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HM order on Patient and doctor safety in response to COVID-19


Health Ministry order on "Patient and doctor safety in response to COVID-19 temporarily restricts planned healthcare services". 

The Health Inspectorate, for the purpose of notification, sends to all medical treatment institutions the order No.59 issued by the Ministry of Health. on "Patient and doctor safety in response to COVID-19 temporarily restricts planned healthcare services"

Veselības inspekcija 
Klijānu iela 7, Rīga, LV-1012 
tālrunis 67081600, fakss: 67819672 ,




Anti-hepatitis medicine surprises



Hepatitis C is a serious disease, but the biggest threat to someone's health is not the virus itself. Rather, it is the diseases that can result from it such as reduced liver functioning, scar tissue in the liver and potentially cirrhosis. 

A new study shows that the antiviral treatment which has been used to fight the disease over the last five years, also helps improve the complications which follow. 

"It's really good news, because the treatment is effective on almost all patients with hepatitis C, but the fact that it also works against complications is new to us. And this is absolutely crucial for this group of patients, because they don't die from the hepatitis C virus, but in worst case scenarios, from the diseases that chronic liver damage can lead to," says Tea Lund Laursen, PhD student at the Department of Clinical Medicine at Aarhus University. 

 The results have just been published in the scientific journal Journal of Viral Hepatitis. 

 Less scar tissue and improved cognitive function
 It can often take 20-30 years from being infected with hepatitis C until a person experiences the symptoms. During that period the liver inflammation becomes chronic for the majority of patients and serious damage develops. 

"With the study, we now know that even though the patients discover the disease late, the new treatment gives them good chances of a more positive prognosis. Simply because the liver is on the mend when they become free of the virus," says Tea Lund Laursen. 

The researchers followed 71 patients with chronic liver inflammation before, during and after treatment. The studies showed that the inflammation in their liver diminished, that there was less scar tissue, and that the liver improved its ability to break down various substances. At the same time, the researchers could measure that the patients reacted quicker to sounds than before they began the treatment. 

"Chronic liver inflammation can also lead to cognitive problems where patients become tired, have poorer memory and also reduced response times. But we could also see an improvement in reaction times one year after the 12 week course of treatment. We therefore expect this to also be the case for the other cognitive functions," says Tea Lund Laursen. 

Major perspectives in antiviral treatment
The Danish Health and Medicines Authority estimates that approx. 17,000 people are infected with hepatitis C in Denmark and that around half of them are not known in the healthcare system. The vast majority have been infected by sharing syringes. They include both former and current drug abusers and people who demonstrated high-risk behaviour in their youth 30-40 years ago - with many of them unaware that they are infected. 

"If the people in the risk category contacted the healthcare system, we would be able to save or improve the lives of a great many people, and also more or less eradicate hepatitis C in Denmark in the long term," says Tea Lund Laursen. 

While the number of people with the infection is relatively limited in Denmark, hepatitis C is a major problem globally with approx. 160 million people infected. The disease is particularly widespread in several West African countries, Russia and Greenland.


Great American Smokeout



What is Great American Smokeout?
The American Cancer Society sponsors the Great American Smokeout on the third Thursday of November (November 21, 2019), challenging smokers to give up cigarettes for 24 hours. If you or a loved one smokes cigarettes, consider joining the movement, and take the first step toward quitting cigarettes forever!

History of Great American Smokeout
The inception of the Great American Smokeout stems from a 1970 event in Randolph, Massachusetts. High school guidance councilor Arthur P. Mullaney asked people to give up cigarettes for one day and donate the money they would have spent on buying cigarettes to a high school scholarship fund. A few years later in 1974, newspaper editor Lynn R. Smith led Minnesota’s first Don’t Smoke Day.

The two efforts caught on and on November 18, 1976, the California Division of the American Cancer Society got 1 million people to quit smoking for the day. This marked the first official Smokeout before the American Cancer Society took it nationwide in 1977. As a result, there was a dramatic change in the public view of tobacco advertising and use. Many public establishments and work places are now smoke-free to protect non-smokers and support people trying to quit.

Every year the Great American Smokeout draws attention to preventing deaths and chronic illnesses caused by smoking. From the late 1980s to the 1990s, many state and local governments have raised taxes on cigarettes, limited promotions, discouraged teen cigarette use, and taken further action to counter smoking. States with strong tobacco control laws saw up to a 42% decrease of smoking in adults.

Though smoking rates have dropped, almost 38 million Americans still smoke tobacco, and about half of all smokers will encounter smoking related deaths. Each year, more than 480,000 people in the United States die from a smoking related illness, meaning smoking causes 1 out of 5 deaths in the US alone.


Botanical Folk Medicines for Hypertension


Lavender, fennel and chamomile among herbs discovered to act upon a shared therapeutic target in blood vessels.

Common herbs, including lavender, fennel and chamomile, have a long history of use as folk medicines used to lower blood pressure. In a new study, University of California, Irvine researchers explain the molecular mechanisms that make them work.

Published today in Proceedings of the National Academy of Sciences (PNAS), the study illustrates how many of the known traditional botanical plants used to lower blood pressure activate a specific potassium channel (KCNQ5) in blood vessels.

KCNQ5, together with other potassium channels including KCNQ1 and KCNQ4, is expressed in vascular smooth muscle. When activated, KCNQ5 relaxes blood vessels, making it a logical mechanism for at least part of the hypotensive actions of certain botanical folk medicines.

"We found KCNQ5 activation to be a unifying molecular mechanism shared by a diverse range of botanical hypotensive folk medicines. Lavandula angustifolia, commonly called lavender, was among those we studied. We discovered it to be among the most efficacious KCNQ5 potassium channel activators, along with fennel seed extract and chamomile," said Geoff Abbott, PhD, professor of physiology and biophysics at the UCI School of Medicine and senior investigator on the study.

Interestingly, the KCNQ5-selective potassium channel activation feature found in the botanicals is lacking in the modern synthetic pharmacopeia. Until now, it seems to have eluded conventional screening methods utilizing chemical libraries, which may account for why it is not a recognized feature of synthetic blood pressure medications.

"Our discovery of these botanical KCNQ5-selective potassium channel openers may enable development of future targeted therapies for diseases including hypertension and KCNQ5 loss-of-function encephalopathy," said Abbott. Documented use of botanical folk medicines stretches back as far as recorded human history.

There is DNA evidence, dating back 48,000 years, that suggests the consumption of plants for medicinal use by Homo neanderthalensis. Archaeological evidence, dating back 800,000 years, even suggests non-food usage of plants by Homo erectus or similar species.

Today, evidence of the efficacy of botanical folk medicines ranges from anecdotal to clinical trials, however the underlying molecular mechanisms often remain elusive.


Chair Yoga Vs Music Therapy for Dementia



As dementia progresses, the ability to participate in exercise programs declines. Sticking to a program also becomes challenging because of impaired cognition, mobility issues or risk of falls and fractures - some exercise regimens are just too complicated or physically demanding.

Although studies have shown the benefits of physical activity on dementia, few have included participants with moderate-to-severe dementia or examined the effects of gentle types of exercise on this population.

Researchers from Florida Atlantic University conducted a pilot study that is the first cluster, randomized controlled trial to examine the effects of chair yoga on older adults with moderate to severe dementia who are unable to participate in regular exercise or standing yoga due to cognitive impairment, problems with balance, or fear of falling.

The key aim of the study was to assess the likelihood of these individuals' ability to participate in non-pharmacological interventions as well as demonstrate the safety and effects of chair yoga on older adults with all levels of dementia.

For the study, published in the American Journal of Alzheimer's Disease & Other Dementias, researchers compared chair yoga with two other types of non-pharmacological interventions: chair-based exercise and music intervention. Participants in each of the three groups attended 45-minute sessions twice a week for 12 weeks.

Researchers collected data at baseline, after six weeks and after completing the 12-week intervention. Results showed that participants with moderate-to-severe dementia could safely adhere to non-pharmacological interventions. More than 97 percent of the participants fully engaged in each session.

Study findings showed that the chair yoga group improved significantly in quality of life compared to the music intervention group. Both the chair yoga and chair-exercise groups showed improvement over time, while the music intervention group declined. In addition, both the chair yoga and chair-based exercise groups showed lower depression across all three time points when compared to the music intervention group.

Researchers examined the effects of chair yoga on physical function, including balance and mobility, and compared the effects with chair-based exercise and music intervention. They also looked at the effects of chair yoga on reducing psychological symptoms like anxiety and depression, behavioral symptoms like agitation or aggression, and improved quality of life. They also explored the effects of chair yoga on sleep problems.

Chair yoga provides a safe environment for stretching, strengthening and flexibility while decreasing the risk of falls by using a chair. It also provides important breathing and relaxation techniques utilizing stationary poses that use isometric contraction and guided relaxation of various muscle groups.

"We think that the physical poses we used in the chair yoga and chair-based exercise groups were an important factor in improving quality of life for the participants in our study," said Juyoung Park, Ph.D., lead author and an associate professor in the Phyllis and Harvey Sandler School of Social Work within FAU's College for Design and Social Inquiry.

"It is fascinating that, although some participants showed mild levels of agitation or wandering in the intervention room prior to the yoga session, they became calm and attentive when the yoga interventionist started demonstrating yoga poses. Although they did not understand the interventionist's verbal instructions due to their cognitive impairment associated with advanced dementia, they followed the instructor's poses."

Park and collaborators did not find any differences in the three intervention groups on physical function, with the exception of handgrip strength, which was higher in the chair yoga group compared to the music intervention group. None of the three groups declined significantly in any of the investigated physical functional measures. Researchers also did not find any significant between-group differences in anxiety at any time point. There were no significant between-group differences in change in depression and anxiety.

The researchers also did not find significant differences among the three intervention groups for sleep quality at any of the three time points. "We did see an increase in agitation in the chair yoga group even though this group reported a higher quality of life score, including physical condition, mood, functional abilities, interpersonal relationships, ability to participate in meaningful activities, and final situations," said Park.

"It's important to note that quality of life is a more comprehensive approach to biopsychosocial and behavioral function than a mere measure of agitation. Meditation and the mind-body connection component of the chair yoga program may have increased quality of life for participants in this study. This finding is consistent with our earlier studies that showed a targeted approach was successful in increasing quality of life in patients with dementia."

Study participants were 60 years or older (mean average age was 84 years-old) and diagnosed with dementia including Alzheimer's disease (the largest diagnostic group), Lewy Body dementia and Parkinson disease dementia. There were no significant demographic differences among intervention groups. More than half of the group (67.7 percent) were taking medication(s) to manage symptoms associated with dementia.


Herbal supplement used to treat addiction and pain



The herb kratom is increasingly being used to manage pain and treat opioid addiction, but it's not safe to use as an herbal supplement, according to new research led by faculty at Binghamton University, State University of New York.

William Eggleston, clinical assistant professor of pharmacy practice at Binghamton University, had been seeing more and more patients presenting with toxicity or withdrawal from kratom use. Kratom is an herbal supplement derived from a plant that grows throughout southeast Asia.

It is well-reported that the active chemicals in the plant act on opioid receptors in the body. Patients report using the supplement to treat/prevent withdrawal, treat opioid use disorder, or treat pain. Eggleston was curious to see what types of toxicities were being reported to Poison Centers nationally in order to better assess whether or not kratom is safe enough to be used as an herbal supplement.

His team conducted a retrospective review of kratom exposures reported to the National Poison Data System to determine the toxicities associated with kratom use. They also reviewed records from a County Medical Examiner's Office in New York State to identify kratom-associated fatalities.

A total of 2312 kratom exposures were reported, with 935 cases involving kratom as the only substance. Kratom most commonly caused agitation (18.6%), tachycardia (16.9%), drowsiness (13.6%), vomiting (11.2%), and confusion (8.1%). Serious effects of seizure (6.1%), withdrawal (6.1%), hallucinations (4.8%), respiratory depression (2.8%), coma (2.3%), and cardiac or respiratory arrest (0.6%) were also reported.

Kratom was listed as a cause or contributing factor in the death of four decedents identified by the County Medical Examiner's Office. The findings suggest kratom is not reasonably safe and poses a public health threat due to its availability as an herbal supplement. "Although it is not as strong as some other prescription opioids, kratom does still act as an opioid in the body," said Eggleston.

"In larger doses, it can cause slowed breathing and sedation, meaning that patients can develop the same toxicity they would if using another opioid product. It is also reported to cause seizures and liver toxicity. Kratom may have a role in treating pain and opioid use disorder, but more research is needed on its safety and efficacy. Our results suggest it should not be available as an herbal supplement."

Eggleston and his team are working with colleagues at SUNY Upstate Medical University to better assess how many patients are actually using kratom and if the risk for toxicity changes depending on the dose of kratom taken.


Alcohol may be less harmful for people over 50



A recent study examines the health impact of consuming alcohol at different ages. The authors conclude that, for people over the age of 50, the health risks may be less severe.

Heavy drinking is linked to a range of serious health consequences. These include certain cancers, liver and heart disease, and damage to the nervous system, including the brain. However, as has been exhaustively covered in the popular press, drinking in moderation might have certain health benefits.

A number of studies have concluded that drinking alcohol at a low level could have a protective effect. One study, for instance, found that light and moderate drinking protected against all-cause mortality, as well as mortality related to cardiovascular disease. It is no surprise that these stories have been well-received and widely read, but not all researchers agree, and the debate is ongoing.

A recent study led by Dr. Timothy Naimi, of the Boston Medical Center in Massachusetts, adds further fuel to an already rampant blaze. The authors take aim at the methodology used in earlier studies, and they published their findings in the Journal of Studies on Alcohol and Drugs earlier this week.

A fresh approach

The researchers argue that the way that earlier studies measured alcohol's impact on health might be flawed. Specifically, they note that the studies are generally observational and usually recruit participants over the age of 50. The authors argue that this is problematic because it excludes anyone who might have died due to alcohol before the age of 50.

As they dryly point out, "Deceased persons cannot be enrolled in cohort studies." Dr. Naimi first outlined his concerns about this inherent selection bias in a paper published in the journal Addiction in 2017.

"Those who are established drinkers at age 50 are 'survivors' of their alcohol consumption who [initially] might have been healthier or have had safer drinking patterns."
Dr. Timothy Naimi

According to the authors, almost 40 percent of deaths due to alcohol consumption occur before the age of 50.

This means that the vast majority of research into the potential risks of alcohol do not take these deaths into account and could underestimate the real dangers. To reinvestigate, the authors dipped into data from the Alcohol-Related Disease Impact Application which is maintained by the Centers for Disease Control and Prevention (CDC).

According to the CDC, this application "provides national and state estimates of alcohol-related health impacts, including deaths and years of potential life lost."

The difference of age
The analysis showed that the level of an individual's alcohol-related risk was heavily influenced by age. In total, 35.8 percent of alcohol-related deaths occurred in people aged 20–49.

When looking at deaths that were prevented by alcohol consumption, the scientists found only 4.5 percent in this age group. When they looked at individuals aged 65 or over, it was a different story: Although a similar 35 percent of alcohol-related deaths occurred in this group, the authors found a huge 80 percent of the deaths prevented by alcohol in this demographic.

The researchers also saw this stark difference between age groups when they looked at the number of potential years lost to alcohol. They showed that 58.4 percent of the total number of years lost occurred in those aged 20–49. However, this age group only accounted for 14.5 percent of the years of life saved by drinking.

The authors conclude that younger people "are more likely to die from alcohol consumption than they are to die from a lack of drinking," but older people are more likely to experience the health benefits of moderate drinking. Although the conclusions are not explosive, they bring us a more complete understanding of alcohol's impact on health: Moderate drinking may benefit people of a certain age group, but heavy drinking is harmful to all.


Experimental Ebola treatments effective in lab study


Two experimental Ebola drugs have been found to be effective in treating the strain of the deadly virus responsible for the deaths of more than 1,600 people in the Democratic Republic of Congo, according to new research published Tuesday.

Laura McMullan, a microbiologist at the US Centers for Disease Control and Prevention who lead the research, said the two treatments were developed based on strains from previous outbreaks and this study was the first to test them on the current one, which researchers are calling the Ituri strain.

"It's vitally important to make sure existing treatments work against the virus that's making people sick now," she said. An antiviral drug called remdesivir and another antibody treatment called ZMapp both inhibited the growth of the virus strain in human cells in laboratory studies, according to the paper published in the medical journal Lancet Infectious Diseases.

"They're currently being tested in a clinical trial but we needed to verify and make sure that they were going to be as effective," she told CNN.

"Information that we knew about how well they worked was based on a different Ebola virus variant so we needed to make sure that, indeed, these compounds were going to bind and block the virus and measure that, and see if it worked as well in order for the clinical trials to proceed," she said.

According to the latest figures from the World Health Organization, the Ebola outbreak in Congo has killed 1,630 people, with 2,418 total cases of the deadly disease. It's the second biggest outbreak of the disease in history; the largest recorded was in West Africa from that killed more 11,000 people starting in 2014.

Experimental treatments
ZMapp and remdesivir are among four promising experimental treatments that have been used in the Congo under what's called a compassionate use framework, with doctors deciding the best treatment for each patient based, in part, on the complexity of administering and monitoring the drug, according to WHO.

In 2014, ZMapp became known when it was used to treat two American missionary workers, Dr. Kent Brantly and Nancy Writebol, who contracted Ebola in Liberia. Prior to that, the experimental drug had been tested only in monkeys.

However, a 2016 study that looked at 72 people who had had Ebola found that Zmapp might not have been a key factor in their survival. It found that although it was beneficial overall, ZMapp "did not meet the prespecified statistical threshold for efficacy."

"This work has benefits beyond the current study," said Inger Damon, chief strategy officer for the CDC's 2018 Ebola response and director of CDC's Division of High-Consequence Pathogens and Pathology.

"Having access to this virus will allow us to explore whether other compounds or potential therapies affect the virus in the lab." Health authorities have also made successful use of an experimental vaccine that has been found to be 97% effective in the Congo Ebola outbreak.

Because the treatments are experimental, meaning they are still being studied, they are administered with strict protocols and require informed consent. Despite the new drugs to fight the disease, Ebola is spreading to new parts of eastern Congo's North Kivu and Ituri provinces and re-infecting areas thought rid of the virus.

Last month, it also made the long-feared jump across the border to neighboring Uganda, though those isolated cases appear to have been contained. Deep mistrust of authorities, attacks on health care workers and simmering conflict in the region has meant that the outbreak has continued unabated 11 months after the first cases were confirmed.

In its latest update on July 4, WHO said that over the past four weeks a "general deterioration of the security situation and the persistence of pockets of community mistrust exacerbated by political tensions and insecurity" had led to delays and temporary suspensions in investigating suspected cases.


Sleep disorder predicts risk



To establish the strength of the connection between the two conditions, the researchers - whose recent findings appear in Brain: A Journal of Neurology - worked with 1,280 people with REM sleep behavior disorder across 24 centers of the International RBD Study Group.

The researchers assessed the participants' motor function, cognitive abilities, and sensory abilities for a number of years. After a 12-year follow-up period, they found that 73.5 percent of the people involved in this study had developed Parkinson's disease.

Moreover, participants who had started experiencing motor function issues in this period had a threefold increase in the risk of developing Parkinson's disease or related conditions, such as dementia with Lewy bodies.

Also at high risk were participants who had developed cognitive impairment or started experiencing problems with their sense of smell. These findings confirm that the presence of RBD is, indeed, a strong predictor of Parkinson's disease.

All the more so, since the researchers conducted the study in centers across North America, Europe, and Asia, which means that the results apply to diverse populations.


People with osteoporosis should avoid spinal poses in yoga


Yoga postures that flex the spine beyond its limits may raise the risk of compression fractures in people with thinning bones, according to research from Mayo Clinic.

The results appear in Mayo Clinic Proceedings. Researchers at Mayo Clinic and elsewhere have described injuries from yoga. This study examines injuries in people with osteoporosis and osteopenia - conditions characterized by low bone density.

Osteoporosis is a disease in which bones become thinner and more porous from loss of mineral content. Bone loss that has not reached the stage of an osteoporosis diagnosis is called osteopenia.

Researchers reviewed the health records of 89 people - mostly women - referred to Mayo Clinic from 2006 to 2018 for pain they attributed to their yoga practice.

Some were new to yoga. Others had practiced for years. They had pain in the back, neck, shoulder, hip, knee or a combination. Patients identified 12 poses they said caused or aggravated their symptoms.

The most common postures involved extreme flexing or extending of the spine. Researchers used patients' health records, medical exams and imaging to confirm and categorize the injuries as soft tissue, joint or bone injuries.

Researchers identified 29 bony injuries, including degeneration of disks, slippage of vertebrae and compression fractures. The latter appeared to be related to postures that put extra pressure on the vertebra and disks.

"Yoga has many benefits. It improves balance, flexibility, strength and is a good social activity," says Mehrsheed Sinaki, M.D., a Mayo Clinic physical medicine and rehabilitation specialist and the study's senior author.

"But if you have osteoporosis or osteopenia, you should modify the postures to accommodate your condition. As people age, they can benefit by getting a review of their old exercise regimens to prevent unwanted consequences." Patients who incorporated recommendations to modify their movements reduced their pain and improved their symptoms.

In a separate commentary, Edward Laskowski, M.D., co-chair of Mayo Clinic Sports Medicine, called on providers, patients and yoga teachers to work together to produce an individualized exercise prescription that considers the yoga student's medical history to protect against injury and provide optimal benefit.

The authors noted study limitations. The patients were seen in a musculoskeletal clinic at a tertiary care center, which makes generalizations difficult.

Researchers received follow-up reports on 22 patients, as most lived out of state.


Increased Risk of Harm from Cannabis



Cannabis resin and herbal cannabis have significantly increased in potency and in price, according to the first study to investigate changes in cannabis across Europe.

The study, published today (Sunday 30 December) in the journal Addiction by researchers from the University of Bath and King's College London, draws on data collected from across 28 EU Member states, as well as Norway and Turkey by the European Monitoring Centre for Drugs and Drug Addiction.

The findings show that for herbal cannabis, concentrations of delta-9-tetrahydrocannabinol ('THC' -- the main psychoactive constituent of cannabis) increased by a similar amount each year, from 5% in 2006 to 10% in 2016. For cannabis resin (or hash), THC concentrations were relatively stable from 2006 to 2011 (from 8% to 10%) but then increased rapidly from 2011 to 2016 (from 10% to 17%). The price of cannabis resin also increased, but to a lesser extent than for herbal cannabis.

Lead author Dr Tom Freeman from the Addiction and Mental Health Group within the Department of Psychology at the University of Bath, said: "These findings show that cannabis resin has changed rapidly across Europe, resulting in a more potent and better value product."

Unlike herbal cannabis, cannabis resin typically contains cannabidiol (CBD) in addition to THC. CBD has recently attracted considerable interest due to its potential to treat several medical conditions including childhood epilepsy syndromes, psychosis and anxiety. When present in cannabis, CBD may offset some of the harmful effects of THC such as paranoia and memory impairment.

Cannabis containing higher levels of THC and / or lower levels of CBD has been linked to greater long-term harms such as the development of cannabis dependence, and an increased risk of psychotic illness.

New resin production techniques in Morocco and Europe have increased levels of THC, but not CBD. Dr Freeman added: "CBD has the potential to make cannabis safer, without limiting the positive effects users seek. What we are seeing in Europe is an increase in THC and either stable or decreasing levels of CBD, potentially making cannabis more harmful.

These changes in the illicit market are largely hidden from scientific investigation and are difficult to target by policy-makers. An alternative option could be to attempt to control THC and CBD content through regulation." It is estimated that 24 million people (or 7.2%) of European adults used cannabis in the last year. Across the globe 192 million people use the drug in a variety of markets, ranging from heavily sanctioned prohibition to commercialised legal sale.

Cannabis policies are rapidly changing across the globe. Recreational use is now legalised in Canada and several US states, and medical use is permitted in many more countries, including very recently in the UK.


Reversing hearing loss by regrowing hairs



Humans are unable to reverse the effects of hearing loss, but a biological process found in other animal species may hold the key to reversing this widespread problem.

How the brain interprets sounds is a relatively simple process. First, a sound enters the ear via soundwaves. It then moves down the ear until it hits the eardrum. Next, the eardrum vibrates and sends these vibrations to bones in the middle ear, which then boost them.

Eventually, hair-like cells in the inner ear or cochlea pick up these vibrations and transform them into electrical signals that the brain can process. Age or excessive exposure to loud noise can damage the cochlea, resulting in permanent hearing loss.

According to the World Health Organization (WHO), hearing loss affects more than 400 million people around the world today. Some people experience more severe loss than others, and traditional treatment involves devices such as hearing aids. The effectiveness of these depends on the individual.

However, scientists have long known that animals such as fish and birds are able to keep their hearing intact by regenerating the sensory hair cells found in the cochlea. In fact, mammals are the only vertebrates that are unable to do this.

Testing the inner ear
In 2012, Dr. Patricia White's laboratory identified a group of receptors responsible for this regeneration process.

The researchers called this group the epidermal growth factor, or EGF, which switches on support cells in the auditory system of birds. These support cells then spark the production of new sensory hair cells.

Now, in a new study that they have published in the European Journal of Neuroscience, Dr. White - together with researchers from the University of Rochester and the Massachusetts Ear and Eye Infirmary - show how they tried to recreate this process in mammals.


Climate change makes heatwaves 30 times more likely


Human-induced climate change has made the United Kingdom's record-breaking 2018 summer heatwave around 30 times more likely than under normal conditions, the country's meteorological body has said.

The UK as a whole endured its joint hottest summer on record in 2018, and the hottest ever for England. Temperatures peaked in the east of England, reaching 35.6C (96F) in Felsham, Suffolk on July 27, and the UK's average temperature matched previous highs recorded in 2006, 2003 and 1976.

A new analysis from the UK's national weather service, the Met Office, presented at the United Nations' COP24 climate change conference in Katowice, Poland Thursday, has shown that the UK now has an approximately 12% chance of average summer temperatures being as high as in 2018.

Such temperatures would typically have a less than 0.5% chance of occurring under "natural" climate conditions. "Our provisional study compared computer models based on today's climate with those of the natural climate we would have had without human-induced emissions," said Professor Peter Stott from the Met Office and Exeter University.

Stott noted that the "rapidly increasing changes" stem from an increase in the concentrations of carbon dioxide and other greenhouse gases in the Earth's atmosphere. Carbon dioxide concentrations reached 405.5 parts per million (ppm) in the atmosphere in 2017, compared with an atmospheric concentration of around 280 ppm in the pre-industrial era (pre-1750).

A new report published this week by the Global Carbon Project, an international research project on global sustainability, revealed that fossil fuel emissions rose by 1.7% in 2017, and are set to rise further by 2.7% this year, to 37.1 billion tonnes of carbon dioxide. The Met Office warned that soaring temperatures are having an increasing impact on people's lives.

"The extreme temperatures experienced in the UK and around the world during summer 2018 had a significant impact upon many people's lives," Met Office chief scientist Professor Stephen Belcher said in a statement.

"We now live in a climate in which heatwaves occur more frequently and, depending on the choices we make around greenhouse gas emissions, we could reach a point in the future when we can expect a hot summer like that of 2018 to occur every year," he concluded.

A quarterly mortality report published by the UK's Office for National Statistics showed that there were 259 more deaths on June 25 and 26 this year compared with the five-year average of 2,146 for the two days.

Crop failures were also recorded across the country, Northern Ireland introduced its first hosepipe ban since 1995, and critical drinking-water reservoirs ran dry. Kathryn Brown, the head of adaptation in the UK's Committee on Climate Change, which advises the government, told CNN that the report reinforces that the government must redouble its efforts to address the impacts of high temperatures and lack of rain.

"The government must address the issue of greater shortages in water supplies for people, agriculture, industry and the natural environment, whilst improving shading and ventilation in new-build properties as well as reversing the decline of urban green spaces," she said.

"Without action, the number of heat-related deaths could increase from 2,000 per year today to 7,000 by the 2050s as a result of climate change and population growth."


Alternative splicing is crucial to muscle mass



Despite the importance that changes in muscle mass have in aging, overall body metabolism and in chronic disease, we still don't fully understand the mechanisms that contribute to the maintenance of adult muscle mass.

"A number of cell signaling and metabolic pathways have been studied regarding their involvement in sustaining adult muscle mass, but not alternative splicing," said Dr. Thomas Cooper, professor of pathology & immunology, of molecular and cellular biology and of molecular physiology and biophysics at Baylor College of Medicine.

Alternative splicing is a cellular mechanism that allows cells to produce many different proteins from a single gene. A gene can be visualized as a short string of 'beads' or exons. Each bead codes for a different piece of the final protein. Alternative splicing allows the cell to make different proteins by combining the 'beads' in different ways.

The researchers and other groups previously determined that alternative splicing regulators Rbfox1 and Rbfox2 were required for muscle development and function, but Cooper's group hypothesized that the two proteins worked together, and their combined role in adult muscle had not been studied before.

"To determine whether alternative splicing played a role in adult muscle maintenance, we disrupted the process in adult mice by knocking out the genes Rbfox1 and Rbfox2 only in skeletal muscles. Then, we looked at the effect this disruption had in muscles in the animals' limbs," said Dr. Ravi Singh, instructor of pathology & immunology at Baylor College of Medicine.

The critical role of alternative splicing

"We observed that the knockout mice rapidly lost about half of their skeletal muscle mass within four weeks," Singh said. "Two weeks after knocking out the genes Rbfox1 and Rbfox2, hundreds of other genes altered their expression and other genes their alternative splicing, including the capn3 gene, which switched splicing to produce an active form of a protease, an enzyme that degrades proteins."

"Taking all our observations together, we attributed the loss of muscle mass to an increase in degradation of muscle protein rather than a reduction of protein synthesis," said Cooper, who also is the S. Donald Greenberg and R. Clarence and Irene H. Fulbright Professor and a member of the Dan L Duncan Comprehensive Cancer Center at Baylor.

"The results indicate that the Rbfox splicing regulators, which are highly conserved from the worm C. elegans to humans, are essential for maintaining skeletal muscle mass in adult mice." "Our contribution has implications for studies on the role of muscle mass in metabolism and on muscle mass loss in aging and chronic disease," Singh said.

Read all the details of this study in the journal Cell Reports.


Yoga music at bedtime is good for the heart



Listening to yoga music at bedtime is good for the heart, according to research presented today at ESC Congress 2018.

Dr Naresh Sen, study author, Consultant Cardiologist at HG SMS Hospital, Jaipur, India, said: "We use music therapy in our hospital and in this study we showed that yoga music has a beneficial impact on heart rate variability before sleeping."

Previous research has shown that music can reduce anxiety in patients with heart disease. However, studies on the effects of music on the heart in patients and healthy individuals have produced inconsistent results, partly they did not state what style of music was used.

The body's heart rate changes as a normal response to being in "fight or flight" or "rest and digest" mode. These states are regulated by the sympathetic and parasympathetic nervous systems, respectively, and together comprise the autonomic nervous system. High heart rate variability shows that the heart is able to adapt to these changes.

Conversely, low heart rate variability indicates a less adaptive autonomic nervous system. Low heart rate variability is associated with a 32-45% higher risk of a first cardiovascular event. Following a cardiovascular event, people with low heart rate variability have a raised risk of subsequent events and death. Failure of the autonomic nervous system to adapt may trigger inflammation, which is linked to cardiovascular disease.

Another possibility is that people with low heart rate variability already have subclinical cardiovascular disease. This study investigated the impact of listening to yoga music, which is a type of soothing or meditative music, before bedtime on heart rate variability.

The study included 149 healthy people who participated in three sessions on separate nights:
(1) yoga music before sleep at night;
(2) pop music with steady beats before sleep at night; and
(3) no music or silence before sleep at night.

At each session, heart rate variability was measured4 for five minutes before the music or silence started, for ten minutes during the music/silence, and five minutes after it had stopped. In addition, anxiety levels were assessed before and after each session using the Goldberg Anxiety Scale.

The level of positive feeling was subjectively measured after each session using a visual analogue scale. The average age of participants was 26 years. The researchers found that heart rate variability increased during the yoga music, decreased during the pop music, and did not significantly change during the silence.

Anxiety levels fell significantly after the yoga music, rose significantly post the pop music, and increased after the no music session. Participants felt significantly more positive after the yoga music than they did after the pop music.

Dr Sen noted that holistic therapies such as music cannot replace evidence-based drugs and interventions, and should only be used as an add-on.

He said: "Science may have not always agreed, but Indians have long believed in the power of various therapies other than medicines as a mode of treatment for ailments. This is a small study, and more research is needed on the cardiovascular effects of music interventions offered by a trained music therapist. But listening to soothing music before bedtime is a cheap and easy to implement therapy that cannot cause harm."


Using tendon transfer surgery



After suffering a severe cervical spinal cord injury from a bad fall at work, Scott McConnell had little function remaining in his hands and arms.

Loyola Medicine orthopaedic surgeon Michael Bednar, MD, was able to restore key functions with a series of operations called tendon transfers. Mr. McConnell now can open his fingers up much more than he could before, and he can close them in a tight grip. He can pinch with his thumb and extend his arms outward. He is able to more easily perform everyday tasks such as grasping a cup, brushing his teeth and using his cell phone.

"I have a lot more ability in both my hands and my arms," Mr. McConnell said. Depending on the extent of the spinal cord injury, tendon transfers can enable a patient to grasp objects, open the hand, pinch the thumb and straighten the elbow. In a tendon transfer, muscles that still work are redirected to do the jobs of muscles that are paralyzed.

For example, the surgeon may detach one of the working muscles that flexes the elbow and reattach it to a nonworking muscle that flexes the thumb. The number of functioning muscles a patient has will determine what tendon transfers the surgeon will perform.

The more working muscles available for transfer, the more functions can be restored. Tendon transfers typically involve two surgeries on each arm, performed three months apart. Arms are done one at a time. During rehabilitation, patients learn how to use the transferred muscles.

Dr. Bednar has performed tendon transfers on about 75 patients and is among the most skilled and experienced surgeons in the country doing the procedure.

"Performing tendon transfers on patients with cervical spinal cord injuries requires a team approach," Dr. Bednar said. "The team works with the surgeon to determine who is an appropriate candidate for surgery. The team then helps the patient through the surgeries and rehabilitation, thereby ensuring maximum benefit from the procedures."

Patients who potentially can benefit the most from tendon transfers have spinal cord injuries in the C5-C8 cervical nerves in the lower neck. Mr. McConnell's injury was C5-C6.

"These are the most satisfying patients with whom I get to work," Dr. Bednar said. "To do the operation and have them activate a muscle for the first time since their injury, and see the look in their eyes and their face light up when they realize the function is back, is one of the most rewarding things I get to do as a surgeon."


Green tea molecule could prevent heart attacks


Green tea could hold the key to preventing deaths from heart attacks and strokes caused by atherosclerosis, according to research funded by the British Heart Foundation and published in the Journal of Biological Chemistry.

Scientists from Lancaster University and the University of Leeds have discovered that a compound found in green tea, currently being studied for its ability to reduce amyloid plaques in the brain in Alzheimer's disease, also breaks up and dissolves potentially dangerous protein plaques found in the blood vessels.

Atherosclerosis is the build-up of fatty material inside our arteries that can reduce the flow of blood to the heart and brain. In advanced stages of the condition, a protein called apolipoprotein A-1 (apoA-1) can form amyloid deposits, which are similar in structure to those associated with Alzheimer's disease. These deposits build up within atherosclerotic plaques. Here, they increase the size of the plaques, further restricting blood flow, and may also make the plaques less stable, increasing the risk of a heart attack or stroke.

Researchers found that epigallocatechin-3-gallate (EGCG), most commonly associated with green tea, binds to the amyloid fibres of apoA-1. This converts the fibres to smaller soluble molecules that are less likely to be damaging to blood vessels. Now, the team are working on finding ways of introducing effective amounts of EGCG into the bloodstream without it being necessary to drink large and potentially harmful quantities of green tea.

This could involve modifying the chemical structure of EGCG, making it easier to be absorbed from the stomach and more resistant to metabolism, or developing new methods to deliver the molecule to the plaques -- such as via an injection.

David Middleton, Professor in Chemistry at Lancaster University, said: "The health benefits of green tea have been widely promoted and it has been known for some time that EGCG can alter the structures of amyloid plaques associated with Alzheimer's disease. "Our results show that this intriguing compound might also be effective against the types of plaques which can cause heart attacks and strokes."

Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said: "Our bodies are very good at breaking down EGCG so swapping your cuppa for green tea is unlikely to make a big difference with respect to your heart health. "But by engineering the molecule slightly, we might be able to make new medicines to treat heart attack and stroke."

Professor Sheena Radford, Director of the Astbury Centre for Structural Molecular Biology at the University of Leeds and co-author of the research, said: "The findings of this round of studies are very encouraging. We now need to apply the best scientific techniques to find how we can take the molecular EGCG element from green tea, and turn it into a functioning tool to combat life-limiting health issues."


Cardiac Arhythmia and Chinese Med Substance



A medicinal plant frequently used in Traditional Chinese Medicine (TCM) -- Evodia rutaecarpa -- contains substances that can cause cardiac arrhythmia.

This is what researchers from the Universities of Basel, Vienna and Utrecht have recently found out. Extracts of the plant Evodia rutaecarpa are used in Traditional Chinese Medicine for a variety of symptoms, such as headaches, nausea and vomiting as well as menstrual complaints and ulcers in the mouth area.

Researchers led by Professor Matthias Hamburger from the Department of Pharmaceutical Sciences at the University of Basel investigated the effect of Evodia extracts in collaboration with pharmacologists and toxicologists from the University of Vienna.

The natural substances dehydroevodiamine (DHE) and hortiamine isolated from the plant in Basel proved to be very potent inhibitors of potassium channels in the heart muscle.

If these channels are blocked, the excitation processes in the heart muscle change, which can trigger severe heart rhythm disturbances -- so-called Torsade de pointes (TdP) -- and ventricular fibrillation and lead to sudden cardiac death.

Effect confirmed in animal models
The development of severe TdP arrhythmias following the administration of DHE was confirmed by researchers at the University of Utrecht in ECG studies on dogs, a model that is also used to test drug safety in the industry.

Further investigations showed that the two natural substances cause oscillations in the heart muscle cells even in very low concentrations, which can cause cardiac arrhythmia.

For instance, these substances can get into a tea made from Evodia fruits. For drugs that may potentially trigger cardiac arrhythmias, it is typically required that a cardiac examination using ECG is carried out before medication.

This is especially true for heart disease patients for their risk to be assessed. To date, no clinical studies have been conducted to investigate the incidence of cardiac arrhythmias after taking Evodia preparations.

Re-evaluate security
Studies at the University of Basel have also shown that the DHE content of Evodia fruits is considerable. Hamburger currently investigates the extent to which these substances find their way into tea preparations.

"If DHE and hortiamine are detected, the safety of Evodia products has to be re-evaluated," says Hamburger. TCM medicinal plants and products reach the European market relatively uncontrolled, and they can also be purchased on the internet.

The authors of the study, therefore, call for increased vigilance regarding possible toxic effects of Evodia preparations.

"The popularization of medicinal plants from other cultures entails risks. These plants can contain highly active substances with side effects, as in the case of Evodia. A closer examination of such risks is therefore indispensable to protect the population," says Hamburger.


Tai Chi improves brain metabolism



Tai Chi improves brain metabolism and muscle energetics in older adults, study finds.

A new Journal of Neuroimaging study provides insights into the biochemical mechanisms by which Tai Chi - a mind-body exercise - may provide both physical and psychological benefits.

Using magnetic resonance spectroscopy, a non-invasive method of measuring brain and muscle chemistry using MRI machines, tests conducted in 6 older adults enrolled in a 12-week Tai Chi program revealed significant increases in a marker of neuronal health in the brain and significantly improved recovery rates of a metabolite involved in energy production in leg muscles.

"The benefits of Tai Chi have been well known anecdotally; however recent research such as our study can quantify these improvements using objective measures," said senior author Dr. Alexander Lin, of Brigham and Women's Hospital and Harvard Medical School.
 Journal of Neuroimaging, 2018


Rapid authentication method of Chinese medicines


The Food Safety and Technology Research Centre under the Department of Applied Biology and Chemical Technology of The Hong Kong Polytechnic University (PolyU) has developed a new method for rapid authentication of Chinese herbal medicines, including Ganoderma (known as Lingzhi in Chinese), and Gastrodiae Rhizoma (known as Tianma in Chinese).

The new method is quick and simple, which takes around 10 minutes to analyse one raw sample, achieving various ends including authentication of genuine and counterfeit species, classification of wild types and cultivated types, as well as differentiation of geographical origins. This method can be further applied to other herbal medicines.

Lingzhi and Tianma are two of the most popular and valuable Chinese medicines. Due to their high commercial values, problem of counterfeiting, adulterating and confusing Lingzhi and Tianma species is not uncommon in the market. Conventionally, fingerprint chromatography is adopted to authenticate and differentiate the species as it can provide comprehensive chemical composition of a sample.

However, it is a labor-intensive and time-consuming method as it takes several hours to undergo the sample preparation and separation process for one sample. Recently, the PolyU research team adopts the direct ionization mass spectrometry (DI-MS) method to detect the major active components of Lingzhi (ganoderic acids) and Tianma (gastrodin, parishin B/parishin C/and parishin).

By directly applying a high voltage on a small piece of raw sample with its surface loaded with solvents, spray ionization could be induced at the tip of the sample to generate corresponding mass spectra within minutes, as if they are fingerprints which helps identification. The presence of major active components in the DI-MS spectra authenticates genuine samples from counterfeit ones.

Moreover, with Principal Component Analysis (PCA), a commonly used dataset analytic tool, wild and cultivated types can be classified, while geographical origins could be differentiated. There are approximately 80 Lingzhi species while only two of them, known as Chizhi and Zizhi in Chinese, are described in Chinese Pharmacopeia. Some other Lingzhi species which have similar appearances are commonly found to be confused with the official species.

On the other hand, Tianma is easily confused with two counterfeit species, namely Cacalia davidii (Franch.) Hand.-Mazz. and Canna edulis Ker. Both wild Lingzhi and Tianma are very rare and cultivation has become the major source. In general, wild types have higher contents of major active components and thus better curative effect. Samples originated from different geographical locations also have variations in components due to varying cultivation conditions.

The method developed by PolyU is simple, rapid, reproducible and can be easily adopted by researchers in relevant fields as no additional specialized device is required. It has the potential to be further expanded for analysis of other herbal medicines, for example, Heshouwu and Wuweizi, and therefore is expected to bring positive impact on the Chinese herbal medicine industry.


Does meditation really make us better people?


According to popular belief, the ancient practice of meditation makes us all happier, shinier, more compassionate human beings. Most of those things might be true – except the compassionate part, suggests new research.

"So... I'm driving, feeling really good about myself, and just like – just so much better than everyone else that's so mad. And that's what meditation's for, is to feel superior to others."

This is the set-up of a joke by one of my favorite stand-up comedians, the hilariously neurotic Jen Kirkman. After meditating for a whole 5 minutes one morning, Jen gets all contemplative in front of a green light, stops the car, and annoys the hell out of every driver behind her who's trying to get to work.

One driver starts yelling at her and calling her names, she lies and says her mother had just died, the whole thing escalates into a hilarious episode of road rage, which culminates with her standing in her seat, poking her head through the sunroof of her car and shouting at the guy: "I'm not crazy!!! I meditated, you... [insert profanity here]!!!"

"I didn't say I was a good person, I just said I meditated," Jen tells the audience, reminding us that the two are often mistakenly conflated. As her anecdote illustrates, meditation doesn't always make you a better person – in fact, according to a new study, it almost never does.

An international team of researchers examined 20 existing studies for evidence that mindfulness and loving-kindness meditation promote less aggression, more kindness, and more pro-social behavior. Contrary to the researchers' expectations, they didn't find any.

Meditation research is biased, study finds
Meditation practices, even devoid of the religious connotations, still "seem to offer the hope of a better self and a better world to many," says a co-author of the new study, Dr. Miguel Farias, from the Centre for Advances in Behavioural Science at Coventry University in the United Kingdom.

But, he continues, "Despite the high hopes of practitioners and past studies, our research found that methodological shortcomings greatly influenced the results we found."

Specifically, it turned out that the studies that reported a rise in levels of compassion among meditators were authored by the very same meditation teacher! "This reveals that the researchers might have unintentionally biased their results," says Dr. Farias.

"To understand the true impact of meditation on people's feelings and behavior further we first need to address the methodological weaknesses we uncovered," Dr. Farias adds, "starting with the high expectations researchers might have about the power of meditation."

So, the new analysis certainly casts some shadow over the much-hailed benefits of meditation, and the results could be used to give the self-righteous meditators that Kirkman was parodying a good reality check. That said, you can't help but wonder, as Kirkman herself does after the road rage episode: if all of this happened after she meditated, what would've happened if she hadn't?


Group exercise improves quality of life


Researchers found working out in a group lowers stress by 26 percent and significantly improves quality of life, while those who exercise individually put in more effort but experienced no significant changes in their stress level and a limited improvement to quality of life, according to a study published in The Journal of the American Osteopathic Association.

"The communal benefits of coming together with friends and colleagues, and doing something difficult, while encouraging one another, pays dividends beyond exercising alone," said Dayna Yorks, DO, lead researcher on this study. "The findings support the concept of a mental, physical and emotional approach to health that is necessary for student doctors and physicians."

Dr. Yorks and her fellow researchers at the University of New England College of Osteopathic Medicine recruited 69 medical students -- a group known for high levels of stress and self-reported low quality of life -- and allowed them to self-select into a twelve-week exercise program, either within a group setting or as individuals.

A control group abstained from exercise other than walking or biking as a means of transportation. Every four weeks, participants completed a survey asking them to rate their levels of perceived stress and quality of life in three categories: mental, physical and emotional.

Those participating in group exercise spent 30 minutes at least once a week in CXWORX, a core strengthening and functional fitness training program. At the end of the twelve weeks, their mean monthly survey scores showed significant improvements in all three quality of life measures: mental (12.6 percent), physical (24.8 percent) and emotional (26 percent).

They also reported a 26.2 percent reduction in perceived stress levels. By comparison, individual fitness participants were allowed to maintain any exercise regimen they preferred, which could include activities like running and weight lifting, but they had to work out alone or with no more than two partners.

On average the solitary exercisers worked out twice as long, and saw no significant changes in any measure, except in mental quality of life (11 percent increase). Similarly, the control group saw no significant changes in quality of life or perceived stress.

"Medical schools understand their programs are demanding and stressful. Given this data on the positive impact group fitness can have, schools should consider offering group fitness opportunities," said Dr. Yorks.

"Giving students an outlet to help them manage stress and feel better mentally and physically can potentially alleviate some of the burnout and anxiety in the profession."


Green Tea May Cut Cognitive Impairment



Green tea ingredient may ameliorate memory impairment, brain insulin resistance, and obesity.

 New research identifies potential therapeutic intervention for memory impairment, neuroinflammation, and brain insulin resistance induced by high-fat, high-fructose diet. A study published online in The FASEB Journal, involving mice, suggests that EGCG (epigallocatechin-3-gallate), the most abundant catechin and biologically active component in green tea, could alleviate high-fat and high-fructose (HFFD)-induced insulin resistance and cognitive impairment.

Previous research pointed to the potential of EGCG to treat a variety of human diseases, yet until now, EGCG's impact on insulin resistance and cognitive deficits triggered in the brain by a Western diet remained unclear. "Green tea is the second most consumed beverage in the world after water, and is grown in at least 30 countries," said Xuebo Liu, Ph.D., a researcher at the College of Food Science and Engineering, Northwest A&F University, in Yangling, China.

"The ancient habit of drinking green tea may be a more acceptable alternative to medicine when it comes to combatting obesity, insulin resistance, and memory impairment."

Liu and colleagues divided 3-month-old male C57BL/6J mice into three groups based on diet:

1) a control group fed with a standard diet,
2) a group fed with an HFFD diet, and
3) a group fed with an HFFD diet and 2 grams of EGCG per liter of drinking water.

For 16 weeks, researchers monitored the mice and found that those fed with HFFD had a higher final body weight than the control mice, and a significantly higher final body weight than the HFFD+EGCG mice. In performing a Morris water maze test, researchers found that mice in the HFFD group took longer to find the platform compared to mice in the control group.

The HFFD+EGCG group had a significantly lower escape latency and escape distance than the HFFD group on each test day. When the hidden platform was removed to perform a probe trial, HFFD-treated mice spent less time in the target quadrant when compared with control mice, with fewer platform crossings.

The HFFD+EGCG group exhibited a significant increase in the average time spent in the target quadrant and had greater numbers of platform crossings, showing that EGCG could improve HFFD-induced memory impairment.

"Many reports, anecdotal and to some extent research-based, are now greatly strengthened by this more penetrating study," said Thoru Pederson, Ph.D., Editor-in-Chief of The FASEB Journal.


Yoga, Aerobic Exercise Boost Heart Health



Heart disease patients who practice yoga in addition to aerobic exercise saw twice the reduction in blood pressure, body mass index and cholesterol levels when compared to patients who practiced either Indian yoga or aerobic exercise alone, according to research to be presented at the 8th Emirates Cardiac Society Congress in collaboration with the American College of Cardiology Middle East Conference October 19-21, 2017 in Dubai.

Lifestyle intervention has been shown to aid in reducing the risk of death and heart disease comorbidities when used alongside medical management. Indian yoga is a combination of whole exercise of body, mind and soul, and a common practice throughout India.

Researchers in this study looked specifically at Indian yoga and aerobic training's effect on the coronary risk factors of obese heart disease patients with type 2 diabetes. The study looked at 750 patients who had previously been diagnosed with coronary heart disease. One group of 225 patients participated in aerobic exercise, another group of 240 patients participated in Indian yoga, and a third group of 285 participated in both yoga and aerobic exercise.

Each group did three, six-month sessions of yoga and/or aerobic exercise. The aerobic exercise only and yoga only groups showed similar reductions in blood pressure, total cholesterol, triglycerides, LDL, weight and waist circumference. However, the combined yoga and aerobic exercise group showed a two times greater reduction compared to the other groups. They also showed significant improvement in left ventricular ejection fraction, diastolic function and exercise capacity.

"Combined Indian yoga and aerobic exercise reduce mental, physical and vascular stress and can lead to decreased cardiovascular mortality and morbidity," said Sonal Tanwar, PhD, a scholar in preventative cardiology, and Naresh Sen, DM, PhD, a consultant cardiologist, both at HG SMS Hospital, Jaipur, India.

"Heart disease patients could benefit from learning Indian yoga and making it a routine part of daily life."


3 Americans Win Nobel Prize for Circadian Rhythm Research



The Nobel Prize for Medicine was awarded to three Americans on Monday for discoveries about the body's daily rhythms.

The laureates are Jeffrey C. Hall, Michael Rosbash and Michal W. Young. Rosbash is on the faculty at Brandeis University, Young at Rockefeller University and Hall is at the University of Maine.

The citation for the 9-million-kronor ($1.1 million) prize says the researchers isolated a gene that controls the normal daily biological rhythm.

They "were able to peek inside our biological clock and elucidate its inner workings."

Circadian rhythms adapt the workings of the body to different phases of the day, influencing sleep, behavior, hormone levels, body temperature and metabolism.

The winners have raised "awareness of the importance of a proper sleep hygiene" said Juleen Zierath of the Nobel academy.


Yoga, meditation improve brain function



Practicing brief sessions of Hatha yoga and mindfulness meditation can significantly improve brain function and energy levels, according to a new study from the University of Waterloo.

The study found that practicing just 25 minutes of Hatha yoga or mindfulness meditation per day can boost the brain's executive functions, cognitive abilities linked to goal-directed behavior and the ability to control knee-jerk emotional responses, habitual thinking patterns and actions.

"Hatha yoga and mindfulness meditation both focus the brain's conscious processing power on a limited number of targets like breathing and posing, and also reduce processing of nonessential information," said Peter Hall, associate professor in the School of Public Health & Health Systems.

"These two functions might have some positive carryover effect in the near- term following the session, such that people are able to focusmore easily on what they choose to attend to in everyday life."

Thirty-one study participants completed 25 minutes of Hatha yoga, 25 minutes of mindfulness meditation, and 25 minutes of quiet reading (a control task) in randomized order.

Following both the yoga and meditation activities, participants performed significantly better on executive function tasks compared to the reading task.

"This finding suggests that there may be something special about meditation - as opposed to the physical posing - that carries a lot of the cognitive benefits of yoga," said Kimberley Luu, lead author on the paper.

The study also found that mindfulness meditation and Hatha yoga were both effective for improving energy levels, but Hatha yoga had significantly more powerful effects than meditation alone.

"There are a number of theories about why physical exercises like yoga improve energy levels and cognitive test performance," said Luu.

"These include the release of endorphins, increased blood flow to the brain, and reduced focus on ruminative thoughts. Though ultimately, it is still an open question."

Hatha yoga is one of the most common styles of yoga practiced in Western countries. It involves physical postures and breathing exercises combined with meditation.

Mindfulness mediation involves observing thoughts, emotions and body sensations with openness and acceptance.

"Although the meditative aspect might be even more important than the physical posing for improving executive functions, there are additional benefits to Hatha yoga including improvements in flexibility and strength," said Hall.

"These benefits may make Hatha yoga superior to meditation alone, in terms of overall health benefits."


Study illuminates potential way for sticking to weight loss goals


When it comes to losing weight, it's not necessarily slow, but steady, that wins the race, according to new research from Drexel University.

In a study of 183 participants, those whose weights fluctuated the most during the first few weeks of a behavioral weight loss program ultimately had poorer weight loss outcomes one and two years later, compared to the men and women who lost a consistent number of pounds each week.

The results were published today in the journal Obesity. "It seems that developing stable, repeatable behaviors related to food intake and weight loss early on in a weight control program is really important for maintaining changes over the long term," said lead author Emily Feig, PhD, a former graduate student in the College of Arts and Sciences at Drexel University.

The psychologists were interested in studying what makes some people less successful in weight loss programs and identifying predictors that could improve treatment outcomes in the future. To find out, they enrolled individuals who were overweight or obese into a year-long weight loss program that used meal replacements along with behavioral goals such as self-monitoring, calorie monitoring and increasing physical activity.

The participants attended weekly treatment groups during which they were weighed, and returned for a final weigh-in two years from the start of the program. The participants also reported on food-related behaviors and attitudes like cravings, emotional eating, binge eating and confidence in regulating intake.

The researchers found that higher weight variability over the initial six and 12 weeks of weight loss treatment predicted poorer subsequent, long-term weight control at 12 and 24 months. For example, someone who lost four pounds one week, regained two and then lost one the next tended to fare worse than someone who lost one pound consistently each week for three weeks.

Exactly why some people have more weight variability than others is a question the researchers are interested in exploring in future studies. Though he is hesitant to equate correlation and causation in this case, principal investigator Michael Lowe, PhD, a psychology professor at Drexel, says the study does illuminate a potential method for sticking to weight loss goals.

"Settle on a weight loss plan that you can maintain week in and week out, even if that means consistently losing ¾ of a pound each week," he said. If future studies can replicate these results, then measuring weight variability may be a way to identify individuals who are less likely to achieve meaningful and sustainable weight loss, and who may benefit from a stronger, more tailored focus on consistency.


Yoga Helps Back Pain in Vets


In a study including 150 military veterans with chronic low back pain, researcher Dr. Erik J. Groessl and his team from the VA San Diego Healthcare System found that veterans who completed a 12-week yoga program had better scores on a disability questionnaire, improved pain intensity scores, and a decline in opioid use.

Groessl is a researcher with the VA San Diego Healthcare System and the University of California, San Diego School of Medicine. The study was published in the American Journal of Preventive Medicine on July 20, 2017. The study shows promise for non-drug treatment of chronic low back pain, said Groessl.

"To be able to reduce the reliance upon opioids and other medications with side effects, it is crucial to establish evidence showing mind-body practices like yoga provide benefit in both veterans and non-veterans with chronic pain," he said.

Veterans in the study who were randomized to the yoga group attended a 12-week yoga program immediately after randomization. Comparison participants were invited to attend the yoga intervention only after six months. The 12-week yoga intervention consisted of two 60-minute instructor-led yoga sessions per week, with home practice sessions encouraged.

The intervention was based on hatha yoga, which involves yoga postures and movement sequences, along with regulated breathing and mindfulness meditation. Outcomes were assessed at the baseline, six weeks, 12 weeks and six months. Both study groups had reductions in disability scores after 12 weeks.

However, notable differences emerged at the six-month assessment, with scores continuing to drop in the yoga group but increasing in the delayed-treatment group. Along with those improvements, pain intensity decreased in the yoga group at all three time periods, while the delayed-treatment group had negligible changes.

There was also a 20 percent drop in opioid pain medication use at 12 weeks in both groups as determined through self-report questionnaires and a review of medical records. Notably, reductions in disability and pain intensity were found despite the reductions in opioid use and other medical and self-help pain treatments at six months.

The trial confirms the findings of two prior randomized controlled trials with non-veterans showing that yoga is safe and can reduce pain and disability among adults with chronic low back pain. The study is one of the first to demonstrate the effectiveness of yoga specifically in military veterans, a population that faces more health challenges and may be harder to treat than non-VA populations, say the researchers.

They point out that as with other non-drug treatments for chronic low back pain, yoga may not help everyone or may not completely eliminate chronic low back pain, but reduced pain and disability can often maintained long-term with ongoing yoga home practice. Military veterans and active duty military personnel have higher rates of chronic pain than the general U.S. population, and the back is the area of the body that is most commonly affected.

In addition to pain, those with the condition also report increased disability, psychological symptoms, and reduced quality of life. In the U.S., chronic low back pain is the leading cause of lost productivity and the second most common cause for physician visits. Billions of dollars are spent each year in the U.S. on health care related to back pain.

The team says that given the results of their study, VA facilities nationwide may want to consider developing and expanding formal yoga programs to help veterans with back pain. Many VA facilities already do offer yoga classes, along with other complementary and integrative health programs.


Yoga just as good as physical therapy


Traditional therapies for chronic low back pain are often ineffective. New research shows that yoga may be a good alternative for treating this condition.

According to the National Institutes of Health (NIH), approximately 80 percent of the American adult population will have low back pain at one point or another, with men and women being equally affected. For most of these people, the pain is acute and does not last very long. For others, however, it turns into chronic back pain - meaning that it lasts for at least 12 weeks, even when the cause of the pain has been dealt with.

Treatment options for low back pain include muscle strengthening exercises, physical therapy sessions, and analgesic medication. When these therapies fail, surgery is also an option. Unfortunately, none of the above therapies have proven highly successful. Between 25 and 80 percent of people who were treated for chronic low back pain experience a recurrence within a year from the treatment.

For this reason, people living with chronic pain often resort to alternative therapies, such as acupuncture or yoga. The NIH report that there is enough evidence to support the "short- and long-term benefits" of yoga for relieving chronic low back pain. Previous studies have indeed suggested that yoga and stretching help ease low back pain.

But chronic low back pain tends to affect racial and ethnic minorities in particular, as well as people with a lower socioeconomic background. In this population - as well as in those who have more severe pain - the benefits of yoga may not have been studied sufficiently.

So, researchers from the Boston Medical Center set out to examine the effect of yoga sessions on a group of 320 adults with chronic low back pain. The participants were of various races and ethnicities; overall, they also had an income equal to or lower than $30,000 per year.

The findings were published in the journal Annals of Internal Medicine. The first author of the study is Dr. Robert B. Saper. The 320 participants were randomly assigned to either attending 12 weekly yoga sessions, 15 physical therapy sessions, or just reading an educational book and newsletters on how to manage chronic low back pain.

After these interventions, the researchers continued to follow the participants for 1 year, which included a 40-week maintenance phase. During the maintenance phase, yoga participants either took yoga drop-in classes or practiced yoga at home. Physical therapy participants took part in physical therapy booster sessions or practiced physical therapy at home.

To assess the participants' functionality, Saper and colleagues used the Roland Morris Disability Questionnaire. To assess pain levels, they used an 11-point scale at 12 weeks. The trial determined that yoga was "statistically as effective" as physical therapy for alleviating pain, helping patients to be more functional, and to reduce their pain medication.


Tai chi significantly reduces depression symptoms


A 12-week program of instruction and practice of the Chinese martial art tai chi led to significantly reduced symptoms of depression in Chinese Americans not receiving any other treatments.

The pilot study conducted by investigators at Massachusetts General Hospital (MGH) and published in the Journal of Clinical Psychiatry enrolled members of Boston's Chinese community who had mild to moderate depression.

"While some previous studies have suggested that tai chi may be useful in treating anxiety and depression, most have used it as a supplement to treatment for others medical conditions, rather than patients with depression," explains Albert Yeung, MD, ScD, of the Depression Clinical and Research Program in the MGH Department of Psychiatry, lead and corresponding author of the report.

"Finding that tai chi can be effective is particularly significant because it is culturally accepted by this group of patients who tend to avoid conventional psychiatric treatment."

Participants were recruited through advertisements offering tai chi for stress reduction, and their eligibility for the study was determined based on in-person interviews and assessments of overall health and depression symptoms.

Eligible participants were Chinese-American adults fluent in either Cantonese or Mandarin, with a diagnosis of major depressive disorder in the mild to moderate range, no history of other psychiatric disorders, no recent practice of tai chi or other mind-body interventions, and no current use of other psychiatric treatments.

Participants were randomized into three groups - one that received the tai chi intervention; an active control group that participated in educational sessions that included discussions on stress, mental health and depression; and a passive control, "waitlist" group that returned for repeat assessments during and after the study period.

The tai chi intervention involved twice weekly sessions for 12 weeks, in which participants were taught and practiced basic traditional tai chi movements. They were asked to practice at home three times a week and to document their practice. The education group also met twice weekly for 12 weeks, and sessions for both groups were offered in Cantonese or Mandarin.

Members of both the education and waitlist groups were able to join free tai chi classes after the initial study period, something they were informed of at the study's outset. Of the 50 participants who completed the 12-week intervention period, 17 were in the tai chi group, 14 in the education group and 19 in the waitlist group.

The 12-week assessments showed that the tai chi group had significantly greater improvement in depression symptoms than did members of either control group.
Follow-up assessment at 24 weeks showed sustained improvement among the tai chi group, with statistically significant differences remaining compared with the waitlist group.

"If these findings are confirmed in larger studies at other sites, that would indicate that tai chi could be a primary depression treatment for Chinese and Chinese American patients, who rarely take advantage of mental health services, and may also help address the shortage of mental health practitioners," says Yeung, who is an associate professor of Psychiatry at Harvard Medical School.

"We also should investigate whether tai chi can have similar results for individuals from other racial and ethnic groups and determine which of the many components of tai chi might be responsible for these beneficial effects."


Finding Alternatives to Opioids



Pressures on primary care doctors to move away from opioid pain management are increasing, but practitioners need practical, evidence-based information on how to employ multidisciplinary pain care successfully in everyday clinical practice.

A senior investigator for Kaiser Permanente, speaking at the American Pain Society Annual Scientific Conference, believes wider use of practical clinical trials and more emphasis on patient self-management are key solutions for achieving wider use of multidisciplinary pain care to improve patient function and help lower use and misuse of opioids.

While the national death toll from opioid overdoses is staggering, Lynn DeBar, PhD, senior investigator, Kaiser Permanente Center for Health Research said that a small minority of pain patients are represented in the mortality data.

"Given the justified apprehensions of primary care doctors to continue prescribing opioids, the central question focuses on what can we do in primary care to help improve function for pain patients," said DeBar.

DeBar said the benefits of multidisciplinary pain care, which employs non-pharmacologic treatments, have been well documented in peer-reviewed studies but it still is not widely available due largely to inadequate insurance coverage.

"Medicare and other health insurance providers need value-based care metrics and outcomes, and more studies are needed to help implement evidence-based multimodal pain care with attention to feasibility and sustainability in everyday clinical practice," DeBar explained.

Widespread gaps in evidence-based knowledge about pain management underscore the need to conduct practical clinical trials designed to meet the needs of clinicians and answer their questions. Such trials are of increasing interest to the National Institutes of Health who are ramping up efforts to support pragmatic trial initiatives.

"Practical clinical trials can bridge the gap between research and clinical care," said DeBar. "Traditional randomized clinical trials are slow and expensive, and results often cannot be implemented easily in clinical practice. Findings can be difficult to translate into the real world because treatments are given to carefully selected populations in ideal conditions."

DeBar said practical clinical trials are designed to improve practice and policy and take place in settings where routine medical care occurs. They seek answers to real-world clinical questions and are designed to test what will work in everyday care. Also, practical clinical trials study diverse populations using broadly inclusive eligibility criteria.

The NIH Health Care Systems Research Collaboratory, is spearheading execution of pragmatic clinical trials in pain management by partnering with health systems and physician groups. "Engaging health systems, provider and patients as partners in pragmatic research accelerates realistic integration of research, policy and practice," said DeBar.

