more than twice as likely to have a mother who'd had a stroke than a father who did. The same link was not found in men with heart problems, however.

Exactly why mothers' history of stroke seems to play a role in their daughters' heart attacks is not known. Banerjee said it's not possible to say whether environment or genes are playing the larger role in the mother-daughter association.

The link found between a mother's stroke history and a daughter's heart attack and stroke held even if the mother had only a stroke, with no heart attack history, Banerjee said.

Dr. Tatjana Rundek, an associate professor of neurology, epidemiology and public health at the University of Miami Miller School of Medicine, said that the association between maternal stroke and a daughter's heart attack is relatively new but that it ties in with other research, including her own, that examines sex differences in cardiovascular risk.

In her own recent study, Rundek said, she found that genetic variations in genes involved in fat metabolism may have gender-dependent effects on plaque in arteries.

Research also has found that women have more systemic inflammation, she said. Inflammation is linked with buildup of fatty deposits in arteries.

What the new findings mean for women whose mothers had a stroke, Rundek said, is the need to "understand your own personal risk of stroke or heart attack." Be sure you know your numbers -- blood pressure, blood glucose and cholesterol levels, she said, and change behaviors to improve the numbers if need be.

Banerjee added that "women whose mothers have had stroke -- particularly before the age of 65 -- should have their blood pressure and cholesterol checked, and think about lifestyle factors such as smoking more than women without family history of stroke."

More information

The American Stroke Association has more about risk factors for stroke.

Tuesday, February 1, 2011

Half of Adults Have Hypertension or High Cholesterol: CDC

By Amanda Gardner
HealthDay Reporter
HealthDay News

Tuesday, February 1, 2011

TUESDAY, Feb. 1 (HealthDay News) -- Despite some improvements, far too many Americans have out-of-control blood pressure and cholesterol levels -- both primary risk factors for heart disease, federal health officials warn.

According to the latest report from the U.S. Centers for Disease Control and Prevention, one-third of U.S. adults have hypertension (high blood pressure), about the same proportion as 10 years ago.

Perhaps more distressing, only 46 percent had the condition controlled, despite the fact that the majority have some form of health insurance -- meaning they could be accessing care -- and 70 percent were actually being treated with blood pressure-lowering drugs.

The CDC reported similar numbers for cholesterol -- one in three U.S. adults have high "bad" cholesterol, but only one-third of them have their cholesterol under control. Only 48 percent are actually treated for the condition. Again, the majority of those affected had health insurance, either public or private.

Together, said CDC director Dr. Thomas R. Frieden, "100 million U.S. adults -- or nearly half of all adults in the U.S. -- have either high blood pressure or high cholesterol."

"Heart disease is the leading killer in America, and high blood pressure and high cholesterol are out of control for most Americans who have these conditions," continued Frieden, who spoke at a Tuesday news conference. "Although there has been progress in the past decade, it hasn't been nearly enough."

Heart disease and stroke cost the country nearly $300 billion a year in direct medical costs alone, he said, costs that are projected to triple by 2030.

Dr. Howard Weintraub, clinical director of the Center for the Prevention of Cardiovascular Disease at NYU Langone Medical Center in New York City, attributes part of the problem to "therapeutic inertia," where physicians aren't adequately motivated to treat the patient, either out of fear that medication could harm the patient or because they're not familiar with the degree of benefit of the medications.

And, in some cases, effective treatment can even be counterproductive because some people think cholesterol levels lowered by statins are "a credit card [that means they can] eat indiscriminately," he said.

According to two reports published in the Feb. 1 issue of the Morbidity and Mortality Weekly Report that analyzed data from the massive National Health and Nutrition Examination Survey (NHANES), control rates for high blood pressure and high cholesterol were especially low among Mexican Americans and people with low incomes.

Not surprisingly, blood pressure and cholesterol levels were also less well controlled among individuals who did not have health insurance.

"Having insurance is necessary but not sufficient to have these conditions controlled," Frieden said. "How likely they are to have this under-controlled is determined by the system they're cared for [rather] than by their personal characteristics, if they have coverage."

The Affordable Care Act offers free screenings for both blood pressure and cholesterol. Meanwhile, certain health care systems have managed to improve blood pressure control, and these systems might be models to emulate, he noted.

Other initiatives, such as the U.S. Department of Agriculture dietary guidelines released Monday and movements to reduce salt and trans fat intake should also help, he said.

The CDC's just-released "Vital Signs" report on hypertension and high cholesterol urges a comprehensive approach that involves improved access to care, better preventive care and better patient adherence. The agency is also working on initiatives to promote staying active, eating well and maintaining a healthy weight.

"The leading preventable cause and leading cause of death is cardiovascular disease, and the leading causes of that include high blood pressure and high cholesterol," Frieden concluded. "Although there has been progress in recent years, it's far too little, and still most Americans with these conditions don't have them under control."

More information

The American Heart Association has a tool to help gauge your risk of heart disease.

Study finds way to predict when cancer will spread

By Maggie Fox

Health and Science Editor


Tuesday, February 1, 2011

WASHINGTON (Reuters) – Researchers have found a compound that tumors make when they are likely to spread, and said they hope to use to it predict which patients are most at risk of dying from their cancers.

And experiments in mice show there may be a way to block the protein, preventing cancer from spreading and becoming deadly.

The findings, published in the Journal of Clinical Investigation, are at a very early stage. But a team at the National Institutes of Health, the University of Hong Kong and elsewhere said on Tuesday they will work to develop both a test and, perhaps, a treatment.

The protein is called CPE-delta N and ordinarily plays a role in processing insulin and other hormones.

"This form is present in large amounts in primary tumors that have spread or metastasized," said Y. Peng Loh of the NIH's National Institute of Child Health and Human Development.

