Obesity link to increased risk for orthopedic conditions and surgical complications

ROSEMONT, Ill.—Obesity affects individual patient care, the healthcare system and nearly every organ in the body. People with obesity often have other health problems, including diabetes, heart disease, certain tumors and cancers, and psychiatric disorders. However, the role of obesity in orthopaedic conditions and their treatment is less well-publicized.

According to orthopaedic surgeon William M. Mihalko, MD, PhD, of Campbell Clinic Orthopaedics in Memphis, Tenn., “obesity can accompany a multitude of comorbidities that can have a significant impact on a patient’s outcome from elective orthopaedic surgery.” He and his co-authors of “Obesity, Orthopaedics, and Outcomes,” a study published in the November issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), suggest that even though patients with obesity face higher surgical complication rates, orthopaedic procedures can help minimize pain and improve bone and joint function.

The Pains of Excess Weight

Obesity is a strong independent risk factor for pain. Adolescents with obesity were more likely to report musculoskeletal pain, including chronic regional pain, than their normal-weight peers. The disease nearly doubles the risk of chronic pain among the elderly—causing pain in soft-tissue structures such as tendons and ligaments, and worsening conditions such as fibromyalgia in individuals already living with constant pain in their muscles and joints.

Obesity and Osteoarthritis

Osteoarthritis (OA)—a progressive “wear and tear” disease of the joints—is frequently associated with obesity. Every pound of body weight places four to six pounds of pressure on each knee joint. Research suggests that excess weight increases pressure, or the biomechanical load, on the knees and increases the likelihood of wearing away the cushioning surface of the knee joint, resulting in the development of OA and the need for total knee arthroplasty (TKA). The need for a TKA is estimated to be at least 8.5 times higher among patients with a body mass index (BMI) greater than or equal to 30, compared with patients who have a BMI within the normal range of 18.5 to 24.9.

Obesity and Injury

In addition to the increased likelihood of wear and tear on joints, excess weight also affects injury status. The odds of sustaining musculoskeletal injuries is 15 percent higher for persons who are overweight and 48 percent higher for people who are obese, compared to persons of normal weight.

Statistically, overweight and obese children also have significantly greater odds of lower extremity injuries and pain than do children of normal weight. Back and lower extremity pain, especially of the knee and foot, are more common among children with obesity.

Pre-Surgical Considerations

“Although no upper weight limits have been established that would contra-indicate elective orthopaedic surgery, every surgeon must understand the unique risks an obese patient faces and understand how to optimize and treat each of these patients on an individual basis,” says Dr. Mihalko. The study authors recommend that patients with morbid obesity (BMI of 40 or higher) be:

  • advised to lose weight before total joint arthroplasty (TJA);
  • offered resources for weight loss before surgery; and,
  • counseled about the possible complications and inferior results that may occur if they do not lose weight.

While patients with obesity may experience slower recovery and higher risks of surgical complications that can compromise outcomes, outweighing the functional benefits of TJA in some cases, orthopaedic interventions still can provide improvements in quality of life for even super-obese patients. Source

Posted in Exercise: Benefits, Obesity, World Health: Obesity | Leave a comment

Why some women are crying at the gym

@jess7bennett

For a generation of stressed-out working women, exercise is as much about emotional release as it is physical training.

It’s 7am on a Tuesday, at a small dance studio in Manhattan’s Tribeca neighborhood, and Taryn Toomey is stomping her feet into the floor like thunder. “Get rid of the bullsh*t!” she shouts. “Get rid of the drama!”

Two dozen women in yoga pants and sports bras sprint in place behind her, eyes closed, arms flailing. Sweat is flying.

The Beastie Boys’ “Sabotage” is blaring in the background. There are grunts and screams.

“Hell yes!” a woman bellows.

When the song ends, Toomey directs the group into child’s pose, torso folded over the knees, forehead on the floor, arms spread forward.

Coldplay comes on, and there is a moment of rest.

“Inhale. Exhale. Feel your center,” Toomey says.

Heads slowly come up, and suddenly, tears are streaming down the faces of half the room.

A woman in front of me is physically trembling. “I just let it all out,” a middle-aged woman in leggings and a tank top whispers.

This is “The Class”—one part yoga, two parts bootcamp, three parts emotional release, packaged into an almost spiritual… no, tribal… 75 minutes.

It is the creation of fashion exec turned yoga instructor Toomey, and it is where New York’s high-flying women go for emotional release (if, that is, they can get a spot). More

Posted in Commercial Fitness Industry, Exercise: Benefits, Human Behavior: Stress | Leave a comment

The frozen food folks say their stuff is better for you than junk food

ATLANTA (October 20, 2014) – New data presented today indicate that consumers of frozen meals (1) had higher daily intakes of dietary fiber, potassium, calcium and protein, and lower daily intakes of calories and saturated fat than consumers of quick service restaurant (QSR) meals (2). The poster, Consumption of Frozen Meals as Compared to Quick Service Restaurant Meals is Associated with Better Nutrient Intakes in Adult Participants of The National Health and Nutrition Examination Survey (2003-2010), was presented at the 2014 Academy of Nutrition and Dietetics Food & Nutrition Conference & Expo (3).

