Health Research Report
58th Issue Date 09 JUN 2009
Compiled By Ralph Turchiano
Editors Top Five:
1. Recycled radioactive metal contaminates consumer products
2. Illness, medical bills linked to nearly two-thirds of bankruptcies: Harvard study
3. Bird flu virus remains infectious up to 600 days in municipal landfills
4. How many scientists fabricate and falsify research?
5. Wet ear wax and unpleasant body odors signal breast cancer risk
In this Issue:
1. Use of acid-suppressive medications associated with increased risk of hospital-acquired pneumonia
2. Cancer drug causes patient to lose fingerprints and be detained by US immigration
3. Green tea extract shows promise in leukemia trials
4. History of hyperactivity off-base, says researcher
5. How many scientists fabricate and falsify research?
6. Omega fatty acid balance can alter immunity and gene expression
7. Bird flu virus remains infectious up to 600 days in municipal landfills
8. Silver nanoparticles show “immense potential” in prevention of blood clots
9. Wet ear wax and unpleasant body odors signal breast cancer risk
10. Commonly used medications may produce cognitive impairment in older adults
11. Why dishing does you good: U-M study
12. Sedatives may increase suicide risk in older patients
13. Illness, medical bills linked to nearly two-thirds of bankruptcies: Harvard study
14. Association Found Between Parkinson’s Disease and Pesticide Exposure in French Farm Workers
15. Multivitamins in pregnancy reduce risk of low birth weights
16. Stopping diabetes damage with vitamin C
17. Recycled radioactive metal contaminates consumer products
Public release date: 26-May-2009
Use of acid-suppressive medications associated with increased risk of hospital-acquired pneumonia
Hospitalized patients who receive acid-suppressive medications such as a proton-pump inhibitor have a 30 percent increased odds of developing pneumonia while in the hospital, according to a study in the May 27 issue of JAMA.
With the introduction of proton-pump inhibitors, used primarily in the treatment of ulcers and gastroesophageal reflux disease, the use of acid-suppressive medications has increased significantly over the last several years, with estimates that between 40 percent and 70 percent of hospitalized patients receive some form of them. But this high use in the inpatient setting has been of concern for several reasons, including use for indications that are not supported by research and data suggesting an increased risk for community-acquired pneumonia with use in outpatient settings, according to background information in the article.
Shoshana J. Herzig, M.D., of Beth Israel Deaconess Medical Center, Boston, and colleagues examined the association between acid-suppressive medication use and hospital-acquired pneumonia. The study included data on patients who were admitted to a large, urban, academic medical center from January 2004 through December 2007, including patients who were at least 18 years of age, hospitalized for 3 or more days, and not admitted to the intensive care unit. Acid-suppressive medication use was defined as any order for a proton-pump inhibitor or histamine2 receptor antagonist. The study included data on 63,878 hospital admissions.
Overall, acid-suppressive medication was ordered in 32,922 admissions (52 percent). Of the group who received these medications, 27,236 (83 percent) received proton-pump inhibitors and 7,548 (23 percent) received histamine2 receptor antagonists, with some exposed to both. The majority of these medications were ordered within 48 hours of admission (89 percent).
Hospital-acquired pneumonia occurred in 2,219 admissions (3.5 percent). The unadjusted incidence of hospital-acquired pneumonia was higher in the group exposed to acid-suppressive medication relative to the unexposed group (4.9 percent vs. 2.0 percent). After further analysis and adjusting for potential factors that could influence the outcomes, receiving acid-suppressive medications was associated with a 30 percent increased odds of hospital-acquired pneumonia. The association was significant for proton-pump inhibitors but not for histamine2 receptor antagonists.
The researchers write that acid-suppressive medications have been thought to increase the risk of pneumonia via modification of upper gastrointestinal bacteria, and, as a result, respiratory bacteria.
“These results occur in the context of an increasing body of literature suggesting an association between acid-suppressive medication and pneumonia. Further scrutiny is warranted regarding inpatient prescribing practices of these medications,” the authors conclude.
Public release date: 26-May-2009
Cancer drug causes patient to lose fingerprints and be detained by US immigration
Immigration officials held a cancer patient for four hours before they allowed him to enter the USA because one of his cancer drugs caused his fingerprints to disappear. His oncologist is now advising all cancer patients who are being treated with the commonly used drug, capecitabine, to carry a doctor’s letter with them if they want to travel to the USA.
The incident is highlighted in a letter to the cancer journal, Annals of Oncology , published online today (Wednesday 27 May). According to the oncologist, several other cancer patients have reported loss of fingerprints on their blog sites, and some have also commented on similar problems entering the USA.
Dr Eng-Huat Tan, a senior consultant in the medical oncology department at the National Cancer Centre, Singapore, described how his patient, a 62-year-old man, had head and neck cancer that had spread (metastatic nasopharyngeal carcinoma), but which had responded well to chemotherapy. To help prevent a recurrence of the cancer the patient was put on a maintenance dose of capecitabine, an anti-metabolite drug.
Capecitabine is a common anti-cancer drug used in the treatment of a number of cancers such as head and neck cancers, breast, stomach and colorectal cancers. One of its adverse side-effects can be hand-foot syndrome; this is chronic inflammation of the palms or soles of the feet and the skin can peel, bleed and develop ulcers or blisters. “This can give rise to eradication of finger prints with time,” said Dr Tan.
