A recent scientific discovery could reduce liver damage and prevent deaths caused by paracetamol overdoses.

Patients who suffer the greatest liver damage have higher levels of a protein known as cyclophilin A in their urine, researchers said treatments to block the harmful effects of the protein may aid such patients.

The University of Edinburgh research team said about 200 people die each year in the UK following a paracetamol overdose.

Around 20 overdose patients underwent a liver transplant last year.

Measuring levels of the protein could also enable doctors to determine much sooner which patients are most at risk of liver failure.

Now the researchers say that high-risk patients could be placed on a liver transplant waiting list sooner, providing more time to find a suitable donor organ.

“Around 30% of patients who have developed significant liver injury following a paracetamol overdose dies,” said lead researcher Dr. James Dear.

He said that if doctors could find a way to block the protein cyclophilin A, it could limit further damage to the liver.

“Alternatively, measuring levels of the protein could indicate straight away which patients will need a liver transplant.

“Waiting a number of days means that valuable time is lost in trying to find a suitable match. Even gaining an extra day or two could save a life.”

A test to assess which patients needed a liver transplant would potentially be of great use, according to Dr. Varuna Aluvihare, a consultant hepatologist at King’s College Hospital, London.

But in many cases, patients who had taken an overdose of paracetamol did not present to specialist services until it was too late to offer effective treatment, he warned.

More than half of all cases of acute liver failure were due to paracetamol overdose at the specialist unit there.

He said that part of the problem was that symptoms took three to four days to appear, but by that stage the damage had already been done.

A meeting of the British Pharmacological Society will debut the findings.

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On the Net:

• Paracetamol
• University of Edinburgh
• King’s College Hospital
• British Pharmacological Society

Men may be able to lower their risk of contracting AIDS and sexually transmitted diseases that cause cervical cancer by being circumcised, according to three new studies released on Wednesday in the Journal of Infectious Diseases.

In one study, Dr. Bertran Auvert of the University of Versailles in France and colleagues in South Africa tested more than 1,200 men visiting a clinic in South Africa.

Participants aged 18 to 24 were divided into two groups. One group was circumcised, and the other was not.

The team discovered that under 15 percent of the circumcised men and 22 percent of the uncircumcised men were infected with the human papilloma virus, or HPV, which is the main cause of cervical cancer and genital warts.

“This finding explains why women with circumcised partners are at a lower risk of cervical cancer than other women,” researchers wrote.

In a study within the U.S., where circumcision rates have been dropping, researchers analyzed 400 men in two cities who showed no signs of HPV.

Carrie Nielson of Oregon Health & Science University and colleagues said they found some indication that circumcision might protect men.

The circumcised men were about half as likely to have HPV as uncircumcised men, after adjustment for other differences between the two groups.

The third report, conducted by Lee Warner of the U.S. Centers for Disease Control and Prevention, studied African-American men in Baltimore.

Warner’s team found 10 percent of those at high risk of infection with HIV who were circumcised had the virus, compared to 22 percent of those who were not.

“Circumcision was associated with substantially reduced HIV risk in patients with known HIV exposure, suggesting that results of other studies demonstrating reduced HIV risk for circumcision among heterosexual men likely can be generalized to the U.S. context,” they wrote.

Experts say the three studies provide more evidence to highlight the need for circumcision as “an additional means of protection from HIV.”

But they noted that the American Academy of Pediatrics does not recommend routine circumcision for newborns.

“As a consequence of this AAP decision, Medicaid does not cover circumcision costs, and this is particularly disadvantageous for poorer African American and Hispanic boys who, as adults, may face high HIV exposure risk,” Gray and colleagues wrote.

“It is also noteworthy that circumcision rates have been declining in the U.S., possibly because of lack of Medicaid coverage.”

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On the Net:

• Journal of Infectious Diseases

A new report on Wednesday underscored the need for more fruits and vegetables in the diets of children in the U.S.

The Institute of Medicine focused on school food programs to show that many students are consuming too many solid fats and sugars rather than getting the necessary amount of key nutrients from fruits and vegetables.

Their review focused on breakfast and lunch programs at U.S. schools. The report found children aged 5-18 ate 50 percent or less of the vegetables recommended by the U.S. government’s dietary guidelines, and fruit intake was 50 percent or less than the suggested amount for kids 9-18 years old.

The report also showed that children consume high amounts of sodium and solid fats from fast food items.

“Most Americans, not just children, are not eating as balanced a diet as we want,” said Virginia Stallings, a professor at The Children’s Hospital of Philadelphia and chair of the committee that conducted the review.

“There are so few times where we have an opportunity to touch every child’s life,” she said.

These programs are overseen by the U.S. Agriculture Department and are slated for reauthorization by Congress in 2009.

Tom Vilsack, who was nominated for Secretary of Agriculture by President-elect Barack Obama on Wednesday, said the USDA “must place nutrition at the center of all food assistance programs administered by the department.”

Officials at the USDA are updating the nutrition and meal requirements used for school breakfast and lunch programs, and looked for recommendations from the Institute of Medicine.

The U.S. Centers for Disease Control and Prevention estimates that 13.9 percent of children aged 2 to 5, 18.8 percent of those aged 6 to 11, and more than 17 percent of those 12 to 19 are overweight.

“School meals are absolutely essential not just to reduce hunger, but to kids’ health,” said Jim Weill of the Food Research and Action center. “Obesity has helped focus attention that school meals should be better.”

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On the Net:

• Institute of Medicine
• Children’s Hospital of Philadelphia
• U.S. Agriculture Department
• USDA
• CDC

A new rating system in the nation’s 16,000 nursing homes is causing anxiety in the nursing home industry. 

The nursing home operators are worried about the ramifications for their businesses on whether they get one or two stars, when five is the best.

On Thursday, the Centers for Medicare and Medicaid Services was to let everyone know just how many stars each home is getting.  The industry is already questioning the validity of the rankings.  Other operators said the five star system is long over due.

The system “is poorly planned, prematurely implemented and hamhandedly rolled out,” said Larry Minnix, president and chief executive officer of the American Association of Homes and Services for the Aging, an industry trade group.

Federal officials expect the ranking system will put nursing homes “on the path to improvement” because they know family members will think twice before putting their loved ones in a one star facility.

The rating system is based on state inspection, staffing levels and quality measures, such as percentage of residents with pressure sores.  Stars will be rewarded for each category as well as for their overall quality.

Consumer groups adheres to the concept, but agree there is room for potential problems with the data.

“From a consumer viewpoint, it’s not stringent enough,” said Alice H. Hedt, executive director of the National Citizens’ Coalition for Nursing Home Reform. “It’s basically taking information already available on Medicare’s Nursing Home Compare Web site and pulling it into an easier system for consumers to use, and that is a good thing.”

Consumers should consider the star rating, but not solely rely on them when comparing facilities, Hedt said.  Her organization also issued a press release warning that nursing homes may appear in the ratings to give better care than they actually do.

“Our initial reaction is that consumers should probably avoid any facility with a one-or two-star rating and even a three-star rating unless people they trust convince them that the rating is inaccurate or unfair,” she said.

In Indiana, there are eight nonprofit nursing homes that have reported to have gotten one star for staffing even though they have some of the highest staffing levels in the states, said Jim Leich, president and chief executive officer of the Indiana Association of Homes for the Aging.  He thinks the one star rating is the result of a records glitch particular to any nursing home that is part of a campus that includes housing for residents with less intensive care needs.

