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Mar 21
CPF Launches National PSA To Educate Public On Pulmonary Fibrosis
Pulmonary Fibrosis (PF) claims a life every 13 minutes in the U.S., the same number of lives each year as to breast cancer; yet most Americans have never heard of the disease until it strikes them, or someone they love. The Coalition for Pulmonary Fibrosis (CPF) launched a new public service announcement (PSA) to increase awareness of PF, which affects more than 128,000 Americans. Since 2001, prevalence has increased an alarming 156 percent, yet awareness and understanding of PF remains low in the general public and medical community. The goal of the PSA is to draw increased national attention to PF by educating the public on this rapidly progressing and ultimately fatal disease, and to urge people to support the CPF in its efforts to help patients and fund research efforts to find a cure.

The PSA, entitled 'Target', portrays a need for increased public awareness of PF by noting the rapidly increasing prevalence of the disease and the need to accelerate efforts to help patients, and understand and treat PF. The aggressive tone of the PSA highlights the ever-increasing need to work with the CPF to help the community of patients and researchers it serves,

"Our goal was to create a dramatic visual metaphor that clearly demonstrates the random and deadly nature of PF. The customized visual effect of an animated high tech moving target in an urban environment delivers a sobering message that 128,000 are now dying from PF with another 48,000 who will be 'targeted' this year by the deadly disease," said David C. Bojorquez, Director - Filmmaker with David Productions, the company that created the PSA for the CPF.

The video conveys the stealth nature of the fatal lung disease that targets its victims randomly. There is no known cause and there are no treatments, making PF a mystery to scientists, and a shocking and devastating diagnosis to patients and their families. It is the CPF's intention to create an open dialogue about the disease with the strong video message in hopes that it will lead to public support of the CPF's continuing efforts in patient services and research efforts to find a cure.

"We are so excited about this opportunity to share this well-produced video with the public. Our patients have long waited for a national voice in the media, and we are filling that void with this production," said Mishka Michon, chief executive officer for the CPF. "Our goal is for this video to spread virally throughout the Internet and for it to also be widely broadcast on television and cable stations nationwide. It is critically important that attention be paid before hundreds of thousands more lives are claimed by PF in the coming years."

About Pulmonary Fibrosis (PF)

Pulmonary Fibrosis (PF) is a lung disorder characterized by a progressive scarring - known as fibrosis -- and deterioration of the lungs, which slowly robs its victims of their ability to breathe. Approximately 128,000 Americans suffer from PF, and there is currently no known cause or cure. An estimated 48,000 new cases are diagnosed each year. PF is difficult to diagnose and an estimated two-thirds of patients die within five years of diagnosis. Sometimes PF can be linked to a particular cause, such as certain environmental exposures, chemotherapy or radiation therapy, residual infection, or autoimmune diseases such as scleroderma or rheumatoid arthritis. However, in many instances, no known cause can be established. When this is the case, it is called idiopathic pulmonary fibrosis (IPF).

About the CPF

The CPF is a 501(c)(3) nonprofit organization, founded in 2001 to accelerate research efforts leading to a cure for pulmonary fibrosis (PF), while educating, supporting, and advocating for the community of patients, families, and medical professionals fighting this disease. The CPF funds promising research into new approaches to treat and cure PF; provides patients and families with comprehensive education materials, resources, and hope; serves as a voice for national advocacy of PF issues; and works to improve awareness of PF in the medical community as well as the general public. The CPF's nonprofit partners include many of the most respected medical centers and healthcare organizations in the U.S. With more than 19,000 members nationwide, the CPF is the largest nonprofit organization in the U.S. dedicated to advocating for those with PF.

Mar 21
Report Highlights Strong Links Between Mothers' Diets And The Health Of Their Children
A new report by University of Southampton academics emphasises the links between poor diet in mothers and ill-health in their children, and calls for women of childbearing age to be made more aware of the importance of good nutrition.

