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Nov 30
A woman's heart attack risk may begin before she's born
A woman's risk of having a heart attack may begin to rise even before she is born, a new study suggests, and the findings may help researchers better understand the nature of heart disease in women.

The study found women's risk of having a heart attack increased more than eight times if they had changes in certain genes; these changes were previously found to be brought on by stress experienced in the womb, such as not getting enough nutrients.

"Health really starts in the womb," said study researcher Bas Heijmans, a molecular epidemiologist at Leiden University Medical Center in The Netherlands.

The findings support the idea that conditions during early life, such as the habits of a mother during pregnancy, influence her baby's risk of later developing heart disease, Heijmans said. Ultimately, the researchers would like to find genetic "signatures " that can tell the tale of someone's early life, such as an exposure to alcohol or cigarette smoke. Those signatures could then be used as markers for the persons' risk of disease later in life, Heijmans said.

The findings are published in the Nov. 17 in the International Journal of Epidemiology.

DNA in early life
The study involved 1,654 participants ages 70 to 82 who hadn't had a heart attack before the study's start. After three years, 122 people had suffered a heart attack. The researchers compared the DNA of these individuals to that of 126 participants who had not experienced a heart attack, but were similar in age and other characteristics.

The researchers looked for changes, called epigenetic changes, in six genes known to be influenced by the in utero environment. During such a change, a chemical "tag" is added to a section of DNA.

They found epigenetic changes in two of the genes were associated with an increased risk of heart attack. Women with a tag on one gene were 2.8 times more likely to have a heart attack, and women with a tag on both genes were 8.6 times more likely to have a heart attack, compared with women who didn't have these changes.

However, more work is needed to validate the results. The new study was conducted in adults, so the researchers don't know exactly what experiences the participants had during the prenatal period.

Men and women
No association between changes in the genes and heart attack risk was found for men. The researchers aren't sure why this is,but it could be that men tend to have heart attacks at earlier ages than the participants included in the study, masking the effect of the gene changes in the study group, Heijmans said.

Because the study was small, these estimates of increased risk for women should be interpreted with caution, Heijmans said. Larger studies that included a wider range of age groups are needed to determine more accurate risk estimates, Heijmans said.

Nov 29
Indian Organ Donation Day marked at AIIMS
Eleven years have elapsed since she received a heart from a 14-year-old boy, but the memory still brings tears to Priti Unhale's eyes. The charitable act made the difference between life and death, and she thanks the anonymous soul every day.

In November 2000, Unhale's condition was diagnosed as dilated cardiomyopathy (a heart condition). She was beset with fear, as a donor was hard to come by. "The doctors told me I had just had six months to find a donor. Every day seemed like a struggle as my family went from one hospital to another. Back then, the systems were not streamlined and I was rather lucky to find a donor," said Unhale.

Though things are not the same, the organ donation has vastly improved her quality of life. "Although I'll have to take medicines all my life, my condition is much better now," she added. Unhale is now a counsellor and helps All India Institute of Medical Sciences (AIIMS) in promoting organ donations. She says she is one of the lucky ones to have received the organ she needed. Her thoughts were echoed by the doctors during a public lecture at AIIMS on the Indian Organ Donation Day 2011.

The data presented by doctors showed a yawning gap between the demand and supply of organs. The first heart transplant in India was back in 1994 but the trend has not picked up. To date, only 30 transplants have taken place against a demand of 50,000 a year. Kidney transplant is quite common, but only 20,952 people have received a kidney between 1972 and 2011.

"In India, the demand outstrips availability of the organs. This can be attributed to lack of public awareness and difficulty in retrieving the organs," said Dr D Bhowmik, additional professor (nephrology) at AIIMS. "In fact, we occasionally come across patients who refuse to accept organs. This is most common in heart transplantation," added Dr Bhowmik.

Doctors say fewer donations are also because of religious beliefs and the lack of infrastructure. "Donors are aplenty; what poses problems is lack of awareness. So many road accidents take place every year in the country. If even 50% of the victims are able to donate their organs, there will be a no shortage. We also need to bring together religious gurus and leaders, and spread the message that no religion bars one from donating organs," said Dr. RK Sharma, director and head department (nephrology) at AIIMS.

