Healthy Lifestyle Drastically Cuts Hypertension Risk

According to a research presented at the ESC Congress, the risk of hypertension could be decreased by 2 thirds through lifestyle changes. Researchers conducted a cohort study that included 9,637 Finnish men and 11,430 women aged between 25 and 74 years. They were analyzed in terms of lifestyle: smoking, alcohol intake, vegetable consumption, physical activity ( at least 3 times per week), BMI (body mass index). At the time of enrollment in the study participants had no signs of hypertension, but during the 16 years in which they were followed, it was found that 709 men and 890 women developed hypertension. After analyzing all healthy lifestyle factors, researchers found that those who had all risk factors present were three times less likely to develop hypertension. In addition, they found that lifestyle changes have a much greater impact on men than women.

Arterial Hypertension

Moreover, Professor Pekka Jousilahti from the National Institute for Health and Welfare, said that there is a much stronger association in men than in women between hypertension and obesity and alcohol. “The risk of hypertension was only one third among those having all four healthy lifestyle factors compared to those having none,” said Professor Jousilahti. He added that lifestyle has a huge impact on hypertension and that both men and women should lead a healthy lifestyle in order not to develop hypertension. Professor Pekka Jousilahti believes that at lifestyle changes should have an impact also on hypertensive patients.

Hypertension is, according to the World Health Organization, the main cause of mortality in the world. Annually, over 7 millions deaths are a direct cause of hypertension. Hypertension is defined by values greater than 140mmHg (systolic) and 90mmHg (diastolic). It is important that hypertension be controlled because there are various complications can occur such as stroke, myocardial infarction, coronary artery disease, heart failure, aneurysm, chronic renal failure. Hypertension can be primary or secondary. Obesity, high sodium intake, increased levels of renin, insulin resistance are among the risk factors for essential hypertension (ie primary hypertension). What is important is that some of these factors can be controlled. Secondary hypertension is caused by various endocrine or renal disease. Cushing’s disease, acromegaly, renal artery stenosis, pheochromocytoma are the most common causes of secondary hypertension.

Hypertension may be asymptomatic, but symptoms such as headache, tinnitus, fainting and others can occur. Sometimes hypertension is diagnosed when a stroke occurs. There are several classes of antihypertensive drugs: diuretics, converting enzyme inhibitors, ARBs, calcium channel blockers, beta blockers and others. Antihypertensive drugs are chosen taking into account the patient’s condition, the degree of hypertension and comorbidities.

New Aortic Valve Replacement Device

Patients who don’t qualify for open-heart surgeries now have a better chance at survival thanks to a new procedure performed by Ronald Regan UCLA Medical Center surgeons. The procedure consists of a transcatheter aortic valve replacement with a new, more efficient device.

There is an increasing number of people who develop aortic stenosis later in life. Due to calcium deposits, there is a narrowing in the aortic valve that does not allow the aortic valve to open and close properly.  Because of the partially blocked blood flow in the aortic valve, the heart has to work harder in order to pump the blood to the body which increases the risk of heart failure or even death.

The aortic valve has a series of leaflets which make the blood flow from the heart to the aorta possible while preventing blood of returning into the heart at the same time. Aortic stenosis prevents these leaflets from working properly, this way forcing the heart to generate more pressure to push blood through the aortic valve.  The most common symptoms that are associated with aortic stenosis include angina, shortness of breath, edema and even fainting.

In the past this condition was treated with minimally invasive surgical procedures during which surgeons made small incisions into the chest wall and had to use a cardiopulmonary bypass in order to provide a permanent blood flow to the body.

 HIV Transmission

A new study led by an international team of scientists reveals that several bioactive components that are found in human milk are closely related to the reduction of HIV transmission from a HIV-positive mother to her child. The study is published in the online journal American Journal of Clinical Nutrition.

The senior author of the study, Lars Bode, an assistant professor at the UCSD (University of California, San Diego) School of Medicine, says that in most less-developed countries around the world, HIV-positive mothers are unsure whether to breastfeed their newborns or not. “Breastfeeding exposes the baby to the virus and increases the risk of the baby dying from HIV infection; but not breastfeeding increases the risk for the baby to die from other intestinal or respiratory infections”, added Dr Bode.

