Working long hours in low socioeconomic status jobs 'increases diabetes risk'

A new study published in The Lancet Diabetes & Endocrinology claims people who work more than 55 hours a week doing jobs of low socioeconomic status are at significantly higher risk of developing type 2 diabetes, compared with those who work fewer hours.

Researchers say people who work long hours doing jobs of low socioeconomic status - such as manual work - are much more likely to develop type 2 diabetes that those who work fewer hours.

Long working hours have previously been associated with poor health outcomes. A study recently reported by Medical News Today, for example, found a higher risk of coronary heart disease among people who work more than 60 hours a week.
The researchers of this latest study, led by Mika Kivimäki, professor of epidemiology at University College London in the UK, notes that past studies have also linked long working hours to stress, unhealthy lifestyles, depressive symptoms and disturbed sleep, which they say are factors that can contribute to development of diabetes.
"However, the direct association between long working hours and incident type 2 diabetes has been assessed in only a few studies," the researchers add.
With this in mind, the team conducted the largest study so far to investigate how long working hours influence the risk of type 2 diabetes.

Long hours in low socioeconomic status jobs 'increases type 2 diabetes risk by 30%'

To reach their findings, the team analyzed data from a selection of published and unpublished studies looking at the effect of long working hours on type 2 diabetes. The data involved 222,120 men and women from the US, Europe, Japan and Australia, and participants were followed up for an average of 7.6 years.
When the researchers compared people who worked 55 hours or more each week with those who worked the standard 35-40 hours a week, they found no significant difference in the risk of developing type 2 diabetes.
However, when they compared results by socioeconomic status, the team found that participants with jobs of low socioeconomic status - such as jobs involving manual labor - who worked 55 hours or more each week were 30% more likely to develop type 2 diabetes, compared with those who worked 35-40 hours a week.
"The strong socioeconomic patterning in the results was surprising," Prof. Kivimäki told MNT. "The higher the person's position in the socioeconomic hierarchy was, the less working long hours was linked to diabetes risk. So, high socioeconomic position appears to protect against the 'diabetogenic' effects of long working hours."
The researchers note that this finding remained even after accounting for age, sex, obesity status, smoking and physical activity. It also remained when the researchers excluded participants who do shift work, which has previously been linked to increased risk of obesity and type 2 diabetes.

'Working long hours in such groups could be marker of other risk factors'

Although the team did not investigate the reasons for this association, they hypothesize that it could be down to a number of factors. Those who work long hours in low socioeconomic status jobs may be more likely to have less sleep and less time to engage in physical exercise, for example, which may increase the risk of type 2 diabetes.
"It is also possible that working long hours in low socioeconomic groups is a marker of other risk factors, such as low pay and financial constraints," said Prof. Kivimäki. "Those with a high socioeconomic status are less likely to have such hardships."
Commenting on their overall findings, Prof. Kivimäki says:

"The pooling of all available studies on this topic allowed us to investigate the association between working hours and diabetes risk with greater precision than has been previously possible.
Although working long hours is unlikely to increase diabetes risk in everyone, health professionals should be aware that it is associated with a significantly increased risk in people doing low socioeconomic status jobs."

When MNT asked Prof. Kivimäki if people in low socioeconomic status jobs should reduce their working hours to reduce diabetes risk, he replied that no studies have suggested that lowering working hours would have such an effect.
"For this reason, my recommendation for people who wish to decrease their risk of type 2 diabetes is to eat and drink healthfully, be physically active, avoid overweight, do not smoke, and keep blood glucose and lipids levels within the normal range. This applies both to individuals who work long hours and those who work standard hours."
He added that in future research, the team plans to investigate the link between long working hours and other health outcomes, such as coronary heart disease, stroke and excessive alcohol consumption.
In an editorial linked to the study, Dr. Orfeu Buxton, of Pennsylvania State University, and Dr. Cassandra Okechukwu, of Harvard School of Public Health in Boston, MA, say that this study offers a "solid foundation" for further research into the risks and interventions for diabetes.
"The results remained robust even after controlling for obesity and physical activity," they add, "which are often the focus of diabetes risk prevention, suggesting that work factors affecting health behaviors and stress may need to be addressed as part of diabetes prevention."
MNT recently reported on a study from the Centers for Disease Control and Prevention (CDC), revealing that rates of diabetes in the US leveled off between 2008 and 2012.

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'Increased risk of venous thromboembolism among NSAID users'

You have probably heard that the most nutritious foods are the ones that are the most colorful. There are even several fad diets that tell you to avoid any white or colorless food, but don't write off cauliflower and other white veggies just yet.
The grain-refining process used in white breads and pastas are processed to remove the bran and the germ parts of the grain, which lower fiber and B vitamin content so it's perfectly fine to avoid these nutrient-lacking foods. Cauliflower, by contrast, is naturally high in both fiber and B-vitamins.
As part of the brassica family, more commonly known as cruciferous vegetables, cauliflower contains antioxidants and phytonutrients that can protect against cancer, fiber that helps with satiety, weight loss and a healthy digestive tract, choline that is essential for learning and memory as well as many other important nutrients.
Cauliflower even ranks among the top 20 foods in regards to ANDI score (Aggregate Nutrient Density Index), which measures vitamin, mineral and phytonutrient content in relation to caloric content. To earn high rank, a food must provide a high amount of nutrients for a small amount of calories.
This MNT Knowledge Center feature is part of a collection of articles on the health benefits of popular foods. It provides a nutritional breakdown of cauliflower and an in-depth look at its possible health benefits, how to incorporate more cauliflower into your diet and any potential health risks of consuming cauliflower.

Contents of this article:

1. Nutritional breakdown of cauliflower
2. Possible health benefits of consuming cauliflower
3. How to incorporate more cauliflower into your diet
4. Potential health risks of consuming cauliflower

Nutritional breakdown of cauliflower

According to the USDA National Nutrient Database, one cup of chopped raw cauliflower (1/2 inch pieces, about 107 grams) contains 27 calories, 2 grams of protein, 0.3 grams of fat, and 5 grams of carbohydrate (including 2.1 grams of fiber and 2 grams of sugar).

Cauliflower contains antioxidants and phytonutrients that can protect against cancer, fiber that helps with satiety, weight loss and a healthy digestive tract.

Eating one cup of raw cauliflower will provide 77% of your vitamin C needs, 20% of vitamin K, 10% or more of vitamin B-6 and folate needs for the day, as well as smaller amounts of thiamin, riboflavin, niacin, pantothenic acid, calcium, iron, magnesium, phosphorus, potassium and manganese.

Possible health benefits of consuming cauliflower

Consuming fruits and vegetables of all kinds has long been associated with a reduced risk of many adverse health conditions. Many studies have suggested that increasing consumption of plant foods like cauliflower decreases the risk of obesity, diabetes, heart disease and overall mortality while promoting a healthy complexion, increased energy, and overall lower weight.

Cancer

Cauliflower contains antioxidants that help prevent cellular mutations and reduce oxidative stress from free radicals. One of these is indole-3-carbinol or I3C, commonly found in cruciferous vegetables like cabbages, broccoli and cauliflower/ I3C has been shown to reduce the risk of breast and reproductive cancers in men and women.²
For the past 30 years, eating a high amount of cruciferous vegetables has been associated with a lower risk of cancer; namely lung and colon cancer. Recently, studies have suggested that the sulfur-containing compounds (namely sulforaphane) that give cruciferous vegetables their bitter bite are also what give them their cancer-fighting power.
Sulforaphane is now being studied for its ability to delay or impede cancer with early promising results associated with melanoma, esophageal, prostate and pancreatic cancers. Researchers have found that the sulforaphane compound can inhibit the enzyme histone deacetylase (HDAC), known to be involved in the progression of cancer cells. The ability to stop HDAC enzymes could make sulforaphane-containing foods a potentially powerful part of cancer treatment in the future.¹

Digestion

Cauliflower is high in both fiber and water content, which helps to prevent constipation, maintain a healthy digestive tract and lower the risk of colon cancer.
Adequate fiber promotes regularity, which is crucial for the daily excretion toxins through the bile and stool, but good digestion is far from all that fiber can do for your body.
Recent studies have shown that dietary fiber may play a role in regulating the immune system and inflammation, consequently decreasing the risk of inflammation-related conditions such as cardiovascular disease, diabetes, cancer, and obesity.
According to the Department of Internal Medicine and Nutritional Sciences Program of the University of Kentucky, high fiber intakes are associated with significantly lower risks for developing coronary heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases. Increased fiber intake has also been shown to lower blood pressure and cholesterol levels, improve insulin sensitivity, and enhance weight loss for obese individuals.