Not just doctors, but even families of organ donors exhorted Delhiites to come forward and donate. "It is important to understand that your loved one can gift life to someone. People should not hesitate in taking this opportunity to save a life," said Yogesh Tanwar, brother of donor Manish Tanwar.

In ideal circumstances, the organs retrieved from one person can benefit 11 people: six people from two corneas, two people from two kidneys, and one each from a heart, liver and pancreas. To facilitate organs donations the government of India had formed the 'National Organ Transplant Programme'. It is under this programme that AIIMS organized the second Indian Organ Donation Day on Monday.

Nov 28
Diabetes Drug Shows Promise in Reducing Risk of Cancer, Study Suggests
An inexpensive drug that treats Type-2 diabetes has been shown to prevent a number of natural and human-made chemicals from stimulating the growth of breast cancer cells, according to a newly published study by a Michigan State University researcher.

The research, led by pediatrics professor James Trosko and colleagues from South Korea's Seoul National University, provides biological evidence for previously reported epidemiological surveys that long-term use of the drug metformin for Type-2 diabetes reduces the risk of diabetes-associated cancers, such as breast cancers.

The research appears in the current edition of PLoS One.

"People with Type-2 diabetes are known to be at high risk for several diabetes-associated cancers, such as breast, liver and pancreatic cancers," said Trosko, a professor in the College of Human Medicine's Department of Pediatrics and Human Development. "While metformin has been shown in population studies to reduce the risk of these cancers, there was no evidence of how it worked."

For the study, Trosko and colleagues focused on the concept that cancers originate from adult human stem cells and that there are many natural and human-made chemicals that enhance the growth of breast cancer cells.

Using culture dishes, they grew miniature human breast tumors, or mammospheres, that activated a certain stem cell gene (Oct4A). Then the mammospheres were exposed to natural estrogen -- a known growth factor and potential breast tumor promoter -- and human-made chemicals that are known to promote tumors or disrupt the endocrine system.

The team found that estrogen and the chemicals caused the mammospheres to increase in numbers and size. However, with metformin added, the numbers and size of the mammospheres were dramatically reduced. While each of the chemicals enhanced growth by different means, metformin seemed to be able to inhibit their stimulated growth in all cases.

"While future studies are needed to understand the exact mechanism by which metformin works to reduce the growth of breast cancers, this study reveals the need to determine if the drug might be used as a preventive drug and for individuals who have no indication of any existing cancers," he said.

"Though we still do not know the exact molecular mechanism by which it works, metformin seems to dramatically affect how estrogen and endocrine-disrupting chemicals cause the pre-existing breast cancers to grow."

In addition, further research needs to be done with human cultures to see if metformin can reduce the risk of pancreatic and liver cancers in Type-2 diabetics as well, he said.

Nov 26
Shakespeare to help solve the mind-body mystery
Shakespeare was a master at portraying profound emotional upset in the physical symptoms of his characters, and many modern day doctors would do well to study the Bard to better understand the mind-body connection, a researcher says.

Kenneth Heaton, a medical doctor and extensively published author on William Shakespeare's oeuvre, systematically analysed 42 of the author's major works and 46 of those of his contemporaries, looking for evidence of psychosomatic symptoms.

He focused on sensory symptoms other than those relating to sight, taste, the heart, and the gut and found that Shakespeare's portrayal of symptoms such as dizziness and blunted or heightened sensitivity to touch and pain in characters expressing profound emotions was significantly more common than in works by other authors of the time.

"Many doctors are reluctant to attribute physical symptoms to emotional disturbance, and this results in delayed diagnosis, overinvestigation, and inappropriate treatment," Heaton said.

"They could learn to be better doctors by studying Shakespeare. This is important because the so-called functional symptoms are the leading cause of general practitioner visits and of referrals to specialists," he said.

Vertigo, also known as giddiness or dizziness, is expressed by five male characters in 'Taming of the Shrew', 'Romeo and Juliet', 'Henry VI' part 1, 'Cymbeline' and 'Troilus and Cressida'.

The nearest approximation in the work of contemporaries was one incident in John Marston's 'The Malcontent'.

There are at least 11 instances of breathlessness associated with extreme emotion in 'Two Gentlemen of Verona', 'The Rape of Lucrece', 'Venus and Adonis', and 'Troilus and Cressida' as compared with just two in the works of other writers.

