World's first medical networking and resource portal

News & Highlights
Please make use of the search function to browse preferred content
Medical News & Updates
May 16
Alzheimer`s could be predicted years before symptoms develop
Many of the biomarkers for Alzheimer`s disease that could potentially predict which patients will develop the disorder later in life have already been identified.

Now, studying spinal fluid samples and health data from 201 research participants at the Charles F. and Joanne Knight Alzheimer`s Disease Research Center, scientists at Washington University School of Medicine in St. Louis have shown the markers are accurate predictors of Alzheimer`s years before symptoms develop.
The researchers evaluated markers such as the buildup of amyloid plaques in the brain, newly visible thanks to an imaging agent developed in the last decade; levels of various proteins in the cerebrospinal fluid, such as the amyloid fragments that are the principal ingredient of brain plaques; and the ratios of one protein to another in the cerebrospinal fluid, such as different forms of the brain cell structural protein tau.

The markers were studied in volunteers whose ages ranged from 45 to 88. On average, the data available on study participants spanned four years, with the longest recorded over 7.5 years.

The researchers found that all of the markers were equally good at identifying subjects who were likely to develop cognitive problems and at predicting how soon they would become noticeably impaired.

Next, the scientists paired the biomarkers data with demographic information, testing to see if sex, age, race, education and other factors could improve their predictions.

"Sex, age and race all helped to predict who would develop cognitive impairment," said Catherine Roe, PhD, research assistant professor of neurology.

"Older participants, men and African Americans were more likely to become cognitively impaired than those who were younger, female and Caucasian," she added.

Roe described the findings as providing more evidence that scientists can detect Alzheimer`s disease years before memory loss and cognitive decline become apparent.

"We can better predict future cognitive impairment when we combine biomarkers with patient characteristics. Knowing how accurate biomarkers are is important if we are going to some day be able to treat Alzheimer`s before symptoms and slow or prevent the disease," she said.

Clinical trials are already underway at Washington University and elsewhere to determine if treatments prior to symptoms can prevent or delay inherited forms of Alzheimer`s disease. Reliable biomarkers for Alzheimer`s should one day make it possible to test the most successful treatments in the much more common sporadic forms of Alzheimer`s.

The study, supported in part by the National Institute on Aging, appears in Neurology.

May 16
Fish oil may stall brain-damaging effects of junk food
Fish oils could minimize the effects that junk food can have on the brain, a review by researchers at the University of Liverpool has shown.

The team at the University`s Institute of Ageing and Chronic Disease reviewed research from around the world to see whether there was sufficient data available to suggest that omega-3s had a role to play in aiding weight loss.
Research over the past 10 years has indicated that high-fat diets could disrupt neurogenesis, a process that generates new nerve cells, but diets rich in omega-3s could prevent these negative effects by stimulating the area of the brain that control feeding, learning and memory.

Data from 185 research papers revealed, however, that fish oils do not have a direct impact on this process in these areas of the brain, but are likely to play a significant role in stalling refined sugars and saturated fats` ability to inhibit the brain`s control on the body`s intake of food.

Research papers showed that on high-fat diets hormones that are secreted from body tissues into the circulation after eating, and which normally protect neurons and stimulate their growth, are prevented from passing into the brain by increased circulation of inflammatory molecules and a type of fat called triglycerides.

Molecules that stimulate nerve growth are also reduced, but it appears, in studies with animal models, that omega-3s restore normal function by interfering with the production of these inflammatory molecules, suppressing triglycerides, and returning these nerve growth factors to normal.

" Fish oils don`t appear to have a direct impact on weight loss, but they may take the brakes off the detrimental effects of some of the processes triggered in the brain by high-fat diets. They seem to mimic the effects of calorie restrictive diets and including more oily fish or fish oil supplements in our diets could certainly be a positive step forward for those wanting to improve their general health," explained Dr Lucy Pickavance, from the University`s Institute of Ageing and Chronic Disease.

The research has been published in the British Journal of Nutrition .

May 15
Now, restorative gel that can reverse paralysis
Scientists have developed a biodegradable implant, which in combination with a gel - that increases nerve growth and healing - can help restore the functionality of a torn or damaged nerve.

