Written by Jessica Orwig, Ohio State University

Researchers are using a new model to learn more about how toe strength can determine how far people can lean while keeping their balance.

The results could help in building robotic body parts that will closely imitate human movement, and might lead to a new generation of advanced prosthetics.

Hooshang Hemami, professor of electrical and computer engineering at Ohio State University built a complex computational model of the human foot to look at the role of the feet and toes in determining the body’s movement and balance.

Many studies concerning human balance have emphasized the legs and upper body while ignoring the feet, he said.

Hemami is one of a handful of researchers who are analyzing how manipulating toe strength can affect human balance.
 
“In order to reduce the complexity of the problem, the feet are often either neglected or modeled using simple shapes that don’t really give full credit to the importance of feet,” Hemami continued.

Hemami and a colleague, Laura Humphrey, designed a computer model of a body and foot which assigned four different sections to represent different parts of the foot, while assigning the body one section. This allowed Hemami and Humphrey to focus primarily on the pressure of the feet and toes as they manipulated the forward motion of the body.
 
Hemami and Humphrey’s work was published in a recent issue of the Journal of Biomechanics. The researchers performed simulations of static balance and forward leaning in the computer-modeled body, and compared the results to those observed in the scientific literature.

Static balance is when a subject stands either straight or at a certain angle, and is able to remain stabilized in that position with the entire surface area of the bottom of the foot on the ground. The computer model can perform forward leaning indefinitely, but human subjects will experience muscle fatigue eventually, explained Hemami.
 
The model that Hemami and Humphrey built allowed them to produce results that supported the findings of balance shown in real subjects. They conducted tests for three different cases: static balance in healthy subjects, static balance in subjects with diminished toe strength, and forward leaning in healthy subjects.

In order to have the model mimic a subject with diminished toe strength, Hemami and Humphrey weakened one of the sections in the computer-modeled foot, which represented a muscle located just above the big toe. This muscle helps control the foot’s arch, which provides support to the body while standing.
 
Results indicated that in a healthy person, toes became increasingly important as the person leans forward.

As the computer-modeled body leaned forward, the pressure underneath the toes increased significantly, and the pressure underneath the heel decreased in a similar fashion.
 
When the same tests of static balance were performed on the computer-modeled body with diminished toe strength, the pressure underneath the toes remained at zero. Initially, the pressure underneath the heel was significantly higher than in the healthy subject, and as the body leaned forward, the pressure underneath the heel only decreased by half the amount that it did in the healthy subject.
 
The maximum angle that a healthy computer-modeled body could lean forward from the waist without its heels lifting off the ground was nearly 12 degrees from vertical. The model with diminished toe strength could only lean forward nearly 10 degrees.

The computer model supports past studies on real people, Hemami explained. One discrepancy: his computer model was able to lean forward 12 degrees without lifting its heels, while real people were only able to lean two-thirds as much — 8 degrees.

“This discrepancy could be psychological ““ that people do not feel comfortable using their maximum theoretical range of motion,” said Hemami.

Hemami’s colleague Laura Humphrey was one of his doctoral students, and she has since graduated from Ohio State.
 
“Now that we have a reasonable computer model, we hope to explore, in the future, the sensory apparatus and other functions of the toes in diverse human activities,” Hemami said.

He will be collaborating with Ian Alexander, professor of orthopaedics at Ohio State, in the near future.

In the future, Hemami wants to model the human spinal cord and develop a mathematical system that can determine the level of reaching and pushing required for certain tasks. Hemami uses the example of how much pressure one should administer to hold an egg in your hands without dropping or crushing it.

“My hope is that my work will inspire construction of robotic models of various body parts that can move similarly to the human body. If you can make a robot or computer model kick a soccer ball like a soccer player, we will have a better understanding of how various parts of the body work during movement. Then, perhaps, you can build an artificial spinal cord that could help the handicapped,” Hemami said. “Attaching a robotic spinal cord to the outside of someone who is handicapped could help muscle development.”

“We try to model what muscles do, which may help to develop more advanced prosthetics, so we have something better to offer people who need them,” Hemami explained.

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On the Net:

• Ohio State University
• Journal of Biomechanics

A breakthrough by scientists at The University of Nottingham could provide hope for any allergy sufferers who have ever had to choose between their health and their household pet.

The team of immunologists led by Drs Ghaem-Maghami and Martinez-Pomares in the University’s School of Molecular Medical Sciences, and funded by the charity Asthma UK, have identified a cell component which plays a key role in triggering allergic responses to cat dander.

The discovery furthers our understanding of how the body’s immune system identifies and reacts to allergens, which could pave the way in developing new ways of treating allergies.

The development is especially good news for the millions of people with asthma whose condition is often worsened by their allergy to airborne allergens from cat dander or house dust mite. Cat dander consists of microscopic pieces of cat skin which easily become airborne.

Dr Amir Ghaem-Maghami said: “There has been a sharp increase in the prevalence of allergies over the past few decades and allergic asthma among children has reached epidemic proportions in many industrialized countries, including the UK.

“Despite improvements in patient care, three people die every day in the UK from asthma, and most therapies target symptoms rather than curing the condition.

“Many people with asthma are highly sensitive to airborne allergens such as cat dander or house dust mite “” in fact many studies have shown that up to 40 per cent of children with asthma are allergic to cat allergens.

“A better understanding of how the interaction between allergens and the immune system leads to allergy is vital if we are to develop more effective and efficient treatments for this debilitating condition.”

Dr Elaine Vickers, Research Relations Manager at Asthma UK, says: “We are delighted to see the rapid progress that Dr Ghaem-Maghami and his colleagues are making in such a complex area of research.

“This is a great example of where Asthma UK’s research funding is leading to a better understanding of asthma which could ultimately benefit thousands of people with both asthma and allergies.”

Allergy is a disorder caused by the body’s immune system reacting to usually harmless substances found in the environment, known as allergens. Believing itself under attack, the immune system produces a molecule called IgE, which eventually leads to release of further chemicals (including histamine) by certain immune cells which together cause an inflammatory response and the classic symptoms of allergy “” itchy eyes, sneezing, runny nose and wheezing.

The Nottingham work, recently published in the Journal of Biological Chemistry, has focused on the role of the mannose receptor (MR), a receptor found on the surface of dendritic cells. These cells are among the first cells in the immune system that come into contact with allergens.

The team recently found that the MR binds to a wide range of allergens and plays an important role in the allergic response to house dust mite allergens. In their latest study they looked at the contribution of MR to allergy caused by a major cat allergen called Fel d 1.

They were able to prove that MR is needed for the body to recognize Fel d 1 as a potential foreign invader and for the production of IgE against Fel d 1. The discovery shows that MR plays a pivotal role not only in recognizing allergens but also in provoking the body’s allergic response to them.

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On the Net:

• University of Nottingham
• Journal of Biological Chemistry

Study uses NSF-supported technology to identify neuronal circuitry

A new study sheds light–both literally and figuratively–on the intricate brain cell connections responsible for anxiety.