Fatigue as a result of grief or distress is a familiar sensation among Shakespeare's characters, most notably in 'Hamlet', 'The Merchant of Venice', 'As You Like It', 'Richard II' and 'Henry IV' part 2.

Disturbed hearing at a time of high emotion occurs in 'King Lear', 'Richard II' and 'King John' while blunted/exaggerated senses are portrayed in 'Much Ado about Nothing', 'Venus and Adonis', 'King Lear', 'Love's Labour's Lost' and 'Coriolanus'.

"Shakespeare's perception that numbness and enhanced sensation can have a psychological origin seems not to have been shared by his contemporaries, none of whom included such phenomena in the works examined," Heaton said.

The Bard also uses coldness and faintness to convey shock, like in 'Romeo and Juliet', 'Titus Andronicus', 'Julius Caesar', 'Love's Labour's Lost', and 'Richard III', significantly more frequently than other writers of the period.

Heaton concludes that his data show that Shakespeare "was an exceptionally body-conscious writer", suggesting that the technique was used to make his characters seem more human and engender greater empathy or raise the emotional temperature of his plays and poems.

Nov 25
New sign of too much stress: Sleep-texting
Day-to-day stress has triggered an unusual habit of sleep texting - where people text messages even while sleeping, according to researchers.

People with this peculiar condition send incoherent messages while asleep to their friends and family - completely unaware of doing it, said researcher Frank Thorne, the Daily Mail reported .

"Patients reported incidents of sleep texting - were advised to leave their mobile phones outside the bedroom, it is one of those things that happen, but it is very rare, and certainly not a common trend," said sleep specialist David Cunnington. He described sleep texting as the result of having too much to do during daytime.

"People are doing so much during a normal day that it makes them feel like they're on call even at night," he explained . "It's so easy to receive emails constantly and get notifications from smartphones, that it becomes difficult for us to separate our waking and sleeping time," he added.

According to him, people struggling to get a quality night's sleep should keep their phones's out of the bedroom.

"If your phone is on the nightstand, then it will be more difficult to have a good night's sleep without feeling compelled to reply to a message or check your Facebook account," he said.

"The key point is that people need to respect their sleep, and make an effort to switch off at night," he added.

Sleep-texting reportedly seems to be the latest fad among today's youth, with increasing numbers of cell phone users text messaging friends while asleep.

Sleep experts said the phenomenon was a natural extension of the younger generation's reliance on modern technology. But they disagree on whether it is possible to send a text while technically being asleep.

Nov 24
Weight loss could be early warning sign of Alzheimer's
People in the earliest stages of Alzheimer's disease are more likely to have a lower body mass index (BMI) than those who did not have the condition, according to a new study.

Previous studies have shown that people who are overweight in middle age are more likely to develop Alzheimer's disease decades later than people at normal weight.

The study examined 506 people with advanced brain imaging techniques and analyses of cerebrospinal fluid to look for biomarkers for Alzheimer's disease, which can be present years before the first symptoms begin.

The study found that in people with no memory or thinking problems and in people with mild cognitive impairment, those who had the Alzheimer's biomarkers were also more likely to have a lower BMI than those who did not have the biomarkers.

For example, 85 percent of the people with mild cognitive impairment who had a BMI below 25 had signs of the beta-amyloid plaques in their brains that are a hallmark of the disease, compared to 48 percent of those with mild cognitive impairment who were overweight.

The relationship was also found in people with no memory or thinking problems.

"These results suggest Alzheimer's disease brain changes are associated with systemic metabolic changes in the very earliest phases of the disease," said study author Jeffrey M. Burns, MD, MS, of the University of Kansas School of Medicine in Kansas City.

"This might be due to damage in the area of the brain called the hypothalamus that plays a role in regulating energy metabolism and food intake.

"Further studies should investigate whether this relationship reflects a systemic response to an unrecognised disease or a long-standing trait that predisposes a person to developing the disease," he added.

The findings have been published in the November 22, 2011, print issue of Neurology, the medical journal of the American Academy of Neurology.

Nov 23
Little overdose of Paracetamol can kill you: Study
Little overdose of paracetamol taken repeatedly over some time can put a person at the risk of dying. The risk is greater in case of a multiple overdose than in a single overdose, a new study says.

Such people do not come to the hospital reporting overdose but because they feel unwell. According to the study, these people need to be identified and treated at the earliest.

