Author Archive (John Tyburski): June 2014

Sunday, June 29, 2014

Hepatitis C infection decreases likelihood of rejection after liver transplant

A group of European researchers found that liver-destroying hepatitis C virus infection may have the unexpected benefit of lowering the chance that a new, transplanted liver will be rejected by the patient’s immune system.

by John Tyburski

First published at Daily Digest News on June 26, 2014

In a rather odd case of “the disease is also the cure.” Hepatitis C virus (HCV) infection may serve as the primary cause of liver injury in a patient and yet may suppress the patient’s immune system in a specific way that lowers the risk of the patient rejecting a transplanted new liver. According to a report published on Wednesday in the journal Science Translational Medicine, Spanish researchers conducting a small clinical trial to study liver transplant tolerance in patients with HCV found that about half of the study subjects were able to go off drugs that prevent organ rejection.

“It is always a hard thing to translate results from clinical studies into the everyday treatment of patients, but our study clearly shows that hepatitis C-infected liver recipients can discontinue the immunosuppressive medication,” said Dr. Felix Bohne, lead author of the study.

Patients who receive organ transplants normally must take medications that suppress their immune systems so that they do not reject the new organ. The reason organs are rejected is because they have come from other individuals who donated them. Each person’s immune system has a strong ability to discriminate between “self” and “foreign.” Tissue from a donor is matched according to blood type, but rejection is still a likely outcome without the immunosuppressing drugs.

Prior research in animal models has suggested that HCV infection may exert a suppressing effect on the immune system and lower the chances that the animals will reject transplanted livers. Observations in patients show also that administration of immunosuppressing drugs in HCV patients who received a transplant allows HCV to flourish, resulting in accelerated injury to the new liver tissue. The finding that at least some HCV-infected patients do better without immunosuppression is encouraging.

“This is exciting research that shows the hepatitis virus changes the immune system in such a way to protect these liver transplants from being rejected by the body,” said Dr. Gregory Pappas, medical director for Hepatitis Foundation International. “This is good news for many of HFI’s constituents and those who will need a liver transplant and/or who have been infected with hepatitis C.” Pappas was not involved in the study.

The report presents the reason why HCV lowers liver transplant rejection risk as relating to the mechanism that HCV has to hide from the immune system. The result is immune system cells that do not function at maximal capacity.

“This is part of the virus’ immune evasion strategy and can be observed in a part of patients developing chronic hepatitis C,” Bohne said.

FDA: Rare but serious allergic reactions to some acne treatments may occur

Popular nonprescription acne treatment products can cause serious and potentially life-threatening hypersensitivity reactions such as tightness in the throat, swelling in the face, difficultly breathing, and fainting.

by John Tyburski

First published at Daily Digest News on June 25, 2014

According to a Drug Safety Communication issued on Wednesday by the U.S. Food and Drug Administration (FDA), over-the-counter (OTC) topical acne products can cause serious and even life-threatening allergic reactions, both at the application sites and systemically. The drugs are already labeled with a caution of redness, itching, peeling, dryness, burning, or mild swelling at the application site, but the new symptoms point to much more serious, albeit rare hypersensitivity reactions.

The safety announcement advises consumers to stop using the OTC acne products and immediately seek emergency medical attention if they experience one or more of the following symptoms: faintness, tightness in the throat, difficulty in breathing, or swelling of the face, lips, tongue, or eyes. Less serious reactions such as hives or itching may also occur, indicating as well that consumers should stop using the products immediately.

The products identified in the announcement contain the active ingredients benzoyl peroxide or salicylic acid. The active ingredients are included on the product labels. Drugs that contain these are marketed under a variety of brand names including Ambi, Aveeno, Clean & Cear, MaxClarity, Neutrogena, Oxy, and Proactiv. These products are sold in a variety of forms including gels, lotions, solutions, washes, pads, toners, and scrubs.

“There is currently no mention of the possibility of these very severe allergic reactions on the product labels,” said Dr. Mona Khurana, a medical officer at FDA, in a FDA statement. “It’s important that consumers know about them, and that they know what to do if they occur.”

At this time, the FDA has not determined which of ingredients of the OTC acne products are responsible for causing the serious allergic reactions. It remains possible that one or more inactive ingredients or a combination of active and inactive ingredients causes the serious hypersensitivity reactions. The reactions may occur within minutes after applying the product but may otherwise take a day or longer to develop.

The decision to release the safety announcement came after the regulatory agency had received 131 reports of serious allergic reactions from both consumer and manufacturer sources. The majority of these reports are recent, having been made since 2012. Although no deaths have been reported, 44 percent of the patients required hospitalization.

New users of these products are advised to test them on a small area of skin and monitor for adverse reactions for three days. If no complications develop, then consumers may use the product according to the manufacturer’s directions printed on the packaging.

Deep brain stimulation procedure helps 37-year-old patient with OCD

Obsessive-compulsive disorder had taken control of most of a California man’s life, but stimulation by electrodes planted deep in his brain has produced some amazing results and sparked hope where there was little before.

by John Tyburski

First published at Daily Digest News on June 24, 2014

Individuals with obsessive-compulsive disorder, or OCD, have irresistible urges to check things repeatedly, perform certain tasks or routines over and over, or repetitious, unrelenting thought patterns. The condition is categorized as an anxiety disorder, and the thoughts and rituals associated with OCD interrupt normal daily life and may cause substantial distress in sufferers.

One common manifestation of OCD is constant, obsessive hand-washing resulting from an obsessive fear of or concern for germs and dirt. Other ways in which OCD may manifest is in neatness, needs to touch something repeatedly, or cycling through certain thoughts, especially those that are forbidden or distasteful. The causes of OCD are unclear, but researchers have found key parts of the brain involved.

