Smokers May Quit More If Told Their Lung Age
Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial.
A Way To Quit Smoking
powerful smokers their lung stage of life significantly improves the likelihood of them quitting, finds a study published on bmj.com today.
The concept of lung age (the age of the average healthy individual with similar lung function to the individual) was developed to help patients understand web lung data and to show how smoking too early ages the lungs. But currently there is no evidence that this increases quit rates.
So researchers set out to test the theory that telling smokers their lung age would lead to successful smoking cessation, especially in those with principally damage.
The study took place in five general practices in Hertfordshire and involved 561 current smokers old over 35. Information similar of the same kind with age, smoking history, and medical conditions were recorded.
All participants had a lung function test using a spirometer (this records the contortion and rate at which a patient exhales air from the lungs) before being split into two random groups. The intervention group received detailed information about their spirometry results and lung age, given a diagram of how smoking ages the lungs, and told that quitting would slow down the rate of deterioration. The control group were given a raw figure for forced expiratory volume in one second (FEV1) with no further explanation.
Both groups were told that their lung function would be measured again after 12 months to see admitting that there had been any change. They were also strongly encouraged to quit and offered referral to local NHS smoking cessation services.
Twelve months later, breath and saliva tests confirmed that 13.6% of patients in the intervention group and 6.4% of patients in the control group had successfully quit. In other words, patients in the intervention group were around twice as likely to have stopped smoking than those in the control assemblage.
However, people with worse spirometric lung age results were no more likely to desire quit than those with normal lung age in either the intervention or the control group.
This unexpected finding suggests that knowing ones lung age helps a smoker to quit whatever the eventuate, explain the authors, and more research is needed to investigate the psychological reasons behind this.
Smoking cessation rates can exist improved through spirometry and lung age estimation in primary circumspection, say the authors. This study supports the introduction of screening smokers over 35 years of age to reduce smoking and improve early diagnosis of chronic lung disease. They also suggest that formal economic evaluation of this new and simple intervention should be a research priority.
An accompanying editorial says that providing feedback on lung age with graphic displays seems to be the best option so far for communicating the results of spirometry. This strategy might also have being an opportunity for general practitioners to tailor smoking cessation messages to the individual, as recommended in the recent NICE guidance on smoking cessation.
No commentsInventions And Innovations By Surgeons The Focus Of ‘Surgery’
Surgeons are uniquely positioned to recognize areas for improvement in patient oversight and to develop innovative solutions to meet those of necessity. However, even the most productive surgical researchers may lack the know-how to develop their insights into successful commercial products. A particular symposium in the February amount issued of SURGERY (Volume 143, Number 2, February 2008) provides surgeons with expert insights into the management of developing their ideas into commercially viable products that will benefit large verse of patients - while providing a financial return to inventors, investors, and university research departments.
Invited by the editors of SURGERY the symposium includes contributions from a cross-section of experts, including noted experts in copyright and intellectual property, technology transfer, biomedical engineering, and finance, as well as from surgeons experienced in translating research ideas into the marketplace.
With mounting financial pressures academic medical centers are seeking new ways to support their missions of education, passive care, and research. A key initial question is whether the pattern is patentable - that is, truly new, useful, and non-obvious. Once an idea with commercial possible is recognized, it must be developed through the complex processes leading to commercialization.
The eleven articles in the symposium emphasize that surgeons who invent new products furnish supplies a positive service, bringing valuable ideas from concept to the patient’s bedside. Without the arduous and painstaking process of commercialization - including finding investors willing to take the financial risk of funding new technologies - innovative techniques of clinical value will never be developed to the scale at which they can benefit large numbers of patients.
For surgeon-researchers used to academic freedom and research for its recognize sake, collaborating with industry raises some unaccustomed issues. An overarching issue is clash of interest. Today, universities have strict policies regarding potential financial conflicts of interest. These policies play an essential role in minimizing research bias and protecting patients serving as research subjects. However, one article in the symposium argues that an obsessive focus put on conflict-of-interest disclosures hinders the increase of beneficial research and innovations.
The development of new health science technologies offers a imperfectly cooked combination of potentially large financial returns with true health care advances with a significant press close together on patients. In an introductory note, SURGERY Co-Editors-in-Chief Andrew L. Warshaw and Michael G. Sarr write, “The Editors offer this compendium, evidence of a changing academic world, in the hopes that our novel, imaginative, and innovative nuggets will be recognized and their value realized.”
