Saturday, 28 September 2013

An antidepressant drug may used for LC’s; that FDA approved

Researchers have discovered a class of FDA-approved antidepressants that may prove effective in treating patients with small-cell lung cancer – one of the deadliest forms of the disease.

Small-cell lung cancer (SLC) comprises 15 percent of all lung cancers and has a particularly grim prognosis rate.  

“SLC is a bad cancer to have,” Dr. Atul Butte, the study’s lead author of the Stanford University School of Medicine. “The five-year survival is only 5 to 6 percent, and most people present with extensive stage cancer.”

The disease is a form of cancer known as neuroendocrine cancer – the same type of cancer that Steve Jobs was diagnosed with –  for which few targeted treatments are available.

Rather than developing new drugs to treat diseases like SLC, Butte and his colleagues have long been interested in the concept of identifying already FDA-approved drugs that might be repurposed to treat new disorders. With this purpose in mind, Butte’s laboratory developed a computer algorithm able to identify drugs that target genes associated with certain diseases – and match them with one another.

“Basically, a report in the past called for drugs,” Butte said.

Using this computerized discovery pipeline, the researchers began to explore whether any existing drugs might prove effective at killing SLC cells.  

“What we started with was looking at experiments where people submitted normal tissue and SLC tissue from the same patients,” Butte said. “We (identify) the gene that is most different in the cancerous cells and then find a drug to reverse that effect.”

Eventually, researchers hit upon a drug called imipramine, which is part of a class of FDA-approved drugs known as tricyclic antidepressants. When researchers exposed SLC-infected tissues to imipramine, the cancerous cells appeared to die off. Researchers tested the drug with success in both a lab setting and using mice genetically engineered to develop small-cell lung cancer.

While tricyclic antidepressants are still on the market, they’ve been overshadowed by the popularity of newer classes of antidepressants, including selective-serotonin reuptake inhibitors (SSRIs), like Prozac, which have been proven to have fewer side effects.

“But not so long ago (tricyclic antidepressants) were commonly used,” Butte said. “They do have side effects, the biggest is on the heart, like arrhythmia… that being said these drugs are still in the pharmacy and you can get them.”

Because these drugs are already FDA-approved, researchers were able to start recruiting patients for phase 2 clinical trials within 15 to 20 months of their discovery.

“Usually it takes $4 billion and 10 plus years to get a brand new drug to market,” Butte said. “This could be a shortcut – finding a drug that works and borrowing it for other disease. We don’t know yet if the trial will work or not but its amazing it will get to trial so quickly.”

However, Butte warns that just because the drug is already on the market, doesn’t mean that patients should attempt to self-medicate.

“We would strongly encourage them to join a trial and get this kind of medication in a research setting, making sure they’re following safety guidelines for this category,” Butte said.


Friday, 27 September 2013

BNST Circuit@ that controls over-eating behavior in the brain, a study says

When a particular circuit in the brain is stimulated, it causes mice to voraciously gorge on food even though they are well fed, and deactivating this circuit keeps starving mice from eating, a new study shows.

The findings suggest that a breakdown within this neural network could contribute to unhealthy eating behaviors, the researchers said, although more work is needed to see whether the findings are also true of people.

The circuit lies in a brain area called the "bed nucleus of the stria terminalis" (BNST), and affects eating by inhibiting activity in another region, called the lateral hypothalamus, which is known to control eating, according to the study, published Sept. 26 in the journal Science.

"Normally, there's a population of neurons in the lateral hypothalamus that's putting the brakes on eating," said study researcher Garret Stuber, a neuroscientist at the University of North Carolina at Chapel Hill. "But when you shut those cells down by stimulating this pathway, that releases the brake, and the animal starts to eat."

The lateral hypothalamus has been known for more than 50 years to be an important part of the brain for controlling eating. Scientists had learned that putting stimulating electrodes in the lateral hypothalamus of animals would influence their eating behavior, but exactly how it works has been a mystery.

"Nobody had a good mechanistic explanation for what's actually being stimulated or activated within this brain structure," Stuber said.

In the new study, the researchers focused on examining how the BNST influences activity in the lateral hypothalamus.

To manipulate the BNST neurons, the researchers used a technique called optogenetics that allowed them to activate specific neurons using light. They found that, upon activation, BNST neurons suppressed activity in the lateral hypothalamus, and caused the well-fed mice to immediately start eating.

"When we stimulate the pathway, the animals eat a third to 50 percent of the calories they eat in a normal day, in about 20 minutes," Stuber said. For a person, that would probably be the equivalent of eating lunch and dinner in one sitting, he said.

What's more, the researchers gave the animals a choice in some of the experiments between regular food and a tasty food with a high fat content, analogous to junk food. They found that when they activated the circuit, the animals showed a strong preference for the junk food.

