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Feb 20
Want to Lose Weight? Try Teamwork
A new study shows that people who shed at least 5% of their initial body weight during a weight loss competition were likely to be on the same teams. Those who said their teammates played a large role in their weight loss were more likely to lose a significant amount of weight.

The findings appear in Obesity.

Shows like The Biggest Loser often have team-, family-, or couples-based competitions that harness the power of peer influence when it comes to weight loss.

"People around us affect our health behaviors," says researcher Tricia Leahey, PhD. She is with The Miriam Hospital's Weight Control and Diabetes Research Center and is an assistant professor of psychiatry and human behavior at Alpert Medical School of Brown University in Providence, R.I.

This is true for healthy and unhealthy behaviors. "It could be quite beneficial if a bunch of friends that choose to lose weight make healthy food choices together, and hold each other accountable to those choices," she says.

Team members can motivate one another to stay the course. "If someone is doing really well, it could influence the whole group," Leahey says.

The findings are based on the results of the 2009 Shape Up Rhode Island campaign, a 12-week statewide, online weight loss competition. Participants competed against other teams for weight loss, physical activity, and the number of steps taken. The weight loss arm included 3,330 overweight or obese people on 987 teams. The teams had between five and 11 members.

Feb 18
Ray of hope for patients with end stage organ failure
Patients with end stage organ failure in the state can hope to prolong their life with the state government launching the Cadaver Transplant Programme. The programme paves the way for transplantation of vital organs harvested from brain-dead person in patients with chronic ailments.

The organs that can be transplanted include eyes, heart, lungs, liver, pancreas, kidneys, heart valves, skin, bones, bone marrow, connective tissues, middle ear, blood vessels and small intestine.

Though the government of India had passed the Transplantation of Human Organs Act in 1994, the state government had not framed rules to implement it in the state, which has the highest number of heart patients in the country and a large number of patients with liver and kidney related diseases.

The orders issued this week give legal backing for the organ transplantation. Issued under the Federal Act, the orders specify norms for determining brain death and procedures for removing and transplanting the organs.

The consent of relatives is a must for removing organs from brain dead persons and the person requiring organs needs to register with the health authorities. The order contains detailed guidelines for determining priority in making the organs available to patients. A provision would be incorporated soon for allowing donors to make donations to patients of their choice.

The government has set up a Core Committee for Cadaver Transplantation under the supervision of the Director of Medical Education to coordinate various functions related to the cadaver transplantation and a Cadaver Transplant Advisory Committee under the Health Secretary.

The Cadaver Transplant Programme was formulated on the basis of the report of an expert committee, which studied the implementation of the programme in the neighbouring states of Tamil Nadu and Andhra Pradesh.

Tamil Nadu has been a role model in cadaver transplantation. The state recorded a deceased donor rate of 1.3 per million as against 0.15 per million population in the country as a whole. Experts say that if the country can push the rate to the Tamil Nadu level it can easily meet the demand for organs. The current demand in the country for kidney transplants is 150,000; liver, 200,000 and heart, 150,000.

India now does only 3,000 kidney transplants and 500 liver transplants a year because there are not enough donors. Though 140, 000 lives are lost in the country through road accidents every year, the precious organs that could save the lives of many have been going waste.

Kerala too could meet the demand for vital organs to a great extent if a programme was in place to retrieve the organs of nearly 4000 road fatalities a year. The Cadaver Transplant Programme may help the state to tap this potential. However, experts say that simply laying the guidelines for cadaver transplant alone will not solve the problem. Though it simplifies the legal procedures there are social and ethical issues to be tackled.

In spite of high literacy people have not been coming forward to donate the organs. Health activists believe this is mainly because of ignorance, superstitious beliefs and religious restrictions. Private initiatives in the past have not been able to break these barriers. The Society for Organ Retrieval & Transplantation (SORT), one such initiative launched under the auspices of Indian Medical Association in 2000 could attract only 1500 donors in the last 12 years.

The society had to wait till 2004 for the first ever multi-organ transplantation. It was made possible by the members of the family of one Ramachandran Nair, who was declared brain dead following a road accident in June 2004. Three patients received the deceased's live and kidneys.

Sort has been organizing seminars on 'Religion and Organ Donation' involving religious heads to create awareness on organ donation. The Rotary Club of Trichur City has also been running a campaign involving doctors, NGOs, hospitals and others concerned to encourage organ donation. It has set up a body called RISORT (Rotary Initiated Society for Organ Retrieval and Transplantation) to popularise cadaver transplant in the state.

