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Fat Cells Help Pancreas Secrete Insulin

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Research carried out at Washington University School of Medicine in St. Louis shows that the body’s fat cells help the pancreas secrete insulin, a finding which could lead to new methods in improving glucose metabolism in type 2 diabetics or insulin-resistant people.

In the November 7, 2007 issue of Cell Metabolism, scientists at the School of Medicine describe a study using laboratory mice where fat cells release a protein that aids insulin secretion from pancreatic beta cells, the sole source of insulin. The protein is an enzyme that the pancreatic cells produce in minimal amounts; the enzyme enhances glucosde-stimulated insulin secretion from pancreatic beta cells.

The enzyme secreted by fat cells is called Nampt (NMN) and is an important component of the insulin-secretion pathway. "We think this secretion process allows fat cells to communicate with the pancreas and aid its function," says senior author Shin-ichiro Imai, M.D., Ph.D., assistant professor of medicine and of molecular biology and pharmacology. "I suspect this process could be critical for compensating pancreatic beta cell function in the face of increasing insulin resistance." "Our work marks a conceptual breakthrough," continued Imai. "Nampt synthesizes a compound in the bloodstream, and when that compound reaches the pancreas it stimulates insulin secretion. This is a surprising mechanism by which a circulating metabolite modulates pancreatic function."

Imai believes that the compound produced by Nampt could be used to raise insulin secretion from pancreatic cells, and so improve the way the body handles sugar. NMN was measured in the bloodstreams of laboratory mice at a concentration sufficient to enhance insulin secretion from pancreatic cells; previously it not known that NMN circulated in the bloodstream.

In conjunction with the Office of Technology Management at the University, Imai has patented the use of Nampt and NMN for the prevention and treatment of metabolic complications, such as type 2 diabetes.

Source: Cell Metabolism, November 7, 2007.

Rheumatoid Arthritis Patients at Risk for Cardiovascular Disease

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Mayo Clinic researchers have created a simple approach for the prediction of heart disease in rheumatoid arthritis patients within ten years of their initial diagnosis.

Mayo researchers had already identified a connection between rheumatoid arthritis patients and increased risk for heart disease. The problem was to detect and prevent heart disease in these patients who showed no symptoms of it.

"Rheumatoid arthritis sufferers are dealing with pain and stress, therefore cardiovascular disease prevention may be delayed," says Hilal Maradit Kremers, M.D., lead study investigator and research associate in the Mayo Clinic Department of Health Sciences Research. "Our findings indicate that evaluation of cardiovascular risk based on risk factor profiles of individual patients can help physicians identify high risk rheumatoid arthritis patients and assist with decisions concerning cardiovascular prevention."

The 10 year absolute risk of cardiovascular disease in 553 patients diagnosed with rheumatoid arthritis was estimated by Mayo Clinic researchers and compared with 574 patients of the same age and gender who did not have rheumatoid arthritis. The researchers also collected subjects’ other risk factors—diabetes, blood pressure, cholesterol, body mass index and smoking.

It was discovered that 85 percent of 60 to 69 year olds newly diagnosed with rheumatoid arthritis had a 1 in 5 chance of developing a serious cardiovascular condition, compared with 40 percent who did not have rheumatoid arthritis.

In each age group, cardiovascular risk to rheumatoid arthritis patients was similar to that of non rheumatoid arthritis subjects aged 7 to 10 years older. "These results emphasize the importance of performing a comprehensive cardiovascular risk assessment for all newly diagnosed rheumatoid arthritis patients," says Sherine Gabriel, M.D., the study’s senior author and Mayo Clinic rheumatologist and epidemiologist.

Members of the Mayo Clinic study team include: Hilal Maradit-Kremers, M.D., Cynthia Crowson, Terry Therneau, Ph.D; Veronique Roger, M.D., and Sherine Gabriel, M.D. Their work was supported by grants from the National Institutes of Health; in particular, the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

The findings were presented at the American College of Rheumatology Annual Scientific Meeting in Boston, November 6-11, 2007.

Source: Mayo Clinic

Most Heart Attack Patients Stop Taking Lifesaving Medications Within Three Years

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Surprisingly, many heart attack victims stop taking their lifesaving medication within three years of the attack. This was the finding of a Mayo Clinic study presented November 5 at the American Heart Association’s Scientific Sessions 2007.