"As everyone knows, cancer cells break away from the primary tumor, pass through surrounding tissues into lymph and blood vessels and these cancer cells then travel through the body and form tumors elsewhere."

This spread of tumors usually kills cancer patients. Early stage cancers that can be completely removed or destroyed usually do not kill the patient.

Loh's team described a series of experiments involving patients with liver cancer, a rare adrenal cancer, colon cancer and other types of cancer.

They tested the tumors of 18 patients with stage 2 liver cancer, which has spread but only within the liver.

"These patients would normally be told by their physicians that the cancer not likely to recur," Loh told reporters in a telephone briefing. They would not get chemotherapy after surgery.

Thirteen of the patients had low levels of CPE-delta N, and 10 of them were still cancer-free three years after surgery. However, three with low CPE-delta N levels did have their cancer come back, giving the test a 77 percent accuracy level in clearing patients.

Five of the original 18 had high levels of CPE-delta N and four of them did have their cancer come back, Loh said -- a 90 percent accuracy rate.

Extra Treatment

Ideally, if the results are confirmed, patients with high CPE-delta N levels could get extra chemotherapy or radiation to control the risk of spread, Loh said.

Other tests showed similar results, the researchers said, notably in 14 patients with pheochromocytoma, a rare tumor of the adrenal glands, and paraganglioma, another rare tumor. Both mostly affect children and adolescents.

"Testing for CPE-delta N, if combined with existing diagnostic methods, offers the possibility of more accurately estimating the chances that a cancer will spread," said NICHD director Dr. Alan Guttmacher.

The researchers also suppressed CPE-delta N in mice using an experimental approach called antisense and found tumors implanted into the animals did not spread. Antisense is a way to block the activity of genes.

"This offers the potential for developing a cure for certain types of cancers using antisense to CPE-delta N," Loh said.

Loh said her team is also studying how the CPE-delta N gene gets activated in tumors in the first place.

"If we can find out what will shut it down we might be able to find some small molecule that might shut down this gene in some other way besides antisense," she said. Small molecules can usually be made into drugs that can be taken as pills and would be far easier to develop into treatments than antisense.

(Editing by Eric Walsh)

Finland: link between swine flu shot, narcolepsy

By Matti Huuhtanen

Associated Press

The Associated Press

Tuesday, February 1, 2011

HELSINKI – Finnish researchers have found an increased risk of narcolepsy among 4 to 19-year-olds who were given swine flu shots, a government health agency said Tuesday.

A preliminary study by the National Narcolepsy Task Force indicates that children vaccinated with Pandemrix "contributed to the observed increase in incidence of narcolepsy" compared to those who were not vaccinated in the same age group, it said.

The agency said, however, that the increase likely was caused "by joint effect of the vaccine and some other factor," and added that it would have to conduct more research as similar increases in narcolepsy cases have not been reported in other countries using the vaccine.

Pandemrix shots were made for the swine flu pandemic, and it is not clear how many people would still be receiving them since the usual flu shot now includes the swine flu strain. In Finland, health personnel stopped administering Pandemrix in August 2010 when concerns were first voiced about the vaccine.

Narcolepsy is a rare disorder that causes people to suddenly fall asleep. It is seldom fatal.

The National Institute for Health and Welfare, which published the findings, said that 60 children and adolescents contracted narcolepsy in Finland in 2009 and 2010. Fifty-two of them — or almost 90 percent — had received the Pandemrix vaccine, it added.

It's not clear how many in the young age group were vaccinated with Pandemrix but half of Finland's 5.3 million population were given the shot during the winter of 2009 to 2010.

"Based on the preliminary analyses, the risk of falling ill with narcolepsy among those vaccinated in the 4-19 years age group was nine-fold in comparison to those unvaccinated in the same age group," the study said.

It found that the biggest increase was among those aged 5 to 15 years. No cases were seen among those under age 4 or over age 19.

The European Medicines Agency, the regulatory body responsible for authorizing use of the vaccine, launched an investigation into a possible link between the swine flu vaccine and narcolepsy in August.

GlaxoSmithKline PLC, which produces Pandemrix, said it was aware of the Finnish report.

"This investigation is independent of a broader ongoing European Medicines Agency investigation initiated in 2010," the company said in a statement. "GlaxoSmithKline is reviewing the report and believes it would be premature to draw any conclusions on a potential association between Pandemrix and narcolepsy until this European investigation has been completed."

The company said that more than 31 million doses of Pandemrix had been administered in 47 countries with 162 cases of narcolepsy reported in people who were vaccinated. Some 70 percent of the cases originated in Finland and Sweden, it said.

The World Health Organization welcomed the report but said it does not recommend any changes to use of Pandemrix and that the vaccine remains on the list of recommended vaccines.

The European Medicines Agency also said that it would not change its assessment of the benefit-risk relating to use of the vaccine.

The Finnish institute said the association between narcolepsy and the Pandemrix vaccine needs more investigation with special attention on "infections and other stimuli in close time association with the pandemic vaccination."

The agency said its final report would be published in August.


National Institute for Health and Welfare:

U.S. health system not helping heart disease: CDC

By Maggie Fox

Health and Science Editor


Tuesday, February 1, 2011

WASHINGTON (Reuters) – Most Americans with the biggest risks for heart disease are not doing enough to control these risks, and the fragmented U.S. healthcare system is partly to blame, federal health officials said on Tuesday.

Two-thirds of adults with high cholesterol and half with high blood pressure are not being treated effectively, the Centers for Disease Control and Prevention said.

While people without health insurance are the least likely to have blood pressure or cholesterol under control, even those with good health insurance are not doing everything they can, the CDC report found.

