What you eat may affect your body's internal biological

clock
Date:
July 10, 2014
Source:
Cell Press
Summary:
Food not only nourishes the body but also affects its internal biological clock, which
regulates the daily rhythm of many aspects of human behavior and biology.
Researchers provide new insights into how adjusting the clock through dietary
manipulation may help patients with various conditions and show that insulin may
be involved in resetting the clock
Food not only nourishes the body but also affects its internal biological clock, which
regulates the daily rhythm of many aspects of human behavior and biology.
Researchers reporting in the Cell Press journalCell Reports provide new insights
into how adjusting the clock through dietary manipulation may help patients with
various conditions and show that insulin may be involved in resetting the clock.
An internal biological or 'circadian' clock plays an important role in preferred sleep times, times
of peak alertness, and the timing of certain physiological processes. The clock enables
maximum expression of genes at appropriate times of the day, allowing organisms to adapt to
the earth's rotation. "Chronic desynchronization between physiological and environmental
rhythms not only decreases physiological performance but also carries a significant risk of
diverse disorders such as diabetes, cardiovascular diseases, sleep disorders, and cancer," says
Dr. Makoto Akashi, of Yamaguchi University, in Japan.
The circadian clock involves two major pathways. The first, which responds to light, has been
well characterized. The second, which responds to food, is less understood. Through
experiments in cells and mice, Dr. Akashi and his colleagues found, using cell culture, that
insulin, a pancreatic hormone that is secreted in response to feeding, may be involved in
resetting the circadian clock. "Insulin-mediated phase adjustment of the clock in feeding-
relevant tissues may enable the synchronization between mealtime and tissue function, leading
to effective digestion and absorption," he says. "In short, insulin may help the stomach clock
synchronize with mealtime."
The researchers' findings provide valuable information on how to adjust the circadian clock
through dietary manipulation. "For example, for jet lag, dinner should be enriched with
ingredients promoting insulin secretion, which might lead to a phase advance of the circadian
clock, whereas breakfast would be the opposite," says Dr. Akashi. The findings also suggest
that clock adjustments through feeding might not work well in individuals with insulin resistance,
a characteristic of patients with type 2 diabetes. Also, there may be side effects related to the
circadian clock when treating patients with insulin.

Story Source:
The above story is based on materials provided by Cell Press. Note: Materials may be edited
for content and length.

Journal Reference:
Miho Sato, Mariko Murakami, Koichi
Node, Ritsuko Matsumura, Makoto
Akashi.The Role of the Endocrine
System in Feeding-Induced Tissue-
SpecStandardization of safe imaging protocols for
children needed, experts say
Date:
July 10, 2014
Source:
Mayo Clinic
Summary:
The benefits of medical imaging far outweigh the risks when children receive The
Right Exam, ordered The Right Way, with The Right Radiation Dose. However,
overuse and misuse of imaging change the benefit-risk ratio, say researchers. "No
hospital or medical imaging facility in the country should be granted the privilege of
imaging children unless it first meets fundamental safe practice performance
measures," says the lead author and radiologist.
1. ific Circadian Entrainment. C
The benefits of medical imaging far outweigh the risks when children receive The Right
Exam, ordered The Right Way, with The Right Radiation Dose. However, overuse and
misuse of imaging change the benefit-risk ratio and Mayo Clinic is leading a collaborative
effort to ensure a national protocol is put into action. The commentary, published online in
theJournal of Patient Safety, calls for the American College of Radiology, the Joint
Commission, the Intersociety Accreditation Commission, and the Centers for Medicare &
Medicaid Services to require three safety practices for accreditation of all American
hospitals and advanced diagnostic imaging facilities.
"No hospital or medical imaging facility in the country should be granted the privilege of imaging children
unless it first meets fundamental safe practice performance measures," says Stephen Swensen, M.D.,
lead author and radiologist, Mayo Clinic.
By design, the three, child-centered measures proposed for accreditation that align perfectly with the
National Quality Forum Safe Practice for Pediatric Imaging include:
1. The Right Exam -- minor head trauma imaging: use of the Pediatric Emergency Care Applied
Research Network Clinical Prediction Rule
1. The Right Way -- protocols to reduce dual-phase head and chest CT imaging
1. The Right Radiation Dose -- use of size-specific pediatric CT imaging protocols
Randall Flick, M.D., Medical Director for Mayo Clinic Children's Center adds, "Establishing these
protocols represents a great step forward on the path to safe imaging for children."
"We have the knowledge and the tools today that can substantially improve the safety and quality of care
for our children (while also decreasing costs). We have a compelling opportunity to reduce harm for the
most susceptible population: our children,"Dr. Swensen concludes.

Story Source:
The above story is based on materials provided by Mayo Clinic. Note: Materials may be edited for
content and length.

