Overweight, obese preschoolers lose more weight when parent is also treated

Primary care treatment of overweight and obese preschoolers works better when treatment targets both parent and child compared to when only the child is targeted, according to research published this week in Pediatrics and conducted at the University at Buffalo and Women and Children’s Hospital of Buffalo.Children enrolled in this study were overweight or obese and had one parent who participated in the study who also was overweight or obese, according to body mass index (BMI) measurements, calculated based on height and weight.During the course of the study, children who were treated concurrently with a parent experienced more appropriate weight gain while growing normally in height. Children in the intervention group gained an average of 12 pounds over 24 months compared to children in the control group who gained almost 16 pounds. This more appropriate weight accrual resulted in a decrease of 0.21 percent over BMI from baseline to 24 months.Parents in the intervention group lost an average of 14 pounds, resulting in a BMI decrease of over 2 units while the weight of parents in the control group was essentially unchanged.”Our results show that the traditional approach to overweight prevention and treatment focusing only on the child is obsolete,” says Teresa A. Quattrin, MD, senior author and UB Distinguished Professor, chair of the Department of Pediatrics in the School of Medicine and Biomedical Sciences and pediatrician-in-chief at Women and Children’s Hospital of Buffalo.”This study is important because while we know that it is critical to begin treating overweight or obese children early, there has been limited data on what works best in preschool-aged children,” she says.The research was part of Buffalo Healthy Tots, a novel family-based, weight control intervention in preschool children that Quattrin directed in urban and suburban pediatric practices in Western New York.When funded in 2010 with a $2.6 million grant by the National Institutes of Health, Buffalo Healthy Tots was the first of its kind in the U.S. The goal was to compare traditional approaches where only the child is treated to family-based, behavioral treatment implemented in pediatric primary care practices.The study of 96 children ages 2-5 found that when overweight and obese youth and their parents were treated in a primary care setting with behavioral intervention, parents and children experienced greater decreases in body mass index (BMI) than did the children who received the traditional treatment, focusing only on the child. Weight loss for both parent and child was sustained after a 12-month followup.Quattrin notes that an important feature of the study was the use of practice enhancement assistants, trained in psychology, nutrition or exercise science. These assistants worked with the families both during treatment and education sessions and afterward by phone.The intervention was delivered through the parents, who were instructed about the appropriate number of food servings for children and appropriate calorie values. They were taught to avoid “high-energy” foods, such as those with high sugar content, more than 5 grams of fat per serving or artificial sweeteners.Parents monitored the number of servings in each food category, using a simple diary to cross off icons pertaining to the food consumed or type of physical activity performed. Parents also were taught to record their own and their child’s weight on a simple graph.Weight loss goals for children were 0.5 to 1 pound per week and for parents it was at least 1 pound per week.Quattrin says that the study results suggest that overweight or obese children and their parents can be successfully treated in the primary care setting with the assistance of practice enhancers.”Instead of the more traditional approach of referring these patients to a specialty clinic, the patient-centered medical home in the pediatrician’s office may be an ideal setting for implementing these family-based treatments,” she says.”We have entered a new era where students, trainees and specialists have to learn how to better interact with primary care providers and implement care coordination. This paper suggests that, indeed, family-based strategies for any chronic disorder, including obesity, can be successful in primary care. …

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Common blood thinner for pregnant women proven ineffective

It’s a daily injection to the belly for pregnant women at risk of developing blood clots and it’s ineffective, according to a clinical trial led by researchers at The Ottawa Hospital and published today by the medical journal The Lancet.As many as one in 10 pregnant women have a tendency to develop blood clots in their veins, a condition called thrombophilia. For two decades these women have often been prescribed the anticoagulant low molecular weight heparin (LMWH) to prevent pregnancy complications caused by placental blood clots. This treatment requires women to give themselves daily injections — a painful and demoralizing process that requires women to poke their abdomen with hundreds of needles over the course of their pregnancy.Now, a randomized clinical trial led by Dr. Marc Rodger, a senior scientist at the Ottawa Hospital Research Institute who heads up the Thrombosis Program of The Ottawa Hospital, provides conclusive evidence that the commonly prescribed LMWH anticoagulant has no positive benefits for the mother or child. In fact, Dr. Rodger’s study shows that LMWH treatments could actually cause pregnant women some minor harm by increasing bleeding, increasing their rates of induced labour and reducing their access to anesthesia during childbirth.”These results mean that many women around the world can save themselves a lot of unnecessary pain during pregnancy,” says Dr. Rodger, who is also a professor in the Faculty of Medicine at the University of Ottawa. “Using low molecular weight heparin unnecessarily medicalizes a woman’s pregnancy and is costly.”Since the 1990s, using LMWH to treat pregnant women with a tendency to develop blood clots became commonplace, despite the fact that a large, multi-site randomized clinical trial had never been conducted to prove its effectiveness. Low molecular weight heparin is also prescribed by many physicians worldwide to women, with and without thrombophilia, to prevent placenta blood clots that may lead to pregnancy loss, as well as preeclampsia (high blood pressure), placental abruption (heavy bleeding) and intra-uterine growth restrictions (low birth weight babies). The anticoagulant LMWH is also prescribed to prevent deep vein thrombosis (leg vein blood clots) and pulmonary embolisms (lung blood clots).”While I wish we could have shown that LMWH prevents complications, we actually proved it doesn’t help,” adds Dr. …

