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Aug 06
Gut Hormone Has 'Remote Control' On Blood Sugar
A gut hormone first described in 1928 plays an unanticipated and important role in the remote control of blood sugar production in the liver, according to a report in the August 6th Cell Metabolism, a Cell Press publication. What's more, the researchers show that rats fed a high-fat diet for a few days become resistant to the glucose-lowering hormone known as cholecystokinin (CCK).

"We show for the first time that CCK from the gut activates receptors to regulate glucose levels," said Tony Lam of the University of Toronto. "It does so via a gut-brain-liver neuronal axis."

Researchers already knew that CCK levels rise in the upper intestine in response to nutrients such as lipids to lower food intake, Lam explained. Now, his team shows that the CCK hormone binds local receptors on nerves of the small intestine, sending a powerful signal to the brain. The brain in turn tells the liver to stop producing glucose.

Lam said his group described the gut-brain-liver circuitry in a paper published last year. The new study shows that it is CCK that acts as the trigger.

A primary increase of CCK-8, the biologically active form of CCK, in the upper intestine lowers glucose production independently of any change to circulating insulin levels, they found. CCK-8's effects depend on activation of CCK-A receptors and the signals they send to the brain and on to the liver, where glucose production slows. Those effects of the hormone begin to fail early in the onset of high-fat diet-induced insulin resistance, they report.

The findings suggest that CCK resistance, like insulin resistance, might be a key contributor to the high blood sugar that often comes with a high-fat diet. It also suggests that drugs targeting the CCK receptors in the gut may hold promise for therapy. That's key, Lam said, because such gut-targeted drugs might be expected to have fewer side effects than currently available diabetes drugs that work directly on the liver.

"This raises the possibility that we might be able to tap into the circuitry [to lower blood sugar]," Lam said. "At least now we know where to start."

Drug combinations that could increase sensitivity to both insulin and CCK might better combat diabetes than either could alone, he added. While the magnitude of CCK's influence over glucose levels relative to the effects of insulin aren't yet known, Lam said it's now clear both are important and neither works properly in the case of diabetes or obesity.

The researchers further suggest that CCK's role in the gut might somehow explain why people often show improvements in their blood sugar levels following gastric bypass surgeries, even before they lose any weight.

"Since we described that duodenal CCK normally triggers a gut-brain-liver axis to lower glucose production but fails to do so in high-fat fed rodents, we propose that duodenal bypass surgeries improve glucose tolerance in diabetes and obesity partly because the surgery bypasses an acquired defect involving duodenal CCK resistance in response to high-fat feeding," they wrote. Further studies are needed to explore that notion.

Aug 06
Despite Repeat Warnings, Skin Cancer Continues To Rise Among Women
Do you intend on getting a healthy tan this summer? You may want to rethink your plans. Tan skin is the body's reaction to sun damage, along with freckles, wrinkles and brown spots. So unless your tan comes from a bottle, it's probably not healthy.

More than one million cases of skin cancer will be diagnosed in the United States this year, according to the American Cancer Society. And despite the countless public service announcements and media messages, the numbers continue to rise.

According to recent studies by both the American Academy of Dermatology and British Association of Dermatologists, people in their teens and early twenties are less likely than any other age group to use sun protection, despite the increasing risk among this demographic.

Many young people ignore the risk because they don't see the detrimental effects of the sun right away. Skin cancer often does not show up immediately. "Most skin cancers take years of cumulative sun exposure to form and reflect sun-worshipping behaviors of years past," says Tanya Futoryan, MD, medical director of the Westport Dermatology and Laser Center in Westport, Conn.

And it's not just young people who suffer the negative effects of the sun. It's only been over the last two decades, that we've learned, as a society, about the dangers of the sun. Millions of women who spent their childhoods basking in the sun are suffering the consequences as well.

"Although we are better educated now on sun protection, it takes a long time to adapt sunscreen use and sun avoidance into our every day lives," says Futoryan. "Every new generation has to be convinced of the dangers of sun damage."

There are three major types of skin cancer. Bad sunburns which include blistering increase a person's risk of melanoma, the most serious type of skin cancer. Long-term exposure to the sun increases the risk of all types of skin cancer including the less serious types: basal-cell and squamous-cell carcinoma.

The diagnosis of all types of skin cancer has increased and melanoma has become the most common cancer among young women aged 25-29, according to the Centers for Disease Control and Prevention in Atlanta, Ga.