Memory

Choline is a very important and versatile "vitamin-like factor" in cauliflower that helps with sleep, muscle movement, learning and memory. Choline also helps to maintain the structure of cellular membranes, aids in the transmission of nerve impulses, assists in the absorption of fat and reduces chronic inflammation.³

Strong bones

Low intakes of vitamin K have been associated with a higher risk for bone fracture and osteoporosis. Adequate vitamin K consumption improves bone health by acting as a modifier of bone matrix proteins, improving calcium absorption and reducing urinary excretion of calcium.⁴

How to incorporate more cauliflower into your diet

An excellent substitute for traditional pizza crust - made from cauliflower.

Cauliflower is most commonly found fresh or frozen. When choosing fresh cauliflower, look for a firm head with no dark spots and bright green leaves attached to the stem. Store in the refrigerator in a plastic bag for up to five days.
New and trendy ways to use cauliflower include cauliflower crust pizza, cauliflower "rice" and buffalo cauliflower "wings."
Try some of these delicious, healthy recipes that incorporate cauliflower:
Creamy cauliflower soup with white cheddar

Garlic parmesan mashed cauliflower with chives

Curry-spiced cauliflower with breadcrumbs

Potential health risks of consuming cauliflower

Foods that are high in fiber such as beans, cabbage, cauliflower, broccoli, lentils, Brussels sprouts, onions, whole grains and cereals may cause increased bloating and flatulence however most people can tolerate these foods in proper portions.
Since vegetables and whole grains are a healthy part of the diet, increase your intake of these foods gradually and monitor your symptoms to determine which foods could be causing bloating.
If you are taking blood-thinners such as Coumadin (warfarin) it is important that you do not suddenly begin to eat more or fewer foods containing vitamin K, which plays a large role in blood clotting.
It is the total diet or overall eating pattern that is most important in disease prevention and achieving good health. It is better to eat a diet with a variety than to concentrate on individual foods as the key to good health.

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UK-based chemists report 'designer proteins' breakthrough

A potential breakthrough in techniques to develop drugs to treat diseases as diverse as cancer and Alzheimer's has been reported by chemists at the University of Leicester in the UK.

Amino acids are used to make all proteins - the Leicester team refers to them as "Mother Nature's building blocks," as they are essential for life.

The Jamieson Research Group in the Department of Chemistry at the University of Leicester claim to have developed a new process for generating a specific synthetic amino acid.
Amino acids are used to make all proteins - the Leicester team refers to them as "Mother Nature's building blocks," as they are essential for life.
"We are very proud of this research," says lead scientist Dr. Andrew Jamieson, "it has taken several years of hard work to master the chemistry techniques to create these new building blocks, but now that we have conquered it, we have access to new building blocks that people have only ever dreamed of before!"
There are 20 naturally produced amino acids in total. By contrast, the new chemical synthesis of unnatural amino acids pioneered by the Leicester team could be used to make designer mini-proteins with entirely new structures and functions from those found in nature.
The researchers say they are particularly interested in using the designer proteins to create innovative new treatments for cancer and Alzheimer's disease.
Dr. Jamieson explains:

"Unnatural amino acids, the building blocks, are described as chiral, meaning they have 'handedness.' A robust synthesis to selectively produce molecules with a particular handedness has not previously been reported. Our new practical method allows us to selectively synthesize only the 'right handed molecules.'
This new research is important because it has uncovered a new, easier and quicker way to make these building blocks which can be used to make new drugs. We now have access to new building blocks to develop innovative new protein drugs for the treatment of disease."

Dr. Jamieson mentions that a student also used the building blocks to synthesize a toxin produced by a sea snail, which the team hopes to develop as a new painkiller.

Other amino acid developments

Back in April, chemists from the University of California, San Francisco (UCSF) reported a similar breakthrough in creating, for the first time, enzyme-like activity using peptides (chemical compounds comprised of amino acids) that are only seven amino acids long.
Ivan V. Korendovych, assistant professor of chemistry who co-led the UCSF study, said:
"It was the first time that a peptide this small self-assembled to produce an enzyme-like catalyst. Our finding suggests that amyloids, whose buildup leads to Alzheimer's in the brain, may also have served as the blueprint for larger, modern-day enzymes."
Also this year, researchers at the University of North Carolina (UNC) published results in the Proceedings of the National Academy of Sciences, reporting that they re-engineered a chain of amino acids in a type of dengue virus.
The UNC investigators think their research may not only provide a potential vaccine for dengue fever, but could also contribute to vaccine development for diseases such as severe acute respiratory syndrome (SARS) and human immunodeficiency virus (HIV).

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Fruit and veg consumption tied to mental health

By now, most of us are aware that eating fruits and vegetables is good for our physical health. But a new study published in the BMJ Open suggests eating five a day is linked to better mental well-being.

Eating your "5 a day" increases changes of higher mental well-being, the researchers say.

A previous study suggested that consuming five portions of fruits and vegetables a day is the optimum amount for lowering the risk of death from any cause, which contradicts another study that suggested we should be eating seven portions of fruit and veg a day.
The researchers from this latest study, led by Dr. Saverio Stranges of the University of Warwick Medical School in the UK, used data from the Health Survey for England, which included nearly 14,000 adults over the age of 16.
This survey collected detailed information on the mental and physical health of the participants, as well as their health-related behaviors, demographics and socio-economic characteristics.
In addition, the team assessed the participants' mental well-being using the Warwick-Edinburgh Mental Wellbeing Scale, putting the top 15% of participants in the "high mental well-being" group, the bottom 15% in the low group, and those between 16-84% in the middle group.

'The higher the veg and fruit intake, the lower the chance of low well-being'

Overall, the researchers found that high and low mental well-being were typically associated with the participants' fruit and vegetable intake.
In detail, 35.5% of participants with high mental well-being ate five or more portions of fruits and vegetables a day, compared with only 6.8% who consumed less than one portion.
Additionally, 31.4% of the individuals from the high mental well-being group ate three to four fruit and veg portions per day, and 28.4% ate one to two.
"The data suggest that [the] higher an individual's fruit and vegetable intake, the lower the chance of their having low mental well-being," says Dr. Stranges.
The researchers also considered other health-related behaviors - such as smoking, alcohol intake and obesity - and found that only smoking and fruit and vegetable intake were consistently associated with mental well-being.
Dr. Stranges explains:

"Along with smoking, fruit and vegetable consumption was the health-related behavior most consistently associated with both low and high mental well-being. These novel findings suggest that fruit and vegetable intake may play a potential role as a driver, not just of physical, but also of mental well-being in the general population."

Alcohol intake and obesity were associated with low, but not high mental well-being, the researchers add.

Enhancing well-being while preventing cancer

According to the team, high mental well-being is more than simply the absence of symptoms or illness - it is the condition of feeling good and functioning well. They add that optimism, happiness, self-esteem, resilience and good relationships are also part of this mode of being.
According to co-author Prof. Sarah Stewart-Brown, mental illness "is hugely costly to both the individual and society, and mental well-being underpins many physical diseases, unhealthy lifestyles and social inequalities in health."
She says enabling people to maintain good well-being is important from a research perspective.
"Our findings add to the mounting evidence that fruit and vegetable intake could be one such factor and mean that people are likely to enhance their mental well-being at the same time as preventing heart disease and cancer," she adds.
When asked about whether the study accounted for physical activity, Dr. Stranges told Medical News Today that one of the limitations of the study was that such data "was not available in the Health Survey for England," leaving room for further study.

