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Victor Smida

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2377

Burmese python, one of the largest snakes in the world, could hold the secret for new treatments that could prevent or combat human heart disease, U.S. researchers announced, in a study published Thursday in Science, informs AFP .

This reptile, which can measure up to nine meters in length and reach a weight of 90 pounds, able to swallow a deer or an alligator, secret fatty acids whose properties seem to be true miracles of the heart, say researchers University of Colorado at Boulder, the authors conducted on this species of pythons and rats.

According to scientists, the quantities of triglycerides – the main element in the structure of natural fats and oils – were over 50 times higher in blood python, a day after they swallow their prey.

Despite strong growth in body fat level of these snakes, the study authors found no fat deposits in the heart.

In addition, scientists have measured increasing the amount of certain enzymes, called superoxide dismutase, known for her powerful protective effect on heart muscle, including humans.

Once you have determined the chemical composition of blood plasma (fluid component of blood) to python, during digestion, U.S. scientists injected the liquid or a similar substance taken from pythons that had an empty stomach.

After these injections, snakes monitored an increase in cardiac muscle and signs of good cardiac health. The researchers repeated the experiment and the mice and found the same beneficial effects in rodent heart.

“We found that a combination of fatty acids can have beneficial effects on cardiac growth in living organisms,” said Cecilia Riquelme, lead author of the study.

“Now, try to understand the molecular mechanism behind the process and hope that our results will lead to new therapies capable of providing better treatment for human cardiovascular disease,” said Cecilia Riquelme.

 

2371

Pap Tests Showing A Higher Predictive Value for Endometrial Cancer

American researchers       reveal that Pap tests can detect endometrial cancer, especially endometrial adenocarcinoma, with a  75.8% positive predictive value. They sustain that if Pap smear is showing some obvious malignant cytologic features for endometrial cancer, the pathologist should provide a diagnosis of positive or suspicious, instead of atypical, because this distinction in diagnosis could provide a more sensitive information to the clinicians and they can fallow their patients very carefully. If Pap smear is revealing a false positive result, then the patients could benefit from a proper management.

The Bethesda System 2001 does not recommend the subclassification of atypical endometrial cells because a lack of well-defined criteria. However, researchers at Henry Ford Hospital in Detroit, Michigan, have pushed that envelope a bit.

“Our division advocates that if a Pap smear shows obviously malignant cytologic features of endometrial adenocarcinoma, we should provide the diagnosis of positive/suspicious instead of atypical. This distinction could provide clinicians with much more sensible information in terms of how they follow their patients. Although this may carry some false positive results, the patients may benefit from proper management in a timely manner,” presenter Linda Szymanski, DO, pathology resident at Henry Ford Hospital, told Medscape Medical News.

This study was undertaken to determine the value of the Pap test in detecting endometrial pathology and the potential pitfalls of a false positive diagnosis.

The researchers conducted a retrospective analysis of 153 patients with a diagnosis suspicious or positive for endometrial adenocarcinoma from 2005 to 2011. All selected cases were followed up surgically.

Diagnostic criteria were based on nuclear size, nuclear irregularity, chromatin pattern, presence of nucleoli, cytoplasmic vacuolization, and tumor diathesis.

In all, 132 cases (age range, 25 to 95 years) had significant pathologic findings: 116 cases of endometrial adenocarcinoma, 14 cases of endometrial hyperplasia, and 2 cases of benign endometrial polyp. There were 21 negative pathology findings (age range, 43 to 83 years).

A second review of the 21 false-positive cases and the 2 benign endometrial polyp cases revealed nuclear hyperchromasia, nucleoli, and cytoplasmic vacuolation, but there was no significant nuclear enlargement or tumor diathesis. Overall, the high-yield cytologic criteria generated a 75.8% PPV for detecting endometrial adenocarcinoma (including all positive and suspicious diagnoses).

“When we eliminated the suspicious diagnosis, we achieved a PPV for outright positive diagnosis of 90%,” said Dr. Szymanski. Despite this success, the researchers say that the Pap test is not an effective screening test for endometrial pathology.