The patient, Mr S, developed a mild case of hand-foot syndrome, and because it was not affecting his daily life he was kept on a low dose of the drug.
“In December 2008, after more than three years of capecitabine, he went to the United States to visit his relatives,” wrote Dr Tan. “He was detained at the airport customs for four hours because the immigration officers could not detect his fingerprints. He was allowed to enter after the custom officers were satisfied that he was not a security threat. He was advised to travel with a letter from his oncologist stating his condition and the treatment he was receiving to account for his lack of fingerprints to facilitate his entry in future.”
Foreign visitors have been asked to provide fingerprints at USA airports for several years now, and the images are matched with millions of visa holders to detect whether the new visa applicant has a visa under a different name. “These fingerprints are also matched to a list of suspected criminals,” wrote Dr Tan.
Mr S was not aware that he had lost his fingerprints before he travelled.
Dr Tan concludes: “In summary, patients taking long-term capecitabine may have problems with regards to fingerprint identification when they enter United States’ ports or other countries that require fingerprint identification and should be warned about this. It is uncertain when the onset of fingerprint loss will take place in susceptible patients who are taking capecitabine. However, it is possible that there may be a growing number of such patients as Mr S who may benefit from maintenance capecitabine for disseminated malignancy. These patients should prepare adequately before travelling to avert the inconvenience that Mr S was put through.”
Dr Tan said that he would recommend patients on capecitabine to carry a doctor’s letter with them. “My patient subsequently travelled again with a letter from us and he had fewer problems getting through.”
Public release date: 26-May-2009
Green tea extract shows promise in leukemia trials
ROCHESTER, Minn. — Mayo Clinic researchers are reporting positive results in early leukemia clinical trials using the chemical epigallocatechin gallate (EGCG), an active ingredient in green tea. The trial determined that patients with chronic lymphocytic leukemia (CLL) can tolerate the chemical fairly well when high doses are administered in capsule form and that lymphocyte count was reduced in one-third of participants. The findings appear today online in the Journal of Clinical Oncology.
“We found not only that patients tolerated the green tea extract at very high doses, but that many of them saw regression to some degree of their chronic lymphocytic leukemia,” says Tait Shanafelt, M.D., Mayo Clinic hematologist and lead author of the study. “The majority of individuals who entered the study with enlarged lymph nodes saw a 50 percent or greater decline in their lymph node size.”
CLL is the most common subtype of leukemia in the United States. Currently it has no cure. Blood tests have enabled early diagnosis in many instances; however, treatment consists of watchful waiting until the disease progresses. Statistics show that about half of patients with early stage diseases have an aggressive form of CLL that leads to early death. Researchers hope that EGCG can stabilize CLL for early stage patients or perhaps improve the effectiveness of treatment when combined with other therapies.
The research has moved to the second phase of clinical testing in a follow-up trial — already fully enrolled — involving roughly the same number of patients. All will receive the highest dose administered from the previous trial.
These clinical studies are the latest steps in a multiyear bench-to-bedside project that began with tests of the green tea extract on cancer cells in the laboratory of Mayo hematologist Neil Kay, M.D., a co-author on this article. After laboratory research showed dramatic effectiveness in killing leukemia cells, the findings were applied to studies on animal tissues and then on human cells in the lab. (See “Green Tea and Leukemia” in Discovery’s Edge magazine.)
In the first clinical trial, 33 patients received variations of eight different oral doses of Polyphenon E, a proprietary compound whose primary active ingredient is EGCG. Doses ranged from 400 milligrams (mg) to 2,000 mg administered twice a day. Researchers determined that they had not reached a maximum tolerated dose, even at 2,000 mg twice per day.
Public release date: 27-May-2009
History of hyperactivity off-base, says researcher
Educators do children and parents a disservice by claiming Mozart and others had ADHD
A Canadian researcher working in the U.K. says doctors, authors and educators are doing hyperactive children a disservice by claiming that hyperactivity as we understand it today has always existed.
Matthew Smith says not only is that notion wrong, it misleads patients, their parents and their physicians. Smith, who is from Edmonton, is finishing up his PhD at the Centre for Medical History at the University of Exeter.
Hyperactivity disorder, or ADHD, is currently the most commonly diagnosed childhood psychiatric disorder, says Smith, and millions of children are prescribed drugs such as Ritalin to treat it. Yet prior to the 1950s, it was clinically and culturally insignificant.
He argues in a paper presented at the Congress for the Humanities and Social Sciences taking place at Ottawa’s Carleton University this week, that hyperactivity disorder as we understand it today is a modern construct that was first described as a disorder in 1957.
Before that, Smith says hyperactive behaviour existed – but it wasn’t always thought of as a disorder or pathology worth treating.
However, Smith says many today assert that hyperactivity is a universal phenomenon, and say evidence of hyperactivity can be seen in historical figures such as Mozart or Einstein. Smith argues that hyperactivity as we understand it is rooted in social, cultural, political and economic changes of the last half century.
“When history is extended back beyond 1957, it overlooks all the social factors that contributed to the idea that children were hyperactive – and that that was a problem,” he says.
“We need to refocus the history of hyperactivity on the period starting from the late 1950s and 60s. “By doing so, we start to understand why people started to think there was a problem with children, why they thought that problem needed to be fixed, and why it became acceptable to fix that problem with drugs.”
