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May 27
Zebrafish Provide A Model For Cancerous Melanoma In Humans
In a new study published in Disease Models & Mechanisms, scientists use the zebrafish to gain insight into the influence of known cancer genes on the development and progression of melanoma, an aggressive form of human skin cancer with limited treatment options.

Inside the cell, signals are delivered that direct the cell on whether to divide, migrate or even die. Cancer often results when the molecules that relay these signals become mutated so that they do not function normally. In cancer, cells divide, grow and migrate when they should not, therefore resulting in an aggressive disease that can spread throughout the body. A key molecule in this signaling pathway is RAS, and mutations in it are known to lead to cancer. In some cases, the type of RAS mutation is a predictor of a patient's response to treatment and their overall prognosis.

Therefore, scientists at the University of Manchester in England and the University Hospital Zürich in Switzerland generated several zebrafish with changes in RAS or other RAS-regulated proteins to create a useful model that can be used to study and understand human melanoma. Zebrafish are a useful tool to understand human disease because they are small, transparent, and easy to propagate and maintain. Tumors created from the pigmented cells of zebrafish, known as melanocytes, are easy to see against their thin, light colored bodies.

The research team notes that these fish may be a useful experimental tool for human disease. Many of the changes they made caused melanoma in the zebrafish, indicating that zebrafish respond similarly to changes in these signals as do humans. Zebrafish that were born from the original mutant fish displayed abnormal growth of their melanocytes, reminiscent of familial atypical mole and melanoma syndrome (FAMM) seen in humans. By producing other signaling molecules in the mutant fish, the researchers were able to identify a pathway that reduced the effects of RAS mutations on melanoma progression in zebrafish.

May 27
Menopause Transition May Cause Trouble Learning
The largest study of its kind to date shows that women may not be able to learn as well shortly before menopause compared to other stages in life. The research is published in the May 26, 2009, print issue of Neurology®, the medical journal of the American Academy of Neurology.

For a four-year period, researchers studied 2,362 women, who were between the ages of 42 and 52 had at least one menstrual period in the three months before the study started.

The women were given three tests: verbal memory, working memory and a test that measured the speed at which they processed information. Scientists tested the women throughout four stages of the menopause transition: premenopausal (no change in menstrual periods), early perimenopausal (menstrual irregularity but no "gaps" of 3 months), late perimenopausal (having no period for three to 11 months) and postmenopausal (no period for 12 months).

The study found that processing speed improved with repeated testing during premenopause, early perimenopause and postmenopause, but that scores during late perimenopause did not show the same degree of improvement. Improvements in processing speed during late perimenopause were only 28 percent as large as improvements observed in premenopause. For verbal memory performance, compared to premenopause, improvement was not as strong during early and late perimenopause. Improvements in verbal memory during early perimenopause were 29 percent as large as improvements observed in premenopause. During late perimenopause, verbal memory improvement was seven percent as large as in premenopause. Combined, these findings suggest that during the early and late perimenopause women do not learn as well as they do during other menopause transition stages.

"These perimenopausal test results concur with prior self-reported memory difficulties--60 percent of women state that they have memory problems during the menopause transition," said Gail Greendale, MD, with the David Geffen School of Medicine at the University of California, Los Angeles. "The good news is that the effect of perimenopause on learning seems to be temporary. Our study found that the amount of learning improved back to premenopausal levels during the postmenopausal stage."

The study also found that taking estrogen or progesterone hormones before menopause helped verbal memory and processing speed. In contrast, taking these hormones after the final menstrual period had a negative effect: postmenopausal women using hormones showed no improvement in either processing speed scores or verbal memory scores, unlike postmenopausal women not taking hormones. "Our results suggest that the 'critical period' for estrogen or progesterone's benefits on the brain may be prior to menopause, but the findings should be interpreted with caution," said Greendale.

The National Institutes of Health (NIH), the National Institute on Aging, the National Institute of Nursing Research and the NIH Office of Research on Women's Health supported the study.