“We learned that when there is a lack of significant nuclear enlargement, we should take a step back. A diagnosis of ‘atypical endometrial cells present’ may be more appropriate than a ‘suspicious or positive’

2040

Avastin Improves Chemo for Refractory HER2-Negative Breast Cancer

In cases of refractory HER2-negative breast cancer, adding bevacizumab (Avastin) to common chemotherapies improves progression-free survival, randomized trial data show.

The data are from the RIBBON-2 trial, conducted in women who needed second-line chemotherapy for metastatic breast cancer. Adding bevacizumab to their chemo did not improve their overall survival, as was originally reported several years ago.

But for women with human epidermal growth factor receptor (HER)-2-negative metastatic disease, bevacizumab delayed disease progression and so might still “expand the treatment options,” said lead investigator Dr. Adam M. Brufsky of the University of Pittsburgh in an email to Reuters Health.

In an October 11th online paper in the Journal of Clinical Oncology, Dr. Brufsky and colleagues reported on 684 women who had previously received at least one cytotoxic treatment for local or distant spread of their HER2-negative tumors.

In RIBBON-2 they each received either a capecitabine-, taxane-, gemcitabine-, or vinorelbine-based chemotherapy regimen, and in addition the researchers randomly assigned them 2:1 to receive bevacizumab or placebo.

Median progression-free survival was 7.2 months in the bevacizumab group and 5.1 months in placebo patients, a significant difference. The objective response rate was also better with bevacizumab, although not significantly so (39.5% vs 29.6%).

One year survival rates were similar in the two arms of the study (69.5% vs 66.2%).

The proportion of women who withdrew from the study due to adverse effects was nearly twice as high in the intervention group (13.3% vs 7.2%). Serious adverse events were also more common with bevacizumab (24.5% vs 17.6%). However, there was no difference in the number of treatment-emergent deaths due to adverse events. The most common cause of death was disease progression.

“Taken together,” the investigators conclude, “these data provide a rationale for adding bevacizumab to second-line cytotoxic therapy for patients with HER2-negative metastatic breast cancer.”

Bevacizumab, however, has had trouble retaining its approval for metastatic breast cancer in the US.

http://www.medscape.com/viewarticle/752841

Bevacizumab initially received accelerated approval in 2008, but its efficacy was questioned and follow-up has not shown a survival improvement. In June of this year a U.S. Food and Drug Administration advisory panel ruled against use of the drug, which reportedly costs about $88,000 per patient per year.

Genentech, which makes the drug for Roche, has appealed and a final decision is expected from the FDA later this year.

Meanwhile, insurers in the U.S., among them Blue Shield of California, have stopped routinely covering new prescriptions for breast cancer patients.

In Europe too, there has been less controversy. Bevacizumab was approved there for use in combination with paclitaxel in 2007. Earlier this year European regulators reversed a previous decision and expanded its use to include administration in combination with capecitabine.

Doctors themselves are divided on the agent, with about 40% of those who responded to a small survey saying that they would continue to use the drug even if the FDA finally rejects it (see Reuters Health report of October 26, 2011).

The study by Dr. Brufsky and colleagues was supported by Genentech of South San Francisco, California. Dr. Brufsky acted in an advisory or consultant capacity but received no compensation from the company. A number of other authors received research funding or are employed by Genentech.

3665

Our Brains Are Mathematical Geniuses

According to Thomas Albright, the director of the Vision Center Laboratory from the Salk Institute, in California, the remote place retreat used by so many people in order to “turn off” their brains is in fact not what it seems. Albright, an expert in the functionality of the visual system explains that the change of scenery makes the brain assess the new information that it receives from the environment.  This includes the assessment of objects, movement and other spatial and temporal properties that the new scenery has.

Sergei Gepshtein, one of the researchers involved in the new study, says that in order to assess these new properties, the brain, can only use a limited amount of neurons. Questions arose around the mechanism that allows the brain to use a limited amount of neurons in an effective way. The research team, consisting of Albright, Gepshtein and Luis Lesmes, a scientist from the Schepens Eye Research Institute, published their new paper in the latest issue of the journal Proceedings of the National Academy of Sciences.

