Atherosclerosis

According to recent studies, new therapeutic strategies to treat atherosclerosis�are based on immunological approaches. Discussions on combating atherosclerosis by vaccines and monoclonal antibodies were held at the�meeting� Frontiers in Cardiovascular Biology (FCVB), held from March 30 until April 1 to at the South Kensington Campus of Imperial College in London.

Atherosclerosis is a disease characterized by narrowing of arteries due to fat deposit in blood vessels, such as cholesterol. Atherosclerosis is a disease that develops over time and can cause heart attack or stroke. According to some studies, the disease kills 2 million people per year in Europe. Atherosclerosis is in fact a chronic inflammatory disease� promoted by� LDL (low density lipoproteins). Once�inside�in a �blood vessel wall, LDL is oxidized by free radicals. This results in a� complicated cascade of immune reactions that in time lead to plaque formation.

Currently, treatment for atherosclerosis is based on reducing risk factors, such as lowering lipids, hypertension, and hyperglycemia. Dr. Nilsson, who is Professor of Experimental Cardiovascular Research at Lund University, Sweden, noted that these conventional therapies are effective only for 40% of patients and that there remains a significant 60% where�atherosclerosis cannot be combated.

The idea of�such a�role of the immune system in�the atherosclerosis process is not completely new. Since the 1990s atherosclerosis has been regarded as an autoimmune disease. Then, scientists believed that the immune system attacks the plaque oxidized LDL. After�many hours of�research, scientists have sought to identify and create structures to induce a protective response and to block the appearance of plaque.

The researchers have analyzed and identified three fragments of amino acids that form apoproteins�B, proteins consistently associated with LDL. One of the three fragments enter the CVX-210�vaccine, which�is about to be approved by the FDA. The vaccine is in a phase 1 clinical trial.�Also is under development�is a second vaccine,�with �intranasal�administration, vaccine based, like the first one, �on one of the fragments of amino acids apo B.

Vaccination

Furthermore, researchers are working on a different therapeutic target to treat atherosclerosis,�that is�preventing LDL oxidation by monoclonal antibodies. Preclinical studies have shown that by injecting monoclonal antibody BI-204, the process of atherosclerosis is reduced by 50%. Currently, BI-204 is in Phase 2 clinical study and is tested on patients with coronary artery disease in 20 centers in U.S. and Canada. The results are promising but Dr. Nilsson notes that these therapies are expensive.” The antibody therapy in particularly is likely to be expensive so you could probably only afford to give it to high risk populations rather than everyone,” he said.

Acute Myeloid Leukemia

According to a study published in Cancer Cell, researchers from the United Kingdom have discovered a new drug for the treatment of an aggressive�form of myeloid leukemia. Acute myeloid�leukemia is a cancer of the myeloid�line of blood cells, which is characterized by abnormal growth of white blood cells. This increase causes aberrant accumulation of white blood cells in bone marrow, which interfere with normal blood cell production. Myeloid�leukemia causes anemia, decreased platelets (thrombocytopenia) and normal white blood cells (neutrophilic).

Symptoms AML installation�are fatigue, dyspnea, bleeding, bruising and increased risk of infection. In terms of causes, they are not clearly defined, but there have been questioned different risk factors such as exposure to certain environmental factors (benzene, radiation), to certain drugs (doxorobicina, cyclophosphamide), chromosomal abnormalities, various rare syndromes (Fanconi�anemia, Down syndrome , Bloom syndrome, neurofibromatosis). However, most patients do not have known risk factors. Untreated, acute myeloid leukemia leads to death within weeks or months.

Acute Myeloid Leukemia

Researchers at the Paterson Institute for Cancer Research at The University of Manchester have found that by blocking an enzyme is inhibited�the production of�proteins that causes an aggressive type of leukemia, called�mixed lineage� leukaemia (MLL). The researchers created synthetic molecules block LSD1�, the enzyme involved in modulating gene activity that causes cancer. Moreover, the lead study author Dr Tim Somervaille, group leader at Cancer Research UK’s Leukaemia Biology Laboratory, said that the experiments on both patients and mice showed promising results.

The National Cancer Institute� divided treatment�for leukemia� into two categories, namely remission induction and consolidation therapy. The first is to remove all visible leukemia cells while the second refers to destroying the remaining� cells and relapse prevention. Until now, treatment options were very limited, ie chemotherapy or radiotherapy or bone marrow transplant. Important to remember that in �the last option, that is�bone marrow transplant,��the patient still has to follow chemotherapy and then receive stem cells from a donor.