For several years, neuroscientists have investigated whether a procedure called deep brain stimulation, or DBS, offers any lasting benefit for OCD patients that do not respond to other, less invasive treatments. In one study published in 2006, researchers followed ten patients with highly resistant OCD for three years following deep brain stimulation and found promising long-term effects. More recent discoveries are helping to focus in on specific targets for DBS.

For 37-year-old Brett Larsen, the advances paved the way for a new glimpse at the hope of a normal life, free of OCD. One of Larsen’s OCD rituals involves opening and closing the refrigerator door several times before reaching in for a bottle of soda. Then, once he has it, a similar ritual takes place with the cap before he takes a sip.

“Just think about any movement that you have during the course of a day — closing a door or flushing the toilet — over and over and over,” said Michele Larsen, Brett’s mother.”I cannot tell you the number of things we’ve had to replace for being broken because they’ve been used so many times.”

Larsen’s OCD began at age 10 when his father died.

“I started worrying a lot about my family and loved ones dying or something bad happening to them,” he said in an interview with CNN. “I just got the thought in my head that if I switch the light off a certain amount of times, maybe I could control it somehow.”

Neither Larsen nor his doctors found a way to control it so in a last-ditch effort, Larsen sought DBS. Doctors inserted electrodes deep into his brain and implanted a battery-powered electrical source under his skin. A noticeable improvement in Larsen’s mood developed during the procedure and lasted during his recovery.

When Larsen had the device activated in January, the improvements were noticeable but transient as doctors optimized the stimulation signal characteristics. By May, however, Larsen was putting on his shoes without completing a ritual of spinning them many times first.

Not all of Larsen’s OCD manifestations have disappeared, but he has hope for the future.

“I feel like I’m getting better every day,” said Larsen, adding that things like going back to school or working now feel within his grasp. “I feel like I’m more able to achieve the things I want to do since I had the surgery.”

FDA committee will consider evidence for ovarian cancer drug candidate

The FDA’s Oncologic Drugs Advisory Committee is holding a day-long hearing on Wednesday to examine the candidate drug olaparib, a PARP inhibitor, for treatment of ovarian cancer, despite equivocations on whether the drug is safe and effective enough.

by John Tyburski

First published at Daily Digest News on June 24, 2014

Some drug classes just do not fare well in regulatory review, and the candidate ovarian cancer drug olaparib, another PARP inhibitor, is under close scrutiny in the looming shadows of rejection. The U.S. Food and Drug Administration (FDA) Oncologic Drugs AdvisoryCommittee (ODAC) is looking closely at whether the evidence for the candidate drug is strong enough to keep it under consideration for approval. The hearing is being held on Wednesday.

Olaparib is a member of the group of pharmacological inhibitors of an enzyme called poly ADP ribose polymerase, or PARP, an important protein in single-strand DNA break repairs. Many cancer cells have been found to rely more on PARP than normal cells so it has been a therapeutic target in drug development. However, the FDA has yet to approve a PARP inhibitor in the treatment of cancer.

One main point of contention between regulatory reviewers at the FDA and olaparib’s maker, AstraZeneca, a multinational pharmaceutical corporation based in London, UK, is that recent clinical data were derived from only a small number of patients. More specifically, there is concern that the patients who benefited from olaparib did so because the control group of the study, the patients that did not receive olaparib, “underperformed,” or suffered worse outcomes than normally expected.

“The small sample size of gBRCAm patients and the retrospective identification of this patient population call into question the reliability of the estimation of treatment effect,” states a briefing document by the ODAC. “[I]t is important to note that the loss of randomization and the selection of a convenient sample of patients who had available whole blood sample for retrospective testing may have led inadvertently to an unequal distribution of unknown factors that may have affected the study results.”

In other words, the ODAC suspects that some potential confounding factors, characteristics in patients that may influence how well they do with their cancer independent of therapy, were not properly identified and taken into consideration.

The ODAC will also carefully consider the risks involved with taking olaparib and offer a recommendation on how safe the drug may be. Approval decisions do not have to follow committee recommendations, but they almost always do.

More children now eligible to receive adult lung transplants

Some children under the age of 12 years may now receive adult lung transplants after a year-long review by officials, prompted by a temporary rule-change last year to save a 10-year-old girl.

by John Tyburski

First published at Daily Digest News on June 23, 2014

Last year, 10-year-old Sarah Murnaghan was dying and in need of a lung transplant. However, the transplant of donor adult lungs into children under 12 was something that the Organ Procurement andTransplantation Network (OPTN) was not considering. A special provision was made that saved young Sarah’s life, and the OPTN launched a year-long study to determine whether more children under 12 should be eligible for adult lung transplants.

On Monday, the OPTN announced that changes were made as a result of the study, and now “a very limited group of young lung transplant candidates” will receive “additional priority for matching offers.”

According to a statement issued by the transplant network, a more individual needs-based approach was considered in the context of the benefits transplantation can provide. In other words, strict guidelines may sometimes exclude those that may benefit from a transplant.

“Nobody wants children, or anybody, to die on the waiting list,” said Dr. George Mallory, medical director of the lung transplant program at Texas Children’s Hospital in Houston, earlier this year as the year-long study was coming to a close.

“This is a difficult balance for very young lung transplant candidates in particular,” said Stuart Sweet, board secretary for the transplant network and its parent organization, the United Network for Organ Sharing. “There are very few candidates in this age group and the progression of their lung disease may be considerably different from other patients, even those just a few years older. This exception is meant to provide an appropriate balance for a specific group of candidates.”