Champagne and Cognitive HealthThe expectations of several researchers haven’t been met in their own previous studies. Thus, the premise that a prolonged exposure to a new scenery would mean that the brain would be capable of detecting the most subtle details was disproved. The results obtained in some of the studies are contradictory. These results reveal that there is no correlation between the amount of time spent examining the environment and the amount of details the brain perceives and remembers. According to Albright, the results of the studies have shown four different types of reactions. The prolonged exposure to the environment had no effect for some people, whilst having an important effect on others. However, people also experienced an increased awareness for other details that weren’t subject of the study.

Gepshtein reveals that their study emerged from the asking of a new question, “What happens when you look at the problem of resource allocation from a system’s perspective?”. Due to the fact that the brain has a limited number of neurons that can be assigned to different tasks, only a part of them are used for the assessment of this new scenery. “As a result of allocating resources to a stimulus, you lose sensitivity to other things, which may or may not be familiar”, said Gepshtein. As a conclusion for their new finding, professor Albrigth says that if you want to improve your abilities in one thing, your ability to improve in other domains will diminish.

The published study reveals a mathematical point of view. According to the research team, the computations made by the visual system in order to accomplish the adaptation to a new scenery is very much alike the signal processing method described by Dennis Gabor. He received the Nobel Prize in physics in 1971 for his discovery in the field of signal processing. In their studies, Gabor and other contemporary scientists have shown that the content frequency and location of a signal are interdependent. It’s easy to understand and measure the location of a signal. However, the challenge is to measure its frequency at the same time. This is due to the fact that frequency takes a longer time to be accurately determined. This translates into a compromise: Either you have a precise measurement of the location of the signal, either you get a precise determination of its frequency, but a precise determination of both cannot be accomplished. In 1971, Gabor invented the “Gabor Filter”, which allows for the best measurement for both properties.

According to Gepshtein, the human brain uses a similar method as the Gabor Filter. ”In human vision, stimuli are first encoded by neural cells whose response characteristics, called receptive fields, have different sizes”, noted Gepshtein, whilst adding that neural cells with larger receptive fields are more sensitive to the signals with a lower spatial frequency. This acts like a filter in the first stages of the visual pathway. This filter is responsible for the stimuli that are received and the ones that aren’t. A change of scenery leads to a change of filter, thus some of the stimuli that were previously received and analyzed are no longer detected, allowing the reception of other stimuli that were previously undetected. “When you see the entire filter, you discover that the pieces – the gains and losses – add up to a coherent pattern”, concluded Gepshtein. Albright added that this process happens whether or not you are consciously paying attention to the change of scenery. However, the adaptation is not an instantaneous process.

2506

Heart defects may be caused by stress during pregnancy, according to study

The latest research reveals that congenital heart defects, some of the most common defects found in newborns, are caused by maternal stress (before and during pregnancy). It seems that maternal stress has consequences on fetal heart development. However, the study results, which were published in the journal Pediatrics, did not show a cause-effect association between maternal stress and congenital heart defects.

Dr. Edward McCabe, senior vice president and medical director of the March of Dimes, said that there are several studies showing an association between heart defects and stress. He said the studies regarding this issue should be continued. Congenital heart defects, some of the most common birth defects in new-borns, include conditions like atrial septal defect, ventricular defect or transposition of vessels. These defects may be surgically resolved after birth if timely discovered and diagnosed by pediatricians. However,  there are situations when these defects do not need surgery or situations when these defects are discovered too late when complications already appeared (pulmonary hypertension or heart failure), and surgery cannot fix them.

