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Jun 13
Changes in gut bacteria may trigger rheumatoid arthritis
Researchers including one of an Indian origin have found that the billions of bugs in our guts regulate the immune system and related autoimmune diseases such as rheumatoid arthritis.

Larger-than-normal populations of specific gut bacteria may trigger the development of diseases like rheumatoid arthritis and possibly fuel disease progression in people genetically predisposed to this crippling and confounding condition, say the scientists, at Mayo Clinic and the University of Illinois at Urbana-Champaign.

"A lot of people suspected that gut flora played a role in rheumatoid arthritis, but no one had been able to prove it because they couldn't say which came first - the bacteria or the genes," says senior author Veena Taneja, Ph.D., a Mayo Clinic immunologist.

"Using genomic sequencing technologies, we have been able to show the gut microbiome may be used as a biomarker for predisposition," she said.

The roughly 10 trillion cells that make up the human body have neighbors: mostly bacteria that often help, training the immune system and aiding in digestion, for example.

The bacteria in the intestines, in addition to a relatively small number of other microorganisms (the gut microbiome), outnumber human cells 10-to-1.

Researchers found that hormones and changes related to aging may further modulate the gut immune system and exacerbate inflammatory conditions in genetically susceptible individuals.

Nearly 1 percent of the world's population has rheumatoid arthritis, a disease in which the immune system attacks tissues, inflaming joints and sometimes leading to deadly complications such as heart disease.

Other diseases with suspected gut bacterial ties include type I diabetes and multiple sclerosis.

Researchers with the Mayo Illinois Alliance for Technology Based Healthcare say that identifying new biomarkers in intestinal microbial populations and maintaining a balance in gut bacteria could help physicians stop rheumatoid arthritis before it starts.

"This study is an important advance in our understanding of the immune system disturbances associated with rheumatoid arthritis. While we do not yet know what the causes of this disease are, this study provides important insights into the immune system and its relationship to bacteria of the gut, and how these factors may affect people with genetic susceptibilities to disease," Eric Matteson, M.D., chairman of rheumatology at Mayo Clinic, who was not a study author, said.

Dr. Taneja and her team genetically engineered mice with the human gene HLA-DRB1*0401, a strong indicator of predisposition to rheumatoid arthritis.

A set of control mice were engineered with a different variant of the DRB1 gene, known to promote resistance to rheumatoid arthritis.

Researchers used these mice to compare their immune responses to different bacteria and the effect on rheumatoid arthritis.

"The gut is the largest immune organ in the body," co-author Bryan White, Ph.D., director of the University of Illinois' Microbiome Program in the Division of Biomedical Sciences and a member of the Institute for Genomic Biology, said.

"Because it's presented with multiple insults daily through the introduction of new bacteria, food sources and foreign antigens, the gut is continually teasing out what's good and bad," White said.

The gut has several ways to do this, including the mucosal barrier that prevents organisms - even commensal or "good" bacteria - from crossing the lumen of the gut into the human body.

However, when commensal bacteria breach this barrier, they can trigger autoimmune responses.

The body recognizes them as out of place, and in some way this triggers the body to attack itself, he says.

These mice mimic human gender trends in rheumatoid arthritis, in that females were about three times as likely to generate autoimmune responses and contract the disease.

Researchers believe these "humanized" mice could shed light on why women and other demographic groups are more vulnerable to autoimmune disorders and help guide development of new future therapies.

"The next step for us is to show if bugs in the gut can be manipulated to change the course of disease," Dr. Taneja says.

The study was recently published in PloS ONE.

Jun 12
Aspirin before heart surgery cuts risk of post-operative kidney failure
Aspirin taken for five days before a heart operation can halve the numbers of patients developing post-operative acute kidney failure, a new research has revealed.

In a study of 3,219 patients, pre-operative aspirin therapy was associated with a reduction in acute renal failure of about three in every 100 patients undergoing coronary artery bypass graft (CABG), valve surgery or both, said Professor Jianzhong Sun (MD, PhD), professor and attending anaesthesiologist at Jefferson Medical College, Thomas Jefferson University (Philadelphia, USA).