Smith says that whether you consider hyperactivity a disease worth treating often depends on context – and the context changed in the late 1950s when the U.S. refocused its education system in response to the space race.
“If a child’s playing soccer, there’s a chance hyperactivity isn’t going to be a problem. But if they are stuck in a classroom, it is a problem.
“We have to look at the social and historical factors that created the idea that children were distractible and that these were pathologies that needed to be treated.
“For patients and their parents, what this means is that the process by which their children are diagnosed is not rooted in a long history. If they understand that, they can develop the tools to question the diagnosis.”
Public release date: 28-May-2009
How many scientists fabricate and falsify research?
Press release from PLoS ONE
It’s a long-standing and crucial question that, as yet, remains unanswered: just how common is scientific misconduct? In the online, open-access journal PLoS ONE, Daniele Fanelli of the University of Edinburgh reports the first meta-analysis of surveys questioning scientists about their misbehaviours. The results suggest that altering or making up data is more frequent than previously estimated and might be particularly high in medical research.
Recent scandals like Hwang Woo-Suk’s fake stem-cell lines or Jon Sudbø’s made-up cancer trials have dramatically demonstrated that fraudulent research is very easy to publish, even in the most prestigious journals. The media and many scientists tend to explain away these cases as pathological deviations of a few “bad apples.” Common sense and increasing evidence, however, suggest that these could be just the tip of the iceberg, because fraud and other more subtle forms of misconduct might be relatively frequent. The actual numbers, however, are a matter of great controversy.
Estimates based on indirect data (for example, official retractions of scientific papers or random data audits) have produced largely discrepant results. Therefore, many researchers have asked scientists directly, with surveys conducted in different countries and disciplines. However, they have used different methods and asked different questions, so their results also appeared inconclusive.
To make these surveys comparable, the meta-analysis focused on behaviours that actually distort scientific knowledge (excluding data on plagiarism and other kinds of malpractice) and extracted the frequency of scientists who recalled having committed a particular behaviour at least once, or who knew a colleague who did.
On average, across the surveys, around 2% of scientists admitted they had “fabricated” (made up), “falsified” or “altered” data to “improve the outcome” at least once, and up to 34% admitted to other questionable research practices including “failing to present data that contradict one’s own previous research” and “dropping observations or data points from analyses based on a gut feeling that they were inaccurate.”
In surveys that asked about the behaviour of colleagues, 14% knew someone who had fabricated, falsified or altered data, and up to 72% knew someone who had committed other questionable research practices.
In both kinds of surveys, misconduct was reported most frequently by medical and pharmacological researchers. This suggests that either the latter are more open and honest in their answers, or that frauds and bias are more frequent in their fields. The latter interpretation would support growing fears that industrial sponsorship is severely distorting scientific evidence to promote commercial treatments and drugs.
As in all surveys asking sensitive questions, it is likely that some respondents did not reply honestly, especially when asked about their own behaviour. Therefore, a frequency of 2% is probably a conservative estimate, while it remains unclear how the figure of 14% should be interpreted.
Public release date: 28-May-2009
Omega fatty acid balance can alter immunity and gene expression
Appearing in the June 5 issue of JBC
For the past century, changes in the Western diet have altered the consumption of omega-6 fatty acids (w6, found in meat and vegetable oils) compared with omega-3 fatty acids (w3, found in flax and fish oil). Many studies seem to indicate this shift has brought about an increased risk of inflammation (associated with autoimmunity and allergy), and now using a controlled diet study with human volunteers, researchers may have teased out a biological basis for these reported changes.
Anthropological evidence suggests that human ancestors maintained a 2:1 w6/w3 ratio for much of history, but in Western countries today the ratio has spiked to as high as 10:1. Since these omega fatty acids can be converted into inflammatory molecules, this dietary change is believed to also disrupt the proper balance of pro- and anti- inflammatory agents, resulting in increased systemic inflammation and a higher incidence of problems including asthma, allergies, diabetes, and arthritis.
Floyd Chilton and colleagues wanted to examine whether theses fatty acids might have other effects, and developed a dietary intervention strategy in which 27 healthy humans were fed a controlled diet mimicking the w6/w3 ratios of early humans over 5 weeks. They then looked at the gene levels of immune signals and cytokines (protein immune messengers), that impact autoimmunity and allergy in blood cells and found that many key signaling genes that promote inflammation were markedly reduced compared to a normal diet, including a signaling gene for a protein called PI3K, a critical early step in autoimmune and allergic inflammation responses.
This study demonstrates, for the first time in humans, that large changes in gene expression are likely an important mechanism by which these omega fatty acids exert their potent clinical effects.
Public release date: 28-May-2009
Bird flu virus remains infectious up to 600 days in municipal landfills
Environmental Science & Technology
Amid concerns about a pandemic of swine flu, researchers from Nebraska report for the first time that poultry carcasses infected with another threat — the “bird flu” virus — can remain infectious in municipal landfills for almost 2 years. Their report is scheduled for the June 15 issue of ACS’ semi-monthly journal Environmental Science & Technology.
Shannon L. Bartelt-Hunt and colleagues note that avian influenza, specifically the H5N1 strain, is an ongoing public health concern. Hundreds of millions of chickens and ducks infected with the virus have died or been culled from flocks worldwide in efforts to control the disease. More than 4 million poultry died or were culled in a 2002 outbreak in Virginia, and the carcasses were disposed of in municipal landfills. Until now, few studies have directly assessed the safety of landfill disposal.