Over time there have been incriminated several factors responsible for the occurrence of these congenital heart defects: drugs, alcohol, smoking, radiation, viruses, prematurity. Genetic factors are involved in about 10% of cases of congenital heart defects (Down syndrome, Turner syndrome).

stress during pregnancy

Babies

Now researchers conducted a study in which they analyzed 1.8 one million children born in Denmark from 1978 to 2008 to see if congenital heart defects are due to certain factors. Mothers of these children were under stress before or during pregnancy (they lost a close relative at the time of conception or during pregnancy). It was found that women who suffered from stress before or during pregnancy had a slightly higher risk of giving birth to children with congenital heart defects. Study co-author Dr. Jorn Olsen, professor and chairman of the department of Epidemiology at the School of Public Health at the University of California, Los Angeles, said it is possible that these congenital heart defects run in families and that some members might have died because of those conditions.

Olsen explained that animal studies have shown that maternal stress during pregnancy affects embryonic development. He said that maternal stress may influence diet and this could adversely affect embryonic development. Another explanation could be that stress induces changes in DNA child in the womb. ”This and other studies tell us to take care of pregnant women who experience severe stressful events shortly before or while they’re pregnant,” Olsen said.

2755

Reseachers uncover new findings about esophageal cancer

A recent study led by researchers at Dana-Farber Cancer Institute reveals new findings on esophageal adenocarcinoma, a cancer whose incidence has increased dramatically in recent years. The research comes with a possible explanation for this alarming increase in the incidence of esophageal adenocarcinoma.

Statistics show that over the last 30 years the incidence of esophageal cancer increased approximately about 600 times in the United States of America. It is believed that an important risk factor for esophageal adenocarcinoma is gastroesophageal reflux disease. Gastroesophageal reflux disease involves the presence of stomach acid into the esophagus, which damages the lining of the esophagus. This condition can sometimes result in Barrett’s esophagus which is a premalignant condition for esophageal cancer.

Cell

Cell

Adam Bass, MD, of Dana-Farber and the Broad Institute, who is co-senior author of the paper, said that esophageal adenocarcinoma, especially those located at the junction between the esophagus and stomach, was extremely rare 40 years ago but now there are about 15,000 new cases that occur each year in the United States. He pointed out the fact that unfortunately esophageal adenocarcinoma is a cancer with poor prognosis as 5-year survival rate is only 15%. Although the incidence has risen dramatically in recent decades, in terms of treatment there have not been many improvements. Bass explained that the purpose of the study was to find other genetic abnormalities that cause this type of cancer, to find new methods of early diagnosis and more effective treatment.

It is not clear why the incidence of esophageal adenocarcinoma has increased so much in recent years, although there are several assumptions in this regard. It seems that an important factor in the development of this cancer is obesity, especially in men. It seems that obesity causes increased abdominal pressure which causes  lower esophageal sphincter incontinence.

To find out more about the genetic basis of cancer of the esophagus researchers conducted a study in which they analyzed specific sections of DNA from 149 patients with esophageal adenocarcinoma. In addition, in 15 of these patients researchers sequenced the entire genome. Gad Getz, PhD, of the Broad Institute and Massachusetts General Hospital, co-author of the study, said the study revealed a pattern of DNA changes that has never been seen before. These DNA changes are in fact some mutations that occur in esophageal cells and it seems that these mutations are caused by reflux of stomach acid. ”Identifying the mutated genes within these tumors will help us understand the underlying biology of the disease,” said Bass.

2470

 Children at higher risk to resistant staph infections during summer

According to a nationwide study led by researchers at the Johns Hopkins University School of Medicine, there is a specific seasonal tendency of resistant staphylococcal infections in adults and children. It seems that children are at greater risk of staphylococcal infections resistant to antibiotics during the summer, while adults have a greater risk in winter. The study is published in the  American Journal of Epidemiology.