“The analysis shows adults (19+ years) who reported eating frozen meals have higher daily intakes of more than 12 important nutrients – including protein, dietary fiber, potassium, calcium, vitamin A, riboflavin, vitamin B6, vitamin C, vitamin E, choline, magnesium and copper – than those who reported eating quick service restaurant meals, and they do it with 253 fewer calories and 2.6 grams less saturated fat a day,” said Dr. Victor L. Fulgoni, co-author of the analysis and vice president of Nutrition Impact, LLC.

Those who Report Dining on Frozen Meals Eat Less Calories and Get More Essential Nutrients

Specifically, the analysis revealed that frozen meal consumers, compared to QSR consumers:

  • Eat 253 fewer calories a day
  • Eat less saturated fat per day (2.6 grams less saturated fat per day)
  • Have higher daily intakes of three of the four nutrients the Dietary Guidelines recommends increasing including:
    • 3.9 more grams (16 percent of the daily value) of dietary fiber (18.2±0.5 g/d frozen meal consumers vs 14.3±0.2 g/d QSR consumers); that’s as much fiber as one cup of cooked, instant oatmeal
    • 511 more mg (15 percent of the daily value) of potassium (3008±63 mg/d frozen meal consumers vs 2497±20 mg/d QSR consumers); that’s as much potassium as a medium banana
    • 135 more mg (14 percent of the daily value) of calcium (1059±43 mg/d frozen meal consumers vs 924±11 mg/d QSR consumers); that’s nearly as much calcium as half a cup of milk
  • Have higher daily protein intakes (90.0±2.2 g/d frozen meal consumers vs 81.5±0.5 g/d QSR consumers) with 8.5 more grams of protein a day; that’s as much protein as 1.5 eggs

“This research is further evidence that frozen meals can play an important role in helping Americans obtain key nutrients of concern highlighted in the US Dietary Guidelines while maintaining calorie and fat levels,” said Kim Krumhar, Ph.D., Scientific Advisor – Nutrition, Nestlé.

Frozen Meals Are Associated with Better Diet Quality

This abstract is a follow-up to data, Consumption of frozen meals as compared to quick service restaurant meals is associated with better diet quality in adult participants of the National Health and Nutrition Examination Survey (2003-2010), presented at the 2014 Experimental Biology Conference which indicated that people who reported eating frozen meals over QSR have better diet quality and come closer to meeting the Dietary Guidelines recommendations for fruits, vegetables, dark green and orange vegetables, greens and beans, whole grains, and total protein foods. Source

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Antibiotic content in farm-raised fish

Antibiotics—one of modernity’s great success stories—are charms that come with a curse. Their overuse in human and animal populations can lead to the development of resistant microbial strains, posing a dire threat to global health.

In a new study, Hansa Done, PhD candidate, and Rolf Halden, PhD, researchers at Arizona State University’s Biodesign Institute, examine antibiotic use in the rapidly expanding world of global aquaculture.

Done and Halden measured the presence of antibiotics in shrimp, salmon, catfish, trout, tilapia and swai, originating from 11 countries. Data showed traces of 5 of the 47 antibiotics evaluated.

The research findings and a discussion of their implications appear in the current issue of the Journal of Hazardous Materials.

Charting resistance

The menace of germs bearing resistance to our best medical defenses is reaching crisis proportions. Each year, resistant microbes sicken some 2 million people in the U.S. alone and kill about 23, 000, according to the Infectious Diseases Society of America.

On September 18, President Obama proposed the first governmental steps to address the problem, establishing a task force to be co-chaired by the secretaries of Health and Human Services, the Department of Defense, and the Department of Agriculture.

The new initiative to reign in antibiotic overuse has been welcomed in the medical community, though many believe that much more needs to be done to safeguard society. The chief complaint is that the proposed measures largely ignore the largest consumers of antibiotics—animals farmed for human consumption, including fish.

“The threat of living in a post-antibiotic era cannot be avoided without revising current practices in the use of antibiotics in animal husbandry, including in aquaculture,” says Halden.

Halden, who directs the Biodesign Institute’s Center for Environmental Security, is a leading authority on the human and environmental impact of chemicals, (particularly their fate once their useful life has ended). In previous research, he has explored the intricate pathways from production to postconsumption fate of antimicrobials and the risks posed.

The new study examines the persistence of antibiotics in seafood raised by modern aquaculture. The research area is largely unexplored, as the primary focus of studies of antibiotics has been on drugs used in human medicine. The current research is the first to evaluate previously unmonitored antibiotics; it represents the largest reconnaissance conducted to date on antibiotics present in seafood.

Farming lifestyle

Aquaculture has undergone rapid growth to meet the burgeoning global demand, nearly tripling over the past 20 years to an estimated 83 million metric tons in 2013. The large increase has led to widespread antibiotic use, applied both to prevent and treat pathogens known to infect fish. The broad effects on health and the environment associated with these practices remain speculative.