The patients were divided into two groups: those taking aspirin within five days before their operation (2,247 patients) and those not taking it (972 patients) [1]. Although the researchers had no record of the precise dose taken, doses of between 80-325mg per day is the normal dose for aspirin that is taken over a period of time.

After adjusting their results for various differing characteristics such as age, disease, and other medications, the researchers found that pre-operative aspirin was associated with a significant decrease in the incidence of post-operative kidney failure: acute renal failure occurred in 86 out of 2247 patients taking aspirin, and in 65 out of 972 patients not taking it. This represented an approximate halving in the risk of acute renal failure.

"Thus, the results of this clinical study showed that pre-operative therapy with aspirin is associated with preventing about an extra three cases of acute renal failure per 100 patients undergoing CABG or/and valve surgery," Prof Sun said.

Acute renal failure or injury is a common post-operative complication and has a significant impact on the survival of patients undergoing heart surgery.

"It significantly increases hospital stay, the incidence of other complications and mortality," said Prof Sun.

"From previous reports, up to 30 percent of patients who undergo cardiac surgery develop acute renal failure. In our studies, about 16-40 percent of cardiac surgery patients developed it in various degrees, depending upon how their kidneys were functioning before the operation. Despite intensive studies we don't understand yet why kidney failure can develop after cardiac surgery, but possible mechanisms could involve inflammatory and neurohormonal factors, reduced blood supply, reperfusion injury, kidney toxicity and/or their combinations.

He continued: "For many years, aspirin as an anti-platelet and anti-inflammatory agent has been one of the major medicines in prevention and treatment of cardiovascular disease in non-surgical settings. Now its applications have spread to surgical fields, including cardiac surgery, and further, to non-cardiovascular diseases, such as the prevention of cancer. Looking back and ahead, I believe we can say that aspirin is really a wonder drug, and its wide applications and multiple benefits are truly beyond what we could expect and certainly worthy of further studies both in bench and bedside research.

Prof Sun said that more observational and randomised controlled clinical trials were required to investigate the role played by aspirin in preventing post-operative kidney failure, but he believed that the effect might also be seen in patients undergoing non-cardiac surgeries.

"For instance, the PeriOperative ISchemic Evaluation-2 trial (POISE-2) [2] is ongoing and aims to test whether small doses of aspirin, given individually for a short period before and after major non-cardiac surgeries, could prevent major cardiovascular complications such as heart attacks and death, around the time of surgery," he noted.

Other findings from Prof Sun's research showed that diabetes, high blood pressure, heart disease, heart failure, and diseases of the vascular system were all independent risk factors for post-operative acute kidney failure.

The research was presented at the European Anaesthesiology Congress in Paris.

Jun 12
Big breasts may be bad for your health, author says
Are women's breasts getting too big?

That's what one author is saying in a new book Breasts: A Natural and Unnatural History, Medical Daily reported. According to her research, author Florence Williams found that the average bra size for women in the U.S. has increased from 34 B to 36 C a trend that Williams says isn't as good as it sounds.

Williams outlines numerous unpleasant reasons that may be contributing to expanding bra sizes, such as women's expanding waistlines a factor that has been linked with increased risk of breast cancer.

Another culprit behind growing cups is early onset puberty, another precursor for breast cancer, Medical Daily said. According to a 2010 study in Pediatrics, 15 percent of American girls start to get breast tissue when they're only seven years old.

Once a woman develops large breasts, she's put at a greater risk of pollution exposure. Bigger breasts have a much higher concentration of fatty tissue, and according to Medical Daily, the body stores toxic chemicals in its fat cells. This means big breasts could be storing dangerous compounds such as mercury or chemicals found in pesticides and paints.

To make matters worse, the more these chemicals are stored in the breast tissue, the more likely they are to be transferred into

Jun 11
Fish medicine for asthma patients
A stampede took place in Hyderabad at the venue of annual 'fish medicine' event yesterday. One person died and over 20 others including women were injured in the stampede as thousands of people rushed for fish 'prasadam' (fish medicine for asthma patients) at the annual distribution at Katedan stadium. A 70-year-old man died of a heart attack as scores of people had queued up to collect the medicine-that is believed to cure asthma. The stampede occurred when the venue's gates were opened to the public.