Conversely, deactivating the circuit caused the animals to immediately stop eating, even if their stomachs were empty.

The BNST is thought to be a hub that integrates emotionally relevant information coming from several parts of the brain. Although the experiments didn't aim to study the link between emotional states and feeding behavior, the findings may explain how emotions can influence eating, Stuber said.

"BNST is really important for affective behavior state in response to emotionally relevant stimuli, and the results show the output of those cells can actually directly modulate feeding behavior," he said.

Identifying a neural circuit that controls feeding, and understanding how the cells in this circuit work, could lead to future treatments for such conditions as obesity, the researchers said.

"Now that we know this is a critical circuit for feeding, we can start looking at this in humans," Stuber said.


Thursday, 26 September 2013

Women were less risk factors than men; for heart disease, why?

Women tend to develop heart disease about 10 years later than men, and new research suggests this is partly due to women's bodies being better at compensating for insensitivity to insulin, which controls blood sugar.

The study found that among people with insensitivity to insulin, women were less likely than men to have risk factors for heart disease and diabetes, such as high blood pressure and triglycerides. This, in turn, could delay the onset of heart disease, the researchers said.

The findings were published today (Sept. 24) in the Journal of Clinical Endocrinology and Metabolism.

Blood sugar

After eating carbohydrates, blood sugar rises. The pancreas produces insulin, a hormone that tells the body's cells to take up glucose from the bloodstream, thereby lowering blood sugar back to normal.

But some people's bodies are insulin-resistant, meaning their cells require a much higher amount of insulin to take up glucose from the blood.

When people develop insulin resistance, initially their blood sugar levels may remain normal, but over time, their bodies can no longer produce enough insulin to keep blood sugar levels in a healthy range.

At this point, people may develop metabolic syndrome, a group of five risk factors including high blood sugar, triglycerides and blood pressure, low levels of good cholesterol and a large waist. Metabolic syndrome can be a precursor to diabetes and heart disease.

Protective effect

Dr. Sun Kim, an endocrinologist at Stanford University Medical School, and her colleagues wanted to understand the factors that affected this process. They asked 468 women and 354 men to fast overnight.

Afterward, they injected the participants with glucose, insulin and a hormone that prevents the body from producing its own insulin, and then measured the participants' blood sugar a few hours later. The test allowed them to measure the exact relationship between insulin levels and blood sugar.

Women under 50 with insulin resistance, meaning they had high blood sugar after a meal, somehow avoided the risk factors associated with metabolic syndrome and heart diseaseBut as women aged, that advantage disappeared, and older women who were insulin-resistant had the same heart disease risk factors as men.

"Younger women, when they are resistant, are able to handle the complications a lot better," Kim said.

Still, it's not clear why younger women have some protection against heart disease. One possibility is that the hormones that affect the menstrual cycle play a role.

But the role of female hormones isn't clear-cut: For instance, giving women synthetic versions of hormones such as estrogen doesn't have the effects seen in the study, Kim said.

Either way, there are things that insulin-resistant people can do to avoid the onset of Type 2 diabetes and heart disease.

"The two lifestyle things that are closely associated with insulin resistance are gaining weight, and being sedentary," Kim told. Exercising and losing weight are the best ways to reverse insulin resistance, she said.


Wednesday, 25 September 2013

Aware; Medical devices are harmed by hackers, new statements says

In an episode of the television series "Homeland," a terrorist organization assassinates the vice president of the United States by wirelessly hacking into his pacemaker. Although the scenario was fictional, the underlying premise is not.

Life-saving medical devices abound in today's world, and many of these devices are connected wirelessly to hospital networks, making them vulnerable to cyberattacks. For example, a malicious person could hack into a pacemaker, causing the device to apply lethal electrical stimulation, or an insulin pump, causing it to deliver a deadly dose of the hormone.

"Just like any other piece of Internet technology, medical devices are susceptible to the same cyberthreats you hear about all the time on the news," said Russel Jones, a partner at the consulting firm Deloitte, which released a report on Sept. 23 on the subject of cybersecurity in medical devices.

As more and more medical devices go online, device manufacturers and health care organizations will need to address security issues to keep patients and their health information safe. 

So far, there have been no known incidents of a hacked medical device injuring or killing a person, but researchers have demonstrated that these events are possible "with the right level of skill and understanding," Jones said.

In the Deloitte study, consultants interviewed representatives from nine health care organizations, in areas spanning from information technology to clinical engineering. The participants answered questions about the regulation, risk management and security of networked medical devices.

The majority of organizations surveyed felt their organizations had strategies and frameworks for managing cybersecurity risks. However, there were differences in the degree of preparedness and approaches for handling cyberthreats.

