October 16, 2006, 9:57 PM CT

Asthma Linked To Soot From Diesel Trucks

Soot particles spewing from the exhaust of diesel trucks constitute a major contributor to the alarmingly high rates of asthma symptoms among school-aged children in the South Bronx, as per the results of a five-year study by scientists at New York University's School of Medicine and Robert F. Wagner Graduate School of Public Service.

Over the course of the study, asthma symptoms, especially wheezing, doubled among elementary school children on high traffic days, as large numbers attend schools in close proximity to busy truck routes because of past land-use decisions.

The South Bronx has among the highest incidences of asthma hospital admissions in New York City, and a recent city survey of asthma in the South Bronx's Hunts Point district found an asthma prevalence rate in elementary school of 21 percent to 23 percent. The South Bronx is surrounded by several major highways, including Interstates 95, 87, 278 and 895. At Hunts Point Market alone, some 12,000 trucks roll in and out daily.

The study is a collaboration of NYU School of Medicine, the Robert F. Wagner Graduate School of Public Service, and four community groups The Point Community Development Corporation, Sports Foundation, Inc., We Stay/Nos Quedamos, Inc., and Youth Ministries for Peace & Justice Inc. Endorsed by Congressman Jose E. Serrano, the aim of the study was to examine the impact of industrial emissions on air quality and to direct policy initiatives. Serrano sponsored the press conference today where the findings were discussed.........

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October 15, 2006, 7:21 PM CT

Drug Might Give Prolonged Arthritis Relief

Scientists at Duke University have devised a new way to significantly prolong the effects of an anti-inflammatory drug, potentially making it useful for providing longer-lasting therapy for osteoarthritis, the most common form of arthritis.

The modified drug, which would be injected directly into arthritic joints, could last for several weeks rather than just the few hours the unmodified drug would last, the scientists said.

In their study, the scientists modified a drug called interleukin-1 receptor antagonist (IL1RA). They observed that the drug, which is a protein, could be improved by attaching a second protein that clumps together at normal body temperatures. The combined drug likewise would assemble into clumps in the body to serve as "drug depots" that gradually release active drug particles, the scientists said.

"Eventhough the conventional drug is being used for autoimmune diseases, no one yet knows how much of it would be needed to achieve a therapeutic effect for osteoarthritis," said Lori Setton, associate professor of biomedical engineering and surgery. "Current estimates suggest it would require perhaps two injections per week of the unmodified drug.

"With this advance, we believe therapys could go from twice a week to perhaps twice a month, and that would be a huge clinical gain," she said.........

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October 15, 2006, 6:44 PM CT

Kidney Damage After Heart Surgery

The incidence of kidney damage associated with coronary artery bypass surgery has increased significantly over the past 16 years in the United States, but the rate of death from such damage has decreased significantly during the period, according to a new analysis.

In their analysis of more than 5 million discharges from hospitals across the United States, the researchers at Duke University Medical Center found that the incidence of acute renal failure associated with coronary artery bypass surgery increased almost five-fold during the study period. The researchers estimate that approximately 20,000 cases of the disorder occur nationwide each year.

The rate of death from acute renal failure caused by bypass surgery dropped almost three-fold during the study period, the researchers said. Still, patients with the disorder tend to have higher death rates, and also to require longer hospital stays, than patients who do not experience kidney damage after surgery.

The findings suggest that current strategies used to prevent acute renal failure following bypass surgery may not be as effective as previously thought, the researchers said.

"Postoperative acute renal failure remains a serious complication of bypass surgery that does not seem to have been influenced by any strategies designed to prevent it," said Patricia McGugan-Clark, R.N., an intensive care nurse and member of the study team. "More research needs to be conducted to identify those patients who are most susceptible to acute renal failure and which strategies are most effective".........

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October 12, 2006, 10:16 PM CT

Leading Reason For Corneal Transplants

Guided by families with an unusual number of cases, scientists at Johns Hopkins have discovered the genetic origins of at least one form of Fuchs corneal dystrophy, FCD, the leading reason for corneal transplantation in the United States.