Dr Bode and his research team wanted to find out why most children that were born from a HIV-positive mother do not contract the HIV virus. Previous studies have shown that only a small number, around 15 percent, of infants receive the HIV infection, even though most of them receive their mother’s milk for more than a few months.

The team discovered that human milk contains an immunologically active component called oligosaccharide (or HMO – human milk oligosaccharide). This is a saccharide polymer that consists of a small number of simple sugars that are linked together. The team also discovered that oligosaccharides are found abundantly in the human milk and are not digestible. This translates into high concentrations of oligosaccharides found on the surface of the child’s gastrointestinal tract.

Breast Feeding

 Dr Bode says that these human milk oligosaccharides have the role of prebiotics, adding that one of their most important role is to aid  the growth of bacteria. Furthermore, the aspect of these oligosaccharides resembles that of glycans (polysaccharides that are found on the surface of epithelial cells). Finally, the human milk oligosaccharides have also been linked to the inflammatory response and were discovered to regulate the immune response in both animal and cellular models.

The research team analyzed the amount of human milk oligosaccharides from the breast milk of more than 200 women. The women participated in an extensive study in Lusaka, the capital of Zambia, a country in the south of the African continent. The women and their children were followed from birth until the child reached the age of 2. Most of the women that participated in the study did not have access to antiretroviral therapy, thus allowing scientists to study the effect human milk oligosaccharides has on HIV-transmission.

The study concludes that a higher concentration of human milk oligosaccharides in breast milk is associated with a better protection against HIV transmission. Future studies will reveal a better understanding on the exact mechanism that allows human oligosaccharides to facilitate or obstruct the transmission of HIV. Researchers suggest that understanding this process will open up new therapy possibilities and new prevention methods for postnatal HIV transmission.

Nokia Will Reveal Two Windows Phone 8 Devices Next Month

Windows Phone 8

The Microsoft company will probably finish its Windows Phone 8 software sometime in the middle of September, and different sources state that concomitantly Nokia will also reveal its next generation of smart devices. The WPDang Chinese website has reported for the first time that the Nokia company will reveal not one but two new Windows Phone 8 Lumia handsets, on September 5th. On the other hand, anyone who knows a little thing or two about the smart phone market will think that Nokia will announce their next generation of Windows 8 phones at the Nokia World event that will take place no sooner than next month.

While the actually release date and the start of shipment of any Windows 8 smart devices only depends on Microsoft’s own schedule, an event that will throw it in for the market before the rumored iPhone 5 will definitely win it some potential buyers. Because the new generation of Apple iPhone is rumored to be announced on September 12th, Nokia does not have very much time to spare, and will probably lack the hardware support to counter any Apple moves that will certainly equip their next generation of smartphones with  breathtaking pieces of hardware.

To sum it up, the Nokia company is the host of an event based on invitation only in Helsinky, between September 5th and September 6th, for its retail partners and operators. This event may be our first chance to see any specs of the new hardware and let us hope that the supposedly two Lumia phones will be available to purchase for the next Holiday buying season.

New Discoveries On Alternating Hemiplegia of Chidhood

New discoveries regarding alternating hemiplegia of chidhood have been made. According to a study published recently in Nature Genetics, alternating hemiplegia of childhood is caused by a mutation in the ATP1A3 gene. This mutation was found in most patients with alternating hemiplegia of childhood. The discovery was made after several investigations made by the  researchers at the University of Utah Departments of Neurology and Human Genetics, in collaboration with Researchers at Duke University Medical Center.

The discovery of the first gene involved in alternating hemiplegia of childhood would not have been possible without access to international database of patients with AHC. Kathryn J. Swoboda, MD, co-first author on the study, associate professor of neurology and pediatrics, and director of the Pediatric Motor Disorders Research Program at the University of Utah, with the AHC Foundation, managed to create an international database of patients with AHC, which includes 200 people.

This discovery helps establish a more rapid diagnosis of the disease. As it is a rare disease, parents spend much time with unnecessary investigations until children are diagnosed. Now, through a simple blood test patients can be diagnoses quickly. In addition, the discovery of this genetic mutation can be the basis for future treatments for children suffering from alternating hemiplegia of childhood.

