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INFECTIOUS DISEASE: AT LEAST 12 PATHOGENS THAT COULD SPREAD INTO NEW REGIONS AS A RESULT OF CLIMATE CHANGE
Wildlife Conservation Society health researchers said there are at least 12 pathogens that could spread into new regions as a result of climate change, with potential impacts to both human and wildlife health and global economies. Called The Deadly Dozen: Wildlife Diseases in the Age of Climate Change, the new report provides examples of diseases that could spread as a result of changes in temperatures and precipitation levels. The best defense, researchers said, is a good offense in the form of wildlife monitoring to detect how these diseases are moving so health professionals can learn and prepare to mitigate their impact. The “Deadly Dozen” list—including such diseases as avian influenza, Ebola, cholera, and tuberculosis—is illustrative only of the broad range of infectious diseases that threaten humans and animals, the researchers said. In addition to the health threats that diseases pose to human and wildlife populations, the pathogens that originate from or move through wildlife populations have already destabilized trade to a large extent and caused significant economic damage, the researchers said. The other diseases include Babesiosis, intestinal and external parasites, Lyme disease, plague, “red tides,” Rift Valley Fever, sleeping sickness, and yellow fever.

DISINFECTANTS: BIOCIDES CAN MAKE BACTERIA RESISTANT TO ANTIBIOTICS
Chemicals used in the environment to kill bacteria could be making them stronger, according to researchers at the Department of Veterans Affairs Medical Center in Detroit. In a paper published in the journal Microbiology, the researchers report that low levels of these chemicals, called biocides, can make the potentially lethal bacterium Staphylococcus aureus remove toxic chemicals from the cell even more efficiently, potentially making it resistant to being killed by some antibiotics. Biocides are used in disinfectants and antiseptics to kill microbes. They are commonly used in cleaning hospitals and home environments, sterilizing medical equipment and decontaminating skin before surgery. At the correct strength, biocides kill bacteria and other microbes. However, if lower levels are used the bacteria can survive and become resistant to treatment. Bacteria like Staphylococcus aureus make proteins that pump many different toxic chemicals out of the cell to interfere with their antibacterial effects. These efflux pumps can remove antibiotics from the cell and have been shown to make bacteria resistant to those drugs. The researchers exposed S. aureus taken from the blood of patients to low concentrations of several biocides and dyes, which are also used frequently in hospitals. They found mutant bacteria that make more efflux pumps than normal were produced.

BLINDNESS: RESEARCHERS IDENTIFY ONE GENE INVOLVED IN AGE-RELATED MACULAR DEGENERATION
Scientists at the University of Southampton have identified one of the genes implicated in age-related macular degeneration, the most common cause of blindness in developed countries. The research, published online in the Lancet, adds to the growing understanding of the genetics of age-related macular degeneration (AMD), which the researchers believe should ultimately lead to novel treatments for the disease. Almost two-thirds of people aged 80 years or older are affected by AMD to some degree, with more than one in ten left blind by the disease. The total yearly costs of healthcare usage are seven-times higher for patients with AMD than for those unaffected. Researchers have previously identified a number of other genes or regions of the genome that affect a person's susceptibility to the disease. The University of Southampton researchers have shown that a particular variant of the gene SERPING1, carried by just under a quarter of the population, appears to offer protection against the disease.

PROSTATE CANCER: MORTALITY HIGHER FOR OVERWEIGHT MEN WITH HIGH INSULIN SECRETION PRE-DIAGNOSIS
Excess bodyweight and high plasma concentrations of C-peptide (a protein that reflects the amount of insulin secretion) in men who are subsequently diagnosed with prostate cancer are reliable indicators that they are more likely to die from their disease than those with lower levels, according to researchers at Harvard University and McGill University. The findings, which are derived from a substudy of the Physician’s Health Study, were published in the online edition of The Lancet Oncology. Men who were overweight or obese before diagnosis were significantly more likely to die from their prostate cancer than men of normal weight. Men with both a high C-peptide concentration and high BMI prior to diagnosis of prostate cancer had a four times higher risk of disease-specific mortality, independent of other clinical predictors. The adverse effect of a high insulin secretion rate (as reflected by high C-peptide levels) on prostate cancer mortality is greater in magnitude than the beneficial effect of chemotherapy currently used for advanced prostate cancer, and clearly points out the need for further research regarding the role of insulin and related hormones and metabolic factors in prostate cancer biology, the researchers said.