She reported that Kaiser Permanente is organizing a practical clinical trial in pain management involving 851 patients in the Portland, Ore. area. DeBar also spoke about the benefits of adopting alternative treatment approaches, such as virtual reality and patient-to-patient reinforcement methods.

"Remote interventions with cognitive behavioral therapies are proving effective and so are new smart phone apps that allow patients to transmit real-time information about their pain," said DeBar.

"Also, more attention should be given to patient-driven models of support, similar to programs like Weight Watchers, which empower patients to take more active roles in managing their care."

Materials provided by American Pain Society.


Yo-yo dieting may raise death risk for people with heart disease


Past studies have associated yo-yo dieting with increased risk of poor heart health.

For individuals with pre-existing heart disease, however, new research finds that the health consequences of repeatedly losing and gaining weight may be even more severe.

Researchers found that people with coronary heart disease who had experienced large fluctuations in weight over an average of 4.7 years were at much higher risk of heart attack, stroke, and death than people who experienced little change in body weight.

Lead study author Dr. Sripal Bangalore, of the Cardiovascular Clinical Research Center at NYU Langone Medical Center in New York, and colleagues recently reported their results in the New England Journal of Medicine. Yo-yo dieting - also known as "weight cycling" or the "yo-yo effect" - is defined as repeated cycles of weight loss and weight gain.

A number of studies have documented the possible health risks of yo-yo dieting. One study reported by Medical News Today last year, for example, uncovered a link between weight cycling and greater risk of death from heart disease.

The new research from Dr. Bangalore and colleagues builds on those findings, revealing how yo-yo dieting may impact the health of individuals who have pre-existing coronary heart disease.

Coronary heart disease (CHD) - also referred to as coronary artery disease - is the most common form of heart disease among men and women in the United States. Each year, the condition kills more than 370,000 people in the country.

CHD is characterized by atherosclerosis - the buildup of plaque in the coronary arteries, which are those that supply the heart with oxygen-rich blood. This plaque buildup may block the blood supply to the heart, which can lead to angina (severe chest pain) or heart attack.

Largest weight fluctuations linked to 124 percent more deaths
For their study, Dr. Bangalore and colleagues analyzed the data of 9,509 men and women with CHD aged between 35 and 75 years. As well as CHD, all subjects had high cholesterol levels and a history of other heart problems. Around half of the participants were undergoing intensive cholesterol-lowering therapy.

Over a median follow-up period of 4.7 years, participants were monitored for changes in body weight, and the researchers looked at whether these changes were associated with poorer outcomes.

Subjects with the greatest changes in body weight experienced a weight fluctuation of up to 3.9 kilograms (around 8.6 pounds) during follow-up, while those with the smallest body weight changes had weight fluctuations of 0.9 kilograms (around 2 pounds).

The team found that for individuals who were overweight or obese at study baseline, there were 117 percent more heart attacks, 124 percent more deaths, and 136 percent more strokes among those who experienced the largest changes in body weight, compared with those who experienced the smallest body weight changes.

Additionally, the researchers found a link between changes in body weight and increased risk of new-onset diabetes. These findings remained after accounting for participants' average body weight and the presence of common risk factors for heart disease, the authors note.

Findings raise concerns about weight fluctuation in people with CHD
Dr. Bangalore and team say that their study is only observational, so it is unable to prove cause-and-effect between yo-yo dieting and increased risk of heart attack, stroke, and death among people with CHD.

Additionally, the authors point to a number of limitations. For example, they were unable to pinpoint precisely why subjects lost or gained weight during follow-up. As such, it is possible that pre-existing heart problems led to weight changes. Still, the researchers believe that their results warrant further investigation.


Shared reading could help to ease chronic pain


Chronic pain affects millions of people in the United States, and it can severely interfere with everyday functioning.

However, recent research suggests a new treatment strategy for the condition: shared reading. Shared reading is an interactive reading experience in which small groups of people gather to read short stories, poetry, and other literature aloud.

By using literature that triggers memories of experiences throughout life - such as childhood and relationships - researchers have found that shared reading might be a more effective strategy to help alleviate chronic pain than cognitive behavioral therapy (CBT).

Study leader Dr. Josie Billington, from the Centre for Research into Reading, Literature and Society at the University of Liverpool in the United Kingdom, and colleagues recently reported their results in the journal Medical Humanities. Chronic pain - defined as any form of pain that lasts for at least 12 weeks - is estimated to affect around 100 million people in the U.S.

Low back pain, severe headache or migraine, and neck pain are the most common forms of pain, with back pain being the leading cause of disability in the U.S. While there are a number of medications that can help with chronic pain management, they are not always effective.

Patients are increasingly turning to non-pharmacological strategies, such as CBT, to help alleviate pain. CBT is a form of talk therapy that aims to change the way people think and behave in order to better manage mental and physical issues. Studies have shown that the technique may be effective for chronic pain, but the results can be short-lived.

Shared reading 'could be an alternative to CBT' for chronic pain
For their research, Billington and colleagues wanted to compare shared reading with CBT for chronic pain, since shared reading is often used to help ease the symptoms of other chronic conditions, such as dementia.

Participants with severe chronic pain were recruited to the study. Some subjects completed 5 weeks of CBT, and parallel to this, the remaining subjects completed 22 weeks of shared reading. After 5 weeks, participants who completed CBT joined the shared reading group.

The shared reading strategy incorporated literature that was designed to prompt memories of relationships, family members, work, and other experiences that arise throughout a lifetime, as opposed to CBT, which focused on a single point in time at which the patient was affected by chronic pain.

Subjects were required to report pain severity and emotions before and after each intervention, and they also kept a diary, where they recorded their pain and emotions twice daily.

While CBT helped participants to "manage" their emotions using organized methods, the researchers found that shared reading helped patients to address painful emotions that might be contributing to their chronic pain. Furthermore, the researchers found that pain severity and mood improved for up to 2 days following shared reading.

While the findings show promise for shared reading as an alternative non-pharmacological approach for chronic pain management, the team says that further studies with larger sample sizes are warranted.


Pain during alcohol withdrawal: Electroacupuncture may help



Hyperalgesia refers to an increased sensitivity to pain. It can occur during alcohol withdrawal, and may contribute to a relapse to drinking.

Alternative therapies such as acupuncture and electroacupuncture (EA, which combines acupuncture with electrical stimulation) are effective in reducing pain and, possibly, alcohol-withdrawal symptoms.

This rodent study investigated whether EA can alleviate hyperalgesia during alcohol withdrawal, potentially reducing the risk of a relapse to drinking, and whether it achieves this effect via action at mu opioid receptors (MORs) located in a brain region called the lateral habenula.

Researchers trained male rats to drink alcohol for eight weeks, after which they discontinued the alcohol supply, which led to withdrawal symptoms, including hyperalgesia.

To assess whether EA alleviated the hyperalgesia, they measured pain sensitivity using radiant heat (a light beam directed at the hind paw of each rat) and measured paw withdrawal latencies to the light stimulation, with and without EA.

The study showed that EA can lessen hyperalgesia during alcohol withdrawal, and that the effect may involve MORs in the habenula.

Although obtained in rodents, the findings suggest that EA is a potential therapy for hyperalgesia in humans.

If shown to be effective in humans, the use of EA to alleviate pain symptoms associated with alcohol withdrawal could potentially lessen the chances of a relapse to drinking in these individuals.


Unhealthy gut microbes a cause of hypertension


Researchers have found that the microorganisms residing in the intestines (microbiota) play a role in the development of high blood pressure in rats.

The study is published in Physiological Genomics. It was chosen as an APS selectarticle for February.

Scientists studied two sets of rats, one group with high blood pressure ("hypertensive") and one with normal blood pressure ("normal").

The research team removed a portion of the biological material from the large intestine of each group.

All animals were then given antibiotics for 10 days to reduce their natural microbiota.

After the course of antibiotics, the researchers transplanted hypertensive microbiota to normal blood pressure rats and normal microbiota to the hypertensive group.

The researchers found that the group treated with hypertensive microbiota developed elevated blood pressure.

A more surprising result is that the rats treated with normal microbiota did not have a significant drop in blood pressure, although readings did decrease slightly.

This finding is "further evidence for the continued study of the microbiota in the development of hypertension in humans and supports a potential role for probiotics as treatment for hypertension," wrote the researchers.

"Studies showing that supplementing the diet with probiotics (beneficial microorganisms found in the gut) can have modest effects on blood pressure, especially in hypertensive models."


American Physiological Society (APS). "Unhealthy gut microbes a cause of hypertension, researchers find." ScienceDaily, 2 February 2017


Yoga can have social benefits for children in care


A new study from The University of Nottingham has found that a certain type of yoga could potentially help to improve the health and psychological wellbeing of children in care.

The study, 'Kundalini Yoga as Mutual Recovery: A feasibility study including children in care and their carers,' published at The Journal of Children's Services, found that the practice of Kundalini yoga in care homes, when both staff and children are involved, can lead to both individual and social benefits.

Corporate care is far from perfect, with evidence showing that children in care are still among the most vulnerable in society. Research for the Department for Education has also shown that children in care have a higher degree of physical and mental health needs than their not-in-care counterparts, and in comparison to children who are in other forms of care, such as foster care.

'Creative practice as mutual recovery'
This new study was carried out under the belief of 'creative practice as mutual recovery', and looked at the idea that shared creativity, collective experience and mutual benefit can promote resilience in mental health and well-being among communities that have been traditionally divided (e.g. children's home staff and children).

The study was carried out by experts from The University of Nottingham's Institute of Mental Health in conjunction with external collaborators Mark Ball, Edge of Care Hub Manager at Nottingham City Council (Children and Families), Emily Haslam-Jones, Kundalini yoga teacher at Yoganova and David Crepaz-Keay from the Mental Health Foundation.

The experts tested a 20-week Kundalini yoga program in three children's homes situated in the East Midlands. The program was evaluated according to recruitment and retention rates, self-reporting questionnaires from the participants and semi-structured interviews.

The findings show that yoga practice in children's homes, especially when participation is high, has the potential to encourage togetherness and mutuality and improve health and psychological outcomes for children in care, as well as within the workforce.

All the participants reported that the study was personally meaningful and experienced both individual (i.e. feeling more relaxed) and social benefits (e.g. feeling more open and positive).

Far-reaching social benefits

Individuals reported that the yoga sessions helped to show them beneficial exercises that they could use in various contexts, such as before going to bed, or during emotionally challenging times at work as well as at home.

The social benefits were also far-reaching with some participants reporting that they felt more positive, open to others and, as a consequence, had seen an improvement in their social lives and out of work. Some staff and residents noticed that other people also interacted more positively with them.

Dr Elvira Perez, a Senior Research Fellow at Horizon, member of the Institute of Mental Health, and lead author of the study, says:

"The findings are very exciting as they suggest that the practice of Kundalini yoga, involving both staff and children in care, is a plausible intervention that can lead to individual and social benefits. This could have potentially huge, wide-reaching benefits for children in care as well as for all the staff working in residential settings. "

The study has generated a number of valuable guiding principles and recommendations that might underpin the development of any future intervention for children in care and the staff working in these homes."


Acupuncture lowers hypertension by activating opioids


Researchers with the UCI Susan Samueli Center for Integrative Medicine have found that regular electroacupunture treatment can lower hypertension by increasing the release of a kind of opioid in the brainstem region that controls blood pressure.

In tests on rats, UCI cardiology researcher Zhi-Ling Guo and colleagues noted that reduced blood pressure lasted for at least three days after electroacupuncture by increasing the gene expression of enkephalins, which one of the three major opioid peptides produced by the body.

Their study, which appears in the Nature's Scientific Reports, presents the first evidence of the molecular activity behind electroacupunture's hypertension-lowering benefits.

Last year, the UCI team reported patients treated with acupuncture at certain wrist locations experienced drops in their blood pressure.

The present study shows that repetitive electroacupuncture evokes a long-lasting action in lowering blood pressure in hypertension, suggesting that this therapy may be suitable for treating clinical hypertension.

Hypertension affects about one third of the adult population of the world, and its consequences, such as stroke and heart attacks, are enormous public health problems, and the potential advantages of acupuncture over conventional medical therapy include few, if any, of side effects.


20 cigarettes daily for 1 year equals 150 lung cell mutations


In-depth genetic research gives new insight into how smoking is capable of causing cancer in such a wide array of organs. The study provides a link between the number of cigarettes smoked and the number of mutations in tumor DNA.

The negative health consequences of smoking are well known and have been heavily studied. An estimated 6 million people die each year due to smoking-related illnesses. If trends continue, according to the World Health Organization (WHO), there will be 1 billion tobacco-related deaths this century.

Smoking is known to cause irreparable damage in a variety of organs. It sparks mutations in DNA via a number of mechanisms. However, it has not been clear how cancer generates so many different types of cancers in disparate body parts. To date, smoking has been associated with 17 types of cancer, but the genetic mechanisms behind this have remained hidden.

Researchers from the Wellcome Trust Sanger Institute and King's College London in the United Kingdom and the Los Alamos National Laboratory, NM, recently undertook a deep dive into the genetics of smoking-related cancers. Their results are published this week in the journal Science. n the most detailed investigation of its type, scientists delved into the the DNA of 5,000 tumors.

They compared tumors from nonsmokers with tumors from smokers and examined any genetic differences. The analysis allowed them to understand the molecular fingerprints of smoking-related DNA damage.

The researchers were able to study these mutational signatures and count the number of mutations in each tumor.

Counting tobacco-related tumor mutations
Once the data was in, the authors could measure the rate of mutations caused per cigarette smoked. They found that smoking a pack of cigarettes per day caused a predictable average number of mutations in the lungs over the course of a year.

"Before now, we had a large body of epidemiological evidence linking smoking with cancer, but now we can actually observe and quantify the molecular changes in the DNA due to cigarette smoking," says first author Dr. Ludmil Alexandrov, of the Los Alamos National Laboratory,.

"With this study, we have found that people who smoke a pack a day develop an average of 150 extra mutations in their lungs every year, which explains why smokers have such a higher risk of developing lung cancer."

The team also developed a clearer picture of the effects of cigarettes on mutations in other organs. They found that a pack a day led to:
* 97 mutations in each cell in the larynx
* 39 mutations in each cell in the pharynx
* 23 mutations in each cell in the mouth
* 18 mutations in each cell in the bladder
* 6 mutations in each cell in the liver.

As mentioned previously, how mutations affect organs of the body other than lungs has been difficult to understand. This new research uncovered ways in which tobacco can develop mutations in different tissues and organs.

Looking into the future of cancer research
The researchers were surprised by some of the results; smoking-related cancers are more complex than previously thought.

Prof. Sir Mike Stratton, from the Wellcome Trust Sanger Institute and joint lead author, says: "This study of smoking tells us that looking in the DNA of cancers can provide provocative new clues to how cancers develop and thus, potentially, how they can be prevented."

Medical News Today recently asked Dr. Alexandrov if they plan to carry out more research in a similar vein. He said: "This study has shown that molecular profiling of cancer patients can be used to identify the mechanisms by which different carcinogens cause cancer. We are planning future studies to reveal the mechanisms by which other known epidemiological factors cause cancer. For example, we are currently working on elucidating the mechanisms by which obesity causes cancer.​"

When MNT asked him what research he would carry out if he was given unlimited time, money, and resources, he said: "I would molecularly profile every single cancer patient across the world to better understand the causes of cancer and use this knowledge for developing future cancer prevention strategies.​"

The current results mark a milestone along the path to understanding how smoking-related cancers negatively influence DNA. There is still much to know, but investigations such as this will steadily bring us closer to understanding and preventing cancer on a molecular level.


Higher CV Risk Seen With Calcium Supplements


Calcium supplements might increase cardiovascular risk, whereas dietary calcium was associated with a protective effect, a new observational study found. Many people - in particular, older women - take calcium supplements to prevent or treat osteoporosis, though the supporting evidence for this use is quite thin.

In recent years, several studies have raised concerns that calcium supplements might be linked to increased cardiovascular risk. But the precise relationship between calcium - both from dietary sources and from supplements - and atherosclerosis has not been carefully studied in randomized trials.

In a paper published in the Journal of the American Heart Association, Erin Michos, MD, MHS, of Johns Hopkins, and colleagues analyzed data from more than 2,700 participants in the MESA (Multi-Ethnic Study of Atherosclerosis) study who did not have diagnosed cardiovascular disease.

Among the 1,567 participants who had no coronary artery calcium at baseline, the group in the highest quintile of calcium intake (as assessed by a food questionnaire and medication inventory) had a significant 27% lower likelihood of development of coronary artery calcium (CAC) at 10 years, after adjustment for differences in baseline risk.

But the investigators found a potentially important difference in effect based on the calcium source. Calcium from supplements was associated with a 22% higher risk of CAC. Any adverse effect of calcium supplements could have broad importance, because 43% of U.S. adults take calcium supplements.

Instead of helping to promote bone health, the authors speculated that excessive doses of calcium might "accrue in vascular tissue." But the authors warned that the study's findings might not be a reflection of the effect of calcium but rather a broader demonstration of the "healthy user effect."

People who consumed large amounts of dietary calcium "may have been engaging in other unmeasurable health-promoting behaviors (ie., the healthy user effect), which could potentially explain why a decrease in risk of CAC development was observed in the highest quintile of calcium intake.

Calcium-rich foods are associated with a healthy diet, and many of the participants with a high dietary calcium intake may be consuming vegetables, dairy, nuts, and fish - that provide cardioprotective benefits."

More generally, the authors cautioned in a press release that "their work only documents an association between calcium supplements and atherosclerosis, and does not prove cause and effect."

In an interview, Michos questioned why so many people are taking calcium supplements. "The fracture data is not very compelling," she noted. Besides the adverse cardiovascular effects suggested by her study, calcium supplements are also known to cause kidney stones, flatulence, and constipation.

"People think that because they can get it over the counter there is no harm." As "we saw no excess risk with diet, I tell my patients to take all their calcium through diet."


Acupuncture, Yoga Good for Treating Common Pain


Data from a review of U.S.-based clinical trials published in Mayo Clinic Proceedings suggest that some of the most popular complementary health approaches - such as yoga, tai chi, and acupuncture -- appear to be effective tools for helping to manage common pain conditions. The review was conducted by a group of scientists from the National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health.

Millions of Americans suffer from persistent pain that may not be fully relieved by medications. They often turn to complementary health approaches to help, yet primary care providers have lacked a robust evidence base to guide recommendations on complementary approaches as practiced and available in the United States. The new review gives primary care providers - who frequently see patients with chronic pain -- tools to inform decision-making on how to help manage that pain.

"For many Americans who suffer from chronic pain, medications may not completely relieve pain and can produce unwanted side effects. As a result, many people may turn to nondrug approaches to help manage their pain," said Richard L. Nahin, Ph.D., NCCIH's lead epidemiologist and lead author of the analysis.

"Our goal for this study was to provide relevant, high-quality information for primary care providers and for patients who suffer from chronic pain." The researchers reviewed 105 U.S.-based randomized controlled trials, from the past 50 years, that were relevant to pain patients in the United States and met inclusion criteria. Although the reporting of safety information was low overall, none of the clinical trials reported significant side effects due to the interventions.

The review focused on U.S.-based trial results on seven approaches used for one or more of five painful conditions - back pain, osteoarthritis, neck pain, fibromyalgia, and severe headaches and migraine - and found promise in the following for safety and effectiveness in treating pain:

* Acupuncture and yoga for back pain
* Acupuncture and tai chi for osteoarthritis of the knee
* Massage therapy for neck pain with adequate doses and for short-term benefit
* Relaxation techniques for severe headaches and migraine.

Though the evidence was weaker, the researchers also found that massage therapy, spinal manipulation, and osteopathic manipulation may provide some help for back pain, and relaxation approaches and tai chi might help people with fibromyalgia.

"These data can equip providers and patients with the information they need to have informed conversations regarding non-drug approaches for treatment of specific pain conditions," said David Shurtleff, Ph.D., deputy director of NCCIH.

"It's important that continued research explore how these approaches actually work and whether these findings apply broadly in diverse clinical settings and patient populations."


Heatwaves, cold snaps may raise preterm birth risk



Being pregnant during a heatwave is far from the most pleasant scenario for a woman, but new research finds such extreme temperatures may do more than make expectant mothers uncomfortable; they could increase the risk of preterm birth. 

In a study published in the journal Environmental Health Perspectives, researchers from the National Institutes of Health (NIH) found that exposure to extreme cold or intense heat during pregnancy increased women's preterm birth risk by up to a fifth. 

According to the Centers for Disease Control and Prevention (CDC), in 2014, around 1 in 10 infants in the United States were born preterm - defined as the birth of a baby before 37 weeks of pregnancy. Preterm birth is the leading cause of infant death in the U.S., and it is also a primary cause of long-term disabilities and neurological disorders, such as cerebral palsy and developmental delay. 

There are a number of known risk factors for preterm birth, including a history of preterm delivery, smoking, alcohol, and drug use, and certain medical conditions, such as urinary tract infections and high blood pressure. 

Now, senior author Pauline Mendola, Ph.D., of the NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and colleagues suggest extreme temperatures could also be a risk factor for preterm birth and early birth - delivery at between 37-38 weeks of pregnancy. 

Mendola and team reached their findings by analyzing the medical records of 223,375 women from 12 medical centers across the U.S. who gave birth between 2002-2008. All women had singleton deliveries. These data were then linked with hourly temperature data - obtained from the Weather Research and Forecasting Model - for the regions surrounding each of the 12 medical centers, in order to determine whether temperatures influenced the women's risk of preterm birth. 

Up to 21 percent greater preterm birth risk with extreme heat exposure 
For the study, extreme heat was defined as above the 90th percentile of average temperatures, mild temperature was defined as between the 10-90th percentile, while extreme cold was defined as below the 10th percentile. 

Overall, the team found that women exposed to extreme heat throughout the duration of pregnancy were 6-21 percent more likely to give birth at 34 weeks or 36-38 weeks of pregnancy, compared with those exposed to mild temperatures. 

Compared with women who were exposed to mild temperatures in the first 7 weeks of pregnancy, those who were exposed to extreme cold were 20 percent more likely to give birth before 34 weeks of pregnancy, were 9 percent more likely to give birth at 34-36 weeks, and were 3 percent more likely to give birth at 37-38 weeks. 

Women exposed to extreme heat in the first 7 weeks of pregnancy were 11 percent more likely to give birth before 34 weeks and 4 percent more likely to deliver at 37-38 weeks, compared with those exposed to mild temperatures. 

The link between extreme cold and preterm birth diminished after 7 weeks, though exposure to extreme heat at 8-14 weeks of pregnancy increased women's risk of giving birth at 37-38 weeks by 4 percent. 

Additionally, the researchers found women exposed to extreme heat between 15-21 weeks of pregnancy were 18 percent more likely to give birth at 34 weeks and between 34-36 weeks, and they were 4 percent more likely to give birth at weeks 37-38. 

Pregnant women 'should minimize exposure to extreme temperatures' 
The researchers are unable to conclude why exposure to extreme cold after 7 weeks of pregnancy did not increase preterm birth risk, but they suggest it is because the effects of cold weather are easier to escape - through seeking shelter, for example - while extreme heat is harder to avoid. 

While it is unclear why extreme cold and heat appear to affect preterm birth risk, the team speculates that extreme temperatures might impair placental development or blood flow to the uterus, which can trigger early labor. 

The researchers say further studies are needed to gain a better understanding of how extreme temperatures raise the risk of preterm birth, though these current findings should act as a warning for expectant mothers and healthcare providers.


Paper-based device spots falsified or degraded medications



The developing world is awash in substandard, degraded or falsified medications, which can either directly harm users or deprive them of needed treatment. And with internet sales of medications on the rise, people everywhere are increasingly at risk. So, a team of researchers has developed a simple, inexpensive paper-based device to screen suspicious medications. 

The researchers will present their work today at the 252nd National Meeting & Exposition of the American Chemical Society (ACS). "People who don't have access to the best-quality medicines also don't have as many resources to buy the analytical instrumentation to detect the quality problems," says Marya Lieberman, Ph.D. 

"Instead of a $30,000 instrument, we've developed a $1 paper card. We designed the card so it would be as easy and inexpensive to use as possible." 

Medications can be compromised in many different ways. For example, they may be bulked up with fillers, or they can degrade because they are stored improperly. Identifying poor-quality medications is challenging, as inspectors may not know in advance what chemical adulterants or degradation products they need to look for. 

Plus, bad-quality medications may contain at least some of the active ingredient, so simply detecting the presence of the real medication isn't enough to rule out issues. 

In this study, Lieberman of the University of Notre Dame, along with Hamline University undergraduate Sarah Bliese, developed a card to detect falsified or degraded antibiotics such as ciprofloxacin or ceftriaxone, both of which the World Health Organization lists as "essential." To screen for a variety of potential quality issues, the researchers included 12 lanes separated by wax barriers on the paper device. 

Each lane contained a different set of reagents to detect materials or functional groups found in active pharmaceutical ingredients, degradation products or common fillers. To run a sample, the researchers crush a pill and rub the resulting powder across all 12 lanes, and then dip the bottom of the paper card in water for three minutes. 

The water wicks up the lanes, bringing reagents into contact with the powder. Colors are formed when the reagents interact with the pharmaceutical, filler or degradation product. 

The researchers then compare the color pattern from the sample with the color patterns obtained from high-quality pharmaceutical products. The comparison can be done by eye or with an image-analysis program on a smartphone. Ceftriaxone is sensitive to heat and breaks down if storage temperatures climb too high. 

As an experiment, the researchers subjected ceftriaxone to high temperatures and ran the card test, simultaneously analyzing the degradation products via liquid chromatography-mass spectrometry. 

They verified that the colorimetric pattern for the degraded antibiotic was different from that of the correctly stored product. In addition to these tests on the pure active ingredient, Lieberman and Bliese analyzed dozens of real-world samples of ceftriaxone from Kenya and Uganda. 

Unscrupulous makers of falsified medication sometimes add colorants containing toxic heavy metals to their products to make the illicit pills more closely resemble their legitimate counterparts, Bliese says. 

So, in a related project at Hamline University, Bliese and Deanna O'Donnell, Ph.D., are exploring whether a portable X-ray fluorescence spectroscopy device can scan pills for these substances. In June, Lieberman and Bliese traveled to Kenya to test a new paper card which can detect substandard antibiotics. 

While Lieberman is currently focusing her work on the developing world, she says her cards could be applicable worldwide to perform, for example, the analysis of herbal medicines and nutritional supplements. "Sometimes those 'herbal products' are actually spiked with pharmaceuticals," she explains. 

"The paper test cards could be a defense against this." Bliese says her next project will be to develop a paper test card to help first responders identify drugs of abuse and differentiate them from household products or legitimate medicines.


Experts off guidance on medical marijuana for pain


Marijuana often is used to self treat chronic pain and, with 24 states legalizing medical use of the herb, the American Pain Society published guidance in The Journal of Pain for physicians caring for patients who use cannabis.
The paper also identified opportunities for future research required to better understand the health effects of cannabinoids. The article is a consensus report with a balanced analysis from experts with diverse opinions about the value of cannabis as a pain treatment. The authors range from legalization advocates to opponents of using cannabis, even for medical purposes.
"We looked at the evidence that is available on the use of clinical cannabis and extrapolated to some degree on management strategies from our experiences with the prescribing of controlled substances," said lead author Seddon R. Savage, M.D., medical director, Silver Hill Hospital Chronic Pain and Recovery Center, in an interview with Medscape at the recent American Pain Society annual meeting.
The article reviews clinical, research and policy issues related to herbal cannabis to counsel clinicians in advising and caring for patients who use cannabis, while recognizing there is a broad range of opinion among pain clinicians and researchers regarding use of herbal cannabis.
However, the authors note that many pain clinicians and researchers agree that cannabinoids are clinically promising chemical compounds, and there is a critical need for robust research on herbal cannabis to identify targets for medical development.
Clinical practice recommendations include:
• Know the federal and state laws governing use of medical cannabis
• Be clear with patients about goals for therapeutic cannabis
• Counsel patients about routes of administration and potential benefits and risks, based on scientific evidence and individual symptoms, conditions and comorbidities
• Advise patients on cannabis strains, cannabinoid medications or extracts, explaining limitations due to lack of herbal/substance uniformity and regulatory oversight
• Monitor patients the same as for treatment with opioids or other controlled substances.
• Patient follow up should assess progress toward achieving treatment goals, incidence of side effects, and evidence of psycho-behavioral changes.
The authors strongly advocate that a robust research agenda is needed to fully realize the clinical potential of cannabinoid therapies.
They recommend:
• Increase federal funding for pain-related cannabis research
• Broaden pain conditions being studied to include cannabis for non-neuropathic pain
• Ease regulatory restrictions that impede approvals of cannabis and cannabinoid research
• Improve access to high-quality plant cannabis for research studies
• Encourage states to collect individual and population level data on patients receiving medical cannabis.
The authors concluded that research on the cultivation of cannabis also is needed. Expanded medical use will require high-quality medicinal grade cannabis with strict quality control and known constituents.


Acupuncture used in settings reduced symptoms of menopause


Acupuncture treatments can reduce the number of hot flashes and night sweats associated with menopause by as much as 36 percent, according to researchers at Wake Forest Baptist Medical Center. The findings are published in the June issue of the journal Menopause.

"Although acupuncture does not work for every woman, our study showed that, on average, acupuncture effectively reduced the frequency of hot flashes and results were maintained for six months after the treatments stopped," said Nancy Avis, Ph.D., professor of public health sciences at Wake Forest Baptist and lead author of the study.

The study, which was funded by National Institutes of Health, included 209 women ages 45 to 60 who had not had a menstrual period for at least three months and had on average at least four hot flashes or night sweats per day in the previous two weeks. Participants received a baseline assessment and were then randomized to one of two groups.

The first group received acupuncture treatments during the first six months. They were then followed without receiving acupuncture for the second six months. The second group did not receive any acupuncture during the first six months, but did receive acupuncture for the second six months. The participants were allowed up to 20 treatments within six months provided by licensed, experienced acupuncturists in the community.

All participants kept a daily diary on the frequency and severity of their hot flashes. They also answered questionnaires about other symptoms every two months. Avis said the study was designed to make it more "real world" by leaving the frequency and number of the acupuncture treatments up to the study participants and their acupuncturists. After six months, the first group reported an average 36.7 percent decline in frequency of hot flashes compared to baseline measurements.

After a year, the benefits persisted, with the group members maintaining an average 29.4 percent reduction from baseline. The second group reported a 6 percent increase in symptom frequency during the six months when they were not getting acupuncture, but had similar results - an average 31 percent reduction in frequency - to the first group after receiving acupuncture during the latter part of the trial.

"There are a number of non-hormonal options for treating hot flashes and night sweats that are available to women," Avis said. "None of these options seem to work for everyone, but our study showed that acupuncture from a licensed acupuncturist can help some women without any side effects. Our study also showed that the maximum benefit occurred after about eight treatments."

Avis cautioned that the effect shown in the study could be due to non-specific effects such as the additional care and attention the study participants received or the expectation of a benefit. She also said that additional research is needed to identify individual differences in response to acupuncture.


Yoga, aquatic exercise can help combat MS symptoms


Exercise can have a positive influence on certain symptoms of multiple sclerosis: Patients who do yoga and aquatic exercise suffer less from fatigue, depression and paresthesia, as reported by researchers from the University of Basel and the Psychiatric University Clinics Basel in a joint study with colleagues in Iran.

Multiple sclerosis (MS) is a chronic progressive auto-immune disease in which the body's own immune system attacks the nervous tissue, potentially resulting in movement disorders. Other typical symptoms of MS include physical and mental fatigue as well as faintness, depression and paresthesia such as pins and needles, itchiness and numbness.

Increased risk of depression
In a random trial, researchers from Basel and Kermanshah (Iran) have now shown that these symptoms significantly improved after an eight-week program of yoga and aquatic exercise.

In comparison to the control group, fatigue, depression and paresthesia were significantly reduced in patients who took part in a three-times weekly training program. In the non-exercising group, the likelihood of moderate to severe depression was 35-fold higher than in the groups who had done yoga or aquatic exercise.

Fifty-four women with MS and an average age of 34 were assigned to one of three groups: yoga, aquatic exercise or no exercise. Before and after the trial, patients were asked to complete a questionnaire about their symptoms. All patients continued with their existing treatment, including any medication taken to regulate the immune system.

Exercise as a complementary therapy
"Exercise training programs should be considered in the future as possible complements to standard MS treatments," write the researchers.

Researchers from the Kermanshah University of Medical Sciences in Iran, the Psychiatric University Clinics (UPK Basel, Center for Affective, Stress and Sleep Disorders) and the University of Basel's Department of Sport, Exercise and Health took part in the study.


Fasting no longer necessary before cholesterol test


For the first time, a team of international experts recommends that most people do not need to fast before having their cholesterol and triglyceride levels tested.

Fasting is a problem for many patients, they explain, and note the latest research shows that cholesterol and triglyceride levels are similar whether people fast or not. The experts represent the European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) joint consensus initiative.

They refer to new research from Denmark, Canada, and the United States that included over 300,000 people and found it is not necessary to have an empty stomach to check cholesterol levels. Apart from Denmark, all countries require that patients fast for at least 8 hours before checking their cholesterol and triglyceride levels - referred to as "lipid profile." In Denmark, non-fasting blood sampling has been in use since 2009.

Arguing their case in a European Heart Journal article, the experts say fasting is a "barrier to population screening" and can be a problem for many patients, particularly children, older adults, diabetes patients, and workers.

"Interestingly, evidence is lacking that fasting is superior to non-fasting when evaluating the lipid profile for cardiovascular risk assessment," they note. "However, there are advantages to using non-fasting samples rather than fasting samples for measuring the lipid profile."

Non-fasting and fasting tests 'not mutually exclusive'

In the journal article, the researchers discuss fasting and non-fasting lipid profile testing and recommends non-fasting for most patients, but they note there are cases when fasting tests are sometimes required, and the two tests should be "viewed as complementary and not mutually exclusive."

Non-fasting is recommended for most patients, particularly if it is their first lipid profile test, if it is for cardiovascular risk assessment, or if patients express a preference for a non-fasting test. Non-fasting is also recommended for children, elderly patients, patients on stable drug therapy, and patients admitted with acute coronary syndrome - they will need repeated lipid profile testing later because the condition lowers lipid concentrations.

Diabetic patients should also have non-fasting tests because of higher risk of hypoglycemia, and because fasting can mask high levels of triglycerides (hypertriglyceridemia). A fasting test can sometimes be required if the non-fasting test shows triglyceride levels above 5 mmol/L (440 mg/dL). There will also be other specific cases, relating to hypertriglyceridemia, when fasting tests will be necessary.

For example, patients with known hypertriglyceridemia being followed in lipid clinic, starting on medications that cause severe hypertriglyceridemia, and recovering from pancreatitis caused by hypertriglyceridemia. There may also be specific cases where the lab test requires a fasting or morning sample - for example, to test fasting glucose or in monitoring certain drug effects.

However, even in the case of fasting glucose, the authors note that in many countries this measurement is being replaced by measurement of hemoglobin A1c without the need to fast.

Non-fasting testing 'will improve patient compliance'
The team says that in Denmark, patients, doctors, and testing labs have all benefited from non-fasting testing. It cuts the cost of return visits, emails, phone calls, and follow-up. Doctors also spend less time having to review tests at a later date.

First author Børge Nordestgaard, a professor in the Department of Clinical Medicine at Herlev Hospital, University of Copenhagen, says moving to a system of non-fasting lipid profile testing "will improve patients compliance to preventive treatment aimed at reducing number of heart attacks and strokes, the main killers in the world."

More patients having the tests also gives doctors opportunity to advise more people on how to prevent heart attacks and strokes, he says.




Every one of your cells contains DNA, the molecular blueprint that makes you you.

Accessing that blueprint may seem like a job for scientists. But extracting DNA from your cells is actually surprisingly simple. Mac Cowell, an advocate for open-source biotechnology, created a set of simple instructions that lets anyone isolate her own DNA in mere minutes. The rough-and-ready procedure uses basic kitchen supplies, including the best possible container: a shot glass.

This DIY process won't create the cleanest sample, but avid biohackers can purify the DNA after it's extracted. Once you have a pure sample, you can try sorting the DNA fragments by size or building a DIY DNA-copying machine.

Materials + Tools
A clean shot glass
Dish soap
Table salt
Pineapple juice (or meat tenderizer, or cleaning solution for contact lenses)
Chilled alcohol (120 proof or higher) -we used high-proof rum
Drinking straw

1. Spit into the shot glass until it's a quarter full of your saliva. (If you're having trouble salivating, imagine you're sucking a lemon-flavored candy.) The saliva is laden with cells, shed from your cheeks and mouth lining, which are full of DNA.
2. Add a few drops of dish soap. This will break open the cells, a process called "lysing."
3. Add a tiny splash of pineapple juice. This will clean up some of the proteins that have spilled out of your cells alongside your DNA.
4. Add a pinch of salt. This causes the DNA to start clumping together.
5. Swirl the shot glass to mix the ingredients.
6. Gently fill the rest of the shot glass with the high-proof alcohol, which should sit in a layer on top of the mixture. To prevent it from mixing too much, you can add the alcohol gradually with a drinking straw: Put the straw into the alcohol, cap it with your finger, hold the straw right over the liquid in the shot glass, and release.
7. Use a toothpick to spool up the cloudy, snot-like material that has formed in the glass. This is your DNA - a gross result of some cool science.


Drinking More Water Tied to Many Benefits


For people who want to control their weight or reduce their intakes of sugar, sodium and saturated fat, tap water may be what the doctor ordered. 

A new study that examined the dietary habits of more than 18,300 U.S. adults found the majority of people who increased their consumption of plain water - tap water or from a cooler, drinking fountain or bottle - by 1 percent reduced their total daily calorie intake as well as their consumption of saturated fat, sugar, sodium and cholesterol. 

People who increased their consumption of water by one, two or three cups daily decreased their total energy intake by 68 to 205 calories daily and their sodium intake by 78 to 235 grams, according to a paper by University of Illinois kinesiology and community health professor Ruopeng An. They also consumed 5 grams to nearly 18 grams less sugar and decreased their cholesterol consumption by 7 to 21 grams daily. 

"The impact of plain water intake on diet was similar across race/ethnicity, education and income levels and body weight status," An said. "This finding indicates that it might be sufficient to design and deliver universal nutrition interventions and education campaigns that promote plain water consumption in replacement of beverages with calories in diverse population subgroups without profound concerns about message and strategy customization." 

An examined data from four waves (2005-12) of the National Health and Nutrition Examination Survey, conducted by the National Center for Health Statistics. Participants were asked to recall everything they ate or drank over the course of two days that were three to 10 days apart. An calculated the amount of plain water each person consumed as a percentage of their daily dietary water intake from food and beverages combined. 

Beverages such as unsweetened black tea, herbal tea and coffee were not counted as sources of plain water, but their water content was included in An's calculations of participants' total dietary water consumption. On average, participants consumed about 4.2 cups of plain water on a daily basis, accounting for slightly more than 30 percent of their total dietary water intake. 

Participants' average calorie intake was 2,157 calories, including 125 calories from sugar-sweetened beverages and 432 calories from discretionary foods, which are low-nutrition, calorie-dense foods such as desserts, pastries and snack mixes that add variety to but are not necessary for a healthy diet. 

A small but statistically significant 1 percent increase in participants' daily consumption of plain water was associated with an 8.6-calorie decrease in daily energy intake, as well as slight reductions in participants' intake of sugar-sweetened beverages and discretionary foods along with their consumption of fat, sugar, sodium and cholesterol. 

While An found that the decreases were greater among men and among young and middle-aged adults, he suggested they could have been associated with these groups' higher daily calorie intakes. The study was published in the Journal of Human Nutrition and Dietetics.


How aggression can change your brain


Aggression can lead to generation of new nerve cells in the brain and also change the activity of existing cells, new research has found

A team of neurobiologists from the US and Russia studied the changes that occurred in the brains of mice demonstrating aggressive behaviour, which attacked other mice and won in fights. After a win, these mice became even more aggressive, and new neurons appeared in their hippocampus - one of the key structures of the brain, the researchers found. 

 In addition to this, in mice that were allowed to continue fighting certain changes were observed in the activity of their nerve cells. The findings were published in the journal Frontiers in Neuroscience. 

The scientists hope that the new information on the neurobiological bases of aggression will not only help in understanding this important phenomenon, but will also encourage research in other areas -- and even help in finding causes of autism and other similar disorders in humans. 

Increased anxiety, stereotypical repetitive behaviour, impaired ability to communicate with others - symptoms partially similar to autism - were observed in the mice with more new neurons in the hippocampus. 

"Once again I am amazed at how the basic building blocks that make up complex behaviour are similar in different organisms and it is truly fascinating how they can be combined with other blocks to create an enormous variety of behavioural reactions in animals and humans," said corresponding author of the study Grigori Enikolopov from Moscow Institute of Physics and Technology in Russia.




Zika situation declared an emergency


A disease linked to the Zika virus in Latin America poses a global public health emergency requiring a united response, says the World Health Organization

Experts are worried that the virus is spreading far and fast, with devastating consequences. The infection has been linked to cases of microcephaly, in which babies are born with underdeveloped brains. The WHO alert puts Zika in the same category of concern as Ebola. It means research and aid will be fast-tracked to tackle the infection. There have been around 4,000 reported cases of microcephaly in Brazil alone since October. 

WHO director general, Margaret Chan called Zika an "extraordinary event" that needed a co-ordinated response. 

"I am now declaring that the recent cluster of microcephaly and other neurological abnormalities reported in Latin America following a similar cluster in French Polynesia in 2014 constitutes a public health emergency of international concern." 

She said the priorities were to protect pregnant women and their babies from harm and to control the mosquitoes that are spreading the virus. She advised pregnant women: to consider delaying travel to areas affected by Zika seek advice from their physician if they are living in areas affected by Zika, as well as protect themselves against mosquito bites by wearing repellent Dr Chan justified declaring an emergency even amid uncertainties about the disease, saying it was time to take action. 

The WHO faced heavy criticism for waiting too long to declare the Ebola outbreak a public emergency. Currently, there is no vaccine or medication to stop Zika. The only way to avoid catching it is to avoid getting bitten by the Aedes mosquitoes that transmit the infection. 

The WHO has already warned that Zika is likely to "spread explosively" across nearly all of the Americas. More than 20 countries, including Brazil, are reporting cases. Most infections are mild and cause few or no symptoms, although there have been some reported cases of a rare paralysis disorder called Guillain-Barre syndrome. The bigger health threat though is believed to be in pregnancy, to the unborn child. 

Dr Jeremy Farrar, Director of the Wellcome Trust, said: "There is a long road ahead. As with Ebola, Zika has once again exposed the world's vulnerability to emerging infectious diseases and the devastation they can unleash. Alongside the emergency response that Zika necessitates, we must put in place the permanent reforms, health systems strengthening and proactive research agenda that are needed to make the global health system more resilient to the threat of future pandemics."




Music Therapy Helps COPD Patients


Music therapy increases effectiveness of pulmonary rehabilitation for COPD patients. 

Patients with Chronic Obstructive Pulmonary Disease (COPD) and other chronic respiratory disorders who received music therapy in conjunction with standard rehabilitation saw an improvement in symptoms, psychological well-being and quality of life compared to patients receiving rehabilitation alone, according to a new study by researchers at The Louis Armstrong Center of Music and Medicine at Mount Sinai Beth Israel (MSBI). 

Study findings were published this week in Respiratory Medicine and suggest that music therapy may be an effective addition to traditional treatment. COPD is the fourth leading cause of death in the United States with symptoms including shortness of breath, wheezing, an ongoing cough, frequent colds or flu, and chest tightness. Patients with COPD are often socially isolated, unable to get to medical services and underserved in rehabilitation programs, making effective treatment difficult. 

The 68 study participants were diagnosed with chronic disabling respiratory diseases, including COPD. Over the course of six weeks, a randomized group of these patients attended weekly music therapy sessions. Each session included live music, visualizations, wind instrument playing and singing, which incorporated breath control techniques. 

Certified music therapists provided active music-psychotherapy. The music therapy sessions incorporated patients' preferred music, which encouraged self-expression, increased engagement in therapeutic activities and an opportunity to cope with the challenges of a chronic disease. 

"The care of chronic illness is purposefully shifting away from strict traditional assessments that once focused primarily on diagnosis, morbidity and mortality rates," said Joanne Loewy, DA, Director of the Louis Armstrong Center for Music and Medicine at MSBI, where the study was conducted. 

"Instead, the care of the chronically ill is moving toward methods that aim to preserve and enhance quality of life of our patients and activities of daily living through identification of their culture, motivation, caregiver/home trends and perceptions of daily wellness routines." 

"Music therapy has emerged as an essential component to an integrated approach in the management of chronic respiratory disease," said Jonathan Raskin, MD, co-author of the study and Director of the Alice Lawrence Center for Health and Rehabilitation at MSBI. 

"The results of this study provide a comprehensive foundation for the establishment of music therapy intervention as part of pulmonary rehabilitation care."


New clues to nicotine addiction


New understanding of how nicotine causes addiction has emerged, according to research published in eLife

Although smoking rates are declining, a consistent portion of the population continues to smoke, making continued research into tobacco addiction important. One reason people find it hard to quit smoking is that each time they have a cigarette, feelings of craving, irritability and anxiety melt away. This is known as negative reward and is partly controlled by a region of the brain called the habenula. 

The neurotransmitters acetylcholine and glutamate are thought to influence nicotine dependence in the habenula, but the molecular details of this regulation are unclear. Neurotransmitters are the chemical messengers of the brain. They are packaged into spherical structures at the ends of neurons, called vesicles. On receiving certain signals, neurons release their vesicle contents into the synapse, sending the signal on to the next neuron. 

Neurons can recycle neurotransmitters by reabsorbing them through reuptake, a process that allows them to control the exact number of neurotransmitters in the synapse. Even a small upset in the balance of neurotransmitters can affect behavior. In the case of acetylcholine, it can influence our ability to cope with addiction. 

Ines Ibanez-Tallon, and colleagues from Rockefeller University in New York, knew that acetylcholine and glutamate played important roles in the neurons in the habenula - but not how they might interact to reinforce addiction. 

Acetylcholine controls glutamate release 
The researchers created a mouse model where a key gene involved in acetylcholine processing was missing; this prevented acetylcholine production in habenular neurons. The elimination of acetylcholine affected glutamate in the habenula in two ways. First, the amount of glutamate released by neurons was reduced; second, the reuptake of glutamate back into vesicles was impaired. 

 Both of these mechanisms disrupt normal signaling, thus affecting the excitability of neurons. Based on these findings, the researchers suggest that acetylcholine regulates how much glutamate is released into the synapse, and at what frequency. It also facilitates the packaging of glutamate into vesicles. Studies using electron microscopy confirmed that the neurotransmitters are in the same place at the same time and are able to affect one another. 

Removing acetylcholine decreases sense of reward 
When the researchers removed acetylcholine from the habenula of the mice, the mice became insensitive to the rewards of nicotine. They did not develop a tolerance to continued nicotine exposure, nor did they experience withdrawal symptoms, such as body shakes and scratching. 

The findings suggest that without acetylcholine, nicotine addiction would not occur. They also reveal new clues about the brain circuitry involved in nicotine dependence, which is relevant to opioid and cannabinoid addiction. In future, the researchers hope to examine how the interaction between acetylcholine and glutamate might work in other areas of the brain.


Not Just for Sex Problems (or Men) Anymore?


Three-month treatment with sildenafil (Viagra) improved insulin sensitivity in overweight patients with prediabetes, according to a small trial reported in the Journal of Clinical Endocrinology & Metabolism. 

The treatment also lowered urinary albumin excretion and improved fibrinolytic balance, said senior investigator Nancy Brown, MD, of the Vanderbilt University School of Medicine in Nashville, Tenn., and colleagues. 

"We need additional strategies to help slow the progression from prediabetes to diabetes," Brown said in a statement. "Weight loss and exercise regimens can be difficult to maintain, and some current medications have been limited by concerns about adverse effects. Sildenafil and related drugs could offer a potential avenue for addressing the rising number of diabetes diagnoses." 

In addition, she said, "because existing drug therapies to prevent type 2 diabetes can have negative effects on the heart or be of limited use in patients with kidney disease, strategies to prevent diabetes without adversely affecting the risk of kidney and heart disease could have a large impact on public health." 

Previous studies have reported that treatment with a phosphodiesterase-5 (PDE5) inhibitor improved measures of insulin sensitivity in insulin-resistant and severely obese patients, Brown and colleagues noted. The current study enrolled 51 overweight patients with prediabetes, about two-thirds of whom were women. The investigators collected blood samples and measured insulin resistance via hyperglycemic clamp at baseline. 

The volunteers were then randomized to receive either sildenafil 25 mg three times per day or a matching placebo. Volunteers underwent a second hyperglycemic clamp and blood tests after 3 months. 

The study's primary endpoints were measures of insulin resistance including the insulin sensitivity index, glucose-stimulated insulin secretion, and the disposition index, a composite measure of insulin sensitivity and secretion. Secondary endpoints included blood pressure, levels of tissue-plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1), urine albumin and creatinine, body weight, resting energy expenditure, and the incidence of side effects. 

Key results included the following: The insulin sensitivity index was significantly greater in the treatment group compared to the placebo group by 1.84 mg/kg/min per µU/mL*100 (95% CI 0.01-3.67; P=0.049). There was a weak trend toward a higher disposition index in the treatment group by 83.5 mg/kg/min (95% CI -7.01-174.02 mg/kg/min; P=0.70.) 

The investigators found no significant effect of treatment on first-phase or late phase glucose-stimulated insulin secretion. Sildenafil treatment also had no significant effect on body weight, resting energy expenditure, or blood pressure, Brown and colleagues reported. The urine albumin-to-creatinine ratio decreased in the treatment group from 12.67 ± 14.67 µg/mg to 6.84 ± 4.86 µg/mg. 

In contrast, the ratio increased from 8.45 ± 14.17 µg/mg to 13.41 ± 17.71 µg/mg in the placebo group (P=0.036 for the treatment effect). Sildenafil also significantly reduced PAI-1 concentrations (P=0.01) without affecting t-PA. 

These findings suggest PDE5 inhibition may improve glucose homeostasis while avoiding detrimental effects on fibrinolysis, Brown and colleagues wrote. Four patients in the treatment group and three in the placebo group discontinued because of side effects, a nonsignificant difference, the investigators said. 

"In conclusion, our study suggests that chronic PDE5 inhibition improves insulin sensitivity, fibrinolytic balance, and albuminuria in subjects with prediabetes," Brown and colleagues wrote. "Larger randomized trials using clinical endpoints are needed to assess whether PDE5 inhibition can prevent the onset of diabetes in high-risk patients." 

"The present study does not address the mechanism through which PDE5 inhibition improves tissue insulin sensitivity," Brown and colleagues noted, adding that, "In rodent models, sildenafil improves muscle glucose uptake through recruitment of vasculature and has no effect on insulin signaling in the muscle." 

"Future studies of the effect of PDE5 inhibition on insulin signaling in muscle biopsies after hyperinsulinemia are needed to address this mechanism," they said. An important limitation of the study was the exclusion of patients with renal dysfunction. 

"Studies are needed to assess the effect of long-term PDE5 inhibition on albuminuria in patients who are heterogeneous with respect to renal function," Brown and colleagues said. 

Why did PDE5 inhibition improve insulin sensitivity but not glucose-stimulated insulin secretion? "Insulin sensitivity and insulin secretion are controlled by different factors," Brown told MedPage Today via email. "If insulin sensitivity improves, the body does not need to make as much insulin to maintain normal glucose." 

"We plan a longer and larger study to look at effects [of PDE5 inhibition] on glucose, hemoglobin A1C, and urine albumin," Brown said.


Imitation biologics are therapeutically equivalent to the original drugs



Drugs produced using biotechnology are among the most expensive medicines available. Biosimilars that offer a real alternative are becoming increasingly available on the market. 

The promise of biosimilars is that, once patent protection has elapsed for established biologics, more patients will be able to access effective and well-tolerated drugs. This is particularly true in relation to preparations used in the treatment of patients with cancer and autoimmune diseases, which also include drugs used for the treatment of rheumatic diseases. 

In 2001, as part of a project led by the European Medicines Agency, step-by-step guidelines were introduced to regulate the approval of these products, and to acknowledge the specific differences that distinguish biosimilars from traditional medicines. 

Biosimilars are complex proteins which, although not required to be identical to their originator products, have to be similar to them in terms of both effect and tolerability. One of the main differences is of course that biosimilars are, or are set to be, available at significantly lower prices than those of the originator products. 

Prof. Dr. Thomas Dörner, from the Medical Department, Division of Rheumatology and Clinical Immunology at Charité, stresses that "the introduction of these medicines needs to be handled in a responsible manner, and requires the input of experienced practitioners." 

Prof. Dörner adds that "the decision as to which medicine a patient is to be given should remain the responsibility of the treating physician. What must not be allowed to happen is what is currently happening with traditional generics, namely that pharmacies automatically substitute one product for another." 

For their article, the authors analyzed a wealth of information on the development of biosimilars. Their review, which covers almost every biological drug available, also addresses the enormous variations currently seen in approval processes across the globe. Their findings suggest that the introduction of biosimilars into clinical practice must go hand-in-hand with the creation of national registers, which allow data on potential side effects to be collated. 

The authors conclude that the approval and introduction of biosimilars offer access to both established and new treatment options. Biosimilars are also likely to reduce the costs associated with the treatment of inflammatory diseases in the fields of rheumatology, dermatology, and gastroenterology.


Tai Chi Could Be Useful Exercise for Elderly


Tai Chi linked to improved physical capacity in certain common long term conditions. 

The ancient Chinese exercise Tai Chi is linked to improved physical capacity among older adults with certain common long term conditions, indicates a pooled analysis of the available evidence, published online in the British Journal of Sports Medicine. 

Among people with breast cancer, heart failure, osteoarthritis and chronic obstructive pulmonary disease (COPD), these improvements were not at the expense of worsening pain or breathlessness, the findings show. Tai Chi consists of slow, gentle, flowing movements that aim to boost muscle power, balance, and posture. It also includes mindfulness, relaxation, and breath control. 

The researchers wanted to find out how effective Tai Chi was in long term conditions that are common among older adults. So they trawled electronic research databases for relevant studies published up to 2014, on the use of Tai Chi in people with cancer, osteoarthritis, heart failure, and COPD. They wanted to find out if Tai Chi relieved symptoms, and improved physical capacity and quality of life in all four long term conditions. 

Out of 1102 articles, 33, involving 24 studies and 1584 participants, were suitable for inclusion; 21 studies were included in the pooled analysis. The average age of participants ranged from the mid 50s to the early 70s, while the average length of the Tai Chi training programme was 12 weeks, with most sessions lasting an hour. Tai Chi training was usually offered two to three times weekly. 

The results showed that Tai Chi was associated with trends, or definite improvement, in physical capacity and muscle strength in most or all four long term conditions. This included improvements in the six minute walking test; muscle strength, as measured by bending and stretching the knees; the time it takes to get up and move known as the TUG test; and quality of life. 

Tai Chi was also associated with an improvement in the symptoms of pain and stiffness in osteoarthritis and in breathlessness in COPD. And it was associated with improved sit to stand times among patients with osteoarthritis. This is an observational study so no definitive conclusions can be drawn about cause and effect, added to which the only cancer included in the analysis was breast cancer. 

But the findings back those of previous research, and provide a reasonable starting point to look at the value of exercise programmes, such as Tai Chi, for people with several co-existing long term conditions, say the researchers. 

"Tai Chi can improve some physical performance outcomes in four chronic conditions...but not at the expense of worsening pain or dyspnoea [breathlessness]," they write, adding that it "may provide a suitable exercise stimulus for people with several comorbidities," and could be used as a complementary therapy in some long term conditions.


Fidgeting may be good for health



As more people live sedentary lifestyles, it seems that any type of movement may be good for us. A recent study published in the American Journal of Preventive Medicine suggests that fidgeting, traditionally considered unacceptable in some circles, could decrease the risk of mortality in those who sit for much of the day.

The study, led by researchers at Leeds University and University College London, both in the UK, builds on growing evidence suggesting that a sedentary lifestyle is bad for one's health, even if the individual is physically active outside work. 

According to the American Heart Association, the number of sedentary jobs in the US has increased by 83% since 1950; in 1960, people working in physically active jobs represented 50% of the workforce, compared with less than 20% today. 

Statistics show that even adults who meet recommended physical activity levels and who sleep for 8 hours per night may spend up to 15 hours a day sitting down. Previous research has indicated that breaks in sitting time are markers of good health, such as body mass index (BMI), glucose and insulin responses. 

The current study follows on from a larger project, the UK Women's Cohort Study, which focused initially on the eating patterns of 35,000 women. 

Women who fidget fare better with sedentary lifestyle 

In 1999-2002, the team invited 12,778 of the same women, ages 37-78, to answer questions about health behaviors, diet, smoking status, alcohol consumption, chronic disease, physical activity levels and fidgeting. 

Participants were followed up for mortality over an average of 12 years, and the relative risk of mortality was estimated in the high (vs. low) and medium (vs. low) sitting time groups. In women who sat for long periods but considered themselves "moderately or very fidgety," no increased risk or mortality was established as a result of the sitting. 

The risk only appeared to increase in the case of "very occasional fidgeters." "While further research is needed, the findings raise questions about whether the negative associations with fidgeting, such as rudeness or lack of concentration, should persist if such simple movements are beneficial for our health." 

Earlier this month, Medical News Today reported on research suggesting a link between sedentary behavior and nonalcoholic fatty liver disease.


High use of alternative medicine in senior oncology patients


Alternative medicines are widely thought to be at least harmless and very often helpful for a wide range of discomforts and illnesses. 

However, although they're marketed as "natural," they often contain active ingredients that can react chemically and biologically with other therapies. Researchers performed a comprehensive review of all of the medications taken by senior oncology patients and found that as 26 percent were using complementary or alternative medicines (CAM), in a report published August 12th, in the Journal of Geriatric Oncology. 

"Currently, few oncologists are aware of the alternative medicines their patients take," says Ginah Nightingale, PharmD, an Assistant Professor in the Jefferson College of Pharmacy at Thomas Jefferson University. "Patients often fail to disclose the CAMs they take because they think they are safe, natural, nontoxic and not relevant to their cancer care, because they think their doctor will disapprove, or because the doctor doesn't specifically ask." 

There are a number of CAMs that are known to interfere with certain cancer treatments. For example, St. John's wart can make some cancer therapy less effective, according to the National Institutes of Health. Others can interfere with anesthesia during surgery for cancer. But not all interactions have been studied. 

Because CAMs fall under the category of health supplements, they are not regulated by the Food and Drug Administration (FDA), which means that dose and potency (and therefore reaction in the body) can vary widely between products, and between patients. In addition, in an elderly population of cancer patients, CAMs can simply add additional medications to an already long list of drugs taken for various ailments. 

"Numerous pills, or what we call polypharmacy in the field, can increase the risk for medication non-adherence, potential drug-drug interactions and increase the risk for drug-disease interactions in a population that has been reported to take several medications and have several medical conditions," says Dr. Nightingale, 

"The use of CAM in this subpopulation warrants substantial interest and concern on behalf of medical oncologists and allied health professionals because of the potential clinical implications associated with CAM use. Patients may be combining these agents while receiving concurrent systemic chemotherapy, radiation therapy and/or surgical interventions which have the potential to compromise the safety and efficacy of treatment interventions." 

Dr. Nightingale and colleagues surveyed the senior oncology patients who came to Jefferson for consultations in the Senior Adult Oncology Multi-Disciplinary clinic. Over the course of one visit, patients were seen by professionals from five different areas crucial to maintaining a senior's health throughout oncology treatment, including a medical oncologist, geriatrician, clinical pharmacist, social worker and dietician. As part of this assessment, the patients brought in the contents of their medicine cabinets, and the medications that were actively used were reviewed and recorded. 

The research team found that 26 percent of patients were taking CAMs at some point during the continuum of their cancer care, with the highest usage among women over the age of 80 - a population that hadn't been captured by previous studies. Among those taking complementary medicine, 68 percent were in the over-80-year-old range. 

Some of the alternative medications that were commonly used in this population were alternative therapies for macular degeneration, stomach probiotics, joint health, and mega-dose vitamins or minerals. While the current study did not examine the potential adverse events caused by these medications, "we know that some can have a biochemical effect on the body and other drugs." says Nightingale. 

"It is very important to do a comprehensive screen of all of the medications that older cancer patients take, including CAMs," says Dr. Nightingale. "Clear and transparent documentation of CAM use should be recorded in the patient's medical record. This documentation should indicate that patient-specific communication and/or education was provided so that shared and informed decisions by the patient can be made regarding the continued use of these medications." 

"Oncology healthcare is undergoing significant transformation in the delivery of effective clinical services and is ripe for greater engagement of pharmacists to reduce drug-related problems and unnecessary medications, in order to optimize medication prescribing," says Dr. Nightingale.


Your Color Perception Changes With the Seasons


The shifting seasons alter the way we feel about the world, but as it turns out, they also literally change the way we see the world. 

Researchers from the University of York in the United Kingdom recently discovered that our vision automatically adjusts the way we perceive colors, particularly yellow, to correspond with the greenery of summer or the grayness of winter. 

 Mellow Yellow 
There’s a seemingly infinite variety of colors in the world, but humans only see four “pure” hues: blue, green, yellow and red. Orange, for example, is perceived as a mixture of red and yellow, and isn’t pure. But the four “pure” colors do not appear to contain mixtures of any other colors. 

Color, of course, is simply various wavelengths of light in the visual spectrum. Greens and purples are shorter wavelengths, whereas reds and oranges are longer. Color definitions are fluid; individuals and cultures define “pure” blue, green and red at different wavelengths. 

However, yellow is a bit unique: Across cultures, everyone settles on a similar wavelength to define pure yellow, even though our eyes are all a little different. Researchers, therefore, wondered if yellow’s stability was a result of the environment, rather than the physiology of the eye. 

 Tuning In 
Researchers recruited 67 volunteers, 45 female, to participate in a simple experiment. Each person entered a darkened room, let their eyes adjust, and were told to adjust the knobs on a colorimeter until they felt they had reached “pure” yellow – unpolluted by hues of green or red. In practice, turning the knobs on a colorimeter is similar to adjusting the color balance on photo editing software. 

Participants completed the test in January and again in June. It’s important to note that in York, where the study took place, winters are gray and drab, while summers are flooded with green from an abundance of foliage. 

Researchers discovered that participants’ perception of pure yellow also shifted with the seasons. In summer, participants’ definition of yellow shifted toward shorter wavelengths, or a more greenish yellow. In winter, yellow perception shifted toward longer wavelengths, or a reddish yellow. The results of the study were published in the journal Current Biology. 

Researchers believe the auto-balancing effect may help us keep our color perception consistent, even when the color palette of our surroundings changes drastically – just like adjusting the picture on your television. Researchers added that it likely takes several weeks for our visual system to re-calibrate to a particular season’s hues. 

This newly discovered quirk in color perception probably won’t lead to any medical breakthrough, but it is a colorful example of how our bodies, unbeknownst to us, adapt to changing environments.


Music could help treat epilepsy


Researchers are increasingly reporting the therapeutic potential of music. 

Now, a new study suggests it could be useful for treating epilepsy. ecently presented at the American Psychological Association's 123rd Annual Convention, the findings reveal that the brains of individuals with epilepsy respond differently to music than those of people without the condition. As such, study co-author Christine Charyton, of The Ohio State University Wexner Medical Center, and colleagues believe music could be used in combination with existing treatments for epilepsy. 

Approximately 2.9 million children and adults in the US have epilepsy - a neurological condition characterized by the occurrence of seizures. According to Charyton, around 80% of epilepsy cases are temporal lobe epilepsy, where seizures begin in the temporal lobe of the brain. The temporal lobe is home to the auditory cortex - the part of the brain that processes sound. With this in mind, the team set out to investigate how music impacts the brains of individuals with epilepsy. 

Music triggered greater synchronization in patients with epilepsy 

The researchers analyzed data from 21 individuals who were admitted to the epilepsy monitoring unit at the Wexner Medical Center between September 2012 and May 2014, alongside data from individuals without epilepsy. Subjects' brainwave patterns were measured via electroencephalogram (EEG) as they took part in a listening exercise. All participants were required to listen to silence for 10 minutes, before listening to one of three songs - Mozart's Sonata in D Major, Andante Movement II (K448) or John Coltrane's rendition of My Favorite Things - followed by another 10-minute silence. 