"Although we're making some progress, the United States is failing to prevent the leading cause of death -- cardiovascular disease -- despite the existence of low-cost, highly effective treatments," said CDC director Dr. Thomas Frieden.

He said 100 million adults -- nearly half the U.S. adult population -- have either high blood pressure or unhealthy cholesterol levels.

"In fact, more than 80 percent of people who have out-of-control blood pressure or out-of-control cholesterol do have public or private health insurance," Frieden told reporters in a telephone briefing.

Heart disease is the No. 1 killer of people in most developed countries. Diet and exercise can prevent heart disease and dozens of drugs are on the market to control the two most common causes -- high blood pressure and unhealthy cholesterol levels.

But the CDC report, based on the most recent available survey data, finds that one-third of adults have high blood pressure, a third of them do not get treated for it and half do not have it fully under control.

The figures are worse for unhealthy cholesterol levels. A third of U.S. adults have poor cholesterol readings, half of them are not treated for it and two-thirds do not have their cholesterol fully controlled.

The CDC said a more comprehensive approach is needed "that involves policy and system changes" that help more people get healthcare and to ensure that doctors, nurses and pharmacists work with each other and with patients.

Frieden praised initiatives like Wal-Mart Stores Inc's announcement last month that it would promote and cut prices on healthier food at its stores.

The CDC said the healthcare reform law now under fire in Congress can help, by requiring health insurers to fully pay for blood pressure and cholesterol screenings and by encouraging the use of electronic medical records.

On Monday, a federal judge in Florida said the law was unconstitutional. The U.S. Supreme Court is likely to have to decide on the fate of the law.

Republicans say they want to repeal and replace it, while most Democrats say it would be more effective to improve existing provisions.

Last month, the American Heart Association projected that the costs of heart disease in the United States would triple between now and 2030, to more than $800 billion a year.

It said treating high blood pressure would be the most expensive part of the cost, rising to $389 billion by 2030.

(Editing by Mohammad Zargham)

Kids gain extra pounds after tonsil surgery

By Frederik Joelving

Reuters Health

Tuesday, February 1, 2011 

NEW YORK (Reuters Health) – Some kids pack on extra weight when their tonsils are removed, U.S. researchers conclude in a review of earlier studies.

The possibility that the surgery -- performed on more than half a million American children every year -- might be contributing to the current obesity epidemic is "alarming," they write in the journal Otolaryngology - Head and Neck Surgery.

"For some patients this surgery might be considered more of a risk than a benefit," said Dr. Anita Jeyakumar, an ear, nose and throat specialist at Saint Louis University in Missouri, who worked on the review.

"Every patient needs to be evaluated as an individual to find out whether the risks outweigh the benefit," she told Reuters Health.

Tonsillectomy, as the procedure is called, is the most common type of major surgery done in kids. Still, with the increasing use of antibiotics to treat the condition, surgeons are doing fewer tonsillectomies than they did 40 years ago.

The procedure is covered by Medicare up to a few hundred dollars. It helps children with breathing trouble that disturbs their sleep, and is a last resort for those who suffer from repeated inflammation of the tonsils, the oval-shaped clumps of tissue at the back of the throat.

Jeyakumar and her colleagues found nine studies that used different methods to look at weight gain after tonsillectomy, with a total of nearly 800 children included.

More than half of the children gained weight, she told Reuters Health. Three of the studies looked at body mass index (BMI), a measure of weight in relation to height, which climbed five to eight percent after the surgery. The others, despite using different weight-scoring methods, showed similar findings -- with several kids crossing the line from normal weight to overweight, and from overweight to obese.

According to the Centers for Disease Control and Prevention, 17 percent of American youths are obese, putting them at higher risk for heart disease, stroke and other disease later in life.

Exactly why this is happening isn't clear, although it may be that kids whose tonsils are often inflamed simply eat less than others -- and tonsillectomy makes them eat like other kids again.

There are alternatives to tonsillectomy -- including antibiotics for tonsillitis and ventilation devices for breathing trouble. But Jeyakumar said the latter usually don't work very well for kids.

Families of kids who already have weight problems may want to think twice about tonsillectomy, she said. And obese kids should consider starting a weight-loss program before surgery to head-off further weight gain afterward.

"It should be part of the discussion with the child and the parents," she said.


Otolaryngology - Head and Neck Surgery, online February 1, 2011.

Monday, January 31, 2011

Hormone Therapy Begun at Menopause May Pose Risk for Breast Cancer


Monday, January 31, 2011

ScienceDaily (Jan. 31, 2011) — Starting hormone therapy at around the time of menopause is associated with a greater risk of breast cancer compared to starting after a longer gap, according to a study published online Jan. 28 in The Journal of the National Cancer Institute. In this large, prospectively followed cohort of women, those who started hormone therapy five years or more after menopause had little or no increased risk, regardless of the type of hormone therapy used, how long they used it, and whether they were overweight or obese.

Many studies have established that breast cancer incidence increases in users of hormonal therapy, in particular among women who use an estrogen-progestin combination as opposed to estrogen-alone. Few studies have looked at the timing of hormone therapy as a risk factor, although two previous studies suggested the interval between menopause and initiating hormone therapy may influence breast cancer risk.

To investigate this question, Valerie Beral, FRS, of Oxford University and colleagues, used data from the Million Women Study (MWS) in the UK. The researchers estimated the adjusted relative risks of breast cancer in hormone therapy users and past users compared to non-users in 1.13 million women in the study. They also compared women on different types of hormone therapy.

They found that women starting hormone therapy at the time of menopause were at greater risk of breast cancer than those starting it later. They write, "A new finding of this study, which has been little investigated previously, is that the interval between menopause and starting hormonal therapy has a substantial effect on breast cancer risk."