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Slow walking speed, memory complaints can predict dementia

A study involving nearly 27,000 older adults on five continents found that nearly 1 in 10 met criteria for pre-dementia based on a simple test that measures how fast people walk and whether they have cognitive complaints. People who tested positive for pre-dementia were twice as likely as others to develop dementia within 12 years. The study, led by scientists at Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center, was published online on July 16, 2014 in Neurology, the medical journal of the American Academy of Neurology.The new test diagnoses motoric cognitive risk syndrome (MCR). Testing for the newly described syndrome relies on measuring gait speed (our manner of walking) and asking a few simple questions about a patient’s cognitive abilities, both of which take just seconds. The test is not reliant on the latest medical technology and can be done in a clinical setting, diagnosing people in the early stages of the dementia process. Early diagnosis is critical because it allows time to identify and possibly treat the underlying causes of the disease, which may delay or even prevent the onset of dementia in some cases.”In many clinical and community settings, people don’t have access to the sophisticated tests — biomarker assays, cognitive tests or neuroimaging studies — used to diagnose people at risk for developing dementia,” said Joe Verghese, M.B.B.S., professor in the Saul R. Korey Department of Neurology and of medicine at Einstein, chief of geriatrics at Einstein and Montefiore, and senior author of the Neurology paper. “Our assessment method could enable many more people to learn if they’re at risk for dementia, since it avoids the need for complex testing and doesn’t require that the test be administered by a neurologist. The potential payoff could be tremendous — not only for individuals and their families, but also in terms of healthcare savings for society. All that’s needed to assess MCR is a stopwatch and a few questions, so primary care physicians could easily incorporate it into examinations of their older patients.”The U.S. …

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University of Pennsylvania’s Mesothelioma Program Receives $8 Million Grant from NCI

The National Cancer Institute awarded an $8 million grant to the University of Pennsylvania’s Perelman School of Medicine to study the effects of photodynamic light therapy (PDT) in patients with malignant pleural mesothelioma. The grant will fund a clinical trial and additional studies looking at the effects of PDT on the patient’s immune response, the mesothelioma tumor cell , and the blood vessels surrounding the tumor.Dr. Eli Glatstein is the principal investigator of the program. He is also the professor and vice chair of Radiation Oncology, and member of Penn’s Mesothelioma and Pleural Program. According to Dr. Glatstein, “This trial represents a major step in understanding the combination of treatment modalities that will offer patients the best hope for survival and extended remission.”The study expects to …

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Novel drug cocktail may improve clinical treatment for pancreatic cancer

Pancreatic cancer is the fourth leading cause of cancer deaths in the U.S. and has the lowest overall survival rate of all major cancers (~6%). With current treatment options being met with limited success it is anticipated that pancreatic cancer will move up to the second leading cause of cancer deaths by as early as 2015. Surgical removal of the tumor presents the best chance of survival, however only 15% of patients are eligible due to the late stage of diagnosis common with this disease. With very limited improvements in patient outcome over the last two decades there remains an enormous need for new therapies and treatment options.David Durrant, a Ph.D. student in the laboratory of Dr. Rakesh Kukreja from the Pauley Heart Center at Virginia Commonwealth University’s School of Medicine, is studying a novel combination therapy for the treatment of pancreatic cancer. The traditional chemotherapy drug, doxorubicin (DOX), has long been used in the treatment of several cancers. However, patients commonly acquire resistance to DOX because of increased activation of specific survival proteins or through increased expression of drug transporters which reduce cellular levels of the drug. This is especially true for pancreatic cancer, which does not respond to multiple treatment strategies, including those that contain DOX. …