Several natural mechanisms exist to help pathogenic microbes evade immune responses or develop drug resistance over time. The overuse of antibiotics, whether for human ingestion in hospitals or for agricultural or aquacultural use, can seriously exacerbate this problem, enriching microbes that bear particular genetic mutations, rendering them antibiotic resistant. In a biological arms race, antibiotics applied to combat disease run the risk of producing multi-drug resistant organisms that are increasingly difficult to kill.

In the new study, 27 seafood samples were examined for the presence of antibiotics. The samples represent five of the top 10 most consumed seafood varieties in the U.S.: shrimp, tilapia, catfish, swai, and Atlantic salmon. The National Oceanic and Atmospheric Administration (NOAA) acquired the samples from stores in Arizona and California.

Five antibiotics were present in detectable amounts: oxytetracycline in wild shrimp, farmed tilapia, farmed salmon and farmed trout; 4-epioxytetracycline in farmed salmon, sulfadimethoxine in farmed shrimp, ormetoprim in farmed salmon, and virginiamycin in farmed salmon that had been marketed as antibiotic-free.

Oxytetracycline, the most commonly used antibiotic in aquaculture, was the most prevalent in the study samples. Surprisingly, the study also detected this antibiotic in wild-caught shrimp imported from Mexico, which the authors suggest may be due to mislabeling, coastal pollution from sewage contamination, or cross-contamination during handling and processing.

On the bright side, all seafood analyzed was found to be in compliance with U.S. FDA regulations; however, the authors note that sub-regulatory antibiotic levels can promote resistance development, according to their extensive meta-analysis of existing literature. (Publications linking aquaculture with antibiotic resistance have increased more than 8-fold from 1991-2013.)

Antibiotics also have the potential to affect the animals themselves, producing alterations in how genes are turned on or off and physiological anomalies. (The latter may include malformations of the spine in trout exposed to the antibiotic oxytetracycline, though more work will be needed to clarify this association.)

Proper monitoring of antibiotic residues in seafood is particularly critical, due to the fact that many antibiotics used in aquaculture are also used in human medicine, for example amoxicillin and ampicillin—common therapeutics for the treatment of bacterial infections, including pneumonia and gastroenteritis.

The future of fish

The use of antibiotics in aquaculture can produce a variety of unintended consequences in addition to antibiotic resistance, including antibiotic dissemination into the surrounding environment, residual concentrations remaining in seafood, and high antibiotic exposure for personnel working in aquaculture facilities.

Changes in aquaculture are needed to ensure the practice can be carried out on a large scale in a sustainable manner. Currently, massive aquaculture operations threaten the health of seas, due to large volumes of fish waste emitted, containing excess nutrients, large amounts of pathogens, and drug resistance genes.

Additionally, many types of farmed fish rely on fishmeal produced from by-catch caught in fishing nets. Several pounds of fishmeal are often required to raise a single pound of farmed fish, thereby contributing to the overfishing of the seas and depletion of ocean diversity.

The current study offers a warning that antibiotics present at levels well below regulatory limits can still promote the development of drug-resistant microorganisms. The dramatic increase in resistant and multi-drug resistant bacterial strains documented over the past three decades indicates that much more thorough monitoring of seafood supplies is needed and a better scientific understanding of the nexus of global aquaculture, antibiotic use, drug resistance emergence, and regulatory measures. Source

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Sport in old age can stimulate brain fitness, but effect decreases with advancing age

Physical exercise in old age can improve brain perfusion as well as certain memory skills. This is the finding of Magdeburg neuroscientists who studied men and women aged between 60 and 77. In younger individuals regular training on a treadmill tended to improve cerebral blood flow and visual memory. However, trial participants who were older than 70 years of age tended to show no benefit of exercise. Thus, the study also indicates that the benefits of exercise may be limited by advancing age. Researchers of the German Center for Neurodegenerative Diseases (DZNE), the University of Magdeburg and the Leibniz Institute for Neurobiology have published these results in the current edition of the journal Molecular Psychiatry. Scientists at the Karolinska Institute in Stockholm and the Max Planck Institute for Human Development were also involved in the study.

The 40 test volunteers were healthy for their age, sedentary when the study commenced and divided into two groups. About half of the study participants exercised regularly on a treadmill for 3 months. The other individuals merely performed muscle relaxation sessions. In 7 out of 9 members of the exercise group who were not more than 70 years old, the training improved physical fitness and also tended to increase perfusion in the hippocampus – an area of the brain which is important for memory function. The increased perfusion was accompanied by improved visual memory: at the end of the study, these individuals found it easier to memorize abstract images than at the beginning of the training program. These effects were largely absent in older volunteers who participated in the workout as well as in the members of the control group.

The study included extensive tests of the volunteers’ physical condition and memory. Furthermore, the study participants were examined by magnetic resonance imaging (MRI). This technique enables detailed insights into the interior of the brain.

Exercising against dementia

Physical exercise is known to have considerable health benefits: the effects on the body have been researched extensively, the effects on brain function less so. An increase in brain perfusion through physical exercise had previously only been demonstrated empirically in younger people. The new study shows that some ageing brains also retain this ability to adapt, even though it seems to decrease with advancing age. Furthermore, the results indicate that changes in memory performance resulting from physical exercise are closely linked to changes in brain perfusion.