May 27
Discovery Of Shared Genetic Link Between The Dental Disease Periodontitis And Heart Attack
The relationship between the dental disease periodontitis and coronary heart disease (CHD) has been known for several years. Although a genetic link seemed likely, until now its existence was uncertain. Now, for the first time, scientists have discovered a genetic relationship between the two conditions, a researcher told the annual conference of the European Society of Human Genetics.

Dr. Arne Schaefer, of the Institute for Clinical Molecular Biology, University of Kiel, Germany, said that his team had discovered a genetic variant situated on chromosome 9 which was shared between the two diseases. "We studied a genetic locus on chromosome 9p21.3 that had previously been identified to be associated with myocardial infarction, in a group of 151 patients suffering from the most aggressive, early-onset forms of periodontitis, and a group of 1097 CHD patients who had already had a heart attack. The genetic variation associated with the clinical pictures of both diseases was identical," he said. The scientists went on to verify the association in further groups of 1100 CHD patients and 180 periodontitis patients.

"We found that the genetic risk variant is located in a genetic region that codes for an antisense DNA called ANRIL", said Dr. Schaefer, "and that it is identical for both diseases."

When a gene is ready to produce a protein, the two strands of DNA in the gene unravel. One strand produces messenger RNA, and will express a protein. Antisense RNA is complementary to the mRNA, and is often carried by the reverse strand, the 'anti-sense' strand of the DNA double helix. This strand does not encode for a protein, but can bind specifically to the messenger RNA to form a duplex. Through this binding, the antisense strand inhibits the protein expression of the mRNA .

Coronary heart disease is the leading cause of death worldwide, and periodontitis, which leads to the loss of connective tissue and the bone support of teeth, is the major cause of tooth loss in adults over 40 years. Periodontitis is very common, and around 90% of people aged over 60 suffer from it. Research has already shown a genetic basis for both diseases.

"We intend to push ahead with our work to try to understand more about the function of this RNA molecule and the pathway in which it operates in healthy gums and also in periodontitis. In the meantime, because of its association with CHD, we think that periodontitis should be taken very seriously by dentists and diagnosed and treated as early as possible", said Dr. Schaefer.

Both CHD and periodontitis are propagated by the same risk factors - most importantly smoking, diabetes and obesity - and there is also a gender relationship, with men possibly more liable to these diseases than women. Researchers have also shown similarities in the bacteria found in the oral cavity and in coronary plaques, and both diseases are characterised by an imbalanced immune reaction and chronic inflammation.

May 27
Male Retirement Age And Dementia
British scientists have found a significant link between later retirement age and later onset of dementia in men.

The research is published in the International Journal of Geriatric Psychiatry.

This result came from an analysis of 382 men with probable Alzheimer's by scientists from the Institute of Psychiatry and Cardiff University. Information based on education and employment was used to determine the effects of early life education, mid life employment and later life retirement on the age of onset of dementia.

A significant affect was found between later retirement age and later onset of dementia. The small sample of men make the other measures difficult to interpret, but they suggest that education or specific job type has a weaker link with dementia risk.

The study was funded by the Medical Research Council and the Alzheimer's Research Trust. 'There could be a number of reasons why later retirement in men is linked with later onset of dementia. Men who retire early often do so because of health conditions, such as hypertension or diabetes, which increase your risk of dementia. It could also be that working helps keep your mind and body active, which may reduce risk of dementia.

The best way to reduce your risk of dementia is to combine keeping physically active, with eating a balanced diet and getting your blood pressure and cholesterol checked regularly. One million people will develop dementia in the next 10 years. Investing in research into how to prevent dementia is vital if we are to defeat this devastating condition.'

May 23
Spring Cleaning: Out With The Allergens And Mold
Spring cleaning? While clearing out cobwebs and boxing up old clothes, don't forget an invisible but crucial component of your home: the air you breathe. Even in the spring, people spend most of their time indoors-as much as 90 percent, according to the Environmental Protection Agency (EPA). For those with allergies or asthma, having clean indoor air is crucial to managing symptoms.

