April Flowers for redOrbit.com – Your Universe Online
Moderate exercise is the key to good health in nearly every situation. That is especially true for older adults, according to countless commercials and public health sources.
A new study, called the Lifestyle Interventions and Independence for Elders (LIFE) Study, found that just a 20-minute walk a day could help seniors hold off major disability and enhance the quality of their life.
LIFE is a collaboration between Yale University, the University of Florida, Southern Connecticut State University, Northwestern University, Pennington Biomedical Research Center, Stanford University, Tufts University, the University of Pittsburg, and Wake Forest University. A total of eight field centers participated in the study, the results of which were published in a recent issue of the Journal of the American Medical Association (JAMA) and presented at the American College of Sports Medicine Conference.
Mobility is the ability to walk without assistance. For older adults, mobility becomes the key to independent living and quality of life. Many older adults suffer from a decrease in mobility, which is a risk factor for illness, hospitalization, disability and death. The LIFE study found that moderate physical activity, such as that 20-minute daily walk, helped seniors maintain their ability to walk at a rate of 18 percent higher than those who did not exercise.
“The very purpose of the study is to provide definitive evidence that physical activity can truly improve the independence of older adults,” said principal investigator Marco Pahor, PhD, director of the UF’s Institute on Aging.
Moderate exercise also helped to prevent long-term mobility loss, as well. The study found a 28 percent reduction in people permanently losing the ability to walk easily.
“The fact that we had an even bigger impact on persistent disability is very good,” said Co-principal investigator Jack Guralnik, PhD, a professor of epidemiology and public health at the University of Maryland School of Medicine, who also holds a faculty position at UF. “It implies that a greater percentage of the adults who had physical activity intervention recovered when they did develop mobility disability.”
For the purposes of the study, the researchers defined mobility as the ability to walk 1,300 feet, or approximately one-quarter of a mile. The research team said that although a quarter mile sounds arbitrary, for older adults it is significant.
“Four hundred meters is once around the track, or from the parking lot to the store, or two or three blocks around your neighborhood,” Guralnik said. “It’s an important distance in maintaining an independent life.”
The research team recruited 1,635 men and women ages 70 to 89. The participants were mostly sedentary, with the ability to walk 1,300 feet in 15 minutes, but were in danger of losing that ability. Pahor said that patients with low physical performance are not often the subject of large studies because it can be a predictor of early death, and higher hospitalization and institutionalization rates. This is the largest randomized controlled trial ever conducted on physical activity and health education in older adults.
“These are people who are patients we see every day. This is why this study is so important: It includes a population that is typically understudied,” Pahor said.
The participants were followed for an average of 2.6 years between February 2010 and December 2013. The cohort was separated into two study groups. One group of 818 patients walked 150 minutes per week and did strength, flexibility and balance training. This group visited field centers twice a week for monitoring. The remaining 817 patients attended health education classes and performed stretching exercises.
The participants were assessed by staff members every six months. They were evaluated for their ability to walk, their body weight, blood pressure and pulse rate, along with other measurements. The participants were assigned to their group randomly, and the staff was not informed which patient was in which group.
One surprising result was found: in the physically active group, the number of hospitalizations was slightly higher than in the education group. The increase was not statistically significant, however. The team suggests this could be due to the more frequent contact with research staff of the physical activity group, allowing more opportunities to report hospitalizations. Underlying heart trouble and other health problems could also have been triggered by the activity, which warrants further study, according to Pahor.
“It’s quite a vulnerable and high-risk population,” Pahor said. “Both age and poor health were factors. We selected people who had low physical performance, which is a strong predictor for future morbidity, hospitalization, institutionalization and mortality.”
Before the launch of the main LIFE trial, Wendy Kohrt, PhD, professor of medicine in the division of geriatric medicine at the University of Colorado, helped review the scientific merit of the study.
“As an exercise scientist, I believe this type of research is absolutely critical to establish scientific evidence on which to make recommendations for how lifestyle can beneficially influence health status,” said Kohrt.
“There is a general belief among the public and the scientific and medical communities that we know exercise is good for you, so why do we need to do more research in this area? However, we still do not know whether certain types or doses of exercise are better than others, particularly for specific health conditions or diseases. The LIFE trial demonstrated that a modest increase in physical activity has the potential to help older adults maintain functional independence.”
A great deal of data remains to be analyzed from the study, including the effects of physical activity on the emotional health of the participants. The team plans to continue their research to determine how physical activity impacted the participants’ physiological, social and biological factors.
“We want to change how people live,” said the director of the Yale field center, Thomas Gill, MD, the Humana Foundation Professor of Geriatric Medicine, who chaired the measurement committee, which was responsible for determining the main study outcomes. “Maintaining independence for older adults is both a public health and a clinical priority, and modifying lifestyle is an important approach to maintaining independence.”
Gill added, “Years from now, LIFE will be considered a landmark study, one that has informed policies to keep older persons independent in the community.”

April Flowers for redOrbit.com – Your Universe Online

If you are a smoker, you know that watching someone else light up can give you the urge to smoke as well. Smoking seems to be as much a psychological and social addiction as it is a physical one. How do electronic cigarettes (e-cigarettes) fit into this pattern?

In the first study to investigate the behavioral effects of exposure to e-cigarettes in a controlled setting, a team of researchers from the University of Chicago has found that observing e-cigarette use increases the urge to smoke in young adult smokers who use regular, combustible cigarettes. The findings, published online in Tobacco Control, reveal that the elevated desire to smoke is just as intense when observing e-cigarette use as when observing combustible cigarette use.

“E-cigarette use has increased dramatically over the past few years, so observations and passive exposure will no doubt increase as well,” said Andrea King, PhD, professor of psychiatry and behavioral neuroscience at the University of Chicago, in a recent statement. “It’s important to note that there could be effects of being in the company of an e-cigarette user, particularly for young smokers. For example, it’s possible that seeing e-cigarette use may promote more smoking behavior and less quitting.”

Electronic cigarettes work by delivering nicotine by way of a heated solution of compounds and flavorings. The resulting vapor, which closely resembles the smoke of regular cigarettes, is inhaled by users. Previous studies have examined the health effects of e-cigarette vapor. Until now, however, none have investigated the visual effects.

[ Watch the Video: Seeing E-Cigarette Use Encourages Young Adult Tobacco Users To Light Up ]

King’s team recruited 60 young adult smokers who were told that their responses to a variety of societal interactions were being assessed. Each participant was paired with an actor who would smoke either a regular or e-cigarette during a conversation. The participants’ urge to smoke was measured at multiple points before and after this interaction.

The observer’s desire to smoke both regular and e-cigarettes was shown to increase significantly. The team found that the urge to smoke a regular combustible cigarette was equally as strong after observing either e-cigarette use, or combustible use. On the other hand, the desire to smoke an e-cigarette did not increase after observing regular cigarette use. To mimic hand-to-mouth behavior for a control, the actors also drank from a bottle of water while engaging in conversation with the participants. In this scenario, no discernible increase in desire for either regular or e-cigarette use was found.

“Whether participants were exposed to someone smoking a combustible or an e-cigarette, the urge to smoke a combustible cigarette was just as high in either condition,” King said. “We know from past research that seeing regular cigarette use is a potent cue for someone to want to smoke. We did not know if seeing e-cigarette use would produce the same effect. But that is exactly what we found. When we re-tested participants 20 minutes after exposure, the desire to smoke remained elevated.”

The researchers say that more study is needed due to the rising sales of e-cigarettes nationwide. This study should focus on the health ramifications for users, as well as the passive, secondary effects on observers.