“Ultimately, we aim to develop measures to purposefully counteract dementia such as Alzheimer’s disease. This is why we want to understand the effects of physical exercise on the brain and the related neurobiological mechanisms. This is essential for developing treatments that are truly effective,” is how Professor Emrah Düzel, site speaker of the DZNE in Magdeburg and director of the Institute of Cognitive Neurology and Dementia Research at the University of Magdeburg, explains the background to the study.

The goal: new brain cells

The researchers’ goal is to cause new nerve cells to grow in the brain. This is how they intend to counter the loss of neurons typical of dementia. “The human brain is able to change and evolve throughout our lives. New nerve cells can form even in adult brains,” says Düzel. “Our aim is to stimulate this so-called neurogenesis. We don’t yet know whether our training methods promote the development of new brain cells. However, fundamental research shows that the formation of new brain cells often goes hand in hand with improved brain perfusion.”

Changes in the hippocampus

Indeed, it did turn out that the treadmill exercise sessions caused more blood to reach the hippocampus in younger participants. “This improves the supply of oxygen and nutrients and may also have other positive effects on the brain’s metabolism,” says the neuroscientist. “However, we have also seen that the effect of the training decreases with age. It is less effective in people aged over 70 than in people in their early 60s. It will be an important goal of our research to understand the causes for this and to find remedies.”

Düzel adds: “It is encouraging to see that visual memory improved as brain perfusion increased. However, effective treatments would also have to affect other brain functions. In our study, the effect was limited to visual short-term memory.”

A combined training for body and mind

Other experiments are now under way in Magdeburg in which test participants are sent on an unusual kind of scavenger hunt: they are assigned the task of finding objects concealed in a computer-generated landscape which is pictured on a large screen. Movement control in this virtual world is done with the help of a treadmill. “This complex situation makes high demands on motor skills and sense of orientation,” explains Düzel. “It challenges both the brain as well as the muscles.”

In the long term, the scientists aim to include people in the early stages of Alzheimer’s disease in their study program. “We are looking for ways of delaying or even stopping the progression of the disease. And we are also researching methods of prevention,” emphasizes Düzel. “Connecting physical activity and mental exercise may have a broad impact, and combined training might become a therapeutic approach. However, this has yet to be shown. In fact, our current results suggest that we may need pharmacological treatments to make exercise more effective.”

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Original Publication

“Vascular hippocampal plasticity after aerobic exercise in older adults”, Anne Maass, Sandra Düzel, Monique Goerke, Andreas Becke, Uwe Sobieray, Katja Neumann, Martin Lövden, Ulman Lindenberger, Lars Bäckman, Rüdiger Braun-Dullaeus, Dörte Ahrens, Hans-Jochen Heinze, Notger G. Müller, Emrah Düzel, Molecular Psychiatry, 2014, doi:10.1038/mp.2014.114 (URL: http://www.nature.com/mp/journal/vaop/ncurrent/abs/mp2014114a.html)

The German Center for Neurodegenerative Diseases (DZNE) investigates the causes of diseases of the nervous system and develops strategies for prevention, treatment and care. It is an institution of the Helmholtz Association of German Research Centres with sites in Berlin, Bonn, Dresden, Göttingen, Magdeburg, Munich, Rostock/Greifswald, Tübingen and Witten. The DZNE cooperates closely with universities, their clinics and other research facilities. Source

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Aspirin may benefit those with schizophrenia: new study

Berlin, 20 October 2014 — A new study shows that some anti-inflammatory medicines, such as aspirin, estrogen, and Fluimucil, can improve the efficacy of existing schizophrenia treatments. This work is being presented at the European College of Neuropsychopharmacology conference in Berlin.

For some time, doctors have believed that helping the immune system may benefit the treatment of schizophrenia, but until now there has been no conclusive evidence that this would be effective. Now a group of researchers at the University of Utrecht in the Netherlands has carried out a comprehensive meta-analysis of all robust studies on the effects of adding anti-inflammatories to antipsychotic medication. This has allowed them to conclude that anti-inflammatory medicines, such as aspirin, can add to the effective treatment of schizophrenia.

Research has shown that the immune system is linked to certain psychiatric disorders, such as schizophrenia and bipolar disorder. Schizophrenia in particular is linked to the HLA gene system, which is found on chromosome 6 in humans. The HLA system controls many of the characteristics of the immune system.

According to lead researcher, Professor Iris Sommer (Psychiatry Department, University Medical Centre, Utrecht, Netherlands):

“The picture on anti-inflammatory agents in schizophrenia has been mixed, but this analysis pulls together the data from 26 double-blind randomised controlled trials, and provides significant evidence that some (but not all) anti-inflammatory agents can improve symptoms of patients with schizophrenia. In particular, aspirin, estrogens (in women) and the common antioxidant N-acetylcysteine (fluimicil) show promising results. Other anti-inflammatory agents, including celecoxib, minocycline, davunetide, and fatty acids showed no significant effect”.

