Health blog

July 22, 2008, 8:22 PM CT

Sugar study is sweetener for stem cell science

Researchers at The University of Manchester are striving to discover how the body's natural sugars can be used to create stem cell therapys for heart disease and nerve damage thanks to a 370,000 funding boost.

All cells that make up the tissues of the body such as skin, liver, brain and blood are surrounded by a layer of sugars that coat the cells.

These sugars help the cells to know what type of cell they are and to respond to the other cells which surround them and the chemical messages that pass between cells.

Now Dr Catherine Merry from The School of Materials has been awarded a prestigious New Investigator Research Grant by the Medical Research Council (MRC) to investigate how different cells make different sugar types and to test out theories on how sugars can influence cell behaviour.

Dr Merry, who is leading the research, said: "At present, the way in which cells make these sugars is not well understood. From the little we do know, we believe isolated fragments of these sugars could be used to instruct cells to behave in particular ways.

"We also think we might be able to force cells to make one particular type of sugar and not another, thereby influencing the way in which that cell grows and interacts with other cells......... Posted by: Emily      Read more         Source

July 22, 2008, 7:45 PM CT

New Guidelines for Treating Rheumatoid Arthritis

Proven combinations of medicines and the introduction of new anti-arthritis drugs have significantly improved the therapy of rheumatoid arthritis (RA), as per guidelines issued by the American College of Rheumatology and co-authored by physicians at the University of Alabama at Birmingham (UAB).

Lead author Kenneth Saag, M.D., M.Sc., a professor in the UAB Division of Clinical Immunology and Rheumatology, said the new guidelines update strategies for treating RA with the goal of preventing joint damage and disability.

The new recommendations do not strive to replace individualized medical decisions, Saag said. Instead, they are meant to guide rheumatologists and other health care workers toward the most updated recommendations. The last set of American College of Rheumatology RA therapy guidelines was published in 2002. "The recommendations developed are not intended to be used in a 'cookbook' or prescriptive manner, or to limit a physician's clinical judgment," Saag said. "They provide guidance based on clinical evidence and expert panel input".

BIOLOGICS AND DMARDs.

The recommendations focus on several classes of anti-arthritic drugs, including a potent group of agents called disease-modifying anti-rheumatic drugs (DMARDs). Newer genetically engineered DMARDs called biologics often work in combination with earlier therapies......... Posted by: Emily      Read more         Source

July 21, 2008, 9:30 PM CT

A virtual toothache helps student dentists

Masha is a dental patient. Her oral health problems continue to change as she meets new Case Western Reserve University student dentists in Second Life's virtual dental office.

The middle-aged avatar is an integral part of a new research project of the Case Western Reserve University School of Dental Medicine and the College of Arts and Sciences department of communication sciences to teach and give students practice time to communicate with mock patients.

Not only do findings from the study have potential to revolutionize dental education but also to change the way national testing is done for patient-side communication skills.

Kristin Z. Victoroff from the dental medicine's department of community dentistry will direct the three-year Innovative Dental Assessment Research and Development (IDEA) Grant project from the American Dental Association's Joint Commission on National Dental Examinations. She will develop patient communication scenarios for simulated education and test their effectiveness in preclinical training for students.

"More dental schools are experimenting with simulation as a way to teach," said Victoroff. She is joined in the research project by Roma Jasinevicius and Catherine Demko from the dental school faculty in testing and implementing simulations in dental education at the university......... Posted by: Emily      Read more         Source

July 20, 2008, 5:04 PM CT

How HIV conquers immune system

New research into the earliest events occurring immediately upon infection with HIV-I shows that the virus deals a stunning blow to the immune system earlier than was previously understood. As per researchers at Duke University Medical Center, this suggests the window of opportunity for successful intervention may be only a matter of days not weeks after transmission, as scientists had previously believed.

Appearing in the recent issue of the Journal of Virology, the finding may make the challenge of designing an effective HIV/AIDS vaccine appear daunting. But scientists say the study has also yielded a blueprint for what a successful vaccine should look like, and moreover, when such a vaccine would need to work.

Until now, researchers believed that the window of opportunity to intervene in the process of HIV-1 infection lay in the three to four weeks between transmission and the development of an established pool of infected CD4 T cells. HIV-1 cripples the immune system by invading and killing CD4 T cells, key infection-fighters in the body.

"But this new study shows that HIV-I does a lot of damage to the immune system very early in that time frame, and now we feel that the opportunity to intervene most effectively may range from about five to seven days after infection," said Barton Haynes, M.D., the senior author of the study and director of the Center for HIV/AIDS Vaccine Immunology (CHAVI) at Duke University Medical Center......... Posted by: Emily      Read more         Source

Sun, 20 Jul 2008 22:17:40 GMT

How Infants Start the Journey to Their First Word

have shown that adults cannot successfully distinguish as wider a range of phonemes as infants.

This is because until about 11 months of age infants are masters of discriminating phonemes used in all different types of languages. But after 11 months infants settle down with one set of phonemes for their first language, and lose the ability to discriminate the phonemes from other languages. Infants are beginning to specialise in their own language.

The specialisation at 11 months in one set of around 40 phonemes, along with other linguistic processes, is clearly crucial as it quickly brings a magical moment: the first word.

