December 1, 2006, 4:37 AM CT

Treating The Bedwetters

Children with a form of bedwetting that does not respond to a common medicine have more sodium and urea in their nighttime urine, possibly because of an imbalance of prostaglandin, a hormone-like substance, a new study has found.

The finding helps physiologists understand why about 30% of children who suffer from bedwetting (nocturnal enuresis) do not respond to desmopressin, a drug that successfully treats the other 70%. The findings, made by Danish medical doctors who treat enuresis, could help lead to better treatment for these children.

The study Nocturnal polyuria in monosymptomatic nocturnal enuresis refractory to desmopressin treatment, was carried out by Konstantinos Kamperis and Jens Christian Djurhuus of the University of Aarhus, Aarhus, Denmark and Soren Rittig and Kaj Anker Jorgensen of the Aarhus University Hospital. The study appears in the recent issue of the American Journal of Physiology-Renal Physiology published by the American Physiological Society.

Circadian rhythm important

Urine output is controlled, in part, by our own internal daily clocks, or circadian rhythm. With the transition from day to night, our bodies reduce the amount of excreted water, electrolytes and other metabolic end products in preparation for hours of sleep. We are not born with this circadian rhythm, but it usually develops in early childhood.........

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November 29, 2006, 9:37 PM CT

Risks Increase On Episodic Antiretroviral Therapy

Results from one of the largest HIV/AIDS therapy trials ever conducted show that a specific strategy of interrupting antiretroviral treatment more than doubles the risk of AIDS or death from any cause. In the study, the researchers used two predetermined levels of CD4+ T cells, the primary immune cell targeted by HIV, to guide them in respectively suspending or restarting the study participants on antiretroviral treatment.

A report describing this researchwhich involved 318 clinical sites in 33 countriesappears in this week's issue of The New England Journal (NEJM). The trial, known as Strategies for Management of Anti-Retroviral Therapies, or SMART, was funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

"The SMART trial has provided important new data that will help physicians and their HIV-infected patients make therapy decisions," says NIAID Director Anthony S. Fauci, M.D. "The study reflects an extraordinary global collaboration among hundreds of dedicated AIDS clinicians and thousands of their patients, all of whom should be commended for their contributions to this pivotal HIV/AIDS therapy study".

As HIV/AIDS has evolved into a chronic disease without a cure, lifelong antiretroviral treatment has become the norm. Lifelong treatment, however, can be difficult to adhere to as well as expensive. For these reasons, there has been a concerted research effort to test therapy interruption strategies that may enhance patients' quality of life and limit adverse drug effects. The experimental strategies vary in their approach to when to interrupt treatment. Some, like SMART, use a specific CD4+ count as a guide; others schedule regular time periods during which therapy is stopped (for example, alternating one month off and three months on).........

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November 29, 2006, 5:03 AM CT

Predicting Outcome of Child Heart Surgery

Georgia Tech and Emory University scientists have developed an innovative new technology that will help pediatric cardiac surgeons design and test a customized surgical procedure before they ever pick up a scalpel. With a better understanding of each child's unique heart defect, surgeons could greatly improve the likelihood that children with complex defects requiring multiple surgeries over a period of several years could have smoother recoveries and an improved quality of life after their operations.

The technology, known as image-based surgical planning and developed with the help of pediatric heart specialists and pediatric surgeons at The Children's Hospital of Philadelphia (CHOP) and Emory University, creates a three-dimensional model of the child's heart with data from the child's MRI scans at different times in the cardiac cycle, also called a 4D MRI. The models allow surgeons to visualize the direction of blood flow and determine any energy loss in the heart. So if a surgeon were planning a certain correction to an area of a child's heart, a model created by the system would show the surgeon how well blood would flow through the newly configured heart.

The goal of the Georgia Tech/Emory project is to create a complete system that allows surgeons to get a detailed look at the child's heart functions with the new MRI system, design surgical procedures for optimum post-operative performance and evaluate the heart's performance with a sophisticated blood flow computer simulation.........

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November 29, 2006, 4:38 AM CT

Scientists Working In A 'Boundary-less' Environment

A cadre of world-renowned scientists working in the most promising areas of cancer research have come together to work as a team at one institution Memorial Health to accelerate findings for the prevention and treatment of cancer.