Acute leukemia is a curable disease, but prognosis depends on various factors. The average survival at 5 years is about 25%. In terms of survival rates,�the younger�had better survival rates than older adults. Dr Somervaille�pointed out the importance of developing new drugs to treat leukemia. Many patients cannot be treated with chemotherapy or hematopoietic stem cell transplantation. Thus, using drugs that block LSD1�is a new hope for such patients.Also, Dr Somervaille believes that this new therapeutic target� may be useful in treating other cancers, but more studies must be done in this respect.

Study Idendifies Markers Of Adverse Effects Of UTI During Pregnancy

Researchers at Nationwide Children’s Hospital studied the effects of urinary infection in pregnant mice and identified markers that indicate whether the infection has negative effects on fetal growth.

In order to notice the adverse effects of urinary infection on fetal growth, researchers used laboratory pregnant�mice. Up until now, the effects of bladder or urinary tract infection have not�been well evidenced in humans. “Observations that an infection isolated to the urinary tract is associated with adverse perinatal outcomes have been anecdotal,” said Sheryl S. Justice said, PhD, principal investigator in the Center for Microbial Pathogenesis at The Research Institute at Nationwide Children’s Hospital and lead study author.

Pregnancy UTI

During the�study , researchers found that�offsprings born�from infected�females were�less developed than those born�from� not�infected females. This finding�suggests that� proinflammatory�cytokines in the blood� have generated a more severe inflammatory response in the uterus than in �the kidney. That means, added Dr. Justice, that the�placenta is more vulnerable to immune changes than other organs. One cytokine involved in the inflammatory response is interleukin 6 (IL-6). Interestingly, the highest concentration of IL-6 was found in female with the�offspring with the lowest birth weight. So, according to the study, IL-6 is correlated with fetal growth�in the uterus. Therefore, results are promising because�these interleukins can be used as predictors to assess the risk of prematurity in offsprings.

Urinary tract infection is actually�a bladder inflammation and�it is a common disease�among many women. During pregnancy� the risk of developing UTIs�increases due to several factors such as hormonal changes or bladder compression by the uterus. Usually, the infection is caused by bacteria (eg E. coli) and it is treated with antibiotics.

On average, it is estimated that about 50% of women suffer from this disease. ITU is manifested by frequent removal of small amounts of urine (polakiuria), permanent feeling of urination, discomfort during urination (dysuria), bloody urine (hematuria) or cloudy color and powerful�smell of urine. In addition, in severe cases, there may be fever, nausea, vomiting, pelvic or back pain. Untreated UTI can cause serious complications such as�pyelonephritis, which is a kidney infection. In terms of fetal growth, UTI can cause premature�or may�interfere with�fetal growth. Moreover,��it has been reported that UTI�may cause� childhood asthma. Usually, all pregnant women in early pregnancy are evaluated for a possible UTI, and those at risk are closely monitored.

Back Pain Relief – Stretching To Relieve Back Pain

Often, successful treatment of back pain and morning�back pain can occur after several attempts, through various forms of treatment. No matter what�type�of�pain you are suffering from,�it is not recommended�to try several different treatment techniques�at once. The explanation offered by experts in the field is�that the back pain gets worse after�patients try many different exercises�and that makes�it difficult�for them�to determine which method triggers�discomfort. It is recommended to start with one or two techniques to improve pain relief�with daily repetitions and if the exercises�show the�desired results,�continue to exercise.

Stretching in the morning

Try to wake up a little earlier than usual to start some light exercises�even before going�out of�bed. These exercises target low intensity back, neck or hip pain.

1. The collars stretch – Lie on your side and curl up slightly in the fetal position, keeping the position for several seconds. Relax and then continue the exercise. As you repeat this type of exercise, you will�feel a mild stretch in the spine.
2. Exercise for�the middle and upper back – Raise your hands above your head and close them. Turn the palms outward and then distance� the arms. Relax and then repeat. Do not try to stretch your arms more than you feel it is�comfortable.
3. Lightweight stretch the lower back – Lie on back with your�knees bent, keeping feet on the mat. Move both feet slightly to the left (5-10 cm) and back into position. Relax for a few seconds and then move the legs towards right. Repeat, moving the feet to either side,��as logn as you feel comfortable. While doing this exercise�it is important to ensure that�you do not�turn�your pelvis too.

Rising from bed

Try when you wake up,�to get�out of bed by turning instead�of immediately�jumping into�vertical position, thus preserving unnecessary pressure on the�head and neck. Easy swing your�legs out of bed�to the�floor and then get up from that angle. Avoid�a very inclined position on the bed.