“It’s really going to be an injustice for some of our best facilities,” he said.

Martha Kutik, the president and CEO of the Jennings Center for Older Adults in Garfield Heights, Ohio, got four stars for her nursing home and she said she is still worried that the rating system relies on surveys that measure cracks in the ceiling but do not measure patient and family satisfaction.

“Any system that’s going to measure quality for consumers should keep satisfaction high on the list,” Kutik said.

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On the Net:

• Centers for Medicare and Medicaid Services
• American Association of Homes and Services for the Aging
• National Citizens’ Coalition for Nursing Home Reform

The findings of the world’s largest study so far on the ability of children and young people to taste and what they like have now been published. The study was conducted jointly by Danish Science Communication, food scientists from The Faculty of Life Sciences (LIFE) at University of Copenhagen and 8,900 Danish schoolchildren.
 
In September, 8,900 schoolchildren from all over Denmark took part in a large-scale experiment conducted by Danish Science Communication and The Faculty of Life Sciences (LIFE) at University of Copenhagen. It is the first time that such a large-scale study has been done on the sense of taste of children and young people and what they like to eat. 
 
Danish schoolchildren help scientists

One of the reasons why it was possible to include so many children and young people in the study was that the experiment itself was conducted in quite an unorthodox way: It was planned as a “Ëœmass experiment’ in conjunction with this year’ s natural science festival at Danish primary and secondary schools.
 
All the participating groups of children were sent a complete kit of taster samples and very detailed instructions, and then conducted the experiment as part of their natural science classes. The various tests were designed to quantify the ability of children and young people to discover and recognise sweet and sour tastes at varying intensities, to establish which sourness or sweetness they prefer, how many taste buds they have and, finally, the children answered a number of questions on their eating habits and fussiness over food.
 
Both pupils and teachers have taken the experiment very seriously: “What is most surprising is that the results are so clear and of such a high quality,” says Bodil Allesen-Holm, MSc in Food Science and Technology, who is the scientific head of the project and head of the Sensory Laboratory at the Department of Food Science at LIFE. “The trends are very clear in all the answers from the many primary and secondary schools; the pupils and teachers have been very thorough and accurate.”
 
Industry must do better, and parents could experiment more

According to Bodil Allesen-Holm, the results provide food for thought for both the food industry ““ and for parents: “It is quite clear that children and young people are very good tasters, and that there are bigger variations between them than most people would expect.
 
There is, for example, a marked difference between boys and girls, and the ability of children to recognise tastes changes with age. So one could easily develop more varied food products and snacks for children and young people. For example, it is quite clear that children do not necessarily prefer sweet things. According to the findings, healthy snacks could easily be developed for boys with slightly extreme and sour flavours.”
 
“This experiment has focused on taste alone, while future studies will include more sensory aspects such as smells and appearance to provide a more all-round understanding of Danish children’s preferences,” says Wender Bredie, Professor of Sensory Science at the Department of Food Science at LIFE.

New Facts About What Children Can Taste – And What They Like:

Girls are better at recognising tastes than boys

One of the many findings shows that girls are generally better at recognising tastes than boys. They are better at recognising all concentrations of both sweet and sour tastes. The difference is not dramatic, but it is quite clear. It is also a known fact that women generally have a finer sense of taste than men.
 
“We also asked the pupils to count “Ëœtaste buds’ or organs of taste on the tongue. However, the experiment showed that boys and girls have largely the same number of taste buds. So it would appear that what makes the difference is the way in which boys and girls process taste impressions,” says Michael Bom Frøst, Associate Professor at the Department of Food Science at LIFE.
 
According to the figures, boys need an average of approximately 10 per cent more sourness and approximately 20 per cent more sweetness to recognise the taste.
 
Every third schoolchild would prefer not to eat sweet things
Another sensational finding is that every third schoolchild would prefer non-sugary soft drinks. All the pupils did a blind test in which they were instructed to give scores to ten different variants of the same soft drink ““ with varying sweetness and sourness.
 
Surprisingly, as many as 30 per cent of the pupils preferred the variant which contained no sugar at all or very little. “This is new. In other words, soft drinks for children and young people do not always have to contain a lot of sugar,” says Bodil Allesen-Holm.
 
On the other hand, 48 per cent of the pupils just couldn’t get enough: They gave top marks to the sweetest of the variants. “It may be because many pupils are quite used to drinking a lot of soft drinks and eating a lot of sweets,” says Bodil Allesen-Holm.
 
Boys like it wild, girls prefer more muted flavours

Funnily enough, girls generally prefer flavours which are not too strong. Boys, on the other hand, tend to like the more extreme flavours. Boys also have a sweeter tooth than girls ““ most of the boys preferred the super sweet soft drink variety. And most boys also gave top marks to the sourest samples.
 
Yes, I like fish!

The study shows that when you ask the children about their likes and dislikes, they actually like fish. As many as 70 per cent of the pupils said they like fish. And you can safely give them exciting foods. As many as 59 per cent of pupils do not consider themselves to be fussy eaters, and this applies to both girls and boys.
 
The world becomes more sour and exciting for teenagers
It would appear that you can safely notch up a gear when it comes to food, drinks and snacks for teenagers. The study showed that their sense of taste changes noticeably: The ability to recognise tastes increases gradually with age, and the greatest shift is seen at 13-14 years when children become markedly more sensitive to sour tastes.
 
At exactly the same time, their love of very sweet flavours starts waning. And it is here too that many more declare they are not fussy eaters. Past studies have shown that children who like sour things tend not to be nearly as fussy as children who are not mad about sour foods. Those who prefer sour flavours are also more open to tasting new foods.
 
Pupils in northern Jutland taste champions

Pupils from northern Jutland are better tasters than all other pupils in Denmark. The figures are clear, but the scientists cannot explain why. Firstly, they are clearly better at recognising sour tastes. Where most other children and young people require 0.5g of citric acid per litre to discern the sourness, children in northern Jutland need no more than 0.37g. This is a significant difference.
 
Children in northern Jutland are also better at recognising sweet tastes, although children from central Jutland and Copenhagen are on a par with them.

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On The Net:

University Of Copenhagen

Individuals suffering from eating disorders may benefit from “talking therapies,” a type of therapy that aims to correct obsessive feelings, announced UK researchers. They stated that this form of cognitive behavioral therapy could be the answer to the majority of these disorders.

An American Journal of Psychiatry study, conducted by the University of Oxford, believes this method to be “complete and lasting.” Currently, the treatment is authoritatively recommended just for bulimia patients.

Statistics say that a million people in the UK suffer from an eating disorder, mainly anorexia nervosa and bulimia.

About 40% of those with eating disorders have bulimia, 20% have anorexia, and the rest have “atypical disorders”, a combination of bulimic and anorexic-type symptoms.

The National Institute of Clinical Excellence has supported cognitive behavioral therapy for bulimia, but Professor Christopher Fairburn, the Wellcome Trust funded researcher who headed the project, insists that his therapy may reach a lot more people. His study pays primary attention to bulimia and “atypical” patients.

The technique involves a series of counseling meetings shows the person involved the links between their emotions and behavior, and address and change the behavior.

Professor Fairburn created two versions especially for people with eating disorders, one focused entirely on the eating problems, and the second one, which address not only the eating disorder, but other issues that may be causing to it.

After their work, researchers discovered most patients had reacted well. Two-thirds showed a “complete and lasting” reaction, with many of the other third presenting considerable development.

Even though the study did not target anorexia, a second study, currently being worked on, is showing hopeful results.