Two previous studies have suggested this association but only in certain subgroups. "In this large study, we found greater risks of breast cancer if hormonal therapy use began either before or soon after menopause than after a longer gap; and this pattern of risk was seen across different types of hormonal therapy, among women who used hormonal therapy for either short of long durations, and also in lean and in overweight and obese women."

In an accompanying editorial, Rowan T. Chlebowski, M.D., Ph.D., of Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center and Garnet Anderson from the Fred Hutchinson Cancer Research Center note the study provides substantial support for similar findings from the Women's Health Initiative (WHI) in the U.S. They add that the similarities between the patterns of breast cancer risk in these two large studies increase the likely validity of the results, especially since the methodologies of the two studies were quite different.

The editorialists also discuss discrepancies in the two studies' findings regarding the risk of estrogen-only hormone therapy; the WHI found little risk associated with estrogen alone while the MWS found a statistically significant increased risk, except in overweight and obese women. They conclude that "the question of the effect of estrogen-only formulation use on breast cancer risk in postmenopausal women, even with longer-term hormone use, still stands unanswered."

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

Journal Reference:

V. Beral, G. Reeves, D. Bull, J. Green. Breast Cancer Risk in Relation to the Interval Between Menopause and Starting Hormone Therapy. JNCI Journal of the National Cancer Institute, 2011; DOI: 10.1093/jnci/djq527

New diet guidelines say eat more fruit, less salt

By Emily Stephenson


Monday, January 31, 2011

WASHINGTON (Reuters) – Americans need to cut salt and fat and eat more fruits and vegetables, the Obama administration said in its latest set of dietary guidelines released on Monday.

The new dietary guidelines also advise cutting out sugary drinks and drinking water instead, and eating less overall.

Secretary of Agriculture Tom Vilsack released the guidelines, saying Americans are too fat. More than one-third of children and two-thirds of adults in the United States are overweight or obese.

"The bottom line is that most Americans need to trim our waistlines to reduce the risk of developing diet-related chronic disease," Vilsack said.

The guidelines are available to consumers but are primarily used as the basis of nutrition education programs, school meals and Meals on Wheels for seniors, and to inform advice provided by doctors and nurses, said Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest.

The Agriculture Department earlier this month issued a proposed rule that would require school lunch and breakfast programs to offer more leafy green and orange vegetables, limit starchy vegetables such as potatoes and corn to one cup per week, and gradually reduce the amount of sodium in meals.

Jean Daniel of the Food and Nutrition Service said the rule was developed separately from the dietary guidelines but that the two are mostly in sync. She said the changes likely will not take effect until the 2012-13 school year.

Consumer groups said the guidelines are more understandable this time around and praised the administration for suggesting specific food choices people should change.

"It's important to have guidelines that will help us deal with that issue of obesity," Vilsack said.

The guidelines include 23 key recommendations for the general public and six for specific groups such as pregnant women. General recommendations include avoiding oversized portions and balancing calorie reduction with exercise.

Some of the tips:

  • Enjoy your food but eat less.
  • Avoid oversized portions.
  • Make half your plate fruits and vegetables.
  • Switch to fat-free or low-fat (1 percent) milk.
  • Compare sodium in foods like soup, bread and frozen meals and choose the foods with lower numbers.
  • Drink water instead of sugary drinks.

Dr. Neal Barnard, president of the pro-vegetarian Physicians' Committee for Responsible Medicine, said this report is the boldest yet in addressing salt intake -- it tells about half the U.S. population to eat less than 1,500 mg per day -- and promoting vegetarian diets.

But he said the guidelines fall short by suggesting people reduce cholesterol and saturated fat instead of warning them away from foods that contain them.

Representatives of the National Cattlemen's Beef Association, the American Meat Institute and other groups issued statements praising the guidelines for including meat and poultry as components of a balanced diet.

Other food makers and sellers -- including grocers and food and drink makers, who last week announced a new system of displaying nutrition information -- issued statements in support of the new guidelines.

The Agriculture Department guidelines are available at

(Reporting by Emily Stephenson and Lisa Baertlein; Editing by Maggie Fox, Jackie Frank and Bill Trott)

Scientists Grow Arteries With High Level of Elastic Protein: Big Step for Living Vascular Grafts


Monday, January 31, 2011

ScienceDaily (Jan. 31, 2011) — University of Pittsburgh researchers have grown arteries that exhibit the elasticity of natural blood vessels at the highest levels reported, a development that could overcome a major barrier to creating living-tissue replacements for damaged arteries, the team reports in the Proceedings of the National Academy of Sciences.

The team used smooth muscle cells from adult baboons to produce the first arteries grown outside the body that contain a substantial amount of the pliant protein elastin, which allows vessels to expand and retract in response to blood flow. Lead researcher Yadong Wang, a professor of bioengineering in Pitt's Swanson School of Engineering, his postdoctoral researcher Kee-Won Lee, and Donna Stolz, a professor of cell biology and physiology in Pitt's School of Medicine, cultured the baboon cells in a nutrient-rich solution to bear arteries with approximately 20 percent as much elastin as an inborn artery.

The Pitt process is notable for its simplicity, Wang said. Elastin -- unlike its tougher counterpart collagen that gives vessels their strength and shape -- has been notoriously difficult to reproduce. The only successful methods have involved altering cell genes with a virus; rolling cell sheets into tubes; or culturing elastin with large amounts of transforming growth factor, Wang said. And still these previous projects did not report a comparison of elastin content with natural vessels.

Wang and his colleagues had strong, functional arteries in three weeks. The team first seeded smooth-muscle cells from 4-year-old baboons -- equivalent to 20-year-old humans -- into degradable rubber tubes chambered like honey combs. They then transferred the tubes to a bioreactor that pumped the nutrient solution through the tube under conditions mimicking the human circulatory system -- the pump produced a regular pulse, and the fluid was kept at 98.6 degrees Fahrenheit. As the muscle cells grew, they produced proteins that fused to form the vessel.