They then listened to the remaining two songs, before listening to another 10-minute silence. As expected, participants with and without epilepsy demonstrated heightened brainwave activity when they listened to music. However, those with epilepsy showed greater synchronization with the music in the frontal and temporal lobes than participants without the disorder. Charyton told Medical News Today the team was surprised by these findings. 

"We knew that musicians synchronize more with music but we were not sure how persons with epilepsy would respond," she said. "Persons with epilepsy synchronize before a seizure. However, in our study, patients with epilepsy synchronized to the music without having a seizure." Based on these findings, Charyton says that in combination with existing treatments, music could be a "novel intervention" to help prevent seizures in patients with epilepsy. 

She told us: "Persons with epilepsy may use the music to relax; stress causes seizures to occur. By listening to the music, many patients reported that they felt relaxed. This study is the first step to see if music could impact the brain." 

Charyton added that the team plans to conduct more research to determine the exact point at which music may stimulate synchronization to prevent seizures in epilepsy. Epilepsy is not the only condition for which music may have therapeutic potential. In 2013, Medical News Today reported on a study suggesting music was more effective that prescription drugs for reducing anxiety, and it may even boost the immune system.

 Music could also boost surgeons' performance in theater, according to a study published in the Aesthetic Surgery Journal earlier this month. Researchers found that when surgeons listened to their preferred music, they closed their incisions more effectively.


Elderberry benefits air travelers


Negative health effects of international air travel are well documented, but now it seems that the common elderberry can provide some relief. 

Associate Professor Evelin Tiralongo and Dr Shirley Wee from Griffith's Menzies Health Institute Queensland (MHIQ) have completed a clinical trial showing that an elderberry supplement can provide some protection from cold and flu-like symptoms following long-haul flights. 

Intercontinental air travel can be stressful and affect a passenger's physical and psychological wellbeing. Whilst jet lag and fatigue remain the best known problems, holidaymakers also often experience upper respiratory symptoms. 

Presenting their results at the 21st Annual International Integrative Medicine Conference in Melbourne, the research team showed how elderberry appears to reduce the duration and severity of the cold. The randomised, double-blind placebo controlled clinical trial was conducted with 312 economy class passengers travelling from Australia to an overseas destination. 

Cold episodes, cold duration and symptoms were recorded in a daily diary and participants also completed surveys before, during and after travel. 

"We found that most cold episodes occurred in the placebo group, but the difference between the placebo and active group was not significant. However, the placebo group had a significantly higher number of cold episode days, and the symptom score in the placebo group over these days was also significantly higher," says Associate Professor Tiralongo. 

"Complementary medicines are used by two in three Australians, thus increasing the evidence base of these medicines should be at the forefront of our efforts. It's often forgotten that the evidence for various herbal medicines is extract specific," says Associate Professor Tiralongo. 

The trial used capsules containing 300mg of a standardised, proprietary membrane-filtered elderberry extract which has shown to be effective in working against respiratory bacteria and influenza viruses. 

The Griffith study follows recent European research published in the open access journal Current Therapeutic Research which suggests that a combination of Echinacea herb and root extract supplemented with elderberry can be as effective as the conventional antiviral medicine Tamiflu for the early treatment of influenza.


Natural Molecule Could Treat Type 2 Diabetes



Researchers at the Université Laval Faculty of Medicine, the Quebec Heart and Lung Institute Research Center, and the Institute of Nutrition and Functional Foods have discovered a natural molecule that could be used to treat insulin resistance and type 2 diabetes. 

The molecule, a derivative of omega-3 fatty acids, mimics some of the effects of physical exercise on blood glucose regulation. The details of the discovery made by Professor André Marette and his team are published today in Nature Medicine. 

It has been known for some time that omega-3 fatty acids can help reduce insulin resistance caused by a diet high in saturated fat. In their earlier work, André Marette and his colleagues had linked these effects to a bioactive lipid called protectin D1. In investigating further, they discovered that another member of the same family named protectin DX (PDX) triggers the production and release of interleukin 6 (IL-6) in muscle cells, a response that also occurs during physical exercise. 

"Once in the bloodstream, IL-6 controls glucose levels in two ways: it signals to the liver to reduce glucose production and acts directly on the muscles to increase glucose uptake," explains the researcher who is also Scientific Director of Université Laval's Institute of Nutrition and Functional Foods. 

The researchers used transgenic mice lacking the IL-6 gene to demonstrate the link between PDX and IL-6. PDX had very little effect on the control of blood glucose in these animals. In similar tests conducted on obese diabetic rats, PDX was shown to dramatically improve responsiveness to insulin, the hormone which regulates blood glucose. 

"The mechanism of action described for PDX represents a new therapeutic strategy for improving glucose control," proposes the researcher. "Its efficacy may be comparable with that of certain drugs currently prescribed to control glycemia." Even though PDX appears to mimic the effect of physical exercise by triggering IL-6 secretion in the muscles, André Marette warns that it is not a substitute for physical activity. 

"Exercise has cardiovascular and other hormonal benefits that go well beyond its metabolic effects on the muscles," adds the researcher whose work is supported by the Canadian Institutes of Health Research (CIHR) and the Canadian Diabetes Association. Professor Marette and Université Laval have filed a patent application for PDX and its therapeutic applications. 

"For us, the next step is to demonstrate the antidiabetic effects in humans and determine the receptor through which PDX acts." In addition to André Marette, the study is authored by Phillip White, Philippe St-Pierre, Alexandre Charbonneau, Patricia Mitchell, Emmanuelle St-Amand, and Bruno Marcotte.


What Physical Activities Provide a Better Sleep?


Physical activities, such as walking, as well as aerobics/calisthenics, biking, gardening, golfing, running, weight-lifting, and yoga/Pilates are associated with better sleep habits, compared to no activity, according to a new study from researchers at the Perelman School of Medicine at the University of Pennsylvania

In contrast, the study shows that other types of physical activity - such as household and childcare - work are associated with increased cases of poor sleep habits. The full results of the study (Abstract #0246) will be presented during the poster session on June 8, at SLEEP 2015, the 29th annual meeting of the Associated Professional Sleep Societies LLC, June 6-10, in Seattle, WA. 

Physical activity is already well associated with healthy sleep, but the new study, led by Michael Grandner, PhD, instructor in Psychiatry and member of the Center for Sleep and Circadian Neurobiology at Penn, yields insight into whether specific types of physical activities may impact sleep quality. 

Using data on sleep and physical activities of 429,110 adults from the 2013 Behavioral Risk Factor Surveillance System, the Penn researchers measured whether each of 10 types of activities was associated with typical amount of sleep, relative to both no activity and to walking. Survey respondents were asked what type of physical activity they spent the most time doing in the past month, and also asked how much sleep they got in a typical 24-hour period. 

Since previous studies showed that people who get less than 7 hours are at greater risk for poor health and functioning, the study evaluated whether people who reported specific activities were more likely to also report sufficient sleep. Compared to those who reported that they did not get physical activity in the past month, all types of activity except for household/childcare were associated with a lower likelihood of insufficient sleep. 

To assess whether these effects are just a result of any activity, results were compared to those who reported walking as their main source of activity. Compared to just walking, aerobics/calisthenics, biking, gardening, golf, running, weight-lifting and yoga/Pilates were each associated with fewer cases of insufficient sleep, and household/childcare activity was associated with higher cases of insufficient sleep. These results were adjusted for age, sex, education level, and body mass index. 

"Although previous research has shown that lack of exercise is associated with poor sleep, the results of this study were surprising," said Grandner. "Not only does this study show that those who get exercise simply by walking are more likely to have better sleep habits, but these effects are even stronger for more purposeful activities, such as running and yoga, and even gardening and golf. It was also interesting that people who receive most of their activity from housework and childcare were more likely to experience insufficient sleep - we know that home and work demands are some of the main reasons people lose sleep." 

"These results are consistent with the growing scientific literature on the role of sleep in human performance," said Grandner. "Lab studies show that lack of sleep is associated with poor physical and mental performance, and this study shows us that this is consistent with real-world data as well. Since these results are correlational, more studies are needed to help us understand whether certain kinds of physical activity can actually improve or worsen sleep, and how sleep habits help or hurt a person's ability to engage in specific types of activity."


Roseroot Herb: Potential Depression Treatment


Rhodiola rosea (R. rosea), or roseroot, may be a beneficial treatment option for major depressive disorder (MDD), according to results of a study in the journal Phytomedicine led by Jun J. Mao, MD, MSCE, associate professor of Family Medicine, Community Health and Epidemiology and colleagues at the Perelman School of Medicine of University of Pennsylvania. 

The proof of concept trial study is the first randomized, double-blind, placebo-controlled, comparison trial of oral R. rosea extract versus the conventional antidepressant therapy sertraline for mild to moderate major depressive disorder. Depression is one of the most common and debilitating psychiatric conditions, afflicting more than 19 million Americans each year, 70 percent of whom do not fully respond to initial therapy. 

Costs of conventional antidepressants and their sometimes substantial side effects often result in a patient discontinuing use prematurely. Others opt to try natural products or supplements instead. All of the study’s 57 adult participants, enrolled from December 2010 and April 2013, had a DSM IV Axis 1 diagnosis of MDD, meaning they exhibited two or more major depressive episodes, depressed mood and/or loss of interest or pleasure in life activities for at least 2 weeks, as well as symptoms including significant unintentional weight loss or gain, insomnia or sleeping too much, fatigue, and diminished ability to think or concentrate, and recurrent thoughts of death. 

The participants received 12 weeks of standardized R. rosea extract, sertraline, or placebo. Changes over time in Hamilton Depression Rating (HAM-D), Beck Depression Inventory (BDI), and Clinical Global Impression (CGI) change scores were measured among groups. Patients who took sertraline were somewhat more likely – as measured by Ham-D scores – to report improvement in their symptoms by week 12 of treatment than those who took R. rosea, although these differences were not found to be statistically significant. 

Patients taking R. rosea had 1.4 times the odds of improvement, and patients on sertraline had 1.9 times the odds of improvement versus those on a placebo. However, patients on sertraline experienced twice the side effects – most commonly nausea and sexual dysfunction -- than those on R. rosea: 63 percent versus 30 percent, respectively, reported side effects. These findings suggest that R. rosea may possess a more favorable risk to benefit ratio for individuals with mild to moderate major depressive disorder. 

“These results are a bit preliminary but suggest that herbal therapy may have the potential to help patients with depression who cannot tolerate conventional antidepressants due to side effects,” Mao said. “Larger studies will be needed to fully evaluate the benefit and harm of R. rosea as compared to conventional antidepressants.”


Vitamin E deficiency could damage brain



Scientists have discovered how a lack of vitamin E could cause damage to the brain - by disrupting the supply of nutrients to the brain that are crucial to neuronal health.

The study, conducted by researchers at Oregon State University and published in the Journal of Lipid Research, involved examining zebrafish fed a diet deficient in vitamin E throughout their lives. Zebrafish deficient in vitamin E were found to have around 30% lower levels of DHA-PC, a component of the cellular membrane of brain cells (neurons). 

Previous research suggests that low levels of DHA-PC in humans are associated with a higher risk of developing Alzheimer's disease. You can't build a house without the necessary materials," says lead author Dr. Maret Traber. "In a sense, if vitamin E is inadequate, we're cutting by more than half the amount of materials with which we can build and maintain the brain." 

In the US, an estimated 96% of adult women and 90% of adult men do not receive enough vitamin E in their diet. According to the study's authors, the zebrafish had levels of vitamin E deficiency equivalent to humans eating a vitamin E deficient diet for a lifetime. 

Vitamin E needed to prevent loss of 'critically important molecule in the brain' 

DHA is a polyunsaturated fatty acid (PUFA) and is identified by experts as one of the most important nutrients obtained from omega-3 fatty acids. These acids are commonly found in foods such as fish oils, flax, walnuts, eggs and leafy dark green vegetables like spinach. 

"Human brains are very enriched in DHA but they can't make it, they get it from the liver," explains Dr. Traber. 

"The particular molecules that help carry it there are these lyso PLs, and the amount of those compounds is being greatly reduced when vitamin E intake is insufficient. This sets the stage for cellular membrane damage and neuronal death." 

Dr. Traber states that other research has demonstrated that the rate of Alzheimer's disease progression can be reduced with increased vitamin E intake. However, she suggests that the neurological disorder may just indicate long-term neuronal damage that has already occurred. 

According to the NIH, most vitamin E is obtained from the oils of soybean, canola, corn and other vegetables. The best sources of the vitamin are nuts and seeds such as sunflower seeds, almonds and hazelnuts. Green leafy vegetables such as spinach and broccoli also contain significant amounts of vitamin E.


Eat rice cold for fewer calories


Scientists say they have found a way to make rice less calorific - boil it with coconut oil and then refrigerate for half a day before eating. 

According to the Sri Lankan researchers, treating rice in this way reduces its calories by up to 60%. They told the American Chemical Society how the method made the starch in the rice less digestible so the body took on less fuel than it otherwise would. UK nutrition experts cautioned there was no quick fix to losing weight. 

Cold carbs
Starchy foods such as rice, which are known as carbohydrates, are a good source of energy. When we eat them, our body breaks them down into simple sugars. Any that is leftover will be stored by the body and quickly converted to glucose as needed. But too much glucose circulating in the blood can ultimately end up being stored as fat. Scientists have been experimenting to see if they can alter foods to trick the body into absorbing less fuel to keep blood sugar, and calories consumed, lower. 

UK researchers have already shown that cooking and then cooling pasta will create a smaller glucose peak - even if you then reheat the cold pasta. And investigators from Sri Lanka say the same is true for rice. They tested 38 varieties of rice to find the best way to boost something called "resistant starch". 

Resistant starch
This type of starch is more resilient to the enzymes the body uses to break down carbohydrates in the gut, meaning less of it is absorbed. And, according to the researchers the best way to make it is to simmer the rice for 40 minutes with a teaspoon of coconut oil, then let it cool and keep it refrigerated for 12 hours. Researcher Sudhair James said: "The cooling is essential because amylose, the soluble part of the starch, leaves the granules during gelatinisation. 

"Cooling for 12 hours will lead to formation of hydrogen bonds between the amylose molecules outside the rice grains which also turns it into a resistant starch." He said reheating the cooled rice was fine too - it would not affect the resistant starch level. The team is now checking out which varieties of rice might be best for the job and whether other cooking oils will also work. 

Sarah Coe, an expert at the British Nutrition Foundation, said resistant starch could have a number of health benefits, as it appears to improve digestion and gut health and can help regulate blood sugar levels. But she said more studies were needed to examine any potential health effects of consuming this type of rice. Reheating cooked rice can be risky because some food poisoning bugs can survive cooking. 

If cooked rice is left standing at room temperature, the bacteria can multiply, which is why rice should be served either hot or cooled and then stored in a fridge. Ms Coe pointed out that although rice and starchy food are an important part of a healthy, balanced diet, rice consumption in the UK is generally low. 

"Therefore, lowering the calorie content by the proposed cooking method will not make a significant difference to obesity levels in the UK." British Dietetic Association spokesperson, Priya Tew, said: "This sounds like it has great potential, however there are no human studies on it yet. It is fantastic that research is being done into different cooking methods. "I would recommend people stick to cooking rice using their normal method until there is more information available." 

Dr Denise Robertson, a nutrition expert at the University of Surrey, said: "Seeing the results of the volunteer tests on blood glucose that are currently underway will be vital in understanding the true potential of this research and whether this can be extrapolated to carbohydrates in the Western Diet."




Energy Drinks Raise Resting Blood Pressure


Healthy young adults who don't consume caffeine regularly experienced greater rise in resting blood pressure after consumption of a commercially available energy drink - compared to a placebo drink - thus raising the concern that energy drinks may increase the risk of cardiac events, Mayo Clinic researchers found.

Results of the study will be presented March 14 at the American College of Cardiology's 64th Annual Scientific Session in San Diego.

In this study, researchers alternately gave a can of a commercially available energy drink or a placebo drink to 25 healthy young adults, age 19 to 40, and assessed changes in heart rate and blood pressure.

Blood pressure and heart rate were recorded before and 30 minutes after energy drink/placebo drink consumption, and were also compared between caffeine-naïve participants (those consuming less than 160 mg of caffeine per day, the amount frequently found in a cup of coffee) and regular caffeine users (those consuming more than 160 mg of caffeine per day).

Participants experienced a marked rise in blood pressure after consuming the energy drink as compared to the placebo. The effect was most dramatic in people who did not typically consume much caffeine, researchers found. Overall, the blood pressure increase was more than doubled in caffeine naïve adults after consuming the energy drink vs. placebo, they found.

"We know that energy drink consumption is widespread and rising among young people. Concerns about the health safety of energy drinks have been raised. We and others have previously shown that energy drinks increase blood pressure," says lead author Anna Svatikova, M.D., Ph.D., cardiovascular diseases fellow at the Mayo Clinic.

"Now we are seeing that for those not used to caffeine, the concern may be even greater. Consumers should use caution when using energy drinks because they may increase the risk of cardiovascular problems, even among young people."


Psychology and Acupuncture for Pain


People with back pain who have low expectations of acupuncture before they start a course of treatment will gain less benefit than those people who believe it will work, according to new research from the University of Southampton

Conversely, those people who have a positive view of back pain and who feel in control of their condition experience less back-related disability over the course of acupuncture treatment. 

The University of Southampton's Dr Felicity Bishop, an Arthritis Research UK career development fellow, carried out the research to find out why some people with back pain gain more benefit from acupuncture than others. The findings of the study, which has been funded by Arthritis Research UK, are published in The Journal of Clinical Pain. 

"The analysis showed that psychological factors were consistently associated with back-related disability," explained Dr Bishop. "People who started out with very low expectations of acupuncture -- who thought it probably would not help them -- were more likely to report less benefit as treatment went on. 

"When individual patients came to see their back pain more positively they went on to experience less back-related disability. In particular, they experienced less disability over the course of treatment when they came to see their back pain as more controllable, when they felt they had better understanding of their back pain, when they felt better able to cope with it, were less emotional about it, and when they felt their back pain was going to have less of an impact on their lives." 

Acupuncture is one of the most established forms of complementary therapy. Recommended in clinical guidelines, there is evidence from clinical trials to show that it can help to reduce pain. Previous research has established that factors -- other than the insertion of needles - play a part in the effectiveness of acupuncture, such as the relationship that the patient develops with the acupuncturist and the patient's belief about acupuncture. 

Dr Bishop recruited 485 people who were being treated by acupuncturists onto the study, and they completed questionnaires before they started treatment, then two weeks, three months and six months later. The questionnaires measured psychological factors, clinical and demographic characteristics and back-related disability. 

Dr Bishop added that to improve the effectiveness of treatment, acupuncturists should consider helping patients to think more positively about their back pain as part of their consultations. Future studies are needed to test whether this could significantly improve patients' treatment outcomes. 

Dr Stephen Simpson, director of research at Arthritis Research UK, said: "This study emphasises the influence of the placebo effect on pain. The process whereby the brain's processing of different emotions in relation to their treatment can influence outcome is a really important area for research. 

"Factors such as the relationship between practitioner and the patient can inform this and we should be able to understand the biological pathways by which this happens. This understanding could lead in the future to better targeting of acupuncture and related therapies in order to maximise patient benefit."


Drinking Green Tea Before Taking Supplements


As high doses of green tea extract supplements for weight loss become more popular, potential liver toxicity becomes a concern. In the last decade, dozens of people have been diagnosed with the condition. However, drinking green tea in the weeks before taking supplements likely reduces risk, according to researchers in Penn State's College of Agricultural Sciences. 

Researchers gave mice high doses of the green tea polyphenol epigallocatechin-3-gallate (EGCG). The dosage was equivalent to the amount of the polyphenol found in some dietary supplements taken by humans. One group of mice was pretreated with a diet containing a low level of ECGC for two weeks prior to receiving high doses of the polyphenol. 

Another group was fed a diet that did not include EGCG prior to receiving the high, supplement-like doses. After three days of high doses, the scientists tested the blood of the mice to determine how their livers handled the EGCG. Pretreated mice had a 75 percent reduction in liver toxicity compared to untreated mice. 

The research data show that dietary pretreatment with the green tea polyphenol protects mice from liver toxicity caused by subsequent high oral doses of the same compound, explained Josh Lambert, associate professor of food science. He suggested that the research has relevance to people who are taking or are considering taking supplements containing green tea extract. 

"We believe this study indicates that those who are chronic green tea consumers would be less sensitive to potential liver toxicity from green-tea-based dietary supplements," he said. "If you are going to take green tea supplements, drinking green tea for several weeks or months ahead of time may reduce your potential side effects." 

Lambert has another suggestion for people considering green tea supplements -- drink green tea instead. "Drinking green tea rather than taking supplements will allow you to realize the benefits and avoid the risk of liver toxicity," he said. "The beneficial effects that people have reported as being associated with green tea are the result of dietary consumption rather than the use of supplements. The relative risk of using supplements remains unclear." 

Tea - Camellia sinensis - is rich in catechins, polyphenols that are natural antioxidants. A number of animal studies have shown the preventive effects of green tea polyphenols against obesity. And Lambert pointed out that a recent analysis of 11 human trials with green tea preparations reported a nearly three-pound average body weight loss in intervention groups compared to control groups. 

Green tea's effect on weight loss may be more noticeable if a person exercises. In research published last year, Lambert showed that mice on a high-fat diet that consumed decaffeinated green tea extract and exercised regularly experienced sharp reductions in final body weight and significant improvements in health. 

Approximately 34 percent of adults in the United States are classified as obese, Lambert noted, leading to a strong interest in the potential benefits of including green tea and green tea supplements in weight-loss efforts. The liver toxicity research, recently published online in Food and Chemical Toxicology, revealed a unique property of the green tea polyphenol EGCG. 

"It appears that EGCG can modulate its own bioavailability and that dietary treatment may reduce the toxic potential of acute high oral doses of EGCG," said lead researcher Sarah Forester, assistant professor of chemistry, California State University, Bakersfield, a former Penn State postdoctoral fellow. "These data may partly explain the observed variation in liver toxicity response to dietary supplements containing green tea." 

Some people drink surprisingly large volumes of green tea, according to Lambert, as much as 10-20 cups a day, but liver toxicity has never been reported in that context. "No person can sit down and drink 16 cups of green tea all at once," he said. "However if you take a supplement you can get that type of green tea extract dose, so there is some indication that the dosage form has an influence on the potential to cause liver toxicity."


Drugs in dirt: Scientists appeal for help


US scientists are asking the public to join them in their quest to mine the Earth's soil for compounds that could be turned into vital new drugs. 

Spurred on by the recent discovery of a potential new antibiotic in soil, the Rockefeller University team want to check dirt from every country in the world. They have already begun analysing samples from beaches, forests and deserts across five continents. But they need help getting samples. Which is where we all come in. 

Citizen science On their Drugs From Dirt website, they say: "The world is a big place and we can't get get to all of the various corners of it. "We would like some assistance in sampling soil from around the world. If this sounds interesting to you - sign up." 

They want to hear from people from all countries and are particularly keen to receive samples from unique, unexplored environments such as caves, islands, and hot springs. Such places, they say, could house the holy grail - compounds produced by soil bacteria that are entirely new to science. 

Researcher Dr Sean Brady told the BBC: "We are not after hundreds of thousands of samples. What we really want is a couple of thousand from some really unique places that could contain some really interesting stuff. So it's not really your garden soil we are after, although that will have plenty of bacteria in it too." 

He said they would also be interested to hear from schools and colleges that might want to get involved in the project. From the 185 samples they have tested so far there are some promising results, the researchers say in the journal eLife. Biosynthetic dark matter Dr Brady and colleagues have found compounds that might yield better derivatives of existing drugs. 

In a hot spring sample from New Mexico, they found compounds similar to those that produce epoxamicin - a natural molecule used as the starting point for a number of cancer drugs. In samples from Brazil, they found genes that might offer up new versions of another important cancer drug called bleomycin. And in soils from the American southwest, they hope to find compounds similar to the drug rifamycin that could help with treatment-resistant tuberculosis. 

Many of the drugs we use today came out of dirt - the antibiotics penicillin and vancomycin to name just two. Uncultured bacteria from the environment could provide a dazzling array of new molecules, many of which could become new medicines, say the research team. There are more microbes in a teaspoon of soil than there are humans on earth, and only a tiny fraction have been cultured, they say. 

Dr Brady, head of the Laboratory of Genetically Encoded Small Molecules, said: "We hope that efforts to map nature's microbial and chemical diversity will result in the discovery of both completely new medicines and better versions of existing medicines." 

The scientists are beginning to identify hotspots around the globe where diverse soil bacteria can be found. "The unbelievable diversity we found is a first step towards our dream of building a world map of chemicals produced by microbes - similar to Google Earth's and others' maps of the world's geography," says Dr Brady. 

Other scientists have been mining the sea bed for undiscovered drug candidate molecules. Prof Marcel Jaspars from Aberdeen University has analysed over 1,500 bacterial strains from the bottom of the ocean, some millions of years old, and says 15 strains look promising.




Learning disability GP health checks show results


A scheme getting GPs to offer health checks to patients with learning disabilities in England is helping to pick up problems, research suggests.

A study in Lancet Psychiatry, looking at data for more than 8,000 patients, found surgeries in the scheme were twice as likely to identify problems. But many patients who are entitled to the checks are still missing out. The Down's Syndrome Association said there was a lack of awareness that the health checks were available. Learning disability health checks were introduced in 2008 through GPs surgeries as a way of monitoring the health of this vulnerable group of people.

Continue reading the main story “ Start Quote We found that surgeries who did health checks did much better - they offered blood tests, reviewed the patients' medication, and drew up health action plans for the next year” End Quote Andre Strydom University College London NHS England decided to pay GPs as part of an incentive scheme for carrying out the health checks. People with learning or intellectual disabilities, such as Down's syndrome, are known to have significantly poorer health than other people. This is because they find it more difficult to talk about symptoms and are less likely to make appointments to talk about their health problems.

'Barriers' Lead researcher Andre Strydom, reader in intellectual disabilities at University College London, said there was good evidence that health checks for people with learning disabilities could help identify previously unrecognised health problems. His study, comparing the results of health checks performed by GP surgeries who signed up to the scheme and those surgeries who did not, found that health concerns were picked up twice as often when surgeries got involved.

"We found that surgeries who did health checks did much better - they offered blood tests, reviewed the patients' medication, and drew up health action plans for the next year." But even with six out of 10 surgeries signed up to the scheme in England, 40% of patients with learning disabilities did not receive a health check. Dr Strydom said this may be owing to the fact that a large number of people with these disabilities were not on the list to receive a health check.

Either they were not known to local social services or their GP, or they were known but had been given the wrong patient code which meant they missed out when the list was collated, he said. Stuart Mills, information officer at the Down's Syndrome Association, said there could be many reasons why this group of people were not being offered the health checks. "It's a relatively complicated picture. It's down to a lack of awareness, not being on the disability register, and the fact there are more barriers for people with Down's syndrome."

He said the Association wanted to increase awareness that people with Down's syndrome were entitled to a health check. The charity has also produced information booklets for GPs about potential health problems, which can include hearing and sight problems, thyroid conditions and muscular-skeletal problems. Depression is also a common health issue. Although there was evidence some people were being given good health checks, others reported that their health checks were poor and lasted only 15 minutes, however.


BBC News


Yoga has potential to reduce risk factors of CVD


There is "promising evidence" that the popular mind-body practice of yoga is beneficial in managing and improving the risk factors associated with cardiovascular disease and is a "potentially effective therapy" for cardiovascular health. 

Indeed, following a systematic review of 37 randomised controlled trials (which included 2768 subjects), investigators from the Netherlands and USA have found that yoga may provide the same benefits in risk factor reduction as such traditional physical activities as biking or brisk walking. 

"This finding is significant," they note, "as individuals who cannot or prefer not to perform traditional aerobic exercise might still achieve similar benefits in [cardiovascular] risk reduction." Their study is published today in the European Journal of Preventive Cardiology. 

Yoga, an ancient mind-body practice which originated in India and incorporates physical, mental, and spiritual elements, has been shown in several studies to be effective in improving cardiovascular risk factors, with reduction in the risk of heart attacks and strokes. This meta-analysis was performed, say the investigators, to appraise the evidence and provide a realistic pooled estimate of yoga's effectiveness when measured against exercise and no exercise. 

Results showed first that risk factors for cardiovascular disease improved more in those doing yoga than in those doing no exercise, and second, that yoga had an effect on these risks comparable to exercise. When compared to no exercise, yoga was associated with significant improvement in each of the primary outcome risk factors measured: body mass index was reduced by 0.77 kg/m2 (measured as a "mean difference"), systolic blood pressure reduced by.21 mm Hg, low-density (bad) lipoprotein cholesterol reduced by 12.14 mg/dl, and high-density (good) lipoprotein cholesterol increased by 3.20 mg/dl. 

There were also significant changes seen in secondary endpoints -- body weight fell by 2.32 kg, diastolic blood pressure by 4.9 mm Hg, total cholesterol by 18.48 mg/dl, and heart rate by.27 beats/min. However, no improvements were found in parameters of diabetes (fasting blood glucose and glycosylated hemoglobin). 

Risk factor improvements (in BMI, blood pressure, lipid levels) were significant when yoga was used in addition to medication. Among patients with existing coronary heart disease, yoga provided a statistically significant benefit in lowering LDL cholesterol when added to medication (statins and lipid-lowering drugs). In comparisons with exercise itself, yoga was found to have comparable effects on risk factors as aerobic exercise. 

The investigators note that this might be because of yoga's impact on stress reduction, "leading to positive impacts on neuroendocrine status, metabolic and cardio-vagal function." The similarity of yoga and exercise's effect on cardiovascular risk factors, say the investigators, "suggest that there could be comparable working mechanisms, with some possible physiological aerobic benefits occurring with yoga practice, and some stress-reducing, relaxation effect occurring with aerobic exercise." 

Commenting on the results, senior author Professor Myriam Hunink from Erasmus University Medical Center, Rotterdam, and Harvard School of Public Health, Boston, said that, although the evidence of yoga's beneficial effect in cardiovascular health is growing, a physiological explanation for this effect remains unclear. 

"Also unclear," she added, "are the dose-response relationship and the relative costs and benefits of yoga when compared to exercise or medication. However, these results indicate that yoga is potentially very useful and in my view worth pursuing as a risk improvement practice." 

Moreover, in view of yoga's ease of uptake, the investigators also note that evidence supports yoga's acceptability to "patients with lower physical tolerance like those with pre-existing cardiac conditions, the elderly, or those with musculoskeletal or joint pain." 

Thus, they conclude that "yoga has the potential to be a cost-effective treatment and prevention strategy given its low cost, lack of expensive equipment or technology, potential greater adherence and health-related quality of life improvements, and possible accessibility to larger segments of the population."


Pain and itch neurons grown in a dish



Nerve cells that transmit pain, itch and other sensations to the brain have been made in the lab for the first time

Researchers say that the cells will be useful for developing new painkillers and anti-itch remedies, as well as understanding why some people experience unexplained extreme pain and itching. 

“The short take-home message would be ‘pain and itch in a dish’, and we think that’s very important,” says Kristin Baldwin, a stem-cell scientist at the Scripps Research Institute in La Jolla, California, whose team converted mouse and human cells called fibroblasts into neurons that detect sensations such as pain, itch or temperature1. In a second paper2, a separate team took a similar approach to making pain-sensing cells. Both efforts were published on 24 November in Nature Neuroscience. 

Peripheral sensory neurons, as these cells are called, produce specialized ‘receptor’ proteins that detect chemical and physical stimuli and convey them to the brain. The receptor that a cell makes determines its properties - some pain-sensing cells respond to chilli oil, for example, and others respond to different pain-causing chemicals. 

Mutations in the genes encoding these receptors can cause some people to experience chronic pain or, in rare cases, to become impervious to pain. o create these cells in the lab, independent teams led by Baldwin and by Clifford Woolf, a neuroscientist at Boston Children’s Hospital in Massachusetts, identified combinations of proteins that - when expressed in fibroblasts - transformed them into sensory neurons after several days. 

Baldwin's team identified neurons that make receptors that detect sensations including pain, itch, and temperature, whereas Woolf’s team looked only at pain-detecting cells. Both teams generated cells that resembled neurons in shape and fired in response to capsaicin, which gives chilli peppers their kick, and mustard oil. 

Both teams say that pain cells ‘in a dish’ could speed the search for new painkillers, as they could be used in screening drugs for their ability to block or alter the activity of these cells. “The number of people who take analgesics is very large, and there’s a pretty big medical need among people who have untreatable pain during chemotherapy,” says Baldwin. 

The anti-malarial drug chloroquine causes some people to itch - especially people of African ancestry — and studying itch cells made from their fibroblasts could help to explain why, she adds. It will be important to make sure that the cells respond to stimuli similarly to bona fide sensory cells, says John Wood, a neuroscientist at University College London, and to determine how they communicate with immune cells and the rest of the nervous system, which both have roles in pain. 

“This is important work,” he says. “Nociceptive [pain-sensing] neurons play a key role in almost all acute and chronic pain conditions, and a better understanding of their biology should produce new analgesic drug targets.”


Serotonin may not be a major factor in depression



New evidence has put into doubt the long-standing belief that a deficiency in serotonin - a chemical messenger in the brain - plays a central role in depression. 

In the journal ACS Chemical Neuroscience, scientists have reported that mice lacking the ability to make serotonin in their brains (and thus will have been "depressed" by conventional wisdom) did not show depression-like symptoms. 

Donald Kuhn and colleagues at the John D. Dingell VA Medical Center and Wayne State University School of Medicine noted that depression poses a major public health problem. The World Health Organization estimates that more than 350 million people suffer from it and it is said to be the leading cause of disability across the globe. 

In the late 1980s, the now well-known antidepressant Prozac was introduced. The drug works mainly by increasing the amounts of one substance in the brain - serotonin. So scientists came to believe that boosting levels of the signaling molecule was the key to solving depression. Based on this idea, many other drugs to treat the condition entered the picture. But now researchers know that 60 to 70 percent of these patients continue to feel depressed, even while taking the drugs. 

Kuhn's team set out to study what role, if any, serotonin played in the condition. To do this, they developed "knockout" mice that lacked the ability to produce serotonin in their brains. The scientists ran a battery of behavioral tests. Interestingly, the mice were compulsive and extremely aggressive, but didn't show signs of depression-like symptoms. 

Another surprising finding is that when put under stress, the knockout mice behaved in the same way most of the normal mice did. In addition, a subset of the knockout mice responded therapeutically to antidepressant medications in a similar manner to the normal mice. The researchers stated that these findings may be evidence that serotonin is not a major player in the condition, and that different factors must be involved. 

They concluded by suggesting that these results could dramatically alter how the search for new antidepressants moves forward in the future.


Specific brain neurons responsible for nicotine addiction


Until now, it has been thought that drug addiction results from two separate systems in the brain: the reward system, activated when a person uses a drug, and the stress system, activated during withdrawal. But a new study suggests there are specific neurons in the brain's reward system that are active during both use of and withdrawal from nicotine. 

The researchers, led by Olivier George, assistant professor at The Scripps Research Institute (TSRI) in San Diego, CA, say they think these same neurons may be active in response to other addictive substances. Their study is published in the journal Nature Neuroscience. 

"If we can find a way to target those neurons in humans," explains George, "maybe we can reduce the 'high' produced by the drug and reduce the withdrawal symptoms." He says he hopes their study will aid drug development or the creation of genetic therapies to target the neurons. 

The researchers explain that previously, the ventral tegmental area (VTA) - an area of the brain where the neurons are found - was only associated with the reward system and not with withdrawal stress. It was known that these VTA neurons produce dopamine, which is a neurotransmitter linked to pleasure. However, 5 years ago, when George was collaborating with a staff scientist at the University of Toronto, they detected a stress peptide in the VTA. 

The stress peptide in question is called corticotropin-releasing factor (CRF), which is associated with anxiety and depression. After running the test two more times, the team came up with the same result. 

CRF-producing neurons in the VTA activated during withdrawal 
After these surprising results, George and colleagues from the Salk Institute in La Jolla, CA, looked more closely at the VTA, using radioactive RNA markers to observe CRF in rodent brain samples. After not finding anything out of the ordinary, one day, the team saw tiny black dots on the X-ray film; these were the CRF-producing neurons found in the VTA. 

"If you look in a textbook," says George, "these neurons don't exist in the VTA. That was the most exciting day of my career." Next, the team looked at the role these neurons play in nicotine addiction by studying brain samples of mice and rats that had been made to develop nicotine dependence equivalent to a human who smokes two packs of cigarettes a day. 

Results revealed that the CRF-producing neurons in the VTA were activated during withdrawal, and upon examining brain samples from humans, the team found that these same VTA neurons are present. 

Previous studies have shown that rodents and humans who have relapsed from quitting smoking often consume more nicotine than they did when first exposed to it. As such, the researchers tested whether CRF production in the VTA was linked to this behavior by targeting a gene in the neurons to decrease CRF production during withdrawal.


UN 'lacks resources' to fight deadly virus


The head of the UN mission charged with fighting Ebola in West Africa has told the BBC he does not yet have the resources necessary to defeat it. 

Tony Banbury said more help was urgently needed, despite significant contributions from the UK, China, Cuba and the US. But he was hopeful of achieving the target of 70% bed space for new cases and 70% safe burials by December. The confirmed death toll is now 4,818, says the World Health Organization. The numbers are down since the WHO previously reported figures last Friday, as it says it has changed the way the figures are collated. 

But it said in the countries worst affected by the outbreak - Liberia, Sierra Leone and Guinea - transmission remained "persistent and widespread, particularly in the capital cities". In other developments: West African heads of state are meeting in Ghana for a special meeting to review the regional response to the crisis. 

The International Finance Corporation, part of the World Bank, has announced an initiative to provide at least $450m (£281m) in commercial financing to enable trade, investment, and employment in Guinea, Liberia and Sierra Leone Mr Banbury was speaking at the UN headquarters for Ebola response in Ghana, which has not been affected by the epidemic, at the end of a regional tour. 

He told the BBC it was difficult to say if the spread of the disease was slowing as it was a "very mixed picture". In Liberia's capital, Monrovia, there was a decline but there was "significant acceleration" elsewhere. The WHO says that of the planned 4,707 beds in Ebola treatment centres, only 22% are operational - blaming delays on insufficient numbers of foreign medical teams. 

"The bed space issue is huge," Mr Banbury admitted, but he said he hoped that by reducing the numbers of people becoming infected, the UN would eventually be able to reach its targets. He said his organisation did not yet have the capacity to defeat the disease. "It's not here yet. There are still people, villages, towns [and] areas that [are] not getting any type of help right now and we definitely don't have the response capability on the ground now from the international community," he said. 

At the same time, he mentioned contributions from the UK, which opened a new Ebola centre in Sierra Leone on Wednesday, and added that the US, China and Cuba had all sent significant numbers of soldiers or medics. Ghana's Health Minister Kwaku Agyemang-Mensah has welcomed the recent progress made in the fight against Ebola but also warned that West African health systems will still need help in the longer term. 

"We... must also look forward to the reconstruction of our countries in revamping the health infrastructure and the health system," he said ahead of the meeting of the West African regional body, Ecowas, in Ghana. Liberia and Sierra Leone have been worst affected, partly because their health systems were destroyed in civil wars. In Liberia, a 25-bed Ebola centre set up by the US army to treat healthcare workers was officially opened in Monrovia on Wednesday by President Ellen Johnson Sirleaf. 

According to the WHO, 546 healthcare workers have been infected with Ebola since the outbreak began, of whom 310 have died. The Liberian president said these frontline staff would now have a "refuge". "You all know that those have suffered - we say 'most' - because they were trained to preserve life and they gave life," she said. 

"The doctors and the nurses and... key healthcare workers who actually went out there not knowing what they were dealing with but demonstrating their professionalism and their service and they paid the ultimate price."




Mushroom extract, AHCC, helpful in treating HPV



Japanese mushroom extract appears to be effective for the eradication of human papillomavirus (HPV), according to a pilot clinical trial at The University of Texas Health Science Center at Houston (UTHealth) Medical School. 

The results were presented at the 11th International Conference of the Society for Integrative Oncology in Houston today by principal investigator Judith A. Smith, Pharm.D., associate professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the UTHealth Medical School. 

Ten HPV-positive women were treated orally with the extract, AHCC (active hexose correlated compound) once daily for up to six months. Five achieved a negative HPV test result -- three with confirmed eradication after stopping AHCC - with the remaining two responders continuing on the study. Currently, there is no effective medicine or supplement to treat HPV, which is associated with more than 99 percent of cervical cancer cases. 

According to the Centers for Disease Control and Prevention, several other cancers are related to HPV, including 95 percent of anal cancer, 60 percent of oropharyngeal, 65 percent of vaginal cancer, 50 percent of vulvar cancer and 35 percent of penile cancer. AHCC is a readily available nutritional supplement that works to improve the innate immune system. 

Human and preclinical studies have shown that AHCC increases the number and/or activity of Natural Killer (NK) cells, dendritic cells and cytokines, which help the body fight off infections and block tumor growth. 

"The results are very encouraging," Smith said. "We were able to determine that at least three months of treatment is necessary but some need to extend that to six months. Since AHCC is a nutritional supplement with no side effects and other immune modulating benefits, we will be planning on using six months of treatment in our phase II clinical study to have consistent study treatment plan. This confirms our earlier preclinical research." 

Smith is director of UTHealth's Women's Health Integrative Medicine Research Team, which focuses on the safe and effective use of nutritional and herbal supplements with pharmacologic modalities as it relates to women's health and cancer. This research is proceeding to a randomized, double-blind, placebo-controlled Phase II clinical trial which has just begun at UTHealth, Smith said.


Acupuncture does not improve chronic knee pain



Acupuncture did not provide any benefit in patients older than 50 years with moderate or severe chronic knee pain, according to a new research study published today in the Journal of the American Medical Association

Researchers from the University of Melbourne randomly assigned 282 patients with chronic knee pain to needle acupuncture, laser acupuncture, no acupuncture or sham (inactive) laser treatment administered by General Practitioners. Treatments were delivered for 12 weeks with participants and acupuncturists blinded to whether laser or sham laser acupuncture was administered. 

Researcher Professor Kim Bennell from the Centre for Health, Exercise and Sports Medicine (CHESM) said there were no significant differences in measures of knee pain and physical function-between active and sham acupuncture at 12 weeks or at one year. 

"Both needle and laser acupuncture resulted in modest improvements in pain compared with the control group who had no treatment at 12 weeks. However, these results were not maintained at one year," said Professor Bennell.

"Needle acupuncture improved physical function at 12 weeks compared with the control but was not different from sham acupuncture and was not maintained at one year," she said. Other secondary outcomes such as quality of life or general change, showed no difference in feeling. Needle acupuncture improved pain on walking at 12 weeks but this improvement did not last one year. 

Chronic knee pain affects many people older than 50 years and is the most common pain concern among older people consulting General Practitioners. Drug free approaches such as physical activity and exercise are important in managing chronic knee pain with many patients also using complementary and alternative medicine. 

Acupuncture is the most popular of alternative medical systems. Although traditionally administered with needles, laser acupuncture (low-intensity laser therapy to acupuncture points) is a non-invasive alternative with evidence of benefit in some pain conditions.


Risks of yoga found for bipolar disorder


Right now no one can say whether yoga provides clinical benefits to people with bipolar disorder, but in a new article in the Journal of Psychiatric Practice, researchers report survey responses they gathered from scores of people with the condition who practice yoga. What the collective testimony suggests is that yoga can be a substantial help, but it sometimes carries risks, too

"There is no scientific literature on hatha yoga for bipolar disorder," said lead author Lisa Uebelacker, associate professor (research) of psychiatry and human behavior in the Alpert Medical School of Brown University and a staff psychologist at Butler Hospital. Hatha yoga is the practice, familiar in the West, in which people move between various poses. It often includes breathing practices and meditation. 

"There is reason to think that there are ways in which it might be wonderful and ways in which it might not be safe. We are interested in studying hatha yoga for bipolar as an adjunctive treatment to pharmacotherapy." The preponderance of responses from more than 70 people who answered the study's online survey were that yoga has benefits for people with bipolar disorder. 

When asked, "What impact do you think yoga has on your life?" the vast majority of responses were positive and about one in five respondents characterized yoga as "life changing." One even said, "Yoga has saved my life. ... I might not be alive today were it not for yoga." Twenty-nine other respondents said yoga decreased anxiety and promoted calm or provided other emotional benefits. Calm also emerged as a specific benefit for 23 survey respondents when asked how yoga affects mania symptoms. Other benefits that were mentioned repeatedly included distraction from depressive thoughts and increased clarity of thought. 

"There is clearly evidence that yoga seems to be a powerful practice for some individuals with BD," the researchers wrote in the paper. "It was striking that some of our respondents clearly believed that yoga had a major positive impact on their lives." Throughout the survey there was also evidence that yoga could be problematic for some people with BD, although fewer people cited problems. In response to survey questions about whether yoga has had a negative impact, for example, five respondents cited cases in which rapid or energetic breathing made them feel agitated. 

Another became too relaxed after a slow, meditative practice: "I fell into a relaxed state ... near catatonic as my mind was depressed already. I was in bed for three days afterward." And like some people in general who practice yoga, 11 respondents warned that there is the potential for physical injury or pain. Another four said they became self-critical or frustrated with their performance sometimes during yoga. "It's possible that you want to avoid any extreme practice, such as extended periods of rapid breathing," Uebelacker said. 

The survey also raised some concerns about heated yoga, which is consistent with evidence that the use of certain medications for bipolar disorder, including lithium and antipsychotic medications, are associated with possible heat intolerance and resulting symptoms of physical illness. Next: a pilot clinical trial The online survey is the first stage in a research program that Uebelacker, who has spent several years studying yoga for unipolar depression, and colleague Lauren Weinstock, an expert in bipolar disorder, are developing to examine yoga for bipolar disorder. 

They now have a grant from the Depressive and Bipolar Disorder Alternative Treatment Foundation to run a pilot clinical trial in which they will compare outcomes from yoga to outcomes from using a well-regarded workbook for bipolar disorder. Those results could set the stage for a larger trial with enough statistical power to rigorously identify benefits and risks, Uebelacker said. For many bipolar patients, symptoms persist for decades despite multiple medications. 

The current studies of yoga, Uebelacker said, are part of a broader program at Butler and Brown to determine what else can help people who are already undergoing conventional therapies. "We're looking at alternative ways to cope with suffering that is part of people's everyday lives so that there are other options in addition to ongoing medication and psychotherapy" Uebelacker said. As their research continues, they will learn what role hatha yoga might play.


Yoga relieves multiple sclerosis symptoms


Paula Meltzer was only 38 when out of nowhere everything she looked at was blurry. For the single mother, who had a lucrative career as a gemologist and spent hours examining valuable pieces of jewelry, it seemed as if - in a split second - her life changed. At first doctors thought Meltzer had a brain tumor. 

What they determined after further tests, however, was that she had multiple sclerosis, an autoimmune disease that affects the brain and central nervous system and was causing optic neuritis, an inflammation of the optic nerve that can cause a partial or complete loss of vision. "I was living independently, doing my job, taking care of my child and then I had to look to my parents to take care of me," Meltzer said. 

Almost two decades later, Meltzer, out of a wheelchair and walking without a cane, was one of 14 women with moderate disability due to MS who participated in a pilot trial conducted by the Rutgers School of Health Related Professions. A specially-designed yoga program for these MS patients not only improved their physical and mental well-being but also enhanced their overall quality of life. 

"I felt like I became steadier and stronger in my core," Meltzer said. Prior to yoga, she described herself as a "wall walker," someone who felt safer holding onto the wall in order to get around. "To be able to stand on one leg and feel balanced is amazing." 

Susan Gould Fogerite, director of research for the Institute for Complementary and Alternative Medicine in the School of Health Related Professions, said that although there is widespread evidence that yoga is being used as a form of exercise by those with MS, much of the feedback has been anecdotal and there isn't much empirical data regarding its safety and efficacy. 

This is why she and her colleagues, Evan Cohen and David Kietrys, physical therapists and associate professors in the School of Health Related Professions at Stratford, decided to undertake the small pilot study, believing that a specialized yoga program for MS patients - which incorporates mind, body and spirit - would be beneficial to everyday living. 

What they discovered at the end of the eight-week trial was that those who participated were better able to walk for short distances and longer periods of time, had better balance while reaching backwards, fine motor coordination, and were better able to go from sitting to standing. Their quality of life also improved in perceived mental health, concentration, bladder control, walking, and vision, with a decrease in pain and fatigue. 

"Yoga is not just exercise, it is a whole system of living," said Fogerite, an associate professor, who, along with Kietrys, will present the results on September 26 at the Symposium on Yoga Research at the Kripalu Institute in Massachusetts. "The panel of experts who advised us on the trial wanted to make sure that we provided a fully integrated program that included philosophy, breathing practices, postures, relaxation and meditation." 

The yoga pilot trial was held at Still Point Yoga Center in Laurel Springs, a southern New Jersey town close to Philadelphia. Of the 72 individuals who were interested in participating, only 16 were eligible based on medical and other criteria and availability. Of those, 15 were enrolled and 14 completed the program after one person had to withdraw because of an unrelated health problem. 

Meltzer and the other women who participated in the trial ranged in age from 34 to 64. Some had been diagnosed with MS within the last two years while others had been living with the illness for up to 26 years. For 90 minutes, twice a week for two months, they practiced techniques and exercises that would improve their posture, help to increase stamina, and teach them how to relax and focus. 

"This study, I hope, is one of many that will give us the clinical information we need," said Fogerite. "Yoga is not currently being widely prescribed for people with MS, although it might turn out to be a very helpful treatment." The yoga practices were done by the women in the study sitting, standing, or lying on yoga mats, and using metal folding chairs situated close to the wall to provide them with more support. 

"What was so nice about this experience was that although everyone was at a different level of the disease, we felt like we were all together, so I think the camaraderie helped," said Meltzer. "And it wasn't just about gaining more mobility and balance in our legs but our arms and necks felt stronger as well." Fogerite said a larger randomized controlled trial would be needed to determine whether yoga could be used as a prescribed treatment for individuals with moderate disability due to MS. 

More than 2.3 million people - two to three times more women than men - throughout the world are diagnosed with this disease which can cause poor coordination, loss of balance, slurred speech, tremors, numbness, extreme fatigue and problems with memory and concentration. "When I was first diagnosed I no longer felt safe in my own body," Meltzer said. "I didn't trust my body at all. What the program did was really bring that trust back."


Study reveals how loud noises can damage hearing


It is common knowledge that loud sounds can damage our hearing. Now, a new study by researchers from the University of Leicester in the UK sheds new light on how this happens, paving the way for new prevention and treatment strategies for hearing loss and tinnitus. 

According to the Hearing Health Foundation, approximately 26 million Americans have high-frequency hearing loss as a result of exposure to loud noises at work or during leisure activities, such as listening to loud music. The research team, including Dr. Martine Hamann, a lecturer in neurosciences at the University of Leicester, notes that many individuals listen to loud music without realizing it can affect their hearing later in life. 

"People who suffer from hearing loss have difficulties in understanding speech, particularly when the environment is noisy and when other people are talking nearby," says Dr. Hamann. She notes that understanding speech is dependent on fast transmission of auditory signals through the auditory nerve - the nerve that transports sound waves from the cochlea of the inner ear to the brain. 

But previous research has shown that after exposure to loud sounds, transmission of these auditory signals slows down, leading to hearing loss. 

Dr. Hamann says it is important to determine the mechanisms behind this. "Understanding these underlying phenomena means that it could be possible to find medicines to improve auditory perception, specifically in noisy backgrounds," she adds. 

Thinning of myelin coat 'primary cause of hearing loss in response to loud sounds' 

Past studies have shown that loud noises can narrow the myelin coat that protects the auditory nerve. Furthermore, loud sounds have been shown to elongate myelin sheath gaps, more commonly known as nodes of Ranvier, which auditory signals jump between in order to process sound. 

But Dr. Hamann says that these findings pose a question: is reduced auditory signaling following exposure to loud sounds a result of the thinning of the myelin coat or the elongation of nodes? For their study, recently published in the journal Frontiers in Neuroanatomy, the researchers used computational modeling to simulate thinning of the myelin coat around the auditory nerve and lengthening of nodes. 

They then assessed how each of these changes affected auditory signaling through the auditory nerve. The team found that hearing loss as a result of exposure to loud noises is primarily caused by the thinning of the protective myelin coat surrounding the auditory nerve, while changes to the nodes only have a small effect on hearing loss. 

Commenting on the findings, Dr. Hamann says: "We have come closer to understanding the reasons behind deficits in auditory perception. This means that we can also get closer to target those deficits, for example by promoting myelin repair after acoustic trauma or during age-related hearing loss." 

The team says their findings may help uncover prevention strategies for hearing loss and tinnitus (ringing in the ears) and could even lead to cures for the conditions. They now plan to test drugs that trigger myelin repair to see if they can restore hearing following hearing loss.


Bothered by hot flashes? Acupuncture might be the answer


In the 2,500+ years that have passed since acupuncture was first used by the ancient Chinese, it has been used to treat a number of physical, mental and emotional conditions including nausea and vomiting, stroke rehabilitation, headaches, menstrual cramps, asthma, carpal tunnel, fibromyalgia and osteoarthritis, to name just a few. 

Now, a meta-analysis of randomized controlled trials which is being published this month in Menopause, the journal of The North American Menopause Society (NAMS), indicates that acupuncture can affect the severity and frequency of hot flashes for women in natural menopause. An extensive search of previous studies evaluating the effectiveness of acupuncture uncovered 104 relevant students, of which 12 studies with 869 participants met the specified inclusion criteria to be included in this current study. 

While the studies provided inconsistent findings on the effects of acupuncture on other menopause-related symptoms such as sleep problems, mood disturbances and sexual problems, they did conclude that acupuncture positively impacted both the frequency and severity of hot flashes. 

Women experiencing natural menopause and aged between 40 and 60 years were included in the analysis, which evaluated the effects of various forms of acupuncture, including traditional Chinese medicine acupuncture (TCMA), acupressure, electroacupuncture, laser acupuncture and ear acupuncture. 

Interestingly, neither the effect on hot flash frequency or severity appeared to be linked to the number of treatment doses, number of sessions or duration of treatment. However, the findings showed that sham acupuncture could induce a treatment effect comparable with that of true acupuncture for the reduction of hot flash frequency. The effects on hot flashes were shown to be maintained for as long as three months. 

Although the study stopped short of explaining the exact mechanism underlying the effects of acupuncture on hot flashes, a theory was proposed to suggest that acupuncture caused a reduction in the concentration of β-endorphin in the hypothalamus, resulting from low concentrations of estrogen. These lower levels could trigger the release of CGRP, which affects thermoregulation. 

"More than anything, this review indicates that there is still much to be learned relative to the causes and treatments of menopausal hot flashes," says NAMS executive director Margery Gass, MD. "The review suggests that acupuncture may be an effective alternative for reducing hot flashes, especially for those women seeking non- pharmacologic therapies." 

A recent review indicated that approximately half of women experiencing menopause-associated symptoms use complementary and alternative medicine therapy, instead of pharmacologic therapies, for managing their menopausal symptoms.


Anti-Malarial Drug Effective Against Asthma


Athmatic patients may soon have a more effective way to control the condition, thanks to a new pharmacological discovery by researchers from the National University of Singapore (NUS)

The team, led by Associate Professor Fred Wong from the Department of Pharmacology at the NUS Yong Loo Lin School of Medicine, together with Dr Eugene Ho Wanxing, a recent PhD graduate from the Saw Swee Hock School of Public Health at NUS, discovered that artesunate, a common herbal-based anti-malarial drug, can be used to control asthma, with better treatment outcomes than other drugs currently available. 

In their latest work, the team revealed for the first time that artesunate is able to suppress airway inflammation and produce an array of anti-inflammatory effects similar to those by dexamethasone, the most potent steroid currently available, and with less side effects. 

This breakthrough discovery was first published in the journal Metabolomics on 16 July 2014. Earlier this year, the NUS team was invited by journal Pharmacology and Therapeutics to pen a comprehensive review of the pharmacological effects of artesunate, and the review article was published in the journal in April 2014. 

The quest for better asthma therapeutics Asthma is an incurable lung disease that inflames and narrows the airways, causing recurring periods of wheezing, chest tightness, coughing and shortness of breath. It is a chronic condition that affects people of all ages, but it most often starts during childhood. To address the global unmet demand for better therapeutics to control allergic asthma, Dr Ho explored the therapeutic values of artesunate, which is herbal-based, as an alternative drug candidate. 

This study was part of Dr Ho's final-year project when he was pursuing a Bachelor of Science in Life Sciences at NUS. His initial findings demonstrated that artesunate possessed promising anti-inflammatory potential. Dr Ho was recognised by the Singapore-MIT Alliance (SMA) in 2010 for his novel discovery, and he was awarded the SMA Graduate Fellowship for his PhD studies at NUS. 

For his postgraduate studies, Dr Ho built upon his findings to better understand the therapeutic properties and molecular mechanisms of artesunate under the supervision of Assoc Prof Fred Wong. The NUS team studied the therapeutic effects of artesunate against oxidative stress and oxidative lung damage which are major inflammatory events that contribute to the severity of asthma attacks. 

They found that artesunate could better prevent oxidative lung damage, a major molecular inflammatory event in asthmatic lungs, than clinically-used corticosteroid, dexamethasone. Their collective results revealed that artesunate can be used to better control asthma, with improved outcomes and lesser adverse effects than currently available drugs. 

As long term usage of steroids may induce many potential side effects in asthmatic patients, the significance of this study suggests that the patients may eventually be able to adopt artesunate as a safer and more effective alternative to control their asthma.


Caffeine intake may worsen menopausal hot flashes


A new Mayo Clinic study, published online by the journal Menopause, found an association between caffeine intake and more bothersome hot flashes and night sweats in postmenopausal women. 

The study also showed an association between caffeine intake and fewer problems with mood, memory and concentration in perimenopausal women, possibly because caffeine is known to enhance arousal, mood and attention. The findings of this largest study to date on caffeine and menopausal symptoms are published on the Menopause website and will also be printed in a future issue of the journal. For the study, researchers conducted a survey using the Menopause Health Questionnaire, a comprehensive assessment of menopause-related health information that includes personal habits and ratings of menopausal symptom presence and severity. 

Questionnaires were completed by 2,507 consecutive women who presented with menopausal concerns at the Women's Health Clinic at Mayo Clinic in Rochester between July 25, 2005, and July 25, 2011. Data from 1,806 women who met all inclusion criteria were analyzed. Menopausal symptom ratings were compared between caffeine users and nonusers. Approximately 85 percent of the U.S. population consumes some form of caffeine-containing beverage daily. Vasomotor symptoms (hot flashes and night sweats) are the most commonly reported menopausal symptoms, occurring in 79 percent of perimenopausal women and 65 percent of postmenopausal women. 

Although it has long been believed that caffeine intake exacerbates menopausal vasomotor symptoms, research has challenged this assumption, as caffeine has been both positively and negatively linked to hot flashes. "While these findings are preliminary, our study suggests that limiting caffeine intake may be useful for those postmenopausal women who have bothersome hot flashes and night sweats," says Stephanie Faubion, M.D., director of the Women's Health Clinic at Mayo Clinic in Rochester. 

"Menopause symptoms can be challenging but there are many management strategies to try." Other strategies Dr. Faubion recommends include: Be aware of triggers such as spicy foods and hot beverages. In addition to caffeine, limit alcohol and tobacco. Dress in layers, so you can remove a layer when you're warm. Consider products to stay cool at night such as wicking sheets and sleepwear, fans, and cooling pillows. 

Try stress management strategies such as meditation, yoga, Tai Chi, acupuncture and massage. Maintain a healthy weight, exercise regularly and stay active. Talk with your provider about hormone therapy and non-hormonal prescription medications to alleviate symptoms.


Study: how marijuana causes paranoia



The research team, led by Prof. Daniel Freeman of the University of Oxford in the UK, recently published their findings in the journal Schizophrenia Bulletin. 

Marijuana, also known as cannabis, is a drug that is produced from the plants Cannabis sativa or Cannabis indica. The main active ingredient in marijuana is delta-9-tetrahydrocannabinol (THC), which is responsible for the majority of the drug's psychological effects, such as hallucinations and delusions. ast research has indicated that marijuana use can induce paranoia - which Prof. Freeman describes as "excessive thinking that other people are trying to harm us." 

"It's very common because in our day-to-day lives we have to weigh up whether to trust or mistrust, and when we get it wrong - that's paranoia," he explains." Many people have a few paranoid thoughts, and a few people have many paranoid thoughts." 

For the study, Prof. Freeman and colleagues tested the effects of THC on 121 participants ages 21-50 in order to see whether the compound triggers paranoid feelings and how it does this. All participants had used cannabis at least once previously and had no history of mental health conditions. Two thirds of participants were injected with THC at a dose equivalent to a strong joint, while a third of participants were injected with a placebo. 

The researchers note that they chose to inject the participants with the compound as it ensured they all had similar levels of THC in their bloodstream. The researchers report that the effects of THC on participants lasted for 90 minutes. THC causes 'negative feelings and changes in perception that induce paranoia' Results of the study revealed that among participants who were injected with THC, around 50% reported paranoid thoughts, compared with 30% of participants who received the placebo. 

The researchers note that as the compound left the bloodstream, feelings of paranoia reduced. The team found that THC also induced anxiety, worry, reduced mood, negative thoughts about oneself, changes in perception - including the report of louder noises and clouds being brighter - and altered their perception of time. Using a statistical analysis, the researchers found that it may be these negative feelings and changes in perception that cause paranoid feelings among marijuana users. 

The team says their findings not only "very convincingly" show that cannabis can cause short-term paranoia in some users, but they may also explain how our mind encourages paranoid feelings. He notes that although the study - funded by the UK's Medical Research Council - provides more information about the immediate effects marijuana can have, it does not look at the effects of cannabis addiction and therefore "does not necessarily hold implications for policing, the criminal justice system or legislation." 

"The implication is that reducing time spent ruminating, being more confident in ourselves, and not catastrophizing when unusual perceptual disturbances occur will in all likelihood lessen paranoia," adds Prof. Freeman. This research is the latest in a line of studies that reveal potential negative implications of marijuana use. Earlier this year, Medical News Today reported on a study suggesting that marijuana use may increase the likelihood of sleep problems, while another study published in the Journal of the American Heart Association links cannabis use to cardiovascular complications and death.


Lost in translation issues in Chinese medicine


Millions of people in the West today utilize traditional Chinese medicine, including acupuncture, herbs and massage therapies. Yet only a handful of Chinese medical texts have so far been translated into English. Given the complexity of the language and concepts, there is a need for accurate, high-quality translations. Researchers have published a document designed to help evaluate and digest Chinese medical texts with greater sensitivity and comprehension.

Given the complexity of the language and concepts in these texts, there is a need for accurate, high-quality translations, say researchers at UCLA's Center for East-West Medicine. To that end, the center has published a document that includes a detailed discussion of the issues involved in Chinese medical translation, which is designed to help students, educators, practitioners, researchers, publishers and translators evaluate and digest Chinese medical texts with greater sensitivity and comprehension.

"This publication aims to raise awareness among the many stakeholders involved with the translation of Chinese medicine," said principal investigator and study author Dr. Ka-Kit Hui, founder and director of the UCLA center.

The 15-page document, "Considerations in the Translation of Chinese Medicine" was developed and written by a UCLA team that included a doctor, an anthropologist, a China scholar and a translator. It appears in the current online edition of the Journal of Integrative Medicine.

Authors Sonya Pritzker, a licensed Chinese medicine practitioner and anthropologist, and Hanmo Zhang, a China scholar, hope the publication will promote communication in the field and play a role in the development of thorough, accurate translations.

The document highlights several important topics in the translation of Chinese medical texts, including the history of Chinese medical translations, which individuals make ideal translators, and other translation-specific issues, such as the delicate balance of focusing translations on the source-document language while considering the language it will be translated into.

It also addresses issues of technical terminology, period-specific language and style, and historical and cultural perspective. For example, depending on historical circumstances and language use, some translations may be geared toward a Western scientific audience or, alternately, it may take a more natural and spiritual tone. The authors note that it is sometimes helpful to include dual translations, such as "windfire eye/acute conjunctivitis," in order to facilitate a link between traditional Chinese medical terms and biomedical diagnoses.

The final section of the document calls for further discussion and action, specifically in the development of international collaborative efforts geared toward the creation of more rigorous guidelines for the translation of Chinese medicine texts.

"Considerations in the Translation of Chinese Medicine," was inspired by the late renowned translator and scholar Michael Heim, a professor in the UCLA departments of comparative literature and Slavic studies. A master of 12 languages, he is best known for his translation into English of Czech author Milan Kundera's "The Unbearable Lightness of Being." The new UCLA document is dedicated to him.