At the time Sarah Murnaghan sought donor lungs, the policy guiding allocations considered candidates under 18 as either adolescents (12 to 18 years of age) and pediatrics (under 12 years of age), and priority was given to adolescents, meaning that they could receive lungs from either adolescent or adult donors. Pediatric candidates could only receive pediatric-donor lungs.

The most recent lung transplant guidelines are available online.

Evidence lacking for recommendation on routine vitamin D screening, panel says

An independent panel of experts in prevention and evidence-based medicine issued a draft recommendation that vitamin D deficiency is too loosely defined to warrant routine, population-level screening.

by John Tyburski

First published at Daily Digest News on June 23, 2014

The U.S. Preventive Services Task Force (USPSTF), an independent panel of non-government primary care providers with expertise in evidence-based medicine and prevention, issued a draft recommendation statement on Monday regarding vitamin D deficiency screening. The draft recommendation is based on a draft evidence report issued at the same time and describes the finding that vitamin D deficiency screening in individuals with no symptoms of vitamin D deficiency is not justified.

The USPSTF cited four key reasons for the draft recommendation. First, there is no consensus definition of vitamin D deficiency, nor do experts agree on how much measurable vitamin D should be present in the blood. This complicates the interpretation of research of conditions associated with vitamin D deficiency.

Secondly, although there are numerous testing methods for measuring blood vitamin D levels, the accuracy of these tests is not verified. The USPSTF discovered variation among the testing methods and within testing facilities.

No screening studies have been done to determine the benefits of screening for vitamin D deficiency in adults. Furthermore, no scientific evidence was found supporting treatment for vitamin D deficiency in asymptomatic adults having any risk-reducing effects on cancer, type II diabetes, and other outcomes.

Finally, neither did the USPSTF find studies examining direct harm from screening for vitamin D deficiency. Therefore, while there is no harm in screening, the costs of screening are not offset by any evidence supporting benefits of screening.

Not all health care professionals are supportive of the draft recommendation. “There’s a lot of controversy here,” says task force co-chair Albert Siu, Professor of Geriatrics at the Icahn School of Medicine at Mount Sinai, New York.

Because there is disagreement with how low the levels of vitamin D need to be to diagnose deficiency, the estimates for what proportion of the U.S. population is deficient ranges from 19 to 77 percent.

Friday, June 27, 2014

Novartis submits application for FDA approval of meningitis B vaccine

Already granted ‘Breakthrough Therapy’ status in April, Novartis aims for its meningitis B vaccine candidate to meet the need of a licensed vaccine for the rare but deadly disease.

by John Tyburski

First published at Daily Digest News on June 19, 2014

Novartis International AG, the large, Swiss pharmaceutical company based in Basel, Switzerland, announced on Tuesday that it submitted an application for Bexsero® to be approved by the U.S. Food and Drug Administration (FDA) as a vaccine against meningitis serogroup B. Bexsero is already approved as such in 34 countries and was recently made available at two U.S. universities as an Investigational New Drug during meningitis B outbreaks.

Four vaccines for meningococcal illness currently exist, but none cover serogroup B, a rare but aggressive illness that can kill or lead to life-long disability. The devastating effects of meningitis B can occur within 24 hours of the onset of illness, which presents with flu-like symptoms, making it difficult to accurately diagnosis unless during an epidemic. Bacterial meningitis is caused by the bacterium Neisseria meningitidis infecting the meninges, or protective coverings of the brain and spinal cord.

“Bexsero is the result of 20 years of groundbreaking research and a testament to our leadership in preventing rare but devastating diseases,” said Andrin Oswald, Division Head, Novartis Vaccines. “With today’s submission, we are one step closer to ensuring that no family in the US has to endure the loss of a loved one from vaccine-preventable meningitis.”

Meanwhile, the U.S.-based multinational pharmaceutical corporation Pfizer also announced Tuesday that it has requested FDA approval for its candidate meningitis serogroup B vaccine candidate called bivalent rLP2086. Pfizer’s candidate vaccine was also granted Breakthrough Therapy Designation by the FDA earlier this year.

“The BLA submission for bivalent rLP2086 marks an important step toward our goal of helping to protect adolescents and young adults against this difficult to diagnose and often deadly disease,” said Dr. Emilio Emini, Senior Vice President of Vaccine Research and Development for Pfizer Inc. “There is an urgent public health need to help prevent meningococcal B disease through vaccination, and we will continue to work closely with the FDA in our efforts to advance our vaccine candidate.”

Canadian woman turned away from ER, video records her own stroke

A picture is worth a thousand words, and a video of one’s stroke symptoms can be priceless as one woman demonstrated this week.

by John Tyburski

First published at Daily Digest News on June 18, 2014

Stroke, defined as an abnormal decrease or loss of blood flow to a brain region, is the leading cause of disability in the United States. Stroke causes disability when the compromised blood flow lasts more than a few minutes, resulting in the death of brain cells from being starved of the crucial oxygen, nutrients, and energy carried and delivered by the blood. A non-fatal stroke can leave a patient disabled because of the loss of brain cells important in motor function.

This week a 49-year-old Toronto woman learned first-hand how dangerous stroke can be. She experienced symptoms that motivated her to seek medical attention. However, doctors simply gave her some stress-management advice and sent her on her way. A few days later, Stacey Yepes’s symptoms returned, and she documented herself having a mild stroke by video recording.

“The sensation is happening again,” Stacey Yepes tells the camera of her smartphone. “It’s all tingling on left side.”

“I don’t know why this is happening to me.”

When the symptoms began again, Yepes was driving. She pulled over and recorded what was happening with her phone’s camera. She showed the video to physicians at Toronto Western Hospital the next day.

Two days prior, emergency room doctors dismissed her after tests for stroke came back negative. Regardless, Yepes went on to suffer two additional mini strokes.