Journal Reference:
1. Stephen J. Swensen, James R. Duncan, Rosemary Gibson, Stephen E. Muething, Rebecca LeBuhn,
Jean Rexford, Carol Wagner, Stephen R. Smith, Becky DeMers, Richard L. Morin, John Santa,
Charles J. Homer. An Appeal for Safe and Appropriate Imaging of Children. Journal of Patient
Safety, 2014; 1 DOI:10.1097/PTS.0000000000000116


New drug active against most aggressive type of lung
cancer cells
Date:
July 10, 2014
Source:
Manchester University
Summary:
A new drug could prove useful in treating small cell lung cancer -- the most
aggressive form of lung cancer, researchers report. Scientists tested a drug --
known as AZD3965 -- on small cell lung cancer cells, with a focus on exploiting the
change in energy production in tumors. In cancer cells, there is a switch to using
glycolysis, a process that requires less oxygen and produces lactate as a by-
product. Certain molecules -- monocarboxylate transporters (MCTs) -- are involved
in the movement of lactate out of cells and drugs that target MCTs have been
shown to stop tumor growth.

Manchester scientists have shown that a new drug could prove useful in treating
small cell lung cancer -- the most aggressive form of lung cancer.
Scientists from the Cancer Research UK Manchester Institute, based at The University of
Manchester and part of the Manchester Cancer Research Centre, teamed up with experts at
AstraZeneca, as part of a collaboration agreed in 2010, to test a drug -- known as AZD3965 --
on small cell lung cancer cells.
The research, published in the journal Clinical Cancer Research, also helps identify which
patients are most likely to respond to the treatment.
One treatment approach currently being investigated by cancer scientists is finding drugs that
exploit the change in energy production in tumours. In cancer cells there is a switch to using
glycolysis, a process that requires less oxygen and produces lactate as a by-product. Certain
molecules -- monocarboxylate transporters (MCTs) -- are involved in the movement of lactate
out of cells and drugs that target MCTs have been shown to stop tumour growth.
The Manchester researchers tested a new drug that targets one of these molecules, MCT1, in
lung cancer cells and in mouse models.
Professor Caroline Dive, who led the research, said: "Small cell lung cancer has a dismal
prognosis and we have seen little improvement in treatment for many years. More targeted
therapies are needed to help those patients whose tumours become resistant to chemotherapy.
This new drug -- AZD3965 -- is currently in clinical trials, but it has not yet been tested in small
cell lung cancer."
The team investigated the sensitivity of small cell lung cancer cells to AZD3965 and showed
that in those cells lacking an alternate lactate transporter, MCT4, the drug had an effect. They
found that the drug increased the level of lactate in cells and, more importantly, reduced tumour
growth.
They then looked at tumour samples taken from lung cancer patients and found that high levels
of MCT1 were linked to worse patient prognosis.
Professor Dive added: "We propose that this drug will be most useful in this subset of patients
who have elevated MCT1 levels and need more effective treatments.
"Our laboratory results are promising and certainly provide encouragement to test this treatment
clinically in patients with small cell lung cancer."
Susan Galbraith, head of the oncology innovative medicines unit at AstraZeneca, said: "Lung
cancer is still the leading cancer killer, and we are working on a number of potential treatment
options that could provide patients with a better chance of beating the disease. Targeting
tumour cell metabolism represents a novel and exciting approach, and we are delighted to be
working with The University of Manchester and Cancer Research UK to investigate the utility of
AZD 3965 as a potential novel cancer treatment."

Story Source:
The above story is based on materials provided by Manchester University. Note: Materials
may be edited for content and length.

Journal Reference:
1. Polaski et al. Activity of the monocarboxylate transporter 1 inhibitor AZD3965 in small
cell lung cancer. Clin Cancer Res, July 2014 DOI:10.1158/1078-0432.CCR-13-2270.

Low back pain? Don't blame the weather
Date:
July 10, 2014
Source:
Wiley
Summary:
Sudden, acute episodes of low back pain are not linked to weather conditions such
as temperature, humidity, air pressure, wind direction and precipitation,
researchers have determined. These findings indicate that the risk of low back pain
slightly increases with higher wind speed or wind gusts, but was not clinically
significant.

Australian researchers reveal that sudden, acute episodes of low back pain are not
linked to weather conditions such as temperature, humidity, air pressure, wind
direction and precipitation. Findings published in Arthritis Care & Research, a journal
of the American College of Rheumatology (ACR), indicate that the risk of low back
pain slightly increases with higher wind speed or wind gusts, but was not clinically
significant.
According to the World Health Organization (WHO) nearly everyone experiences low back pain
at some point in their life, making it the most prevalent musculoskeletal condition and affecting
up to 33% of the world population at any given time. Those with musculoskeletal (bone, muscle,
ligament, tendon, and nerve) pain report that their symptoms are influenced by the weather.
Previous studies have shown that cold or humid weather, and changes in the weather increase
symptoms in patients with chronic pain conditions.
"Many patients believe that weather impacts their pain symptoms," explains Dr. Daniel Steffens
with the George Institute for Global Health at the University of Sydney, Australia. "However,
there are few robust studies investigating weather and pain, specifically research that does not
rely on patient recall of the weather."
For the present case-crossover study 993 patients seen at primary care clinics in Sydney were
recruited between October 2011 and November 2012. Weather data from the Australian Bureau
of Meteorology were sourced for the duration of the study period. Researchers compared the
weather at the time patients first noticed back pain (case window) with weather conditions one
week and one month before the onset of pain (control windows).
Results showed no association between back pain and temperature, humidity, air pressure,
wind direction or precipitation. However, higher wind speed and wind gusts did slightly increase
the chances of lower back pain, but the amount of increase was not clinically important.
"Our findings refute previously held beliefs that certain common weather conditions increase risk
of lower back pain," concludes Dr. Steffens. "Further investigation of the influence of weather
parameters on symptoms associated with specific diseases such as fibromyalgia, rheumatoid
arthritis, and osteoarthritis are needed."