Over two lakh persons from different parts of the country were already administered the medicine at the event, which is organised by the Bathini Mrigasira Trust that provides the free medicine claimed to cure asthma, an official said. The stampede occurred as thousands of people rushed for fish medicine for asthma patients at the annual distribution at Katedan stadium.
"Additional counters have been opened and things are now put in order with queue being maintained," the official said.

However, several persons complained that no proper arrangements were made at the distribution site. The distribution that began yesterday morning would go on non-stop for 48 hours even as district authorities had arranged for 60,000 fingerlings for the event. The venue of the fish 'prasadam' event was organised at Nampally exihibition grounds every year, but was shifted to Katedan this year.

Jun 11
Alzheimer's jab: New vaccine could cure 50% of cases
A vaccine which could cut the number of Alzheimer's cases in half has passed its first human trials.

The jab could delay the onset of what is the most common form of dementia by five years and be the first step to a cure.

Scientists in Sweden tested the vaccine called CAD106 on patients aged 50 to 80 over a three-year period.

In three out of four cases it increased the levels of antibodies in their blood, suggesting the vaccine had boosted their immune system.

And those taking part had no serious side-effects.

Authors of the study in the journal Lancet Neurology called it a "promising option in the treatment of people suffering from mild-to-moderate Alzheimer's disease".

Commenting on the research, Thomas Wisniewski, of the New York School of Medicine, said: "Development of immunotherapy that can delay the onset of Alzheimer's disease by five years would reduce the prevalence of the disease by half."

Alzheimer's attacks nerves, brain cells and neurotransmitters which carry messages to and from the brain.

Currently more than 650,000 suffer from the disease in Britain alone.

Dr Simon Ridley, of Alzheimer's Research UK said: "This trial is an important first step.

"Larger scale trials of CAD106 will determine whether it can help people's memory and thinking skills.

"It's likely any new treatment will be most effective when given in the early stages of the disease."

Jun 09
Trying to Quit Smoking? Try Eating More Fruits and Vegetables
If you're trying to quit smoking, eating more fruits and vegetables may help you quit and stay tobacco-free for longer, according to a new study published online by University at Buffalo public health researchers.

The paper, in the journal Nicotine and Tobacco Research, is the first longitudinal study on the relationship between fruit and vegetable consumption and smoking cessation.

The authors, from UB's School of Public Health and Health Professions, surveyed 1,000 smokers aged 25 and older from around the country, using random-digit dialing telephone interviews. They followed up with the respondents fourteen months later, asking them if they had abstained from tobacco use during the previous month.

"Other studies have taken a snapshot approach, asking smokers and nonsmokers about their diets," says Gary A. Giovino, PhD, chair of the Department of Community Health and Health Behavior at UB. "We knew from our previous work that people who were abstinent from cigarettes for less than six months consumed more fruits and vegetables than those who still smoked. What we didn't know was whether recent quitters increased their fruit and vegetable consumption or if smokers who ate more fruits and vegetables were more likely to quit."

The UB study found that smokers who consumed the most fruit and vegetables were three times more likely to be tobacco-free for at least 30 days at follow-up 14 months later than those consuming the lowest amount of fruits and vegetables. These findings persisted even when adjustments were made to take into account age, gender, race/ethnicity, education, household income and health orientation.

They also found that smokers with higher fruit and vegetable consumption smoked fewer cigarettes per day, waited longer to smoke their first cigarette of the day and scored lower on a common test of nicotine dependence.

"We may have identified a new tool that can help people quit smoking," says Jeffrey P. Haibach, MPH, first author on the paper and graduate research assistant in the UB Department of Community Health and Health Behavior. "Granted, this is just an observational study, but improving one's diet may facilitate quitting."

Several explanations are possible, such as less nicotine dependence for people who consume a lot of fruits and vegetables or the fact that higher fiber consumption from fruits and vegetables make people feel fuller.

"It is also possible that fruits and vegetables give people more of a feeling of satiety or fullness so that they feel less of a need to smoke, since smokers sometimes confuse hunger with an urge to smoke," explains Haibach.

And unlike some foods which are known to enhance the taste of tobacco, such as meats, caffeinated beverages and alcohol, fruits and vegetables do not enhance the taste of tobacco.