“I think it was just to show somebody, because I knew it was not stress-related,” Yepes said inan interview with the Canadian Broadcasting Corporation. “And I thought if I could show somebody what was happening, they would have a better understanding.”

Yepes recorded her third mini stroke and showed it to coworkers who urged her to go to the hospital.

Stroke risk increases with age, and women are more likely to have a stroke than men. Other risk factors for stroke include smoking, overweight, hypertension, high cholesterol and, for women, oral contraception, and hormone replacement therapy.

Study finds no link between antidepressants and heart defects in newborns

Concerns over whether the use of certain antidepressant medications during pregnancy led to cardiac defects in the infants are allayed somewhat by a new study of nearly one million pregnant women that found no connection.

by John Tyburski

First published at Daily Digest News on June 18, 2014

A new cohort study that followed just under 950,000 pregnant women enrolled in Medicaid examined whether there is a connection between the use of selective serotonin-reuptake inhibitors (SSRIs), drugs that are commonly prescribed to treat depression, and cardiac defects in liveborn infants. The results of the study, which found no connection between SSRIs and infant heart problems, were published this week in the New England Journal of Medicine.

Past findings and an alert issued in 2005 by the U.S. Food and Drug Administration had created concern about using SSRIs like paroxetine (Paxil) and sertraline (Zoloft) during the first trimester of pregnancy. Experts suspected a link between right ventricular outflow tract obstruction and ventricular septal defects and Paxil and Zoloft, respectively.

“I don’t know if it will completely settle the debate over antidepressants during pregnancy, but I’m pleased to hear more support for the safety of these medicines in pregnancy,” Dr. Rebecca Starck, Director of Regional Obstetrics and Gynecology at the Cleveland Clinic, Ohio, told Reuters Health. “I think many practitioners and obstetricians will be happy to see this study come out.” Starck was not involved with the study.

The study was conducted with Medicaid records on subjects of the Medicaid Analytic eXtract, a larger, nationwide effort, from 2000 through 2007. During these years, women in the Medicaid program from three months before their last menstruation through one month after giving birth to a live infant were followed. Among these women, more than 64,000, or 6.8 percent, used antidepressants during the first trimester of their pregnancies. In comparison, approximately 10 to 15 percent of pregnant women in the U.S. are diagnosed with depression.

“We did not find any association for any of the antidepressant categories or the individual drugs we studied,” lead author Dr. Krista Huybrechts of Brigham and Women’s Hospital in Boston said. “It will be up to individual physicians and women to determine how much it will sway their opinion one way or the other.”

Looking only at antidepressant use and cardiac defects in the infants born to the depressed mothers suggested an almost 25 percent increase of risk associated with SSRI use. However, once the researchers adjusted their risk model for activities that depressed women engage in, the association disappeared.

“Women with depression often have behaviors that tend to increase their risk,” said Huybrechts. “They tend to have a high use of alcohol, they tend to be smokers and they use other psychotropic medications that might have some association.”

The authors of the report did not disclose any potential conflicts of interest or funding from drug makers.

Monday, June 23, 2014

Scientists reverse autism-like condition in laboratory mice

Researchers successfully reverse experimentally induced autism spectrum disorders-like symptoms in mice, even in adult mice, and shed new light on a possible underlying mechanism for why the condition occurs.

by John Tyburski

First published at Daily Digest News on June 18, 2014

Approximately one to two percent of children born in the U.S. are diagnosed with autism spectrum disorders (ASDs), a collection of conditions involving a number of physical, cognitive, and social impairments. Despite extensive study, the causes of ASDs are not fully understood, and no known cures exist. Recent research published Tuesday in the journal Translational Psychiatry indicates that ASDs may be reversible or at least possibly managed better.

A team of researchers at the University of California, San Diego (UCSD), led by Dr. Robert Naviaux, professor of medicine and co-director of the Mitochondrial and Metabolic Disease Center at UCSD, set out to test whether treating the underlying metabolic disorders that accompany ASDs produces improvement in ASDs symptoms. Past work in children with ASDs has shown temporary improvements in most following high fever. Although the symptoms returned as the fevers subsided, the observations suggested that ASD impairments are reversible.

The UCSD researchers induced mice to be born with ASD-like symptoms by exposing pregnant females to simulated viral infections. The mouse pups are born with ASD-like symptoms that are thought to be the result of activation of cell danger response (CDR), a metabolic response to threat (such as simulated viral infection during gestation).

Then the researchers inhibited the CDR response with a drug called suramin, a drug that attacks purine pathways and has been around for treating African sleeping sickness for nearly 100 years. The result of blocking CDR function with suramin was a restoration of normal behavior in the mice with ASD-like symptoms.

“Cells behave like countries at war,” said Naviaux. “When a threat begins, they harden their borders. They don’t trust their neighbors. But without constant communication with the outside, cells begin to function differently.”

“In the case of neurons, it might be by making fewer or too many connections,” continued Naviaux. “One way to look at this related to autism is this: when cells stop talking to each other, children stop talking.”

The researchers stressed caution in interpreting these results with mice in the context of human applications. Regardless, a small phase one trial to assess suramin in treating children with ASDs is planned for this year.

E-cigarette market red hot, growing rapidly

The numbers of brands of e-cigarette devices and products are large and rapidly increasing as internet sales remain strong in a largely unregulated nicotine delivery system, a new survey finds.

by John Tyburski

First published at Daily Digest News on June 17, 2014

Findings from a comprehensive survey of electronic cigarettes, or e-cigarettes–and the liquids intended for use with them–marketed online show that the market is rapidly expanding and will likely pose challenges for regulatory agencies that are still determining how best to proceed. Researchers at the University of California, San Diego School of Medicine reported the results of the survey in the July supplement to the journal Tobacco Control.