Scientists at Stanford University recently used light to activate mouse neurons and precisely identify neural circuits that increase or decrease anxiety-related behaviors. Pinpointing the origin of anxiety brings psychiatric professionals closer to understanding anxiety disorders, the most common class of psychiatric disease.

A research team led by Karl Deisseroth, associate professor of psychiatry and behavioral sciences and bioengineering, identified two key pathways in the brain: one which promotes anxiety, and one which alleviates anxiety.

The pathways are in a brain region called the amygdala. Prior research suggests the amygdala plays a role in anxiety, but earlier studies used widespread modifications of the amygdala, through drugs or physical disruption of the brain region, to study the way in which it affects anxiety. This new work, published in this week’s Nature, uses a tool called optogenetics–developed by Deisseroth and recently named Method of the Year by Nature Methods–to specifically tease out which pathways contribute to anxiety.

Optogenetics combines genetics and optical science to selectively manipulate the way a neuron fires in the brain. Neurons are electrically excitable cells that convey information through electrical and chemical signaling.

Directed genetic manipulations cause specific neurons to assemble a light-activated protein normally found in algae and bacteria. When triggered by certain wavelengths of light, these proteins allow researchers to increase or decrease neuronal activity in the brain and observe the effects on rodent models in an experiment.

Using optogenetic manipulation of various amygdala pathways, Deisseroth and colleagues examined how mouse behavior was affected. Since mice display anxiety-related behaviors in open spaces, they measured changes in anxiety by analyzing how much time mice spent exploring the center of an open field, or exploring the length of a platform without walls.

While optogenetics has been used to study amygdala function in behaviorally-conditioned fear, this is the first time it has been used to study anxiety. “Fear and anxiety are different,” Deisseroth explained. “Fear is a response to an immediate threat, but anxiety is a heightened state of apprehension with no immediate threat. They share the same outputs, for example physical manifestations such as increased heart rate, but their controls are very different.”

Anxiety disorders are the most prevalent among all psychiatric diseases, and include diseases such as post-traumatic stress disorder, obsessive-compulsive disorder and phobias. Anxiety also contributes to other major psychiatric disorders such as depression and substance abuse.

“Now that we know that these cell projections [in the amygdala] exist, we can first use this knowledge to understand anxiety more than we do now,” Deisseroth noted.

Deisseroth has previously used optogenetics to study deep brain stimulation in Parkinson’s disease. This research was detailed last year in the journal Science and reported online by the National Science Foundation (NSF).

“Deep brain stimulation is increasingly being considered for psychiatric disorders, so after studying Parkinson’s disease, we started building towards research on psychiatric disorders,” Deisseroth commented. Next he wants to use these tools to study depression and autism spectrum disorders.

Groundwork for the optogenetics technique was funded by NSF. This research was supported by the National Alliance for Research on Schizophrenia and Depression, the National Institutes of Health and NSF.

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Image Caption: A new study supports the role of a brain region called the amygdala in processing anxiety. In this 3-D magnetic resonance imaging (MRI) rendering of a human brain, functional MRI (fMRI) activation of the amygdala is highlighted in red. Credit: NIMH Clinical Brain Disorders Branch

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On the Net:

• NSF
• Stanford University
• Nature

On International Women’s Day (8th March), the European Society of Cardiology (ESC) is calling for action to reduce the gender disparities that are currently resulting in women receiving second rate cardiovascular (CV) care. Studies published online today in the European Heart Journal (EHJ), ´ ² the official journal of the ESC, show a persistent under-utilization of guideline recommended treatments for heart disease in women compared to men.

“The ESC wants to raise awareness, among both cardiologists and the public, that women still are not receiving equal access to medical treatments and also are not being represented sufficiently in clinical trials,” says Marco Stramba Badiale, an ESC spokesman on women’s issues from IRCCS Istituto Auxologico Italiano (Milan, Italy). “The problem is that despite female gender being associated with worse CV outcomes there are still major misconceptions among both health professionals and the public that cardiovascular disease (CVD) isn’t as serious in women as men.”

Data from the World Health Organization (WHO) show that CVD in Europe accounts for 55% of deaths in women compared to just 43% of deaths in men. While breast cancer – perhaps the most feared illnesses among women – is responsible for only 3% of female deaths. Moreover, recent data from the National Health and Nutrition Examination Surveys (NHANES) looking at tends in midlife coronary heart disease risk show over the past two decades the prevalence of myocardial infarction (MI) has increased in women aged 35 to 54 years, while declining in men of the same age.

“It’s very important that physicians are aware that coronary artery disease (CAD) is a frequent disease among women, that gets more common as they get older,” says Thomas Lscher, editor of the EHJ, who has brought together a special issue exploring CV issues facing women.

The studies published in the themed issue raise particular concerns that women are being prescribed fewer drugs than men. “We were shocked to find that even after infarction – the most dramatic cardiac situation we envisage – there’s still a dramatic under-utilization of drugs in women,” says Prof. Thomas F. Lscher, from University Hospital Zurich (Switzerland). “These issues need to be urgently corrected to ensure that women get equal access to state of the art treatments as men.”

In the first EHJ study ´, published online today, cardiologists from the University of Bologna (Bologna, Italy), and the University of Toronto (Toronto, Ontario, Canada), analyzed the medical details of 4471 men and 2087 women who had experienced an acute coronary syndrome (heart attack) between 1999 and 2003. The details (which included 23 clinical variables) were recorded on the Canadian Registry of ACS I and I. Results show that women were less likely to:

* Receive beta-blocker: 75.76 % of women received beta blockers in comparison to 79.24% of men (P<0.01).

* Receive lipid-modifying agents: 56.37 % of women received lipid-modifying agents compared to 65.44% of men (P<0.0001).

* Receive angiotensin-converting enzyme (ACE) inhibitors ““ 55.52% of women received ACE inhibitors compared to 59.99% of men (P<0.01).

The authors led by Raffaele Bugiardini, from the University of Bologna (Bologna, Italy) say that the disparity appears to depend upon multiple factors related to patient age (women are more likely to be older with concerns about prescribing drugs in the elderly), congestive heart failure (women are more likely to develop heart failure during ACS and physicians are reluctant to initiate beta blockers in patients with congestive heart failure), and the physician’s decision to undertake catheterization (women are less frequently referred for cardiac catheterization than men).

However, after adjusting for age, the presence of congestive heart failure, and whether or not the patient underwent catheterization, women still received fewer ACE-inhibitors and lipid lowering drugs than men. “We’ve known for years that women are treated differently from men, but now this study shifts the philosophy and starts to explain why,” says Bugiardini.

In the second study between 2006 and 2008, Nina Johnston and colleagues ² from Uppsala University Hospital and Center for Gender Medicine, Karolinska Institutet, (Stockholm, Sweden) analyzed use of cardiovascular medications and diagnostic coronary angiography in 7195 men and 5005 women with suspected coronary artery disease (CAD) after experiencing chest pain. The patients were all registered in the Swedish Coronary Angiography and Angioplasty Register (SCAAR).