In spite the fact that schizophrenia affects around 24 million people worldwide1, treatment has not changed much in over 50 years, and largely relies on correcting the regulation of dopamine in the brain of schizophrenia sufferers. This has been shown to help symptoms such as hallucinations and delusions, but has been unable to help many other symptoms such as decreased energy, lack of motivation and poor concentration. In addition, around 20 to 30% of all patients don’t respond to antipsychotic treatment. Co-treatment with anti-inflammatory agents holds the possibility of improving patient’s response to treatment.

Professor Sommer continued:

“The study makes us realise that we need to be selective about which anti-inflammatory we use. Now that we know that some effects are replicated, we need to refine our methods to see if we can turn it into a real treatment. We have just started a multicenter trial using simvastatine to reduce inflammation in the brain of patients with schizophrenia. Studies like these will provide the proof-of-concept for targeting the immune system in schizophrenia”.

Commenting for the ECNP, Professor Celso Arango (Hospital General Universitario Gregorio Marañón, Madrid) said:

“Inflammation and oxidative stress seem to be important factors in different mental disorders. Patients with different mental conditions, including schizophrenia, have been shown to have reduced antioxidants in the brain as well as excess inflammatory markers. Animal models and clinical trials have shown that antioxidants and anti-inflammatory drugs could not only reduce symptoms associated with the disorders but also prevent the appearance of neurobiological abnormalities and transition to psychosis if given early during brain development. This work is a step towards the possibility of better treatment, but we need more research in this area, especially with younger subjects where we might expect more brain plasticity”. Source

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Fish may ease depression symptoms


Berlin, 20 October 2014  – Up to half of patients who suffer from depression (Major Depressive Disorder, or MDD) do not respond to treatment with SSRIs (Selective Serotonin Reuptake Inhibitors). Now a group of Dutch researchers have carried out a study which shows that increasing fatty fish intake appears to increase the response rate in patients who do not respond to antidepressants. This work is being presented at the European College of Neuropsychopharmacology congress in Berlin.

According to lead researcher, Roel Mocking (Amsterdam):

“We were looking for biological alterations that could explain depression and antidepressant non-response, so we combined two apparently unrelated measures: metabolism of fatty acids and stress hormone regulation. Interestingly, we saw that depressed patients had an altered metabolism of fatty acids, and that this changed metabolism was regulated in a different way by stress hormones”.

The researchers were looking at the relationship between depression and fatty acids, and various hormones, including the stress hormone cortisol. They took 70 patients with depression and compared them to 51 healthy controls, by measuring their fatty acid levels and cortisol levels. They then gave the depressed patients 20mg of an SSRI daily for 6 weeks, and in those who did not respond to the SSRIs the dose was gradually increased up to 50mg/day. Fatty acid and cortisol levels were measured during the trial.

They found that the MDD patients who didn’t respond to the SSRI also tended to have abnormal fatty acid metabolism, so they checked the dietary habits of all those taking part in the trial. Fatty fish is rich in fatty acids, such as the well-known Omega-3 DHA. So the researchers looked at the amount of fatty fish in the diet of all involved in the trial. They categorised the patients into 4 groups, according to their fatty fish intake, and they found that those who took the least fish tended to respond badly to anti-depressants, whereas those who had most fish in the diet responded best to anti-depressants. Those who ate fatty fish at least once a week had a 75% chance of responding to antidepressants, whereas those who never ate fatty fish had only a 23% chance of responding to antidepressants. Roel Mocking continued:

“This means that the alterations in fatty acid metabolism (and their relationship with stress hormone regulation) were associated with future antidepressant response. Importantly, this association was associated with eating fatty fish, which is an important dietary source of omega-3 fatty acids. These findings suggest that measures of fatty acid metabolism, and their association with stress hormone regulation, might be of use in the clinic as an early indicator of future antidepressant response. Moreover, fatty acid metabolism could be influenced by eating fish, which may be a way to improve antidepressant response rates”.

“So far this is an association between fatty acids in blood and anti-depressant response; so it’s not necessarily a causal effect. Our next step is to look at whether these alterations in fatty acid metabolism and hormonal activity are specific for depression, so we are currently repeating these measurements in patients with post-traumatic stress disorder and schizophrenia”.

ECNP President, Professor Guy Goodwin (Oxford) said:

‘Understanding non-response to treatment with SSRIs remains an important known unknown. There is already an intriguing association between eating fish and general health. The present study, while preliminary, takes the story into the realm of depression. Larger scale definitive studies will be of considerable interest”. Source

Posted in Antidepressants, Mental Health: Depression, Nutrition: Fish Oil, Nutrition: Food: Fish, Nutrition: Food: Shellfish | Leave a comment

Panic attacks associated with fear of bright daylight


Berlin, 20 October 2014 – Fear of bright daylight is associated with panic disorder, according to new presented at the ECNP congress in Berlin.

Panic disorder is where a person has recurring and regular panic attacks. In the UK, it affects about two in 100 people, and it’s about twice as common in women as it is in men1. Previous studies have shown that there is a strong seasonal component in panic disorder, but this is the first study to look specifically at panic disorder patients’ reactions to light.