Keep your back straight – Posture is very important in the morning�for your�muscles, joints and ligaments as they�begin to recover from physical inactivity during the night. Before you get out of bed, arch your�back and lean slightly forward towards the hips.

Before your muscles�start to�warm up, avoid sudden movements and any position that�overstretches muscles or joints. After a period of inactivity, the body is prone to injury. An extended hot shower will relax your entire body�when it comes into�contact with hot water.

Nicotine Patches Little To No Effect In Aiding Pregnant Woman Quit Smoking

A new study led by Dr. Tim Coleman�at the�University of Nottingham in England and published in the� New England Journal of Medicine shows that nicotine patches have little to no effect in aiding pregnant women to quit smoking. The scientists used 1,050 pregnant women for their study. The women were divided into two groups, one that received counseling and nicotine patches and the second group that also received counseling but the patches they received�contained no nicotine (placebo).

Although women that were part of the first group, the ones that received the patch had a quit rate of over 20 percent after the first month, by the time of delivery, the rate of quitting dropped to 9.4 percent. Only 12 percent of the women from the second group had quit after one month of study, buy the percentage also dropped, to 7.6 percent, at delivery. This shows that between the women in the two groups statistically there is ni�significant difference.

The reason the percentage of quitters is so low could be the fact that more than 90 percent of the women from both groups had stopped using the nicotine patch by the time of delivery.

Older studies show that patches, gum or even nasal sprays containing nicotine (also referred to as nicotine replacement therapy) has a beneficial effect on patients trying to quit smoking. According to the current study, these therapies have little to no effect on pregnant women.

Smoking While Pregnant

The nicotine patch improved short-term but not long-term quit rates�, said Dr. Cheryl Oncken, while also adding that The other significant finding is that there was low compliance. Women didn’t really take the patch for any period of time. So you really can’t tell from this data whether it’s safe or effective for use in pregnancy�.

Dan Jacobsen of the Center for Tobacco Control, N.Y., says that the U.S. Centers for Disease Control and Prevention only use nicotine patches as a last resort, for women who cannot quit smoking with the help of counseling�due to�safety concerns.

Studies show that women who smoke during pregnancy can affect the birth and life of their newborns, known problems being miscarriage, stillbirth or low birth weight. Nicotine, be it from a cigarette or from patches, also has a direct impact on the fetus, causing colics, shows a study conducted by researchers from Netherlands.

Symptoms in infantile colic include cramping, moaning and excessive crying for more than 3 hours a day, more than 3 days a week and more than 3 weeks. This condition usually disappears before the baby is 4 months old, but cases where infantile colic lasts for more than 12 months have been signaled.

Some researchers believe that nicotine alters the serotonin receptors found at the intestinal level. Dan Jacobsen says that several other studies indicate that nicotine is eliminated faster from the bodies of pregnant women, thus the 15 milligrams of nicotine provided by the patch are insufficient. There is no conclusive study that indicates Jacobsen’s suggestion, because conducting such a study would raise many safety concerns.

Whether or not�women started smoking and then quit using the patch, or quit using the patch and started smoking afterwards remains in doubt. Dr. Cheryl Oncken says that knowing which activity occurred first would be of use for researchers. Knowledge on this matter would help find out whether further studies should focus on developing a better nicotine replacement therapy or not. Nevertheless, studies conducted so far show that nicotine patches aid patients that want to quit smoking, whilst having a reduced effect on pregnant women.

Insomnia And Depression

A new�research which will be conducted at the Monash University’s School of Psychology and Psychiatry,�may offer new hope for people suffering from insomnia and depression.

Insomnia is a sleep disorder, more�exactly�it represents�the inability of an individual to�sleep. Often insomnia is a symptom of a mood disorder, such�as depression. Insomnia may be primary, when there is�no cause�that can be identified�or�it can be determined by somatic causes, specific�behaviors (copious meals,�hectic lifestyle, physical inactivity), or excessive consumption of certain substances (tobacco, coffee).

Insomnia And Depression

If the average normal sleep is 7-8 hours in healthy adults, people with insomnia�wake up after a short period after falling asleep or even�fail to sleep all night. This sleep deprivation is detrimental to the body, the individual is exhausted and exposed to a higher risk�of certain diseases. There is a strong link between depressive disorders and insomnia (the latter precedes depression). Thus,�if�insomnia is treated, depression can be prevented.

Dr. Damon Ashworth, who leads the study, pointed out�that insomnia�actually causes�the depressive episode. Although depression is treated with antidepressants or using other spcific methods, the insomnia may still affect the patient. In other words,�when�sleep disorder continues to affect the patient,�the patients�will be at risk of relapsing.