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Scientists report success growing cartilage to reconstruct nostrils and implanting tissue-engineered vaginal organs into humans

Two new articles published in The Lancet report the first ever successful operations in humans to reconstruct the alar wings of the nose (nostrils) (Martin et al), and to implant tissue-engineered vaginal organs in women with a rare syndrome that causes the vagina to be underdeveloped or absent (Atala et al), in both cases using the patients’ own tissue.In one paper, led by Professor Ivan Martin from the University of Basel in Switzerland, scientists report having engineered a human cartilage graft from patients’ own nasal septum cartilage cells to successfully rebuild the nostrils (alar lobule) of five individuals whose noses were damaged by skin cancer. One year after reconstruction, all five recipients were satisfied with their ability to breathe, as well as the cosmetic appearance of their nose, and did not report any local or systemic adverse events.The nose is the most common site of non-melanoma skin cancer, because of its cumulative exposure to sunlight, with the highest frequency of cancer occurring on the alar lobule. Currently, when removing skin cancers, surgeons often have to cut away parts of cartilage, (for instance from the nasal septum, ear, or rib) as grafts to functionally reconstruct the tumour excision site. However, this painful and invasive procedure involves major additional surgery, and has been associated with complications at the site from which cartilage has been removed.A team from the University of Basel, Switzerland, investigated an alternative approach using engineered cartilage tissue grown from patients’ own cells. They extracted the cartilage cells (chondrocytes) from the nasal septum of each patient, and multiplied the cells by exposing them to growth factors for two weeks. The expanded cells were seeded onto collagen membranes and cultured for two additional weeks, generating cartilage 40 times larger than the original biopsy. When the engineered grafts were ready they were shaped according to the defect and implanted.According to Professor Martin, “The engineered cartilage had clinical results comparable to the gold standard cartilage graft surgery. This new technique could help the body accept the new tissue more easily, and improve the stability and functionality of the nostril. Our success is based on the long-standing, effective integration in Basel between our experimental group at the Department of Biomedicine and the surgical disciplines. It opens the way to using this engineered cartilage for more challenging reconstructions in facial surgery such as the complete nose, eyelid, or ear. …

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New Chinese herbal medicine has significant potential in treating hepatitis C, study suggests

ata from a late-breaking abstract presented at the International Liver CongressTM 2014 identifies a new compound, SBEL1, that has the ability to inhibit hepatitis C virus (HCV) activity in cells at several points in the virus’ lifecycle.[i]SBEL1 is a compound isolated from Chinese herbal medicines that was found to inhibit HCV activity by approximately 90%. SBEL1 is extracted from a herb found in certain regions of Taiwan and Southern China. In Chinese medicine, it is used to treat sore throats and inflammations. The function of SBEL1 within the plant is unknown and its role and origins are currently being investigated.Scientists pre-treated human liver cells in vitro with SBEL1 prior to HCV infection and found that SBEL1 pre-treated cells contained 23 percent less HCV protein than the control, suggesting that SBEL1 blocks virus entry. The liver cells transfected with an HCV internal ribosome entry site (IRES)-driven luciferase reporter that were treated with SBEL1 reduced reporter activity by 50% compared to control. This suggests that that SBEL1 inhibits IRES-mediated translation, a critical process for viral protein production.In addition, the HCV ribonucleic acid (RNA) levels were significantly reduced by 78 percent in HCV infected cells treated with SBEL1 compared to the control group. This demonstrates that SBEL1 may also affect the viral RNA replication process.Prof. Markus Peck-Radosavljevic, Secretary-General of the European Association for the Study of the Liver and Associate Professor of Medicine, University of Vienna, Austria, commented: “People infected with hepatitis C are at risk of developing severe liver damage including liver cancer and cirrhosis. In the past, less than 20 percent of all HCV patients were treated because the available treatments were unsuitable due to poor efficacy and high toxicity. Recent advances means that we can now virtually cure HCV without unpleasant side effects. …

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New patenting guidelines needed for biotechnology

