Enterovirus may be a possible trigger for Chron’s disease

Latest research on Crohn’s disease points out some new findings regarding one possible trigger: it seems that this inflammatory bowel disease may be caused by an infection with enterovirus. The study results, which were published in the journal Clinical and Translational Gastroenterology emphasize that all children with Crohn’s disease who were investigated had enterovirus infection. Although other studies should be made in order to establish a clear correlation between enterovirus and Chron’s disease, however, this should be taken into account.  Alkwin Wanders, one of the scientists behind the study at Uppsala University and Uppsala University Hospital, said that these findings pave the way for a better understanding of this debilitating disease.

Crohn’s disease and ulcerative colitis are rare, chronic inflammatory bowel diseases that affect an average 2-10/100 000 population, and the incidence is increasing. There have been numerous studies that have attempted to explain the cause of Crohn’s disease, such as smoking, diet (refined carbohydrates, lack of vitamins or fibers in the diet), birth control pills, etc., but researchers have not been able to establish clear correlations between these environmental factors and Crohn’s disease. However, an essential role in this disease is played by the immune system as it seems that the intestinal mucosal inflammation is caused by immune attack of antibodies against different antigens.

Chron’s disease

Crohn’s disease and ulcerative colitis have similar symptoms, but there are some differences however because Crohn’s disease predominantly affects the terminal ileum, while ulcerative colitis affects especially the rectum. These symptoms include abdominal pain, diarrhea, intestinal bleeding.

Latest research shows that RNA viruses may have a link with Crohn’s disease. This is why a team of researchers from Sweden wanted to find out which is the implication of these RNA viruses in the etiology of this inflammatory disease. In the present study the researchers investigated the prevalence of enteroviruses (which are RNA viruses) in children with Crohn’s disease. The results showed that among children with Crohn’s disease, the presence of enteroviruses was typical, while in the control group these viruses were not present or were present in insignificant amounts.

To increase the accuracy of the research, the investigators used two different methods. It was also found that enteroviruses were present not only in the mucosa but also in the nerve ganglia, which are located in the deeper layers of the intestine. This discovery has led researchers to think that a way of dissemination of enteroviruses is via nerve fibers. Wanders Alkwin pointed that this explains why the disease is intermittent and affects several segments of intestine.

Postmenopausal women should take calcium and vitamin D supplements

It is known that vitamin D and calcium are essential to have healthy and strong bones. Paediatricians encourage mothers to supplement children’s diet with calcium and vitamin D to prevent rickets, which can leave serious consequences in children. If vitamin D and calcium deficiency leads to rickets in children, in adults it can lead to osteoporosis, which mean that the bone are prone to fractures. However there is debate whether postmenopausal women should take vitamin D and calcium supplements to maintain healthy bones. Although there are many recommendations, an analysis made by the Women’s Health Initiative (WHI) has shown that menopausal women should take supplements of vitamin D and calcium, at least those who are under hormone therapy.

Bones

The conclusion that women who take hormone therapy should also receive vitamin D and calcium supplements, was drawn from a study that included almost 30,000 postmenopausal women. Approximately 8,000 women were treated with calcium (1,000 mg / day) and vitamin D (400 mg / day) and as many received placebo treatment. Menopausal women included in the study were under hormone therapy, that is estrogen and progesterone, estrogen only or placebo. What  investigators looked for was the rate of hip fractures in the group of women who took hormones and calcium supplements compared with the group who only took hormones (without supplements ) and the group who took no hormones and no supplements.

It seems that treatment with hormones and supplements of calcium and vitamin D had a synergistic effect as it was showed that women who took both estrogen (and or progesterone) and calcium and vitamin D supplements had a lower rate of hip fracture than women who took a single treatment. Single treatment with calcium and vitamin D was not better   then taking no supplements or no hormones.

It was also demonstrated that treatment benefit was stronger in the group of women who received a total calcium intake (diet plus supplements) greater than 1,200 mg / day. Also, the benefit was stronger in women who had a higher intake of vitamin D. However, the researchers could not determine the individual benefit of each of them (calcium and vitamin D) because they were given together.