Results showed that prior to undergoing angiography 83% of women had been prescribed aspirin in comparison to 86.1 % of men (P=0.001).

The study also showed that in the youngest age group (those aged under 59 years) 78.8% of women who underwent angiography were found to have normal/ non-significant CAD in comparison to 42.3% of men (P<0.001), and furthermore that 18.2% of men were diagnosed with left main or three vessel disease compared to 4.2% of women (P<0.001). This, say the authors, underlines the difficulty faced by clinicians in diagnosing CAD in women.

In the print version of the EHJ (to be published later in the year) the two papers will be accompanied by an editorial by Noel Bairey Merz, from Cedar-Sinai Heart Institute (California, USA). Merz is an international expert on microvascular coronary dysfunction, a condition where dysfunction of the artery’s ability to dilate causes narrowing and reduced oxygen flow. The condition, Merz believes, affects women far more frequently than men and may explain why it is more difficult to make a diagnosis in women.

“We estimate that microvascular coronary dysfunction accounts for a third to one half of heart disease in mid-life women, but unlike obstructive CAD, it doesn’t show up on an angiogram making it more difficult to diagnose,” explains Merz.

The ESC, who has been campaigning for some time for the inclusion of greater numbers of women in clinical trials for CVD, are calling upon the European Medicines Agency (EMA) to make the fair representation of women in clinical trials a requirement for the licensing of all pharmaceutical agents.

The need for more women to be involved in trials is supported by Work Package 6 of the EuroHeart project, a study that was undertaken by the ESC in conjunction with the European Heart Network to assess the representation of women in clinical trials. The study, which reviewed 62 randomized clinical trials that had been published since 2006 found that out of 389,891 participants, 127.716 (33.5%) were women, and that additionally only 31 out of the 62 trials (50%) reported their analysis by gender.

“It’s very important that data concerning women is analyzed separately because there are often differences in the pharmacodynamics, pharmacokinetics and physiology in comparison to men, making it possible that the efficacy of drugs might be completely different in women,” says Stramba-Badiale.

References

1. R Bugiardini. AT Yan, RT Yan et al. Factors influencing underutilization of evidence-based therapies in women. European Heart Journal. Doi: 10.1093/eurheartj/ehr027.

2. N Johnston, K Schenck-Gustafsson, B Lagerqvist et al. Are we using cardiovascular medications and coronary angiography appropriately in men and women with chest pain? European Heart Journal. Doi: 10.1093/eurheartj/ehr009

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On the Net:

• European Society of Cardiology
• European Heart Journal

Health officials have reported close to a 30 percent drop in young children’s visits to the doctor for ear infections over the past 15 years, and some researchers suggest the decline is partly due to a decline in smoking by parents.

Why the numbers are falling is somewhat of a mystery, but researchers at Harvard University think a decline in the number of smoking parents could be contributing, meaning less irritation of children’s airways. Many doctors credit the growing use of a vaccine against bacteria that causes ear infections. Others think increased breast-feeding is protecting more kids.
ã
Dr. Richard Rosenfeld, an ear, nose and throat specialist form New York, speaking for the American Academy of Pediatrics, said: “We’re sort of guessing here.”

While once being the most common reason parents brought their young children to a doctor, the Centers for Disease Control and Prevention has not issued a report on ear infections in nearly 20 years.

Between 1975 and 1990 visit rates for children under 6 more than doubled for ear infections. One of the main reasons, according to Rosenfeld, was a steady rise in dual-career families. More families put their kids in daycare, and daycare is a breeding ground for germs that can lead to ear infections.

But a Harvard University study suggests that cigarette smoke could be another contributor.

Most infections of the ear occur after a cold. In children, the ear is more directly connected to the back of the nose. So infections in a child’s nose and throat can easily cause ear inflammation, which can then lead to infection.

When a child inhales cigarette smoke through the nose, it can cause the same level of irritation and swelling in the ear, said Dr. Gordon Hughes of the National Institute of Deafness and Other Communication Disorders.

Figures from the CDC show that exposure to secondhand smoke declined from 88 percent in 1990 to about 40 percent in 2007/08.

Harvard research indicates the decline is in line with a drop in childhood cases of ear infections.

“When people are smoking less around their kids, when homes are smoke-free, the rate of ear infections can and has decreased,” Hillel Alpert, lead author of a study published recently by the journal Tobacco Control, told The Associated Press.

The number of medical visits in which the main diagnosis was ear infection dropped by nearly 30 percent from 1993 to 2008 in children 6 and under — from about 17.5 million to 12.5 million. The rate of visits for ear infections dropped by 32 percent, from 636 visits per 1,000 children to 431 per 1,000.

The downward trend, however, has seemed to level off in the past few years.

Some doctors said they have noticed fewer ear infections in their waiting rooms compared to years ago. “We don’t see them that much anymore,” said Dr. Michael Baron, a family practice doctor in Stone Mountain, a suburb of Atlanta.

A vaccine meant to protect against strep bacteria could be another factor in the decline of ear infections in children. The vaccine was first licensed in 2000 and would not account for the drop in cases in the 1990s, however, but has probably contributed to the decline since, according to several experts.

Some studies have also credited antibody-rich breast milk for lowering infants’ risk for respiratory and middle ear infections. Breast-feeding mothers have been on the incline with 77 percent now, up from less than two-thirds in the early 90s.

But for some, these theories may not seem to hold water.

In the Willis household in Charlotte, NC, neither parent smokes, both children had all recommended vaccines, and the mother breast-fed each child for about three months.

Yet their 6 ½-year-old son Hatcher got 10 ear infections in one year when he was younger, and their 21-month-old daughter Libby Jeanne has had four.

Jessica Hyatt, a 21-year-old mother in Spokane, Washington, whose home is also smoke-free, said her 2-year-old daughter Chesnie has had four ear infections, with one lasting nearly two months.

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On the Net:

• American Academy of Pediatrics
• Harvard University
• Centers for Disease Control and Prevention
• Tobacco Control

Under a measure approved on Thursday by the Texas House of Representatives, women seeking an abortion would have to first get an ultrasounds, Reuters is reporting. Women seeking an abortion at any clinic in the state of Texas would have to get an ultrasound between 24 and 72 hours before an abortion, according to the legislation.
 
Patients would view the sonogram, hear an explanation of the image and listen to any audible heartbeat. This first significant bill considered by the House this year, was designated by Republican Governor Rick Perry as an emergency priority. A similar measure has already been approved by the state Senate.

“We want to make sure that they’re fully informed, that they understand the medical consequences, the psychological consequences and everything involved in the procedure,” said the bill’s author, Republican state Rep. Sid Miller.

Rep. Carol Alvarado held up a trans-vaginal probe used for sonograms early in pregnancy to illustrate what she called a “very intrusive process,” in order to illustrate the traumatization for women already in a difficult situation. “This is not the jelly on the belly that most of you think,” said Alvarado, a Houston Democrat. “This is government intrusion at its best.”