The report 'Early Nutrition and Lifelong Health', published this month by the British Medical Association Board of Science, looks at the evidence that the diets of women of reproductive age, and those of their foetuses and young children, are significant factors in influencing the risk of chronic diseases such as heart disease, diabetes, obesity, brittle bone disease and even some forms of cancer and mental illness, later in those children's lives.

Lead author Professor Mark Hanson, director of the Centre for the Developmental Origins of Health and Disease at the University of Southampton, comments: "Society and public health organisations need to pay much greater attention to these issues if the rising epidemic of these diseases is to be prevented. Tackling the diseases once children reach adulthood is often too late. By taking steps to improve maternal nutrition we could save many people from a lifetime of ill health."

The research was funded in part by the Medical Research Council (MRC) and Professor Hanson's co-authors are Professor Caroline Fall, Dr Sian Robinson and Dr Janis Baird of the MRC Epidemiology Research Centre at the University of Southampton.

Their report raises concerns about diets in the UK, but also in developing countries in many parts of the world.

According to the authors, unbalanced nutrition, whether too much or too little or of poor quality, can have long-term effects. In the UK, for example, many have diets low in certain nutrients although they have access to plentiful food.

The numbers of women who breastfeed their infants is still too low, they say, with many women starting to breastfeed, but then stopping too soon, and many infants being fed inappropriate foods at the weaning stage.

"The nutritional transitions occurring in many developing societies will have major effects on diets between generations, and this will increase the risk of chronic disease dramatically," continues Professor Hanson.

"It's not only women who need to be careful about they quality of their food intake. Prospective fathers should also eat well and steps need to be taken to ensure that young people understand the importance of good nutrition as part of their lifestyle choices."

The report suggests that the medical profession can help by advising people about the importance of good nutrition, especially before and after they have children and by promoting breastfeeding and appropriate early foods for babies.

More advice could be given to people with young children about the importance of a balanced diet for those children and more support could be given to women to help them start breastfeeding and to continue with it.

Mar 21
Environmental Issues Not Considered When Analyzing Fish Consumption Guidelines
An analysis in CMAJ expresses reservations about recommendations to raise fish consumption for health benefits. Dr. David Jenkins and his team, St. Michael's Hospital, Toronto, say such advice may not consider environmental issues, and that further research to explain the benefits of omega-3 fatty acids is required. http://www.cmaj.ca/press/pg633.pdf.

Around the world, the medical community and health agencies praise fish consumption for health benefits. In developed countries, people have been advised to double or triple their fatty fish intake.

Evidence and unsuccessful studies in demonstrating a significant health benefit from omega-3 fatty acids have received little interest, suggesting that not all individuals do indeed benefit from fish consumption. This study examines the facts to prove the health benefits of fish.

The researchers explain that global fisheries are in serious crisis with the present fish consumption levels because demand outweighs supply. There are severe consequences for the food security of poorer countries and coastal communities, as diminishing stocks are redirected from local to affluent markets. Since the late 1980's, global stocks have been declining and more than a hundred cases of marine extinctions have been reported.

"These trends imply the collapse of all commercially exploited stocks by mid-century," the authors write. "Yet the dire status of fisheries resources is largely unrecognized by the public, who are both encouraged to eat more fish and are misled into believing we live in a sea of plenty."

Mar 19
Depressed People Have Trouble Learning 'Good Things In Life'
While depression is often linked to negative thoughts and emotions, a new study suggests the real problem may be a failure to appreciate positive experiences.

Researchers at Ohio State University found that depressed and non-depressed people were about equal in their ability to learn negative information that was presented to them.

But depressed people weren't nearly as successful at learning positive information as were their non-depressed counterparts.

"Since depression is characterized by negative thinking, it is easy to assume that depressed people learn the negative lessons of life better than non-depressed people - but that's not true," said Laren Conklin, co-author of the study and a graduate student in psychology at Ohio State.

The study appears in the March issue of the Journal of Behavior Therapy and Experimental Psychiatry.

Researchers tested 34 college students, 17 of whom met criteria for clinical depression and 17 of whom were not depressed.

