Thursday, February 28, 2013

Vitamin D And Calcium May Not Prevent Fractures

Vitamin D and calcium supplements do not prevent fractures in adult men or women, according to a report published in the journal Annals of Internal Medicine.
After discovering that there was not sufficient scientific proof to demonstrate that vitamin D and calcium supplements help protect bones from breaking in men or the majority of postmenopausal women, the U.S. Preventive Services Task Force (Task Force) made their final recommendation.

Studies on both vitamin D and calcium were reviewed by the Task Force before coming up with their new suggestions.

A report published last year in BMJ said the risk of fractures later in life is not lowered by a high daily calcium intake. A different report on vitamin D injections showed that they do not reduce the rate of bone fractures suffered by elderly people.

The new recommendations say that women who are postmenopausal should not take daily vitamin D doses of 400 international units or less or calcium doses of 1,000 milligrams or less.

However, women should keep taking the supplements if they are told to do so by their doctor because they are vitamin D deficient or have osteoporosis.

The experts explained:

These recommendations apply to noninstitutionalized or community-dwelling asymptomatic adults without a history of fractures. This recommendation does not apply to the treatment of persons with osteoporosis or vitamin D deficiency.

The Task Force suggested that healthy men stay away from the supplements as well. This is because the risk of getting kidney stones is greater than the advantages of taking them.

However, even though calcium and vitamin D do not prevent fractures, they are both important to the health of bones.

Seventeen percent of adults in the U.S. take vitamin D and 20% take calcium supplements, even though not of all those people actually need them.

Extra vitamins are not always necessary when individuals are active and in good health.

The authors wrote:

"The USPSTF recognizes that clinical decisions involve more considerations than evidence alone. Clinicians should understand the evidence but individualize decision making to the specific patient or situation. Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms."

New Recommendations For Screening And Testing Newborn Children

New recommendations on testing and screening newborn children for genetic diseases have been published in the latest policy statements of the American Academy of Pediatrics (AAP) and The American College of Medical Genetics and Genomics (ACMG).
They believe that it is necessary to test all newborn children as it is in the best interest of their health, showing their support for mandatory genetic testing and screening.

Millions of newborns undergo genetic screening every year.

However, additional genetic testing after the initial screening is far less common.

Most additional genetic testing conducted after the newborn period is mainly carried out on children who show signs and symptoms of intellectual disability for diagnostic purposes.

Beyond the initial screening, the decision to carry out additional testing should rest on the parents, say the experts.

There were distinct differences between the recommendations for testing for childhood-onset conditions and testing for conditions that appear in adulthood. The experts encouraged testing children who are at risk of childhood-onset conditions, but discouraged testing for diseases or conditions that appear later in adulthood.

They also noted that when a child shows early symptoms of a disease, it is necessary to make a quick diagnosis and evaluate the best courses of action, guiding the family in making a decision for the best of the child.

In fact, according to a previous study published in the journal Pediatrics, the majority of parents would accept and embrace predictive genetic testing for their children if offered.

Even though these two reports discourage testing for adult-onset conditions, some experts believe that results concerning these conditions could help adjust lifestyle risks early on.

One of the policy authors, Dr. Lainie Friedman Ross, said:

"There is an important role for counseling before and after genetic screening. The focus should be on education of families, counseling them and helping them make decisions that focus on the child's best interest.

Clearly, if a child has symptoms, we need a diagnosis to help the family make clinical decisions that are in the child's best interest. This is important even when the disease has no current therapies."

Sometimes genetic testing can give incorrect results or interpretations; the ACMG suggests that a person who is certified in either Clinical Molecular Genetics (ABMG) or Molecular Genetic Pathology (ABPath/ABMG) should always review test results.

In addition, they state that pre- and post-test counseling should be provided to patients by an ABMG certified Clinical Geneticist or ABGC/ABMG certified Genetic Counselor.

In view of the rapid advances made in genetics and genomics, the authors stress that health care providers and pediatricians should always be informed on what the best new practices are.

Stress Early In Life Can Affect Heart Function Early

Life stress early on such as that experienced by babies who are sick, appears to have an early impact on heart function, affecting the heart's ability to refill with oxygen-rich blood and relax.
A group of researchers from Georgia Regents University conducted a study using rat pups, separating them from their mothers for a couple hours everyday. Then, an extra stress was added to raise blood pressure.

The researchers saw a noteworthy fall in basic heart function. The rates of relaxation and re-filling stayed low in the separation model, however, reductions remained steady by ages two and six months, as the rats progressed to middle age.

The model as well as the controls had reductions in those functions that generally come naturally with age.

Surprisingly, the power with which the heart released blood stayed consistent with the added stressor, angiotensin II - a strong constrictor of blood vessels. Echocardiography was used to measure heart function.

Dr. Catalina Bazacliu, neonatologist at the Medical College of Georgia and Children's Hospital of Georgia at Georgia Regents University, said:

"We expected the heart's ability to relax and refill to lag behind in our model. We believe these babies may be at increased risk for cardiovascular disease and we are working to understand exactly what puts them at risk."

The authors are presenting their findings today at the Southern Regional Meetings in New Orleans.

The findings also show that the blood pressure of rats that are separated from their mothers rises more frequently in response to angiotensin II, their heart rates also increased.

Generally, a compensatory mechanism pushes the heart rate down a bit when blood pressure increases.

Previous studies have indicated persistent blood vessel changes in the early stress model, such as elevated contraction and decreased relaxation when similarly stressed.

Other longitudinal studies in humans have revealed long-term cardiovascular consequences, like babies born during the Dutch famine of World War II, maturing with elevated risks of:
  • cardiovascular disease
  • diabetes
  • obesity
  • other health related issues
In another related study by Bazacliu, she used a similar animal model showing that babies whose growth was limited in-utero by health issues such as preeclampsia - high blood pressure in mothers during pregnancy - were at an elevated risk for cardiovascular disease as adults.

These observations were seen whether the babies were born at full term or prematurely. Higher pressure during development decreases blood flow from mother to baby; decreased oxygen and nutrition to the baby is an example of environmental stress.

Bazacliu points out that although neonatal intensive care units are designed to save and treat premature babies, they can actually cause more stress. The NICU at the Children's Hospital of Georgia works to reduce the negative effects, such as enacting visiting hours, minimizing noise, and other family targeted techniques.

Bazacliu conclues, "All the procedures we must do, the separation from the mother, the environment, even though the babies need the help, it represents a stress."

Breast Cancer Rates Increase Among Young Women

here has been a small increase in the incidence of advanced stage breast cancer among women 25 to 39 years old, according to a recent study in JAMA.

Breast cancer is the most common form of malignant tumor in women aged 15 to 39 and accounts for nearly 14% of all cancer cases in men and women in that age group. The risk of a woman developing breast cancer before the age of 40 is 1 in 173, according to a 2008 study.

The authors wrote:

"Young women with breast cancer tend to experience more aggressive disease than older women and have lower survival rates. Given the effect of the disease in young people and a clinical impression that more young women are being diagnosed with advanced disease, we reviewed the national trends in breast cancer incidence in the United States."

The study involved assessing three U.S. National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) registries from 1973-2009, 1992-2009 and 2000-2009. Rebecca H. Johnson, M.D., the leader of the study, and her colleagues obtained information from the registries regarding the incidence of breast cancer, any incidence trends, the survival rate as a function of age, and the extent of the cancer at diagnosis.

The SEER defines localized breast cancer as cancer only found in the breast, regional cancer as cancer that's spread to adjacent organs such as the chest well, and distant cancer as cancer that's spread from one part of the body to another part not directly related to it (in this case the brain and lungs would be an example).

Over the past three to four decades, the incidence of distant breast cancer in young women aged 25 to 39 has gone up steadily, from a rate of 1.53 per 100,000 in 1976 to 2.90 per 100,000 in 2009. This difference translates to an annual increase in incidence of 2.07 percent per year.

The authors added:

"The trajectory of the incidence trend predicts that an increasing number of young women in the United States will present with metastatic breast cancer in an age group that already has the worst prognosis, no recommended routine screening practice, the least health insurance, and the most potential years of life."