The rate of hip fracture among women taking combination therapy (hormones and vitamin D supplementation) were 11 fractures in 10,000 women per year, in those taking just hormones or just supplements was 18, respectively 25/10, 000 women per year, and among women who received no therapy was 22/10000 women per year.

Vitamin World

Why anti-cancer treatment fails to work at a some point

Researchers at the Hebrew University of Jerusalem and in California have made important discoveries about cancer treatment. These findings came after they understood why a cancer treatment that involves the protein mTOR (mammalian target of rapamycin) failed in destroying tumor cells.

The study results published in the Proceedings of the National Academy of Sciences (PNAS) in the U.S., have several important implications in cancer therapy. First of all, the study explains why mTOR inhibitors in cancer treatment do not work. Apart from this, the study shows that complex biological behaviors can be better understood if the interpretation of the results would take into account theoretical tools derived from the physical sciences.

The therapy that failed involved the suppression of the protein mTOR (mammalian target of rapamycin), a protein that regulates signals from outside the cell. Since researchers have observed that mTOR is activated in many solid cancers, this protein has been considered a promising therapeutic target in cancer treatment. The therapy based on the suppression of mTOR has worked in the destruction of tumor cells in the external layers of the tumor, but it has not have the same effect on the core of the tumor. It is already known that hypoxia, which means lack of oxygen, influences how tumors respond to cancer treatment. It is also known that mTOR signaling is affected and altered by hypoxia, but researchers could not elucidate the link between hypoxia and mTOR and why this happen.

Tumor

A team of researchers, led by Professor Emeritus Raphael D. Levine of the Institute of Chemistry at the Hebrew University of Jerusalem and researchers from the California Institute of Technology and the David Geffen School of Medicine at UCLA, investigated whether the influence of hypoxia may explain the poor result of drugs that inhibit mTOR in brain cancer model systems. They measured the protein mTOR signaling network in cancer cells using a new microchip technology and compared the results with a set of theoretical tools.

It seems that the combination of theoretical and experimental results led to some observations that could not be detected in biological systems. In this way they could find out that at a certain level of hypoxia, mTOR signaling network changes, which means that drugs that inhibit mTOR are no longer effective. It seems that this phase transition occurs very abruptly. This change in signaling means the cell body does not respond to treatment anymore and if the drugs that inhibit mTOR are no longer effective, the cancer cannot be cured.

New Diabetes Treatment Just Around The Corner

Diabetes is a metabolic disease characterized by high blood sugar, either because the pancreas is not capable of producing enough insulin, or the cells are unresponsive to the insulin that the pancreas produces. Recently, a team of scientists from the HSCI (Harvard Stem Cell Institute) discovered that a new hormone might be capable of increasing the effectiveness of both types of diabetes. Currently, diabetes affects approximately 26 million US residents. Their paper was published in the online journal Cell, followed by a publication in the May 9th printed edition of the journal.

The hormone in question in called betatrophin. The research team observed that it caused laboratory mice to produce high amounts of pancreatic beta-cells. These are the cells responsible for the secretion of insulin. The newly formed beta-cells only produce insulin when the organism needs them to, thus the organism is capable of naturally regulating the production of insulin. This could possibly lead to the reduction of the medical complications that are associated with diabetes.

The leaders of the research team, postdoctoral fellow Peng Yi and the co-director of the institute, Doug Melton, say that there is still a lot of research to be conducted before the new hormone will be released as a treatment for human patients. Melton, one of the few  University Professors from Harvard notes that, “Instead of taking insulin injections three times a day, you might take an injection of this hormone once a week or once a month, or in the best case maybe even once a year”.

Type 2 diabetes is currently associated with the United States obesity epidemic. The onset of the disorder is frequently associated with lack of physical exercise and excessive eating. These cause the patients’ pancreas to lose a part of its beta-cells, thus leading to an inappropriate production of insulin. Recent studies have shown that the treatment of diabetes and its complications makes up for almost 10% of the US medical health bill.