Unsuccessfully attempting to include amendments to the bill, Democrats tried to add a series of amendments to the bill. One of those said that if the woman decided not to go through with the abortion, the state would have to pay for the college education for the child.

Another, which also would have applied to cases in which the woman decided not to have the abortion, would have allowed women to get a court order to require the father of the child to get a vasectomy.

Differences between the House and Senate bills need to be worked out, before the bill can go to Perry for his signature. Republicans tried unsuccessfully to pass the sonogram proposal in 2007 and 2009. The measure benefitted from a much larger Republican majority in the House this year after the Republican victories in the 2010 elections.

Strong Republican legislative majorities in 18 other states have regulated the provision of ultrasound by abortion providers, according to the Guttmacher Institute. The requirements in those states vary widely; some of them require women to get an ultrasound before an abortion, while others require only that she be offered the chance to see the image if an ultrasound is performed.

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On the Net:

• Texas House of Representatives

Researchers on Tuesday said that millions of women in developing countries will live with the threat of disease and early death in the coming decades due to tobacco, stemming from their rising economic and political status.

The study, published in the World Health Organization (WHO) Bulletin, analyzed 74 countries and found that men are five times more likely to smoke than women in countries where women have lower rates of female empowerment, such as China, Indonesia, Pakistan and Saudi Arabia.

In countries like the United States, Australia, Canada and Sweden, where female empowerment is relatively high, the gap is small and women tend to smoke almost as much as men do.

The findings showed there is great need for governments to act quickly to cut smoking rates among women, especially in less-developed countries, said Douglas Bettcher, director of the WHO Tobacco Free Initiative.

“The tobacco epidemic is still in its early stages in many countries but is expected to worsen,” Bettcher told Reuters in a statement. “Strong tobacco control measures such as bans on tobacco advertising are needed to prevent the tobacco industry from targeting women.”

The WHO describes tobacco as “one of the biggest public health threats the world has ever faced.” The annual death toll associated with tobacco use is more than 5 million, according to experts, and it could rise beyond eight million by 2030 unless action is taking to curb smoking.

The study found that in China, for example, 61 percent of men are reported to be current smokers, with only 4.2 percent of those being women, while in many rich nations the ratio gap between men and women smokers is nearly non-existent.

The United Nations Development Program measures women empowerment using data such as representation in parliament, voting rights and comparisons of male and female income.

“Our study makes a strong case for implementing gender-specific tobacco control activities … such as more higher tobacco taxes, more prominent graphic health warnings, smoke-free laws, and advertising and promotion bans,” said Geoffrey Fong from the University of Waterloo in Ontario, Canada, who led the study.

Coauthor of the study, Sara Hitchman, said authorities should investigate “the ways in which the tobacco industry is capitalizing on societal changes to target women, such as marketing cigarettes to women as a symbol of emancipation.”

A useful step could be to monitor how price and tax measures affect women’s choices in taking up smoking in countries where tobacco is not yet widely used by them, said the two authors of the study.

“Further research into patterns of uptake could help governments take more effective action and reduce adoption rates for smoking among women in the future,” Hitchman said.

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On the Net:

• World Health Organization Bulletin
• WHO Tobacco Free Initiative
• United Nations Development Program
• University of Waterloo

The U.S. Drug Enforcement Administration (DEA) used its emergency powers on Tuesday to ban five chemicals used to produce “K2”, “Spice” and other brands of synthetic marijuana.

The agency classified the five banned chemicals in Schedule I, the most restrictive category under the federal government’s Controlled Substances Act.

Schedule I substances are reserved for those materials with a high potential for abuse, no accepted medical use for treatment and a lack of accepted safety for use under medical supervision.

“The DEA today exercised its emergency scheduling authority to control five chemicals (JWH-018, JWH-073, JWH-200, CP-47,497, and cannabicyclohexanol) used to make so-called “fake pot” products,” the DEA said.

“Except as authorized by law, this action makes possessing and selling these chemicals or the products that contain them illegal in the United States.”
 
“This emergency action was necessary to prevent an imminent threat to public health and safety.”

The agency filed a final notice on Monday that the chemicals will be banned for sale for at least a year, while the DEA and the U.S. Department of Health and Human Services determine whether these chemicals should be permanently controlled.

The Final Order was published Tuesday in the Federal Register to alert the public.

Synthetic marijuana is typically sold in drug paraphernalia shops and over the Internet, and is marketed under various brands including Spice, K2, Blaze and Red X Dawn. The products contain organic leaves coated with chemicals that, when smoked, trigger a marijuana-like high.

DEA officials announced plans for the emergency measure in November, amid increasing reports from poison control centers, hospitals and law enforcement regarding these products.

“Emergency room physicians report that individuals that use these types of products experience serious side effects which include: convulsions, anxiety attacks, dangerously elevated heart rates, increased blood pressure, vomiting, and disorientation,” the DEA said in a statement.

“Young people are being harmed when they smoke these dangerous “Ëœfake pot’ products and wrongly equate the products’ “Ëœlegal’ retail availability with being “Ëœsafe’,” said DEA Administrator Michele Leonhart.

“Parents and community leaders look to us to help them protect their kids, and we have not let them down. Today’s action, while temporary, will reduce the number of young people being seen in hospital emergency rooms after ingesting these synthetic chemicals to get high.”

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On the Net:

• DEA Statement
• Federal Register Filing
• Image Courtesy Schorle/Wikipedia (CC BY-SA 3.0)

U.S. researchers said on Monday that half of the men in the general population may be infected with human papillomavirus or HPV, the virus that causes cervical and other cancers.

U.S. vaccine advisers have been weighing whether boys and young men should be vaccinated against the human papillomavirus, but some worry the vaccine is too costly to justify its use.

HPV infection is know best for causing cervical cancer, which is the second most common cancer in women around the world.  However, various strains of HPV cause anal, penile, head and neck cancers.  Vaccinating men and boys would prevent some of these cancers.

Anna Giuliano of the H Lee Moffitt Cancer Center and Research Institute in Tampa, Florida, and colleagues studied infection rates among over 1,100 men aged 18 to 70 in the U.S., Brazil and Mexico to get a snapshot of the natural progression of HPV infection in men.

“We found that there is a high proportion of men who have genital HPV infections. At enrollment, it was 50 percent,” Giuliano, whose study appears online in the journal Lancet, told Reuters.

The team found that the rate at which men acquire new HPV infections is very similar to women.

They also found that about 6 percent of men per year will get a new HPV 16 infection, which is the strain that is known for causing cervical cancer in women and other cancers in men.

Vaccines made by Merck & Co. and GlaxoSmithKline offer protection against this strain of HPV.

“The biology seems to be very similar (to women),” Giuliano said in a telephone interview with Reuters.

“What is different is men seem to have high prevalence of genital HPV infections throughout their lifespans.”

She said it appears that some women are able to clear an HPV infection, especially as they age, but men do not appear to have this same ability.

Vaccine experts said the study builds momentum for widespread HPV vaccination among boys.

U.S. Centers for Disease Control and Prevention (CDC) recommends Gardasil vaccinations for girls and women between the ages 11 and 26.  Gardasil had sales of over $1 billion last year.