This study is one of the first to be able to link clinical levels of depression to how people form attitudes when they encounter new events or information, said Daniel Strunk, co-author of the study and assistant professor of psychology at Ohio State.

Strunk said the key to conducting this study was the use of a computer game paradigm co-developed at Ohio State in 2004 by Russell Fazio, a professor of psychology and co-author of this new study. Fazio and his collaborators, Natalie Shook, a PhD graduate of Ohio State now at Virginia Commonwealth University and J. Richard Eiser of the University of Sheffield (England) have used the game in many studies examining differences in the development of positive and negative attitudes.

The developers affectionately call the game "BeanFest." It involves people encountering images of beans on the computer screen. The beans could be good or bad, depending on their shape and the number of speckles they had.

Good beans earned the players points, while bad beans took points away. The goal was to earn as many points as possible.

While the game may seem trivial to a naive audience, Strunk said it offers a unique and powerful way to measure how people learn new attitudes.

"Before, if researchers wanted to investigate how people formed new attitudes, it was very difficult to do," Strunk said. If researchers asked about real-life issues, the problem is that prior learning and attitudes may impact how people respond to new information. But in this game, participants don't have any prior knowledge or attitudes about the beans so researchers could learn how they formed their attitudes in a novel situation, without interference from past experiences.

In the game phase of this study, participants had to choose whether they would accept a bean when it appeared on the screen. If they accepted the bean, the points were added or deducted from their total. If they rejected the bean, they were still told how many points they would have earned or lost if they had accepted it.

Each of the 34 beans was shown three times during the game phase, giving the participants a good opportunity to learn which beans were good and which were bad.

Then, in the test phase, participants had to indicate whether beans they learned about in the game phase were "good" (choosing it would increase points) or "bad" (choosing it would decrease points). The researchers tallied how well participants did in correctly identifying positive and negative beans.

The non-depressed students correctly identified 61 percent of the negative beans, which was about the same as the depressed students, who correctly identified 66 percent of the "bad" beans.

But while the non-depressed students correctly identified 60 percent of the positive beans, depressed students correctly classified only 49 percent of these good beans. Non-depressed students identified the good beans better than the depressed students, who failed to identify good beans better than chance.

"The depressed people showed a bias against learning positive information although they had no trouble learning the negative," Strunk said.

One of measures researchers used in the study classified whether the depressed participants were currently undergoing a mild, moderate or severe episode of depression. In the study, those undergoing a severe depressive episode did more poorly on correctly choosing positive beans than those with mild depression, further strengthening the results.

While more research is needed, Conklin and Strunk said this study suggests possible ways to improve treatment of depressed people.

"Depressed people may have a tendency to remember the negative experiences in a situation, but not remember the good things that happened," Conklin said. "Therapists need to be aware of that."

For example, a depressed person who is trying out a new exercise program may mention how it makes him feel sore and tired -but not consider the weight he has lost as a result of the exercise.

Mar 19
New Study Finds Daily Drinking Rather Than Binge Drinking Is Biggest Risk Factor In Serious Liver Di
Long-term daily drinking, rather than weekly binge drinking, is by far the biggest risk factor in serious liver disease, according to a new report from the University of Southampton.

The study, published in Addiction journal this week, concludes that increases in UK liver deaths are a result of daily or near daily heavy drinking, not episodic or binge drinking, and this regular drinking pattern is often discernable at an early age. It also recommends that several alcohol-free days a week is a healthier drinking pattern.

In the study of drinking patterns, dependency and lifetime drinking history in 234 subjects with liver disease, 106 had ALD (Alcohol-related Liver Disease) - 80 of whom had evidence of cirrhosis or progressive fibrosis - the team found that 71 per cent of ALD patients drank on a daily basis.

In contrast to the patients with alcohol-related cirrhosis or fibrosis, patients with other forms of liver disease tended to drink sparingly with only 10 subjects (8 per cent) drinking moderately on four or more days each week.