New Hormone

Professor Melton says that through the injection of this hormone into diabetic patients will cause their pancreas to produce new beta-cells, thus increasing the secretion of insulin and slowing down the progression of diabetes. Although the hormone is believed to be an effective treatment for type 2 diabetes, the researchers believe that progression towards the treatment of type 1 diabetes can also be made through the use of betatrophin. Melton added that even though the first studies were done on laboratory mice, they already discovered the human gene responsible for the production of betatrophin. He also suggested that the new hormone could be ready for human clinical trials in less than five years.

The research team led by Melton and Yi have signed a collaboration with Evotec, a German drug research company located in Hamburg. Currently Evotec has a team of 15 researchers that are studying betatrophin. Janssen Pharmaceuticals licensed the new hormone under their company and has also dispatched a team of researchers in order to speed up the admittance of the drug into human clinical trials.

When they first discovered the molecule, Melton and Yi, named it “Rabbit” due to the fact that it caused the pancreatic beta-cells to quickly multiply. Professor Melton initially began his studies on type 1 diabetes when his son was diagnosed with the disorder. The majority of his studies included the use of stem cells. However, it wasn’t the stem cells that led him to the discovery of betatrophin. “I would like to tell you this discovery came from deep thinking and we knew we would find this, but it was more a bit of luck”, said professor Melton.

One of the questions that were asked was “What happens during pregnancy?”. Due to pregnancy, the need for carbohydrates increases and so does the need for insulin. According to the researchers, the levels of betatrophin in pregnant mice was higher than the levels found in female mice that weren’t pregnant. Melton and Yi’s medical breakthrough came after almost 4 years of continuous research. Yi recounts that he ran into Melton’s office with a printed image of what he just discovered under the microscope. “I showed him this picture and told him this is a secreted protein, and he was really, really excited about this result”, said Yi.

According to Professor Melton, the paper that Yi brought him was a black and white paper of the pancreas. Usually, the cells that are photographed during their division appear as white spots on the black conformation of the pancreas. The black and white photograph showed a lot of small clusters of white spots. “I’ve never seen any treatment that causes such an enormous leap in beta cell replication”, concluded Professor Melton.

Anti-reflux Surgery More Effective Than Medication

According to a study led by researchers at the University of Aberdeen, anti-reflux surgery is more effective in relieving symptoms of gastro-oesophageal reflux disease (GORD) than drug therapy. GORD is one of the most common diseases in gastroenterology and affects about 20-30% of Western adults.

GORD is a condition that is manifested by heartburn and the symptoms can be diverse and of different intensity (mild, moderate, etc.). Although there are several categories of drugs that can be given to patients with GORD, this is a chronic condition that can affect patient quality of life.

Drug treatment consists mainly in a class of drugs called proton pump inhibitors such as pantoprazole, omeprazole, lansoprazole and others. These drugs reduce gastric acid secretion and thus relieve the symptoms. But for these drugs to take effect,  they must have taken in the morning before breakfast. There is also another class of medications called H2 receptor inhibitors, such as ranitidine, famotidine which take effect faster.

Heart Burn

Gastroesophageal reflux disease is caused by the acid gastric reflux into the esophagus resulting in esophagitis. This reflux is favored by a number of factors such as certain foods (soft drinks, French fries, coffee, citrus, etc), obesity, certain medications that relax the lower esophageal sphincter, etc.. GORD  is often associated with hiatal hernia. Patients with gastroesophageal reflux have heartburn, acid regurgitation, pain on swallowing (in severe cases) and other less common symptoms such as coughing.

Antireflux surgery may be an option when drugs do not take effect. However, opinions regarding which therapy is best for GORD have been controversial. In order to find out which is more effective (surgery or drugs), researchers conducted a study that compared the two treatment options. The study included 800 patients in the UK suffering from GORD for more than 12 months. Of these, 178 were treated surgically and 179 were randomly treated with medication. The rest chose to be treated with either surgery (261) or drug (192). Treatment follow-up period was 5 years.