One way to protect information sent to or from a medical device is to encrypt it. The problem is, encryption takes up valuable processing time on the device. The challenge, Jones said, is to develop encryption that addresses cyberrisk without impacting the functionality of the device.

In June, the U.S. Food and Drug Administration (FDA) released draft guidance for cybersecurity concerns. The FDA's previous guidance from 2005 was pretty vague, but the new draft lays out specific concerns that must be addressed when applying for FDA approval for new devices.

Ensuring cybersecurity in medical devices will require collaboration, Jones said. "This is going to be a problem that's jointly solved by health care systems, providers, device manufacturers and the FDA," he said.


Tuesday, 24 September 2013

Doc’s should warn about chemicals; health expert says

Two top reproductive health organizations have taken on the controversial subject of chemicals in the environment, saying the federal government isn’t doing enough to keep people safe.

They say chemicals might cause a range of problems, from birth defects to diabetes, but also say there isn’t enough research to show which ones are the most dangerous.

But other experts say the joint statement from the American College of Obstetricians and Gynecologists (ACOG) and the American Society of Reproductive Medicine (ASRM) is too broad, and that it will probably needlessly scare pregnant women without offering much useful new advice.

“The real goal is to raise awareness, increase the education of health care professionals -- physicians, nurses, office staff -- and patients who are either pregnant or are thinking of getting pregnant with regard to some of the environmental threats,” said Dr. Jeanne Conry, president of ACOG.

“There is a backdrop of disease processes that have increased in the past 30-40 years. In that backdrop we have seen an increase in the release of chemicals into the environment.”

The statement, published in the journals Fertility and Sterility, calls for doctors to help patients reduce their exposure to chemicals. “Reducing exposure to toxic environmental agents is a critical area of intervention for obstetricians, gynecologists, and other reproductive health care professionals,” it reads.

The problem, says Dr. Janet DiPietro, associate dean of research at Johns Hopkins University, is that what they can do isn’t always very clear. “What is your average OB going to say?” asked DiPietro, a reproductive health expert who was not involved in writing the statement.

It’s true that pregnant women have chemicals circulating in their bodies, say DiPietro and other experts. Studies have shown that chemicals such as DDT are in virtually every human being’s body.

“There is very little that a provider can tell women to do or that women can avoid, from a practical perspective,” DiPietro said in a telephone interview. “We have relatively little data on either the fetal effects or long-term developmental effects,” she added.

“So you tell a woman, ‘OK you have DDT in your system. It may have come from your mother. It may have come from your environment when you were a kid.’ But what are you going to do about it?”

Some of the chemicals mentioned in the ACOG/ASRM statement have been clearly shown to be harmful -- mercury and lead, for instance. But the evidence about some of the others, such as bisphenol A (BPA) and a large group of chemicals called phthalates, is less clear. The Food and Drug Administration says BPA, for instance, is safe, even if it does get into food.

The FDA stopped allowing the use of BPA in baby bottles and sippy cups, but only after manufacturers of those products stopped using it voluntarily.

Tracey Woodruff, director of the Program on Reproductive Health and the Environment at the University of California, San Francisco, -- who played a role in developing the statement -- says agencies like the FDA should do more.

“The problem with the regulatory agencies is they are not keeping up with the science,” Woodruff said in a telephone interview.

But she agreed it could be difficult to tell people to avoid chemicals without knowing whether the alternatives are any safer. “This issue about alternatives are a real challenge. Maybe you choose another plastic water bottle. Maybe it is BPA-free but we don’t know what’s in another plastic water bottle,” Woodruff said.

But she said government agencies should ask these questions. “You know why we don’t know? It is because the government doesn’t have the power to require the testing.”

Scientists working to test the safety of chemicals say it is very hard to determine if a specific chemical is harmful because people have so many circulating in their bodies. Is it the chemical that is harmful, or something else that causes it to build up in the body? And other factors, such as obesity and a lack of exercise, may play a bigger role in reducing fertility in both men and women, studies suggest.

Dr. Linda Giudice, president of ASRM, says there is good evidence in many areas. “I think a really good example is cigarette smoking,” she said. Women who smoke are more likely to have dangerously small babies, she said. “Women who smoke actually have almost two times the need for services, medical therapy, for achieving pregnancy,” Giudice added.

And she defended the need to talk to patients about chemicals whose threats are not yet clearly established. “If it is biologically plausible and we have a way to minimize exposures, I think that is an important contribution,” Giudice said. “We don’t want everyone being afraid to go outside or to use their personal care products or to walk outside and breathe the air. But it is important that if it is a very polluted day that one may choose to stay indoors.”

“I think they make it sound like the knowledge base is clearer than it is,” counters DiPietro. “I tell pregnant women you should be issued a pair of earmuffs to wear. We know we are all living in a chemical brew and what about it?”