The document, the authors say, was influenced in large part by the American Council of Learned Societies' "Guidelines for the Translation of Social Science Texts," which are intended to promote communications in the social sciences across language boundaries. It was also influenced by Pritzker's longstanding anthropological study of translation in Chinese medicine, which is detailed in her new book, "Living Translation: Language and the Search for Resonance in U.S. Chinese Medicine," recently published by Berghahn Books. Funded by a UCLA Transdisciplinary Seed Grant, the document is available for free in both English and Chinese (PDF format) on the UCLA Center for East-West Medicine website.


Call to halve target for added sugar


People need to more than halve their intake of added sugar to tackle the obesity crisis, according to scientific advice for the government in England.

A draft report by the Scientific Advisory Committee on Nutrition (SACN) says sugar added to food or naturally present in fruit juice and honey should account for 5% of energy intake.

Many fail to meet the old 10% target.

The sugar industry said "demonising one ingredient" would not "solve the obesity epidemic".

The body reviewed 600 scientific studies on the evidence of carbohydrates - including sugar - on health to develop the new recommendations.

One 330ml can of fizzy pop would take a typical adult up to the proposed 5% daily allowance, without factoring in sugar from any other source.

Prof Ian MacDonald, chairman of the SACN working group on carbohydrates, said: "The evidence that we have analysed shows quite clearly that high free sugars intake in adults is associated with increased energy intake and obesity.

"There is also an association between sugar-sweetened beverages and type-2 diabetes.

"In children there is clear demonstration that sugar-sweetened beverages are associated with obesity.

"By reducing it to 5% you would reduce the risk of all of those things, the challenge will be to get there."

The target of 5% of energy intake from free sugars amounts to 25g for women (five to six teaspoons) and 35g (seven to eight teaspoons) for men, based on the average diet.


BBC News


Statins linked to lower physical activity


Initiating statin therapy in older men was associated with a modest but significant drop in physical activity, according findings from a large, observational study published online June 9 in JAMA Internal Medicine.

In addition, older men who used statins showed lower activity levels and higher levels of sedentariness than did nonusers, for as long as they took the drugs. Although results of an observational study such as theirs cannot prove causality, it is likely that the statins’ well-known adverse effects of inducing muscle pain, myopathy, and muscular fatigue account for these differences, said David S.H. Lee, Pharm.D., Ph.D., of Oregon State University/Oregon Health and Science University, Portland, and his associates.

To assess the relationship between statin use and physical activity, the investigators analyzed data from the MrOS (Osteoporotic Fractures in Men Study), an observational study of healthy aging involving men aged 65 years and older who resided in six geographic regions across the United States and were followed at intervals for roughly 7 years.

Dr. Lee and his colleagues performed both a cross-sectional analysis involving 4,137 of the participants (mean age, 73 years) and a longitudinal analysis involving 3,039 of them. About 24% were statin users at baseline, 48% never used statins throughout the study period, and the remainder began using statins during the study. Activity level was measured subjectively, using the PASE (Physical Activity Scale for the Elderly), and objectively, using an accelerometer.

Men who began using statins during the study showed a modest but significant decline of about 10% in physical activity, compared with those who never took statins.

After the data were adjusted to account for possible confounders between users and nonusers such as medical history, body mass index, and smoking status, it was found that statin users engaged in 9.6% fewer minutes of moderate physical activity and 9.0% fewer minutes of vigorous activity per day than nonusers did. They also engaged in sedentary behavior for 1% more minutes per day than men who didn’t use statins. This equates to a mean decrease of approximately 151 minutes/week of walking and 37.8 minutes/week of more vigorous exercise, and an increase of 21.8 hours/week in sedentariness, for the statin users (JAMA Intern. Med. 2014 June 9).


Leptin Affects Appetite Control Brain Cells


Twenty years after the hormone leptin was found to regulate metabolism, appetite, and weight through brain cells called neurons, Yale School of Medicine researchers have found that the hormone also acts on other types of cells to control appetite.

Published in the June 1 issue of Nature Neuroscience, the findings could lead to development of treatments for metabolic disorders such as obesity and diabetes.

"Up until now, the scientific community thought that leptin acts exclusively in neurons to modulate behavior and body weight," said senior author Tamas Horvath, the Jean and David W. Wallace Professor of Biomedical Research and chair of comparative medicine at Yale School of Medicine. "This work is now changing that paradigm."

Leptin, a naturally occurring hormone, is known for its hunger-blocking effect on the hypothalamus, a region in the brain. Food intake is influenced by signals that travel from the body to the brain. Leptin is one of the molecules that signal the brain to modulate food intake. It is produced in fat cells and informs the brain of the metabolic state. If animals are missing leptin, or the leptin receptor, they eat too much and become severely obese.

Leptin's effect on metabolism has been found to control the brain's neuronal circuits, but no previous studies have definitively found that leptin could control the behavior of cells other than neurons.

To test the theory, Horvath and his team selectively knocked out leptin receptors in the adult non-neuronal glial cells of mice. The team then recorded the water and food intake, as well as physical activity every five days. They found that animals responded less to feeding reducing effects of leptin but had heightened feeding responses to the hunger hormone ghrelin.

"Glial cells provide the main barrier between the periphery and the brain," said Horvath. "Thus glial cells could be targeted for drugs that treat metabolic disorders, including obesity and diabetes."


Melatonin makes old bones stronger


McGill researchers have shown that melatonin supplements may make bones stronger in old rats. This suggests a possible avenue for the prevention of osteoporosis.

Bones are built up by certain cells known as osteoblasts during the daytime and broken down by others (osteoclasts) at night. As we age, we sleep less, and so the cells that break down the bones are more active. By giving old rats melatonin supplements to regulate their circadian rhythms, the McGill researchers have been able to make their bones denser, less brittle and more flexible. Next step is to explore whether melatonin supplements prevent bone breakdown or can actually repair damage.

Research on elderly rats suggests possible avenue for prevention of osteoporosis

Faleh Tamimi, a professor in McGill's School of Dentistry, is the leader of a research team that has just discovered that melatonin supplements make bones stronger in elderly rats and therefore, potentially, in elderly humans too. "Old rats are tedious to work with because they get sick a lot and that means they also cost a lot more. But if you're interested in diseases like osteoporosis, they're an essential part of the process."

Dem bones, dem bones, dem dry bones -- sleep and bone regulation

The process of bone breakdown and buildup is affected by our circadian rhythms. The cells which break down our bones (known as osteoclasts) are more active at night, while those responsible for bone formation (osteoblasts) are more active during daylight hours. "As we age, we sleep less well, which means that the osteoclasts are more active," says Tamimi. "This tends to speed up the process of bone breakdown."

It is already well established that melatonin plays a role in regulating our body clocks and can potentially help us sleep better. So the researchers suspected that a melatonin supplement would help regulate the circadian rhythms of the elderly rats, thus reducing the activity of the osteoclasts and slowing down the process of bone breakdown. And that is exactly what they found.

22-month-old rats are the equivalent of 60-year-old humans

Researchers at the University of Madrid, where the rats were housed, gave twenty 22-month-old male rats (the equivalent of 60 year-old humans) melatonin supplements diluted in water for 10 weeks (the equivalent of six years in human years). The femurs taken from the elderly rats which had received the melatonin supplements were then compared with those of a control group (which had not received the supplements) using a series of tests to measure bone density and strength.

The researchers found that there was a significant increase in both bone volume and density among the rats that had received melatonin supplements. As a result, it took much more force to break the bones of rats that had taken the melatonin supplements, a finding that suggests to the researchers that melatonin may prove a useful tool in combatting osteoporosis.

For Tamimi and his colleagues the next big question is whether melatonin is preventing or actually reversing the process of bone breakdown. "Until there is more research as well as clinical trials to determine how exactly the melatonin is working, we can't recommend that people with osteoporosis go ahead and simply take melatonin supplements," says Tamimi. "I am applying for funding to pursue the research and we hope to have answers soon."


Meditation and the brain


Meditation is more than just a way to calm our thoughts and lower stress levels: our brain processes more thoughts and feelings during meditation than when you are simply relaxing, a coalition of researchers from Norway and Australia has found.

Mindfulness. Zen. Acem. Meditation drumming. Chakra. Buddhist and transcendental meditation. There are countless ways of meditating, but the purpose behind them all remains basically the same: more peace, less stress, better concentration, greater self-awareness and better processing of thoughts and feelings.

But which of these techniques should a poor stressed-out wretch choose? What does the research say? Very little - at least until now.
A team of researchers at the Norwegian University of Science and Technology (NTNU), the University of Oslo and the University of Sydney is now working to determine how the brain works during different kinds of meditation.

Their most recent results were published in the journal "Frontiers in Human Neuroscience".
Different meditation techniques can actually be divided into two main groups. One type is concentrative meditation, where the meditating person focuses attention on his or her breathing or on specific thoughts, and in doing so, suppresses other thoughts.

The other type may be called nondirective meditation, where the person who is meditating effortlessly focuses on his or her breathing or on a meditation sound, but beyond that the mind is allowed to wander as it pleases. Some modern meditation methods are of this nondirective kind.
"No one knows how the brain works when you meditate. That is why I'd like to study it," says Jian Xu, who is a physician at St. Olavs Hospital in Trondheim, Norway and a researcher at the Department of Circulation and Medical Imaging at NTNU.

Nondirective meditation led to higher activity than during rest in the part of the brain dedicated to processing self-related thoughts and feelings. When test subjects performed concentrative meditation, the activity in this part of the brain was almost the same as when they were just resting.

"I was surprised that the activity of the brain was greatest when the person's thoughts wandered freely on their own, rather than when the brain worked to be more strongly focused," said Xu. "When the subjects stopped doing a specific task and were not really doing anything special, there was an increase in activity in the area of the brain where we process thoughts and feelings. It is described as a kind of resting network. And it was this area that was most active during nondirective meditation."

"The study indicates that nondirective meditation allows for more room to process memories and emotions than during concentrated meditation," says Svend Davanger, a neuroscientist at the University of Oslo, and co-author of the study.

"This area of the brain has its highest activity when we rest. It represents a kind of basic operating system, a resting network that takes over when external tasks do not require our attention. It is remarkable that a mental task like nondirective meditation results in even higher activity in this network than regular rest," says Davanger.

Most of the research team behind the study does not practice meditation, although three do: Professors Are Holen and Øyvind Ellingsen from NTNU and Professor S"
Acem meditation is a technique that falls under the category of nondirective meditation. Davanger believes that good research depends on having a team that can combine personal experience with meditation with a critical attitude towards results.

"Meditation is an activity that is practiced by millions of people. It is important that we find out how this really works. In recent years there has been a sharp increase in international research on meditation. Several prestigious universities in the US spend a great deal of money to research in the field. So I think it is important that we are also active," says Davanger.vend Davanger from the University of Oslo.


E-cigarettes and Teenagers


Aerosol and vapors emitted by electronic cigarettes may end up causing serious irritation  to a young smoker's airways  new research cautions.   And this irritation could worsen pre-existing respiratory problems such as asthma or bronchitis.

The e-cigarette assessment  was based on data generated by a custom-designed machine  that realistically mimicked  the human respiratory system.  The data showed that, when smoked,  e-cigarettes release a sizeable amount  of chemical particles. 

Most notably,  those include glycerin and glycol ethers  alongside nicotine, preservatives,  flavorings, and fragrances.  In turn,  the smoking patterns of a 14-year old male  demonstrated that 47% of those chemicals  end up deposited in the lung.  In fact most inhaled chemicals  ultimately made their way  into the lung's deepest parts  known as the alveolar region.   

The study authors concluded  that e-cigarettes may pose unique health respiratory risks  not only to smokers  but also to the general public  given that 53% of chemical emissions  are not inhaled  forming a possible source  of second-hand smoke.



Electronic Cigarettes: Q&A


The big news out of the FDA’s announcement on e-cigarettes is that people under age 18 will no longer be able to buy them.

That ban will go into effect 30 days after the rules are approved. But it could take more than 2 years for many of the other rules to go into effect. And while everyone from the American Lung Association to e-cigarette makers praised the plan, others say it won’t do enough to keep the products out of the hands of teens. 

E-cigarettes contain a nicotine solution that is heated to create a vapor the user breathes in, or “vapes.” Before the FDA’s announcement Thursday, no federal rules existed to regulate what’s in them, who they can be sold to, or how they are advertised.

Here are some details from experts about the proposed e-cigarette rules.

Q: In addition to banning sales to minors, what else do the proposed rules do?

A: Makers of the tobacco products that would come under the FDA’s new rules would have to:

  • Register with the FDA
  • Provide a list of ingredients
  • Seek FDA approval to market their products
  • Seek approval to make direct and implied claims of reduced risk
  • Include health warnings
  They could not distribute free samples or sell products in vending machines (unless the facility never allows people under 18 to enter).

Right now, "We can't even tell you what compounds are in the vapor," says Mitch Zeller, director of the FDA Center for Tobacco Products, who spoke at a press briefing about the new rules.

Q: What don't the new rules cover?

A: The new rules do not ban online sales, TV ads, or flavored e-cigarettes. Zeller says once the rules are finalized, the FDA could propose separate rules for those areas.

It's yet to be decided if cigars that are ''premium" -- hand-rolled with a tobacco leaf wrapper -- will be included. The FDA is seeking comments on that question, Zeller says.

Q: Why didn’t they include the flavors and the marketing?

A: Public health advocates worry that the sweet flavors of e-cigarettes will continue to attract teens, along with marketing.

But CDC Director Tom Frieden, MD, said in an interview with NPR that rules in those areas could be challenged in court.

"One of the challenges that the FDA has is the balance between stringent regulation and regulation that will stand up to a court challenge,” Frieden told NPR.  He noted that the e-cigarette industry has already won one court case against the FDA.

“It is a real balancing act between how effective regulation can be and how sustainable it will be in court.”

Q: What other products are included in the new rules?

A: Besides electronic cigarettes, the proposed rules also cover cigars, pipe tobacco, nicotine gels, water pipe tobacco, and hookah tobacco.

The FDA already regulates cigarettes, cigarette tobacco, roll-your-own tobacco, and smokeless tobacco.


Chinese Herbal Remedy Can Treat Arthritis


A traditional Chinese herbal remedy used to relieve joint pain and inflammation works as well as methotrexate, a standard drug treatment that is frequently prescribed to control the symptoms of active rheumatoid arthritis, reveals research published online in the Annals of the Rheumatic Diseases.

Furthermore, combining the herbal remedy with methotrexate -- the disease modifying drug (DMARD) most commonly used to treat rheumatoid arthritis -- was more effective than treatment with methotrexate alone, the findings showed. Triptergium wilfordii Hook F, or TwHF for short, is used in traditional Chinese medicine to treat joint pain, swelling, and inflammation, and is already approved for the treatment of rheumatoid arthritis in China.

The research team randomly assigned 207 patients with active rheumatoid arthritis to one of three treatment groups: methotrexate 12.5 mg once a week; or TwHF 20 mg three times a day; or a combination of the two over a period of 24 weeks. The researchers wanted to find out which of these approaches would sufficiently alleviate symptoms to reach an ACR 50 response.

This indicates a 50% improvement in the number of tender or swollen joints and other criteria including pain, disability, and the doctor's assessment of disease severity. It's a measure defined by the American College of Rheumatology. Most (174; 84%) of the participants completed the full 24 weeks of the trial. The proportion of patients achieving ACR 50 was almost 46.5% in those treated with methotrexate alone; 55% in those treated with TwHF alone; and just under 77% in those treated with both.

Similar clinically significant patterns of improvement in disease activity and remission rates also occurred among the three treatment groups. There was little difference between the frequency or type of side effects experienced in the different treatment groups, although the number of women who developed irregular periods was slightly higher in those treated with TwHF.

More than 300 compounds have been identified in TwHF, including diterpenoids, which experimental research suggests can suppress genes controlling inflammation and dampen down the immune response, the authors point out. And an extract of the root has recently been investigated for its potential to treat automimmune diseases and some cancers, say the researchers.

They caution that 24 weeks is too short a time to evaluate disease progression, and that the dose of methotrexate used in the trial is lower than that typically given to patients in the West. But they suggest that TwHF could be a promising approach to the treatment of active rheumatoid arthritis, particularly as not all patients respond to DMARDs, and because these drugs are expensive.


Smoking visibility mapped for the first time


The visibility of smoking in city streets has for the first time anywhere been mapped, in new research from the University of Otago, Wellington, New Zealand.

The research found that up to 116 smokers outside bars/cafés could be seen from any one location in the outdoor public areas of downtown Wellington (e.g. on a footpath).

Of 2600 people observed in the outdoor areas of bars and cafés, 16% were smoking, with a higher proportion than this in evenings.

Data from observations across the downtown area were mapped by the researchers, producing a record of the street areas where the most smokers could be seen.

They used mapping methods previously used for landscape ecology and archeology.

Lead researcher Dr Amber Pearson says that the methods developed through this research will help policymakers demonstrate the visibility of smoking in different areas, and provide scientific evidence for local authorities to advance smokefree outdoor policies.

Another of the researchers, Associate Professor George Thomson, says the results show the need for policies to reduce the normality of smoking:

"Smokefree outdoor areas help smokers to quit, help those who have quit to stick with it, and reduce the normalisation of smoking for children and youth. They also reduce litter, water pollution and cleaning costs for local authorities and ratepayers," Thomson says.

In Australia, North America and other places, local authorities are increasingly creating smokefree streets and promoting smokefree al fresco dining and drinking, he says.


Doctors raise blood pressure in patients


Doctors routinely record blood pressure levels that are significantly higher than levels recorded by nurses, the first thorough analysis of scientific data has revealed.

A systematic review led by the University of Exeter Medical School, and supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care in the South West Peninsula (NIHR PenCLAHRC), has discovered that recordings taken by doctors are significantly higher (by 7/4mmHg) than when the same patients are tested by nurses. Dr Christopher Clark, of the University of Exeter Medical School, said the findings, published in the British Journal of General Practice, should lead to changes in clinical practice.

"Doctors should continue to measure blood pressure as part of the assessment of an ill patient or a routine check-up, but not where clinical decisions on blood pressure treatment depend on the outcome. The difference we noted is enough to tip some patients over the threshold for treatment for high blood pressure, and unnecessary medication can lead to unwanted side-effects. Some patients may be erroneously asked to continue to monitor their own blood pressure at home, which can build anxiety. These inappropriate measures could all be avoided by the simple measure of someone other than a doctor taking the blood pressure recording."

  "Researchers should also think carefully about how to account for this effect in studies that compare treatment by doctors and nurses. Some studies have concluded that nurses are better at treating hypertension, when in fact those findings could be down to this recording bias." The phenomenon of doctors recording higher blood pressure is known as the "white coat effect," and is thought to result from the patient's physical response to being assessed by a doctor. It has previously been noted in a number of studies, but Dr Clark's research is the first comprehensive analysis of available data to quantify this effect.

The team examined the blood pressure levels of 1,019 individuals whose measurements had been taken by both doctors and nurses at the same visit. Dr Clark said: "Our results were pooled from different settings across ten countries, so we can be confident that they can be generalised to any healthcare environment where blood pressure is being measured. These results were all from research trials -- our next task will be to examine data from GP surgeries."

Professor John Campbell, Professor of General Practice and Primary Care at the University of Exeter Medical School and a co-author on the study said: "This interesting study forms part of our portfolio of primary care research examining factors which might need to be considered when doctors and other healthcare professionals undertake assessments of patient's risk of cardiovascular disease. Increasing doctor's awareness of factors which might affect the accurate assessment of blood pressure is of great importance since this is one of the commonest clinical assessments undertaken, and one where important decisions regarding a patient health and well-being may follow."

The University of Exeter Primary Care Research Group is part of the Medical School's Institute of Health Research. Primary Care academic staff have attracted around £25 million in research funding in the past 10 years. The group's research interests focus on primary care research examining the accessibility and quality of primary care, the assessment and mitigation of cardiovascular risk, and the assessment and care of patients with mental health problems in primary care.


Novel smartphone case measures key vital signs


It is no surprise that more than 91.4 million Americans use a smartphone. The devices are so much more than a phone - they are a world of knowledge right in the palms of our hands. And now, they can even monitor our health.

Technology company Azoi has launched a smartphone case that can measure key vital signs. The health tracker is called Wello. It consists of a number of sensors that are embedded into a case that fits onto a smartphone. When held up with both hands, the sensors can measure a series of vital signs, including blood pressure, heart rate, temperature and blood oxygen. It also comes with an add-on device that can measure lung function. The data is then sent to a Wello app that can be downloaded onto the smartphone.

This allows users to have quick access to their health information and even track trends that may indicate they are becoming ill. Wello can also connect with other health and fitness devices, such as pedometers and sleep monitors. Furthermore, it has remote access, meaning it can monitor and track the vital signs of family members.

Wello could enable earlier detection of health problems

According to the Heart Foundation, heart disease is the leading cause of death in the US. By 2020, it is predicted to be the leading cause of death worldwide.

Hamish Patel, CEO and founder of Azoi, says that Wello can help individuals regularly monitor their vital signs, allowing earlier detection of heart disease and other health problems. In addition, Patel says the device could help ease the growing burden on health care services. Wello is currently available for preorder in the US, UK, Canada, China, India, Hong Kong, Singapore and across the European Union.

The device is priced at $199 (£120) and - dependent on approval from the US Food and Drug Administration (FDA) - will be shipped later this year. It is compatible with all iOS and Android KitKat phones with BLE (Bluetooth Low Energy). Wello is currently available as a case for the iPhone and as an individual insert for use with all other smartphones, but Azoi plans to offer the device in the form of an Android phone case in the future.

  Smartphones and the medical world

Although Wello is the first vital signs monitoring device to be incorporated with a cell phone case, it is not the first device to measure vitals and send them to a smartphone. Last year, Medical News Today reported on a device called the Scanadu Scout. By placing the gadget to the forehead, it can read a person's vital signs in 10 seconds and send the data to a Scanadu smartphone app via bluetooth.

  And it is not only the measurement of vital signs that smartphones are being used for in the medical world. We recently reported on two new smartphone apps that the creators say can detect epilepsy and improve the care of stroke patients. Another study detailed the development of a smartphone device that can test for kidney damage, while other research talks of a smartphone eye testing kit that can diagnose cataracts, check prescriptions for vision lenses, and check the retina for signs of disease.

  As well as detecting signs of illness, the cell phone is being incorporated into the medical research field. Last year, we reported on the creation of a smartphone microscope that can identify viruses and particles less than one-thousandth the width of a human hair.


Acupuncture for Treating Inflammatory Disease?


When acupuncture first became popular in the western hemisphere it had its doubters. It still does. But over time, through detailed observation, scientists have produced real evidence that ancient Chinese practitioners of the medical arts were onto something.

Now new research documents a direct connection between the use of acupuncture and physical processes that could alleviate sepsis, a condition that often develops in hospital intensive care units, springs from infection and inflammation, and takes an estimated 250,000 lives in the United States every year.

"Sepsis is the major cause of death in the hospital," says Luis Ulloa, an immunologist at Rutgers New Jersey Medical School who led the study, which has been published by the journal Nature Medicine. "But in many cases patients don't die because of the infection. They die because of the inflammatory disorder they develop after the infection. So we hoped to study how to control the inflammatory disorder."

The researchers already knew that stimulation of one of the body's major nerves, the vagus nerve, triggers processes in the body that reduce inflammation, so they set out to see whether a form of acupuncture that sends a small electric current through that and other nerves could reduce inflammation and organ injury in septic mice. Ulloa explains that increasing the current magnifies the effect of needle placement, and notes that electrification is already FDA-approved for treating pain in human patients.

When electroacupuncture was applied to mice with sepsis, molecules called cytokines that help limit inflammation were stimulated as predicted, and half of those mice survived for at least a week. There was zero survival among mice that did not receive acupuncture. Ulloa and his team then probed further, to figure out exactly why the acupuncture treatments had succeeded. And they made a discovery that, on its face, was very disappointing.

They found that when they removed adrenal glands - which produce hormones in the body - the electroacpuncture stopped working. That discovery, on its face, presented a big roadblock to use of acupuncture for sepsis in humans, because most human cases of sepsis include sharply reduced adrenal function. In theory, electroacupuncture might still help a minority of patients whose adrenal glands work well, but not many others.

  So the researchers dug even deeper - to find the specific anatomical changes that occurred when electroacupuncture was performed with functioning adrenal glands. Those changes included increased levels of dopamine, a substance that has important functions within the immune system. But they found that adding dopamine by itself did not curb the inflammation. They then substituted a drug called fenoldopam that mimics some of dopamine's most positive effects, and even without acupuncture they succeeded in reducing sepsis-related deaths by 40 percent.

Ulloa considers the results a double triumph. On the one hand, he says, this research shows physical evidence of acupuncture's value beyond any that has been demonstrated before. His results show potential benefits, he adds, not just for sepsis, but treating other inflammatory diseases such as rheumatoid arthritis, osteoarthritis and Crohn's disease. On the other hand, by also establishing that a drug reduced sepsis deaths in mice, he has provided an innovative roadmap toward developing potential drugs for people.

That roadmap may be crucial, because no FDA-approved drug to treat sepsis now exists. "I don't even know whether in the future the best solution for sepsis will be electroacupuncture or some medicine that will mimic electroacupuncture," Ulloa concludes. The bottom line, he says, is that this research has opened the door to both.


Geranium extracts inhibit HIV-1


Extracts of the geranium plant Pelargonium sidoides inactivate human immunodeficiency virus type 1 (HIV-1) and prevent the virus from invading human cells. In the current issue of "PLOS ONE," scientists from the Helmholtz Zentrum München report that these extracts represent a potential new class of anti-HIV-1 agents for the treatment of AIDS.

Scientists from the Helmholtz Zentrum München demonstrate that root extracts of the medicinal plant Pelargonium sidoides (PS) contain compounds that attack HIV-1 particles and prevent virus replication.

A team spearheaded by Dr. Markus Helfer and Prof. Dr. Ruth Brack-Werner from the Institute of Virology and Prof. Dr. Philippe Schmitt-Kopplin from the Analytical BioGeoChemistry research unit (BGC) performed a detailed investigation of the effects of PS extracts on HIV-1 infection of cultured cells.

They demonstrated that PS extracts protect blood and immune cells from infection by HIV-1, the most widespread type of HIV. PS extracts block attachment of virus particles to host cells and thus effectively prevent the virus from invading cells.

Chemical analyses revealed that the antiviral effect of the PS extracts is mediated by polyphenols. Polyphenol mixtures isolated from PS extracts retain high anti-HIV-1 activity but are even less toxic for cells than the crude extract. Safety of PS-extracts has been established in several clinical trials.

In Germany PS extracts are licensed as a herbal medicine and used to reduce symptoms of acute bronchitis. Research group leader Brack-Werner says, "PS-extracts are a very promising lead for the development of the first scientifically validated phytomedicine against HIV-1. PS extracts attack HIV-1 with a mode-of-action that is different from all anti-HIV-1 drugs in clinical use.

Therefore a PS-based phytomedicine may be a valuable supplement for established anti-HIV therapies. Furthermore, PS extracts are attractive candidates for increasing anti-HIV-1 therapy options in resource-limited settings, since they are easy to produce and do not require refrigeration. The results of our study and the proven safety of PS extracts encourages their testing in HIV-1 infected individuals as next step."

According to the World Health Organisation (WHO), more than 35 million people in the world are infected with HIV, the majority with HIV-1. Without treatment, HIV destroys the immune system and causes the acquired immunodeficiency syndrome (AIDS), which is a life-threatening disease. HIV/AIDS is one of the 10 leading causes of death worldwide.

The goal of research at the Helmholtz Zentrum München is to develop new approaches to diagnosing, treating and preventing common diseases. In the interest of translational research, the acquired knowledge is to be applied to humans as quickly as possible in order to provide concrete benefits for society.


TCM stall progression of diabetes


Traditional Chinese herbal medicines hold promise for slowing the progression from prediabetes to an official diabetes diagnosis, according to new research accepted for publication in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).

Prediabetes is diagnosed an individual has developed elevated blood sugar levels, but glucose levels have not yet risen to the point of developing type 2 diabetes. People who are prediabetic face a heightened risk of developing type 2 diabetes as well as heart disease and stroke. According to the Centers for Disease Control and Prevention, about 79 million American adults age 20 years or older have prediabetes.

“With diabetes evolving into a serious public health burden worldwide, it is crucial to take steps to stem the flood of cases,” said one of the study’s authors, Chun-Su Yuan, MD, PhD, of the University of Chicago. “Patients often struggle to make the necessary lifestyle changes to control blood sugar levels, and current medications have limitations and can have adverse gastrointestinal side effects. Traditional Chinese herbs may offer a new option for managing blood sugar levels, either alone or in combination with other treatments.”

During the double-blind, randomized, placebo-controlled trial, 389 participants at 11 research sites in China were randomly assigned to take either a capsule containing a mixture of 10 Chinese herbal medicines or a placebo. For a year, subjects took capsules of either the Chinese herb mixture, called Tianqi, or the placebo three times a day before meals. All participants received a month of lifestyle education at the outset of the trial and met with nutritionists several times during the course of the study.

Subjects’ glucose tolerance was measured on a quarterly basis. At the end of the trial, 36 participants in the Tianqi group and 56 in the placebo group had developed diabetes. The analysis found taking Tianqi reduced the risk of diabetes by 32.1 percent compared with the placebo, after adjusting for age and gender. The overall reduction in risk was comparable to that found in studies of diabetes medications acarbose and metformin, and study participants reported few side effects from the Tianqi herbs. Tianqi includes several herbs that have been shown to lower blood glucose levels and improve control of blood glucose levels after meals.

“Few controlled clinical trials have examined traditional Chinese medicine’s impact on diabetes, and the findings from our study showed this approach can be very useful in slowing the disease’s progression,” said one of the study’s lead authors, Xiaolin Tong, MD, PhD, of Guang’anmen Hospital in Beijing, China, said. “More research is needed to evaluate the role Chinese herbal medicine can play in preventing and controlling diabetes.”


New health benefits associated with hempseed oil


Hemp is a crop full of oils with potential health benefits, according to a new study in the Journal of Agricultural and Food Chemistry.

A derivative of cannabis (marijuana), hemp has been used for millennia in textiles, medicine and food, by people all over the world. Despite this, hempseed has been banned in North America since the 1930s, when all varieties of cannabis were made illegal due to its tetrahydrocannabinol (THC) content.

THC is the compound that induces the "high" in recreational use of cannabis. However, hemp with low THC content (0.3%) has been legalized by the European Union, and the global economic market for low-THC hemp - used in medicines, papers and fabrics - is valued at $100-200 million annually.

Researchers analyzed a portion of hempseed oil to see what beneficial qualities it may have. They found that some of its components are effective at promoting good health. These include sterols, aliphatic alcohols and linolenic acids.

Linolenic acids, sterols and aliphatic alcohols
One of the linolenic acids contained in hempseed oil is an omega-3 fatty acid that some studies have recognized as preventing coronary heart disease. Sterols are steroid alcohols. Experts know that sterols are useful in lowering cholesterol, and daily dietary intake of sterols has been linked to a lower risk of heart attack.

  The aliphatic alcohols contained in hempseed oil have also been known to lower cholesterol and reduce platelet aggregation. One of these alcohols, phytol, is associated with antioxidant and anticancer benefits, and can also be found in healthy foods such as spinach, beans, raw vegetables and asparagus.

Another antioxidant in hempseed oil is tocopherol, which is known to be beneficial against degenerative diseases, such as atherosclerosis and Alzheimer's. Among other benefits, hempseed oil has also shown a positive effect on dermatological diseases and lipid metabolism (the process by which fatty acids are broken down in the body).

 Hempseed also has high levels of vitamins A, C and E and β-carotene, and it is rich in minerals like phosphorus, potassium, magnesium, sulfur and calcium. As a food, hempseed oil is nutritious - it contains an excellent balance of polyunsaturated fatty acids - and it reportedly tastes good, too.

Colorado recently legalized marijuana for recreational use and some states have passed laws allowing the medicinal use of marijuana. In 2013, Medical News Today reported on a study suggesting that the THC content of marijuana may be medically beneficial for people who have an autoimmune disease.


Prince Charles makes plea on alternative medicine


Prince of Wales calls for alternative medicine to be treated fairly and for regulation to govern its use.

The Prince of Wales is pushing for an acceptance of complementary medicines and urging medical watchdogs to regulate their professions in order to better protect patients.

Two years ago the Coalition pledged to bring in an official register of practitioners of herbal and Chinese medicines, which would see therapists regulated alongside other health care workers. It followed two public consultations which found overwhelming support for the proposals. But ministers have blocked the proposals, instead setting up a new committee – which has just secretly drawn up plans to spend a further 18 months re-examining the matter.

Prince Charles is said to be increasingly frustrated about “delay tactics” which mean that the proposals may not be published until next year and then would be highly likely to be cast aside again as an election looms. Well-placed sources said that the Prince was passionate about integrated health policies and the proper regulation of complementary as well as mainstream medicines. He is understood to have raised his concerns with Jeremy Hunt, the Health Secretary, during a meeting at Clarence House.

A source said that the Prince wanted to see “evidence-based complementary treatments taking a proper integrated approach that gives people choice and where regulation would build confidence in making choices”. Senior figures in complementary medicine said the safety of the public was being compromised by a reluctance of ministers to tackle the controversial issue and set standards to weed out rogue practitioners.

Dr Michael Dixon, the chairman of the College of Medicine, which advocates an “integrated” approach to medicine – so that complementary therapies such as homoeopathy, acupuncture and herbal remedies are evaluated alongside mainstream medicine – said: “The Prince of Wales has consistently pushed for stricter controls over complementary medicines so that the public has a real choice about treatment, and is properly protected.”

Dr Dixon, a GP, who previously worked as medical director on a health charity set up by Prince Charles, said: “We need to introduce regulation in order to protect the public and also to make sure that good practitioners don’t get tainted by the bad apples out there.” Under Labour, there were two public consultations – in 2004 and 2009 – which found high levels of public support for regulation of those practising herbal and Chinese medicines.

In 2011 Andrew Lansley, the health secretary at the time, pledged to introduce a register, which would see therapists regulated by the Health and Care Professions Council, alongside 16 other types of health-care professionals, such as physiotherapists, speech therapists and dietitians. Plans were drawn up to bring in regulation by the end of 2012.

Last month, however, Dr Dan Poulter, the health minister, wrote to senior figures in the industry, inviting them to become part of an independent Herbal Practitioners and Medicines Working Group “with the aim of reviewing, advising and making recommendations to government on the way forward in this complex area”. Draft terms of reference, seen by The Telegraph, set out a timetable for discussions – with a final report not scheduled until March 2015, meaning any recommendations would almost certainly be put aside in the run-up to an election.

Michael McIntyre, the chairman of the European Herbal and Traditional Medicine Practitioners Association – one of those invited to join the committee – said that he was “deeply concerned” by the apparent delay tactics. He told The Sunday Telegraph: “In February 2011 Andrew Lansley agreed that these plans would go ahead. Since then there has been nothing, until now, and the setting up of yet another committee about it, starting all over again.”

In an article published last month by a health-care journal, Mr McIntyre wrote: “For over 30 years, the Prince of Wales has been a tireless advocate of such an integrated health approach not just in the interests of patient choice but also because it created a powerful focus on the prevention of ill health.” He said the Prince had “consistently urged politicians and health-care professionals to progress as fast as possible with the regulation of herbal medicine practitioners to safeguard the public.”

Mr McIntyre raised his concerns about the delays with ministers last month. In a letter to Dr Poulter, he wrote: “This invitation and its terms of reference add to widespread concern that the Government is going back on its public promise of February 2011 to bring in statutory regulation of UK herbal practitioners – a view borne out by the protracted timetable set for this work.”

A spokesman for the Department for Health said that its officials had been working with the UK’s devolved administrations since 2011 in order to determine how best to “balance public protection with consumer choice” in herbal medicine and had set up the working group because the issues involved were complex.


Multiple medication use not always hazardous


New research finds that patients with a single illness who take multiple drugs - referred to as "polypharmacy" - have a higher risk of hospital admission, compared with polypharmacy patients with multiple health conditions, who have a "near-normal" admission risk. This is according to a study published in the British Journal of Clinical Pharmacology.

The study researchers, led by Dr. Rupert Payne of the Cambridge Centre for Health Services Research in the UK, say that their findings suggest a need for doctors to take "more sophisticated approaches" when prescribing medications to patients.

The incidence of polypharmacy is growing, according to the investigators, mainly because the number of elderly people is increasing and more people are being diagnosed with multiple illnesses.

However, the researchers note that increasing numbers of prescribed medications have been associated with a series of adverse health outcomes.

  "These include high-risk prescribing, adverse drug reactions and death. Excessive numbers of medicines may contribute to poorer medication adherence, as well as being associated with lower quality of life," the study authors write.

To determine how pharmacology impacts the risk for hospital admission, the research team analyzed Scottish National Health Service (NHS) primary care data for 180,815 adults aged 20 years or older who had long-term medical conditions.

They assessed the number of medications each person was receiving and linked this to the number of times each patient was admitted to a hospital the following year.

Assumption that polypharmacy is always hazardous is 'misleading'

The analysis revealed that just under 50% of patients were prescribed at least one regular medication, while 25.2% were prescribed one to three medications, 11% were prescribed four to six, 5.9% were prescribed seven to nine, and 4.6% were prescribed 10 or more medications.

  The researchers found that patients who had a single illness who were taking 10 or more medications were three times more likely to have an unplanned admission to the hospital, compared with patients with a single illness who took one to three medicines.

However, on analyzing patients who had six or more illnesses who used 10 or more medications, the researchers found they only increased their risk of hospital admission by 1.5 times, compared with patients with six or more illnesses who took one to three medicines. Commenting on the findings, Dr. Payne says:

"The commonly held assumption that polypharmacy is always hazardous and represents poor care is misleading. Our work shows that we need more sophisticated approaches to assessing the appropriateness of each patient's set of medicines."

He adds that these improved approaches are particularly relevant to medication prescribing in general practice, as it is in this environment where most of the long-term clinical care is carried out, and where clinicians prescribe drugs for long periods.

  "It is particularly important at times when doctors are caring for older patients and those with multiple medical conditions in whom multiple medications are often used," Dr. Payne adds. The research team notes that the findings of this study are strong, as they directly analyzed the interaction between morbidity and medication burden - something they say other studies looking at polypharmacy have failed to do.  

Dr. Payne adds that future research that measures the impact of pharmacology should adopt more "sophisticated and nuanced approaches."


Ear Acupuncture Can Help Shed Pounds


Ear acupuncture can help shed the pounds, indicates a small study published online in Acupuncture in Medicine.

Using continuous stimulation of five acupuncture points may be better at reducing abdominal fat (the midriff bulge) than single point stimulation, the findings suggest. Auricular acupuncture therapy is based on the understanding that the outer ear represents all parts of the body. It was first used in France in 1956 by Dr Paul Nogier who noticed that a patient's back-ache was cured after s/he sustained a burn on the ear. Since then the approach has been used to treat drug addiction and help people give up smoking and lose weight.

The Korean researchers compared acupuncture of five points on the outer ear - shen-men (divine gate); spleen, stomach, hunger, and endocrine - and one point (hunger) - with sham treatment on 91 overweight adults (BMI of 23 or more). Participants were asked to follow a restrictive (although not weight loss) diet and not to take any extra exercise during the eight week period of their treatment. Thirty one people were randomly assigned to the five point treatment, which involved the insertion of acupuncture needles 2mm deep into the outer ear.

These were kept in place with surgical tape for a week, after which the same treatment was applied to the other ear, with the process repeated over eight weeks. Another 30 people were assigned to the same treatment process, but at just the one hunger point. And a further 30 were given sham treatment - with the same process and timescales, but with the removal of the needles immediately after insertion. All participants were weighed and measured at the start and end of treatment, and four weeks in, to include BMI, waist circumference, body fat mass, percentage body fat, and blood pressure to see what impact acupuncture might have.

Twenty four people dropped out before the eight weeks were up, 15 of whom were in the sham treatment group, suggesting that perhaps they found it harder to regulate their desire to eat and cope with the restrictive diet, say the authors. But among those who kept going for the entire period, significant differences were apparent after four weeks, with the active treatment groups showing a 6.1% (5-point treatment) and 5.7% (1-point treatment) reduction, respectively, in BMI compared with the sham treatment group among whom there was no reduction in BMI.

Weight also differed significantly after four weeks in both active treatment groups compared with the sham treatment group. Waist circumference fell, with the largest drop seen in the group on the 5-point treatment compared with the sham groups, although this difference disappeared after taking account of age. Measures of body fat also fell after eight weeks, but only in those receiving the 5-point treatment. There were no significant differences in blood pressure among the groups.


Genetic Clue to Fighting New Strains of Flu


Researchers at the University of Melbourne have discovered a genetic marker that can accurately predict which patients will experience more severe disease in a new strain of influenza (H7N9) currently found in China.

Published in the journal Proceedings of the National Academy of Sciences, senior author, Associate Professor Katherine Kedzierska from the Department of Microbiology and Immunology said that being able to predict which patients will be more susceptible to the emerging influenza strain, will allow clinicians to better manage an early intervention strategy.

"By using genetic markers to blood and lung samples, we have discovered that there are certain indicators that signal increased susceptibility to this influenza. Higher than normal levels of cytokines, driven by a genetic variant of a protein called IFITM3, tells us that the severe disease is likely," she said.

"We call this a Cytokine Storm and people with the defective genetic variant of the protein IFITM3 are more likely to succumb to severe influenza infection. Professor Peter Doherty, AC, Laureate Professor and a lead author of the study from the University of Melbourne said predicting how influenza works in individuals has implications for the management of disease and the resources on our health system.

"We are exploring how genetic sequencing and early identification can allow us to intervene in treating patients before they become too unwell. As new cases of influenza emerge in the Northern Hemisphere, we try to keep a season ahead and prepare to protect the most vulnerable in our community," he said.

Though the H7N9 strain has not been found in Australia, researchers from the University of Melbourne are collaborating closely with Prof Jianqing Xu and his group from the Shanghai Public Health Clinical Center in China. In addition to this, Dr Zhongfang Wang, an NHMRC Australian-China Exchange Fellow is also working closely with Melbourne experts.


Acupuncture significantly reduces pain following C-section


Acupuncture significantly reduces both pain and painkiller use following surgeries including Cesarean sections, research has shown.

In one study, published in the Chinese Medical Journal in 2009, researchers from Kaohsiung Medical University in Taiwan assigned 60 women who had undergone C-sections either to a control group or to a group that received pain treatment via acupuncture or electro-acupuncture.

They found that compared with the control group, women in the acupuncture group had significantly lower pain scores in the two hours following surgery, requested morphine an average of 10 minutes later, and used 30 to 35 percent less morphine within the first 24 hours after surgery. They also experienced significantly fewer opioid-related side effects.

Acupuncture for pain relief

Acupuncture is a traditional Chinese medical practice that consists of inserting thin needles into specific bodily locations (meridians), as indicated by the problem being treated. A growing body of scientific research now supports the effectiveness of acupuncture in treating a wide variety of health conditions, particularly pain. Its use is now covered by many private insurance plans.

Indeed, the Cesarean study is not the first to link acupuncture to lower painkiller use following surgery. A study conducted by researchers from Duke University and presented at a 2008 conference of the American Society for Anesthesiology reviewed the results of 15 separate clinical trials involving the use of acupuncture either preceding or following surgery. Whether undergone before and after surgery, acupuncture led to significantly lower pain levels and use of painkillers in post-surgical patients. Less painkiller use also meant fewer side effects.

Participants who had not received acupuncture were 1.5 times more likely to experience nausea, 1.6 times more likely to experience dizziness, and 3.5 times more likely to experience urinary retention problems related to painkiller use. Acupuncture appears to be highly effective for the treatment of all types of pain, not simply post-surgical pain.

In a study published in the Archives of Internal Medicine in 2008, 1,162 adults with chronic-lower back pain were randomly assigned to be treated either with traditional acupuncture, "sham" acupuncture (in which needles were not inserted at the appropriate meridians), or the standard Western treatment of drugs combined with exercise.

The researchers found that only 27 percent of participants in the Western treatment group reported at least a 33 percent decrease in pain and an improvement in their ability to function, compared with 44 percent of the sham acupuncture participants and 48 percent of the traditional acupuncture participants. Another meta-analysis, published in the Archives of Internal Medicine in 2012, reviewed the data from 29 prior studies involving almost 18,000 people.

Participants in the original studies had suffered from chronic pain due to causes including arthritis, recurring headaches, and back, neck and shoulder pain. All participants had been assigned either to acupuncture, sham acupuncture or standard Western treatments (including drugs and physical therapy). The researchers found that on a pain scale of 100, the average participant had a pain score of 60 at the start of any given study.

After Western treatment, the score dropped to 43, compared with a drop to 35 for sham acupuncture and 30 for traditional acupuncture. Findings such as these have led some researchers to speculate that much of acupuncture's pain-relieving benefit comes from the placebo effect.

But why it works is less important than the fact that it does work, says researcher Andrew Avins of the University of California-San Francisco. Writing in the Archives of Internal Medicine in 2012, he suggested that the scientific evidence now supports offering all patients acupuncture for pain relief.


Diet drinks’ link to cardiometabolic disease elusive


Diet drinks might be protective rather than causative in cardiometabolic diseases such as obesity and type 2 diabetes, but definitive data are lacking.

"I would say that based on the scientific evidence to date, it might be a good idea to switch to artificially sweetened beverages, but I don’t see the evidence to either promote or avoid them," said Mark Pereira, Ph.D., of the School of Public Health at the University of Minnesota, Minneapolis.

There are data linking sugar-sweetened beverages to metabolic disorders. Findings from a recent, small, but "pretty provocative" randomized pilot study point to a relationship between sugar-sweetened beverages’ strong effect on visceral fat, particularly in the intra-abdominal cavity, he said. Diet drinks were not found in the study to have a positive association with this kind of adiposity (Am. J. Clin. Nutr. 2012;95:283-9).

The significance of this is that visceral adipose tissue in the gut "is consistent with a higher cardiometabolic risk profile," he said at Obesity Week, presented by the Obesity Society and the American Society for Metabolic and Bariatric Surgery.

The study supports findings from the National Heart, Blood, and Lung Institute’s prospective Coronary Artery Risk Development in Young Adults (CARDIA) study of 3,000 individuals.

Imaging done across the cohort at year 25 of the study showed a weak association between artificially sweetened beverages and the volume of fat in the visceral cavity, but a "really, really strong" association with sugar-sweetened beverages and visceral cavity adipose tissue, said Dr. Pereira.

"If you look at the true drivers of metabolic risk, the visceral fat, it’s not there with the artificially sweetened drinks, it’s only there with the sugar-sweetened ones," he said. Although both diet and sugar-sweetened drinks have positive associations with incident diabetes and other metabolic disturbances, the relationship between "diet drinks and cardiometabolic risk may be an anomaly of reverse causality," Dr. Pereira said.

While findings from the CARDIA study show an association between waist circumference and consumption of diet drinks, there was not an association with blood sugar, lipids, or blood pressure. "So, the question is, ‘Why isn’t [diet drink consumption] driving the risk factors?" asked Dr. Pereira.

However, the extent of reverse causality in this patient population, said Dr. Pereira, is still unknown: "There could be an increased risk [of cardiometabolic disease] with a higher intake of artificially sweetened drinks, but you could also say it is protective."

The lack of certainty, according to Dr. Pereira, is due to a drought of data from well designed studies.


Quitting Tips for Thursday's Great American Smokeout


In advance of Thursday's Great American Smokeout, an expert offers some tips on how to quit smoking.

Being mentally ready to quit smoking is the most important indicator for success, said Robert DiGregorio, senior director of pharmacy services at the Brooklyn Hospital Center and an expert in smoking cessation. For some people, graphic antismoking ads are a motivator. Others may decide to quit due to education and awareness about the effects of secondhand smoke on children. Still others quit because of the high cost of smoking.

Regardless of their reasons, many people find it difficult to quit. It can take an average of four tries over one to two years to kick the habit, DiGregorio said. There are a variety of questionnaires available online or from doctors that can help smokers determine if they're ready to quit. The simplest indicator is to ask yourself if you are thinking about quitting in the next 30 days.

If you are, then you are ready to quit and should seek help from a health professional to develop a specific plan, DiGregorio said in a hospital center news release. He said the 30-day question is important for two reasons. First, it has been shown to be an effective predictor of readiness. Second, certain treatments take up to 14 days to be effective. Many products are designed to help people quit smoking, including nicotine patches and the medications Chantix (varenicline) and Zyban (bupropion).

Short-acting aids include nicotine gum, inhalers, nasal spray and lozenges. Chantix and Zyban are effective, but have drawbacks, according to the news release. Chantix carries a warning about psychiatric side effects, and Zyban has been linked to seizures and mood disorders in some patients. As for electronic cigarettes, the jury is still out on whether they are a safe and effective way to help people quit smoking, DiGregorio said.

If you are trying to quit smoking and have cravings, DiGregorio recommended using the five Ds: Delay until the urge passes, usually three to five minutes; distract yourself; drink an ice-cold glass of water; deep breaths to relax; and discuss your feelings with someone. DiGregorio said successful quitters have a support network or coaches to help them get through the most difficult challenges and reward themselves for success.



Acupuncture Lowers Hypertension


A new recently published case study highlights the efficaciousness of acupuncture for the treatment of hypertension, high blood pressure.

Researchers measured several key improvements as a result of acupuncture treatments. The patient had a significant reduction in blood pressure, fewer side effects from antihypertensive medications and an increased sense of well-being. The goal of the study was to measure the effects of acupuncture on hypertension for a patient having difficulty tolerating medications for the condition.

The researchers concluded that acupuncture has a synergistic effect when combined with antihypertensive medication. The patient highlighted in the study began with a blood pressure reading of 160/100 mm Hg. The first step of his treatment regime began with medication therapy, which was able to reduce his blood pressure to 150/99 mm Hg.

However, he experienced flushing, palpitations, diarrhea, fatigue, decreased sexual function and a variety of other clinical disorders. Acupuncture was added to the regime and the blood pressure lowered to 128/85 mm Hg. By the seventh week of acupuncture treatments combined with medication therapy, the blood pressure averaged 130/80 mm Hg and the antihypertensive medication side effects completely disappeared.

The patient no longer suffered from issues such as impotence, fatigue and diarrhea. The acupuncture points used in the study were: LI4, LI11, ST36, ST9. Acupuncture needles were inserted bilaterally and perpendicularly to a depth of 0.8 to 1.0 cun.

Tonification needle techniques were applied to LI11, ST36, and ST9 using a twirling technique for a duration of 1 minute. LI4 was stimulated with a twirling, reducing method for 1 minute. The total duration of needle retention per acupuncture treatment was 30 minutes.

Additional points were added to eliminate the side effects of the blood pressure medications: CV4, CV6 and SP6. An intensive schedule of 60 acupuncture treatments over the course of 12 weeks was administered.

The authors of the study note that abundant research supports the use of acupuncture points LV3, LI11, GB20, ST36 and ST40 for the treatment of hypertension. The researchers chose the acupuncture point prescription for this patient based on Traditional Chinese Medicine (TCM) meridian theory.

Yangming channel acupuncture points such as LI11, ST36 and LI4 were chosen for their ability to ‘reconcile qi and blood.’ Additionally, ST9 was included for its specific function in regulating qi and blood and because it is a meeting point of the Stomach and Gallbladder meridians. The authors also note ST9’s proximity to the carotid sinus and its specialized ability to regulate blood pressure.


Yoga in Menopause May Help Insomnia


Taking a 12-week yoga class and practicing at home was linked to less insomnia - but not to fewer or less bothersome hot flashes or night sweats.

The link between yoga and better sleep was the only statistically significant finding in this MsFLASH (Menopause Strategies: Finding Lasting Answers for Symptoms and Health) Network randomized controlled trial.

"Many women suffer from insomnia during menopause, and it's good to know that yoga may help them," said lead author Katherine Newton, PhD, a senior investigator at Group Health Research Institute. She e-published these findings in Menopause, ahead of print.

"Hormone therapy is the only Food and Drug Administration-approved treatment for hot flashes and night sweats," Dr. Newton said, "and fewer women are opting for hormone therapy these days."

That's why MsFLASH tried to see whether three more "natural" approaches - yoga, exercise, or fish oil- might help ease these menopause symptoms.

The study assigned 249 healthy, previously sedentary women at multiple sites, including Group Health, to do yoga, a moderate aerobic exercise program, or neither - and to take an omega-3 fatty acid supplement or a placebo.

Exercise seemed linked to slightly improved sleep and less insomnia and depression, and yoga also was linked to better sleep quality and less depression - but these effects were not statistically significant.

The omega-3 supplement was not linked to any improvement in hot flashes, night sweats, sleep, or mood.


Shake Off Stress by Walking in the Woods


Work, home, even in the car, stress is a constant struggle for many people. But it's more than just exhausting and annoying. Unmanaged stress can lead to serious health conditions such as high blood pressure, heart disease, obesity and diabetes.

"The American lifestyle is fast-paced and productive, but can be extremely stressful. If that stress it not addressed, our bodies and minds can suffer," said Dr. Aaron Michelfelder, professor of family medicine at Loyola University Chicago Stritch School of Medicine.

Our bodies need sleep to rejuvenate and if we are uptight and stressed we aren't able to get the rest we need. This can lead to serious physical and mental health issues, which is why it's extremely important to wind down, both body and mind, after a stressful day.

According to Michelfelder, one of best ways to wind down and reconnect after a stressful day is by taking a walk. Though any walking is good, walking in the woods or in nature has been proven to be even better at reducing stress and improving your health.

"When we get to nature, our health improves," Michelfelder said. "Our stress hormones rise all day long in our bloodstream and taking even a few moments while walking to reconnect with our inner thoughts and to check in with our body will lower those damaging stress hormones. Walking with our family or friends is also a great way to lower our blood pressure and make us happier."

  Research out of Japan shows that walking in the woods also may play a role in fighting cancer. Plants emit a chemical called phytoncides that protects them from rotting and insects. When people breathe it in, there is an increase in the level of "natural killer" cells, which are part of a person's immune response to cancer.

  "When we walk in a forest or park, our levels of white blood cells increase and it also lowers our pulse rate, blood pressure and level of the stress hormone cortisol," Michelfelder said. He also suggests reading, writing, meditating or reflecting to help calm the mind after a long day. To help calm the body yoga and breathing exercises also are good.

"If you want to wind down, stay away from electronic screens as they activate the mind. Electronic devices stimulate brain activity and someone's post on Facebook or a story on the evening news might cause more stress," Michelfeder said.


Vitamin D pills' effect on healthy bones queried


Healthy adults do not need to take vitamin D supplements, suggests a study in The Lancet which found they had no beneficial effect on bone density, a sign of osteoporosis.

But experts say many other factors could be at play and people should not stop taking supplements. University of Auckland researchers analysed 23 studies involving more than 4,000 healthy people. The UK government recommends children and over-65s take a daily supplement.

The New Zealand research team conducted a meta-analysis of all randomised trials examining the effects of vitamin D supplementation on bone mineral density in healthy adul14ts up to July 2012. The supplements were taken for an average of two years by the study participants. Bone mineral density is a measure of bone strength and measures the amount of bone mineral present at different sites in the body. It is often seen as an indicator for the risk of osteoporosis, which can lead to an increased risk of fracture.

The trials took place in a number of different countries including the UK, the US, Australia, Holland, Finland and Norway. Although the results did not identify any benefits for people who took vitamin D, they did find a small but statistically significant increase in bone density at the neck of the femur near the hip joint. According to the authors, this effect is unlikely to be clinically significant.

Free up resources Prof Ian Reid, lead study author, from the University of Auckland, said the findings showed that healthy adults did not need to take vitamin D supplements.

"Our data suggest that the targeting of low-dose vitamin D supplements only to individuals who are likely to be deficient could free up substantial resources that could be better used elsewhere in healthcare." Writing about the study in The Lancet, Clifford J Rosen from the Maine Medical Research Institute agrees that science's understanding of vitamin D supports the findings for healthy adults, but not for everyone.

"Supplementation to prevent osteoporosis in healthy adults is not warranted. However, maintenance of vitamin D stores in the elderly combined with sufficient dietary calcium intake remains an effective approach for prevention of hip fractures."

The Department of Health currently recommends that a daily supplement of vitamin D of 10 micrograms (0.01mg) should be taken by pregnant and breastfeeding women and people over 65, while babies aged six months to five years should take vitamin drops containing 7 to 8.5 micrograms (0.007-0.0085mg) per day.


BBC News


Olympic athletes lose to poor dental health


Olympic athletes appear to be at an increased risk of poor dental health, an outcome that may negatively impact on their well-being and also on their ability to train and perform, research shows.

“It is amazing that many professional athletes – people who dedicate a huge amount of time and energy to honing their physical abilities – do not have sufficient support for their oral health needs, even though this negatively impacts on their training and performance,” says lead author of the study Professor Ian Needleman from the UCL Eastman Dental Institute in London, UK.

As reported in the British Journal of Sports Medicine, 302 athletes representing 25 different sports underwent an oral health check at a dental clinic in the Olympic village at the London 2012 Olympic games. They were also asked to describe any impact of oral health on their quality of life, training and performance.

Results showed that, overall, the athletes had a high level of poor oral health. More than three quarters (76%) had gingivitis or gum disease and 15% had periodontitis, a severe form of gum disease that damages the soft tissue and bone that surround and support the teeth. Fifty-five percent of the participants had tooth decay, 45% had dental erosion, and 41% had tooth decay that had irreversibly eroded the dentine - the calcified material underneath the enamel that forms the main part of the tooth.

In addition, 40% of the participants reported being “bothered” by their oral health, with 28% saying the problem impacts on their quality of life and 18% claiming detrimental effects on their training and performance. Needleman and team also report that nearly half (46.5%) of the athletes said they had not attended a dental examination in the previous year and 8.7% said they had never visited a dentist at all. "Oral health assessment should be part of every athlete's routine medical care,” advises Needleman.

"If we are going to help them optimise their level of performance we need to concentrate on oral health promotion and disease prevention strategies to facilitate the health and wellbeing of all our elite athletes." The findings support previous studies reporting poor oral health among athletes, something which researchers suggest may result from frequent consumption of carbohydrates, an impaired immune response as a result of intensive training and a general lack of awareness about the possible impacts of poor oral health on performance.


Obamacare premium rates lower than expected


The Obamacare premiums will cost less than predicted, according to data released Wednesday by the Obama administration.

The release provided the first look into rates for consumers buying individual insurance on the 36 federally run exchanges. The national average premium for the benchmark plan will be $328 a month before subsidies, 16% less than projected by the Congressional Budget Office. The benchmark is the second-lowest cost "silver" policy for 48 states, upon which federal subsidies are based.

Related: See the Obamacare insurance rates
Subsidies will offer maximum caps for low- and moderate-income Americans in the benchmark plans. But for those who opt for other levels of coverage, or make too much to qualify for subsidies, prices vary widely based on one's age, income and state. For instance, a 27-year-old living in Dallas making $25,000 could pay as little as $74 a month for the cheapest "bronze" plan after subsidies, according to the Department of Health and Human Services. But a 60-year-old in Wyoming who makes more than $46,000 a year -- too much to get a tax credit -- could pay as much as $758 for a similar plan. The majority of people uninsured today will be able to find a policy for $100 or less a month, taking into account subsidies and Medicaid eligibility, the administration said.

Obamacare out-of-pocket cost confusion
Consumers will be able to start enrolling in the exchanges on Oct. 1, with coverage beginning in January. Starting in 2014, nearly everyone must have insurance -- either through their jobs, government programs or the individual market -- or face a penalty. The rates released Wednesday do not apply to those who receive insurance through their employer.

Subsidies: What you'll actually pay for Obamacare
Most people who are expected to sign up for coverage in the exchange have incomes up 400% of poverty and will therefore be eligible for federal subsidies. The lower your income and the more expensive the benchmark plan in your state, the larger your subsidy. For instance, those making $17,235 a year will pay no more than 4% of income, or $57 a month, for the benchmark plan. Those with incomes between $34,470 and $45,960 will pay a maximum of 9.5% of income, or $364 a month, for that benchmark plan.

The federal government will cover the rest. But these consumers can put their subsidy toward a cheaper plan than the benchmark policy and pay less per month. They can also choose a more expensive plan and pay more. Anyone earning more than $45,960 would be responsible for the entire tab on the Obamacare health plan of his choice. Additional information, including the names of insurers offering plans on the federal exchanges and the deductibles and co-pays associated with the policies, has yet to be unveiled.

The department just said that the number of plans ranges from 6 to 169, depending on the area. Consumers will have a choice of as few as one insurer and as many as 13, based on where they live. In states where there are only a handful of insurers, premiums are much higher, said Gary Claxton, vice president at the Kaiser Family Foundation. In the three most expensive states, Wyoming, Alaska and Mississippi, residents will only have a choice of two insurers.

Check out Kaiser's calculator to estimate your subsidy amount.
While the administration's report looks only at monthly premiums, a health care advisory firm issued a report Wednesday saying that consumers in the exchange will face high out-of-pocket costs in the bronze- and silver-level plans. These policies have lower deductibles than gold and platinum plans, but carry higher cost sharing burdens. The average silver plan will carry a $2,550 deductible and $30 primary care co-pay, while the typical bronze plan will have a $5,150 deductible and $39 co-pay, according to Avelere Health. The firm looked at policies in six states that have released detailed data.


Treat the Fungus Among Us With Nontoxic Medicinal Compound


A Kansas State University microbiologist has found a breakthrough herbal medicine treatment for a common human fungal pathogen that lives in almost 80 percent of people.

Govindsamy Vediyappan, assistant professor of biology, noticed that diabetic people in developing countries use a medicinal herb called Gymnema slyvestre to help control sugar levels. He decided to study the microbiological use of Gymnema slyvestre -- a tropical vine plant found in India, China and Australia -- to see if it could treat a common human fungal pathogen called Candida albicans.

The investigation was successful on two levels: Vediyappan's research team found the medicinal compound is both nontoxic and blocks the virulence properties of the fungus so that it is more treatable. The results are important for human health, biomedical applications and potential drug development.

"We have shown that this compound is safe to use because it doesn't hurt our body cells, yet it blocks the virulence of this fungus under in vitro conditions," Vediyappan said. "Taking the medicine could potentially help patients control the invasive growth of the fungus and also help bring their sugar levels down."

Candida albicans is one of the major fungal pathogens in humans because it lives in oral and intestinal areas as a normal flora, Vediyappan said. But the fungus can overgrow and can cause oral, intestinal and genital infections. The mortality rates for those with candidemia and invasive candidiasis has been reported to be quite high, and it is a concern among cancer patients - especially patients with neck or oral cancer - HIV patients, organ transplant patients and other people with compromised immune systems.

The fungus can grow in two forms: a treatable yeast and a difficult-to-treat hyphal form. Once the fungus transforms from a yeast to a hyphal growth it becomes difficult to treat because the hyphal growth has long filament-like structures that can spread into various organs. Vediyappan's study aimed to block the hyphal growth form.

"Once it gets into the tissue, it spreads like roots and is difficult to contain by our immune system," Vediyappan said. If the fungus remains in yeast form, it is easy to manage and does not invade tissues. Vediyappan's research team purified gymnemic acid compounds that prevented the transition stage from occurring and stopped the fungus spread. The gymnemic acids come from the leaves of Gymnema sylvestre, a traditional medicinal plant.

The research appears in the peer-reviewed journal PLOS ONE in an article titled "Gymnemic acids inhibit hyphal growth and virulence in Candida albicans." Gymnema extract is commonly used to treat diabetes and other ailments because it is a cost-effective treatment, Vediyappan said. Often, people drink the extract to control their sugar levels or to lose weight.

Although Vediyappan's research team is not the first to discover gymnemic acid compounds, the team is the first to discover that the compounds block the fungal transition. The researchers found that the compounds work quickly, too, which was an important characteristic. The treatable fungal yeast can transition to a hyphal growth within 30 minutes of an infection. When the hyphal transition has occurred, it will grow into branched filaments.


Doctor Reprimanded For Prescribing Narcotics Via Skype


An Oklahoma doctor was penalized on Thursday for allegedly prescribing medicine via the Internet video-messaging platform Skype.

These prescriptions were given by Dr. Thomas Trow, of the eastern Oklahoma town Park Hill, without an initial in-person evaluation.

According to a News OK investigative report, the medications included “controlled dangerous drugs," such as Xanax and other potent narcotic pharmaceuticals.

One of Trow’s patient’s - known as “R.C.” in official documents - was subsequently treated for three incidents of drug overdosing within a six-month period, according to the medical board review.

  Although doctor-patient chats via Skype are growing in popularity across the country, this video chat platform is not approved for telemedicine communication in Oklahoma.