» Read other top 10 child psychology studies on the emergence of infant memory, self-concept, self-concept, attachment, self-concept, theory of mind and self-concept.

[Image credit: self-concept]

Reference

Eimas, P. D., Siqueland, E. R., Jusczyk, P., & Vigorito, J. (1971). self-concept. Science, 171(3968), 303-306.Labels: Child Psychology Posted by: Jerry      Read more     Source

July 20, 2008, 2:57 PM CT

Standards in stem cell research

Standards in stem cell research help both researchers and regulators to manage uncertainty and the unknown, as per new research funded by the Economic and Social Research Council. Efforts to standardise practices across different labs is, however, a balancing act where the autonomy of researchers and fragility of living material need to be weighed against the need for comparable data.

The ambition in a number of quarters to scale up the production of human embryonic stem cells and move towards clinical trials requires that different laboratories are able to produce to a standard quality of cells. Developing common standards in stem cell production is not straightforward as so much is still unknown in this new science.

Professor Andrew Webster and Dr Lena Eriksson of York University interviewed and observed a range of researchers and technicians working in stem cell laboratories in the UK, USA and Sweden.

Accurately describing human embryonic stem cell lines is one way to begin setting standards. A stem cell line is a family of constantly-dividing cells, the product of a single parent group of stem cells. Embryonic stem cells are unique in that they have yet to 'decide' which developmental path to choose: they have the ability to turn into almost all human cell types. However each human embryonic stem cell holds the genetic signature of the donor which differs between donors just as people themselves differ. Further the state of a stem cell is by its very nature temporary as it is defined by its ability to develop into a number of different cell types......... Posted by: Emily      Read more         Source

July 20, 2008, 2:13 PM CT

Stem cell chicken and egg debate

Logic says it has to be the niche. As air and water preceded life, so the niche, that hospitable environment that shelters adult stem cells in a number of tissues and provides factors necessary to keep them young and vital, must have emerged before its stem cell dependents.

A team of researchers at the Salk Institute for Biological Studies led by Leanne Jones, Ph.D., assistant professor in the Laboratory of Genetics, now suggests that this is not always the case. They report in the July 20 advance online edition of the journal Nature that the cells that comprise a specialized niche in the testis of fruit flies actually emerge from adult stem cells, a finding with implications for regenerative medicine, aging research, and cancer therapeutics.

Previously, researchers thought that a fruit fly's allotment of testis niche cells was handed out at birth and meant to last a lifetime. "What this paper demonstrates is that once a fly becomes an adult, some stem cells that function in spermatogenesis start making the very cells that support them," said Jones. "Once a fly develops into an adult, some of these niche cells can be replaced".

Using microscopy and fluorescent markers enabling them to image specific cell types over time, Jones' group, led by first author Justin Voog, actually caught a testis stem cell population in the act of turning into their own niche, known in the fly testis as the hub......... Posted by: Emily      Read more         Source

July 19, 2008, 10:24 AM CT

Give antibiotics within hour before first incision

Giving children preventive antibiotics within one hour before they undergo spinal surgery greatly reduces the risk for serious infections after the surgery, suggests a Johns Hopkins study would be reported in the recent issue of Pediatric Infectious Disease Journal (also available online ahead of print). Children who received antibiotics outside of the golden one-hour window were three and half times more likely to develop serious infections at the surgery site, scientists report, pointing out that something as simple as ensuring that a child gets timely prophylaxis can prevent serious complications and reduce the length of hospital stay.

"When it comes to preventing infections, when a child gets antibiotics appears to be one of the most critical yet most easily modifiable risk factors, and may matter just as much as the type and dosage of the medicine ,"says lead researcher Aaron Milstone, M.D., infectious disease specialist at the Johns Hopkins Children's Center. "The moral of this is that an ounce of timely prevention is indeed worth a pound of therapy".

Nearly 780,000 postsurgical infections occur in the United States each year, as per estimates from the Institute for Healthcare Improvement. An infection after surgery nearly doubles a patient's risk of death, doubles a patient's hospital stay and adds up to $50,000 to therapy costs per patient, scientists say......... Posted by: Emily      Read more         Source

July 16, 2008, 8:56 PM CT

Genetic variation increases HIV risk in Africans

A genetic variation which evolved to protect people of African descent against malaria has now been shown to increase their susceptibility to HIV infection by up to 40 per cent, as per new research. On the other hand, the same variation also appears to prolong survival of those infected with HIV by approximately two years.

The discovery marks the first genetic risk factor for HIV found only in people of African descent, and sheds light on the differences in genetic makeup that play a crucial role in susceptibility to HIV and AIDS.

The research, published recently in Cell Host & Microbe, was co-authored by Professor Robin Weiss, UCL Infection and Immunity, who worked with colleagues in the US to analyse data from a 25-year study of thousands of Americans of different ethnic backgrounds.

The gene that the research focused on encodes a binding protein found on the surface of cells, called Duffy Antigen Receptor for Chemokines (DARC). The variation of this gene, which is common in people of African descent, means that they do not express DARC on red blood cells. DARC influences the levels of inflammatory and anti-HIV blood factors called chemokines.