While it's not entirely clear why the risk of skin cancer is skyrocketing in women, there are certainly a few clues. Alarming numbers of young people, mostly women, are using tanning beds in the United States. Study after study suggests that the UV rays at tanning salons are just as damaging as natural sunlight.

"In young women ages 15-29, the torso is the most common location for developing melanoma, which may be due to high risk tanning behavior," according to Francesco Fusco, MD, assistant clinical professor of dermatology at Mt Sinai School of Medicine NYC and an educational spokesperson for the Skin Cancer Foundation. "This is most likely due to increased UV exposure which includes natural as well as artificial UV light."

There is also strong evidence suggesting that young people continuously ignore the threat of skin cancer. According to results from a recent study conducted by the American Academy of Dermatology, only one in three American teenagers between the ages of 12 and 18 used sunscreen.

"While great advances have been made in early detection and prevention of skin cancer, it is important to educate young women about the importance of sun protection in the fight against skin cancer," says Futoryan.

Here are some tips on how to stay safe in the sun:

- Use sunscreen (with broad spectrum UVA/UVB protection) liberally when outdoors.

- Seek shade between 10 am and 4 pm large sun umbrellas work great.

- Wear sun-protective clothing; hats and longer pants, shirts with sleeves, sarongs and wraps.

- Use UV absorbing sunglasses to protect the eyes.

In addition to your own monthly skin checks, an annual head-to-toe skin examination by a dermatologist, or skin doctor, should be a routine part of your health maintenance.

Aug 06
India may have its own H1N1 vaccine by September
India could have its very own indigenous vaccine against H1N1 influenza
by September.

Among three India companies — Serum Institute, Bharat Biotech and Panacea — working towards producing this India-specific vaccine, two have assured the health ministry that the vaccine would be ready by September-end. This was confirmed by director general of health services
(DGHS) Dr R K Srivastava.

He told TOI, “Two of these companies have told us that they will be able to provide the vaccine by September while the third one hasn’t given any time frame yet.” He added, “Once we are near to having the vaccine, we will decide who will get it first, how many vaccine doses we will require and what the regimens will be.”

The Indian Council for Medical Research (ICMR) and the National Institute of Virology in Pune
isolated the deadly H1N1 virus from a sample of India’s first human infection in Hyderabad on May 16. However CDC Atlanta, which grew what’s called a seed stock — a strain of the virus that’s the first step toward growing a vaccine — has sent it to the three manufacturers for the vaccine.

Health ministry officials said the vaccine should be available with India before the second wave of the pandemic arrives sometime in November. Dr V M Katoch, ICMR director general, told TOI, “For a pandemic vaccine there is no time to see its long-term effects. The manufacturers will ensure that the vaccine is safe and is effective. They will look at whether the human immune system is producing antibodies against the virus or not. We should therefore have a vaccine in the next three months.”

Aug 04
Pune teen is first swine flu fatality in India
Swine flu claimed its first victim in India when a 14-year-old girl died of H1N1 infection at Pune’s Jahangir Hospital on Monday.

Seven more people — two in Delhi, three in Pune and one each in Chennai and Ahmedabad — tested positive for swine flu, taking India’s tally to 558 in the 79 days since the first case was reported in the country. Of these, 470 have recovered.

Jahangir Hospital did not give the name of the victim. Sources said her name was Ria Shaikh and she was from Pune.

She developed a sore throat, runny nose, headache and fever on July 21, but she went to a private doctor. He treated her for a cold and fever, and she returned to school on July 23.

The teenager again developed fever on July 25, for which she went to another private doctor. Since the fever did not respond to treatment, she was admitted to a private nursing home in Pune on July 27.

Her condition worsened and she was shifted to ICU and put on a ventilator on July 29.

“It is very unfortunate, she was brought for testing and treatment two weeks after she got infected,” said Vineet Chawdhry, joint secretary, ministry of health.

“They kept going to private doctors and her lung aspirate was finally sent to Pune’s National Institute of Virology (NIV) for testing on July 31, where she tested positive for swine flu. By then, it was too late.”

The girl did not respond to the anti-flu drug oseltamivir and died of multi-organ failure.
“This underlines the fact that people should go to a public health facility at once,” said Chawdhry.

“She had come in contact with 40 students who travelled to NASA in the US, and though she had not travelled herself, she got the infection from them.”

The Maharashtra government has assigned two Pune hospitals — Naidu Hospital and Yashwantrao Hospital — to treat swine flu patients.

It was not clear why Jahangir Hospital did not shift the girl to one of these hospitals despite the NIV confirming swine flu two days ago.

