Moderate Use May Avert Failure of Type 2 Diabetes Drugs
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Drugs widely used to treat type 2 diabetes may be more likely to keep working if they are used in moderation, researchers at Washington University School of Medicine in St. Louis have found in a study using an animal model.
The drugs, sulfonylureas, help type 2 diabetics make more insulin, improving control of blood sugar levels. But in most patients the effects of sulfonylureas are lost after several years of use, causing insulin secretion to shut down. This typically forces patients to switch to regular insulin injections.
“Why this happens isn’t clear yet, but we’ve found what may be cause for hope,” says senior author Colin G. Nichols, Ph.D., Carl F. Cori Professor and professor of cell biology and physiology. “We’ve shown in a mouse model that whatever causes this shutdown doesn’t kill the insulin-making beta cells of the pancreas or stop them from making insulin. Instead, it somehow stops them from secreting insulin.”
Don’t Forget the Men in October’s Sea of Pink
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Pink is all the rage in October as money and awareness are raised for the most common cancer for women (other than skin cancer) during Breast Cancer Awareness month. But what about some attention for one of the most common cancers in men? Prostate cancer is the second leading cause of cancer death in men, according to the American Cancer Society.
Men in Plano have a new way to share their concerns and raise awareness, through the Us TOO prostate cancer patient support group at Baylor Regional Medical Center at Plano. The group, which is the first Us TOO chapter in Plano, helps men and their families learn more about prostate cancer so they can make better decisions on treatment options. The group also provides support as men deal with quality of life issues as a survivor.
Tom Dillon was inspired to form the chapter after his own experience with prostate cancer.
Healing process found to backfire in lung patients
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A mechanism in the body which typically helps a person heal from an injury, may actually be causing patients with idiopathic pulmonary fibrosis (IPF) to get worse, researchers at the National Institute of Environmental Health Sciences (NIEHS), a part of the National Institutes of Health (NIH), and their collaborators have found.
“We identified a new mechanism that explains why some patients with IPF get more short of breath than others, in spite of similar levels of lung scarring,” said Stavros Garantziotis, M.D., an NIEHS staff clinician and lead author on the new paper highlighted on the cover of the Nov. 1 issue of the American Journal of Respiratory and Critical Care Medicine.
Idiopathic pulmonary fibrosis is an incurable lung disease that affects approximately 50,000 people in the United States. In IPF, the lung tissue becomes scarred and patients have difficulty breathing, often resulting in death. The cause is unknown, though genes as well as environmental factors such as smoking and exposure to metal dust particles, are thought to raise the risk.
Anti-inflammatory medications may become a treatment for schizophrenia
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Many of the structural and neurochemical features of schizophrenia are present long before the full syndrome of schizophrenia develops. What processes tip the balance between the ultra-high risk states and the development of schizophrenia? One candidate mechanism is cerebral inflammation, studied by Dr. Bart van Berckel and colleagues in the November 1st issue of Biological Psychiatry.
Using positron emission tomography, or PET, imaging, the researchers provide evidence of a brain inflammatory state that may be associated with the development of schizophrenia. The authors reported increased binding levels of [11C]PK11195, a radiotracer with high affinity for the peripheral benzodiazepine receptor (PBR) in patients who had carried the diagnosis of schizophrenia for five years or less. PBR is a molecular target that is present at higher levels in activated microglia. Microglia are activated during inflammatory states. Drs. van Berckel and Kahn further explain: “It was found that microglia activation is present in schizophrenia patients early after disease onset, suggesting brain cells are damaged in schizophrenia. In addition, since microglia can have either a protective or a toxic role, activated microglia may be the result, but also the cause of damage to brain cells.”
John H. Krystal, M.D., Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, adds, “It will be important to understand whether this process takes place in a special way in association with the first onset of symptoms or whether inflammation is more generally a process that contributes to worsening of symptoms.” Because this data suggests that inflammation may contribute to features of the early course of schizophrenia, a new potential avenue of treatment for schizophrenia may be to use anti-inflammatory agents. Although some anti-inflammatory medications have already been studied, with limited success, in schizophrenia patients, a new generation of these drugs that more specifically target activated microglia have yet to be explored.
Eating whole grains lowers heart failure risk, according to new study
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About 5 million people in the United States suffer from heart failure (HF). While some reports indicate that changes to diet can reduce HF risk, few large, prospective studies have been conducted. In a new study researchers observed over 14,000 participants for more than 13 years and found that whole grain consumption lowered HF risk, while egg and high-fat dairy consumption raised risk. Other food groups did not directly affect HF risk. The results are published in the November 2008 issue of the Journal of the American Dietetic Association.