Feb 18
Smoking kicks out good bacteria from mouth
Smoking causes the body to turn against its own helpful bacteria, leaving smokers more vulnerable to disease, says an Indian-origin scientist.

They revealed that the mouth of a smoker is much more susceptible to invasion by harmful bacteria.

As a group, smokers suffer from higher rates of oral diseases -- especially gum disease -- than do nonsmokers, which is a challenge for dentists, according to Purnima Kumar, assistant professor of periodontology at Ohio State University.

"The smoker's mouth kicks out the good bacteria, and the pathogens are called in. So they're allowed to proliferate much more quickly than they would in a non-smoking environment," said Kumar

The results suggest that dentists may have to offer more aggressive treatment for smokers and would have good reason to suggest quitting smoking, Kumar said.

"A few hours after you're born, bacteria start forming communities called biofilms in your mouth. Your body learns to live with them, because for most people, healthy biofilms keep the bad bacteria away," stated Kumar.
She likens a healthy biofilm to a lush, green lawn of grass. "When you change the dynamics of what goes into the lawn, like too much water or too little fertilizer, you get some of the grass dying, and weeds moving in," she said.

For smokers, the "weeds" are problem bacteria known to cause disease.

In a new study, Kumar's team looked at how these bacterial ecosystems regrow after being wiped away. For 15 healthy nonsmokers and 15 healthy smokers, the researchers took samples of oral biofilms one, two, four and seven days after professional cleaning.
The researchers were looking for two things when they swabbed subjects' gums. First, they wanted to see which bacteria were present by analyzing DNA signatures found in dental plaque. They also monitored whether the subjects' bodies were treating the bacteria as a threat. If so, the swab would show higher levels of cytokines, compounds the body produces to fight infection.

The team found that for nonsmokers, bacterial communities regain a similar balance of species to the communities that were scraped away during cleaning. Disease-associated bacteria are largely absent, and low levels of cytokines show that the body is not treating the helpful biofilms as a threat.

"By contrast," said Kumar, "smokers start getting colonized by pathogens-bacteria that we know are harmful-within 24 hours. It takes longer for smokers to form a stable microbial community, and when they do, it's a pathogen-rich community."

Smokers also have higher levels of cytokines, indicating that the body is mounting defenses against infection. Clinically, this immune response takes the form of red, swollen gums-called gingivitis-that can lead to the irreversible bone loss of periodontitis.

In smokers, however, the body is not just trying to fight off harmful bacteria. The types of cytokines in smokers' gum swabs showed the researchers that smokers' bodies were treating even healthy bacteria as threatening.

Although they do not yet understand the mechanisms behind these results, Kumar and her team suspect that smoking is confusing the normal communication that goes on between healthy bacterial communities and their human hosts.

Practically speaking, these findings have clear implications for patient care, according to Kumar.

Feb 17
To tame chronic pain, erase brain memory
Researchers have discovered that it may be possible to ease chronic pain by erasing memories stored in the brain.

It has long been known that the central nervous system "remembers" painful experiences, that they leave a memory trace of pain. And when there is new sensory input, the pain memory trace in the brain magnifies the feeling so that even a gentle touch can be excruciating.

"Perhaps the best example of a pain memory trace is found with phantom limb pain," suggests neuroscientist Terence Coderre of McGill University. "Patients may have a limb amputated because of gangrene, and because the limb was painful before it was amputated, even though the limb is gone, the patients continue to feel they are suffering from pain in the absent limb.
"That's because the brain remembers the pain. In fact, there's evidence that any pain that lasts more than a few minutes will leave a trace in the nervous system."

It's this memory of pain, which exists at the neuronal level, that is critical to the development of chronic pain. But until now, it was not known how these pain memories were stored at the level of the neurons.

Recent work has shown that the protein kinase PKMzeta plays a crucial role in building and maintaining memory by strengthening the connections between neurons.

In the new research, published in the journal Molecular Pain, Coderre and colleagues have discovered that PKMzeta is also the key to understanding how the memory of pain is stored in the neurons. They were able to show that after painful stimulation, the level of PKMzeta increases persistently in the central nervous system (CNS).

Even more importantly, the researchers found that by blocking the activity of PKMzeta at the neuronal level, they could reverse the hypersensitivity to pain that neurons developed after irritating the skin by applying capsaicin-the active ingredient in hot peppers. Moreover, erasing this pain memory trace was found to reduce both persistent pain and heightened sensitivity to touch.