Biotechnology scientists must be aware of the broad patent landscape and push for new patent and licensing guidelines, according to a new paper from Rice University’s Baker Institute for Public Policy.Published in the current issue of the journal Regenerative Medicine, the paper is based on the June 2013 U.S. Supreme Court ruling in the case Association for Molecular Pathology (AMP) v. Myriad Genetics that naturally occurring genes are unpatentable. The court case and rulings garnered discussion in the public about patenting biological materials.”The AMP v. Myriad Genetics case raises questions about the patent system,” said Kirstin Matthews, the Baker Institute fellow in science and technology policy and an expert on ethical and policy issues related to biomedical research and development. She co-authored the paper with Maude Rowland Cuchiara, the Baker Institute scholar for science and technology policy. The paper has timely significance in light of President Barack Obama’s recent announcements on reforming the nation’s patent process, including an initiative announced in February to “crowdsource” the review of patents.”There are not many opportunities to challenge patents once they have been granted, and the options that are available are costly and mostly limited to lawsuits,” Matthews said. Judges typically do not have the scientific knowledge to understand some of the technical arguments that are made in their courts, she said. “It may be better, as President Obama has proposed, to revise patenting guidelines at the U.S. Patent and Trademark Office based on feedback from scientists, engineers, ethicists and policy scholars as opposed to leaving it up to the courts.”Until the Supreme Court’s decision, Myriad Genetics was the only company in the U.S. …

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Well-known cancer gene NRAS produces 5 variants, study finds

A new study shows that a gene discovered 30 years ago and now known to play a fundamental role in cancer development produces five different gene variants (called isoforms), rather than just the one original form, as thought.The study of the NRAS gene by researchers at The Ohio State University Comprehensive Cancer Center — Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC — James) identified four previously unknown variants that the NRAS gene produces.The finding might help improve drugs for cancers in which aberrant activation of NRAS plays a crucial role. It also suggests that NRAS might affect additional target molecules in cells, the researchers say.The isoforms show striking differences in size, abundance and effects. For example, the historically known protein (isoform 1) is 189 amino-acids long, while one of the newly discovered variants, isoform 5, is only 20 amino-acids long.The study is published in the Proceedings of the National Academy of Sciences.”We believe that the existence of these isoforms may be one reason why NRAS inhibitors have so far been unsuccessful,” says corresponding author Albert de la Chapelle, MD, PhD, professor of Medicine and the Leonard J. Immke Jr. and Charlotte L. Immke Chair in Cancer Research.Co-senior author Clara D. Bloomfield, MD, Distinguished University Professor and Ohio State University Cancer Scholar, notes that one of the newly discovered isoforms might play a greater role in the development of some cancers than the known protein itself.”Targeting the NRAS pathway may have been unsuccessful in the past because we were unaware of the existence of additional targets of these novel isoforms,” says Bloomfield, who is also senior adviser to the OSUCCC — James and holds the William Greenville Pace III Endowed Chair in Cancer Research.”The discovery of these isoforms might open a new chapter in the study of NRAS,” says first author Ann-Kathrin Eisfeld, MD, a postdoctoral fellow in the laboratories of de la Chapelle and of Bloomfield. “Knowing that these isoforms exist may lead to the development of drugs that specifically decrease or increase the expression of one of them and provide more effective treatment for cancer patients.”For this study, de la Chapelle, Eisfeld and their colleagues analyzed expression of the NRAS isoforms in a variety of normal and matched tumor samples. …

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The mammography dilemma: 50 years of analysis

A comprehensive review of 50 year’s worth of international studies assessing the benefits and harms of mammography screening suggests that the benefits of the screening are often overestimated, while harms are underestimated. And, since the relative benefits and harms of screening are related to a complex array of clinical factors and personal preferences, physicians and patients need more guidance on how best to individualize their approach to breast cancer screening.The results of the review by researchers at Harvard Medical School’s Department of Health Care Policy and Brigham and Women’s Hospital are published today in JAMA.The American Cancer Society estimates that about 40,000 U.S. women will die of breast cancer this year. In 2009, based on evidence that the benefit-risk ratio for mammography screening is higher among women over 50 and with less frequent screening, the U.S. Preventive Services Task Force (USPSTF) reversed its previous recommendation of mammography every one to two years beginning at age 40, and recommended routine screening every two years starting at age 50, the researchers noted. The recommendations remain controversial among the general public and the medical community. Recent evidence suggests that use of mammography in the U.S. has not changed following the updated recommendations.”What I tell my patients is that the mammogram is not a perfect test,” said Nancy Keating, co-author of the report, associate professor of Health Care Policy at HMS and associate professor of medicine at Brigham and Women’s. “Some cancers will be missed, some people will die of breast cancer regardless of whether they have a mammogram, and a small number of people that might have died of breast cancer without screening will have their lives saved.”The authors report that the best estimate of the reduction in mortality from breast cancer due to annual screening for women overall is about 19 percent. For women in their 40s, the reduction in risk was about 15 percent, and for women in their 60s, about 32 percent. …