The study also explored lifetime drinking histories of 105 subjects and found that ALD patients started drinking at a significantly younger age (on average at 15 years old) than other subjects and had significantly more drinking days and units than non-ALD patients from the age of 20 onwards.

Lead author of the study Dr Nick Sheron, consultant hepatologist and senior lecturer at the University of Southampton, comments: "If we are to turn the tide of liver deaths, then along with an overall reduction in alcohol consumption - which means tackling cheap booze and unregulated marketing - we need to find a way to identify those people who are most likely to develop alcohol-related illnesses at a much earlier stage, and perhaps we need to pay as much attention to the frequency of drinking occasions as we do to binge drinking.

"The transition from a late teenage and early 20's binge drinking pattern to a more frequent pattern of increased intake may prove to be a useful point of intervention in the future, and the importance of three alcohol-free days each week should receive more prominence."

Mar 19
Obese People Seem To Fare Worse After Pancreatic Cancer Surgery
After having surgery for pancreatic cancer, obese people with a BMI of 35 or more seem to be the most likely to have poorer outcomes such as cancer that has spread to the lymph nodes, lower rates of survival and higher rates of cancer recurrence.

The study was the work of Dr Jason B Fleming, from the University of Texas MD Anderson Cancer Center in Houston, and colleagues and is published online in the March issue of the Archives of Surgery a Journal of the American Medical Association.

A person is classed as obese if their Body Mass Index (BMI, weight in kilos divided by the square of height in metres, kg/m2) is 30 or more. The "ideal" or normal range is 18.5 to 25: being outside of this range is linked to various health problems for underweight, overweight and obese people.

Rates of obesity have risen sharply in the US in the last 20 years, wrote the authors in their background information.

"In many obesity-related diseases and malignant neoplasms [cancerous tumors], an increased prevalence of pancreatic cancer has been reported in numerous epidemiologic and cohort studies focusing on obese patients," they wrote.

"Further, obesity has been associated with decreased survival in patients with pancreatic adenocarcinoma, although the mechanism remains unknown," they added.

For this study they wanted to examine the link between obesity, as measured by BMI, and medical outcomes and survival of patients who have had their pancreas removed to treat pancreatic adenocarcinoma.

The study looked at the results retrospectively (that is they found data relating to surgeries that had already taken place as opposed to setting up the study beforehand). The researchers looked at records from 285 consecutive patients whose BMI data was available and who had undergone "potentially curative pancreas resection to treat adenocarcinoma".

All the patients had attended a referral center with a dedicated multidisciplinary pancreas cancer program between 1 January 1999 and 31 October 2006.

In their statistical analysis the researchers looked for links between BMI and other prognostic information and the incidence of lymph nodes metastasis (how far the cancer had spread if it had), and survival rates.

The results showed that:

* Over the 16 month midpoint of the study (median follow up), 152 patients died (53 per cent).

* Patients whose BMI was over 35 survived a median of 13.2 months compared with 27.4 months for those whose BMI was under 23.

* At the last follow up, 15 of 20 patients (75 per cent) whose BMI was over 35 had died, compared with 137 of 265 patients (52 per cent) whose BMI was 35 or less.

* Cancer spreading to the lymph nodes was 12 times more likely in obese patients with BMI over 35 than in patients whose BMI was 35 and under.

* Disease-free and overall survival was also lower in patients whose BMI was above 35, and the risk of cancer recurrence and death after having their pancreas removed was nearly twice that of patients whose BMI was 35 and under.

The researchers concluded that:

"Obese patients with a BMI of more than 35 are more likely to have node-positive pancreatic cancer and decreased survival after surgical resection."

"Data suggest that the negative influence of BMI of more than 35 on cancer-related end points is unrelated to the potential complexity of performing major oncologic surgery in obese patients," they added.

Other studies have shown links between BMI over 35 and increased risk of death from pancreatic cancer, noted the authors, who wrote that:

"Our findings extend these observations to those patients who undergo surgery to treat pancreatic cancer and suggest that obesity is a host factor affecting tumor biology independent of the difficulties (patient- and treatment-related) involved in delivering oncologic care in obese patients."