The popular messaging system does not meet Health Insurance Portability and Accountability Act (HIPAA) standards for web-based security, meaning privileged health conversations on Skype between physicians and patients are vulnerable to hackers.

Many hospitals and healthcare providers are working with private telemedicine companies to create innovative systems that provide HIPAA compliance. Trow cited his own failing health as his reason for using Skype.

“He said his (registered nurse) traveled to the various satellite clinics and presented the patients to him via Skype,” a board investigator wrote in the complaint against Trow, according to News OK.

“He stated that he did not think he had to see patients in person since they were psychiatric patients.” Three of Dr. Trow’s patients - including R.C. - died while under his care, although those deaths were not ultimately attributed to Trow during his disciplinary hearing.

Trow was given two years of medical probation and must complete a course on prescribing rules before seeing patients again.


Stick Insect May Hold Key To Antibiotic Resistance


A stick insect may hold the key to unraveling antibiotic resistance in bacteria.

BBC reports that a microbe in the digestive system of the the Giant Lime Green stick insect may inspire researchers in their endeavor to develop new drugs against antibiotic resistant superbugs. In light of the recent statistical surge in such bacteria cultures, the discovery could be of crucial importance to national disease prevention strategies.

"We have discovered the microbe in the stick insect's gut is resistant to toxins and infections it could never have been exposed to,” said Tony Maxwell, head of biology at the John Innes Centre (JIC) in Norwich, England, where the insect is currently being studied.

“This indicates that there is a general mechanism at work. If we can unravel that, then it opens the way to understanding antibiotic resistance and this will enable us to build a chemical strategy against it.”

The finding may also allow researchers to implement into drugs a mechanism that counters the resistance offered by superbugs. That said, the Giant Lime Green stick insect is not the only candidate for humanity’s antibiotic savior.

Several other organisms are currently being studied all around the world - particularly soil bacteria, in which modern-day antibiotics originate. Another example is the tropical leafcutter ant, whose populations cultivate and protect a particular fungus food source. The evolutionary dependence has endowed the species with a wide spectrum of antibiotic agents used to repel parasites and microbes.

According to the UK’s deputy chief medical officer, Professor David Walker, the circumvention of antibiotic resistance in pathogens has become a global priority. Failure to address the situation may result in further mutations and more resilient agents. Eventually, it could render the global mainstay in disease prevention utterly useless.



Scientists uncover secrets of sleep effect on tasks


Sleep is well-known to help us better understand what we have learned. But now, researchers believe they have discovered exactly how sleep helps our brains to better learn specific motor tasks, such as typing or playing the piano.

The study, published in the Journal of Neuroscience, is the first to use three different brain scans in order to determine changes in particular brainwaves and the exact location of changed brain activity in specific motor learning subjects. Researchers carried out an analysis of 15 subjects who volunteered for motor learning experiments, which involved a series of finger-tapping tasks. For the first 3 nights, the participants slept at whatever time they wanted to.

During this period, their brains were scanned using magnetoencephalography (MEG). This measured oscillations in the brain - rhythmic neural activity in the central nervous system - as well as polysomnography (PSG), which is tracking of the sleep phase. The study authors say that by the end of the 3 nights, they had good baseline measurements of brain activity, and the participants had become used to sleeping in their surroundings.

Finger tapping tasks The participants were then required to carry out a series of finger-tapping tasks on their "non-dominant" hand, in order to make it harder to learn. Nine of the participants then slept for 3 hours, while the other six stayed awake. All participants were then scanned again with MEG and PSG. One hour later, all participants were asked to perform the finger-tapping task. The results of this experiment showed that those who slept performed the task faster and more accurately compared with those who stayed awake.

Each participant was then scanned using magnetic resonance imaging (MRI) in order to see where the MEG oscillations they observed earlier were located in each individual's brain. The findings revealed five different oscillations over eight different brain regions - four on each side of the brain. The researchers expected the most significant activity to take place in the M1 region of the brain - the area responsible for motor control.

However, significant changes were instead discovered in the SMA (supplementary motor area) - a region in the top-middle of the brain. The researchers then used caps of EEG sensors to further monitor brainwave changes in the participants. They found that the brainwave changes occurred during a specific phase of sleep called "slow-wave" sleep. The study showed that two specific brainwave oscillations were identified in the SMA that play a part in the "reorganization" the brain carries out during sleep, in order to encourage motor learning.

"Delta" oscillations appeared to control changes in the connectivity of the SMA, while "fast-sigma" oscillations seemed to be related to changes in the SMA itself. Further studies to incorporate visual tasks These findings support the two criteria set at the beginning of the study, the researchers say. The delta and fast-sigma oscillations changed substantially after the subjects were trained in the finger-tapping tasks, and the strength of that change was linked to how much the participant's performance improved on each task.

The study authors say they have already started a new study to further understand how the brain consolidates the learning of visual tasks. They add that they would like to see whether similar frequency bands would be uncovered along with a similar organization of brain areas.


Coffee drinking tied to lower risk of suicide


Drinking several cups of coffee daily appears to reduce the risk of suicide in men and women by about 50 percent, according to a new study by researchers at the Harvard School of Public Health (HSPH).

The study was published online July 2 in The World Journal of Biological Psychiatry.

“Unlike previous investigations, we were able to assess association of consumption of caffeinated and non-caffeinated beverages, and we identify caffeine as the most likely candidate of any putative protective effect of coffee,” said lead researcher Michel Lucas, research fellow in the Department of Nutrition at HSPH.

The authors reviewed data from three large U.S. studies and found that the risk of suicide for adults who drank two to four cups of caffeinated coffee per day was about half that of those who drank decaffeinated coffee or very little or no coffee. Caffeine not only stimulates the central nervous system but may act as a mild antidepressant by boosting production of certain neurotransmitters in the brain, including serotonin, dopamine, and noradrenaline.

This could explain the lower risk of depression among coffee drinkers that had been found in past epidemiological studies, the researchers reported. In the new study, researchers examined data on 43,599 men enrolled in the Health Professionals Follow-Up Study (HPFS) (1988–2008), 73,820 women in the Nurses’ Health Study (NHS) (1992–2008), and 91,005 women in the Nurses’ Health Study II (NHSII) (1993–2007). Caffeine, coffee, and decaffeinated coffee intake was assessed every four years by questionnaires. Caffeine consumption was calculated from coffee and other sources, including tea, caffeinated soft drinks, and chocolate.

However, coffee was the major caffeine source — 80 percent for NHS, 71 percent for NHS II, and 79 percent for HPFS. Among the participants in the three studies, there were 277 deaths from suicide. In spite of the findings, the authors do not recommend that depressed adults increase caffeine consumption, because most individuals adjust their caffeine intake to an optimal level for them and an increase could result in unpleasant side effects.

“Overall, our results suggest that there is little further benefit for consumption above two to three cups/day or 400 mg of caffeine/day,” the authors wrote. The researchers did not observe any major difference in risk between those who drank two to three cups of coffee per day and those who had four or more cups a day, most likely due to the small number of suicide cases in these categories.

However, in a previous HSPH coffee-depression study published in JAMA Internal Medicine, the investigators observed a maximal effect among those who drank four or more cups per day. One large Finnish study showed a higher risk of suicide among people drinking eight or nine cups per day. Few participants in the two HSPH studies drank such large amounts of coffee, so the studies did not address the impact of six or more cups of coffee per day.

Other HSPH researchers participating in the study included senior author Alberto Ascherio, professor of epidemiology and nutrition; Walter Willett, chair, Department of Nutrition and Fredrick John Stare Professor of Epidemiology and Nutrition; and research associates Eilis O’Reilly and An Pan. Pan now works at the National University of Singapore.


Antioxidants do not improve fertility


A new study suggests that antioxidants do not improve a woman's chances of conceiving as previously suggested, according to researchers from the University of Auckland, New Zealand.

The study, published in The Cochrane Library, found that women who take oral antioxidants are no more likely to conceive and that there was "limited information" about potential harmful effects. Other research has suggested that antioxidants could boost fertility within men.

A previous study, also from the University of Auckland, showed that partners of men who take antioxidants may be more likely to become pregnant. The study authors say that around 25% of people planning to have a baby experience trouble conceiving and many take dietary supplements, such as antioxidants, to try and improve their chances of becoming pregnant.

However, the researchers say that there is no sufficient evidence that this is the case, and they add that many of the antioxidants taken are unregulated, with little evidence on their safety and effects. The researchers conducted an analysis of data from 28 trials involving 3,548 women who were undergoing fertility treatment.

The duration of the fertility treatment ranged from 12 days to 2 years, and the age of the women ranged between 18 to 42. The analysis of the trials showed that a variety of antioxidants were used in the fertility treatment process of some women.

These included individual doses or combinations of:
* OctatronR
* Multiple micronutrients and Fertility Blend
* N-acetylcysteine
* Melatonin
* L-arginine
* Vitamin E
* Myo-inositol
* Vitamin C Vitamin D and Calcium Omega-3
* polyunsaturated fatty acids.

Results of the analysis showed that compared to women taking placebos or being given standard treatments including folic acid, there was no significant increase of women taking antioxidants becoming pregnant.


Will Green Tea Help You Lose Weight?


Evidence has shown that green tea extract may be an effective herbal remedy useful for weight control and helping to regulate glucose in type 2 diabetes. In order to ascertain whether green tea truly has this potential, Jae-Hyung Park and his colleagues from the Keimyung University School of Medicine in the Republic of Korea conducted a study, now published in the Springer journal Naunyn-Schmedeberg's Archives of Pharmacology.

The active constituents of green tea, which have been shown to inhibit intestinal glucose and lipid uptake, are a certain type of flavonoid called gallated catechins. The authors had previously suggested that the amount of gallated catechins necessary to reduce blood glucose concentrations can be achieved from a daily dose of green tea. However, the amount of green tea needed to decrease lipid uptake from the gut is higher and has been shown to have adverse effects in humans.

Once in the bloodstream, gallated catechins can actually increase insulin resistance, which is a negative consequence especially in obese and diabetic patients. For their study, the researchers tested the effects of green tea extract on body weight and glucose intolerance in both diabetic mice and normal mice fed a high-fat diet. To prevent a high dose of gallated catechins from reaching the bloodstream, the authors also used a non-toxic resin, polyethylene glycol, to bind the gallated catechins in the gut to prevent their absorption.

They then looked at the effects on the mice of eating green tea extract alone, and eating green tea extract plus polyethylene glycol. They compared these against the effects of two other therapeutic drugs routinely prescribed for type 2 diabetes. Results showed that green tea extract in isolation did not give any improvements in body weight and glucose intolerance. However, when green tea extract was given with polyethylene glycol, there was a significant reduction in body weight gain, insulin resistance and glucose intolerance in both normal mice on a high fat diet and diabetic mice.

The polyethylene glycol had the effect of prolonging the amount of time the gallated catechins remained in the intestines, thereby limiting glucose absorption for a longer period. Interestingly, the effects of the green tea extract in both the intestines and in the circulation were measurable at doses which could be achieved by drinking green tea on a daily basis. In addition, the effects of green tea extract were comparable to those found when taking two of the drugs which are currently recommended for non-insulin dependent diabetes.

The authors conclude that "dietary green tea extract and polyethylene glycol alleviated body weight gain and insulin resistance in diabetic and high-fat mice, thus ameliorating glucose intolerance. Therefore the green tea extract and polyethylene glycol complex may be a preventative and therapeutic tool for obesity and obesity-related type 2 diabetes without too much concern about side effects."


Drug Combo Cuts Stroke Risk After TIA


A simple combination of two anti-clotting drugs, clopidogrel and aspirin, can cut the risk of a stroke in patients who have already experienced a mini-stroke or transient ischemic attack (TIA).

This was the result of a phase 3 clinical trial conducted in China with the help of a US physician who says it could change the standard of care in the US. The investigators report their findings in the 26 June online issue of the New England Journal of Medicine, NEJM.

The trial took place at several sites in China and was designed in partnership with S. Claiborne Johnston, a professor of neurology and associate vice chancellor of research at University of California - San Francisco (UCSF).

A mini-stroke (minor ischemic stroke) or TIA is where the supply of much needed oxygen-rich blood to the brain is temporarily blocked because of a blood clot that the body naturally disperses, usually within a few minutes. About 10-20% of people who have a TIA go on to have a subsequent stroke within three months, so patients who suffer TIAs are usually given aspirin to prevent blood clots.

Clopidogrel (marketed as Plavix) has a similar effect as aspirin. Both drugs target blood platelets, that form blood clots, and stop them clumping together. The US Food and Drug Administration (FDA) approved generic versions of clopidogrel in 2012. People who have a heart attack are also at higher risk of blood clots afterwards, but they are usually given both aspirin and clopidogrel.

However, until this study there wasn't enough evidence that this might also work after TIA or mini-stroke. The trial results show that giving clopidogrel in addition to aspirin within 24 hours of the TIA, can reduce the risk of a further stroke by nearly a third over aspirin alone in the ensuing 90 days. The trial involved 5,170 patients admitted to hospital after suffering mini-stroke or TIA.

They were randomly assigned into two treatment groups. One group received aspirin alone, and the other group received aspirin plus clopidogrel. Treatment in both groups lasted for three months. The results show that overall, 8.2% of the patients in the combination drug group suffered further strokes during the follow- up compared to 11.7% of the aspirin-only group. Johnston says in a statement: "the results were striking".

The Chinese trial, called CHANCE, is nearly identical to one called POINT, that is already enrolling patients in the US. Johnston says if the US trial confirms the Chinese one, "then we're done", and the "two-drug combination becomes the standard of care".

Johnston says it is important to do the US trial as well as the Chinese one because important differences between the two countries's populations, such as different genes, ways of practising medicine, and risk factors, could produce different trial results. Funds from the Ministry of Science and Technology (MST) of the People's Republic of China helped finance the study.


Adding silver to antibiotics boosts their effectiveness


With the recent rise of deadly drug-resistant bacteria in the United States, once potent antibiotics are losing their luster as they increasingly becoming powerless in the fight against these dangerous infections.

 But new research suggests that an extra ingredient could help boost antibiotics’ overall effectiveness. All they need is a bit of “bling.” A new study from Boston University revealed that adding silver to antibiotics enhanced the drugs’ abilities to fight off lethal infections in mice. Even more encouragingly, the added silver component also helped make an antibiotic-resistant strain of bacteria more sensitive to antibiotics once again.

  Silver has been used for thousands of years as an antimicrobial agent and has been included in wound dressings and bandages to inhibit the growth of infectious microorganisms. In this study, researchers wanted to gain a more comprehensive understanding of why silver acts this way against bacteria.

“We found that (silver) was affecting the membrane of gram-negative bacteria, such as E. coli, making their membranes more permeable,” study author Jim Collins, the William F. Warren Distinguished Professor at Boston University and a faculty member at the Wyss Institute for Biologically Inspired Engineering, told

  Collins explained that the silver also interacts with central metabolism, leading to the disruption of iron homeostasis. In turn, this causes the production of molecules known as reactive oxygen species (ROS), which ultimately damage the bacterial cell’s DNA and enzymes. “We recognized that one or both of these mechanisms could be exploited to enhance the killing efficacy of antibiotics,” Collins said.

Along with his colleague J. Ruben Morones-Ramirez, a former post-doctoral fellow in Collins’ laboratory who is currently a professor at Universidad Autónoma de Nuevo Leon in Mexico, Collins and his team conducted a series of tests on the antibiotic-silver combination in vitro (in petri dishes) and in vivo (in mouse models).

  Through their tests, the team showed that just a small amount of silver made E. coli bacteria between 10 and 1,000 times more sensitive to commonly prescribed antibiotics, such as penicillin. In the mice models, Collins and his team demonstrated that silver was able to change the membrane permeability of gram-negative bacteria.

This enabled a large antibiotic called vancomycin, which has normally been used to fight gram-positive bacteria, to be effective against gram-negative as well. Most importantly, the researchers showed that silver helped the antibiotic tetracycline fight a previously resilient strain of E. coli. This signified that the combination of silver and antibiotics could be used to resensitize antibiotic-resistant strains of bacteria.

  “Overall, what we show is that small amounts of silver, non-toxic levels, can be used in conjunction with commonly used antibiotics to treat persistent infection and to treat bio-film based infections, which are problematic for medical implants,” Collins said.

The rise of antibiotic-resistant bacteria, such as deadly MRSA or Clostridium difficile, has been considered a major health threat by the Food and Drug Administration. To fight this growing problem, the FDA has called for the reduction of drug-resistant bacteria in foods and animals used in food production, as well as the creation of new antibiotics to combat these deadly infections. But the study’s findings indicate that the development of new drugs may not be necessary, Collins said.

 The team suggested silver could be used as coating on existing antibiotics or incorporated into medical implants, to help prevent or eradicate infections that often occur during such medical procedures. “Can we make our antibiotic arsenal stronger using these engineering methods?” Collins said.

 “The number of antibiotic-resistant strains has been growing, and the number of new antibiotics being made and approved are dramatically dropping. So instead of discovering and developing novel antibiotics, could we figure out ways to make the ones we have better?” The research was published June 19 in Science Translational Medicine.


US Supreme Court says human DNA cannot be patented


Human genes may not be patented, but artificially copied DNA can be claimed as intellectual property, the US Supreme Court has ruled unanimously.

The court quashed patents held by a Utah-based firm on two genes linked to breast and ovarian cancer. The opinion said DNA came from nature and was not eligible for patenting. The US biotechnology industry had warned any blanket ban on such patents would jeopardise huge investment in gene research and therapies.

"We hold that a naturally occurring DNA segment is a product of nature and not patent eligible merely because it has been isolated," Justice Clarence Thomas wrote in Thursday's opinion. But his ruling said that synthetic molecules known as complementary DNA can be patented "because it is not naturally occurring".

'Different chemical structure'
Myriad Genetics, the company at the heart of the lawsuit, saw its shares rise after Thursday's compromise decision. The legal battle was prompted by a lawsuit from the American Civil Liberties Union (ACLU) in 2009 that centred on whether companies should be able to patent genes.

Currently, researchers and private companies work to isolate genes in order to use them in tests for gene-related illnesses, and in emerging gene therapies. The genes at the centre of the lawsuit are linked to breast and ovarian cancer.

Myriad Genetics developed a pioneering test to look for mutations in those genes that might increase the risk of developing cancer. Myriad, based in Salt Lake City, argued that the genes in question had been "isolated" by the company, making them products of human ingenuity and therefore patentable.

But the ACLU argued that genes are products of nature, and therefore cannot be patented under US laws. In 2010 a New York federal court ruled in favour of the ACLU. In a concurring opinion, Justice Antonin Scalia wrote "the portion of the DNA isolated from its natural state sought to be patented is identical to that portion of the DNA in its natural state".

Sandra Park, a lawyer for the ACLU, welcomed the decision. "Because of this ruling, patients will have greater access to genetic testing and scientists can engage in research on these genes without fear of being sued," she said.

Universities and medical research firms have been able to claim intellectual property over human genes for nearly three decades. According to researchers at Weill Cornell Medical College in the US, patents now cover some 40% of the human genome.


BBC News


Gut Bacteria Play Key Role In Vaccination


The bacteria that live in the human gut may play an important role in immune response to vaccines and infection by wild-type enteric organisms, according to two recent studies resulting from a collaborative effort between the University of Maryland School of Medicine Institute for Genome Sciences and the Center for Vaccine Development.

The first study, published online in PLOS ONE,* examines the impact of an oral typhoid vaccination on the microbiota, or populations of bacteria, in the human gut. The second study, also published online in PLOS ONE,** looks in monkeys at the impact in the gut microbiota of vaccines against Shigella, as well as exposure to wild-type Shigella, another group of bacteria that, like S. Typhi, gain access to the host via the oral route.

These studies find that higher diversity in the gut microbiota, i.e., more types of bacteria in the gut, affect the characteristics and magnitude of the immune responses to the vaccines and, in the case of exposure to wild-type Shigella, appear to be more resistant to infection. This research provides a window into how vaccines and resistance to enteric pathogens work. It also helps scientists understand more about how the "good" bacteria in the body affect human health, a growing area of research known as the human microbiome.

"Our research raises the intriguing possibility that the gut microbiota may play an important role in response to vaccines and susceptibility to enteric pathogens, or bacteria that affect the intestinal tract," says the senior author on both papers, Claire M. Fraser, Ph.D., Professor of the Departments of Medicine and Microbiology and Immunology and director of the Institute for Genome Sciences (IGS) at the University of Maryland School of Medicine.

"The results are preliminary and more research is needed. In future studies, we plan to expand the subject pool and add metagenomic analysis. Metagenomics, also known as community or environmental genomics, will allow us to look at the function of the gut microbiota and how it is changing under various vaccination schedules. This research provides a fascinating window into the human microbiome, and how the bacteria in our bodies impact our health.

Both S. Typhi and Shigella are still devastating to populations in certain parts of the world. We hope that this work might one day help to provide relief to those areas that still suffer from these diseases." The first study analyzed the impact of an oral typhoid vaccination with an attenuated Salmonella enterica serovar Typhi (S. Typhi) on the human gut microbiota. While typhoid is not considered endemic in Western countries today, it is estimated that there are over 20 million illnesses associated with typhoid worldwide, particularly in south-central and south-east Asia.

Scientists at the Center for Vaccine Development and other institutions have long been working to develop an improved oral vaccine to prevent the disease. Differences in the effectiveness of experimental vaccines have been attributed to heterogeneous immunogenicity among subjects, host genetics, nutrition, socioeconomic status and other factors.

Researching the impact of the composition of intestinal microbiota is a new approach made possible by state-of-the-art advances in high-throughput sequencing technologies. The cutting edge facilities at the University of Maryland Institute for Genome Sciences generate huge quantities of data far more quickly than older technology. Similarly, advanced instrumentation and immunological techniques at the Center for Vaccine Development have, and continue to provide significant insights into the immune responses that are likely to correlate with protection.


Probiotics may help when on antibiotics


People who are on antibiotics may benefit from taking probiotics at the same time, a review of evidence shows.

Scientists at the Cochrane Collaboration say taking the supplements could prevent diarrhoea - a common side-effect of many antibiotics. They looked specifically at cases of diarrhoea caused by the potentially dangerous Clostridium difficile bug. Experts say probiotics could be a "pre-emptive strike" to ensure a healthy balance of bacteria in the gut.

Antibiotics can disturb the ecosystem of organisms normally present in the digestive system, allowing bacteria such as C. difficile to overwhelm the gut. And people infected with the bug can suffer from diarrhoea, an inflamed and painful bowel or even death. Researchers worldwide have been investigating whether probiotics - cocktails of micro-organisms - can keep gut bacteria in check by competing with more harmful bugs.

'Special bacterium' Scientists from the independent Cochrane Collaboration looked at data from 23 trials involving 4,213 patients who were on antibiotic treatment for a variety of reasons. The researchers found 2% of patients given probiotics developed C. difficile-associated diarrhoea compared with 6% of patients who were taking placebos.

Professor Brendan Wren of the London School of Hygiene and Tropical Medicine, who was not involved in the review, said: "Research into the prevention of C difficile is important - there is something special about the bacterium and the toxin it produces which allows it to have competitive advantage over other bugs and makes it difficult to get rid of.

"The probiotic approach is a good idea. It could provide a pre-emptive strike to make sure the balance in your gut is fine." The authors suggest probiotics could be particularly useful when there are outbreaks of C. difficile. Dr Bradley Johnston, part of the Cochrane team, said: "Implementing the appropriate dose and strains of probiotics in hospitals could provide cost savings and improve quality of life."

And the review showed that people taking probiotics had fewer unwanted side-effects than those on placebos, including stomach cramps, nausea and taste disturbances. The authors say more work needs to be done to to pinpoint exactly which types of probiotics work best. And though probiotics were seen to prevent diarrhoea associated with the bug, they note they did not prevent infections with C. difficile.

They suggest this property needs further investigation to help them understand more about how probiotics work.


Higher IQ link to good concentration


People with higher IQs are slow to detect large background movements because their brains filter out non-essential information, say US researchers.

Instead, they are good at detecting small moving objects. The findings come in a study of 53 people given a simple, visual test in Current Biology. The results could help scientists understand what makes a brain more efficient and more intelligent. In the study, individuals watched short video clips of black and white bars moving across a computer screen. Some clips were small and filled only the centre of the screen, while others filled the whole screen.

The participants' sole task was to identify in which direction the bars were drifting - to the right or to the left. Participants also took a standardised intelligence test. The results showed that people with higher IQ scores were faster at noticing the movement of the bars when observing the smallest image - but they were slower at detecting movement in the larger images. Michael Melnick of the University of Rochester, who was part of the research team said the results were very clear.

"From previous research, we expected that all participants would be worse at detecting the movement of large images, but high IQ individuals were much, much worse. The authors explain that in most scenarios, background movement is less important than small moving objects in the foreground, for example driving a car, walking down a hall or moving your eyes across the room. As a person's IQ increases, so too does his or her ability to filter out distracting background motion and concentrate on the foreground. In an initial study on 12 people, there was a 64% correlation between motion suppression and IQ scores.

In this larger study on 53 people, a 71% correlation was found. In contrast, previous research on the link between intelligence and reaction times, colour discrimination and sensitivity to pitch found only a 20-40% correlation. But the ability to ignore background movements is not the only indicator of intelligence. "Because intelligence is such a broad construct, you can't really track it back to one part of the brain," says Duje Tadin, who also worked on the study.

"But since this task is so simple and so closely linked to IQ, it may give us clues about what makes a brain more efficient, and, consequently, more intelligent. "We know from prior research which parts of the brain are involved in visual suppression of background motion. "This new link to intelligence provides a good target for looking at what is different about the neural processing, what's different about the neurochemistry, what's different about the neurotransmitters of people with different IQs."


BBC News


Yoga Can Help Lower Blood Pressure


According to a new study presented at the "28th Annual Scientific Meeting", yoga can help lower a person's blood pressure.

Desirable or normal blood pressure is generally considered to be below 120/80 (one-twenty over eighty). Where 120 represents the systolic measurement and 80 represents the diastolic measurement. However, high blood pressure, also known as the "silent killer", affects approximately one billion people worldwide, with nearly 1 in three adults in the U.S suffering from the condition.

Many patients with mild hypertension would prefer alternative methods of lowering their blood pressure than chronic lifelong treatment with medication. Yoga is becoming increasingly popular and is viewed as a possible alternative. In this study, Dr. Debbie Cohen of the University of Pennsylvania, led a team of researchers to evaluate exactly the effect yoga had on blood pressure among a total of 58 women and men, aged 38 to 62.

The researchers said:
"Based on our pilot data we are conducting a study to assess the effects of yoga alone, or with dietary intervention, on BP reduction in subjects with pre-HTN and stage 1 HTN in unmedicated, healthy, yoga naive subjects."

The 58 participants were divided into three different groups: a supervised 'Diet'/weight reduction and walking program a 'Yoga' practice in a studio 2 to 3 per week for 24 weeks a 'Combo' program consisting of both Yoga and Dietary intervention The team found that patients who did yoga in a studio 2 to 3 times per week for 24 weeks experienced a statistically significant drop in their blood pressure, greater than the diet only group.

Patients who followed a specialized diet but didn't participate in the yoga program also experienced a drop in blood pressure, although it was smaller compared to those in the yoga group. The yoga group experienced an average of three points for both systolic and diastolic blood pressure, from 133/80 to 130/77, whereas the controlled diet group - who did not practice yoga - saw only a decrease of one point, from 134/83 to 132/82.

Surprisingly, those who followed both a special diet as well as the yoga program didn't experience a greater drop in blood pressure compared to those who were part of the yoga group alone. They believe that the reason why yoga is able to lower blood pressure so successfully is because of the relaxation and mindfulness associated with it.

In fact, researchers from Boston University School of Medicine (BUSM) found that yoga may be superior to other forms of exercise in its positive effect on mood and anxiety. The authors said that yoga could have a very beneficial effect on people suffering from high blood pressure, especially when used in addition with other lifestyle modifications.

According to a previous study by researchers at the University of Ulster, low levels of weekly exercise can drive down blood pressure and boost overall fitness. Is is important to note that blood pressure treatments should be patient-specific - some treatment options may work for some but not for others. For example, obese people generally respond best to diuretic medications which shouldn't be given to those who aren't obese.

Therefore, blood pressure treatments aimed at preventing complications, such as heart attacks and strokes,work best if the doctor takes into account your body mass index (BMI) as well as other lifestyle factors.


Fast food menus not much healthier than in the past


Fast food restaurants have made disappointing progress towards creating healthier menus, according to a new study in the American Journal of Preventive Medicine.

While more salads, fruits and vegetables are now offered at these establishments, many fast food chains have also increased the number of unhealthy options available – causing the overall nutritional quality of their menus to remain relatively stagnant over the years.

Researchers performed a nutritional analysis of the menus offered at the following restaurants between 1997 and 2010:

• McDonald's
• Burger King
• Wendy's
• Taco Bell
• Kentucky Fried Chicken (KFC)
• Arby's
• Jack in the Box
• Dairy Queen.

Results were measured using the U.S. Department of Agriculture’s Healthy Eating Index, a 100-point scale that assesses nutritional quality. Overall, researchers said that fast food restaurants had only been able to improve their scores by three points in the past 14 years – a result that study authors found discouraging.

“I was surprised; I expected to see greater improvements,” lead investigator Mary Hearst, associate professor of public health at St. Catherine’s University in St. Paul, Minn., told Some restaurants – like Kentucky Fried Chicken and Jack in the Box – improved their scores by offering more protein or grain options and lowering the amount of sugar and saturated fats on their menus. But other restaurants, like Burger King, offered fewer sources of protein relative to their entire menu and increased levels of sodium, saturated fats and added sugars in their foods.

“These were slight increases, but it does indicate a negative downward trend over time,” Hearst said. Hearst pointed out that even though some restaurants did add healthier options to the menu, they also added more unhealthy options too. “I did expect that total vegetables would have increased because of number of different salad options available,” Hearst said. “But because it is relative to total calorie numbers, while they may have increased salads, they’ve increased other things that are of a high calorie.”

Margo G. Wootan, author of a commentary accompanying the study and director of nutrition policy at the Center for Science in the Public Interest in Washington, D.C., wants the fast food industry to start taking more concrete steps towards improving their menus. “You hear all these pronouncements by the fast food industry about new items adding to the menu and reformulations and efforts to reduce sodium,” Wootan told

“But when you look at the menus comprehensively, as these researchers did, there’s been very little improvement in the nutritional quality of fast food over a long period of time.” Wootan said that restaurants need to start by changing portion sizes and introducing better calorie labeling on the menus.

“When McDonald’s first opened, the hamburger, French fries and soft drink you got as an adult back then, is now considered a children’s meal,” Wootan said. Fast food restaurants also need to add more appealing, healthier options to their menus, without also increasing the number of unhealthy options.

“A choice between plain, baby cut carrots and potato chips is tough...but maybe if the carrots were roasted in great spices or had an interesting dipping sauce,” Wootan suggested. “Restaurants have been so unimaginative in providing healthy options.”

Hearst noted that fast food restaurants have a long way to go in order to get their menus to a standard considered healthy. “Fast food restaurants, given how ubiquitous they are, if they improved the dietary quality of the menus, it would help improve the diets of the whole country. They have a great opportunity to continue to improve,” Hearst said.


Calm down genes treat epilepsy in rats


Adding "calm down" genes to hyperactive brain cells has completely cured rats of epilepsy for the first time, say UK researchers. They believe their approach could help people who cannot control their seizures with drugs.

The study, published in the journal Science Translation Medicine, used a virus to insert the new genes into a small number of neurons. About 50 million people have epilepsy worldwide. However, drugs do not work for up to 30% of them. The alternatives include surgery to remove the part of the brain that triggers a fit or to use electrical stimulation.

The brain is alive with electrical communication with individual neurons primed to fire off new messages. However, if a group of neurons become too excited they can throw the whole system into chaos leading to an epileptic seizure.

Researchers at University College London have developed two ways of manipulating the behaviour of individual cells inside the brain in order to prevent those seizures. Both use viruses injected into the brain to add tiny sections of DNA to the genetic code of just a few thousand neurons.

One method boosts the brain cells' natural levels of inhibition in order to calm them down. After a fortnight the number of seizures dropped dramatically and the mice were "effectively cured" within a month. One of the researchers, Dr Robert Wyke, told the BBC: "It's the first time a gene therapy has been used to completely stop these seizures.

"Obviously we're very hopeful for this. Drugs haven't done anything for epilepsy in the last 20 to 30 years, just less side effects. "There's a real need for a new therapy, we're very excited about this." The other technique harnessed a gene from algae which can be controlled by light.

After the therapy the function of the neurons did not change until a light was shined on them with an implanted laser. The light prevented the neurons from firing, preventing a seizure. The researchers think this method could work in a similar way to an implanted defibrillator, which is used to control an irregular heartbeat.

'Very encouraging'
Much more testing of the epilepsy gene therapies would be needed before it could be used in patients. If further animal tests are successful the first patients involved in any trial are likely to be those who are suitable and prepared for brain surgery. If there were problems or if the treatment did not work, the offending region of the brain could still be removed.

Philip Lee, the chief executive of Epilepsy Action, said: "Gene therapy research is an important development in our understanding of epilepsy. It is very encouraging that progress is being made in this arena to help people with epilepsy.

"Currently, there is no treatment to cure epilepsy other than surgery, which is only effective for small numbers and around 30% of people with epilepsy do not respond to traditional drug therapies. "It is therefore vital that there are as many treatment options available as possible to help people with epilepsy achieve seizure control.

"Although it is too early to say if this research will directly benefit people with epilepsy in the future, we hope it helps us to move closer to more effective treatments."


BBC News


Road to HIV Vaccine Hits Another Speed Bump


HIV experts reacted with dismay and resignation to the news that the National Institute of Allergy and Infectious Diseases halted its HIV Vaccine Trials Network 505 trial because it wasn't working.

"I wish I could say I was surprised," commented Robert Schooley, MD, of the University of California San Diego. He told MedPage Today that it has been "difficult to make headway" in HIV vaccine research despite decades of effort and an increasingly profound understanding of how the human body and the deadly virus interact. But the announcement that the agency will halt immunizations in the trial illustrates that there remain gaps in that scientific understanding – gaps that will have to be filled before a vaccine can succeed, he said. The decision is "disappointing," said Michael Saag, MD, of the University Alabama Birmingham.

"We were, of course, hoping we would actually have a vaccine that would have some degree of efficacy." Instead, he told MedPage Today, the trial was halted because investigators decided there was no chance it would show a benefit. And the data, Saag noted, actually show more HIV infections among those who got the vaccine. The increase was not statistically significant, but "it was clear this vaccine was not going to protect," he said.

The trial was halted when the study's data safety monitoring board found a slight excess of new HIV infections in the vaccine arm compared with the placebo arm. The investigators had enrolled 2,504 HIV-negative volunteers - men who have sex with men and transgendered people who have sex with men – in 19 cities in the U.S. In a planned interim review April 22, the safety board looked at new infections among those who had been in the study at least 28 weeks - time enough for the vaccine to stimulate an immune response.

In those participants, there were 27 infections in vaccine recipients and 21 in those who got the placebo. And among volunteers who got infected before they had spent 28 weeks in the study, there were 14 HIV infections in the vaccine arm and 9 among placebo recipients. There was also no evidence that the vaccine lowered viral load among people who got infected despite it – a secondary endpoint of the trial. The difference between the study arms was not statistically significant and doesn't mean the vaccine increased the risk of HIV infections, commented Mitchell Warren, executive director of the New York-based vaccine advocacy group AVAC.

The outcome is "disappointing," Warren said in a statement, but it highlights the need to continue vaccine research. But the result is another setback to the HIV vaccine enterprise, which had an unbroken record of futility until late 2009, when for the first time an investigational vaccine was shown to reduce the risk of infection. The so-called RV-144 trial, conducted in Thailand mainly among heterosexuals, showed that in a large population of everyday people at relatively low risk for HIV, the vaccine reduced the chances of infection by 31.2% compared with placebo.

It was not a home run, but the finding was hailed as the first evidence that perhaps researchers were finally on the right track. Warren noted that trials building on the RV-144 results are currently underway in Thailand and South Africa. There are some similarities between the Thai vaccine candidate and the HVTN 505 approach. Both used what is called a prime-boost strategy, in which the immune system of a volunteer is exposed to HIV antigens and then boosted later with another shot to increase the response.

But there were differences in the details; the trials used different primers and different boosters. One possible culprit in the failure is the adenovirus 5 booster used on the HVTN 505 trial – a common virus used as a vector to carry antigens into the body. The virus – dubbed ad5 for short - was used in an earlier unsuccessful trial, the STEP study, and was linked to an increased risk of HIV in people who got that candidate vaccine.

In that study, uncircumcised men with antibodies to the virus seemed to be most at risk, so the HVTN 505 investigators enrolled only men who had been circumcised and had no antibodies. But it may not have worked and it may be enough to rule out further use of the adenovirus in vaccine studies. "It basically puts to rest – at least for the moment – this approach to AIDS vaccine development," Schooley told MedPage Today.

Saag concurred, saying, "We've got to go back to the drawing board and ask what about this study didn't work." It may even be, he said, that giving an HIV vaccine of this type in some way "primes" the immune system in the wrong direction, making it more susceptible to HIV. But the key for vaccine researchers now is to find out what went wrong and to use the increasing body of knowledge to overcome the latest roadblock, Saag said.

"I really believe we have a lot of clues we can follow up on," he said. Schooley noted that intensive research in recent years has vastly improved scientific understanding of how the human body responds to HIV infection. In particular, he said, it is now much clearer how some people manage to fight off the virus. What's not clear, he said, is how to cause those reactions in people before they come in contact with HIV. "Until we can do that," he said, "it's going to be difficult to have a vaccine that will prevent infection."


Alternative Treatments May Help Cut Blood Pressure


Alternative treatments like transcendental meditation, biofeedback and guided breathing appear to reduce high blood pressure in some people, a new report suggests.

But only one method that does not involve medication - aerobic exercise - is both proven to have a major impact and highly recommended. The report, by the American Heart Association, also says research doesn't support a reduction in high blood pressure from other relaxation and meditation techniques, yoga or acupuncture.

However, the quality of research into these strategies is limited, the report adds, suggesting that there's still hope they have an effect. "In general, there's a surprising level of evidence supporting some of the alternative techniques being effective, and surprisingly little or conflicting evidence in regard to other techniques," said Dr. Robert Brook, an associate professor of medicine at the University of Michigan.

"These alternative techniques are a neglected stepchild and often not given nearly as much attention or funding for research, and are often not taken as seriously as other approaches." Two things are clear, he said: The alternative approaches don't appear to be harmful, and they shouldn't be used instead of following a doctor's advice regarding medication.

The American Heart Association launched its report to give guidance to doctors and patients about treatments for high blood pressure, Brook said. "Traditionally, we'll talk about weight loss, diet, salt restriction and exercise. They're difficult to comply with, and people don't follow them. We decided it was time to review all of the research into alternative ways to lower blood pressure."

The report ranks aerobic exercise, like brisk walking, as having the greatest effect on high blood pressure and the highest quality research to support it. Biofeedback, weight lifting, transcendental meditation and synchronized breathing (such as breathing to a series of tones) also scored well in terms of effectiveness.

When they're effective, the techniques may reduce the systolic number in a high blood pressure reading - the top number - by a modest 5 to 10 millimeters of mercury (mmHg), Brook said. A reading of 140 or higher is a sign of potential trouble.

How do the strategies work to reduce blood pressure?
It's not clear in some cases, he said, although exercise appears to boost the functioning of blood vessels by widening them. Samuel Sears, director of health psychology programs at East Carolina University, in Greenville, N.C., said the report is important but its focus misses the "mental benefits" of alternative treatments.

"Patients seek and may gain broader benefits from some of these therapies, such as psychological and perceived control of their condition," he said.

So, should you try these strategies?
Dr. Kirsten Bibbins-Domingo, an associate professor of medicine at the University of California, San Francisco, said they're generally considered safe. However, "the inappropriate reliance on these approaches could result in delays in seeking medical treatment of hypertension," she said.

"And many of these interventions are associated with out-of-pocket costs for patients, which is an additional consideration particularly if such interventions are ultimately shown not to be effective."

The report appears April 22 in the journal Hypertension.


Brain Signature Reveals Our Level of Pain


A thermometer is great for measuring a fever, but when it comes to pain, doctors must rely on the age-old question, "How bad is it?"

Scientists have long struggled to find physiological signs that can reliably tell "ouch" from and everything in between. Now, a brain scanning study suggests that painful heat excites a specific pattern of neural activity that could hold the key to better diagnosis and treatment of all kinds of pain in the future.

Functional magnetic resonance imaging (MRI) studies have shown that certain areas of the brain—including the anterior cingulate cortex, somatosensory cortex, and thalamus—activate when people experience pain.

But those same regions also light up in response to other experiences, such as painful thoughts or social rejection. In recent years, scientists have looked for a particular pattern of activity across these areas that single out the experience of physical pain.

"What we're evolving towards is trying to predict quantitatively from patterns of brain activity how much an individual is feeling," says Tor Wager, a neuroscientist at the University of Colorado, Boulder.

  In the new study, Wager's group performed MRI brain scans on a total of 114 healthy participants while delivering different amounts of heat to the volunteers' arms with a computer-controlled hot plate.

In an initial experiment, the scientists used data from 20 people to find a brain-wide pattern of excitation and inhibition—a neural "signature"—that changed reliably as people experienced varying degrees of heat, ranging from painless to scalding.

In the remainder of the study, Wager and his colleagues were able use the signature derived from the first group to predict pain responses in a completely different set of subjects - a promising sign for one day using such a model on patients suffering from unknown conditions, he says.

 The strength of the signature response scaled with increasing temperatures and correlated well with each person's reports of increasing pain as researchers cranked up the temperature from a toasty but painless 44.3°C to a scalding 49.3°C—akin to a hot cup of coffee, Wager says.

Based solely on the intensity of the signature, the team could distinguish whether participants had experienced painful heat or nonpainful warmth with 93% accuracy. The neural reading could also predict which of two painful temperatures hurt more for the subjects, as reported today in The New England Journal of Medicine.


What we exhale is unique to us – our breathprint


Our breath may be as unique as our fingerprint. Compounds in exhaled air produce a unique and stable molecular autograph or "breathprint" – one that could be used to monitor disease or track response to medication.

Renato Zenobi at the Swiss Federal Institute of Technology in Zurich and his colleagues discovered breathprints by analysing the breath of 11 healthy individuals. The team did this four times a day over nine days, and used a technique called mass spectrometry to identify the molecules in each breath sample.

The team was interested in metabolites, compounds produced by the body's metabolism. The molecules are volatile and small enough to pass from the blood into airways via the alveoli in our lungs, so are present in our breath – albeit in miniscule amounts, sometimes less than one molecule per billion molecules of air.

The team found that metabolites in individuals' breath remained "constant and clear", says Zenobi. "Our genomes are unique, our epigenomes are unique, our microbiomes are unique, so it is not surprising our breath metabolomes are also unique," says Jeremy Nicholson from Imperial College London, who was not part of the team.

 "What is important is how they vary from individual to individual and how they differ in relation to development of disease or in response to therapy." Zenobi's team can identify compounds in breath immediately, so our breathprint could be used to detect signature metabolites associated with disease, giving an instant diagnosis.

In a preliminary study, Zenobi has shown that breath samples can reveal whether people have chronic obstructive pulmonary disease. The clever part of the work is that they use a special scheme to selectively charge the trace amounts of volatile compounds, which provides results quicker than other types of gas chromatography, says Patrik Spanel from Keele University, UK, who was not part of the study.


Unraveling the molecular roots of Down syndrome


Researchers discover that the extra chromosome inherited in Down syndrome impairs learning and memory because it leads to low levels of SNX27 protein in the brain.

What is it about the extra chromosome inherited in Down syndrome—chromosome 21—that alters brain and body development? Researchers have new evidence that points to a protein called sorting nexin 27, or SNX27. SNX27 production is inhibited by a molecule encoded on chromosome 21. The study, published March 24 in Nature Medicine, shows that SNX27 is reduced in human Down syndrome brains. The extra copy of chromosome 21 means a person with Down syndrome produces less SNX27 protein, which in turn disrupts brain function. What’s more, the researchers showed that restoring SNX27 in Down syndrome mice improves cognitive function and behavior.

“In the brain, SNX27 keeps certain receptors on the cell surface—receptors that are necessary for neurons to fire properly,” said Huaxi Xu, Ph.D., Sanford-Burnham professor and senior author of the study. “So, in Down syndrome, we believe lack of SNX27 is at least partly to blame for developmental and cognitive defects.”

SNX27’s role in brain function
Xu and colleagues started out working with mice that lack one copy of the snx27 gene. They noticed that the mice were mostly normal, but showed some significant defects in learning and memory. So the team dug deeper to determine why SNX27 would have that effect. They found that SNX27 helps keep glutamate receptors on the cell surface in neurons. Neurons need glutamate receptors in order to function correctly. With less SNX27, these mice had fewer active glutamate receptors and thus impaired learning and memory.

SNX27 levels are low in Down syndrome
Then the team got thinking about Down syndrome. The SNX27-deficient mice shared some characteristics with Down syndrome, so they took a look at human brains with the condition. This confirmed the clinical significance of their laboratory findings—humans with Down syndrome have significantly lower levels of SNX27.

Next, Xu and colleagues wondered how Down syndrome and low SNX27 are connected—could the extra chromosome 21 encode something that affects SNX27 levels? They suspected microRNAs, small pieces of genetic material that don’t code for protein, but instead influence the production of other genes. It turns out that chromosome 21 encodes one particular microRNA called miR-155. In human Down syndrome brains, the increase in miR-155 levels correlates almost perfectly with the decrease in SNX27.
Xu and his team concluded that, due to the extra chromosome 21 copy, the brains of people with Down syndrome produce extra miR-155, which by indirect means decreases SNX27 levels, in turn decreasing surface glutamate receptors. Through this mechanism, learning, memory, and behavior are impaired.
Restoring SNX27 function rescues Down syndrome mice 
If people with Down syndrome simply have too much miR-155 or not enough SNX27, could that be fixed? The team explored this possibility. They used a noninfectious virus as a delivery vehicle to introduce new human SNX27 in the brains of Down syndrome mice.

“Everything goes back to normal after SNX27 treatment. It’s amazing—first we see the glutamate receptors come back, then memory deficit is repaired in our Down syndrome mice,” said Xin Wang, a graduate student in Xu’s lab and first author of the study. “Gene therapy of this sort hasn’t really panned out in humans, however. So we’re now screening small molecules to look for some that might increase SNX27 production or function in the brain.”


Acupuncture Improves Memory And Reduces Anxiety


A new study shows that acupuncture improves memory, test performance, and reduces anxiety.

The study will appear in an upcoming edition of The Journal of Acupuncture and Meridian Studies. Dr. Jason Bussell, PhD, conducted an experiment with 90 undergraduate students. Half the students received acupuncture and half did not; and the placebo effect was controlled.

Then all the students took a computerized test of Working Memory- the Automated Operation Span Task. Tests of Working Memory have been associated with predicting performance with such diverse abilities as reading comprehension, arithmetic calculation, note taking, language comprehension, playing bridge, learning a computer language, learning to spell, following directions, building vocabulary, writing, complex learning, and reasoning ability.

So Working Memory is a good measure of mental aptitude. Tests of Working Memory assess how well a subject can keep items in the back of their mind (memory) while performing tasks in the front of their mind (processing). Subjects who received acupuncture scored 9.5% higher on the measure of keeping items in memory and committed 36% fewer processing errors.

"Considering how competitive school has become, I'm sure this will be of interest to a lot of parents and students", said Bussell. To assess anxiety, the State-Trait Anxiety Inventory was administered before and after the treatment. Subjects who received acupuncture reported significantly less anxiety than those who did not receive it.

 "This technique may be especially helpful for those students who suffer with test anxiety. But even those who were not anxious still had performance improved by the acupuncture. So this technique can help everyone" explained Bussell. Research has already shown that a series of treatments can help individuals with impaired memory.

This research was innovative in that it is the first study to show that just one acupuncture treatment can improve performance in healthy individuals. The study involved undergraduate students, but it is very likely that this technique can help people of all ages improve their memory and test taking; and reduce their anxiety.


Caffeine Linked to Low Birth Weight Babies


Maternal nutrition is important to a developing embryo and to the health of the child later in life. Supplementing the diet with specific vitamins is known to increase health of the fetus for example folic acid (vitamin B9) reduces the risk of spina bifida.

However not everything an adult might consume is beneficial to a developing baby. New research published in BioMed Central's open access journal BMC Medicine shows that caffeine is linked to low birth weight babies and that caffeine from coffee in linked to increasing length of pregnancy. Along with nutrients and oxygen, caffeine freely passes the placental barrier, but the developing embryo does not express the enzymes required to inactivate it efficiently.

The WHO currently suggests a limit of 300mg per day during pregnancy but some countries recommend a limit of 200mg, which can be less than a single cup of coffee from some high street cafes. To investigate the impact of maternal caffeine during pregnancy on babies, a research team from the Norwegian Institute for Public Health used information about mother's diet and birth details collected over ten years.

After excluding women with medical and pregnancy-related conditions almost 60,000 pregnancies were included in the study. All sources of caffeine were monitored in the study: coffee, tea, fizzy drinks, as well as food including cocoa-containing cakes and deserts and chocolate.

Explaining their results, Dr Verena Sengpiel, from Sahlgrenska University Hospital, Sweden, who led the project said, "Although caffeine consumption is strongly correlated with smoking which is known to increase the risk for both preterm delivery and the baby being small for gestational age at birth (SGA).

In this study we found no association between either total caffeine or coffee caffeine and preterm delivery but we did find an association between caffeine and SGA. This association remained even when we looked only at non-smoking mothers which implies that the caffeine itself is also having an effect on birth weight." In fact they found that caffeine from all sources reduced birth weight. For a child of expected average weight (3.6kg) this equates to 21-28g lost per 100mg caffeine per day.

This association means that it is not just the caffeine in coffee which increases gestational length but either there must be a substance in coffee which is responsible for the extra time or there is a behaviour associated with coffee drinking not present in women who drink only tea (for example).

SGA babies are at higher risk of both short term and lifelong health problems and it seems from these results that since even 200-300mg caffeine per day can increase the risk of SGA by almost a third these recommendations need to be re-evaluated.


First Documented Case of Child Cured of HIV


Researchers today described the first documented case of a child being cured of HIV. The landmark findings were announced at the 2013 Conference on Retroviruses and Opportunistic Infections in Atlanta, GA.

Dr. Deborah Persaud, of Johns Hopkins University and an amfAR grantee, detailed the case of a two-year-old child in Mississippi diagnosed with HIV at birth and immediately put on antiretroviral therapy. At 18 months, the child ceased taking antiretrovirals and was lost to follow-up. When brought back into care at 23 months, despite being off treatment for five months, the child was found to have an undetectable viral load. A battery of subsequent highly sensitive tests confirmed the absence of HIV.

"The child's pediatrician in Mississippi [Dr. Hannah Gay, a pediatric HIV specialist at the University of Mississippi] was aware of the work we were doing, and quickly notified our team as soon as this young patient's case came to her attention," said Dr. Rowena Johnston, amfAR vice president and director of research.

"Because the collaboratory was already in place, the researchers were able to mobilize immediately and perform the tests necessary to determine if this was in fact a case of a child being cured." According to Dr. Persaud, comprehensive tests have confirmed beyond doubt that both mother and child were HIV positive when the child was born, and today no signs of HIV infection in the child can be detected by the most sensitive means available.

The only other documented case of an HIV cure to date remains that of Timothy Brown, the so-called "Berlin patient." In 2006, while on treatment for HIV, Mr. Brown was diagnosed with leukemia. His physician was able to treat his leukemia with a stem-cell transplant from a person who was born with a genetic mutation causing immunity to HIV infection. Following the transplant, Mr. Brown was able to stop HIV treatment without experiencing a return of his HIV disease.

The Mississippi case also underscores the importance of identifying HIV-positive pregnant women, expanding access to treatment regimens than can prevent mother-to-child transmission, and of immediately putting infants on antiretroviral therapy in the event that they are born HIV positive. "We are proud to have played a leading role in bringing this first pediatric HIV cure to light," said amfAR CEO Kevin Robert Frost.

"The case is a startling reminder that a cure for HIV could come in ways we never anticipated, and we hope this is the first of many children cured of HIV in the months and years to come."


New App Turns iPhone into Mobile Urine Test


The new uChek smartphone app was revealed at this year's Technology, Education and Design (TED) conference in Los Angeles, and can be used as an iPhone urine test indicator of 25 different medical conditions like diabetes, urinary tract infections, preeclampsia, kidney and liver problems, and cancers, as well as to assess general health.

The uChek iPhone app was invented by 29-year-old MIT graduate Myshkin Ingawale, co-founder of Biosense Technologies, a company based in Mumbai that specializes in accessible and cheap medical technologies. "We all have two things, cell phones and urine," Ingawale told the chuckling TED audience when presenting the app. "We figured we had to be able to do something with this."

The urine test iPhone app works by combining a standard urinalysis dipstick kit with smartphone technology. First you collect a urine sample in a cup, just as you would at a doctor's office, and dip the paper test strip in the sample for two seconds. Next, slide the urine-soaked strip into a color-coded mat that comes with the uChek pack.

The urinalysis strip contains chemicals that gradually change color if your urine contains high concentrations of substances related to any of the medical conditions. Taking a photo of the urine strip with the uChek smartphone app allows the iPhone to quickly and accurately analyze the image to give a concise reading of your urine sample.

The smartphone app produces easily understood information, with either positive or negative results or more quantitative information that explains what different concentration levels in urine indicate. "The idea is to get people closer to their own information," Ingawale said.

"I want people to better understand what is going on with their bodies." Since the iPhone app color-corrects the images automatically, it reduces the chance of human error in analyzing personal urine test results. It can also monitor trends in urinalysis over time that you can share with a doctor. Urine tests are a basic method of judging the presence of health problems, which is why doctors always ask for a urinalysis when you go for a check-up.

Many chemical indicators of health are released in urine samples, like glucose, proteins, ketones, bilirubin, leukocytes, and nitrites, and the app checks up to 10 of those elements. Ingawale stresses that it is important to see a doctor regularly and get a proper medical opinion, and that uCheck is meant to inform users about health issues, not diagnose disease from urine.

Still, a smartphone app that tests urine could help cut costs by reducing medical visits. According to Wired, more sophisticated urinalysis machines cost up to $10,000 and only read specific types of test strips.

UChek could be especially useful in areas with poor medical coverage, like rural areas and developing nations. Ingawale's own father-in-law, who is diabetic, was an early tester of the Uchek urinalysis app. "My wife is the one who wants the information," said Ingawale.

"She wants to make sure he's taking care of himself. He just takes the test and e-mails her the results." The uChek smartphone app will cost only 99 cents for the iPhone, and another $20 will supply the urine kit which includes a color-coded test map and a pack of urine dipsticks.

The urinalysis application is currently being tested in the King Edward Memorial Hospital in Mumbai, India. It is expected to be available for iPhones in Apple's iOS App Store in March. A version for Android smartphones is in development. No word yet if the uChek app will eventually be able to asses urine for drug or pregnancy tests, but it seems like only a matter of time before smartphones allow those urinalysis functions.

UChek joins a number of other personal healthcare apps that are becoming increasingly popular, which assess health indicators like heart rate and sleep patterns. "Mobile health has immense potential to improve people's lives since it increases patient access to quality healthcare whilst reducing costs," Michael O'Hara, chief marketing officer at the GSMA, told the BBC.

"These positive impacts will only grow as the mobile and health industries collaborate on new connected innovations," he added. Ingawale has a strong commitment to boosting grassroots healthcare.

This year's urinalysis app was preceded by a portable device called ToucHb that Ingawale presented at least year's TED conference. Easy for untrained health workers to use, it screens hemoglobin levels for anemia without drawing blood, and is designed to keep women from dying from anemia.

"The medical device industry operates on proprietary, closed hardware and a recurring revenue business model," Ingawale says. "I am trying to democratize healthcare."


Chavez reportedly going through complex alternative treatment


Venezuelan President Hugo Chavez, who has been missing from the public eye for the last two months, is reportedly undergoing “tough and complex” alternative medical treatment, according to the latest statement by Nicholas Maduro. In an interview on state-owned VTV television, Maduro announced Chavez was facing his medical dilemmas with a “fighting spirit,” but his current treatments were considered complex and extremely tough.

The report came after Maduro made a trip to Cuba to visit Chavez, accompanied by Chavez’s bother, Adan. Maduro and the Venezuelan government have remained secretive regarding the health of Hugo Chavez, telling the public only that he is battling a form of abdominal or pelvic cancer which was recently complicated by a post-surgical respiratory infection.

Rumors on Chavez’s condition have ranged from prostate cancer to induced coma to assumed death. Initially, renowned reporter Dan Rather came out with breaking news, Chavez was on his death bed suffering from rhabdomyosarcoma, a rare form of cancer typically affecting children.

Through all the media speculation, the truth regarding President Hugo Chavez’s condition has been kept quiet. He eventually started receiving all medical treatment in Cuba where his medical records could be kept private.

At this point in time, all accounts indicate Chavez is still alive and recovering, but as to what particular form of alternative treatment he is receiving, no one knows.

The National Cancer Institute notes “alternative medical treatment” could refer to a number of medical procedures, but is most often used to refer to treatments being used instead of standard protocols.

This means Hugo Chavez could be undergoing any form of treatment including Chinese herbal medicine, mind-and-body techniques, nutritional therapies or treatment with medications in ways other than those which they were originally intended.

Alternative medicine is often used when standard medical treatments are not achieving a desired result, though some individuals are simply more comfortable knowing they have chosen a more holistic route, depending on the therapy.


Red Wine Could Mask Testosterone Levels


Red wine could give athletes and players a boost in the sports arena by increasing the amount of performance-enhancing hormone testosterone in their bodies, according to researchers from London's Kingston University.

However not only could the beverage help them to trophy success, it could also allow them to beat anti-doping tests. A team led by Professor Declan Naughton, from the University's School of Life Sciences, found that red wine might reduce the amount of testosterone excreted by the body, which could distort the findings of drug tests taken from urine samples.

Testosterone is a naturally-occurring steroid hormone present in both men and women. It can increase muscle mass, boost stamina and speed up recovery. Sportspeople, however, are prohibited from taking it, or a synthetic version of it, to try to gain a competitive edge. Although red wine is not a banned substance away from the sports field, Professor Naughton's team has referred its findings to the World Anti-Doping Agency because of the newly-discovered side effect of potential change to the amount of testosterone in the body.

"Previous research has shown the effect over-the-counter anti-inflammatory drugs can have on enzymes," Professor Naughton explained. "Since many of these drugs are derived from plants, we decided to look at the effect particular foods and beverages can have on enzymes involved in testosterone excretion. We chose green tea and then red wine because both have a huge variety of natural molecules and we wanted to see if they affected the amount of testosterone excreted in urine."

The team found that a compound in red wine, known as quercetin, partially blocked the action of an enzyme called UGT2B17, which looks for testosterone and then sends a message to the kidneys to excrete it. Professor Naughton stressed that the research had so far been conducted in test tube experiments and had yet to be trialled on humans.

"A full clinical study would be needed to determine the effects on people but, if the same results were found, it would confirm that compounds in red wine can reduce the amount of testosterone in urine and give a boost to testosterone levels," he explained. The effect of red wine on an individual would vary because of factors such as weight, fitness, health and diet, making it hard to estimate how much was needed to improve performance, Professor Naughton said.

Teetotallers are not exempt from the effects. In fact, the alcohol content of red wine has very little impact because non-alcoholic molecules are responsible for inhibiting testosterone excretion. The team also found the results were the same for red wine extract in supplement form. The active compounds such as quercetin are found in many foodstuffs as well as supplements.

The findings have been published in leading international journal Nutrition. The research follows an earlier study from Professor Naughton's team which showed that green and white tea could also inhibit testosterone excretion.


Apixaban Wins Long-Awaited Nod from FDA


The FDA has approved the oral anticoagulant drug apixaban (Eliquis) to prevent stroke and systemic embolism in patients with nonvalvular atrial fibrillation, the agency announced late Friday.

The approval follows similar decisions by regulators in Europe, Canada, and Japan, which also cleared the oral Factor Xa inhibitor for this indication in recent weeks.

Apixaban's safety and efficacy for the afib indication in the U.S. were evaluated in a clinical trial involving more than 18,000 patients that compared the drug with warfarin, the FDA said in a statement. In the trial, patients taking apixaban had fewer strokes than those who took warfarin.

However, in another trial, apixaban failed to show a benefit relative to a different comparator, enoxaparin (Lovenox). Concerns were also raised about possibly increased bleeding risks, although these have not been seen consistently.

In June, the FDA said it was delaying a decision until the drug's sponsors, Bristol-Myers Squibb and Pfizer, submitted additional data related to the pivotal ARISTOTLE trial. In announcing the approval, the FDA said the drug is contraindicated in patients with prosthetic heart valves.

The agency also noted that there is currently no antidote to reverse the drug's anticoagulant effect should severe bleeding occur. Apixaban will come with a patient medication guide that provides instructions on its use and drug safety information, the FDA said.

"Healthcare professionals should counsel patients on signs and symptoms of possible bleeding," the agency added.


Antibiotic-resistant diseases pose apocalyptic threat


Britain's most senior medical adviser has warned MPs that the rise in drug-resistant diseases could trigger a national emergency comparable to a catastrophic terrorist attack, pandemic flu or major coastal flooding.

Dame Sally Davies, the chief medical officer, said the threat from infections that are resistant to frontline antibiotics was so serious that the issue should be added to the government's national risk register of civil emergencies. She described what she called an "apocalyptic scenario" where people going for simple operations in 20 years' time die of routine infections "because we have run out of antibiotics".

The register was established in 2008 to advise the public and businesses on national emergencies that Britain could face in the next five years. The highest priority risks on the latest register include a deadly flu outbreak, catastrophic terrorist attacks, and major flooding on the scale of 1953, the last occasion on which a national emergency was declared in the UK.

Speaking to MPs on the Commons science and technology committee, Davies said she would ask the Cabinet Office to add antibiotic resistance to the national risk register in the light of an annual report on infectious disease she will publish in March. Davies declined to elaborate on the report, but said its publication would coincide with a government strategy to promote more responsible use of antibiotics among doctors and the clinical professions.

"We need to get our act together in this country," she told the committee. She told the Guardian: ""There are few public health issues of potentially greater importance for society than antibiotic resistance. It means we are at increasing risk of developing infections that cannot be treated – but resistance can be managed. "That is why we will be publishing a new cross-government strategy and action plan to tackle this issue in early spring."

The issue of drug resistance is as old as antibiotics themselves, and arises when drugs knock out susceptible infections, leaving hardier, resilient strains behind. The survivors then multiply, and over time can become unstoppable with frontline medicines. Some of the best known are so-called hospital superbugs such as MRSA that are at the root of outbreaks among patients. "In the past, most people haven't worried because we've always had new antibiotics to turn to," said Alan Johnson, consultant clinical scientist at the Health Protection Agency.

"What has changed is that the development pipeline is running dry. We don't have new antibiotics that we can rely on in the immediate future or in the longer term." Changes in modern medicine have exacerbated the problem by making patients more susceptible to infections. For example, cancer treatments weaken the immune system, and the use of catheters increases the chances of bugs entering the bloodstream.

"We are becoming increasingly reliant on antibiotics in a whole range of areas of medicine. If we don't have new antibiotics to deal with the problems of resistance we see, we are going to be in serious trouble," Johnson added. The supply of new antibiotics has dried up for several reasons, but a major one is that drugs companies see greater profits in medicines that treat chronic conditions, such as heart disease, which patients must take for years or even decades.

"There is a broken market model for making new antibiotics," Davies told the MPs. Davies has met senior officials at the World Health Organisation and her counterparts in other countries to develop a strategy to tackle antibiotic resistance globally. Drug resistance is emerging in diseases across the board. Davies said 80% of gonorrhea was now resistant to the frontline antibiotic tetracycline, and infections were rising in young and middle-aged people.

Multi-drug resistant TB was also a major threat, she said. Another worrying trend is the rise in infections that are resistant to powerful antibiotics called carbapenems, which doctors rely on to tackle the most serious infections. Resistant bugs carry a gene variant that allows them to destroy the drug. What concerns some scientists is that the gene variant can spread freely between different kinds of bacteria, said Johnson.

Bacteria resistant to carbapenems were first detected in the UK in 2003, when three cases were reported. The numbers remained low until 2007, but have since leapt to 333 in 2010, with 217 cases in the first six months of 2011, according to the latest figures from the HPA.


Alternative medicines popular among pediatric outpatients


Use of complementary and alternative medicines such as vitamins, homeopathy and chiropractic therapy is common among children with chronic conditions, say Canadian researchers who suggest doctors should routinely be asking about their use.