Coderre and his colleagues believe that building on this study to devise ways to target PKMzeta in pain pathways could have a significant effect for patients with chronic pain.

"Many pain medications target pain at the peripheral level, by reducing inflammation, or by activating analgesia systems in the brain to reduce the feeling of pain," says Coderre.

"This is the first time that we can foresee medications that will target an established pain memory trace as a way of reducing pain hypersensitivity. We believe it's an avenue that may offer new hope to those suffering from chronic pain."

Feb 17
Seven-hour sleep helps high school students do better
High school students seem to do better in studies when they have seven hours of sleep, rather than nine recommended by federal guidelines, a study reveals.

"We're not talking about sleep deprivation, the data simply says that seven hours is optimal at that age," said study co-author Eric Eide from Brigham Young University (BYU). The new study, led by Eide and BYU economics professor Mark Showalter, is the first in a series where they examine sleep and its impact on our health and education.

Surprisingly, the current federal guidelines are based on studies where teens were simply told to keep sleeping until they felt satisfied, said a university statement. "If you used that same approach for a guideline on how much people should eat, you would put them in a well-stocked pantry and just watch how much they ate until they felt satisfied," Showalter said. "Somehow that doesn't seem right," he added.

Analysing data from a representative sample of 1,724 primary and secondary school students across the country, they found a strong relationship between the hours of sleep youths got and how they fared on standardised tests.

"We don't look at it just from a 'your kid might be sleeping too much' perspective. From the other end, if a kid is only getting 5.5 hours of sleep a night because he's overscheduled, he would perform better if he got 90 minutes more each night," Eide said.

The size of the effect on test scores depends on a number of factors, but an 80-minute shift toward the optimum is comparable to the child's parents completing about one more year of schooling.

Feb 16
Rise in TB, pneumonia cases as UT felt the chill
With the recent dip in mercury, and changing weather conditions, the Advanced Paediatrics Centre of PGIMER, is witnessing an increase in number of cases of pneumonia in patients below five years of age.

Dr Meenu Singh said, "Low birth weight, malnutrition, lack of breast feeding, lack of measles vaccination, over-crowding and indoor air pollution due to biomass fuel are some of the risk factors which cause pneumonia in children." Most of these cases come from neighbouring states of Punjab and Haryana.

Other respiratory ailments in children are Tuberculosis (TB), which the children get mostly after they come in contact with an adult who is suffering from it. It is very commonly seen in patients from Saharanpur, Jharkhand, Punjab and Haryana.

"Tuberculosis is quite common in adolescent girls but due to social stigma, they are not taken to the DOTS centre which makes them drug resistant and complicates the disease. We get adolescent girls, who suffer from advanced stage of TB but they are not taken to treatment centres known as DOT centres for the parents feel that if it gets known publicly their chances of getting married will be adversely affected," said Dr Meenu Singh.

On an average, PGI gets about 10 to 12 children suffering from TB per week who have already stopped responding to medicines. Most of them are girls.

In light of these observations, PGI's Paediatrics department is organising a two-day scientific meet on "evidence based management of common respiratory disorders in children" on February 18-19 to disseminate information.

Feb 16
Hot new tip. eating a curry once (or twice) a week could stave off dementia, say scientists
Few of us need too much encouragement when it comes to heading off to the curry house.

But scientists have come up with one of the best excuses ever: a spicy ingredient in curry could be an effective treatment for Alzheimer's disease.

Tests on fruit flies with a nervous disorder similar to the neurodegenerative illness found those given curcumin - the key chemical in turmeric used in everything from mild Kormas to the hottest Vindaloos - lived 75 per cent longer.

Alzheimer's is linked to the build up of knots of protein in the brain called amyloid plaques, damaging the wiring in brain cells.

The findings, published in the journal PLoS One, could help explain why rates of dementia are much lower among the elderly in India than in their Western peers.

Previous research has found Alzheimer's affects just one per cent of people over the age of 65 living in some Indian villages.

Drugs with similar properties to curcumin could potentially be used as preventative treatments.

In the study Professor Per Hammarstrom and colleagues also found five groups of fruit flies genetically engineered to develop Alzheimer's-type symptoms manipulations maintained their mobility longer when given curcumin.

The scientists saw no decrease of amyloid in the brain or eyes of the insects.