The increasing incidence of distant cancer was greatest among women aged 25 to 34 and got progressively smaller in women as they got older, by 5-year age intervals. There was no real increase in the incidence of distant breast cancer in women 55 years old or above. The authors added that: "For young women aged 25 to 39 years, the incidence of distant disease increased in all races/ethnicities assessed since at least 1992, when race/ethnicity became available in the SEER database."

This finding is particularly concerning, considering that young women, between 20 to 34 years of age who develop breast cancer, have the lowest 5-year breast cancer survival rate as a function of age.

Researchers from the Institut Jules Bordet, in Brussels, Belgium, identified that breast cancer in young women is in itself a biologically unique disease, requiring customized management strategies, and is associated with age related biological processes that are independent from other, more common factors, used in prognosis by oncologists.

Young women who are diagnosed with breast cancer often find themselves feeling isolated and alone, given that most medical resources for the disease are designed for women over 50. In addition, a study in the Journal of National Cancer Institute revealed that health-related quality of life is a lot lower in young women with breast cancer - it is linked with weight gain, increased psychological distress and early onset of menopause.

Mosquito Repellent DEET Is Becoming Less Effective

Mosquitos are now able to ignore the scent of the insect repellent DEET three hours after being exposed to it.
The finding, published in PLoS One, suggests that even though historically, insects have been strongly repelled by the scent of DEET, other studies by Dr.James Logan reveal that some mosquitoes and flies carry a genetic alteration in their aroma receptors rendering them insensitive to the smell.

DEET is one of the most successful protectors against mosquito bites that can transmit deadly diseases, such as:
  • West Nile Virus
  • Malaria
  • Dengue fever
  • Encephalitis
  • Yellow fever
Products that have DEET come in many different forms including liquids, sprays, lotions, wristbands. DEET has been in use by the public since 1957.

In this latest study, Dr. Logan and his peers from the London School of Hygiene & Tropical Medicine discovered a response in mosquitoes that occurred due to short-term changes (not genetic ones).

The investigators examined changes in responses to DEET in Aedes aegypti mosquitoes - which are well known for biting during the day and transmit deadly diseases, such as yellow fever and dengue fever.

They discovered that a slight exposure to DEET was enough to make some mosquitoes less sensitive to the repellent.

Three hours following exposure, the mosquitoes were put off seeking out attractants like human skin and heat even though they had been previously exposed to DEET.

The investigators also saw that this ineffectiveness of the odor could be linked to a fall in the sensitivity of smell receptors on the mosquito's antennae after an earlier exposure.

Dr Logan, medical entomologist and Chief Scientific Officer for the Arthropod Control Product Test Centre, said:

"We think that the mosquitoes are habituating to the repellent, similar to a phenomenon seen with the human sense of smell also. However, the human olfactory system is very different from a mosquito's so the mechanism involved in this case is likely to be very different.

Our study shows that the effects of this exposure last up to three hours. We will be doing further research to determine how long the effect lasts. This doesn't mean that we should stop using repellents - on the contrary, DEET is a very good repellent, and is still recommended for use in high risk areas. However, we are keeping a close eye on how mosquitoes can overcome the repellent and ways in which we can combat this."

In 2008, a new class of bug repellent was found to be effective for three times longer than DEET, which is the quality standard of all repellents.

Scaling Up HIV Treatments Worth The Price, South Africa

According to two studies published in this week's Science journal, ramping up HIV antiretroviral treatments in the South African province of KwaZulu-Natal has been worth the extra expense.
According to the findings of the HTPN 052 (HIV Prevention Trials Network 052) trial, people who are HIV positive have a 96% lower chance of transmitting the virus to their partners if they are receiving ART (antiretroviral) medications.

Jacob Bor, from Harvard University, Massachusetts, USA, and team followed up on this trial. They reported that the life expectancy of the average KwaZulu-Natal adult is now 11.3 years longer since ART was expanded in this rural region of the country - life expectancy rose from 49.2 years in 2003 to 60.5 years in 2011.

Scaling up antiretroviral treatments is expensive

By local standards, these treatments are not cheap. Annual ART costs between $500 and $900 per year for each person. Experts and agencies had disagreed on whether scaling up such treatments could be justified.

The authors gathered and analyzed data on the changes in adult life expectancies of about 100,000 people from 2000 to 2011. They focused on the difference in life expectancy four years before ARTs were scaled up in the region, and eight years afterwards, and "determined that the survival benefits of antiretroviral treatments exceeded the cost of the treatments 26 times over."

The longer adult life expectancy in the region was nearly entirely due to changes in HIV-related deaths, they added.

In a related news release from the Harvard School of Public Health, Bor said:

"Many people have been worried that the ART scale-up, which is a massive public health intervention, would negatively affect populations who do not suffer from HIV but need care for other diseases. We do not find any evidence to support this worry."

In an Abstract in Science, the authors concluded "These gains in adult life expectancy signify the social value of ART and have implications for the investment decisions of individuals, governments, and donors."

One of the limitations in the study, the authors explained, was that access to clean water and electricity occurred at the same time the antiretroviral treatments were being scaled up. Even so, they added, in a worst-case scenario, increasing access to retroviral treatments in southern Africa would save lives and money.

In another study published in the same journal, Frank Tanser and team discovered that the risk of becoming infected with HIV in sub-Saharan Africa is reduced considerably when ARTs are scaled up.

They followed up 16,667 people who were not infected with HIV in KwaZulu-Natal for a period of eight years after ARTs were expanded in 2004. They found that HIV-free people had a 38% lower risk of becoming infected when they lived in areas with high ART coverage, compared to areas where coverage was low.

For years, experts have been saying that if the South African government started ART for HIV-positive residents earlier, the country would save money and many deaths would be prevented.

Early HIV Antiretroviral Therapy is Cost-Effective

Researchers from Weill Cornell Medical College and GHESKIO (Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes) showed in PLoS Medicine that early treatment for HIV is not only a life-saving move, but also a cost-effective one.

Before 2009, WHO (World Health Organization) recommended that antiretroviral therapy for HIV-positive patients should only start when their CD4 T cells went below 200 cells per cubic millimeter. Weill Cornell scientists carried out a randomized clinical trial in Haiti which demonstrated that early ART reduced mortality by 75% in HIV-positive adults with a CD4 cell count between 200 and 350 cells/mm3.

After looking at their findings, WHO changed their recommendation to start ART in HIV-positive patients when their CD4 cell count drops below 350 cells/mm3.

Infants Who Develop Slowly Catch Up On Growth In Time

New research reveals that most babies who put on weight at a slow rate during their first 9 months do eventually catch up to normal weight by the time they are teenagers, however, they will remain slightly shorter and lighter than their peers for a long time.

The findings, which were published by researchers at the University of Bristol in the journal Pediatrics, finally provides conclusive evidence to show that, with careful care, babies who are slow to put on weight during their first 9 months can eventually catch up to within a normal range.

A total of 11,499 people who were born in the 90s participated in the study. The researchers studied and analyzed their weight gain during their first 9 months as children. 507 of the infants gained weight at a slower than normal rate before the age of eight weeks and were part of the 'early group'. 480 put on weight at a slower than normal rate between the age of eight weeks and 9 months and were part of the 'late group'.

Children in the early group were able to quickly recover to a normal weight before the age of two, while those in the late group took a bit longer to recover, gradually gaining weight until the age of seven and then experiencing a spurt.

At the age of 13 those in the late group were found to be an average of 4.4 cm shorter and 5.5 kg lighter than other children, while infants in the early group were an average of 3.25 cm shorter and 2.5 kg lighter.

Clinicians often face a dilemma when treating infants with slow weight gain as they have to ensure that they are able to increase daily calorie intake without putting the children at risk of obesity later in life.

There were significant differences in the patterns of recovery between the early group and the late group.

Professor Alan Emond noted Professor of Community Child Health in the University's School of Social and Community Medicine, noted that the reason why children in the early group might have recovered more quickly is because they had feeding difficulties which were identified within the first eight weeks, resulting in earlier and more effective treatment.

He said:

"As Children of the 90s is an observational study, there is limited information available about which infants received nutritional supplements or medical treatments. Those children who showed slow weight gain later in infancy took longer to recover, because of the longer period of slow growth and because their parents were smaller and lighter too."