A group of researchers from the University of Siena (Italy) compared 24 patients with panic disorder (PD) against 33 healthy controls. Using a standard Photosensitivity Assessment Questionnaire (PAQ), they found that healthy controls showed a slight (not statistically significant) tendency to be photophilic – to be attracted to bright light. In contrast, the patients with panic disorder showed medium to high levels of aversion to bright light.

The Photosensitivity Assessment Questionnaire asks subjects to agree or disagree with a series of questions about their attitude towards light, for example “My ideal house has large windows” or “Sunlight is so annoying to me, that I have to wear sunglasses when I go out”. The mean values in the Photosensitivity Assessment Questionnaire were as follows: patients with photophobia scored 0.34 (± 0.32 SD), healthy subjects scored 0,11 (± 0,13 SD).

According to lead researcher, Dr Giulia Campinoti:

“There have been several hints that photophobia is associated with panic disorder; for example in some people, fluorescent light can induce panic attacks. It had also been noted that people with panic disorder often protect themselves from light, for example by wearing sunglasses.

We believe that photophobia is one of the elements which may increase the risk of people suffering from panic attacks, but this is a small study, so it needs to be confirmed by a longer-term follow-up trial. For example, we need to understand if the photosensitivity and panic attacks continue to be related over time. If we can confirm this, then we may be able to take steps to avoid some of the triggers to panic attacks. It is important to note that our work shows an association, not necessarily a cause and effect. We don’t yet know exactly what the relationship might be, but there is probably some underlying biochemical basis”.

Commenting for the ECNP, Professor Siegfried Kasper (Vienna) said: “This is a very interesting study that confirms our previous finding that anxiety components within depression cannot be treated with light therapy”. Source

Posted in Human Behavior: Panic Attacks, Mental Health: Anxiety | Leave a comment

Calories are counted automatically by your brain


As you glance over a menu or peruse the shelves in a supermarket, you may be thinking about how each food will taste and whether it’s nutritious, or you may be trying to decide what you’re in the mood for. A new neuroimaging study suggests that while you’re thinking all these things, an internal calorie counter of sorts is also evaluating each food based on its caloric density.

The findings are published in Psychological Science, a journal of the Association for Psychological Science.

“Earlier studies found that children and adults tend to choose high-calorie food,” says study author Alain Dagher, neurologist at the Montreal Neurological Institute and Hospital. “The easy availability and low cost of high-calorie food has been blamed for the rise in obesity. Their consumption is largely governed by the anticipated effects of these foods, which are likely learned through experience.”

“Our study sought to determine how people’s awareness of caloric content influenced the brain areas known to be implicated in evaluating food options,” says Dagher. “We found that brain activity tracked the true caloric content of foods.”

For the study, 29 healthy participants were asked to examine pictures of 50 familiar foods. The participants rated how much they liked each food (on a scale from 1 to 20) and were asked to estimate the calorie content of each food.

Surprisingly, they were poor at accurately judging the number of calories in the various foods, and yet, the amount participants were willing to bid on the food in a simulated auction matched up with the foods that actually had higher caloric content.

Results of functional brain scans acquired while participants looked at the food images showed that activity in the ventromedial prefrontal cortex, an area known to encode the value of stimuli and predict immediate consumption, was also correlated with the foods’ true caloric content.

Participants’ explicit ratings of how much they liked a food, on the other hand, were associated with activity in the insula, an area of the brain that has been linked to processing the sensory properties of food.

According to Dagher, understanding the reasons for people’s food choices could help to control the factors that lead to obesity, a condition that is linked to many health problems, including high blood pressure, heart disease, and Type 2 diabetes. Source

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Co-authors on the research include Deborah W. Tang and Lesley K. Fellows, also of McGill University.

This work was funded by the Canadian Institutes of Health Research.

The article abstract is available online: http://pss.sagepub.com/content/early/2014/10/08/0956797614552081.abstract

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Emergency epinephrine used 38 times in Chicago Public School academic year

More than half of students who used the emergency medication had no known history of allergic reaction

CHICAGO — During the 2012-2013 school year, 38 Chicago Public School (CPS) students and staff were given emergency medication for potentially life-threatening allergic reactions. This finding is detailed in a new Northwestern Medicine report in partnership with CPS.

Following national and local legislation, CPS was the first large, urban school district in the nation to develop and implement an initiative to supply all public and charter schools in Chicago with epinephrine auto-injectors (EAIs) — medical devices used to treat acute allergic reactions.

The impact during the initiative’s first year, the 2012-2013 school year, underscores the need for stocking undesignated epinephrine in schools across the country, according to the report.

“Currently, there is no treatment or cure for food allergy,” said Ruchi Gupta, M.D., Northwestern Medicine pediatrician and the corresponding author of the report. “Timely administration of an EAI is a child’s first and primary line of defense in the event of anaphylaxis resulting from allergic reaction.”

Gupta is an associate professor of pediatrics at Northwestern University Feinberg School of Medicine and a physician at Ann & Robert H. Lurie Children’s Hospital of Chicago.

Anaphylaxis, a severe, potentially life-threatening allergic reaction, can occur within seconds or minutes of exposure to an allergen.

Since last year, 41 states passed policies encouraging schools to stock undesignated epinephrine auto-injectors in their schools for a possible anaphylactic emergency.