Monday, 23 September 2013

How comes consciousness to Patients?; during the surgery even given enough anesthesia

With anesthetics properly given, very few patients wake up during surgery. However, new findings point to the possibility of a state of mind in which a patient is neither fully conscious nor unconscious, experts say.

This possible third state of consciousness may be a state in which patients can respond to a command, but are not disturbed by pain or the surgery, according to Dr. Jaideep Pandit, anesthetist at St John's College in England, who discussed the idea Thursday at The Annual Congress of the Association of Anaesthetists of Great Britain and Ireland.

Pandit dubbed this state dysanaesthesia, and said the evidence that it exists comes partly from a recent study, in which 34 surgical patients were anesthetized, and had their whole body paralyzed except for their forearm, allowing them to move their fingers in response to commands or to signify if they are awake or in pain during surgery.

One-third of patients in the study moved their finger if they were asked to, even though they were under what seemed to be adequate anesthesia, according to the study led by Dr. Ian F. Russell of Hull Royal Infirmary in England and published Sept. 12 in the journal Anaesthesia.

"What's more remarkable is that they only move their fingers if they are asked. None of the patients spontaneously responded to the surgery. They are presumably not in pain," said Pandit, who wrote an editorial about the study.

Normally, while patients are under anesthesia, doctors continuously monitor them, and administer anesthetic drugs as needed. The goal is to ensure the patient has received adequate medication to remain deeply unconscious during surgery. However, it is debated how reliable the technologies used during surgery to "measure" unconsciousness are.

"We don't have a model for consciousness," Pandit said. "It is very difficult to design a monitor, to monitor something you don't have a model for.

The study of 34 patients was aimed at investigating whether patients are fully unconscious when the monitoring technology commonly used in the operating rooms indicates so. The researchers kept patients' arms separated from rest of the body, which was receiving routine paralyzing drugs, by blocking the blood supply. Patients were able to move their arm if they were still conscious.

In the patients who responded to the doctor's command by moving their hand, the doctors took it as a sign of consciousness, and increased the anesthetic dose.

However, Pandit argues these patients were not "conscious." The fact that patients only responded to command, and didn't move spontaneously, shows their state of mind is different from normal consciousness, he said.

The idea of a third state of consciousness may explain the discrepancies in the reported prevalence of awareness during surgery, Pandit said. Previous surveys have shown that when patients are asked if they recalled being aware during surgery, about 1 in 500 will say they did. In contrast, a recent national survey in the United Kingdom, in which patients were not directly asked about awareness during surgery, 1 in 15,000 patients spontaneously reported they were aware during their surgery. Only 1 in 45,000 reported pain or distress during their surgery.

Together, these statistics suggest there's a state in which patients are aware but not reporting it, perhaps because it is an acceptable and neutral experience for them, Pandit said. They may be aware of their surroundings to some extent, but not concerned by this knowledge, especially because they are not in pain.
Pandit's hypothesis may serve as basis for developing anesthesia monitors in the future, he said. Although the state of dysanaesthesia seems harmless, it could be a precursor to unpleasant awareness during surgery that doctors, and patients, wish to avoid.

"It's a hypothesis for future research, it's something that we can explore further and design experiment to see if it really exist," he said.


Friday, 20 September 2013

Warning! A weight loss drug linked to cataract development

The risk of developing cloudy lenses in the eyes may be linked to the use of cholesterol-lowering drugs known as statins, according to a new study.

While the researchers can't prove the drugs caused the eye condition, they found that people who took statins - such as Zocor and Lipitor - were about 27 percent more likely to develop cataracts, compared to people who didn't take the medication.

"The results were consistent that there was a higher risk of being diagnosed with cataracts among statin users," Dr. Ishak Mansi, the study's senior author from UT Southwestern Medical Center and the Dallas VA Medical Center in Texas, said.

Statins are popular drugs that block a substance the body needs to make cholesterol, which can get trapped in arteries and ultimately lead to heart attacks and strokes.

About one-quarter of U.S. adults aged 45 and older take statins. The drugs are especially recommended for people with diabetes or a history of cardiovascular problems.

Researchers have looked at the link between statins and cataracts before with mixed results. While some studies found that taking statins lowered the risk of developing cataracts, other studies found the drugs increased the risk.

For the new research, Mansi and his colleagues used data collected from the medical records of people between the ages of 30 and 85 years old who were enrolled in one healthcare system in San Antonio, Texas, and received care between 2003 and 2005.

In one analysis, they compared about 7,000 people who were on statins for at least 90 days to about 7,000 people who were not on statins but were similar in about 40 other characteristics, including other health conditions, medications and healthcare use.

About 36 percent of statin users were diagnosed with cataracts, compared to about 34 percent of people not taking statins.

In a second analysis, the researchers looked at people with no other known health conditions. It included 6,113 statin users and 27,400 people who did not take statins.