Professor Fairburn stated: “Now, for the first time, we have a single treatment which can be effective at treating the majority of cases, without the need for patients to be admitted into hospital.

“It is increasingly being used across the NHS, and has the potential to improve the lives of the hundreds of thousands of people living with eating disorders.”

Susan Muir is a patient who insists that CBT techniques freed her from a long battle with an eating disorder.

“The CBT helped me realize what I was doing, and turned those irrational thoughts into rational ones,” Muir said. “It really helped me deal with my self-esteem problems and made me feel very positive.”

Susan Ringwood, the chief executive of Beat, the eating disorders campaign group, noted that: “This research shows that people can benefit from psychological therapy even at a very low weight.

“There has been so little research into eating disorders and anorexia in particular, and this has really added to our knowledge in a challenging field.”

Dr Alan Cohen, mental health spokesperson for the Royal College of GPs, is pleased with the results.

He said: “Access to this service, and appropriate training for therapists to deliver this new form of treatment, is very important.”

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On the Net:

• American Journal of Psychiatry
• University of Oxford
• Wellcome Trust
• National Institute of Clinical Excellence

Hundreds of foreigners choose every year to end their life in an ordinary building nestled by the railroad tracks, just east of Zurich.

Many who end their life are terminally ill, but some are young and physically healthy except for a permanent disability or severe, debilitating mental disorder.

Switzerland is known around the world as a somewhat easy place for foreigners to end their lives.  More than 100 Germans, Britons, French, Americans and others come to this small commuter town each year to lie down on a bed in an industrial park building and drink a lethal dose of barbiturates.

The decades old practice was revealed last week, when a British TV special showed Craig Ewert, a 59-year-old Chicago man with a severe form of motor neuron disease, killing himself in Switzerland two years ago.

Other places have recently passed laws that allow the terminally ill to find a doctor who can hasten their death, those include the Netherlands, Belgium, and Oregon and Washington in the United States.

Switzerland is the only place that permits foreigners to come and kill themselves, placing few restrictions on the how, when and why. The controversial law was passed in 1942.

Doctors have the ability to prescribe a veterinary drug for that very purpose, and five minutes after drinking a glass of water laced with sodium pentobarbital, they fall asleep.

Death follows about half an hour later.

Dignitas is one of several Swiss organizations dedicated to the cause. It was founded by Ludwig A. Minelli, who built the group into a nonprofit operation.

Critics say Switzerland is turning into a black hole of so-called “suicide tourism.”

Dr. Bertrand Kiefer, editor-in-chief of the Revue Medicale Suisse, a medical journal, says he’s worried some people are killing themselves not to escape intolerable suffering but to relieve family or society of a burden.

Dignitas says the only criteria for assisting a suicide are that the person “suffers from an illness that inevitably leads to death, or from an unacceptable disability, and wants to end their life and suffering voluntarily.”

Kiefer also says assisted-groups lack financial transparency.

Dignitas says it charges 10,000 Swiss francs ($8,300) for its services, which include taking care of legal formalities and arranging consultations with a doctor who will prescribe the deadly medicine.

“We need to ensure that there’s no economic incentive for these organizations to encourage people to commit suicide,” says Kiefer.

Officials in the canton of Zurich threatened to restrict services by forcing doctors to see each patient more than once, and by limiting the supply of sodium pentobarbital.

In return, many groups hoarded the drug and Dignitas was criticized after it was reported they were suffocating people with plastic bags and helium.

The bag is placed over the head of a person who then opens a flow of helium, falls into a coma and dies “in 99.9 percent of cases,” according to Derek Humphry, a British author who wrote the suicide manual “Final Exit.”

The canton of Zurich investigated the helium process and determined this year that the group had done nothing illegal.

However, Minelli was transformed into a tabloid hate figure, because the use of helium reminded many Swiss of Nazi gas chambers.

Like most Swiss, the townspeople support the principle of assisted suicide, but “the helium was the last straw,” says Manfred Milz, who is evicting Dignitas from his building.

Dignitas claims demand continues to grow. Its membership has reached nearly 6,000 over the past decade. Some are supporters of its work; others want to die with its help when the time comes.

Bernard Sutter, a spokesman for Exit, Switzerland’s largest assisted-suicide group, which only helps Swiss residents, says other countries should change their laws.

“We can’t solve all the problems of Germany, England, France and Italy,” he said.

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On the Net:

• Dignitas

Tufts study compared women’s cognition on low-carb and reduced-calorie diets

A new study from the psychology department at Tufts University shows that when dieters eliminate carbohydrates from their meals, they performed more poorly on memory-based tasks than when they reduce calories, but maintain carbohydrates. When carbohydrates were reintroduced, cognition skills returned to normal.
 
“This study demonstrates that the food you eat can have an immediate impact on cognitive behavior,” explains Holly A. Taylor, professor of psychology at Tufts and corresponding author of the study. “The popular low-carb, no-carb diets have the strongest potential for negative impact on thinking and cognition.”
 
Taylor collaborated with Professor Robin Kanarek, former undergraduate Kara Watts and research associate Kristen D’Anci. The study, “Low-carbohydrate weight-loss diets. Effects on cognition and mood,” appears in the February 2009 edition of the journal “Appetite.”
 
While the brain uses glucose as its primary fuel, it has no way of storing it. Rather, the body breaks down carbohydrates into glucose, which is carried to the brain through the blood stream and used immediately by nerve cells for energy. Reduced carbohydrate intake should thus reduce the brain’s source of energy. Therefore, researchers hypothesized that diets low in carbohydrates would affect cognitive skills.
 
Study participants included 19 women ages 22 to 55 who were allowed to select the diet plan they preferred — either a low-carbohydrate diet or a low-calorie, macronutrient balanced diet recommended by the American Dietetic Association. Nine women chose a low-carbohydrate diet and 10 selected the low-calorie diet.
 
“Although the study had a modest sample size, the results showed a clear difference in cognitive performance as a function of diet,” says Taylor.
 
The 19 dieters completed five testing sessions that assessed cognitive skills, including attention, long-term and short-term memory, and visual attention, and spatial memory. The first session was held before participants began their diets, the next two sessions occurred during the first week of the diet, which corresponded to the week when low-carb dieters eliminated carbohydrates. The final two sessions occurred in week two and week three of the diets, after carbohydrates had been reintroduced for those on the low-carb diet.
 
“The data suggest that after a week of severe carbohydrate restriction, memory performance, particularly on difficult tasks, is impaired,” Taylor explains.
 
Low-carb dieters showed a gradual decrease on the memory-related tasks compared with the low-calorie dieters. Reaction time for those on the low-carb diet was slower and their visuospatial memory was not as good as those on the low-calorie diet. However, low-carb dieters actually responded better than low-calorie dieters during the attention vigilance task. Researchers note that past studies have shown that diets high in protein or fat can improve a person’s attention in the short-term, which is consistent with the results in this study.
 
Participants were also asked about their hunger levels and mood during each session. The hunger-rating did not vary between participants on a low-carb diet and those on a low-calorie diet. The only mood difference between dieters was confusion, which was higher for low-calorie dieters during the middle of the study.
 
“Although this study only tracked dieting participants for three weeks, the data suggest that diets can affect more than just weight,” says Taylor. “The brain needs glucose for energy and diets low in carbohydrates can be detrimental to learning, memory, and thinking.”