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CDC: Ebola cases in West Africa could exceed 550,000 by January

In their latest report on the current Ebola epidemic in West Africa, the US Centers for Disease Control and Prevention urge that immediate interventions be put in place quickly, and warn that the "cost of delay will be devastating."

If current trends continue, they say the future number of cases in Liberia and Sierra Leone could exceed 550,000 by January. That estimate is based on reported cases. If under-reporting is taken into account, their calculations suggest that figure is likely to be nearer 1.4 million.
While the Centers for Disease Control and Prevention (CDC) say they cannot guarantee the accuracy of their estimates, they are clear about their key messages: "if conditions remain unchanged, the situation will rapidly become much worse," and they serve as "a warning and a call to action."
The CDC report their calculations - and how they arrived at them with a new model - in their latest Morbidity and Mortality Weekly Report (MMWR). The report details the CDC estimates for future Ebola cases in Liberia and Sierra Leone, where the epidemic is uncontained and out of control.

Number of cases doubling every few weeks

The report notes that on March 22, 2014, there were 49 reported cases of Ebola virus disease (usually referred to as Ebola) in Guinea, where the current outbreak in West Africa began.

According to the CDC, there will be up to 21,000 cases of Ebola in Liberia and Sierra Leone by the end of September.

By the end of August, the outbreak had spread to neighbouring Liberia and Sierra Leone, and the total number of probable, confirmed and suspected cases had risen to 3,685.
The CDC estimate that by the end of September, there will be around 8,000 Ebola cases - or as many as 21,000 cases if corrections for under-reporting are included - in Liberia and Sierra Leone.
And if current trends continue, "without additional interventions or changes in community behavior," these figures will rise to around 550,000 cases - or 1.4 million including under-reported cases.
The estimates assume the current conditions of disease transmission will remain unchanged. The main driver of the estimates is that in Liberia, the number of cases is doubling about every 15-20 days, and in Sierra Leone and Guinea, they are doubling around every 30-40 days.

EbolaResponse modeling tool takes into account disease stages and types of isolation

For their calculations, the CDC constructed a new modelling tool called EbolaResponse, comprising an Excel spreadsheet containing a set of formulae and assumptions.
The model allows researchers to estimate the daily movement of patients within disease stages (i.e. susceptible, incubation, infectious, recovery or death) using probabilities for three different types of isolation.
The three different types of isolation are: hospitalization (such as in an Ebola treatment unit or medical care facility), home with effective isolation (a home or community setting where there is reduced risk of disease spread, including safe burial where needed), and home with no effective isolation.
Ideally, Ebola treatment units and appropriate medical care facilities have infection control procedures that prevent disease spread, but the CDC note this is not always the case. So the model assumes there is an average daily risk that transmission will occur - however this is fewer than one person infected per infectious patient.
The model includes information from previous Ebola outbreaks - for example, periods of infectivity, time between exposure and illness. There is no evidence that the virus is spreading differently from previous outbreaks.
To estimate the number of under-reported cases, the report uses a factor of 2.5. This was calculated using estimates of beds-in-use from the model and comparing them to expert opinions of actual beds-in-use on a given day (August 28th). The difference is a potential under-reporting correction factor (1.5 more beds were being used than the model estimated.)

'Cost of delay will be devastating'

The CDC say we know how to control and stop the epidemic. The model suggests this will require about 70% of people infected with Ebola be cared for in Ebola treatment units, or if these are full, they should be cared for at home or in a community setting, where risk of disease is reduced and burials are conducted safely.
Every month of delay in reaching this 70% target will increase the number of cases and deaths, and the need for more beds and resources. "The cost of delay will be devastating," say the CDC.
If we are to avoid the catastrophic scenario the model projects for January, effective interventions need to occur quickly, says the federal agency. This includes "appropriate disease control methods, communication, changes in community behavior, and adequate resources (such as staff, beds, equipment, supplies)."
The CDC model estimates the number of beds that would be needed in medical facilities and Ebola treatment units, but it is not designed to give details of resources such as enhanced protection measures to minimize disease spread.
In a recent Science editorial, Peter Piot, who in 1976 co-discovered the Ebola virus in Zaire (now Democratic Republic of Congo) while working at the Institute of Tropical Medicine in Antwerp, Belgium, says that the current Ebola crisis requires a "rapid response at a massive global scale."
Now a professor at the London School of Hygiene & Tropical Medicine, Prof. Piot says the epidemic in West Africa is the result of a "perfect storm" that combines dysfunctional health services, low trust in Western medicine and governments, denials that the Ebola virus exists, and unhygienic burial practices.
Meanwhile, the UN Security Council has resolved that the Ebola outbreak in Africa constitutes a threat to international peace and security, and calls on member states to respond urgently to the crisis.
The crisis is so urgent that an expert panel of the World Health Organization (WHO) concluded in August that it would be ethical to evaluate unregistered investigational treatments for Ebola virus disease in people.
To this end, the aid agency MSF/Doctors without Borders, recently reported that Ebola treatment trials are to be fast-tracked in West Africa for the first time.

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Can fish oil protect against brain damage caused by alcohol abuse?

According to a new study in PLOS ONE, omega-3 fish oil could protect against damage to the brain caused by alcohol abuse.

Previous studies have suggested that long-term alcohol abuse causes brain damage and increases the risk of dementia.
However, researchers from Loyola University Chicago Stritch School of Medicine in Illinois - who conducted this recent study - previously performed a meta-analysis that found drinking alcohol at moderate, social levels - a maximum of two drinks per day for men and one drink per day for women - may reduce risk of dementia and cognitive impairment during aging.

Studies have suggested that long-term alcohol abuse causes brain damage and increases the risk of dementia.

The team reasons that alcohol in moderate amounts "toughens up" brain cells, which makes them more resilient to damage, but that excessive amounts of alcohol overwhelms the cells, causing neuroinflammation and cell death.
To investigate the extent to which omega-3 fish oil may protect against this damage, the researchers behind the meta-analysis - with collaborators at the University of Kentucky and the National Institute of Alcohol Abuse and Alcoholism - conducted a new experiment with cultures of adult rat brain cells.
Over several days, they exposed the cell cultures to alcohol concentrations the equivalent of four times the legal limit for driving. This level of alcohol exposure is similar to that seen in chronic alcoholics.
The researchers then compared the brain cultures with other cultures that had also been exposed to the same levels of alcohol, but with the addition of the omega-3 docosahexaenoic acid (DHA) compound found in fish oil.
The team observed that there was up to 90% less neuroinflammation and neuronal death in the brain cells that had been exposed to DHA than in the cells that had just been exposed to alcohol.
"Fish oil has the potential of helping preserve brain integrity in chronic alcohol abusers," says study author Michael A. Collins, PhD. "At the very least, it is unlikely that it would hurt them."
However, the team states that further studies are needed to confirm their findings.
They add that the best way for people abusing alcohol to avoid brain damage is to reduce their drinking to low or moderate amounts, or to give up alcohol altogether.

"Fish oil has the potential of helping preserve brain integrity in chronic alcohol abusers," says study author Michael A. Collins, PhD.

"We don't want people to think it is okay to take a few fish oil capsules and then continue to go on abusing alcohol," says Collins.
Recently, Medical News Today reported on a study published in BMJ that found alcohol does not benefit the heart. The authors of that study suggest that reduced alcohol consumption - even among light-to-moderate drinkers - improves heart health.
Also, in April, we reported on a study by University of Utah neuroscientists, which investigated the region of the brain that regulates our sensitivity to the negative effects of alcohol.
The team behind that study found that when they inactivated a brain region called the lateral habenula in a group of rats and gave the animals access to alcohol, the rats escalated their drinking faster than a control group of rats.
The researchers concluded that the rats with the inactive lateral habenulas were unable to learn from bad experiences, unlike the control rats, who modified their behavior to avoid the negative consequences of a hangover.

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'The higher the cigarette taxes, the lower the suicide rates'

In a new study, researchers at Washington University School of Medicine in St. Louis, MO, find a link between suicide rates and cigarette taxes and smoking policies. 