Staphylococcus aureus is a Gram-positive bacteria that is normally found on the skin surface, about 25% of adults being carriers of S. aureus. But under certain conditions (immunosuppression, the presence of other systemic diseases), it can produce a series of superficial or deep, systemic or local infections, which sometimes can be fatal. It should be noted that Staphylococcus aureus is one of the most common pathogens involved in hospital infections. It is also worth saying that Staphylococcus releases some toxins, so this bacteria can generate not only infections but also intoxications.

staph infections

staph infections

Regarding this seasonal and age preference of treatment-resistant staphylococcal infections, Eili Klein, Ph.D., lead author on the study and a researcher at the Johns Hopkins Center for Advanced Modeling in the Social, Behavioral and Health Sciences, said they do not yet know why this trend occur. However, he believes that excessive use of antibiotics in winter may be the cause. It seems that the strain that infects adults in winter is usually acquired in hospitals and is more resistant to antibiotics. Summer strain of  MRSA ( methicilin resistant Staphilococcus aureus) that occurs especially in children during the summer is often a germ acquired in the community and resistant to fewer antibiotics.

Klein said that excessive prescribing of antibiotics can have negative effects. Antibiotic is quite common in winter, when the incidence of respiratory infections and the common cold is maximum. But inadequate administration of antibiotics to treat upper tract respiratory infections and colds contribute to the development of resistance. In addition, it is already known that antibiotics has no benefit when given to patients with influenza, because flu is given by a virus and not by a bacterium.

Staphylococcus is responsible for a range of infections such as skin infections (such as folliculitis, cellulitis, furuncle, erysipelas), respiratory tract infections (pneumonia, lung abscess), bone infection (osteomyelitis, arthrytis), etc.. These infections are difficult to treat because  Staphylococcus  is one of the germs that easily develops resistance to antibiotics. However, a targeted treatment applied correctly can cure staph infection.

2987

Asthma drug found effective in treating Chronic Urticaria

Researchers have found that a drug used to treat severe asthma, omalizumab, is effective in treating chronic urticaria. This monoclonal antibody was tested on patients with chronic idiopathic urticaria or chronic spontaneous urticaria and it was found that they respond well to omalizumab. The study was conducted by researchers at the Johns Hopkins University School of Medicine and published in the New England Journal of Medicine.

Omalizumab is a humanized monoclonal antibody that was approved in 2003 in the United States for the treatment of severe asthma. It is not known exactly how it works in the treatment of urticaria but it is believed that this drug may act by altering the number of IgE receptors on the surface of immune cells (mast cell and basophils). IgE antibodies are involved in allergic reactions (asthma, allergies to dust, pollen) and omalizumab binds to these circulating IgE in the blood.   Sarbjit (Romi) Saini, M.D., a Johns Hopkins allergist and immunologist, and study co-investigator said that urticaria patients can now opt for a new better treatment. Unlike histamine, omalizumab does not cause sedation which is an advantage over conventional treatment used currently.

Asthma Pills

Asthma Pills

Johns Hopkins researchers did a randomized, double-blind study that took place between 2009 and 2011 on 323 patients ( composed mostly of women) aged between 12 and 75 years. The 323 patients received either placebo or omalizumab in different doses and were monitored for 4 months. Neither the patients nor the doctors knew what kind of drug was administered. It should be noted that in the study there were recruited only patients suffering from chronic urticaria, meaning at least 6 months. Another condition was that the symptoms (rash, itch) to persist for at least two consecutive months despite current treatment with H1-antihistamines. After 12 weeks, 53% of those receiving 300 mg of omalizumab were free of hives, while in the placebo group percentage was only 10%. During the study, there were no severe adverse reactions (anaphylaxis) so as to cause patients to stop treatment. It should be noted that the most common side effect of treatment with omalizumab was headache.

Saini, an Associate Professor at the Johns Hopkins University School of Medicine, said that patients with chronic urticaria need better option treatment because chronic hives and rashes are difficult to treat and can be very debilitating. He added that the study shows that the new drug not only works but is also safer than other treatments such as corticosteroids and immunosuppressants which have a lot of side effects.

1895

Why some melanoma patients are resistant to treatment

According to a study recently published in the Journal of Experimental Medicine, resistance to treatment of certain patients with melanoma may be due to a gene called TP63. Researchers at Queen Mary, University of London, have discovered that this gene is highly expressed in some melanomas and that these forms of melanoma are resistant to treatment. They hope that these findings will help them develop more effective therapies to treat this form of cancer.

