6th Feb 2014, 01:39 PM #781
Re: Health Bulletin
Blood test can predict all birth defects: Expert
The All India Congress of Obstetrics and Gynaecology, on its last day on Wednesday, brought to light the findings of another innovative research. A normal blood test of mother can predict almost all birth defects and genetic disorders and sign of impending diabetes or colour blindness.
Delivering a talk, Dr Niharika Malhotra (Agra) said birth defects like Down's syndrome are on the rise due to late marriages. "While the ultrasound may miss it, another test that requires taking fluid of foetus has proved fatal for baby on many an occasion. In this scenario, this new test is a boon. "This test, however, is performed at select places in Patna and costs approximately Rs 35, 000," said several delegates.
The conference also held a workshop to develop "menopause" into "lovely autumn." After 60, women tend to suffer from Alzheimer (temporary dementia). To avoid this, their brain must be kept engaged by asking them to read. The experts also said their diet must be replete with milk, green vegetables and fruits to prevent deficiency of nutrients. Post-menopausal bleeding must not be taken lightly as it might be a symptom of cancer, said Patna-based senior gynaecologist, Dr Pramila Modi. Experts said women should not misconstrue absence of menses for four-five months as menopause, but wait for two years to reach any such conclusion.
Delivering the prestigious FOGSI MSD oration, US-based gynaecologist Lee Shulman said there is a whole range of options available for contraception and the couples have to take a call after counselling. The newlyweds especially need to be educated about it. If they do not plan pregnancy for two years, Copper T is the most suitable option, the doctors said. "Otherwise, if the youngest child of the couple is more than five years, permanent contraception is the best option," they said. Male vasectomy is the best of all because then female partner does not need to take any protection, provided the seminal fluid of the male partner has shown zero presence of sperms.
Summing up the purpose of the conference, Dr Tripti Sinha said modern techniques of imaging (ultrasonography) and infertility are the two important fields in which the delegates were enlightened. Doctors also learned about in-vitro surgery in which foetus is taken out of the womb, corrected for malformation and implanted back. "Doctors due to their hectic schedule may not be able to exchange knowledge. This all-India conference was a great platform to share the advancements occurring across the world," she said. The "paperless partogram" developed by Dr A K Debdas, Jamshedpur, was also accepted at the conference. The partogram ensures that mothers do not go into long difficult labour.
In some of the sessions new developments in the field of obstetrics and gynaecology like stem cell therapy, expanding horizons of minimal invasive surgery and robotic surgery were highlighted.
7th Feb 2014, 02:52 PM #782
Re: Health Bulletin
Yoghurt reduces type 2 diabetes chance by 28%, says study
Yoghurt (dahi) has been found to be a giant diabetes slayer. British scientists have said higher consumption of yoghurt, compared with no consumption, can reduce the risk of type 2 diabetes by 28%.
Lead scientist Dr Nita Forouhi from the Medical Research Council at the University of Cambridge has found higher consumption of low-fat fermented dairy products, which include all yoghurt varieties and some low-fat cheeses, also reduced the relative risk of diabetes by 24%.
Dairy products are an important source of high-quality protein, vitamins and minerals. But they are also a source of saturated fat, which dietary guidelines advise people not to consume in high quantities.
The research was based on a large EPIC-Norfolk study which includes more than 25,000 men and women living in Norfolk, UK. (EPIC, or the European Prospective Investigation of Cancer, is a large multi-centre cohort study looking at the connection between diet and cancer.) It compared a detailed daily record of all the food and drink consumed over a week at the time of study among 753 people who developed new-onset type 2 diabetes over 11 years of follow-up with 3,502 randomly selected study participants.
This allowed the researchers to examine the risk of diabetes in relation to the consumption of total dairy products and also types of individual dairy products.
The consumption of total dairy, total high-fat dairy or total low-fat dairy products was not associated with new-onset diabetes once important factors such as healthier lifestyles, education, obesity levels, other eating habits and total calorie intake were taken into account. Total milk and cheese intakes were also not associated with diabetes risk.
In contrast, those with the highest consumption of low-fat fermented dairy products (such as yoghurt and low-fat cottage cheese) were 24% less likely to develop type 2 diabetes over the 11 years, compared with non-consumers.
When examined separately from the other low-fat fermented dairy products, yoghurt, which makes up more than 85% of these products, was associated with a 28% reduced risk of developing diabetes. This risk reduction was observed among individuals who consumed an average of four-and-a-half standard 125g pots of yoghurt per week.
A further finding was that consuming yoghurt in place of a portion of other snacks such as crisps also reduced the risk of developing type 2 diabetes.