Discussing the findings, Professor Weiss said: "The big message here is that something that protected against malaria in the past is now leaving the host more susceptible to HIV......... Posted by: Emily      Read more         Source

July 16, 2008, 8:06 PM CT

Psychological and social issues associated with tooth loss

Are feelings of depression overwhelming you? Is your self-esteem an issue? Having problems advancing in life or your career? Maybe you feel nervous or self conscious in social settings? Do you avoid social settings all together? Check your smile; tooth loss could be the culprit and you're not alone. Nearly 20 million teeth are extracted each year leaving scores of people to deal with the psychological affects of a less than perfect smile. However, during the Academy of General Dentistry's (AGD) 56th Annual Meeting & Exhibits in Orlando, Fla., July 16-20, H. Asuman Kiyak, PhD, will address the psychological issues affecting people who must deal with the loss of a tooth, as well as explain how this loss can affect the quality of life.

In Dr. Kiyak's course, "Enhancing the Oral Health and Quality of Life for Partially Edentulous or Fully Edentulous Patients: The Importance of Communication," she will reveal the post traumatic effects a patient endures after the loss of a tooth and will also pinpoint ways a doctor can communicate with a patient to help them cope with and understand their options for restoring their smile.

"The major impact of tooth loss is on the appearance and social relations component of quality of life because people cannot change their appearance with missing teeth," says Dr. Kiyak......... Posted by: Emily      Read more         Source

July 15, 2008, 10:08 PM CT

Genetic contribution to autism

Some parents of children with autism evaluate facial expressions differently than the rest of us--and in a way that is strikingly similar to autistic patients themselves, as per new research by neuroscientist Ralph Adolphs of the California Institute of Technology and psychiatry expert Joe Piven at the University of North Carolina at Chapel Hill.

Adolphs, Bren Professor of Psychology and Neuroscience and professor of biology, and his colleague Michael Spezio (now at Scripps College in Claremont, California) collaborated with Piven and autism experts at the University of North Carolina to study 42 parents of children with autism, a complex developmental disability that affects an individual's ability to interact socially and communicate with others. Based on psychological testing, 15 of the parents were classified as being socially aloof.

"This manifests as a tendency not to prefer interactions with others, not to enjoy 'small talk' for the sake of the social experience, and to have few close friendships involving sharing and mutual support. This characteristic is really a variation of the normal range of social behavior and not linked to any functional impairment," says Piven, director of the Carolina Institute for Developmental Disabilities.

The parents participated in an experiment that measured how they make use of the face to judge emotions. The subjects were shown images depicting facial expressions of emotion that were digitally filtered so that only certain regions of the face were discernible--the left eye, for example, or the mouth. The subjects were then asked to decide as quickly as possible if the emotion depicted was "happy" or "fear." The part of the face shown, and the size of the revealed area, randomly varied from trial to trial......... Posted by: Emily      Read more         Source

July 10, 2008, 9:41 PM CT

Middle Eastern families yield intriguing clues to autism

Research involving large Middle Eastern families, sophisticated genetic analysis and groundbreaking neuroscience has implicated a half-dozen new genes in autism. More importantly, it strongly supports the emerging idea that autism stems from disruptions in the brain's ability to form new connections in response to experience consistent with autism's onset during the first year of life, when a number of of these connections are normally made.

Interestingly, not all the affected genes were actually deleted, but only prevented from turning on offering hope that therapies could be developed to reactivate the genes. The study, led by scientists at Children's Hospital Boston and members of the Boston-based Autism Consortium, is the cover article in the July 11 issue of Science

Autism genes have been difficult to identify because the disorder is complex, with a variety of causes stemming from a number of possible genes or combinations of genes. In addition, since people with autism tend not to have children, most of the genes identified thus far aren't inherited from a parent, but instead are mutated during embryonic development, making them hard to track through traditional linkage studies in families.

Christopher Walsh, MD, PhD, chief of genetics at Children's Hospital Boston, approached the problem by studying Middle Eastern families. In traditional Arab societies, it is common for cousins to marry, increasing the likelihood that offspring will inherit rare mutations. Middle Eastern families also tend to have a number of children, making them ideal for mapping genes......... Posted by: Emily      Read more         Source

July 9, 2008, 9:05 PM CT

Frequent dialysis may benefit but at what cost?

More frequent hemodialysis sessions might improve the health of patients with end-stage renal disease (ESRD), but under reasonable assumptions of expected benefit, the overall costs are likely to increase, as per a research studyappearing in the September 2008 issue of the Journal of the American Society Nephrology (JASN). The findings indicate that strategies are needed to reduce the costs of delivering hemodialysis if patients receive hemodialysis more than three times a week.

Despite ongoing treatment with current in-center hemodialysis procedures, which involve three sessions a week for three to four hours at a clinic per session, patients with ESRD experience relatively poor health and high mortality rates. Published studies suggest that more frequent hemodialysis for patients may improve their quality and length of life and cut down on hospitalizations and other costs. In recent years, several hemodialysis centers around the world have explored this strategy, and two ongoing clinical trials in the United States are currently comparing frequent and conventional hemodialysis.