Child Hemiplegia

Alternating hemiplegia pf childhood is a rare neurological disease whose etiology has long been unknown. On average one in one million people suffer from this disease. Alternating hemiplegia of childhood patients have episodes of temporary paralysis on one side or both sides of the body. These attacks can be of different duration and not are necessarily associated with paralysis, it may also involve mild muscle weakness. Episodes of paralysis occur in childhood and are accompanied by other neurological manifestations such as tremor, dysphagia, dysarthria, dyspnea.

Alternating hemiplegia of childhood is also associated with epilepsy, which makes it hard to diagnose because children are often diagnosed with epilepsy. Epilepsy is a neurological disease characterized by seizures. An important feature of this disease is that symptoms disappear with sleep. In more severe attacks,  they may reappear after wakening. It is also important to know that patients with alternating hemiplegia of childhood are  mentally deficient. Cognitive impairment is almost always present in these patients and may be mild, moderate or severe. It should be noted that alternating hemiplegia  of childhood may be  associated with permanent damage: motor impairment, cognitive impairment, psychiatric disorders etc..

Alternating hemiplegia of chidhood respond to AEDs, such as carbamazepine, valproic acid. Other drugs  used to control symptoms are  flunarizine or sodium oxybat.

Detecting Ovarian Cancer

Researchers have found a new method to diagnose ovarian cancer. It seems that a simple blood test was discovered by those at Vermillion, a medical diagnostics company which may determine whether ovarian tumors are benign or malignant. The test, OVA1, was approved in clinical trials since 2009, and the results are encouraging. Researchers turned their attention to the two target groups: group of women with early stage ovarian cancer and those that are premenopausal. Studies were performed on 494 patients and test sensitivity was 91% for women with early stage ovarian cancer and 94% for premenopausal women. Also, the percentage of false positives was very low (2%). Such a test would be very useful in clinical practice not only for  suspected  ovarian cancer patients but also for doctors. Needless to say,  a blood test to settle the origin of benign or malignant ovarian tumor would be money and time-saving.

Ovarian Cancer Blood Test

OVA1 test is recommended for women suspected of ovarian cancer before they undergo surgery or biopsy. This test analyses actually more specific markers of ovarian cancer : transthyretin (TT), apolipoprotein A-1 (ApoA-1), beta2-microglobulin (Beta2M), transferrin (TFR), and cancer antigen 125 (CA -125). In other words, the test highlights if the tumor is malignant or not. This would be a very easy way to diagnose an ovarian cancer. There are many ovarian tumors, some are malignant and some are benign. Needless to say that treatment differs for the two different categories of tumors. Benign tumors can be usually removed and they do not spread or invade other tissues, unlike malignant tumors. It  is therefore extremely important to determine the origin of the tumor.

Ovarian tumors may have multiple origins. Most are derived from ovarian epithelium, but there are also tumors derived from germ cells (so-called teratomas) or tumors derived from ovarian stroma. There is an important class of benign tumors, which means that it is not cancer. The most common ovarian tumors is manifested by bloating, abdominal or pelvic pain, vaginal bleeding, urinary symptoms, etc.. So the symptoms are vague. On palpation one can observe an abdominal or pelvic mass. There are situations in which ovarian cancer remains long time asymptomatic or it is discovered incidentally.

In most cases, ovarian cancer is diagnosed using a clinical examination,  blood tests (blood tests and tumor markers, CA 125), and  imaging. Intravaginal ultrasound, along with CT, MRI can help diagnose ovarian cancer. But only the histopathological examination performed on a biopsy sample  can tell if the tumor is benign or malignant .

New Drug Found Effective Against Different Cancer Types

Researchers at The Institute of Cancer Research in London have discoverd a new drug which may represent a breakthrough cancer treatment. AT13148, the new drug, is a multi-targeted kinase inhibitor that has proved efficacy in blocking different types of cancers.  The study, recently published in Clinical Cancer Research,  shows that AT13148 can block several types of cancers such as breast cancer (HER2-positive, PIK3CA-mutated breast BT474), prostate (PTEN-deficient PC3 human prostate cancer) and cancer ( PTEN-deficient tumor xenografts MES-SA uterine). Dr. Michelle Garrett, lead author and team leader in the Cancer Research UK Cancer Therapeutics Unit at The Institute of Cancer Research, said that due to the promising results of the study,  the drug will make the next step – the clinical trial.