The study has been carried out by scientists from the University of Edinburgh and the Scottish Liver Transplantation Unit, Scotland. The results appeared in the British Journal of Clinical Pharmacology on Tuesday.

This kind of overdose or staggered overdose can occur when people have pain and repeatedly take a little more paracetamol than they should, scientists said.

"They haven't taken the sort of single-moment, one-off massive overdoses taken by people who try to commit suicide, but over time the damage builds up, and the effect can be fatal," Dr Kenneth Simpson, the scientist who led the study, said.

Doctors normally assess danger to a patient by testing how much paracetamol is present in the blood. In the cases of single overdose, the blood sample gives valuable information, but people with staggered overdoses may have low levels of paracetamol in their blood even though they are at a high risk of liver failure and death, scientists said.

The team analysed data from 663 patients who had been admitted to a hospital between 1992 and 2008 with paracetamolinduced liver injury. They found that 161 had taken a staggered overdose, usually to relieve common pains such as abdominal or muscular pains, headache and toothache.

"On admission, staggered overdose patients were more likely to have liver and brain problems, require kidney dialysis or help with breathing and were at a greater risk of dying than people who had taken single overdoses," Simpson said.

The outcome for people coming to a hospital more than a day later taking a single overdose was also bad and they were also at a high risk of dying or needing a liver transplant, the scientists said.

"Staggered overdoses or patients presenting themselves late after an overdose need to be closely monitored and considered for the paracetamol antidote, N-acetylcysteine, irrespective of the concentration of paracetamol in their blood," Simpson said.

Since measuring paracetamol in the blood is a poor assessment for a patient's status in cases of staggered overdoses or delayed presentation, doctors must find new ways of assessing whether a patient can be sent home, need medical treatment to counteract the paracetamol, or need to be considered for a liver transplant.

Nov 23
Encephalitis death toll rises to 585 in UP
Gorakhpur: With five more children succumbing to encephalitis in eastern Uttar Pradesh, the death toll in the viral disease has climbed to 585 this year, a senior health official said on Wednesday.

Five children suffering from the disease died in the BRD Medical College hospital here yesterday, Additional Director (Health) Diwakar Prasad said.

As many as 175 encephalitis patients are undergoing treatment in BRD and other hospitals in the region, he said.

Nov 22
Why we forget things midway
If you forget what you were going to do, or get, or find, after entering a room, then blame your doorways. University of Notre Dame Psychology Professor Gabriel Radvansky has suggested that passing through doorways is the cause of these memory lapses.

"Entering or exiting through a doorway serves as an 'event boundary' in the mind, which separates episodes of activity and files them away," Radvansky explained.

kid"Recalling the decision or activity that was made in a different room is difficult because it has been compartmentalized," she stated.

Conducting three experiments in both real and virtual environments, Radvansky's subjects - all college students - performed memory tasks while crossing a room and while exiting a doorway.

In the first experiment, subjects used a virtual environment and moved from one room to another, selecting an object on a table and exchanging it for an object at a different table. They did the same thing while simply moving across a room but not crossing through a doorway.

Radvansky found that the subjects forgot more after walking through a doorway compared to moving the same distance across a room, suggesting that the doorway or "event boundary" impedes one's ability to retrieve thoughts or decisions made in a different room.

The study was published recently in the Quarterly Journal of Experimental Psychology.

Nov 22
Progress achieved in world AIDS treatment
Global AIDS deaths and new HIV infections have each dropped 21 percent since the peak of the AIDS pandemic in 1997, according to a UN report released Monday.

One major factor responsible for the result is that life-saving HIV treatments have become more popular and got to 1.35 million more people in 2010 than in 2009.

In middle-income and underdeveloped nations, these treatments have saved 2.5 million lives since 1995.

"We have seen a massive scale-up in access to HIV treatment, which has had a dramatic effect on the lives of people everywhere," said Michel Sidibe, executive director of the U.N. AIDS program.

However, 53 percent of people who need HIV/AIDS treatments -- about 7.6 million people -- cannot get them, which accounted for 1.8 million AIDS deaths in 2010.

There are now 34 million people living with HIV. And just in last year there were 2.7 million new infections.

The decline in deaths and new infections means the AIDS pandemic is at a turning point, the UNAIDS report argues, adding smart investment can save millions of future deaths.

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