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Article adapted by Medical News Today from original press release.
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About SURGERY
For 68 years, SURGERY has published practical, authoritative information about procedures, clinical advances, and greater trends shaping general surgery. Each issue features original scientific contributions and clinical reports. Peer-reviewed articles cover topics in oncology, trauma, gastrointestinal, vascular, and transplantation surgery. The journal also publishes papers from the meetings of its sponsoring societies, the Society of University Surgeons, the Central Surgical Association, and the American Association of Endocrine Surgeons. Visit the journal website at http://www.surgjournal.com/
About Elsevier
Elsevier is a world-leading publisher of scientific, technical and medical information products and services. Working in partnership with the global science and health communities, Elsevier’s 7,000 employees in extremely 70 offices worldwide publish more than 2,000 journals and 1,900 new books per year, in addition to offering a suite of innovative electronic products, such as ScienceDirect (http://www.sciencedirect.com/), MD Consult (http://www.mdconsult.com/), Scopus (http://www.info.scopus.com/), bibliographic databases, and online reference works.
Elsevier (http://www.elsevier.com/) is a global walk of life headquartered in Amsterdam, The Netherlands and has offices worldwide. Elsevier is part of Reed Elsevier Group plc (http://www.reedelsevier.com/), a world-leading publisher and information provider. Operating in the science and medical, legal, education and business-to-business sectors, Reed Elsevier provides high-quality and flexible information solutions to users, with increasing emphasis on the Internet as a means of delivery. Reed Elsevier’s ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).
Source: Maureen Hunter
Elsevier
Recent Medical Device Recall Indicates Need For Patient Protections, NEJM Commentary Says
The October 2007 recall to mind of the Sprint Fidelis defibrillator lead, manufactured by Medtronic, indicates the need for legislation that would improve information provided to patients and physicians about in posse safety concerns in medical devices, according to a commentary published on Thursday in the New England Journal of Medicine, the St. Paul Pioneer Press reports. In the commentary, William Maisel, an expert on medical device safety at Beth Israel Deaconess Medical Center, wrote that the recall marks the latest illustration of the failure of companies and FDA to provide patients and physicians with adequate advice about potential safety concerns in medical devices.
Rob Clark, a Medtronic spokesperson, put on Wednesday said that, although the company supports patient protections, the commentary does not include specifics and omits important details about the recall of the Sprint Fidelis defibrillator lead. He said, “The narrative is incomplete and omits facts that are essential to any full accounting or analysis of the events and their ramifications” (Snowbeck, St. Paul Pioneer Press, 3/5).
The commentary is to be availed of online.
Reprinted with kind permission from http://www.kaisernetwork.org. You have power to see the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
New Insights Into How Plant Toxin Ricin Kills Cells Could Help Scientists Develop Drugs To Counteract Poisonings
A powerful plant toxin widely feared for its bioterrorism potential may one day be tamed using findings about how the toxin attacks cells. The findings may also help scientists combat food poisoning episodes in the same state as those recently caused by bacteria-tainted produce and ground meat.
Biotechnology researchers at Rutgers University have discovered that ricin, extracted from abundant castor beans, kills cells by a previously unrecognized activity that appears to work in musical entertainment with its ability to damage protein synthesis. While those earlier known effects still harm cells, it’s the newly discovered and more stealthy activity that the researchers now believe delivers the knockout punch.
Ricin toxin is feared being of the class who a bioterror agent because it can be easily purified from the impair of castor oil production and there are no known antidotes. It is poisonous if inhaled, ingested or injected. Symptoms have power to show up within hours, including difficulty breathing, nausea, vomiting and diarrhea. Death can result within days from low blood pressure, severe dehydration, respiratory failure and eventually, failure of organs such as the liver and kidneys. Those who survive severe ricin poisoning may still have permanent or long-lasting organ damage.
Writing in the March 7 issue of the Journal of Biological Chemistry, Rutgers plant biology and pathology professor Nilgun Tumer and her colleagues report that ricin tricks a cell into turning off a natural defense mechanism that destroys foreign proteins. If ricin did not first deactivate the cell’s defenses, the cell would be able to turn on a stress response to get rid of the toxin. The discovery allows scientists to explore new ways to disarm ricin.