Previous research has shown that smokers are more likely to commit suicide than people who do not smoke. The factor driving this association was assumed by some researchers to be because people with psychiatric disorders are both more likely to smoke and more likely to commit suicide than the general population.

The map displays the range of state cigarette taxes from the lowest (lightest blue) to the highest (darkest blue).
Image credit: Richard A. Grucza, PhD

However, the new study suggests that it may be smoking itself that increases suicide risk - possibly increasing the risk for psychiatric disorders, or making existing disorders more severe. The study also claims that policies aimed at limiting smoking may reduce suicide rates.
"We really need to look more closely at the effects of smoking and nicotine, not only on physical health but on mental health, too," says lead author and associate professor of psychiatry Richard A. Grucza, PhD.
"We don't know exactly how smoking influences suicide risk. It could be that it affects depression or increases addiction to other substances. We don't know how smoking exerts these effects, but the numbers show it clearly does something."
The Washington University team analyzed National Center for Health Statistics' data from 1990 to 2004, a period when individual states began to take different approaches to cigarette taxes and smoking policies.

Fast facts on US suicide rates

• The average annual suicide rate during the study period was about 14 deaths for every 100,000 people
• Suicide is the 10th leading cause of death in the US, according to the Centers for Disease Control and Prevention
• In 2010, nearly 40,000 people died of suicide across the US.

The National Center for Health Statistics records data on every death that occurs in the US. The researchers looked at the states where each person who had committed suicide had lived, and how aggressive the tobacco policies in those states were.
They found that in the states that adopted aggressive tobacco-control policies, suicide rates decreased compared with the national average.
By contrast, in states with low cigarette taxes and less restrictive smoking policies, suicide rates were shown to be up to 6% higher than the national average during the same period.
The researchers also determined whether the people who had committed suicide were likely to have been smokers. They claim that suicide risk among the people most likely to smoke was associated with smoking restrictions and tobacco taxes.
"Our analysis showed that each dollar increase in cigarette taxes was associated with a 10% decrease in suicide risk," Grucza says. "Indoor smoking bans also were associated with risk reductions."
Nicotine may be an important influence on suicide risk, says Dr. Grucza:

"Nicotine is a plausible candidate for explaining the link between smoking and suicide risk. Like any other addicting drug, people start using nicotine to feel good, but eventually they need it to feel normal. And as with other drugs, that chronic use can contribute to depression or anxiety, and that could help to explain the link to suicide."

Grucza adds that he is concerned that many restrictions on public smoking do not cover e-cigarettes, which deliver nicotine through a vapor rather than smoke. He also hypothesizes that if states that have low cigarette taxes and relaxed smoking policies raise taxes and restrict public smoking, then their suicide rates will most likely fall.

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60-year old gives birth through IV

There is good news for women who think age is a barrier to conception.
A woman said to be 60 has just been delivered of a baby at a Lagos hospital.
For 31 years, Mrs Omolara Irurhe was globetrotting not for pleasure but in search of a child.   She was a guest in the best hospitals.
But in 2010, her journey ended in the most unlikely hospital and country when she began an Invitro Fertilization (IVF) treatment at the St. Ives Hospital in Lagos. On Monday, what began as a seed hope four years ago culminated in the delievery of a bouncing baby girl.
Mrs. Irurhe  becomes the oldest IVF mother in Africa. The global recognition for oldest IVF delivery goes to Rajo Deri Lohan, an Indian who in 2008 was delivered of a baby at 69 years.
The IVF Unit at St. Ives Hospital successfully aided the conception and delivery of the baby and has now equaled the United Kingdom’s record of IVF age delivery.
The team of doctors at the hospital was led by the Chief Medical Director, Dr. Tunde Okewale, who expressed joy at the successful delivery. Okewale said the physical condition of the mother – and not just the age – is a major factor that determines the success of conception and delivery through IVF.
“We treat only after strict medical check of couples. For us, age is not important in our decision to take her on; what was important is the physical condition of the mother. Older women generally make better patients in our experience,” Okewale said.
When The Nation spoke to the new mother, she was full of enthusiasm and joy over her new baby. She said what kept her going after many years of childlessness was faith in God and a belief in herself.
Mrs. Irurhe said she had tried to have a baby for many years and had gone to many hospitals both within and outside the country for a solution to her childlessness. But in 2010, her journey came to an end when she was introduced to St. Ives Hospital and the treatment began.
“I believe we should not limit God and what the doctors can do in this modern age. I believe this is the appointed time. I was very hopeful throughout the years I was childless and I remained focused on God. We went to many hospitals but we didn’t give up,” she said.
The joyful mother said her husband’s Catholic faith prevented him from marrying a second wife as the two of them put their faith in God.
“We didn’t have much pressure, even though our marriage is cross cultural –I am Yoruba; my husband is Edo- but we remained hopeful,” she said.
Desmond Adekunle Irurhe was elated at the birth of his baby. When asked if she supported his wife going for the IVF he replied: “ I supported her throughout because my wife was dogged and she believed in herself. When I saw her faith, I had no choice but to go with her. She kept telling me she would have her child”.
The husband said even though there was some pressures, it wasn’t too much. “I wasn’t thinking of another wife. I came from a monogamous family and I decided she is all I will have. The family was understanding too and we fought together to get this baby.”
Irurhe praised the medical team at the hospital, saying they made everything easy for them. “ The hospital didn’t give us any problem, they were very helpful and we thank them for the successful delivery.”
With the successful delivery, hope rises for older women who may want to go the way of IVF in child conception. In Nigeria, the cost of the IVF treatment varies but from available statistics, the most expensive treatment is under N2million. The Iruhres paid less than N1 million for their successful treatment.
“I will advise couples who are trying to get a baby to try the IVF. My case has rekindled hope for the barren woman. I will say the couple should relax and take it as it comes, they will surely smile,” the mother said.
Having a first child at the age of 60 years may not be the norm but for the mother, it is an experience she does not mind going through again. “ I don’t know if I will have another baby, but if the doctors say I can, I will try it,” she said, smilling.
Mrs. Omolara Irurhe: We have tried for many years to have a baby and after we failed to get a baby naturally we opted for the IVF. We had gone to many hospitals before here but the treatments that we received didn’t work. We came in contact with this hospital in 2010 before we delivered this baby.
“I give glory to God, we kept our faith in God, we believe this is God’s appointed time.

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UK facing 'major' sperm shortage

The UK is facing a major sperm shortage that may be tempting fertility clinics to accept poorer quality sperm, the British Fertility Society (BFS) warns.

Some clinics rely on imported sperm to keep up with demand.
However, the BFS chairman, Dr Allan Pacey, said he was "worried" that some clinics may be setting a lower bar to "get donors through the door".
He said women may be subjected to more invasive and expensive techniques if poor-quality sperm were used.
There are thought to have been fewer sperm donors after the right to anonymity was removed in 2005.
The demand for donors has been falling as advances in fertility treatment let more men father their own children.
However, a shortage of donors has still emerged.
Figures from the fertility regulator, the Human Fertilisation and Embryology Authority (HFEA), show nearly one in four donated sperm samples is from abroad.
The figure was one in 10 in 2005.
Sperm banks in Denmark and the US are the major suppliers.
Dr Pacey warned this was limiting patient choice and increasing waiting times, which led to potential risky practices, including DIY insemination with a friend's sperm or seeking treatment in a country with less fertility regulation.