Currently, there are several types of chemotherapy drugs that target cancer cells: alkylating agents, antimetabolites, immunosuppressants, immunomodulators, etc.. Alkylating agents alter the nucleic acids. This type of chemotherapy containing highly reactive alkyl groups binds nitrogen, phosphate groups or proteins from the nucleic acids. Important to note is that alkylating agents act only on preformed DNA and affects only the cells during division. There are also anticancer drugs that act on preformed DNA such as cisplatin, procarbazine, anthracyclines etc.. On the other hand, antimetabolites (azathioprine, cytarabin, etc.) inhibit the synthesis of nucleic acids. In this category, methotrexate is included which, by inhibiting folic acid, blocks DNA synthesis. Anthracyclines (doxorubicin, mitomycin) are antitumor antibiotics that act in all phases of cell cycle by binding to certain enzymes.

Cancerous Cell – Cancer

Chemotherapy drugs are drugs designed to selectively destroy tumor cells. Usually, in addition to anti-tumor effect, there is also an immunosuppressive effect which is responsible for the negative effects of chemotherapy. Selectivity of action is because tumor cells multiply faster than normal cells. There are some healthy cells that are multiplying faster (hair follicles, digestive system, hematopoietic cells, etc.), which explains the gastrointestinal adverse effects (nausea, vomiting), hematological (thrombocytopenia, leukopenia), hair loss, etc.. In addition, the effect of chemotherapy depend on the degree of synchronization of multiplication. If tumor cells multiply more chaotic and more asynchronous, the chemotherapeutic effect is low. Regarding chemotherapy resistance to the drugs, that occurs due to genetic mutations that cause tumor cell not to be influenced by the drug. There are several mechanisms by which resistance occurs: some cancer cells increase their capacity to repair lesions induced by the drug, others do not allow penetration of drug into the cell, etc.. All in all, finding a drug to act in several ways simultaneously represents a clearly step forward in cancer treatment.

New Heart Attack Prediction Method

Researchers at the University of Edinburgh, the BHF Centre of Research Excellence, in collaboration with the University of Cambridge, have tested a new method for diagnosis of patients with increased risk of heart attack. Researchers have developed a combined technique of PET and CT scanning of active calcification leading to coronary artery stenosis. Dr Marc Dweck, lead author on the research paper and a BHF Clinical Research Fellow at the University of Edinburgh, noted that screening patients at high risk of heart attack is not easy because investigations are not perfect. He added that this new discovery is very promising in predicting a heart attack. However, further investigations are necessary for PET CT scan to be used in current clinical practice. New imaging technique not only determines the cardiovascular risk of patients with coronary artery disease, but can also reduce the chances for a patient to present heart attacks.

Patients with calcified plaque and active calcifications may be  stented in order to  recanalize blood vessel.
The study was published in the Journal of the American College of Cardiology, and was conducted on 100 patients with coronary heart disease. Patients were injected two tracers that can visualize active calcified plaque inactive. 18F-sodium fluoride (18F-NaF), is one of the tracers, which is taken up in cells in which calcifications are active. 18F-NaF PET scans is then measured. Interesting to note that 18F-NaF was found in very high levels in patients with multiple cardiovascular factors.

Cardiovascular diseases are the leading cause of mortality in the world. In the UK alone they kill 88,000 people each year. Generally speaking, coronary disease  refers to a stenosis of blood vessel from the heart. If the vessel is occluded blood does not circulate properly, and the heart muscle is not oxygenated. Therefore, myocardial ischemia occurs and this condition is sometimes translated as angina, a chest pain that has a constrictive character. It should be noted that myocardial ischemia may also be silent, as in patients with diabetes who have sensory neuropathy. When the blood vessel is completely blocked a heart attack occurs. The vessel is blocked due to plaque buildup. In time, plaque can be complicated by platelet aggregation and calcification. Patients with unstable plaque buildup are investigated by coronagraphy to see how much of the vessel is blocked and what is the risk of myocardial infarction. There are other tests such as intracoronary echocardiography, MRI, exercise testing, scintigraphy with technetium.