Allergy & Asthma Network Mothers of Asthmatics (AANMA), the sole organization whose mission is to eliminate suffering and death due to asthma, allergies and related conditions, gives you five tips for spring-cleaning the air in your home to make it lung-friendly by reducing allergens and irritants.

1. Smoking: Ask family members or visitors not to smoke in your home. Consider having your family take the EPA Smoke-Free Home Pledge.

2. Mold: Search under sinks, around tubs and showers, on windowsills and in laundry areas for any signs of dampness and mold. Track the source of water, plug it up and clean up visible mold. Purchase and use a dehumidifier in basement areas.

3. Air it out: Give your bedroom a thorough airing out-wash curtains, linens and bedspreads, and make sure to clean anywhere dust and allergens collect.

4. Use a HEPA vacuum: If you don't have one already, consider getting a HEPA (High Efficiency Particulate Air) vacuum. These vacuums have special filters that keep dust and allergens from blowing back into the air in your home.

5. Replace HVAC filters: Replace your furnace filters before air-conditioning season. And since the filter that comes with your HVAC (heating, ventilating and air conditioning) system isn't designed to help you breathe better (it simply keeps dust and debris from clogging parts of the system) look into a high-efficiency filter or an air-cleaning unit.

May 23
Risk Of Facial Fractures In Motor Vehicle Crashes Decreasing
Facial fractures from motor vehicle crashes appear to be decreasing, most likely due to design improvements in newer vehicles, according to a report in the May/June issue of Archives of Facial Plastic Surgery, one of the JAMA/Archives journals.

Facial trauma is the most common injury among individuals involved in motor vehicle collisions, according to background information in the article. Fractures to the face often occur simultaneously with other injuries, including damage to the eyes and brain. In 2000, the National Highway Traffic Safety Administration estimated that facial injuries cost between $9,000 and $725,000 per injury in lost productivity, medical costs, emergency services and other expenses.

Brian T. McMullin, M.D., plastic and reconstructive surgery resident at the Medical College of Wisconsin, Milwaukee, and colleagues analyzed records from a national database of individuals (drivers and front seat occupants) with facial fractures following motor vehicle crashes. Between 1993 and 2005, 167,391 individuals involved in collisions had one or more facial fractures, 55,150 had skull base fractures (breaks in the bones of the skull) and 196,855 had nasal fractures.

Each year during that time period, the incidence of facial fractures decreased. In addition, a decline in the probability of injury was associated with newer car models. "As older cars are scrapped and more vehicles with next-generation safety features enter the vehicle fleet, we would expect decreasing injury probabilities and ultimately overall decreased injury incidence for year-to-year trends," the authors write.

Individuals involved in side-impact collisions, in vehicles in which speed increased as a result of collision, who were taller or who collided with a stationary object, light truck, sports utility vehicle or van were significantly more likely to sustain facial fractures. "Occupants who were restrained with seat belts only, as well as those restrained with seat belts and air bags, were significantly less likely to have facial fractures," the authors write. "Air bags alone were not associated with a reduced probability of facial fractures, and there was no difference in injury probability between sexes or based on occupant weight."

"Restraint use continues to be the most significant element for facial and skull base injury prevention, and more research is necessary to elucidate the mechanisms for facial and skull base fractures in side impacts, as well as to determine the effectiveness of side impact supplemental restraint systems," they conclude.

May 23
FDA Approves Samsca For The Treatment Of Hyponatremia
The FDA (Food and Drug Administration) has approved Samsca (tolvaptan), in tablet form, for the treatment of hyponatremia. Hyponatremia is when levels of sodium in the blood are abnormally low - it is associated with dehydration.

Norman Stockbridge, M.D., Director, Division of Cardiovascular and Renal Products, Center for Drug Evaluation and Research, FDA, said "With the approval of Samsca, physicians will have an additional tool to treat hyponatremia."

Samsca is approved to treat hyponatremia associated with congestive heart failure, liver cirrhosis, and the syndrome of inappropriate antidiuretic hormone secretion.