In one form or another, FCD's trademark deterioration of the cells covering the clear, outermost lens of the eye affects more than 4 percent of the population over 40. Late in life, the dystrophy causes swelling of the cornea and can severely affect vision, making it impossible to see well even with glasses or contact lenses. It's believed that various forms of FCD are due to multiple gene mutations.

In a report in the recent issue of Investigative Ophthalmology, a team led by Hopkins ophthalmologist John Gottsch, M.D., says they were able to map a common form of Fuchs, found most often in women, to chromosome 18.

"Finding this chromosomal locus is putting us in the right neighborhood to find culprit genes," says Gottsch. "Now we have to start knocking on every door".

Gottsch is heartened by success with earlier Fuchs gene-hunting studies. The Hopkins group tracked down its first FCD-related gene in a Virginia family with multiple, early onset cases. That gene, labeled COL8A2, was mapped to chromosome 1.........

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October 12, 2006, 4:53 AM CT

Antioxidants Fish Oil And AMD

The National Institutes of Health (NIH) announces a nationwide study to see if a modified combination of vitamins, minerals, and fish oil can further slow the progression of vision loss from AMD, the leading cause of vision loss in the United States for people over age 60. This new study, called the Age-Related Eye Disease Study 2 (AREDS2), will build upon results from the earlier Age-Related Eye Disease Study (AREDS). The original study results were released five years ago today. The study found that high-dose antioxidant vitamins and minerals (vitamins C and E, beta-carotene, zinc, and copper), taken by mouth, reduced the risk of progression to advanced AMD by 25 percent, and the risk of moderate vision loss by 19 percent.

AREDS2 will refine the findings of the original study by adding lutein and zeaxanthin (plant-derived yellow pigments that accumulate in the macula, the small area responsible for central vision near the center of the retina) and the omega-3 fatty acids DHA and EPA (derived from fish and vegetable oils) to the study formulation. The main study objective is to determine if these nutrients will decrease a person's risk of progression to advanced AMD, which often leads to vision loss. Previous observational studies have suggested these nutrients may protect vision.........

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October 11, 2006, 4:44 AM CT

Timing Of Spinal Surgery

When it comes to a devastating spinal injury, says spine surgeon Alexander Vaccaro, M.D., timing might be nearly everything. It's also a topic of great debate and discussion among orthopaedic surgeons.

Dr. Vaccaro, professor of orthopaedic surgery and neurological surgery at Jefferson Medical College of Thomas Jefferson University in Philadelphia and the Rothman Institute at Thomas Jefferson University Hospital and his colleagues are trying to answer a very difficult and controversial question: Should surgeons operate immediately, within hours of the severe spinal injury, to try to limit the damage to the spinal cord and surrounding tissues, as many surgeons believe? Or won't it make a difference in how a patient ultimately fares, as others, citing their experiences, say?

Dr. Vaccaro, in conjunction with Michael G. Fehlings, M.D., at Toronto Western Hospital, is spearheading a multicenter trial called STASCIS, which looks at timing of surgery, the timing of spinal reduction and a prospective evaluation of how patients do.

STASCIS is an acronym for the Surgical Treatment of Acute Spinal Cord Injury Study. Begun in 2003, STASCIS is both an observational and prospective randomized study aimed at determining if patients with spinal cord injury will benefit from early treatment to reduce pressure on the spinal cord.........

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October 10, 2006, 10:24 PM CT

Poultry And Antibiotic Resistance

Clinic researcher and colleagues have found.

Results of the nearly $1.4 million three-year study, funded by the Centers for Disease Control and Prevention, Atlanta, Georgia, are in the November 1 issue of The Journal of Infectious Diseases.

Edward Belongia, M.D., Marshfield Clinic Research Foundation, Marshfield, Wis., and colleagues examined poultry exposure as a risk factor for antibiotic resistance in Enterococcus faecium, a gut bacterium that is increasingly the cause of infections in hospitals. The investigation team focused on use of a growth-promoting antibiotic, called virginiamycin, in poultry.

Virginiamycin is closely correlation to quinupristin-dalfopristin, an antibiotic licensed to treat patients with serious, antibiotic-resistant infections. The drug is prescribed under the brand name Synercid.