Benefit of PET / CT has been shown before, when Dr. Dweck has used this technique to analyze more closely aortic stenosis, a valvular heart disease characterized by narrowing of the aortic orifice.

Precancerous Breast Lessions

According to a new study conducted on 29,000 young women, small amounts of alcohol ingested daily can substantially increase the risk of benign breast lesions. Important to remember is that these  benign injuries can lead with time to cancer. The study, published recently in the journal Pediatrics, highlight the already established link between alcohol and breast cancer. According to the American Cancer Society, women who drink the equivalent of five drinks have an increased risk 1.5 times higher in cancer than those who do not drink alcohol. Dr. Graham Colditz, a professor of surgery and associate director for prevention and control at the Siteman Cancer Center of Washington University School of Medicine in St.. Louis, notes that the risk of cancer is substantial for young women who drink alcohol daily. Study results show that the risk increases to 15% for every 10 grams of alcohol ingested. Dr.Colditz  also cautions that such  women can reduce this risk by changing behavior and lifestyle.

Drinking

Even if the link between alcohol and breast cancer has not been clearly established, it seems that alcohol affects estrogen and androgen levels, meaning their growth. Also, apparently alcohol leads to  DNA lesions and cancer cells have a higher metastatic potential. It is well-known that alcohol lowers levels of folic acid (vitamin B9) which is important in the synthesis and repair process of the cellular DNA. However, it seems that the role of folate in cancer is bivalent, because not only low levels of folic acid can lead to early carcinogenesis, but also increased levels can promote tumor growth. Regarding breast cancer, several studies suggest that an adequate level of folate is associated with decreased risk of breast cancer. However, studies are controversial in this regard. There have been studies that have shown that folate supplementation with 300 mg / d in women who consume alcohol may reduce the risk of breast cancer. Interestingly, researchers found that folate intake is not related to benign breast tumors, but alcohol has.

The study was conducted on a sample of 29 000 young women who responded to questions about how often they  drink, how much etc .Researchers analyzed the results and found that as the amount of alcohol consumed is higher your risk of developing cancer is higher. After a follow-up period of 10 years, over 600 women had already developed benign breast tumors. Note that not all benign lesions lead to cancer but it is an important risk factor.

Researchers point out the fact that alcohol consumption and alcohol especially in young people influence health later in life and that it is important to lead a healthy lifestyle.

Multiple Sclerosis

Multiple sclerosis represents a chronic inflammatory and degenerative disease of the central nervous system that leads both to demyelination and axonal loss. It is characterized by axonal myelin sheath destruction, gliosis, different grades of axonal loss and progressive neurological dysfunction. Multiple sclerosis represents the most frequent cause of chronic neurological disability in the young adult.

Multiple Sclerosis Epidemiology :

The incidence and prevalence of multiple sclerosis is higher in North America, Northern Europe, South of Africa and Australia ( 100-150/ 100,000 inhabitants) and lower in ecuatorial regions, Central Africa, Asia and Southern Europe (20-50/ 100,000 inhabitants).

Onset age is between 23 to 29 years (16-60 years) as follows:

• between 20 to 40 years in 70% of cases;
• over 50 years in 10% of cases;
• under 10 years in 0.3% of cases.

The female/ male ratio is 1.8.

Multiple Sclerosis

Multiple Sclerosis Etiology:

The exact cause of multiple sclerosis is unknown but is suspected the contribution of environmental, genetic and immunological factors.