He added:

"Overall, parents can be reassured that well babies showing slow weight gain in the first year do eventually recover to within the normal range, but at 13-years tend to be lighter and smaller than many of their peers."

It's important to monitor and check a baby's weight progression during their first months of development. However, parents should not overly worry if their baby is well but growing at a slow rate, as they will often catch up with the national average in time.

The findings suggest that, unless urgently required, doctors shouldn't necessarily increase the calorie intake among infants too quickly as it can severely increase their risk of weight problems later in life.

Asthma Drug Treats Chronic Hives, Severe Itch

A commonly used asthma drug, omalizumab, has shown to be effective in treating chronic hives and severe, itchy rash in adolescents and adults.
The finding came from a new study published in The New England Journal of Medicine after examining the effects of a once-a-month, high-dose injection of omalizumab on 323 subjects at 55 medical centers.

The participants had previously been taking standard antihistamine therapy, however, it did not put an end to their underlying, allergy-like response, referred to as chronic spontaneous urticaria or chronic idiopathic urticaria.

Sarbjit (Romi) Saini, M.D., a Johns Hopkins allergist and immunologist, and study co-author, said:

"Physicians and patients may now have a fast, safe and well-tolerated treatment option to consider before prescribing even more antihistamines, which can be highly sedating."

The results of the report correspond with the researchers' first presentation at the American Academy of Allergy, Asthma & Immunology's yearly meeting in San Antonio, Texas.

The majority of the study participants were female and were between 12 and 75 years old. The investigation started in 2009 and lasted until 2011.

The volunteers were randomly assigned to take one of three dosing regimens of omalizumab, or placebo, and then for fourth months after, they were observed via uniform checkups.

The investigators and the subjects were both unaware of what particular dose each person was taking throughout the trial.

Chronic hives and rash affected all participants for at least 6 months, while several had the condition for over 5 years. Hives or a severe itchy rash were still a problem in all of the patients even after taking antihistamines for seven days.

Saini, an associate professor at the Johns Hopkins University School of Medicine who has studied omalizumab since 2005, explained:

"Patients suffering with this condition need more and better treatment options because chronic hives and rash are profoundly hard to treat and can be very debilitating."

The antihistamine XYZAL(R) (Levocetirizine Dihydrochloride) was approved by the U.S. FDA for chronic hives in 2011. However, fewer than 50% of the people who are treated respond to traditional drug therapies with antihistamines, according to Saini.

Omalizumab is safer than other treatments

The novel research provides considerable proof that this first injection treatment option is not only effective, but is also safer than other drugs, including corticosteroids and the immunosuppressant cyclosporine, which are associated with possible severe and toxic reactions, such as bone thinning, infection, and high blood pressure.

The most serious reaction seen with the drug omalizumab was headache. None of the volunteers died or experienced anaphylactic shock, or had to back out of the study because of negative site effects.

About 3 million people in the United States are affected by chronic idiopathic urticaria, which sometimes involves swelling. Women are two times more likely to suffer from these "socially isolating conditions" than men, Saini said.

Some patients have a hard time breathing because they develop such bad swelling of their hands, eyes, lips, face, and throat. Some people will not even leave their house during flare-ups, meaning they have to miss work.

Hives can be treated with a single, uniform dose of the drug

The American and European researchers injected a 300-milligram dose of the treatment, marketed as Xolair, once a month for 3 months.

After one week, the initial relief from symptoms occurred. Fifty-three percent of subjects experienced a complete elimination of hives after 3 months, and 44% did not develop hives or itch again afterward.

The drug was 50% as successful at lower doses (150 milligrams, 75 milligrams and 0 milligrams - placebo) as the next larger dose, or had nearly no impact at all.

Prior studies had been conducted by Saini on the test doses, which are different from those used in omalizumab therapy for treating asthma. Saini is also the director of Johns Hopkins' medical fellowship training program in allergy and clinical immunology.

Although dosing for asthma is measured by the person's weight and blood levels of IgE antibodies, which is important to allergic responses, hives can be treated with single, uniform doses of omalizumab.

How does the treatment actually work?

Exactly how omalizumab, first approved in 2003 in the U.S. as drug for treating asthma, prevents the allergy-like responses that cause severe hives and itching is still not known, the authors explained.

However, Saini explained, they are aware that omalizumab binds up free IgE flowing in the body, and reduces the number of IgE receptors on other immune system cells that carry histamine.

In an allergic response, what normally happens is that allergens, including dust particles and pollen, bind to IgE receptors that are found on these immune system cells.

A controlled, wave-like release of histamine, a crucial triggering chemical that plays a role in inflammation, results from the process.

However, since the release of histamine seems to be more spontaneous in the itchy rash of chronic hives, the scientists believe that the histamine-carrying mast cells and basophils are abnormal.

Saini is now planning to conduct more research on the impact of omalizumab on IgE, and how it plays a role in chronic hives and rash. He hopes "to understand the underlying mechanism of the disease and explain why the drug is effective."

Written by Sarah Glynn

View drug information on Xolair.

Wednesday, February 13, 2013

New Measles Cases Highest In 18 Years, England

New cases of measles have reached their highest level in 18 years in the England and Wales, many of them young adults and teenagers who were not immunized after the fraudulent 1998 MMR scare. Health authorities say that many young people and children have had to be taken to hospital.
According to the HPA (Health Protection Agency), there were 2,016 confirmed cases in England and Wales last year, the highest total for one year since 1994.

In 2012, there were prolonged outbreaks in Merseyside and Sussex, as well as several minor outbreaks among travelling communities across the country.

Eighty-seven percent of the 7,392 measles cases reported in the EU (European Union) up to the end of November 2012 came from Romania, Spain, Italy, France and the UK.

Head of immunization at the HPA, Dr Mary Ramsay, said:

"Coverage of MMR is now at historically high levels but measles is highly infectious and can spread easily among communities that are poorly vaccinated, and can affect anyone who is susceptible, including toddlers in whom vaccination has been delayed. Older children who were not vaccinated at the routine age, who may now be teenagers, are at particular risk of becoming exposed, while at school for example.

Measles continues to circulate in several European countries that are popular with holidaymakers. Measles is a highly infectious disease so the only way to prevent outbreaks is to make sure the UK has good uptake of the MMR vaccine, and that when cases are reported, immediate public health action is taken to target unvaccinated individuals in the vicinity as soon as possible."

Dr. Ramsay explained that many people are not aware that measles can strike people today, can cause severe disease and even death; they see it as a disease of the past. Parents need to make sure that their children are immunized against rubella, mumps and measles with two doses of the MMR vaccine.

UK health authorities are urging parents whose kids have not been vaccinated to see their GP (general practitioner, primary care physician) to get immunized. Unvaccinated adults should also see their doctor.

Dr. Ramsay said "If you are unsure whether you or your child has had two doses of the vaccine, speak to your GP who will have a record."

The following signs and symptoms are common in people with measles:
  • Flu-like symptoms
  • Fever
  • Photophobia (sensitivity to light)
  • Red eyes
  • Gray-white spots in the throat and mouth
  • Within a few days a red-brown spotty rash appears on the skin, which usually starts off behind the ears, makes its way around the head and neck, and then spreads to the legs and the rest of the body.

USA - 2011 saw highest number of measles cases in 15 years

In April 2012, the CDC (Centers for Disease Control and Prevention) informed that in 2011 there were more reported cases of measles in the United States than in any of the previous 15 years. Most cases involved foreigners visiting the country or Americans who became infected abroad.

However, the total, at 222 is dwarfed by the current figures coming out of the European Union. One third of all the measles cases in the USA in 2011 had to be hospitalized - however, there were no deaths from the disease that year.

The Sexual Revolution May Have Been Launched, Not By 'The Pill' But By Penicillin

The rise in risky, non-traditional sexual relations that marked the swinging '60s actually began as much as a decade earlier, during the conformist '50s, suggests an analysis recently published by the Archives of Sexual Behavior.

"It's a common assumption that the sexual revolution began with the permissive attitudes of the 1960s and the development of contraceptives like the birth control pill," notes Emory University economist Andrew Francis, who conducted the analysis. "The evidence, however, strongly indicates that the widespread use of penicillin, leading to a rapid decline in syphilis during the 1950s, is what launched the modern sexual era."