After adjusting the results for the participants' age, sex, weight, medications, healthcare use, other vision conditions and cigarette, alcohol and drug use, the researchers found about 34 percent of statin users were diagnosed with cataracts, compared to about 10 percent of people not taking statins.

What's more, the researchers found that the risk of developing cataracts increased with the length of time a person took the medication.

While Mansi and his colleagues can't say how statins may affect the formation of cataracts, they write in JAMA Ophthalmology that there are a few possible explanations.

One is that the body needs high levels of cholesterol to maintain a clear lens and statins may interfere with the cells that control that process.

Dr. Jack Cioffi, head of ophthalmology at Columbia University Medical Center in New York, said the study is very well done, but has some limitations, including that the researchers used billing data rather than medical records, so they can't say how severe the cataracts were.

"I don't think we should overstate the significance of this. It goes back to if there is a good reason for you to be on that statin, it outweighs the risk of a mild increase in risk of cataract," Cioffi, who was not involved in the new study, said.

He added that the treatments for cataracts have evolved over time. The National Institutes of Health says the procedures to remove cataracts are some of the most common and safest surgeries performed in the U.S.

"For patients themselves, my advice is to discuss what your benefit and risk ratio is for you with your doctor," said Mansi, who added that he hopes the results will also encourage people to improve their cholesterol levels through lifestyle changes.

"This should motivate patients to do their part. Quit smoking, eat healthy and be active so doctors don't have to give you a tablet that may have some side effects," he said.


Thursday, 19 September 2013

Five essential oils; that become make better from injury

Essential oils, containing potent medicinal and cosmetic properties, are a versatile part of a natural medicine cabinet. They work to support the body’s own healing system, and when used correctly, may be able to take the place of conventional over-the-counter remedies.

Essential oils have a very small molecular size, which means that their healing properties are easily absorbed by the skin, but should not be ingested. The potency ensures that only a few drops are needed at a time, so a small bottle can last a few years when used sparingly. Most have a shelf life of five to 10 years with the exception of citrus oils, which lose their potency after about two years.

When purchasing essential oils, keep in mind that they are not the same as fragrance oils, which are synthetic and may not be safe to use on the skin; essential oils are always natural.

Many oils also need to be diluted with a “carrier oil” which serves as a base to add a few drops of essential oils to. Some good carrier oils are sweet almond, sesame and coconut oil.

Always use a carrier oil when using essential oils on babies and children since their skin is much more sensitive to the effects, and to be safe, all essential oils should be avoided during the first trimester of pregnancy. And always check with your doctor before using essential oils on yourself or your children.

Here are five essential oils that are great for beginners since they have few contraindications and can be used for a variety of different ailments.

Lavender is the most well known of the essential oils, and for good reason. It has antiviral and antibacterial properties, which can reduce the healing time for scrapes, bites and stings. It doesn’t require a carrier oil, and can be put directly onto the affected area. Lavender has also been shown to promote relaxation and sleep. Try adding a few drops to the bath, or on your pillow to help you unwind and fall asleep.

Peppermint is a wonderful cooling oil that can help you beat the heat of a hot day or a fever. Just add a few drops to a carrier oil and rub on your back, neck and chest for an instant cooling effect. The smell of peppermint can also help combat feelings of nausea making it a great choice for motion or morning sickness. When combined with a few drops of lavender oil and applied to the temples, it can also reduce the intensity of headaches and migraines. As a bonus, peppermint can also help get rid of an insect invasion without the use of harsh chemicals; simply add a few drops to hot water and wipe the surfaces with a peppermint-infused cloth.

Eucalyptus is a powerful antispasmodic, antiviral and antibacterial oil that is ideal for coughs and colds. Adding a few drops to a basin of steaming water to inhale, or a vaporizer, can help disinfect and clear both the nasal passages and lungs. Some eucalyptus on a handkerchief is a handy way to inhale the powerful oil throughout the day, and regular use during cold season may help prevent a full cold.

Tea tree oil is a powerful antibacterial, antifungal and antiseptic oil. Just a few drops mixed with a carrier oil is all you need to help treat cuts, scrapes, fungal infections, insect bites, warts and even dandruff. It can also be used as a powerful acne treatment when mixed with coconut oil or aloe vera gel.  Adding some to a vaporizer will also help loosen chest congestion. Tea tree oil is so powerful that mixing two teaspoons of oil in two cups of water will give you a safe, natural, all-purpose cleaner.

Roman chamomile has a beautiful, mild scent that is known for its ability to help unwind, but it is also a powerful anti-inflammatory. It is the ideal choice for red, inflamed or sensitive, acne-prone skin. It is much gentler than tea tree oil, so this bactericide is a good choice for delicate skin and can even be used with an antibacterial carrier oil such as coconut oil to help treat diaper rash and soothe eczema.