By following patients at 6, 12 and 36 months after an attack, it was found that smokers were more likely to discontinue taking their prescribed medications within three years. Longer term, patients who were enrolled in cardiac rehabilitation programs tended to continue their medications longer than those who were not enrolled.

The researchers recommended a two-program plan for improving the public’s heart health: first, direct education at heart attack patient who are smokers, encouraging them to adopt physicians’ aftercare advice about continuing medications education; and second, encourage all heart patients to participate in a cardiac rehabilitation program, possibly increasing their likelihood of continuing prescribed treatments.

"The study clearly documented that treatments exist that improve outcomes following heart attacks, but patients need to comply with the treatment regimens for the goal of improved patient health to be realized," says Nilay Shah, Ph.D., the study’s lead researcher.

Patients discontinue taking medications too soon for a variety of reasons, including cost, says Veronique Roger, M.D., M.P.H., co-author of the study. More research is crucial to understand and resolve the barriers patients face as they recover from heart attacks she says.

The Mayo researchers evaluated 292 patients enrolled at the Olmsted County, Minnesota registry of heart attack patients, together with their medication histories up to 10 years. These patients had been discharged from the hospital and were taking ACE inhibitors, beta-blockers and statins to help prevent another heart attack.

Results showed that:

  • At six months, smokers were significantly less likely to continue all three heart medications compared to nonsmokers.
  • At six months, 92 percent of the patients taking statins continued treatment, and by three years only 44 percent of the patients continued taking statins.
  • Similarly, the rate of beta-blocker continuation dropped from 89 percent at six months to 47 percent at three years.
  • The rate of ACE inhibitor continuation dropped from 77 percent at six months to 37 percent at three years

Other members of the Mayo research team are: Henry Ting, M.D., Victor Montori, M.D., and Amy Wagie. Their work was supported by the Mayo Foundation for Medical Education and Research.

Childcare by Mothers with Low Education Levels More Likely to Lead to Aggresive Child Behavior

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In a recent study of mothers with low education levels and their children, those kids receiving regular care from adults other than their mothers during their preschool years were found to exhibit less physical aggression, such as hitting, kicking or biting.

"The origin of physical aggression problems can be traced back to early childhood, and studies have specifically shown that maternal characteristics, especially low levels of education, are among the best predictors of high physical aggression from early childhood to adolescence," the study’s authors write.

Sylvana M. Cote, Ph.D. of the University of Montreal and colleagues studies 1,795 infants, a cross-section of all children born in Montreal in 1997 and 1998. Mothers were asked to provide information on family, parent and child characteristics from when the child was 5 months to 60 months, including details of adult non-maternal care provided, including daycare centers, family arrangements or other non-maternal care provided regularly during preschool years.

Overall, 1,691 children were followed for the whole study, of which 111 (6.6 percent) received no non-maternal care before preschool, 234 (13.8 percent) received some type of non-maternal care beginning before age 9 months and 1,346 (79.6 percent) received non-maternal care beginning at age 9 months or after.

Children whose mothers had a low education level (i.e., did not have a high school diploma) were less likely to receive daycare. However, those children who did receive non-maternal care had lower levels of physical aggression, and the association was statistically significant among children who started day care before age 9 months.

Children of mothers who graduated from high school were at lower risk of developing physical aggression problems, and non-maternal care had no additional effect on their behavior.

The study’s authors conclude that "provision of non-maternal care services to children of mothers with low levels of education could substantially reduce their risk of chronic physical aggression, and that the protective impact is more important if children begin to receive these services before age 9 months… Because the children most likely to benefit from non-maternal care services are those less likely to receive them, universal programs involving the provision of non-maternal care should include special measures encouraging the use of non-maternal care services among high-risk families."

The study was supported by the Quebec Government Ministry of Health and Fond, Quebecois de la Recherche sur la Societe et la Culture, Canada’s Social Science and Humanities Research Council, Canadian Institutes for Health Research, St-Justine Hospital’s Research Center and the University of Montreal.

Source: Arch Gen Psychiatry. 2007;64(11):1305-1312.

Counseling Plus Medication May Help Teens Quit Smoking

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A clinical trial of 312 teenagers aged 14 to 17 who smoked six or more cigarettes a day and had tried quitting at least twice, found that counseling and medication may help teens quit smoking, though in some cases (26-week time period), the placebo group had higher quit-rates than those taking the drug tested in the study, bupropion.

The subjects were divided into three groups and administered 150 milligrams (105 teens) or 300 milligrams (104 teens) of bupropion daily, or a placebo (103 teens).