The team of Tel Aviv University researchers, including Dr. Shimon Rochkind of TAU`s Sackler Faculty of Medicine and Tel Aviv Sourasky Medical Center and Prof. Zvi Nevo of TAU`s Department of Human Molecular Genetics and Biochemistry, invented the method for repairing damaged peripheral nerves.

The innovative project`s initial successes were reported recently at several renowned scientific congresses, and the therapy, already tested in animal models, is only a few years away from clinical use, Rochkind said.

A nerve is like an electrical cable, which loses its functionality when it is either severed or damaged.

Similarly, a nerve that is damaged loses the ability to transfer signals for movement and feeling through the nervous system.

But in Rochkind and Nevo`s method, the two severed ends of a damaged nerve are reconnected by implanting a soft, biodegradable tube that serves as a bridge to help the nerve ends connect.

Rochkind said that the innovative gel named Guiding Regeneration Gel (GRG), which lines the inside of the tube, nurtures nerve fibers` growth, encouraging the nerve to reconnect the severed ends through the tube, even in cases with massive nerve damage.

The researchers said that the key lies in the composition of the gel, which has three main components: anti-oxidants, which exhibit high anti-inflammatory activities; synthetic laminin peptides, which act as a railway or track for the nerve fibers to grow along; and hyaluronic acid, commonly found in the human fetus, which serves as a buffer against drying, a major danger for most implants.

They said that these components allow the nerve to heal the way a fetus does in the womb - quickly and smoothly.

Rochkind said that GRG is not only able to preserve cells, it can support their survival while being used for therapy and transplantation.

When grown in the gel, cells show excellent development, as well as intensive fiber growth, which could have implications for the treatment of diseases like Parkinson`s, for which researchers are actively exploring cell therapy as a potential solution.

May 15
Rotavirus most common cause of diarrhoeal disease: Study
A new study has identified rotavirus as the most common cause of diarrhoeal deaths among children around the world.

The Global Enteric Multicenter Study (GEMS), involving 20,000 children from across Asia and Africa was designed to identify the aetiology and population-based burden of paediatric diarrhoeal disease in developing countries.
It is a 3-year, prospective, age-stratified, matched case-control study of moderate-to-severe diarrhoea in children aged 0-59 months residing in censused populations at four sites in Africa and three in Asia.

The researchers said that recruited children with moderate-to-severe diarrhoea seeking care at health centres along with one to three randomly selected matched community control children without diarrhoea.

From patients with moderate-to-severe diarrhoea and controls, they said they obtained clinical and epidemiological data, anthropometric measurements, and a faecal sample to identify enteropathogens at enrolment.

One follow-up home visit was made about 60 days later to ascertain vital status, clinical outcome, and interval growth.

They enrolled 9439 children with moderate-to-severe diarrhoea and 13 129 control children without diarrhoea.

Analysing data from the study, researchers found that approximately one in five children under the age of two suffer from moderate-to-severe diarrhoea (MSD) each year, which increased children`s risk of death 8.5-fold and lead to stunted growth over a two-month follow-up period.

"Without a full picture of which pathogen causes the most harm, it had been difficult to make evidence-based decisions around diarrhoeal disease control," said Dipika Sur, principal investigator, National Institute of Cholera and Enteric Diseases, Kolkata.

By analysing adjusted population attributable fractions, they found that most attributable cases of moderate-to-severe diarrhoea were due to four pathogens: rotavirus, Cryptosporidium, enterotoxigenic Escherichia coli producing heat-stable toxin (ST-ETEC; with or without co-expression of heat-labile enterotoxin), and Shigella.

Other pathogens were important in selected sites (eg, Aeromonas, Vibrio cholerae O1, Campylobacter jejuni).

Pathogens associated with increased risk of case death were ST-ETEC and typical enteropathogenic E coli in infants aged 0-11 months, and Cryptosporidium in toddlers aged 12-23 months.

The researchers noted that interventions targeting five pathogens (rotavirus, Shigella, ST-ETEC, Cryptosporidium, typical enteropathogenic E coli) could substantially reduce the burden of moderate-to-severe diarrhoea.

New methods and accelerated implementation of existing interventions (rotavirus vaccine and zinc) are needed to prevent disease and improve outcomes, they added.

More than 100,000 children die from diarrhoea in India every year, and approximately 4,57,000- 8,84,000 are hospitalised with the disease.