Once you become familiar with these basic essential oils, branching out and creating your own combinations is simple and fun. They can easily be incorporated into your daily life, whether it is as a home remedy or even just aromatherapy to boost your mood.

Always check for contraindications, especially during pregnancy or a condition requiring medical treatment.


@MX2 gene is the new way of HIV treatments

Scientists have identified a gene which they say may have the ability to prevent HIV, the virus that causes AIDS, from spreading after it enters the body.

In an early-stage study in the journal Nature, researchers said the gene, called MX2, appears to play a key role in how HIV is controlled in human cells, so using it could lead to the development of new, less toxic treatments that harness the body's natural defenses and mobilize them against the virus.

Although there are many more years of research ahead, Mike Malim, who co-led the research at King's College London, described the finding as "extremely exciting" and said it advanced scientists' understanding of how the HIV virus interacts with the immune system.

"Until now we knew very little about the MX2 gene, but now we recognize both its potent anti-viral function and a key point of vulnerability in the life cycle of HIV," he said in a statement about the study, published on Wednesday.

Some 34 million people worldwide are infected with the human immunodeficiency virus (HIV) that causes AIDS - the vast majority of them in poor and developing countries.

But while, particularly in wealthy nations, there are many effective drugs available that allow HIV patients to live long, healthy lives, they often have side-effects and drug resistance can become a problem with long-term use.

In this study, Malim and a team of researchers conducted experiments on human cells in the laboratory, introducing the HIV virus to two different cell lines - one in which the MX2 gene was "switched on", and in the other it which is was "silenced" - and then observing the effects.

They found that in the cells where MX2 was silenced, the AIDS virus replicated and spread, while in the cells where it was switched on, the HIV was unable to replicate and produce new viruses to spread.

Malim said the findings suggest MX2 is a key player in establishing viral control in people with HIV, and that armed with this new knowledge, there are two possible routes for potential drug development using the gene.
"It may be possible to develop either a molecule that mimics the role of MX2 or a drug which activates the gene's natural capabilities," he said.

News Published by Caribbean Medical Schools

Tuesday, 17 September 2013

Overuse of antibiotics; resistant infections (CDC report: says)

The prevalence of antibiotic-resistant infections is increasing rapidly in the United States, according to a report released by the Centers for Disease Control and Prevention on Monday.

More than two million people in the U.S. get drug-resistant infections annually. About 23,000 die from these diseases that are becoming increasingly resistant to antibiotics in doctors' arsenals.

"It is not too late," CDC director Dr. Tom Frieden said to during a press conference. "If we're not careful, the medicine chest will be empty when we go there to look for a lifesaving antibiotic for someone with a deadly infection. If we act now, we can preserve these medications while we continue to work on lifesaving medications."

World Health Organization (WHO) Director-General Dr. Margaret Chan said in March 2012 that the overuse of antibiotics was becoming so common that she feared we may come to a day where any normal infection could become deadly because bacteria have evolved to survive our treatments.

The new report noted that antibiotic resistance costs $20 billion in excess health care costs in the U.S. each year, with costs to society for lost productivity reaching as much as an additional $35 billion.

The CDC estimated in April that enough antibiotics are prescribed each year for four out of five Americans to be taking them. Doctors and other health care providers prescribed 258 million courses of antibiotics in 2010 for a population a little less than 309 million. They also estimated in this current report that up to 50 percent of antibiotics are prescribed incorrectly or to people who do not need them.

Pediatricians have also urged doctors to avoid giving antibiotics unless it is absolutely necessary, especially for ear infections and sinusitis.

This is the first time the CDC has released statistics on which germs were most harmful. The antibiotic-resistant germs were designated either as urgent, serious or concerning. Researchers came up with the categories depending on how the germs impacted a person's health, the economic impact of the germ, how common the infection was, a 10-year projection of how dangerous the infection could become, how easily the germ spreads, how many antibiotics were available to treat it and how easy it infections can be prevented.

Carbapenem-resistant Enterobacteriaceae (CRE), drug-resistant gonorrhea and Clostridium difficile (C. diff), a serious infection typically caused by antibiotic use were all designated as urgent infections.

CRE infections are caused by a family of 70 bacteria that normally live in the digestive system. They are extremely resistant to even the strongest kinds of antibiotics, and can kill one out of every two patients who develop bloodstream infections caused by them. Thirty-eight states reported at least one case of CRE last year, up from just one state a decade ago.

The CDC previously said in February that drug-resistant gonorrhea was on the rise, especially among men who have sex with men (MSM) living in the western U.S.