"Future investigations should include a search for systemic or tumor biomarkers in this group of patients that could provide additional insight," they added.

Mar 17
A Population Based Study Of 2,856 School-Age Children With Urinary Incontinence
UroToday.com - A study by Dr. Premala Sureshkumar et al. evaluated the risk spectrum and risk factors for diurnal enuresis in school-age children.

The group found that overall there was a poor concordance between frequency and amount of daytime incontinence. They also found that of children who wet with the least frequency during the day, almost half were more likely to experience the greatest amounts of incontinence in regards to volume. In those who experienced severe frequency, the majority (98%) reported very mild to moderate levels of amount of incontinence. They found that a definite UTI was much more strongly associated with frequency of daytime urinary incontinence in males than in females. Of course, constipation was associated with a stronger effect on daytime incontinence. The group acknowledged that the study did have limitations, the first one being a low response rate (35%). They also stated that their study was by no means establishing cure guidelines for incontinence. They feel that longitudinal studies will be necessary to further explore the relationships and associations of risk factors with daytime incontinence.

There was an editorial comment by Julian Wan stating that he had some concern with the data collection. He felt that 35% response rate could have been an over reporting. There was also some concern about how criteria was established such as, "does your child strain more than 25% of the time?" or "are there lumpy or hard stools more than 25% of the time"? He states that a more practical input to data can help clinical recommendations.

With the move forward to an electronic medial record keeping system, hopefully we can keep some of this data in a prospective manner. Nonetheless, the true task lies in how we establish the criteria to collect it prospectively.

Mar 17
Pitt Study Of Pregnant Women Shows Antidepressants, Depression May Raise Risk Of Premature Birth
Pregnant women who had untreated major depression in all three trimesters of pregnancy, as well as those who took certain antidepressants, had preterm birth rates exceeding 20 percent, according to a study by University of Pittsburgh School of Medicine researchers published in the March issue of American Journal of Psychiatry.

Approximately 10-to-20 percent of women struggle with symptoms of major depression during their pregnancies, but treating it can be complicated. Selective serotonin reuptake inhibitor (SSRI) antidepressants are usually the first line of depression treatment, but can lead to unwanted outcomes such as preterm births if used continuously throughout pregnancy, the findings suggest.

"It is well-known that the prevalence of depression in women is highest during the childbearing years, and treating the symptoms with SSRIs is a common medical therapy," said Katherine L. Wisner, M.D., M.S., director of the Women's Behavioral HealthCARE program at Western Psychiatric Institute and Clinic of UPMC, associate investigator at Magee-Womens Research Institute, and professor of psychiatry, obstetrics, gynecology and reproductive sciences and epidemiology at the University of Pittsburgh School of Medicine. "However, given the similarity in outcomes we found for continuous SSRI treatment and continuous depression, it is possible that underlying depressive disorder is a factor in preterm birth among women taking SSRIs."

Throughout this prospective study, researchers followed 238 women with no, partial, and continuous exposure to either depression or SSRI treatment during pregnancy and compared neonatal outcomes. They found that women exposed to either continuous SSRI treatment, or to continuous depression with no SSRI treatment, had comparable levels of increased risk for preterm birth at 21 percent and 23 percent, respectively. However, women with no exposure to either depression or SSRI medication had lower rates of preterm births, around 6 percent.

The researchers also discovered that either depression or SSRI treatment did not affect the baby's birth weight or the mother's weight gain during pregnancy or influence the rate of minor physical birth defects in the infant.

Previous studies have associated both depression and SSRIs with an increased risk for miscarriage. But taking these antidepressants during pregnancy does not greatly increase the overall risk of birth defects, noted Dr. Wisner.

While the results add more evidence linking SSRI treatment to risk of preterm birth, the risk of untreated depression conveys no less risk and suggests that factors independently related to both the disease and its treatment are associated with preterm birth.

