September 28, 2008, 8:44 PM CT
Existing anti-obesity drugs may be effective against flu, hepatitis and HIV
Viruses dramatically increase cellular metabolism, and existing anti-obesity drugs may represent a new way to block these metabolic changes and inhibit viral infection, as per a research studypublished recently in the journal Nature Biotechnology
Metabolism refers to all the reactions by which living things break down nutrients to produce energy, along with those by which they rebuild broken-down nutrients into complex molecules (e.g. DNA). A significant example is the breakdown of blood sugar (e.g. glucose) and its conversation via chain reactions into adenosine triphosphate, the energy-storing currency of cellular life. As an important offshoot of that process, glucose can also be converted into fatty acids, the lipid building blocks of human hormones and cell membranes. A number of viruses, including influenza, HIV and hepatitis, use those same fatty acids to build instead their viral envelopes, outer coatings that help them penetrate human cells. Going into the study, little was known about the mechanisms through which viruses hijack metabolic building blocks from their cellular hosts, with older techniques providing a limited picture.
In the current study, a team of scientists from the University of Rochester Medical Center and Princeton University created a new technique to clarify these mechanisms, and observed that the technique could identify anti-viral therapeutic targets. Scientists combined drug discovery technologies to capture for the first time the exact concentrations and turnover, in other words, the fluxes, of interchangeable molecules within the metabolic chain reactions that convert sugars into fatty acids. The fields of metabolomics and fluxomics have emerged to measure these patterns, and to provide insight into diseases with a metabolic component, from diabetes to infectious diseases to cancer.........
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September 28, 2008, 8:42 PM CT
'Hub' of fear memory formation identified in brain cells
A protein mandatory for the earliest steps in embryonic development also plays a key role in solidifying fear memories in the brains of adult animals, researchers have revealed. An apparent "hub" for changes in the connections between brain cells, beta-catenin could be a potential target for drugs to enhance or interfere with memory formation.
The results are published online this week and appear in the recent issue of Nature Neuroscience
The protein beta-catenin acts like a Velcro strap, fastening cells' internal skeletons to proteins on their external membranes that connect them with other cells. In species ranging from flies to frogs to mice, it also can transmit early signals that separate an embryo into front and back or top and bottom.
During long-term memory formation, structural changes take place in the synapses the connections between neurons in the brain, says Kerry Ressler, MD, PhD, associate professor of psychiatry and behavioral sciences at Emory University School of Medicine. Ressler is a researcher at Emory University's Yerkes National Primate Research Center, where the research was conducted, and a Howard Hughes Medical Institute investigator.
"We thought beta-catenin could be a hub for the changes that take place in the synapses during memory formation," says Ressler. "But because beta-catenin is so important during development, we couldn't take the standard approach of just knocking it out genetically".........
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September 25, 2008, 11:06 PM CT
Continuous glucose monitoring in diabetic pregnant women
Continuous glucose monitoring as part of antenatal care for women with diabetes improves maternal blood glucose control and lowers birth weight and risk of macrosomia* (excessive birth weight in babies), as per a research studypublished on bmj.com today.
During pregnancy it is important that women with diabetes keep their blood glucose under control. If not, there may be an increase in the amount of glucose reaching the baby, which makes the baby grow faster than normal, and may cause difficulties at birth as well as an increased longer term risk of insulin resistance, obesity and type 2 diabetes.
Evidence suggests that measuring glucose more often improves outcomes, but the optimum frequency of blood glucose testing is not known.
Dr Helen Murphy and his colleagues examined whether continuous glucose monitoring during pregnancy can improve maternal glucose control and reduce birth weight and risk of macrosomia in babies of mothers with diabetes.
They recruited 71 pregnant women with type 1 and type 2 diabetes from antenatal clinics in the UK.
The women were randomly assigned to standard antenatal care (intermittent self monitoring of glucose levels using the finger prick technique) or intermittent monitoring plus continuous glucose monitoring (using glucose values from subcutaneous tissues measured electronically every 10 seconds, giving up to 288 measurements a day).........
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September 25, 2008, 11:04 PM CT
English health care system failing to encourage breastfeeding
The English healthcare system is failing to encourage breast feeding and a national strategy to promote breast feeding is urgently needed, say experts on bmj.com today.