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On the Net:

• Tufts University
• Appetite

Canada-US study published in Journal of Clinical Endocrinology & Metabolism recommends young people be screened for low vitamin D levels

Insufficient vitamin D can stunt growth and foster weight gain during puberty, according to a new study published in the Journal of Clinical Endocrinology & Metabolism. Even in sun-drenched California, where scientists from the McGill University Health Centre (MUHC) and the University of Southern California conducted their study, vitamin D deficiency was found to cause higher body mass and shorter stature in girls at the peak of their growing spurt.

While lack of vitamin D is common in adults and has been linked to diseases such as osteoporosis, cancer and obesity, until this study, little was known about the consequences of insufficient vitamin D in young people. The research team measured vitamin D in girls aged 16 to 22 using a simple blood test (25-hydroxy vitamin D). They also assessed body fat and height to determine how vitamin D deficiency could affect young women’s health.

“The high prevalence of vitamin D insufficiency in young people living in a sun-rich area was surprising,” says study lead author, Richard Kremer, co-director of the Musculoskeletal Axis of the MUHC. “We found young women with vitamin D insufficiency were significantly heavier, with a higher body mass index and increased abdominal fat, than young women with normal levels.”

Vitamin D fosters growth, healthier weight

The researchers examined 90 Caucasian and Hispanic girls and discovered that young women with normal vitamin D levels were on average taller than peers deficient in vitamin D. Yet in contrast to what’s been previously reported in older women, their investigation found no association between lack of vitamin D and bone strength.

“Although vitamin D is now frequently measured in older adults, due to a higher level of awareness in this population, it is rarely measured in young people ““ especially healthy adolescents,” says Dr. Kremer.

“Clinicians need to identify vitamin D levels in younger adults who are at risk by using a simple and useful blood test,” says the co-author, Dr. Vicente Gilsanz, head of musculoskeletal imaging at the Children’s Hospital Los Angeles of the University of Southern California.

“Because lack of vitamin D can cause fat accumulation and increased risk for chronic disorders later in life, further investigation is needed to determine whether vitamin D supplements could have potential benefits in the healthy development of young people,” added Dr. Gilsanz.

About the study:

“Vitamin D Status and its Relationship to Body Fat, Final Height and Peak Bone Mass in Young Women,” published in the Journal of Clinical Endocrinology & Metabolism, was authored by Richard Kremer of the McGill University Health Centre, Patricia P. Campbell and Vicente Gilsanz of the Children’s Hospital Los Angeles of the University of Southern California, and Timothy Reinhardt of the U.S. Department of Agriculture’s National Animal Disease Center.

Partners in research:

This work was supported by the U.S, Department of the Army; the National Institutes of Health (a part of the U.S. Department of Health and Human Services); the Natural Sciences and Engineering Research Council of Canada (NSERC); and the Dimensional Fund Advisors Canada Inc (a subsidiary of U.S.-based Dimensional Fund Advisors).

On the Web:

• Journal of Clinical Endocrinology & Metabolism
• McGill University Health Centre

Recently, millions of asthma patients have begun taking long-acting drugs to allow them to breathe a bit more normally, which allow them to experience continual sleep in the evenings or workouts at the gym.

At the moment, the Food and Drug Administration is examining if these medications could increase the risk of severe asthma problems.

At a meeting on Wednesday, independent medical advisers will review the scientific facts and make a decision on if the drugs should continue to be used in treating asthma.

Under discussion are four inhaler medications: Advair, Foradil, Serevent and Symbicort. The safety office advises that Foradil and Serevent should not be used for asthma, and none of the drugs be taken by children 17 and under.

However, the head of the FDA office that supervises respiratory medications has announced that prohibition of the drugs would be “an extreme approach,” and will backfire by causing additional cases of uncontrolled asthma.

The companies that manufacture the medications insist that they are not dangerous, and that the medical evidence being used by the FDA is weak. Doctors who take care of asthma patients are apprehensive that the drugs may be banned.

“We would lose a medicine that patients find helpful,” said Dr. Paul Greenberger of Northwestern University in Chicago, president-elect of the American Academy of Allergy, Asthma & Immunology. “We would be going backward, and the consequences of that would be more untoward effects of asthma. That’s a major deal, because asthma hospitalizations continue to be too high.”

The four drugs include a long-acting medication called LABA (for “long-acting beta 2-adrenergic agonist”). The drug loosens up constricted muscles around narrowed airways. Medical procedures for treating moderate to severe asthma advise the use of a LABA along with a steroid, which targets the inflammation around the airways.

Foradil and Serevent are LABA-only products. Advair and Symbicort merge a LABA and a steroid together in one inhaler that patients employ every 12 hours. Asthma patients should also have a “rescue” inhaler to treat with the unexpected onset of symptoms.

On the agenda for the meeting is the reviewing of the findings from 110 clinical trials concerning 61,000 patients, which compares patients who took a medication that had a LABA with those who only used a steroid to treat their asthma. Experts were on the lookout for deaths, hospitalizations and instances where a patient had to have a breathing tube inserted.

The investigation located 20 deaths from asthma complications, of which 16 were taking a LABA-only medication, Serevent.

Approximately 22 million people in the United States have asthma, and children account for one out of every three patients. Asthma kills 3,600 people annually in the U.S.

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On the Net:

• FDA
• American Academy of Allergy, Asthma & Immunology

The world’s first prescription pistol was denied registration on Monday by the Food and Drug Administration.

The single-bullet Palm Pistol set the Internet abuzz with speculation that Medicare might even pay for the elderly and disabled to pack heat.

But now the FDA says the Palm Pistol doesn’t stand a chance of being listed as a medical device.

The agency released a statement saying the product is not a medical device and now its inventor is crying foul.

“I would assume it’s due to political pressure,” said Matthew M. Carmel, from Maplewood, N.J. He said he’s researching a possible appeal.

But most experts believe Medicare, the giant health care program for seniors and the disabled, would have never covered guns for the elderly in the first place.

“Medicare will not cover it because there is no approved category for weapons,” said spokesman Peter Ashkenaz. “So it would not be viewed as reasonable and necessary.”

The elderly and disabled are easy targets for criminals, said Carmel, and the Palm Pistol could be an equalizer. Shaped like an oval, it fits in your palm. The barrel sticks out through your fingers. And instead of pulling a trigger, you push down on a button with your thumb. Carmel added, however, that no working models currently exist.

But when he decided to start advertising to seniors, he contacted the FDA and was advised to register his company, Constitution Arms, as a medical device facility and list the Palm Pistol as a “recreational adaptor.” The registration seemed to go through without any problems.

But Siobhan DeLancey, an FDA spokeswoman, said Carmel apparently got some bad advice from an FDA representative.

Had Carmel paid closer attention to the registration notice he filled out, he would have noticed it’s warning: “Registering … does not, in any way, constitute FDA approval of your facility or your devices.”

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On the Net:

• FDA
• Palm Pistol
• Medicare

A fully automated process is set to improve the production of artificial tissue: medical scientists can perform transplants with skin produced in the laboratory. This tissue is also suitable for testing chemicals at a low cost without requiring animal experiments.

Some patients wish they had a second skin ““ for instance because their own skin has been burnt in a severe accident. But transplanting skin is a painstaking task, and a transplant that has to cover large areas often requires several operations. Medical scientists have therefore been trying for a long time to grow artificial tissue. This “artificial skin” would allow them to treat these patients better and faster.