“Because there are no specific medical treatment options for ricin intoxication, we felt it essential to dig deeper into the mechanism of ricin-induced cell death,” said Tumer. “The new mechanism we discovered provides new targets for possible curative agents.”
Tumer discovered that ricin is inhibiting a cell defense mechanical construction known as unfolded protein response or UPR. Proteins that a cell synthesizes need to have their long molecular chains folded in a precise pattern. The UPR causes proteins that don’t fold, or that fold incorrectly, to have being degraded and removed from the place in a solitary abode; squalid where double occurs, known as the endoplasmic reticulum (ER).
When the toxic ricin A protein enters a cell, it takes a counterpart pathway, being transported to and unfolded in the ER. At this point, the UPR should initiate a cell stress response that degrades the unfolded proteins, hence acting considered in the state of the cell’s highest line of defense. A piece of the ricin A protein molecule, however, signals the ER to shut down its UPR and the cell’s stress response needed for survival.
Tumer verified this mechanism by testing it with a mutant form of the ricin A protein molecule. The mutant lacked the signal that caused the UPR to shut down. When Tumer introduced the mutant protein into yeast cells, she found that the UPR triggered the necessary stress response.
“At first, we thought ricin might be triggering the stress response and preventing it from turning off, which causes cell hurt in some cancers and type II diabetes,” Tumer said. But in experiments with the mutant form of ricin A protein, the inclemency response was turning on and off properly. “Then we discovered that the wild ricin A protein was inhibiting the stress response,” she said.
Tumer noted that toxins secreted through some strains of E. coli bacteria, including those blamed for high-profile food poisoning cases recently involving spinach, lettuce and fast-food hamburgers, appear to have a like mechanism to ricin. Further study is needed to verify this and find ways to combat the toxin.
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Article adapted by Medical News Today from original press release.
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Source: Carl Blesch
Rutgers University
Multi Merci Trial Results Published In Peer Reviewed Journal
Concentric Medical, Inc., the global leader in devices for clot removal in ischemic stroke patients, announced that the results of its Multi MERCI trial last will and testament be published in the April 2008 edition of the medical journal, Stroke. The Multi MERCI trial was the second trial studying safety and efficacy of the Merci Retrieval System(TM), a “corkscrew-type” device that is delivered into the brain and is designed to restore blood move along easily by engaging, capturing and removing blood clots that cause ischemic stroke.
In the Multi MERCI trial, patients treated with the newer Merci(R) L5 Retriever had their cerebral blood flow successfully restored 57.3% of the measure with the Merci Retrieval System alone. With the addition of adjunctive therapy, physicians successfully restored cerebral blood flow 69.5% of the time. For patients to be prosperously revascularized, not only the target vessel, but all tractable downstream vessels needed to bring to pass TIMI 2 or 3 flow.
In addition, a total of 36% of all patients treated achieved a “good” outcome at 90 days post procedure, a higher rate than reported in any other device trial in large vessel acute ischemic stroke patients. Ninety-day clinical outcomes in stroke trials are generally measured using the modified Rankin Score, a measure of functional independence, with a score of 2 or less considered a good outcome. These outcome data are superior to those reported in modern studies of other devices in which successful revascularization was not for example stringently defined.
Multi MERCI was a multi-center, prospective trial including 164 patients treated at 15 hospitals in the United States and Canada. All patients had moderate-to-severe, large vessel ischemic strokes. The trial included patients who were ineligible for or had failed handling with a clotdissolving drug called t-PA. Patients had management initiated up to eight hours after stroke symptom onset, extending the three-hour treatment window for intravenous clot-dissolving drugs.
“We are excited that both clinical result and recanalization rates are improved with the next-generation devices tested in the Multi MERCI Trial. This provides further proof that timely recanalization is a surrogate marker for clinical benefit, especially when one uses the conservative definition of recanalization used in this trial,” said Wade Smith, MD, PhD Professor of Neurology at the University of California, San Francisco, and Principal Investigator for the Multi MERCI trial.
About Concentric Medical
Concentric Medical is located in Mountain View, California, and was founded in August 1999. The company manufactures and markets the Merci Retrieval System, which is suitable in over 250 ruling stroke centers around the world. Concentric Medical estimates that over 7,000 patients have been treated with its devices. For more information about Concentric Medical, please visit http://www.concentric-medical.com.