Professor Craig Ramsay, of the University’s Health Services Research Unit, said that after one year of treatment, patients who had surgery had a greater improvement in symptoms than those who took medication. He added that other studies have shown that surgery patients had side effects such as difficulty in swallowing or inability to vomit, but now their study showed that these effects are present both in patients undergoing surgery and in patients taking medication. Fortunately, modern medicines relieve the symptoms for most patients, but surgery, when appropriate, can do even better”, said Professor Zygmunt Krukowski, a surgeon at Aberdeen Royal Infirmary.

Surgical treatment of endometriosis lowers the risk of Ovarian Cancer

A new study by led researchers at the Karolinska Institute shows that women who are treated surgically for endometriosis have a lower risk of developing ovarian cancer. However it seems that drug therapy (ie hormonal) for endometriosis did not reduce the risk of ovarian cancer.
Endometriosis is a leading cause of infertility in young women (aged between 25 and 40 years). Endometriosis is characterized by endometrial tissue outside the uterus, which most often is found in the fallopian tubes, ovaries, or other organs in the pelvis. Symptoms and signs of this disease are due to hormonal changes during the menstrual cycle: abdominal pain, menorrhagia, pelvic pain or back pain, dysmenorrhea etc. This endometrial tissue lining acts as the lining inside the uterus ( which means that every month it bleeds), and over time cysts and areas of fibrous tissue develop in those locations where endometrial tissue is found.

Endometrioza

Endometriosis treatment is aimed at reducing estrogen levels and consists of medication and surgery. Drug treatment includes several types of drugs such as oral contraceptives, aromatase inhibitors, agonists and antagonists of Gn-RH and the main goal is to adjust the level of estrogen hormones to reduce symptoms of endometriosis. Surgery may be conservative, ie ectopic endometrial tissue removal, or radical, which involves removing the ovaries and/or uterus.

Statistics show that endometriosis affects approximately 14% of fertile women. Some studies have shown that women with endometriosis are at increased risk for certain cancers such as cancer of the ovary. Other studies, in contrast, showed that women with endometriosis who are treated surgically (tubal ligation or hysterectomy) have a lower risk of developing these cancers. Dr. Anna-Sofia Melin from the Karolinska Institute and Karolinska University Hospital in Stockholm, Sweden, the lead-author, explained that patients with endometriosis are typically treated with hormone therapy or in severe cases through surgery. She added that they wanted to see which is the association between the two types of treatment (surgical and hormonal) and ovarian cancer risk.

The study included patients diagnosed with endometriosis that were selected from the Swedish National Patient Register during 1969-2007. There have been found 220 women with ovarian cancer and endometriosis and 416 women with endometriosis only. Dr. Melin said that the study showed a significant correlation between ovarian cancer risk and removal of ovarian or endometrial tissue visible. “Our study suggests that surgical removal of an ovary and removal of visible endometriosis protects women from developing ovarian cancer at a later point,” concludes Dr. Melin.

New drug against hepatitis C is being investigated

Researchers are investigating a new drug to treat hepatitis C virus,  a type of hepatitis that is most commonly associated with cirrhosis and liver cancer. Clinical studies so far show that miravirsen decreases viral load of patients infected with C virus. In addition, it appears that the risk of resistance to treatment is much lower unlike other medications used to treat hepatitis C.

However it must be said that more studies need to be done in order that this drug become part of the standard treatment of hepatitis C virus. The mechanism of action of this drug is inhibition of virus C replication. In a small phase 2 clinical trial, it has been demonstrated that miravirsen used in the highest dose, decreased viral load of approximately 500 times. It was also showed that patients taking miravirsen have not developed resistance to treatment, unlike others drugs that are used in managing hepatitis C.

Dr. Judy Lieberman, chairwoman of cellular and molecular medicine at Boston Children’s Hospital, said this is the first real trial and the results are encouraging. She added that what seems interesting is that now there seems to be no resistance to treatment.