When levels of sodium fall in the fluid outside of cells throughout the human body, water enters the cells to balance sodium levels - this makes the cells swell. Many symptoms of hyponatremia are thought to arise from the swelling of the brain cells, the FDA informs. Symptoms include:

* Headache
* Weakness
* Confusion
* Decreased consciousness
* Nausea

Samsca removes extra body water in the urine, thus helping raise sodium levels in the blood. In clinical trials, participants taking Samsca had higher increases in blood sodium levels compared to participants receiving a placebo (dummy drug).

The approval of Samsca includes a boxed warning that alerts doctors, pharmacists, other health care professionals, and patients that the medication should be started only in a hospital where blood sodium levels can be monitored carefully. If blood sodium levels rise to quickly there is a risk of osmotic demyelination syndrome (ODS). ODS can lead to coma, and even death. It can cause the patient to have problems speaking, swallowing, as well as causing drowsiness, confusion, mood changes, seizures, and problems controlling body movement with muscle weakness in the limbs.

Even though there were no cases of ODS detected during the clinical trials of Samsca, ODS is a known risk and it is crucial that doctors be aware of it, and make sure rapid increases in sodium levels do not occur, the FDA said. In addition, the FDA is requiring a Risk Evaluation and Mitigation Strategy that requires a patient Medication Guide be given when the drug is dispensed. The Medication Guide will have information about the risks and benefits of the drug.

During the clinical trials, the following side-effects were reported by participants: thirst, dry mouth, weakness, constipation, excessive urination, frequent urination, and raised blood sugar levels.

May 23
Binge Drinking In Childhood And Adolescence
German adolescents are top at boozing! In the current edition of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2009; 106 (19): 323 - 8), Martin Stolle et al. of the German Center for Addiction Research in Childhood and Adolescence in Hamburg report that the main change has been the increase in the number of intoxicated girls. In their article, the authors present motivating short-term interventions to counteract secondary problems.

According to the German Federal Commissioner for Narcotic Drugs, the number of adolescents admitted to hospital for alcohol poisoning has more than doubled, increasing from 9500 in 2007 to more than 23 000 in 2007. About 3800 of these patients were between 10 and 15 years old. Teenagers who start drinking alcohol regularly before the age of 15 have a 4-fold increased risk of becoming alcohol dependent.

The German Federal model project "Hart am Limit"("Close to the Limit/On the Edge") even starts in the emergency ambulance. The authors consider that it would be desirable to supplement this with a brief motivational intervention, based on the principle of motivational interviewing. Drinking motivation will be discussed in short individual sessions of maximally 60 minutes. Topics will include the negative consequences of drinking, such as accidents or violence. The objective is to make it clear to the adolescents that they bear responsibility for changing their own consumption behavior. Studies in the USA show that as few as one to four sessions can yield a lasting effect.

May 22
India's Smoking Epidemic Is Catastrophic Say Researchers
A new study suggests that by 2010, India's death toll due to tobacco smoking will be about 1 million people a year (10 lakh in Indian counting system), taking the country's smoking epidemic to catastrophic proportions. This figures will represent one fifth of deaths in men and one twentieth of deaths in women aged 30 to 69, with smoking causing deaths from tuberculosis, respiratory disease, cardiovascular disease, and cancer.

There are about 120 million (12 crore in Indian counting system) smokers in India. About 5 per cent of women and more than one third of men aged between 30 and 69 smoke either conventional cigarettes or bidis, a type of Asian cigarette made from one quarter of the tobacco content of a conventional cigarette and wrapped in the leaf of a temburni plant.

The researchers calculated that on average in India, compared with non smokers, men who smoke bidis die about six years earlier, women who smoke them die about eight years earlier, and men who smoke cigarettes die about 10 years earlier (about the same as in the West).

Even low levels of smoking were not found to be safe, wrote the researchers. Smoking a few bidis a day brought substantial risks, and smoking a few cigarettes a day brought even more, to the point of doubling the risk of death in middle age, they wrote.