To assess the potential effects of hemodialysis frequency on life expectancy and costs, Dr. Glenn Chertow of the Stanford University School of Medicine in Stanford, CA, and colleagues from Stanford's Graduate School of Business and the Wharton School at the University of Pennsylvania examined data from a national registry that is representative of the US hemodialysis population. Using a sophisticated simulation model, they set out to determine if more frequent hemodialysis strategies could enhance longevity at a reasonable cost......... Posted by: Emily      Read more         Source

July 8, 2008, 8:58 PM CT

Protein marker for schizophrenia risk

A protein found in immune cells may be a reliable marker for schizophrenia risk, report scientists in a new proteomics study appearing in the recent issue of Molecular and Cellular proteomics.

Schizophrenia is a severe and complex psychiatric illness that affects about 1% of the population. Diagnosis currently relies on subjective clinical interviews and the assessment of ambiguous symptoms, which frequently leads to delayed diagnosis and therapy. As such, biomarkers that would indicate schizophrenia risk or onset would be extremely useful.

Sabine Bahn and his colleagues sought to find such a "protein fingerprint" in the blood (due to its accessibility). They compared protein profiles of schizophrenia patients and controls using mass spectrometry and identified two peaks highlighting a significant change. These were identified as alpha defensins, proteins responsible for killing microbes and viruses in the innate immune response.

Bahn and his colleagues confirmed their findings by examining alpha defensin levels in the blood of 21 twin pairs discordant for schizophrenia (where one sibling manifests the disease while the other does not). In these twin sets, both siblings had significantly elevated alpha defensins as compared with a group of control twins. Changes were also found in patients who were investigated soon after diagnosis, which means that higher levels of alpha defensins were not caused by medicine or progression of the disease......... Posted by: Emily      Read more         Source

July 7, 2008, 10:11 PM CT

Recommends increased adolescent immunization

Vaccinating infants and toddlers is an almost universal practice in the United States. Vaccines to prevent flu are a regular part of medical care for senior citizens and at-risk patients. But, as per a research studyreported in the August 2008 issue of the American Journal of Preventive Medicine, the US healthcare system is not very effective in getting vaccines to the adolescent population.

In response to a request from the Assistant Secretary for Health, the Adolescent Working Group of the National Vaccine Advisory Committee (NVAC) conducted an assessment of the current state of adolescent immunizations and identified issues that will require national attention in the coming months and years if current and future recommended adolescent immunizations will be used to their potential.

There are three new vaccines available and recommended for adolescents that prevent a total of five diseases that can have a range of devastating health consequences. Individual vaccines protect against meningococcal meningitis and human papillomavirus and a combined vaccine protects against tetanus, diphtheria, and pertussis. All three vaccines have been shown to be safe and effective.

The authors cite six topics with unique applications to adolescent immunization. There are venues for vaccine administration, consent for immunizations, communication, financing, surveillance, and the potential for school mandates......... Posted by: Emily      Read more         Source

July 7, 2008, 9:15 PM CT

Relationship violence among college students

Violence between partners, friends and acquaintances appears prevalent both during and before college, as per results of a survey of students at three urban college campuses reported in the recent issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

The transition from living at home to attending college may increase adolescents' vulnerability to relationship violence, as per background information in the article. Factors linked to this risk include less parental monitoring and support, isolation in an unknown environment and a strong desire for peer acceptance that can change behaviors toward others.

Christine M. Forke, M.S.N., C.R.N.P., of the Children's Hospital of Philadelphia, and his colleagues anonymously surveyed 910 undergraduates age 17 to 22 (57.1 percent female) in 67 randomly chosen college classes. The students answered demographic questions about sex, age, race and length of time in school and reported whether and when they had experienced physical, emotional or sexual violence in a relationship.

The scientists observed that:

• 407 (44.7 percent) of participants experienced relationship violence either before or during college, including 383 (42.l percent) who were victims of such violence and 156 (17.1 percent) of participants who reported perpetrating violence.........
  
  
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July 7, 2008, 9:10 PM CT

Early-life nutrition and adult intellectual functioning

Adults who had improved nutrition in early childhood may score better on intellectual tests, regardless of the number of years they attended school, as per a report in the recent issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

"Schooling is a key component of the development of literacy, reading comprehension and cognitive functioning, and thus of human capital," the authors write as background information in the article. Research also suggests that poor nutrition in early life is linked to poor performance on cognitive (thinking, learning and memory) tests in adulthood. "Therefore, both nutrition and early-childhood intellectual enrichment are likely to be important determinants of intellectual functioning in adulthood".

Between 1969 and 1977, Guatemalan children in four villages participated in a trial of nutritional supplementation. Through the trial, some were exposed to atolea protein-rich enhanced nutritional supplementwhile others were exposed to fresco, a sugar-sweetened beverage. Aryeh D. Stein, M.P.H., Ph.D., of the Rollins School of Public Health, Emory University, Atlanta, and his colleagues analyzed data from intellectual testing and interviews conducted between 2002 and 2004, when 1,448 surviving participants (68.4 percent) were an average of 32 years old......... Posted by: Emily      Read more         Source

July 3, 2008, 9:05 PM CT

Brain noise is a good thing

Toronto, Canada Canadian researchers have shown that a noisy brain is a healthy brain.

"Brain noise" is a term that has been used by neuroresearchers to describe random brain activity that is not important to mental function. Intuitive notions of brain-behaviour relationships would suggest that this brain noise quiets down as children mature into adults and become more efficient and consistent in their cognitive processing.

