Use of omega-3 does not appear to reduce recurrence of atrial fibrillation
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Although some data have suggested that omega-3 fatty acid supplements, such as from fish oil, may improve treatment of atrial fibrillation, a randomized trial with more than 600 patients finds that treatment with high-dose prescription omega-3 did not reduce the recurrence of atrial fibrillation over six months, according to a study that will appear in the December 1 issue of JAMA. The study is being released early online because it will be presented at the American Heart Association’s annual meeting.
“Atrial fibrillation (AF) is a highly prevalent disease that is responsible for reduced quality of life, costly hospitalizations, heart failure, stroke, and death. No current therapy, drug, device, or ablation [removal of tissue or cells] is uniformly effective, and several available therapies have the potential to cause harm. Consequently, useful alternatives are being sought,” the authors write. “Limited data from small trials suggest omega-3 polyunsaturated fatty acids may provide a safe, effective treatment option for AF participants.”
Peter R. Kowey, M.D., of the Lankenau Institute for Medical Research, Wynnewood, Pa., and colleagues conducted a randomized clinical trial to assess the efficacy of a pure prescription formulation of omega-3 fatty acids (prescription omega-3), at a dose considerably higher than what has been tested in previous trials, for preventing recurrent atrial fibrillation. The study included 663 U.S. outpatient participants with confirmed symptomatic paroxysmal (sudden attacks) (n = 542) or persistent (n = 121) AF, with no substantial structural heart disease, who were recruited from November 2006 to July 2009 (final follow-up was January 2010). Participants received prescription omega-3 (8 grams/day) or placebo for the first 7 days; prescription omega-3 (4 grams/day) or placebo thereafter through week 24.
Family ties play big role in atrial fibrillation
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People who have a close family member with atrial fibrillation are 40 percent more likely to develop the heart condition than other people, U.S. researchers said on Saturday.
And the finding was even stronger for people whose relatives developed the heart rhythm problem at a younger age—before they turned 65.
“It was a threefold increased risk,” Dr. Emelia Benjamin of Boston University School of Medicine, who worked on the study to be published in the Journal of the American Medical Association.
Landmark Study Shows Suboptimal Asthma Care
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Researchers assessed asthma burden and treatment practice in the U.S. based on results of the recently completed Asthma Insight and Management telephone survey in a new study presented at the American College of Allergy, Asthma and Immunology annual meeting in Phoenix, Nov. 11-16. The asthma survey, the most comprehensive in the U.S. in the past 10 years, reported 73 percent of patients experienced asthma symptoms or an asthma attack in the past 12 months, 63 percent were affected by asthma throughout the year, and 41 percent believed their asthma was interfering with their life. Authors conclude that “despite the availability of asthma management guidelines and effective asthma treatments, asthma care is inferior, underscoring the need for improved patient education and use of written action plans.”
Title: Patient-Reported Asthma Burden and Treatment Practice in the United States: Results of the Asthma Insight and Management Survey
Lead Author: Eli O. Meltzer, MD, ACAAI Fellow
Cystic Fibrosis Gene Typo Is a Double Whammy
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An imbalance of salt and water in patients with cystic fibrosis makes their lungs clog up with sticky mucus that is prone to infection. The cause of the offending imbalance is a well-known genetic error, one that blocks the molecular expressway for tiny chloride ions to move across the surface of the lungs.
But how does that same gene mutation upset a parallel roadway controlling the flow of the other component of salt, sodium ions? Now, researchers at the University of North Carolina at Chapel Hill School of Medicine have found the answer, demonstrating that the gene mutated in cystic fibrosis not only controls traffic on the chloride highway, but also keeps the sodium highway from being overused.
The finding suggests that the infamous mutation – in a gene called CFTR – is a double whammy, affecting the flow of two different ions that are important to keep the mucus on the surfaces of the airways hydrated. Clarifying this link between the genetic defect and the thick sticky mucus in cystic fibrosis lungs could help researchers develop better therapies.
UNC Miscarriage Expert Available to Comment on Bush’s Miscarriage Disclosure
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Kristen M. Swanson, Ph.D., dean of the School of Nursing at the University of North Carolina at Chapel Hill, is available for interviews about President George W. Bush’s disclosure of his mother’s miscarriage in his book ‘Decision Points.’
Swanson is an expert on miscarriage and how couples respond emotionally to it. She began her work on miscarriage 25 years ago with her dissertation, “The Unborn One: A Profile of The Human Experience of Miscarriage,” and has continued studying this area both as an investigator and as a consultant to other researchers’ works.
Although some have been shocked that President George W. Bush saw the fetus in a jar when he drove his mother to the hospital, Swanson said that the holding of the fetus is one of the most tender and private losses that a woman goes through when she miscarries.