Melanoma is diagnosed in about 13,000 people each year in the UK and the incidence of this type of cancer is increasing. Although among the other forms of skin cancer, melanoma is the least common, though this cancer has the highest mortality rate. This high mortality rate is due to dissemination that occur in early stages of the disease. It is estimated that about 2000 of skin cancer deaths are due to melanoma, which means 75% of all cancer dealths.

melanoma patients

Melanoma treatment

It should be noted that melanoma is difficult to treat if not eradicated in the early stages because of systemic dissemination. If advanced melanoma requires multimodal approach (chemotherapy, immunotherapy, surgery etc), in the early stages this cancer can be successfully treated by surgical excision and careful follow-up . Dr. Daniele Bergamaschi, a senior lecturer in cutaneous research at Queen Mary, said that in order to find more effective treatments of melanoma, one should understand the mechanisms that cause tumor cells to become resistant.

Researchers concluded that TP63 gene is associated with resistance to treatment after they analyzed 156 samples from 129 melanoma tissue. They found that the expression of p63 protein, which is encoded by the TP63 gene, is increased in more than 50% of samples. Dr. Bergamaschi said they did not expect to find this in the samples because p63 is a protein  that is not usually found in melanocytes. It seems however that this gene become activated as the tumor begins to grow. In addition, researchers believe that the TP63 gene inhibits p53, a gene with implicated in apoptosis, that is programmed cell death. It should be mentioned that apoptosis is a natural mechanism by which cells die.

Based on these findings and on the possible implication that p63 protein may have in apoptosis pathway, researchers want to target this protein in order to develop more efficient treatments: “We therefore suggest that p63 should be considered when designing new treatments for melanoma which are focused on re-activating the apoptotic pathway in order to make the cancer cells easier to kill,” Dr. Bergamaschi said.

2073

CT angiography proves useful in heart attack risk prediction

According to a study published in the journal Radiology, coronary computed tomography angiography (CCTA) is an effective method in determining the risk of myocardial infarction in patients with suspected coronary artery disease. Jonathon Leipsic, MD, FRCPC, from the University of British Columbia in Vancouver, the study’s first author, says that CCTA may be considered first-line investigation in patients with atypical angina and suspected but not confirmed coronary artery disease.

According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death in the United States and worldwide. Treatment in heart disease mainly addresses the risk factors that can be modified such as blood pressure, high cholesterol, smoking, diabetes, obesity. It should be noted that in addition to these modifiable cardiovascular risk factors, there are also other non-modifiable risk factors such as age (old age), sex (males) or familial history. In other words, cardiovascular disease can be prevented in part by adopting a healthy lifestyle (healthy diet,  sport) and by quitting smoking. On the other hand, there are situations when these risk factors such as blood pressure or high cholesterol cannot be reduced only through lifestyle changes, and then one has to resort to medication, such as antihypertensives or statins (drugs that lowers cholesterol).

Heart attack

Heart attack Prdiction

The main symptom in coronary artery disease is angina, which is chest pain. But there are cases when the patient is symptomatic, that is he has chest pain but the risk factors cannot be identified. Dr. Leipsic said that this situation is common in clinical practice this is why a tool to stratify these patients is strongly needed. CCTA is a non-invasive method with high accuracy that can help diagnose or exclude coronary artery disease. However, currently, the suspicion of coronary artery disease is based on clinical risk factor scoring.

Therefore, Dr. Leipsic and colleagues made research on 5262 patients with suspected coronary artery disease without medical modifiable risk factors. Then the CCTA results were correlated with the risk of major adverse cardiac events. It was found an increased prevalence of coronary artery disease because more than a quarter of patients had non-obstructive disease or disease related to the buildup of plaque in the arteries. ”We found that patients with narrowing of the coronary arteries on CT had a much higher risk of an adverse cardiac event,” Dr. Leipsic said.  He added that they are collecting data in order to determine the prognostic value of CCTA after five years or more of follow-up.