As per Belongia, "There is a relative lack of data on the impact of antibiotic use in livestock and its relationship to antibiotic resistance in humans, but there is a fair amount of indirect evidence suggesting that antibiotic use could pose a risk to human health".

"We've known for a long time that resistant bacteria can be found on retail poultry products, but our study is one of the first to show an association between human carriage of antibiotic resistance genes and eating poultry or handling raw poultry.........

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October 9, 2006, 9:29 PM CT

Celiac Disease And Cognitive Decline

Mayo Clinic scientists have uncovered a new link between celiac disease, a digestive condition triggered by consumption of gluten, and dementia or other forms of cognitive decline. The investigators' case series analysis -- an examination of medical histories of a group of patients with a common problem -- of 13 patients would be reported in the recent issue of Archives of Neurology.

"There has been very little known about this correlation between celiac disease and cognitive decline until now," says Keith Josephs, M.D., Mayo Clinic neurologist and study investigator. "This is the largest case series to date of patients demonstrating cognitive decline within two years of the onset of celiac disease symptom onset or worsening".

Says Joseph Murray, M.D., Mayo Clinic gastroenterologist and study investigator, "There has been a fair amount written before about celiac disease and neurological issues like peripheral neuropathy (nerve problems causing numbness or pain) or balance problems, but this degree of brain problem -- the cognitive decline we've found here -- has not been recognized before. I was not expecting there would be so a number of celiac disease patients with cognitive decline".

The next step in the research will be to investigate the measure and nature of the correlation between the two conditions.........

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October 8, 2006, 7:20 PM CT

Exercise For Older Adults

For many older adults, a visit to the doctor is not complete without the bestowal of at least one prescription. What if, in addition to prescribing medications as necessary, physicians also prescribed exercise? Ann Yelmokas McDermott, PhD, a researcher in the Lipid Metabolism Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging (USDA HNRCA) at Tufts University, and Heather Mernitz, PhD, now of the Nutrition and Cancer Biology Laboratory at the USDA HNRCA, propose using the familiar concept of a prescription to help physicians incorporate exercise recommendations into their routine practice. In the journal American Family Physician, McDermott and Mernitz provide clinicians with explicit guidelines for giving their older patients effective "exercise prescriptions".

Their motto for determining an exercise prescription is 'FITT-PRO':

• Frequency
• Intensity
• Type
• Time
• Progression

According to FITT-PRO principles, an exercise prescription must explicitly instruct the patient regarding what type of exercise to do, how often, how hard, and for how long. The exercises must also progress over time as the patient becomes more physically fit. McDermott and Mernitz caution that, as with medicine prescriptions, these exercise parameters must be personalized to suit each patient's health status and goals.........

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October 8, 2006, 7:11 PM CT

Genes Diet And Heart Disease

Scientists from the Jean Mayer USDA Human Nutrition Research Center (USDA HNRCA) at Tufts University and his colleagues have found another link among genes, heart disease and diet. The study, published in Circulation, examined apolipoprotein A5 (APOA5), a gene that codes for a protein, which in turn plays a role in the metabolism of fats in the blood. The results show that people who carry a particular variant of APOA5 may have elevated risk factors that are linked to heart disease, but only if they also consumed high amounts of omega-6 fatty acids in their diets.

Corresponding author Chao-Qiang Lai, PhD, a USDA-Agricultural Research Service (ARS) scientist at the USDA HNRCA, and his colleagues analyzed lipid levels and dietary assessment questionnaires of more than 2,000 participants in the Framingham Heart Study and quantified their intake of different types of fats.

Omega-6 fatty acids, as well as omega-3 fatty acids, are polyunsaturated fatty acids (PUFAs) and, as per a report from the National Institutes of Health Office of Dietary Supplements, most Americans consume about 10 times more omega-6s than omega-3s. Omega-3s are found in nuts, leafy green vegetables, fatty fish, and vegetable oils like canola and flaxseed, while omega-6s are found in grains, meats, vegetable oils like corn and soy, and also processed foods made with these oils. Both omega-3s and omega-6s, known as essential fatty acids, must be consumed in the diet because they are not made by the body.........

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