Students received six weeks of treatment and one week of post-treatment, in addition to 10-20 minutes of individual counseling. Followup interviews were conducted by phone after 12 weeks, and in person after 26 weeks.

Quit rates were higher for the 300 milligram group every week except the fourth week. After six weeks, 5.6 percent of subjects in the placebo group, 10.7 percent taking 150 milligrams of bupropion, and 14.5 percent taking 300 milligrams of bupropion had quit smoking. At 26 weeks, 10.3 percent of placebo subjects, 3.1 percent of those taking 150 milligrams of bupropion, and 13.9 percent who took 300 milligrams were still not smoking.

The results indicate that although 300 milligrams of bupropion plus counseling were effective in helping teens quit smoking in the short term, quit rates at the end of the treatment were lower than for adults taking the same medication.

The high rate of relapse after medication stopped suggests the need for a longer treatment period than the 12 weeks recommended for adults may be needed.

"This study provides hope for helping a generation of smokers to quit before they become adults," the authors conclude. "These results are critically important because few effective treatment options are available for adolescent smokers who want to quit."

This study noted that fully one fourth of U.S. high school student currently smoke cigarettes.

The study was conducted by Myra L. Muramoto, M.D., M.P.H., Scott Leischow, Ph.D., and colleagues at the University of Arizona, Tucson, and supported by a National Cancer Institute grant, The Robert Wood Johnson Foundation (financial support for all aspects of the study) and GlaxoSmithKline (maker of bupropion).

Source: Arch Pediatr Adolesc Med. 2007;161(11):1068-1074

Infertility and Testicular Cancer Linked, Says Study

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University of California, San Francisco researchers have found that men with a history of infertility have a markedly increased risk of subsequently developing testicular cancer. The purpose of the study was to assess testicular cancer in infertile men usingna cohort study methodology.

More than 51,000 couples, drawn from 15 California infertility centers during the period 1965 and 1995, were evaluated for infertility. Male subjects’ medical records were linked to the California Cancer Registry, the cumulative Surveillance Epidemiology and End Results Registry (SEER) for the State of California. Cancers preceding infertility were excluded from analysis, and the incidence of testicular cancer in this cohort was compared to age-matched men from the general population.

The study found that men from infertile couples were 60% more likely to develop testicular cancer than other men (standardized incidence ratio 1.695% confidence interval 1.2 to 2.2). This risk was relatively constant across all age strata.

Source: UroToday

Teaching Kids Hand Washing Habits to Avoid Flu

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A new study, presented at the American Public Health Association’s Annual Meeting & Exposition in Washington, D.C. shows that with a little effort, kids can be taught to make hand-washing a lifetime habit.
A sample of 492 children in grades 1 through 6 was coached by a teacher, with role-playing and education on hand hygiene and a visual demonstration of its effectiveness. The coaching resulted in a lasting increase in the frequency of hand hygiene among elementary school-aged children.
The researchers suggest that with parent volunteers and the limited funds available, the school nurse could train the volunteers to teach a hand hygiene method, using germ-simulating lotion. The teachers could then prompt students to wash their hands before lunch, setting the example by washing their own hands.
"With flu season right around the corner, now is a great time to be having a conversation about what schools can do to encourage kids to develop the habit of washing their hands," said Michelle Snow, RN, MSPH, SHR, lead researcher on the study. "Our research shows that for a very low cost and just a little bit of effort, we can have an impact on a behavior that is important for our children’s health, not just now, but throughoutmtheir lives."
Source: American Public Health Association (APHA)

Ringing in the Ears? Researchers Now Think They Know Why

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Cells in the developing ear can make their own noise, long before the ear can detect sounds around them. This may explain why people sometimes hear sounds that appear to come from nowhere. Reported in the current issue of Nature, the study results also helps explain how the developing auditory system generates brain activity in the absence of sound.

Non-nerve cells in the ears of young rats were studied, and to the researchers’ surprise these support cells showed strong, spontaneous electrical activity, similar to nerve cells.

"It’s long been thought that nerve cells that connect auditory organs to the brain need to experience sound or other nerve activity to find their way to the part of the brain responsible for processing sound," says the study’s lead author, Dwight Bergles, Ph.D., an associate professor of neuroscience at Hopkins. "So when we saw that these supporting cells could generate their own electrical activity, we suspected they might somehow be involved in triggering the activity required for proper nerve wiring."