“This study was our first investigation, and there are still many unanswered questions. We don’t know about the effects on a non-smoker or a person who has quit smoking or if responses are different for the various e-cigarette brands,” she said. “But if the results do generalize and we show this in other groups, it’s important to consider policy going forward in terms of reducing harm for both users and observers of e-cigarettes.”

redOrbit Staff & Wire Reports – Your Universe Online
Wikipedia may be the most popular general reference website on the Internet, but it is far from the most accurate, as evidenced by a new study that discovered inaccuracies in 90 percent of its health-related entries.
In the study, lead investigator Dr. Robert Hasty of Campbell University and his colleagues reviewed the collaboratively edited, free access online encyclopedia’s articles on 10 of the most costly medical conditions, including coronary artery disease, lung cancer, osteoarthritis, chronic obstructive pulmonary disease, hypertension, and diabetes mellitus.
The study authors, whose work appears in a recent edition of the Journal of the American Osteopathic Association, randomly assigned a pair of investigators to independently review each article, identifying implications and assertions passed off as fact in those entries. The reviewers then conducted a literature search to find out whether or not there was evidence to support those claims.
According to Alice Philipson of The Telegraph, the researchers found multiple articles that contained factual errors, largely because of the fact that anyone can create and edit entries. For example, the hypertension article claims that for the condition to be correctly diagnosed, high blood pressure readings have to be obtained on three separate occasions – erroneous information that could delay treatment and put patients at risk.
“While Wikipedia is a convenient tool for conducting research, from a public health standpoint patients should not use it as a primary resource because those articles do not go through the same peer-review process as medical journals,” Dr. Hasty, whose team reviewed the 10 Wikipedia articles on April 25, 2012 and found misinformation in all but one of them, told BBC News health reporter Pippa Stephens on Tuesday.
Wikipedia, which launched in 2001, contains over 31 million entries (including at least 20,000 health-related entries) in 285 languages, according to The Daily Mail’s Sophie Freeman. The study authors added that Wikipedia is the sixth most visited website in terms of global traffic, and that between 47 percent and 70 percent of all physicians and medical students having admitted to using it as a reference.
They also note that Wikipedia “has several mechanisms in place to deal with unverifiable information and vandalism,” and that “most instances of vandalism only exist for a few days after being identified, with half of the corrections being posted less than 3 minutes after being identified.” In fact, they cite research which found that corrections were made almost immediately in 42 percent of those incidents.
Furthermore, they pointed that there were several limitations to their study, including the fact that it did not address errors of omission, meaning that they did not check to make sure that the entries lacked essential information about a topic. They also said their findings would have been stronger had more than two reviewers analyzed each article, and that using physicians-in-training rather than content experts as reviewers could have created a bias.
Even so, Dr. Hasty and his co-authors cautioned that “health care professionals, trainees, and patients should use caution when using Wikipedia to answer questions regarding patient care. Our findings reinforce the idea that physicians and medical students who currently use Wikipedia as a medical reference should be discouraged from doing so because of the potential for errors.”
Stevie Benton of Wikimedia UK told Stephens that there were a “number of initiatives” being enacted to help improve the quality of the articles, “especially in relation to health and medicine.” He said that the online encyclopedia was teaming up with Cancer Research UK, having all cancer-related articles reviewed by clinical researchers and making sure that each of them are accurate and contain the latest information on the disease.
“However, it is crucial that anybody with concerns over their health contacts their GP as a first point of call,” he added. “Wikipedia, like any encyclopedia, should not take the place of a qualified medical practitioner.”

Brett Smith for redOrbit.com – Your Universe Online
Critics of so-called ‘diet’ beverages have called them everything from slightly misleading products to liquid poison, but a new study published in the journal Obesity has found that drinking diet beverages can help a person lose weight – compared to water.
“This study clearly demonstrates that diet beverages can in fact help people lose weight, directly countering myths in recent years that suggest the opposite effect – weight gain,” said study author James O. Hill, executive director of the University of Colorado’s Anschutz Health and Wellness Center.
“In fact, those who drank diet beverages lost more weight and reported feeling significantly less hungry than those who drank water alone,” Hill added. “This reinforces that if you’re trying to shed pounds, you can enjoy diet beverages.”
The 12-week study, which included more than 300 participants, directly compared the impact of either water or diet beverages on weight loss within the context of a behavioral weight loss regimen. Study volunteers were randomly put into one of two groups: individuals who were able to drink diet beverages, including diet soft drinks and flavored water, or a control group that could drink only water. Aside from beverage options, both groups followed a similar diet and exercise program for the length of the study.
The study team found that volunteers in the diet beverages group lost an average of 13 pounds – 44 percent more than the control group. Participants in the diet beverage group also reported feeling more satiated, showed cholesterol-related improvements and had lower levels of triglycerides. Both groups had smaller waist sizes and lower blood pressure after the 12-week program.
Nearly two-thirds of the diet beverage group lost at least five percent of their body weight, as opposed to 43 percent of the control group. The researchers noted that losing just five percent of body weight has been linked to a lower risk of heart disease, high blood pressure and type 2 diabetes.
“There’s so much misinformation about diet beverages that isn’t based on studies designed to test cause and effect, especially on the Internet,” said study author John C. Peters, the chief strategy officer of the CU Health and Wellness Center. “This research allows dieters to feel confident that low- and no-calorie sweetened beverages can play an important and helpful role as part of an effective and comprehensive weight loss strategy.”
The results of the new study contradict a study published last year in the journal Cell Press that said diet beverages and other non-caloric, artificially sweetened foods and drinks do not help with weight loss.
The study reviewed data from several recent studies and found a greater risk of type 2 diabetes, high blood pressure, heart disease and metabolic syndrome as a result of regularly consuming artificially sweetened beverages. Some of the studies in the review found that individuals who consume artificially sweetened beverages had twice the risk of developing metabolic syndrome compared to those who avoided them.
Another recent study also found troublingly high levels of a carcinogenic brown food coloring in Pepsi One, a diet soda.

April Flowers for redOrbit.com – Your Universe Online

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released a report showing that the abuse of Xanax, also known as Alprazolam, is rising in the US — as is the number of emergency room visits associated with the drug.

“We’re seeing growth in the number of people who are getting into trouble with these drugs,” says Pete Delany, director of SAMHSA’s Center for Behavioral Health Statistics and Quality, according to USA Today. “Patients really need to be educated that if these drugs are misused, they can be really, really dangerous.”

Between the years of 2005 and 2010, emergency department visits following non-medical use of Xanax more than doubled from 57,419 to 124,902 patients. In 2011, this number remained stable at 129,744 patients.

Xanax is a Schedule IV drug, according to the Food and Drug Administration (FDA), putting it low on what the government considers to be “potential for abuse.” The numbers on the SAMHSA report, which are based on data from SAMHSA’s 2011 Drug Abuse Warning Network (DAWN), seem to disagree.

According to the researchers, using alprazolam in a non-medical manner can result in physical dependence, causing withdrawal symptoms such as tremors and seizures. Combining it with central nervous system depressants such as alcohol or narcotic pain relievers can dangerously enhance the effects of those drugs and result in depressed breathing and heart rate. At worst, the combination can result in unconsciousness and death.

A massive 81 percent of those abusing Xanax used it in combination with some other prescription drug or alcohol. Close to two-thirds of this group used alprazolam with another prescription drug, and one-third of these used it with a prescription pain killer such as oxycodone.

For comparison, in 2011 emergency departments saw 1,200,000 visits related to the non-medical use of prescriptions drugs. Around 10 percent of that number was for Xanax alone.

In 2011 as well, Xanax was the single most commonly prescribed psychiatric medicine. In 2012, the drug was the 13th most commonly sold medication over long. Alprazolam is also known as Xanax XR and Niravam.

“When used as directed, alprazolam is safe and effective, but misuse can result in serious health consequences,” said SAMHSA Administrator Pamela S. Hyde in a recent statement. “This report highlights the need to educate people about the dangers of misusing or sharing prescription medications and the importance of properly disposing of unused medication.”