As penicillin drove down the cost of having risky sex, the population started having more of it, Francis says, comparing the phenomena to the economic law of demand: When the cost of a good falls, people buy more of the good.

"People don't generally think of sexual behavior in economic terms," he says, "but it's important to do so because sexual behavior, just like other behaviors, responds to incentives."

Syphilis reached its peak in the United States in 1939, when it killed 20,000 people. "It was the AIDS of the late 1930s and early 1940s," Francis says. "Fear of catching syphilis and dying of it loomed large."

Penicillin was discovered in 1928, but it was not put into clinical use until 1941. As World War II escalated, and sexually transmitted diseases threatened the troops overseas, penicillin was found to be an effective treatment against syphilis.

"The military wanted to rid the troops of STDs and all kinds of infections, so that they could keep fighting," Francis says. "That really sped up the development of penicillin as an antibiotic."

Right after the war, penicillin became a clinical staple for the general population as well. In the United States, syphilis went from a chronic, debilitating and potentially fatal disease to one that could be cured with a single dose of medicine.

From 1947 to 1957, the syphilis death rate fell by 75 percent and the syphilis incidence rate fell by 95 percent. "That's a huge drop in syphilis. It's essentially a collapse," Francis says.

In order to test his theory that risky sex increased as the cost of syphilis dropped, Francis analyzed data from the 1930s through the 1970s from state and federal health agencies. Some of the data was only available on paper documents, but the Centers for Disease Control and Prevention (CDC) digitized it at the request of Francis.

For his study, Francis chose three measures of sexual behavior: The illegitimate birth ratio; the teen birth share; and the incidence of gonorrhea, a highly contagious sexually transmitted disease that tends to spread quickly.

"As soon as syphilis bottoms out, in the mid- to late-1950s, you start to see dramatic increases in all three measures of risky sexual behavior," Francis says.

While many factors likely continued to fuel the sexual revolution during the 1960s and 1970s, Francis says the 1950s and the role of penicillin have been largely overlooked. "The 1950s are associated with prudish, more traditional sexual behaviors," he notes. "That may have been true for many adults, but not necessarily for young adults. It's important to recognize how reducing the fear of syphilis affected sexual behaviors."

A few physicians sounded moralistic warnings during the 1950s about the potential for penicillin to affect behavior. Spanish physician Eduardo Martinez Alonso referenced Romans 6:23, and the notion that God uses diseases to punish people, when he wrote: "The wages of sin are now negligible. One can almost sin with impunity, since the sting of sinning has been removed."

Such moralistic approaches, equating disease with sin, are counterproductive, Francis says, stressing that interventions need to focus on how individuals may respond to the cost of disease.

He found that the historical data of the syphilis epidemic parallels the contemporary AIDS epidemic. "Some studies have indicated that the development of highly active antiretroviral therapy for treating HIV may have caused some men who have sex with men to be less concerned about contracting and transmitting HIV, and more likely to engage in risky sexual behaviors," Francis says.

"Policy makers need to take into consideration behavioral responses to changes in the cost of disease, and implement strategies that are holistic and longsighted," he concludes. "To focus exclusively on the defeat of one disease can set the stage for the onset of another if preemptive measures are not taken."

Protected Sex Just As Enjoyable As Using No Protection At All

American men and women consider protected sex with condoms to be just as enjoyable and arousing as using no protection at all, according to a recent study published in The Journal of Sexual Medicine, conducted by researchers from Indiana University School of Public Health.
The researchers conducted an online questionnaire to assess the characteristics of condom and lubricant use among men and women aged 18 to 59. They were able to gather information detailing the quality of the participants' most recent sexual experience and conclude whether condoms or lubricants have any influence on their quality of sex.

Results from the 2009 National Survey of Sexual Health and Behavior indicated that men and women consider sex to be just as pleasurable and arousing regardless of whether condoms or lubricants are used, with safe sex using condoms to have the same score of quality as unprotected sex. Men admitted that using condoms or lubricant had made no big difference in their ability to have an erection.

Women were found to be a lot more unsure than men whether the condoms used in sex were lubricated or not and were also less likely to know what material the condom was made from. This highlights the need for women to become more aware of the different kinds of contraceptions available and understand them more fully in order to practice safe sex.

Dr Debby Herbenick, lead author of the study, said:

"This may be because men are more likely than women to purchase condoms and to apply condoms. However, it's important for more women to become familiar with the condoms they use with their partner so that they can make choices that enhance the safety and pleasure of their sexual experiences."

The country still faces a serious problem tackling sexually transmitted infections, HIV, and unwanted pregnancies, the researchers believe that it's imperative to understand why people buy certain products and avoid others which are related to safer or more pleasurable sex. Understanding more about the nature of current condom use can help health care providers.

Herbenick concluded:

"We need to understand how people make choices about the products they use, or avoid using, and how these products contribute to the safety and pleasurable aspects of their sexual experiences. This is particularly important as the products themselves evolve and become more mainstream in American society. We also need to understand what men and women know, or don't know, about the products they use so that we can better target public health education messages to individuals and groups."

A recent study revealed that one of the leading concerns among health professionals is the improper and misuse of condoms during intercourse. Proper use of contraception is vital in reducing the prevalence of sexually transmitted diseases and HIV.

Husbands Who Share Housework Have Less Sex

Husbands who help out with household chores have less sex than men in so-called "traditional" marriages where housework is done exclusively by the wife, researchers from the USA and Spain reported in the journal American Sociological Review.
In faithful relationships, the wife whose husband is involved in housework obviously has less sex too, the authors added.

This latest study contradicts most previous ones, which tended to imply that married men generally have more sex in exchange for doing housework. However, those studies did not take into account which chores the husbands did.

The researchers, all sociologists, said that their study demonstrated that sex is not a bargaining chip in marriage. Rather, it is associated with the kinds of chores each partner completes.

Married couples reported greater sexual frequency if the women did the cooking, cleaning and shopping and the men did the gardening, electrics and plumbing, car maintenance and paid the bills.

Co-author Julie Brines, professor of sociology at the University of Washington, said:

"The results show that gender still organizes quite a bit of everyday life in marriage. In particular, it seems that the gender identities husbands and wives express through the chores they do also help structure sexual behavior."

Lead author, Sabino Kornrich, warned that men should not assume from these findings that they should not become involved in traditionally female household tasks, such as shopping, cleaning or cooking. "Men who refuse to help around the house could increase conflict in their marriage and lower their wives' marital satisfaction."

The researchers gathered and examined data from a national survey of approximately 4,500 heterosexual married couples in the USA who took part in the National Survey of Families and Households. The survey, the largest to measure sexual frequency among married couples, included data from 1992 to 1994.

Brines does not believe that the division of household chores - which in this study did not include child care - and sex have changed much since 1994.

RIAN archive 114768 Inside the IKEA shopping center
"Traditional female tasks" include shopping, cleaning, looking after the kids, and cooking
According to the study, husbands and wives spent an average of 34 hours each week on traditionally female chores. The men's average age was 46, and the women's 44. The couples spent an extra 17 hours each week on "men's work".

On average, the males were involved in about one-fifth of traditionally female chores, and slightly more than half of male-type work. The researchers found that women tend to be more involved with helping out in traditionally male chores, than men do with female tasks.

The couples reported having sex approximately five times, on average, during the four weeks before the survey. In marriages where the woman carried out all the traditionally female tasks, the couples had sex 1.6 times as often, compared to couples where the man was involved in all the female chores.

Brines says she is not surprised that there was more sex among the traditional couples. "If anything surprised us, it was how robust the connection was between a traditional division of housework and sexual frequency." Brines is an expert in family and household dynamics.

The following possible explanations for their findings were ruled out by the researchers:
  • Male coercive behavior played no role, because women reported similar satisfaction levels in their sex lives in both types of households (traditional or "modern")
  • In two-income households, the difference in sexual frequency was still driven by male behavior regarding traditional female chores. Also, the wife's income had no impact on sexual frequency.
  • The following had no impact on sexual frequency - gender ideology, religion, and happiness in marriage.
Brines said:

"Marriage today isn't what it was 30 or 40 years ago, but there are some things that remain important. Sex and housework are still key aspects of sharing a life, and both are related to marital satisfaction and how spouses express their gender identity."