Researchers surveyed parents about the use of complementary and alternative medicines (CAM) at five specialty clinics at both Stollery Children's Hospital in Edmonton and Children's Hospital of Eastern Ontario in Ottawa.

"CAM use is high among pediatric cardiology, gastroenterology, neurology, oncology, and respiratory patients, most of whom use CAM concurrently with conventional care," Dr. Sunita Vohra, of the pediatrics department at the University of Alberta and her co-authors, said in Monday's issue of the journal Pediatrics.

"Many patients, using CMA alongside their conventional medicines, are still not discussing their CAM use with their physicians and are increasing the likelihood for potential interactions and preventable harms."

Among those who said their child currently uses CAM with prescription medications, nearly 20 per cent didn't consult with a doctor or pharmacist, the researchers said. Of the parents surveyed in Western Canada, 71 per cent reported their child had at some point used CAM compared with 42 per cent in central Canada.

The most common CAM products for both cities were:
Vitamins and minerals, 91.2 per cent.
Herbals, 29.2 per cent.
Homeopathics, 37 per cent.
Others, including food and hormone-based products, probiotics and fish oil, 38.9 per cent.

The most common therapies were:
Massage, 42.5 per cent.
Chiropractic, 38.2 per cent.
Relaxation, 13.1 per cent.

The average age of the children was 8.8 years, most gave their overall health status as excellent, very good or good and the time since diagnosis was mainly more than a year. Parents rated most CAM products (84.2 per cent) and practices (76.2 per cent) as helpful or may have been helpful.

The researchers said families trust health-care providers but are more likely to disclose use of alternative medicines if an open, nonjudgmental approach is used. They urged clinicians to inquire about CAM use when routinely taking a history during every patient visit, suggested points to cover and resources on interactions between CAM and drugs.

The study was supported by the SickKids Foundation.


Chinese Medicine Yields Secrets


Chinese herbal medicine used for thousands of years to treat fevers associated with malaria have been uncovered thanks to a high-resolution structure solved at The Scripps Research Institute (TSRI).

Described in the journal Nature this week, the structure shows in atomic detail how a two-headed compound derived from the active ingredient in Chang Shan works. Scientists have known that this compound, called halofuginone (a derivative of the febrifugine), can suppress parts of the immune system but nobody knew exactly how.

The new structure shows that, like a wrench in the works, halofuginone jams the gears of a molecular machine that carries out "aminoacylation," a crucial biological process that allows organisms to synthesize the proteins they need to live. Chang Shan, also known as Dichroa febrifuga Lour, probably helps with malarial fevers because traces of a halofuginone-like chemical in the herb interfere with this same process in malaria parasites, killing them in an infected person's bloodstream.

"Our new results solved a mystery that has puzzled people about the mechanism of action of a medicine that has been used to treat fever from a malaria infection going back probably 2,000 years or more," said Paul Schimmel, PhD, the Ernest and Jean Hahn Professor and Chair of Molecular Biology and Chemistry and member of The Skaggs Institute for Chemical Biology at TSRI. Schimmel led the research with TSRI postdoctoral fellow Huihao Zhou, PhD.

Halofuginone has been in clinical trials for cancer, but the high-resolution picture of the molecule suggests it has a modularity that would make it useful as a template to create new drugs for numerous other diseases.

The Process of Aminoacylation and its Importance to Life
Aminoacylation is a crucial step in the synthesis of proteins, the end products of gene expression. When genes are expressed, their DNA sequence is first read and transcribed into RNA, a similar molecule.

The RNA is then translated into proteins, which are chemically very different from DNA and RNA but are composed of chains of amino acid molecules strung together in the order called for in the DNA. Necessary for this translation process are a set of molecules known as transfer RNAs (tRNAs), which shuttle amino acids to the growing protein chain where they are added like pearls on a string.

But before the tRNAs can move the pearls in place, they must first grab hold of them. Aminoacylation is the biological process whereby the amino acid's pearls are attached to these tRNA shuttles. A class of enzymes known as aminoacyl-tRNA synthetases is responsible for attaching the amino acids to the tRNAs, and Schimmel and his colleagues have been examining the molecular details of this process for years.

Their work has given scientists insight into everything from early evolution to possible targets for future drug development. Over time what has emerged as the picture of this process basically involves three molecular players: a tRNA, an amino acid and the aminoacyl-tRNA synthetase enzyme that brings them together. A fourth molecule called ATP is a microscopic form of fuel that gets consumed in the process.

The new work shows that halofuginone gets its potency by interfering with the tRNA synthetase enzyme that attaches the amino acid proline to the appropriate tRNA. It does this by blocking the active site of the enzyme where both the tRNA and the amino acid come together, with each half of the halofuginone blocking one side or the other.


Apixaban Wins Long-Awaited Nod from FDA


The FDA has approved the oral anticoagulant drug apixaban (Eliquis) to prevent stroke and systemic embolism in patients with nonvalvular atrial fibrillation, the agency announced late Friday.

The approval follows similar decisions by regulators in Europe, Canada, and Japan, which also cleared the oral Factor Xa inhibitor for this indication in recent weeks.

Apixaban's safety and efficacy for the afib indication in the U.S. were evaluated in a clinical trial involving more than 18,000 patients that compared the drug with warfarin, the FDA said in a statement.

In the trial, patients taking apixaban had fewer strokes than those who took warfarin. However, in another trial, apixaban failed to show a benefit relative to a different comparator, enoxaparin (Lovenox).

Concerns were also raised about possibly increased bleeding risks, although these have not been seen consistently. In June, the FDA said it was delaying a decision until the drug's sponsors, Bristol-Myers Squibb and Pfizer, submitted additional data related to the pivotal ARISTOTLE trial.

In announcing the approval, the FDA said the drug is contraindicated in patients with prosthetic heart valves. The agency also noted that there is currently no antidote to reverse the drug's anticoagulant effect should severe bleeding occur.

Apixaban will come with a patient medication guide that provides instructions on its use and drug safety information, the FDA said. "Healthcare professionals should counsel patients on signs and symptoms of possible bleeding," the agency added.


Simple eye scan can reveal extent of Multiple Sclerosis


A simple eye test may offer a fast and easy way to monitor patients with multiple sclerosis (MS), medical experts say in the journal Neurology.

Optical Coherence Tomography (OCT) is a scan that measures the thickness of the lining at the back of the eye - the retina. It takes a few minutes per eye and can be performed in a doctor's surgery. In a trial involving 164 people with MS, those with thinning of their retina had earlier and more active MS.

The team of researchers from the Johns Hopkins University School of Medicine say larger trials with a long follow up are needed to judge how useful the test might be in everyday practice. The latest study tracked the patients' disease progression over a two-year period.

Unpredictable disease
Multiple sclerosis is an illness that affects the nerves in the brain and spinal cord causing problems with muscle movement, balance and vision. In MS, the protective sheath or layer around nerves, called myelin, comes under attack which, in turn, leaves the nerves open to damage.

There are different types of MS - most people with the condition have the relapsing remitting type where the symptoms come and go over days, weeks or months. Usually after a decade or so, half of patients with this type of MS will develop secondary progressive disease where the symptoms get gradually worse and there are no or very few periods of remission. Another type of MS is primary progressive disease where symptoms get worse from the outset.

There is no cure but treatments can help slow disease progression. It can be difficult for doctors to monitor MS because it has a varied course and can be unpredictable. Brain scans can reveal inflammation and scarring, but it is not clear how early these changes might occur in the disease and whether they accurately reflect ongoing damage. Scientists have been looking for additional ways to track MS, and believe OCT may be a contender.

OCT measures the thickness of nerve fibres housed in the retina at the back of the eye. Unlike nerve cells in the rest of the brain which are covered with protective myelin, the nerve cells in the retina are bare with no myelin coat. Experts suspect that this means the nerves here will show the earliest signs of MS damage.

The study at Johns Hopkins found that people with MS relapses had much faster thinning of their retina than people with MS who had no relapses. So too did those whose level of disability worsened. Similarly, people with MS who had inflammatory lesions that were visible on brain scans also had faster retinal thinning than those without visible brain lesions.

Study author Dr Peter Calabresi said OCT may show how fast MS is progressing. "As more therapies are developed to slow the progression of MS, testing retinal thinning in the eyes may be helpful in evaluating how effective those therapies are," he added. In an accompanying editorial in the same medical journal that the research is published in, MS experts Drs Robert Bermel and Matilde Inglese say OCT "holds promise" as an MS test.


FDA approves Tamiflu for infants with new flu symptoms


The U.S. Food and Drug Administration on Friday expanded the use of Tamiflu, the flu drug from Roche, to children as young as 2 weeks old who have shown flu symptoms for no more than two days.

The FDA said the drug cannot be used to prevent flu infection in this age group.

The drug is currently approved as both a flu treatment and preventative flu drug for children ages 1 and older, and adults.

It aims to help lessen the length and severity of the flu.

Tamiflu was approved in 1999 and is distributed in the United States by Genentech, part of Roche.

It was co-developed by Gilead Sciences. Its most common side effects include vomiting and diarrhea.

The FDA said its expanded use is based on extrapolating data from previous study results in adults and older children, and supporting studies by the U.S. National Institutes of Health and Roche.

Tamiflu, which had peak sales of $3 billion in 2009 because of the H1N1 swine flu epidemic, is approved by regulators worldwide but some researchers claim there is little evidence it works and have asked Roche to hand over data so they can study its effectiveness.


Just 3% Of Americans Have Healthy Hearts


Surprisingly, only three percent of the U.S. population report having ideal heart health. Also, cardiovascular health differs greatly from state to state. These findings appeared in a study published in the Journal of the American Heart Association.

The new study is the first to examine cardiovascular health at the state level. Researchers took data from the 2009 Behavioral Risk Factor Surveillance System, a survey conducted by telephone of over 350,000 people in the 50 states and Washington D.C. Information was collected on what the American Heart Association identified as the seven major heart-health factors: body mass index, smoking, total cholesterol, diabetes, blood pressure, fruit and vegetable consumption, physical activity.

The researchers discovered that the percentage of the U.S. population with best heart health, having ideal levels of all seven factors, was lowest in Mississippi, Oklahoma, and West Virginia; highest in Vermont, Virginia, and Washington D.C. Just three percent of the total population documented having ideal cardiovascular health.

Around 10 percent of the population documented having poor heart health with two or less factors at ideal levels. Overall, the western and New England states tended to have a higher percentage of people with good cardiovascular health.

Jing Fang, M.D., M.S., an epidemiologist with the CDC's Division for Heart Disease and Stroke Prevention in Atlanta, Ga, says, "Americans reported having on average more than four of the seven risk factors for heart disease. We also found large disparities by age, sex, race/ethnicity and levels of education."

Americans 65 years of age or older reported the lowest percentage of ideal cardiovascular health, while the 35-54 age group documented the highest percentage of ideal cardiovascular health. Women showed better rates than men. Blacks, Native Americans, and Alaska Natives did poorly on rates of heart health, while whites and Asian/Pacific Islanders reported the best rates. People with higher levels of education documented better health than other groups.

The authors of the report hope that these findings may help encourage those health authorities to set up statewide goals for decreasing risk and improving heart health. Fang said, "This study gives us important information about the factors and behaviors that need the most improvement in each state to achieve the American Heart Association's goal of improving cardiovascular health for all Americans."

By 2020, the American Heart Association hopes to improve the heart health of all Americans by 20 percent while decreasing deaths from stroke and cardiovascular diseases by 20 percent.

Donna Arnett, Ph.D., president of the American Heart Association and author of an editorial that accompanies the Fang paper in JAHA concludes: "The comparisons offered by Fang and colleagues illustrate a critical point: Cardiovascular health status in the United States varies considerably by age, sex, race/ethnicity and education as well as by state. This diversity necessitates that innovative, customized strategies be developed to most effectively improve cardiovascular health for specific states and among subpopulations."

Ideal cardiovascular health has been historically linked to a healthy lifestyle. Healthy lifestyle factors such as not smoking, regular exercise, a diet rich in fruits and vegetables, maintaining a health body weight and drinking moderate amounts of alcohol are associated with a lower lifetime risk of heart failure.


Heart cells coaxed to divide and conquer


The heart does have a limited ability to heal itself — and a genetic 'trick' can harness this.

Can heart cells renew themselves, and can scientists help them do so? Two papers published online in Nature today suggest that heart muscle cells can make copies of themselves at a very low rate1, but that a genetic trick can prompt them to do a better job2. Those results give hope that hearts damaged by cardiovascular disease — which causes the deaths of almost 17 million people a year — could be coaxed to regenerate themselves.

Heart muscle cannot renew itself very well. Researchers would like to help that process by finding populations of cells in the heart that can do so, and then boosting that capacity. But it has not been easy to find evidence of these regenerating cells, or to assess the extent of their powers.

The two Nature papers aim to get to the heart of the matter. In one, a team led by Richard Lee at the Brigham and Women’s Hospital and Harvard Medical School, both in Boston, Massachusetts, traced the birth and fate of heart muscle cells in mice. Lee and his colleagues found that a small proportion of heart cells — less than 1% — can regenerate themselves normally. After a heart attack that proportion goes up, but only to 3%.

“These studies dispel any notion of the heart having a robust ability to regenerate,” says Charles (Chuck) Murry, who studies heart regeneration at the University of Washington in Seattle.

Heart hope
That those cells exist at all is heartening, however. “If there is some capacity for the heart to produce new heart muscle cells, that’s a foothold that we can work with,” says Matthew Steinhauser, a co-author on the paper1 and a member of Lee’s lab. Then, he says, the team can ask: “Can we make it work better?”.

A second group has done just that. Mauro Giacca and his colleagues at the International Centre for Genetic Engineering and Biotechnology in Trieste, Italy, used small snippets of RNA called microRNAs to stimulate heart cells to start regenerating. The researchers screened hundreds of microRNAs for the ability to prompt mouse and rat heart cells to proliferate.

The team then induced heart attacks in live mice and showed that two particular microRNAs helped to build the damaged hearts back up again so that they were functioning almost normally. After two months, the size of the area of tissue killed off by the heart attack was reduced by half, and the heart’s capacity to pump blood was signifcantly improved.

The microRNAs need further testing in larger animal models with more human-like hearts, says Giacca. Other scientists would like to see the results confirmed. “Those who know this field have seen many claims of heart regeneration that have not withstood the test of time,” says Murry. “If this study can be reproduced, it will be a major breakthrough.”


FDA panel backs J&J tuberculosis drug


Johnson & Johnson said that a panel of federal health experts ruled that its experimental treatment for multidrug-resistant tuberculosis appears to be safe and effective.

J&J's Janssen Research & Development has asked the Food and Drug Administration to approve bedaquiline, or TMC207, as part of combination therapy for adults with multidrug-resistant tuberculosis lung infections.

On Wednesday a panel of outside experts voted unanimously that the drug is effective in treating patients with the disease.

The same panel voted 11-7 that the drug was safe for the indication. Some panel members raised concerns about abnormal liver enzymes in patients treated with the drug.

The FDA is not required to follow the panel's advice, though it often does.

The agency has agreed to evaluate the drug under its priority review system, which aims to decide whether to approve an application within six months, rather than the standard 10 months.

Bedaquiline would be the first drug specifically for multidrug-resistant tuberculosis, and the first new type of TB drug in more than four decades.

About 1.4 million people worldwide die from tuberculosis each year, roughly 10 percent of them from forms resistant to at least two of the standard drugs for the deadly bacterial disease.

 J&J applied for approval to market the drug in the European Union on Aug. 31.


Canada finds Pfizer’s Viagra patent is invalid


The Supreme Court of Canada has unanimously decided that drug giant Pfizer Canada Inc.’s patent on Viagra is invalid, opening the door to less expensive, generic versions of the little blue pill to become available on the Canadian market.

The 7-to-0 decision, announced Thursday, means that generic drug company Teva Canada Limited will be allowed to market its own version of the erectile dysfunction drug onto the Canadian market. And just hours after the decision, Teva Canada posted a notice to its website introducing “a generic alternative to Viagra.”

The top court issued the decision in response to a challenge to Pfizer’s Canadian patent by the generic drug company. Teva Canada had argued in an April hearing that the Viagra patent was invalid because Pfizer did not disclose sufficient information when it applied for it, in violation of the Patent Act. Specifically, Teva said Pfizer did not sufficiently disclose the exact compound that is effective in treating erectile dysfunction, sildenafil, among a list of 260 quintillion chemical compounds named in the patent, according to court documents.

And the Supreme Court agreed, even though the lower courts had previously ruled in favour of Pfizer, whose patent was set to expire in 2014. “Pfizer had the information needed to disclose the useful compound and chose not to release it. Even though Pfizer knew that the effective compound was sildenafil at the time it filed the application, it limited its description,” Justice Louis LeBel wrote in the decision.

“If there is no quid – proper disclosure – then there can be no quo – exclusive property rights.” Pfizer is disappointed with the ruling and expects to face generic competition in Canada shortly, the company said in a statement Thursday. “Pfizer will continue to vigorously defend against challenges to its intellectual property. Patents provide a vital incentive for biopharmaceutical companies to invest in new and life-saving medicines that benefit millions of patients worldwide,” the company said.

  The company is also on the hook for Teva’s court costs. The ruling is great news for generic drug companies and for consumers, and Canadians are likely to see more generic drugs coming onto the Canadian market as a result, said Eugene Meehan, a partner at Supreme Advocacy LLP in Ottawa, and former executive legal officer at the Supreme Court But, more broadly, the decision clarifies the disclosure requirements of all patents, he said.

  There has been a “certain complacence” amongst patent lawyers that if the disclosure information was sufficient to satisfy the patent office, then that patent was unassailable, Meehan said. “The Supreme Court of Canada is saying that these patents may not be as rock solid as previously thought,” Meehan said. “The decision is a legal earthquake in the patent world – it’s like hurricane Sandy blew through the Patent Act.”

  While recognizing that there must be a balance between the rights of the innovators and of the public, the court’s central message is that companies and researchers should not be allowed to game the system, said Richard Gold, a patent law expert and professor in the faculty of law at Montreal’s McGill University.


HIV Infections and AIDS Deaths Dropping


A new global report on the HIV/AIDS epidemic spotlights success in both prevention and treatment efforts, but also stresses that countries must dramatically ramp up both if the world hopes to meet the ambitious goals agreed upon last year at a special session of the United Nations.

The report, released today by the Joint United Nations Programme on HIV/AIDS (UNAIDS), estimates that the world had 34 million HIV-infected people at the end of 2011. The most heartening news is that the rate of new infections, 2.5 million people last year, represents a 20% drop from 2001.

The decline has been greater than 50% in 25 low- and middle-income countries, including some of the hardest hit in sub-Saharan Africa. Roughly one-half of the decline is the result of interventions that aim to prevent transmission of HIV from pregnant women to their babies.

"It's amazing what's happening," UNAIDS Executive Director Michel Sidibé tells ScienceInsider. "We're increasing the pace of action. What was taking 10 years now is taking 2 years, even with the same level of resources."

Similarly impressive gains have occurred with treatment. Antiretroviral (ARV) drugs are now provided to 8 million people, a 20-fold jump since 2003. AIDS-related deaths have also fallen to 1.7 million, down from 2.3 million in 2005.

The report, which UNAIDS issued on the eve of World AIDS Day (1 December) describes this news as "encouraging," but also squarely acknowledges the daunting challenge of hitting several of the 2015 targets set at the United Nations meeting.

Specifically, countries agreed that 3 years from now, they will be providing 15 million people with ARVs, slash sexual and injecting drug transmission by 50%, and eliminate mother-to-child transmission.

"The next thousand days will be a real test to our collective commitment and action," said UNAIDS official Bernhard Schwartländer at a teleconference today.


Green Tea Help Lower Blood Sugar Spikes


An ingredient in green tea that helps reduce blood sugar spikes in mice may lead to new diet strategies for people, according to Penn State food scientists.

Mice fed an antioxidant found in green tea - epigallocatechin-3-gallate, or EGCG -and corn starch had a significant reduction in increase in their blood sugar - blood glucose - levels compared to mice that were not fed the compound, according to Joshua Lambert, assistant professor of food science in agricultural sciences.

"The spike in blood glucose level is about 50 percent lower than the increase in the blood glucose level of mice that were not fed EGCG," Lambert said. The dose of EGCG fed to the mice was equivalent to about one and a half cups of green tea for a human. Lambert, who worked with Sarah C. Forester, postdoctoral fellow, and Yeyi Gu, graduate student, both in food science, said EGCG was most effective when the compound was fed to the mice simultaneously with corn starch.

For humans, this may mean that green tea could help them control the typical blood sugar increases that are brought on when they eat starchy foods, like breads and bagels that are often a part of typical breakfasts. "If what you are eating with your tea has starch in it then you might see that beneficial effect," Lambert said. "So, for example, if you have green tea with your bagel for breakfast, it may reduce the spike in blood glucose levels that you would normally get from that food."

The EGCG had no significant effect on blood sugar spikes in mice that were fed glucose or maltose, according to the researchers who released their findings in the online version of Molecular Nutrition and Food Research. Lambert said that the reason blood sugar spikes are reduced when the mice ate starch, but not these sugars, may be related to the way the body converts starch into sugar. An enzyme called alpha-amylase that is produced in both the mouth and by the pancreas helps break down starch into maltose and glucose.

EGCG may inhibit the enzymes ability to break down the starch, the researchers indicated, since they also found that EGCG reduced the activity of alpha amylase in the pancreas by 34 percent. If the mechanism holds in humans, this may mean that people who want to limit the blood sugar spike should skip adding sugar to their cup of green tea.

"That may mean that if you add sugar into your green tea, that might negate the effect that the green tea will have on limiting the rise in blood glucose level," Lambert said. Lambert added that the green tea and the starch would need to be consumed simultaneously. For example, drinking a cup of tea well after eating a piece of toast would probably not change the blood sugar spike.

For the study, researchers separated mice into several groups based on body weight. After a fasting period, the mice were given common corn starch, maltose, or sucrose. One group of mice received EGCG along with the feed, while a control group was not fed the compound. The researchers then tested the blood sugar levels of both groups. Lambert said the researchers next step is to test the compound on people.


Female Viagra Tefina Being Developed As Nasal Spray


Ever get an orgasm through the nose? According to The Huffington Post, researchers are developing a nasal spray called Tefina, designed to boost women’s sexual arousal as a kind of a “female Viagra.”

The drug, a testosterone gel that is absorbed into the body through the nose, is about to undergo clinical trials in Australia and Canada. Tefina, which would take a few hours to boost libido, is meant to treat Female Orgasmic Disorder (FOD), which is defined as “Persistent or recurrent delay in, or absence of, orgasm following a normal excitement phase.”

Considering Viagra pulls in $2 billion a year in the U.S., it’s no surprise that drugmakers would want to reap similar economic benefits from women. Critics of the drug claim that FOD isn’t really a disease – but a 2011 survey found that women have orgasms about half as often as men do.

“Female sexual dysfunction is a real thing and we think up to 43 percent of women suffer some form of sexual dysfunction,” said Dr. Fiona Jane of Melbourne’s Monash University. “A lot of people have thought that drumming up the idea of a female ‘Viagra’ is just for pharmaceutical companies. In fact, there is a huge need for women to have their sexual dysfunction addressed.”

But the 2009 documentary Orgasm Inc suggested that drug companies “might be trying to take advantage of women (and potentially endanger their health) in pursuit of billion dollar profits.” The question is: does a lack of orgasm come from a medical problem? (We’ve all had a clueless partner or two.)

The research seems to indicate that biology is definitely a factor. A study released earlier this year found that women gradually lose interest in sex the longer they’re with their partners. Of course, all women should consider the risks before taking drugs – but any argument against research in this field seems sexist.

It’s just like how for years, health insurance companies covered Viagra but not birth control. Men’s problems are taken seriously – and taken care of – while women’s problems are dismissed or blamed on the woman.


Anti-Tumor Nanoparticles Using Tiger Milk Mushroom


Tapping into the power of natural ingredients for safer treatment is the next frontier in the battle against cancer. A recent breakthrough from HKPolyU uses tiger milk mushroom to prepare anti-tumor nanoparticles is bringing us one step closer.

Cancer is a word dreaded by many. Many cancers are deadly and difficult to treat while conventional remedies such as chemotherapy often cause physical and emotional sides effects, giving struggling patients more harm just as the cancer. What if cancer-killing drugs can become more natural and in harmony with our body? Tapping into the power of natural ingredients for safer treatment is the next frontier in the battle against cancer.

A recent breakthrough from PolyU's Department of Applied Biology and Chemical Technology using tiger milk mushroom to prepare anti-tumor nanoparticles is bringing us one step closer. A natural compound found in mushrooms may hold the key to a new class of cancer drugs. In Tiger Milk mushrooms from Africa, Dr Wong Ka-hing, Associate Director of the Food Safety and Technology Research Centre, has discovered a polysaccharide-protein complex (PSP) which can turn selenium, a common nutrient, into new cancer therapy to benefit millions of breast cancer patients around the world. Selenium is a trace mineral essential for good health.

Health benefits include boosting immune systems against viral infections. Staple foods and vegetables in our diet such as rice, wheat, potatoes, broccolis and onions are great sources of antioxidant. In nano-size, selenium was found to have potent anti-cancer effect in the laboratory. However, efficacy diminished as the nanoparticles fell back into bigger aggregates which suppressed the up-take into cancer cells. Finding new ways or compounds to halt the rebinding process is harder than it seems. Literally, it is quite like searching for a needle in a haystack. The use of mushroom PSP as stabilizing force is a significant breakthrough.

Combined with cutting-edge nanotechnology, Dr Wong and his team successfully made selenium nanoparticles to destroy breast cancer cells. "Lab-test results were exciting. Our selenium nanoparticles were found to have remarkable inhibition effect on the growth of human breast cancer cells by triggering the cells into self-destruction. The next stage will be tests on animals," Dr Wong said. The research is still in a very early phase. But if successful, it could lead to a new drug much less toxic and more reliable, capable of killing cancer cells while leaving healthy tissues unharmed, which could mean fewer agonizing side-effects, greater comfort and better chances of recovery.

Dr Wong also planned on developing a dietary supplement as auxiliary cancer treatments. Scientists around the world have been looking into the therapeutic value of produces such as fish oil, broccoli, cauliflower, cabbage, and green tea. For safe human consumption, a natural ingredient must be effective against cancer in low concentration. Dr Wong's work has advanced medicine with a working tool for boosting the effectiveness of natural cancer killing compounds. "Mushroom PSP has striking effects on controlling selenium nanoparticles," Dr. Wong added, "and a better understanding of this mechanism may help us find the next suitable compounds and make better nano-medicines for a whole host of cancers."

Tiger Milk, similar to Chinese mushrooms we have in dishes and soups mushroom, is a common foodstuff in Africa, and the groundbreaking biomedical research opens door to making cancer drug from 100% natural ingredients. The drug development process is equally natural and green because all it takes are room temperature and water, which is little waste and without much power consumption. Holding new promise for beating cancer, this research has won Dr Wong the Young Investigator Award at the 2011 International Conference of Food Factors and the Gold Medal in 40th International Exhibition of Inventions of Geneva.


Meningitis Cases, Deaths Up Again


Another 18 cases of fungal meningitis have been identified in the past 24 hours, the CDC reported, and one more patient has died.

As before, Tennessee continues to have more cases of the fungal disease - linked to three lots of an injectable steroid used to control back pain - than any other state. Five more cases have been identified in the state – which was the first to report the outbreak - bringing the total there to 44.

All told, the CDC has been informed of 137 cases in 10 states, with 12 deaths. The new death was reported in Florida, which now has a total of six cases, up from four earlier in the week. Tennessee health officials told MedPage Today that the upper limit of people in the state exposed to the steroid - preservative-free methylprednisolone acetate – is about 1,000.

But they said only about 5% of those injected with the drug have developed the typical symptoms of the fungal infection - fever, new or worsening headache, nausea, and new neurological deficit consistent with deep brain stroke. No new exposures are likely – the three contaminated lots have been recalled, as have all products made by the New England Compounding Center in Framingham, Mass.

But officials say the incubation period of the fungus involved is not known, and expect to identify new cases for several weeks. Aside from Tennessee and Florida, Indiana, Michigan and Virginia each reported three new cases, bringing their totals to 15, 28, and 27, respectively.

Maryland and New Jersey each identified one more case, for totals of eight and two, respectively. There have been no cases reported west of Minnesota, although some of the suspect steroid was shipped to Texas, Idaho, and California. Drugs sent to pain clinics in Nevada were recalled before any were used, the CDC said.

All told, the company shipped 17,676 vials of the steroid to pain clinics in 23 states. It was used in epidural injections to help control back pain.


Green Tea – The Brainy Beverage


The study involved focus on a particular chemical in the tea namely epigallocatechin-3 gallate (EGCG).

The team has revealed that there are beneficial effects against degenerative diseases associated with aging. According to the scientists the EGCG chemical helps improve the cognitive functions of the brain and impacts neurogenesis – the generation of brain cells (neurons).

Another focus was on the hippocampus part of the brain that is involved in the conversion of information from short term memory to long term. It also promotes the production of the progenitor brain cells that are similar to stem cells. In that, they can differentiate into different types of brain cells.

Effects of green tea on mice
Scientists used this information to find out if the EGCG in the green tea caused an increase in the neural cell production, and if yes then did it impact memory and spatial learning. For this, they set up experiments on 2 groups of mice.

The first group received EGCG, while the other did not and was treated as a control group. They were subjected to seven days of training in a maze chase which had a hidden platform.

During this training scientists found that the mice which had taken EGCG were able to find the hidden platform easily in less time as compared to the control group.

This proved that the chemical EGCG in green tea was helpful in spatial learning and memory that aided in object recognition and the overall process of learning.

Treating degenerative brain diseases using green tea
The final outcome of the experiments revealed that the organic compound EGCG in green tea is responsible for increased production of progenitor neural cells in mice as well as glass tests.

According to Dr. Bai, this property of green tea has the potential to become a treatment option for degenerative diseases such as Alzheimer’s and Parkinson’s, where the patients suffer rapid memory loss due to rapid reduction in neural cells.


Botox Can Help Overactive Bladder In Women


Botox (onabotulinum toxin-A) treatments administered to the bladder are just as likely to tackle urinary urgency incontinence problems in women as medications, and are 2 times as effective in eliminating symptoms completely, according to a recent study conducted by Loyola University Chicago Stritch School of Medicine (SSOM) and other experts from the National Institutes of Health network.

This new report coincides with a 2011 trial, which suggested that botox had been approved to help urinary incontinence in patients with neurological conditions. Urinary incontinence occurs when urine leaks involuntarily, and is almost always due to an underlying medical condition.

Urgency incontinence is the same as urinary incontinence, but accompanied by an intense, out-of-the-blue need to use the bathroom. The most common reason for urgency urinary incontinence is when detrusor muscles contract spontaneously.

Parkinson's, Alzheimer's, multiple sclerosis, spina bifida, stroke and other injuries can all damage muscles and bladder nerves. This condition has traditionally been treated by prescribing medications which weaken bladder contractions (anticholinergics). Anticholinergics affect the bladder muscle via the nervous system.

The problem with these medications is that women often report constipation, dry mouth, dry eyes, and other side effects. Roughly 15.7% of women suffer from urinary incontinence, and women have a two-fold likelihood over men of developing the annoying condition.

Bladder problems have been linked to diabetes and obesity; women who suffer from lack of bladder control have a higher chance of developing depression.

During the trial, the researchers examined 241 women suffering from urinary urgency incontinence. Of these individuals, some were given six-months of oral drugs to be taken daily in addition to a saline shot. The others were given one shot of Botox (onabotulinum toxin-A), as well as a placebo pill to be taken every day.

When the study commenced, the participants had, on average, 5 urgency incontinence occurrences every day. Over the course of 6 months, the occurrences were reduced to 3.4 with the oral drugs and 3.3 with Botox (onabotulinum toxin-A).

Urgency incontinence completely disappeared among 13% of women who were taking anticholinergics and 27% among those taking onabotulinum toxin-A. Both groups of women showed a boost in quality of life.

In terms of side effects, 46% of patients in the anticholinergic group reported dry mouth, compared to only 31% in the onabotulinum toxin-A group.

Incomplete emptying of the bladder was reported more among the onabotulinum group as well (5%), compared to 0% in the other group. Those who had incomplete bladder emptying problems had to be treated with catheterization.

Dr. Brubaker, continued: "These results will help doctors weigh treatment options for women and make recommendations based on individual patient needs.


Meditation Reduces Loneliness


Many elderly people spend their last years alone. Spouses pass and children scatter. But being lonely is much more than a silent house and a lack of companionship. Over time, loneliness not only takes a toll on the psyche but can have a serious physical impact as well.

Feeling lonely has been linked to an increased risk of heart disease, Alzheimer's disease, depression and even premature death. Developing effective treatments to reduce loneliness in older adults is essential, but previous treatment efforts have had limited success. What to do? Researchers at UCLA now report that a simple meditation program lasting just eight weeks reduced loneliness in older adults.

Further, knowing that loneliness is associated with an increase in the activity of inflammation-related genes that can promote a variety of diseases, the researchers examined gene expression and found that this same form of meditation significantly reduced expression of inflammatory genes.

In the current online edition of the journal Brain, Behavior and Immunity, senior study author Steve Cole, a UCLA professor of medicine and psychiatry and a member of the Norman Cousins Center for Psychoneuroimmunology at UCLA, and colleagues report that the two-month program of mindfulness-based stress reduction (MBSR), which teaches the mind to simply be attentive to the present and not dwell in the past or project into the future, successfully reduced the feelings of loneliness.

Remarkably, the researchers said, MBSR also altered the genes and protein markers of inflammation, including the inflammatory marker C-reactive protein (CRP) and a group of genes regulated by the transcription factor NF-kB. CRP is a potent risk factor for heart disease, and NF-kB is a molecular signal that activates inflammation.

Inflammation is a natural component of the immune system and can help fight a wide variety of bodily insults, ranging from infections to a whack by a hammer. But chronic inflammation is now known to be a primary player in the pathology of many diseases and psychological disorders. "Our work presents the first evidence showing that a psychological intervention that decreases loneliness also reduces pro-inflammatory gene expression," Cole said.

"If this is borne out by further research, MBSR could be a valuable tool to improve the quality of life for many elderly." In the study, 40 adults between the ages of 55 and 85 were randomly assigned to either a mindfulness meditation group or a control group that did not meditate. All the participants were assessed at the beginning and the end of the study using an established loneliness scale. Blood samples were also collected at the beginning and end to measure gene expression and levels of inflammation. The meditators attended weekly two-hour meetings in which they learned the techniques of mindfulness, including awareness and breathing techniques.

They also practiced mindfulness meditation for 30 minutes each day at home and attended a single daylong retreat. These MBSR participants self-reported a reduced sense of loneliness, while their blood tests showed a significant decrease in the expression of inflammation-related genes. "While this was a small sample, the results were very encouraging," said Dr. Michael Irwin, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA and director of the Cousins Center. "It adds to a growing body of research that is showing the positive benefits of a variety of meditative techniques, including tai chi and yoga."

Just last month, for example, Dr. Helen Lavretsky, a UCLA professor of psychiatry and a Cousins Center member, published a study showing that a form of yogic meditation involving chanting also reduced inflammatory gene expression, as well as stress levels, among individuals who care for patients with Alzheimer's disease. "These studies begin to move us beyond simply connecting the mind and genome, and identify simple practices that an individual can harness to improve human health," Irwin said.


Singla gene mutation found to cause insulin sensitivity


Oxford researchers have discovered the first single gene responsible for insulin sensitivity in humans. Since the opposite condition of insulin resistance is a significant marker of type 2 diabetes, the discovery could potentially lead to new pathways for diabetes drugs and future treatments.

The scientists decided to look at the gene – PTEN – based on previous studies, which examined common variants across the human genome that might lead to an increased risk for diabetes.

“They’ve shown a link between the cell cycle and a risk for type 2 diabetes, which has started to suggest there might be a genetic overlap in terms of your predisposition for getting diabetes and cancer,” study author Dr. Anna Gloyn, of the Oxford Center for Diabetes, Endocrinology and Metabolism at Oxford, told, Mutations in just one PTEN gene have been associated with an increased risk of cancers – such as breast, womb and thyroid cancer.

To go along with this established link, mouse models have shown that PTEN also plays a role in the pathways important for metabolism.

“This gene was a good candidate to pick because you could hypothesize that if there was a defect in this gene, it could impact not only cell growth, which would lead to cancer, but it could also affect their metabolic outcome,” Gloyn said. The scientists, interested in learning more about the gene’s dual role, recruited people in the U.K. with a condition known as Cowden syndrome, which is caused by a faulty mutation in the PTEN gene.

People with Cowden syndrome have a higher risk for cancer and often develop polyps on their skin, mouth and bowels. Cowden syndrome is rare; only one out of every 200,000 people have the condition. An estimated 300 people have the condition in the U.K., which made it difficult for the researchers to study.

However, they were able to assemble 15 people with the condition, matching each participant with a healthy counterpart who served as their control test subject. Both the participants and the control subjects were given glucose drinks to see how well their bodies could cope. Those with Cowden syndrome showed increased insulin sensitivity.

“With very low amounts of this [insulin] hormone, they could clear the glucose from their system,” Gloyn said. “… the cells in our pancreas are responsible for secreting insulin – which helps to clear glucose from our blood. The people who have these mutations respond very quickly to lower levels of glucose.”

For those suffering from type 2 diabetes, the opposite is true. The body’s insulin is less effective at clearing glucose – essentially sugar – from the blood. Because it is more difficult for their bodies to metabolize glucose, people who suffer from diabetes are typically overweight or obese. Drugs used to combat diabetes typically strive to boost insulin sensitivity.

However, while those with Cowden syndrome were better at clearing glucose, they also had higher levels of obesity than the control group – providing an interesting paradox for the researchers. “You would think if we have insulin sensitive people they’d be thin, but that wasn’t the case,” Gloyn said.

Now that faulty PTEN has been identified as having this metabolic effect in humans, Gloyn said the discovery could lead to new treatments for diabetes – but further research is definitely needed.

“If you were going to design a PTEN inhibitor…there’d be a strong chance you’d have cancer like properties,” Gloyn said. “It’s like a ying yang – you’d have an increased risk of cancer, but a decreased risk of diabetes.” Gloyn said that because of this duality, it’s important to know exactly what the target effects will be when developing new drugs.


Tea Ingredients Can Kill Micro-Organisms


New research has revealed that a nice cup of tea could hold the solution to a range of deadly weapons in the bioterrorist's arsenal.

As well as being the UK's favorite drink, research has shown that the morning brew has the ability to kill micro-organisms and inactivate toxins.

Dr Simon Richardson, Senior Lecturer in Biopharmaceutical Sciences at the University of Greenwich's School of Science, is part of a team of researchers who have discovered that a principal component of black tea can neutralize ricin, a highly toxic substance which has been at the center of a number of attempted terrorist attacks.

Dr Richardson says: "One cup of char won't cure you if you have been poisoned, but compounds extracted from tea could, with further research, provide an antidote to poisoning following a terrorist attack.

I've been working on neutralizing ricin poisoning for about six years as a by-product of my work in drug delivery.

Professor Les Baillie from Cardiff University is leading this project, which is in its preliminary stages but there is real progress! The next stage, as well as securing more funding, is seeing if other components of tea have a greater effect."

Ricin was the poison used to kill the Bulgarian dissident Georgie Markov on Westminster bridge in 1978 after a small pellet containing the poison was fired out of what was thought to be a modified umbrella.


Sensor detects glucose in saliva and tears


Researchers have created a new type of biosensor that can detect minute concentrations of glucose in saliva, tears and urine and might be manufactured at low cost because it does not require many processing steps to produce.

"It's an inherently non-invasive way to estimate glucose content in the body," said Jonathan Claussen, a former Purdue University doctoral student and now a research scientist at the U.S. Naval Research Laboratory.

"Because it can detect glucose in the saliva and tears, it's a platform that might eventually help to eliminate or reduce the frequency of using pinpricks for diabetes testing. We are proving its functionality."

Claussen and Purdue doctoral student Anurag Kumar led the project, working with Timothy Fisher, a Purdue professor of mechanical engineering; D. Marshall Porterfield, a professor of agricultural and biological engineering; and other researchers at the university's Birck Nanotechnology Center.

Findings are detailed in a research paper being published this week in the journal Advanced Functional Materials. The paper, featured on the journal's cover, was written by Claussen, Kumar, Fisher, Porterfield and Purdue researchers David B. Jaroch, M. Haseeb Khawaja and Allison B. Hibbard.

The sensor has three main parts: layers of nanosheets resembling tiny rose petals made of a material called graphene, which is a single-atom-thick film of carbon; platinum nanoparticles; and the enzyme glucose oxidase. Each petal contains a few layers of stacked graphene.

The edges of the petals have dangling, incomplete chemical bonds, defects where platinum nanoparticles can attach. Electrodes are formed by combining the nanosheet petals and platinum nanoparticles. Then the glucose oxidase attaches to the platinum nanoparticles. The enzyme converts glucose to peroxide, which generates a signal on the electrode.

The technology is able to detect glucose in concentrations as low as 0.3 micromolar, far more sensitive than other electrochemical biosensors based on graphene or graphite, carbon nanotubes and metallic nanoparticles, Claussen said "These are the first findings to report such a low sensing limit and, at the same time, such a wide sensing range," he said.

The sensor is able to distinguish between glucose and signals from other compounds that often cause interference in sensors: uric acid, ascorbic acid and acetaminophen, which are commonly found in the blood. Unlike glucose, those compounds are said to be electroactive, which means they generate an electrical signal without the presence of an enzyme.

Glucose by itself doesn't generate a signal but must first react with the enzyme glucose oxidase. Glucose oxidase is used in commercial diabetes test strips for conventional diabetes meters that measure glucose with a finger pinprick.


India Launches a New Lab for HIV Research


India opened a $12 million, government-backed laboratory whose mission is to create a new vaccine against HIV.

The HIV Vaccine Translational Research Laboratory, which aims to recruit about 30 scientists, is embedded within the Translational Health Science and Technology Institute, a $200 million facility under development on the outskirts of New Delhi.

It will work in collaboration with the New York based-International AIDS Vaccine Initiative (IAVI); operating costs will be shared equally.

India has the world's third largest burden of AIDS, despite the fact that "HIV infections have declined by 56% during the last decade, from 270,000 in 2000 to 120,000 in 2009," says India’s health minister Ghulam Nabi Azad.

He says there is a desperate need for a vaccine against HIV. "Designing a new broad-spectrum HIV vaccine will be the mandate of this new lab," says Margaret G. McGlynn, CEO of IAVI.

The goal is achievable, she says: "Researchers have long known that after a few years of infection, a minority of HIV-positive people produce antibodies that can neutralize a broad spectrum of HIV variants."

The aim is to find a suitable broad spectrum antibody for the purpose. McGlynn says the plan is to make and test a vaccine in India, which she says is "suitably placed with its talented scientific manpower, well-established pharma industry, and a huge commitment from the government."


Why do infants get sick so often?


University of Michigan Health System researchers reveal cell signaling prevents the growth of essential immune cells.

Researchers at the University of Michigan Health System are helping to quell parents’ worry about why infants seem to get sick so often.

It’s been believed that, like walking and talking, fighting viral infections is something children will develop when they get older. But a U-M study suggests the natural ability to fight infection is there early on.

Scientists learned key cell signals inhibit the growth of essential immune cells early in life. Blocking this signaling could lead to improving an infant’s response to infection, according to the study published online ahead of print in Nature Immunity.

“What happens at early age is that natural killer cells, like many other immune cells, do not complete their functional maturation until adulthood,” says study senior author Yasmina Laouar, Ph.D., assistant professor in the U-M Department of Microbiology and Immunology.

”During this time we are left with an immature immune system that cannot protect us against infections, the reason why newborns and infants are more prone to infection,” she says. There is a large gap in understanding infant immunity, specifically why the natural killer cell responses are deficient.

The study by immunologists at the U-M demonstrates the role of a cell called transforming growth factor beta that can explain why. The study showed the production of natural killer cells is controlled by TGF-β, which is produced in the bone marrow.

In infant mice, the maturation of natural killer cells progressed faster in the absence of TGF-β signaling. By adulthood, mice had 10 times more mature natural killer cells if TGF-β signaling was blocked.

“Our overall goal was to determine the factors that constraint the production and maturation of natural killer cells early in life,” says Laouar.

“To our surprise, we discovered that natural killer cells can complete maturation as early as 10 days of age if TGF-β signaling is blocked.”

Authors say it’s tempting to propose the functional inactivation TGF-β signaling as a strategy to reverse the deficit of natural killer cells early in life. Additional testing will be required.


Yoga May Help Stroke Survivors Improve Balance


Group yoga can improve balance in stroke survivors who no longer receive rehabilitative care, according to new research in the American Heart Association journal Stroke. In a small pilot study, researchers tested the potential benefits of yoga among chronic stroke survivors - those whose stroke occurred more than six months earlier.

"For people with chronic stroke, something like yoga in a group environment is cost effective and appears to improve motor function and balance," said Arlene Schmid, Ph.D., O.T.R., lead researcher and a rehabilitation research scientist at Roudebush Veterans Administration-Medical Center and Indiana University, Department of Occupational Therapy in Indianapolis, Ind.

The study's 47 participants, about three-quarters of them male veterans, were divided into three groups: twice-weekly group yoga for eight weeks; a "yoga-plus" group, which met twice weekly and had a relaxation recording to use at least three times a week; and a usual medical care group that did no rehabilitation.

The yoga classes, taught by a registered yoga therapist, included modified yoga postures, relaxation, and meditation. Classes grew more challenging each week. Compared with patients in the usual-care group, those who completed yoga or yoga-plus significantly improved their balance.

Balance problems frequently last long after a person suffers a stroke, and are related to greater disability and a higher risk of falls, researchers said. Furthermore, survivors in the yoga groups had improved scores for independence and quality of life and were less afraid of falling.

"For chronic stroke patients, even if they remain disabled, natural recovery and acute rehabilitation therapy typically ends after six months, or maybe a year," said Schmid, who is also an assistant professor of occupational therapy at Indiana University-Purdue University in Indianapolis and an investigator at the Regenstrief Institute.

Improvements after the six-month window can take longer to occur, she said, "but we know for a fact that the brain still can change. The problem is the healthcare system is not necessarily willing to pay for that change.

The study demonstrated that with some assistance, even chronic stroke patients with significant paralysis on one side can manage to do modified yoga poses." The oldest patient in the study was in his 90s. All participants had to be able to stand on their own at the study's outset.

Yoga may be more therapeutic than traditional exercise because the combination of postures, breathing and meditation may produce different effects than simple exercise, researchers said. "However, stroke patients looking for such help might have a hard time finding qualified yoga therapists to work with," Schmid said.

"Some occupational and physical therapists are integrating yoga into their practice, even though there's scant evidence at this point to support its effectiveness." Researchers can draw only limited conclusions from the study because of its small number of participants and lack of diversity.

The study also didn't have enough participants to uncover differences between the yoga and control groups. The scientists hope to conduct a larger study soon. Researchers also noticed improvements in the mindset of patients about their disability.

 The participants talked about walking through a grocery store instead of using an assistive scooter, being able to take a shower and feeling inspired to visit friends.


AI predicts when you're about to get sick


If you've been walking around a public place lately, you've come in contact with a lot of people.

Some of those people may have been sick. And if you've been hanging around enough of them as they cough and sneeze, then you might be about to get sick too.

That may sound obvious, but Adam Sadilek at the University of Rochester in New York and colleagues have applied the idea to a pile of Twitter data from people in New York City, and found that they can predict when an individual person will come down with the flu up to eight days before they show symptoms.

It's a similar idea to Google Flu Trends, which tracks how often people search for "flu" and related terms on the search engine and uses that information to provide daily updates on where outbreaks are occurring and how they're spreading.

To see whether it was possible to bring such a service down to the level of the individual, Sadilek and his team analysed 4.4 million tweets tagged with GPS location data from over 630,000 users in the New York City area over one month in 2010.

They trained a machine-learning algorithm to tell the difference between tweets by healthy people - who might say something like "I am so sick of this traffic!" - and someone who is actually sick and showing signs of the flu. The video above shows a heat map of flu occurrence over the course of one day, based on their findings.

The researchers were able to predict when healthy people were about to fall ill - and then tweet about it - with about 90 per cent accuracy out to eight days in the future.

The system is limited in several ways. For instance, it misses many cases of illness because people don't reliably tweet about their symptoms. And there are many factors that go into people getting sick, not just who they've had contact with. Sadilek is addressing some of these confounding factors.

In unpublished findings described to New Scientist during an interview at the Conference on Artifical Intelligence in Toronto, Canada, yesterday, his team showed that people who go to the gym regularly are moderately less likely to get sick. People with low socio-economic status, on the other hand, are much more likely to become ill.

Such information could one day be used to power a smartphone app that warns you when you've entered a public place with a high incidence of flu. Or after a big day out, it might buzz you with a message to say you are at high risk of getting sick over the next few days.


Severe Flu Increases Risk of Parkinson's


Severe influenza doubles the odds that a person will develop Parkinson's disease later in life, according to University of British Columbia researchers.

However, the opposite is true for people who contracted a typical case of red measles as children - they are 35 per cent less likely to develop Parkinson's, a nervous system disorder marked by slowness of movement, shaking, stiffness, and in the later stages, loss of balance.

The findings by researchers at UBC's School of Population and Public Health and the Pacific Parkinson's Research Centre, published online this month in the journal Movement Disorders, are based on interviews with 403 Parkinson's patients and 405 healthy people in British Columbia, Canada.

Lead author Anne Harris also examined whether occupational exposure to vibrations - such as operating construction equipment - had any effect on the risk of Parkinson's.

In another study, published online this month by the American Journal of Epidemiology, she and her collaborators reported that occupational exposure actually decreased the risk of developing the disease by 33 percent, compared to people whose jobs involved no exposure.

Meanwhile, Harris found that those exposed to high-intensity vibrations - for example, by driving snowmobiles, military tanks or high-speed boats - had a consistently higher risk of developing Parkinson's than people whose jobs involved lower-intensity vibrations (for example, operating road vehicles).

The elevated risk fell short of the statistical significance typically used to establish a correlation, but was strong and consistent enough to suggest an avenue for further study, Harris says.

"There are no cures or prevention programs for Parkinson's, in part because we still don't understand what triggers it in some people and not others," says Harris, who conducted the research while earning her doctorate at UBC.

"This kind of painstaking epidemiological detective work is crucial in identifying the mechanisms that might be at work, allowing the development of effective prevention strategies."


EEG Patterns Suggests a Potential Diagnostic Test for Autism


Widely available EEG testing can distinguish children with autism from neurotypical children as early as age 2, finds a study from Boston Children's Hospital.

The study is the largest, most rigorous study to date to investigate EEGs as a potential diagnostic tool for autism, and offers hope for an earlier, more definitive test.Researchers Frank H. Duffy, MD, of the Department of Neurology, and Heidelise Als, PhD, of the Department of Psychiatry at Boston Children's Hospital, compared raw EEG data from 430 children with autism and 554 control subjects, ages 2 to 12, and found that those with autism had consistent EEG patterns indicating altered connectivity between brain regions - generally, reduced connectivity as compared with controls.

While altered connectivity occurred throughout the brain in the children with autism, the left-hemisphere language areas stood out, showing reduced connectivity as compared with neurotypical children, consistent with neuroimaging research. Findings were published June 26 in the online open-access journal BMC Medicine.

Duffy and Als focused on children with "classic" autism who had been referred for EEGs by neurologists, psychiatrists or developmental pediatricians to rule out seizure disorders. Those with diagnosed seizure disorders were excluded, as were children with Asperger's syndrome and "high functioning" autism, who tend to dominate (and skew) the existing literature because they are relatively easy to study.

The researchers also excluded children with genetic syndromes linked to autism (such as Fragile X or Rett syndrome), children being treated for other major illnesses, those with sensory disorders like blindness and deafness and those taking medications.

"We studied the typical autistic child seeing a behavioral specialist - children who typically don't cooperate well with EEGs and are very hard to study," says Duffy. "No one has extensively studied large samples of these children with EEGs, in part because of the difficulty of getting reliable EEG recordings from them."

The researchers used techniques developed at Boston Children's Hospital to get clean waking EEG recordings from children with autism, such as allowing them to take breaks. They used computer algorithms to adjust for the children's body and eye movements and muscle activity, which can throw off EEG readings.

To measure connectivity in the brain, Duffy and Als compared EEG readings from multiple electrodes placed on the children's scalps, and quantified the degree to which any two given EEG signals - in the form of waves - are synchronized, known as coherence. If two or more waves rise and fall together over time, it indicates that those brain regions are tightly connected.

(Duffy likens coherence to two people singing "Mary Had a Little Lamb" together. If they can see and hear each other, they are more likely to sing in synchrony - so their coherence is high.)


Alzheimer's gene 'diabetes link'


Scientists say they have identified a possible genetic link between diabetes and Alzheimer's disease.

It has been known for some time that people with diabetes have a much higher risk of developing Alzheimer's, but not why this is so. Now US researchers writing in Genetics say a study of worms has indicated a known Alzheimer's gene also plays a role in the way insulin is processed. Dementia experts said more work in humans was now needed. Alzheimer's is the most common cause of dementia, which affects 820,000 people in the UK.

There are medications which can slow the progress of the disease, but none that can halt its progress. A key indication of Alzheimer's, which can only be seen after death, is the presence of sticky plaques of amyloid protein in decimated portions of patients' brains. Scientists have already found mutations in a gene involved in the processing of amyloid protein in Alzheimer's which run in families.

'Open new doors'
In this study, a team from the City College of New York looked at a similar gene in the nematode worms (C. elegans). Continue reading the main story “ Start Quote As this research looked at the effects of a gene in worms, studies are now needed to discover whether the equivalent gene in people has the same effect” End Quote Dr Marie Janson, Alzheimer's Research UK These worms are often studied because they, perhaps surprisingly, a useful model for human research.

The researchers, led by Prof Chris Li, found the gene in the worms also affected the insulin pathway - the chemical reactions involved in its production and processing. Prof Li said: "People with type 2 diabetes have an increased risk of dementia.

"The insulin pathways are involved in many metabolic processes, including helping to keep the nervous system healthy." She said more work was needed to investigate this potential link and its effects further. Mark Johnston, editor-in-chief of the journal Genetics, said it was "an important discovery". "We know there's a link between Alzheimer's and diabetes, but until now it was somewhat of a mystery. "This finding could open new doors for treating and preventing the disease."

Dr Marie Janson, director of development at Alzheimer's Research UK, which has itself funded studies looking at the link between diabetes and Alzheimer's said: "This early-stage study may provide an interesting clue to help scientists unravel how diabetes and Alzheimer's are linked, but questions still remain to be answered."As this research looked at the effects of a gene in worms, studies are now needed to discover whether the equivalent gene in people has the same effect, and exactly what mechanisms may be involved."

And Dr Anne Corbett, research communications manager at Alzheimer's UK, added: "There is a growing body of evidence linking the development of diabetes with an increased risk of dementia. "By identifying a potential relationship between genes involved in diabetes and Alzheimer's disease, this study offers further clues as to what this link could be. "However, further research is needed to know whether these findings, from research with worms, will be the same in humans."


Meditation practice may decrease risk for cardiovascular disease


Regular meditation could decrease the risk of developing cardiovascular disease in teens who are most at risk, according to Georgia Health Sciences University researchers.

Pictured here is Dr. Vernon Barnes, a physiologist in the Georgia Health Sciences University Institute of Public and Preventive Health and a co-author on the study published in Evidence-Based Complementary and Alternative Medicine.

Regular meditation could decrease the risk of developing cardiovascular disease in teens who are most at risk, according to Georgia Health Sciences University researchers.

In a study of 62 black teens with high blood pressure, those who meditated twice a day for 15 minutes had lower left ventricular mass, an indicator of future cardiovascular disease, than a control group, said Dr. Vernon Barnes, a physiologist in the Medical College of Georgia and the Georgia Health Sciences University Institute of Public and Preventive Health.

Barnes, Dr. Gaston Kapuku, a cardiovascular researcher in the institute, and Dr. Frank Treiber, a psychologist and former GHSU Vice President for Research, co-authored the study published in Evidence-Based Complementary and Alternative Medicine.

Half of the group was trained in transcendental meditation and asked to meditate for 15 minutes with a class and 15 minutes at home for a four-month period. The other half was exposed to health education on how to lower blood pressure and risk for cardiovascular disease, but no meditation. Left ventricular mass was measured with two-dimensional echocardiograms before and after the study and the group that meditated showed a significant decrease.

"Increased mass of the heart muscle's left ventricle is caused by the extra workload on the heart with higher blood pressure," Barnes explained. "Some of these teens already had higher measures of left ventricular mass because of their elevated blood pressure, which they are likely to maintain into adulthood."

During meditation, which Barnes likens to a period of deep rest, the activity of the sympathetic nervous system decreases and the body releases fewer-than-normal stress hormones.

"As a result, the vasculature relaxes, blood pressure drops and the heart works less," he said. School records also showed behavioral improvements. "Transcendental meditation results in a rest for the body that is often deeper than sleep," Barnes said.

"Statistics indicate that one in every 10 black youths have high blood pressure. If practiced over time, the meditation may reduce the risk of these teens developing cardiovascular disease, in addition to other added health benefits. "


Acupuncture for Spinal Cord Recovery- New Paralysis Research


Breakthrough research has discovered that implanted electro-acupuncture combined with bone marrow cell transplantation increases success rates in the healing of spinal cord injuries.

Transplantation of bone marrow derived stromal cells into injured spinal cords helps in the restoration of motor functionality. However, survival Integrated Acupuncturerates for transplanted cells is low thereby limiting the therapeutic value of the procedure.

Researchers combined implanted electro-acupuncture with the cell transplantation procedure and concluded that electro-acupuncture “induced a significantly higher functional improvement in locomotor functions” than cell transplantation only.

Electro-acupuncture also “significantly increased the number of surviving BMSCs (bone marrow derived mesenchymal stromal cells) compared to the BMSCs alone group.

” The researchers concluded that “our experiment showed that the approach of coupling iEA (implanted electro-acupuncture) electric stimulation and BMSCs transplantation remarkably promotes functional improvements in animals with spinal cord injury and holds promising potential to treat spinal cord injury in humans.”

New successes with electrochemical approaches to spinal cord recovery procedures is not isolated. Recently, researchers combined electrical stimulation to the motor area of the brain and the spinal cord below the area of the injury.

In addition, drugs were infused into the region of the wounded area to promote healing. The results were dramatic. Paralyzed rats were able to walk and run after severe spinal cord injuries.

This research followed last year’s revelation, reported in the Lancet, that a 23 year old paraplegic man regained the ability to stand and walk using a functional electrical stimulation (FES) device.


Super-Sensitive Tests Could Detect Diseases Earlier


Scientists have developed an ultra-sensitive test that should enable them to detect signs of a disease in its earliest stages, in research published May 27in the journal Nature Materials.

The scientists, from Imperial College London and the University of Vigo, have created a test to detect particular molecules that indicate the presence of disease, even when these are in very low concentrations. There are already tests available for some diseases that look for such biomarkers using biological sensors or 'biosensors'.

However, existing biosensors become less sensitive and predictable at detecting biomarkers when they are in very low concentrations, as occurs when a disease is in its early stages. In the new study, the researchers demonstrated that the new biosensor test can find a biomarker associated with prostate cancer, called Prostate Specific Antigen (PSA).

However, the team say that the biosensor can be easily reconfigured to test for other diseases or viruses where the related biomarker is known.

Professor Molly Stevens, senior author of the study from the Departments of Materials and Bioengineering at Imperial College London, said: "It is vital to detect diseases at an early stage if we want people to have the best possible outcomes - diseases are usually easier to treat at this stage, and early diagnosis can give us the chance to halt a disease before symptoms worsen.

However, for many diseases, using current technology to look for early signs of disease can be like finding the proverbial needle in a haystack. Our new test can actually find that needle. We only looked at the biomarker for one disease in this study, but we're confident that the test can be adapted to identify many other diseases at an early stage."

The team demonstrated the effectiveness of their biosensor by testing PSA biomarker samples in solutions containing a complex mixture of blood derived serum proteins. Monitoring the levels of PSA at ultralow concentrations can be crucial in the early diagnosis of the reoccurrence of prostate cancer, but classic detection approaches are not sensitive enough to carry out this analysis with a high degree of accuracy.

The new test could enable more reliable diagnosis, but more research will need to be done to further explore its potential. In their study, the team detected PSA at 0.000000000000000001 grams per millilitre, which is at the limits of current biosensor performance.

By comparison, an existing test called an Enzyme-Linked Immunosorbent Assay (ELISA) test can detect PSA at 0.000000001 grams per millilitre, which is nine orders of magnitude more concentrated. The biosensors used in the new study consist of nanoscopic-sized gold stars floating in a solution containing other blood derived proteins. Attached to the surface of these gold stars are antibodies, which latch onto PSA when they detect it in a sample.

A secondary antibody, which has an enzyme called glucose oxidase attached to it, recognises the PSA and creates a distinctive silver crystal coating on the gold stars, which is more apparent when the PSA biomarkers are in low concentrations. This silver coating acts like a signal that PSA is present, and it can be easily detected by scientists using optical microscopes.

The next stage of the research will see the team carrying out further clinical testing to assess the efficacy of the biosensor in detecting a range of different biomarkers associated with conditions such as HIV and other infections. They will also explore ways of commercialising their product.


Integrative Medicine More Effective in Treatment of Diabetes


Around the world, some 285m people now have diabetes, a figure expected to climb to 440m within 20 years.

In the UAE too there has been a sharp rise in diabetes cases. International Diabetes Federation estimates that over 20 per cent of the country’s population could be living with the condition within a generation. Research is growing worldwide – revealing many new strategies for dealing with diabetes in a way that helps patients to overcome it successfully. Conventional medicine is often criticized because of the side-effects of pharmaceutical drugs or the risks associated with their long-term use. As a resultmany are combining prescription drugs with natural remedies and unconventional medical therapies.

Dr Li Xiaoling, from Chaslu Dubai Wellbeing Centre and of acupuncture in Dubai is one such expert. She said, “There is a growing acceptance ofalternative treatments that range from well recognized therapies such as acupuncture and Ayurveda to more novel treatments like the humbleYiluohe Chinese Green Herbal Tea. Acupuncture is used for a huge range of diseases and disorders including arthritis, headache and migraine, sinusitis, neck and back pain, joint pain, hot flushes, allergies, hay fever, eczema, depression, anxiety, irritable bowel syndrome, facelift, infertility and insomnia.

The ancient Chinese practice is increasingly gaining acceptance in mainstream medicine with growing clinical evidence of its effectiveness in treating diabetes.” Acupuncture has been used as part of traditional Chinese medicine for at least 3000 years and in Western countries since the 70s. The British Medical Association too approved acupuncture for treatment of several conditions in the year 2000. The Chinese believe we all have energy called Qi – pronounced chee – flowing through the body along channels called meridians.

The theory is that we become ill when this energy flow is interrupted and inserting tiny needles into so called pressure points around the body can restore the flow. The good thing is that you can go for alternative therapies alongside conventional medicine.Dr Liexplained, “With time and experience, you learn there is more to the treatment of illness than giving medicine or performing surgery. ‘Integrative medicine’ is being found to be highly effective in case of diabetes which means blending of best evidence-based alternative medicine with the best of conventional medicine.”

Dr Li has been a strong proponent of alternative medicine in the UAE and few years back conducted a special study with other doctors on its effective use in diabetes. The report, titled A Clinical and Experimental Study in Treating Diabetes Mellitus by Acupuncture in the UAE, studied 60 diabetic patients from the region who were divided randomly into two groups: the acupuncture group (38 patients) and the control group (22 patients). Both groups followed a regulated diet during the study period, but one group received acupuncture at ten points once a day for 30 days. Among the 22 participants who took the usual diabetes-prescribed drugs, there were 12 cases rated as effectively treated and eight cases as markedly effective.

However, 20 of them showed side effects. Of the acupuncture group, 27 were treated successfully and 11 needed more treatment. None of the 38 patients showed any side effects. “Our programme is a combination of acupuncture, Western medicine, Yilouhe Chinese Green Herbal Tea and Chinese exercises”, Dr Li said.

“Long-term Western medicine is not good for the liver, kidneys, heart and eyes. Type 2 diabetes is related with energy balance in the body. If you are eating more than your metabolism, the excess energy will be stored in the liver and other parts of your body as fat, which can lead to type 2 diabetes in some people. Acupuncture restores the balance in your body, improves your immune system and enhances pancreas to produce insulin that leads to lowering levels of blood sugar. This when combined with low-caloric diet and a healthy lifestyle can reverse the disease.”