The new approach to making advances in cancer research is focused on a "boundary-less" environment which the scientists expect will stimulate faster, cross-disciplinary results and increased collaboration between scientists and physicians. The "boundary-less" approach applies to all aspects of the research and even extends to the physical facility which features a laboratory that literally has no internal walls.

This team of scientists, all recruited from top institutions in the United States, is focused exclusively on translational or "bench to bedside" research of molecular genetics, allowing them to work closely with physicians to translate laboratory findings into individualized treatments, earlier diagnostics, and new cancer prevention methods for patients.

Tapped to lead Memorial Health's newly created Laboratory Research Program, Jeff Boyd, Ph.D., a distinguished scientist from Memorial-Sloan Kettering Cancer Center in New York City, selected some of the nation's top research talent including Dominique Broccoli, Ph.D., Fox Chase Cancer Center; Nagendra Ningaraj, Ph.D., Vanderbilt University; Ranjan Perera, Ph.D., Burnham Institute, La Jolla, California; Apostolos Psychogios, M.D., Harvard University; John Risinger, Ph.D., National Cancer Institute; and, Cindy Yee, Ph.D., Memorial Sloan-Kettering Cancer Center.........

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November 27, 2006, 4:53 AM CT

Second Cancer Risk For Stem Cell Transplant Recipients

Hematopoietic stem cell transplant (HSCT) recipients face a significant long-term risk for developing a second cancer, particularly if they were older at the time of transplant or received stem cells from a female donor, according to a new study. Reported in the January 1, 2007 issue of CANCER (http://www.interscience.wiley.com/cancer-newsroom), a peer-reviewed journal of the American Cancer Society, the study reveals that within 10 years of an allogeneic HSCT, the relative risk of a second, solid cancer is almost twice that of the general population. In addition, cancer risk almost quadruples for patients who were over 40 years old at the time of transplant or for patients who received stem cells from a female donor.

Myeloablative, allogeneic HSCT is an effective standard therapy for specific life-threatening diseases, such as leukemia or myelodysplastic syndrome, for which blood cell lineages (which originate principally in the bone marrow and circulate in the blood) are abnormal. Destroying the patient's own unhealthy stem cells in the bone marrow and replacing them with a compatible donor's stem cells offers the chance of cure for a disease that otherwise has a high mortality rate with non-transplant therapies. While the procedure can be lifesaving, it is associated with serious short-term adverse effects, such as mucostitis, infections, and liver vascular obstruction as well as the potential long-term complication of developing of a second, usually solid cancer.........

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November 20, 2006, 5:02 AM CT

Confusion About Calories Is Nothing New

While enjoying a Thanksgiving dinner with friends and family, most try to avoid thinking about the seemingly unending number of Calories they're consuming.

It probably never crosses their minds, however, to think about why food is measured in Calories.

James L. Hargrove, associate professor of foods and nutrition in the University of Georgia's College of Family and Consumer Sciences, said many nutritionists aren't even sure of the true origin of the Calorie (or why it's supposed to be capitalized).

"We all teach this unit, and nobody knows where it came from, not even the historians of nutrition," he said.

After this realization, Hargrove began studying the origins of the Calorie. He details his findings in a study would be published in the recent issue of the Journal of Nutrition.

Formally, a Calorie is a measure of the amount of energy required to heat one kilogram of water one degree Celsius. It was first used in engineering and physics, but eventually found its niche in nutrition, where it is used to measure the amount of energy food contains.

Hargrove found that there's some controversy about who "invented" the Calorie. Some references show that two Frenchmen, P.A. Favre and J.T. Silbermann, invented the Calorie in 1852. Other texts state that a German physician, Julius Mayer, effectively invented the Calorie in a study he published in 1848.........

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November 15, 2006, 5:03 AM CT

Obesity An Advantage In Hemodialysis Patients

Despite significant improvements in dialysis treatments, currently over 20% of the 350,000 maintenance hemodialysis (MHD) patients in the United States die each year. A study published in Hemodialysis International finds that this high mortality rate may be attributed to malnutrition.

MHD patients experience what has been termed the "obesity paradox," wherein obesity is associated with increased chance of survival. "A larger body fat mass as seen in obesity probably represents protective reserves that may mitigate the adverse effects of malnutrition in patients," according to Kamyar Kalantar-Zadeh M.D., author of the study.