Healthcare reform not top voter issue: poll
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Americans who turned out to vote last week dislike healthcare reform but it was not their top concern—the economy was.
A poll released on Tuesday by the non-profit Kaiser Foundation showed healthcare came only fourth in a list of concerns voiced by people who voted in the congressional elections on November 2.
“When voters were asked in our open-ended question to voice, in their own words, what influenced their vote, they said healthcare was a factor, but not a dominant one,” the foundation said in a statement.
Stress takes its toll in Parkinson’s disease
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We all know that living a stressful lifestyle can take its toll, making us age faster and making us more susceptible to the cold going around the office.
The same appears to be true of neurons in the brain. According to a new Northwestern Medicine study published Nov. 10 in the journal Nature, dopamine-releasing neurons in a region of the brain called the substantia nigra lead a lifestyle that requires lots of energy, creating stress that could lead to the neurons’ premature death. Their death causes Parkinson’s disease.
“Why this small group of neurons dies in Parkinson’s disease is the core question we struggled with,” says lead author D. James Surmeier, the Nathan Smith Davis Professor and chair of physiology at Northwestern University Feinberg School of Medicine. “Our research provides a potential answer by showing this small group of neurons uses a metabolically expensive strategy to do its job. This ‘lifestyle’ choice stresses the neurons’ mitochondria and elevates the production of superoxide and free radicals – molecules closely linked to aging, cellular dysfunction and death.”
A comparison of severe outcomes during the waves of pandemic (H1N1) 2009
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The second wave of the pandemic (H1N1) was substantially greater than the first with 4.8 times more hospital admissions, 4.6 times more deaths and 4 times more ICU cases, according to a study published in CMAJ (Canadian Medical Association Journal) (pre-embargo link only) http://www.cmaj.ca/embargo/cmaj100746.pdf. However, because of the larger number of people hospitalized during the second wave compared to the first, the percentage of people with severe outcomes was smaller.
The researchers compared demographic and clinical characteristics as well as outcomes of patients with (H1N1) influenza admitted to hospital during the first wave with those admitted during the second wave and post-peak period of the pandemic.
In the first wave, Nunavut, Manitoba and Quebec had the highest rates for hospital admissions. In the second wave, all provinces and territories were affected with the Maritimes provinces, Alberta, British Columbia, the Yukon Territory and the Northwest Territories experiencing much higher rates of hospital admission than in the first one. Quebec and Ontario were impacted in both waves, with Quebec reporting the highest number of hospitalizations and Ontario reported the most deaths overall.
Combined imaging technologies may better identify cancerous breast lesions
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By combining optical and x-ray imaging, radiologists may be better able to distinguish cancer from benign lesions in the breast, according to a new study published in the online edition and January issue of Radiology.
Researchers at Martinos Center for Biomedical Imaging at Massachusetts General Hospital in Boston helped develop a combined optical/x-ray imaging system capable of obtaining both structural and functional information of the breast.
The two technologies used were digital breast tomosynthesis (DBT), a three-dimensional application of digital mammography, and diffuse optical tomography (DOT), which measures levels of hemoglobin concentration, oxygen saturation and other cellular characteristics, based on how light from a near-infrared laser is absorbed and scattered within tissue.
Statins Not Routinely Indicated for Children and Adolescents with Lupus
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While statins are known to help prevent the progression of atherosclerosis, research presented this week at the American College of Rheumatology Annual Scientific Meeting in Atlanta indicates they should not be routinely prescribed in children and adolescents with lupus despite their increased risk of premature atherosclerosis.
Lupus, or SLE, is a chronic inflammatory disease that can affect the skin, joints, kidneys, lungs, nervous system, and other organs of the body. Usually, patients have skin rashes and arthritis, as well as fatigue and fever. It is often more severe when it begins in childhood. Lupus has been identified as a strong independent risk factor for heart attack and stroke, and children with lupus are at a particularly high risk because of their lifelong exposure to the disease. Atherosclerosis—a buildup of fatty deposits in the artery walls—which normally leads to heart attack and strokes in older adults, starts at an at an unusually early age and progresses more quickly in people with lupus.
Statins have been shown to reduce cardiovascular complications and death among the general adult population, but they have not been studied in the prevention of atherosclerosis among young people with lupus. In the largest trial of its kind—and the first major trial completed by the Childhood Arthritis and Rheumatology Research Alliance (called CARRA)—researchers recently completed a study looking at whether the use of statins would be helpful enough in the prevention of atherosclerosis in children and adolescents with lupus to make it worthwhile for them to start taking at such a young age.
Combination of Methotrexate and Prednisone Produces Remission In People with Newly-Developed Rheumatoid Arthritis and Undifferentiated Arthritis
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People with newly-developed rheumatoid arthritis or undifferentiated arthritis may be able to achieve remission, with continued drug therapy, after four months of treatment with methotrexate and prednisone, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Atlanta.