Mechanical tests revealed that the cultured artery could withstand a burst pressure between 200 and 300 millimeters of mercury (mmHg), the standard unit for blood pressure, Wang said; healthy human blood pressure is below 120 mmHg. In addition to containing elastin, the artery also had approximately 10 percent of the collagen found in a natural vessel, Wang said.

The process the Pitt team used to cultivate the artery resembles how it would be used in a patient, he explained. The cell-seeded tube would be grafted onto an existing artery. As the rubber tube degrades, the vascular graft would develop into a completely biological vessel.

The next steps in the project, Wang said, are to design a vessel that fully mimics the three-layer structure of a human artery and to prepare for surgical trials.

The project received support from the National Heart, Lung, and Blood Institute of 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.

Journal Reference:

Kee-Won Lee, Donna B. Stolz and Yadong Wang. Substantial expression of mature elastin in arterial constructs. PNAS, January 31, 2011 DOI: 10.1073/pnas.1017834108

Diabetes in pregnancy a risk for mom years later

By Lauran Neergaard

AP Medical Writer

The Associated Press

Monday, January 31, 2011

WASHINGTON – A type of diabetes that strikes during pregnancy may disappear at birth, but it remains a big red flag for moms' future health — one that too many seem to be missing.

Roughly half of women who've had gestational diabetes — the pregnancy kind — go on to develop full-fledged Type 2 diabetes in the months to years after their child's birth.

Yet new research shows fewer than one in five of those women returns for a crucial diabetes test within six months of delivery. That's the first of the checkups they're supposed to have every few years to guard against diabetes' return, but no one knows how many do.

The research, by testing-lab giant Quest Diagnostics, is sobering because if they only knew, many of these new mothers could take steps to reduce their chances of later-in-life diabetes that can bring with it such complications as heart disease and kidney damage.

"It's almost as if you got a preview ... a window to the future," says Dr. Ann Albright, a diabetes specialist with the Centers for Disease Control and Prevention. "This is a population that really should be targeted for intervention."

And more mothers-to-be soon may join the ranks. The American Diabetes Association is recommending a change in how pregnant women are tested that will identify more mild cases than today, based on some recent studies that found treating even those mothers leads to easier deliveries. If obstetricians eventually sign on, it has the potential to double diagnoses — although most mild cases would need only better nutrition and exercise, not diabetes medications, the association cautions.

New CDC estimates show nearly 26 million Americans have some form of diabetes, the vast majority of them the Type 2 kind that's linked to being overweight. Tens of millions more have high enough blood sugar to be classified as pre-diabetic.

Women can have either Type 2 diabetes or the insulin-dependent Type 1 variety at the time they become pregnant. That's a separate issue, and those women are urged to have their diabetes tightly controlled to avoid a range of risks to baby and mother.

But according to the CDC, somewhere between 2 percent and 10 percent of pregnant women develop diabetes for the first time during pregnancy, the gestational type. If untreated, the mother's high blood sugar can make the fetus grow too large, leading to C-sections and early deliveries. It also can trigger a potentially life-threatening condition called preeclampsia. It even increases the baby's risk of becoming obese in childhood.

So medical groups urge screening of most pregnant women. They drink a sweetened liquid and then have blood tests to see how their body processes it.

But nearly a third of pregnant women aren't getting that test, according to the new Quest study, which examined the testing records of more than 900,000 pregnant women. The study, published in the journal Obstetrics and Gynecology, couldn't say why. For some, doctors may have decided they were at low risk. Others may not have followed their doctor's advice to get the test.

More worrisome: Usually, mom's blood sugar returns to normal a few weeks after the birth, but doctors make clear that patients need to be checked within six to 12 weeks to be sure. Quest tracked those patient records for a full six months, and found 19 percent had gotten that first postpartum check.

"The reality is that women get busy" with their new family, says Dr. Ellen Landsberger, obstetric diabetes director at New York's Montefiore Medical Center, whose clinic takes steps to track those patients down. "Women take care of their children more than themselves."

The CDC says women whose gestational diabetes disappears still need their blood sugar checked every one to three years, because they're at such high risk of developing Type 2 diabetes within the next decade or two.

That's because the body's underlying ability to process blood sugar is forever altered, says Dr. Carol Wysham of the American Diabetes Association, who heads the Rockwood Clinic diabetes center in Spokane, Wash.

The good news: For anyone at risk for Type 2 diabetes, losing a modest amount of weight — 5 percent to 7 percent of your starting pounds — and doing 2 1/2 hours of physical activity a week are proven to prevent or at least postpone it. Women who had gestational diabetes are no exception, making it especially important to shed those pregnancy pounds.

In New York, Rewatie Hussain had never heard of gestational diabetes before her first pregnancy. She was promptly treated, and while her son needed some extra care at birth, he left the hospital healthy.

Hussain's own blood sugar returned to normal that time, but gestational diabetes struck again with her second pregnancy. This time, she required insulin treatment. Her son was fine, but a few months after delivery, Hussain was diagnosed with Type 2 diabetes.

"It just never left," she says. She was able to drop the insulin for diet and oral medication, and "I'm still pretty OK. I just know to be careful and look out for it."

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

Super Bowl Losses Can Increase Cardiac Death, Study Finds


Monday, January 31, 2011

ScienceDaily (Jan. 31, 2011) — A new study published in the journal Clinical Cardiology reveals that a Super Bowl loss for a home team was associated with increased death rates in both men and women and in older individuals.

Sports fans may be emotionally involved in watching their favorite teams. When the team loses, it can cause some degree of emotional stress.