Curcumin did not dissolve the plaque, but accelerated the formation of nerve fibres by reducing the amount of their precursor forms, known as oligomers, from which they were formed.

Prof Hammarstrom, of Linkoping University in Sweden, said: 'The results confirm our belief that it is the oligomers that are most harmful to the nerve cells.'

Several theories have been established about how oligomers can instigate the disease process.

According to one hypothesis they become trapped at nerve junctions inhibiting impulse signals. Others claim they destroy brain cells by puncturing membrane.

Curcumin is extracted from the root of turmeric and has been used as medicine for thousands of years. It aids digestion, helps fight infection and guards against heart attacks.

More recently it has been tested against pain, thrombosis and cancer.

Feb 15
Blood donors website in Limca Record
A voluntary blood donors' website www.friends2support.org has made it to the Limca Book of Records for having the largest blood donors database. The website, started six years ago, has a database of 90,000 voluntary blood donors.

Friends to Support Organisation founder Sk Shareef said the Limca Book of Records on Monday communicated to them about the entry made in the latest series of the book. The Limca Book of Records authorities lauded the services of the organisation stating that no other website provides information about such a large number of blood donors.

"If a donor is willing to display his/her contact information for the benefit of the people, we put it up online. The database is not run by any blood bank and no large institution monopolises it," said Shareef. A new SMS feature will be launched on Tuesday for voluntary blood donors registered with the website allowing them to login to the website, modify their online data.

Feb 15
No single diet will work for all diabetics
Some people were troubled that even after she was diagnosed, she continued to cook high-fat, high-sugar, high-calorie recipes on her TV show - foods that people with the disease are advised to consume infrequently. Deen said she eats such foods only in moderation.

Meanwhile, Alec Baldwin told Entertainment Tonight he lost 30 pounds since being diagnosed with prediabetes in May. He says he gave up sugar, which was a real "killer" for him.

So what's the best diet for people with diabetes? There is no one diet, whether it's a Mediterranean, low-carb or low-fat diet, that is consistently better at helping people manage diabetes, says Stephanie Dunbar, director of nutrition and medical affairs for the American Diabetes Association. She is one of the authors of a new review of the research on diabetes diets published in February's Diabetes Care.

"People need to do what works for them. There are people who do well on a lower-fat diet and others who do well on a lower-carb diet." One thing that helps in keeping blood sugar under control is losing weight, even as little as 5% to 10% of body weight, Dunbar says.
Don't expect perfection

People with diabetes need to be counseled by a capable registered dietitian who can tailor their meal plan to their taste, says Ann Albright, director of the diabetes division for the Centers for Disease Control and Prevention. "If you give someone a list that says they have to eat this or that, and those are not foods they like, then they won't be successful, and they'll end up eating in secrecy." They need to make healthy choices most of the time, but an occasional indulgence is OK, she says. "That's one of the big burdens that people carry. Many say, 'I can't be perfect, so why try at all?' "

Almost 26 million adults and children, about 8.3% of the U.S. population, have diabetes, the CDC says. There are two major forms of diabetes: type 1 and 2. Type 2 accounts for more than 90% of cases. Factors that increase the risk of type 2 include a family history, obesity, inactivity and age.

In people with diabetes, the body does not make enough of the hormone insulin, or it does not use it properly. Insulin helps glucose (sugar) get into cells, where it is used for energy. If there's an insulin problem, sugar builds up in the blood, damaging nerves and blood vessels.

Symptoms include thirst, hunger, fatigue, blurry vision, healing problems and frequent urination. Complications can include heart attacks, blindness, kidney failure, nerve damage and amputations.

Lots of healthy choices

The diabetes association gives general guidance on carbohydrates, advising people to try to get about 45 to 60 grams at a meal, Dunbar says. "Some people may need more or less. About 45 grams allows someone to follow the diabetes plate method; we call it create your plate. It calls for half the plate to be non-starchy veggies, a fourth plate whole grains and a fourth plate protein."

People with the disease can eat from a wide range of healthy choices, says Geralyn Spollett, president of health care and education for the diabetes association and associate director of the Yale Diabetes Center. "It's really a balancing game of trying to eat healthy foods but still enjoy many of the things that they love."

But the diet shouldn't include a lot of sweets, Spollett says. "We stress reduced intake from concentrated sweets because they cause a spike in glucose, and that makes it difficult to manage your diabetes. We usually say to avoid things like soda and ginger ale and only to occasionally drink juice, because even though it has vitamins, it tends to cause blood sugar to skyrocket."