“The objectives of this study were to assess the survival of avian influenza in landfill leachate and the influence of environmental factors,” says the report. The data showed that the virus survived in landfill leachate — liquid that drains or “leaches” from a landfill — for at least 30 days and up to 600 days. The two factors that most reduced influenza survival times were elevated temperature and acidic or alkaline pH. “Data obtained from this study indicate that landfilling is an appropriate method for disposal of carcasses infected with avian influenza,” says the study, noting that landfills are designed to hold material for much longer periods of time.
Public release date: 28-May-2009
Silver nanoparticles show “immense potential” in prevention of blood clots
Scientists are reporting discovery of a potential new alternative to aspirin, ReoPro, and other anti-platelet agents used widely to prevent blood clots in coronary artery disease, heart attack and stroke. Their study, scheduled for the June 23 issue of ACS Nano, a monthly journal, involves particles of silver — 1/50,000th the diameter of a human hair — that are injected into the bloodstream.
Debabrata Dash and colleagues point out that patients urgently need new anti-thrombotic agents because traditionally prescribed medications too-often cause dangerous bleeding. At the same time, aging of the population, sedentary lifestyle and spiraling rates of certain diseases have increased the use of these drugs. Researchers are seeking treatments that more gently orchestrate activity of platelets, disk-shaped particles in the blood that form clots.
The scientists describe development and lab testing of silver nanoparticles that seem to keep platelets in an inactive state. Low levels of the nanosilver, injected into mice, reduced the ability of platelets to clump together by as much as 40 percent with no apparent harmful side effects. The nanoparticles “hold immense potential to be promoted as an antiplatelet agent,” the researchers note. “Nanosilver appears to possess dual significant properties critically helpful to the health of mankind — antibacterial and antiplatelet — which together can have unique utilities, for example in coronary stents.”
Public release date: 1-Jun-2009
Wet ear wax and unpleasant body odors signal breast cancer risk
New research in the FASEB Journal shows that a “breast cancer gene” causes osmidrosis and makes earwax wet and sticky
If having malodorous armpits (called osmidrosis) and goopy earwax isn’t bad enough, a discovery by Japanese scientists may add a more serious problem for women facing these cosmetic calamities. That’s because they’ve found that a gene responsible for breast cancer causes these physical symptoms. The report describing this finding is featured on the cover of The FASEB Journal’s June 2009 print issue (http://www.fasebj.org), and should arm physicians with another clue for detecting breast cancer risk.
“We do strongly hope that our study will provide a new tool for better predication of breast cancer risk by genotyping,” said Toshihisa Ishikawa, Ph.D., a professor from the Department of Biomolecular Engineering at the Tokyo Institute of Technology and the senior researcher involved in the work. “Using a rapid and cost-effective typing method presented in this study would provide a practical tool for pharmacogenomics-based personalized medicine.”
To draw their conclusions, Ishikawa and colleagues monitored the activities of a protein created by a gene associated with breast cancer, called “ABCC11.” By studying this gene and its complex cellular and molecular interactions in the body, the researchers discovered a distinct link between the gene and excessively smelly armpits and wet, sticky earwax. Specifically, the researchers expressed the ABCC11 gene and variant proteins in cultured human embryonic kidney cells and showed exactly how the ABCC11 gene produces the wet-type earwax and excessive armpit odor. This discovery could lead to practical tools for clinicians—especially those in developing nations—to rapidly identify who may have a higher risk for breast cancer.
“Wet, sticky earwax might not be easily noticed, but most people can’t miss unpleasant body odors,” said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal, “As it turns out, the type of ear wax one has is linked to a gene that leads to bad odors from one’s armpit. These may become lifesaving clues to the early detection and treatment of breast cancer.”
Public release date: 1-Jun-2009
Commonly used medications may produce cognitive impairment in older adults
INDIANAPOLIS – Many drugs commonly prescribed to older adults for a variety of common medical conditions including allergies, hypertension, asthma, and cardiovascular disease appear to negatively affect the aging brain causing immediate but possibly reversible cognitive impairment, including delirium, in older adults according to a clinical review now available online in the Journal of Clinical Interventions in Aging, a peer reviewed, open access publication.
Drugs, such as diphenhydramine, which have an anticholinergic effect, are important medical therapies available by prescription and also are sold over the counter under various brand names such as Benadryl®, Dramamine®, Excederin PM®, Nytol®, Sominex®, Tylenol PM®, and Unisom®. Older adults most commonly use drugs with anticholinergic effects as sleep aids.
While it is known that these medications do have an effect on the brain and in the case of sleeping pills, are prescribed to act on the brain, the study authors suggest the amount of cognitive impairment caused by the drugs in older adults is not well recognized.
“The public, physicians, and even the Food and Drug Administration, need to be made aware of the role of these common medications, and others with anticholinergic effects, in causing cognitive impairment. Patients should write down and tell their doctor which over-the-counter drugs they are taking. Doctors, who often think of these medications simply as antihistamines, antidepressants, antihypertensives, sleep aids or even itching remedies, need to recognize their systemic anticholinergic properties and the fact that they appear to impact brain health negatively. Doing so, and prescribing alternative medications, should improve both the health and quality of life of older adults,” said senior study author Malaz Boustani, M.D., Indiana University School of Medicine associate professor of medicine, Regenstrief Institute investigator, and research scientist with the IU Center for Aging Research.