The Drug Enforcement Agency (DEA) has created a National Prescription Drug Take-Back Day Initiative. SAMHSA supports this program, which provides a safe, convenient, and responsible way for people to dispose of both prescription and over the counter drugs at designated locations. The program also provides education to the public on drug misuse and abuse.

April Flowers for redOrbit.com – Your Universe Online
A great deal of research and marketing has gone into understanding exactly how smoking changes your life expectancy. The outcomes from heavy smoking are bleak, and most people are well aware of these facts. Recently, a team of scientists from Oxford University decided to compare the mortality rates of heavy smoking with those of some of the more common mental illnesses, and the results were surprising.
On average, the study found that mental illness reduces a person’s life expectancy by 10 to 20 years. This is equivalent, or worse than, the loss of years attributed to heavy smoking. The study, published in World Psychiatry, hopes to galvanize governments and social services to put a much higher priority on dealing with mental health issues as a public health issue, the way they do with smoking.
The researchers say that an estimated 25 percent of people in the UK will experience some sort of mental health issue in the course of a year. The number of smokers is similar, with 21 percent of men and 19 percent of women identified as smokers.
To conduct their analysis, the research team collected 20 of the best systemic reviews of clinical studies reporting on mortality rates for a wide range of diagnoses — mental health problems, substance and alcohol abuse, dementia, autistic spectrum disorders, learning disability and childhood behavioral disorders. In total, these studies included over 1.7 million individuals and over 250,000 deaths.
A second collection of studies and reviews was conducted, this time with those reporting life expectancy and risk of dying by suicide. The results were then compared to mortality risks for heavy smoking.
The researchers found that, on average, heavy smokers lose eight to 10 years.
The reduction in average life expectancy for mental illnesses varies. For example, people with bipolar disorder average between nine and 20 years. Schizophrenia sufferers see a reduction of 10 to 20 years, drug and alcohol abuse garners between nine and 24 years, and sufferers of recurrent depression lose seven to 11 years.
Every diagnosis covered in the studies showed an increase in mortality risk. Even though the risk varied greatly between diagnoses, many of them were equal to or greater than that of heavy smoking.
According to a statement by Dr Seena Fazel of the Department of Psychiatry at Oxford University: “We found that many mental health diagnoses are associated with a drop in life expectancy as great as that associated with smoking 20 or more cigarettes a day.”
“There are likely to be many reasons for this. High-risk behaviors are common in psychiatric patients, especially drug and alcohol abuse, and they are more likely to die by suicide. The stigma surrounding mental health may mean people aren’t treated as well for physical health problems when they do see a doctor.”
Fazel, who is also an honorary consultant in forensic psychiatry, believes that one challenge is the tendency of doctors and patients to separate mental illness and physical illness. “Many causes of mental health problems also have physical consequences, and mental illness worsens the prognosis of a range of physical illnesses, especially heart disease, diabetes and cancer. Unfortunately, people with serious mental illnesses may not access healthcare effectively,” says Dr Fazel.
Dr Fazel is certain, however, that “All of this can be changed. There are effective drug and psychological treatments for mental health problems. We can improve mental health and social care provision. That means making sure people have straightforward access to health care and appropriate jobs and meaningful daytime activities. It’ll be challenging, but it can be done.”
He notes, “Beyond that, psychiatrists have a particular responsibility as doctors to ensure that the physical health of their patients is not neglected. De-medicalization of psychiatric services mitigates against that.”
Fazel feels that his results should be a wakeup call for governments and clinicians. He adds, “What we do need is for researchers, care providers and governments to make mental health a much higher priority for research and innovation. Smoking is recognized as a huge public health problem. There are effective ways to target smoking, and with political will and funding, rates of smoking-related deaths have started to decline. We now need a similar effort in mental health.”
Dr John Williams, Head of Neuroscience and Mental Health at the Wellcome Trust, which funded the study, said, “People with mental health problems are among the most vulnerable in society. This work emphasizes how crucial it is that they have access to appropriate healthcare and advice, which is not always the case. We now have strong evidence that mental illness is just as threatening to life expectancy as other public health threats such as smoking.”

[ Watch the Video: Protein May Lead To Malaria Vaccine ]
Lawrence LeBlond for redOrbit.com – Your Universe Online
Malaria remains a dangerous disease in the developing world, killing more than 627,000 people a year, according to the World Health Organization (WHO). Because most deaths associated with malaria occur in children in Sub-Saharan Africa, finding a vaccine against the deadly virus is all too important.
New research, by a team from Rhode Island Hospital (RIH), has uncovered a protein, or antigen, that is essential for malaria-causing parasites to escape from red blood cells. This protein also generates antibodies that can hinder the ability of malaria parasites to multiply, which may protect against severe malaria infection.
This antigen, known as PfSEA-1, was associated with reduced parasite levels among children and adults in malaria-endemic areas. An investigational vaccine was developed using the antigen and when exposing mice to this antigen, the rodents experienced lower malaria parasite levels.
This discovery could be a critical addition to the limited number of antigens that are currently being used in candidate malaria vaccines. The study findings, published in the journal Science, results from a collaboration of scientists from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and NIAID grantees.
“This research really began in 2002 when our colleagues from the National Institutes of Health, led by Patrick Duffy and Michal Fried, enrolled a birth cohort of children in Tanzania,” said lead author Jonathan Kurtis, MD, PhD, director of the Center for International Health Research at RIH. “Six years ago we began using these samples to identify novel vaccine candidates and now it’s coming full circle. While a portion of this research was conducted in mice, the actual vaccine discovery experiments were performed using human samples, thus we believe the results will effectively translate to humans.”
In the mouse experiments, the team conducted five independent vaccine trials in which they were vaccinated with the novel PfSEA-1 (Schizont Egress Antigen-1). All mice were then injected with malaria parasites. In all five experiments, the vaccinated mice had lower levels of parasites and survived much longer than the unvaccinated group.
“When my post-doctoral fellow Dipak Raj discovered that antibodies to this protein, PfSEA-1, effectively trapped the malaria-causing parasite within the red blood cells, it was truly a moment of discovery,” Kurtis said. “Many researchers are trying to find ways to develop a malaria vaccine by preventing the parasite from entering the red blood cell, and here we found a way to block it from leaving the cell once it has entered. If it’s trapped in the red blood cell, it can’t go anywhere… it can’t do any further damage.”
Kurtis and colleagues then measured antibodies to PfSEA-1 in the entire Tanzanian birth cohort of 785 children. They found that among children with antibodies to PfSEA-1, there were zero cases of severe malaria.
The team then went back to a serum bank they had collected from 140 children in Kenya in 1997. They found that the children who had antibodies to PfSEA-1 in this group had 50 percent lower parasitemea than those without the antibodies during a high transmission season.
“Our findings support PfSEA-1 as a potential vaccine candidate, and we are confident that by partnering with our colleagues at the National Institutes of Health and other researchers focused on vaccines to prevent the parasites from entering red blood cells, we can approach the parasite from all angles, which could help us develop a truly effective vaccine to prevent this infectious disease that kills millions of children every year,” Kurtis said in a statement.
The researchers said the results were encouraging, but stressed that more research was required before human trials could begin.
“I am cautious. I’ve seen nothing so far in our data that would cause us to lose enthusiasm. However, it still needs to get through a monkey study and the next phase of human trials,” Kurtis told BBC News.
This study adds to the growing body of work being explored in the race to find a malaria vaccine.
The RTS,S vaccine, developed by GlaxoSmithKline, is one of the more advanced vaccine candidates being pushed for regulatory approval after Phase III clinical trials showed that the drug almost halved the number of malaria cases in young children and in infants reduced the number of malaria cases by 25 percent.
“The identification of new targets on malaria parasites to support malaria vaccine development is a necessary and important endeavor,” Dr Ashley Birkett, director of the PATH Malaria Vaccine Initiative, said in a comment following the latest study.
“While these initial results are promising with respect to prevention of severe malaria, a lot more data would be needed before this could be considered a leading vaccine approach – either alone or in combination with other antigens,” he said in an interview with the BBC.