While this type of study cannot prove that eating dairy products causes the reduced diabetes risk, dairy products do contain beneficial constituents such as vitamin D, calcium and magnesium. In addition, fermented dairy products may have beneficial effects against diabetes through probiotic bacteria and a special form of vitamin K associated with fermentation.
Dr Forouhi said that "at a time when we have a lot of other evidence that consuming high amounts of certain foods, such as added sugars and sugary drinks, is bad for our health, it is very reassuring to have messages about other foods like yoghurt and low-fat fermented dairy products, that could be good for our health".
7th Feb 2014, 02:57 PM #783
Re: Health Bulletin
Study suggests misplaced fears in longer childbirths
Epidural anesthesia lengthens the second stage of labour, the one in which women push. But a study published on Wednesday has found that epidurals are associated with an even longer duration in the second stage than is generally recognized, suggesting that some women may be subject to unnecessary interventions by doctors who wrongly fear labour has become prolonged.
The finding indicates that "clinicians might need to wait later before intervening with oxytocin, forceps, vacuum or a cesarean," said Dr S Katherine Laughon, an investigator at the National Institutes of Health who was not involved in the study, which was published in Obstetrics and Gynecology. Still, she added, "clinicians and women need to balance benefits of vaginal delivery with potential increases in risk for mom and baby."
Current guidelines by the American Congress of Obstetricians and Gynecologists, or ACOG, define an abnormally long second stage as more than three hours for women who received an epidural and are giving birth for the first time, and more than two hours for first births without an epidural.
The new study suggests a normal second stage can take as long as 5.6 hours for women who get epidurals during their first births, and as long as 3.3 hours for those who do not get epidurals.
For women who have given birth previously, the group's guidelines define an unusually long second stage as two hours with an epidural, one hour without. The new study found that the second stage for these women can be as long as 4.25 hours and 1.35 hours, respectively.
"This paper is very important, and ACOG needs to update its 2003 guidelines," said Dr. Robert L. Barbieri, chairman of obstetrics and gynecology at Brigham and Women's in Boston, who was not involved in the new study. He added, "I will change my practice and feel more comfortable going to five and a half hours with a first birth after an epidural with reassuring fetal monitoring."
Researchers at the University of California, San Francisco, analyzed the records of 42,268 women who delivered vaginally without problems between 1976 and 2008. Roughly half had epidurals.
The investigators compared the average length of the second stage of labour among women who had epidurals with that among women who did not. They also compared the upper limits of duration for both groups.
Thirty-one percent of first births and 19 percent of subsequent labours would have been classified as abnormally long by the current ACOG definition, the researchers found.
"It's time to re-examine what normal and abnormal is, and revise our guidelines based on modern obstetric population," said Dr. Yvonne W. Cheng, the lead author of the study and an associate professor of obstetrics and gynecology at the University of California, San Francisco.
The research is part of a growing body of evidence suggesting that a normal second stage of labour is now longer than it was decades ago. In 2010, a study of more than 62,000 women found it was as long as 3.6 hours for first-time mothers after an epidural, and 2.8 hours for women who did not get one.
A 2012 summary of a joint meeting of ACOG and the National Institutes of Health concluded that adequate time for each labour stage "appears to be longer than traditionally estimated." For the second stage, it is closer to four hours for first-time mothers who had epidurals, and three hours for those who did not.
But this latest study is the first to suggest such an extended second stage may be ordinary.
"One of the messages of this study is, sit on your hands a little longer, don't rush into an instrumental vaginal delivery or a cesarean, because really everything could be fine," said Dr. Barbara Leighton, an obstetric anesthesiologist who has researched the effects of epidurals on labour.
But while Dr. Leighton supports revising ACOG recommendations, she believes that the current study did not prove that longer labour is caused by epidural anesthesia. Women who request anesthesia may be predisposed to longer labour for other reasons, she said.
Dr. Jeffrey Ecker, the chairman of the committee on obstetrics practice for ACOG, said today's clinicians are "increasingly recognizing there can be healthy outcomes and vaginal deliveries of healthy babies when the second stage extends beyond how it's traditionally been defined."
He added, "Often what's best and most appropriate — and most difficult — during labour is patience." He would not say whether a revision of guidelines is in the works.
Patience during labour is not risk-free. The new study found that babies are more likely to have birth trauma, such as a bruise on the head or a clavicle fracture, after longer second-stage labour. But these infants did not have lower scores on tests designed to measure physical health in newborns, nor did they experience more admissions to intensive care.
The risks of significant perineal lacerations and postpartum hemorrhage were higher in women who experienced prolonged second-stage labour, both by ACOG's definition and by the upper limits of the study's definition of normal.