Story Source:
The above story is based on materials provided by Wiley. Note: Materials may be edited for
content and length.

Journal Reference:
1. Daniel Steffens, Chris G. Maher, Qiang Li, Manuela L. Ferreira, Leani S.M. Pereira, Bart W.
Koes, Jane Latimer. Weather does not affect back pain: Results from a case-crossover
study. Arthritis Care & Research, 2014; DOI: 10.1002/acr.22378


Vasectomy may increase risk of aggressive prostate cancer
Date:
July 9, 2014
Source:
Harvard School of Public Health
Summary:
Vasectomy was associated with a small increased risk of prostate cancer, and a stronger risk
for advanced or lethal prostate cancer according to a new study. Vasectomy is a common
form of contraception in the U.S., with about 15% of men having the procedure. Prostate
cancer is the second-leading cause of cancer death among U.S. men, so identifying risk
factors for lethal prostate cancer is important for public health.

Vasectomy was associated with a small increased risk of prostate cancer, and a
stronger risk for advanced or lethal prostate cancer according to a new study from
Harvard School of Public Health (HSPH). The researchers found that the association
remained even among men who received regular PSA screening, suggesting the
increased risk of lethal cancer cannot be explained by diagnostic bias. It is the
largest and most comprehensive study to date to look at the link between vasectomy
and prostate cancer.
The study appears online July 7, 2014 in Journal of Clinical Oncology.
"This study follows our initial publication on vasectomy and prostate cancer in 1993, with 19
additional years of follow-up and tenfold greater number of cases. The results support the
hypothesis that vasectomy is associated with an increased risk of advanced or lethal prostate
cancer," said co-author Lorelei Mucci, associate professor of epidemiology at HSPH.
Vasectomy is a common form of contraception in the U.S., with about 15% of men having the
procedure. Prostate cancer is the second-leading cause of cancer death among U.S. men, so
identifying risk factors for lethal prostate cancer is important for public health.
The researchers analyzed data from 49,405 U.S. men in the Health Professionals Follow-up
Study, who were followed for up to 24 years from 1986 to 2010. During that time, 6,023 cases of
prostate cancer were diagnosed, including 811 lethal cases. One in four of the men in this study
reported having a vasectomy.
The results showed a 10% increased risk of prostate cancer overall in men who had a
vasectomy. Vasectomy was not significantly associated with risk of low-grade cancer. However,
vasectomy was associated with a stronger risk of advanced and lethal prostate cancer, with an
increased risk of 20% and 19% respectively. Among men who received regular PSA screening,
the relative increase in risk of lethal prostate cancer was 56%. The effect appeared to be
stronger among men who had a vasectomy at a younger age.
Prior work on this topic raised concerns that the positive associations could be linked to bias.
However, in the present study, the researchers had access to diverse information and could rule
out potential biases, including that men who have vasectomies may seek more medical care in
general, that they may have a higher rates of PSA screening, or that the association was due
possible confounding by sexually transmitted infections.
In this study, 16 in 1,000 men developed lethal prostate cancer during 24 years of follow-up.
Although the relative increase in the risk associated with vasectomy was significant, this
translates to a relatively small increase in absolute difference in the risk of lethal prostate
cancer, say the researchers. "The decision to opt for a vasectomy as a form of birth control is a
highly personal one and a man should discuss the risks and benefits with his physician," said
co-author Kathryn Wilson, research associate in the Department of Epidemiology at HSPH.

Story Source:
The above story is based on materials provided by Harvard School of Public Health.Note:
Materials may be edited for content and length.

Journal Reference:
1. Mohummad Minhaj Siddiqui, Kathryn M. Wilson, Mara M. Epstein, Jennifer R. Rider, Neil E.
Martin, Meir J. Stampfer, Edward L. Giovannucci, Lorelei A. Mucci.Vasectomy and risk of
aggressive prostate cancer: a 24-year follow-up study. Journal of Clinincal Oncology,
July 2014 DOI: 10.1200/JCO 2013.54.8446

New medication shows promise in treating common skin
disease
Date:
July 9, 2014
Source:
University of Rochester Medical Center
Summary:
An investigational medication shows promise in treating eczema or atopic
dermatitis, the most common skin disorder, according to a study. The findings
could eventually bring significant relief for many who suffer intense itching and
other troubling features of atopic dermatitis, according to the study's lead author.