While doctors are free to use the vaccine in boys and men ages 9 through 26, U.S. health officials have declined to recommend routine vaccination for males.

“This study highlights the high incidence of HPV infection in men, which emphasizes their role in transmission of HPV to women,” Dr. Anne Szarewski of the Wolfson Institute of Preventive Medicine in London said in a statement.

“It must surely strengthen the argument for vaccination of men, both for their own protection, and that of their partners.”

The U.S. Food and Drug Administration (FDA) approved Merck’s Gardasil HPV vaccine for prevention of anal cancers in both men and women, based on studies showing Gardasil was effective in men who have sex with men.

Anal cancer is less common than other types of cancer.  It shows up in about 5,300 new U.S. cases each year, but the incidence is increasing.

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On the Net:

• H Lee Moffitt Cancer Center and Research Institute
• Lancet

Discovery could lead to new therapies for alcoholism

University of Maryland School of Medicine researchers have identified two genes associated with binge drinking that may open doors to new, more effective treatments for excessive alcohol drinking. The scientists found that manipulating two receptors in the brain, GABA receptors and toll-like receptor 4 (TLR4), “caused profound reduction” of binge drinking for two weeks in rodents that had been bred and trained to drink excessively. The study was published online the week of Feb. 28 in the journal the Proceedings of the National Academy of Sciences.

About 30 percent of Americans who drink do so excessively, and about 75,000 people die each year from the effects of excessive drinking. Current treatments for excessive alcohol drinking include prescription drugs Revia and Campral for controlling cravings. To ease withdrawal symptoms, doctors often prescribe medications such as Valium and Librium that carry their own risks of addiction. Valium and Librium reduce the anxiety alcoholics feel when they stop drinking but do not reduce cravings for alcohol.

The new study found that treatments that manipulate both the GABA receptor and toll-like receptor 4 have the potential to reduce anxiety and control cravings, with little to no risk for addiction, according to lead investigator Harry June, Ph.D., professor of psychiatry and pharmacology and experimental therapeutics at the University of Maryland School of Medicine. The study was funded in part by the National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health.

“Binge drinking “” defined as achieving a blood-alcohol content of .08 g percent, the legal limit in many states, in a two-hour period “” is a serious form of excessive drinking,” says Dr. June. “This is the kind of drinking we see with college students on spring break, and even some adults. It doesn’t meet the classic definition of alcoholism, characterized by dependence and a long period of drinking followed by withdrawal. But binge drinking carries the same serious health risks as other types of excessive drinking: Cancer, heart disease and, most notably, the serious public health issue of vehicle accidents.”

In the study, Dr. June and senior author Laure Aurelian, Ph.D., professor of pharmacology and experimental therapeutics and microbiology and immunology at the University of Maryland School of Medicine, examined the effect of alcohol on the GABA receptor and TLR4. GABA receptors are a class of receptors in the brain that react to the neurotransmitter GABA and act as inhibitory receptors, calming down or inhibiting the activity of neurons in the brain. GABA receptors react to alcohol, giving drinkers a calm and euphoric feeling and reinforcing excessive drinking behavior. Dr. June has long been interested in the role GABA receptors play in alcoholic drinking. This is the first scientific study to document GABA receptors’ key involvement in binge drinking specifically, though scientists already believed that the receptors had a role in excessive drinking in general.

“The University of Maryland School of Medicine employs a dual approach to addiction and substance abuse, providing treatment for those struggling with addiction through its Division of Alcohol and Drug Abuse, as well as invaluable scientific research into the biological roots of addiction and alcoholism,” says E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs for the University of Maryland and the John Z. and Akiko K. Bowers Distinguished Professor and dean of the School of Medicine. “We hope that basic science discoveries such as this one will translate rapidly into better treatments to improve the lives and health of those struggling with alcohol, and address the serious public health issue of addiction and substance abuse.”

One of the study’s most novel findings concerns TLR4’s important role in binge drinking. Science has traditionally considered TLR4 to be an innate immunity receptor involved with neuroinflammation in the brain. Scientists associated TLR4 with microglia, cells that support inflammatory responses in the brain. “What makes this finding particularly important for the field of neuroscience is that we’re showing that TLR4 plays a significant role in neurons, specifically, the neurons that are connected to the GABA receptor,” says Dr. June.

To establish the connection between the GABA receptors, TLR4 and alcohol, the scientists manipulated this pathway in the binge drinking rodents. Dr. Aurelian was a pioneer in developing a method to inhibit gene expression, helping scientists to pinpoint the role of individual genes in the body. In this study, she used a herpes viral vector “” a deactivated herpes virus “” to deliver a gene-modifying agent directly to the neurons in the brain, to target TLR4 and GABA receptors. The scientists found that when they artificially stimulated the GABA receptors and TLR4 in order to simulate the good feelings binge drinkers feel when drinking alcohol, the rats lost interest in alcohol for two weeks after the procedure.

Compounds exist that would stimulate the receptors in the same way the scientists did in the study. “It’s very likely that, down the road, these compounds could become new therapies for binge drinking,” says Dr. June. “These compounds would act like a substitute for alcohol, much like methadone acts as a substitute for heroin. They would help alcoholics stop drinking, giving them relief from their cravings and from the anxiety that they try to alleviate with drinking.”

The next step is to further investigate the newly discovered role that TLR4 plays in binge drinking. Future treatments could target both GABA receptors and TLR4, or just TLR4, depending on what scientists find, according to Dr. June. More study is needed, says Dr. Aurelian: “The discovery of this involvement of TLR4 in a pathway with GABA is most remarkable. This study provides basically a totally new understanding of what TLR4 and GABA are all about. That’s exciting, but there is a lot more to learn about this pathway and where it goes beyond this point. This is a fascinating new paradigm we plan to explore further.”

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On the Net:

• University of Maryland Medical Center
• Proceedings of the National Academy of Sciences

Going to college to earn an advanced degree could keep you healthier in the long run, according to a new study that had discovered a link between education and lower blood pressure.

The research, published Sunday in the journal BMC Public Health, used data from the Framingham Offspring Study to follow 3,890 subjects for a period of 30 years.

Over that time, they discovered that men who received at least 17 years of education had a lower average body mass index (BMI), smoked less and consumed fewer alcoholic drinks than their lesser-educated counterparts.

Likewise, they discovered that women who pursued post-secondary education had lower BMI and smoked less than women who did not receive more than 17 years of lifetime education.

Unlike their male counterparts, however, they did tend to drink more than those who did not spend a considerable amount of time attending college or university after high school.

In fact, according to an AFP report on Monday, the study discovered that “women with 17 years or more of education–a master’s degree or doctorate–had systolic blood pressure readings 3.26 millimeters of mercury lower than female high school drop-outs.”

“Men who went to graduate school had systolic blood pressure readings that were 2.26 millimeters of mercury (mmHg) lower than their counterparts who did not finish high school,” the authors of the study also discovered, according to the French news agency.