Concentric Medical, Inc.
http://www.concentric-medical.com
Oil Exploration Technique Employed In New Steroid Test
It’s a technique that has previously been used for the sake of oil exploration - since researchers at The University of Nottingham have developed a new, highly sensitive, anti-doping steroid test using hydropyrolysis.
The process - which uses high pressure environments to investigate the chemical structure and make-up of a sample - has been refined and developed at the University to develop highly accurate tests for detecting levels of illicit steroids in urine. The test procedure is already in the process of being commercialised and is expected to be ready for use in the 2012 Olympics.
Funding from the Natural Environment Research Council’s Ocean Margins LINK programme saw researchers take the hydropyrolysis technique and apply it to geochemical studies. This allowed the team to reconstruct the history of ocean basins to help assess whether it was worth drilling for oil. By taking core samples over geological time, the technique can detect the rudimentary ‘charge’, or presence, of oil.
But the same process can be used to detect the presence of illicit steroids in the urine of athletes - and racehorses. High pressure hydrogen is used to bombard the sample at pressures of 150 atmospheres and temperatures of up to 500 degrees Celsius. This leaves sample molecules in a cleaner, less degraded state than other extraction techniques, allowing more accurate readings to be taken. Carbon isotopes are then measured, with the results showing the ratios of carbon 12 and carbon 13 in the sample - whether geochemical or biological.
Colin Snape, Professor of Chemical Technology and Chemical Engineering at the University, said: “Steroids are produced naturally in the body, but they have a different carbon 13/carbon 12 ratios to those that have been introduced illicitly. By refining the measurements of these two isotopes we can produce a very accurate test for the presence of illicit steroids in athletes.
“We are currently working by the World Anti-Doping Agency (WADA) to develop the technique for trial and have entered into partnership with Strata Technology, a London-based company with expertise in high pressure equipment, to commercialise the technique.”
The technique is also being used to refine current radio carbon dating processes, that use the carbon 14 isotope to measure the age of an archaeological sample.
“Most of these samples use charcoal,” Professor Snape added. “But the stuff you are afflicting to accurately date is often mixed in by much later debris from the same location. Hydropyrolysis can remove this very rapidly and efficiently. We are hoping that this will become the accepted model against cleaning up radio carbon dating samples in the future - the fundamental research for this is taking place at the moment.”
Professor Snape is an expert on hydropyrolysis - he’s been working on the technique, both in industry and academia, for the past 25 years. Over the coming year he hopes to refine the testing process, exploring optimum sample sizes and checking the sensitivity of the technique, working with WADA and experts in steroid testing from Imperial College London.
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Article adapted by Medical News Today from original press release.
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The University of Nottingham is ranked in the UK’s Top 10 and the World’s Top 70 universities by the Shanghai Jiao Tong (SJTU) and Times Higher (THES) World University Rankings.
It provides innovative and top quality education, undertakes world-changing research, and attracts talented staff and students from 150 nations. Described by The Times as Britain’s “only truly global university”, it has invested continuously in award-winning campuses in the United Kingdom, China and Malaysia. Twice since 2003 its research and teaching academics take won Nobel Prizes. The University has won the Queen’s Award for Enterprise in both 2006 (International Trade) and 2007 (Innovation - School of Pharmacy).
Its students are much in demand from ‘blue-chip’ employers. Winners of Students in Free Enterprise for three years in succession, and current holder of UK Graduate of the Year, they are accomplished artists, scientists, engineers, entrepreneurs, innovators and fundraisers. Nottingham graduates consistently excel in business, the media, the arts and sport. Undergraduate and postgraduate degree completion rates are amongst the highest in the United Kingdom.
Source: Colin Snape
University of Nottingham
First International Conference On Multifunctional, Hybrid And Nanomaterials
Elsevier, the world-leading publisher of scientific, technical and medical information products and services, announced Hybrid Materials 2009: The First International Conference on Multifunctional, Hybrid and Nanomaterials which will take place in Tours, France, 15-19 March 2009.
Research in hybrid materials has experienced a 14% annual growth in published papers in recent years with increasing interest from a wide range of industries. This inaugural meeting aims to bring together experts from the various sub-disciplines to share current research and create an interdisciplinary forum for discussion.