 

The UK faces a sperm donor shortage

He told the BBC: "We do still have a major sperm shortage in the UK.
"The worry is clinics might decide to change the quality of sperm they are willing to accept in order to get donors through the door and I think that's a very dangerous road to go down."
He said one possible example was sperm being accepted that would be suitable only for injecting into an egg - intra-cytoplasmic sperm injection - rather than for artificial insemination.
"That is putting the woman through more procedures, in terms of eggs being collected, than would be done if sperm of higher quality was collected and she could be treated with a simple insemination.
"My worry is clinics may be tempted to bend the rules, I have no evidence that they are, but I think when we have a national sperm shortage they're the kind of things we need to be looking for and warding against."
'Fully inform patients' Professor Yakoub Khalaf, of the assisted conception unit at Guy's Hospital in London, commented: "We are now more reliant on external sperm banks than ever before.
"I don't think it is an issue as such, but what I have observed is that when people get sperm from abroad they can be given an option of 'suitable for insemination', or 'suitable for IVF or ICSI' [sperm injected to the egg].
"But how can donor sperm be less than adequate for all treatments?"
He said that based on his experience of the quality of imported sperm "the same could be happening here".
A HFEA spokesperson said: "We expect our clinics to use only donor sperm of a quality that will ensure the best outcome for the patient, and under our code of practice clinics are required to fully inform patients of the different treatment options available to them."

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Fake Medicine, a Real Danger for Health

The problem of counterfeit medicine is not a new one but it is a growing worldwide criminal trend that poses a real danger for patient health. Compounding the problem is the fact that it is no longer just about lifestyle products, medicines for treating chronic and serious diseases such as cardiovascular diseases or cancer can now be counterfeited.

In the recent Sanofi Fights Against Counterfeit Medicines Report, Sanofi’s Dr. Caroline Atlani, director, anti-counterfeiting coordination says: “They don’t contain the expected amount of active ingredient and they don’t meet any of the standard requirements for quality, efficiency and safety,” Atlani continues: “So patients run a number of risks: besides the presence of toxic substances, these medicine can be inactive and cause major adverse effects and complications for patients.”

While the World Health Organization (WHO) estimates that 10 to 15 percent of the global drug supply is fake, in Africa fake medicines may account for up to 30% of medicines in circulation. “The general public is not really aware of the existence of counterfeit medicines and the risks they may incur in certain purchasing situations,” says Atlani in the 2014 report.

A newly released Sanofi commissioned European consumer opinion survey of 5,010 people shows that very few of the Europeans surveyed associate the term ‘counterfeiting’ with medicines (20%). While the majority (66%) have heard of medicine counterfeiting, respondents seem to have little information on the issue of counterfeit medicines: 77% of those surveyed feel they do not receive sufficient information about counterfeit medicines. 84% of those surveyed say they have never seen or identified a counterfeit drug although there is a consensus among Europeans about the danger of counterfeit medicines insofar as 96% believe that counterfeit medicine can be and are probably dangerous. These results confirm the need to continue our fight against drug counterfeiting, especially by raising public awareness.

Drug counterfeiting across the globe
In recent years, medicines were the leading counterfeit products seized by European customs, ahead of counterfeit cigarettes (Pharmaceutical Security Institute “2011 situation report”) Other shocking statistics include:
- 1 in 10 medicne sold worldwide is counterfeit; this figure reaches 7 out of 10 in some countries (LEEM 2011) $75 billion in 2010: the profits yielded by counterfeit medicines; greater than those derived from drug trafficking (Institute of Research Against Counterfeit Medicines (IRACM)

- For every $1,000 invested, criminals can generate $20,000 in profits from heroin trafficking and $400,000 by trafficking counterfeit medicines. As of 22 May 2014, Interpol reported that nearly 200 enforcement agencies across 111 countries have collaborated on Operation Pangea VII targeting criminal networks behind the sale of fake medicines via illicit online pharmacies. To date this has resulted in the closure of more than 10,600 websites and the seizure of 9.4 million fake and illicit medicines worth a total of $36 million. (Interpol “Operation Pangea VII”)

Public Health
Atlani warns that counterfeit medicines can also lead to collective risks, especially due to the emergence of drug-resistance in the case of treatments for infectious diseases with antibiotics or antimalarials.

In accordance to the directive issued by the National Agency for Food and Drug Administration and Control (NAFDAC) in 2012 to all Market Authorization Holders, Sanofi Nigeria implemented the Mobile Authentication Service (MAS) in 2013, an anti-counterfeit tool deployed with high-security labels to help both the patients and distributors ensure product authenticity verification for its antibiotics or antimalarials products.

According to the American Enterprise Institute 100,000 people worldwide die each year because they take branded and generic counterfeit drugs. In an article in the medical journal The Lancet in mid-2012, it was noted that one third of malaria medicines used in East Asia and sub-Saharan Africa are fraudulent.

Raising Awareness

“The general public is not sufficiently informed about the existence of counterfeit drugs and the risks it may be taking in certain purchasing situations. Counterfeit medicines are a real danger to patients’ health. For example, they may not contain the same amount of active ingredient as the genuine drug or not meet the same requirements in terms of quality, efficiency and safety as the genuine treatments”, said Dr Caroline Atlani, anti-counterfeiting coordination director at Sanofi.

According to Mrs. Uzo Amatokwu, Sanofi Nigeria’s Anti-counterfeit Coordinator, “it takes collaboration to really fight the counterfeit battle”. Sanofi recently signed a partnership with Interpol together with 29 major pharmaceutical companies at a total cost of 4.5 million euros, which covers the creation of the Interpol Pharmaceutical Crime Program focusing on fighting counterfeit medicines and combines training with targeted enforcement actions.

Sanofi has created its own laboratory dedicated to analyzing counterfeit Sanofi products in Tours, France manned by a dedicated team of experts. All Sanofi medicines suspected of being counterfeited are sent to the Central Anti-Counterfeit Laboratory (LCAC) to be analyzed.

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Alcohol's Effects on the Body

Drinking too much – on a single occasion or over time – can take a serious toll on your health.  Here’s how alcohol can affect your body:
Brain:
Alcohol interferes with the brain’s communication pathways, and can affect the way the brain looks and works. These disruptions can change mood and behavior, and make it harder to think clearly and move with coordination. 
Heart:
Drinking a lot over a long time or too much on a single occasion can damage the heart, causing problems including:

• Cardiomyopathy – Stretching and drooping of heart muscle
• Arrhythmias – Irregular heart beat
• Stroke
• High blood pressure  

Research also shows that drinking moderate amounts of alcohol may protect healthy adults from developing coronary heart disease.
Liver:
Heavy drinking takes a toll on the liver, and can lead to a variety of problems and liver inflammations including:

• Steatosis, or fatty liver
• Alcoholic hepatitis
• Fibrosis
• Cirrhosis

Pancreas:
Alcohol causes the pancreas to produce toxic substances that can eventually lead to pancreatitis, a dangerous inflammation and swelling of the blood vessels in the pancreas that prevents proper digestion.
Cancer:
Drinking too much alcohol can increase your risk of developing certain cancers, including cancers of the:

• Mouth
• Esophagus
• Throat
• Liver
• Breast

Immune System:
Drinking too much can weaken your immune system, making your body a much easier target for disease.  Chronic drinkers are more liable to contract diseases like pneumonia and tuberculosis than people who do not drink too much.  Drinking a lot on a single occasion slows your body’s ability to ward off infections – even up to 24 hours after getting drunk.

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ALCOHOL’S DAMAGING EFFECTS ON THE BRAIN

ALCOHOL’S DAMAGING EFFECTS ON THE BRAIN

Difficulty walking, blurred vision, slurred speech, slowed reaction times, impaired memory: Clearly, alcohol affects the brain. Some of these impairments are detectable after only one or two drinks and quickly resolve when drinking stops. On the other hand, a person who drinks heavily over a long period of time may have brain deficits that persist well after he or she achieves sobriety. Exactly how alcohol affects the brain and the likelihood of reversing the impact of heavy drinking on the brain remain hot topics in alcohol research today.
We do know that heavy drinking may have extensive and far–reaching effects on the brain, ranging from simple “slips” in memory to permanent and debilitating conditions that require lifetime custodial care. And even moderate drinking leads to short–term impairment, as shown by extensive research on the impact of drinking on driving.
A number of factors influence how and to what extent alcohol affects the brain (1), including

• how much and how often a person drinks;
• the age at which he or she first began drinking, and how long he or she has been drinking;
• the person’s age, level of education, gender, genetic background, and family history of alcoholism;
• whether he or she is at risk as a result of prenatal alcohol exposure; and
• his or her general health status.