In the UK, the women most likely to use formula milk are young, white and from low socioeconomic backgrounds, and this has created a major public health and inequalities challenge, write Professor Mary Renfrew from the University of York and Professor David Hall from the University of Sheffield.
It is well known that breast feeding improves infant health, and it has been shown to be the single most important preventive approach to saving children's lives.
In spite of national and international policy initiatives, 40% of women in the UK who start to breast feed discontinue by the time their baby is 6 weeks old, and only 20% of infants are exclusively breast fed at six weeks.
Yet evidence has shown that the main reasons cited for discontinuing breastfeeding could be easily remedied. For example, problems getting the baby to feed, or women reporting that breast feeding is painful.
In addition, recent data show that health professionals, particularly doctors, are not adequately trained in giving advice on breast feeding, and often do not know how to position the baby so that feeding is effective and pain free.........
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September 25, 2008, 11:03 PM CT
Are we spending too much on health?
In this poor economic climate and period of lower growth is it time to consider limiting spending on healthcare budgets? Two experts debate the issue on bmj.com today.
The key challenge is to get more value for money from the already vast sums of money spent on health services rather than increasing spending, argues Professor Nick Bosanquet from Imperial College, London.
In the UK, health care spending is growing 2% points faster than GDP and this is unsustainable in an era of lower growth when the government says it has reached the limits of taxable capacity, he writes.
"There will be no incentive to invest in a new kind of health service while the easy option of continued growth in high spending in the old one remains", he warns.
Bosanquet suggests that capping spending to current percentages of GDP (8%) would encourage more efficiency and better financial management by creating pressure to redesign more effective health systems.
Decisions on health spending should be made on the basis of value, and priority must be given to raising value from the pound or Euro, he writes. From 1990 the return on health expenditure was 148% in the UKfor every pound spent, we got 2.48 worth of health gain back, and the USA has had similar gains.........
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September 25, 2008, 11:01 PM CT
Prevention and treatment of pancreatic cancer
A number of gastrointestinal tumors, including pancreas cancer, have been shown to overexpress the EGFR. The overexpression of EGFR correlates with rapidly progressive disease and poor prognosis. Targeting EGFR pathway as a potential therapeutic strategy for pancreas cancer has been developed. Erlotinib is a small molecule tyrosine kinase inhibitor that efficiently blocks EGFR. Preliminary results of phase III trial in pancreas cancer revealed an improvement in survival with the addition of erlotinib. Treatment with anti-EGFR agents is used as a potential therapeutic strategy for pancreas cancer, but the mechanisms are still not precisely understood.
This article was published on September 21, 2008 in the World Journal of Gastroenterology
The research team from Department of Gastroenterology, Affiliated First People's Hospital, Shanghai Jiao Tong University, China studied the effects of erlotinib on six different pancreas cancer cell lines. How erlotinib exhibits its antineoplastic activity in vivo needs to be further elucidated.
In this study authors revealed the efficacy of erlotinib, as a single agent, on pancreas cancer cells growth in vitro, and in vivo study using a nude mice xenograft model and the mechanisms involved were also explored. Erlotinib repressed BxPC-3 cell growth in a dose-dependent manner, triggered G1 arrest and induced cell apoptosis,and suppressed capillary formation of endothelium in vitro. In vivo, erlotinib treated mice demonstrated a reduced tumor volume and weight as compared with control. The relationship between EGFR and angiogenesis has also been investigated using tube formation assay in vitro and immunohistochemical analysis of tumor-associated blood vessels in vivo. These findings provide evidence for the inhibitive activity of erlotinib in pancreas cancer cells. Inhibition of EGFR may be a promising adjuvant in chemotherapeutic strategy in the therapy of the dismal disease. The results also demonstrate that EGFR signaling pathway is an important target in pancreas cancer.........
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September 24, 2008, 9:43 PM CT
Young women with early form of breast cance
Young women with DCIS, a common form of early breast cancer that arises in and is confined to the mammary ducts, are presumed more likely to have recurrences than older women with the same diagnosis. But a new study from Fox Chase Cancer Center rebuffs this conventional thinking.
"There are discrepancies among past studies that looked at the outcomes of very young women with DCIS treated with radiation, but a number of suggested a less favorable outcome than for older women," explains Aruna Turaka, MD, a fellow in the Department of Radiation Oncology at Fox Chase. "Because each of these studies reflects diverse factors, including how the cancer was managed by the surgeons and radiation oncologists, we wanted to look at our institution's experience in treating DCIS in this population".