Hepatitis C

The study, led by Dr. Harry Janssen, a professor of medicine at the University of Toronto and Erasmus University Rotterdam in the Netherlands, included 36 patients who were divided into 4 groups. The first three groups received miravirsen in different doses (3 mg, 5 mg or 7 mg / kg) and the fourth group received placebo for 29 days. It was found that in patients who received the highest dose of drug viral load decreased 500 times and that in 4 of 9 patients the viral load was beyond the detectable limits. Regarding side effects, there were no significant toxic effects except for a local reactions at the injection site and a slight increase in liver enzymes.

Statistics show that hepatitis C affects approximately 170 million people worldwide, but the number of those infected may be much greater because the infection has an asymptomatic period. The virus C infection is transmitted through needles and blood transfusions, unprotected sex, etc., and patients may be a good while asymptomatic or may present asthenia, fatigue, bloating, loss of appetite etc.. The risk that a patient with hepatitis C will result in cirrhosis and liver cancer is quite high, this is why treatment is essential. However, Dr. David Bernstein, chief of the division of hepatology at North Shore University Hospital in Manhasset, N.Y, said: “It’s a novel concept, but it’s only 36 patients and a phase 2 study. It’s impressive that their viral loads came down, but most suffered a recurrence of the virus.”

Medscape – Probably The Best Android Medical App Of All Time

Medscape is one of the best Android apps used by over 2 million medical students, physicians and healthcare professionals in general. Medscape provides medical resources in countless areas being the leader of the market surpassing by far many other apps especially designed for doctors and android powered smartphones.

To understand better what Medscape app provides, we’ll go through the app features.

Medscape benefits from a large news database that can be accessed also with the app. The news and medical alerts cover 34 specialty fields being updated on a daily bases. All you have to do is make a list with your favorite areas of interest and you will receive daily updates and news. The app also provides you direct search access to the entire Medscape News database but also the MEDLINE database. It also has great social media integration, allowing you to email the articles that you like and also share them on Facebook. The great thing is that you don’t need an internet connection to use the app which is also usable offline.

Another feature of the app is to provide clinical references from the Medscape references. You can get information on drugs such as safety info and prescribing of over eight thousand drugs and brands and also herbal drugs and OTC drugs. You can make a list with the most searched drugs to get quick access to. Also the drugs contain information such as pill images or usage guidelines.

Another interesting feature is the drug interaction checker that allows you to check the interaction safety of up to 30 drugs and supplements.

You can also access information on diseases and medical procedures with over 4000 specialized medical articles by leading physicians. The articles are also supported by videos, especially the ones that teach you procedures with over 600 videos. You can get almost any type of information you want on these topics, whether it’s a treatment, a diagnose or epidemiology.

One of the newest features of Medscape app is the medical calculator. This tool allows you to check 129 medical formulas and other classifications. You can calculate dosage of over 600 drugs and many more.

Users are giving Medscape app very good reviews. A recent medical school graduate says that student says that the app became his main source of information on the go or during his rounds. Also other users says that it is a great resource for medical information that can help you save a lot of money that you would usually spend on handbooks and other resources. It seems that the app is well regard by people in the medical field.

How to use Medscape app?

After downloading the app from Google Play, the official Android market, you can enter the app. You will be asked to create a Medscape account that will give you access to their entire database of information and tools. After that you can do anything you want with the app, even if you don’t have an internet connection.

The app supports Android 2.0 and up. There have been some reported issues with users that have rooted their devices or users that have ad-blockers installed. It’s preferred that you uninstall the ad-blockers if you encounter loading problems with the app.

Preeclampsia Risk Factors, Symptoms. Diagnosis & Treatment

Preeclampsia is a serious medical condition that occurs after the first 20 weeks of pregnancy and is characterized by hypertension, edema (of the feet) and proteinuria (that is leak of proteins in urine). Preeclampsia is a complication that occurs during pregnancy and can progress to eclampsia, which is a life-threatening condition. It seems that preeclampsia is more common in women with multiple pregnancies or those who have never born.