Nearly 800,000 deaths are caused by diarrhoea across the world.

May 14
How defect in cells trigger hearing, vision loss and kidney disease
Johns Hopkins scientists have unearthed clues about which protein signaling molecules are allowed into hollow, hair-like "antennae," called cilia, that alert cells to critical changes in their environments.

Researchers found that the size limit for entry is much greater than previously thought, allowing most of a cell`s proteins into cilia.

The researchers believe that the specific collection of proteins in each cilium, customized to the needs of each cell type, is determined by whether and how cilia keep proteins inside once they enter-not which ones they allow in initially.

"According to our experiments, 90 percent of the proteins in mammalian cells should be able to fit inside cilia based on their size," said Takanari Inoue, Ph.D., assistant professor of cell biology at the Johns Hopkins University School of Medicine.

"But most of them have never been found [inside the cilia], so we think that most proteins do wander in at some point, but only certain ones remain inside," Inoue added.

So-called "primary cilia" have been attracting intense attention as recent research has confirmed their role in monitoring the cell`s exterior environment and conveying information to the rest of the cell using an arsenal of signals stored inside the thin interior of each antenna-like cilium.

The results of this study have helped explain how that arsenal is developed.

Primary cilia are found protruding from most cells in a wide variety of organisms, and defects in cilia have been implicated in everything from polycystic kidney disease to vision and hearing loss.

In the kidney, they monitor the flow of urine; in the eye, they sense the wavelength of light; in cartilage, they sense pressure; and in the heart, blood flow. No matter where they are, Inoue said, their job is to translate such mechanical forces-or, in some cases, chemical ones-into molecular signals for the cell, so that it can respond appropriately to its environment.

The signaling molecules inside cilia are tailored to the required responses. For example, some are proteins that bind to DNA to modify gene activity, letting a cell respond to environmental cues by producing more of a particular protein. The only way into the cilial column is through a hole at its base.

"A cilium forms like a short drinking straw being pushed outwards from inside an inflated balloon. What we don`t know is whether there is some sort of cap over the hole, regulating what goes in and out. We found that more signaling molecules could enter the straw than we thought," explained Inoue.

Previous research in other laboratories suggests that a fixed pore exists at the base of a cilium that only allows relatively small molecules inside. By developing more sensitive experimental methods, the Inoue group was able to show that molecules almost 10 times larger than those known before could enter.

Specifically, they first engineered an anchor-like molecule that selectively embedded itself in the membranes of cilia. On the inside end of the anchor was half of a "molecular snapper." Inside the watery interior of the cell, the team placed fluorescent molecules of known size, fitted with the other half of the molecular snapper. If these fluorescent molecules entered cilia, they would carry their fluorescence with them and be trapped inside when the snappers clicked together, allowing the researchers to easily take images of them.

By repeating this experiment many times with molecules of increasing size, the Inoue team was able to show that every molecular size they tested was able to enter the cilia. The only difference between the molecules of different sizes was their rate of entry: Smaller molecules entered more quickly than larger ones.
Figuring out how cilia select their captives is a question for another study, Inoue noted.

The results of this study will be published online in the journal Nature Chemical Biology.

May 14
Dose of dengue virus needed for transmission identified
Researchers have identified the dose of dengue virus in human blood that is required to infect mosquitoes when they bite.

Mosquitoes are essential for transmitting the virus between people so the findings have important implications for understanding how to slow the spread of the disease.

By defining the threshold of the amount of virus needed for transmission, the research also provides a target that experimental dengue vaccines and drugs must prevent the virus from reaching in order to be successful at preventing the spread of disease during natural infection.

Recent estimates indicate that there are 390 million infections of dengue across the globe each year and with no vaccine or specific treatment available, current measures to prevent the spread of disease are focused on controlling the mosquito vector.

In research funded by the Wellcome Trust, scientists and doctors at the Oxford University Clinical Research Unit at the Hospital for Tropical Diseases in Vietnam studied the factors that influence the transmission of dengue viruses from dengue patients to the mosquitoes that feed on them.

Their findings reveal that mosquitoes that feed on dengue patients with very high levels of virus in their blood are more likely to be infectious to other humans two weeks later.