India's Health Minister, Dr Abumani Ramadoss, said he was alarmed at the results of the study, and that:

"The government of India is trying to take all steps to control tobacco use; in particular by informing the many poor and illiterate of smoke risks."

Professor Prabhat Jha of the Centre for Global Health Research (CGHR), St. Michael's Hospital at the University of Toronto in Canada, who led the study said:

"The extreme risks from smoking that we found surprised us, as smokers in India start at a later age than those in Europe or America and smoke less. And, smoking kills not only from diseases like cancer and lung diseases but also from tuberculosis and heart attacks."

The large study employed some 900 field workers to carry out a nationally representative survey of 1.1 million (11 lakh) homes throughout India. From this the researchers were able to compare the smoking histories of 74,000 adults who had died (33,000 women and 41,000 men) with 78,000 living unmatched controls (35,000 women and 43,000 men). They then worked out the risk ratios for death comparing smokers and non smokers and adjusted them for age, educational level, and alcohol consumption.

The results showed that among men who died at ages 30 to 69, smoking was responsible for:

* 38 per cent of all deaths from tuberculosis (1,174 deaths out of 3,119).
* 31 per cent of all deaths from respiratory disease (1,078 of 3,487).
* 20 per cent of all deaths from vascular disease (1,102 of 5,409).
* 32 per cent of all deaths from cancer (709 of 2,248).
* 23 per cent of all deaths from any disease (5,651 of 25,290)

Jha and colleagues found that 61 per of male smokers are likely to die between the ages of 30 and 69 compared with only 41 per cent of their non smoking counterparts. For women the researchers calculated the figures to be 62 per cent can expect to die in the age range 30 to 69 compared with only 38 per cent of their non smoking counterparts.

The study also found that:

* Smoking 1 to 7 bidis a day raised risk of death by one-third, and smoking 1 to 7 cigarettes a day nearly doubled it.

* Smoking is responsible for most of the gap between male and female rates of death in middle age.

* The risks were significant among both educated and illiterate adults, in both urban and in rural areas.

* Quitting smoking works, but only 2 per cent of adults in India have quit, mostly after falling ill.

Professor Amartya Sen, well known Indian economist and philosopher who won the Nobel Prize for Economics in 2001, said:

"It is truly remarkable that one single factor, namely smoking, which is entirely preventable, accounts for nearly one in ten of all deaths in India."

He said that the study "brings out forcefully the need for immediate public action in this much neglected field".

May 22
India Reduces Rate Of HIV Transmission In Some States, UNAIDS Report Says
India has managed to reduce the rate of HIV transmission in some states through increased awareness, resources and legislation, according to a report released Monday by India's Prime Minister Manmohan Singh, Reuters reports.

According to the report, titled "Redefining AIDS in Asia: Crafting an Effective Response," about 440,000 people die annually of AIDS-related causes in Asia, and the rate is expected to rise to about 500,000 by 2020 if measures are not taken (Majumdar, Reuters, 6/30). The report -- conducted by a UNAIDS-supported independent group called the Commission of AIDS on Asia and the Pacific -- noted that $3.1 billion annually would be required to effectively respond to the epidemic on the continent, United News of India reports.

According to the report, India accounts for about half of the estimated five million HIV-positive people in Asia (United News of India, 6/30). The report warned that India must be extremely cautious because many people are still unaware about the benefits of condom use in preventing HIV transmission, especially among injection drug users and women in rural parts of the country. India's efforts are garnering positive results in the southern states of Tamil Nadu and Andhra Pradesh and Maharashtra in the west, according to the report.

Denis Broun, head of UNAIDS in India, said the country "has managed to slow down the epidemic in some states with more decisive planning." He added, "We have really worked a lot in mobilizing politicians and they have been able to visit around the country and understand the realities of AIDS and interact with people." Broun said that new HIV diagnoses are "dropping in Tamil Nadu and it has been successful in Maharashtra," and "[w]e are sure we are going to see success in Andhra Pradesh before a year" .

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