This Alcohol Alert reviews some common disorders associated with alcohol–related brain damage and the people at greatest risk for impairment. It looks at traditional as well as emerging therapies for the treatment and prevention of alcohol–related disorders and includes a brief look at the high–tech tools that are helping scientists to better understand the effects of alcohol on the brain.

BLACKOUTS AND MEMORY LAPSES

Alcohol can produce detectable impairments in memory after only a few drinks and, as the amount of alcohol increases, so does the degree of impairment. Large quantities of alcohol, especially when consumed quickly and on an empty stomach, can produce a blackout, or an interval of time for which the intoxicated person cannot recall key details of events, or even entire events.
Blackouts are much more common among social drinkers than previously assumed and should be viewed as a potential consequence of acute intoxication regardless of age or whether the drinker is clinically dependent on alcohol (2). White and colleagues (3) surveyed 772 college undergraduates about their experiences with blackouts and asked, “Have you ever awoken after a night of drinking not able to remember things that you did or places that you went?” Of the students who had ever consumed alcohol, 51 percent reported blacking out at some point in their lives, and 40 percent reported experiencing a blackout in the year before the survey. Of those who reported drinking in the 2 weeks before the survey, 9.4 percent said they blacked out during that time. The students reported learning later that they had participated in a wide range of potentially dangerous events they could not remember, including vandalism, unprotected sex, and driving.

Binge Drinking and Blackouts

• Drinkers who experience blackouts typically drink too much and too quickly, which causes their blood alcohol levels to rise very rapidly. College students may be at particular risk for experiencing a blackout, as an alarming number of college students engage in binge drinking. Binge drinking, for a typical adult, is defined as consuming five or more drinks in about 2 hours for men, or four or more drinks for women.

Equal numbers of men and women reported experiencing blackouts, despite the fact that the men drank significantly more often and more heavily than the women. This outcome suggests that regardless of the amount of alcohol consumption, females—a group infrequently studied in the literature on blackouts—are at greater risk than males for experiencing blackouts. A woman’s tendency to black out more easily probably results from differences in how men and women metabolize alcohol. Females also may be more susceptible than males to milder forms of alcohol–induced memory impairments, even when men and women consume comparable amounts of alcohol (4).

ARE WOMEN MORE VULNERABLE TO ALCOHOL’S EFFECTS ON THE BRAIN?

Women are more vulnerable than men to many of the medical consequences of alcohol use. For example, alcoholic women develop cirrhosis (5), alcohol–induced damage of the heart muscle (i.e., cardiomyopathy) (6), and nerve damage (i.e., peripheral neuropathy) (7) after fewer years of heavy drinking than do alcoholic men. Studies comparing men and women’s sensitivity to alcohol–induced brain damage, however, have not been as conclusive.
Using imaging with computerized tomography, two studies (8,9) compared brain shrinkage, a common indicator of brain damage, in alcoholic men and women and reported that male and female alcoholics both showed significantly greater brain shrinkage than control subjects. Studies also showed that both men and women have similar learning and memory problems as a result of heavy drinking (10). The difference is that alcoholic women reported that they had been drinking excessively for only about half as long as the alcoholic men in these studies. This indicates that women’s brains, like their other organs, are more vulnerable to alcohol–induced damage than men’s (11).
Yet other studies have not shown such definitive findings. In fact, two reports appearing side by side in the American Journal of Psychiatry contradicted each other on the question of gender–related vulnerability to brain shrinkage in alcoholism (12,13). Clearly, more research is needed on this topic, especially because alcoholic women have received less research attention than alcoholic men despite good evidence that women may be particularly vulnerable to alcohol’s effects on many key organ systems.

BRAIN DAMAGE FROM OTHER CAUSES

People who have been drinking large amounts of alcohol for long periods of time run the risk of developing serious and persistent changes in the brain. Damage may be a result of the direct effects of alcohol on the brain or may result indirectly, from a poor general health status or from severe liver disease.
For example, thiamine deficiency is a common occurrence in people with alcoholism and results from poor overall nutrition. Thiamine, also known as vitamin B1, is an essential nutrient required by all tissues, including the brain. Thiamine is found in foods such as meat and poultry; whole grain cereals; nuts; and dried beans, peas, and soybeans. Many foods in the United States commonly are fortified with thiamine, including breads and cereals. As a result, most people consume sufficient amounts of thiamine in their diets. The typical intake for most Americans is 2 mg/day; the Recommended Daily Allowance is 1.2 mg/day for men and 1.1 mg/day for women (14).

Wernicke–Korsakoff Syndrome

Up to 80 percent of alcoholics, however, have a deficiency in thiamine (15), and some of these people will go on to develop serious brain disorders such as Wernicke–Korsakoff syndrome (WKS) (16). WKS is a disease that consists of two separate syndromes, a short–lived and severe condition called Wernicke’s encephalopathy and a long–lasting and debilitating condition known as Korsakoff’s psychosis.
The symptoms of Wernicke’s encephalopathy include mental confusion, paralysis of the nerves that move the eyes (i.e., oculomotor disturbances), and difficulty with muscle coordination. For example, patients with Wernicke’s encephalopathy may be too confused to find their way out of a room or may not even be able to walk. Many Wernicke’s encephalopathy patients, however, do not exhibit all three of these signs and symptoms, and clinicians working with alcoholics must be aware that this disorder may be present even if the patient shows only one or two of them. In fact, studies performed after death indicate that many cases of thiamine deficiency–related encephalopathy may not be diagnosed in life because not all the “classic” signs and symptoms were present or recognized.

Human Brain

Schematic drawing of the human brain, showing regions vulnerable to alcoholism-related abnormalities.

Approximately 80 to 90 percent of alcoholics with Wernicke’s encephalopathy also develop Korsakoff’s psychosis, a chronic and debilitating syndrome characterized by persistent learning and memory problems. Patients with Korsakoff’s psychosis are forgetful and quickly frustrated and have difficulty with walking and coordination (17). Although these patients have problems remembering old information (i.e., retrograde amnesia), it is their difficulty in “laying down” new information (i.e., anterograde amnesia) that is the most striking. For example, these patients can discuss in detail an event in their lives, but an hour later might not remember ever having the conversation.
Treatment

The cerebellum, an area of the brain responsible for coordinating movement and perhaps even some forms of learning, appears to be particularly sensitive to the effects of thiamine deficiency and is the region most frequently damaged in association with chronic alcohol consumption. Administering thiamine helps to improve brain function, especially in patients in the early stages of WKS. When damage to the brain is more severe, the course of care shifts from treatment to providing support to the patient and his or her family (18). Custodial care may be necessary for the 25 percent of patients who have permanent brain damage and significant loss of cognitive skills (19).
Scientists believe that a genetic variation could be one explanation for why only some alcoholics with thiamine deficiency go on to develop severe conditions such as WKS, but additional studies are necessary to clarify how genetic variants might cause some people to be more vulnerable to WKS than others.

LIVER DISEASE

Most people realize that heavy, long–term drinking can damage the liver, the organ chiefly responsible for breaking down alcohol into harmless byproducts and clearing it from the body. But people may not be aware that prolonged liver dysfunction, such as liver cirrhosis resulting from excessive alcohol consumption, can harm the brain, leading to a serious and potentially fatal brain disorder known as hepatic encephalopathy (20).
Hepatic encephalopathy can cause changes in sleep patterns, mood, and personality; psychiatric conditions such as anxiety and depression; severe cognitive effects such as shortened attention span; and problems with coordination such as a flapping or shaking of the hands (called asterixis). In the most serious cases, patients may slip into a coma (i.e., hepatic coma), which can be fatal.
New imaging techniques have enabled researchers to study specific brain regions in patients with alcoholic liver disease, giving them a better understanding of how hepatic encephalopathy develops. These studies have confirmed that at least two toxic substances, ammonia and manganese, have a role in the development of hepatic encephalopathy. Alcohol–damaged liver cells allow excess amounts of these harmful byproducts to enter the brain, thus harming brain cells.
Treatment

Physicians typically use the following strategies to prevent or treat the development of hepatic encephalopathy.