Aug 03
New Chemical Imaging Technique Could Help In The Fight Against Atherosclerosis, Suggests Research
A new chemical imaging technique could one day help in the fight against atherosclerosis, suggests research published in the August 2009 edition of the Journal of the Royal Society Interface.

Atherosclerosis is the disease underlying most heart attacks and strokes and it is characterised by lesions in the arteries, made of fats, collagen and cells. The lesions cause artery walls to harden and thicken, which severely restricts the flow of blood around the body and they can also rupture, leading to heart attacks and strokes. Understanding the precise chemical composition of an individual's lesions is important because the ones with higher levels of a type of fat called cholesteryl ester are more prone to rupture.

The team behind the new imaging technique, which is known as Attenuated Total Reflection Fourier Transform Infrared Spectroscopic Imaging (ATR-FTIR imaging), believe that with further refinement, it could become a useful tool for doctors wanting to assess a patient's lesions. For example, by combining fibre optic technology with ATR-FTIR imaging, the researchers believe doctors could carry out real-time inspections of patients with atherosclerosis, in order to assess the progress of the disease and establish which patients are at the greatest risk of complications.

Currently, doctors can use ultrasound to assess the size and location of lesions but they need to take biopsies of lesions in order to determine their chemistry. This is a complex and invasive procedure.

The researchers say the ATR-FTIR imaging could potentially improve current imaging techniques because it could combine imaging and chemical analysis, which would provide a comprehensive and accurate picture of a patient's lesions in one procedure. In the present study, the researchers demonstrated that ATR-FTIR imaging was able to reveal the precise composition and size of the lesions and the levels of elastin, collagen and cholesteryl ester in them.

The ATR-FTIR imaging technology works by using infrared light to identify different chemical molecules, which are mapped by an array detector to create a 'chemical photograph'.

The researchers used the technique to study the effects of age and an amino acid called L-arginine on the composition of lesions in cholesterol-fed rabbits. The work appeared to confirm that dietary L-arginine can remove lesions in the arteries of mature rabbits.

The researchers say further studies need to be done before the ATR-FTIR imaging could be used for patient care.

Aug 03
Over 50 Million Suffer From Asthma In Central And Southern Asia - Prevalence Predicted To Continue I
Over 50 million people in Central and Southern Asia* have asthma, and many do not have access to the medications that can control the disease, according to a report released today, World Asthma Day. The Global Burden of Asthma Report, which details the prevalence, morbidity, and mortality of asthma in 20 regions around the world, reveals a number of alarming facts about the burden of this chronic respiratory disease in Central and Southern Asia.

Due to rapid industrialization and urbanization throughout the region, the prevalence of asthma is predicted to increase rapidly in the coming years. The increase is likely to be particularly dramatic in India, which is projected to become the world's most populous nation by 2050. An absolute 2% increase in the prevalence of asthma in India would result in an additional 20 million people with the disease.

The prevalence of asthma in Central and Southern Asia ranges from 1.5% in Nepal to 4.6% in Uzbekistan - relatively low compared to some other parts of the world. However, the prevalence of asthma has increased markedly in recent years, with up to a threefold increase seen among children in Southern Asia over the last two decades.

Asthma is a chronic lung disease characterized by recurrent breathing problems and symptoms such as breathlessness, wheezing, chest tightness, and coughing. Asthma symptoms vary over time, and also differ in severity from one individual to another. When it is not effectively treated, asthma often leads to hospitalization, missed work and school, limitations on physical activity, sleepless nights and in some cases death.

Although asthma cannot be cured, effective medications to treat and manage the disease exist. One of the authors of the Global Burden of Asthma Report, Professor Richard Beasley, of the Medical Research Institute of New Zealand, says, "In Central and Southern Asia, effective asthma management is often limited by lack of availability or affordability of medications." In some areas widespread misconceptions about asthma and its treatment, and reluctance of patients to use the inhaler devices that are key to effective delivery of asthma medicines, also pose challenges. "Low-cost asthma education and management programs are needed to ensure that asthma care is available and affordable for all segments of the population in Central and Southern Asia," adds Professor Beasley.

The high levels of air pollution in Central and Southern Asia are also cause for concern. "The inhabitants of some Indian and Bangladeshi cities are exposed to some of the highest air pollution levels in the world," Professor Beasley says. "Air pollution can trigger asthma attacks, and can also worsen the symptoms of a variety of other respiratory diseases." Indoor air pollution, from burning biomass fuel for cooking and heating in poorly ventilated dwellings, also contributes to the burden of asthma and other respiratory diseases in the region.

