Month: September 2013

Anorexia linked to how cholesterol processes in our body

Scientists have linked the eating disorder anorexia to variants in a gene coding for an enzyme that regulates cholesterol metabolism.

The study suggests that anorexia could be caused in part by a disruption in the normal processing of cholesterol, which may disrupt mood and eating behavior.

For this project-the largest-ever sequencing study of anorexia – Nicholas J. Schork, a professor at The Scripps Research Institute (TSRI) worked with an international team of collaborators representing more than two dozen research institutions.

The project made use of genetic information from more than 1,200 anorexia patients and nearly 2,000 non-anorexic control subjects.

For an initial “discovery” study in 334 subjects, the researchers catalogued the variants of a large set of genes that had already been linked to feeding behavior or had been flagged in previous anorexia studies.

Of more than 150 candidate genes, only a handful showed statistical signs of a linkage with anorexia in this group of subjects.

One of the strongest signs came from the gene EPHX2, which codes for epoxide hydrolase 2-an enzyme known to regulate cholesterol metabolism. ”

The team followed up with several replication studies, each using a different cohort of anorexia patients and controls, as well as different genetic analysis methods. The scientists continued to find evidence that certain variants of EPHX2 occur more frequently in people with anorexia.

Schork noted that people with anorexia often have remarkably high cholesterol levels in their blood, despite being severely malnourished.

The study has been published online in the journal Molecular Psychiatry.

 

New vaccine promises to treat AIDS

Researchers have developed a vaccine that seems to have the capability of completely clearing an AIDS-causing virus from the body.

The promising vaccine candidate that is being developed at OHSU’s Vaccine and Gene Therapy Institute is being tested through the use of a non-human primate form of HIV, called simian immunodeficiency virus, or SIV, which causes AIDS in monkeys.

Louis Picker, M.D., associate director of the OHSU Vaccine and Gene Therapy Institute, said that the latest research suggests that certain immune responses elicited by a new vaccine may also have the ability to completely remove HIV from the body.

The Picker lab’s approach involves the use of cytomegalovirus, or CMV, a common virus already carried by a large percentage of the population. In short, the researchers discovered that pairing CMV with SIV had a unique effect.

They found that a modified version of CMV engineered to express SIV proteins generates and indefinitely maintains so-called “effector memory” T-cells that are capable of searching out and destroying SIV-infected cells.

T-cells are a key component of the body’s immune system, which fights off disease, but T-cells elicited by conventional vaccines of SIV itself are not able to eliminate the virus.

The SIV-specific T-cells elicited by the modified CMV were different. About 50 percent of monkeys given highly pathogenic SIV after being vaccinated with this vaccine became infected with SIV but over time eliminated all trace of SIV from the body.

In effect, the hunters of the body were provided with a much better targeting system and better weapons to help them find and destroy an elusive enemy.

The research has been published today by the journal Nature.

New hope for women suffering from recurrent miscarriage

Deficient steroid production in turn leads to reduced formation of fats and vitamins that are essential for pregnancy nutrition

Researchers have brought out new data that could prove useful for advances in care for women suffering from recurrent miscarriage.

The recurrent loss of pregnancy through miscarriage causes significant distress to couples, often exacerbated by there being so few treatments available to clinicians.

Scientists have been uncertain about how these natural killer cells (NK cells) could contribute to a miscarriage and this has raised doubt over their importance in causing pregnancy loss.

Led by Professor Jan Brosens of Warwick Medical School, the team found that elevated uterine NK cells in the lining of the womb indicate deficient production of steroids.

Deficient steroid production in turn leads to reduced formation of fats and vitamins that are essential for pregnancy nutrition.

This study has been published in The Journal of Clinical Endocrinology and Metabolism.

Roche drug works in early-stage breast cancer

The Food and Drug Administration has issued a positive review of a breast cancer drug from Roche that could soon become the first pharmaceutical option approved for treating early-stage disease before surgery.