"Our findings suggest that focused public health intervention strategies to prevent transmission from these `high risk` spreaders of the virus could have a major impact in slowing the spread of disease," Professor Cameron Simmons, a Wellcome Trust Senior Fellow at the Oxford University Clinical Research Unit in Vietnam said.

The study is published online in the journal Proceedings of the National Academy of Sciences.

May 13
Food and exercise tips for summer slim down
University of Alabama at Birmingham (UAB) exercise and nutrition experts have offered tips for those in search of a summer slim down.

EatRight by UAB Weight Management Services Clinical Dietitian Lindsey Lee R.D., said nutrition is necessary to support weight loss efforts.

"Incorporate good nutrition habits - eating fruits and vegetables, low-fat dairy products, whole grains and lean protein sources - to get the calories you need to maintain an exercise program," Lee said.

"If you restrict calories too much, you could start to feel burn out," Lee stated.

To bolster the burn, Lee suggested: Fill up on lower calorie fruits and vegetables, choose water over high calorie sodas and decrease high calorie, high fat options.

The expert suggests switching up food preparation: Instead of steaming vegetables, grill them or toss unique vegetables like skewered okra or fresh asparagus on the grill.

"The one important thing to remember is to limit the fat source you use. Try different herbs and spices to season your veggies instead of heavy amounts of olive oil, canola oil, or butter," Lee said.

Restaurant meals can be deceptive and pose a special challenge to healthy eating.

"Even meals you think are healthy in restaurants are loaded with calories because of cooking methods that add a lot of fat and sodium, so ask to have foods prepared as light as possible to avoid extra calories," Lee suggested.
She also suggests that people generally underestimate the calories they take in, and they overestimate the calories they burn. The best bet, she said, is to watch the calories consumed daily and get in at least 30 minutes of physical activity five days per week.

UAB School of Education Associate Professor of Health Education Retta Evans, Ph.D., said to start by adding a walk or bike ride to a daily routine, then mix it up with other activities to keep things interesting.

"Piloxing, which is a combo of Pilates and kickboxing, is fun," Evans said.

"There are also a variety of yoga disciplines to try, as well as barre fitness dance classes. Mixing it up with different activities is a good way to ramp up your program," she added.

Evans said a personal trainer could take physical activity and weight loss goals to another level.

"They can sit down with you and map out a timeline to meet your goals, and then they can be there as a motivator to keep reaching those," Evans explained.

If a personal trainer is not in the cards, Evans suggests looking to the internet for free exercise programming instruction. Either way, properly setting expectations is important.

"In a three month period, you can expect to drop up to three percent of your body composition. Some people will drop more, and some will drop less. But in that time frame, you`ll start to see changes in how your body looks and feels," she asserted.

May 13
How to use aspirin to treat and prevent heart disease, cancers
A Florida Atlantic University researcher has published a review for clinicians on the optimal utilization of aspirin to treat and prevent heart attacks as well as commentary on the cholesterol lowering drugs to prevent colorectal and other cancers.

Charles H. Hennekens, M.D., Dr.P.H., the first Sir Richard Doll professor and senior academic advisor to the dean in the Charles E. Schmidt College of Medicine at the University and James E. Dalen, M.D., M.P.H., dean emeritus, University of Arizona College of Medicine and executive director of the Weil Foundation published this update in the current issue of the American Journal of Medicine.

In a commentary published in Clinical Investigation, Hennekens and David J. Bjorkman, M.D., M.S.P.H., dean and executive director of medical affairs for the Charles E. Schmidt College of Medicine consider the emerging evidence on aspirin in the prevention of colorectal and other cancers and provide advice to doctors.

"All patients suffering from blockage of an artery in the heart or brain should receive 325 mg regular aspirin promptly and daily aspirin thereafter to reduce their death rate as well as subsequent heart attacks and strokes," said Hennekens.

In addition, he also stressed that "among long-term survivors of prior heart attacks, occlusive strokes or blockages in the arteries of the legs, aspirin should be continued long-term unless there is a specific contraindication."

Hennekens and Bjorkman advise doctors that, based on the current totality of evidence, in the primary prevention of vascular disease and cancer, any judgments about prescribing long-term aspirin therapy for apparently healthy individuals should be based on individual clinical judgments between the doctor and each of his or her patients.
General guidelines that advocate the routine use of aspirin in all apparently healthy individuals do not seem to be justified for the primary prevention of either cardiovascular disease (CVD) or cancer.