Suspecting that a chemical might be involved in the cells’ ability to generate electrical pulses, Bergles’ team applied a number of drugs to the cochlea—the small, hollow and liquid-filled inner ear chamber that converts sound waves to electrical signals—hoping to block the mystery trigger.

The breakthough came when it was discovered that ATP (adenosine triphosphate) also caused the supporting cells to change their shape. The team videotaped the developing cochlea to monitor where and where ATP was released. It was found to be released near hair cells, which transfer sound information to auditory nerves. ATP then signals the hair cells to release another chemical, glutamate, which then activate the nerve cells that project into the brain.

"It’s as if ATP substitutes for sound when the ear is still immature and physically incapable of detecting sound," says Bergles, adding that "the cells we have been studying seem to be warming up the machinery that will later be used to transmit sound signals to the brain."

The research was funded by the National Institutes of Health. Authors on the paper are Nicholas Tritsch, Eunyoung Yi, Elizabeth Glowatzki, and Bergles, all of Hopkins, and Jonathan Gale of University College, London.

Source: Johns Hopkins Medicine

Study Finds CO2 Relieves Seasonal Allergies

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A recent Creighton University study shows that non-inhaled, intranasal carbon dioxide may be an effective treatment for many of the 40 million Americans who suffer from seasonal allergic rhinitis (SAR) due to pollens such as grass and ragweed.

Patients receiving CO2 reported improvement in congestion, sneezing and other nasal conditions within 10 minutes, and lasting 24 hours. Within 30 minutes of treatment, 50 percent of those taking CO2 reported more than a 50 percent improvement in nasal symptoms, compared to 27.6 percent in the placebo group.

The study used 89 subjects, 18 to 75 years of age, who had at least a two-year history of seasonal allergies requiring pharmacology. Of these, 60 received CO2, and 29 received plain air. Patients took the gas intranasally twice, once for each nostril, for a total dosage of 1,200 milliliters, avoiding inhaling the gas by breathing through the mouth, allowing the gas to flow in one nostril and out the other.

"It could be a good alternative for people who don’t want to take intranasal steroids," said Dr. Thomas B. Casale, MD, Chief of the Creighton School of Medicine’s Division of Allergy Immunology. He noted that despite currently available treatments, a significant number of patients with allergic rhinitis continue to suffer symptoms that impair their quality of life. The medical costs associated with SAR are estimated at $6 billion a year in the United States.

Thomas B. Casale, M.D., the study’s principal investigator, is president of the American Academy of Allergy, Asthma and Immunology, and the study will be published in the Journal of Allergy & Clinical Immunology.

Source: Creighton University

CT Heart Scan Reliable for Detecting Blocked Arteries

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An international team of cardiac specialists, led by Johns Hopkins researchers, found that sophisticated computed tomography (CT) heart scans are almost as reliable as more invasive procedures.

The 64-slice CT scans, initially tested at Hopkins, will help cardiologists select patients who can avoid more invasive procedures. But the newer scans will not replace the cardiac catheterization, or coronary angiography, although perhaps 25% of the 1.3 million cardiac catheterizations performed annually in the U.S may be unnecessary.

In addition, the latest study showed that early detection with 64-CT would be a good forecaster of patients needing angioplasty or coronary bypass surgery.

Researchers chose 291 men and women over 40 years of age who already planned to have cardiac catheterization to check for blocked arteries. They were then checked to see who developed coronary artery disease, and who required subsequent bypass surgery. On average 91% of patients with blockages were detected by 64-CT scan, which also identified 83% without blockages. This accuracy, said researchers, enabled them to identify patients needing angioplasty or bypass surgery. More than 250,000 Americans undergo coronary bypass surgery annually.

"This study is the first step to realizing the full potential of CT imaging in predicting coronary artery disease, and these scans complement the arsenal of diagnostic tests available to physicians to prevent heart attacks," says cardiologist Julie Miller, M.D., who led the study at Hopkins.

"Use of 64-CT scans will dramatically improve our ability to detect and treat people with suspected coronary disease and chest pain much earlier in their disease," says cardiologist João Lima, M.D., senior investigator to the team whose findings will be presented at the American Heart Association’s (AHA) annual Scientific Sessions in Orlando, Florida. "Cardiac catheterization is still the gold standard for evaluating clogged arteries, but our results show that this test could easily be the best backup or alternative."

Source: Johns Hopkins Medicine