Led by Robert A. Kloner, MD, PhD, of the Heart Institute, Good Samarian Hospital and Keck School of Medicine at USC in Los Angeles, researchers assessed how often this emotional stress may translate to increases in cardiac death. They ran regression models for mortality rates for cardiac causes for the 1980 Los Angeles Super Bowl loss and for the 1984 Los Angeles Super Bowl win.

Results show that the Los Angeles Super Bowl loss of 1980 increased total and cardiac deaths in both men and women and triggered more death in older than younger patients. In contrast, there was a trend for a Super Bowl win to reduce death more frequently in older people and in women.

Specifically, in men there was a 15 percent increase in all circulatory deaths associated with the Super Bowl loss; in women there was a 27 percent increase in all circulatory deaths associated with the loss. Thus, unlike previous reports from some soccer games, the findings were not confined mainly to male fans, but also were seen in women. In older patients, there was a 22 percent increase in circulatory deaths associated with the Super Bowl loss.

"Physicians and patients should be aware that stressful games might elicit an emotional response that could trigger a cardiac event," Kloner notes. "Stress reduction programs or certain medications might be appropriate in individual cases.

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

Journal Reference:

Robert A. Kloner, Scott A. McDonald, Justin Leeka, W. Kenneth Poole. Role of Age, Sex, and Race on Cardiac and Total Mortality Associated With Super Bowl Wins and Losses. Clinical Cardiology, 2011; DOI: 10.1002/clc.20876

Too many narcotics prescribed after surgery: study

By Amy Norton

Reuters Health

Monday, January 31, 2011

NEW YORK (Reuters Health) – Many people who undergo urology procedures may be sent home with more narcotic painkillers than they need -- leaving home medicine cabinets filled with the potentially addictive drugs, a new study suggests.

Researchers found that of 213 patients prescribed narcotic painkillers after surgery for a urological condition, two-thirds had leftover pills a few weeks later. And most -- 91 percent -- were keeping those leftovers in their medicine cabinets.

That's a problem, the researchers say, because those pills can be abused by anyone with access to the medicine cabinet.

Prescription painkillers like oxycodone (Oxycontin) and hydrocodone (Vicodin) are second only to marijuana as Americans' illicit drugs of choice. A federal government survey found that in 2007, more than 5 million Americans age 12 or older said they had used a prescription narcotic for "non-medical" reasons in the past month.

Just over 56 percent said they got those pills from a family member or friend.

So leftovers from legitimate narcotic prescriptions could be an important source for people looking to abuse the drugs, according to Dr. Cory Bates, the lead researcher on the new study.

As it stands, doctors basically use guesswork to decide how much pain medication to prescribe for post-surgery recovery.

"Really, it's pretty arbitrary," said Bates, a urologist at the University of Utah Health Sciences Center in Salt Lake City. "Most doctors try to make an educated guess about how painful (recovery) is going to be. But it's hard, because people perceive pain differently."

Bates said he is now prescribing fewer pills to start. "What I've done is basically cut what I would normally give in half."

Some narcotic prescriptions can be refilled, so patients who need more pain relief can get additional pills, he said.

But most patients in the current study were happy with their pain relief even though the majority did not take the entire prescription. Two to four weeks after surgery, 86 percent said they were satisfied with their pain control.

The findings, published in the Journal of Urology, are based on 275 patients who underwent a urological procedure at one of three Utah hospitals. The procedures ranged from relatively minor outpatient ones -- like "shock wave" therapy to break up kidney stones -- to major open surgery for prostate or kidney removal. Roughly two to four weeks afterward, the patients completed a survey either by mail or over the telephone.

Of those 275 patients, 213 said they had filled a prescription for a narcotic painkiller.

The majority -- 63 percent -- were prescribed hydrocodone with acetaminophen (brands like Vicodin and Lortab), while 28 percent were on oxycodone with acetaminophen (Percocet, Endocet). On average, they were prescribed 22 to 29 pills.

Overall, Bates and his colleagues found, the patients reported taking only 58 percent of the medication, and 67 percent said they had leftover pills.

And most of those leftovers were lingering in people's medicine cabinets. More than 90 percent of the study patients said they had received no instruction from their doctor or pharmacist on what to do with unused pills.

A drawback of the study is that the researchers had to depend on patients' memory and trust them to report accurately.

But even so, it seems clear that leftover narcotics "(end) up just sitting in people's medicine cabinets, and that's a real danger," Bates said. He noted that anyone with access to your medicine cabinet, from your teenage child to your plumber, could easily take the medication.

In general, narcotic painkillers should either be flushed down the toilet or mixed with something unappealing -- like cat litter or coffee grounds -- and thrown away. But it gets confusing, Bates said, because the advice varies according to the specific narcotic.

Federal guidelines on safe disposal of narcotics and other drugs are available online, at .

The written information that comes with narcotic prescriptions should also give instructions on how to dispose of leftover pills. But if you're in doubt, Bates said, ask your pharmacist.

"In general," he added, "make sure you know what's in your medicine cabinet, and be aware of who has access to it. And if you have to have (narcotics) on hand, make sure they are secure."


Journal of Urology, February 2011.

Specific Populations of Gut Bacteria Linked to Fatty Liver


Monday, January 31, 2011 

ScienceDaily (Jan. 31, 2011) — The more we learn about biology, the closer we get to being able to treat disease -- and the more complicated our understanding of disease itself becomes.

A new research finding showing a strong relationship between complex microbial ecologies in human intestines and the common but serious medical condition known as fatty liver illustrates this paradox.

From past genomic studies, we have learned that a mind-boggling multitude of different kinds of benign bacteria inhabit our intestines and that these populations can vary almost infinitely from one human being to the next. We know that the kind of food we eat is important to our health and we know that having the right bacteria in our intestines is important in digesting our food properly, but we still do not know how our individual variations in gut bacteria might influence more specific health issues. In particular, we do not know how these bacteria influence how the substances we eat affect our organ systems.