“The product has caught on fire,” said Shu-Hong Zhu, a public health researcher at the University of California-San Diego who helped lead the research.

The team found that from 2012 to 2014, an average of 10 new e-cigarette brands entered the online marketplace per month. Today, there are a little over 466 e-cigarette brands available for purchase via the internet, and more than 7,700 flavors of the liquid mixture used in the devices are available to customers. Among the available flavors are candy mimics such as gummy bear and marshmallow, flavors some experts worry are too alluring to children. In contrast, traditional tobacco cigarettes sold in the U.S. come in two flavors, plain and menthol.

Another trend that Zhu and colleagues found is a move away from the look of traditional cigarettes. When e-cigarettes first became available, they looked like regular cigarettes. Over time, however, the devices have looked less and less like cigarettes and more like pens, flashlights, and other objects not resembling traditional cigarettes at all.

E-cigarettes do not produce smoke. They are battery-powered devices that heat flavored, nicotine-rich liquids to form vapors that the user inhales, much like cigarette smoke but without the toxic ingredients of tobacco smoke. The devices generally deliver lower amounts of nicotine per inhalation than do traditional cigarettes.

Health experts debate whether or not the devices are harmful or helpful, and a number of publications have emerged recently supporting and attacking the idea that they may be effective smoking-cessation aids.

“Some consider them promising products to help smokers quit traditional cigarettes, while others believe they will re-normalize smoking, which will keep more people smoking,” Zhu said.

Wednesday, June 18, 2014

Viewing computer screens decreases eye secretions similar to dry eye disease

Spending long periods in front of a computer monitor may be associated with symptoms almost identical to dry eye disease.

by John Tyburski

First published at Daily Digest News on June 16, 2014

There are occupational hazards in any field, and the office-based ones are not exempt. Workers who spend long hours viewing computer monitors exhibit changes in their eye secretions, making the composition of their tears very similar to that of tears in people with dry eye disease. This was the finding of a new study conducted in Japan. The results were published on June 5 in JAMA Ophthalmology.

The tear fluid that protects and lubricates the eye contains a protein called MUC5AC that is secreted by specialized cells in the upper eyelid. The Japanese researchers found that in those who stare for long periods at computer screens, the levels of MUC5AC in their tears wear almost as low as in the tears of people with authentic dry eye disease.

“To understand patients’ eye strain, which is one of major symptoms of dry eye disease, it is important that ophthalmologists pay attention to MUC5AC concentration in tears,” said study author Dr. Yuichi Uchino, an ophthalmologist at the School of Medicine at Keio University in Tokyo. “When we stare at computers, our blinking times decreased compared to reading a book at the table.”

In addition to less frequent blinking, computer monitor viewers tend to draw their eyelids back off of their eyes more than they do while completing other tasks such as reading a book. This behavior exposes more of the eye to air and increases the loss of tear film to drying.

The researchers sampled tears from both eyes of 96 Japanese office workers, roughly two-thirds of which were men. They then measured the concentration of MUC5AC as a proportion of total protein amount in the tears. The amount of MUC5AC in the tears of workers who looked at screens for more than seven hours per day was, on average, 38.5 percent lower than the amount in the tears of workers who spent fewer than five hours a day looking at screens.

Among the subjects, 14 percent were diagnosed with dry eye disease and had 57 percent less MUC5AC in their tears compared without dry eye disease.

Previous studies indicate that workers with dry eye disease-like symptoms are less productive and at higher risk of being depressed.

Increased risk of heart failure in men linked to processed red meats

Moderate consumption of processed red meat but not unprocessed red meat is associated with significantly higher risk of heart failure among men over 45 years of age.

by John Tyburski

First published at Daily Digest News on June 13, 2014

Not a lot of work has been done to examine whether there is a cardiovascular risk associated with eating processed red meats such as salami, sausage, ham, bacon, and hot dogs. On Wednesday, Polish and Swedish researchers reported new findings that indicate there may, in fact, be concern when it comes to consuming these foods.

Joanna Kaluza and colleagues described the results of their recent analysis of data from the population-based prospective Cohort of Swedish Men (COSM) study, a long-term epidemiological study of over 37,000 men, age 45–79 years at the time of enrollment, when they reported meat consumption on questionnaires. The subjects were followed for just under 12 years, and health outcomes were documented, including heart failure. Results are published in the journal Circulation: Heart Failure.

“Processed red meat commonly contains sodium, nitrates, phosphates and other food additives, and smoked and grilled meats also contain polycyclic aromatic hydrocarbons, all of which may contribute to the increased heart failure risk,” senior author Alicja Wolk, D.M.Sc., a professor in the Division of Nutritional Epidemiology at the Institute of Environmental Medicine, Karolinska Institute in Stockholm, Sweden, said in a statement. “Unprocessed meat is free from food additives and usually has a lower amount of sodium.”

The researchers found that out of 37,035 COSM subjects, 2,891 men were diagnosed with heart failure, and 266 died as a result. Using heart failure as an outcome, the researchers found that those who ate the most processed red meat were 28 percent more likely to be among those that died of heart failure compared to those who ate the least, a risk increase of almost two-fold.

“To reduce your risk of heart failure and other cardiovascular diseases, we suggest avoiding processed red meat in your diet, and limiting the amount of unprocessed red meat to one to two servings per week or less,” lead author Joanna Kaluza, Ph.D., an assistant professor in the Department of Human Nutrition at Warsaw University of Life Sciences in Poland, said in a statement. “Instead, eat a diet rich in fruit, vegetables, whole grain products, nuts and increase your servings of fish.”