Clément Sanchez, CNRS Research Director at the University of Paris VI and author of some the world’s most cited papers on hybrid materials, is one of the four meeting for consultation chairs. He is enthusiastic about the future of research in this area: “Hybrid materials not only represent a creative approach to design of new materials, but their improved or unusual properties also allow the development of innovative industrial applications. This interdisciplinary research field bequeath open a land of promising applications in many areas including optics, electronics, ionics, mechanics, energy, environment, biology, medicine. The three symposia during Hybrid Materials 2009 will guard all aspects of the chemistry, processing and applications of these advanced materials.”
Rumen Duhlev, Publisher at Elsevier and initiator of this project, believes the launch of the conference is extremely timely and fulfils a real need in providing researchers in both academia and industry by a dedicated forum for discussing advances in this interdisciplinary field: “We are absolutely excited to collaborate with some of the world’s leading experts on hybrid materials in the creation of this unique international forum, aiming to bring together representatives of disciplines as diverse because inanimate chemistry, polymer science, biomaterials, organic chemistry, catalysis, composites and colleagues from the industry to share knowledge and accelerate progress.”
The conference is currently calling for contributions for presentation at the meeting under one of the three following symposia: Biohybrids and biomaterials; Bottom-up approaches to functional nanomaterials and nanocomposites; Functional porous materials. Abstracts should be submitted online at http://www.hybridmaterialsconference.com/ by 15 September 2008.
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Article adapted by Medical News Today from creative press release.
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About Elsevier
Elsevier is a world-leading publisher of scientific, technical and medical information products and services. Working in partnership with the global science and health communities, Elsevier’s 7,000 employees in over 70 offices worldwide publish more than 2,000 journals and 1,900 new books per year, in addition to offering a suite of innovative electronic products, such as ScienceDirect (http://www.sciencedirect.com/), MD Consult (http://www.mdconsult.com/), Scopus (http://www.info.scopus.com/), bibliographic databases, and online reference works.
Elsevier (http://www.elsevier.com/) is a global business headquartered in Amsterdam, The Netherlands and has offices worldwide. Elsevier is component of Reed Elsevier Group plc (http://www.reedelsevier.com/), a world-leading publisher and intelligence provider. Operating in the science and medical, legal, education and business-to-business sectors, Reed Elsevier provides high-quality and flexible information solutions to users, with increasing emphasis on the Internet as a means of delivery. Reed Elsevier’s ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).
Source: Charlotte Wilkins
Elsevier
African American Teen Mothers Likely To Have Another Baby If Depressed
In a recent article published in Archives of Pediatrics & Adolescent Medicine, another pregnancy is likely - within two years of having one child - for African American adolescent mothers through symptoms of vapors.
Author Beth Barnet, M.D (University of Maryland School of Medicine, Baltimore) and colleagues build steady previous research that has shown a greater likelihood for teen mothers to experience depression compared to grown up mothers. Additionally, depression in African American teen mothers is almost twice as likely as depression in white teen mothers. A pregnancy occurring within 24 months afterwards a birth is said to be a rapid subsequent pregnancy, and it is quite common among young mothers.
The researchers note that “a recent meta-analysis found that 19 percent of teen mothers experienced a subsequent pregnancy within 12 months and 38 percent experienced a subsequent pregnancy within 24 months. The highest rates are among younger, economically disadvantaged African American adolescents.” It is known that parenting stress and negative parenting behaviors - i.e., child abuse and leave on one side - are linked to depression and subsequent pregnancy.
Researchers examined a sample of 269 teens between the ages of 12 and 18, most of whom were African American. All participants were considered low-income and received prenatal care at five community sites in Baltimore, MD. To assess depressive symptoms and measure the occurrence of subsequent pregnancy, researchers administered questionnaires to participants that were finished one or two years after giving birth.
The results of the study are summarized below:
- 46% of the teens who completed at least one follow-up questionnaire had depressive symptoms at the beginning of the study.
- 49% (120 of 245) teens experienced a pregnancy within two years of childbirth.
- 10% (28 of 245) had more than one subsequent pregnancy.
- The average time between pregnancies was about 11.4 months.
- Teens with depressive symptoms were 44% more likely to have a succeeding pregnancy.