Dr. Boustani and colleagues conducted a systematic evidence-based analysis of 27 peer reviewed studies of the relationship of anticholinergic effect and brain function as well as investigating anecdotal information. They found a strong link between anticholinergic effect and cognitive impairment in older adults.
“One of the goals of our work is to encourage the Food and Drug Administration to expand its safety evaluation process from looking only at the heart, kidney and liver effects of these drugs to include effects of a drug on the most precious organ in human beings, our brain,” Dr. Boustani said.
“Many medications used for several common disease states have anticholinergic effects that are often unrecognized by prescribers” said Wishard Health Services pharmacist, Noll Campbell, Pharm.D., first author of the study, noting that these drugs are among the most frequently purchased over the counter products. “In fact, 50 percent of the older adult population use a medication with some degree of anticholinergic effect each day.”
“Our main message is that older adults and their physicians should have conversations about the benefits and harms of these drugs in relation to brain health. As the number of older adults suffering from both cognitive impairment and multiple chronic conditions increases, it is very important to recognize the negative impact of certain medications on the aging brain,” said Dr. Boustani.
The brain pharmacoepidemiology group of the IU Center for Aging Research currently is conducting a study of 4,000 older adults to determine if the long term use of medications with anticholinergic effects is linked to the irreversible development of cognitive impairment such as Alzheimer disease.
Public release date: 2-Jun-2009
Why dishing does you good: U-M study
ANN ARBOR, Mich.—Why does dishing with a girlfriend do wonders for a woman’s mood?
A University of Michigan study has identified a likely reason: feeling emotionally close to a friend increases levels of the hormone progesterone, helping to boost well-being and reduce anxiety and stress.
“This study establishes progesterone as a likely part of the neuroendocrine basis of social bonding in humans,” said U-M researcher Stephanie Brown, lead author of an article reporting the study findings, published in the current (June 2009) issue of the peer-reviewed journal Hormones and Behavior.
A sex hormone that fluctuates with the menstrual cycle, progesterone is also present in low levels in post-menopausal women and in men. Earlier research has shown that higher levels of progesterone increase the desire to bond with others, but the current study is the first to show that bonding with others increases levels of progesterone. The study also links these increases to a greater willingness to help other people, even at our own expense.
“It’s important to find the links between biological mechanisms and human social behavior,” said Brown, is a faculty associate at the U-M Institute for Social Research (ISR) and an assistant professor of internal medicine at the U-M Medical School. She is also affiliated with the Ann Arbor Veterans Affairs Hospital. “These links may help us understand why people in close relationships are happier, healthier, and live longer than those who are socially isolated.”
Progesterone is much easier to measure than oxytocin, a hormone linked to trust, pair-bonding and maternal responsiveness in humans and other mammals. Oxytocin can only be measured through an invasive spinal tap or through expensive and complex brain imaging methods, such as positron emission tomography scans. Progesterone can be measured through simple saliva samples and may be related to oxytocin.
In the current study, Brown and colleagues examined the link between interpersonal closeness and salivary progesterone in 160 female college students.
At the start of the study, the researchers measured the levels of progesterone and of the stress hormone cortisol in the women’s saliva, and obtained information about their menstrual cycles and whether they were using hormonal contraceptives or other hormonally active medications.
To control for daily variations in hormone levels, all the sessions were held between noon and 7 p.m.
The women were randomly assigned to partners and asked to perform either a task designed to elicit feelings of emotional closeness or a task that was emotionally neutral.
In the emotionally neutral task, the women proofread a botany manuscript together.
After completing the 20-minute tasks, the women played a computerized cooperative card game with their partners, and then had their progesterone and cortisol sampled again.
The progesterone levels of women who had engaged in the emotionally neutral tasks tended to decline, while the progesterone levels of women who engaged in the task designed to elicit closeness either remained the same or increased. The participants’ cortisol levels did not change in a similar way.
Participants returned a week later, and played the computerized card game with their original partners again. Then researchers measured their progesterone and cortisol. Researchers also examined links between progesterone levels and how likely participants said they would be to risk their life for their partner.
“During the first phase of the study, we found no evidence of a relationship between progesterone and willingness to sacrifice,” Brown said. “But a week later, increased progesterone predicted an increased willingness to say you would risk your life to help your partner.”
According to Brown, the findings are consistent with a new evolutionary theory of altruism which argues that the hormonal basis of social bonds enables people to suppress self-interest when necessary in order to promote the well-being of another person, as when taking care of children or helping ailing family members or friends.
The results also help explain why social contact has well-documented health benefits—a relationship first identified nearly 20 years ago by U-M sociologist James House.
“Many of the hormones involved in bonding and helping behavior lead to reductions in stress and anxiety in both humans and other animals. Now we see that higher levels of progesterone may be part of the underlying physiological basis for these effects,” Brown said.
Public release date: 3-Jun-2009
Sedatives may increase suicide risk in older patients
Sleeping tablets have been associated with a four-fold increase in suicide risk in the elderly. Researchers writing in the open access journal BMC Geriatrics have shown that, even after adjusting for the presence of psychiatric conditions, sedatives and hypnotics were both associated with an increased risk of suicide.