Those benefits “persisted, although at a lower level” even when other factors, such as smoking, drinking, and obesity, were taken into account, the AFP also reported.

According to the researchers, whose journal findings were reprinted in a BBC News article on Sunday, “Low educational attainment has been demonstrated to predispose individuals to high strain jobs, characterized by high levels of demand and low levels of control, which have been associated with elevated blood pressure.”

As study co-author and Brown University Professor Eric Loucks told the British news agency, “Women with less education are more likely to be experiencing depression, they are more likely to be single parents, more likely to be living in impoverished areas and more likely to be living below the poverty line.”

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On the Net:

• BMC Public Health
• Framingham Offspring Study
• Brown University

Reynolds and Lorillard, the second- and third-biggest US cigarette makers, filed suit to block the US Food and Drug Administration (FDA) from receiving recommendations from an advisory committee that the cigarette makers claim have conflicts of interest, Reuters is reporting.

Reynolds, a unit of Winston-Salem, North Carolina-based Reynolds American Inc., makes Camel and Winston cigarettes in addition to its Kool and Salem menthol brands. Lorillard Tobacco is a unit of Lorillard Inc., based in Greensboro, North Carolina. It makes Newport, the top-selling menthol brand.

The plaintiffs seek an order preventing the FDA from receiving the report, which is thought to include recommendations on the use of menthol in cigarettes. Mentholated cigarettes make up roughly 30 percent of US annual cigarette sales of more than $83 billion, according to Euromonitor International.

The FDA was given regulatory power over tobacco products in 2009 and the legislation called on the FDA to seek advice from a panel of outside experts before determining whether menthol cigarettes should also be taken off the US market.

Filed in US District Court for the District of Columbia, the lawsuit accuses three panel members of having “severe financial and appearance conflicts of interest and associated biases,” and the suit claims these three advisers have received funding for research or consultation work from drug makers that make smoking-cessation products.

According to the suit, two others on a panel subcommittee also have biases because they have served as paid expert witnesses in lawsuits against tobacco companies. Health advocates denounced the lawsuit as a frivolous attempt to keep the FDA panel’s recommendation from coming to light.

Matthew Myers president of the Campaign for Tobacco-Free Kids, tells Reuters, “They fear that the committee, having examined the evidence, will recommend effective actions that reduce or eliminate the lucrative market for menthol cigarettes, said “Once again, they are putting profits ahead of lives and health.”

Since the FDA’s panel began holding meetings last year, all three companies have spoken out against any menthol ban. The advisers are scheduled to meet on March 2 and March 17 ahead of issuing its report. The FDA is not bound to follow its recommendations and the law did not set a deadline for any action on menthol.

“As a matter of general policy, the FDA does not comment on possible, pending or ongoing litigation,” FDA spokesman Jeff Ventura concluded.

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On the Net:

• FDA
• Reynolds American Inc.
• Lorillard Inc.

New research in the FASEB Journal suggests that a gene called CMAH has been lost during the course of recent evolution, and may lead to an increased risk of Type 2 diabetes in humans

As if the recent prediction that half of all Americans will have diabetes or pre-diabetes by the year 2020 isn’t alarming enough, a new genetic discovery published online in the FASEB Journal (http://www.fasebj.org) provides a disturbing explanation as to why: we took an evolutionary “wrong turn.” In the research report, scientists show that human evolution leading to the loss of function in a gene called “CMAH” may make humans more prone to obesity and diabetes than other mammals.

“Diabetes is estimated to affect over 25 million individuals in the U.S., and 285 million people worldwide,” said Jane J. Kim, M.D., a researcher involved in the work from the Department of Pediatrics at the University of California, San Diego in La Jolla, CA. “Our study for the first time links human-specific sialic acid changes to insulin and glucose metabolism and therefore opens up a new perspective in understanding the causes of diabetes.”

In this study, which is the first to examine the effect of a human-specific CMAH genetic mutation in obesity-related metabolism and diabetes, Kim and colleagues show that the loss of CMAH’s function contributes to the failure of the insulin-producing pancreatic beta cells in overweight humans, which is known to be a key factor in the development of type 2 diabetes. This gene encodes for an enzyme present in all mammalian species except for humans and adds a single oxygen atom to sialic acids, which are sugars that coat the cell surface.

To make their discovery, the researchers used two groups of mice. The first group had the same mutant CMAH gene found in humans. These mice demonstrated that the CMAH enzyme was inactive and could not produce a sialic acid type called NeuSGc at the cell surface. The second group had a normal CMAH gene. When exposed to a high fat diet, both sets of mice developed insulin resistance as a result of their obesity. Pancreatic beta cell failure, however, occurred only in the CMAH mutant mice that lacked NeuSGc, resulting in a decreased insulin production, which then further impaired blood glucose level control. This discovery may enhance scientific understanding of why humans may be particularly prone to develop type 2 diabetes. Results may also suggest that conventional animal models may not accurately mirror the human situation.

“The diabetes discovery is an important advance in its own right. It tells us a lot about what goes wrong in diabetes, and where to aim with new treatments,” said Gerald Weissmann, M.D., Editor-in-Chief of the FASEB Journal, “but its implications for human evolution are even greater. If this enzyme is unique to humans, it must also have given us a survival advantage over earlier species. Now the challenge is to find the function of CMAH in defending us against microbes or environmental stress or both. This evolutionary science explains how we can win some and lose some, to keep our species ahead of the extinction curve.”

Details: Sarah Kavaler, Hidetaka Morinaga, Alice Jih, WuQiang Fan, Maria Hedlund, Ajit Varki, and Jane J. Kim. Pancreatic ÃŽ²-cell failure in obese mice with human-like CMP-Neu5Ac hydroxylase deficiency. FASEB J. fj.10-175281; doi:10.1096/fj.10-175281 ; http://www.fasebj.org/content/early/2011/02/22/fj.10-175281.abstract

Ranked among America’s Top Surgeons & Gynecologists, Tamer Seckin, MD has over two decades of experience and has established himself internationally as a leading specialist in Advanced Laparoendoscopic Surgery for the treatment of endometriosis and associated pelvic pain pathologies.  An active educator and philanthropist, Dr. Seckin has set forth efforts to correct misdiagnoses and raise public awareness for this disease that, though estimated to affect the lives of 1 in 10 women and adolescents, is commonly ignored. Through his founding of the Endometriosis Foundation of America, Dr. Seckin has lent a voice and sense of urgency to endometriosis.

What is Endometriosis?

During monthly menstruation, the female body sheds the uterine lining (endometrium); for women with endometriosis, menstrual fluids leak back into the body in areas outside of the uterus, leading to the development of painful and invasive nodules, adhesions and inflammation of surrounding areas.

Who does it affect?

This reproductive disorder afflicts an estimated 176 million women and girls globally; 8.5 million in North America alone.

What are possible signs?

These may include severe cramping and chronic pelvic pain, severe painful periods, infertility and pain associated with sex.

What happens?