Tissue engineering has been at the focus of research for many years, and tissues such as cartilage or skin are already being cultured in numerous biotechnology laboratories. But the researchers at the Fraunhofer Institute for Interfacial Engineering and Biotechnology IGB in Stuttgart plan to go a step further than that. They are aiming to enable fully automated tissue production. “Until now, methods of culturing tissue like that used for skin transplants have been very expensive,” says IGB head of department Professor Heike Mertsching. “Most of the steps are carried out manually, which means that the process is not particularly efficient.” The researchers have therefore elaborated a novel conceptual design in collaboration with colleagues from the Fraunhofer Institutes for Production Technology IPT, Manufacturing Engineering and Automation IPA, and Cell Therapy and Immunology IZI.

First of all, a biopsy ““ that is, a sample of human tissue ““ is checked for sterility. A gripper arm then transports the biopsy into the automated device where the individual steps are performed: The machine cuts the biopsy into small pieces, isolates the different cell types, stimulates their growth, and mixes the skin cells with collagen. A three-dimensional reconstruction of the different skin layers is produced with the aid of a special gel matrix ““ and the skin is ready. In the final step, the machine packages the cells for shipment. Alternatively, the tissue can be cryopreserved ““ that is, deep-frozen and stored for later use. “It was important for us that the entire mechanical process is divided into separate modules,” says Mertsching. “This enables us to replace or modify individual modules, depending what is needed for the production of different tissue types.” The method opens up almost unlimited new possibilities for the medical scientists. One of their upcoming projects is to produce intestinal tissue for resorption tests.

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Image Caption: Cross-section through artificial skin (left) compared to section through human skin (right). Both the natural and the artificial skin are made up of three layers. © Fraunhofer IGB 

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On the Net:

• Fraunhofer Institute for Interfacial Engineering and Biotechnology

International health experts said Tuesday that cancer will be the world’s leading cause of death by 2010, with rates of cancer more than doubling by 2030.  

The trend was largely attributed to improvements in cancer diagnoses and the increasing use of tobacco in developing countries, particularly India and China, which now include 40 percent of the world’s smokers. The experts also pointed to a downward trend in infectious diseases that were formerly the world’s top killers.

The report was released Tuesday by the WHO’s International Agency for Research on Cancer at a news conference with the American Cancer Society, the Lance Armstrong Foundation, Susan G. Komen for the Cure and the National Cancer Institute of Mexico.

Global cancer diagnoses have been consistently on the rise, and are expected to reach 12 million this year alone, with 7 million deaths, according to the World Health Organization (WHO).

An annual one percent rise in both cases and deaths is expected, with even larger increases in Russia, China and India. 

According to the report, annual new cases of cancer will likely surge to 27 million by 2030, with deaths reaching 17 million.

The report cited the predicted rise in the global population as playing a role in the increased cancer cases — meaning there are simply more people around to get cancer.

John Seffrin, CEO of the American Cancer Society, called the gathering of organizations “unprecedented”, and said it was an attempt to draw the world’s attention to the threat posed by cancer. 

The organizations are urging the U.S. government to fund cervical cancer vaccinations and to ratify an international tobacco control treaty.

“If we take action, we can keep the numbers from going where they would otherwise go,” Seffrin told the Associated Press.

Other organizations are also supporting the call to action. 

“Cancer is one of the greatest untold health crises of the developing world,” said Dr. Douglas Blayney, president-elect of the American Society of Clinical Oncology.

“Few are aware that cancer already kills more people in poor countries than HIV, malaria and tuberculosis combined. And if current smoking trends continue, the problem will get significantly worse,” he said.
 
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On the Net:

• International Agency for Research on Cancer
• American Cancer Society
• American Society of Clinical Oncology

After a string of product safety scandals including contaminated infant formula believed to have killed six babies and sickened thousands of others, many shoppers are now wary of buying products made in China.

Sally Villegas, a mother of two in Australia, said after the melamine-tainted infant formula scandal in September, she won’t purchase any product made in China.

“If I’m shopping and I pick one up, yes I would put it back.”

The Chinese have experienced several high-profile safety problems that included lead paint on toy cars and contaminated Chinese-made blood thinner heparin which was blamed for fatalities in the United States and Germany and prompted a global recall early this year.

Beijing, however, seemed to have the same response after each scandal: launching a crackdown, destroying tainted goods on television, jailing a few officials and saying they “pay great attention” to the problem.

But analysts say it seems the scandals keep happening, and will likely keep on happening, due to lax rule enforcement, fragmented industries, widespread poverty and the sheer size of China.

“I’m sure that there will be more. It’s a near certainty. Not only in the fields that we’ve seen already, but in other ones,” said Duncan Innes-Ker, a China analyst at the Economist Intelligence Unit in Beijing.

“China faces a lot of problems because it is developing into a big but very poor economy, and obviously you can’t have Western-style safety mechanisms in an economy where half the population doesn’t earn much more than a couple of dollars a day,” he added.

The melamine problem has dented the country’s already badly tattered reputation overseas, according to Jin Biao, vice president of Inner Mongolia Yili Industrial Group, one of China’s largest dairy producers.

“The contamination was our management problem. We must first resolve it without trying to pass the blame on to the farmers, or to society, or the country,” he said.

Yili was one of 22 companies found to have produced drinking milk contaminated with melamine, though after thorough inspections China now insists the problem has been effectively removed from the dairy industry.

The chemical melamine is used to make plastics, but was added to infant formula to cheat quality control tests on protein levels. The scandal led to bans around the world on food containing Chinese dairy products.

Last month, the U.S. issued an import alert for Chinese-made food products, calling for foods to be stopped at the border unless importers can certify that they are either free of dairy goods or free of melamine.

“I think it’s evident to the Chinese that when there’s a quality problem, it does more than just hurt that industry segment,” said U.S. Health Secretary Mike Leavitt. “It damages the entire made-in-China brand.”

After the melamine problem, Taiwan supermarkets reported soaring sales from goods clearly marked as being “made in Taiwan,” stressing that they did not come from across the strait and were therefore trustworthy and top notch.

But Matthew Crabbe, managing director of research firm Access Asia, said it is not a simple matter just to boycott all Chinese goods.

“I don’t think people understand how much is actually made in China. Moving production to some other low-cost country would also not solve the problem,” he said.

“They’d just have the same problems over again. They’d go to Bangladesh or somewhere, and then they’d have exactly the same problems yet again. It’s the quality control.”

China’s poverty challenges are exacerbated by corruption and the autonomy carved out by local governments, many of them hundreds of kilometers from officials in Beijing trying to rehabilitate the country’s reputation.

A culture of covering-up bad news, or delaying reporting problems to higher-ups, only adds to the challenge.

The Sanlu Company initially failed to report the melamine problem, fearing perhaps it could have wrecked the happy image being portrayed for the Beijing Olympics.

But observers say this attitude is changing.

China has begun sharing information following the melamine scandal, according to Anthony Hazzard, the World Health Organization’s Manila-based regional adviser on food safety.

“That there is an openness and sharing of information will strengthen confidence,” he said.

“Of course, confidence at the moment is battered. But the only way to rebuild confidence is to put in place an effective food control system from the farm to the table, and we hope that they do that.”

But experts believe it may be only a matter of time before the next scandal unfolds in a country where even drugs are fair game for the unscrupulous seeking to make a fast buck.

“Next would probably be the fake pharmaceuticals industry, the herbal pills sector,” said Access Asia’s Crabbe. “God knows what goes into those things, and what regulation there is, if any, of that industry.”

A smile really is infectious, researchers happily announced on Thursday.