An investigational medication shows promise in treating the most common skin
disorder, often referred to as eczema or atopic dermatitis, according to a study
published July 9 in the New England Journal of Medicine. The findings could
eventually bring significant relief for many who suffer intense itching and other
troubling features of atopic dermatitis, according to the study's lead author Lisa A.
Beck, M.D., professor of Dermatology and Medicine at the University of Rochester
Medical Center.
The drug, dupilumab, blocks the action of two proteins involved in inflammation, interleukin-4
and interleukin-13, which play a key role in atopic dermatitis (AD). AD is a common skin disease
with troubling signs that include severely dry skin, red lesions that may crust or ooze, skin
thickening, and symptoms of intense itching that may lead to skin wounds, infections and sleep
disturbance.
Moderate-to-severe AD is a more chronic version of the disease that typically has more
systemic features and is seen in up to 3 percent of adults with the disease. AD can impact a
person's ability to lead a full and active life. In addition, people with AD are more likely to have
asthma and other allergic disorders such as hay fever. Current treatments for AD include topical
and oral steroids as well as phototherapy, but their effectiveness is limited or the side effects
associated with their chronic use are significant.
"We are encouraged by the consistent findings across these studies, which show that patients
treated with dupilumab had a marked improvement in disease activity and itch," Beck said. "At
this point, dupilumab appears to be remarkably effective for adults with severe AD, although
larger studies are needed to confirm its safety and efficacy."
Dupilumab is administered as a skin injection, and has shown promise in both Phase I and
Phase II studies. Participants in a 12-week Phase II study showed a 74 percent reduction in the
Eczema Area Severity Index, a tool used to measure the severity of a patient's condition,
compared to only 23 percent in the placebo group. The majority of patients in the group
receiving dupilumab experienced significant reductions in itch.
The study's findings set the stage for Phase III clinical trials of dupilumab, to confirm its
effectiveness, monitor side effects, and compare it to commonly used treatments.

Story Source:
The above story is based on materials provided by University of Rochester Medical
Center. Note: Materials may be edited for content and length.

Journal Reference:
1. Lisa A. Beck, Diamant Thai, Jennifer D. Hamilton, Neil M. Graham, Thomas Bieber, Ross
Rocklin, Jeffrey E. Ming, Haobo Ren, Richard Kao, Eric Simpson, Marius Ardeleanu, Steven
P. Weinstein, Gianluca Pirozzi, Emma Guttman-Yassky, Mayte Surez-Farias, Melissa D.
Hager, Neil Stahl, George D. Yancopoulos, Allen R. Radin. Dupilumab Treatment in Adults
with Moderate-to-Severe Atopic Dermatitis. New England Journal of Medicine, 2014; 371
(2): 130 DOI:10.1056/NEJMoa1314768

Weather conditions do not affect fibromyalgia pain or fatigue
Date:
June 4, 2013
Source:
Wiley
Summary:
Weather conditions including temperature, sunshine, and precipitation have no impact on
fibromyalgia symptoms in female patients, study suggests. Results suggest, however, that
individual patients may be sensitive to some changes in the weather.

Dutch researchers report that weather conditions including temperature, sunshine, and
precipitation have no impact on fibromyalgia symptoms in female patients. Results
published in Arthritis Care & Research, a journal of the American College of Rheumatology
(ACR), suggest that individual patients may be sensitive to some changes in the weather.
Medical evidence shows that fibromyalgia affects 2% of the world population with a greater prevalence
among women. In the U.S., the ACR estimates that five million people experience the widespread pain,
unexplained fatigue, headaches, and sleep disturbances from this chronic pain syndrome. While the
cause of fibromyalgia remains a mystery, studies suggest patients have increased sensitivity to a range of
stimuli and up to 92% cite weather conditions exacerbate their symptoms.
"Many fibromyalgia patients report that certain weather conditions seem to aggravate their symptoms,"
explains first author, Ercolie Bossema, Ph.D. from Utrecht University in the Netherlands. "Previous
research has investigated weather conditions and changes in fibromyalgia symptoms, but an association
remains unclear."
To further explore the impact of weather on pain and fatigue in fibromyalgia, the team enrolled 333 female
patients with this pain syndrome in the study. Participants had a mean age of 47 years and had a
diagnosis of fibromyalgia for nearly 2 years. The patients completed questions regarding their pain and
fatigue symptoms over a 28-day period. Researchers obtained air temperature, sunshine duration,
precipitation, atmospheric pressure, and relative humidity from the Royal Netherlands Meteorological
Institute.
Findings indicate that in 10% of analyses, weather variables showed a significant but small effect on pain
or fatigue symptoms. In 20% of analyses, researchers found significant small differences between
patients' responses to weather, suggesting pain and fatigue symptoms were differentially affected by
some weather conditions, i.e. greater pain with either low or high atmospheric pressure. The differences
in individual symptom response to weather conditions did not appear to be associated with any
demographic, functional or mental health status, nor seasonal or weather-related variations.
"Our analyses provide more evidence against, than in support of, the daily influence of weather on
fibromyalgia pain and fatigue," concludes Dr. Bossema. "This study is the first to investigate the impact of
weather on fibromyalgia symptoms in a large cohort, and our findings show no association between
specific fibromyalgia patient characteristics and weather sensitivity." The authors suggest that future
research include more patient characteristics, such as personality traits, beliefs about chronic pain, and
attitude regarding the influence of weather on symptoms, to help explain individual differences in weather
sensitivity and its impact on fibromyalgia pain and fatigue.

Story Source:
The above story is based on materials provided by Wiley. Note: Materials may be edited for content and
length.



Air apparent: Using bubbles to reveal fertility problems
Date:
June 23, 2014
Source:
University of California, San Diego Health Sciences
Summary:
Doctors in California are the first fertility specialists in the county to use a new
ultrasound technique to assess fallopian tubes by employing a mixture of saline
and air bubbles that is less painful, avoids X-ray exposure and is more convenient
to patients during an already vulnerable time. Using the technique, the physician
delivers the mixture of saline and air bubbles into the uterus through a small
catheter, which then flows into the fallopian tubes. Under ultrasound, the air
bubbles are highly visible as they travel through the tubes, allowing the physician
to determine if a blockage exists.