Asthma is now one of the world's most common long-term conditions, according to the Global Burden of Asthma Report. The disease is estimated to affect as many as 300 million people worldwide - a number that could increase by a further 100 million by 2025.

The Global Burden of Asthma Report is a comprehensive survey of the prevalence and impact of asthma around the world, based on standardized data collected in epidemiology studies in more than 80 countries.

Aug 03
Benefits From Upper Airway Surgery For Sleep Apnea Found To Equal CPAP
Adults who struggle with CPAP treatment for obstructive sleep apnea (OSA) should be considered candidates for reconstructive surgery on the upper airway, because it holds the same quality-of-life (QOL) benefits but with more permanence. This thesis is in new research published in the August 2009 edition of Otolaryngology-Head and Neck Surgery.

Continuous positive airway pressure (CPAP) therapy is a highly effective means for treating obstructive sleep apnea, but because it involves a mask and set of hoses, it can be frustrating and uncomfortable for some patients, and compliance may be short-lived.

The Australian authors of the study discovered that among moderate-to-severe OSA-suffering patients, those treated through upper airway surgery experienced the same level of long-term quality-of-life improvement as their peers who were treated with CPAP therapy. Among the QOL benefits were improvements in snoring, sleepiness, and neurocognitive impairment. In contrast, those patients who were prescribed, but did not adequately use CPAP, had minimal QOL improvement.

The upper airway includes nose and throat (pharyngeal) areas, particularly behind the soft palate and tongue. Reconstructive surgery to treat sleep apnea involves clearing any blockages in those areas that might be hindering breathing.

Aug 01
Scientists Develop A Highly Accurate Method To Peer Into The Brain
Researchers at Rutgers University in Newark and the University of California, Los Angeles, have developed a highly accurate method to peer into the brain.

This method can help uncover a person's mental state and determine what sort of information is being processed before it reaches conscious awareness.


The discovery of this new window into the brain has provided scientists with a means to develop a more accurate model of the inner functions of the brain.

Led by Stephen Jose Hanson
, a professor of Psychology at Rutgers, the study has provided direct evidence that a person's mental state can be predicted with a high degree of accuracy through functional magnetic resonance imaging (fMRI).

The research has also suggested that a more comprehensive approach is needed to map brain activity, and that the widely held belief that localized areas of the brain are responsible for specific mental functions is misleading and incorrect.

In their analysis of global brain activity, the researchers found that different processing tasks have their own distinct pattern of neural connections stretching across the brain, similar to the fingerprints that distinctively identify each of us.

However, instead of being a static pattern, the brain is able to arrange and rearrange the connections based on the mental task being undertaken.

"You can't just pinpoint a specific area of the brain, for example, and say that is the area responsible for our concept of self or that part is the source of our morality.

It turns out the brain is much more complex and flexible than that. It has the ability to rearrange neural connections for different functions. By examining the pattern of neural connections, you can predict with a high degree of accuracy what mental processing task a person is doing," said Hanson.


The findings open up the possibility of categorizing a multitude of mental tasks with their unique pattern of neural circuitry, and also represent a potential first, early step in developing a means for identifying higher-level mental functions, such as 'lying' or abstract reasoning.

They potentially also could pave the way for earlier diagnosis and better treatment of mental disorders, such as autism and schizophrenia, by offering a means for identifying very subtle abnormalities in brain activity and synchrony.

The findings provide a more accurate direction for mapping the effective connectivity of the brain.

Known as the Connectome Project, the goal of researchers involved in the work is to provide a complete map of the neural circuitry of the central nervous system.

The study involved 130 participants, each of whom performed a different mental task, ranging from reading, to memorizing a list, to making complex decisions about whether to take monetary risks, while being scanned using fMRI.

By analyzing the participants' fMRI data against classifications developed from the fMRIs of other individuals, the researches could identify which of eight tasks participants were involved in with more than 80 percent accuracy.

The researchers could also identify what class of objects (faces, houses, animals, etc.) a person was viewing before he or she could report that information by analyzing the pattern of brain activity at the back of the brain where information is processed and then conveyed towards the frontal regions associated with awareness.

"What our research shows is that if you want to understand human cognitive function, you need to look at system-wide behavior across the entire brain. You can't do it by looking at single cells or areas. You need to look at many areas of the brain to even understand the simplest of functions," explained Hanson.

Aug 01
Scientists find new way to fix a broken heart
A new way to mend damage to the heart has been found by scientists.