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Rural versus urban causes of childhood concussion

Researchers at Western University (London, Canada) have found youth living in rural areas are more likely to sustain concussions from injuries involving motorized vehicles such as all-terrain vehicles and dirt bikes, whereas youth living in urban areas suffer concussions mostly as a result of sports. Hockey accounts for 40 per cent of those injuries. The study which reveals where and how children are receiving concussions is published in the Journal of Trauma and Acute Care Surgery.Dr. Doug Fraser, a scientist with the Children’s Health Research Institute at Lawson Health Research Institute and Tanya Charyk Stewart, the Injury Epidemiologist for the Trauma Program at Children’s Hospital, London Health Sciences Centre (LHSC) and their team tracked all the youth under the age of 18 who presented to the LHSC emergency departments with a concussion over a six year period. There were 2,112 paediatric concussions, with a steady increase in number treated each year.”It was important for us to learn about who is getting injured, where they’re getting injured, and why they’re getting injured. Once you answer those questions, then you can implement targeted injury prevention programs,” says Dr. Fraser, an associate professor in the Departments of Paediatrics, Physiology & Pharmacology and Clinical Neurological Sciences at Western’s Schulich School of Medicine & Dentistry.Concussions are a particular concern for children and adolescents because their brains are still developing and they are more susceptible to effects of a head injury. The goal following this research is to create injury prevention programs that target and educate those at high risk of sustaining a concussion.Concussions can often be predictable. Along with properly following the rules of the sport and wearing the protective equipment, Charyk Stewart suggests, “In sports, if you have been hit, then just get off the field immediately and stop play. If you are experiencing any symptoms, be seen by a doctor.”Dr. …

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Carbohydrate digestion and obesity strongly linked

New research indicates that obesity in the general population may be genetically linked to how our bodies digest carbohydrates.Published today in the journal Nature Genetics, the study investigated the relationship between body weight and a gene called AMY1, which is responsible for an enzyme present in our saliva known as salivary amylase. This enzyme is the first to be encountered by food when it enters the mouth, and it begins the process of starch digestion that then continues in the gut.People usually have two copies of each gene, but in some regions of our DNA there can be variability in the number of copies a person carries, which is known as copy number variation. The number of copies of AMY1 can be highly variable between people, and it is believed that higher numbers of copies of the salivary amylase gene have evolved in response to a shift towards diets containing more starch since prehistoric times.Researchers from Imperial College London, in collaboration with other international institutions, looked at the number of copies of the gene AMY1 present in the DNA of thousands of people from the UK, France, Sweden and Singapore. They found that people who carried a low number of copies of the salivary amylase gene were at greater risk of obesity.The chance of being obese for people with less than four copies of the AMY1 gene was approximately eight times higher than in those with more than nine copies of this gene. The researchers estimated that with every additional copy of the salivary amylase gene there was approximately a 20 per cent decrease in the odds of becoming obese.Professor Philippe Froguel, Chair in Genomic Medicine in the School of Public Health at Imperial College London, and one of the lead authors on the study, said: “I think this is an important discovery because it suggests that how we digest starch and how the end products from the digestion of complex carbohydrates behave in the gut could be important factors in the risk of obesity. Future research is needed to understand whether or not altering the digestion of starchy food might improve someone’s ability to lose weight, or prevent a person from becoming obese. We are also interested in whether there is a link between this genetic variation and people’s risk of other metabolic disorders such as diabetes, as people with a low number of copies of the salivary amylase gene may also be glucose intolerant.”Dr Mario Falchi, also from Imperial’s School of Public Health and first author of the study, said: “Previous genetic studies investigating obesity have tended to identify variations in genes that act in the brain and often result in differences in appetite, whereas our finding is related to how the body physically handles digestion of carbohydrates. We are now starting to develop a clearer picture of a combination of genetic factors affecting psychological and metabolic processes that contribute to people’s chances of becoming obese. This should ultimately help us to find better ways of tackling obesity.”Dr Julia El-Sayed Moustafa, another lead author from Imperial’s School of Public Health, said: “Previous studies have found rare genetic variations causing extreme forms of obesity, but because they occur in only a small number of people, they explained very little of the differences in body weight we see in the population. On the other hand, research on more common genetic variations that increase risk of obesity in the general population have so far generally found only a modest effect on obesity risk. …

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TV linked to poor snacking habits, cardiovascular risk in middle schoolers