In documents posted online, FDA scientists said women who received the drug Perjeta as initial treatment for breast cancer were more likely to be cancer-free at the time of surgery than women who received older drug combinations. Although the results come from mid-stage trials of the drug, FDA scientists recommended accelerating approval of the drug.

That step is reserved for groundbreaking drugs to treat life-threatening diseases.

Perjeta was first approved last summer to treat women with a subtype of breast cancer that has already spread to other parts of the body. But Roche’s Genentech unit is now seeking approval to use the drug at a much earlier stage of the disease: after diagnosis and before surgery to remove the tumor.

Surgery to remove tumors is the first step in treating virtually all forms of cancer. If approved, Perjeta would be the first cancer drug approved for use as a pre-surgical step. Using cancer drugs before surgery is still experimental, but doctors hope the approach could help shrink tumors to make them easier to remove. In some breast cancer cases, a tumor that is easier to operate on could allow women to keep their breasts, rather than having them surgically removed.

On Thursday, the FDA will ask an outside panel of cancer specialists whether Perjeta’s benefits outweigh its risks for treating early-stage breast cancer. Among other questions, the experts will be asked whether the preliminary results reported by Genentech are likely to result in longer overall survival for patients. The government agency isn’t required to follow the group’s advice, though it often does.

The panel will review a 417-woman study comparing Perjeta in different combinations against older breast cancer treatments. When Perjeta was combined with Herceptin, another Genentech drug, and standard chemotherapy, 39 percent of women saw their cancer reach undetectable levels. Only 21 percent of women experienced the same results from taking Herceptin and chemotherapy alone. After drug treatment all the women received standard breast surgery to remove any cancerous tumors. Genentech says this surgery allowed researchers to confirm the presence or absence of cancer.

Last year the FDA released guidelines for studying breast cancer drugs in the pre-surgical setting, with the aim of accelerating approval of promising therapies. Perjeta is the first drug to undergo FDA review since those recommendations were released. If approved, it could encourage more drugmakers to study cancer drugs for early-stage use.

“Despite advances in systemic therapy of breast cancer, there remains a need to expedite drug development and approval of highly effective therapies for patients with high-risk early-stage breast cancer,” the FDA states in its review.

Like Herceptin, Perjeta only works in a subset of about 20 percent of breast cancer patients who have tumors that overproduce a protein known as HER-2, which makes cancer cells rapidly divide and grow.

Breast cancer is the second most deadly form of cancer in U.S. women, and is expected to kill more than 39,000 Americans this year, according to the National Cancer Institute. About 6,000 to 8,000 deaths per year are attributed to the HER-2 form of the disease.

FDA scientists stress in their review that Genentech’s results are preliminary and will have to be confirmed in future trials. The company only measured the patients’ immediate response to the drug, and did not submit follow-up data showing whether the cancer returned or whether women ultimately lived longer. But agency scientists said the company’s approach “is reasonably likely to predict clinical benefit,” and noted that Genentech is already enrolling patients in a late-stage trial that could confirm the results.

Since the early 1990s the FDA has granted accelerated approval to dozens of drugs based on promising early results, on the condition that their effectiveness is confirmed in later studies. That policy has been praised by patients with HIV, cancer and other deadly diseases where access to experimental treatments can mean life or death.

But the flipside of the program means removing drugs from the market if their initial promise isn’t confirmed by later studies. In 2011 the FDA was criticized by some cancer patients when it revoked breast cancer approval for another Genentech drug, Avastin. The FDA concluded that the drug did not help breast cancer patients live longer or bring enough other benefit to outweigh its dangerous side effects. The drug is still approved to treat colon cancer and other forms of the disease.

The FDA is scheduled to make a decision on whether to approve Perjeta for early-stage breast cancer by Oct. 31.

Source: Fox news

Adopted teens may be at higher risk of suicide

Adopted children may be more likely than their non-adopted siblings to attempt suicide, according to a new U.S. study.

Researchers urged doctors to be on the lookout for signs of trouble in adopted teen patients but said parents should not be overly alarmed by the results.