"Foods like fruit and vegetables may actually worsen the taste of cigarettes," says Haibach.

While smoking rates in the U.S. continue to decline, Giovino notes, the rate of that decline has slowed during the past decade or so. "Nineteen percent of Americans still smoke cigarettes, but most of them want to quit," he says.

Haibach adds: "It's possible that an improved diet could be an important item to add to the list of measures to help smokers quit. We certainly need to continue efforts to encourage people to quit and help them succeed, including proven approaches like quitlines, policies such as tobacco tax increases and smoke-free laws, and effective media campaigns."

The UB researchers caution that more research is needed to determine if these findings replicate and if they do, to identify the mechanisms that explain how fruit and vegetable consumption may help smokers quit. They also see a need for research on other dietary components and smoking cessation.

Gregory G. Homish, PhD, assistant professor in the UB Department of Community Health and Health Behavior, also is a co-author.

Funding was provided by the Robert Wood Johnson Foundation and Legacy®.

Jun 09
Female gene link may hold key to beat migrain
The key to curing unbearable migraine headaches may lie with the people of Norfolk Island, scientists say.

Led by Professor Lyn Griffiths from the University's Griffith Health Institute, the team has identified a new region on the X chromosome that is responsible for playing a role in migraine

The research provides compelling evidence for a new migraine susceptibility gene involved in migraine.

The study also indicated that there may be more than one X chromosomal gene involved and implicated a gene involved in iron regulation in the brain.

All females have two X chromosomes whilst males have an X and a Y chromosome.

"These results provide more support for the role of the X chromosome in migraine and may explain why so many more females suffer from the disorder," Professor Griffiths said.

Tracking down and identifying the various genes that cause migraine is very important as it provides insights to develop better means of diagnosis and more targeted treatments.

"Currently, 12 percent of the population suffers from migraine. Even though we have some very good treatments for this very debilitating disease, they certainly don't work for everyone and can have some adverse side effects. Hence there is a real need to develop new migraine treatments," Griffiths said.

This National Health and Medical Research Council funded work involved a unique population study of the remote Norfolk Island where 80 percent of inhabitants are able to trace their ancestry back to the famous historical event, The Mutiny on the Bounty.

"This population was used due to its unusual pedigree structure in which genetic relationships can be traced through genealogical data to the island's original founders, and also the high incidence of migraine sufferers in this population. It's very useful for gene mapping purposes because of the reduced genetic and environmental diversity," Professor Griffiths said.

A comprehensive chromosome analysis of around 300 Norfolk participants from a large multigenerational Norfolk family, including many who are affected by migraine, was conducted using DNA samples obtained from the islanders.

Jun 08
Flying can be a real headache. Fact
IT'S no secret that flying is a headache for most, but according to researchers the "aeroplane headache" is the real deal.

The unusual, specific head pain that flares up during landing is more than just a figure of speech, Italian researchers have discovered, and argue it should now be considered a new sub-type of headache, Reuters reported.

"Aeroplane headache" was first reported in medical literature back in 2004, with dozens more cases documented in the following years.

"The 'headache attributed to aeroplane travel', also named 'aeroplane headache', is a recently described headache disorder that appears exclusively in relation to aeroplane flights, in particular during the landing phase," lead researcher Federico Mainardi, of Giovanni e Paolo Hospital in Venice, wrote.

In a recent article in the Cephalalgia journal, Mainardi's team reports on another 75 people with symptoms suggestive of aeroplane headache.

Those individuals contacted doctors after reading a case report by Mainardi published in 2007.

Overall, they fit the features of past cases of aeroplane headache - severe pain on one side of the head that's usually limited to the time the plane was landing.

The headache was almost always short lived, less than 30 minutes for 96 per cent of the people. Only a minority consistently had headaches during landings, and for most it happened on some flights but not on others.

While it's not clear what might trigger the headaches, one theory is that the pain may be related to pressure changes in the sinus cavities, based on the idea that passengers with colds or sinus infections can get severe headaches during take-off or landing.

"Is (aeroplane headache) a unique disorder? I think it is. But others might disagree," R. Allan Purdy, a neurologist and professor at Dalhousie Medical School in Halifax, Canada, who wrote an editorial on the report, said.