The increasing burden of CVD in developed and developing countries underscores the need for more widespread therapeutic lifestyle changes as well as the adjunctive use of drug therapies of proven net benefit in the primary prevention of CVD. These should include statins to lower cholesterol, and the multiple drug therapies likely to be necessary to achieve control of high blood pressure.

Hennekens was the first to discover that aspirin prevents a first heart attack and has lifesaving benefits when given during a heart attack or among long-term survivors of prior events.

Science Watch ranked Hennekens as the third most widely cited medical researcher in the world from 1995-2005, and five of the top 20 were his former trainees and/or fellows. In 2012, Science Heroes ranked Hennekens No. 81 in the history of the world for having saved more than 1.1 million lives.

On March 2, the American Heart Association honored the Charles E. Schmidt College of Medicine as well as Hennekens, Dick and Barbara Schmidt, and Bjorkman for their past, current, and future contributions to reducing suffering and death from heart attacks and strokes.

On May 1, Hennekens received the Presidential Award from his alma mater, Queens College, the highest honor bestowed upon any graduate.

May 11
India tops cervical cancer deaths: Study
With nearly 73,000 women dying every year, India has the highest number of cervical cancer deaths in the world, according to a report released today by a US-based research and advocacy group.

India represents 26.4 per cent of all women dying of cervical cancer globally, with China, Bangladesh, Pakistan, Indonesia and Thailand also showing high death incidence, says the "Cervical Cancer Global Crisis Card" released by the Cervical Cancer-Free Coalition.

According to the report card, cervical cancer kills an estimated 275,000 women every year and 500,000 new cases reported worldwide. This entirely preventable disease is the second largest cancer killer of women in low and middle-income countries, with most women dying in the prime of life, it said.

Using data from the WHO, United Nations, the World Bank and IARC Globocan, the Crisis Card has ranked 50 countries in the descending order of cancer mortality rates.

The Crisis Card report also highlighted the startling disparities between women in the developed and developing world personified by cervical cancer.

"A woman in Zambia is 25 times more likely to die from cervical cancer than a woman in Australia and India has 750 times more deaths than Norway. This level of inequity is also reflected across gender indicators with girls less likely to attend school but more likely to be malnourished and married as a child," said the report.

Recent data released by India`s Health Ministry based on the National Cancer Registry Programme (NCRP) report in 2009 the number of cervical cancer cases were 101938 which has increased to 107690 in 2012.

In Uttar Pradesh a total of 17367 cases were reported in 2009 and it increased to 18692 in 2012. After Uttar Pradesh the number of cases of cervical cancer in 2012 which has shown an increasing trend are Maharashtra (9892), Bihar (9824), West Bengal (8396), Andhra Pradesh (7907), Tamil Nadu (7077) and others.

"Cervical cancer can happen to anyone. Certain women are at greater risk. These include women who started sexual activity at an early age, had multiple pregnancies, had multiple partners themselves, or their partners have multiple partners," said Dr Neerja Bhatla, Professor, Department of Obstetrics and Gynaecology at All India Institute of Medical Sciences (AIIMS).
Dr Bhatla said, "Also, women with STIs like chlamydia, gonorrhoea, herpes simplex, women with immune suppression, for example, HIV or transplant recipients, smokers and prolonged use of oral contraceptives have a higher risk. There is thought to be a small element of genetic predisposition as well."

It is being estimated that the number of cervical cancer cases and deaths are estimated to increase by 2025 to 203,757 and 115,171, respectively.

Cervical cancer is caused by the human papillomavirus (HPV), a fairly ubiquitous virus that will be acquired by about 80 per cent of women some time during their lives. Most women clear this virus by their immune system, but in about 8-10 percent of cases the infection remains persistent.

These women are at risk of the disease and in the presence of certain co-factors, risk factors; they can go on to develop precancerous lesions called CIN (cervical intraepithelial neoplasia). Again, if left untreated, some of these women will develop cervical cancer. The main spread of HPV is by sexual contact, but spread by fomites and mother to child transmission are reported.