The report will be published Oct. 20 in the American Journal of Preventive Medicine, and Gupta will present the findings at the American College of Allergy, Asthma and Immunology Annual Scientific Meeting, to be held Nov. 6 to 10 in Atlanta.

Other highlights from the report:

  • The majority of those receiving an EAI were students (92 percent)
  • More than half didn’t know they had an allergy (55 percent)
  • Twenty-one of the EAIs given were to treat food induced allergic reactions
  • Among food-induced reactions, peanut was the most common followed by fin fish
  • The trigger of more than a third of all reactions are unknown
  • Elementary schools had the most cases of EAIs administered
  • School nurses administered the medication the majority of the time

“At CPS, it is our goal to prevent any health-related barriers to learning, which is why we have worked with all of our schools to address this critical issue by equipping them with tools and guidance that they need to keep students safe and healthy,” said Stephanie A. Whyte, M.D., study coauthor and chief health officer of CPS.

The district-issued medication is available at all CPS schools and is to be used when a person is having a severe allergic reaction and his/her own epinephrine is unavailable or if he/she has no history of allergic reactions.

“Because of the amount of time kids spend in school, and given the fact that many first-time allergic reactions occur on school grounds, it is imperative for school districts across the country to provide access to emergency epinephrine to students who may not otherwise have access to the potentially life-saving medication,” Gupta said.

Most district-issued EAIs were administered on the city’s north-northwest side where the rate of food allergy has been found to be higher, the report found. However, a large number of these EAIs were used on the far south side, too — an area of the city with a low reported rate of food allergy. This highlights the need for access to district-issued EAIs citywide, as children on the far south side may not have access to food allergy diagnosis and could experience their first allergic reaction at school.

“This is definitely a national issue in schools around the country,” Gupta said. “We think the situation in Chicago schools is representative of schools everywhere. Most states now have policies in place for stocking epinephrine in schools. This is an essential step to keep kids with food allergies safe.”

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Victoria Rivkina served as the other Northwestern investigator, and other CPS project team members include Lilliana DeSantiago-Cardenas and Blair Harvey-Gintoft. Source

Posted in Allergies, Milk Allergy, Nutrition: Allergies, Nutrition: Allergies: Nut | Leave a comment

Harvard announces its own Ebola travel restrictions

UPDATED: October 20, 2014, at 2:45 a.m.

Harvard affiliates wishing to travel on University business to the countries most affected by Ebola must now obtain the approval of University Provost Alan M. Garber ’76 and their respective School dean, according to a new set of guidelines the University disseminated on Friday.

Unrelated to that approval process, the new policy also mandates that any Harvard affiliate returning from Sierra Leone, Guinea, and Liberia must complete a medical screening with Harvard University Health Services before arriving on campus. Travelers could also be asked to stay away from campus for 21 days, the length of the virus’s incubation period.

The guidelines, outlined in an email from Garber and UHS Director Paul J. Barreira, expand on those detailed in August that asked for Harvard students, faculty, and staff to avoid nonessential travel to the three countries.

In an interview Friday, University President Drew G. Faust added that UHS is also undertaking a set of planning exercises to prepare for a case of Ebola at the University, training staff so that they can properly respond and recognize the disease.

“The CDC is working out its procedures, the President’s sitting in the White House trying to figure out what the next steps are, so we’re all very eager to do the right thing and define the parameters of our engagement,” Faust said.

She added that Harvard researchers, particularly those working in public health, have the potential to play a large role in addressing the outbreak.

Still, Harvard’s latest round of efforts to head off the epidemic for affiliates comes with the acknowledgement that the social, political, and medical climate in the region may make it difficult for the University to aid individuals once they are there.

“To contribute effectively in-country entails great personal risk and requires complex logistical support, which only a few aid organizations and governments are capable of providing. Only clinicians with the highest level of readiness—personal, mental, and professional—should even consider traveling,” the guidelines from Harvard Global Support Services read.

In a section specifically targeted at sponsored affiliates in the region, the guidelines state, “Harvard’s ability to help you in an emergency is very limited at best.”

Inquiries to University officials regarding the number of affiliates on the ground in Sierra Leone, Guinea, and Liberia were not immediately answered.

In one high-profile case, University Professor Paul E. Farmer and associate professor of medicine Joia Mukherjee travelled to Liberia in mid-September to assess conditions on the ground. They met with Liberian President Ellen Johnson Sirleaf, a 1971 Kennedy School alumna.

Both were working in their capacity as leaders of the global health organization Partners in Health and were not sponsored by Harvard. Farmer did however participate in a Harvard global health event via video from Monrovia, Liberia.

Garber and Barreira wrote on Friday that the University has not identified any University affiliate or campus visitor who has been deemed to be at elevated risk for Ebola to date.

The updated policy comes as tests of a Yale graduate student suspected of having contracted Ebola came back negative last week. The patient recently returned from researching the Ebola outbreak in Liberia and was admitted to Yale-New Haven Hospital with “Ebola-like symptoms” on Wednesday night. Source

Posted in Infectious Diseases: Ebola | Leave a comment

Phast Pharma: Local herb molecule has potential for faster drug development

Scientists at Nanyang Technological University (NTU Singapore) have discovered a new molecule which can join together chains of amino acids – the building blocks of protein.