The current study,�conducted by a�collaboration between Monash University, Monash Medical Centre and the Melbourne Sleep Disorder Centre, enrolls patients who followed treatments with antidepressants but had no significant improvement. The aim is to show whether treating insomnia helps treating depression.

It is a well�known fact that depression and insomnia are interconnected . Previous studies have shown that simultaneous treatment of depression and sleep disorders�is effective. However,�these findings�have not clearly shown�which treatment was effective. Dr. Damon Ashworth T, underlined� that this particular�study is trying to identify more accurately the link between depression and insomnia. Furthermore, the scientists�intend to develop a new approach in order to treat patients that suffer from insomnia.

During the study, patients�will be monitored during sleep and undertake fifty-minute sessions of Cognitive Behavioural Therapy or sleep education for insomnia (CBT-I). Cognitive Behavioral therapy for insomnia is a method of treatment without using any�medication. Pharmacological therapy for treating insomnia may include over-the-counter sleep medications (antihistamines), antidepressants with sedative effects, benzodiazepines, and new drugs, such as non-benzodiazepines (zaleplon, zolpidem). Even if in some cases, medication therapy is effective, there are many side effects that can occur�including�dizziness, drowsiness, dry mouth, headache, constipation or diarrhea.

Research Involves Nicotine In The Pathogenesis Of Atherosclerosis

It is a well-known fact that cigarette smoke is a risk factor for cardiovascular disease, along with obesity, high cholesterol levels, diabetes mellitus and others. Recently,�a study conducted�at Brown University in Providence, RI,�uncovers how nicotine contributes to cardiovascular disease.
According to the study, nicotine�determines�the endothelium, cells lining blood vessels, to remodel. Blood vessels consist of three layers: adventitia, media, containing smooth muscle cells, and intima, consisting of endothelial cells.�Nicotine�promotes�the invasion of vascular smooth muscle cells (VSMCs) from the media to the intima. In addition, nicotine causes invading cells�to remodel. More specifically, the actin cytoskeleton forms podosomes, which regulate metalloproteinase�(MMP) release for�the extracellular matrix (ECM) degradation.�Consequently, this fact leads to vessel degradation and, eventually, to atherosclerosis. The results of this study will be presented at the 56th Annual Meeting of the Biophysical�Society (BPS), held in February. 25-29 in San Diego, California.

Blood vessel Affected by Atherosclerosis

The fact that nicotine has the same effect as cigarette smoke on cardiovascular disease has to be confirmed by other studies. If the results are similar, than�treatment with nicotine (patches, gum) used by those who want to quit smoking�is�not beneficial�in�order to reduce�the risk of�cardiovascular disease. Atherosclerosis is a process triggered as a result of�an endothelial injury such as�mechanical�injury brought about by�hypertension, hyperglycemia, high levels of low-density (LDL) lipoproteins or�tobacco�smoke. It is, in fact, an�inflammatory process in the vessel wall in response to�retention of�low-density lipoproteins. Once inside the vessel wall, the low-density lipoproteins�are oxidized�thus leading to a cascade of immune responses which can lead to the formation of an atheroma . Now, nicotine itself appears to play an important role in atherosclerosis.

The discovery of a possible link between nicotine and podosomi in plaque formation could mean future�therapeutic targets able to�halt the process: targeting cell structures modified by nicotine, structures which promote blood vessel smooth muscle lining invasion. Intervention at this level could prevent or even stop the process of atherosclerosis.

An atheroma�remains asymptomatic�until�it�ulcerates, thus leading to immediate blood clotting. Progressively�the clot enlarges and obstructs�the blood vessel. Consequently,� the downstream tissue is�deprived of oxygen. If�the blocked�blood vessel�is represented�by a�coronary artery the event leads to a myocardial infarction.

The lead researcher Chi-Ming Hai, professor of medical science in the Department of Molecular Pharmacology, Physiology, and Biotechnology at Brown University, notes that�those�who want�to quit smoking�using nicotine replacement therapy�may need to reconsider their treatment option.

Better Prognosis For 40-49 Year-Olds Breast Cancer Patients Diagnosed Using Mammography

According to a study conducted at the Swedish Cancer Institute in Seattle, mammography-detected breast cancers�between 40 and 49 years�have a better prognosis and longer survival rates.