Monday, June 16, 2014

High protein diet may help lower risk of stroke

Chinese researchers reported this week that people eating high amounts of animal protein in their diets may suffer substantially fewer strokes compared with those who consume little or no animal protein.

by John Tyburski

First published at Daily Digest News on June 11, 2014

Dust off the Atkins diet book from a decade ago because protein may be coming back in style. According to a report published this week in the journal Neurology, people who consumed the most animal protein, particularly protein from lean animal sources like fish, experienced 20 percent fewer strokes than those who ate little or no animal protein.

Xinfeng Liu and colleagues at the Nanjing University School of Medicine in Nanjing, China, conducted what is called a “meta-analysis” of seven previously published prospective cohort studies of a cumulative total of 254,489 participants for which dietary protein intake information and whether they suffered one or more strokes were available. The researchers found that for every 20 grams of daily protein consumed, risk of stroke dropped by 26 percent.

“If everyone’s protein intake were at this level, that would translate to more than 1.4 million fewer deaths from stroke each year worldwide, plus a decreased level of disability from stroke,” Liu said in a news release from the American Academy of Neurology.

Animal protein was found to be far superior in reducing stroke risk compared with vegetable protein. The 29 percent risk reduction from lean animal protein consumption was twice that of vegetable protein consumption. Liu stressed that their findings do not support a turn toward higher consumption of red meat, however. Fish protein is the key, as evidenced by two of the considered studies that were conducted with Japanese subjects who ate far less red meat than westerners tend to eat.

“These results indicate that stroke risk may be reduced by replacing red meat with other protein sources, such as fish,” Liu said.

Other experts confirmed that the results should be interpreted with caution.

“I don’t think this study means to the public you should run out and start eating burgers and red meat,” said Dr. Ralph Sacco, chair of neurology at the University of Miami’s Miller School of Medicine. “Focusing on lean protein consumption and/or even vegetable protein is important.”

Why high protein consumption is associated with lower risk of stroke is not yet clear. Dietary protein may protect against high blood pressure, diabetes, and hardening of arteries, according to Sacco. These conditions are all risk factors for stroke.

The reason the Chinese researchers found a lower risk with animal compared with vegetable dietary protein is also a matter of speculation. Animal proteins contain all of the amino acids necessary for human health, whereas vegetable sources do not.

Fit body, fit mind: New study links cognition with fitness

Researchers have found a correlation between physical fitness level and cognitive performance on learning, memory, and verbal fluency tests.

by John Tyburski

First published at Daily Digest News on June 11, 2014

Feeling winded after a flight of stairs? It could be a sign of not only inadequate cardiovascular fitness but also a drop in brain fitness as well.

Researchers at Brigham Young University in Utah reported this week that cognitive functions such as learning and memory decrease as physical fitness levels decrease. They used a metric of modifiable health behaviors and factors developed by the American Heart Association called “Life’s Simple 7” to examine whether physically fit people have lower cognitive or brain function difficulties.

The report, published on Wednesday online in the Journal of the American Heart Association, describes the study in detail and the finding that intermediate and high cardiovascular health (CVH) both associated with lower incidence or occurrence of cognitive impairment. There was not a gradual decrease in incidence but a similarly lower risk for both medium and high CVH compared with low CVH. This means that an individual may need only to achieve moderate CVH through physical activity and healthy diet to lower his or her risk of cognitive impairment.

“Even when ideal cardiovascular health is not achieved intermediate levels of cardiovascular health are preferable to low levels for better cognitive function,” Dr. Evan L. Thacker, assistant professor and chronic disease epidemiologist, said in a statement. “This is an encouraging message because intermediate cardiovascular health is a more realistic target for many individuals than ideal cardiovascular health.”

Thacker and coworkers studied over 17,700 subjects in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study. They classified scores from the Simple 7 assessments as low, intermediate, and high CVH and then assessed cognitive function by testing on verbal learning, memory, and fluency. Cognitive impairment was found in 4.6 percent of the low CVH scorers, 2.7 percent in the intermediate scorers, and 2.6 percent in the high scorers.

The results suggest a fit body, even moderately so, may actually help maintain a fit mind, but the reason mental fitness may be linked to physical fitness is still unknown.

Friday, June 13, 2014

Possible link found between moles and increased risk of breast cancer

Two independent reports published this week describe minor association between the number of moles women have and their risk of developing breast cancer, but the details of what link moles have to these risks are not known.

by John Tyburski

First published at Daily Digest News on June 11, 2014

The open-access journal PLoS Medicine reported on Tuesday that two prospective cohort studies–large population-based studies that follow subjects over time and monitor for disease development–found that the risk of developing breast cancer increased slightly with increases in number of moles on the skin of women.

In one of the studies, researchers at Harvard and Indiana Universities followed over 74,500 female nurses from 1986 through 2010 in a large, nation-wide cohort study called The Nurses’ Health Study. The ages of the women at the beginning of the study ranged from 40 to 65 years. During the 24-year study period, nearly 5,500 women were diagnosed with invasive breast cancer. Women with 15 or more moles on their left arm were 35 percent more likely to develop breast cancer than those who reported no moles at the beginning of the study. Those with fewer than 15 moles exhibited a slightly higher risk than those without moles.

Among women with no moles, 8.5 percent developed breast cancer. Among those with one to 14 moles, 11.4 percent developed breast cancer and among those with 15 or more moles, 11.4 percent developed the disease.

A group of French researchers reported in the same issue that women in France, ages 39 to 66 years at the time of enrollment in the E3N Teachers’ Study Cohort in 1989–1991, exhibited similar links between moles and breast cancer risk. The researchers followed nearly 90,000 women through 2008 and by that time, a total of almost 6,000 had developed breast cancer. Women with the most moles had a 13 percent higher risk of developing breast cancer. However, the association, found only in premenopausal women, was weak and could not hold after controlling for non-cancerous breast problems and family history of breast cancer–both factors that can increase the risk of breast cancer.