• Treatment that lowers blood ammonia concentrations, such as administering L–ornithine L–aspartate.
• Techniques such as liver–assist devices, or “artificial livers,” that clear the patients’ blood of harmful toxins. In initial studies, patients using these devices showed lower amounts of ammonia circulating in their blood, and their encephalopathy became less severe (21).
• Liver transplantation, an approach that is widely used in alcoholic cirrhotic patients with severe (i.e., end–stage) chronic liver failure. In general, implantation of a new liver results in significant improvements in cognitive function in these patients (22) and lowers their levels of ammonia and manganese (23).

ALCOHOL AND THE DEVELOPING BRAIN

Drinking during pregnancy can lead to a range of physical, learning, and behavioral effects in the developing brain, the most serious of which is a collection of symptoms known as fetal alcohol syndrome (FAS). Children with FAS may have distinct facial features (see illustration). FAS infants also are markedly smaller than average. Their brains may have less volume (i.e., microencephaly). And they may have fewer numbers of brain cells (i.e., neurons) or fewer neurons that are able to function correctly, leading to long–term problems in learning and behavior.

Fetal Alcohol Syndrome

Children with fetal alcohol syndrome (FAS) may have distinct facial features.

Treatment

Scientists are investigating the use of complex motor training and medications to prevent or reverse the alcohol–related brain damage found in people prenatally exposed to alcohol (24). In a study using rats, Klintsova and colleagues (25) used an obstacle course to teach complex motor skills, and this skills training led to a re–organization in the adult rats’ brains (i.e., cerebellum), enabling them to overcome the effects of the prenatal alcohol exposure. These findings have important therapeutic implications, suggesting that complex rehabilitative motor training can improve motor performance of children, or even adults, with FAS.
Scientists also are looking at the possibility of developing medications that can help alleviate or prevent brain damage, such as that associated with FAS. Studies using animals have yielded encouraging results for treatments using antioxidant therapy and vitamin E. Other preventive therapies showing promise in animal studies include 1–octanol, which ironically is an alcohol itself. Treatment with l–octanol significantly reduced the severity of alcohol’s effects on developing mouse embryos (26). Two molecules associated with normal development (i.e., NAP and SAL) have been found to protect nerve cells against a variety of toxins in much the same way that octanol does (27). And a compound (MK–801) that blocks a key brain chemical associated with alcohol withdrawal (i.e., glutamate) also is being studied. MK–801 reversed a specific learning impairment that resulted from early postnatal alcohol exposure (28).
Though these compounds were effective in animals, the positive results cited here may or may not translate to humans. Not drinking during pregnancy is the best form of prevention; FAS remains the leading preventable birth defect in the United States today.

GROWING NEW BRAIN CELLS

For decades scientists believed that the number of nerve cells in the adult brain was fixed early in life. If brain damage occurred, then, the best way to treat it was by strengthening the existing neurons, as new ones could not be added. In the 1960s, however, researchers found that new neurons are indeed generated in adulthood—a process called neurogenesis (29). These new cells originate from stem cells, which are cells that can divide indefinitely, renew themselves, and give rise to a variety of cell types. The discovery of brain stem cells and adult neurogenesis provides a new way of approaching the problem of alcohol–related changes in the brain and may lead to a clearer understanding of how best to treat and cure alcoholism (30).
For example, studies with animals show that high doses of alcohol lead to a disruption in the growth of new brain cells; scientists believe it may be this lack of new growth that results in the long–term deficits found in key areas of the brain (such as hippocampal structure and function) (31,32). Understanding how alcohol interacts with brain stem cells and what happens to these cells in alcoholics is the first step in establishing whether the use of stem cell therapies is an option for treatment (33).

SUMMARY

Alcoholics are not all alike. They experience different degrees of impairment, and the disease has different origins for different people. Consequently, researchers have not found conclusive evidence that any one variable is solely responsible for the brain deficits found in alcoholics. Characterizing what makes some alcoholics vulnerable to brain damage whereas others are not remains the subject of active research (34).
The good news is that most alcoholics with cognitive impairment show at least some improvement in brain structure and functioning within a year of abstinence, though some people take much longer (35–37). Clinicians must consider a variety of treatment methods to help people stop drinking and to recover from alcohol–related brain impairments, and tailor these treatments to the individual patient.
Advanced technology will have an important role in developing these therapies. Clinicians can use brain–imaging techniques to monitor the course and success of treatment, because imaging can reveal structural, functional, and biochemical changes in living patients over time. Promising new medications also are in the early stages of development, as researchers strive to design therapies that can help prevent alcohol’s harmful effects and promote the growth of new brain cells to take the place of those that have been damaged by alcohol.

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Antibiotic-resistant bacteria disarmed with fungus compound

Fungal compound makes superbugs susceptible to conventional antibiotic defence

 

Researchers at McMaster University in Hamilton have discovered a way to disarm one of the most frightening weapons bacteria have developed to resist antibiotic drugs. And they discovered this potentially lifesaving compound in an unlikely place: a soil sample from a national park in  Nova Scotia. The discovery is featured today on the cover of the prestigious journal Nature.

 

"Our finding offers the first hope that we might be able to get around this resistance mechanism," said Prof. Gerry Wright, who led the research.

 

The discovery targets antibiotic-resistant "superbugs," which produce an enzyme called NDM-1 (New Delhi metallo-beta-lactamase), allowing them to fight off almost every antibiotic in the medicine cabinet, including carbepenems — an important class of drugs that doctors keep in reserve as a last resort against multi-resistant bacteria.  The emergence of NDM-1 in pathogens such as E. coli has turned formerly treatable infections into potentially deadly diseases. The only weapons left on the shelf are highly toxic with extreme side-effects, and doctors predict the bugs will soon develop resistance even to those drugs.

 

"It’s an antibiotic resistance enzyme that we didn’t really know about until about five years ago. It has spread around the world and multiple organisms have acquired it, and so it’s become a pretty significant public health threat in a very short period of time," Wright said.

 

"NDM-1 is the pinnacle of antibiotic resistance," said Dr. John Conly, director of the Centre for Antimicrobial Resistance at the University of Calgary. NDM-1 has spread to every continent except Antarctica, and there have been NDM-1 outbreaks in Canada, including in B.C.’s Fraser Valley.  

 

With so much concern in the medical community, Wright went looking for something that could tackle NDM-1. What he found was sitting in a refrigerator in his laboratory. That’s where he keeps his collection of soil bacteria, harvested from random samples of Canadian dirt that he has asked students and friends to collect as they travel around the country.

 

Those bacteria produce hundreds of chemical compounds, which they use to defend themselves against other bacteria — chemicals that might ultimately become the basis of future drugs for humans.

 

"We screened that collection for molecules that would reverse this resistance, that would block this NDM-1 protein," Wright said, "and lo and behold, we found one."

 

The compound they discovered is produced by the Aspergillus fungus. It was harvested from a forest soil sample collected by one of Wright’s students who was hiking in Kejimkuijik National Park near Caledonia, N.S.

 

The molecule is called AMA (aspergillomarasmine A). Once it was isolated, the researchers checked the chemical structure on a computer database and realized they had rediscovered a long-discarded compound, first identified in the 1960s as a cause of leaf wilt in plants.

 

"It had been catalogued," Wright said, "and then no one ever thought of it again as being useful until we repurified it one more time 50 years later."

 

AMA works not by killing the bacteria, but by turning off the resistance mechanism, making the bacteria vulnerable to an existing drug again.

 

The goal is to develop AMA into a compound that could be used along with older antibiotics, a combination approach that, if it works in humans, could reverse antibiotic resistance, and breathe new life into the antibiotic arsenal.

 

"The drugs that we have are fantastic. We’ve used them for years, we know how to treat patients with them. Clinicians are familiar with their side-effects, they’re familiar with how to dose them," Wright said. "If we can stop the resistance, then we get to use the drugs again."