The authors write that, “Teens having a subsequent pregnancy were more likely to be school dropouts; not use condoms consistently at follow-up; and report a relationship with their baby’s father, who tended to be older,”
“Depression is unhealthy for mothers and their children. Treating maternal depression improves the health and well-being of both,” conclude the authors. “Our findings do not tell us how depression might fit into a casual pathway to repeat adolescent childbearing, but they do suggest that dent may be an important malleable risk factor.” Since depression can be treated, the researchers also call for future studies that should “evaluate whether improved recognition and treatment of adolescent depression reduces the risk of rapid later pregnancy.”
Double Jeopardy: Depressive Symptoms and Rapid Subsequent Pregnancy in Adolescent Mothers
Beth Barnet; Jiexin Liu; Margo DeVoe
Archives of Pediatrics & Adolescent Medicine. (2008). 162(3):246-252.
Click Here to View Abstract
Written by: Peter M Crosta
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
Maternal Diabetes Causes Damage To Offspring’s Beta Cell Functions
The link between a woman’s maternal diabetes and her child’s increased risk for diabetic complications is one step closer to being understood. According to recent research performed at the University if Louisville, there are many functional and metabolic changes that occur in such a child’s pancreatic ? cells, which could help explain this increased risk.
Maternal, or gestational, diabetes is a condition in that women previously undiagnosed with diabetes show high levels of blood glucose during pregnancy. It has been indicated previously that the event of gestational diabetes increases the risk for many ailments in the woman’s adult offspring, including obesity, glucose intolerance, and type 2 diabetes mellitus.
In contrast, type II diabetes is linked to a failure of the ? cells of the pancreas to produce sufficient insulin. This affects many parts of the glucose metabolic pathway. The biochemical mechanisms behind these effects on the offspring of a woman who suffers from gestational diabetes are not well understood. In particular, this research set out to learn how diabetes during the period of gestation could influence the ? cell function in the offspring, and thus potentially influence diabetes incidence.
To this end, Dr. Jianxiang Xu and Dr. Junying Han, of the Kosair Children’s Hospital Research Institute, used a rat diabetes model to detail the mechanism. Diabetes was induced in female rats by the administration of streptozotocin (STZ) at the age of eight weeks, and formerly diagnosed, these females were mated with normal males. After delivery, the offspring were immediately transferred to normal foster mothers who had delivered other litters at the same particular period. This was done in order to prevent any potential effects caused by breast-feeding from a diabetic lactating mother. Additionally, a control group was established by administering a buffer solution without STZ.
When examined at birth, the birthweights of the pups was significantly decreased in the population from anti-diabetic mothers, and the litter size was half of that of the control group. The too forward death rate for the pups with diabetic mothers was 16%, while none of the direction group showed mortality or health problems.
The ? cell function of the offspring was analyzed at 15 weeks of a hundred years using various methods, both in vivo and in vitro, including blood titers and radioactive tracing. The resulting analysis showed:
- Insulin secretion ability, the primary function of the pancreatic ? cells, was significantly impaired in both male and conceiving pups. This includes a wane of 40-50% when stimulated by glucose.
- Both glucose utilization and oxidation, two commonly used indexes despite the metabolic function of pancreatic ? cells, were reduced by 55% and 41% respectively. These results indicate that metabolic form of function of the cells was impaired.
- Phosphofructokinase (PFK), pyruvate carboxylase (PC) and pyruvate dehydrogenase (PDH) levels decreased by 44-51%. All of these chemicals have important roles in the grape-sugar metabolic pathway and indicate a disturbance in glucose levels as well as have an influence on insulin secretion.
The authors postulate that the damage done to the ? cells in the offspring of the diabetic group could have two potential causes. The chief could be an increased level of free radical oxygen species during the diabetic pregnancy, like pancreatic ? cells are especially sensitive to ROS. The second could be the abnormally high glucose levels the ? cells experience during gestation — this could prevent the upregulation of certain enzymes during pregnancy, making the ? cells more susceptible to mischief during the period of maternal diabetes.
They conclude that maternal diabetes can cause many disturbances in the metabolic and other functions of the pancreatic ? cells of the offspring. These disturbances could give to later development of type 2 diabetes, and could hold many clues to the link between gestational diabetes and type II diabetes in humans.