Diet is among the prominent lifestyle factors that influence major HF risk factors: coronary artery disease, obesity, diabetes and insulin resistance and hypertension.
Using data from the Atherosclerosis Risk in Communities (ARIC) study, researchers from the Division of Epidemiology and Community Health, University of Minnesota and the Department of Epidemiology and Cardiovascular Diseases Program, University of North Carolina, analyzed the results of baseline exams of more than 14,000 White and African American adults conducted in 1987-89, with follow-up exams completed during 1990-92, 1993-95, and 1996-98.
In game of tennis, seeing isn’t always believing
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A universal bias in the way people perceive moving objects means that tennis referees are more likely to make mistakes when they call balls “out” than when they call them “in,” according to a new report in the October 28th issue of Current Biology, a Cell Press publication. Because recent rule changes allow professional tennis players to challenge the refs’ calls, athletes could exploit the new findings to their advantage, according to researchers at the University of California, Davis.
Like all visual illusions, the new discovery provides visual neuroscientists with a window on how the brain processes information, explained David Whitney.
“The visual system faces a big challenge when trying to code the locations of objects so that we can perceive them,” Whitney said. “Consider one of the difficulties: every time we move our eyes, the image on our retina moves. Even if our coffee cup is actually stationary on our desk, we move our eyes and head while reaching to pick it up so the image of the cup will move on our retina. This is a problem because the visual system is sluggish—it takes a hundred or more milliseconds for us to become aware of an image that strikes our retina. So, by the time we perceive an object like the coffee cup in one location, it will have already changed location as we move toward it. Our perception lags behind reality. The visual system has mechanisms that help alleviate this problem of living in the past, but these mechanisms are not perfect and occasionally result in visual illusions—like the misperception of tennis ball location we discovered.”
Nicotine replacement safe during pregnancy
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For women trying to quit smoking during pregnancy, using nicotine replacement therapy such as nicotine patches or nicotine gum does not increase the likelihood of a stillbirth, a study shows.
“Smoking during pregnancy increases the risk of stillbirth,” the researchers write in the British Journal of Obstetrics and Gynaecology. “The use of NRT (nicotine replacement therapy) in pregnancy is a possible harm reduction strategy,” they add.
Using national data, Dr. K. Strandberg-Larsen, at the University of Southern Denmark in Copenhagen, and colleagues gathered information on NRT use and smoking for 87,032 singleton pregnancies.
Study examines repeated exposure to HIV in treatment-suppressed HIV patients
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A new study looking at unprotected intercourse within gay couples when each partner has established HIV-infection found a correlation between anti-HIV immune response and sexual activity.
Study results showed that individuals who had regular unprotected receptive anal intercourse with partners with significant levels of HIV in their blood showed a stronger anti-HIV immune response. In addition, the magnitude of anti-HIV specific immune response correlated with their exposure to HIV through sex.
Published in the October 24th, 2008 issue of PLoS Pathogens, the study paper is authored by a research team from UCSF and the Gladstone Institute for Virology and Immunology.
Boston Medical Center researchers educating chief residents about addiction
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Researchers from Boston Medical Center (BMC) have found that education on addiction is inadequate during medical training, resulting in suboptimal medical care for those at risk. However, the research also found that a Chief Resident Immersion Training (CRIT) program in addiction medicine is an effective “train the trainers” model for dissemination of addiction knowledge and skills to generalist physician trainees. These findings appear in the Journal of General Internal Medicine.
The goal of the CRIT program is to provide incoming generalist chief residents from internal medicine, family medicine and emergency medicine with the scientific foundation of addiction medicine and state-of-the-art diagnosis and management skills of addiction medicine, and to facilitate the integration of addiction medicine content into residency program curricula and chief resident teaching.
A total of 86 incoming chief residents applied to the annual CRIT program over a three year period, with 64 participating in the CRIT intervention group and 22 attended the control group. Each member of the program received a questionnaire at baseline and again at six months after the program to assess changes in addiction medicine knowledge, skills, clinical practice and teaching.
30,000 Children with Form Of Juvenile Rheumatoid Arthritis May Have New Treatment Option
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Anakinra may be effective in the treatment of an estimated 30,000 children with a certain form of juvenile arthritis, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in San Francisco, Calif.