While Dr. Laughon applauded the large number of participants in the study, she cautioned that "they are saying we should wait longer, but we still don't know if that's safe."
A lot has changed since the 1950s, when labour progression norms were established. Back then, more babies were delivered by forceps and continuous fetal monitoring was not used.
"We are doing less interventions to facilitate a shorter second stage, and we're letting the power of the uterus and a mother's pushing determine the length of the second stage," Dr Barbieri said.
7th Feb 2014, 02:59 PM #784
Re: Health Bulletin
Potential new anti-malarial drug identified at University of Dundee
A significant milestone in the development of a potential new antimalarial medicine has been reached by scientists at the University of Dundee, in partnership with the Medicines for Malaria Venture (MMV).
In a statement issued on Thursday, a compound developed in the Drug Discovery Unit at Dundee has been selected by MMV, following a positive recommendation by MMV's expert scientific advisory committee, to enter preclinical development.
Professor Ian Gilbert, chair of Medicinal Chemistry at Dundee and one of the project leaders, said: "This compound has impressive antimalarial properties. It has potential for a single dose treatment of malaria. It also has the possibility to protect people from getting malaria in the first place and in stopping malaria being spread from infected people to others (a feature known as transmission-blocking)."
Dr Kevin Read, co-project leader and also based at Dundee, said: "We are very excited by this compound which belongs to a different chemical class to current antimalarial drugs. This compound will now undergo scale-up and further safety testing with a view to it entering human clinical trials within the next 18 months."
Every year, there are over 200 million cases of malaria across the globe, resulting in about 627,000 deaths from this disease. Most of the deaths occur in children under the age of five and pregnant women are particularly vulnerable. There is an urgent need for new, well-tolerated, effective and affordable drugs. One reason for this is that the parasite that causes malaria is developing resistance to current medicines.
The DDU team has been working with MMV to identify potential new treatments for malaria.
This project began when one of the DDU collections of compounds was screened against the parasite that causes malaria. This process identified a start point for a drug discovery programme. This start point was then modified through subsequent cycles of design, synthesis and testing by expert teams of chemists and biologists, resulting in the discovery of this new antimalarial compound.
"Identifying a compound like this is no small feat," said Dr Paul Willis, one of MMV's Drug Discovery Project directors. "It's a great achievement, particularly given the exciting properties of the compound, which give it potential for use in the treatment, prevention and transmission-blocking of malaria.
7th Feb 2014, 03:24 PM #785
Re: Health Bulletin
Changing meal times could affect liver
A new study of mice has suggested that merely changing meal times could have a significant effect on the levels of triglycerides in the liver.
The results of this Weizmann Institute of Science study not only have important implications for the potential treatment of metabolic diseases, they may also have broader implications for most research areas in the life sciences. In studying the role of circadian rhythm in the accumulation of lipids in the liver, postdoctoral fellow Yaarit Adamovich and the team in the lab of Dr. Gad Asher of the Weizmann Institute's Biological Chemistry Department, together with scientists from Dr. Xianlin Han's lab in the Sanford-Burnham Medical Research Institute, Orlando, US, quantified hundreds of different lipids present in the mouse liver. They discovered that a certain group of lipids, namely the triglycerides (TAG), exhibit circadian behaviour, with levels peaking about eight hours after sunrise.
The scientists were astonished to find, however, that daily fluctuations in this group of lipids persist even in mice lacking a functional biological clock, albeit with levels cresting at a completely different time - 12 hours later than the natural schedule. "These results came as a complete surprise: One would expect that if the inherent clock mechanism is 'dead,' TAG could not accumulate in a time-dependent fashion," Adamovich said. So what was making the fluctuating lipid levels "tick" if not the clocks? "One thing that came to mind was that, since food is a major source of lipids - particularly TAG - the eating habits of these mice might play a role." However, in mice lacking a functional clock, the team noted that they ingest food constantly throughout the day. This observation excluded the possibility that food is responsible for the fluctuating patterns seen in TAG levels in these mice.
The study was published in the journal Cell Metabolism
8th Feb 2014, 12:51 PM #786
Re: Health Bulletin
Are you a coffee addict? Check for caffeine use disorder
If you can't live without your cup of coffee early morning or that tea to prevent the after-lunch slump, you may be suffering from caffeine use disorder. Researchers at American University in Washington, DC, indicate that more people are dependent on caffeine to the point that they suffer withdrawal symptoms.