Recovery from Workload Influenced by Housework and Leisure Activity Balance

How rapidly and effectively male and female spouses recover from the burdens of work is probably influenced by a balance of housework time and leisure time, a study by experts from the University of Southern California reported in the Journal of Family Psychology.

Over half of all married couples in the USA are two-income households. The authors wondered whether the winner was the one who had the most help with the housework.

They found that what seems to be good for the male partner was bad for the female, but what is good for the female does not have enough of an impact on the male.

In another study involving 17,000 people in 28 countries, researchers from George Mason University found that married men did less housework than live-in boyfriends. The study was published in the Journal of Family Issues.

Harm Caused By Bullying, Whether Online Or Off

Children who are bullied online or by mobile phone are just as likely to skip school or consider suicide as kids who are physically bullied, according to a study led by a Michigan State University criminologist.

The findings, published in the International Criminal Justice Review, suggest parents, school officials and policymakers should consider bullying experiences both on and offline when creating anti-bullying policies and procedures.

"We should not ignore one form of bullying for the sake of the other," said Thomas Holt, associate professor of criminal justice. "The results suggest we should find ways to develop school policies to combat bullying within the school environment and then figure out how to translate that to the home, because the risk goes beyond the schoolyard."

The study is one of two new research papers from MSU scholars dealing with cyberbullying. The other study, led by Saleem Alhabash in the Department of Advertising and Public Relations, suggests positive online comments are an effective way to fight cyberbullying.

Holt and colleagues, using survey data from more than 3,000 third- through 11th-grade students in Singapore, analyzed the relationships between physical bullying, cyberbullying and mobile phone bullying on skipping school and suicidal thoughts. The study, one of the first to explore bullying in Southeast Asia, echoes research findings from the United States and Canada.

According to the study, 22 percent of students who were physically bullied skipped school or thought about skipping. By comparison, 27 percent of students who were bullied online (which includes email, blogs and chat rooms) and 28 percent who were sent bullying text messages on a mobile phone skipped school or thought about skipping.

Similarly, 22 percent of students who were physically bullied reported suicidal thoughts, while 28 percent of those who reported cyberbullying and 26 percent who were bullied via cell phone said they considered suicide.

In addition, females and younger students were more likely to consider suicide, which reflects other research findings.

Holt said parents should pay attention to warning signs of bullying such as mood changes, sadness, school failures, social withdrawal and a lack of appetite.

When it comes to cyberbullying, he said "careful supervision of youth activity online, including the use of filtering software, can help reduce the likelihood that the child is targeted by bullies via the Web."

Managing the child's mobile phone use is encouraged, Holt said, although there is evidence kids are less likely to report this type of bullying for fear of losing their phone.

"Thus," he said, "parents must carefully educate their children on the risk of bullying victimization via mobile phones and ensure that they can speak to one or both parents about negative experiences."

Women Who Carry Small-For-Gestational-Age Babies In First Pregnancy At Increased Risk For Recurrence In Second Pregnancy

In a study to be presented on February 16 between 8 a.m., and 10 a.m. PST, at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting ™, in San Francisco, researchers will report findings that suggest women whose babies are small-for-gestational-age (SGA) in their first pregnancy have a strongly increased risk for SGA in a second pregnancy.

The aim of this study was to assess and describe in detail the incidence of SGA infants and the SGA recurrence rate in general. Additionally, it sought to assess the incidence and recurrence rate of SGA in women with and without a hypertensive disorder in their first pregnancy.

Infants who are small for gestational age (birth weight below the fifth percentile) are a heterogeneous group comprised of infants that have failed to achieve their growth potential (fetal growth restriction; FGR) and infants who are constitutionally small. SGA infants are at increased risk for perinatal mortality and adverse perinatal and health outcomes later in life.

"The main strength of this study was the size and composition of the cohort," said B J Voskamp, MD. "Data were derived from a large, well-maintained, population-based national perinatal registry."

The study was performed in a prospective nationwide cohort with the use of the Netherlands Perinatal Registry (PRN). The PRN consists of population-based data that includes information on pregnancy and delivery of 96 percent of pregnancies in the Netherlands. From this, they studied a cohort of women who delivered two subsequent singleton pregnancies (first and second deliveries) in the Netherlands from Jan. 1, 1999, through Dec. 31, 2007.

The primary outcome measure was SGA. Researchers registered demographic and obstetric characteristics including maternal age, parity, ethnicity, and socioeconomic status (SES).

Cases were analyzed in total and stratified into two groups: women with and without a hypertensive disorder in their first pregnancy. The analysis was stratified by gestational age at delivery in the first pregnancy in 3 groups: very preterm, late preterm, and full-term.

After exclusions, the study population was comprised of 259,481 women (518,962 deliveries). Five percent (12,943) of the women gave birth to SGA infants in their first pregnancy, and of those same women, SGA recurred in 2996 women (23.2 percent) in the subsequent pregnancy. SGA in the second pregnancy in women who had not previously had an SGA baby occurred in 3.4 percent of the women.

Further, the risk of SGA recurrence in women with hypertensive disorder in their first pregnancy was smaller than in women who did not. However, the risk of "de novo" SGA in the second pregnancy was higher for those with hypertensive disorder than their counterparts.

Abstract 86: SGA recurrence: analysis of first and subsequent singleton pregnancies in the Netherlands, 1999-2007.

Objective: Patterns of recurrence of restricted fetal growth are important for patient counseling and adequate care in subsequent pregnancies. Our objective was to study the recurrence rate of small for gestational age (SGA) neonates.

Study Design: We performed a prospective national cohort study using the Netherlands Perinatal Registry. The study population comprised all women with a first and subsequent pregnancy between 24 + 0 and 42 + 6 weeks gestation between 1999 and 2007. Multiple gestations and fetuses with structural or chromosomal abnormalities were excluded. SGA was defined as birth weight below the 5th percentile. The Dutch reference curves for birth weight by gestational age separate for parity, sex and ethnic background were used. Cases were categorized by gestational age at delivery in the first pregnancy; very preterm (24 + 0-31 + 6wks), preterm (32 + 0-36 + 6wks) and term (37 + 0-42 + 6wks). We compared the recurrence rate of SGA in the second pregnancy in women with and without SGA in their first pregnancy. Moreover, we assessed the incidence and recurrence rate of SGA in women with and without a hypertensive disorder (HTD) in their first pregnancy.

Results: We studied 259,481 pregnant women, of which 12.943 (5.0%) had an SGA baby in their first pregnancy. The overall risk of SGA recurrence was 23% , the risk of de novo SGA in the second pregnancy was 3.4% (Odds Ratio (OR) 8.5, 95% Confidence interval (CI) 8.1-8.9). The risk of SGA recurrence in HTD women was smaller than in non-HTD women (21.0% vs 23.7%, OR 0.86, 95% CI 0.77- 0.95). However, the risk of de novo SGA in the second pregnancy was higher for HTD women than for non-HTD women (4.1% vs. 3.4% OR 1.2 95% CI 1.2-1.3).

Conclusion: Women with SGA in their first pregnancy have a strongly increased risk for SGA in subsequent pregnancies. The SGA recurrence rate is smaller for women with a HTD in their first pregnancy than for women without a HTD. The risk on de novo SGA in the second pregnancy however, is higher in the HTD group than in the non-HTD group.

Thursday, February 7, 2013

Health Risk To Tourists From Contact With Captive Sea Turtles

Tourists coming into contact with sea turtles at holiday attractions face a risk of health problems, according to research published by JRSM Short Reports. Encountering free-living sea turtles in nature is quite safe, but contact with wild-caught and captive-housed sea turtles, typically through handling turtles in confined pools or through consuming turtle products, carries the risk of exposure to toxic contaminants and to zoonotic (animal to human) pathogens such as bacteria, viruses, fungi and parasites. Symptoms, which may take some time to emerge, can resemble gastrointestinal disorders or flu but people more severely affected can suffer septicaemia, pneumonia, meningitis and acute renal failure.

The review included a case study of the Cayman Turtle Farm in Grand Cayman, which between 2007 and 2011 attracted approximately 1.2 million visitors. CTF sells farmed turtle meat to the public and local restaurants. One of the researchers, Clifford Warwick of the Emergent Disease Foundation, said: "The subsequent distribution of visitors exposed to turtle farm conditions may also involve opportunities for further dissemination of contaminants into established tourist hubs including cruise ship and airline carriers."