The team has conducted a study that shows that the more joyful people you are acquainted with, the larger the chance is that you will be happy.

“It’s extremely important and interesting work,” said Daniel Kahneman, an emeritus psychologist and Nobel laureate at Princeton.

“What we are dealing with is an emotional stampede,” added Nicholas Christakis, a professor of medical sociology at Harvard Medical School.

“There’s kind of an emotional quiet riot that occurs and takes on a life of its own, that people themselves may be unaware of. Emotions have a collective existence “” they are not just an individual phenomenon.”

Christakis and James Fowler, a political scientist at the University of California, San Diego, used information from the 4,700 children of volunteers at the Framingham Heart Study, a huge health investigation conducted in Framingham, Massachusetts in 1948.

They evaluated an individual’s happiness be giving subjects a straightforward, four-question test.

“People are asked how often during the past week, one, I enjoyed life, two, I was happy, three, I felt hopeful about the future, and four, I felt that I was just as good as other people,” Fowler said.

The 60 percent of people who rated extremely well on all four questions were labeled as happy, while the rest were determined to be unhappy.

“Your happiness depends not just on your choices and actions, but also on the choices and actions of people you don’t even know who are one, two and three degrees removed from you,” stated Christakis.

People who are deemed socially connected to friends, spouses, neighbors, and relatives, were also the happiest, the data indicated. “Each additional happy person makes you happier,” Christakis said.

“Imagine that I am connected to you and you are connected to others and others are connected to still others. It is this fabric of humanity, like an American patch quilt.”

Every individual person hypothetically sits on a singular-colored patch. “Imagine that these patches are happy and unhappy patches. Your happiness depends on what is going on in the patch around you,” Christakis stated.

“It is not just happy people connecting with happy people, which they do. Above and beyond, there is this contagious process going on.”
Furthermore, cheerfulness is extra contagious instead of unhappiness, they revealed.

“If a social contact is happy, it increases the likelihood that you are happy by 15 percent,” Fowler noted. “A friend of a friend, or the friend of a spouse or a sibling, if they are happy, increases your chances by 10 percent,” he added.

“But every extra unhappy friend increases the likelihood that you’ll be unhappy by 7 percent,” Fowler said.
The findings are incredibly interesting, are also useful, too Fowler added.

“Among other benefits, happiness has been shown to have an important effect on reduced mortality, pain reduction, and improved cardiac function. So better understanding of how happiness spreads can help us learn how to promote a healthier society,” he said.

In another study that will be released on Friday in the British Medical Journal, Ethan Cohen-Cole, an economist at the Federal Reserve Bank of Boston, and Jason Fletcher, an assistant professor at the Yale School of Public Health, disapprove of the methods used by the Christakis-Fowler team.

They say that while it is possible to connect social contagion effects with physical conditions like acne, headaches and height, this kind of contagion effects diminish when researchers take into account environmental issues that friends or neighbors have in common.

“Researchers should be cautious in attributing correlations in health outcomes of close friends to social network effects,” the authors state.
An supplementary BMJ editorial covering the two studies called the Christakis-Fowler study “groundbreaking,” but added that “future work is needed to verify the presence and strength of these associations.”

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On The Net:

Princeton University

Harvard Medical School

British Medical Journal

High obesity and smoking rates have moved Louisiana to the top of a U.S. list, marking it the unhealthiest state.

According to an annual report, the overall health of Americans remained static for a fourth year. Topics studied included binge drinking, health insurance coverage, air pollution, infectious disease rates, crime levels and immunization coverage.

“We’ve just not made any improvement in the overall healthiness of the nation,” said Dr. Reed Tuckson of UnitedHealth Group Inc, the largest U.S. health insurer, and the private United Health Foundation.

The foundation, American Public Health Association and the Partnership for Prevention advocacy group put together the 19th annual state-by-state rankings.

Many Southern states were clustered near the bottom of the rankings because the region has some of the highest rates of obesity, which contributes to heart disease, stroke, diabetes and some types of cancer.

Twenty percent of Louisiana residents lacked health insurance, while 31 percent were obese. The state suffers from high child poverty, infant mortality, premature death rate and cancer deaths, according to the report.

Vermont topped the rankings for the second year, followed by Hawaii, New Hampshire, Minnesota, Utah, Massachusetts, Connecticut, Idaho and Maine.

Vermont had the third-highest public health spending and an obesity rate of 22 percent, four points below the national average. It also had low child poverty and violent crime, a large number of doctors per capita and good high school graduation rates.

Louisiana fell from 49th to 50th, replacing Mississippi. Rounding out the bottom 10 were South Carolina, Tennessee, Texas, Florida, Oklahoma, Arkansas, Nevada and Georgia.

President-elect Barack Obama said he wants to change U.S. health care. Currently, 45.7 million people are without coverage while costing more than any other national health system.

The United States lags behind wealthy nations in the categories of infant mortality, life expectancy, mortality for treatable conditions and overall health care system performance.

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On The Net:

APHA

UnitedHealth Group Inc

Rare injuries accounted for 3.5 percent of high school athletes’ injuries 2005 through 2007, according to the first study to examine rare injuries and conditions of U.S. high school athletes. Rare injuries include eye injuries, dental injuries, neck and cervical injuries and dehydration and heat illness, which may result in high morbidity, costly surgeries and treatments or life-altering consequences.

Football was associated with the highest rate of rare injuries, accounting for 21 injuries per 100,000 exposures, according to the study published in the current issue of the Journal of Athletic Training and conducted by researchers at the Center for Injury Research and Policy (CIRP) of The Research Institute at Nationwide Children’s Hospital.

“Neck and cervical injuries were higher in boys at 8 per 100,000 exposures while girls accounted for 1 per 100,000 exposures,” explained the study’s author Ellen Yard, MPH, CIRP research associate at Nationwide Children’s Hospital. “This difference could easily be attributed to girls not playing football. Of those neck and cervical injuries in football, 93 percent were caused by contact with another player during tackling or blocking. Overall though, boys had 12 per 100,000 exposures while girls had three per 100,000.”

Football also was correlated with the majority of dehydration and heat illnesses. Sixty percent of these injuries occurred during pre-season practice after the athlete had already been participating for an hour.

“This finding is consistent with previous research, which stresses the need for athletes to be hydrated. Many times, the athletes just aren’t used to the environmental conditions during pre-season practice,” said study co-author Dawn Comstock, PhD, CIRP principal investigator at Nationwide Children’s and a faculty member of The Ohio State University College of Medicine.

The sports studied included football, boys’ and girls’ soccer, volleyball, boys’ and girls’ basketball, wrestling, baseball and softball. Data for the study were collected from the 2005-2007 National High School Sports Injury Surveillance Study (High School RIOâ“ž¢) and was funded in part by the Centers for Disease Control and Prevention.

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On the Net:

• Nationwide Children’s Hospital
• The Center for Injury Research and Policy

Previous studies have shown that babies exposed to tobacco in utero are more likely to have a low birth weight and are at increased risk for sudden infant death syndrome. Now new research by The Miriam Hospital reveals that these babies are also less likely to self-soothe and are more aroused and excitable than newborns whose mothers did not smoke during pregnancy.

Researchers from The Miriam Hospital’s Centers for Behavioral and Preventive Medicine say early identification and targeted intervention efforts aimed at both infants and parents may help prevent possible disruption in early maternal-infant bonding and, ultimately, long-term adverse outcomes. The study is published online by the Journal of Pediatrics.