Many women struggling to become pregnant may suffer from some degree of tubal
blockage. Traditionally, an x-ray hysterosalpingogram (HSG) that uses dye is the
most common procedure to determine whether a blockage exists, but it can cause
extreme discomfort to the patient. UC San Diego Health System's doctors are the
first fertility specialists in the county to use a new ultrasound technique to assess
fallopian tubes by employing a mixture of saline and air bubbles that is less painful,
avoids x-ray exposure and is more convenient to patients during an already
vulnerable time.
Using the FemVue Sono HSG, the physician delivers the mixture of saline and air bubbles into
the uterus through a small catheter, which then flows into the fallopian tubes. Under ultrasound,
the air bubbles are highly visible as they travel through the tubes, allowing the physician to
determine if a blockage exists.
"The traditional x-ray approach involves higher pressure and usually causes significant
cramping as the dye is administered. The anticipated pain prevents some women from even
attempting the test. Others cannot do the test because they are allergic to the dye. Assessing
the tubes for a blockage is a key component of the diagnostic workup in fertile couples, and not
doing so because of pain or allergy is a real concern," said Sanjay Agarwal, MD, director of
Fertility Services in the Department of Reproductive Medicine at UC San Diego Health System.
"The new approach is not only much more comfortable for patients, it also uses saline, so the
issue of an allergy does not arise. We are also able to assess the cavity of the uterus at the
same time -- all without x-rays."
Kristina, a mother who has been trying to conceive a second child for almost a year, agreed: "I
was willing to do whatever it took to address the fertility issues we were facing, but after
everything we had been through emotionally, it was a relief to undergo a procedure that wasn't
physically painful."
The ultrasound is performed in the clinic, and at present, ideal candidates include those with a
prior pregnancy and those at low risk for tubal disease.
"Like the traditional x-ray HSG, the new test should be performed after the period has ended but
before ovulation. The fact that the patient can schedule this ultrasound-based test in the clinic
and not in radiology prevents a delay in care and allows the patient's physician to be more
involved in the process," said Agarwal, also director of the UC San Diego Center for
Endometriosis Research and Treatment (CERT).
Kristina said she was scheduled for the ultrasound just two days after her initial appointment
and received the results from Agarwal in the clinic right after the procedure.
"I'm an impatient person, especially in this situation, so to immediately rule out a blockage in my
fallopian tubes was a relief," said Kristina, who will soon undergo fertility treatment.
Reasons for blocked fallopian tubes often include an infection, endometriosis and prior
surgeries. Agarwal says there is no cookie cutter treatment plan.
"Each case is unique, and if I find a blockage in the fallopian tubes, I work with my patient to
formulate an appropriate treatment plan -- one that is medically sound and is also acceptable to
the patient," said Agarwal, who performs one to three of the new ultrasound tests weekly.
Some of those treatment plans for women with tubal blockage may involve taking fertility
medicines, having the diseased tube removed surgically or undergoing in-vitro fertilization.
"The ultrasound was a significant part of the puzzle, and now we are trying to fill in the missing
pieces," said Kristina. "I am hopeful and not giving up on my dream to have another baby."

Story Source:
The above story is based on materials provided by University of California, San Diego Health
Sciences. Note: Materials may be edited for content and length.

acterial colonization prior to catching flu may protect
against severe illness
Date:
July 10, 2014
Source:
The Wistar Institute
Summary:
Severe illness and even death are likely to result if you develop another respiratory
infection after catching the flu. Now, however, a team of researchers has
determined that if you reverse the order of infection, pneumococcus bacteria may
actually protect against a bad case of the flu. The bacterial protein pneumolysin, a
bacterial virulence factor, might protect certain immune system cells
(macrophages) in the alveoli of the lungs, preventing inflammation and, thus,
pneumonia.

Many studies have shown that more severe illness and even death are likely to
result if you develop a secondary respiratory infection after developing influenza.
Now, however, a team of researchers based at The Wistar Institute has determined
that if you reverse the order of infection, the bacteria Streptococcus pneumoniae
(often called pneumococcus) may actually protect against a bad case of the flu.
The researchers discovered that the bacterial protein pneumolysin, which is described as a
bacterial virulence factor, might protect macrophages -- a type of immune system cell -- in the
lungs. Their findings, performed in a mouse model of influenza infection, appear in the August
issue of the journal Virology, available online now.
"Influenza remains a major killer, and there is a preponderance of evidence, both scientific and
historical, to show how secondary bacterial infections can be fatal," said Jan Erikson, Ph.D.,
professor at The Wistar Institute. "However, pneumococci often colonize the respiratory tract
asymptomatically, particularly in children, leading us to consider how pre-colonization would
impact a subsequent influenza infection."
"Our studies showed that prior colonization offered a protective effect against severe disease in
mice," Erikson said, "and we were able to point to the bacterial virulence factor pneumolysin in
mediating this protection."
In their investigations, Erikson and her colleagues found that mice who were colonized by
Streptococcus pneumonia ten days prior to exposure to influenza were significantly less likely to
develop severe disease or pneumonia than mice who were not colonized by the bacteria. In
contrast, disease symptoms were exacerbated in mice that were exposed to the flu prior to a
secondary pneumococcal infection.
"Mice that were first exposed to pneumococci exhibited less inflammation in the lungs following
influenza infection. Virus infection wasn't blocked but the response to it was changed such that
the mice no longer showed signs of illness," Erikson said.
The researchers then went about investigating how this might occur. Using mutant strains of
pneumococcus that lacked certain proteins, Erikson and her colleagues were able to single out
one bacterial protein, pneumolysin, which was necessary to generate the protective effect of
pneumococcus. While the exact mechanisms by which pneumolysin lessens the severity of
disease remain unknown, Erikson and her colleagues were able to show how alveolar
macrophages were less likely to recruit inflammation-causing immune cells to the lungs. Less
inflammation would mean less chances of developing pneumonia, which is a major source of flu
deaths, Erikson says.
According to Erikson, her results suggest that one factor contributing to the highly variable
response to influenza virus infection and severity of disease observed in humans is the
presence of specific respiratory tract microbes. "It remains to be seen what lessons we can
learn from pneumococcus in lessening flu infections," Erikson said, "but I would be interested in
seeing if we could get the benefit of pneumococcal colonization without the associated risks."