FDA reviews first rapid, take-home test for HIV


The Food and Drug Administration is considering approval of the first over-the-counter HIV test that would allow consumers to quickly test themselves for the virus at home, without medical supervision.

FDA reviewers said Friday the OraQuick In-Home HIV test could play a significant role in slowing the spread of HIV, according to briefing documents posted online. But they also raised concerns about the accuracy of the test, a mouth swab that returns results in about 20 minutes. The review comes one day after an FDA advisory panel endorsed the HIV pill Truvada for preventive use. If FDA follows the group's advice, the daily medication would become the first drug approved to prevent healthy people from becoming infected with the virus that causes AIDS.

Public health experts estimate one-fifth, or about 240,000 people, of the 1.2 million HIV carriers in the U.S. are not aware they are infected. Testing is one of the chief means of slowing new infections, which have held steady at about 50,000 per year for two decades. In a trial conducted by the company OraSure Technologies Inc., the test correctly detected HIV in those carrying the virus 93 percent of the time. That rate is below the FDA-recommended 95 percent threshold for accuracy.

The FDA estimates the test would miss about 3,800 HIV-positive people per year, if approved for U.S. consumers. The test was more accurate at correctly clearing patients who do not have the disease. In company studies, OraQuick correctly identified HIV-negative users 99 percent of the time. In their briefing documents, FDA scientists noted both the benefits and risks of expanding HIV testing with the take-home diagnostic kit.

"There is considerable personal and public health value in informing infected, but otherwise untested, persons of their true positive HIV status," the reviewers state. "However, this benefit is offset in some measure by HIV-positive individuals who receive an incorrect message that they are not infected." The lukewarm endorsement apparently spooked investors. OraSure's stock tumbled $1.32, or 11.8 percent, to close at $9.85 in trading Friday.

On Tuesday, the FDA will ask a panel of outside experts whether the test should be approved for over-the-counter sales in U.S. The agency is not required to follow the group's advice, though it usually does. Based in Bethlehem, Pa., OraSure has marketed a version of OraQuick to doctors, nurses and other health care practitioners since 2004. The test sells for $17.50, though OraSure declined to discuss how it would price the consumer version. When used by professionals, the test is shown to accurately identify both carriers and non-carriers 99 percent of the time.

While it's not clear why the test was less accurate in consumer trials, CEO Doug Michels said company researchers anticipated that its "performance in the hands of a consumer would be different from that observed in hands of a professional." OraSure tried the new version of the test in a study of 5,800 people of various sexual orientation, race and income levels. The trial identified about 100 HIV carriers who were previously undiagnosed.

The FDA has already approved HIV test kits that people take home. However, those kits, which require a blood sample, must be sent to a laboratory for development. But OraSure argues that a test that can be done at home will appeal to a much broader group of people. According to the company's study, 41 percent of people who discovered they were HIV-positive using OraQuick had never been tested previously. In its own briefing documents, the company estimates that 9,000 new HIV carriers would be identified for every 1 million people who use the test.


Liquorice Root Found to Contain Anti-Diabetic Substance


Researchers have discovered a promising anti-diabetic substance in the amorfrutin class of natural substances.

It provides the raw material for liquorice candy, calms the stomach and alleviates diseases of the airways: liquorice root. Chosen as the "Medicinal plant 2012," the root has been treasured in traditional healing since ancient times.

Researchers at the Max Planck Institute for Molecular Genetics in Berlin have now discovered that liquorice root also contains substances with an anti-diabetic effect. These amorfrutins not only reduce blood sugar, they are also anti-inflammatory and are very well tolerated. Thus, they may be suitable for use in the treatment of complex metabolic disorders.

Natural substances have a surprising and often largely unexploited potential in the prevention and treatment of common diseases. For example, liquorice root Glycyrrhiza contains different substances that help to alleviate disorders of the airways and digestive system. It has been used for millennia in traditional healing and is mainly administered in the form of tea.

A team of researchers working with Sascha Sauer from the Max Planck Institute for Molecular Genetics in Berlin has now discovered that the plant from the papilionaceae or leguminous family might also be effective in the treatment of adult (type 2) diabetes.

The scientists identified a group of natural substances with an anti-diabetic effect, the amorfrutins, in the plant's edible root. The substances, which have a simple chemical structure, are not only found in liquorice root, but are also in the fruit of the Amorpha fruticosa bush. The new anti-diabetic agents were named after this plant, which is native to the US, Canada and Mexico.

As the researchers demonstrated using diabetic mice, the amorfrutins not only have characteristics that reduce blood sugar, they are also anti-inflammatory in their effect. Moreover, they also prevent fatty liver - a common disease caused by excessively fat-rich nutrition.

"The health-beneficial effects are based on the fact that the amorfrutin molecules dock directly onto a receptor in the nucleus called PPARγ," explains Sascha Sauer. PPARγ plays an important role in the cell's fat and glucose metabolism.

The binding of the amorfrutin molecules activates various genes that reduce the plasma concentration of certain fatty acids and glucose. The reduced glucose level prevents the development of insulin resistance - the main cause of adult diabetes.

"Although there are already drugs on the market that affect the PPARγ receptor, they are not selective enough in their effect and cause side effects like weight gain and cardio-vascular problems," says Sascha Sauer. In contrast, as demonstrated by the studies carried out to date, the amorfrutins are very well tolerated.

"However, drinking liquorice tea or eating liquorice will not help to treat diabetes," explains the scientist. "The concentration of the substances in the tea and liquorice is far too low to be effective."

The researchers therefore developed special extraction processes to obtain the amorfrutins from the plant in sufficient concentrations. This could be used to produce amorfrutin extracts on an industrial scale.


Alternative therapies may benefit diabetics


Blood testing plays an important role in the ability of diabetics to manage their glucose levels, which is important for avoiding health complications.

However, this is not the only consideration when it comes to living with diabetes. The condition can cause a person to feel as though they have little control over their life, which sometimes leads to depression.

A new study published in the journal BMC Complementary and Alternative Medicine indicates that alternative therapies and counseling can help diabetics overcome these problems.

The findings indicated that individuals who received this type of treatment ate better, exercised more, had healthier moods, maintained normal HbA1c levels and felt more in control of their lives, compared to diabetics who only received standard care.

Results from the study may come as welcome news to diabetics and physicians who treat these individuals.

The American Diabetes Association reports that diabetics have higher rates of depression than those in the general public, largely as a result of the mental strain caused by caring for themselves.

This can interfere with their ability and desire to manage glucose levels.

However, alternative therapies may help alleviate many of these concerns, making easier for diabetics to manage their condition.


Interferon-Free Hepatitis C Trial Achieves 82% Viral Cure


According to new data from the largest Phase II interferon-free trial to date, after only 28 weeks of treatment, almost 82% of hepatitis C patients achieved a viral cure.

The results were achieved in patients with two frequent types of hepatitis C, i.e. HCV genotypes-1a CC and -1b, and will be presented at The International Liver CongressTM at the 47th Annual Meeting of the European Association of the Study of the Liver (EASL), in Barcelona on Saturday 21st April.

Hepatitis C is a viral disease caused by the hepatitis C virus (HCV). It mainly affects the liver and is a leading cause of chronic liver disease and liver transplants. Worldwide, around 170 million people suffer from chronic HCV infections, with 3 to 4 million new infections being diagnosed every year.

Overall, only around 20 to 45% patients manage to achieve a viral cure during the acute phase of the disease, whilst 20% of the remaining chronically infected patients will develop liver cirrhosis within an average of 20 years, and the mortality rate of HCV patients with liver cirrhosis is 2 to 5% per year.

At present, liver damage caused by HCV is the leading cause of chronic liver disease, leading to liver failure and end-stage liver disease, which is the major reason for liver transplants in the Western world. Therefore, an early viral cure for HCV is vital in order to minimize long-term liver damage.

The phase II trial involved 362 patients, including those patients with advanced liver disease. All participants were administered with the interferon-free combination of two investigational compounds, the once-a-day protease inhibitor BI 201335 and the polymerase inhibitor BI 207127. Both drugs were administered with and without ribavirin and with different lengths of treatments.

The outcome demonstrated that 68% of all participants, including those with the most difficult to treat HCV type genotype-1a non-CC, achieved a viral cure after 28 weeks of treatment. Most significantly, 82% of patients with the most common HCV types in Europe and Asia, i.e. genotypes-1a CC and -1b also achieved a viral cure after 28 weeks of therapy. The unique findings in patients with the most common HCV types suggest that interferon could potentially be eliminated in future, however, at present interferon still has to be administered with all treatment options.

HCV has a minimum of six distinct genotypes, i.e. different sequences of the virus, which are identified by a number. Patients with HCV genotype-1 (GT1) are known to be the most difficult to cure. Genotypes have more than 50 subtypes, which are identified by a lowercase letter. An individual's own genetic make-up, represented by uppercase letters like CC, non-CC or CT, is another determining factor in whether treatment will be successful.

Leading researcher Stefan Zeuzem, M.D., Chief of the Department of Medicine and Professor of Medicine at the Johann Wolfgang Goethe University Hospital in Frankfurt, Germany declared:
"Eliminating interferon from HCV treatment is an urgent need. Releasing patients from the side effects and the lengthy treatment commitment seen with interferon would be a huge advance. Such treatments would minimize the impact on patients' lives, and may encourage them to start and stay on treatment, to achieve the ultimate goal of a virologic cure."

Interferon can have severe side effects, including heart failure, sepsis, leucopenia, which is a decrease of white blood cells and loss of vision. The results demonstrated that Boehringer Ingelheim's interferon-free combination therapy was generally well tolerated amongst all five participant groups in the SOUND-C2 trial. Plans of the Phase III clinical trial program are currently underway to further investigate interferon-free combination therapies BI 201335 and BI 207127 efficacy and safety in genotype-1 patients.

Professor Klaus Dugi, Corporate Senior Vice President Medicine at Boehringer Ingelheim declared:
"We very much look forward to the final results from this study, that we hope will be a significant step towards an interferon-free future for patients with HCV. Our commitment to the millions of people around the world who are chronically infected with HCV is to deliver simpler and better tolerated solutions to treatment, including for those with traditionally difficult to cure virus types."


Acupuncture & Chinese Medicine Agree On Sleep Research


Acupuncture and Chinese medicine theory predicted the effects of sleep deprivation as discovered in a new clinical study.

New research concludes that sleep deprivation and odd hours of sleep lowers levels of insulin (a hormone that controls blood sugar) and lowers the metabolic rate thereby leading to weight gain.

Participants in the study averaged a drop of approximately 8 percent in the resting metabolic rate, which could lead to a gain of over 12 pounds of fat per year.

This does not come as a surprise to acupuncturists. Chinese medicine theory asserts that sleep hygiene is essential to good health.

It is accepted within Chinese medicine that sleep habits affect serum lipid levels and the BMI (Body Mass Index) in light of recent medical studies. According to Chinese medicine, 8 hours is enough sleep for most individuals, however, more sleep is necessary for ill or weak patients.

Children require approximately 11 hours of sleep per day (including naps).

Adults should go to sleep between 9 and 10pm and children should retire earlier.


Thyme May Be Better for Acne Than Prescription Creams


Herbal preparations of thyme could be more effective at treating skin acne than prescription creams, according to research recently presented at the Society for General Microbiology's Spring Conference in Dublin.

Further clinical testing could lead to an effective, gentler treatment for the skin condition. Researchers from Leeds Metropolitan University tested the effect of thyme, marigold and myrrh tinctures on Propionibacterium acnes - the bacterium that causes acne by infecting skin pores and forming spots, which range from white heads through to puss-filled cysts.

The group found that while all the preparations were able to kill the bacterium after five minutes exposure, thyme was the most effective of the three. What's more, they discovered that thyme tincture had a greater antibacterial effect than standard concentrations of benzoyl peroxide - the active ingredient in most anti-acne creams or washes. Dr Margarita Gomez-Escalada who is leading the research project explained how tinctures are made from plants and herbs.

"The plant material is steeped in alcohol for days or even weeks to prepare a tincture. This process draws out the active compounds from the plant. While thyme, marigold and myrrh are common herbal alternatives to standard antibacterial skin washes, this is the first study to demonstrate the effect they have on the bacterium that causes the infection leading to acne," she said.

The researchers used a standard in vitro model that is used to test the effect of different substances applied to the skin. The effects of the tinctures were measured against an alcohol control - proving their antibacterial action was not simply due to the sterilizing effect of the alcohol they are prepared in. These initial findings pave the way for more research into the use of tinctures as a treatment for acne.

"We now need to carry out further tests in conditions that mimic more closely the skin environment and work out at the molecular level how these tinctures are working. If thyme tincture is proven to be as clinically effective as our findings suggest, it may be a natural alternative to current treatments," explained Dr Gomez-Escalada.

A herbal treatment for acne would be very welcome news -- particularly for acne sufferers who experience skin sensitivity. "The problem with treatments containing benzoyl peroxide is the side-effects they are associated with," said Dr Gomez-Escalada.

"A burning sensation and skin irritation are not uncommon. Herbal preparations are less harsh on the skin due to their anti-inflammatory properties while our results suggest they can be just as, if not more, effective than chemical treatments."


Novel Therapy Discovered for Crohn's Disease


The Nutritional Immunology and Molecular Medicine Laboratory (NIMML) research team at Virginia Tech has discovered important new information on the efficacy of conjugated linoleic acid (CLA) in treating Crohn's disease, a form of inflammatory bowel disease (IBD).

CLA is a naturally occurring acid found in meat and dairy products known for its anti-cancer and immune modulatory properties. In collaboration with the Division of Gastroenterology and Hepathology at University of North Carolina School of Medicine and the Wake Forest Medical Center, researchers found that Crohn's patients who took supplementary CLA showed noticeable improvement.

"In our recent open label study of CLA as a supplement in study subjects with mild to moderate CD there was a marked improvement in disease activity and quality of life in 50% of the subjects. CLA was well tolerated by all of the study subjects. These findings are very encouraging and will need to be verified in a randomized controlled trial," said Professor Kim L.

Isaacs, a Professor of Gastroenterology at the University of North Carolina at Chapel Hill. The two main manifestations of IBD -- Crohn's and ulcerative colitis - afflict over 1.4 million people in the United States. Symptoms include abdominal cramping, fever, fatigue, loss of appetite, skin and mouth ulcers, and diarrhea or constipation.

In addition, the risk of developing colorectal cancer increases by about one percent yearly in IBD patients. Currently, there is no cure for Crohn's disease and the exact causes of it aren't fully understood. CLA affords those afflicted with mild to moderate IBD an effective treatment without the unwanted side effects of many synthetic drugs.

"Furthermore, we have demonstrated that probiotic bacteria can produce CLA locally and suppress colitis. Therefore, CLA can be administered directly in capsules or indirectly through CLA-producing probiotic bacteria," said Dr. Raquel Hontecillas, an Assistant Professor of Immunology at NIMML.

NIMML strives to develop safer and more effective therapies for human chronic inflammatory diseases from Nature's own medicine cabinet. To achieve this, NIMML uses advanced computational modeling in addition to mechanistic and clinical experimentation.

"The validation of the anti-inflammatory actions of CLA in the gut is in line with our goal because CLA is a natural fatty acid found in milk and ruminant products. The fully integrated bioinformatics, nutrition and immunology experimentation capabilities of NIMML enable the acceleration of translational biomedical research from computational and mathematical modeling into the clinic.

CLA is an example of an anti-inflammatory compound in a pipeline of naturally occurring and synthetic compounds (e.g., abscisic acid, eleostearic acid, terephthalanilides) with tremendous therapeutic and prophylactic potential as anti-inflammatories," said Dr. Josep Bassaganya-Riera, a Professor of Immunology, principal investigator of this human clinical trial, and the Director of the NIMML and the Center for Modeling Immunity to Enteric Pathogens.


Minimum alcohol price planned for England and Wales


The government is proposing a minimum price of 40p per unit of alcohol in England and Wales in an effort to "turn the tide" against binge drinking.

It believes this could transform the behaviour of those who cause the most problems for hospitals and police. A new alcohol strategy also aims to help local areas tackle problems and work with the drinks industry to encourage responsible drinking. Some in the industry suggest minimum pricing would face a court challenge.

The industry said a minimum price was misguided and would hit consumers hard. Similar proposals are already being considered by the Scottish Parliament. Under the minimum price proposal, such as at the suggested 40p level, it would act as a floor and retailers would not be allowed to offer alcohol cheaper than that.

Sobriety schemes
While most prices would be unaffected, it could significantly alter the price of heavily-discounted ciders, super-strength lager and cheap spirits.
The impact could include:
A £2.99 bottle of red wine, containing 9.4 units of alcohol, would be priced up to £3.76
Cheap, strong lager at 75p a can, with three units per can, would become at least £1.20
Bulk-bought strong cider, costing 87p a can and containing four units, would almost double to at least £1.60
Cheap supermarket whisky at £16.10, with 40 units of alcohol, would probably be unchanged in price.

A proposed ban on multi-buy offers would affect top-end promotions, such as a percentage discount on a half-case of wine, as well as the likes of buy-one-get-one-free budget deals.
The alcohol strategy also seeks to give local agencies an "extensive range of tools and powers" to tackle problem drinkers and premises, such as by restricting opening hours and density of licensed premises.
It also plans to "end the notion that drinking is an unqualified right by piloting sobriety schemes for those people whose offending is linked to excessive alcohol consumption", says the strategy document.
Plans are outlined to work with the drinks industry on "changing the drinking culture, from one of excess to one of responsibility; and from one where alcohol is linked to bad behaviour to one where it is linked to positive 'socialising'".




Resistance to antibiotics could bring the end of modern medicine


The world is entering an antibiotic crisis which could make routine operations impossible and a scratched knee potentially fatal, the head of the World Health Organisation has claimed.

Margaret Chan, director general of the WHO, warned that bacteria were starting to become so resistant to common antibiotics that it could bring about “the end of modern medicine as we know it.” As a result, she claimed, every antibiotic ever developed is at risk of becoming useless, making once-routine operations impossible.

This would include many of the breakthrough drugs developed to treat tuberculosis, malaria, bacterial infections and HIV/AIDS, as well as simple treatments for cuts. Speaking to a conference of infectious disease experts in Copenhagen, Dr Chan said we could be entering into a “post-antibiotic era”. Replacement medicines could become more expensive, with longer periods of treatment required to bring about the same effect, she added.

Dr Chan said: “Things as common as strep throat or a child’s scratched knee could once again kill. “Antimicrobial resistance is on the rise in Europe and elsewhere in the world. We are losing our first-line antimicrobials. “Replacement treatments are more costly, more toxic, need much longer durations of treatment, and may require treatment in intensive care units.

“For patients infected with some drug-resistant pathogens, mortality has been shown to increase by around 50 per cent. “A post-antibiotic era means, in effect, an end to modern medicine as we know it.” The stark warning comes shortly after the World Health Organisation published a new book warning of the “global crisis”, entitled “The evolving threat of antimicrobial resistance.”

It reads: “Bacteria which cause disease react to the antibiotics used as treatment by becoming resistant to them, sooner or later. “A crisis has been building up over the decades, so that today many common and life-threatening infections are becoming difficult or even impossible to treat, sometimes turning a common infection into a life-threatening one.”

The paper blamed the current situation largely on the misuse of antibiotics, which are not prescribed properly and used too frequently and for too long. It added that an “inexorable increase in antimicrobial-resistant infections, a dearth of new antibiotics in the pipeline and little incentive for industry to invest in research and development” had led to a need for innovation”. The WHO has now appealed to governments across the world to support research into the antimicrobial resistance.


Daylight Savings Affects Some People's Overall Health


With Daylight Savings approaching, some are excited for the start of longer and warmer days, while others are only thinking of the fact that this Sunday, Daylight Savings, they will lose an hour of sleep.

On Sunday, March 11th, the clocks will be pushed forward one hour, which means everyone will lose an hour of sleep.

According to experts, adjusting to the lost hour of sleep in the spring is harder than adjusting to the gained hour of sleep in the fall.

Aside from losing a precious hour of sleep, there are other health problems that seem to come after Daylight Savings Time.

A study, published in the New England Journal of Medicine, determined that after the Daylight Savings time change, risks of heart attacks actually rise.

Edith F. Honeycutt, Chair in Nursing at the Nell Hodgson Woodruff School of Nursing, says: "If you regularly are getting seven to eight hours of sleep, you're likely to have fewer problems adjusting to the time change. However, if you are sleep-deprived already, getting by on just six or seven hours of sleep a night, you'll probably feel more fatigued than usual on Sunday morning."

Experts offer a few suggestions to help deal with the loss of an hour of sleep:
*Stick to your normal routine.
*Go to bed at the same time you normally would, and wake up at the same time.
*Children should go about their routines normally as well, including eating and nap times.
*Drive carefully to work Monday morning because your internal clock may be off, even if you feel fine.
*Expose yourself and your family to sunlight - it encourages energy and makes you feel awake.
*All year long, make sure you are getting the adequate amount of sleep, not just during Daylight Savings Time.


New high definition fiber tracking reveals damage caused


A powerful new imaging technique called High Definition Fiber Tracking (HDFT) will allow doctors to clearly see for the first time neural connections broken by traumatic brain injury (TBI) and other disorders, much like X-rays show a fractured bone, according to researchers from the University of Pittsburgh in a report published online today in the Journal of Neurosurgery.

In the report, the researchers describe the case of a 32-year-old man who wasn't wearing a helmet when his all-terrain vehicle crashed. Initially, his CT scans showed bleeding and swelling on the right side of the brain, which controls left-sided body movement. A week later, while the man was still in a coma, a conventional MRI scan showed brain bruising and swelling in the same area. When he awoke three weeks later, the man couldn't move his left leg, arm and hand.

"There are about 1.7 million cases of TBI in the country each year, and all too often conventional scans show no injury or show improvement over time even though the patient continues to struggle," said co-senior author and UPMC neurosurgeon David O. Okonkwo, M.D., Ph.D., associate professor, Department of Neurological Surgery, Pitt School of Medicine.

"Until now, we have had no objective way of identifying how the injury damaged the patient's brain tissue, predicting how the patient would fare, or planning rehabilitation to maximize the recovery." HDFT might be able to provide those answers, said co-senior author Walter Schneider, Ph.D., professor of psychology at Pitt's Learning Research and Development Center (LRDC), who led the team that developed the technology.

Data from sophisticated MRI scanners is processed through computer algorithms to reveal the wiring of the brain in vivid detail and to pinpoint breaks in the cables, called fiber tracts. Each tract contains millions of neuronal connections. "In our experiments, HDFT has been able to identify disruptions in neural pathways with a clarity that no other method can see," Dr. Schneider said.

"With it, we can virtually dissect 40 major fiber tracts in the brain to find damaged areas and quantify the proportion of fibers lost relative to the uninjured side of the brain or to the brains of healthy individuals. Now, we can clearly see breaks and identify which parts of the brain have lost connections."


Men Still Manly: Y Chromosome Not Going Away


The rapid gene loss and genetic "decay" that characterized early Y chromosome evolution has tapered off, with the male sex chromosome remaining relatively stable for tens of millions of years, according to a study published online today in Nature.

A Whitehead Institute for Biomedical Research-led group sequenced 11 million bases of the rhesus macaque's Y chromosome. By comparing this sequence to the same Y chromosome region in humans and chimpanzees, the team garnered evidence that the male sex chromosome has conserved almost all of its genes over the past 25 million years or so.

That pattern stands in stark contrast to the evolutionary decay that marked much of the Y chromosome's first 200 to 300 million years, researchers explained, suggesting its prospects are probably not as bleak as some had imagined.

"The Y [chromosome] was in free fall early on, and genes were lost at an incredibly rapid rate," the study's senior author David Page, director of the Whitehead Institute, said in a statement. "But then it leveled off, and it's been doing just fine since."

Once two members of an autosomal chromosome pair, X and Y chromosomes began morphing into distinct sex chromosomes around 200 to 300 million years ago, Page and his co-authors explained. Since then, a series of so-called "stratification events" curbed genetic exchange between the X and Y chromosomes, which had swapped bits of genetic material through the process of crossing over during their autosomal chromosome days.

As chunks of sequence in the male-specific region of the Y chromosome stopped trading genetic material with the X chromosome, these regions became prone to deletions and gene loss, the researchers explained. Over five such stratification events, the human male-specific region of the Y chromosome, or MSY, lost all but around 3 percent of the genes originally shared by the X and Y chromosomes' autosomal pre-cursors.

That evolutionary history fueled speculation by some that the Y chromosome might continue decaying to the point of extinction. Still, while researchers had evidence for evolutionary decay on the Y chromosome as recently as 30 million years ago in the ancestors of Old World monkeys and primates in the human lineage, more recent Y chromosome patterns were less well understood.

"Although speculation abounds regarding ongoing decay and looming extinction of the human Y chromosome, remarkably little is known about how many MSY genes were lost in the human lineage in the 25 million years that have followed its separation from the Old World monkey lineage," the study authors explained.

In an effort to retrace these more recent evolutionary patterns, the team used bacterial artificial chromosome sequencing and single-haplotype iterative mapping and sequencing to characterize 11 million bases of sequence from the rhesus macaque MSY.

They then compared this sequence to human and chimpanzee MSY regions to get a glimpse at the gene loss, if any, that has occurred on the male sex chromosome in the 25 million years since ancestors of the Old World monkeys diverged from the lineage leading to humans and chimpanzees.

While there were structural differences in the rhesus macaque MSY — along with less extensive gene family amplification and fewer palindromes — neither the rhesus macaque MSY nor the human MSY showed signs of significant gene loss or genetic decay. In contrast, the researchers' results indicate that the rhesus macaque MSY has retained all of the ancestral genes believed to have been present in the common ancestor of rhesus macaques, chimpanzees, and humans.

The human MSY has lost one ancestral gene from a chunk of sequence representing the youngest "stratum," where crossing over ceased most recently. On the other hand, the team reported, all four of the older strata in the human MSY have remained stable and managed to hold on to their ancestral genes.

Based on these findings, the study's authors concluded that over the course of human MSY evolution "each stratum transitioned from rapid, exponential loss of ancestral genes to strict conservation through purifying selection."

"With no loss of genes on the rhesus Y [chromosome] and one gene lost on the human Y, it's clear the Y isn't going anywhere," first author Jennifer Hughes, a researcher in Page's Whitehead lab, said in a statement.


Tai chi may help balance in people with Parkinson's


The slow, controlled motions of tai chi can help the impaired balance of people with mild or moderate Parkinson's disease, and the improvements persist for at least three months, according to a small study out Wednesday.

Compared with people who received stretching exercises, tai chi practitioners had fewer falls, longer strides and better balance, researchers found. "Tai chi fits very well to address the problem Parkinson's disease patients face," said Fuzhong Li of the Oregon Research Institute in Eugene, whose findings appear in the New England Journal of Medicine.

Difficulty walking and remaining standing are hallmarks of Parkinson's, which results from the death of brain cells that generate the chemical dopamine. "We're not going to get rid of the symptoms. It's not a drug. It can't cure the disease. But, in my view, it can slow down the progression of the disease," Li told Reuters Health.

Although not all studies agree, other research has shown that because it is a balance-based exercise, tai chi may help improve strength and reduce falls in older adults. But there are few large studies in Parkinson's patients. Li and his colleagues sent 195 seniors, all from Oregon, to one of three classes that met twice weekly for an hour. All could stand unaided, but some needed a device to help them walk.

The tai chi exercises were designed to improve balance with a controlled displacement of the center of mass. Resistance training with ankle weights and weighted vests was used in a second group to strengthen muscles important to posture, balance and gait. A third group had classes that involved gentle stretching.

People in all three groups started off with similar 64-point scores on a 100-point scale that measured how far they could lean or shift their center of gravity without falling. But after 24 weeks of classes, those in the stretching group saw their average score drop by two points, indicating some deterioration in their condition. The typical score rose by four points in the resistance group and by 10 points among the tai chi practitioners. All of the volunteers were tested when their medication was working and their symptoms were controlled.

The improvement with tai chi was even more significant on a test to see how far the person could move toward a target without extraneous movement. Stride length, walking velocity, knee movement and other measurements also showed more improvement. And people who did tai chi reported only 62 total falls during the training - less than half of what the other groups reported. Three months after the classes stopped, some of the benefits persisted. For instance, tai chi practitioners had 60 percent fewer falls than the resistance-training group and 69 percent fewer than the stretching group.

"This is the first time to my knowledge that a study was able to show some durability as a treatment for balance," Li said. "This was a big gap in a research field that didn't have any follow-up data with an exercise regimen." There was, however, some slippage. The average score for leaning and shifting gravity, which had improved by 10 points in the tai chi practitioners, appeared to drop slightly. The nice thing about tai chi, he said, is that "this is not equipment-dependent. It can be practiced at any place, at any time."

Parkinson's affects at least 500,000 Americans, most of them elderly, according to the National Institute of Neurological Disorders and Stroke, which funded the new study. The cost of tai chi classes varies, but prices are typically similar to those of other types of exercise classes.

  Tai chi may help balance in people with Parkinson's


Nearly 1 in 20 US adults over 50 have fake knees


Nearly 1 in 20 Americans older than 50 have artificial knees, or more than 4 million people, according to the first national estimate showing how common these replacement joints have become in an aging population.

Doctors know the number of knee replacement operations has surged in the past decade, especially in baby boomers. But until now, there was no good fix on the total number of people living with them. The estimate is important because it shows that a big segment of the population might need future knee-related care, said Dr. Daniel Berry, president of the American Academy of Orthopedic Surgeons and chairman of orthopedic surgery at the Mayo Clinic in Rochester, Minn.

He was not involved in the research. People with knee replacements sometimes develop knee infections or scar tissue that require additional treatment. But also, even artificial knees wear out, so as the operations are increasingly done on younger people, many will live long enough to almost certainly need a second or even third knee replacement. The new estimate comes in an analysis being presented Friday at the academy's annual meeting in San Francisco.

"These data are sobering because we didn't know what an army of people we've created over the last decade," said Elena Losina, lead author of the analysis and co-director of the Orthopedics and Arthritis Center for Outcomes Research at Harvard's Brigham and Women's Hospital. "The numbers will only increase, based on current trends."

Replacement joints can greatly improve quality of life for people with worn-out knees, but they're not risk-free and it's a major operation that people should not take lightly, she said. Modern knee replacements in the United States date back to the 1970s. Since then, advances in materials and techniques, including imaging scans to create better-fitting joints, have made the implants more durable and lifelike, surgeons say. Losina and colleagues came up with their estimate by analyzing national data on the number of knee replacements done from 1998-2009, U.S. census data, death statistics and national health surveys.

For example, in 2009, more than 600,000 knee replacement operations were done nationwide. The study estimate includes people who had knee replacement operations that year and in previous years who are still living. Overall, 4.5 million Americans are living with artificial knees. That includes an estimated 500,000 who have had at least two replacement operations on the same knee.

Knee replacements are most common in people older than 80 - 1 in 10 people in this age range have them, the study found. Though they're less prevalent in people younger than that, there are still more than half a million Americans in their 50s with the artificial joints, and based on current trends, operations in that age group are expected to increase.

According to the federal Agency for Healthcare Research and Quality, knee replacements tripled in people ages 45 to 64 between 1997 and 2009. Doctors think two trends have contributed to that increase: the nation's obesity epidemic and amateur athletes who don't adjust workouts to spare aging or even injured joints. Both can lead to or worsen arthritis, the main reason for replacing knees. Donna Brent, 63, is in the latter category.

The Deerfield, Ill., administrative assistant says decades of racket ball, tennis, softball and other sports took a toll on her knees, but she got used to living with the pain, even when she became bowlegged and developed a limp. When pain "started getting in the way of some of my sports," she gave in to her doctor's advice and had the operation last June on her right knee. She said she feels better than ever, is back to exercising and plans to resume tennis and softball when the weather warms up.

During knee replacement operations, surgeons slice off a small portion of the worn-out surface on the ends of both leg bones that meet at the knee, then implant an artificial joint usually made of plastic or metal. Typical operations last about two hours, require a few days in the hospital, and cost roughly $40,000. Artificial knees generally last 15 to 20 years.

While some are promoted as lasting 30 years, these estimates are generally based on use among older people more sedentary than baby boomers who expect new knees to let them be as active as they were before surgery. Sometimes that's possible, though doctors often discourage knee replacement patients from engaging in high-impact sports including jogging.


Malaria deaths hugely underestimated


Worldwide malaria deaths may be almost twice as high as previously estimated, a study reports. The research, published in the British medical journal the Lancet, suggests 1.24 million people died from the mosquito-borne disease in 2010.

This compares to a World Health Organisation (WHO) estimate for 2010 of 655,000 deaths. But both the new study and the WHO indicate global death rates are now falling. The research was funded by the Bill and Melinda Gates Foundation. It used new data and new computer modelling to build a historical database for malaria between 1980 and 2010.

The conclusion was that worldwide deaths had risen from 995,000 in 1980 to a peak of 1.82 million in 2004, before falling to 1.24 million in 2010. The rise in malaria deaths up to 2004 is attributed to a growth in populations at risk of malaria, while the decline since 2004 is attributed to "a rapid scaling up of malaria control in Africa", supported by international donors. While most deaths were among young children and in Africa, the researchers noted a higher proportion of deaths among older children and adults than previously estimated.

In total, 433,000 more deaths occurred among children over five and adults in 2010 than in the WHO estimate. "You learn in medical school that people exposed to malaria as children develop immunity and rarely die from malaria as adults," said Dr Christopher Murray of the University of Washington in Seattle, who led the study.

"What we have found in hospital records, death records, surveys and other sources shows that just is not the case." The researchers also concluded malaria eradication was not a possibility in the short-term. "We estimated that if decreases from the peak year of 2004 continue, malaria mortality will decrease to less than 100,000 deaths only after 2020," they write.

Disturbing numbers The Lancet's editor, Richard Horton, told the BBC: "Right now we don't actually have any reliable primary numbers for malaria deaths in some of the most malarious regions of the world, so what numbers we have come from estimates.

"What this paper reports is a new way of estimating the number of malaria deaths, where they've used additional data sets and improved mathematical models from calculating mortality." But despite what he calls the "disturbing" number of deaths recorded, he believes the underlying message of the report is that the disease can and is being controlled.

"Since 2004, the number of malaria deaths has dropped by about a third, and that's really been the time when the Global Fund to Fight Aids, Tuberculosis and Malaria has swung into action" he said.

"Over the past decade, 230 million cases of malaria have been treated and the same number of bed nets have been distributed to people at risk of malaria, and the result of that has been this huge downturn. So what we know is that we're actually able to turn off malaria with our existing interventions."


BBC News


Alzheimer's disease be diagnosed with a simple blood test


Pilot study suggests infrared analysis of white blood cells is a promising strategy for diagnosis of Alzheimer's disease.

 Spanish researchers, led by Pedro Carmona from the Instituto de Estructura de la Materia in Madrid, have uncovered a new promising way to diagnose Alzheimer's disease more accurately.

Their technique, which is non-invasive, fast and low-cost, measures how much infrared radiation is either emitted or absorbed by white blood cells. Because of its high sensitivity, this method is able to distinguish between the different clinical stages of disease development thereby allowing reliable diagnosis of both mild and moderate stages of Alzheimer's.

The work is published online in Springer's journal Analytical & Bioanalytical Chemistry.Alzheimer's disease is the most common form of adult onset dementia and is characterized by the degeneration of the nervous system. In particular, as the disease progresses, the amount of amyloid-ß peptide in the body rises.

At present, the most reliable and sensitive diagnostic techniques are invasive, e.g. require analysis of cerebrospinal fluid (the liquid that surrounds the brain and spinal cord). However, white blood cells (or mononuclear leukocytes) are also thought to carry amyloid-ß peptide in Alzheimer patients.

The researchers used two-dimensional infrared spectroscopy to measure and compare the infrared radiation emitted or absorbed by white blood cells of healthy controls, versus those of patients with mild, moderate and severe Alzheimer's disease. A total of 50 patients with Alzheimer's and 20 healthy controls took part in the study and gave blood samples.

The authors found significant differences in the range of infrared wavelengths displayed between subjects, which were attributable to the different stages of formation of amyloid-ß structures in the blood cells. The results showed that, with this method, healthy controls could be distinguished from mild and moderate sufferers of Alzheimer's disease. The method is being explored as a tool for early diagnosis.

The authors conclude: "The method we used can potentially offer a more simple detection of alternative biomarkers of Alzheimer's disease. Mononuclear leukocytes seem to offer a stable medium to determine ß-sheet structure levels as a function of disease development. Our measurements seem to be more sensitive for earlier stages of Alzheimer's disease, namely mild and moderate."


Does the G-spot really exist?


The controversy over the G-spot is about to heat up again. Either science has been using the wrong techniques or wrong technologies in the hunt for the mysterious pleasure button allegedly located inside a woman’s vagina, or the spot simply doesn’t exist, according a new review of existing research.

“Objective measures have failed to provide strong and consistent evidence for the existence of an anatomical site that could be related to the famed G-spot,” writes Amichai Kilchevsky, a Yale urological surgeon, and his colleagues, in the most recent issue of the Journal of Sexual Medicine. Those are fighting words to a legion of G-spot believers who have vociferously battled any G-spot denials for decades.

But Kilchevsky searched through all the medical and scientific literature -- everything he could find between 1950 and 2011 -- in a hunt for proof. He found none. The research team admits that some women swear there is a distinct “area in the distal anterior vaginal wall” that leads to orgasms if it’s stimulated. It’s possible, Kilchevsky admits, the right investigatory tools haven’t been brought to bear, although that seems unlikely since everything from MRI scans to plain old fingers have been tried.

“My view is that the G-spot is really just the extension of the clitoris on the inside of the vagina, analogous to the base of the male penis," said Kilchevsky. Kilchevsky’s argument is supported by anatomists who say that the clitoris is like an iceberg. You can see just a little. The rest extends well into the vagina. We all start as female in the womb. Males develop male anatomy only if their cells are signaled by androgen hormones. Then, labia turn into a scrotum, a clitoris into a penis.

Kilchevsky thinks there’s no evolutionary reason why women would have a separate spot capable of generating orgasms. It certainly isn’t required for reproduction. Yet some women -- and and some doctors and researchers -- have been insisting that not only is there a G-spot, but that figuring out how yours works can mean wonderful, intense, orgasms.

“Lots of women feel almost as though it is their fault,” they can’t find it, Kilchevsky said. “Men are upset they can’t stimulate it for their partners. The reality is that it is probably not something, historically or evolutionarily, that should even exist.” He blames the porn industry and G-spot promoters for encouraging the myth.

“It’s like penis size,” he said, with a laugh. Male porn stars aren’t typical at all (that’s why they’re porn stars), but “now men are all talking about penis size. “The reality is, most men have the exact same-sized penis.”


Opioids Erase Memory Traces of Pain


A team of researchers at the MedUni Vienna's Department of Neurophysiology (Centre for Brain Research) has discovered a previously unknown effect of opioids: the study, which has now been published in the journal Science and was led by Ruth Drdla-Schutting and Jürgen Sandkühler, shows that opioids not only temporarily relieve pain, but at the right dose can also erase memory traces of pain in the spinal cord and therefore eliminate a key cause of chronic pain.

The scientists recreated a surgical procedure in vivo in which pain fibres were stimulated under controlled conditions. Says Sandkühler: "Although deep anaesthesia prevents any sensations of pain, we were able to reserve long-term synaptic potentiation in the spinal cord. Despite anaesthesia, there appears to be a memory trace for pain and a pain amplifier has engaged." High doses of intravenous opioids over the course of an hour - normally opioids are delivered at moderate doses over a longer period - were able to completely resolve the potentiation. Says Sandkühler:

"The memory trace for pain was therefore deleted again and the pain amplifier switched off." The memory trace, as it is termed, is triggered by a variety of mechanisms, including the potentiation of signal transmission at the contact points (synapses) between the nerve cells. This is known as long-term synaptic potentiation. This pain memory can result in the sensation of amplified pain lasting much longer than the actual cause of the pain, even leading to a condition known as chronic pain syndrome.

A paradigm shift in pain therapy?
The project, which is sponsored by the Vienna Fund for Science, Research and Technology (WWTF), is currently investigating how this discovery can be put to use in clinical settings. To this end, test subjects or patients with pain syndrome are being given a high dose of an opioid over a period of 60 minutes.

"If our approach turns out to be effective under clinical conditions, this would herald a paradigm shift in pain therapy. It would mean moving away from the temporary, purely symptom-based pain therapy to a long-term removal of the cause of pain based on pain mechanisms using opioids."

The effect of opioids (morphine or morphine-like substances) is based on their ability to bind to specific binding sites, known as µ-opiate receptors (MOR) which are found on nerve cells and which process pain-related information.

Until now, it has been assumed that opioids are only able to alleviate pain while they are bound to the MOR and therefore suppress stimulation in the pain-processing system. Says Drdla-Schutting: "As soon as the medication is stopped, the pain-relieving effect disappears too." In clinical practice, opioids are therefore given continuously in moderate doses in order to achieve permanent binding to the MOR.

This may relieve pain very effectively, but its cause cannot be eliminated. The new, high-dose, short-term therapy with opioids, on the other hand, causes a reversal of cellular changes that play an important role in pain memories, therefore possibly eliminating one of the causes of chronic pain.


Coloradans can make money by losing weight


Companies have been making similar offers to their employees for years as a way to reduce obesity in the workplace and lower health costs, but Kaiser is taking it one step further and making the offer to any adult in Colorado.

It's one of the first programs in the nation to make such an offer to all adults. Participants in the "Weigh and Win" program earn anywhere from $15 to $150 every three months to lose weight and keep it off. Twelve kiosks with scales and a video camera to record progress are located in medical facilities, recreation centers, libraries and even a furniture store throughout the state.

The insurer is spending $500,000 to help jump start the program, which it hopes will eventually be funded by the cities and other health care groups that it's working with. Kaiser hopes to expand Weigh and Win by adding 10 kiosks next year as part of its community outreach programs.

"Weight loss is as effective as mammograms, or colon cancer screenings or blood pressure control when you speak about the amount of dollars you spend for the life years you gain from the program," said Dr. Eric France, who's in charge of developing the program at the insurer.

"And from the medical perspective, losing about 5 percent body weight is considered valuable and helpful," said France, Kaiser's chief of population care and prevention services. About 8,900 Coloradans have signed up since the program began in April. The average weight loss has been about 12 pounds.

Tanya Amaro, a pediatrics nurse practitioner at Denver Health Medical Center, checks in every week at the kiosk in the hospital's cafeteria. She began her quest to lose weight last November, losing about 27 pounds on her own, and found that she couldn't lose any more. She has lost an additional 37 pounds through the program, earning her $75 since May.

"It's pretty cool," she said. She found the grocery store shopping lists; recipes for low-fat, healthy meals; and a workout regime from a personal trainer assigned to her through the program helpful in breaking through the plateau she had reached. "Not just that I need to walk or I need to run. I knew that stuff, you know, that's commonsense stuff," she said.

"It actually tells you how to do it, when to do it. You get text messages on your phone." France said it's difficult to put a dollar amount on the benefits the program may bring. "It's not really a medical solution to obesity problems, the obesity epidemic," France said.

"It has to be a community solution. It's about access to good food, it's access to places to exercise, places to ride your bicycle, use transit, policies at school, policies at work and opportunities to have supportive programs to help you lose weight."

  Coloradans can make money by losing weight


Recycled Paper Towels Had the Highest Bacterial Counts


Grabbing a paper towel in a public restroom may leave more on your hands than you bargained for. Researchers say they’ve found bacteria, including some that are known to make people sick, in unused paper towels.

They also found that those bacteria could be transferred to hands after washing. The study is published in the American Journal of Infection Control. It did not find any illnesses connected to paper towel use. Experts say the findings are probably most important for people in hospital isolation units and those with weakened immune function who need to be extra cautious about contact with germs.

Germs Lurk in Paper Towels
Researchers at Laval University in Canada tested six brands of commercial paper towels -- the kind doled out in many public bathrooms. They found bacteria in all of them, but the towels made from recycled fibers were the most heavily contaminated. “In our study, the concentration of bacteria in the recycled paper was between 100- to 1,000-fold higher than the virgin wood pulp brand,” the researchers write.

Bacterial slime is known to be a problem at recycled paper mills, where it corrodes machines and may damage finished paper sheets. Researchers say the new paper towel finding fits with other studies that have noted high bacterial counts in other kinds of recycled paper products. Bacteria may thrive in recycled paper because it contains binding ingredients like starches and fillers that serve as food.

Most of the bacteria found in paper towels were Bacillus bacteria. Many Bacillus strains can produce toxins that cause food poisoning. One brand of paper towel contained Bacillus cereus bacteria. In addition to food poisoning, B. cereus has been associated with infections of the eyes, lungs, blood, and central nervous system. Although the found amounts of B. cereus probably wouldn’t harm healthy people, researchers note it may be more dangerous for people who have weakened immune systems, like babies and the elderly, and for people who take medications that suppress their immune function.

Germ experts said the study was an eye-opener.
“These findings are interesting in that we do not think of paper towels as being contaminated,” says Elizabeth Scott, PhD, who is co-director of the Center for Hygiene and Health in Home and Community at Simmons College in Boston. Scott says the study also made her curious about bacteria in other kinds of paper products. “It makes me wonder about kitchen towels. These are put to all kinds of uses in direct contact with food, for example, covering and wrapping food,” she says.

“And what about facial tissues, which come into close contact with our eyes and noses?” Advice for Consumers Scott and other experts note that the study did not find paper towels caused anyone to get sick. Until more is known, experts agree that this one study shouldn’t be a reason for healthy people to avoid paper towels.

“People shouldn’t think that it’s better not to wash their hands if they only have paper towels available to dry them,” says Angela Golden, DNP, who is president-elect of the American Academy of Nurse Practitioners. She says 20 seconds with soap and water is still the rule, especially after activities that dramatically increase exposure to germs, like handing raw meat. Golden says air dryers, if they’re available, may be the healthiest and most environmentally responsible option of all.


Tai Chi Improves Balance Control


Research carried out in Hong Kong on people over the age of 70 has shown that practicing Tai Chi improves the balance control of older people with visual impairment.

A study carried out by researchers from the Center for East-meets-West in Rehabilitation Sciences at Hong Kong Polytechnic University has found that practicing Tai Chi improves the balance control of older people with poor vision, usually a major problem for them. Researchers designed and conducted a 16-week trial in residential care homes involving 40 people aged over 70.

The home residents were divided into two groups – Tai Chi participants and the control group. The Tai Chi participants were taught a modified 8-form Yang style routine and practiced this in 90-minute sessions, thrice a week for 16 weeks. The style emphasized multi-directional weight shifting, head and trunk rotation and awareness of body alignment.

Residents in the control group participated in a musical activity instead. The findings, published in the journal Age and Ageing, showed that the Tai Chi participants made significant improvements in knee proprioception (awareness of the position of one’s limbs) and in their visual and vestibular ratios (ability to balance) compared to the control group.

The participants were assessed pre- and post-intervention using three tests:
1) passive knee joint repositioning to test knee proprioception;
2) concentric isokinetic strength of the knee extensors and flexors;
3) a sensory organization test to quantify an individual’s ability to maintain balance in a variety of complex sensory conditions.

This study’s results support the findings of a previous study published in 2008, which reported that the knee joint proprioception of persons with normal vision could be improved with 16 weeks of Tai Chi training. This study extends those findings to visually impaired older people. “Our study shows that Tai Chi can be a suitable form of exercise for those with visual impairment and indeed assists with improving their balance control,” said Dr. William Tsang, senior author on the paper.

“It would be interesting to extend this study to involve community dwelling older people, who tend to be more independent and could benefit differently from the training,” he added. The article can be found at: Chen EW et al. (2011) The effects of Tai Chi on the balance control of elderly persons with visual impairment: a randomised clinical trial.


Acupuncture Flops as Relief for Muscle Pain


Acupuncture for the reduction of aromatase inhibitor–related musculoskeletal symptoms in breast cancer patients proved a disappointment in an interim analysis of a double-blind, randomized, sham-controlled, multicenter clinical trial.

Both real and sham acupuncture turned out to provide similar reductions in the Health Assessment Questionnaire Disability Index (HAQ-DI), the primary study end point. The two groups also experienced similar improvement in scores on a pain visual analog scale after eight weekly real or sham treatment sessions, Dr. Ting Bao reported at the San Antonio Breast Cancer Symposium.

The double-blind randomized trial included 47 postmenopausal women with early-stage breast cancer who were experiencing musculoskeletal symptoms related to aromatase inhibitor use. None of the patients had received acupuncture in the previous year. The acupuncture group received eight weekly sessions targeting 15 acupuncture points. The control group got a sham acupuncture procedure at 14 non-acupuncture points.

The sham therapy utilized the Park Sham Device, which consists of a nonpenetrating, retractable acupuncture needle and an adhesive tube. From a median baseline HAQ-DI score of 0.75, 8 of 23 patients in the real acupuncture group achieved the minimum clinically important improvement, predefined as a 0.22-point reduction. So did 13 of 24 women in the sham acupuncture group.

Pain scores on a visual analog scale improved to a similar extent in the two study arms, from a baseline median of 50 out of a possible 100 to 41 in the real acupuncture group and 36 in the sham group. When the blinded patients were asked to guess their treatment assignment, 55% in each group did so accurately, according to Dr. Bao, a medical oncologist and licensed acupuncturist at the University of Maryland Greenebaum Cancer Center, Baltimore.

Plasma estradiol levels remained undetectable in most patients during the study period. No significant side effects were noted in either study arm. About half of breast cancer patients on adjuvant aromatase inhibitor therapy experience musculoskeletal symptoms. These side effects can be sufficiently debilitating as to lead to poor compliance or even treatment discontinuation.

Among the possible explanations for the negative results in this study are that the HAQ-DI may not be a sufficiently sensitive tool to detect small differences in effectiveness between real and sham acupuncture, and that sham acupuncture may not be an inert procedure, Dr. Bao said. Although this randomized trial originally was scheduled to enroll 100 patients, it was halted early for futility based on the interim results.

The study was funded by a Komen grant and an ASCO Young Investigator Award. Dr. Bao declared having no financial conflicts.


Funds dedicated to personalized genetics


The US National Institutes of Health has earmarked nearly half a billion dollars for a plan that it hopes will usher in an era of diagnoses and treatments based on genome sequencing.

The National Human Genome Research Institute (NHGRI), part of the National Institutes of Health (NIH) in Bethesda, Maryland, today released a breakdown of its funding priorities. The four-year plan expands its flagship Large-Scale Genome Sequencing Program to focus on medical applications "to begin to explore the front edge of genomics, which will move us into genomic medicine", says Eric Green, director of the NHGRI.

That goal is now within striking distance, thanks to recent advances in sequencing technology, says Green. During the past decade, the per-base cost of sequencing has dropped by nearly 500,000-fold, (see Megabase boom, below) raising the possibility of individuals routinely undergoing sequencing for medical purposes. This is already a reality for a small minority (see: Genomes on prescription).

The lion's share of the $461 million announced by the NHGRI, starting at $86 million a year, will be divided amongst existing projects at three large genome-sequencing centres: the Broad Institute in Cambridge, Massachusetts, the Genome Institute at Washington University in St. Louis, Missouri, and the Human Genome Sequencing Center at Baylor College of Medicine in Houston, Texas. The amount of funding for the centres will decrease each year, according to the NHGRI.

These centres, which were all part of the Human Genome Project, will continue their work on projects such as the 1000 Genomes Project, which aims to catalogue human genetic variability, and the Cancer Genome Atlas, which is exploring the genomic changes associated with human cancer.

About $20 million over the four years will help develop genome sequence analysis software that can be used by researchers outside of large sequencing centers who may not have the expertise to process raw sequence data into clinically useful information. The software funds will be distributed in early 2012.

Mendel and the clinic
About 20% of the funding will be used to establish two new programmes. The first, the Mendelian Disorders Genome Centers, will aim to identify the genetic basis of all Mendelian diseases — those that arise from a mutation in a single gene. Although many Mendelian diseases are rare, they provide a clear look at the function of a given gene in the body. A number of drugs in widespread use today, such as statins, have their origins in Mendelian-disease studies1.

However, of the estimated 6,000 human Mendelian diseases, the cause of fewer than half is known.But with the reduction in sequencing costs and time, this stands to change. "All the barriers have been ostensibly eliminated by the new sequencing technologies," says Richard Lifton, a principal investigator of the Center for Mendelian Disorders being established by the NHGRI funds at Yale University in New Haven, Connecticut.

The NHGRI money, along with $8 million from the National Heart, Lung, and Blood Institute, will fund the Center for Mendelian Genomics at the University of Washington in Seattle and the Baylor–John Hopkins Center for Mendelian Genetics, a collaboration between the campuses in Houston and in Baltimore, Maryland. All three groups plan to join the International Rare Disease Research Consortium next year (see: Rare-disease project has global ambitions).

In contrast to the targeted Mendelian disease centres, the second new programme, the Clinical Sequencing Exploratory Research Project, is tasked with an open-ended question: what are the medical, ethical and social impacts of using genomic sequencing in a clinical setting?

Projects at five institutions — Baylor College of Medicine, the Brigham and Women's Hospital in Boston, Massachusetts, the Children's Hospital of Philadelphia in Pennsylvania, the University of North Carolina at Chapel Hill, and the University of Washington in Seattle — will each run trials of the effects of clinical sequencing for different diseases. In Seattle, for example, researchers will test how sequencing the protein-encoding regions of the genome in patients with colon cancer affects people's diagnoses, treatment, mental well-being and finances.

Medical geneticist Gail Jarvik at the University of Washington, a principal investigator on the project, says that the time is right to test the utility of clinical sequencing. "The technology is there, but there is a lot of work to be done on what to do with the technology," she says. There is also the matter of patients' views on the subject.

"How do people feel about getting genomic data?" she asks. Green acknowledges that moving sequencing into the clinic is not going to be simple. "We expect there to be surprising findings, we expect some things not to work," he says. "One of the things our institute can do on behalf of all of NIH is to get data on varying overarching sets of issues around applying genomics to medicine."


WiFi may damage sperm quality


WiFi technology may cause a major handicap for men hoping to build a family: sperm damage.

A team of Argentine scientists led by Conrado Avendano of the Nascentis Center for Reproductive Medicine in Cordoba found that placing drops of semen from healthy men under a laptop connected wirelessly to the Internet kills or maims the little swimmers. The scientists reported their findings this month in the medical journal Fertility and Sterility.

After four hours next to the WiFi-connected computer, 25% of the sperm had stopped moving and nine percent showed DNA damage. By comparison, semen kept at the same temperature but away from the computer showed just a 14% drop in mobility and only 3% suffered DNA damage.

Semen placed under the computer without the WiFi connected did not experience significant levels of sperm damage, the study says. Avendano blames the discrepancy on the electromagnetic radiation emitted by wireless communication.

"Our data suggest that the use of a laptop computer wirelessly connected to the Internet and positioned near the male reproductive organs may decrease human sperm quality," Avendano and his team wrote in this month's article, Reuters reports.

The study is not the first to sound an alarm over the potential of mobile communications technology to undermine sperm health. A Canadian study reported last year also found evidence indicating that wireless radiation caused DNA damage in sperm. Computers also wreck havoc on semen just by being hot.


Acupuncture Is Safe in Children, Study Finds


Is acupuncture safe for children?
According to a large new study in the journal Pediatrics, the short answer is yes — in the hands of a trained practitioner. The study, the first large-scale systematic review on the safety of pediatric acupuncture, found that about one in 10 children had experienced mild side effects, like bruising and pain and numbness at the puncture site. More serious side effects, like infections and nerve impairment, were rare.

Large studies in the past have generally focused on acupuncture in adults and found similar complication rates, with serious side effects occurring in about five of every million treatment sessions.

Acupuncture is one of the most common alternative medicines in the United States, practiced by about three million people — mostly adults — every year. But it is also used with growing frequency in children to relieve pain, migraines and other complaints. About 150,000 children in the United States underwent acupuncture in 2007, according to government estimates. Whether acupuncture poses any particular hazards to children, however, has not been entirely clear.

In the latest study, researchers at the University of Alberta in Canada focused specifically on children, combing through data from 37 international studies. The authors cast a wide net, pooling data from high-quality randomized trials conducted over the past few decades as well as single case reports of injuries.

Over all, out of 1,422 children and teenagers who were included in the analysis, 168 experienced “mild” side effects. More serious problems were rare and tended to be limited to clinics that did not adhere to strict safety standards, including 12 cases of “deformity” from damage to a muscle in the thumb, all reported from the same clinic in China between 1983 and 1989. In another case, a 15-year-old boy in the United States had to be treated with “an extended course” of antibiotics when he developed a fever after undergoing acupuncture and chiropractic treatment for back pain.

“I would say the circumstances in which the serious harms happened do not reflect the modern-day standard of training and credentialing,” said Dr. Sunita Vohra, a professor of medicine at the University of Alberta and an author of the study. “That kind of practice is not what would be expected in most places.” Most American states and Canadian provinces now regulate acupuncture to ensure certain standards of safety and certification, though the regulations vary by state.

The research, financed in part by the Canadian Institutes of Health Research, did not try to answer whether acupuncture is actually effective in children. While some studies have shown that acupuncture can ease chronic neck and back pain and migraine symptoms in adults, “the amount of research done in kids is pretty minimal,” said Michael Waterhouse, the head of acupuncture at the University of California, Los Angeles, pediatric pain program. He added that the results he sees in children who are treated with acupuncture at U.C.L.A. “are as good as the results we get in adults,” though more research is needed.

“There have been some small studies on migraine showing it’s helpful in reducing their frequency and increasing endorphin levels, but that has not been repeated,” he added.

One study from Harvard Medical School in 2000 looked at the effects of acupuncture on a group of about 50 children, most of them teenagers seeking relief from migraines or endometriosis, a condition that can cause painful menstruation. “Most families found acupuncture pleasant and helpful, even for pain that had been very resistant to standard treatment,” the authors wrote. “Although some began with anxiety about the needles and misgivings about the treatment, many developed more positive attitudes over the course of treatment.”

The researchers nonetheless said they believed more research was needed before the results could be generalized to other young patients. “Most of the patients in this study were adolescents; younger children’s experiences might be quite different,” they wrote. “Future studies will need to examine children’s and families’ experience with acupuncture for the entire spectrum of illnesses for which it is used.” .


San Rafael champion says Kung Fu saved his life


STRENGTH AND flexibility are two benefits to becoming an expert in the marial art of Kung Fu.

Scott Jensen believes those qualities saved his life — twice. The 49-year-old San Rafael resident survived two major car accidents before he turned 25. The first crash stopped his heart and broke his pelvis, the second sprained nearly all his vertabrae. With the help of his martial arts training, he recovered.

Now, 25 years later, Jensen is considered a Kung Fu master and credits his physical health to his devotion to the art.

"One of the reasons I got good at all this stuff and some of my friends have told me I should write a book, 'I Can't Stop,'" said Jensen, who lives with his wife of five years, Rachel, and his 14-year-old son, Connor.

"Because if I keep training, I keep doing the Tai Chi and the Kung Fu, I feel great and I'm super athletic, I can do what I want. If I stop for a couple months, I'll start feeling terrible and I'll start having pain again in my back and I'll sort of lose the tone and alignment of my whole body."

Last month, Jensen competed in the World International Martial Arts Championship held at Wu Dang Mountain, China.

There were over 1,200 competitors and Jensen won a gold medal for his performance of the Yang Family Style of Tai Chi Chuan. He also won a silver medal for his performance of the Plum Blossom Double Straight Swords.

Family Style is the most common worldwide and it's a long sequence of movements of different martial arts techniques. The Double Straight Swords form is a rare, difficult and fast sequence. Jensen was the only competitor to use that particular form.

"I feel especially good about my silver medal in the weapons form because I had some really stiff competition," he said. "I was competing against a lot of people that were 20 years younger than I was."

Jensen's wife Rachel, a native of Taiwan, accompanied him to Wu Dang Mountain, a place of great significance in the martial arts world. She served as his translator.

"I knew of the history and the background a little bit already," said Rachel, who met Scott after taking one of his martial arts classes. "But being there, I was just in awe of the surroundings, the setting of the whole place. The energy of the place is just amazing."

Jensen has had quite a few great martial arts instructors during his years of training, but credits Grandmaster Wong Jackman, for having a great influence on his passion for Kung Fu. Jackman is considered to be a living legend in San Francisco's Chinatown and in the martial arts world, according to Jensen.

Jackman is best known for a secret duel with Bruce Lee, the movie star considered to be the most famous Kung Fu expert. With some of Jensen's instructors retiring from teaching Kung Fu, he feels a responsibility now that he must take it upon himself to teach and keep the art alive.

"There's only a couple people like me in those arts that can pass it on," Jensen said. "My intention is that I'm dedicating the next 10, maybe 15 years and I'm going to start with the kids. "... (After) a few more years we're going to have some really good Kung Fu competitors coming out of Marin and a few more we'll have a whole crop of instructors as well. I'm really on this sort of mission to do this."

Jensen, who is known as Sifu (Chinese for "father of secret knowledge"), operates the 10,000 Victories School of Chinese Kung Fu and Tai Chi. He holds classes in Marin and the East Bay. The reference "10,000 Victories" is a double sabre form in Kung Fu and also was a well-known body guard company in China.

"It's not just about winning medals or trophies," Jensen said. "It's really people becoming healthier or stronger and more capable, more confident, being able to be leaders in their own lives. To me, that's really the kind of victories we're trying to create."


Neuron Number and Size of Children With Autism


Autism often involves early brain overgrowth, including the prefrontal cortex (PFC).

Although prefrontal abnormality has been theorized to underlie some autistic symptoms, the cellular defects that cause abnormal overgrowth remain unknown. Objective To investigate whether early brain overgrowth in children with autism involves excess neuron numbers in the PFC.

Design, Setting, and Cases Postmortem prefrontal tissue from 7 autistic and 6 control male children aged 2 to 16 years was examined by expert anatomists who were blinded to diagnostic status. Number and size of neurons were quantified using stereological methods within the dorsolateral (DL-PFC) and mesial (M-PFC) subdivisions of the PFC.

Results Children with autism had 67% more neurons in the PFC (mean, 1.94 billion; 95% CI, 1.57-2.31) compared with control children (1.16 billion; 95% CI, 0.90-1.42; P = .002), including 79% more in DL-PFC (1.57 billion; 95% CI, 1.20-1.94 in autism cases vs 0.88 billion; 95% CI, 0.66-1.10 in controls; P = .003) and 29% more in M-PFC (0.36 billion; 95% CI, 0.33-0.40 in autism cases vs 0.28 billion; 95% CI, 0.23-0.34 in controls; P = .009).

Brain weight in the autistic cases differed from normative mean weight for age by a mean of 17.6% (95% CI, 10.2%-25.0%; P = .001), while brains in controls differed by a mean of 0.2% (95% CI, −8.7% to 9.1%; P = .96).

Plots of counts by weight showed autistic children had both greater total prefrontal neuron counts and brain weight for age than control children. Conclusion In this small preliminary study, brain overgrowth in males with autism involved an abnormal excess number of neurons in the PFC.


China to launch massive survey on TCM resources


China will soon launch its fourth national survey on Traditional Chinese Medicine (TCM) resources to secure the industry's sustainable development, according to a senior health official.

The preparatory work has been completed and a pilot program for the survey will commence soon, covering six provinces and regions, including Anhui, Hunan, Hubei, Sichuan, Xinjiang and Yunnan, said Wang Guoqiang, vice minister of health.

Wang, also director of the State Administration of TCM, made the remarks Sunday at the annual gathering for the country's pharmaceutical professionals. The last survey on this subject, conducted between 1983 and 1987, indicated that the country had over 12,000 types of TCM resources with the majority in the wild.

Experts predict that it is very likely that has changed after more than two decades. "A new survey is crucial in drawing major plans for TCM resources' management, protection and utilization," said Prof. Huang Luqi, vice president of the China Academy of Chinese Medical Science. It may also help to build a dynamic assessment system for those precious resources, Huang added.

TCM generally refers to the comprehensive Chinese medical system based upon the body's balance and harmony. Among the components of TCM are traditional herbal drugs and inherent therapies, including acupuncture, physical exercise, and remedial massage.

Official figures showed that the TCM industry posted a strong performance in 2010, with the output value up 29.5 percent year-on-year to reach 317.2 billion yuan (50 billion U.S. dollars), which exceeded that of the country's entire pharmaceutical industry.

In addition, experts have forecasted that TCM's annual output value in China will exceed one trillion yuan by 2015. Overseas markets, however, have only granted limited recognition to TCM, partly due to Chinese pharmaceutical enterprises' failure to obtain accreditations from markets such as the European Union, where TCM is generally categorized as a "food supplement."