It is not known exactly what mechanism underlies this disease although several theories have been questioned over time. It seems that hypertension is caused by damage to the endothelium of blood vessels in the placenta and a maternal immune system imbalance. Vasoconstriction of the blood vessels in the placenta has consequences not only on the mother, but also on the fetus. These complications include fetal growth retardation, death in utero or fetal distress in the first days after birth.

Pregnany

Risk factors for preeclampsia

Statistics show that about 5-10% of pregnant women suffer from this disorder. Risk factors that predispose to this disease include age over 35 years, chronic hypertension, obesity, diabetes, multiple pregnancies, clotting disorders, kidney disease, collagen diseases (lupus, scleroderma disease), antiphospholipid syndrome.

Symptoms and signs

Preeclampsia symptoms are due to hypertension, that is headache, tinnitus (ringing in the ears), blurred vision (diplopia, that is double vision). Besides these symptoms, epigastric abdominal pain, nausea, vomiting, weight gain due to edema may appear. The main complication is eclampsia, which is characterized by tonic-clonic seizures. It should be noted that seizures can occur not only during pregnancy but also postpartum (especially in the first week after birth). Other possible complications are cerebral edema, acute renal failure, pulmonary edema and bleeding disorders (disseminated intravascular coagulation). HELLP syndrome is another complication and is characterized by hemolysis, elevated liver enzymes, low platelets.

Diagnosis

The diagnosis of preeclampsia include high blood pressure: 140/90 mmHg, proteinuria (protein in the urine over 300mh per 24 hours).  Blood pressure should be measured twice every 6 hours in order to be relevant.

Treatment

The treatment of preeclampsia is medical ( antihypertensives) but in eclampsia the only cure is Cesarean section (among other medical care). Antihypertensives that are used in preeclampsia are calcium blockers (eg nifedipine) and alpha-beta adrenergic blockers such as labetolol. Treatment is adapted to the level of hypertension and the patient’s condition. In some cases intravenous magnesium sulfate is used to prevent the onset of seizures.

Besides pharmacological treatment, bed rest and strict supervision are required.

Depressed children more likely to become obese, smokers and sedentary

A new study led by researchers at Washington University School of Medicine in St.. Louis and the University of Pittsburgh, shows that depression in children lead to cardiovascular disease later in life. Also, it seems that children who suffer from depression are more likely to become sedentary, smokers and obese than their peers. First author Robert M. Carney, PhD, a professor of psychiatry at Washington University, said that what is worrying is that many studies have shown that children who suffer from depression have a greater risk of developing cardiovascular disease later in life, and even to have a lower life expectancy. He also said that active smokers in adolescence have a two times higher risk of dying before age 55 than non-smokers and that applies to similar risks for obesity.

Depressed

Discovering these risks points out the importance of monitoring young people who have suffered from depression. It has long been known that depression is associated with increased cardiovascular risk, but what has not been known is at what stage in life the effects of depression will become evident.

To develop the study, researchers looked at 201 children suffering from depression and 195 children without depression, with a mean age of 9 years. The researchers also took into account a third group of children (161), of unrelated age, gender and without depression. They were followed for 7 years and at the age of 16 years, they were evaluated to detect the rate of smoking, obesity and physical activity. It was found that of the children who were depressed at the age of 9 years, 22% of them were obese at age 16.

In non-depressed group, the rate of obesity was 17% and the rate of obesity in the control group was 11%. Also, a third of the depressed children were smokers at the age of 16, while in the non-depressed group and in the control group smoking was present in only 13% and, respectively, 2.5% of patients.

Cardiovascular risk factors were common among children who were depressed, even if at the time of the second survey  depression was not present in all of them. There has been a decrease in the rate of depression as only 15% of adolescents  suffered from depression at the second survey. Depression “is playing an important, if not a causal, role. There may be some related genetic influences that give rise to both depression and to heart disease, or at least to these types of cardiac risk behaviors, but more study will be required before we can draw any firm conclusions about that, ” said Carney.