CROHN’S: INFLAMMATORY BOWEL DISEASE TRACED TO DISABLED GUT CELLS
Scientists at Washington University School of Medicine in St. Louis report that they have linked the health of specialized gut immune cells to a gene associated with Crohn’s disease, an often debilitating inflammatory bowel disorder. Research previously revealed that some Crohn’s disease patients have a mutation in a gene known as Atg16L1. The mutation increases risk but doesn’t automatically lead to Crohn’s disease. In a study published online in Nature, the researchers found decreased Atg16L1 protein had pronounced effects on Paneth cells, which are immune cells in the lining of a portion of the small intestine. These cells make proteins and antimicrobial peptides that they package as granules and secrete into the intestine to defend the body against infection. When they have less Atg16L1 the Paneth cells survive, but their ability to secrete granules is significantly impaired, the researchers said. It is not yet known why having abnormal Paneth cells would predispose a person to Crohn’s disease or to what degree other genes linked to Crohn’s may affect the Paneth cell, but those are just a few of the very interesting questions to follow up on from these results.
 
CARDIOVASCULAR DAMAGE: ANTI-CANCER DRUG PREVENTS, REVERSES HEART INJURY IN MOUSE MODEL OF PREMATURE AGING DISORDER
An experimental anti-cancer drug can prevent—and even reverse—potentially fatal cardiovascular damage in a mouse model of progeria, a rare genetic disorder that causes the most dramatic form of human premature aging, according to National Institutes of Health researchers. In a study published in Proceedings of the National Academy of Sciences, researchers said there currently are no treatments for progeria, which is estimated to affect about one child in 4 million and leads to premature cardiovascular disease, causing death from heart attack or stroke at about the age of 13. Building upon past experiments in cells and mice, the researchers examined the effects of an experimental cancer drug, tipifarnib, in a strain of mice genetically engineered to develop cardiovascular damage similar to that seen in progeria patients. Tipifarnib belongs to a class of drugs known as farnesyltransferase inhibitors, which are being tested in people with myeloid leukemia, neurofibromatosis, and other conditions. The team had previously found that these drugs could reverse structural abnormalities in skin cells taken from progeria patients and grown in the laboratory. Researchers said not only did this drug prevent these mice from developing cardiovascular disease, it reversed the damage in mice that already had disease. But they said more work needs to be done to determine whether FTI drugs will reverse progeria-associated cardiovascular disease in humans the same way they do in mice.

DIABETES: COMMON INTESTINAL BACTERIA MAY PROVIDE SOME PROTECTION FROM DEVELOPING TYPE 1 FORM OF THE DISEASE
Researchers at Yale University and the University of Chicago said common intestinal bacteria may provide some protection from developing type 1 diabetes. The findings provide an important step towards understanding how and why type 1 diabetes develops in people, and may lead to potential cures said the researchers in a study reported this week in Nature. The results lend further support to the “hygiene hypothesis,” that exposure to an appropriate amount and composition of bacteria may be important to living a healthy life, and that susceptibility to type 1 diabetes and other autoimmune disorders may actually be caused by a lack of exposure to certain parasites and microbes, researchers said. In the study, researchers found that exposure to certain bacteria will trigger an immune system response in mice. That response is believed to be what prevents autoimmune disorders—conditions where the immune system attacks healthy cells in the body. In people with type 1 diabetes, the immune system attacks the beta cells in the pancreas, stopping a person’s ability to detect glucose and produce insulin. For the purposes of the study, the bacteria used were harmless microbes typically found in the human intestine. The researchers said that safe, measured exposure to certain bacteria may lower the risk of immune disorders.