Ductal carcinoma in situ, or DCIS, is generally treated with breast-conserving surgery (lumpectomy) and radiation. At Fox Chase, surgeons will usually re-excise the tumor site until the pathologists and surgeons have "clear margins," or find no sign of cancer around where the tumor was removed. General radiation guidelines dictate that the entire affected breast be irradiated. At Fox Chase, additional radiation also is delivered to the site where the cancer was removed. This is called a "boost." .........
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September 24, 2008, 9:40 PM CT
Age alone should not be used to determine whether to treat prostate cancer
Concerns regarding the association of hormone treatment used to treat prostate cancer with cardiovascular disease in some older men may lead doctors to forgo hormone therapy solely on the basis of age. But a new study by physicians at Fox Chase Cancer Center shows that men over age 70 with high-risk prostate cancer lived longer and experienced increases in PSA less frequently when treated with long-term androgen deprivation treatment.
The benefit of long-term (i.e. 2-3 years) androgen deprivation treatment has been established in high-risk patients with prostate cancer in several prospective, randomized clinical trials. However, concern that androgen deprivation treatment may result in cardiovascular disease, especially in older patients men with certain risk factors for cardiovascular disease, has led researchers to question its role in older men.
"Several studies have demonstrated a survival benefit when androgen deprivation treatment is used along with radiotherapy in men with high-risk, clinically localized prostate cancer," said the study's lead author, Joshua Silverman, MD, PhD, a resident in the Department of Radiation Oncology at Fox Chase. "What we did not know until now is whether this benefit outweighs the risks of cardiovascular and metabolic adverse effects from androgen deprivation treatment." .........
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September 24, 2008, 9:37 PM CT
Call for warning labels for energy drinks
Johns Hopkins researchers who have spent decades researching the effects of caffeine report that a slew of caffeinated energy drinks now on the market should carry prominent labels that note caffeine doses and warn of potential health risks for consumers.
"The caffeine content of energy drinks varies over a 10-fold range, with some containing the equivalent of 14 cans of Coca-Cola, yet the caffeine amounts are often unlabeled and few include warnings about the potential health risks of caffeine intoxication," says Roland Griffiths, Ph.D., one of the authors of the article that appears in the journal Drug and Alcohol Dependence
The market for these drinks stands at an estimated $5.4 billion in the United States and is expanding at a rate of 55 percent annually. Advertising campaigns, which principally target teens and young adults, promote the performance-enhancing and stimulant effects of energy drinks and appear to glorify drug use.
Without adequate, prominent labeling; consumers most likely won't realize whether they are getting a little or a lot of caffeine. "It's like drinking a serving of an alcoholic beverage and not knowing if its beer or scotch," says Griffiths.
Caffeine intoxication, a recognized clinical syndrome included in the Diagnostic and Statistical Manual of Mental Disorders and the World Health Organization's International Classification of Diseases, is marked by nervousness, anxiety, restlessness, insomnia, gastrointestinal upset, tremors, rapid heartbeats (tachycardia), psychomotor agitation (restlessness and pacing) and in rare cases, death.........
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September 24, 2008, 7:04 PM CT
Not a moment to lose in therapy for acute stroke
In an editorial response to a report in the September 25 issue of the New England Journal (NEJM)
on the efficacy of intravenous thrombolysis therapy in the hours after acute ischemic stroke, Patrick Lyden, M.D., professor of neurosciences and director of the UC San Diego Stroke Center, cautions that the study should not be interpreted to mean that such treatment can be withheld for hours or even minutes.
"The risk of withholding such therapy from patients with acute stroke greatly exceeds the risk of giving it," said Lyden. "The potential for reversing the disabling side effects of stroke declines with every passing minute".
The study, ("Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke") by Werner Hacke, M.D. et al, reports the findings from the European Cooperative Acute Stroke Study III (ECASS III).
The design of this study closely mirrored that of the original National Institute of Neurological Disorders and Stroke (NINDS) trial of recombinant tissue plasminogen activator (rt-PA) for acute stroke, a pivotal trial that Lyden helped lead that showed the first proven treatment for stroke. The important exception in the ECASS III trial is that the window of treatment was expanded to a period of three to four and a half hours, in comparison to under three hours in the NINDS trial.........
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