1. Environmental factors.The nature of environmental factors is not precisely known, but multiple sclerosis has a regional incidence which has to be taken into account.
2. Genetic factors. There is a genetic susceptibility with a varying prevalence according to the ethnic group ( high in Northern European Caucasians and low in East Asians). There is an association between the high frequency of the disease and certain alleles within the MHC ( major histocompatibility complex) region of chromosome 6. For Northern Europeans there is an association of multiple sclerosis with HLA-DR2 antigen.
3. Immunologic factors. Arguments that plead in favor of the autoimmune pathogenesis of multiple sclerosis are represented by the fact that demyelinisation is mediated by the peripheral activation of T cells and possibly by antibodies against different myelin antigens and central nervous system. In multiple sclerosis the blood brain barrier becomes permeable and allow the passage of the activated inflammatory cells (mainly lymphocytes) in the brain. This cells will initiate an inflammatory attack on myelin mostly through macrophages and microglia, influencing the nervous conduction and causing the loss of the myelin forming olygodendrocytes. Inflammatory episodes lead to progressive neuronal loss, astrocyte overgrowth and scar forming.

Multiple Sclerosis Pathogensis

According  to recent immunohystological investigations on biopsied or autopsied brain fragments from multiple sclerosis patients, four possible pathological subtypes of lesions have been identified according to the inflammatory degree, myelin destruction and olygodendrocytes preservation. In all situations macrophages are ten time greater than T cells, that themselves are ten time more numerous than B cells.

The following pathological subtypes are described:

1. T cell and macrophage-mediate demyelination, in 18% of cases.
2. T-cell and macrophage, plus antibody-induced or complement-mediated demyelination, in 56% of cases.
3. Oligodendrocyte dystrophy and apoptosis with myelin deregulation, in 24% of cases.
4. Primary oligodendrocyte degeneration with features similar to viral, ischemic or toxic oligodendrocyte damage, in 2% of cases.

Multiple Sclerosis Pathophysiology:

Demyelination causes a conduction block and accounts for acute deficits characteristic of the early years of the disease. Inflammation also contributes to acute conduction block, which is clinically manifested with neuronal function loss, leading to neuronal deficits. This pathophysiological mechanisms are characteristic for the initial phase of the disease. Inflammation is followed by a recovery phase, resolution of inflammatory edema, remyelination, conduction restoration in persistently deyelinated fibers by insertion of sodium channels into internodal membrane and cortical readaptation. Irreversible deficits may be due to failure of demyelinated fibers to restore nervous conduction or due to axonal loss.

Multiple Sclerosis Symptoms:

For 90% percent of patients, the disease will evolve with symptoms in a relapsing-remitting manner. The firs clinical attack consist in focal neurological signs (unique or multiple) that typically develop over a few days, persist for several weeks and resolve spontaneously over several weeks or months. The first clinical manifestation is called clinically isolated syndrome. The most common presenting symptoms relate to lesions in the spinal cord  (in 50%  of cases), optic nerve (in 25% of cases) or brainstem/cerebelum (in 20% of cases).

Multiple Sclerosis Symptoms

Spinal cord onset:

• sensory symptoms such as tingling, numbness, burning, tight bands, altered temperature sensation, Lhermitte’s symptom ( the sensation of electric discharge along the spine, at neck flexion);
• motor symptoms such as weakness, paraparesis, monoparesis, tetraparesis, clumsiness;
• sphincter incontinence, constipation, impotence.

Optic nerve onset is unilateral in 90% of cases and consists in blurred vision, visual loss, reduced color perception, pain on eye movement, phosphenes or optic atrophy.

Brainstem/Cerebelum onset with symptoms such as diplopia, dysarthria, vertigo, nystagmus, facial numbness or weakness, deafness and paroxymal symptoms such as trigeminal neuralgia and tonic spasm.

Other symptoms can be represented by hemiparesis, hemianopia, dysphasia, seizures or cognitive impairment.

Multiple Sclerosis Diagnosis:

Diagnosis of multiple sclerosis consists of the clinical evolution of the disease in separate attacks and of the paraclinical findings.

Paraclinical examinations are represented by:

• increased Ig G;
• MRI examination evidence demyelination lesions in the white periventricular matter, in pons, cerebellum and cervical spine ( this are the elective zones);
• visual, auditory and sensory examination can evidence the disease.

Diagnosis of multiple sclerosis can be:

1. Certain – two attacks in different sites of central nervous system that last more than 24 hours and are separated by at least one month + paraclinical confirmation.
2. Probable – two attacks and one clinical evident lesion or one attack and two clinical evident lesions, confirmed by MRI examination.
3. Possible – one attack and one clinical lesion confirmed by MRI.