Barbara Fuhrman, assistant professor at the University of Arkansas for Medical Sciences in Little Rock and co-author of a commentary that accompanied the two research reports in the same issue of the journal, said that women with skin moles should not panic because the results probably do not reflect accurately on the risk of individual women.

“[The moles] could be a marker of lifetime exposure to estrogen,” said Fuhrman.

The U.S. researchers found in a subset of their subjects that estrogen and testosterone levels were higher in the women with 15 or more moles. They speculated that the hormone levels may bridge the gap between moles and elevated cancer risk. Even so, Fuhrman stressed that the increase in risk found by the study was overall very small.

FDA and EPA: Pregnant women and young children should eat more fish

The FDA and EPA issued draft updates to their joint Advice and Questions & Answers documents regarding fish consumption as research suggests fish provides nutrients important for healthy development.

by John Tyburski

First published at Daily Digest News on June 11, 2014

On Tuesday, the U.S. Food and Drug Administration and the U.S. Environmental Protection Agency together issued a draft update to their joint Advice and Questions & Answers statements regarding fish consumption. Officials in the agencies concluded that evidence supports an increase in the amount of recommended fish in the diets of pregnant and breastfeeding women, women who might become pregnant, and young children. Important in the draft advice is that the fish ought to be species low in mercury in order to benefit from nutrients specific to fish, without the potential toxicity of mercury.

Because of concerns surrounding mercury in fish, the FDA and EPA had recommended limits in their 2004 Advice statement on fish consumption. Some fish build up mercury in their tissues through a process called bioaccumulation. The long-standing Advice set a maximum per week amount but did not suggest a minimum. The update recommends a minimum amount per week for receiving nutrients important in proper human development.

“For years many women have limited or avoided eating fish during pregnancy or feeding fish to their young children,” said Stephen Ostroff, M.D., the FDA’s acting chief scientist. “But emerging science now tells us that limiting or avoiding fish during pregnancy and early childhood can mean missing out on important nutrients that can have a positive impact on growth and development as well as on general health.”

The FDA found, in an analysis of data from 1,000 pregnant U.S. women, that 21 percent ate no fish or ate far less fish than the recommended in the Dietary Guidelines for Americans (2010). Now the agencies recommend that pregnant women eat eight to 12 ounces–or two to three servings–per week of fish low in mercury. Fish that are low in mercury include, but are not limited to, Pollock, salmon, tilapia, catfish, cod, canned light tuna, and shrimp.

Thursday, June 12, 2014

Ebola a growing concern as Sierra Leone death toll doubles in one week

Sierra Leone has seen its death toll from the Ebola virus illness double in the past week, reaching 12 just as health officials express dismay in trying to control the deadly outbreak.

by John Tyburski

First published at Daily Digest News on June 9, 2014

West Africa, mainly Guinea, has been hit hard recently by an outbreak of the Ebola virus, one of the world’s most deadly viral illnesses for which there are no cures or vaccines available. Guinea is the epicenter of this recent outbreak that has claimed over 200 lives this year. Now Sierra Leone health officials are expressing fading optimism in controlling the virus within their borders as the death toll in that nation jumped to 12, up by six from a week ago. In addition to Guinea and Sierra Leone, Liberia has reported 12 suspected cases of Ebola and nine deaths.

The Health Ministry said that the deaths were in the Kailahun district near the border with Guinea, in the eastern part of the country. Now there are 42 confirmed cases, including new ones recorded in the Kambia district to the north. The new cases indicate spreading as people travel and transmit the virus.

Ebola is also known as hemorrhagic fever because of the primary symptoms of high fever and bleeding. Brain damage can also occur, and the virus can kill up to 90 percent of those it infects. Ebola virus is passed from one individual to another through bodily fluids such as urine, sweat, saliva, and blood. A substantial aspect of the illness that makes it so difficult to control is its incubation period–up to 21 days. People may be exposed and then move about over the subsequent three weeks, infecting others before symptoms present. What is more, patients who recover may still infect others up to seven weeks after their symptoms subsided.

As with most viral illnesses, supportive care focusing on hydration can facilitate recovery, and the most vulnerable are those at the young and old ends of the age spectrum. Chances of surviving the illness improve if it is caught early. Unfortunately, however, many in the affected regions tend to shun medical aid and ride it out or turn to traditional healers instead.

Researchers find that men taking statins exercise less

All men followed in a recent study decreased in their time spent exercising, but those men who began taking statins during the study decreased their time devoted to exercise faster than the others.

by John Tyburski

First published at Daily Digest News on June 9, 2014

Statins are wonderful drugs for decreasing levels of low-density lipoprotein, or “bad” cholesterol, and thus reducing the risk of atherosclerosis and heart disease. However, although usually mild, statins do have side effects, and new research shows that some of them may prompt some men just starting out on statins to exercise less. The new report appears this week in the Journal of the American Medical Association (JAMA) Internal Medicine.

A team of researchers in Portland, Oregon determined that the statin users they studied exercised approximately 40 minutes less each week than those who were not taking any statin drugs, including Lipitor, Zocor, Crestor, Lescol, Pravachol, and Vytorin. The results confirm previous observations by others, although the authors of the report stress that statin use should not be discontinued. The side effects of statin drugs sometimes include muscle ache, weakness, and fatigue.