"If you have found out you have cervical cancer, it does not mean that it is the end. Cervical cancer is a treatable cancer if found early enough. Just go through the treatments, they are hard and the side effects are awful, but life will continue as normal after everything is done," said Genevieve Sambhi, former Miss Universe Runner Up and a cervical cancer survivor.

Genevieve who was diagnosed with cervical cancer at the age of 35 said initially she had no symptoms, a little abnormal bleeding but nothing that made her think she had cancer.

She then went for a Pap smear and that`s when she found out she had cancer.
"Cervical cancer, like all cancers, may be asymptomatic in its precancerous phase and while it is an early cancer. Symptoms that point to the cancer include, inter menstrual and post coital bleeding, postmenopausal bleeding and persistent vaginal discharge," said Dr Bhatla.

Recently, Ghulam Nabi Azad, Minister of Health and Family Welfare had responded to a starred question in Lok Sabha.

"Data of the Indian Council of Medical Research (ICMR) of the number of breast and cervical cancer cases among women has increased in the country. At present the Government of India is looking for alternative techniques and affordability to implement test to be used for detection of cervical cancer."

The minister further added that while health is a state subject, the Centre has launched the national programme for prevention and control of cancer, diabetes, cardiovascular disease and stroke (NPCDCS) in 2010 in 100 districts across 21 states.

Strengthening of government medical college and erstwhile regional Cancer Centres (RCC) across the country as Tertiary Cancer Centre (TCC) for providing comprehensive Cancer care was also undertaken as well as campaigns are carried out through print and electronic media, he said.

May 11
Proper dose of exercise needed for depressed patients revealed
There`s now sufficient research data to provide specific guidance on how to prescribe exercise for people with major depressive disorder (MDD), according to researchers including an Indian origin.

Despite the substantial evidence supporting the use of exercise in the treatment of MDD, previous studies have not provided a clear indication of the proper dose of exercise needed to elicit an antidepressant effect, noted Chad Rethorst, PhD, and Madhukar Trivedi, MD, of the Department of Psychiatry at the University of Texas Southwestern Medical Center, Dallas.

To fill this gap, the researchers reviewed available data from randomized controlled trials, with the goal of developing specific and detailed recommendations for clinicians on how to prescribe exercise for their patients with MDD.

Randomised trials have shown that exercise is effective in reducing depressive symptoms in patients with MDD, on its own and in conjunction with other treatments, such as antidepressant medication and/or psychotherapy.

Exercise may help to meet the need for cost-effective and accessible alternative therapies for depressive disorders-particularly for the substantial number of patients who don`t recover with currently available treatments.

Based on the available data, aerobic exercise is the preferred form of exercise for patients with MDD-although there is also support for resistance training, Drs Rethorst and Trivedi noted.

In terms of session frequency and duration, they recommend that patients participate in three to five exercise sessions per week, for 45 to 60 minutes per session.

In terms of intensity, for aerobic exercise, they recommend achieving a heart rate that is 50 to 85 percent of the individual`s maximum heart rate (HRmax). For resistance training, they recommend a variety of upper and lower body exercises, three sets of eight repetitions at 80 percent of 1-repetition maximum (RM-that is, 80 percent of the maximum weight that the person can lift one time).

Data suggest that patients may experience improvement in depressive symptoms as little as four weeks after starting exercise. However, Drs Rethorst and Trivedi emphasize that the exercise program should be continued for at least ten to twelve weeks to achieve the greatest antidepressant effect.

Some people have questioned whether patients with MDD will be willing to participate in an exercise program. But Drs Rethorst and Trivedi noted that, in the studies they reviewed, only about fifteen percent of patients dropped out of exercise programs-comparable to dropout rates in studies of medications and psychotherapy.

They discuss strategies that may help improve adherence to exercise programs, such as consulting patients about their preferred types of exercise and providing individualized educational materials and feedback.
They also provide some practical tips for clinicians on how to estimate exercise intensity using readily available information.

Even if the depressed patient can`t reach the target intensity and frequency levels, exercise can still be helpful.

"Taken as a whole, these findings suggest that exercise doses below the current recommendations may still be beneficial for patients with MDD," Drs Rethorst and Trivedi added.

The results were published in the May Journal of Psychiatric Practice .

Browse Archive