"They are unable to reduce caffeine consumption even if they have another condition that may be impacted by caffeine - such as a pregnancy, a heart condition or a bleeding disorder," said psychology professor Laura Juliano at American University. The negative effects of caffeine are often not recognised as such because it is a socially acceptable and widely consumed drug that is well integrated into our customs and routines.
"While many people can consume caffeine without harm, for some it produces negative effects, physical dependence, interferes with daily functioning, and can be difficult to give up, which are signs of problematic use," Juliano added.
The study, published in the Journal of Caffeine Research, shows how widespread the caffeine dependence is and the significant physical and psychological symptoms experienced by habitual caffeine users.
Caffeine is found in everything from coffee, tea and soda to OTC pain relievers, chocolate, and now a whole host of food and beverage products branded with some form of the word 'energy'. "Genetics research may help us to better understand the effects of caffeine on health and pregnancy as well as individual differences in caffeine consumption and sensitivity," Juliano contended.
Based on current research, Juliano advises that healthy adults should limit caffeine consumption to no more than two to three cups. Pregnant women and people who regularly experience anxiety or insomnia - as well as those with high blood pressure, heart problems, or urinary incontinence - should also limit caffeine.
8th Feb 2014, 06:55 PM #787
Re: Health Bulletin
Temporary blindness 'helps hearing'
Temporary blindness can improve hearing, a new study has shown. Scientists have discovered that keeping mice in the dark for several days altered their brain circuit and made their hearing better.
Researchers now predict humans that humans will respond in the same way, because mammals have a similar brain structure in the region that controls these senses.
The phenomenon has been called the " Ray Charles effect," as the soul singer and pianist was thought to have more sensitive hearing because of his blindness.
Researchers from the US reported in the journal 'Neuron' that neural connections in the brain that control vision and hearing work together to support the other sense.
The findings could be used to help people with hearing loss, and the distressing "ringing" in the ears known as tinnitus.
Dr Hey-Kyoung Lee, a leading member of the team from the Mind/Brain Institute at the Johns Hopkins University in the US, said: "In my opinion, the coolest aspect of our work is that the loss of one sense - vision - can augment the processing of the remaining sense, in this case, hearing, by altering the brain circuit, which is not easily done in adults.
"By temporarily preventing vision, we may be able to engage the adult brain to now change the circuit to better process sound, which can be helpful for recovering sound perception in patients with cochlear implants for example."
In the study, healthy adult mice were placed in a darkened environment for six to eight days, to simulate blindness, while their brain activity and response to sound was monitored.
When the mice were reintroduced to the light, their vision was unchanged, but their hearing was better than before.
As the researchers played a series of one-note tones, neurons in the auditory cortex involved in hearing fired faster and more powerfully than normal. They were also more sensitive to quiet sounds and better at discriminating between different sounds.
In addition the mice developed more nerve connections, or synapses, between the thalamus - a part of the brain that acts as a "switchboard" for sensory information - and the auditory cortex.
Co-author Dr Patrick Kanold, from the US University of Maryland, said: "We don't know how many days a human would have to be in the dark to get this effect, and whether they would be willing to do that. But there might be a way to use multi-sensory training to correct some sensory processing problems in humans."
After returning to normal lighting conditions the mice reverted to their usual standard of hearing in a few weeks.
In the next phase of their five-year study, the scientists plan to look for ways to make the sensory improvements permanent and to expand their scope beyond changes to individual neurons.
8th Feb 2014, 07:02 PM #788
Re: Health Bulletin
How brain wires up for better social behaviour decoded
Scientists have for the first time identified a way in which different parts of the brain don't talk to each other very well in many people with autism and other neurodevelopmental disorders.
Researchers at the European Molecular Biology Laboratory (EMBL) in Monterotondo, Italy, and collaborators at the Istituto Italiano di Tecnologia (IIT), in Rovereto, and La Sapienza University in Rome, demonstrate that it can be caused by cells called microglia failing to trim connections between neurons.
"We show that a deficit in microglia during development can have widespread and long-lasting effects on brain wiring and behaviour," said Cornelius Gross, who led the study.
"It leads to weak brain connectivity, decreased social behaviour, and increased repetitive behaviour, all hallmarks of autism," said Gross.
The findings indicate that, by trimming surplus connections in the developing brain, microglia allow the remaining links to grow stronger, like high-speed fibre-optic cables carrying strong signals between brain regions.
But if these cells fail to do their job at that crucial stage of development, those brain regions are left with a weaker communication network, which in turn has lifelong effects on behaviour.
Yang Zhan, a postdoctoral fellow in Gross' lab at EMBL, analysed the strength of connections between different areas of brain in mice that were genetically engineered to have fewer microglia during development.