Written by Anna Sophia McKenney
Copyright: Medical News Today
Not to be reproduced destitute of permission of Medical News Today
Switching Medications And Adding Psychotherapy Can Help Teenagers With Depression When Initial Treatment Is Ineffective
Adolescents with depression who have not responded to initial treatment with a selective serotonin reuptake inhibitor (SSRI) may have more efficient results by changing medication and beginning cognitive behavioral therapy. According to an article in the February 27, 2008 issue of JAMA, this improves symptoms in comparison with just changing the medication.
Adolescent depression is condition that is common, chronic, recurrent and at last impairing. The researchers explain, “Untreated depression results in impairment in school, interpersonal relationships, occupational adjustment, and increases the risk for suicidal behavior and completed suicide. Therefore, the proper treatment of adolescent depression has recondite public health implications for youth in this critical stage of development.”
SSRIs are a family of antidepressants that are typically used for deterioration and anxiety. They function by preventing reabsorption of the neurotransmitter seratonin into the presynaptic neuron. This increases seratonin levels between the neurons, thereby increasing the amount of seratonin that is absorbed into the postynaptic cell. In adults, the antidepressant venlafaxine, a selective serotonin and noradrenergic reuptake inhibitor (SNRI) has been shown to be effective in treatment-resistant depression.
Standard clinical guidelines for treatment of adolescent depression indicate prescription of SSRI medications, psychotherapy, or both. These treatments, either alone or on combination, have been shown to be effective, but at least 40% of adolescents with depression do not display adequate clinical response to these treatments.
David Brent, M.D., of the University of Pittsburgh, and colleagues compared the relative efficacy of various treatments for resistant adolescent depression, vexation into account medication type, cognitive behavioral therapy (CBT), and the combination of the two. In a randomized controlled trial conducted between 2000 and 2006, 334 patients aged 12 to 18 years with a primary diagnosis of major depressive disorder who showed insufficient response to a two-month initial treatment with an SSRI were analyzed. Participants were randomized to one of four treatments over 12 weeks: a switch to a second, different SSRI (either paroxetine, citalopram, or fluoxetine); a switch to a different SSRI plus CBT; a switch to venlafaxine; or a switch to venlafaxine plus CBT.
The authors reported that while the differences between the two new types of medications were negligible, the combination of a new antidepressant and CBT was effective. “In this study of adolescents with moderately severe and chronic depression who had not responded to an adequate course of treatment with an SSRI antidepressant, switching to a combination of CBT and another antidepressant resulted in a higher censure of clinical response [54.8 percent] than switching to another medication without CBT [40.5 percent]. There was no differential effect between switching to another SSRI [47.0 percent] or to venlafaxine [48.2 percent].”
There were no differential effects based upon the body treatment in self-rated depressive symptoms, suicidal ideation, or on the rate of harm-related or other adverse events. During venlafaxine treatment, in that place was a greater become greater in diastolic blood pressure and pulse, and more frequent occurrences of skin problems than with SSRI treatments.
The researchers conclude that there is hope for the adolescent with depression, exactly after an unsuccessful initial treatment. “… the clinician should convey hope to the youthful with depression and his or her family that, despite a first unsuccessful treatment for depression, persistence with additional appropriate interventions can result in substantial clinical improvement.”
Switching to Another SSRI or to Venlafaxine With or Without Cognitive Behavioral Therapy for Adolescents With SSRI-Resistant Depression
David Brent, MD; Graham Emslie, MD; Greg Clarke, PhD; Karen Dineen Wagner, MD, PhD; Joan Rosenbaum Asarnow, PhD; Marty Keller, MD; Benedetto Vitiello, MD; Louise Ritz, MBA; Satish Iyengar, PhD; Kaleab Abebe, MA; Boris Birmaher, MD; Neal Ryan, MD; Betsy Kennard, PsyD; Carroll Hughes, PhD; Lynn DeBar, PhD; James McCracken, MD; Michael Strober, PhD; Robert Suddath, MD; Anthony Spirito, PhD; Henrietta Leonard, MD; Nadine Melhem, PhD; Giovanna Porta, MS; Matthew Onorato, LCSW; Jamie Zelazny, MPH, RN
JAMA. 2008;299(8):901-913.