[ Watch The Video: Microneurosurgical Clipping Of An Unruptured Intracranial Aneurysm ]

University of Helsinki

The lifetime risk for rupture of a brain aneurysm depends heavily on the patient’s overall load of risk factors. However, a recent study by researchers from the University of Helsinki and Helsinki University Central Hospital demonstrated that the size of an aneurysm has no great significance on the risk of rupture.

This is a unique study in that it monitored aneurysm patients over their entire lifetimes, whereas typical follow-up studies last only between one and five years in duration. The study is also exceptionally broad in scope; Dr. Seppo Juvela points out that the only other place where a study of similar scope has been conducted is Japan.

“It is unlikely that another similar, non-selected lifetime follow-up study on aneurysm patients will ever be conducted again,” he states.

Current care practices are based largely on the results of previous, shorter studies. Such studies have shown that the size of the aneurysm is the most significant factor predicting its risk for rupture. Consequently, small (<7mm) aneurysms have often been left untreated, even though such aneurysms have also been known to rupture and cause brain hemorrhages.

The new study established that approximately one third of all aneurysms and up to one fourth of small aneurysms will rupture during a patient’s lifetime. The risk of rupture is particularly high for female smokers with brain aneurysms of seven millimeters or more in diameter. What surprised the researchers most was that the size of an aneurysm had little impact on its risk for rupture, particularly for men, despite a previously presumed correlation. In addition, the risk of rupture among non-smoking men was exceptionally low.

“This is not to say that aneurysms in non-smoking men never rupture, but that the risk is much lower than we previously thought. This means treating every unruptured aneurysm may be unnecessary if one is discovered in a non-smoking man with low blood pressure,” Juvela clarifies.

But why have previous studies not reached these same results if they are so obvious?

“It is difficult to conduct reliable epidemiological research in brain aneurysms. The past 10 years have seen a distortion in the field due to a very limited group of researchers determining the direction for research. Now the situation is clearly changing, and clinically reasonable, population-based studies using non-selected data are on the rise again,” states Docent Miikka Korja of the HUCS neurosurgery clinic.

Finland has a strong tradition of studying the prevalence, risk factors and care of brain aneurysms, and the Helsinki University Central Hospital is one of the world’s leading units to provide treatment for brain aneurysms. Major studies in the field published by Finnish researchers include the world’s most extensive twin study on the hereditability of subarachnoid hemorrhage, the largest follow-up study on subarachnoid hemorrhages among diabetics, the most extensive study on the life expectancy of subarachnoid hemorrhage survivors and a study on the risk factors for subarachnoid hemorrhages using the most extensive population data.

Columbia University Medical Center

Researchers have discovered how a gene commonly linked to obesity—FTO—contributes to weight gain. The study shows that variations in FTO indirectly affect the function of the primary cilium, a little-understood hair-like appendage on brain and other cells. Specific abnormalities of cilium molecules, in turn, increase body weight, in some instances, by affecting the function of receptors for leptin, a hormone that suppresses appetite. The findings, made in mice, suggest that it might be possible to modify obesity through interventions that alter the function of the cilium, according to scientists at Columbia University Medical Center (CUMC).

“If our findings are confirmed, they could explain how common genetic variants in the gene FTO affect human body weight and lead to obesity,” said study leader Rudolph L. Leibel, MD, the Christopher J. Murphy Memorial Professor of Diabetes Research, professor of pediatrics and medicine, and co-director of the Naomi Berrie Diabetes Center at CUMC. “The better we can understand the molecular machinery of obesity, the better we will be able to manipulate these mechanisms and help people lose weight.”

The study was published on May 6 in the online edition of Cell Metabolism.

Since 2007, researchers have known that common variants in the fat mass and obesity-associated protein gene, also known as FTO, are strongly associated with increased body weight in adults. But it was not understood how alterations in FTO might contribute to obesity. “Studies have shown that knocking out FTO in mice doesn’t necessarily lead to obesity, and not all humans with FTO variants are obese,” said Dr. Leibel. “Something else is going on at this location that we were missing.”

In experiments with mice, the CUMC team observed that as FTO expression increased or decreased, so did the expression of a nearby gene, RPGRIP1L. RPGRIP1L is known to play a role in regulating the primary cilium. “Aberrations in the cilium have been implicated in rare forms of obesity,” said Dr. Leibel. “But it wasn’t clear how this structure might be involved in garden-variety obesity.”

Dr. Leibel and his colleague, George Stratigopoulos, PhD, associate research scientist, hypothesized that common FTO variations in noncoding regions of the gene do not change its primary function, which is to produce an enzyme that modifies DNA and RNA. Instead, they suspected that FTO variations indirectly affect the expression of RPGRIP1L. “When Dr. Stratigopoulos analyzed the sequence of FTO’s intron—its noncoding, or nonprotein-producing, portion—we found that it serves as a binding site for a protein called CUX1,” said Dr. Leibel. “CUX1 is a transcription factor that modifies the expression of RPGRIP1L.”

Next, Dr. Stratigopoulos set out to determine whether RPGRIP1L plays a role in obesity. He created mice lacking one of their two RPGRIP1L genes, in effect, reducing but not eliminating the gene’s function. (Mice that lack both copies of the gene have several serious defects that would obscure the effects on food intake.) Mice with one copy of RPGRIP1L had a higher food intake, gained significantly more weight, and had a higher percentage of body fat than controls.

In a subsequent experiment, the CUMC team found that RPGRIP1L-deficient mice had impaired leptin signaling. “The receptors didn’t convene properly on the cell surface around the base of cilium,” said Dr. Leibel. “RPGRIP1L appears to play a role in getting leptin receptors to form clusters, where they are more efficient in signaling.”

“Overall,” said Dr. Leibel, “our findings open a window onto the possible role of the primary cilium in common forms of obesity.”

The CUMC team is now conducting studies to learn more about the various components of the FTO- RPGRIP1L pathway, which ciliary proteins are affected by changes in this pathway, and how these proteins mediate actions of leptin receptors.

Brett Smith for redOrbit.com – Your Universe Online

One year ago last week, Angelina Jolie announced in a New York Times op-ed that she had undergone a preventative double mastectomy – but now a new study indicates that surgically removing both breasts may be unnecessary for women who are diagnosed with cancer in a single breast.

Published in the journal JAMA Surgery, the new study found that approximately 70 percent of women that have both breasts removed after having a breast cancer diagnosis in a single breast do it regardless of having a low risk of having cancer in the healthy breast.

The results of the study are particularly concerning given report of female breast cancer patients increasingly choosing to undergo the preventative measure – called contralateral prophylactic mastectomy (CPM).

“Women appear to be using worry over cancer recurrence to choose contralateral prophylactic mastectomy. This does not make sense, because having a non-affected breast removed will not reduce the risk of recurrence in the affected breast,” said study author Sarah Hawley, an associate professor of internal medicine at the University of Michigan’s Medical School.

In the study, researchers examined more than 1,400 women who had been treated for breast cancer and who had not had a recurrence. They discovered that 8 percent of women had both breasts removed and 18 percent thought about it.

Overall, around three-quarters of patients said they were very concerned about their cancer recurring. Those who decided to have both breasts removed were considerably more prone to say they were worried about recurrence. However, a prognosis of cancer in one breast does not boost the odds of breast cancer affecting the other breast for most women.

The study also looked into approximate clinical signs for double mastectomy, such as the patients’ family background of breast and ovarian cancer and the outcomes of any genetic evaluating.