Middle school kids who park themselves in front of the TV for two hours or more each day are more likely to consume junk food and have risk factors for cardiovascular disease, even compared to those who spend an equal amount of time on the computer or playing video games, according to research to be presented at the American College of Cardiology’s 63rd Annual Scientific Session.”While too much of both types of screen time encourages sedentary behavior, our study suggests high TV time in particular is associated with poorer food choices and increased cardiovascular risk,” said Elizabeth Jackson, M.D., M.P.H., associate professor, Division of Cardiovascular Medicine, University of Michigan Systems, Ann Arbor, Mich., and the senior author of the study.In fact, sixth-graders who reported watching between two and six hours of TV a day were more likely to have higher body mass index, elevated systolic and diastolic blood pressure and slower recovery heart rate compared with those reporting low screen time or kids who had comparable computer/video game use. This is the first time researchers have looked at the impact of different kinds of screen time kids get in relation to snacking habits and physiological measures associated with heart health, according to the authors.The study included 1,003 sixth-graders from 24 middle schools participating in Project Healthy Schools across five diverse communities in Southeast Michigan. Researchers used standardized questionnaires to collect information about health behaviors including the type and frequency of screen time, snacking habits, and food and beverage choices in the last 24 hours. Physiological measurements were also assessed, including blood pressure, cholesterol, heart rate recovery after exercise (a marker of fitness), height and weight. Students were divided into three groups: low screen time (less than one-half hour a day), high TV time (two to six hours a day) and high computer/video games (two to six hours a day). Self-reported snack behavior and physiologic markers were then compared.The research found that kids who spent more time in front of a screen — regardless of the type — snack more frequently and are more likely to choose less healthy snacks. High TV viewers and computer/video game users both reported eating roughly 3.5 snacks a day — one full snack more than kids who had minimal exposure to these technologies. But children who watched two to six hours a day of TV were more likely than the high computer/video game group to eat high-fat foods such as French fries and chips.Jackson said this is likely because these kids are bombarded by TV commercials that tend to reinforce less healthy foods — often higher in sugar, salt and fats. In addition, kids tend to have free hands while watching TV as opposed to when they are on the computer or playing video games, which provides more opportunity for mindless snacking. Earlier studies have also shown that children tend to eat more when they watch TV.”Snacks are important, and choosing a piece of fruit rather than a bag of chips can make a really big difference for one’s health,” Jackson said. …

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Are statins good for your love life?

Statins are associated with a significant improvement in erectile function, a fact researchers hope will encourage men who need statins to reduce their risk of heart attack to take them, according to research to be presented at the American College of Cardiology’s 63rd Annual Scientific Session.Erectile dysfunction is common in older men, especially among those with cardiovascular risk factors where cholesterol-lowering statins are frequently prescribed. Previous research has suggested a negative association between statin therapy and testosterone levels, leading to questions about the effects of these widely used medications on the quality of erection.In the first meta-analysis of previous studies on erectile dysfunction and statins, researchers identified 11 randomized, controlled trials that measured erectile function using the International Inventory of Erectile Function — a self-administered survey with five questions, each scored on a five-point scale and totaled, with lower values representing poorer sexual function. Analysis of all 11 studies combined found a statistically significant effect of statins on erectile function in men who had both high cholesterol and erectile dysfunction. Overall, erectile function scores increased by 3.4 points in men who took statins (from 14.0 to 17.4, a 24.3 percent increase).”The increase in erectile function scores with statins was approximately one-third to one-half of what has been reported with drugs like Viagra, Cialis or Levitra,” said John B. Kostis, M.D., director of the Cardiovascular Institute and associate dean for Cardiovascular Research at Rutgers Robert Wood Johnson Medical School, and the lead investigator of the study.”It was larger than the reported effect of lifestyle modification,” Kostis said. “For men with erectile dysfunction who need statins to control cholesterol, this may be an extra benefit.”Researchers believe that statins may work to improve erectile function by helping blood vessels dilate properly and improving vascular blood flow to the penis, which is often restricted in men with erectile dysfunction. While statins are not recommended as a primary treatment for erectile dysfunction in patients with healthy cholesterol levels, the added benefit may encourage more men who need statins to take them. Millions of Americans are prescribed statins to prevent heart disease, but some stop taking the medication or take less than the prescribed dose, Kostis said. Rather than preventing the possibility of a heart attack in the future, the more immediate benefit of improving erectile function might improve adherence to statin therapy, he added.Erectile dysfunction affects an estimated 18 million to 30 million men and occurs more often in men over the age of 40. Common causes include heart disease, high cholesterol, high blood pressure, diabetes, obesity, tobacco use, depression and stress.Kostis said that larger randomized controlled trials are needed to further investigate the link between statin therapy and erectile function.This study will be simultaneously published online in the Journal of Sexual Medicine at the time of presentation.Story Source:The above story is based on materials provided by American College of Cardiology. …