Story Source:
The above story is based on materials provided by The Wistar Institute. Note: Materials may
be edited for content and length.


Caffeine consumption linked to female infertility, study
suggests
Date:
July 21, 2011
Source:
University of Nevada, Reno
Summary:
Caffeine reduces muscle activity in the Fallopian tubes that carry eggs from a
woman's ovaries to her womb. "Our experiments were conducted in mice, but this
finding goes a long way towards explaining why drinking caffeinated drinks can
reduce a woman's chance of becoming pregnant," says one of the researchers.

Caffeine reduces muscle activity in the Fallopian tubes that carry eggs from a
woman's ovaries to her womb. "Our experiments were conducted in mice, but this
finding goes a long way towards explaining why drinking caffeinated drinks can
reduce a woman's chance of becoming pregnant," says Sean Ward, professor of
physiology and cell biology, at the University of Nevada School of Medicine, who
conducted the study.
Ward's study was recently published in the British Journal of Pharmacology.
Human eggs are microscopically small, but need to travel to a woman's womb if she is going to
have a successful pregnancy. Although the process is essential for a successful pregnancy,
scientists know little about how eggs move through the muscular Fallopian tubes. It was
generally assumed that tiny hair-like projections, called cilia, in the lining of the tubes, waft eggs
along assisted by muscle contractions in the tube walls.
By studying tubes from mice, Ward and his team discovered that caffeine stops the actions of
specialized pacemaker cells in the wall of the tubes. These cells coordinate tube contractions so
that when they are inhibited, eggs can't move down the tubes. In fact these muscle contractions
play a bigger role than the beating cilia in moving the egg towards the womb.
"This provides an intriguing explanation as to why women with high caffeine consumption often
take longer to conceive than women who do not consume caffeine," said Ward.
Discovering the link between caffeine consumption and reduced fertility has benefits.
"As well as potentially helping women who are finding it difficult to get pregnant, a better
understanding of the way Fallopian tubes work will help doctors treat pelvic inflammation and
sexually-transmitted disease more successfully," said Ward.
It could also increase our understanding of what causes ectopic pregnancy, an extremely
painful and potentially life-threatening situation in which embryos get stuck and start developing
inside a woman's Fallopian tube.

Story Source:
The above story is based on materials provided by University of Nevada, Reno.Note:
Materials may be edited for content and length.

Aspirations and sex: Coming of age in the eye of the HIV
storm
Date:
July 2, 2014
Source:
Institute of Tropical Medicine Antwerp
Summary:
How do you shape your hopes, ambitions and expectations when growing up in an
environment devastated by HIV/AIDS? One researcher found that young people
between 16 and 25 in rural Kenya take a pragmatic approach to sexual risks
because sexuality plays an important role in their quest for a better future.
Anthropologists have an important role to play in prevention projects that take
expectations of youngsters better into account.