Warwick added that awareness of potential threats may be modest among health-care professionals and low among the public. "To prevent and control the spreading of sea turtle-related disease, greater awareness is needed among health-care professionals regarding potential pathogens and toxic contaminants from sea turtles, as well as key signs and symptoms of typical illnesses."

The study was funded by the World Society for the Protection of Animals. Warwick said: "Significantly, the captive farming of turtles arguably increases the threat to health, in particular from bacteria, due to the practice of housing many turtles in a relatively confined space and under intensive conditions."

Warwick concluded: "People should avoid food derived from sea turtles and perhaps also other relatively long-lived species regardless of their role in the food chain as all these animals potentially have more time in which to accumulate hazardous organisms and toxins and present an increased risk of animal-linked human pathology."

Mothers Who Are Affectionate, Less Controlling During Play Have Strongest Relationships With Their Children

Researchers long have evaluated the roles parents play in children's development. Now, researchers at the University of Missouri have found that mothers' directiveness, the extent to which they try to control the content and pace of young children's play, varies based on the children's ages and the mothers' ethnicities. In addition, the study found that the more directive the mothers were during play, the less engaged children were with them and the more negative emotion the children displayed toward their mothers.

"Children flourish when they have opportunities to make choices about what they do, particularly in play situations," said Jean Ispa, lead author of the study and professor of human development and family studies at MU. "Mothers who are highly directive do not allow that kind of choice. In our study, the children were playing with some toys, and the very directive mothers were making the decisions about how to play, what to play and how quickly to play."

For example, during play with her child, a highly directive mother might make her toddler put the plastic cow in the toy barn through the barn's door instead of through its window. If a child is playing with a pretend kitchen set, the mom might not let the child touch the fake burners on the stove. Mothers often think they are helping their children by correcting them, but they are limiting the children's creativity and possibly making their children enjoy being with them less, Ispa said.

"It's often noted that European-American mothers are less directive generally than African-American and Mexican-American mothers, and that's also what we found," Ispa said. "When children were only a year old, on average, African-American mothers were the most directive, Mexican-American mothers were second and European-American mothers were third. As children got older, mothers of all ethnicities displayed less directiveness."

When mothers were highly directive during playtime, children expressed less positive regard for their moms and more negative feelings toward them, Ispa said. The researchers also evaluated how affectionate the mothers were to their children and found that higher levels of warmth reduced the negative effects of directiveness.

"Even if mothers were very directive, if they were also warm, the negative effects of high directiveness lessened in every one of the ethnic groups we studied," Ispa said. "If mothers were negative or seemed critical of their kids, then the negative effects of directiveness increased."

To benefit their children's development, mothers should show affection to their children while supporting their play and being careful to limit the extent to which they dictate exactly how their children should play, Ispa said.

"We know that children, regardless of culture, need to feel loved," said Ispa. "Children take in the meaning of what their mothers are trying to do, so if a mom is being very directive and is generally a very warm person, I think the child feels, 'My mom is doing this because she cares about me, and she's trying to do the best for me.' If that warmth is missing, then the child might feel, 'My mom is trying to control me, and I don't like it.'"

Ispa and her colleagues used pre-recorded videos to analyze pairs of mothers and children interacting in play environments when the children were 1, 2, 3 and 5 years old. The mothers and children in the study all participated in the Early Head Start Research and Evaluation project, a federal study of Early Head Start, a nationwide program designed to help the cognitive, social and emotional development of children from low-income families.

Those Who Help Others Derive Significant Health Benefits Not Available To Recipients

A five-year study by researchers at three universities has established that providing tangible assistance to others protects our health and lengthens our lives.

This, after more than two decades of research failed to establish that the same benefits accrue to the recipients of such help.

Principal investigator Michael J. Poulin, PhD, assistant professor of psychology at the University at Buffalo, says, "This study offers a significant contribution to the research literature on the relationship between social environment and health, and specifically to our understanding of how giving assistance to others may offer health benefits to the giver by buffering the negative effects of stress."

Poulin, along with colleagues at Stony Brook University and Grand Valley State University, produced the study, "Giving to Others and the Association Between Stress and Mortality," which was recently posted online by the American Journal of Public Health, which will publish the study in an upcoming print issue.

The authors point out that although it is established that social isolation and stress are significant predictors of mortality and morbidity, 20 years of studies and meta-analytical review have failed to establish that receiving social support from others buffers recipients against mortality after exposure to psychosocial stress.

"As the title of our study indicates," Poulin says, "we tested the hypothesis that providing help to others would predict a reduced association between stress and mortality for the helpers. Specifically, over the five years of the study, we found that when dealing with stressful situations, those who had helped others during the previous year were less likely to die than those who had not helped others," he says.

The study's 846 subjects, all from the Detroit, Mich., area, completed baseline interviews that assessed stressful events they had experienced in the previous year and whether they had provided tangible assistance to friends or family members in the past year.

Self-reported stressful experiences included such things as serious, non-life-threating illness, burglary, job loss, financial difficulties or death of a family member.

Respondents also reported the total amount of time in the past 12 months they had spent helping friends, neighbors or relatives who did not live with them by providing transportation, doing errands and shopping, performing housework, providing child care and other tasks.

"When we adjusted for age, baseline health and functioning and key psychosocial variables," Poulin says, "the Cox proportional hazard models (the most widely used method of survival analysis) for mortality revealed a significant interaction between helping behavior, stressful events, morbidity and mortality.

"Our conclusion," he says, "is that helping others reduced mortality specifically by buffering the association between stress and mortality.

"These findings go beyond past analyses to indicate that the health benefits of helping behavior derive specifically from stress-buffering processes," Poulin says, "and provide important guidance for understanding why helping behavior specifically may promote health and, potentially, for how social processes in general may influence health."

Middle-Aged Men May Need More Protein To Maintain Muscle Mass

People tend to lose muscle mass as they age; researchers are investigating ways to delay or counteract age-related muscle loss. A study conducted by the Exercise Metabolism Research Group at McMaster University suggests that current guidelines for meat consumption are based on the protein needed to prevent deficiency without consideration for preservation of muscle mass, particularly for older individuals who are looking to maintain their muscle as they age. This research was published in the journal Applied Physiology, Nutrition, and Metabolism.

Thirty-five middle-aged men (~59 years old) participated in a study that found that eating a 6-ounce serving of 85% lean ground beef resulted in significant improvements in the rate of muscle protein synthesis following exercise. The investigators measured muscle protein synthesis (MPS), which is essential to the body's ongoing growth, repair and maintenance of skeletal muscle in men who did and did not lift weights. What researchers determined was that the quantity of beef needed for optimal MPS for this age group is double the current recommended serving size of meat.

"Canada's Food Guide now suggests that consuming about 3oz (0.80 g/kg/d) of meat per serving is adequate to provide protein at the recommended level," says Dr. Stuart Phillips, the study's senior author and a researcher with the Exercise Metabolism Research Group at McMaster University. "However, our work shows that the quantity of beef needed to maximize the renewal of new muscle proteins was at least 6oz in middle-aged men. Our findings have clear ramifications for the current recommendations regarding protein to prevent muscle loss in aging."

Vitamin D Deficiency An Increased Risk In Obesity

Obesity can lead to a lack of vitamin D circulating in the body, according to a study led by the UCL Institute of Child Health (ICH). Efforts to tackle obesity should thus also help to reduce levels of vitamin D deficiency in the population, says the lead investigator of the study, Dr Elina Hypponen.

While previous studies have linked vitamin D deficiency with obesity, the ICH-led paper, published in the journal PLOS Medicine, sought to establish the direction of causality i.e. whether a lack of vitamin D triggers a weight gain, or whether obesity leads to the deficiency.

This study, based on an ICH-led D-CarDia Collaboration, used genetic markers derived from an analysis of 21 adult cohort groups (up to 42,000 participants) to explore the link between body mass index (BMI) and genes associated with the synthesis and metabolism of vitamin D. Associations between vitamin D and BMI were further confirmed using data from another genetic consortium with over 123,000 participants.