BLOOD CANCER: KEY PROTEINS IN BLOOD STEM CELL REPLICATION PINPOINTED
Researchers at the Stanford University School of Medicine said a family of cancer-fighting molecules helps blood stem cells in mice decide when and how to divide, signaling an important step in understanding the initiation of human cancer at a cellular level. The researchers in the Cell Stem Cell study said blocking the molecules’ function spurs the normally resting cells to begin proliferating strangely—making too much of one kind of cell and not enough of another. Many types of human blood cancers involve a similar disruption in the expression of that same family of molecules, they said. The blood stem cells’ misguided enthusiasm also inhibits their ability to successfully repopulate the immune system of a recipient animal after a bone marrow transplant—a common leukemia treatment. Researchers said the discovery is the first to directly link the notorious members of the retinoblastoma family of proteins to the cellular production factories responsible for churning out all the blood and immune cells in the body. Retinoblastoma protein proteins have been shown to be involved in preventing many different types of human cancers. The researchers found that blood, or hematopoetic, stem cells in the mice, which usually hang around quietly waiting to be called into action, began actively proliferating when Rb family members were missing. And while unmodified blood stem cells give rise to two main groups of cells—myeloid and lymphoid—the cells missing the Rb family strongly favored the myeloid lineage.

DOWN SYNDROME: A NEW PRENATAL BLOOD TEST DETECTS IT AND TWO OTHER SERIOUS CHROMOSOMAL DEFECTS IN A SMALL STUDY
Howard Hughes Medical Institute and Stanford University researchers said they developed a new prenatal blood test that accurately detected Down Syndrome and two other serious chromosomal defects in a small study of 18 pregnant women. If confirmed in larger trials, the researcher said, the test would offer a safer and faster alternative to invasive prenatal tests such as amniocentesis that pose a small risk of miscarriage. The study was published in the Proceedings of the National Academy of Sciences. Researchers have long known that a pregnant woman’s blood contains small amounts of DNA from the fetus. The researchers said they devised a way to the scan fetal DNA present in the mother’s blood to determine whether the fetus’ cells contain extra chromosomes associated with several types of severe birth detects. They said the test was more accurate than techniques used in previous efforts to diagnose aneuploidy by analyzing fetal DNA. Aneuploidy occurs when there are either too many or too few chromosomes in cells. Down syndrome, for example, is caused by a trisomy—three copies instead of two—of chromosome 21. Amniocentesis and chorionic villus sampling (CVS), which are currently considered the “gold standard” in prenatal testing, involve sampling cells in amniotic fluid. The procedure carries up to a 1 percent risk of inducing a miscarriage. With the new test, scientists only need to draw a small amount of blood from the woman.

OBESITY: A LITTLE EXERCISE GOES A LONG WAY FOR SEVERLY OVERWEIGHT
A little exercise goes a long way toward helping severely obese individuals improve their quality of life and complete important daily tasks, according to researchers at the Duke Diet and Fitness Center. In a pre-program assessment where patients reported, on average, just under one hour of exercise per week, individuals who were more active reported better overall quality of life. They also reported improvements in their ability to perform daily tasks as measured on a physical functioning scale. In a presentation at the Obesity Society’s annual scientific meeting in Phoenix, the researchers said that things many people take for granted like tying one’s shoes, getting dressed, or simply moving around were easier for those who reported routine exercise. Other quality of life improvements associated with higher activity levels included the ability to complete basic daily tasks, such as getting up from chairs, using the stairs, dressing and undressing, and improved physical symptoms like feeling short of breath. The researchers said that the benefits of exercise have not been studied as extensively in the severely obese population as in mild or moderately overweight populations. The study suggests that even a little activity offers benefits may spur some severely obese people to be more active.

PSYCHOLOGICAL STRESS: COMPASSION MEDITATION MAY IMPROVE PHYSICAL AND EMOTIONAL RESPONSE
Researchers at Emory University report that individuals who engage in compassion meditation may benefit by reductions in inflammatory and behavioral responses to stress that have been linked to depression and a number of medical illnesses. The study, published in the journal Psychoneuroendocrinology, suggests that meditation practices designed to foster compassion may impact physiological pathways that are modulated by stress and are relevant to disease. One group in the study underwent a secular presentation of compassion meditation based on a thousand-year-old Tibetan Buddhist mind-training practice called “lojong.” A control group attended classes designed by study investigators on topics relevant to the mental and physical health of college students such as stress management, drug abuse, and eating disorders. After the study interventions were finished, the students participated in a laboratory stress test designed to investigate how the body’s inflammatory and neuroendocrine systems respond to psychosocial stress. No differences were seen between students randomized to compassion meditation and the control group, but within the meditation group there was a strong relationship between the time spent practicing meditation and reductions in inflammation and emotional distress in response to the stressor. Consistent with this, when the meditation group was divided into high and low practice groups, participants in the high practice group showed reductions in inflammation and distress in response to the stressor when compared to the low practice group and the control group.