“A baby who is harder to soothe and more irritable could be more difficult to take care of and could potentially affect the developing mother-child relationship, especially for mothers who are already stressed and have fewer resources,” says lead author Laura Stroud, PhD, a psychologist with The Miriam Hospital’s Centers for Behavioral and Preventive Medicine. “We need better treatment programs to help women not smoke during pregnancy, to keep them from starting smoking after the baby is born, and to help them take care of an excitable or colicky baby.”

Between 11 and 30 percent of women continue to smoke during pregnancy, according to the Centers for Disease Control and Prevention. In addition to the physical side effects, tobacco exposure in utero has also been linked to long-term adverse neurobehavioral outcomes in children, including conduct disorder and hyperactivity. However, researchers say relatively less attention has focused on the effects of maternal smoking on newborn neurobehavior.

In the study, Stroud and colleagues from Women & Infants Hospital in Providence, RI, and the Warren Alpert Medical School of Brown University focused on newborns between 10 and 27 days old. The researchers decided on this infant age range because it is well past the half-life of nicotine, meaning the acute effects of nicotine withdrawal were unlikely to be a factor in the study. All 56 babies ““ 28 smoking-exposed and 28 unexposed ““ were healthy and full-term. Maternal social class, age and alcohol use were similar in each group.

Mothers in the study were assigned to the smoking or non-smoking group based on self-reports of cigarette use during pregnancy assessed shortly after babies were born. This was verified biochemically by measuring cotinine, the primary metabolite of nicotine, in the mother’s saliva. Cotinine is readily passed from mother to infant, with the baby absorbing nearly as much as the mother does.

On average, the number of cigarettes mothers smoked each day decreased over the course of the pregnancy, from about 15 cigarettes per day in the first trimester to approximately five cigarettes in the third trimester.

Postnatal smoke exposure was quantified by infant saliva cotinine levels. All infants were then assessed using the Neonatal Intensive Care Unit (NICU) Network Neurobehavioral Scale, a tool developed for the National Institutes of Health to measure the effects of prenatal drug exposure in infants, including withdrawal and general signs of stress.

According to the study’s findings, smoking-exposed infants showed a greater need for handling, or external intervention, in order to be soothed and calmed down. These babies also tended to be more easily aroused and excitable.

“Although the effects of maternal smoking at 10 to 27 days were subtle, in combination with a high-stress postnatal environment and deficits in parenting, they could represent early precursors for long-term, negative behavioral outcomes,” says Stroud, who is also an assistant professor of psychiatry (research) at Alpert Medical School.

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Image Courtesy Of Google

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Lifespan

A class of small RNAs inherited from the mother determines offspring’s fertility trait

Hereditary information flows from parents to offspring not just through DNA but also through the millions of proteins and other molecules that cling to it. These modifications of DNA, known as “epigenetic marks,” act both as a switch and a dial ““ they can determine which genes should be turned on or off, and how much message an “on” gene should produce.

One way in which epigenetic information is known to be passed from parent to offspring is through the pattern of chemical “caps” added onto certain “letters” of the DNA sequence, ensuring the sequence is “silenced.” How these DNA capping patterns, which are inherited, are precisely set is not yet known. But in some cases, enzymes that add these caps are guided to DNA by small RNA molecules. These guides themselves do not carry hereditary information, but they do mark the spots where DNA is to be modified.

A team of scientists at Cold Spring Harbor Laboratory (CSHL) led by Professor Gregory J. Hannon, Ph.D., has now discovered that a class of small RNAs does carry epigenetic information and in fact passes on the trait of fertility from mother to offspring in fruit flies.

A new mechanism of inheritance

In a paper to be published on Nov 27th in Science, the CSHL team reports that maternal small RNAs called Piwi-interacting RNAs (piRNAs) that are deposited into fruit fly embryos “silence” DNA sequences that induce sterility, thus ensuring the fertility of the progeny. “This is a whole new way in which heredity can be transmitted,” says Professor Hannon, who is a pioneer in small RNA research. “With this finding we’ve effectively doubled the number of mechanisms by which epigenetic information is known to be inherited.”

The piRNAs are found only in cells of sex organs and partner up with proteins called Piwi to suppress the activity of mobile DNA sequences called transposons. Discovered half a century ago by CSHL scientist and Nobel laureate Barbara McClintock, Ph.D., transposons jump around the genome, inserting themselves into genes and causing mutations. Such genetic havoc is thought to underlie many diseases, including cancer.

A high rate of mutations also disturbs gametogenesis ““ the process of creating viable sex cells ““ and can result in sterility. Piwi proteins and piRNAs form something akin to an immune system in sex cells that guards against transposon-inflicted genome damage.

Solving the fruit fly fertility puzzle

The CSHL team wondered whether piRNAs were also the key to a long-standing conundrum about fertility in fruit flies. When lab-bred female flies are bred with male flies caught in the wild, their progeny are sterile or unable to produce offspring — a phenomenon called hybrid dysgenesis. But the genetically identical offspring of wild-caught female flies and lab-bred males are fertile. The genetic difference between the lab-bred and wild flies is a single transposon, which is absent in lab strains.

In hybrid dysgenesis, the transmission of the transposon by a parent induces sterility in the offspring unless the offspring also inherits a factor that suppresses the transposon and maintains fertility. Since the phenomenon had only been seen when the transposon-transmitting parent was male, the suppressing factor was thought to be maternally transmitted. But it was never identified.

Hannon’s team has now found that the stockpile of maternally derived proteins, RNA, and nourishing raw material in developing fruit fly oocytes, or egg cells, also includes piRNAs. And these maternally deposited piRNAs prove to be essential for mounting a silencing response against transposons.

Inheritance via small RNAs

Hannon likens this protection to that afforded by the adaptive immune system which protects against pathogens like bacteria and viruses. “We’ve evolved ways to transmit immunity from mother to child via the secretion of antibodies,” he says, referring to the proteins that can cross the placenta and protect the fetus or get passed on to an infant via breast-milk. “We now have a way in which immunity (against sterility) is passed on from mother to child, in flies but possibly other organisms also, via small RNAs.”

In contrast to short-lived adaptive immunity, however, this small RNA-driven immunity has a long reach. The team’s experiments show that the effect on fertility doesn’t just impact the child alone, but also the next generation. Because the trait ““ fertility ““ is controlled or encoded in the RNA, “you’re passing on a trait that’s essentially not only controlling an event that happens in the organism’s adulthood, but is also propagated to the progeny of that organism,” explains Hannon.

The impact of environment

The ability of the mother to transmit epigenetic information can be altered by the environment that she finds herself in. Other researchers have found that raising the temperature in which female flies are reared raises the proportion of fertile progeny.

To the CSHL team, this suggests that “the experience of the mother translates into a dominant effect on the progeny.” The group’s data suggest that one way that the mother’s experience might get communicated to the child is through variations in the populations of small RNAs that get deposited in the oocytes.

Now that one trait has been discovered to be driven by maternally inherited piRNA, Hannon is eager to know if the spectrum of information that’s transmitted in this way can be broadened to cover other cellular processes. And of course, it also remains to be seen whether this mechanism of epigenetic inheritance is found in organisms besides fruit flies. “Small RNAs are probably deposited in oocytes of every animal,” he hypothesizes.

“An epigenetic role for maternally inherited piRNAs in transposon silencing” appears online on November 27th in Science. The full citation is: Julius Brennecke, Colin D. Malone, Alexei A. Aravin, Ravi Sachidanandam, Alexander Stark, Gregory J. Hannon. —

On the Net:

• Cold Spring Harbor Laboratory
• Science

In the same way that winter is commonly known to be the “flu season,” a new study suggests that the dog days of summer may well be the “bacterial infection” season.