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Sensing gravity with acid: Scientists discover role for protons in neurotransmission

While probing how organisms sense gravity and acceleration, scientists at the Marine Biological Laboratory (MBL) and the University of Utah uncovered evidence that acid (proton concentration) plays a key role in communication between neurons. The surprising discovery is reported this week in the Proceedings of the National Academy of Sciences.The team, led by the late MBL senior scientist Stephen M. Highstein, discovered that sensory cells in the inner ear continuously transmit information on orientation of the head relative to gravity and low-frequency motion to the brain using protons as the key means of synaptic signal transmission. (The synapse is the structure that allows one neuron to communicate with another by passing a chemical or electrical signal between them.)”This addresses how we sense gravity and other low-frequency inertial stimuli, like acceleration of an automobile or roll of an airplane,” says co-author Richard Rabbitt, a professor at University of Utah and adjunct faculty member in the MBL’s Program in Sensory Physiology and Behavior. “These are very long-lasting signals requiring a a synapse that does not fatigue or lose sensitivity over time. Use of protons to acidify the space between cells and transmit information from one cell to another could explain how the inner ear is able to sense tonic signals, such as gravity, in a robust and energy efficient way.”The team found that this novel mode of neurotransmission between the sensory cells (type 1 vestibular hair cells) and their target afferent neurons (calyx nerve terminals), which send signals to the brain, is continuous or nonquantal. This nonquantal transmission is unusual and, for low-frequency stimuli like gravity, is more energy efficient than traditional synapses in which chemical neurotransmitters are packaged in vesicles and released quantally.The calyx nerve terminal has a ball-in-socket shape that envelopes the sensory hair cell and helps to capture protons exiting the cell. “The inner-ear vestibular system is the only place where this particular type of synapse is present,” Rabbitt says. “But the fact that protons are playing a key role here suggests they are likely to act as important signaling molecules in other synapses as well.”Previously, Erik Jorgensen of University of Utah (who recently received a Lillie Research Innovation Award from the MBL and the University of Chicago) and colleagues discovered that protons act as signaling molecules between muscle cells in the worm C. elegans and play an important role in muscle contraction. …

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New guidelines deem 13 million more Americans eligible for statins

New guidelines for using statins to treat high cholesterol and prevent cardiovascular disease are projected to result in 12.8 million more U.S. adults taking the drugs, according to a research team led by Duke Medicine scientists.The findings for the first time quantify the impact of the American Heart Association’s new guidelines, which were issued in November and generated both controversy and speculation about who should be given a prescription for statins.In an analysis of health data published online March 19, 2014, in the New England Journal of Medicine, a team led by researchers at the Duke Clinical Research Institute found that most of the additional statin users under the new guidelines would be people older than age 60.”We sought to do a principled, scientific study to try to answer how the new guidelines might affect statin use, particularly as they focused eligibility on patients with an increased risk of developing cardiovascular disease,” said lead author Michael J. Pencina, Ph.D., professor of biostatistics at DCRI. “By our estimate, there might be an uptake in usage as a result of the guidelines, from 43.2 million people to 56 million, which is nearly half of the U.S. population between the ages of 40 and 75.”Pencina and colleagues from McGill University and Boston University used the National Health and Nutrition Examination Surveys (NHANES) for their analysis, focusing on 3,773 participants between the ages of 40-75 who had provided detailed medical information, including fasting cholesterol levels from blood tests.The new guidelines expand the criteria for statin use to include people whose 10-year risk of developing cardiovascular disease, including stroke, is elevated based on a risk-assessment score.The DCRI-led research team determined that the new guidelines could result in 49 percent of U.S. adults ages 40-75 being recommended for statin therapy, an increase from 38 percent.The increase is much more pronounced among adults free of cardiovascular disease who are over age 60, with 77 percent recommended for statin use under the new guidelines vs. 48 percent under the previous standards. This contrasts with a modest increase from 27 percent to 30 percent among U.S. adults between the ages of 40 and 60.Those most affected by the new recommendations are older men who are not on statins and do not have cardiovascular disease. Under the earlier guidelines, about 30.4 percent of this group of men between the ages of 60-75 were recommended for statin use. …