Endometriosis is a leading cause of infertility and chronic pelvic pain; while treatable, early diagnosis and timely intervention are crucial, as length and degree of treatment increases. Many patients are incorrectly informed by their doctors and treated for symptoms – but not the disease itself.

Leading extensive research and collaboration with scientists, women’s health professionals and patients, as well as continued outreach and education efforts, Dr. Seckin and the EFA strive to further develop public knowledge of endometriosis and promote early diagnosis and effective intervention.

Dr. Seckin is a NOTES patent holder and has given presentations and lectures at all major conferences in his field on topics ranging from endometriosis awareness to advanced Laparoendoscopic techniques in New York City, Mexico, Croatia, Turkey, Italy, Malaysia, India, South Africa, Portugal, China, Argentina, Japan and Germany. In addition to his duties as Chief of the Gynecological Department at Kingsbrook Jewish Medical Center in Brooklyn, NY, Dr. Seckin serves as an Associate Attending Physician and Clinical Instructor at Lenox Hill Hospital and New York Methodist Hospital (Weill Medical College of Cornell University) and maintains a busy private practice in New York City. Dr. Seckin serves on the board of the International Society for Gynecologic Endoscopy, is a member of the American Medical Association, the American College of Obstetrics & Gynecology, the European Society of Reproductive Endocrinology, the Society of Laparoendoscopic Surgeons, the American Association of Gynecologic Laparoscopy, the American Fertility Society, the American Society for Reproductive Medicine, the Society of Reproductive Surgeons, the New York Gynecological Society and the Society of Reproductive Endocrinology and Infertility.

The Endometriosis Foundation of America (EFA) is a non-profit organization focused on fighting against the devastating effects of a disease that affects millions of women and adolescent girls. Through increased awareness, education, research and legislative advocacy, the EFA is committed to improving affected individuals’ lives by early detection and treatment.

For further information, please visit www.endofound.org.

Speaking directly into a cellphone while holding it against your ear can alter brain activity in those areas closest to the device’s antenna, claims a new study published Tuesday in the Journal of the American Medical Association (JAMA).

Researchers at the National Institutes of Health (NIH) and the Brookhaven National Laboratory in New York studied 47 adults over the course of a year, using positron emission tomography (PET) to measure their glucose metabolism, or the amount of sugar it takes a cell to fuel activity, according to Shirley S. Wang of the Wall Street Journal.

“They conducted scans after subjects had cellphones held to their left and right sides for 50 minutes on two different days,” she said. “The first day neither cellphone was turned on. The second day the right phone was activated but muted so the participants wouldn’t hear any noise. Because the participants didn’t know which phone was active, their expectations couldn’t skew the results.”

They discovered that areas of the brain that were closest to the antenna became “significantly more active” when an operational cellphone was held next to the ear, even when it wasn’t used to conduct a conversation, according to Wang.

In fact, their glucose metabolism levels spiked an average of 8% to 10%, which is said to be comparable to the increase in metabolism in the visual cortex when speaking to someone, study author Dr. Nora Volkow told the Wall Street Journal.

What remains unclear is whether or not that alteration of brain activity can cause harm to the orbitofrontal cortex, which is the region affected by the cellphone activity.

In an interview with USA Today’s Mary Brophy Marcus, Murali Doraiswamy, the head of biological psychiatry at Duke Medical Center, said that the orbitofrontal cortex is “broadly associated with emotion, sense of smell, memory, eating, aggression–a whole range of behaviors. It’s like an orchestra conductor instead of just an individual musician with specific task.”

Doraiswamy was not involved in the study.

Neither was Keith Black, chairman of neurosurgery at Cedars-Sinai Medical Center in Los Angeles, who told Marcus, “This study raises a lot of questions”¦ Will cellphones impact how we remember things, is there any relation to the risk of Alzheimer’s? Will it affect our cognitive ability to manipulate language functions?”

Black told Marcus that cellphone users should uses a headset, and that texting probably would not have any adverse effects either. Doraiswamy noted that he “always” used speaker phone and never placed the device close to his head, and Volkow herself told Julie Steenhuysen of Reuters that the results of the study have prompted her to begin using an earpiece as well.

“I don’t say there is any risk, but in case there is, why not?” the NIH researcher added.

Earlier this month, a University of Manchester study reported that radio frequency exposure from cellphone use did not appear to significantly increase the risk of developing brain cancer.

“Our research suggests that the increased and widespread use of cellphones, which in some studies was associated to increased brain cancer risk, has not led to a noticeable increase in the incidence of brain cancer in England between 1998 and 2007,” lead researcher Dr. Frank de Vocht, an occupational and environmental health expert at the university, said in a statement.

“It is very unlikely that we are at the forefront of a brain cancer epidemic related to cellphones, as some have suggested, although we did observe a small increased rate of brain cancers in the temporal lobe corresponding to the time period when cellphone use rose from zero to 65% of households,” he added.

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On the Net:

• Journal of the American Medical Association (JAMA)
• National Institutes of Health (NIH)
• Brookhaven National Laboratory
• University of Manchester

The Department of Health and Human Services (HHS) said Tuesday that it has imposed a $4.3 million civil money penalty (CMP) on Maryland-based Cignet Health, saying the company had violated the 1996 HIPAA Privacy Rule.

The move represents the first time the HHS has issued such a penalty for a covered entity’s violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule.

“Ensuring that Americans’ health information privacy is protected is vital to our health care system and a priority of this Administration. The U.S. Department of Health and Human Services is serious about enforcing individual rights guaranteed by the HIPAA Privacy Rule,” said HHS Secretary Kathleen Sebelius.

The penalty is based on the violation categories and increased penalty amounts authorized by Section 13410(d) of the Health Information Technology for Economic and Clinical Health (HITECH) Act, the Department said.

In a Notice of Proposed Determination issued last October, the Department’s Office for Civil Rights (OCR) found that Cignet violated 41 patients’ rights by denying them access to their medical records when requested between September 2008 and October 2009.

These patients individually filed complaints with the OCR, triggering investigations of each complaint.

The HIPAA Privacy Rule requires that a covered entity provide a patient with a copy of their medical records within 30 days (and no later than 60 days) of the patient’s request. The CMP for these violations is $1.3 million.

However, during the investigations, Cignet refused to respond to OCR’s demands to produce the records, or to produce the records in response to an OCR subpoena, the Department said. 

OCR filed a petition to enforce its subpoena in U.S. District Court, obtaining a default judgment against Cignet last March.  One month later, Cignet produced the medical records to OCR, but “otherwise made no efforts to resolve the complaints through informal means,” the Department said.

OCR also found that Cignet failed to cooperate with its investigations on a continuing daily basis from March 17, 2009, to April 7, 2010, and that the failure to cooperate was due to Cignet’s willful neglect to comply with the Privacy Rule.

Covered entities are required by law to cooperate with the Department’s investigations or face CMP’s of $3 million, HHS said.

“Covered entities and business associates must uphold their responsibility to provide patients with access to their medical records, and adhere closely to all of HIPAA’s requirements,” said OCR Director Georgina Verdugo.