But new research from the Rotman Research Institute at Baycrest, reported in the July 4, 2008 issue of the Public Library of Science - Computational Biology, overturns this notion.

"What we discovered is that brain maturation not only leads to more stable and accurate behaviour in the performance of a memory task, but correlates with increased brain signal variability," said lead author, Dr. Randy McIntosh, a senior scientist with the Rotman Research Institute at Baycrest. "This doesn't mean the brain is working less efficiently. It's showing greater functional variability, which is indicative of enhanced neural complexity".

In the study, 79 participants representing two main age groups children (eight to 15) and young adults (20 to 33 years of age) completed a series of face memory tasks to measure their ability to recall faces with accuracy. EEG recordings were collected to measure their brain signal activity while performing the task. EEG electroencephalography is a powerful brain imaging tool that allows for precise measurement of the timing of brain activity in response to external stimuli......... Posted by: Emily      Read more         Source

Thu, 03 Jul 2008 02:11:08 GMT

When Children Begin to Simulate Other Minds

of the world that represented Maxi''s experience - they weren''t capable of a theory of mind.

From about 4 to 5-years-old the situation changed dramatically. Suddenly the children tended to point to the cupboard where Maxi thought the chocolate was, rather than where they knew it was. However in some variations of the experiment children up to 5-years-old still had problems understanding someone else''s false belief.

Finally, at 6-years-old, the children did consistently understand that another person can hold a false belief about the world.

End of innocenceThis experiment suggested that at about 4 to 6-years old a range of remarkable skills start to emerge in young children that are vital for their successful functioning in society. They begin to understand that others can hold false beliefs, they themselves can lie, and that others can lie to them.

From one perspective it is a sad end to innocence, but from another it is a necessary base for a skill required for social success. At around 4-years-old children are starting to understand that we don''t live out there in the world, we actually create a model of the world in our heads, a model that can easily be wrong.

Criticisms and alternative explanationsLike many child psychology studies, this experiment has sparked much debate about what its results mean. Here are some of the alternative explanations addressed by the experimenters:

• Were the kids concentrating? Yes, they correctly answered questions that showed they were concentrating.
• Had the younger children forgotten the story? No, they were given a memory test which they passed.
• Were the younger children just pointing at where the chocolate was without thinking about the question? In another experiment children were specifically told to stop and think - this didn''t help the younger children.

While this experiment has been criticised, and other methods have been developed for examining theory of mind in children, tasks like this one are still in use around the world to this day, helping to uncover how and when we first develop the ability to understand other people''s thoughts.

» Read other top 10 child psychology studies on the emergence of infant memory, self-concept, self-concept, attachment and self-concept.

[Image credit: self-concept]

References

Wimmer, H., & Perner, J. (1983). self-concept Cognition, 13(1), 103-28.Labels: Child Psychology Posted by: Jerry      Read more     Source

July 1, 2008, 9:55 PM CT

Making more bone and less fat

A small protein may have a big role in helping you make more bone and less fat, scientists say.

"The pathways are parallel, and the idea is if you can somehow disrupt the fat production pathway, you will get more bone," says Dr. Xingming Shi, bone biologist at the Medical College of Georgia Institute of Molecular Medicine and Genetics.

He's found the short-acting protein GILZ appears to make this desirable shift and wants to better understand how it does it with the long-term goal of targeted therapies for osteoporosis, obesity and maybe more.

"Osteoporosis and obesity are two major public health problems, but people have no idea whether they have a connection," says Dr. Shi. Bone and fat do have a common source: both are derived from mesynchymal stem cells. Bone loss and fat gain also tend to happen with age and with use of the powerful, anti-inflammatory steroid hormones glucocorticoids. "When you age, your bone marrow microenvironment changes; the balance between the bone and fat pathway is broken," says Dr. Shi, a faculty member in the MCG Schools of Medicine and Graduate Studies. "You have more fat cells accumulate".

"The bones of elderly people or those who take glucocorticoids are yellow inside instead of red," he says. And it gets worse: in a classic vicious cycle, the more fat, the more cytokines that stimulate production of bone-destroying osteoclasts and inhibit bone-forming osteoblasts. He recently showed that even the stem cells change with age: their numbers and their ability to differentiate decrease......... Posted by: Emily      Read more         Source

July 1, 2008, 9:36 PM CT

HIV death rate has decreased

In industrialized countries, persons infected sexually with HIV now appear to experience mortality rates similar to those of the general population in the first 5 years following infection, though a higher risk of death remains as the duration of HIV infection lengthens, as per a research studyin the July 2 issue of JAMA

Many studies have reported the dramatic decreases in mortality among individuals infected with human immunodeficiency virus (HIV) since the widespread introduction of highly active antiretroviral treatment (HAART) in industrialized countries. "It is important to provide up-to-date and robust estimates of expected mortality as anti-HIV drugs and strategies continue to improve. Such estimates help policy makers and those planning health care to monitor the effectiveness of therapys at a population level and provide an indicator of the ongoing and likely future impact of HIV disease on health care needs," the authors write.