SMOKING: MENTALLY ILL SMOKE AT FOUR TIMES THE RATE OF GENERAL POPULATION
Australians with mental illness smoke at four times the rate of the general population, according to researchers from the University of Melbourne. The study, published in the Australian and New Zealand Journal of Public Health, said despite smoking halving among Australia’s general population over the past 20 years, there has been little change in smoking rates among people with psychiatric disabilities. Researchers said smoking rates remain high even though three quarters of those involved in the study said they wanted to quit or cut down on cigarettes. The study surveyed 280 clients of a psychiatric support service—most had schizophrenia—in Melbourne’s northern suburbs. The study found that more than six in 10 (or 62 percent) of those surveyed smoked, compared to fewer than two in 10 (16 percent) members of the general population. The study also found that smokers with mental illness consumed 50 per cent more cigarettes a day than the general population, averaging 22 cigarettes a day. The heaviest smokers in the group smoked up to 80 cigarettes in a day, researchers said. Researchers said the study showed the need for specialist services to help people with mental illness stop smoking. The researchers said smoking also placed a big financial imposition on many people with mental illness, some of whom spent more than 20 per cent of their income on cigarettes.

IMAGING: PORTABLE IMAGING SYSTEM WILL HELP MAXIMIZE PUBLIC HEALTH RESPONSE TO NATURAL DISASTERS
Researchers at the Georgia Tech Research Institute said they have developed a low-cost, high-resolution imaging system that can be attached to a helicopter to create a complete and detailed picture of an area devastated by a hurricane or other natural disaster. The resulting visual information can be used to estimate the number of storm refugees and assess the need for health and humanitarian services, the researchers said. Aid organizations currently don’t have a quick and accurate way to determine how many people need assistance. Satellites can collect images of areas affected by a natural disaster, but there are dissemination restrictions and cloud cover can prevent collection of images, they said. The imaging system was developed with funding from the Centers for Disease Control, and agency officials would like to begin using this device as soon as possible, the researchers said. After responding to the recent devastation caused by Hurricanes Hanna and Ike, the CDC asked the institute to accelerate delivery of the imaging device for use during the 2008 hurricane season, the researchers said. The imaging system is called the “Mini ModPOD,” which stands for “Miniature Modular Photographic Observation Device.” It consists of an off-the-shelf Canon Digital Rebel XTi digital camera, a global positioning system receiver, a small circuit board that uploads mission parameters, and an inertial measurement unit that measures the aircraft’s rate of acceleration and changes in rotational attributes, including pitch, roll and yaw. The images collected from the system can be stitched together to create a complete picture of the affected area, the researchers said.

STRESS: SOOTHING MUSIC SIGNIFICANTLY REDUCES ANXIETY AND DEPRESSION DURING PREGNANCY
Music therapy can reduce psychological stress among pregnant women, according to researchers from the College of Nursing at Kaohsiung Medical University, Taiwan who randomly assigned 116 pregnant women to a music group and 120 to a control group. The music group showed significant reductions in stress, anxiety, and depression after just two weeks, using three established measurement scales, said the researchers in the Journal of Clinical Nursing. The researchers said the control group showed a much smaller reduction in stress, while their anxiety, and depression scores showed little or no improvement. Women in the music group also expressed preferences for the type of music they listened to, with lullabies, nature, and crystal sounds proving more popular than classical music, researchers said. The women who took part in the study were an average age of 30, were between 18 to 34 weeks’ pregnant, and expected to have uncomplicated vaginal deliveries. Before they took part in the study, women in the music group scored 17.44 on the Perceived Stress Scale, which ranges from zero to 30. After the intervention their stress levels had dropped by an average of 2.15, which is statistically significant, the researchers said. Women in the control group reported a much smaller fall of 0.92, researchers said. Anxiety was measured by the State Scale of the State-Trait Anxiety Inventory, which ranges from 20 to 80. It fell by 2.13 from 37.92 in the music group and rose by 0.71 in the control group, researchers said. Depression was measured by the Edinburgh Postnatal Depression scale, which ranges from zero to 30. The music group reported an average level of 12.11 before the intervention and a reduction of 1.84 at the end of the two-week period. The score was almost constant in the control group, falling by an insignificant 0.03, the researchers said.