Anders Carlsten and Margda Waern from Gothenburg University carried out a case control study to determine whether specific types of psychoactive drugs were associated with suicide risk in later life. According to Carlsten, “Sedative treatment was associated with an almost fourteen-fold increase of suicide risk in the crude analyses and remained an independent risk factor for suicide even after adjustment for the presence of mental disorders. Having a current prescription for a hypnotic was associated with a four-fold increase in suicide risk in the adjusted model”.
The researchers speculate that the drugs may raise suicide risk by triggering aggressive or impulsive behavior, or by providing the means for people to take an overdose. They also point out the possibility that these drugs may merely be markers for some other factor related to suicide risk, such as somatic illness, functional disability, alcohol use disorder, interpersonal problems, lack of social network or sleep disturbance. Carlsten said, “Persons with these problems might be more likely to seek health care and perhaps more likely to receive prescriptions for psychotropic drugs. However, given the extremely high prescription rates for these drugs, a careful evaluation of the suicide risk should always precede prescribing a sedative or hypnotic to an elderly individual”.
Public release date: 3-Jun-2009
Illness, medical bills linked to nearly two-thirds of bankruptcies: Harvard study
Harvard study finds 50 percent increase from 2001
*Most of those bankrupted by illness were middle class and had insurance
Medical problems contributed to nearly two-thirds (62.1 percent) of all bankruptcies in 2007, according to a study in the August issue of the American Journal of Medicine that will be published online Thursday. The data were collected prior to the current economic downturn and hence likely understate the current burden of financial suffering. Between 2001 and 2007, the proportion of all bankruptcies attributable to medical problems rose by 49.6 percent. The authors’ previous 2001 findings have been widely cited by policy leaders, including President Obama.
Surprisingly, most of those bankrupted by medical problems had health insurance. More than three-quarters (77.9 percent) were insured at the start of the bankrupting illness, including 60.3 percent who had private coverage. Most of the medically bankrupt were solidly middle class before financial disaster hit. Two-thirds were homeowners and three-fifths had gone to college. In many cases, high medical bills coincided with a loss of income as illness forced breadwinners to lose time from work. Often illness led to job loss, and with it the loss of health insurance.
Even apparently well-insured families often faced high out-of-pocket medical costs for co-payments, deductibles and uncovered services. Medically bankrupt families with private insurance reported medical bills that averaged $17,749 vs. $26,971 for the uninsured. High costs – averaging $22,568 – were incurred by those who initially had private coverage but lost it in the course of their illness.
Individuals with diabetes and those with neurological disorders such as multiple sclerosis had the highest costs, an average of $26,971 and $34,167 respectively. Hospital bills were the largest single expense for about half of all medically bankrupt families; prescription drugs were the largest expense for 18.6 percent.
The research, carried out jointly by researchers at Harvard Law School, Harvard Medical School and Ohio University, is the first nationwide study on medical causes of bankruptcy. The researchers surveyed a random sample of 2,314 bankruptcy filers during early 2007 and examined their bankruptcy court records. In addition, they conducted extensive telephone interviews with 1,032 of these bankruptcy filers.
Their 2001 study, which was published in 2005, surveyed debtors in only five states. In the current study, findings for those five states closely mirrored the national trends.
Subsequent to the 2001 study, Congress made it harder to file for bankruptcy, causing a sharp drop in filings. However, personal bankruptcy filings have soared as the economy has soured and are now back to the 2001 level of about 1.5 million annually.
Dr. David Himmelstein, the lead author of the study and an associate professor of medicine at Harvard, commented: “Our findings are frightening. Unless you’re Warren Buffett, your family is just one serious illness away from bankruptcy. For middle-class Americans, health insurance offers little protection. Most of us have policies with so many loopholes, co-payments and deductibles that illness can put you in the poorhouse. And even the best job-based health insurance often vanishes when prolonged illness causes job loss – precisely when families need it most. Private health insurance is a defective product, akin to an umbrella that melts in the rain.”
“For many families, bankruptcy is a deeply shameful experience,” noted Elizabeth Warren, Leo Gottlieb Professor of Law at Harvard and a study co-author. Professor Warren, a leading expert on personal bankruptcy, went on: “People arrive at the bankruptcy courts exhausted – financially, physically and emotionally. For most, bankruptcy is a last choice to deal with unmanageable circumstances.”
According to study co-author Dr. Steffie Woolhandler, an associate professor of medicine at Harvard and primary care physician in Cambridge, Mass.: “We need to rethink health reform. Covering the uninsured isn’t enough. Reform also needs to help families who already have insurance by upgrading their coverage and assuring that they never lose it. Only single-payer national health insurance can make universal, comprehensive coverage affordable by saving the hundreds of billions we now waste on insurance overhead and bureaucracy. Unfortunately, Washington politicians seem ready to cave in to insurance firms and keep them and their counterfeit coverage at the core of our system. Reforms that expand phony insurance – stripped-down plans riddled with co-payments, deductibles and exclusions – won’t stem the rising tide of medical bankruptcy.”
Dr. Deborah Thorne, associate professor of sociology at Ohio University and study co-author, stated: “American families are confronting a panoply of social forces that make it terribly difficult to maintain financial stability – job losses and wages that have not kept pace with the cost of living, exploitation from the various lending industries, and, probably most consequential and disgraceful, a health care system that is so dysfunctional that even the most mundane illness or injury can result in bankruptcy. Families who file medical bankruptcies are overwhelmingly hard-working, middle-class families who have played by the rules of our economic system, and they deserve nothing less than affordable health care.”