Researchers found that a 10 per cent rise in BMI was linked to a four per cent drop in concentrations of vitamin D in the body. Overall, the findings suggest that a higher BMI leads to lower levels of available vitamin D, while the effect of a lack of vitamin D on BMI appears to be very small.

The association between obesity and vitamin D status found here was consistent between genders, being apparent both in men and in women, and in younger and older age groups.

Vitamin D, which is essential for healthy bones as well as other functions, is made in the skin after exposure to sunlight but can also be obtained through the diet and through supplements.

Obesity and vitamin D status are known to be associated, but the direction of the association and whether it is causal has been uncertain up to now. Vitamin D deficiency is a growing public health concern, and there is evidence that vitamin D metabolism, storage and action both influence and are influenced by adiposity or body fat. While experiments in rats have suggested that large doses of vitamin D2 can boost the amount of energy they burn, trials testing the effect of vitamin D supplements on weight loss in obese or overweight people have not shown any consistent findings.

It has also been suggested that obesity could result from an excessive adaptive winter response, and that the decline in vitamin D skin synthesis from less exposure to sunlight contributes to the tendency to put on weight during colder seasons. However, vitamin D is stored in fatty tissue and thus, the most likely explanation for the association found in the ICH-led study is that the larger storage capacity for vitamin D in obese people leads to lower circulating concentrations of vitamin D.

Overall, the ICH results suggest that although increases in vitamin D are not likely to help with weight regulation, increased risk of vitamin D deficiency could contribute to the adverse health effects associated with obesity.

Dr Elina Hypponen, UCL Institute of Child Health and lead author of the study, says: "Vitamin D deficiency is an active health concern around the world. While many health messages have focused on a lack of sun exposure or excessive use of suncreams, we should not forget that vitamin D deficiency is also caused by obesity."

"Our study highlights the importance of monitoring and treating vitamin D deficiency in people who are overweight or obese, in order to alleviate adverse health effects caused by a lack of vitamin D."

Purified Extracts From Green Tea And Red Wine Interrupt Alzheimer's Disease Pathway In Cells

Natural chemicals found in green tea and red wine may disrupt a key step of the Alzheimer's disease pathway, according to new research from the University of Leeds.

In early-stage laboratory experiments, the researchers identified the process which allows harmful clumps of protein to latch on to brain cells, causing them to die. They were able to interrupt this pathway using the purified extracts of EGCG from green tea and resveratrol from red wine.

The findings, published in the Journal of Biological Chemistry, offer potential new targets for developing drugs to treat Alzheimer's disease, which affects some 800,000 people in the UK alone, and for which there is currently no cure.

"This is an important step in increasing our understanding of the cause and progression of Alzheimer's disease," says lead researcher Professor Nigel Hooper of the University's Faculty of Biological Sciences. "It's a misconception that Alzheimer's is a natural part of ageing; it's a disease that we believe can ultimately be cured through finding new opportunities for drug targets like this."

Alzheimer's disease is characterised by a distinct build-up of amyloid protein in the brain, which clumps together to form toxic, sticky balls of varying shapes. These amyloid balls latch on to the surface of nerve cells in the brain by attaching to proteins on the cell surface called prions, causing the nerve cells to malfunction and eventually die.

"We wanted to investigate whether the precise shape of the amyloid balls is essential for them to attach to the prion receptors, like the way a baseball fits snugly into its glove," says co-author Dr Jo Rushworth. "And if so, we wanted to see if we could prevent the amyloid balls binding to prion by altering their shape, as this would stop the cells from dying."

The team formed amyloid balls in a test tube and added them to human and animal brain cells. Professor Hooper said: "When we added the extracts from red wine and green tea, which recent research has shown to re-shape amyloid proteins, the amyloid balls no longer harmed the nerve cells. We saw that this was because their shape was distorted, so they could no longer bind to prion and disrupt cell function.

"We also showed, for the first time, that when amyloid balls stick to prion, it triggers the production of even more amyloid, in a deadly vicious cycle," he added.

Professor Hooper says that the team's next steps are to understand exactly how the amyloid-prion interaction kills off neurons.

"I'm certain that this will increase our understanding of Alzheimer's disease even further, with the potential to reveal yet more drug targets," he said.

Dr Simon Ridley, Head of Research at Alzheimer's Research UK, the UK's leading dementia research charity, which part-funded the study, said: "Understanding the causes of Alzheimer's is vital if we are to find a way of stopping the disease in its tracks. While these early-stage results should not be a signal for people to stock up on green tea and red wine, they could provide an important new lead in the search for new and effective treatments. With half a million people affected by Alzheimer's in the UK, we urgently need treatments that can halt the disease - that means it's crucial to invest in research to take results like these from the lab bench to the clinic."

Gold Nanoparticle Created That Can Transport Powerful Radioactive Particles Directly To Tumors For Treatment

We've all heard that "it's not wise to use a cannon to kill a mosquito." But what if you could focus the cannon's power to concentrate power into a tiny space? In a new study, University of Missouri researchers have demonstrated the ability to harness powerful radioactive particles and direct them toward small cancer tumors while doing negligible damage to healthy organs and tissues. The study is being published this week in PLOS ONE, an international, peer-reviewed and open-access publication.

Typically, when radiation treatment is recommended for cancer patients, doctors are able to choose from several radiopharmaceuticals that use low-energy radiation particles, known as beta particles. For years, scientists have been studying how to use "alpha particles," which are radioactive particles that contain a large amount of energy, in cancer treatments. The challenges to using alpha particles, which are more than 7,000 times heavier than beta particles, include confining the powerful alpha particles in a designated location inside the body while preventing radiation from wandering to healthy organs and tissues.

"If you think of beta particles as slingshots or arrows, alpha particles would be similar to cannon balls," said J. David Robertson, director of research at the MU Research Reactor and professor of chemistry in the College of Arts and Science. "Scientists have had some successes using alpha particles recently, but nothing that can battle different cancers. For example, a current study using radium-223 chloride, which emits alpha particles, has been fast-tracked by the U.S. Food and Drug Administration because it has been shown to be effective in treating bone cancer. However, it only works for bone cancer because the element, radium, is attracted to the bone and stays there. We believe we have found a solution that will allow us to target alpha particles to other cancer sites in the body in an effective manner."

Robertson and researchers from Oak Ridge National Laboratory and the School of Medicine at the University of Tennessee in Knoxville used the element "actinium," which is an element known as an "alpha emitter" because it produces alpha particles. As it decays, actinium creates three additional elements that produce alpha particles. Due to the strength of these particles though, keeping the elements in place at cancer sites was not possible, until Robertson and Mark McLaughlin, MU doctoral student and co-author on the study, designed a gold-plated nanoparticle that serves as a holding cell for the elements, keeping them in place at the cancer site.

Robertson's nanoparticle is a layered device. At the core is the original element, actinium. Robertson's team then added four layers of material and then coated the nanoparticle with gold. This made the nanoparticle strong enough to hold the actinium - and the other alpha emitters that are eventually created - long enough for any alpha particles to destroy nearby cancer cells.

"Holding these alpha emitters in place is a technical challenge that researchers have been trying to overcome for 15 years," Robertson said. "With our nanoparticle design, we are able to keep more than 80 percent of the element inside the nanoparticle 24 hours after it is created."

While alpha particles are extremely powerful, they don't travel very far, so when the nanoparticles get close to cancer cells, the alpha particles move out and destroy the cell much more effectively than current radiation therapy options, Robertson said.

"Previously, basic research had established that scientists can attach antibodies onto gold nanoparticles that help drive the nanoparticles to the tumor sites in the body," Robertson said. "Without that groundbreaking work, we would not have been able to put this puzzle together."

The early-stage results of this research are promising. If additional studies are successful within the next few years, MU officials will request authority from the federal government to begin human drug development (this is commonly referred to as the "investigative new drug" status). After this status has been granted, researchers may conduct human clinical trials with the hope of developing new treatments for cancer.

Researchers Gather To Discuss Therapy Alternative For Breast Cancer

Radiation oncologists from some of the country's leading cancer centers will meet in Phoenix later this week to discuss the appropriate use of proton beam therapy in the treatment of breast cancer. Proton therapy is a highly precise form of radiation currently being used to treat a number of cancers and non-cancerous tumors.