MHD patients tend to have a high degree of protein-energy malnutrition and inflammation. The combination of these two conditions, termed Kidney Disease Wasting (KDW), leads to increased risk of death. Conversely, it has been shown that an increase in protein intake yields the greatest survival in patients.

The study suggests that improved diet as well as appetite-stimulating agents may be a way to improve nutrition and, consequently, outcome in MHD patients. Understanding the factors that lead to KDW will be the key to improving survival in MHD patients, as well as in the 20 to 40 million Americans who exhibit similar risk-factor paradoxes such as those with chronic heart failure, AIDS, rheumatoid arthritis and malignancy.........

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November 15, 2006, 4:40 AM CT

Holiday Season Could Ring In 'Heartburn Season'

Making merry is often synonymous with overindulging whether from holiday feasts or rich desserts or alcoholic beverages ringing in the holiday season as "heartburn season".

Heartburn generally caused by naturally occurring acids splashing back up from the stomach is often marked by a characteristic burning sensation that sufferers describe as rolling up into their chest. Fatty foods play a starring role in this process.

"Most of the time heartburn is a nuisance, not a tremendous threat to your health," said Dr. Stuart Spechler, professor of internal medicine in digestive and liver diseases at UT Southwestern Medical Center. "I tell most of my patients that it's going to be a tradeoff is the food going to taste good enough to suffer through the heartburn?

"If you know you're going to eat something that ordinarily gives you heartburn, there are medications that you can take before eating that food that might help".

Prevention now emphasized

For decades, the plop-plop-fizz-fizz approach of antacids taken after people already were experiencing heartburn was the only treatment available. Emphasis has since shifted to prevention.

Those who are planning to indulge in foods likely to cause them heartburn can now take a histamine receptor blocker (H2 blockers), which slow the production of stomach acid and are generally available over the counter.........

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November 8, 2006, 9:23 PM CT

Social Exclusion Changes Brain Function

Poor Bridget Jones. At the beginning of the first film about her diary and life, the character, played by actress Rene Zellweger, is fat and alone in her apartment where she mimes one of the great self-pitying song hits of all time: "All by Myself." But Bridget's problem may be more than skin deep.

In new research, reported in the current online issue of the journal Social Neuroscience, researchers from the University of Georgia and San Diego State University report for the first time that social exclusion actually causes changes in a person's brain function and can lead to poor decision-making and a diminished learning ability.

"Our findings indicate that social rejection can be a powerful influence on how people act," said W. Keith Campbell, a psychologist who led the research. The new research is the first to examine subjects' brain patterns following social exclusion using the magnetoencephalography (MEG) technique.

Other authors of the paper include Jean Twenge of San Diego State University; Brett Clementz and Jennifer McDowell, also psychology faculty members at UGA; and UGA graduate students Elizabeth Krusemark, Kara Dyckman and Amy Brunnell.

Researchers have known for a long time that there is a link between social exclusion and the failure of self-control. For instance, people who are rejected in social situations often respond by abusing alcohol, expressing aggression or performing poorly at school or work. (Bridget Jones chooses "vodka and Chaka Khan.").........

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November 7, 2006, 11:07 PM CT

Bones At The Nanoscale

A bone is made up of two different elements: half of it is a stretchable fibrous protein called collagen and the other half a brittle mineral phase called apatite. These components make this biomineralized tissue highly strong and tough. at the same time, In order to understand how this construction is achieved and functions, scientists from the Max Planck Institute of Colloids and Interfaces in Potsdam (Germany) came to the ESRF. Using X-rays they were able to see for the first time the simultaneous re-arrangement of organic and inorganic components at a micro and nanoscale level under tensile stress.

The scientists realised that when strain/pressure is applied to a bone, this is absorbed by soft layers at successively lower length scales, and less than a fifth of the strain is actually noticed in the mineral phase. The soft structures form a single rigid unit at the next level and so on, enabling the tissue to sustain large strains. This is why the brittle apatite remains shielded from excessive loads and does not break.

The results also showed that the mineral crystallites are nonetheless very strong, capable of carrying more than 2 - 3 times the fracture load of bulk apatite. Their small size preserves them from large cracks. This is the first experimental evidence for this effect in biomaterials - small particles resist failure better.........

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