Women with a family background of breast or ovarian cancer or who tested positive for mutations in the BRCA1 or BRCA2 genes may be asked to think about having both breasts removed, because they are at an elevated risk of a new cancer establishing in the other breast. This signifies approximately 10 percent of all women identified as having breast cancer. Women devoid of these signs will probably not develop another cancer in the healthy breast.

The study discovered that among women undergoing double mastectomy, almost 70 percent did not have either a family history or positive genetic test. Angelina Jolie did report testing positive for a mutation in the BRCA1 gene.

“For women who do not have a strong family history or a genetic finding, we would argue it’s probably not appropriate to get the unaffected breast removed,” Hawley said.

“Decision making surrounding early breast cancer, with respect to CPM in particular, provides an opportunity to encourage a supportive, shared decision-making approach,” wrote Shoshana M. Rosenberg and Dr. Ann H. Partridge of the Dana-Farber Cancer Institute, Boston in an editorial accompanying the study.

“Not only should pros and cons of different treatment options be communicated, but there needs to be consideration of the patient’s personal circumstances and perceptions, all the while addressing anxiety and concerns about breast cancer recurrence and new primary disease (and the distinction between the two),” the editorial continued. “Finding balance around this issue, like the decision process itself, should be a goal shared by patients and clinicians alike.”

April Flowers for redOrbit.com – Your Universe Online

An international team of researchers has discovered a direct link between eating fish, fruit and dairy products with improved lung function in patients with chronic obstructive pulmonary disease (COPD). The study, which is being presented at the American Thoracic Society (ATS) 2014 International Conference, specifically examined COPD patients’ lung function within 24 hours of consuming fish, cheese, grapefruit and bananas.

“Diet is a potentially modifiable risk factor in the development and progression of many diseases, and there is evidence that diet plays a role in both the development and clinical features of COPD,” said Corinne Hanson, PhD, assistant professor of Medical Nutrition at the University of Nebraska Medical Center. “This study aimed to evaluate that association.”

The research team used data collected as part of the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints study (ECLIPSE), which was designed to determine the progression of COPD and identify biomarkers associated with the disease. The team analyzed limited diet records for 2,167 ECLIPSE subjects. The participants provided dietary intake information eight times over a three-year period, reporting the amount of a specific food they had consumed during the past 24 hours.

Standard lung functionality measurements for the same group were analyzed. These assessments included the six-minute walk test (SMWT), St. George’s Respiratory Questionnaire (SGRQ) scores and inflammatory biomarkers. The team adjusted their findings for age, sex, body mass index (BMI) and smoking.

According to the results, people who reported recently consuming fish, grapefruit, bananas or cheese showed improvement in lung function, less emphysema, improved scores on the SMWT, improved scores on the SGRQ, and a decrease in certain inflammatory biomarkers associated with poor lung function including white blood cells and C-reactive protein.

“This study demonstrates the nearly immediate effects a healthy diet can have on lung function in in a large and well-characterized population of COPD patients,” Hanson said. “It also demonstrates the potential need for dietary and nutritional counseling in patients who have COPD.”

Hanson believes that the link between diet as a modifiable risk factor in COPD and the results of the new study deserves further investigation.

University of Southern Denmark
When the doctor gives us medicine, it is often in the shape of a pill. But when it comes to brain diseases, pills are actually an extremely ineffecient way to deliver drugs to the brain, and according to researchers from University of Southern Denmark we need to find new and more efficient ways of transporting drugs to the brain. Spraying the patient’s nose could be one such way.
Every time we have an infection or a headache and take a pill, we get a lot more drugs than our body actually needs. The reason is that only a fraction of the drugs in a pill reaches the right places in the body; the rest never reaches its destination and may cause unwelcome side effects before they are flushed out of the body again. This kind of major overdosing is especially true when doctors treat brain diseases, because the brain does not easily accept entering drugs.
“People with brain diseases are often given huge amounts of unnecessary drugs. During a long life, or if you have a chronic disease, this may become problematic for your health,” says Massimiliano Di Cagno, assistant professor at the Department of Physics, Chemistry and Pharmacy, University of Southern Denmark.
He is concerned with finding more efficient ways of delivering drugs to the brain. He and his colleagues at University of Southern Denmark and Aalborg University have turned their attention to the nose – specifically the nasal wall and the slimy mucosa that covers it.
As we know from e.g. cocaine addicts, substances can be assimilated extremely quickly and directly through the nose. But many medical substances, however, need help to be transported through the nasal wall and further on to the relevant places in the brain.
Researchers have long struggled with this challenge and have come up with different kinds of transport vehicles that are very good at transporting the active ingredients through the nasal wall into the brain. The problem with these vehicles, though, is that they cannot release their cargo of drugs once they have reached the inside of the brain. The drugs stay locked inside the strong vehicles.
“If the drugs cannot get out of their vehicles, they are no help to the patient. So we needed to develop a vehicle that does not lock the drug in,” explains Massimiliano Di Cagno.
The vehicles for drug delivery through the nose are typically made of so called polymers. A polymer is a large molecule composed of a large number of repeats of one or more types of atoms or groups of atoms bound to each other. Polymers can be natural or synthetic, simple or complex.
Direct track to the brain
Massimiliano Di Cagno and his colleagues tested a natural sugar polymer and they now report that this particular polymer is not only capable of carrying the drugs through the nasal wall but also – and most importantly – releasing the drug where it is needed.
“This is an important breakthrough, which will bring us closer to delivering brain drugs by nasal spray,” says Massimiliano Di Cagno.
With this discovery two out of three major challenges in nasal delivery of brain drugs have been met:
“We have solved the problem of getting the drug through the nose, and we have solved the problem of getting the drug released once it has entered the brain. Now there is a third major challenge left: To secure a steady supply of drugs over a long period. This is especially important if you are a chronic patient and need drug delivery every hour or so,” says Massimiliano Di Cagno.
When a patient sprays a solution with active drugs into his nose cavity, the solution will hit the nasal wall and wander from here through the nasal wall to the relevant places in the brain.
“But gravity also rules inside the nose cavity and therefore the spray solution will start to run down as soon as it has been sprayed up the nose. We need it to cling to the nasal wall for a long time, so we need to invent some kind of glue that will help the solution stick to the nasal wall and not run down and out of the nose within minutes,” says Massimiliano Di Cagno.
The work is a collaboration between Massimiliano Di Cagno, Professor Annette Bauer-Brandl and Associate Professor Judith Kuntsche from the Institute of Physics, Chemistry and Pharmacy at the University of Southern Denmark, and Assistant Professor Thorbjorn Terndrup Nielsen and Associate Professor Kim Lambertsen Larsen from the Department of Chemistry and Environmental Engineering at Aalborg University. The team’s work is published in the International Journal of Pharmaceutics.

April Flowers for redOrbit.com – Your Universe Online

There are currently 148 known strains of the human papillomavirus (HPV), and a new study led by NYU Langone Medical Center reveals that 69 percent of otherwise healthy US adults are infected with one or more strains.

The findings, presented at the 2014 American Society for Microbiology Meeting, are derived from what is believed to be the largest and most detailed genetic analysis of its kind. The analysis showed that, out of the 103 people whose DNA was publically available through a government database, they found 109 strains of HPV. Only four participants had either of the two HPV strains known to cause most cases of cervical cancer, some throat cancers, and genital warts.

The majority of the 109 strains appear to be harmless, so far, and can remain dormant in the body for years. In the body, where many viral strains keep each other in check to prevent other strains from spreading uncontrollably, the overwhelming presence of HPV indicates a delicate balancing act. Researchers are increasingly aware that HPV can be spread through skin-to-skin contact, however it remains the most common sexually transmitted infection (STI) in the US — so common, in fact, that if estimates are correct, nearly all men and women contract some strain of it during their lives.