Only three other known molecules have been discovered to be able to perform this function, which is an important process in the development of new drugs. A key difference is that the new molecule is able to do the same process 10,000 times faster than the other three and “cleanly” without leaving any residue behind.

This new molecule, which is a type of catalyst or enzyme, was derived from a common medicinal plant found in Singapore and Southeast Asia. Scientifically known as Clitoria ternatea or the Blue Butterfly Pea, this plant’s blue flowers are commonly used to make food colouring such as those used in Pulut Inti, a Malay glutinous rice delicacy. The plant is also commonly used as a traditional herb to enhance memory, as well as an anti-depressant and anti-stress agent.

Named Butelase-1 after the plant’s Malay name Bunga Telang, the new enzyme acts as a ligase, joining longer chains of amino acids known as proteins or peptides (which are smaller in size than proteins) together.

Professor James Tam from NTU’s School of Biological Sciences, the lead scientist of this project, said that the properties of the new molecule make it a very useful tool in protein biotechnology and the development of new peptide and protein therapeutics, including anti-cancer agents.

“While we already have the tools to cut peptides easily, joining them together is much harder, as the most commonly used ligase usually leaves residues behind, which may affect the efficacy of the final product,” said the director of NTU’s Drug Discovery Centre.

“The ability to cut and join bits and pieces of peptides fast, easily and cleanly will speed up our search for novel drugs and treatments.”

Prof Tam’s breakthrough discovery was first published last month in Nature Chemical Biology, a top international scientific journal. The significance of the finding resulted in no less than four independent commentaries so far published by Nature Publishing Group, Structural Biology Knowledgebase, and Science Business eXchange – all top scientific publishers.

Ligase such as Butelase-1 is the reason why plants are able to join together end-to-end to create circular chains of amino acids, commonly known as macrocycles. Such circular chains make plants more resilient to harsh weather such as extreme cold or heat.

These circular proteins were rarely found before the 1990s, and their biosynthesis had remained a mystery until the NTU team published their work. Butelase-1 was found to be responsible for this backbone cyclization – the circular joining of a protein chain.

The NTU researchers believe that their discovery of Butelase-1 could potentially change the landscape of how proteins are studied and manipulated in the development and design of new drugs.

This project, which took about a year to complete, is part of a bigger herbalomics research programme led by Prof Tam, which received a $10 million grant under the National Research Foundation’s (NRF) Competitive Research Programme (CRP) in 2012.

The herbalomics programme aims to do a system-wide analysis of active ingredients in functional food and herbal medicine. Key goals of the programme include finding novel approaches to ensure the safety, quality and efficacy of plant-based products.

This research, which has impact on biomedical research and applications, is part of Future Healthcare, one of NTU’s Five Peaks of Excellence which are interdisciplinary areas of research that the university focuses on. The other four peaks are Sustainable Earth, Innovation Asia, New Media, and the Best of East and West. Source

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Cold sores increase the risk of Alzheimer’s, dementia: Umea University study

Infection with herpes simplex virus increases the risk of Alzheimer’s disease. Researchers at Umeå University, Sweden, claim this in two studies in the journal Alzheimer’s & Dementia.

“Our results clearly show that there is a link between infections of herpes simplex virus and the risk of developing Alzheimer’s disease. This also means that we have new opportunities to develop treatment forms to stop the disease,” says Hugo Lövheim, associate professor at the Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, who is one of the researchers behind the study.

Alzheimer’s disease is the most common among the dementia diseases. In recent years research has increasingly indicated that there is a possible connection between infection with a common herpes virus, herpes simplex virus type 1, and Alzheimer’s disease. A majority of the population carries this virus. After the first infection the body carries the virus throughout your lifetime, and it can reactivate now and then and cause typical mouth ulcer. The hypothesis which links the herpes virus and Alzheimer’s disease is based on that a weakened immune system among the elderly creates opportunities for the virus to spread further to the brain. There this can in turn start the process which results in Alzheimer’s disease.

Hugo Lövheim and Fredrik Elgh, professor at the Department of Virology, have now confirmed this link in two large epidemiological studies. In one study, which is based on the Betula project, a study on ageing, memory and dementia, the researchers show that a reactivated herpes infection doubled the risk of developing Alzheimer’s disease. This study had 3,432 participants who were followed for 11.3 years on average. In another study, samples donated to the Medical Biobank at Umeå University from 360 people with Alzheimer’s disease were examined and as many matched people who had not developed dementia. The samples were taken on average 9.6 years before diagnosis. This study showed an approximately doubled risk of developing Alzheimer’s disease if the person was a carrier of the herpes virus.

“Something which makes this hypothesis very interesting is that now herpes infection can in principle be treated with antiviral agents. Therefore within a few years we hope to be able to start studies in which we will also try treating patients to prevent the development of Alzheimer’s disease,” says Hugo Lövheim. Source

Posted in Alzheimer's, Dementia, Herpes | Leave a comment