Scientists combined this approach with high-resolution fMRI (functional Magnetic Resonance Imaging) scans of the mice's brains, taking full advantage of a novel technique developed at IIT, which enables scientists to obtain detailed, three-dimensional maps of the brain's functional connections.
The team found that mice with fewer microglia had weaker connections between neurons, and less cross-talk between different brain regions.
Researchers discovered that mice with fewer microglia and decreased connectivity displayed behaviours commonly associated with autism spectrum disorders.
These mice spent more time repeatedly grooming themselves, and avoided social interactions.
"This is an exciting time to be studying microglia, they're turning out to be major players in how our brain gets wired up," Gross said.
The study was published in the journal Nature Neuroscience.
9th Feb 2014, 04:09 PM #789
Re: Health Bulletin
First step to personalized medicine
Cancer scientists in France have made "one of the first steps" toward the creation of personalized medicines targeted to combat an individual patient's breast cancer. By scanning all of the DNA — the entire genome — of more than 400 women with late stage breast cancer for the first time, researchers have provided "proof of principle" that the technique can be used to understand the genetic cause of cancer in an individual, and help design tailor-made drugs to target it.
However, the number of patients whose genetic alterations could be "matched" with new treatments was small — only 13 per cent, and experts cautioned that the number of drug trials underway would have to increase if the dream of "precision medicines" for cancer were to become a reality. The SAFIR01 trial, led by Professor Fabrice Andre of the Institute Gustave Roussy in Paris, involved patients from 18 cancer centres in France.
Biopsy samples including at least 50 per cent cancer tumour cells were analyzed from 407 patients . It was possible to analyze the entire genome of two thirds of the patients.
Half were found to have a targetable genetic alteration — but in a large number of cases these had no current drug treatment, either undergoing trials or currently available, to be matched with.
"So far 55 of those enrolled have been matched with new treatments being tested in clinical trials," Professor Andre said. "This emphasizes the need to increase the range of drug trials. Our goal is to have 30 per cent of patients in clinical trials testing therapies targeting the alterations in their tumours."
The results of the study were published in The Lancet medical journal this week. Dr Kat Arney, science information officer at Cancer Research UK said that while the outcome of the study for patients may have been disappointing, it nonetheless provided proof that whole genome testing for a large group of patients "could be done" and could aid the development of new drugs.
"We already test certain genetic mutations to put patients on targeted drugs, but this is the first time that the whole genome has been tested — this is the future," she told The Independent. "For several years the field of cancer research and treatment has been moving towards the idea of precision medicine — the idea that you take samples of someone's tumour, you find out the particular molecular faults that are driving it and then you give them the right targeted treatment."
However, she said there was "an awful long way to go" before the research would yield widespread benefits for patients, adding that complications such as the ability of cancer cells to evolve resistance to even targeted drug treatments would need to be overcome.
Dr Charles Swanton, from Cancer Research UK's London Research Institute, said that the study had brought "important insights into the logistical, scientific, and clinical challenges of implementing national cancer genomic assessment".
However, he said that the patient outcomes were "sobering" and provided "a stark reminder" that understanding of the biological mechanisms behind the spread of advanced breast cancer was still "basic" . "Efforts to accelerate genomic analyses for personalized medicine must continue to be embedded within the context of clinical trials, and integrated with scientific and clinical collaborative structures to deliver measurable benefits to patients ," he said.
9th Feb 2014, 04:09 PM #790
Re: Health Bulletin
Short height? Blame it on X chromosome
The secret to the differences between male and female traits - including body mass index (BMI), height, blood pressure and lipid levels - lies in chromosome X.
Researchers from University of Helsinki analyzed the commonly occurring genetic variation in chromosome X in almost 25,000 northern European individuals to know some of the well-known differences between men and women in certain traits, such as height.
"We had a strong belief that opening 'the X files' for research would reveal new, interesting biological insights," said researcher Taru Tukiainen.
Studying the X chromosome has some particular challenges.
The fact that women have two copies of this chromosome and men only one has to be taken into account in the analysis, Tukiainen added.
The study showed that a genetic variant close to ITM2A - a gene that has a role in cartilage development - is frequent among the people being shorter than average.
Interestingly, the effect of this variant on height was shown to be much stronger in women.
The double dose of X-chromosomal genes in women could cause problems during the development. To prevent this, there is a process by which one of the two copies of the X chromosome present in the cell is silenced.
"When we realised that the height associated variant we identified was nearby a gene that is able to escape the silencing, we were particularly excited," said lead researcher Samuli Ripatti.
"Because both copies of ITM2A remain active, the gene is expressed in higher levels in women," he said in the study published in the journal PLOS Genetics.