People with diabetes can have a sweet occasionally if they do it properly, Spollett says. "If someone is using insulin, they can calculate how much insulin they would need to reduce the spike in blood sugar caused by a sweet food. They can keep their blood glucose fairly even."

If they have type 2 diabetes and are not on insulin, they don't have that flexibility and need to be more conscious of how many sweet foods they eat, she says.

Fruit contains natural sugar fructose, so it can raise blood glucose, but it is a good source of vitamins and minerals and people should include it in their diet, Spollett says. Some find that the berries do not raise their glucose levels as much and will eat them, she says.

Even if you are taking medications for diabetes, making healthy food choices is important, Albright says.

Some people with diabetes appear to have a greater reaction to the foods they eat, she says. They have much more difficulty managing their blood sugar (A1C), blood pressure and cholesterol than others, she says.

But if people with diabetes keep their A1C level at 7% or less (an average glucose of 150-170 mg/dl), it can help reduce the risk of complications, Spollett says. "Unless people are eating in a way that is diabetes-friendly, it's very difficult to control their blood sugars."

Still, diabetes is a progressive disease, no matter how perfectly you live, Spollett says. "What people want to hear is that there is a cure, and we hope someday there will be, but in the meantime, people with diabetes need to do the best they can to keep their glucose in a healthy range."

Feb 14
Using Mobile Phones & Social Networks to Fight Noncommunicable Diseases
Here's some shocking statistics: According to the World Health Organization, nearly two-thirds of all deaths occur due to noncommunicable diseases (NCDs), which contribute to more than 60 percent of deaths worldwide.

Over the coming decade, some 388 million worldwide will die of one or more chronic illnesses, and the cumulative losses in global economic output due to NCDs will total $47 trillion by 2030.

But before you go jump off a tall building, some new solutions developed by university teams could soon be harnessed to help manage the glowing global problem of such NCDs like asthma, diabetes, stroke, and cancer.

As part of the NCD Challenge, sponsored by IBM and the pharmaceutical maker Novartis, a global competition was held to bring together industry and academia to create innovative, easy-to-use solutions that help fight the human and social burden of NCDs.

Like a social media-enabled support system for pregnant women with gestational diabetes and an advanced smartphone service, both of which could have tremendous impact in managing diabetes and other diseases.

Developing World Solution: 2Vidas

Winners of the competition were the Hass School of Business, University of California, Berkeley, and ESADE Business School-Universidad Ramon Llull in Barcelona, Spain.

The developing world solution, from Berkeley, involved "2Vidas," a pharmacy-based membership program for low- to middle-income pregnant women to address the growing problem of diabetes in Mexico.

The project's aim is to make a lasting health impact on two lives during a finite period in which women have increased motivation to take better case of themselves for the health of their babies.

The program works by providing pregnant women access to monitoring tools at local pharmacies, support through peer-led sessions, and encouragement via positive SMS messaging that rewards self-management and offers health tips.

The potential economic impact is the ability to save women 58-98 percent of out-of-pocket monitoring costs, depending on frequency of use, and the health system an average of $110 per enrolled women per year through improved diabetes control -- lowering the risk profile of the mother's pregnancy and the baby's propensity for NCDs.

The 2Vidas membership program will deliver an estimated $10.4 million in systemic cost savings and $475,000 in added value creation over five years.

Developed World Solution: Dr. Diabetes

Developed by the ESACE Business School-Universidad Ramon Llull, the Barcelona-based team's effort, "Dr. Diabetes," utilizes a handheld device with an application and two cloud servers.

It is a total solution designed to provide diabetes awareness, monitoring, and management to patients with chronic illness, initially for China.

It also provides early awareness to the public and streamlines diabetes management for patients. The solution provides medical data via cloud computing to physicians for accurate diagnosis, and to pharmaceutical companies and hospitals for efficient research and development.

The solution is designed to be scalable to support other NCDs. It is designed to lower the risk of complications, decrease treatment costs to patients by up to 73 percent, and decrease their hospital visits by 65 percent.

Winning teams were recognized this week during the NCD Awards Ceremony at IBM headquarters in Armonk, N.Y., and Novartis headquarters in East Hanover, New Jersey.

People interested in learning more and in joining the conversation on the topic of fighting noncommunicable diseases can do so in the People for a Smarter Planet on Facebook, and via Twitter at #NCD.

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