 

The World Health Organization has called antibiotic resistance an international public health threat. In April, it warned that the world is headed for a post-antibiotic era where common infections and minor injuries could become fatal if bacteria can fight off all of the existing drugs. Already, Canadian doctors report that up to 25 per cent of formerly routine urinary tract infections are resistant to common antibiotics.

 

As resistance grows, the supply of new drugs dwindles. Many of the large pharmaceutical companies have gotten out of the antibiotics business, partly because the challenges in finding effective new compounds, along with regulatory hurdles, mean the antibiotic business is no longer profitable.  

 

All of that means there are few new antibiotics in the drug development pipeline. That’s why researchers are now exploring the idea of using a combination approach to disarm resistant bacteria and make them vulnerable to the old drugs.

 

"We need to look at synergistic ways to attack bacteria, rather than one drug," said Dr. David Patrick, medical epidemiology lead for antimicrobial resistance at the B.C. Centre for Disease Control. "It’s a wonderful discovery, if it can bridge the gap from test tube to people."

 

"This may rank as a very significant discovery, provided this agent is non-toxic in humans," said Conly.

 

So far, the McMaster researchers have shown that the compound is effective against bacteria carrying NDM-1. They’ve also shown that it fights infection in mice and rats.

 

But it still must be extensively tested in humans to see if it works and to discover possible side-effects. And at this point, the biggest hurdle is convincing a drug company to make the multimillion dollar investment to begin the long process of moving the discovery from the lab to the pharmacy shelf.$

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Antibody That Protects Against Hendra Virus Proves Effective Against Deadly Nipah "Contagion" Virus

The human monoclonal antibody known as m102.4, which has proven effective in protecting against the frequently fatal Hendra virus, has now been shown in studies to protect against the closely related Nipah virus -- the basis of the 2011 movie "Contagion" -- a highly infectious and deadly agent that results in acute respiratory distress syndrome and encephalitis, person-to-person transmission, and greater than 90 percent case fatality rates among humans. The results of the study, conducted by a team of Federal and university scientists, will appear in Science Translational Medicine online: “Therapeutic Treatment of Nipah Virus Infection in Nonhuman Primates with a Neutralizing Human Monoclonal Antibody." The full study will be available following the release of the embargo at 2 p.m. June 25, 2014.

 

The collaborative research team members are from the Uniformed Services University of the Health Sciences (USU), the University of Texas Medical Branch (UTMB) and Galveston National Laboratory (GNL), the National Institutes of Health (NIH’s) National Institute of Allergy and Infectious Diseases (NIAID) and Rocky Mountain Laboratories (RML), and the National Cancer Institute (NCI), NIH.

 

Nipah virus and the closely related Hendra virus are naturally found in Pteropid fruit bats (flying foxes). They are considered emerging viruses and are capable of causing severe illness and death in a variety of domestic animals and humans.

 

In experiments carried out in non-human primates at the GNL in Galveston, Texas, where there is a high-containment facility for working with live Nipah virus, the team of researchers, under the direction of Thomas W. Geisbert, Ph.D., professor, in the Department of Microbiology, UTMB and study corresponding author, demonstrated that administering a human monoclonal antibody therapy after exposure to Nipah virus protected the animals from disease.

 

“Previously, our team showed that this same antibody therapy could protect nonhuman primates from a deadly Hendra virus infection, but here we have shown for the very first time, that not only does this antibody protect against Nipah virus infection, but remarkably can do so even when given the therapy much later after infection and when the animals show clinical signs of disease. What this means is that as far as people are concerned these latest findings strongly suggest that a real potential treatment for Nipah virus infection is at hand,” said Christopher C. Broder, Ph.D., professor of Microbiology at USU and also study corresponding author.

 

It was earlier work at USU and NCI, supported by NIAID that isolated and characterized the monoclonal antibody known as m102.4. The antibody attacks a critical component of Nipah and Hendra viruses and blocks their ability to infect cells. Antibodies – proteins found in blood or other bodily fluids of vertebrates – are used by the immune system to identify and neutralize viruses and bacteria.

 

“This recent success of the antibody therapy against Nipah virus disease in a nonhuman primate is a key step towards its development as a therapeutic for use in people,” according to Dr. Geisbert.

 

“There are no other effective therapeutic options for Nipah virus infection,” according to Dr. Broder. “Indeed, because of data now reported here, and from our previous work with this antibody in Hendra virus experiments, there was sufficient interest for the Queensland government in Australia to initiate a phase I clinical safety trial with m102.4 that is set to commence later this year.”

 

Nipah virus and Hendra virus, members of the paramyxovirus family, are highly infectious agents that emerged from flying foxes in the 1990s to cause serious disease outbreaks in humans and livestock in Australia, Malaysia, Singapore, Bangladesh and India.

 

“There are currently no licensed and approved vaccines or therapeutics for prevention and treatment of disease caused by these viruses for humans or livestock,” said Dr. Geisbert. “This human monoclonal antibody is the first effective antiviral drug against Nipah virus and Hendra virus that has a real potential for human therapeutic applications.”

 

The human monoclonal antibody, m102.4, is protected under issued and pending patents in many countries around the world.

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A Bright, New Future for Prostate Cancer

 

New tests and methods take on the most commonly diagnosed cancer in men

 

Prostate cancer is the most commonly diagnosed cancer in males, with about 240,000 diagnoses expected this year. And there are 2.5 million people currently living with this disease. Recently there have been some dramatic changes in the way prostate cancer is diagnosed and treated. Wayne Waltzer, MD, Chairman, Department of Urology, Stony Brook Medicine explains these major medical advances and what they mean for men across the nation.

 

“With prostate cancer being the number one solid organ cancers in most country, it is important for all men to be vigilant about getting screened,” says Dr. Waltzer. “And a newly developed series of genetic tests is now offering a more accurate and individualized approach in identifying and treating prostate cancer.”

 

Currently there are various blood tests in use. One is called the Prostate Health Index (PHI) and the other is called the 4K test. Both measure the variance of the PSA in the blood and are designed to reduce the number of unnecessary negative biopsies that detect only low-grade cancer. “This means that not all men with elevated PSA levels will require a biopsy, with its potential for complications and side effects,” says Dr. Waltzer.

 

There are also new tests available that help to further individualize biopsies, if one is required. “If the biopsy is positive for cancer, two tests — the Polaris and the Genomic Prostate Score — help doctors distinguish between aggressive cancers that need treatment and those that are slow growing and may need only the “watch and wait” approach,” says Dr. Waltzer. “These tests work by measuring a series of genomic patterns to reveal how the cancer cells are wired to behave.”

 

If the biopsy is negative but you still have elevated PSA levels, there is now a test called Confirm MDX that helps ensure that cancer cells were not missed during the biopsy. “The biopsy may have sampled tissue that was in an area where there were no cancer cells,” says Dr. Waltzer. “This could give you a false negative. This new test looks for hyper methylation, which indicates the presence of individual prostate cancer tissue near the site of the biopsy.”

 

If no hyper methylation is detected, the biopsy is considered negative. If some is detected, additional testing will be needed. Another test, the PCA3 test is also available in case of negative biopsy. This gene-based urine test offers additional information on the probability of finding prostate cancer in the biopsy.

 

In addition, if you have had prostate cancer surgery, there are genetic tests post-surgery that help determine whether additional treatment is needed based on the genetic composition of the cancer cells and the risks associated with it.

 

“These new tests, which are available at Stony Brook Medicine, are absolutely the future for cancer diagnostics — and not just for prostate cancer,” says Dr. Waltzer. “These innovations are happening for almost every form of cancer, with more on the horizon.” 

 

Dr. Waltzer says, gene analysis of tissue, the study of genetic markers, patterns, sequencing and abnormalities, is providing physicians with unprecedented information on who to treat and how to treat them. “Not only is it helping us to find the most appropriate approach and treatment for people with cancer, but it also keeping many people with the less aggressive forms of the disease from undergoing the rigors of treatment unnecessarily. This is both a health issue and a quality of life issue. 

 

The fact that we can take such a highly individualized approach for very specific forms of cancer also means that we can look forward to better and more predictable outcomes.”

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