Recent studies have reported that long-term side effects from standard radiation therapy for breast cancer can include damage to the heart and lungs, particularly in cases where the left breast is involved and radiation treatments "bathe" these vital organs. In many cases, the side effects do not emerge until 10 years or more after treatment.

Proton therapy is ionizing (high energy) radiation and has the same destructive mechanism in attacking cancer cells as X-ray radiation, but because of its precision, protons are able to provide higher doses of radiation energy to tumors without increasing rates of side effects.

"We now know that breast cancer patients treated with standard radiation have a risk of developing secondary side effects," said Dr. Eugen Hug, ProCure's chief medical officer. "That is why it is important for us as a medical community to come together and discuss new therapies and treatment options that can be equally as effective, but spare the long-term damage."

The two-day conference, to be held at The Arizona Biltmore Feb. 8-9, is being sponsored by ProCure Treatment Centers, Inc., and is drawing in over 35 researchers from around the country.

Proton therapy is most often used to treat tumors of the brain, central nervous system, head and neck, lung and prostate, as well as sarcomas and many pediatric cancers. Its precision makes it especially effective for treating children and adults with anatomically complex tumors such as base of skull and tumors along the spinal cord.

Clinical trials are currently under way to evaluate the effectiveness of proton therapy for breast cancer. Physicians at ProCure Centers in Oklahoma City, Warrenville, Ill., and Somerset, N.J., will be opening two trials within the coming months to study proton therapy for women with breast tumors who would be at a high risk for heart and lung side effects. One trial will study women with advanced breast tumors while another will study proton therapy for women with early stage tumors. Additional trials are being developed.

"Proton therapy may not be the right treatment option for everyone with breast cancer, which is why discussions like these and clinical trials are important to help physicians determine which patients can be treated most effectively with maximum long-term benefit," Hug said. "Providing patients with the best possible treatment options is our priority."

FDA Clears Sculptor Robotic Guidance Arm™ For Unicompartmental Knee Replacement Surgery

Stanmore Implants ('Stanmore'), specialists in the design and manufacture of patient specific and modular orthopaedic implants, announced today that it has received 510(k) clearance from the US Food and Drug Administration (FDA) to market its Sculptor Robotic Guidance Arm™ ("Sculptor RGA™") for precision implant placement in unicompartmental knee surgery, also known as partial knee resurfacing.

Partial knee resurfacing only replaces the parts of the knee that are worn out and painful rather than cutting away the entire joint This preservation technique retains the natural ligaments around the knee, reduces surgical damage to tissue and is less invasive compared to total knee replacement. Sculptor RGA™ utilises a robotic guidance arm to assist the surgeon's operation of a cutting tool, limiting the removal of bone to a pre-defined safe area using Stanmore's patent protected 'Active Constraint™' technology.

Stanmore's unique personalised procedural approach to surgery seamlessly integrates advanced technologies. From proprietary planning software, personalised implants are designed in-house, then manufactured and placed precisely. During surgery, bone is removed corresponding to the implant shape whilst a tracking arm determines and monitors the location of the patient ensuring that the surgeon accurately prepares the bone surface to match the implant precisely.

This new and unique approach to the treatment of osteoarthritis of the knee has been used at a number of leading centres in the UK since the first patient specific personalised knee was implanted in July 2011 and builds upon the earlier clinical work undertaken using the Active Constraint™ technology featured in the Sculptor RGA™ device. Active Constraint™ technology has been shown to provide better functional outcome at 7 year follow up for partial knee surgery compared to the saws and jigs currently used in most knee surgery procedures, which are prone to a much higher degree of placement error.

The Sculptor RGA™ will be introduced in the United States for unicompartmental knee surgery in a limited release to a select group of surgeons from mid-2013, as Stanmore continues its evidence based approach to new product introduction. The Company is also developing additional applications for Sculptor RGA™ with the goal of broader commercialisation next year.

Brian Steer, Executive Chairman of Stanmore, said:

"Following this FDA clearance for Sculptor RGA™ we are excited by the opportunity to bring our personalised approach to knee surgery to patients in the United States. Robotic technology represents a major advance in orthopaedics, providing accurate placement that is critical to implant longevity and reproducibility along with tangible cost benefits, making access to robotic surgery more widely available to patients. Stanmore is now looking forward to working further with surgeons to continue to develop innovative solutions for the global orthopaedic market."

I Will If You Will: What Motivates Spouses To Get Fit, Manage Illness

Before spouses take their first step toward fitness, their partner's interest or willingness to participate can sway them, says a Purdue University family studies expert.

"Marriage commitments focus on a couple's devotion in either a state of sickness or in health, but it's also about the in between - a person's readiness to change for better health," says Melissa M. Franks, an assistant professor of human development and family studies. "Married people are likely to engage in similar health behaviors and, in general, a married person's lifestyle choices can directly and indirectly influence their partners. So what happens, when one just person is ready to change?"

Franks, who studies marriage and chronic illness management, says people often focus on the action: what a person is doing to lose weight or get fit. But, she says, it's also important to consider whether individuals are thinking about change and how spouses influence each other in early stages of change.

"If I'm trying to change, and you are not with me, that may affect my process and ability to change," says Franks who has studied married couples with Type 2 diabetes and spouses who participate in worksite wellness programs. "Our research suggests that partners realize one other's willingness to make a change - even if they haven't talked about it with their spouse. The other's position affects their confidence to change."

Franks says there are some patterns based on gender. For example, in one of her studies, a husband feels less confident about losing weight if his wife is not as ready to lose weight. But, the husbands' confidence about getting more exercise was not associated with what their wives were thinking.

"However, a husband's readiness to change was associated more consistently with his wife's confidence," says Franks, who also is affiliated with Purdue's Center on Aging and the Life Course and Regenstrief Center for Healthcare Engineering. "Women tend to be the family's gatekeeper on health issues, so we speculate that women may be more aware if the husband is ready to make changes."

Written by Amy Patterson Neubert

Drinkers Can Underestimate Alcohol Habits, UK

Some people could be underestimating their alcohol intake by as much as 40 per cent, according to new figures the Department of Health published today.

The snapshot into the nation's drinking habits come as this year's Change4life TV ad campaign is launched to raise awareness of the health harms caused by regularly drinking over the guidelines.

The recent Health Survey for England highlighted underestimations in both the amount and frequency that people drink, raising major concerns about the nation's knowledge of alcohol.

The campaign, which calls on people to check their intake using an online Drinks Checker tool, shows how simple changes can save both money and reduce calories.

Research shows across the country 80 per cent of those that drink too much acknowledge the health risks but think of themselves at most as moderate drinkers. More than 60 per cent of these drinkers have no intention of cutting down.

To get a picture of drinking habits, the Change4Life team asked 19 individuals to keep a detailed drinks diary for two weeks. The findings show those that took part were drinking on average the equivalent of an extra large glass of wine each day, or 40 per cent more that they thought.

After keeping a drinks diary for a week, people were offered simple tips on cutting down and as a result, they:
  • cut their alcohol consumption by over a third;
  • saved around £33.35 a week - or over £1,730 a year; and
  • consumed 1,658 fewer calories a week an average of 236 calories a day - around 10 per cent of the average person's daily intake and the equivalent to 125ml (a small wine glass) of cream per day.
Participants also said that cutting down improved their physical and emotional wellbeing. And those involved also reported that adding more mixer to drinks and substituting alcoholic drinks with soft drinks were the most popular tips to include in their lifestyle.

Other tips for cutting down included having booze-free days if they drink every day, not drinking at home before going out, swapping to low-alcohol or alcohol-free drinks and simply using smaller glasses.

Chief Medical Officer Professor Dame Sally Davies said:

"I understand that people enjoy having a glass of wine or beer to unwind at the end of a busy day - but these drinks stack up and can increase your risk of high blood pressure, cancer or liver disease.

"The alcohol guidelines recommend that men should not regularly drink more than three to four units a day and women should not regularly drink more than two to three units a day.

"The Change4Life campaign aims to help and encourage people to check how much they are drinking using the Drinks Checker app or online and if they find they are drinking over the guidelines, provide helpful tips and advice to cut down.

"Cutting back your drinking can reduce your health risks, reduce your calorie intake, help you sleep better and boost your energy. To find out more I strongly recommend people to search Change4Life."