“While our findings suggest that adoptees may have an elevated risk for suicide attempt, the majority of the adopted individuals in our study were psychologically well-adjusted,” lead author Margaret Keyes, a psychologist at the University of Minnesota in Minneapolis, said.

Suicide is the third leading cause of death for young people between the ages of 10 and 24 years old, according to the Centers for Disease Control and Prevention. According to the agency, 4,600 youth deaths each year in the U.S. are suicides, and a much larger number of young people make attempts to take their own lives.

Previous research in Sweden found that adopted kids in that country were more likely to attempt suicide than non adopted kids, but no comparable study had been done in the U.S., according to Keyes and her coauthors writing in the journal Pediatrics.

They examined data from an existing University of Minnesota study of 692 adopted children and 540 non adopted siblings in Minnesota.

All of the adopted kids, who were between 11 and 21 years old during the study period, had been taken in by their families before age two and had a biologically unrelated teenage sibling in the same home.

Almost three quarters of the adopted children were born abroad, most of the foreign-born children were from South Korea and 60 percent of those were girls.

At the beginning of the study, and again about three years later, the researchers asked participating parents and kids if either of the children had made a suicide attempt.

Over the three years of the study, 56 children attempted suicide at least once, according to the family members’ reports. Of those kids, 47 were adopted and nine were not adopted.

When previous self-harm behavior was taken into account, researchers calculated that adopted teens were 3.7 times more likely to attempt suicide than the other teens.

When the researchers adjusted for other factors often linked with suicidal thinking or behavior, including drug use, depression, academic struggles and personality traits like alienation and impulsivity, the increased risk for adopted kids remained.

Although this study could not determine why the adopted teens were more likely to attempt suicide, the authors note that other research has suggested burdens carried by adopted children that may be contributing factors.

In the Swedish study, for example, researchers showed that substance abuse, suicidal behavior and mental illness among the biological parents of domestically adopted kids could explain about one third of the children’s increased risk for suicide.

For children adopted from abroad, Keyes’ team writes, there is also the possibility that loss of cultural identity and experience of ethnic discrimination only add to the pressures on a child.

“Other mediating factors, not considered in our study, may include: heritable risk, prenatal factors, factors unique to relinquishment by a biological parent, early trauma, weak attachment to adoptive families and loss of cultural identity and ethnic discrimination,” Keyes told Reuters Health by email.

Two of those factors may be most critical in determining suicide risk, according to Ritch C. Savin-Williams, a professor of developmental psychology at Cornell University in Ithaca, namely: genetics and early trauma.

“Many of us believe that these two might well be the most important distinguishing factors separating the two groups, answering the question of why were these babies put up for adoption in the first place,” he told Reuters Health.

The small size of the study and limited ethnic diversity make these results not generalizable to the whole of the United States, Savin-Williams said.

The study was also limited to self-reported suicide attempts and did not distinguish between types of attempts, some of which can be far more serious and worrisome than others, Savin-Williams noted.

“We do not believe that adoptive parents should be alarmed by these findings,” Keyes said.

“However, parents and clinicians may want to be aware of the increased potential for suicide attempt in adopted adolescents who evidence other risks for suicidal behavior,” she said.

Source : Fox News

 

FDA beefs up pain-drug warnings in face of abuse epidemic

The U.S. Food and Drug Administration has proposed stronger safety language on labels of long-acting and extended-release opioids in response to an epidemic of overdoses and deaths from the widely used pain medicines.

The labels need to highlight dangers of abuse and possible death, as well as risks to newborns of mothers taking the medicines, the agency said on Tuesday.

Opioids include formulations of morphine, oxycodone and fentanyl. One of the best-known opioids is Oxycontin, a long-acting form of oxycodone.

Some 16,651 people in 2010 died from overdose deaths related to opioid abuse, the FDA said, including long-acting formulations.

In a conference call, FDA officials said long-acting forms of opioids have played a “disproportionate role” in drug abuse and deaths.

The FDA said the drug labels currently are indicated for patients with moderate to severe pain, but in the future will indicate they should only be used for severe pain.