How do you shape your hopes, ambitions and expectations when growing up in an
environment devastated by HIV/AIDS? For her doctoral thesis, Ellen Blommaert
looked for answers in Winam, a rural area of western Kenya where HIV/AIDS
wreaked havoc among the population. She found that young people between 16 and
25 take a pragmatic approach to sexual risks because sexuality plays an important
role in their quest for a better future. According to Blommaert, who defends her
thesis at the University of Amsterdam, anthropologists have an important role to play
in prevention projects that take expectations of youngsters better into account.
Ellen Blommaert investigated the way youngsters between 16 and 25 years engaged in sexual
relations, how (if at all) they avoided health risks associated with sex, and how they interpreted
the relationship between sex, love and money. When Ellen began her fieldwork in 2005,
antiretroviral drugs (ARVs) in Winam were only available at very high cost. Nyanza province, of
which Winam is part, was hit harder by the HIV/AIDS epidemic compared to any other Kenyan
region. The disease was able to spread quickly and extensively because of chronic poverty and
high mobility. Many, often very young people, lost their life.
"Young people hope to move out of rural areas to urban areas not only for education or jobs, but
also to expand their social and sexual networks. Due to the instability of their social networks,
some of the youngsters increase their sexual networks, including, sometimes, sexual liaisons
with multiple, concurrent partners," says Ellen Blommaert.
While trying to enjoy "playing sex," these youngsters behave pragmatically to avoid the health
risks linked to sex. But instead of reducing their number of sexual partners or changing their
sexual behavior as advocated in government and NGO health campaigns, they have developed
a tactic, which is embedded in locally meaningful modes of reasoning. Within their social
network, they try to reconstruct the sexual and medical history of their potential sexual partners
through informal conversations. They hope thus to minimize their risk of exposure to HIV.
However, the many small groups of sexually active people are in turn combined to several
larger groups. The result is that the sexually active youngsters in Winam were, one way or the
other, all sexually connected to each other, even though they had no direct sexual contact. "
Individuals could escape infection by chance, but in the end, all were structurally highly likely to
get HIV.," says Blommaert.
In Winam young women under 20 are HIV-positive more often than their male counterparts (6%
vs 0.5%). According to Blommaert, this development is directly related to "structural violence,"
created by the prolonged socio-economic crisis in Winam and the fragmentation of social
networks. It is important to see the decisions young people face in this context of enduring
uncertainty in which youngsters, despite their inventiveness, struggle to realize their plans. In
her study, she tried also to broaden the concept of 'transactional sex' and untangle stereotypical
ideas about female subordination, male dominance and transactional sex in sexual
relationships.
The study in Kenya confirms that biomedical prevention messages, promoting the use of
condoms and Voluntary Counseling and Testing (VCT), are incomplete and do not reflect the
realities of young people's lives. In her thesis, Ellen describes and analyses an existing HIV
prevention project for young people in Winam and whether this type of projects makes a
difference at all in the everyday lives of these youngsters. And while these projects do certainly
have an impact, it is not necessarily the one anticipated by the designers, the implementers or
the participants. According to Blommaert, these activities often start with objectives which
respond to the priorities of funding agencies but are not necessarily connected to the needs of
young people. At the time when ARVs were only available at a very high cost, young people had
few future perspectives when they were informed about their HIV status. "Therefore, many
youngsters in Winam preferred to live in uncertainty instead of knowing the biomedical truth.
Prevention projects should take this into account," said Blommaert.
Prevention: a closer collaboration between epidemiologists and anthropologists
"Combination HIV prevention" (a package of interventions taking into account both the individual
and the socio-economic context) remains a must in the fight against AIDS, even at a time where
the disease has become chronic rather than fatal. Blommaert remarks that young people in
particular will welcome projects that arise from their aspirations and expectations. She believes
that anthropologists have an important role to play, together with epidemiologists. The latter still
have a major influence in the set up and implementation of current projects. Blommaert claims
that "anthropologists have an important role in the fight against AIDS. An integral collaboration
between anthropologists and epidemiologists should today be the rule rather than the exception.
"

Story Source:
The above story is based on materials provided by Institute of Tropical Medicine
Antwerp. Note: Materials may be edited for content and length.


Safety of fecal transplant to treat C. difficile examined in
study
Date:
July 9, 2014
Source:
Lifespan
Summary:
Fecal transplantation is effective and safe for treating C. difficile in
immunocompromised patients, research has found. Clostridium difficile, or C. diff,
has increased to epidemic proportions over the past decade. It is an infection that
is often difficult to treat and leaves sufferers with frequent diarrhea, abdominal
pain, nausea, and fever and can lead to dehydration, loss of appetite and weight
loss. Patients who are immunocompromised, or considered high-risk, are more
susceptible.

Researchers have found that fecal transplantation is effective and safe for treating C.
difficile in immunocompromised patients. This is the result of a study led by Colleen Kelly,
M.D., a gastroenterologist in the Center for Women's Gastrointestinal Medicine at The
Women's Medicine Collaborative. The study and its findings have been published online in
advance of print in the American Journal of Gastroenterology.
Clostridium difficile, or C. diff, has increased to epidemic proportions over the past decade. It is an
infection that is often difficult to treat and leaves sufferers with frequent diarrhea, abdominal pain, nausea,
and fever and can lead to dehydration, loss of appetite and weight loss. Patients who are
immunocompromised, or considered high-risk, are more susceptible, and historically, there has been
concern that these patients may be at increased risk of infections related to fecal transplant. However,
this study found fecal transplant to be effective for the treatment of C. diff infection among
immunocompromised patients.
"To date, no study has consistently investigated the safety and efficacy of fecal transplant in
immunocompromised patients," Kelly said. "These patients have previously been excluded from clinical
trials of fecal transplant because of the fear that they are at high risk of infection related to the procedure.
As a result, doctors might be cautious about treating patients with compromised immune systems using
fecal transplant."
Increased lengths of stay in hospitals and extended-care facilities, in addition to broad-spectrum
antibiotics, increase C. diff infection risk among immunocompromised patients. The infection is
responsible for 15 to 25 percent of hospital acquired antibiotic-associated diarrhea and has increased
rapidly over the past 10 years to an incidence of 10.4 cases per 1,000 patient admissions. Recurrence is
common and occurs in up to 20 percent of patients after initial treatment for C. diff infection.
Kelly and her colleagues have treated a number of immunocompromised patients with fecal transplant,
and sought to use this collective experience to describe C. diffinfection cure rates among
immunocompromised individuals, as well as adverse events, such as death or hospitalization,
experienced by immunocompromised patients after fecal transplant. Researchers reviewed the records of
75 adult and five pediatric patients with fecal transplant for C. diff infection. Reasons for being
immunocompromised included: HIV/AIDS, solid organ transplant, an oncologic condition,
immunosuppressive therapy for inflammatory bowel disease, and other medical conditions/medications,
such as cirrhosis and end stage kidney disease.
Analysis found an overall cure rate of 89 percent. While not directly related to fecal transplant, 12 patients
had serious adverse effects (such as hospitalization) within 12 weeks of the procedure. Among these
were two deaths -- one resulted from aspiration during sedation for the colonoscopy used to administer
fecal transplant; the other was unrelated to fecal transplant. Some patients with inflammatory bowel
disease experienced disease flares after transplant, but no patient suffered infections related to fecal
transplant.
"Our study demonstrated the effective use of fecal transplant for C. diff infection in immunocompromised
patients with few undesired harmful effects, and, importantly, there were no related infectious
complications in these high-risk patients," Kelly said. "The key message here is that physicians do not
need to be afraid to use fecal transplant in patients who are immunocompromised. Our findings show
fecal transplant is both safe and effective in immunocompromised patients."