“Our study offers initial and broad evidence of a seemingly ‘normal’ HPV viral biome in people that does not necessarily cause disease and that could very well mimic the highly varied bacterial environment in the body, or microbiome, which is key to maintaining good health,” says NYU Langone pathologist and associate professor Zhiheng Pei, who presented the findings this week.

NYU Langone research scientist Yingfei Ma, PhD, said “the HPV ‘community’ in healthy people is surprisingly more vast and complex than previously thought, and much further monitoring and research is needed to determine how the various non-cancer-causing HPV genotypes interact with the cancer-causing strains, such as genotypes 16 and 18, and what causes these strains to trigger cancer.”

During the two-year study, the research team analyzed data obtained from the National Institutes of Health (NIH) Human Microbiome Project. The project gathers information on the effect microorganisms have on human health.

The NIH researchers used a technique called shotgun sequencing to assemble a comprehensive DNA analysis of the samples. Shotgun sequencing allowed the research team to sort through vast amounts of genetic material contained in the 748 tissue swabs. The tissue samples were collected from the major organs (skin, mouth, vagina, and gut) of healthy participants ages 18 to 80. Shotgun sequencing deciphers the genetic code of long strands of DNA in a random firing pattern.

Until the harm or benefits of the many HPV strains can be understood, Dr. Pei cautions that people should not be overly concerned. To understand any potential threat before seeking treatment, he suggests that they consult with their clinician or an infectious disease specialist. Pei also recommends getting vaccinated against types 16 and 18 to prevent cervical cancer until a broader anti-HPV vaccine becomes available to target other harmful effects.

Additional key findings for the study include:

• Skin infections made up 61 percent, vaginal infections 41 percent, oral infections made up 30 percent, and gut infections counted for 17 percent.

• Seventy-one participants were infected. Of these, 42 had HPV in only one organ (59 percent), 22 had it in two organs (31 percent), and seven had it in three (10 percent). None had HPV infections in all four organs tested.

• The most varied strains of HPV were found in the skin samples (80 types total, with 40 that were only found in skin). The second highest number was found in vaginal tissue 43 types of HPV, with 20 strains exclusive to the organ), followed by mouth tissue (33 types, of which five were exclusively oral in origin), and gut tissue (six types, all of which were found in other organs).

The findings illustrate the weaknesses in current clinical testing for HPV, which are designed to recognize only around a dozen of the viral types most closely tied to cervical cancer. To more accurately assess people’s true HPV infection status, Pei says that broader detection methods are necessary.

Dr. Ma says that the research team intends to continue their investigations by determining which non-cancer-causing strains of HPV might play a role in cancers of the cervix, mouth and skin, as well as developing more comprehensive diagnostic testing kits to detect all strains of HPV.

redOrbit Staff & Wire Reports – Your Universe Online

Couples who are having trouble conceiving might want to have their cholesterol levels checked, according to new research published online Tuesday by The Journal of Clinical Endocrinology and Metabolism.

According to the study authors, high cholesterol could impair fertility, and couples in which each partner had elevated levels took the longest time to conceive. Furthermore, cases in which the woman had a high cholesterol level but not the man also took a greater amount of time to successfully conceive when compared to couples in which both the male and female partners had cholesterol levels that fell in the acceptable range.

“We’ve long known that high cholesterol levels increase the risk for heart disease,” explained first author Dr. Enrique Schisterman, chief of the Epidemiology Branch at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). “In addition to safeguarding their health, our results suggest that couples wishing to achieve pregnancy could improve their chances by first ensuring that their cholesterol levels are in an acceptable range.”

Cholesterol, which is a waxy fat-like substance found within all of the body’s cells, is used to produce vitamin D, hormones and several other types of substances, the researchers explained. Approximately 71 million Americans over the age of 18, or one-third of all adults in the US, have elevated low-density lipoprotein (LDL) or “bad cholesterol” levels, according to the Centers for Disease Control and Prevention (CDC).

The population-based prospective cohort study looked at the pregnancy rate of 501 heterosexual couples from four counties in Michigan and 12 counties in Texas between 2005 and 2009. Each of the couples was involved in the Longitudinal Investigation of Fertility and the Environment (LIFE) study, which examined the link between fertility and exposure to environmental chemicals and lifestyle, and all of them were actively trying to conceive.

Over the course of the 12-month study, 347 of the couples became pregnant, while 54 did not conceive and 100 others withdrew from the study (including some who changed their mind about having a child). Dr. Schisterman and his colleagues measured the cholesterol levels of each potential mother and father by testing a blood sample that was taken at the outset of the study.

Instead of directly measuring HDL cholesterol, LDL cholesterol and triglycerides separately, the investigators opted to measure the total and free amounts of cholesterol in the blood. Based on their findings, they found that couples where one or both partners had high cholesterol took significantly longer to conceive. They believe that blood cholesterol could be linked to fertility because it is used to manufacture the sex hormones testosterone and estrogen.

“Couples in which both the prospective mother and father had high cholesterol levels took the longest time to conceive a child,” said Dr. Schisterman, who was joined on the study by experts from NICHD, Emory University and the University of Buffalo. “Our study also found couples in which the woman had high cholesterol and the man did not took longer to become pregnant than couples where both partners had cholesterol levels in the normal range.”

Brett Smith for redOrbit.com – Your Universe Online
Young children are often encouraged to pursue activities besides watching TV and playing with electronic devices, and a new report has found that sedentary children can exhibit increased risk for type 2 diabetes and cardiovascular disease as young as 6 to 8 years old.
Published in the International Journal of Behavioral Nutrition and Physical Activity, the new report is based on the Finland-based Physical Activity and Nutrition in Children Study (PANIC), which included more than 510 children between the ages of 6 and 8 years old from 2007 to 2009.
Researchers from the University of Eastern Finland administered a survey of their young participants given by parents and validated activity levels by a monitor that tracked heart rate and accelerometry. The study team also assessed body fat percentage, waist circumference, blood glucose, blood pressure and several other biomarkers. Based on this data the team calculated a cardiometabolic risk score for each child.
The researchers found low levels of exercise – and particularly unstructured exercise – are associated with heightened risk factors for type 2 diabetes and vascular diseases. Also, heavy usage of electronic media was associated with greater levels of risk factors in children. The greatest increases in risk factors were discovered in children with lowest amounts of physical activity and highest amounts of electronic media time.
Heavy use of electronic media boosted risk factors not only in inactive children, but also in children who were physically active. Furthermore, irregular eating habits and an unhealthy diet were associated with higher risk factors for type 2 diabetes and vascular diseases. These nutrition-related factors somewhat explain the connection between heavy use of electronic media and the risk factors, the researchers said.
“The results of our study emphasize increasing total and unstructured (physical activity) and decreasing watching TV and videos and other sedentary behaviors to reduce cardiometabolic risk among children,” the Finnish team wrote in their conclusion.
Another electronic device study, currently being conducted by Imperial College and the University of London, is looking to see if Wi-Fi transmissions from devices are damaging to a child’s brain. The UK team is monitoring the development of 11- to 14-year olds while their device usage is tracked via a specially-designed app.
“We need to investigate because it is a new technology,” Paul Elliot, director of Medical Research Council Centre for Environment and Health at Imperial College, told The Telegraph.
“Scientific evidence available to date is reassuring and shows no association between exposure to radiofrequency waves from mobile phone use and brain cancer in adults in the short term,” he added. “But the evidence available regarding long term heavy use and children’s use is limited and less clear.”
The Study of Cognition, Adolescents and Mobile Phones (SCAMP), which claims to be the largest such study in the world, will examine cognitive functions such as memory and attention that develop as a child progresses through adolescence.
“As mobile phones are a new and widespread technology central to our lives, carrying out the SCAMP study is important in order to provide the evidence base with which to inform policy and through which parents and their children can make informed life choices,” said study investigator Mireille Toledano, an epidemiologist at Imperial College.