Public release date: 3-Jun-2009
Association Found Between Parkinson’s Disease and Pesticide Exposure in French Farm Workers
Paris, France – June 04, 2009 – The cause of Parkinson’s disease (PD), the second most frequent neurodegenerative disease after Alzheimer’s disease, is unknown, but in most cases it is believed to involve a combination of environmental risk factors and genetic susceptibility. Laboratory studies in rats have shown that injecting the insecticide rotenone leads to an animal model of PD and several epidemiological studies have shown an association between pesticides and PD, but most have not identified specific pesticides or studied the amount of exposure relating to the association.
A new epidemiological study involving the exposure of French farm workers to pesticides found that professional exposure is associated with PD, especially for organochlorine insecticides. The study is published in Annals of Neurology, the official journal of the American Neurological Association.
Led by Alexis Elbaz M.D., Ph.D., of Inserm, the national French institute for health research in Paris, and University Pierre et Marie Curie (UPMC, Paris 6), the study involved individuals affiliated with the French health insurance organization for agricultural workers who were frequently exposed to pesticides in the course of their work. Occupational health physicians constructed a detailed lifetime exposure history to pesticides by interviewing participants, visiting farms, and collecting a large amount of data on pesticide exposure. These included farm size, type of crops, animal breeding, which pesticides were used, time period of use, frequency and duration of exposure per year, and spraying method.
The study found that PD patients had been exposed to pesticides through their work more frequently and for a greater number of years/hours than those without PD. Among the three main classes of pesticides (insecticides, herbicides, fungicides), researchers found the largest difference for insecticides: men who had used insecticides had a two-fold increase in the risk of PD.
“Our findings support the hypothesis that environmental risk factors such as professional pesticide exposure may lead to neurodegeneration,” notes Dr. Elbaz.
The study highlights the need to educate workers applying pesticides as to how these products should be used and the importance of promoting and encouraging the use of protective devices. In addition to the significance of the study for those with a high level of exposure to pesticides, it also raises the question about the role of lower-level environmental exposure through air, water and food, and additional studies are needed to address this question.
Public release date: 8-Jun-2009
Multivitamins in pregnancy reduce risk of low birth weights
Prenatal multivitamin supplements are associated with a significantly reduced risk of babies with a low birth weight compared with prenatal iron-folic acid supplementation, found a new study in the Canadian Medical Association Journal (CMAJ) http://www.cmaj.ca/press/pgE99.pdf (www.cmaj.ca).
The World Health Organization currently recommends iron-folic acid supplements for all pregnant women. Previous studies have not shown an advantage from prenatal multimicronutrient supplementation over iron-folic acid supplementation.
“Low birth weight and related complications are considered the most common cause of global infant mortality under the age of 5 years,” write Dr. Prakash Shah and study coauthors from Mount Sinai Hospital in Toronto. “With the possibility of reducing low birth weight rates by 17%, micronutrients supplementation to pregnant women, we believe, offers the highest possible return for the investment. These results are synthesized findings from 15 studies published worldwide.”
It is estimated that of the total 133 million births worldwide per year, 15.5% are low birth weight babies. The authors suggest that approximately 1.5 million babies born with a low birth weight could be avoided each year globally, if all mothers receive prenatal multimicronutrient supplementation.
The research is limited by variability among the included studies, including timing, duration, composition of micronutrients, and characteristics of the study populations.
In a related commentary http://www.cmaj.ca/press/pg1188.pdf, Dr. Zulfiqar Bhutta and Dr. Batool Azra Haider of the Aga Khan University in Karachi, Pakistan recommend that multimicronutrient supplementation during pregnancy replace iron and folate supplements in susceptible populations if it is proven safe and effective. They note that multiple interventions in developing countries may be necessary to improve maternal nutrition and fetal status such as fortified food supplements, interventions that address specific nutrient deficiencies, and measures to reduce the burden of HIV, malaria and other diseases.
Public release date: 8-Jun-2009
Stopping diabetes damage with vitamin C
First test in humans gets dramatic results from blood sugar control and antioxidant
Researchers at the Harold Hamm Oklahoma Diabetes Center have found a way to stop the damage caused by Type 1 diabetes with the combination of insulin and a common vitamin found in most medicine cabinets.
While neither therapy produced desired results when used alone, the combination of insulin to control blood sugar together with the use of Vitamin C, stopped blood vessel damage caused by the disease in patients with poor glucose control. The findings appear this week in the Journal of Clinical Endocrinology and Metabolism.
“We had tested this theory on research models, but this is the first time anyone has shown the therapy’s effectiveness in people,” said Michael Ihnat, Ph.D., principal investigator and a pharmacologist at the OU College of Medicine Department of Cell Biology.
Ihnat said they are now studying the therapy in patients with Type 2 diabetes.
The goal of the work being done by Ihnat and British scientists from the University of Warwick led by Dr. Antonio Ceriello is to find a way to stop the damage to blood vessels that is caused by diabetes. The damage, known as endothelial dysfunction, is associated with most forms of cardiovascular disease such as hypertension, coronary artery disease, chronic heart failure, peripheral artery disease, diabetes and chronic renal failure.
By reducing or stopping the damage, patients with diabetes could avoid some of the painful and fatal consequences of the disease that include heart disease, reduced circulation and amputation, kidney disease and diabetic retinopathy, which can lead to blindness.