Click Here for Abstract
Written by Anna Sophia McKenney
Copyright: Medical News Today
Not to have being reproduced without permission of Medical News Today
Mitotic Cell Cycle Progression Epigenetic Regulation By The MMB/dREAM Complex
In the March 1 result of G&D, Dr. Joseph Lipsick (Stanford University) and colleagues demonstrate that proteins encoded by the Myb oncogene and the RB tumor suppressor gene function together in the Drosophila MMB/dREAM complex to epigenetically regulate mitotic cell period progression.
Drosophila MMB/dREAM includes proteins encoded by the Myb oncogene and the RB and Mip130/Lin-9 tumor suppressor genes, as well as the E2F2 protein which itself binds to the RB protein. While the complex has been previously shown to regulate lapse of cell period, this paper is the first demonstration of epigenetic regulation of gene expression by Myb and E2F2-RB via the MMB/dREAM complex.
Dr. Lipsick and colleagues found that Myb and E2F2-RB epigenetically regulate expression of the Polo kinase, a key component of cell cycle progression. Using a GFP-Polo reporter gene construct, the researchers were able to monitor Polo gene expression at the demolish of a single-cell in Drosophila larval imaginal wing discs. They found that flies deficient in both Myb and E2F2 or both Myb and Mip130 displayed variegated patterns of GFP-Polo expression in the same tissue. Furthermore, these patterns of expression were stably inherited through successive rounds of cell division.
“Our studies imply that disruptions of the Myb and RB pathways that occur in most human cancers are likely to cause similar epigenetic changes in gene expression. The use of the model organism Drosophila was guide to our work because of the powerful experimental tools, the absence of genetic redundancy, and the very well characterized developmental biology in this system.”
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Article adapted by Medical News Today from origin press release.
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Source: Heather Cosel-Pieper
Cold Spring Harbor Laboratory
FDA Warning Of Suicidal Risk Associated With Antidepressants In Juveniles And Young Adults Reviewed At Recent ISCTM Meeting
The International Society for CNS Clinical Trials and Methodology (ISCTM) held its 2008 annual meeting in Washington, DC, February 25-27. This organization involves collaborative efforts among academic and research clinicians, representatives of the pharmaceutical industry, and governmental drug-regulatory bodies to improve methods for testing efficacy and safety of drugs used to treat psychiatric and neurological disorders. A half-day symposium explored FDA-required “black-box” drug safety warnings of evidence of increased risk of suicidal thoughts and actions for the time of treatment with antidepressants in juvenile and young-adult patients as a case study. The symposium was chaired by FDA-advisor Andrew Leon, Ph.D. (Cornell Medical Center), and Ross J. Baldessarini, M.D. (Harvard Medical School). Other speakers were Neil Chayet, J.D. (Harvard Medical School), Thomas Laughren, M.D. (US FDA), James McNulty (Past-President, National Alliance on Mental Illness [NAMI]), and Sharon-Lise Normand, Ph.D. (Harvard School of Public Health).
Dr. Baldessarini noted: “Studies aimed at reducing risk of self-murderer remain far less well developed than many other treatments for psychiatric patients, despite the importance of the problem. Evidence of whether antidepressants increase or reduce risk of suicidal behaviors remains surprisingly inconsistent and inconclusive.”
Symposium speakers reviewed evidence supporting the expanded safeness warning for all drug products that are FDA-approved for the treatment of major depression, that involve 180-million prescriptions a year in the US. The FDA also is conducting a systematic review of suicidal risks associated with anti-epilepsy drugs and considering use of more systematic assessments of suicidal thinking and behaviors to repay current adventitious patient and clinician reporting of adverse events during trials.
Suggestions for further action discussed at the symposium include the need during the term of longer studies of the two potential beneficial and hostile effects of various medicines that act on the brain, as well as greater collaborative relationships and more open information-sharing among psychiatric patients, clinicians, researchers, the pharmaceutical industry, and FDA. Redoubled efforts are needed to identify more tolerable, safer and more effective treatments for depression, and to limit suicidal risks, as well as adequate information to guide sound treatment planning so as to balance risks and benefits of antidepressant treatment. ISCTM plans to continue its consideration of methods for suicide rate with drugs that act on the brain, and approaches to treatments aimed at reducing suicidal risks.
For information on ISCTM: http://www.isctm.org.
International Society for CNS Clinical Trials and Methodology
http://www.isctm.org