“The FDA is invoking its authority to require safety labeling changes and postmarket studies to combat the misuse, abuse, addiction, overdose and death from these potent drugs that have harmed too many patients and devastated too many families and communities,” FDA Commissioner Margaret Hamburg said in a release.

Updated language in the drug labels will stress the medicines are meant for pain severe enough to require daily, round the clock, long-term opioid treatment, and only for those who have not had adequate pain relief from alternative medicines.

The labels will also include prominent boxed warnings that chronic maternal use of the drugs can result in potentially fatal opioid withdrawal syndrome in newborns.

The agency will require extra studies of the drugs to assess known risks of abuse, overdose and death.

Janina Kean, chief executive of High Watch Recovery Center, an addiction treatment facility in Kent, Connecticut, said stronger safety language by itself won’t make a noticeable dent in the numbers of addictions and overdoses of opioids.

She said the drugs are being prescribed for countless uses, many of which are far from severe, with no apparent oversight.

“Doctors are prescribing them for dental work, for chronic back pain and every ache and pain you can imagine,” Kean said. “The FDA would be better served by trying to regulate when doctors prescribe those drugs.”

Kean said about 20 to 25 percent of her substance-abuse clients are addicted to opioids, up from just 1 to 4 percent a decade ago.

“It’s getting worse,” she said, noting that many clients are teenagers or young adults who became addicted by going into their parents’ medicine cabinets and taking their legally prescribed opioids.

“But now, when they go to the street they can’t afford the opioids. So they go to heroin, which is also an opioid, because it’s cheaper.”

Morgan Liscinsky, an FDA spokesman, said the agency’s hands are largely tied. While the FDA has authority to regulate drugmakers and drug labeling, he said it cannot intervene with doctors.

“The FDA does not have the authority to regulate the practice of medicine, and health care practitioners may choose to prescribe a legally marketed drug, based on their clinical assessment,” Liscinsky said.

 

9 ways to eliminate sugar cravings

According to the American Heart Association, the average American consumes approximately 16 teaspoons more added sugar than is recommended per day.

Sugar stimulates the brain to release serotonin, the “feel good” chemical, which provides a natural high. The endorphins released after eating sugar calm and relax us, leaving us wanting more. Eliminating a sugar addiction can be difficult, but following these steps can greatly reduce cravings and make it easier to kick the habit for good.

Nix the artificial sweeteners.  Artificial sweeteners have not been proven to curb sugar cravings. The taste, artificial or real, will have the same effect on the body creating the same cycle of wanting more and more.

Eat protein. Protein deficiency can contribute to sugar cravings as the body searches for a quick energy source. Adding protein to every meal ensures that the body always has fuel to access and maintains a steady blood sugar level, preventing any spikes and crashes.

Eliminate or reduce processed foods. The amount of sugar in processed food is usually underestimated. Something as seemingly innocent as whole-wheat crackers can have as much as 4 grams of sugar per serving. Always read the label to double check the sugar content, or steer clear of packaged foods altogether.

Eat a balanced diet. Eating too much of one flavor profile can create extreme cravings for the opposite flavor. A diet high in salty foods tends to create cravings for sweet foods. Listen to your body and take note of what you’re eating to find balance with a variety of flavors.

Sweeten up with vegetables. Sweet vegetables such as carrots, sweet potatoes, podded peas, beets and sweet bell peppers can provide you with a quick burst of energy when you need a pick me up. By regularly incorporating these sweet flavors you can more easily keep intense sugar cravings away since you’ll be satisfying the need for sweet flavors.

Season with sweet spices. Spices such as coriander, cinnamon, nutmeg, clove and cardamom will naturally sweeten foods without the need for added sweeteners, working wonders to reduce cravings.

Check your mineral levels. Magnesium is used in the regulation of glucose, insulin, and the neurotransmitter dopamine; a deficiency can manifest in the form of intense sugar cravings, especially for chocolate. Zinc is needed for proper insulin and glucose utilization; a deficiency can also lead to sugar cravings.