“The U.S. Department of Health and Human Services will continue to investigate and take action against those organizations that knowingly disregard their obligations under these rules.”

A copy of the OCR’s Notice of Proposed Determination and Notice of Final Determination can be found at http://www.hhs.gov/ocr/privacy/hipaa/news/cignetnews.html.

Hearing tests in more than 2,800 adults between the ages of 21 to 84 concluded that one in seven had lost some degree of hearing, and as expected, the rate of hearing loss increased with age. Among people aged 45 to 54, one in nine showed signs of hearing impairment.

Of those older than 80 years – about 90 percent – had some hearing impairment, but the rate had already reached one in nine among adults 45 to 54 years old, the largest age group in the population, Reuters Health is reporting.

Hearing loss “is a significant problem, even in middle age,” says Dr. Peter Rabinowitz of Yale University, who was not involved in the study. Scott Nash of the University of Wisconsin, leading the study, explained how someone was hearing impaired if at least one ear had trouble hearing within the range of human speech.

Nash explains the cutoff is considered “mild impairment,” so much so, that people may not even realize they have trouble hearing. “Not everyone is aware of it, since the changes can occur relatively slowly,” said Rabinowitz. 

Hearing loss, the authors concluded, might be linked to risks for heart disease and stroke. Specifically, hearing loss was seen as correlated with the health of the blood vessels of the retina in the eye, an indication of blood vessel health overall.

Rabinowitz says other studies have also linked ear health to heart disease and stroke risk. These findings “provide additional evidence” that such risk “may be associated with hearing.” The association makes sense, he noted – the inner ear depends on a rich supply of blood, and research shows that when blood circulation is compromised, the ear can suffer.

No association, however, was seen between hearing impairment and other measures of heart disease and stroke risk in middle-aged adults, such as high blood pressure, diabetes, and obesity. “This may have been due to the younger age of the cohort, or the low prevalence of some of these conditions in this population,” Nash suggested. “As this population ages, however, it will be very informative to see what effect, if any, these diseases have on future hearing.”

Physicians do not typically screen middle-aged adults for hearing loss. The US Preventive Services Task Force, sponsored by the US government’s Agency for Healthcare Research and Quality, is currently evaluating new evidence as 1996 was when it issued its last recommendations.

Maintaining your cardiovascular health helps protect your ears as you age, Rabinowitz  tells Reuters Health. “Taking care of your overall health may help your hearing.” Currently, 29 million Americans are living with hearing impairment, most commonly men, older adults, and those exposed to loud noises, according to the Archives of Otolaryngology-Head & Neck Surgery report. To take a closer look at hearing loss in various age groups, Nash and his team surveyed 2,837 adults.

The rate of hearing impairment increased with age, exceeding 40 percent in those 65 and older. These rates are high, but “unfortunately not all that surprising,” Nash told Reuters Health in an e-mail, since previous studies have also found similar numbers.

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On the Net:

• University of Wisconsin
• US Preventive Services Task Force

By Caroline Arbanas, Washington University in St. Louis

Scientists have decoded the DNA of the parasitic worm that causes trichinosis, a disease linked to eating raw or undercooked pork or carnivorous wild game animals, such as bear and walrus.

After analyzing the genome, investigators at Washington University School of Medicine in St. Louis and their collaborators report they have identified unique features of the parasite, Trichinella spiralis, which provide potential targets for new drugs to fight the illness. The research was published online Feb. 20 in Nature Genetics.

While trichinosis is no longer a problem in the United States ““ fewer than a dozen cases are reported annually ““ an estimated 11 million people worldwide are infected. Current treatments are effective only if the disease is diagnosed early.

“It takes less than two weeks for the larvae to travel from the intestine to muscle, where they live,” says lead author Makedonka Mitreva, PhD, research assistant professor of genetics at Washington University’s Genome Center. “Once the worms invade the muscle, drugs are less effective. While the disease is rarely deadly, patients often live for months or years with chronic muscle pain and fatigue until the worms eventually die.”

Today, trichinosis occurs most often in areas of Asia and Eastern Europe where pigs are sometimes fed raw meat, and meat inspections are lax.

The new research also has implications far beyond a single parasitic disease, the researchers say. T. spiralis is just one of many thousands of parasitic roundworms called nematodes that, according to the World Health Organization, infect 2 billion people worldwide, severely sickening 300 million. Other species of parasitic nematodes cause diseases in pets and livestock and billions of dollars of crop losses annually.

Among nematodes, T. spiralis diverged early, some 600-700 million years before the crown species, C. elegans, a model organism used in research laboratories. To date, the genomes of 10 nematodes, including five parasitic worms, have been decoded. The latest addition of the T. spiralis genome now allows scientists to compare species that span the phylum.

“T. spiralis occupies a strategic position in the evolutionary tree of nematodes, which helps fill in important knowledge gaps,” explains senior author Richard K. Wilson, PhD, director of Washington University’s Genome Center and professor of genetics. “By comparing nematode genomes, we have identified key molecular features that distinguish parasitic nematodes, raising the prospect that a single targeted drug may be effective against multiple species.”

Over all, the genome of T. spiralis is smaller than that of C. elegans. It has 15,808 genes, compared to C. elegans’ 20,000.

Moreover, about 45 percent of T. spiralis genes appear to be novel. These genes have not been found in other organisms and are not listed in public gene databases. The researchers say the worm’s early evolutionary split or its distinctive lifestyle ““ it can’t survive outside the body ““ may account for this extensive collection of enigmatic genes.

The researchers also found 274 families of proteins that are conserved among all nematodes and that do not exist in other organisms, including humans. Furthermore, they identified 64 protein families that are exclusive to parasitic nematodes.

“This provides opportunities for scientists to dig deeper into the distinctive features of parasitic nematodes that can be targeted with new drugs,” Mitreva says. “If those drugs target molecular features unique to parasitic worms, it is more likely the side effects of those drugs will be minimal in humans.”

The research is supported by the National Human Genome Research Institute and the National Institute of Allergy and Infectious Diseases, both of the National Institutes of Health.

Collaborators include scientists at Washington State University, the U.S. Department of Agriculture, Cornell University and Divergence, Inc.

Mitreva M, Jasmer DP, Zarlenga DS, Wang Z, Abubucker S, Martin J, Taylor CM, Yin Y, Fulton L, Minx P, Yang S-P, Warren WC, Fulton RS, Bhonagiri V, Zhang X, Hallsworth-Pepin K, Clifton SW, McCarter JP, Appleton J, Mardis ER, Wilson RK. The draft genome of the parasitic nematode Trichinella spiralis. Nature Genetics. Advance online publication, Feb. 20, 2011

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Image Caption: Trichinosis is caused by eating raw or undercooked pork or carnivorous wild game animals, such as bear and walrus, infected with the parasitic worm, Trichinella spiralis. While the disease is rarely deadly, some patients live for months or years with chronic muscle pain and fatigue until the worms eventually die. Credit: Photo by Jonathan Eisenback, Mactode Publications

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On the Net:

• Washington University School of Medicine
• Nature Genetics