The boffins have devised a method to coax heart muscle cells into re-entering the cell cycle, allowing the differentiated adult cells to divide and regenerate healthy heart tissue after a heart attack, according to studies in mice and rats by Children's Hospital Boston reported in the issue of the journal Cell.

If the same mechanisms identified by the researchers can be shown to work in the human heart, it opens up real possibilities for new and more efficient ways to treat people with heart disease
, reports The BBC.

Theoretically, it could be used to treat heart attack patients, those with heart failure and children with congenital heart defects.

The key ingredient is a growth factor known as neuregulin1 (NRG1).

Previously, it was believed that the heart was incapable of repairing itself. During prenatal development, heart muscle cells (cardiomyocytes) proliferate but were thought to lose that ability shortly after birth. But, recent research has indicated that the adult cells do have some ability to replace themselves at a low level.

And, the new study provides evidence that this is true - and that NRG1 can ramp up the process significantly.

The Boston team tested the ability of various molecules to spur cell division in cultured cardiomyocytes, including several factors known to drive proliferation of the cells during prenatal development. NRG1 produced the most significant effect, and it was repeated when the factor was injected into adult mice.

When administered to animals who had suffered a heart attack, it promoted regeneration of heart muscle, and improved the overall function of the organ.

Writing in the journal, they said: "We have identified the major elements of a new approach to promote myocardial regeneration.

"Many efforts and important advances have been made toward the goal of developing stem-cell based strategies to regenerate damaged tissues in the heart as well as in other organs.

"The work presented here suggests that stimulating differentiated cardiomyocytes to proliferate may be a viable alternative."

Professor Jeremy Pearson, associate medical director of the British Heart Foundation, said: "This fascinating study shows, remarkably, that a significant fraction of adult heart cells in mice can be made to replicate and help to repair damaged hearts.

"If the same mechanisms identified by the researchers can be shown to work in the human heart, it opens up real possibilities for new and more efficient ways to treat people with heart disease."

Aug 01
Developing Gene Therapy To Fight Blindness
An international team of scientists and clinicians from the United States and Saudi Arabia are working to develop gene therapy for treating a rare, hereditary retinal disease. The therapy has been shown to restore lost vision in animal models of retinitis pigmentosa (RP). Their work is being funded in part by a $1.5 million grant from the Prince Salman Center for Disability Research in Saudi Arabia, where the recessive gene mutation that leads to the eye disease RP has been found in children from several families.

RP is a type of hereditary retinal dystrophy, a group of inherited disorders in which abnormalities of the photoreceptor rods and cones lead to progressive visual loss. Rods and cones are specialized light-sensitive nerve cells that line the retina. They collect light and then send nerve signals that the brain interprets as vision. Rods facilitate black and white vision and are used mainly at night. During the day, humans depend on cones for color vision.

In people with the genetic mutations that cause RP, rods and cone cells die. Affected individuals first experience defective dark adaptation or "night blindness," followed by reduction of the peripheral visual field known as tunnel vision, sometimes followed by loss of central vision late in the course of the disease. RP affects one in 3,000 to 4,000 people in the United States.

The planned clinical approach of this research trial involves a receptor protein called MERTK that is expressed in the retinal pigment epithelium, the pigmented cell layer just outside the retina that closely interacts with photoreceptors in the maintenance of visual function. Patients with loss of MERTK function have a defect in phagocytosis �" a mechanism used to remove pathogens and cell debris. As a result of this defect, debris accumulates between the photoreceptors and retinal pigment epithelium, resulting in death of photoreceptors and loss of vision.

The researchers plan to deliver the MERTK gene in a viral vector - a carrier commonly used to deliver genetic material to treat these cells in order to restore function of photoreceptors. Using a rodent model of RP with a similar MERTK mutation, the researchers have demonstrated in proof-of-concept studies that viral vector delivery of MERTK corrects the mutant gene and restores vision.

The eye is an ideal place for gene therapy because it's an "immune-privileged site," meaning that the eye is able to tolerate the introduction of foreign cells with a minimal, if any, inflammatory immune response, according to Zhang.

The research team's next step is to show that such gene therapy is safe in further animal studies, to be conducted in China, along with additional rat studies that will be conducted at UC San Diego and at the University of Florida.

Once safety for the procedure has been shown, the team hopes to proceed to a human clinical trial in seven patients identified in Saudi Arabia, perhaps as early as spring of 2010.

The same type of vector has been successfully tested in both animals and humans for a similar type of early-onset retinal degeneration called Leber's congenital amaurosis.

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