Krishnan Bhaskaran, M.Sc., of the Medical Research Council Clinical Trials Unit, London, and his colleagues reviewed changes in the excess mortality of HIV-infected individuals compared with expected mortality in the general uninfected population, adjusting for duration of HIV infection. Mortality following HIV seroconversion (development of antibodies in blood serum as a result of infection) in a large multinational collaboration of HIV seroconverter cohorts (CASCADE) was compared with expected mortality, calculated by applying general population death rates matched on demographic factors. A model was created, adjusted for duration of infection, to assess changes over calendar time in the excess mortality among HIV-infected individuals. Data pooled in September 2007 were analyzed in March 2008, covering years at risk 1981-2006......... Posted by: Emily      Read more         Source

July 1, 2008, 9:34 PM CT

Newborns in ICUs often undergo painful procedures

An examination of newborn intensive care finds that newborns undergo numerous procedures that are linked to pain and stress, and that a number of of these procedures are performed without medicine or treatment to relieve pain, as per a research studyin the July 2 issue of JAMA

"Repeated invasive procedures occur routinely in neonates [a baby, from birth to four weeks] who require intensive care, causing pain at a time when it is developmentally unexpected. Neonates are more sensitive to pain than older infants, children, and adults, and this hypersensitivity is exacerbated in preterm neonates. Multiple lines of evidence suggest that repeated and prolonged pain exposure alters their subsequent pain processing, long-term development, and behavior. It is essential, therefore, to prevent or treat pain in neonates," the authors write. "Effective strategies to improve pain management in neonates require a better understanding of the epidemiology and management of procedural pain."

Ricardo Carbajal, M.D., Ph.D., of the Hpital d'enfants Armand Trousseau, Paris, and his colleagues collected data on neonatal pain, based on direct bedside observations in intensive care units (ICUs) in the Paris region. The study, conducted between September 2005 and January 2006, included data on all painful and stressful procedures and corresponding analgesic (a medicine used to relieve pain) treatment from the first 14 days of admission collected within a 6-week period from 430 neonates admitted to tertiary care centers. The average gestational age was 33 weeks, and the average intensive care unit stay was 8.4 days......... Posted by: Emily      Read more         Source

June 23, 2008, 7:05 PM CT

Fish-based fatty acids in preventing asthma

Asthma and allergic reactions have observed that a molecule produced by the body from omega-3 fatty acids helps resolve and prevent respiratory distress in laboratory mice. The research, supported by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, was led by a research team at Brigham and Women's Hospital and Harvard Medical School.

Resolvin E1 (RvE1) is a metabolic product of an omega-3 fatty acid found in cold-water fish such as salmon, mackerel and anchovies. It is made by the body in response to the onset of inflammation. This study identified RvE1 as having a key role in both dampening the development of airway inflammation and promoting its resolution in mice, in part by dampening innate immune signals that trigger inflammation. Other studies have indicated that increased levels of omega-3 fatty acids are linked to lower asthma prevalence in people, but the mechanisms to support that observation are poorly understood. This study provides researchers an opportunity to focus on the role of RvE1 as a potential therapeutic candidate......... Posted by: Emily      Read more         Source

June 19, 2008, 9:31 PM CT

Allergy expert has advice for flood victims

As if the emotional and financial impact of flood damage isn't bad enough, floodwaters can also bring health problems. H. James Wedner, M.D., professor of medicine and chief of the Division of Allergy and Immunology at Washington University School of Medicine in St. Louis, says after the water recedes, damp homes and businesses are fertile grounds for mold growth, which can cause allergic reactions and asthmatic symptoms in sensitive people.

"Mold loves water," Wedner says. "When your building is flooded, it's very difficult to dry it out quickly and completely, and that allows mold to grow. Walls made of Sheetrock soak up water far above the floodline, and mold can be hidden under wallpaper, carpet and floorboards and in ceiling tiles, furniture and clothing".

Wedner is a Washington University allergy and asthma specialist at Barnes-Jewish Hospital. He has conducted research investigating the molds and other allergens present in homes following the 1993 flood in the Midwestern United States.

Molds (and mildew, a type of mold) are fungi, which reproduce by releasing spores. Inhaling the spores causes allergic reactions in some people. Symptoms of mold allergy include itchy, watery eyes; itchy, runny nose; headaches above and below the eyes; itchy ears and changes in hearing; itchy throat and palate; difficulty breathing; coughing; and shortness of breath. Mold spores may also trigger asthmatic reactions in asthma sufferers......... Posted by: Emily      Read more         Source

June 17, 2008, 10:04 PM CT

Save Precious Minutes In Deploying Ambulances

Every extra second it takes an ambulance to get to its destination can mean life or death. But how, besides driving faster, can ambulances get emergency services to people in need as efficiently as possible, every day? It's a classic operations research question that three Cornell scientists are tackling in groundbreaking ways.

A National Science Foundation grant of almost $300,000 is allowing associate professor of operations research Shane Henderson, assistant professor of operations research Huseyin Topaloglu and applied mathematics Ph.D. student Mateo Restrepo to work on this problem. They are seeking to perfect a computer program that estimates how best to spread ambulances across a municipality to get maximum coverage at all times.

The scientists are working on a computerized approach to take such available information as historical trends of types and incidences of calls, geographical layout and real-time locations of ambulances to figure out where ambulance bases should be, and where ambulances should be sent once finished with a call.