Some producers complain that TCM's clinical efficacy and the chemical composition of the drugs can hardly be explained in scientific terms. To curb these difficulties for market access, Chinese regulators have invested heavily in TCM's R&D projects and called for innovation in building clinical R&D systems, setting up key TCM labs, facilitating technology transfers into the industry and improving R&D management and quality control.

Promoting TCM is not only a solution to help China achieve universal health care at less expense, but also an indicator of the country's soft power and influence abroad, Wang said.


Yoga Eases Back Pain in Largest U.S. Yoga Study to Date


Yoga classes were linked to better back-related function and diminished symptoms from chronic low back pain in the largest U.S. randomized controlled trial of yoga to date, published by the Archives of Internal Medicine as an "Online First" article on October 24.

But so were intensive stretching classes. "We found yoga classes more effective than a self-care book -- but no more effective than stretching classes," said study leader Karen J. Sherman, PhD, MPH, a senior investigator at Group Health Research Institute.

Back-related function was better and symptoms were diminished with yoga at 12 weeks; and clinically important benefits, including less use of pain medications, lasted at least six months for both yoga and stretching, with thorough follow-up of more than nine in 10 participants. In the trial, 228 adults in six cities in western Washington state were randomly assigned to 12 weekly 75-minute classes of either yoga or stretching exercises or a comprehensive self-care book called The Back Pain Helpbook.

Nine in 10 of them were primary-care patients at Group Health Cooperative. Participants in the trial typically had moderate -- not severe -- back pain and relatively good mental health, and most had been at least somewhat active before the trial started. The class participants received instructional videos and were encouraged to practice at home for 20 minutes a day between their weekly classes. Interviewers who didn't know the patients' treatment assignments assessed their back-related function and pain symptoms at six weeks, 12 weeks, and six months.

In 2005, Dr. Sherman and her colleagues conducted a smaller study that found yoga effective for easing chronic low back pain. "In our new trial," she said, "we wanted both to confirm those results in a larger group and to see how yoga compared to a different form of exercise of comparable physical exertion: stretching. Both the yoga and stretching classes emphasized the torso and legs: The type of yoga used in the trial, called viniyoga, adapts the principles of yoga for each individual and physical condition, with modifications for people with physical limitations.

The yoga classes also used breathing exercises, with a deep relaxation at the end. The stretching classes used 15 different stretching exercises, including stretches of the hamstrings and hip flexors and rotators. Each was held for a minute and repeated once, for a total of 52 minutes of stretching. Strengthening exercises were also included.

"We expected back pain to ease more with yoga than with stretching, so our findings surprised us," Dr. Sherman said. "The most straightforward interpretation of our findings would be that yoga's benefits on back function and symptoms were largely physical, due to the stretching and strengthening of muscles." But the stretching classes included a lot more stretching than in most such classes, with each stretch held for a relatively long time.

"People may have actually begun to relax more in the stretching classes than they would in a typical exercise class," she added. "In retrospect, we realized that these stretching classes were a bit more like yoga than a more typical exercise program would be." So the trial might have compared rather similar programs with each other. "Our results suggest that both yoga and stretching can be good, safe options for people who are willing to try physical activity to relieve their moderate low back pain," Dr. Sherman concluded.

"But it's important for the classes to be therapeutically oriented, geared for beginners, and taught by instructors who can modify postures for participants' individual physical limitations." In an invited commentary, Timothy S. Carey, MD, MPH, of the University of North Carolina, Chapel Hill, called Dr. Sherman's study "an excellent example of a pragmatic comparative effectiveness trial," noting that the Institute of Medicine has identified chronic back pain as a priority condition for such studies.


No link to cancer in large-scale mobile phone study


The largest study of its kind found no link between long-term use of mobile phones and increased risk of brain tumours, the British Medical Journal (BMJ) reported on Friday.

Danish researchers found no evidence of enhanced risk among more than 350,000 mobile-phone subscribers whose health was monitored over 18 years. Earlier research on the possible link between cell phone use and cancerous tumours has been inconclusive, partly due to lack of long-term data.

In June, the World Health Organisation's International Agency for Research on Cancer (IARC) classified the radio-frequency electromagnetic fields emitted by mobile phones as "possibly carcinogenic to humans." The new study follows up an earlier investigation that compared the cancer risk faced by all mobile phone subscribers in Denmark - some 420,000 people - with the rest of the adult population.

Patrizia Frei, a postdoctoral research fellow at the Danish Cancer Society, and colleagues examined health records from 1990 to 2007 for 358,403 cell phone subscribers. Overall, 10,729 tumours of the central nervous system were diagnosed. But among people with the longest mobile phone use - 13 years or more - cancer rates were nearly the same as for non-subscribers.

"The extended follow-up allowed us to investigate effects in people who had used mobile phones for 10 years or more, and this long-term use was not associated with higher risks of cancer," the study concluded. The findings, however, could not rule out the possibility of a "small to moderate increase in risk" for very heavy users, or people who have used cell phones for longer than 15 years.

"Further studies with large study populations where the potential for misclassification of exposure and selection bias is minimised are warranted," the researchers said. In a commentary, Anders Ahlbom and Maria Feychting from Sweden's Karolinska Institute said the new evidence was reassuring but called for continued monitoring of health registers.

There are about five billion mobile phones registered in the world, a figure that continues to rise sharply along with the average amount of time spent using them. The IARC does not issue formal recommendations, but its experts pointed in June to a number of ways consumers can reduce possible risk. Texting and using hands-free sets for voice calls lower exposure to potentially harmful radiation, compared to device-to-ear voice calls, by at least 10-fold, they said.




Electro-acupuncture boosts IVF success in study


Women who have an electro-acupuncture session as part of their infertility treatment may have a better chance of ultimately having a baby, a new clinical trial suggests.

The study, of 309 women undergoing in vitro fertilization (IVF), found that those who had electro-acupuncture at the time that their embryos were implanted were more likely to give birth.

Just over 37 percent had a baby (or babies), versus 21 percent of women who underwent a "sham" version of electro-acupuncture. A third study group, where the women received an additional electro-acupuncture session the day before embryo implantation, had an even higher birth rate, at 42 percent.

But that difference from the one-session group could have been a statistical fluke, researchers warn. The findings, reported in the journal Fertility and Sterility, add to a conflicting body of evidence on whether acupuncture can boost IVF success.

In 2002, a study in Germany was the first to report that traditional needle acupuncture seemed to improve pregnancy rates in women undergoing IVF. (The study did not look at birth rates.) But studies since then have turned up mixed results, and the role of acupuncture in IVF, if any, remains controversial.

For the latest study, researchers in China examined the effects of electro-acupuncture, which uses electrodes on the skin, rather than needles, to deliver an electrical current to traditional acupuncture points.

The researchers, led by Rong Zhang of the Peking University Health Science Center, divided their 309 IVF patients into three groups. In one, women received one electro-acupuncture session 30 minutes after having their embryos implanted in the uterus; in a second group, the women had two sessions, with the additional one taking place the day before embryo implantation.

The third group received "sham" electro-acupuncture 30 minutes after embryo implantation. Electrodes were placed on the body at traditional acupuncture sites, but only a weak current came through -- enough that the women could feel a sensation, but not enough to have a physiological effect, according to Zhang's team. In the end, women in the two electro-acupuncture groups had higher birth rates.

The results, Zhang's team writes, suggest that larger clinical trials, at multiple treatment centers, are now "warranted." An infertility expert not involved in the study said that conclusion is "very sensible." Large-scale trials are needed before electro-acupuncture should be adopted as part of infertility treatment, according to Dr. Tarek El-Toukhy, a reproductive medicine specialist at Guy's and St. Thomas' Hospital in London.

El-Toukhy and his colleagues recently published a meta-analysis of the dozen-plus clinical trials that have looked at acupuncture and IVF. A meta-analysis pools the results from several studies to try to get an overall idea of the evidence on a therapy. El-Toukhy's team concluded that there is no strong evidence that acupuncture improves IVF results - whether it's done at the time of embryo transfer or when a woman's eggs are collected. In an email, El-Toukhy told Reuters Health that the new study was "reasonably well-conducted," but that it also needs to be considered within the context of all the research that has been done on acupuncture and IVF.

He pointed to a U.S. study published earlier this year that looked at the effects of needle acupuncture at the time of embryo implantation. Researchers found that 45 percent of the women given true acupuncture became pregnant, versus 53 percent of those given a sham version. That study did not look at birth rates. As for electro-acupuncture in particular, this appears to be the first study to look at its effects during embryo implantation.

And El-Toukhy said it's not something that's commonly available during IVF. Zhang's team acknowledges that if acupuncture, or its electrode version, do affect IVF outcomes, it's not clear how. But a couple studies, they say, have suggested it may improve uterine blood flow. Other research is looking at whether electro-acupuncture might affect the "receptivity" of the uterine lining to implanted embryos, the researchers note.

Dr. Peter Lipson, an internal medicine specialist in southeastern Michigan, was more critical of the study. For one, he told Reuters Health in an email, the study was not really "blinded" -- that is, the electro-acupuncture operators knew which therapy they were delivering, and all of the women in the study knew they were receiving electrical stimulation because they could feel it. Having both the patient and the provider blinded as to who is receiving the real treatment is considered key to maintaining objectivity in a clinical trial.

Lipson also pointed out that there was no clear difference between the one-session electro-acupuncture group and the sham-acupuncture group when it came to the percentage of women who had a positive pregnancy test. There's no clear explanation for why one electro-acupuncture session would have no effect on pregnancy test results, but ultimately affect birth rates, according to Lipson. And in general, he said, the fact that studies have come to conflicting findings on acupuncture and IVF suggests that there are no real effects.




Green Tea Helps Mice Keep Off Extra Pounds


Green tea may slow down weight gain and serve as another tool in the fight against obesity, according to Penn State food scientists.

Obese mice that were fed a compound found in green tea along with a high-fat diet gained weight significantly more slowly than a control group of mice that did not receive the green tea supplement, said Joshua Lambert, assistant professor of food science in agricultural sciences. "In this experiment, we see the rate of body weight gain slows down," said Lambert.

The researchers, who released their findings in the current online version of Obesity, fed two groups of mice a high-fat diet. Mice that were fed Epigallocatechin-3-gallate -EGCG a compound found in most green teas, along with a high-fat diet, gained weight 45 percent more slowly than the control group of mice eating the same diet without EGCG.

"Our results suggest that if you supplement with EGCG or green tea you gain weight more slowly," said Lambert. In addition to lower weight gain, the mice fed the green tea supplement showed a nearly 30 percent increase in fecal lipids, suggesting that the EGCG was limiting fat absorption, according to Lambert. "There seems to be two prongs to this," said Lambert.

"First, EGCG reduces the ability to absorb fat and, second, it enhances the ability to use fat." The green tea did not appear to suppress appetite. Both groups of mice were fed the same amount of high-fat food and could eat at any time.

"There's no difference in the amount of food the mice are eating," said Lambert. "The mice are essentially eating a milkshake, except one group is eating a milkshake with green tea." A person would need to drink ten cups of green tea each day to match the amount of EGCG used in the study, according to Lambert. However, he said recent studies indicate that just drinking a few cups of green tea may help control weight.

"Human data -- and there's not a lot at this point -- shows that tea drinkers who only consume one or more cups a day will see effects on body weight compared to nonconsumers," said Lambert. Lambert, who worked with Kimberly Grove and Sudathip Sae-tan, both graduate students in food science, and Mary Kennett, professor of veterinary and biomedical sciences, said that other experiments have shown that lean mice did not gain as much weight when green tea is added to a high fat diet.

However, he said that studying mice that are already overweight is more relevant to humans because people often consider dietary changes only when they notice problems associated with obesity. "Most people hit middle age and notice a paunch; then you decide to eat less, exercise and add green tea supplement," said Lambert.


Maker of cognitive training game seeks FDA approval


Imagine walking away from a doctor's office with a prescription to play a video game.
Brain Plasticity, the developer of a cognitive training game, has begun talks with the Food and Drug Administration (FDA) to market the game as a therapeutic drug. Brain Plasticity has been fine-tuning a game to help people with schizophrenia improve the deficits in attention and memory that are often associated with the disorder. Early next year, they will conduct a study with 150 participants at 15 sites across the country. Participants will play the game for one hour, five times a week over a period of six months.

If participants' quality of life improves at that "dosage," Brain Plasticity will push ahead with the FDA approval process. FDA approval for computer games in general – whether for schizophrenia or more common disorders such as depression or anxiety – could change the medical landscape, says Daniel Dardani, a technology licensing officer at the Massachusetts Institute of Technology. But FDA involvement in the brain game industry will come with pros and cons. Panellists drawn from research and industry debated the issue at a meeting of the Entertainment Software and Cognitive Neurotherapeutics Society in San Francisco earlier this week.

Controversial industry
Some hope that an FDA stamp of approval will add integrity to a controversial industry. "The world of brain games is just full of bullshit," Michael Merzenich, co-founder of Posit Science, a developer of cognitive games told New Scientist at the meeting. He points to a study last year showing that cognitive training games do nothing for brain fitness (Nature, DOI: 10.1038/nature09042).

FDA involvement might help to single out those games with a demonstrable benefit. But identifying beneficial games might be a complicated process. Since the Nature study was published, critics of the study have pointed out that the 11,430 participants were self-selected, healthy and did not follow a strict "dosing" regimen. They believe the games need to be tested more rigorously. Unlike the cognitive tasks that featured in the Nature study, the Brain Plasticity game targets a specific section of the population and comes with stringent "dosage" requirements for how often and how long participants need to play to see results.

Game scrutiny
Even if the FDA gives approval for games like Brain Plasticity's, it might not scrutinise the many games that claim to firm up healthy people's brains, says Henry Mahncke, a senior scientist at Brain Plasticity. Some worry that FDA approval would actually stymie development of cognitive training games, because the agency will be too slow to approve the minor tweaks that let games evolve. "I think it's premature to have the FDA get involved," says Alice Medalia, a cognitive remediation specialist at Columbia University in New York City.

Compromise may be possible. The FDA could issue guidelines for what consumers should look for in a therapeutic gaming product – similar to its handling of medical smartphone apps, says Alvaro Fernandez, CEO of SharpBrains, a Washington DC-based market research firm that tracks non-invasive neuroscience tools.


ADHD Natural Medicine Looking At A Homeopathic Remedy


Did you know that about 36% of Americans are now changing over to natural and complementary medicine?

Some of that percentage will certainly be moving over to ADHD natural medicine. That will usually consist of herbal remedies, using supplements and homeopathic treatments. The reason for this massive swing is quite simply that the psychostimulants so long touted by the medical community do not function as they should and in many cases, do a lot of harm because of the nasty side effects and the considerable health risks. Their effects also tend to wear off after two or three years.

So the best ADHD natural medicine is a homeopathic remedy? You may well be skeptical because you will have listened to a lot of the propaganda which has concentrated on the fact that this medicine has not convinced researchers that it can actually work. Now that the placebo scandal has rocked the medical community, they do not have a leg to stand on. According to a recent report in the Annals of Medicine, the randomized placebo trials (RTC) so beloved of the pharmaceutical companies, do not disclose what is actually in the placebos! This has cast many doubts on the validity of all the medicine trials ever conducted.

Why do I think that ADHD natural medicine and especially homeopathic remedies are actually the safest of all? The first reason is that the actual ingredients work in a different way and help to restore a lost mind body balance. As they work in a completely way to conventional allopathic medicine, they do not cause any side effects in the body or in the mind. Then there are no effects on the long term health of the child as they are a very gentle remedy and are working as a harmonizing force.

The next thing to look for in ADHD natural medicine is to make sure that the homeopathic remedy is really safe. The best way is to check that it has been manufactured to the highest standards. That means it should come from a FDA registered facility, it should be using the HPUS, The Homeopathic Pharmacopeia of the United States and it should also be adhering to GMP practices.

In addition, they should be able to offer a convincing guarantee such as twelve months, for example. So there we have it. ADHD natural medicine does actually work and the effects on the child’s health are only positive. Why risk all the psychostimulants which are nothing more than amphetamines. Isn’t it time you chose a safer option for your child?


Tai chi may lessen rheumatoid arthritis symptoms


Practicing tai chi on a regular basis may significantly improve the symptoms of rheumatoid arthritis.

There have been a number of studies demonstrating the benefits of tai chi for the symptoms of osteoarthritis including joint pain, stiffness and weakness. A recent medical study demonstrated that the benefits of tai chi extend beyond simply reducing symptoms.

Rheumatoid arthritis is an autoimmune disease characterized by significant joint pain, fatigue and weakness. Over time the destruction of the joints can become so severe as to cause significant deformity. Although most patients with rheumatoid arthritis experience primarily joint pain, other organs in the body can be affected.

Rheumatoid arthritis is most common in people between the ages of 40 and 50 years old and affects about 1 percent of the population. Women are usually affected three to four times more often than men. Destruction of the joint and weakening of the muscles ligaments and tendons surrounding the joint is common. Ultimately the joint becomes too weak for normal activity and, if untreated, the patient is eventually incapacitated.

There are a number of medical therapies that can slow the progress of rheumatoid arthritis. These include anti-inflammatory medications, steroids, powerful disease modifying medications like methotrexate and biologic agents specifically targeting the immune system.

However, side effects significantly limit their use. Fortunately, physical therapies are beneficial for rheumatoid arthritis and reduce the need for medication. There is robust data to indicate that maintaining physical activity can improve the long-term outcomes of patients with rheumatoid arthritis. Long-term compliance with exercise programs is a problem, but with tai chi exercises compliance is better. Tai chi is a Chinese martial art that is practiced primarily for health benefits.

The movements are characterized as slow, methodical and repetitive. This type of activity seems to be perfect for strengthening the tissues around joints, improving balance and strength, and reducing pain. Over the past two decades, there is significant research published in the medical literature on the benefits of tai chi for arthritis and rheumatoid arthritis. A recent medical study published in the medical journal BMC Musculoskeletal Disorders re-examined the use of tai chi exercises in patients with rheumatoid arthritis.

The study was different because not only did they look at the physical benefits of tai chi, but also they explored why with rheumatoid arthritis people practiced tai chi. This is important because compliance with any physical therapy program, over time, is essential with rheumatoid arthritis patients. What they found was that there was the expected improvement in physical function, but that patients also felt better, mentally, after practicing tai chi.

The stress levels were lower, energy levels were higher and overall mental outlook was brighter. Patients continued to practice tai chi because they simply felt better. I strongly agree with the results of the study. In my experience, martial art based exercises not only improve the physical condition, but in many cases have positive impact on the mental and emotional state. It simply feels good.


Cardiologists Examine Alternatives to Halt High Blood Pressure


More and more, patients show up to appointments with hypertension expert John Bisognano, M.D., Ph.D. carrying bags full of "natural" products that they hope will help lower their blood pressure. And like most physicians, Bisognano doesn't always know if these products will do any good, or if they will cause any harm.

"Right now we're seeing a cultural shift where an increasing number of people want to avoid standard pharmaceuticals," said Bisognano, professor of Medicine and director of Outpatient Cardiology at the University of Rochester Medical Center. "We're also seeing a growing number of patients who require a large number of drugs to control their blood pressure and are looking for something else to help manage it." In an effort to better educate health care professionals and patients, Bisognano and Kevin Woolf, M.D., a cardiology fellow at the Medical Center, conducted the most comprehensive review to date of the evidence behind a wide range of non-drug interventions for the treatment of high blood pressure.

The review is featured in the September issue of the Journal of Clinical Hypertension. Woolf said there is not enough data to recommend any of these alternative options on a routine basis, but on an individual basis he thinks they are useful. "Patients have different backgrounds and different approaches to living their lives," said Woolf. "This is where the art of medicine comes in; getting to know patients and what they will and will not embrace can help physicians identify different therapies that suit their patients' habits and that will hopefully make a difference for them."

Woolf and Bisognano, who is a member of the editorial board of the Journal of Clinical Hypertension, emphasize that all patients with hypertension should adhere to the low-salt DASH diet, which is high in fiber, low in fats and incorporates lots of fruits and vegetables, and follow an exercise and weight loss regimen -- lifestyle modifications recommended by the American Heart Association.

Any alternative options should be considered for use in addition to these lifestyle changes. When it comes to safety, Bisognano adds, "These alternative options are usually harmless, except when they keep patients from taking medications they need to take. If a patient is taking a supplement instead of something that we know is useful, that could be a problem."

Dietary Supplements
The shining star among supplements is coenzyme Q10, an enzyme involved in energy production that also acts as an antioxidant. Patients with hypertension tend to have lower levels of the enzyme, and a meta-analysis -- an overarching analysis of past studies -- found that treatment with coenzyme Q10 supplements significantly reduced blood pressure.

Woolf noted that "Coenzyme Q10 has a pretty profound effect on blood pressure, but whenever research is based on a collection of other data you have to have some skepticism." Woolf said he still thinks the compound is promising. Woolf also found that potassium helps lower blood pressure, and there is evidence that increasing the amount of potassium we get through the foods we eat could carry some of the same mild benefits as taking supplements.

Herbal Remedies
The potential herbal remedies Woolf identified include mistletoe extract, used in traditional Chinese medicine to treat hypertension. Mistletoe extract reduced blood pressure in animal studies, but Woolf cautions that it may be toxic at high doses. The extract from Hawthorn, a type of tree, is also used, but provides only a slight reduction in blood pressure. Conversely, Woolf uncovered a handful of herbal remedies -- St. John's wort, ephedra/ma huang, yohimbine and licorice -- that may increase blood pressure.

Woolf and Bisognano stress that the Food and Drug Administration does not regulate dietary and herbal supplements the way they regulate traditional pharmaceuticals. They say health care providers and patients need to be aware that the safety of these products is not always rigorously established and that formulations can vary.

Research on both practices is mixed -- the types of patients included, the methods used, and the results, which vary from study to study. While there is no conclusive evidence that either lowers blood pressure, researchers found that acupuncture reduces blood pressure compared to placebo in patients also taking anti-hypertensive medications, while in a meta-analysis, transcendental meditation appeared to lower blood pressure. Other techniques that may provide some benefit include Zen Buddhist meditation and Qi Gong.

Some devices developed in recent years involve a medical procedure, while others use technology that requires patients to participate in various exercises. Those that involve a procedure include the implantable Rheos® device, which regulates blood pressure much like a pacemaker regulates heart rhythm, and the Symplicity® catheter system, which ablates or destroys nerves around the kidneys that send inappropriate signals to the brain to increase blood pressure. Both are designed for patients with difficult-to-treat hypertension and led to significant drops in blood pressure in clinical trials. They are only available to research participants at this time.


Anti-cancer virus shows promise


An engineered virus, injected into the blood, can selectively target cancer cells throughout the body in what researchers have labelled a medical first.

The virus attacked only tumours, leaving the healthy tissue alone, in a small trial on 23 patients, according to the journal Nature. Researchers said the findings could one day "truly transform" therapies. Cancer specialists said using viruses showed "real promise".

Using viruses to attack cancers is not a new concept, but they have needed to be injected directly into tumours in order to evade the immune system.

Smallpox to cancer
Scientists modified the vaccinia virus, which is more famous for being used to develop a smallpox vaccine.

The virus, named JX-594, is dependent upon a chemical pathway, common in some cancers, in order to replicate. It was injected at different doses into the blood of 23 patients with cancers which had spread to multiple organs in the body. It is thought that the virus could be used to deliver treatments directly to cancerous cells in high concentrations.

Prof Bell acknowledges that the research is still in the very early stages, but he said: "I believe that some day, viruses and other biological therapies could truly transform our approach for treating cancer."

Cancer Research UK's Prof Nick Lemoine, also director of Barts Cancer Institute, said: "Viruses that multiply in just tumour cells - avoiding healthy cells - are showing real promise as a new biological approach to target hard-to-treat cancers.

"This new study is important because it shows that a virus previously used safely to vaccinate against smallpox in millions of people can now be modified to reach cancers through the bloodstream - even after cancer has spread widely through the patient's body.

"It is particularly encouraging that responses were seen even in tumours like mesothelioma, a cancer which can be particularly hard to treat."


BBC News


Filling without drilling


Researchers at the University of Leeds have discovered a pain-free way of tackling dental decay that reverses the damage of acid attack and re-builds teeth as new.

The pioneering treatment promises to transform the approach to filling teeth forever. Tooth decay begins when acid produced by bacteria in plaque dissolves the mineral in the teeth, causing microscopic holes or 'pores' to form. As the decay process progresses these micro-pores increase in size and number.

Eventually the damaged tooth may have to be drilled and filled to prevent toothache, or even removed. The very thought of drilling puts many people off going to see their dentist, whether or not they actually need treatment.

This tendency to miss check-ups and ignore niggling aches and pains means that existing problems get worse and early signs of decay in other teeth are overlooked. It's a vicious cycle, but one that can be broken, according to researchers at the University of Leeds who have developed a revolutionary new way to treat the first signs of tooth decay.

Their solution is to arm dentists with a peptide-based fluid that is literally painted onto the tooth's surface. The peptide technology is based on knowledge of how the tooth forms in the first place and stimulates regeneration of the tooth defect.

"This may sound too good to be true, but we are essentially helping acid-damaged teeth to regenerate  themselves. It is a totally natural non-surgical repair process and is entirely pain-free too," said Professor Jennifer Kirkham, from the University of Leeds Dental Institute, who has led development of the new technique.
The 'magic' fluid was designed by researchers in the University of Leeds' School of Chemistry, led by Dr. Amalia Aggeli. It contains a peptide known as P 11-4 that - under certain conditions - will assemble together into fibres. In practice, this means that when applied to the tooth, the fluid seeps into the micro-pores caused by acid attack and then spontaneously forms a gel. This gel then provides a 'scaffold' or framework that attracts calcium and regenerates the tooth's mineral from within, providing a natural and pain-free repair.
The technique was recently taken out of the laboratory and tested on a small group of adults whose dentist had spotted the initial signs of tooth decay. The results from this small trial have shown that P 11-4 can indeed reverse the damage and regenerate the tooth tissue.
"The results of our tests so far are extremely promising," said Professor Paul Brunton, who is overseeing the patient testing at the University of Leeds Dental Institute. "If these results can be repeated on a larger patient group, then I have no doubt whatsoever that in two to three years time this technique will be available for dentists to use in their daily practice."
"The main reason that people don't go to the dentist regularly is fear. If we can offer a treatment that is completely non-invasive, that doesn't involve a mechanical drill, then we can change that perceived link between dental treatment and pain. This really is more than filling without drilling, this is a novel approach that enables the patients to keep their natural teeth!"
The study is being funded by credentis ag who have licensed the technology and are preparing to introduce P11-4 to dentists worldwide.


Tai Chi Helps Prevent Falls in The Elderly


Tai chi, an exercise to maintain balance, gait and strength training, is being recommended for elderly people to prevent falls. The recommendations have been released by the American and British Geriatrics societies to suggest the ways of preventing falls in elderly people.

These recommendations have been suggested after the evidences proved that maintaining balance, gait and strength training reduce the risk of falls and Tai chi was the exercise that showed lower risk of falling in elderly. This study is an updated version of previous guidelines that were published in 2001. The panel which wrote the guidelines included physical therapists, pharmacists, nurses and experts in orthopaedics, home care, care of the elderly and emergency medicine.

The study was carried out by researchers from the American and British Geriatrics societies. The complete guidelines were published on the American Geriatrics Society website and a special article summarizing the guidelines was published in the Journal of the American Geriatrics Society. In this research, researchers looked at the earlier published studies and records on various medical research and science databases.

They were particularly interested in studies that looked at non-drug ways to prevent falls outside of hospitals. The panel made the recommendation that older adults that are under the care of a health professional should be asked at least once a year about falls, frequency of falls and difficulties in gait or balance.

The group recommend that elderly people who have a history of falls, or are shown to have abnormalities in gait or unsteadiness, should be investigated by a health team for possible risks of falling. These risks include the condition of feet and footwear, mobility and muscle strength, heart function, vision, neurological impairments, medications, low blood pressure and environmental hazards.

The researchers say that all interventions to prevent falls should have an exercise component that includes balance, gait and strength training such as tai chi or physical therapy, in group programs or individual program at home. They particularly highlight tai chi because of new evidence showing that this type of exercise is of particular benefit for preventing falls.


Students Ace First Half 2011 NCCAOM Exams



American College of Traditional Chinese Medicine (ACTCM) San Francisco students have once again led the nation with their National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) exams passing rates during the period from January 1-June 30, 2011.

Established in 1982, NCCAOM is the only national organization that validates entry-level competency in the practice of acupuncture and Oriental medicine (AOM) through professional certification.

“Our NCCAOM pass rates are consistently and substantially higher than the national average,” said Alissa Cohan, ACTCM’s Director of Communications. Clearly anyone wishing to pursue an education in acupuncture and Chinese medicine should consider ACTCM. NCCAOM certification or a passing score on the NCCAOM certification examinations are documentation of competency for licensure as an acupuncturist by 43 states plus the District of Columbia which represents 98% of the states that regulate acupuncture.

Acupuncture with Point Location

exam Pass rate ACTCM first time takers 100%
National pass rate first time takers 86.5%
Pass rate ACTCM repeat test takers 100%
National pass rate repeat test takers 73.8%
Biomedicine exam Pass rate ACTCM first time takers 92.3%
National pass rate first time takers 77.8%
Chinese Herbology exam Pass rate ACTCM first time takers 92.3%
National pass rate first time takers 81.0%
Foundations of Oriental Medicine exam Pass rate ACTCM first time takers 100%
National pass rate first time takers 93.3%

All NCCAOM certification programs are currently accredited by the National Commission for Certification Agencies (NCCA). All NCCAOM Certification Programs carry the NCCA seal. In order for the NCCAOM certification programs in Acupuncture, Chinese Herbology, Oriental Medicine, and Asian Bodywork Therapy to remain accredited by the NCCA, the NCCAOM must adhere to strict national standards for examination development.

All Diplomate level certification exams must meet examination content validity standards set forth by NCCA. For more information about ACTCM’s pass rates, or for information about the school and its community clinics, call (415) 202-5713 or visit their website at About the American College of Traditional Chinese Medicine The American College of Traditional Chinese Medicine (ACTCM) has been at the forefront of educating student in Traditional Chinese Medicine in the Bay Area since its inception in 1980.

Their two degree programs—the Master of Science in Traditional Chinese Medicine (MSTCM) and the Doctorate of Acupuncture and Oriental Medicine (DAOM)—provide a truly exceptional professional education. ACTCM’s community clinics serve as a diverse and demanding training ground for their students, while providing affordable health care services to the community. ACTCM’s certificate programs in Tui Na and Shiatsu and its introductory classes for the public offer additional educational opportunities for current ACTCM students, healthcare professionals and the general public.

Bay Area acupuncture treatment, as taught by ACTCM, restores balance and health, and is used for everything from chronic pain to drug dependence. It is also effective for allergy relief , weight loss, pain management and fertility treatment. During treatment sterile, disposable needles are inserted at acupuncture points along the meridians. Because of the thin and pliable needles used, most people feel little to no discomfort as the needles are inserted, and patients often feel energized or a deep sense of relaxation and well-being.


Americans Are Flocking to Alternative Therapies



Most Americans believe that prescription medications are the most effective treatments for many common illnesses, but a Consumer Reports survey of more than 45,000 people finds that three-fourths of us are turning to alternative therapies like yoga and acupuncture.

The new report says 38 million adults make more than 300 million visits per year to acupuncturists, chiropractors, massage therapists, and other practitioners of alternative and complementary techniques.

"Despite the hoopla over alternative therapies, when we asked respondents how well the therapies they used worked for 12 common health problems, results showed that they were usually deemed far less helpful than prescription medicine for most of the conditions," Consumer Reports Health says in its September issue.

Also, over-the-counter medications in many cases are more popular among consumers than widely used dietary supplements, according to the survey.

Chiropractic, deep-tissue massage, and mind-body practices like yoga dominated the list of alternative treatments that respondents said were helpful for back pain, neck pain, and the aches of osteoarthritis. And though meditation is widely touted as an effective way to relieve anxiety, insomnia, and depression, the survey says prescription antidepressants are used by more people.

Among key findings of the survey: Consumers ranked prescription drugs as most effective for nine of 12 conditions -- allergies, cold and flu, depression, anxiety, digestive problems, headache and migraine, insomnia, irritable bowel syndrome, and osteoarthritis.

Of the 46% of respondents who used prescription drugs for osteoarthritis pain, 53% said it helped a lot; 54% of respondents used glucosamine/chondroitin for osteoarthritis symptoms, and 25% said it helped a lot. Of the 27% of respondents who used meditation, 42% said it helped "a lot" with anxiety. 43% of respondents used deep-breathing exercises for anxiety, and 34% found it helped a lot.

Chiropractic care was ranked as the most effective treatment for back pain. Pilates, yoga, and deep-tissue massage all rated about the same as prescription medication for back pain. Vitamins and minerals were the most commonly used alternative treatments for general health, with 73% of respondents taking them. A majority of people who said they used alternative therapies had told their doctors about it.


Indianapolis Billboard Compares Hot Dogs to Cigarettes


Race fans who attend the Indianapolis Motor Speedway – and residents who live near the track – are being warned of a possible link between hot dogs and cancer, Fox 59 reported.

A billboard on West 16th Street shows hot dogs inside of a cigarette pack. “Hot dogs can wreck your health,” it reads. The cigarette package has a picture of a skull and crossbones.

The American Institute for Cancer research says one, 50-gram piece of processed meat – such as a hot dog – can increase the risk of colorectal cancer by 21 percent.

Colorectal cancer is the third most common cancer in the U.S., according to the American Cancer Society. A recent study published in the Journal of Epidemology says that processed foods like bacon and hot dogs do not increase the risk of pancreatic cancer.


Acupuncture As Hormone Regulation Therapy


A small study released in March found that acupuncture reduces hot flashes and mood swings in postmenopausal women. This confirms what other recent health headlines indicate - acupuncture is clearly a better option than HRT (hormone replacement therapy) for treating menopause symptoms.

Earlier this year, big news also came out of the U.K., where a large study of over one million postmenopausal women took place. The findings show that women who took HRT in the early stages of menopause were at higher risk of developing breast cancer than those who took it five or more years after menopause began. This is a big deal because popular belief was that younger women who began HRT earlier into menopause had little risk of developing side effects.

 In other words, the women who were thought to be at the lowest risk were found to be at the highest. These findings fuel an already blazing fire over the potential dangers of HRT, which include increased risk of not only breast cancer but also heart problems, stroke and blood clots. These risks were highly publicized in 2002, when another large-scale HRT study, the Women's Health Initiative, was halted three years ahead of schedule.

Researchers pulled the plug when they realized that women were experiencing severe side effects at high rates. Although detractors are quibbling about the method used in the latest research from Britain—it was an observational study rather than a randomized trial—the findings support the notion that artificially upping women's hormone levels is probably not very safe. They also highlight an inherent problem with introducing foreign substances to treat menopause symptoms.

The body's hormonal balance, and therefore overall homeostasis, is thrown into disarray during menopause. It's uncomfortable and an enormous burden for a lot of women. But it's also a normal part of life. Regulating the body's existing components rather than replacing something that's not meant to be there anymore is safer and more consistent with the natural aging process.

Regulation is the bread and butter of acupuncture. Menopause symptoms usually get acupuncturists thinking about the kidneys. In TCM-style acupuncture, the most common approach is to address Kidney Yin Deficiency. Many of the common symptoms associated with menopause—hot flashes, night sweats, emotional instability, insomnia, poor memory, headache, lack of concentration, and dryness—fall into this pattern. Kidney Essence, which is related to brain marrow, belongs to Kidney Yin, thus poor memory and mental confusion occur when Kidney Yin is deficient. Similarly, aching bones and low back soreness are a result of Kidney Essence/Yin failing to nourish the bones.

This is part of why acupuncturists treat the kidneys in cases of osteoporosis, which becomes increasingly common as women near menopause. Kidney Yin nourishes the body fluids that keep the bones lubricated and strong. In addition to affecting bone health, when body fluids are depleted, there is general dryness throughout the body. This can lead to constipation, dry mouth, scanty dark urine and vaginal dryness. Any Yin Deficiency also is associated with what's called Empty or False Heat, which gives rise to hot flashes, night sweats, and face flushing.

Acupuncture points that nourish Kidney Yin are a safe bet for most women with menopause symptoms, but sometimes further investigation is required. Kidney Yin often appears in conjunction with another pattern. Kidney Yin is considered the foundation for both the Liver and Heart, so a deficiency in this area can lead to Liver and/or Heart patterns as well. Most commonly, additional TCM patterns associated with menopause include Liver Yin or Blood Deficiency, Liver Yang Rising, Kidney and Heart Not Communicating, or Heart Yin Deficiency.

Kiiko Matsumoto, a renowned Japanese acupuncturist, offers a slightly different take on menopause. She describes it as Zong Qi Leaking, a syndrome that involves the relationship between the Lungs and Kidneys, and what are known as the upper and lower heaters. Zong Qi plays a vital role in ensuring that various parts of the body remain at their desired temperatures.

Zong Qi Leaking means that the body's temperature-regulating function is off, causing there to be too much heat in the upper part of the body (upper heater) and not enough in the lower part (lower heater). Excess heat in the upper heater causes hot flashes, night sweats, insomnia, anxiety, and emotional instability. Lack of warmth in the lower heater can cause depression and low back pain.

Different styles of acupuncture approach menopause in various ways, but all are similar in that they regulate the structural and functional components that get disorganized as women's hormone levels change. If the "R" stood for "regulation," the name HRT still works to describe effective treatment for menopause symptoms. But why tarnish a good thing with a bad name? Let's just call it acupuncture.


A Wise Man's Treatment for Arthritis: Frankincense?


The answer to treating painful arthritis could lie in an age old herbal remedy -- frankincense, according to Cardiff University scientists. Cardiff scientists have been examining the potential benefits of frankincense to help relieve and alleviate the symptoms of the condition.

"The search for new ways of relieving the symptoms of inflammatory arthritis and osteoarthritis is a long and difficult one," according to Dr Emma Blain, who leads the research with her co-investigators Professor Vic Duance from Cardiff University's School of Biosciences and Dr Ahmed Ali of the Compton Group.

"The South West of England and Wales has a long standing connection with the Somali community who have used extracts of frankincense as a traditional herbal remedy for arthritic conditions.

"What our research has focused on is whether and how these extracts can help relieve the inflammation that causes the pain," she added. The Cardiff scientists believe they have been able to demonstrate that treatment with an extract of Boswellia frereana - a rare frankincense species - inhibits the production of key inflammatory molecules which helps prevent the breakdown of the cartilage tissue which causes the condition.

Dr Ali adds: "The search for new drugs to alleviate the symptoms of conditions like inflammatory arthritis and osteoarthritis is a priority area for scientists. What our research has managed to achieve is to use innovative chemical extraction techniques to determine the active ingredient in frankincense."

"Having done this we are now able to further characterise the chemical entity and compare its success against other anti-inflammatory drugs used for treating the condition."

The research comes as a result of a seedcorn project, funded by the Severnside Alliance for Translational Research (SARTRE), through the MRC Developmental Pathway Funding Scheme devolved portfolio.


347 Million Diabetics Counted Worldwide


The global prevalence of diabetes reached 347 million in 2008, more than doubling the number of people with diabetes worldwide since 1980, researchers said. Using data from some 280 health surveys and epidemiological studies from around the world, Majid Ezzati, PhD, of Imperial College London, and colleagues estimated an average, age-standardized, global prevalence of diabetes of 9.8% in adult men (95% CI 8.6% to 11.2%) and 9.2% in adult women (95% CI 8.0% to 10.5%).

Corresponding figures in 1980 were 8.3% in men and 7.5% in women, for a total worldwide diabetic population of 153 million, the researchers reported online in The Lancet. They noted that population growth and longer lifespans in many countries accounted for about 70% of the increase in absolute numbers of diabetics. Nevertheless, the remaining 30% was likely related to changes in diets, exercise habits, and other factors that drive development of diabetes.

The analysis showed that age-standardized levels of fasting plasma glucose averaged 99.2 mg/dL among men and 97.7 mg/dL in women globally in 2008. These represented increases of 1.3 mg/dL for men and 1.6 mg/dL for women since 1980. Increases in mean fasting plasma glucose were seen in every region, with Pacific Ocean nations, "southern and tropical" Latin American countries, and the world's high-income nations showing the biggest rises. The world's highest diabetes prevalence was seen in the Marshall Islands, at about 28.5% for both sexes combined.

The lowest rates were in Cambodia and the Netherlands, where just over 5% of the adult population was considered diabetic. Diabetes prevalence in the U.S. rocketed upward in the new analysis, as it has in CDC studies and others. In 1980, the U.S. had one of the lowest diabetes prevalence rates in the world, but in 2008 it ranked in the upper third of the 199 nations included in the current study. Prevalence in U.S. men soared from 6% in 1980 to 12.5% in 2008, the researchers calculated. A smaller but still very steep rise was seen in American women, among whom diabetes prevalence jumped to 9.5% from 5% in 1980.

More surprisingly, rapid industrialization and increasing wealth in China was not reflected in rising glucose levels or diabetes prevalence through 2008. Ezzati and colleagues found, for example, that 10% of Chinese men were diabetic in 1980 -- and that only about 9.5% were diabetic in 2008. Similar findings were seen for a number of other countries with growing economies, such as Malaysia and Cambodia.

Elsewhere in the world -- such as in the U.S. -- increasing affluence has driven shifts to the high-carb diets and relatively sedentary lifestyles thought to promote type 2 diabetes. Most regions with slower-than-average growth in diabetes were those with slower-than-average economic growth: central and eastern Europe, central Asia, and northern and sub-Saharan Africa. Ezzati and colleagues also thought it was interesting that men in South Asia -- principally India -- "had the second smallest change in body mass index (almost zero)" among the 21 regions they studied, "but the sixth highest rise in mean fasting plasma glucose."

Such interregional variations during the 29-year study period probably reflects differences in "genetic factors associated with ethnic origin, fetal and early life nutritional status, diet quality, and physical activity" that affect glycemic values and metabolism. Ezzati and colleagues had reviewed some 1,700 published studies of population-based diabetes prevalence and/or fasting plasma glucose measurements, as well as 154 national health surveys and epidemiological studies plus data retrieved from a World Health Organization database. After excluding studies with duplicated data, those that did not break out findings by age and sex, and studies measuring capillary rather than plasma glucose levels, the researchers were left with a total of 282 studies, representing 370 country-years of data and 2.7 million individual participants.

"Our systematic analysis shows that glycemia and diabetes are a rising global hazard, with the number of adults with diabetes having more than doubled over nearly three decades," Ezzati and colleagues wrote. In an accompanying editorial, an official with New Zealand's health ministry called the findings "stark," but also called for more reliable and comprehensive data collection to get a better picture of the global situation. "Country-level survey-based surveillance for dysglycemia and diabetes should use HbA1c as the test of choice, because it does not necessitate a fasting blood sample, is readily calibrated against an international reference standard, and is accepted by WHO as a diagnostic test for diabetes," Martin Tobias, MBBCh, said in the editorial.

He also indicated that many countries could easily do away with health surveys. Data from their health information systems can include far more detail and cover more of the population than is feasible with survey instruments, Tobias suggested. He recommended that data on the degree of glycemic control and other parameters important to diabetes management, such as blood pressure and kidney function, should be included in future studies of diabetes prevalence. Ezzati and colleagues acknowledged that they faced several hurdles and limitations in assembling data for their study.

Most notably, they indicated that data were sparse for some regions in the 1980s and for certain low- and middle-income countries throughout the study period. Also, the included surveys and studies used a variety of glycemic metrics, including mean postprandial glucose, HbA1c, and diabetes prevalence with 18 different definitions. However, Ezzati and colleagues wrote, their reported confidence intervals reflected the uncertainties introduced by these differences and other defects in the data.


Fake Fat Linked To Weight Gain


Rats fed a high-fat diet gained more weight after eating low-calorie potato chips made with "fake fat", a synthetic fat substitute designed to taste like fat but without the calories, according to a study due to appear online in the journal Behavioral Neuroscience this week.

The findings challenge the notion that using fat substitutes in place of real fats in foods helps people lose weight: they would be better off sticking to low-fat, low-calorie diets, said the researchers. Lead author Dr Susan E Swithers, a psychology professor at Purdue University in West Lafayette, Indiana, said in a statement that: "Our research showed that fat substitutes can interfere with the body's ability to regulate food intake, which can lead to inefficient use of calories and weight gain."

Swithers and colleagues fed one group of laboratory rats a high-fat diet and the other group a low-fat diet. In addition, half of the high-fat group and half of the low-fat group were also fed normal Pringles potato chips: these are high in fat and high in calories. The other half of each group of rats was fed the normal high-fat Pringles on some days and on other days they were fed low-calorie Pringles Light chips, which in the United States contain olestra, a synthetic fat substitute that tastes like fat but has zero calories and passes through the body undigested.

The results showed that the rats on the high-fat diet that ate both the high-fat and the fake-fat Pringles ate more food, put on more weight, and gained more body fat than their counterparts on the high-fat diet that were given only the high-fat Pringles. In fact, even when the researchers stopped feeding them the Pringles, the heavier rats did not shed the extra weight. In contrast, the rats on the low-fat diet did not experience significant weight gain, regardless of which type of chips they ate.

But, when the researchers swapped those same rats to the high-fat diet, the rats that had eaten both the high-fat and the fake-fat chips put on more weight and body fat than the rats that had only eaten the high-fat chips. Swithers said these results suggest sticking to a low-fat, low-calorie diet is probably a better way to lose weight than using fat substitutes. However, she warned results from rat feeding studies don't always translate to humans, even though we have similar biological responses to food.

Speculating on why they got these results, the researchers said when humans, and other animals like rats, taste food that is sweet or fatty, this sends a signal that the food is likely to be calorie-rich, and triggers the body to respond in preparation to digest it, such as producing more saliva, hormones and changes in metabolism. If the anticipated calories don't appear, this interferes with that relationship.

In their report, they discuss the principle that energy regulation is a learned process, which is reinforced every time the anticipation of a high-calorie meal (as signalled from the encounter of sight, smell and taste) is followed by the actual cosumption of a high number of calories.


Tornado Victims Get Free Acupuncture


A local group of acupuncturists offered free treatments to tornado victims in Minneapolis over the weekend to help alleviate stress.

Practitioners offered up their services free of charge on Friday afternoon to residents and community workers affected by the twister.

Acupuncture can help treat traumatic stress, insomnia, pain and many other symptoms.

The effort was supported by a group called Acupuncturists Without Borders, a non-profit agency formed in the wake of Hurricane Katrina to help storm victims cope with stress.


The Future of Ophthalmology


Ensuring good eye sight for life is perhaps one of the most personal of health concerns; particularly since around 50% of the population wear spectacles or need some aid to vision.

But how is ophthalmology developing? There are in fact 5 trends. First is cataract surgery. Until relatively recently surgery involved having a major operation under anaesthetic. But with advances in technology cataracts are now removed by laser surgery.

According to one ophthalmologist, Dr. Packer, who runs a practice in Oregon in the USA: “The laser essentially automates the principle steps of cataract surgery that are traditionally done by hand.” He added: “It’s going to change the way we do cataract surgery because the technique is so different. There’s no question that we’re moving in this direction.” Another trend is for many ophthalmologists (particularly in the USA) to offer patients a number of what have been described as premium services.

These include corrective laser eye treatment. Having this done enables patients to get rid of their glasses. A similar ‘operation’ is lens implants. Dr. Packer said: “Initially, in 2005, it was presbyopia-correcting lenses, and then it became toric lenses, which correct astigmatism.”

Commenting on how American ophthalmic surgeons can offer these new techniques Dr. Parker added: “It’s kind of akin to a plastic surgeon who may do reconstructive work that is covered, but also does all these cosmetic, non-covered, out-of-pocket procedures.” A third trend is age related surgery. An increasing number of older people are electing to have cataracts removed by say LASIK treatment and other treatments.

But Dr. Packer has also noticed that even younger patients below 65 are asking for treatment because they perceive it to be safer than leaving till old age creeps up. Dr. Packer said: “People elect to have surgery earlier because it’s perceived as safer. They think, ‘Why should I put up with difficulty driving at night? My neighbour had it done and had a great outcome.’ I think we’ll see a bit of a downward drift in mean age for cataract surgery.”

The fourth trend is more one of organisation with many more ophthalmic surgeons opting to use technology to help organise their practices. No doubt the same is happening in Britain. The fifth trend (which currently doesn’t apply to Britain) is stricter regulations.

With the onset of medical reforms in the USA ophthalmologists as with other medical practitioners face extra legislative conditions, including more regular inspections of practices; not to mention the necessity to ensure they have proper legal protection in case things go wrong. Along with the greater use of technology is the greater propensity for accidents, which can result in medical practitioners being sued.


Tai Chi Appears to Benefit Quality of Life


Tai chi exercise appears to be associated with improved quality of life, mood and exercise self-efficacy in patients with chronic heart failure, according to a report in the April 25 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

"Historically, patients with chronic systolic heart failure were considered too frail to exercise and, through the late 1980s, avoidance of physical activity was a standard recommendation," the authors write as background information in the study. "Preliminary evidence suggests that meditative exercise may have benefits for patients with chronic systolic heart failure; this has not been rigorously tested in a large clinical sample."

Gloria Y. Yeh, M.D., M.P.H., of the Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, and colleagues evaluated 100 outpatients with systolic heart failure who were recruited between May 1, 2005 and September 30, 2008. Fifty patients were randomized to a 12-week tai chi-based exercise intervention group, and 50 were randomized to a time-matched education group.

The tai chi intervention group consisted of one-hour group classes held twice weekly for 12 weeks. The education sessions were also held twice weekly for the same duration as the tai chi lessons, and were led by a nurse practitioner. The two groups were generally similar in demographics, clinical classification of heart disease severity, and rates of comorbidities.

At completion of the study, there were no significant differences in change in six-minute walk distance and peak oxygen uptake when comparing the tai chi and control groups; however, patients in the tai chi group had greater improvements in quality of life. The tai chi group also showed improvements in exercise self-efficacy (confidence to perform certain exercise-related activities), with increased daily activity, and related feelings of well-being compared with the education group.

"In conclusion, tai chi exercise, a multi-component mind-body training modality that is safe and has good rates of adherence, may provide value in improving daily exercise, quality of life, self-efficacy and mood in frail, deconditioned patients with systolic heart failure," the authors write. "A more restricted focus on traditional measured exercise capacity may underestimate the potential benefits of integrated interventions such as tai chi."


Paralyzed Man Stands, Moves With Epidural Stimulation


Rob Summers was 20 in the summer before his junior year at Oregon State University in 2006. A pitcher on the school's baseball team, he went out around midnight to get his gym bag out of his car when a hit-and-run driver jumped the curb, striking him and leaving him paralyzed with an injury to the spinal cord from C7-T1.

Today Summers can stand for several minutes and move his legs, feet, and toes. He has regained some bladder control and sexual functioning, as well as the ability to regulate his body temperature through mechanisms such as perspiration. These gains are the result of unprecedented treatment -- begun in December 2009 -- using electrical stimulation of the spinal cord. After 80 sessions of task-specific training, epidural stimulation from an implanted unit allowed Summers to stand, bearing all his weight, for up to 4.25 minutes, Susan Harkema, PhD, of the University of Louisville in Kentucky, V. Reggie Edgerton, PhD, of the University of California Los Angeles, and colleagues reported online in The Lancet. Summers had previously undergone 26 months of locomotor training with assistance on a treadmill that had failed to produce any changes in electromyographic activity in the legs, the researchers explained.

"This unexpected recovery of supraspinally mediated movement suggests that activity-dependent mechanisms promoted plasticity of anxonal projections that presumably were spared by the injury," observed Grégoire Courtine, PhD, of the University of Zurich in Switzerland, and colleagues in a commentary accompanying the case report. Animal studies had shown that the spinal cord is capable of generating motor commands without signals from the brain by means of neural networks known as central pattern generators. In paralyzed humans, epidural stimulation has been shown to induce rhythmic movements of the legs while the patient lies supine.

 Most [spinal cord injuries] involve a contusion or compressive injury of the cord that causes a great deal of damage, but leaves a certain number of nerve fibers that connect the brain with the spinal cord," Edward D. Hall, PhD, of the University of Kentucky and the Spinal Cord and Brain Injury Research Center in Lexington, observed in an email to ABC News and MedPage Today. Harkema's team in Louisville had been doing research to see if spinal cord stimulation could activate neural circuits in the spine and, coupled with sensory input from the legs, permit standing and locomotion. Summers went to Louisville to see if they could help him. In December of 2009, the team implanted a 16-electrode array over the young man's spinal segments L1-S1. They also implanted a pulse generator connected to an electrode lead in the abdomen.

The researchers explained that, although Summers was paralyzed below the chest, he was classified as grade B on the American Spinal Injury Association's neurologic impairment scale since he had light touch sensation below the area of the spinal injury. But he had no voluntary control over the muscles of legs and trunk and no ability to contract the bladder. The investigators tested various amplitudes ranging from 0.5 to 10 V and frequencies of 5 Hz to 40 Hz, in stimulation sessions ranging from 40 minutes to two hours. Summers has reported tingling sensations at the site of the implanted electrode and in the muscles being activated, but did not experience pain during the stimulation sessions.

Initially, he was able to stand only with 65% body weight support, but over time he progressed to full weight bearing. In addition to learning to stand unaided, Summers eventually progressed to the extent that he could stand up from a sitting position, which resulted in a marked increase in electromyographic activity. He then learned task-specific sensory cues such as positioning of the legs, hips, and knees to accomplish step-like movements during 30 Hz to 40 Hz epidural stimulation. But without the epidural stimulation, no electromyographic activity could be detected when his trainers assisted him in performing these stepping movements. Hall cautioned that if this approach is shown to help in other patients, it may allow them to walk with the aid of a walker.

"While this will have value, it is important to note that it will not reproduce normal walking," Hall said. If Summers isn't running around any baseball diamonds, he has a renewed sense of well being and self-esteem. Now 25, he lives in Los Angeles. And last summer, he spent 10 days helping at a baseball camp in Florida. "One possible explanation for this recovery is that residual supraspinal connections that existed but could not be detected clinically were reactivated or that new supraspinal connections to the spinal networks were formed," Edgarton's group noted in their paper.

 "Challenges lie ahead," stated Courtine and colleagues in their commentary and the findings need to be replicated in a clinical trial with sufficient numbers of patients. Nonetheless, they wrote, "The exceptional results bring new hope in a field that has remained unsatisfying -- with limited progress despite decades of research throughout the world." Naomi Kleitman, PhD, of the National Institutes of Health in Bethesda, Md., also found Summers' story hopeful. Most people are unaware of the complex circuits in their spine that transmit commands to the body from the brain, she told MedPage Today and ABC News in an email.

"Spinal cord injuries break this vital connection but the sophisticated circuitry of the spinal cord remains, ready to coordinate stepping if it receives the right commands. Harnessing that potential has been the goal of decades of research to understand spinal cord function and to find effective ways to restore function after injury," Kleitman explained.


Medicare to Run Dry in 2024


Funding for the Medicare program will dry up in 2024, according to an annual report from the program's trustees. Last year's report projected the entitlement program to be solvent through 2029.

The bleaker projection is a result of a smaller-than-expected influx of payroll taxes in 2010 because of a slower-than-predicted economic recovery, Health and Human Services Secretary Kathleen Sebelius told reporters during a Friday afternoon press briefing. And inpatient and hospital-related care was more expensive last year than actuaries originally predicted, Sebelius noted.

Total Medicare costs are currently about 3.6% of the nation's Gross Domestic Product (GDP), but that percentage is expected to balloon up to 5.5% of GDP by 2035, and then increase gradually to about 6.2% of GDP by 2085. Two separate trust funds provide money for Medicare. The Hospital Insurance Trust Fund pays for inpatient hospital and related care. The Supplementary Medical Insurance (SMI) Trust Fund pays for outpatient physicians and other outpatient services (known as Part B of Medicare) and Part D, which covers prescription drugs.

It's the Hospital Insurance Trust Fund specifically that is projected to be exhausted in 2024. However, "exhaustion" to actuaries means the program will only take in enough funds to pay out three-quarters of benefits, which means hospitals would receive much lower reimbursements for treating Medicare patients. Part B -- which includes doctor's bills, outpatient expenses, and prescription drug coverage -- will remain steady because it's automatically funded each year, through legislation and insurance premiums, to meet the following year's expected costs.

However, those costs will grow, largely because of the increased cost to provide care to an aging population. SMI costs are currently about 1.9% of GDP, but will grow to 3.4% of GDP in 2035 and reach 4.1% of GDP by 2084, projected the trustees, which include Sebelius, Labor Secretary Hilda Solis, Treasury Secretary Tim Geithner, Commissioner of Social Security Michael J. Astrue, and two new public trustees.

However, that projection assumes that the short-term sustainable growth rate (SGR) fix passed by Congress in December will indeed expire on Jan. 1, 2012, at which point doctors will be subject to a 29% cut in Medicare reimbursements. Every year since 2003, Congress has prevented steep cuts from happening, and it's expected that will happen again. The American Medical Association (AMA) said the report shows exactly why the SGR formula needs to be fixed.

"The Medicare trustees report leaves no doubt that the time to repeal the Medicare physician payment formula is now -- to keep from digging a deeper financial hole and to preserve access to care for patients," AMA immediate past president J. James Rohack, MD, said in a statement. "Across-the-board cuts in Medicare do not get to the root of the cost challenge and can hamper patients' ability to receive care," said Rohack.

"Instead of focusing only on cuts, the ultimate goal should be to achieve better value for our healthcare spending." Although this year's Medicare assessment is less rosy than last year -- when the trustees projected the program would remain solvent until 2029 thanks to the Affordable Care Act (ACA) -- the trustees still said the healthcare reform law is a life raft for Medicare and will make Medicare costs 25% lower than they would have been otherwise. If the law hadn't passed, the Medicare program would have run out of money in 2016, Sebelius said.

Many of the main provisions that Democrats expect to save money -- including changing how care is paid for and delivered, in part through accountable care organizations -- won't begin to save money for years. If those reforms don't work, Medicare's cost will be much higher, wrote the two public trustees. "If the legislation's cost-reduction innovations in the delivery of and payment for health services were not successful, or if healthcare providers could not accommodate the slower growth in Medicare payment rates mandated by the new law, Medicare costs would be significantly higher than shown in the trustees report," wrote Charles Blahous and Robert Reischauer.


New EU regulations on herbal medicines come into force


New European Union rules have come into force banning hundreds of traditional herbal remedies.

The EU law aims to protect consumers from possible damaging side-effects of over-the-counter herbal medicines. For the first time, new regulations will allow only long-established and quality-controlled medicines to be sold. But both herbal remedy practitioners and manufacturers fear they could be forced out of business. To date, the industry has been covered by the 1968 Medicines Act, drawn up when only a handful of herbal remedies were available and the number of herbal practitioners was very small. But surveys show that about a quarter of all adults in the UK have used a herbal medicine in the past two years, mostly bought over the counter in health food shops and pharmacies.

The regulations will cover widely used products such as echinacea, St John's Wort and valerian, as well as traditional Chinese and Indian medicines. But safety concerns have focused on the powerful effects of some herbal remedies, as well as the way they interact with conventional drugs. For example, St John's Wort can interfere with the contraceptive pill, while ginkgo and ginseng are known to have a similar effect to the blood-thinning drug warfarin. From now on only products that have been assessed by the Medicine and Healthcare products Regulatory Agency (MHRA) will be allowed to go on sale.

Manufacturers will have to prove that their products have been made to strict standards and contain a consistent and clearly marked dose. And to count as a traditional medicine, products must have been in use for the past 30 years, including 15 years within the EU. They will also only be approved for minor ailments like coughs and colds, muscular aches and pains, or sleep problems. Remedies already on sale will be allowed to stay on the shelves until they reach their expiry date.

Free from contamination

Richard Woodfield, head of herbal medicine policy at the MHRA, says so far there have been 211 applications, of which 105 have been granted registration. "Crucially, this EU directive and the registration scheme puts consumers in the driving seat so they can identify that a product meets assured standards on safety, quality and information about safe use. "Safety speaks for itself, but quality means, are they using the right part of the plant? Is it free from contamination? Is the claimed shelf life suitable?  "Product information will include possible side effects and interactions with other drugs, but above all it must make very clear that it is based on traditional use." And that is a key point for the Royal Pharmaceutical Society, which believes the new regime is a step forward in improving safety and quality.

But Prof Jayne Lawrence, chief science adviser to the society, says there are still some concerns about herbal products. "They certainly haven't been tested on the same basis as a conventional medicine and some of these compounds are very potent. "Patients might not realise that in some cases they should not take other medicines with them, or if they're going for surgery they should tell their doctors they are taking these particular medicines because there may be complications. "So we're very concerned that patients appreciate they must be very careful when they take these medicines and, ideally, should talk to their doctor or pharmacist." The manufacturers of herbal remedies have had seven years to prepare for the new rules after the European Directive on Traditional Herbal Medicinal Products was introduced in 2004.

Too onerous?

These regulations apply to over-the-counter sales, which form the bulk of herbal remedies sold in the UK. But some manufacturers and herbal practitioners have expressed concern, arguing the new rules are too onerous for many small producers. Michael McIntyre, chairman of the European Herbal and Traditional Medicines Practitioners Association, says there will be a significant impact on herbal medicine practitioners and their suppliers, but admits the rules do need bringing up to date. "Products that go on the market now will definitely do what it says on the bottle, while we didn't know how good they were in the past. "But registration is expensive so perhaps there may be fewer products on the market and a smaller range. "It's difficult to argue that the market should stay as it is, without any regulation, but how many businesses will pack up and walk away? I can't say."

A Department of Health spokesperson said: "We have swiftly introduced a system to register herbal practitioners using unlicensed herbal medicines, so consumers will be able to continue to use unlicensed herbal medicines if they wish."


Contradictory Evidence over Stress and Infertility


It’s been a widely held belief that stress is probably a key component in infertility problems.

However recent research appears to put this in doubt. Researchers in Britain pored over past reports involving some 3,500 women from 10 countries diagnosed as infertile. They looked at the women’s level of stress prior to in vitro fertilisation treatment, and compared this with stress levels of women who did and didn’t get pregnant subsequently.

The researchers concluded that while women can become stressed as a result of having treatment, the treatment itself had no statistical effect on whether they became pregnant. Jacky Boivin, a professor in the School of Psychology at Cardiff University told reporters that this latest research should reassure many women.

Infertility is defined in women under 35 as being unable to become pregnant after 12 months of trying. For women over 35 the time frame is 6 months. Infertility problems may also arise if women can get pregnant but are constantly aborting naturally. While stress is probably not a factor in causing infertility, toxic chemicals however are a major problem.

As such, the Massachusetts legislature in the USA is taking steps to take another look at the 1976 Toxics Substances Control Act which allows toxic and dangerous chemicals to be used in the manufacture of every day household products.

It has the backing of Dr. Ted Schettler, Science Director of the Science and Environmental Health Network who told reporters: “A substantial body of scientific research shows that the public is exposed to chemicals that increase the risk of serious health threats, including cancer, asthma, infertility, and learning and developmental disabilities.”

He added: “For most chemicals, no government agency has the authority to require safety testing before they are put into widespread use. It’s an uncontrolled experiment and individuals and families across the country are paying the price.”


Acupuncture can treat hot flashes, study finds


Women who suffer from hot flashes and other uncomfortable symptoms of menopause may be able to find relief through acupuncture, according to a new study.

The idea of having to lie still for 20 minutes with needles sticking out of you may not appeal to everyone. On the other hand, hormone replacement therapy – often employed to make menopause more bearable – has some problems of its own, including an increased risk of coronary heart disease, stroke and breast cancer.

So Turkish researchers recruited 53 postmenopausal women and assigned 27 of them to a five-week course of acupuncture (twice a week for 20 minutes at a time) and 26 of them got sham treatments that they thought were real.

Women in the treatment group had needles inserted at 10 acupuncture points (bilaterally at ST36, LI4, KI3 and LR3, and also at EX-HN3 and CV3); women in the placebo group were treated with blunted needles that didn’t penetrate the skin.

RELATED: Acupuncture can calm anxious dental patients, study finds.

At the end of the study period, the women who got acupuncture showed more relief from their symptoms compared to their counterparts who got the fake treatment. Their hot flashes were less severe (there was no change for women who got the sham treatment).

Both groups had improvements in their psychological symptoms (as measured by the Menopause Rating Scale), though the benefit was much greater for women who got acupuncture.

In addition, estrogen levels were significantly higher for the women in the treatment group compared to the controls. Had there been more than 10 sessions, the benefits of acupuncture might have been even greater, the researchers said.

The results were published in the journal Acupuncture in Medicine. This isn’t the first study to evaluate the effectiveness of acupuncture for hot flashes. In prior studies, results have been mixed. But from what I hear about hot flashes, some women are willing to try anything.