SPECIMEN LABELING ERRORS: RADIO-FREQUENCY IDENTIFICATION REDUCES THEM
Mayo Clinic researchers said they are recommending a new technologically advanced labeling system aimed at reducing specimen labeling errors in a high-volume gastrointestinal endoscopy center. They said the conclusion is based on the results of a study they are presenting at the 2008 American College of Gastroenterology Annual Meeting showing a big decline in errors after implementing the system. Researchers reviewed the number of specimen-labeling errors for the first three months of 2007, prior to the implementation of the initiative and the first three months of 2008, six months after the initiation of RFID specimen labeling. Specimen-labeling errors were categorized as Class 1 (only typographical with no potential patient care consequences), Class 2 (minor error, unlikely to have patient care consequences) and Class 3 (significant error that has the potential to detrimentally impact patient care). The endoscopy unit sent 8,231 specimen bottles to the pathology laboratory for evaluation during the first three months of 2007, and 8,539 bottles in the first three months of 2008. Compared to 765 errors in 2007, only 47 errors were noted in 2008, researchers said. Overall, serious errors were low anyway, but the new labeling system reduced such errors even more, minimizing risk for patients, researchers said. The two incidents of Class 3 errors in the first quarter of 2008 were recognized and corrected prior to specimen processing in the pathology laboratory. Most labeling errors have been due to either the wrong patient label or no label being affixed to a specimen bottle, researchers said. As a result, a quality improvement initiative was created to reduce the number of specimen-labeling errors, they said.

INFLAMMATORY BOWEL DISEASE: VITAMIN D DEFICIENCY COMMON IN PATIENTS WITH IBD, CHRONIC LIVER DISEASE
Researchers at the Medical College of Wisconsin found patients with inflammatory bowel disease or chronic liver disease were at increased risk of developing Vitamin D deficiencies. Vitamin D, a fat-soluble vitamin, helps the body absorb calcium and plays a crucial role in the growth and maintenance of strong, healthy bones, said the researchers in the study presented at the Annual Scientific Meeting of the American College of Gastroenterology in Orlando. A lack of vitamin D causes calcium-depleted bone, which can weaken the bones and increase the risk of fractures resulting from osteoporosis. The researchers analyzed vitamin D levels of 504 inflammatory bowel disease patients and found almost 50 percent of the patients were Vitamin D deficient at some point, with 11 percent being severely deficient. Researchers from the University of Tennessee in Memphis measured the vitamin D levels of 118 chronic liver disease patients and found 92.4 percent of chronic liver patients had some degree of vitamin D deficiency and at least one third were severely deficient. Severe vitamin D deficiency was more common among cirrhotics. A diet rich in vitamin D, such as fish, eggs, fortified milk, and cod liver oil, is essential to maintaining good bone health.

OBESITY: PARENTS FOSTER SIGNIFICANT MISPERCEPTIONS OF CHILDREN’S WEIGHT
Many parents do not accurately perceive their children as overweight or at risk for adulthood obesity, according to University of Washington in Seattle and the University of Minnesota. In the survey presented at the American College of Gastroenterology’s 73rd Annual Scientific Meeting in Orlando, researchers measured parental perceptions of their children’s current weight and perceived risk for developing obesity as an adult. Researchers found that even though all of the children in the survey had an elevated body mass index, less than 13 percent of the parents of overweight kids reported their child as currently overweight. Fewer than one-third perceived that their child’s risk for adult obesity was above average or very high, the researchers said. Forty-six parents of children ages 5 to 9 with a body mass index (BMI) in the 70th percentile or higher were recruited for the study. Child height and weight were measured during a routine pediatric clinic visit. Parents were mailed a series of questionnaires, which included questions on their perception of their child’s current weight, and whether they perceived that their child was at risk for developing obesity as an adult. Researchers said that if they are going to address the growing epidemic of childhood obesity, parents’ description and awareness of their children’s overweight will have to be much more accurate.