"Nobody knows what causes it. Nobody knows how many people have it. Nobody knows what treatments work," he said, but noted that classifying it as a distinct disorder would allow it to be studied more directly.

The good news is that aeroplane headache seems harmless.

"It doesn't appear to be a serious or life-threatening disorder," Purdy said.

Jun 08
Eight glasses of water daily 'a myth'
Drinking eight glasses of water a day to lose weight and stay healthy is a myth, an Australian academic says.

New Zealand recommendations suggest an adequate daily fluid intake is about 2.2 litres for women and 3 litres for men.

However, this includes fluid found in food and beverages.

La Trobe University lecturer Spero Tsindos said people could get their daily fluid intake from fruit, vegetables, juices and even tea and coffee.

"If you're feeling thirsty then drink by all means a beverage. It doesn't have to be water," Tsindos said.

"I'm not saying you shouldn't drink water. I'm saying the need to drink two litres of water on a regular basis is a complete myth.

"We should be telling people that beverages like tea and coffee contribute to a person's fluid needs and, despite their caffeine content, do not lead to dehydration."

He said drinking a large quantity of water in one sitting to reach the daily intake level was pointless because it would not be distributed where it was needed. It would just dilute the urine, he said.

Drinking large amounts of water to lose weight would not work either without a low-calorie diet, he added.

"There is further evidence that water and a well-balanced diet does far more than water alone," Tsindos wrote in The Australian and New Zealand Journal of Public Health, published this week.

"Water is important for health, however, the recommendation of eight glasses of pure water a day appears an overestimation of requirements," he said.

The eight glasses a day notion may have stemmed from guidelines published in the US in 1945, Mr Tsindos wrote.

Jun 07
CT scans on children 'could triple brain cancer risk'
Multiple CT scans in childhood can triple the risk of developing brain cancer or leukaemia, a study suggests.

The Newcastle University-led team examined the NHS medical records of almost 180,000 young patients.

But writing in The Lancet the authors emphasised that the benefits of the scans usually outweighed the risks.

They said the study underlined the fact the scans should only be used when necessary and that ways of cutting their radiation should be pursued.

During a CT (computerised tomography) scan, an X-ray tube rotates around the patient's body to produce detailed images of internal organs and other parts of the body.

In the first long-term study of its kind, the researchers looked at the records of patients aged under 21 who had CT scans at a range of British hospitals between 1985 and 2002.

Because radiation-related cancer takes time to develop, they examined data on cancer cases and mortality up until 2009.

Brain cancer and leukaemia are rare diseases.
'Significant increases'

The study estimated that the increased risk translated into one extra case of leukaemia and one extra brain tumour among 10,000 CT head scans of children aged under ten.

Dr Mark Pearce, an epidemiologist from Newcastle University who led the study, said: "We found significant increases in the risk of leukaemia and brain tumours, following CT in childhood and young adulthood.

"The immediate benefits of CT outweigh the risks in many settings.

"Doses have come down dramatically over time - but we need to do more to reduce them. This should be a priority for the clinical community and manufacturers."

CT scans are useful for children because anaesthesia and sedation are not required.

This type of check is often ordered after serious accidents, to look for internal injuries, and for finding out more about possible lung disease.

Regulations on their use in the UK mean CT scans should only be done when clinically justified - and the researchers said their study underlined that point.

Professor Sir Alan Craft, a co-author and leading expert in child health, said: "The important thing is that parents can be reassured that if a doctor in the UK suggests a child should have a CT scan, the radiation and cancer risks will have been taken into account.

"There's a much greater risk of not doing a CT scan when it's suggested.

"This study will push us to be even more circumspect about using it. We have much stricter rules here about using CT than in the United States, for example."

Dr Hilary Cass, the president of the Royal College of Paediatrics and Child Health, said: "We have to take very seriously the link between repeated CT scans and increased risk of these cancers amongst children and young people.

"But with both tumours rare, the absolute risk remains low."

A Department of Health spokesman said: "The UK uses lower levels of radiation in CT scans than other countries.

"We also have clear regulations to ensure a CT scan is only carried out when clinically justified."

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