"The relationship of preterm birth to depression and SSRI exposure must be clarified through further research," said Dr. Wisner. "In the meantime, it is recommended that each pregnant woman consult with her doctor to weigh the benefits and risks of depression treatment with antidepressants."

Mar 17
New Human Genetic Link To High Levels Of 'Good' Cholesterol
HDL cholesterol (HDL-C), or "good" cholesterol, carries excess cholesterol - that might otherwise block arteries - from blood vessels back to the liver for processing and elimination. As such, individuals with high plasma HDL-C levels have a decreased risk of developing coronary artery disease. Genetics contribute to determining a person's plasma HDL-C level, and in a new JCI study Daniel Rader and colleagues from the University of Pennsylvania show that mutations in the LIPG gene, which codes for an enzyme known as endothelial lipase, result in high plasma HDL-C levels.

The authors examined the LIPG gene in 585 subjects of European ancestry and identified 10 people with previously unreported rare mutated forms of this gene that were unique to subjects with very high HDL-C levels. Further studies revealed that mutations in the LIPG gene that cause loss of endothelial lipase activity were the cause of increased plasma HDL-C levels. These data provide important human genetic evidence that inhibition of endothelial lipase is likely to raise HDL-C levels in humans. Whether or not the resulting increase in HDL-C level due to this inhibition would impact cardiovascular health requires further study.

Mar 17
Research Suggests Scientists Should Follow The Body's Lead To Prevent HIV From Taking Root
For 25 years, researchers have tried and failed to develop an HIV vaccine, primarily by focusing on a small number of engineered "super antibodies" to fend off the virus before it takes hold. So far, these magic bullet antibodies have proved impossible to produce in people. Now, in research published March 15 online by Nature, scientists at The Rockefeller University have laid out a new approach. They have identified a diverse team of antibodies in "slow-progressing" HIV patients whose coordinated pack hunting knocks down the virus just as well as their super-antibody cousins fighting solo.

By showcasing the dynamic, natural immune response in these exceptional patients, the research, led by Michel C. Nussenzweig, Sherman Fairchild Professor and head of the Laboratory of Molecular Immunology, suggests that an effective HIV vaccine may come from a shotgun approach using of a wide range of natural antibodies rather than an engineered magic bullet.

"We wanted to try something different, so we tried to reproduce what's in the patient. And what's in the patient is many different antibodies that individually have limited neutralizing abilities but together are quite powerful," says Nussenzweig, who also is a Howard Hughes Medical Institute investigator. "This should make people think about what an effective vaccine should look like."

HIV strains mutate rapidly, making them especially wily adversaries of the immune system. But one element is shared almost universally among the diverging strains - a protein on the envelope of the virus called gp140 that HIV needs to infect immune cells. Prior research has shown that four randomly engineered antibodies that block the activity of that protein prevent the virus from infecting immune cells in culture, but all attempts to coax the human body into producing those four have failed.

So Johannes Scheid, a visiting student in Nussenzweig's lab who is now a doctoral candidate, turned his attention to the antibodies produced by six people infected with HIV whose immune systems put up an exceptionally strong fight. The patients represent the roughly 10 to 20 percent of HIV patients who are able to control the virus and are very slow to progress to disease. Their immune systems' memory B cells produce high levels of antivirus antibodies, but until now, researchers have known little about the antibodies or how effective they are.

With help from Rockefeller's Center for Clinical and Translational Science and Rockefeller scientists David D. Ho and Jeffrey V. Ravetch, Scheid and colleagues isolated 433 antibodies from these individuals' blood serum that specifically targeted the envelope protein - the chink in HIV's protean armor. He cloned the antibodies and produced them in bulk, mapped which part of the envelope protein each targeted, and gauged how effective each was in neutralizing the virus. In the process, he identified a new structure within the envelope protein - called the gp120 core - that had never been recognized as a potential target for antibodies. "It's the first time that anyone has defined what is really happening in the B cell response in these patients," says Scheid.

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