“Statins are extremely helpful for people who need them,” stressed study lead author David Lee, an assistant professor in the Department of Pharmacy Practice at Oregon State University/Oregon Health and Science University’s College of Pharmacy in Portland. “They’ve really changed the landscape of cardiovascular health over the last 20 years.”

“But the thing I want people to be aware of is that they can have some adverse effects on muscles that might lead to a decrease in exercise,” Lee continued. “Because by being aware of that problem perhaps we can encourage patients to actually make an effort to push themselves to maintain their exercise habits. Because exercise is really very important, both for maintaining general health and for maintaining the ability to carry on independently as we age.”

This was a large study involving 3,000 male subjects of ages 65 years and older with an average age of 73. All men in the study were followed from 2000 to 2002, lived independently, and could walk without assistance during this period. About 25 percent of the men were already taking statins at the time of enrollment, and about another 25 percent began using statins during the study period, leaving about 1,500 men not taking statins at any time during the study.

All of the men reported their exercise habits and wore activity monitors for one-week periods near the end of the study. Activity levels for all men declined slightly over the study period, but men who began statin use during the study exhibited faster rates of activity decline compared with the men who did not take statins.

“Now, we didn’t look at the underlying cause or reason for decreased exercise,” Lee acknowledged. “But the main hypothesis is that people who take a statin do experience an increase in muscle pain. It’s actually the most common side effect. And observational studies have shown that as many as 20 percent of people taking statins will have muscle pain.”

Monday, June 9, 2014

BLOG – WAS ELLIOTT RODGER AN UNINTENDED CONSEQUENCE OF THE SEXUAL REVOLUTION?

What life-long lessons about sexuality brought this young man to the notion that he was entitled to casual sex? On what basis did he decide sex was something to which he was entitled but of which by a great injustice deprived?

by John Tyburski

First published at I Need Politics on May 30, 2014

After every mass murder episode, the flurry of responses always includes a demand that we not discuss the incident specifics nor mention the name of the perpetrator. This attitude grows stronger with each mass public homicide, and I saw the strongest espousing of it ever this week with the latest spotlight case involving Elliott Rodger in Santa Barbara, California. The general hypothesis that drives this sentiment is that the mass killer ostensibly seeks attention and gets it through media coverage of his violence. Therefore, we must deprive the killer of the attention he seeks, although it is difficult to comprehend how much a dead killer can revel in his crime. I do not subscribe to this notion, and I find the hypothesis behind it lacking in insight. No, we must discuss these events in an effort to understand them and to learn what motivates the killers. We must maintain an ongoing national conversation that explores all plausible causes and influences in this kind of violence. Otherwise, we have absolutely no hope of preventing mass murders in the future. But this is only my minor point. Here, I propose the notion that a key determinant in Elliott Rodger’s killing spree was immersion in a sexually promiscuous society. Let us ask today: Is the violence perpetrated by Elliott Rodger an unintended consequence of the sexual revolution? Will we see more like him?

I will only briefly recap the Elliott Rodger killing spree; extensive information is available elsewhere. Rodger, who was attending the University of California in Santa Barbara, was a very lonely, troubled young man at the lower edge of Los Angeles affluence. According to his published videos and writings, his number one obsession was the seemingly unattainable intimate sexual relationship with a woman—any woman. On May 23, Rodger posted a video on Youtube titled “Elliott Rodger’s Retribution” and on that same day murdered his three male roommates by stabbing them to death. That evening, around 9:30 p.m., Rodger shot and killed two young women and a young man and later died during a police chase, presumably from a self-inflicted gunshot wound. Thus ended another murderous spree perpetrated by a young American man who from the outside did not seem to have such a bad life.

What went wrong for Elliott Rodger? In order to find out, we need to avoid vague abstractions and the usual scapegoats and talk about Elliott Rodger the person. Every act of violence has common threads as well as unique specifics. We have to talk about Rodger the person, if we think we have any chance of preventing another Rodger from killing in the future. Certainly, the motivation for Rodger to kill his three roommates and three others at a nearby sorority was multifactorial. However, one common thread is revealed in his 137-page “manifesto.” Wrote Rodger, "All of those beautiful girls I've desired so much in my life, but can never have because they despise and loathe me, I will destroy." Chilling words by a killer who also had it in for men who scored with those beautiful girls: "I will kill them all and make them suffer, just as they have made me suffer," Rodger added. "It is only fair." Lengthy details of Rodger’s struggle in this regard are available elsewhere. One thing is very clear. This guy wanted casual sex and was angry that he could not get it.

And this gets me to my main point. What life-long lessons about sexuality brought this young man to the notion that he was entitled to casual sex? On what basis did he decide sex was something to which he was entitled but of which by a great injustice deprived? It certainly was not an oft-ridiculed conservative idea that sex is intended to be enjoyed by married couples in the security of a life-long commitment. We are talking about sex outside the life-long commitment and boundaries of marriage, about recreational sex, the kind of sex brought into our society by the sexual revolution of the 1960s. We are talking about the sex that is built on the premise that intercourse between two (or more) consenting adults cannot possibly hurt anyone else. By killing six people and himself, Elliott Rodger challenged this premise. Rodger showed us what happens when the message is, “Hey, sex is great fun so do it whenever you want!” but the reality is, “You are not sexually appealing.” Rodger showed us what happens when recreational sex is commonplace for some and unattainable for others. Rodger is arguably an unintended consequence of the sexual revolution. I ask that we consider the role that a sexually promiscuous society plays in widening the gap between socially accepted and even celebrated members and their unattractive counterparts. I find it difficult to resist the conclusion that a society in which sex is not portrayed as a recreational activity but as something wonderful between two married adults will raise far fewer Elliott Rodgers. Since we obviously have the opposite, all we need to do to find out is wait while we distract ourselves with the usual vague explanations.

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