The whole process is not unlike the puzzle game Tetris, Restrepo said. The easy part is knowing what an ideal system should look like. The hard part is anticipating various outcomes in a limited period of time, like the falling blocks in the video game......... Posted by: Emily      Read more         Source

June 17, 2008, 9:50 PM CT

Hypertension Treatment To Reversing Vascular Damage

A high blood pressure medicine called olmesartan medoxomil is effective in reversing the narrowing of the arteries that occurs in patients with high blood pressure, as per a new study.

Carlos M. Ferrario, M.D., one of the study's lead researchers and director of the High blood pressure and Vascular Research Center at Wake Forest University Baptist Medical Center, said, "We believe the data add to the growing evidence for the role of angiotensin receptor blockers in preventing or reversing vascular damage at a number of stages during this disease process." .

The one-year study, titled Vascular Improvement with Olmesartan medoxomil Study (VIOS), was reported in the current Journal of the American Society of Hypertension. The study reviewed the effects of an angiotensin receptor blocker (olmesartan medoxomil) vs. a beta-blocker (atenolol) on vascular function and structure in patients with stage 1 hypertension.

Olmesartan medoxomil is marketed in the United States as Benicar® and in Europe as Olmetec® by Daiichi Sankyo, Inc., which funded the study.

After one year of therapy, olmesartan medoxomil improved the artery abnormalities in hypertension patients and returned arterial architecture to normal levels. This was not seen with the atenolol......... Posted by: Emily      Read more         Source

June 17, 2008, 9:44 PM CT

People with lower incomes, lower education levels have higher death rates

Scientists have long suspected that socioeconomic factors like education level and income also might affect survival rates following heart attack. In the recent issue of Mayo Clinic Proceedings, Mayo Clinic scientists present new data suggesting that people with lower incomes and education levels are more likely to die after heart attack than more affluent, educated people. Over the past several decades, medical research has helped identify a list of factors that increase a person's risk for myocardial infarction, the disruption of blood flow to the heart usually known as heart attack. These factors include behaviors such as smoking or inactivity, and a variety of physical characteristics, including high blood pressure, high blood cholesterol and obesity. Today, better awareness of heart attack signs and symptoms and improved therapys help a number of survive that first heart attack.

Mayo authors examined medical records from 705 patients residing in Olmsted County, Minn. -- the location of Mayo Clinic -- who were treated for heart attack between Nov. 1, 2002 and May 31, 2006. Scientists recorded the years of schooling completed (self-reported by the patients via a questionnaire) and neighborhood income (obtained by linking the participant address to the 2000 U.S. Census Bureau data) for each participant. Participants were divided into three income groups and three education groups. Scientists analyzed survival data across these different groups......... Posted by: Emily      Read more         Source

June 17, 2008, 9:34 PM CT

Grape seed extract for Alzheimer's disease

A compound found in grape seed extract reduces plaque formation and resulting cognitive impairment in an animal model of Alzheimer's disease, new research shows. The study appears in the June 18 issue of The Journal of Neuroscience

Lead study author Giulio Pasinetti, MD, PhD, of Mount Sinai School of Medicine and his colleagues observed that the grape seed extract prevents amyloid beta accumulation in cells, suggesting that it may block the formation of plaques. In Alzheimer's disease, amyloid beta accumulates to form toxic plaques that disrupt normal brain function.

The scientists tested a grape seed polyphenolic extract product sold as MegaNatural-AZ, made by Polyphenolics, which in part supported the study. Polyphenolic compounds are antioxidants naturally found in wine, tea, chocolate, and some fruits and vegetables. To determine whether the extract could mitigate the effects of Alzheimer's disease, the scientists used mice genetically modified to develop a condition similar to Alzheimer's disease. They exposed pre-symptomatic "Alzheimer's mice" to the extract or placebo daily for five months. The daily dose of the polyphenolic extract was equivalent to the average amount of polyphenolics consumed by a person on a daily basis.

After the five-month period, Alzheimer's mice were at an age at which they normally develop signs of disease. However, the extract exposure reduced amyloid beta accumulation and plaque formation in brains of Alzheimer's mice and also reduced cognitive decline: in comparison to placebo, extract-exposed Alzheimer's mice showed improved spatial memory. These data suggest that before symptoms begin, the grape seed extract may prevent or postpone plaque formation and slow cognitive deterioration linked to Alzheimer's disease......... Posted by: Emily      Read more         Source

June 17, 2008, 8:55 PM CT

Gene variants linked to metabolic syndrome and HDL cholesterol levels

Nutrition scientists at Washington University School of Medicine in St. Louis have identified five common genetic variations that increase the risk of metabolic syndrome, a group of factors associated with heart disease and diabetes. Another variant they found appeared to protect against the condition.

People with metabolic syndrome have at least three of the following symptoms: abdominal obesity, high blood triglyceride levels, lower good cholesterol (HDL), elevated blood pressure and elevated fasting blood glucose. They are four times as likely to develop heart disease and at least seven times more likely to develop diabetes as individuals without metabolic syndrome.

The investigators, who report their findings in the recent issue of the journal Human Molecular Genetics, looked for changes in the CD36 gene, which is located in a region of chromosome 7 that has been associated with metabolic syndrome in several genome-wide studies.