MEDICAL ERRORS: PEDIATRICIANS MORE LIKELY TO DISCLOSE THE ONES THAT ARE APPARENT TO FAMILIES, SURVEY FINDS
A survey of pediatricians found wide variation in whether and how they would disclose medical errors to patients and their families, and may be less likely to share information about errors that are less obvious to parents, according to researchers at the University of Washington School of Medicine, Seattle. Parents want to be told when an error occurs in their child’s care, but such disclosure does not always occur, according to background information in the article, which appears in Archives of Pediatrics & Adolescent Medicine. A total of 176 pediatric attending physicians and 29 trainees responded to the survey, which asked 11 questions about one of two scenarios. In the first, the pediatrician administered an overdose of insulin that resulted in the child’s admission to the intensive care unit—an error deemed apparent to the family. The second scenario involved failure to follow up on a child’s laboratory test, which resulted in an infection and hospitalization. This error was considered less obvious to parents. Compared with those who received the lab test scenario, twice as many who received the apparent error scenario would disclose the error (73 percent vs. 33 percent) and more would offer an explicit apology (33 percent vs. 20 percent), the researcher said. Some 161 (79 percent) described either error as serious, and 171 (83 percent) said they would feel very or extremely responsible. Another 91 (44 percent) would be concerned that their reputation would be damaged by the error, and 69 (34 percent) believed it was likely to result in a lawsuit. Some 109 (53 percent) would definitely disclose the error, 82 (40 percent) would probably do so and 14 (7 percent) would disclose only if asked by the parent. The researchers said 95 (46 percent) would use the word “error” when disclosing, 54 (26 percent) would include an explicit apology acknowledging the harm caused to the child and 103 (50 percent) would explain detailed plans for preventing future errors.

LEUKEMIAS: TECHNIQUE MAY ALLOW RAPID DIAGNOSIS OF CERTAIN BLOOD CANCERS
A new twist on a well-known cell sorting technique may allow physicians to diagnose rare leukemias in hours instead of weeks, according to a study by researchers at the Stanford University School of Medicine and the University of California, San Francisco. The clinical promise of the Stanford-developed approach is likely to extend to many other disorders in which cell-signaling pathways are disrupted. The technique, reported on in the journal Cancer Cell, builds on an experimental method called flow cytometry, in which fluorescently labeled antibodies are used to classify and sort cells based on proteins displayed on their outer surface. The new approach creates small holes in the cell membrane prior to sorting. These holes allow other antibodies to enter the cell and bind to signaling molecules involved in the cell’s internal signaling. The technique can reduce a diagnosis to a matter of hours from two to three weeks using existing methods. It also provides a way to monitor disease progress, the researchers said.

OBESITY: STUDY SHOWS HOW FATTY FOODS CURB HUNGER
Fatty foods rich in unsaturated fats—such as avocados, nuts and olive oil—have been found to play a pivotal role in sending a message to the brain that a person is full and to stop eating, according to a new study by researchers at the University of California, Irvine. The study, which appears in Cell Metabolism, said fats trigger production of a compound in the small intestine that curbs hunger pangs. This discovery, the researchers said, points toward new approaches to treating obesity and other eating disorders. The researchers studied how a fat-derived compound called oleoylethanolamide regulates hunger and body weight. They found that an unsaturated fatty acid called oleic acid stimulates production of OEA, which in turn decreases appetite. Oleic acid is transformed into OEA by cells in the upper region of the small intestine. OEA then finds its way to nerve endings that carry the hunger-curbing message to the brain. There, it activates a brain circuit that increases feelings of fullness, researchers said. In previous studies, researchers said they found that increasing OEA levels can reduce appetite, produce weight loss and lower blood cholesterol and triglyceride levels. The researchers believe OEA could be used in a variety of drugs because it is a key to the way the body naturally handles fatty foods and regulates eating and body weight.

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