Insulin and many other drugs have long been used to control blood sugar, but Ihnat – in an earlier project with scientists in Italy and Hungary – found that cells have a “memory” that causes damage to continue even when blood sugar is controlled. By adding antioxidants like Vitamin C, Ihnat found that cell “memory” disappeared and cell function and oxidation stress were normalized.
“We have speculated that this happens with endothelial dysfunction, but we did not know until now if it was effective in humans. We finally were able to test it and proved it to be true,” Ihnat said. “For patients with diabetes, this means simply getting their glucose under control is not enough. An antioxidant-based therapy combined with glucose control will give patients more of an advantage and lessen the chance of complications with diabetes.”
While researchers do suggest diabetic patients eat foods and take multivitamins rich in antioxidants like Vitamin C, they warn that additional study is needed. The Vitamin C utilized in their study was given at very high doses and administered directly into the blood stream, so it is unlikely someone would get similar results with an over-the-counter vitamin supplement.
The team is now working to determine how antioxidants work at the molecular level to halt the destructive chain reaction set in motion by high blood sugar levels. In addition, they are evaluating several other antioxidants with an ultimate hope that their work will translate into simple, effective and inexpensive treatments for the control of diabetes.
Public release date: 8-Jun-2009
Recycled radioactive metal contaminates consumer products
* A recent example emerged last summer, when a Flint, Mich., scrap plant discovered a beat-up kitchen cheese grater that was radioactive. The China-made grater bearing the well-known EKCO brand name was laced with the isotope Cobalt-60. Tests showed the gadget to be giving off the equivalent of a chest X-ray over 36 hours of use, according to NRC documents.
Submitted by SHNS on Wed, 06/03/2009 – 13:38. By ISAAC WOLF, Scripps Howard News Service national
Thousands of everyday products and materials containing radioactive metals are surfacing across the United States and around the world.
Common kitchen cheese graters, reclining chairs, women’s handbags and tableware manufactured with contaminated metals have been identified, some after having been in circulation for as long as a decade. So have fencing wire and fence posts, shovel blades, elevator buttons, airline parts and steel used in construction.
A Scripps Howard News Service investigation has found that — because of haphazard screening, an absence of oversight and substantial disincentives for businesses to report contamination — no one knows how many tainted goods are in circulation in the United States.
But thousands of consumer goods and millions of pounds of unfinished metal and its byproducts have been found to contain low levels of radiation, and experts think the true amount could be much higher, perhaps by a factor of 10.
Government records of cases of contamination, obtained through state and federal Freedom of Information Act requests, illustrate the problem.
In 2006 in Texas, for example, a recycling facility inadvertently created 500,000 pounds of radioactive steel byproducts after melting metal contaminated with Cesium-137, according to U.S. Nuclear Regulatory Commission records. In Florida in 2001, another recycler unintentionally did the same, and wound up with 1.4 million pounds of radioactive material. And in 1998, 430,000 pounds of steel laced with Cobalt-60 made it to the U.S. heartland from Brazil.
But an accounting of the magnitude of the problem is unknown because U.S. and state governments do not require scrap yards, recyclers and other businesses — a primary line of defense against rogue radiation — to screen metal goods and materials for radiation or report it when found. And no federal agency is responsible for oversight.
“Nobody’s going to know — nobody — how much has been melted into consumer goods,” said Ray Turner, an international expert on radiation with Fort Mitchell, Ky.-based River Metals Recycling. He has helped decontaminate seven metal-recycling facilities that unwittingly melted scrap containing radioactive isotopes.
“It’s your worst nightmare,” Turner said.
It is also one that has only barely begun to register as a potential threat to health and safety.
What is known now is that — despite the shared belief of officials in six state and federal agencies that tainted metal is potentially dangerous, should be prevented from coming in unnecessary contact with people and the environment, and should be barred from entering the United States — there is no one in charge of making sure that happens.
In fact, the Scripps investigation found:
— Reports are mounting that manufacturers and dealers from China, India, former Soviet bloc nations and some African countries are exporting contaminated material and goods, taking advantage of the fact that the United States has no regulations specifying what level of radioactive contamination is too much in raw materials and finished goods.Compounding the problem is the inability of U.S. agents to fully screen every one of the 24 million cargo containers arriving in the United States each year.
— U.S. metal recyclers and scrap yards are not required by any state or federal law to check for radiation in the castoff material they collect or report it when they find some.
— No federal agency is responsible for determining how much tainted material exists in how many consumer and other goods. No one is in charge of reporting, tracking or analyzing cases once they occur. In fact, the recent discovery of a radioactive cheese grater triggered a bureaucratic game of hot potato, with no agency taking responsibility.
— It can be far cheaper and easier for a facility stuck with “hot” items to sell them to an unwitting manufacturer or dump them surreptitiously than to pay for proper disposal and cleaning, which can cost a plant as much as $50 million.
— For facilities in 36 states that want to do the right thing, there is nowhere they can legally dump the contaminated stuff since the shutdown last year of a site in South Carolina, the only U.S. facility available to them for the disposal.
— A U.S. government program to collect the worst of the castoff radioactive items has a two-year waiting list and a 9,000-item backlog — and is fielding requests to collect an additional 2,000 newly detected items a year.
Full text of Article Can be found at http://www.scrippsnews.com/node/43577 (It gets worse)
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