Systemic onset juvenile idiopathic arthritis (often referred to as systemic-onset juvenile rheumatoid arthritis or Still’s disease) affects about 10 percent of children with arthritis. It begins with a recurrent fever that can be 103° F or higher, often accompanied by a pink rash that comes and goes. Systemic onset JIA may cause inflammation of the internal organs as well as the joints. Swelling of the joints may not be present initially, and may appear months or even years after the onset of fevers. Anemia (a low red blood cell count) and elevated white blood cell counts are also typical. Arthritis may persist despite the fevers and other systemic symptoms going away.
In a recent multicenter, randomized, double-blind trial, researchers compared the effectiveness of a one-month treatment with anakinra (Kineret)—which was delivered at 2 milligrams per kilogram, subcutaneously, each day with a maximum of 100 milligrams—to a placebo in two groups of children, each containing 12 patients with JIA. Treatment was blinded so that neither the children nor the investigators knew which injection was being given. After 1 month, patients were allowed to continue un-blinded therapy for another 11 months.
Gene Expression May Influence Lack of Response to RA Treatment
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Genes might explain why some patients with rheumatoid arthritis respond better to anti-TNF therapy than others, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in San Francisco, Calif.
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.
Drugs known as tumor necrosis factor, or TNF, inhibitors are often prescribed to individuals with rheumatoid arthritis. They work by targeting and blocking the inflammation, and can help reduce pain, morning stiffness, tender and swollen joints, limit damage to the joints and improve function.
Traditional Cardiovascular Risk Factors Increase, Treatments Reduce Heart Attack Risk in People
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Traditional Cardiovascular Risk Factors Increase, Treatments Reduce Heart Attack Risk in People with Rheumatoid Arthritis
Age, sex and traditional risk factors—such as hypertension, diabetes, smoking, and body mass—are more important predictors of heart attack in patients with rheumatoid arthritis than the use of certain medications that have been considered the link between the two and lipid-lowering medications may actually reduce this risk, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in San Francisco, Calif.
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.
Disease-modifying antirheumatic drugs, or DMARDS as they are commonly called, are often the therapy of choice for patients with RA as they not only reduce inflammation and pain, but can slow the overall progression of the disease.
Early-onset depressive disorders predict the use of addictive substances in adolescence
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In a prospective study of over 1800 interviewed young Finnish twins, early-onset depressive disorders at age 14 significantly predicted daily smoking, smokeless tobacco use, frequent illicit drug use, frequent alcohol use and recurrent intoxication three years later, even among those adolescents who were not users at baseline.
Analysis of twins discordant for early-onset depressive disorders confirm predictive associations of early-onset depressive disorders with smokeless tobacco use and frequent drinking at age 17½, in within-family replications with co-twins matched on half or all their segregating genes, and on their family structure, socio-economic status, and household environment.
Chronic inflammation can help nurture skin cancer, study shows
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Inflammation, a frontline defense against infection or disease, can help nurture skin cancer, researchers have found.
IDO, an enzyme that works like a firefighter to keep inflammation under control, can be commandeered to protect early malignant cells, say Medical College of Georgia researchers studying an animal model of chronic inflammation and skin cancer.
“Inflammation should really help prevent a tumor,” says Dr. Andrew Mellor, director of the MCG Immunotherapy Center and Georgia Research Alliance Eminent Scholar in Molecular Immunogenetics. In fact, there is strong evidence that inflammation triggers the immune response. “You want a good immune response; this is what protects you from pathogens,” he says. “In this case, it’s an unfortunate exploitation by malignant cells.”
Markers of inflammation and blood-clotting tied to hazards of intermittent HIV treatment
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Episodic treatment of HIV/AIDS with antiretroviral drugs increases the overall risk of death when compared with continuous antiretroviral treatment (ART), but the reasons why have been unknown. Now, researchers have found that higher levels of certain markers of inflammation and blood-clotting are strongly associated with intermittent ART and with a higher risk of death from non-AIDS diseases.
The new report, published in the open access journal PLoS Medicine, is a further analysis of the “Strategies for Management of Antiretroviral Therapy” (SMART) study supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.
SMART, which ended in 2006, compared the standard practice of continuous ART to suppress HIV in infected individuals with episodic ART based on CD4+ T-cell counts. The goal was to determine whether reducing exposure to antiretroviral drugs, which may have toxic side effects and can engender drug resistance, would be equally or more beneficial than suppressing HIV continuously. Unexpectedly, those who received episodic ART were more than twice as likely to develop disease or die, and the study ended early as a result.