In the condition known as fatty liver, fat deposits build up in the liver, with potentially serious health consequences for nearly a third of the American population. Fatty liver can be caused by alcohol abuse, obesity, hormonal changes and/or diabetes. Recent work has suggested that diet is also important with strong indications that deficiencies in the essential nutrient choline might be partially involved in some incidences of the condition. Choline deficiency also implicates genetics, since many people lack the genes to efficiently make choline internally.

Now, a new bioinformatics finding shows that the abundance or scarcity of certain types of bacteria in the gut may also help predict susceptibility to non-alcoholic fatty liver. The implication of the finding is that these groups of bacteria may be influencing the body's ability to properly use the choline available in food, though the study does not examine the specific metabolic activity of the bacteria involved.

In a metagenomic analysis of the microbial communities living in the intestinal tracts of 15 female patients participating in a study of the effects on liver condition from a choline-depleted diet, bioinformatics researchers at the University of North Carolina at Charlotte found a strong correlation between the relative abundances of two specific classes of bacteria and the development of fatty liver. A report on the finding appears in the current issue of the journal Gastroenterology.

"Certain bacterial populations correlated very strongly with increased fat in the liver during a restricted choline diet," said Melanie Spencer, a doctoral student in bioinformatics at the University of North Carolina at Charlotte and the lead author on the paper. "To us, it's an amazing result because you just don't see this clear a correlation in biological experiments in humans very often."

The authors on the paper are Spencer, Anthony Fodor, Timothy Hamp and Robert Reid from the department of bioinformatics and genomics at UNC Charlotte, as well as Steven Zeisel and Leslie Fischer from the department of nutrition at the University of North Carolina at Chapel Hill.

Using a metagenomic technique that compares versions of a ribosomal RNA gene known to vary between bacterial groups, the researchers analyzed the genomes of the patients' gut bacteria before, during and after the patients were put on a choline deficient diet. Because all patients consumed identical diets during the study, the researchers predicted that the initially distinct and complex communities of microbes in the patients' intestinal tracts would react by becoming less distinct from each other. The researchers found instead that, though each of the patients' bacterial communities did change a bit, each individual's community still remained distinctive throughout the study.

"What we expected we might find would be that when we put the patients on exactly the same diets, everyone's gut microbe mixture would begin to look similar, with the microbial communities converging. It did not happen -- everybody was clearly individual throughout the entire study," Spencer noted.

"So we also looked at how the patients' microbes actually changed in pattern, even though they remained distinct from each other," she said. "The patterns of change were very interesting. Some of the patterns were very distinct in themselves."

The researchers noticed that among the numerous classes of bacteria present in each patient, variations in the populations of two particular groups seemed to correspond with variations between patients in the degree to which they developed a fatty liver during the period of dietary choline depletion.

"Those patients with the highest abundance of Gammaproteobacteria at the beginning of the study seemed to have the lowest fatty liver development. The ones with the least developed the most fatty liver," Spencer noted. "Erysipeoltrichi showed exactly the opposite association, though this relationship was not quite as strong. So there seemed to be change going on in opposite directions."

When the trends of Gammaproteobacteria abundance and Erysiptoltrichi scarcity were combined and related to fatty liver development, the relationship became even stronger.

Finally, the researchers factored in individual genetic variations that affect internal production of the nutrient choline and that should explain why some patients developed fatty liver and others did not. Surprisingly, the results showed that each person's genetics did not entirely account for their fatty liver outcome. When the researchers modified the analysis to include the abundances of the two bacterial groups and each individual's genetics, the correlation between fatty liver development and these three factors was nearly perfect. Further mathematical tests were performed to show that the correlations were not likely to be an artificial result of some bias hidden in the analysis.

"There was some concern that we were 'over-fitting' the model," Spencer noted, "so we tested it out and ran a million permutations, altering the bug abundance and subject association, to see if we could identify how many actually showed a higher correlation by chance. What we found is that the p values still held up. We can have a lot of confidence in the result."

The big question that remains for the team is why the two bacterial populations correlate so strongly to the development of fatty liver. Anthony Fodor, UNC Charlotte assistant professor of bioinformatics and the project's director, sees a possible explanation, while warning against drawing specific conclusions without further study.

"We cannot yet assign cause and effect, but it implies that some bacteria are doing something that is making it easier for people to deal with a choline deficiency and for the liver to metabolize fat."

Conversely, the bacteria whose high population levels correlate with disease may be somehow removing available forms of choline from digested food. Fodor explains that further study will be needed to answer those questions.

"We're debating what the next step is," he said. "In some ways, this is a very specialized experiment because we are inducing fatty liver in a very specific way. In the general population, fatty liver is induced in many, many ways and not everyone who has fatty liver has low choline.

"It's probably like Alzheimer's or cancer, where there are many different causes for a disease that displays a common phenotype. More research will be required to determine the extent to which bacterial populations play a role in fatty liver development in the general population, but our results strongly suggest that there may be a link in some people."

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

Journal Reference:

Melanie D. Spencer, Timothy J. Hamp, Robert W. Reid, Leslie M. Fischer, Steven H. Zeisel, Anthony A. Fodor. Association Between Composition of the Human Gastrointestinal Microbiome and Development of Fatty Liver With Choline Deficiency. Gastroenterology, 2010; DOI: 10.1053/j.gastro.2010.11.049 

Brisk Walks May Boost Memory in Older Adults

By Jenifer Goodwin
HealthDay Reporter

HealthDay News

Monday, January 31, 2011

MONDAY, Jan. 31 (HealthDay News) -- Older adults who took a brisk walk three times a week did better on memory tests and increased the size of their hippocampus, a portion of the brain involved with memory formation, researchers report.