Though C. diff infections typically happen to older adults in hospitals or long-term care facilities after use of antibiotics, the Mayo Clinic reports that studies have shown that cases among people who are younger and healthier without having a history of antibiotic use or being near healthcare facilities are going up. The CDC report pointed out that C. diff causes about 250,000 hospitalizations and at least 14,000 deaths every year in the United States.

"We're getting closer and closer to the cliff," Dr. Michael Bell, deputy director of CDC's Division of Healthcare Quality Promotion, told reporters Monday.

Frieden said that the most acute source of antibiotic-resistant germs are hospitals, and urged facilities to take charge to prevent unnecessary illnesses. Antimicrobial stewardship programs, which measure and promote the correct use of antibiotics, have been shown to lower antibiotic-resistant infections in different facilities by as much as 80 percent.

"Every time antibiotics are used in any setting, bacteria evolve by developing resistance. This process can happen with alarming speed," Dr. Steve Solomon, director of CDC's Office of Antimicrobial Resistance, said in a press release.

Frieden added that simple measures like making sure doctors wash their hands and checking that IVs and catheters -- which are major sources of infection -- only stay in as long as necessary can help reduce infection rates. He also pointed out that the CDC is encouraging hospitals to be transparent with their infection rates, and many websites now host that information for potential patients.

Bell added it is important that patients or family members are comfortable enough to ask questions if they feel something might be amiss.

The CDC also noted that some reports have shown that widespread use of antibiotics in food production have caused many resistant infections. The agency pointed out that the FDA has been pushing for responsible use of antimicrobials,and is telling producers to cut down on using the antibiotics for growth promotion in animals.

"We support appropriate antibiotic use," Bell said. "But, across the board there is always going to be bleedover in the environment and the ecosystem."


Monday, 16 September 2013

# 7 Ways to Expand; Your Memory Power

I used to have a memory that amazed people, but in the last few years I've had trouble remembering names and movie titles. ("You know, the one about the guy who goes somewhere? It won that award...") I hope to have many years of sharp thinking ahead of me—I'm in my mid-40s, nowhere near senior-moments territory—so I got to wondering: Is there something I should be doing now to counteract the lapses that already seem to be taking place?

There's no way around the fact that memory erodes as we get older. The hippocampus, the area of your brain responsible for building memory, loses 5 percent of its nerve cells with each passing decade. Plus, aging slows production of acetylcholine, a neurotransmitter vital to learning and memory. Based on these facts, scientists once believed that a person's mental ability peaked early in adulthood, then went downhill from there. But over the last few decades, research has found that adults' brains are still able to form new, memory-building neural networks in a process known as neuroplasticity. The reassuring latest thinking: With a little effort, anyone can boost their power of recollection.

To test this theory in the real world, I tried an array of research-backed brain-sharpening techniques over one six-week period. Am I now able to list all 44 U.S. presidents? No. But can I more easily summon up where I put my keys? Yes. And I think being able to leave my apartment and lock the door is a more valuable life skill than remembering James K. Polk. Here's what worked for me—and what fell flat.

Technique #1: Play brain games

Puzzles like Sudoku and crosswords may improve memory and delay brain decline, though experts are not yet sure why. "My guess is that playing them activates synapses in the whole brain, including the memory areas," says Marcel Danesi, PhD, author of Extreme Brain Workout. Research so far is decidedly mixed: Some studies have found that, while doing crossword puzzles may make you better at remembering the capital of Burkina Faso, there's little evidence they'll boost your performance at more general tasks, like remembering where your car is parked. But a 2011 study showed that participants who played a computer game called Double Decision for six years improved their concentration so much that they had a 50 percent lower rate of car accidents.

The main problem: You have to play the games every day, forever, to keep up the benefits. I've mostly kept up. (Except on weekends. Or if I've had a busy week. OK, I haven't kept up.) 

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Technique #2: Eat the right foods

According to Gary Small, MD, director of the UCLA Memory Clinic, memory super foods include antioxidant-rich, colorful fruits and vegetables, which protect your brain from harmful free radicals. He's also enthusiastic about low-glycemic carbs, like oatmeal, and anything with omega-3 fatty acids. In fact, a recent study published in Neurology found that people with low levels of omega-3s had brains that appeared to be a full two years older in MRI scans. That was incentive enough for me to follow the memory-enhancing diet from Dr. Small's book The Memory Prescription, which claims it works in just two weeks. Much like the Mediterranean diet, it's heavy on produce, legumes, nuts and fish. It's low on meat, since meat's omega-6 fatty acids may contribute to brain inflammation, a possible underlying mechanism for Alzheimer's.

Related: 25 Signs and Symptoms of Alzheimer’s Disease

Refined sugars produce a similar effect, so they were also out. (That was the toughest for me.) I ate a farmers market's worth of blueberries, spinach, avocado and beets, and consumed enough fish to sprout gills. I also went beyond Dr. Small's advice and took 2.4 micrograms of vitamin B12, the standard recommended daily amount—since studies show people with low levels perform poorly on memory tests—and 1,000 international units of vitamin D, discovered by Tufts University researchers to boost cognitive function. (My doctor signed off on the supplements.)