Researchers have discovered that serious infections caused by gram-negative bacteria can go up as much as 17 percent with every 10 degree increase in seasonal temperature. The findings, which were based on seven years of data from infections in a Baltimore hospital, suggest that the incidence there of some of these illnesses might be up to 46 percent higher in summer than in winter.

The cause is not known, scientists said, but the seasonal variation is clear.

“Gram-negative bacteria are a frequent cause of urinary tract, gastrointestinal and respiratory infections, as well as more serious things like pneumonia, wound or blood infections,” said Jessina McGregor, an assistant professor in the College of Pharmacy at Oregon State University. “Everyone knows there is a seasonality to some viral infections such as influenza or the common cold, but we’re now finding that some of these bacterial infections peak in the heat of summer.”

Recognition of these seasonal trends, the researchers said, may improve disease diagnosis, prompt treatments and better interventions to prevent the infections in the first place.

The findings were made by scientists from OSU; Dr. Eli N. Perencevich, associate professor of epidemiology and preventive medicine at the University of Maryland School of Medicine; and researchers from the University of Florida and the Research Institute of the Hospital for Sick Children in Toronto. They were just published in Infection Control and Hospital Epidemiology, a professional journal.

The study examined infections caused by several gram-negative bacteria, including E. coli, Pseudomonas aeruginosa, E. cloacae, and Acinetobacter baumannii. The greatest increases in infection due to higher temperatures were found with P. aeruginosa, a common cause of burn, external ear, urinary tract and lung infections; and A. baumannii, an opportunistic pathogen that can cause death and serious illnesses, particularly in people with compromised immune systems.

The study also found that there was no apparent seasonal increase in gram-positive bacterial infections, which have a slightly different cell structure and are the source of fewer pathogenic infections in humans.

“Bacterial infections in general have been rising for some time, probably due at least in part to increased antibiotic resistance,” McGregor said. “The more we can learn about what is causing them and when they are most likely to occur, the better we can treat or prevent them.”

There are several possible causes for the summertime increase in gram-negative bacterial infections, the researchers said, but none are proven. P. aeruginosa is an aquatic organism, and infections caused by it could be linked to more people swimming in lakes or pools during the summer. Cattle have higher bacterial shedding rates in the summer, and the peak of E. coli infections could be connected to higher consumption of ground beef or other factors during the “outdoor grill” season.

Several of these gram-negative bacteria cause urinary tract infections, and a known risk factor for that is recent sexual intercourse ““ the frequency of which also peaks in the summer, when there is more sunlight.

“Regardless of the mechanisms responsible for infections, recognition of the link between the physical environment and the incidences of pathogenic infection could aid in infection prevention interventions or the selection of optimal empirical antimicrobial therapy,” the researchers wrote in their report.

The link between this type of bacterial infections and heat, the study suggested, should also be considered along with the many other possible impacts of global climate change.

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On the Net:

• Oregon State University
• Infection Control and Hospital Epidemiology

The research council FORMAS, Sweden, has granted 5.9 million SEK ($740,000 USD) to a new research project that will study the environmental fate and effects of the anti-viral drug Tamiflu on the development on influenza resistance.

Tamiflu is being stockpiled all over the world for use in fighting the next influenza pandemic. However, there are growing signs that influenza viruses may develop resistance to this vital pharmaceutical, because it is routinely prescribed for seasonal influenza.

This research project is interdisciplinary and will combine studies on the environmental fate of the drug with in vivo studies of the development of Tamiflu resistant viruses say the project leader Björn Olsen at the Department of Medical Sciences Uppsala University.

This research project presents an innovative approach to studying the development of Tamiflu resistance in influenza viruses caused by environmental contamination which is a potential threat to one of our few defenses against a future influenza pandemic.

Scientists from Uppsala University, Umea University and Karolinska Institute will investigate the potential problem from an environmental chemical, virological and infectious diseases aspect.

A wide range of topics will be addressed; studies of the degradation of Tamiflu in sewage treatment plants will be combined with screening of the environmental levels in surface water in Japan. Japan is one of the world’s top-per-capita consumers of Tamiflu and it has been estimated that approximately 40% of those that are infected by influenza viruses are treated with Tamiflu. This makes Japan one of the “Hot Spots” in the world and the research project has established collaboration with scientists at Kyoto University and several field sampling campaigns in Japan has been scheduled. Detected environmental levels will then be used in an in vivo Mallard infection model for detailed studies on the development of Tamiflu resistance in low pathogenic avian viruses. This will be combined with a screening study of the occurrence of resistant viruses in fecal samples from wild ducks in the vicinity of Japanese sewage treatment plants.

The full title of the project is “Occurrence and fate of the antiviral drug Oseltamivir in aquatic environments and the effect on resistance development in influenza A viruses.” and the applicants are Björn Olsen, Dept. of Medicinal Sciences, Uppsala University, Ó¦ke Lundkvist, Dept. of Microbiology Tumor and Cellbiology, Karolinska Institute, Johan Lennerstrand, Dept. of Medicinal Sciences, Uppsala University and Hanna Söderström and Jerker Fick, Dept of Chemistry, UmeÃ¥ University

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On the Net:

• Uppsala University
• FORMAS, Sweden
• Tamiflu

Do you regularly take aspirin or antiplatelet medications? Do you know whether or not these drugs should be stopped before dental procedures or surgeries? According to a study published in the May/June issue of General Dentistry, the clinical, peer-reviewed journal of the Academy of General Dentistry (AGD), stopping antiplatelet medications prior to a surgical procedure places a patient at greater risk of permanent disability or death.

The probability of a patient bleeding depends on the over-the-counter and/or prescribed drug or combinations of drugs.

“A thorough drug history should be reviewed prior to any procedures,” notes Mary Aubertin, DMD, lead author of the study. Dr. Aubertin recommends that the dentist and patient start with a simple discussion. “The dentist and the patient should discuss the risks and benefits of treatment with or without the drugs versus no treatment and include the patient’s physician’s opinion in the decision making process. This will allow everyone involved to understand and prevent medical risks.”

Fortunately, due to the prevalence of this type of medication, dentists are prepared to treat these situations. According to AGD spokesperson Carolyn Taggart-Burns, DDS, “excessive bleeding is a major concern with many dental procedures due to the extensive prescribing of blood thinners in America. Heart disease is so prevalent that many patients are on these drugs, which can complicate even the simplest procedure.” Dr. Taggart-Burns reminds patients that it is very important “to communicate medical history with your dentist so that they can provide the best care possible.”

What happens after a procedure is also important to the dentist. Patients who experience excessive bleeding or bruising after the surgery, in spite of applying pressure to the site with wet gauze or a wet tea bag for 20-30 minutes, should contact the dentist for evaluation and treatment.

“Informing the dentist of medical issues is the first step. Working with the patient’s physician and the patient to develop a plan is also important. Last, staying healthy is the best way to have a successful procedure,” says Dr. Taggart-Burns.

What you should do before a dental procedure:

• Schedule a consultation with the dentist
• Disclose all prescribed and over-the-counter medicines to your dentist
• Disclose your medical history and concerns
• Discuss the risks and benefits of treatment with or with out the drugs
• Ask the dentist if they have an office emergency plan

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On the Net:

• Academy of General Dentistry