April Flowers for redOrbit.com – Your Universe Online

How food tastes can influence healthy habits by encouraging or discouraging us from eating certain foods, but can taste do more? According to two new studies published in the Proceedings of the National Academy of Science (PNAS), taste may play a role in our longevity as well.

Our taste buds control our longing for sweet, salty or bitter foods, but the research teams from the University of Michigan, Wayne State University and Friedrich Miescher Institute for Biomedical Research in Switzerland found that they may also play a powerful role in a long and healthy life.

The researchers found that suppressing the ability to taste food in fruit flies, regardless of how much the animal eats, can cause significant increases or decreases in length of life, as well as promote healthy aging.

The fruit flies demonstrated that bitter tastes could negatively affect lifespan, while sweet tastes had positive effects on longevity. The most surprising, however, was the effect of the taste of water. Fruit flies that were unable to taste water lived up to 43 percent longer than flies with the ability, suggesting that the loss of taste might cause physiological changes to help the body adapt to the perception that it’s not getting adequate nutrients.

The researchers suggest fruit flies that have lost the ability to taste water might compensate for a perceived water shortage by storing greater amounts of fat. These fat stores would produce water internally. The researchers plan to continue their studies to understand why bitter and sweet tastes affect aging.

“This brings us further understanding about how sensory perception affects health. It turns out that taste buds are doing more than we think,” said Scott Pletcher, Ph.D., associate professor in the Department of Molecular and Integrative Physiology at the University of Michigan and research associate professor at the Institute of Gerontology and senior author on the first study.

“We know they’re able to help us avoid or be attracted to certain foods but in fruit flies, it appears that taste may also have a very profound effect on the physiological state and healthy aging,” said Pletcher, who worked with Michael Waterson, a PhD graduate student in U-M’s Cellular and Molecular Biology Program.

“Our world is shaped by our sensory abilities that help us navigate our surroundings and by dissecting how this affects aging, we can lay the groundwork for new ideas to improve our health,” said senior author of the other study, Joy Alcedo, Ph.D, assistant professor in the Department of Biological Sciences at Wayne State University, formerly of the Friedrich Miescher Institute for Biomedical Research in Switzerland. Ivan Ostojic, Ph.D., of the Friedrich Miescher Institute for Biomedical Research in Switzerland collaborated with Alcedo on this study.

Health-related characteristics such as athletic performance, Type II diabetes and aging have been shown to be influenced by sensory perception in prior research. These studies, however, are the first to provide in-depth looks into the role of taste perception.

“These findings help us better understand the influence of sensory signals, which we now know not only tune an organism into its environment but also cause substantial changes in physiology that affect overall health and longevity,” Waterson added. “We need further studies to help us apply this knowledge to health in humans potentially through tailored diets favoring certain tastes or even pharmaceutical compounds that target taste inputs without diet alterations.”

Brett Smith for redOrbit.com – Your Universe Online

Although urine has long-been thought to be sterile, a new study has found that not only can bacteria survive in urine – they are relatively prolific in women with overactive bladder (OAB).

“Doctors have been trained to believe that urine is germ-free,” said Linda Brubaker, dean of Loyola University Chicago’s Stritch School of Medicine (SSOM) and an investigator in the new study, which was presented on Sunday as part of the 2014 General Meeting of the American Society for Microbiology being held in Boston.

“These findings challenge this notion, so this research opens the door to exciting new possibilities for patient treatment,” Brubaker added.

In their presentation, the study team said the presence of bacteria had gone undetected because normal bacteria assays aren’t calibrated properly to analyze urine. Co-investigator Evann Hilt said, quite frankly, that researchers in the past weren’t looking to find latent bacteria in urine.

“For all these years, (analyses looked at) whether or not a person had an infection and with that there was a certain threshold that they used to determine whether or not a person was suffering from an infection,” said Hilt, a graduate student at Loyola. “All the bacteria that we see present are below that threshold.”

To detect these bacteria, the researchers assessed urine specimens of 90 women with and without OAB utilizing a new technique known as expanded quantitative urine culture (EQUC). EQUC was capable of finding bacteria that were not discovered by the typical urine culture means normally used to identify urinary tract syndromes.

The team found that the bacteria in the bladders of healthy women vary considerably from those in women suffering from OAB, indicating that particular bladder bacteria are likely involved in OAB. Around 15 percent of women have OAB and about 40 to 50 percent of impacted women do not benefit from typical treatments. One possible reason behind the insufficient therapy response could be the bacteria within the bladder of these women.

“The presence of certain bacteria in women with overactive bladder may contribute to OAB symptoms,” Hilt said. “Further research is needed to determine if these bacterial differences are clinically relevant for the millions of women with OAB and the doctors who treat them.”

“If we can determine that certain bacteria cause OAB symptoms, we may be able to better identify those at risk for this condition and more effectively treat them,” said co-investigator Alan Wolfe, professor of Microbiology and Immunology at SSOM.

“While traditional urine cultures have been the gold standard to identify urine disorders in the past, they do not detect most bacteria and have limited utility as a result,” added Paul Schreckenberger, director of the clinical microbiology laboratory in the Loyola University Health System. “They are not as comprehensive as the EQUC protocol used in this study.”

The study team said they now plan to find out which bacteria in the bladder are beneficial and which are hazardous. They said they will also investigate how these bacteria communicate with each other and interact with their host.

American Thoracic Society
Patients who have survived a stay in the intensive care unit (ICU) have a greatly increased risk of developing symptoms of post-traumatic stress disorder (PTSD), according to a new study presented at the 2014 American Thoracic Society International Conference.
“An ICU stay can be traumatic for both patients and their families,” said Ann M. Parker, MD, a Pulmonary and Critical Care Medicine fellow at Johns Hopkins University in Baltimore, Maryland. “In our analysis of more than 3,400 ICU patients, we found that one quarter of ICU survivors exhibited symptoms of PTSD.” The systematic review of 28 studies involved a total of 3,428 adult ICU survivors. Evaluation included testing with validated PTSD instruments, most commonly the Impact of Events Scale (IES, score range 0-75), administered one month or more after the ICU stay.
In a subset of 429 patients assessed 1-6 months after their stay in the ICU, meta-analysis demonstrated the pooled prevalence of PTSD symptoms was 23% at an IES threshold of ≥35 and 42% at a threshold of ≥20. In 698 patients assessed at 7-12 months, corresponding pooled PTSD prevalence rates were 17% and 34%. Rates in other studies included in the analysis ranged from 5% to 62%.
Risk factors for the occurrence of PTSD symptoms included younger age, use of benzodiazepines and/or mechanical ventilation during the ICU stay, and post-ICU memories of frightening ICU experiences. In some studies of European ICU patients, keeping an ICU diary significantly reduced the occurrence of PTSD symptoms.
Importantly, 3 of 3 studies demonstrated that more PTSD symptoms were associated with worse health-related quality of life.
A potential limitation of this systematic review is the variability of patient populations and PTSD survey instruments studied, which makes direct comparison between studies difficult.
“Our meta-analysis confirms that a large proportion of patients who survive an ICU stay will suffer PTSD symptoms, which are associated with worse health-related quality of life,” said Thiti Sricharoenchai, MD, Instructor in the Division of Pulmonary and Critical Care Medicine at Thammasat University, Thailand who conducted this study as a post-doctoral research fellow at Johns Hopkins University. “Further research should focus on PTSD screening, prevention, and treatment in this vulnerable patient population.”
Dr. Parker and her mentor, Dr. Dale Needham, Associate Professor of Pulmonary and Critical Care Medicine at Johns Hopkins University, are currently planning a study to evaluate an out-patient intervention to address PTSD symptoms in ICU survivors.