The scientists say linking changes in the CD36 gene to the risk for metabolic syndrome and abnormal levels of good cholesterol is important because as more people in the United States become obese, they also become susceptible to these problems. Better understanding of the relationships between obesity, the gene and disease risk may allow for earlier identification of individuals who are more susceptible to develop metabolic syndrome. Treatments such as medicine or changes in lifestyle could begin earlier, perhaps preventing or delaying future problems with diabetes or heart disease......... Posted by: Emily      Read more         Source

June 16, 2008, 10:21 PM CT

Aging and bone mineral density

"Change in bone mineral density as a function of age in women and men and association with the use of antiresorptive agents".

Older women and men experience increasing rates of hip fracture because of the age-related acceleration in bone loss. David Goltzman and his colleagues studied a large cohort of Canadians and observed that antiresorptive medicine attenuates this loss.

The authors observed that even among women aged 50-54, the range within which the greatest bone loss was noted, the rate was only 1.3% per year. This finding is consistent with rates of loss reported among women in other longitudinal studies. The authors also note that a loss of 1.3% is within the margin of error of most bone densitometry machines.

"The extent of the bone loss that we observed suggests that repeat measurements of bone density could be delayed to intervals of up to 5 years in the absence of other risk factors," conclude the authors.

In a related commentary, Dr. Mark Cooper, Department of Endocrinology, Division of Medical Sciences, University of Birmingham, United Kingdom (m.s.cooper@bham.ac.uk), highlights the 2-phased nature of bone loss, first around menopause and then after the age of 70. He also stresses that the change in bones over time is complex and that bone density is only one of a number of factors that can influence an individual's risk for fracture......... Posted by: Emily      Read more         Source

June 16, 2008, 10:19 PM CT

Drink and drugs fuel Scottish suicide and homicide rates

Alcohol and drug misuse mean Scots are almost twice as likely to kill or take their own life in comparison to people living in England and Wales, research published recently (Monday, June 16) reveals.

The findings by The University of Manchester's National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCI) also show that the number of mental health patients committing homicide or suicide was proportionately much higher in Scotland.

The 'Lessons for Mental Health Care in Scotland' report, commissioned by the Scottish Government, blames these higher death rates north of the border on alcohol and drug consumption, both in the general population and among mental health patients.

The NCI examined all suicides and homicides in the general population in Scotland, as well as those committed by people who had sought help from mental health services, and compared them to its findings for England and Wales.

Suicide rates in Scotland equated to 18.7 per 100,000 of the population, in comparison to 10.2 per 100,000 in England and Wales, while homicide rates north of the border were 2.12 per 100,000 people in comparison to 1.23 per 100,000 in England and Wales. The north-south divide was highest among teenagers, the report found......... Posted by: Emily      Read more         Source

June 16, 2008, 9:23 PM CT

Immune molecule that plays a powerful role in avoiding organ rejection

When a mouse's immune system is deciding whether to reject a skin graft, one powerful member of a molecular family designed to provoke such a response can effectively reduce the visibility of the mouse's own cells and help the graft survive, scientists say.

"This is a molecule with huge potential to regulate immune response," Dr. Anatolij Horuzsko, reproductive immunologist at the Medical College of Georgia Center for Molecular Chaperone/Radiobiology and Cancer Virology, says of HLA-G dimer.

Dimer appears to be the most powerful among several known forms of HLA-G at inhibiting the immune response, scientists have found. Fetuses use this natural mechanism to hide from the mother's immune system and it's at work in some transplant patients as well.

Now that the researchers know which HLA-G is best at down-regulating the immune response and how it works, they believe the molecule's action can be augmented in people with organ transplants and autoimmune disease and turned down to help fight a tumor. Measuring endogenous levels of HLA-G dimer may also help physicians identify which transplant patients require little, if any, immune suppression.

Research published online in Proceedings of the National Academy of Sciences details that when HLA-G dimer binds with its inhibitory receptor, ILT4, it triggers a signaling pathway in which immune molecules IL-6 and STAT3 play a major role. "Biologically this is an interaction that requires several important suppressive molecules," says Dr. Horuzsko, the study's corresponding author and a faculty member in the MCG Schools of Medicine and Graduate Studies......... Posted by: Emily      Read more         Source

June 10, 2008, 8:34 PM CT

First national study to examine golf cart-related injuries

The popularity of golf carts has skyrocketed in recent years, and unfortunately so has the number of golf cart-related injuries. In fact, a new study conducted by scientists in the Center for Injury Research and Policy of The Research Institute at Nationwide Children's Hospital observed that the number of golf cart-related injuries rose 132 percent during the 17-year study period.

As per the study, reported in the recent issue of the American Journal of Preventive Medicine (available online), there were an estimated 148,000 golf cart-related injuries between 1990 and 2006, ranging from an estimated 5,770 cases in 1990 to approximately 13,411 cases in 2006.

As golf carts have become faster and more powerful, they are no longer limited to use on the golf course. In addition to their traditional role, golf carts are now routinely being used at sporting events, hospitals, airports, national parks, college campuses, business parks and military bases. While the study observed that the majority of golf cart-related injuries (more than 70 percent) took place at sports or recreational facilities, individuals injured in carts on the street had an increased risk of concussions and were more likely to require hospitalization than individuals injured in other locations......... Posted by: Emily      Read more         Source