Story Source:
The above story is based on materials provided by Lifespan. Note: Materials may be edited for content
and length.

Urban heat: Not a myth, and worst where it's wet
Date:
July 9, 2014
Source:
Yale School of Forestry & Environmental Studies
Summary:
A new quantifies for the first time the primary causes of the 'urban heat island'
(UHI) effect, a common phenomenon that makes the world's urban areas
significantly warmer than surrounding countryside and may increase health risks
for city residents. In an analysis of 65 cities, researchers found that variation in how
efficiently urban areas release heat back into the lower atmosphere is the dominant
factor in the daytime UHI effect.

new Yale-led study quantifies for the first time the primary causes of the "urban heat island"
(UHI) effect, a common phenomenon that makes the world's urban areas significantly
warmer than the surrounding countryside and may increase health risks for city residents.
In an analysis of 65 cities across North America, researchers found that variation in how efficiently urban
areas release heat back into the lower atmosphere -- through the process of convection -- is the dominant
factor in the daytime UHI effect. This finding challenges a long-held belief that the phenomenon is driven
principally by diminished evaporative cooling through the loss of vegetation.
The effects of impaired "convective efficiency" are particularly acute in wet climates, the researchers say.
In cities such as Atlanta, Georgia, and Nashville, Tennessee, this factor alone contributes a 3-degree C
rise in average daytime temperatures, according to the study, published July 10 in the journal Nature.
The phenomenon could have profound impacts on human health in cities worldwide as mean global
temperatures continue to rise -- and as more and more people move into cities -- said Xuhui Lee, the
Sara Shallenberger Brown Professor of Meteorology at the Yale School of Forestry & Environmental
Studies (F&ES) and one of the study's authors.
"There is a synergistic relationship between climate conditions and the urban heat island," Lee said. "This
relationship suggests that the urban heat island will exacerbate heat wave stress on human health in wet
climates where temperature effects are already compounded by high humidity.
"This is a huge concern from a public health perspective."
For years scientists have recognized the primary causes of the UHI effect. In addition to the changes in
convection efficiency and evaporative cooling, these include the tendency of buildings, pavement, and
other structures to store more heat than vegetation and soil; heat generated by human-built industrial
systems; and changes to the albedo of Earth's surface. (Albedo refers to the proportion of sunlight or
radiation reflected by the surface of the planet. Light-colored parking lots, for instance, reflect more
sunlight back into space than darker surfaces.)
Using satellite data of land surface temperatures and vegetation cover from cities in the United States
and Canada, researchers calculated the mean temperature differentials between urban centers and their
rural surroundings during both daytime and nighttime hours. They also used climate modeling to produce
a more complex range of variables -- from air density to aerodynamic resistance -- which were then used
to quantify the roles of each of the primary drivers of UHI (radiation, convection, evaporation, heat
storage, and human-generated heat).
Their results reaffirmed the consensus view that, regardless of the local climate, the release of heat
stored in human-built structures is the dominant contributor to UHI during the nighttime.
But during the daytime, researchers found, convection is the dominant factor -- particularly in "wetter"
cities of the southeastern United States. In those places, the smooth surfaces of buildings and other
human-made features are far less conducive to heat diffusion than the densely vegetated areas that
surround them. Overall, in wetter climates urbanization reduces convection efficiency by 58 percent.
"The 'rougher' surfaces of the vegetation triggers turbulence, and turbulence removes heat from the
surface to the atmosphere," said Lei Zhao, a doctoral student at F&ES and lead author of the study. "But
where there is a smoother surface, there is less convection and the heat will be trapped in the surface."
Convection plays a key role in drier cities, too -- albeit with far different consequences. In those settings --
including in urban areas of the U.S. Southwest where surrounding vegetation is typically shorter and
scrubbier -- the rural areas are less effective at dissipating heat. As a result, the urban landscapes are
actually 20 percent more efficient in removing heat than their rural surroundings, triggering a 1.5-degree
C cooling within the cities.

Story Source:
The above story is based on materials provided by Yale School of Forestry & Environmental Studies.
The original article was written by Kevin Dennehy. Note: Materials may be edited for content and length.