Supplement with L-glutamine. This amino acid has been found to help reduce, and even eliminate, cravings by helping to steady blood sugar. Add 500 milligrams three times a day with meals and an extra dose when a craving hits. Taking as little as a quarter teaspoon at the onset of a sugar craving should stop it in its tracks.

Get moving, and then rest. Being overtired will create a craving for a quick energy source, such as sugar, to counteract exhaustion. Instead, get plenty of sleep and move your body daily to reduce tension boost energy and diminish your chances of needing a quick sugar rush.

When a craving hits and feels uncontrollable remember that it won’t last for more than 20 minutes. Distract yourself until it passes. The more you resist the easier quicker your cravings will disappear.

Source: Fox news

Inducing labor linked with lower C-section rate

Pregnant women who are near their due date or have just passed it can have labor induced with drugs or other medical procedures — or they can simply wait for labor to start on its own.

Sometimes, there is a medical reason to induce labor, such as a woman having gestational diabetes, but in other cases, women undergo elective induction, when labor is induced without a medical reason. Now, a new study suggests that women who elect to induce labor are less likely to wind up having a cesarean section (or C-section) compared with women who give labor a longer chance to begin naturally.

Among women in the study who had previously had a baby, the odds of having a C-section for their current pregnancy were cut by about half in those who underwent elective induction. About 3 percent of these women who were induced wound up having a C-section, while about 7 percent of those who waited for labor to start on its own had the surgery, said study researcher Blair G. Darney, an obstetrics and gynecology researcher Oregon Health & Science University.

Lightning strike leaves Ohio boy brain-damaged

A 13-year-old southwest Ohio boy seriously hurt by a lightning strike at an Indiana summer camp in June is breathing on his own but hasn’t been able to speak or move without help, his family and doctors said.

The jolt of lightning stopped Ethan Kadish’s heart and led to brain damage, his parents and doctors at Cincinnati Children’s Hospital said Tuesday. The boy is still undergoing treatment and rehabilitation at the hospital, and the damage to his brain was significant, said Dr. David Pruitt, the hospital’s medical director of in-patient rehabilitation.

“It’s very early in Ethan’s recovery process, and I expect his overall brain recovery time will extend at least for a couple of years,” Pruitt said.

The boy was injured June 29 at Goldman Union Camp Institute, a Reform Jewish camp that serves children in the Midwest entering grades three to 12. A 9-year-old Chesterfield, Mo., girl, and a 9-year-old Louisville, Ky.-area boy were also hospitalized for injuries from the lightning strike but were released a few days later.

Camp Director and Rabbi Mark Covitz said Kadish was teaching younger campers how to play ultimate Frisbee when the lightning struck near the athletic field on a mostly sunny day with a rumble of thunder in the distance, The Cincinnati Enquirer reported. Covitz said no one saw the lightning, but a loud crack was heard and staffers later found a dead tree about 40 yards from the field.

The boy’s father, Scott Kadish, said he heard people who were there refer to the lightning “as a bolt out of the blue.”

Covitz speculated that the lightning may have bounced off the tree.

The boy’s mother, Alexia Kadish, said she sees some small progress and often climbs into her son’s hospital bed to comfort and talk to him.

“I see more light behind his eyes,” she said of her son, who loved playing baseball.

She said she often talks to him about what his brother and sister are doing and about TV shows and the Cincinnati Reds.

 

FDA approves Botox for crow’s feet

 

If you have a high school reunion coming up, here’s a medical development that you may want to keep an eye on.

Federal regulators for the first time have approved Botox injections to treat crow’s feet.

The Food and Drug Administration said Wednesday that Allergan’s Botox Cosmetic injection is the first drug approved to treat the wrinkles that form on the outside edge of the eyes.

Allergan Inc. studied use of the drug in 833 adults with crow’s feet who randomly received Botox or a sham injection.  Patients who received Botox had fewer visible wrinkles than those who received the placebo drug.

The most common side effects seen in patients were swelling and excess liquid around the eyelids.
Source: Fox News