Dr. Malmgren along with a team�researchers have conducted a study and reviewed the�charts of patients with breast cancer aged between 40 and 49 years, treated between 1990 to 2008. The study included�a sample of 1977 patients�on which�researchers evaluated the method of diagnosis, disease stage, treatment and annual follow-up.

The purpose of this study was to assess differences between breast cancer diagnosed�using�mammography�and those detected by other means and to asses�whether�early detection provides any benefit to the patient. The results revealed an increase in breast cancer cases detected by mammography during the study, 1990-2008.�A decrease in breast cancer cases detected by the patients�and physicians was also observed.

Image of A Normal Digital Mammogram

Dr. Malmgren pointed out that changing modalities of diagnosis of breast cancer during the last�18 years and the�introduction of mammography�led to an earlier diagnosis. Thus, the number of breast cancers detected in stage�0 increased to 66%, while the number of stage 3 decreased by 66%.

Regarding the type of cancer, most�diagnosed cases were ductal carcinoma in situ (DCIS), an early type�of�cancer that does not infiltrate deeper tissues.

Another objective of the study was to identify the type of treatment. He noted that in mammography diagnosed breast cancer, patients underwent a conservative treatment. Specifically, these patients underwent lumpectomy, and not radical mastectomy as other patients. Furthermore, cancer mortality was considerably smaller.

Discovery of breast cancer in an early stage not only reduces mortality but also morbidity.�Early diagnosis�translates into no courses of chemotherapy and�radical mastectomy surgery.�The side effects of chemotherapy and the�psychological radical mastectomy has must not be overlooked and should be avoided if possible.

The American Cancer Society and other medical organizations recommend�that all women over 40 year not to avoid or delay their annual mammography�screening for breast cancer. In 2009, the U.S. Preventive Services Task Force implemented controversial guidelines that eliminated the recommendation of annual breast cancer�screening by mammography,�arguing that�the false-positive outcomes surpass the benefits.

Dr. Malmgren�emphasised the crucial role of mammography and concluded that�its main�objective is to detect breast cancer�in its�earlier stages and therefore�contributing�a better�prognosis and chances of�complete remission.

Doxycycline Highly Effective Against Tuberculosis, According To New Study

According to a new finding, a new oral antibiotic is�very efficient�as a treatment option for�tuberculosis.

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. It affects particularly the�lungs, but it can affect other parts of the body, such as lymph nodes, kidneys and�bones. The main symptoms are weight loss, chronic cough, blood tinged sputum, night sweats. It is considered that one-third of the world population has been infected with M. tuberculosis at some point.

Although it has been introduced in 1967, up until now, doxycycline�has not been acknowledged�as being efficient against tuberculosis. According to�a new study, published in the American Journal of Respiratory and Critical Care Medicine,�doxycycline not only fights against�bacterial� growth, but also stops the progression of the disease.

Doxycycline�is a semisinthetic�tetracycline that kills the bacteria at certain doses�or stops�growth at lower doses�. It is�currently used to treat a variety conditions such as sinusitis, syphilis, prostatitis, pelvic inflammatory�disease or�acne. It is efficient not only as an�antibacterial drug, but also as an�antiprotozoal�(can be used for�prophylaxis,�against malaria), and as anthelmintic�(against parasites such as Wuchereria�bancrofti).

Researchers at Imperial College London found that doxycycline�stops the secretion of MMP-1, an enzyme that destroys lung tissue. Another interesting discovery�was that doxycycline is also�effective against the growth of Mycobacterium tuberculosis in guinea pigs. This finding is really astonishing�considering that�this�particular antibiotic has been used in medical practice�for over 40 years but has�never been included in the tuberculosis treatment scheme.

Tuberculosis

The effect of MMP-1�on HIV-infected TB patients in�South Africa was also studied. In HIV-infected TB patients, the levels of MMP-1 were low,� which explains why these patients do not suffer from such extensive lung destruction.

Currently TB is treated with isoniazid�,rifampicin and pyrazinamide�for two months, followed by isoniazid�and rifampicin�for four months. These drugs are considered first line anti-tuberculous drugs. Second line anti-tuberculosis drugs are amynoglicosides, polypeptides, fluoroquinolones, thioamides. Tuberculosis has been treated with this combination therapy for over�30 years. This is why drug-resistant strains�have emerged. Dr. Paul Elkington, from the Department of Medicine at Imperial College London, who led the study, points�out the necessity of a new�effective drug that could fight TB. He also underlined the idea that doxycycline�is a cheap, safe and widely available antibiotic that could be used as an alternative for treating�TB.

Even though the study�results are very�promising, a clinical trial still needs to be conducted on patients for more detailed results.