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Young athletes with knee pain may turn to meniscus transplant

Patients undergoing meniscal allograft transplantation (MAT) surgery require an additional operation approximately 32% of the time, but overall see a 95% success rate after an average five-year follow-up, according to new research released today at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Specialty Day.”Our research shows a positive mid to long-term outcome for patients who require MAT surgery,” commented lead author Dr. Frank McCormick from Holy Cross Orthopedic Institute in Fort Lauderdale Florida, and Rush University Medical Center in Chicago. “While 64 patients out of the 172 we followed needed additional surgery, the overall survival of transplanted grafts suggests we can confidently recommend this procedure moving forward.”The study took place from January 2003 to April 2011, with patients receiving the same surgical technique as well as the same 4-6 week rehab. Follow-up surgeries included removal of tissue, equipment, and in some cases a revision of the original surgery.”A healthy meniscus is critical to a fully functioning knee, and so also key to leading an active lifestyle,” noted McCormick. “Our latest data shows that patients with damaged knees can certainly recover and return to form with the right kinds of treatment.”Story Source:The above story is based on materials provided by American Orthopaedic Society for Sports Medicine (AOSSM). Note: Materials may be edited for content and length.

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The Escalating Debate Over E-Cigarettes

Follow the bouncing ping-pong ball. “E-cigarettes are likely to be gateway devices for nicotine addiction among youth, opening up a whole new market for tobacco.”—Lauren Dutra, postdoctoral fellow at the UCSF Center for Tobacco Control Research and Education.“You’ve got two camps here: an abstinence-only camp that thinks anything related to tobacco should be outlawed, and those of us who say abstinence has failed, and that we have to take advantage of every opportunity with a reasonable prospect for harm reduction.”—Richard Carmona, former U.S. Surgeon General, now board member of e-cigarette maker NJOY.“Consumers are led to believe that e-cigarettes are a safe alternative to cigarettes, despite the fact that they are addictive, and there is no regulatory oversight …

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Contagious yawning a mystery: May not be linked to empathy after all

While previous studies have suggested a connection between contagious yawning and empathy, new research from the Duke Center for Human Genome Variation finds that contagious yawning may decrease with age and is not strongly related to variables like empathy, tiredness and energy levels.The study, published March 14 in the journal PLOS ONE, is the most comprehensive look at factors influencing contagious yawning to date.The researchers said a better understanding of the biology involved in contagious yawning could ultimately shed light on illnesses such as schizophrenia or autism.”The lack of association in our study between contagious yawning and empathy suggests that contagious yawning is not simply a product of one’s capacity for empathy,” said study author Elizabeth Cirulli, Ph.D., assistant professor of medicine at the Center for Human Genome Variation at Duke University School of Medicine.Contagious yawning is a well-documented phenomenon that occurs only in humans and chimpanzees in response to hearing, seeing or thinking about yawning. It differs from spontaneous yawning, which occurs when someone is bored or tired. Spontaneous yawning is first observed in the womb, while contagious yawning does not begin until early childhood.Why certain individuals are more susceptible to contagious yawning remains poorly understood. Previous research, including neuroimaging studies, has shown a relationship between contagious yawning and empathy, or the ability to recognize or understand another’s emotions. Other studies have shown correlations between contagious yawning and intelligence or time of day.Interestingly, people with autism or schizophrenia, both of which involve impaired social skills, demonstrate less contagious yawning despite still yawning spontaneously. A deeper understanding of contagious yawning could lead to insights on these diseases and the general biological functioning of humans.The current study aimed to better define how certain factors affect someone’s susceptibility to contagious yawning. The researchers recruited 328 healthy volunteers, who completed cognitive testing, a demographic survey, and a comprehensive questionnaire that included measures of empathy, energy levels and sleepiness.The participants then watched a three-minute video of people yawning, and recorded the number of times they yawned while watching the video.The researchers found that certain individuals were less susceptible to contagious yawns than others, with participants yawning between zero and 15 times during the video. Of the 328 people studied, 222 contagiously yawned at least once. When verified across multiple testing sessions, the number of yawns was consistent, demonstrating that contagious yawning is a very stable trait.In contrast to previous studies, the researchers did not find a strong connection between contagious yawning and empathy, intelligence or time of day. The only independent factor that significantly influenced contagious yawning was age: as age increased, participants were less likely to yawn. …

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