My grade: A It was difficult to eat meat only once a week, until I noticed how much less physically and mentally sluggish I felt. And my memory became markedly sharper over 14 days. (For instance, I quit using a bookmark because I could remember the page number I'd stopped on the night before.) Planning those meals took a lot of prep, but it paid off tremendously. I still try to use the diet as a guideline: I eat meat once a week, aim for five fruits and vegetables a day and pop omega-3 supplements (since I don't get as much fish as I did on the diet).

Technique #3: Quit multitasking

"One reason people can't remember where their keys are is they're not paying attention when they put them down," says Mark McDaniel, PhD, a psychology professor and memory researcher at Washington University in St. Louis. (His suggestion for always finding them: "When you put them down, stop and say out loud, 'I'm leaving my keys on my dresser,'" or wherever you're placing them.) Studies show that it takes eight seconds to fully commit a piece of information to memory, so concentrating on the task at hand is crucial. I willed myself to stop giving everything "continuous partial attention," a term coined by tech honcho Linda Stone. I put away my gadgets when they weren't absolutely needed.

Technique #4: Master a new skill

A recent Swedish study found that adults who learned a new language showed improved memory for people's names, among other things. Any activity that is practiced diligently, such as knitting or skiing, will likely have this effect, researchers say. I vowed to learn to play the keyboard. On YouTube I found PlayPianoKing, an affable guy who teaches everything from Pachelbel's Canon to "Gangnam Style."

My grade: C- While I did learn a mean "Gangnam" and felt my concentration improve, I soon gave up: With brain games and a diet overhaul crowding my schedule, the hour-long, every-other-day lesson was making me cranky, even before I saw any noticeable memory gains.

Technique #5: Get more sleep

Researchers at the University of Pennsylvania have discovered that losing half a night's rest—three or four hours—on just one evening can erode memory. And the journal Nature Neuroscience recently reported that one way to slow decline in aging adults is to improve the length and quality of sleep. During a deep sleep of eight hours or more, it's believed that the brain shifts memories from temporary to longer-term storage. Yet according to the Centers for Disease Control and Prevention, one third of us get less than seven hours a night—including me.

So, for more than a month, I implemented a stringent schedule: I would put my preschooler to bed and take a bath. Then I'd hit my own bed with a book, rather than watch TV or movies, which several studies reveal will make you feel too keyed up to wind down. Normally I fall asleep at 11:30 p.m. and wake at 5:45 a.m., but the new routine put me out by 10.

My grade: A+ Nothing had a better effect on my memory than that long stretch of sleep. I was able to semi-credibly measure the difference because I started my other interventions a few weeks before this one. I bounded out of bed fully recharged. My mind became as focused as a laser beam; I even remembered every mom's name during the school run (no more "Hey, you!" or just "Hi!").

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Technique #6: Use mnemonic devices

These are basically memory tools that give meaning and organization to a random group of words or concepts. They could be an acronym (BOG for "Buy oranges and grapes"), an exaggerated visualization (imagining a massive stethoscope to remember a doctor's appointment) or a rhyme (to recall a co-worker's name, I'd remember, "Ted has a giant forehead"). Memory champions also love chunking, or breaking a large amount of information into more manageable nuggets.

My grade: A+ I found these tactics enormously helpful. I usually forget my poor nephew's birthday, but this year I actually sent a gift, thanks to the unpleasant but memorable NITS ("Nephew is 10 Sunday").

Technique #7: Hit the gym

Researchers from the University of California at Irvine recently discovered that a little exercise might yield big mental benefits. They had one group of subjects ride stationary bikes for six minutes, while another group cooled their heels. Afterward, the active group performed significantly better on a memory test. Instant results! The researchers believe the boost may be tied to an exercise-induced brain chemical called norepinephrine, which has a strong influence on memory. And Dr. Small contends that exercise is the best memory aid of all. "It can increase your brain size," he says—and the bigger your brain, the greater your capacity to remember. His recommendation: 20 minutes of brisk walking a day.

Get started with this Slim and Strong Walking Workout.

I began doing an hour daily—more than Dr. Small recommends, but also more consistent than the gym workouts a few times a week I used to favor, and, according to many experts, more effective in juicing up memory.

My grade: A- This moderate, regular activity worked wonders on my stress levels, and it became much easier to concentrate afterward, so I could fix things (like a grocery list) into my memory. I grew addicted to my walks and still take them. In fact, I found that the memory-boosting healthy lifestyle habits—exercising more, stressing less, eating a better diet —were the most sustainable over time. And that's a win-win.

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