The findings suggest that loss of brain volume in old age can be delayed, and may even be reversible. Brain shrinkage is associated with memory impairment in the elderly.

"We can change the brain in older adults," said lead study author Kirk Erickson, an assistant professor of psychology at the University of Pittsburgh. "It's amazing that a one-year period of moderate exercise isn't just slowing down the atrophy, it's actually reversing it."

For their the study, researchers from the University of Pittsburgh, University of Illinois, Rice University and Ohio State University divided 120 sedentary adults in their mid to late 60s, on average, into two groups: one group walked around a track for 40 minutes of aerobic exercise, three days a week, while the other group (the control group) did stretching.

Both groups performed better on a test of spatial memory. Spatial memory helps us to remember things like driving directions or where we left our keys.

But the groups differed in one important way. MRI brain scans showed that after a year on the exercise program, the aerobic exercise group's hippocampus was about 2 percent bigger than it was when they started, the equivalent to a reversal in age-related brain shrinkage of about one to two years, the researchers said.

Those in the stretching group had a decrease of hippocampal volume of about 1.4 percent, the investigators found.

Those who showed the greatest improvements in memory also showed the greatest increases in hippocampal volume, according to the study, published online Jan. 31 in the Proceedings of the National Academy of Sciences.

The researchers found that those whose hippocampus grew the most showed higher levels of brain-derived neurotrophic factor, a growth factor in the blood that's associated with brain health.

Even late in life, the hippocampus continues to grow new neurons, said Dr. Gary Kennedy, director of geriatric psychology at Montefiore Medical Center in New York City.

"It's very, very exciting and is essentially proving a theory that has been around for a while, which is that exercise can promote neurogenesis, or the transformation of neural stem cells in the brain into mature, functioning neurons," Kennedy said. "Exercise seems to enhance it or speed it up."

It's possible that exercise could help ward off not only ordinary mental decline but also dementia, Erickson said.

But questions remain. If three days a week is good, would six days a week be better? Would running be better than walking?

"We really don't have a good answer for that," Erickson said, though his prior research found that older people who walked between six and nine miles a week showed significantly less decrease in brain volume over nine years than couch potatoes, but walking more than that didn't seem to increase brain volume any more.

The researchers also looked at the effect of aerobic exercise on two other regions of the brain, the caudate nucleus, which deteriorates with age and disease, and the thalamus, a more stable brain region, but no changes were evident.

"This suggests the effect is not just a widespread increase in brain mass, but it's relatively specific to the hippocampus," Erickson said.

According to background information in the study, in otherwise healthy adults the hippocampus shrinks by about 1 to 2 percent a year, and the decrease is even more rapid among people with dementia.

More information

The American Academy of Family Physicians has tips for starting an exercise program.

Key Protein Suppresses Prostate Cancer Growth in the Laboratory


Monday, January 31, 2011

ScienceDaily (Jan. 31, 2011) — Cancer researchers have discovered an important protein, produced naturally inside cells, that appears to suppress the growth of prostate cancer cells in the laboratory. The findings, published February 1 in the journal Cancer Research, offer promising leads for research towards new treatments.

Prostate cancer is the most common cancer among men in the UK, with 37,500 men diagnosed with the disease every year. Many prostate cancers are slow growing, but in some cases the cancer is aggressive and spreads to other parts of the body, such as the bone. These cases are much more likely to be fatal.

In the new study, scientists at Imperial College London found that a protein called FUS inhibits the growth of prostate cancer cells in the laboratory, and activates pathways that lead to cell suicide.

The researchers also looked for the FUS protein in samples from prostate cancer patients. They found that in patients with high levels of FUS, the cancer was less aggressive and was less likely to spread to the bone. Higher levels of FUS also correlated with longer survival. The results suggest that FUS might be a useful marker that can give doctors an indication of how aggressive a tumour will be.

"At the moment, there's no way to say whether a prostate tumour will kill you or be fairly harmless," said Dr Charlotte Bevan, senior author of the study, from the Department of Surgery and Cancer at Imperial College London. "Current hormonal therapies only work for a limited time, and chemotherapy is often ineffective against prostate cancer, so there's a real need for new treatments.

"These findings suggest that FUS might be able to suppress tumour growth and stop it from spreading to other parts of the body where it can be deadly. It's early stages yet but if further studies confirm these findings, then FUS might be a promising target for future therapies."

Prostate cancer depends on male hormones to progress as these hormones stimulate the cancer cells to divide, enabling the tumour to grow. Treatments that reduce hormone levels or stop them from working are initially effective, but eventually the tumour stops responding to this treatment and becomes more aggressive.

Dr Bevan and her team began by exposing prostate cancer cells to male hormones and looking at how the levels of different proteins changed. They discovered that the hormones made the cells produce less of the FUS protein, and examined further whether FUS might influence cell growth by inserting extra copies of the gene for FUS into cells grown in culture. They found that making the cells produce more FUS led to a reduction in the number of cancer cells in the dish.

Greg Brooke, first author of the study, from the Department of Surgery and Cancer at Imperial College London said: "Our study suggests that FUS is a crucial link that connects male hormones with cell division. The next step is to investigate whether FUS could be a useful test of how aggressive prostate cancer is. Then we might look for ways to boost FUS levels in patients to see if that would slow tumour growth or improve response to hormone therapy.

"If FUS really is a tumour suppressor, it might also be involved in other cancers, such as breast cancer, which has significant similarities with prostate cancer."

The study was funded by Prostate Action, the Medical Research Council, the Imperial College Experimental Cancer Medicine Centre (set up with a grant from Cancer Research UK and the Department of Health) and the Prostate Cancer Charity.

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.