Rheumatoid arthritis is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in other organs as well. An estimated 1.3 million Americans have RA, and the disease typically affects women twice as often as men. The new ACR/EULAR 2010 Rheumatoid Arthritis Classification Criteria are based on the recognition that undifferentiated arthritis may be the earliest clinical manifestation of RA.
Researchers recently assessed whether people with RA (which had developed less than two years before the start of the study) or undifferentiated arthritis (defined, for this study, as having arthritis in more than one joint and being considered at risk for developing RA) could achieve remission after four months of taking a combination of methotrexate and prednisone.
Tai Chi Relieves Arthritis Pain, Improves Reach, Balance, Well-Being
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In the largest study to date of the Arthritis Foundation’s Tai Chi program, participants showed improvement in pain, fatigue, stiffness and sense of well-being.
Their ability to reach while maintaining balance also improved, said Leigh Callahan, PhD, the study’s lead author, associate professor in the University of North Carolina at Chapel Hill School of Medicine and a member of UNC’s Thurston Arthritis Research Center.
“Our study shows that there are significant benefits of the Tai Chi course for individuals with all types of arthritis, including fibromyalgia, rheumatoid arthritis and osteoarthritis,” Callahan said. “We found this in both rural and urban settings across a southeastern state and a northeastern state.”
Timing is everything in combination therapy for osteoporosis
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The adult human skeleton undergoes constant remodeling, with new bone forming at sites that have been broken down by a precise process called resorption. During remodeling, skeletal stem cells are recruited to resorption sites and directed to differentiate into bone-forming cells. Osteoporosis, a condition characterized by weak and fragile bones, develops when there is an imbalance in the remodeling process and more bone is lost than replaced. Now, new research published by Cell Press in the November issue of the journal Cell Stem Cell uncovers a mechanism that may guide development of better strategies for treatment osteoporosis.
Osteoporosis is often treated with drugs that inhibit bone resorption, such as alendronate, or drugs that stimulate bone formation, such as parathyroid hormone (PTH). Surprisingly, previous attempts to combine these approaches were not effective. “In clinical trials where PTH and alendronate were administered concurrently, the bone building effects of PTH were impaired,” explains senior study author Dr. Xu Cao from The Johns Hopkins School of Medicine in Baltimore, MD. “This suggests that bone resorption is necessary for PTH-induced bone formation, but the underlying mechanisms are obscure. An improved understanding of the role that bone resorption plays in PTH-induced bone formation would provide a key mechanistic rationale for the development of strategies that maximize use of both PTH and antiresorptive drugs in the treatment of osteoporosis.”
Dr. Cao’s group had previously shown that transforming growth factor (TGF)-?1 plays a key role in bone formation after bone resorption.
Burning pain and itching governed by same nerve cells
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There are disorders and conditions that entail increased itching and can be extremely troublesome for those suffering from it. The mechanisms behind itching are not well understood today. For one thing, what is it about scratching that relieves itching?
In the current study, which was performed on mice, the research team led by Professor Klas Kullander at the Department of Neuroscience examined the nerve cells that transfer heat pain. When these nerve cells had lost its capacity to signal, the mice reacted less to heat, as expected, but surprisingly they also started to itch incessantly.
“These findings link together pain from a burn with regulating sensitivity to itching, which was highly surprising and interesting,” says Klas Kullander.
Study shows a single shot of morphine has long lasting effects on testosterone levels
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A single injection of morphine to fight persistent pain in male rats is able to strongly reduce the hormone testosterone in the brain and plasma, according to a new paper published in Molecular Pain. The study, led by Anna Maria Aloisi, M.D., of the Department of Physiology – Section of Neuroscience and Applied Physiology at the University of Siena, Italy, Sbarro Institute for Cancer Research and Molecular Medicine at Temple University in Philadelphia, University of Siena, and the Human Health Foundation in Spoleto, Italy, showed that opioids had “long lasting genomic effects in body areas which contribute to strong central and peripheral testosterone levels” including the brain, the liver and the testis.
The study showed increases in aromatase, an enzyme that is responsible for a key step in the biosynthesis of estrogen. The findings are particularly important since testosterone is the main substrate of aromatase, which is involved in the formation of estradiol. Both testosterone and estradiol are important hormones, engaged in cognitive functions as well as in mood, motor control and in many other functions, such as bone structure remodeling.
“Our lab became interested in gonadal hormones several years ago when it became clear that there were many differences in pain syndromes between the sexes,” says Dr. Aloisi. “In looking at differences, it was immediately apparent that these changes were introduced by different treatments, opioids in particular.”