Elsevier Health Sciences
Magnet ingestions by children have received increasing attention over the past 10 years. With the growing availability of new and stronger neodymium-iron-boron magnets being sold as “toys,” there has been an increase of cases of ingestion, resulting in serious injury and, in some cases, death. In a new study scheduled for publication in The Journal of Pediatrics, researchers studied the trends of magnetic ingestions at The Hospital for Sick Children (SickKids), Canada’s largest children’s hospital.
Matt Strickland, MD, and colleagues reviewed all cases of foreign body ingestion seen in the emergency department from April 1, 2002 through December 31, 2012. Inclusion criteria included being less than 18 years of age, with suspected or confirmed magnetic ingestion. According to Dr. Strickland, “We chose to limit our scope to the alimentary tract because the majority of serious harm from magnets arises from perforations and fistulae of the stomach, small bowel, and colon.” To reflect the introduction of small, spherical magnet sets in 2009, the study was divided into two time periods, visits during 2002-2009 and those during 2010-2012.
Of 2,722 patient visits for foreign body ingestions, 94 children met the inclusion criteria. Of those, 30 children had confirmed ingestion of multiple magnets. Overall magnet ingestions tripled from 2002-2009 to 2010-2012; the incidence of injuries involving multiple magnets increased almost 10-fold between the two time periods. Six cases required surgery for sepsis or potential for imminent bowel perforation, all of which occurred in 2010-2012. The average size of the magnets also decreased approximately 70% between 2002-2009 and 2010-2012.
This study shows a significant increase in the rate of multiple magnet-related injuries between 2002 and 2012. “More concerning, however,” notes Dr. Strickland, “is the increased number of high-risk injuries featuring multiple, smaller magnets.” Despite new magnet-specific toy standards, labeling requirements, product recalls, and safety advisories issued in the past 10 years, continuing efforts should focus on educating parents and children on the dangers inherent in magnetic “toys.”

April Flowers for redOrbit.com – Your Universe Online
Nearly two million Americans a year suffer from ischemia reperfusion injuries. A wide variety of scenarios can be caused by these injuries that result in restricted blood flow—from traumatic limb injuries, to heart attacks, to donor organs. Restoring the blood flow to an injured leg, for example, seems like it would be a good idea. A new study from Georgia Regents University, however, suggests that restoring the flow could cause additional damage that actually hinders recovery.
Rather than promoting recovery, restoring blood flow actually heightens inflammation and cell death for many of these patients.
“Think about trying to hold onto a nuclear power plant after you unplug the electricity and cannot pump water to cool it down,” said Dr. Jack Yu, Chief of MCG’s Section of Plastic and Reconstructive Surgery. “All kinds of bad things start happening.”
Yu collaborated with Dr. Babak Baban, immunologist at the Medical College of Georgia and College of Dental Medicine at Georgia Regents University. Their study, published in PLOS ONE, reveals that one way stem cell therapy appears to intervene is with the help of an enzyme also used by a fetus to escape rejection by the mother’s immune system.
Baban notes that previous studies have found a correlation between stem cells and recovery. The stem cells both enable new blood vessel growth and by turning down the now-severe inflammation. The new findings reveal that ndoleomine 2,3 dioxygenase, or IDO, widely known to dampen the immune response and create tolerance, plays an important role in regulating inflammation in that scenario. IDO is expressed by stem cells and numerous other cell types.
Stem cell efficiency was boosted by approximately one-third when tested on animal models comparing the therapy in normal mice versus mice missing IDO. Decreased expression of inflammatory markers, swelling and cell death were all observed. These are all associated with shorter, improved recoveries.
“We don’t want to turn off the immune system, we want to turn it back to normal,” Baban said.
Even a brief period of inadequate blood flow, and the resulting lack of nutrients, can start problems that result in the rapid accumulation of destructive acidic metabolites, free radicals, and damage to cell structures. Mitochondria, which are the cells’ power plants, should be producing the energy source ATP. Instead, they quickly become fat, leaky and dysfunctional in this situation.
“The mitochondria are sick; they are very, very sick,” Yu said. Enormous additional stress is added to these sick powerhouses when blood flow is restored.
“They start to leak things that should not be outside the mitochondria,” he said. Cells quickly give up without a source of adequate energy and leaky powerhouses. Inflammation is part of the normal healing process that escalates to help clean up the injury. In this case, however, it makes the problem worse.
The researchers focused their studies on limb injuries, but their findings should translate to any number of scenarios resulting in reperfusion injury. Yu notes that he has seen free flaps, where tissue is moved from one area of the body to another to cover a burn or rebuild a breast, start dying from ischemia reperfusion injury in just two hours.
“It cuts across many, many individual disease conditions,” Yu said. To avoid reperfusion trauma, transplant centers are experimenting with pulsing donor organs.
The team plans to continue their studies by seeing if “more is better”—in other words, giving more stem cells, as well as IDO enhancing drugs. This will include incubating stem cells with IDO. During this study, only one dose was given.
Stem cell therapy isn’t currently in use for aiding in the recovery of limb injuries, but it is being clinically studied to aid stroke and heart attack recovery at MCG and other centers. The best treatment currently available for reperfusion injuries is to restore blood flow and give broad-spectrum antibiotics.
“Sometimes it works, sometimes it doesn’t,” Yu said. “That is why this kind of pharmacologic intervention could be very, very important.”

Brett Smith for redOrbit.com – Your Universe Online

New research from a large team of American researchers has revealed evidence that schizophrenia may originate during fetal development in the womb.

For the study, published in the journal Molecular Psychiatry, researchers analyzed neurons grown in the laboratory from the skin cells of individuals with schizophrenia. The study team noted in its report that these neurons behaved strangely and a similar type of neuronal development in the womb could be a root cause for schizophrenia.

“This study aims to investigate the earliest detectable changes in the brain that lead to schizophrenia,” said study author Fred H. Gage, a professor of genetics at the Salk Institute for Biological Studies in La Jolla, California. “We were surprised at how early in the developmental process that defects in neural function could be detected.”

Scientists currently do not know much regarding the underlying causes of schizophrenia, including which cells in the brain are affected and how. Previous research only had the opportunity to analyze schizophrenia by evaluating the brains of individuals with the condition after death. The effects of age, stress, treatment or substance abuse often ruined the minds of these individuals – making it challenging to pinpoint the disease’s beginnings.

To skirt around these confounding effects, the study team took skin cells from people with schizophrenia, engineered the cells into a stem cell form, and then pushed them to become extremely early-stage neurons called neural progenitor cells (NPCs). These NPCs are very similar to the cells found in the brain of a developing fetus.

“We realized they weren’t mature neurons but only as old as neurons in the first trimester,” said study author Kristen Brennand, the first author of the paper and assistant professor at Icahn School of Medicine at Mount Sinai. “So we weren’t studying schizophrenia but the things that go wrong a long time before patients actually get sick.”

The scientists produced NPCs from the skin cells of four patients with schizophrenia and six individuals without the condition. They screened the cells in two kinds of assays: one in which they viewed how far the cells moved and acted on selected surfaces – and one in which they measured stress in the cells by imaging mitochondria, which are small energy-generating organelles.

The results on both tests showed major discrepancies between cells taken from those with schizophrenia and those without the condition. Cells linked to schizophrenia exhibited abnormal activity in two main classes of proteins: those related to adhesion and connectivity, and those related to oxidative stress. The cells from individuals with schizophrenia also seemed to have both unusual migration – which may cause the development of poor connectivity – and heightened levels of oxidative stress.

The study team said their findings are in keeping with a predominant theory that states events happening during pregnancy can give rise to schizophrenia, despite the fact that the disease doesn’t reveal itself until early adulthood. Past analyses indicate that mothers who suffer from an infection, poor nutrition or extreme stress during pregnancy are at a greater risk of having children who will develop schizophrenia. Scientists suspect both genetic and environmental factors likely play a role in the development of the condition.

“The study hints that there may be opportunities to create diagnostic tests for schizophrenia at an early stage,” Gage said.