Researchers at Johns Hopkins have made a remarkable discovery that could change the future of plastic and reconstructive surgery. In their experiments on rodents, researchers have been able to regenerate damaged nerves in the leg with a specific type of stem cells found in bone marrow and fat cells.

Study leaders W.P. Andrew Lee , MD, and Gerald Brandacher, MD, said that such a discovery marks a step forward in the field of stem cells research. Such stem cells can stimulate nerve regeneration or transplantation and can minimize the need for immunosuppressive drugs. Immunosuppressive drugs are given to patients to decrease the risk of rejection it is performed a transplant from another person. John Pang, a medical student at the Johns Hopkins University School of Medicine, said the mesenchyme stem cells ( MSCs) may be a promising therapy for regenerating damaged nerves. Pang believes that they still have to learn more in this area but that researchers are stimulated by what they learned from these experiments.

Mesenchyme cells are multipotent stem cells that are capable of self-renewal and differentiation into multiple classes of cells: osteoblasts ( bone cells ), chondrocytes ( cartilage cells ), adipocytes ( fat tissue cells ), neurons and myocytes ( cells muscle tissue ). MSCs can be harvested from several places such as umbilical cord, amniotic fluid, adipose tissue; moreover recent studies showed that these cells can be harvested even from peripheral blood. What is interesting is that studies have shown that these mesenchymal cells have immunomodulatory function that is they avoid allorecognition. In other words these cells create an immunosuppressive microenvironment which reduces the risk of rejection.

MSCs are not recognized as foreign by the immune system, that is these cells do not trigger an immune response in the body. Researchers have found that these cells secrete some substances that interfere with the immune system in several ways. Now they want to make use of these properties and not only to help regeneration of damaged nerves but also to and avoid the use of immunosuppressive drugs in transplanted patients.

Researchers at Johns Hopkins have performed three types of experiments in mice to examine the potential of MSCs in nerve regeneration: mice with femoral nerves cut and repaired ; mice with hind-leg transplant from the same biological type of rat and mice transplanted from a different type. Researchers injected MSCs either directly in the sciatic nerve or directly into bloodstream. At 16 weeks, there was a significant improvement in both nerve regeneration and nerve signaling. Mice that received transplants from the same type of mice also benefited from this  procedure, but those who received a transplant from different mice rejected the transplant.

Researchers at the University of Reading have made a remarkable discovery about how of blood clots are formed that could lead to the development of new drugs for cardiovascular diseases. Statistics show that cardiovascular diseases such as stroke, hypertension, angina pectoris, and other conditions, are responsible for over 200 000 deaths each year in the UK . Most of these deaths are due to complications of cardiovascular disease which involves blocking the blood vessels that carry blood to the heart or brain by blood clots.

The study on how  blood clots are formed is based on an amazing discovery made last year by researchers at the University’s Institute for Cardiovascular and Metabolic Research ( ICMR ), when it was found how platelets communicate with each other. It should be noted that platelets play an important role in homeostasis, ie stop bleeding. This is the role of platelets in normal conditions, but there are also situations when an inadequate platelet activation could lead to the formation of clots in the bloodstream; this could lead to heart attack or stroke, which can be fatal.

There are several drugs that are used in patients with heart disease to decrease the risk of thrombosis like aspirin or clopidogrel. However, there are patients in whom these drugs are not effective and in addition there is a risk of side effects among which the most important is bleeding.

A team of researchers led by Professor Jonathan Gibbins and Dr Sakthivel Vaiyapuri investigated how platelets form blood clots and found that they communicate through gap junctions. Gap junctions are pore-like structures that allows direct communication. Researchers already knew that these gap junctions connect cells ( all sorts of other cells, epithelial cells , etc. ) but their discovery in platelets was an unexpected.

According to Professor Gibbins, understanding the mechanism of formation of blood clots and thrombosis may lead to the discovery of drugs that could save lives. Effective antithrombotic therapies could be developed if the molecules that control these channels would be discovered. In this way heart attack or stroke could be prevented. Professor Jeremy Pearson, Associate Medical Director at the BHF , which funded the study, said that antiplatelet drugs are widely used in patients with coronary heart disease to prevent heart attack and stroke. He added that Professor Gibbins’ s discovery offers the opportunity to develop new drugs that reduce the risk of thrombosis. But further studies are needed to see which are the signals that occur during this communication and how they control the ability of platelets to form clots.

According to a study led by researchers at the Columbia Center for Children’s Environmental Health at the Mailman School of Public Health, maternal exposure to air pollution and psychological distress during pregnancy have a harmful effect on the child. According to researchers, maternal psychological distress, defined as the mother’s ability to cope with stressful situations, is associated with a range of behavioral problems of the child such as depression, anxiety, aggressive behavior etc. It was shown that the most significant behavior problems occur in children who were exposed during pregnancy to high levels of polycyclic aromatic hydrocarbons ( PAH).

This is the first study to investigate the relationship between PAH found in the air breathed by the mother during pregnancy and maternal psychological distress and its effect on the child. Polycyclic aromatic hydrocarbons are pollutants resulting from combustion engines of motor vehicles, coal-burning, domestic heating, cigarette smoke, etc and have an adverse effect on health. Even though  in Krakow, Poland, where the study was conducted, the level of PAH is quite high, though, it does not exceed the level found in other urban centers. Dr Perera noted that exposure to air pollution is practically everywhere and usually occurs with socioeconomic disadvantage and maternal psychological distress.

Frederica Perera , PhD, director of the Center and lead author of the study, explained that this study shows that combined exposure to psychological distress and psychosocial stressors during fetal development amplify the harmful effect on the child. She added that the results are concerning because it was showed that attention problems , anxiety and depression affect the relationships with friends, academic performance and well-being of children.

The study was conducted on a sample of 248 mother-child pairs that were followed from pregnancy to the age of 9. To assess the effect of pollutants on the child during fetal development, researchers took air samples during pregnancy to investigate prenatal exposure to PAH. Behavioral problems were assessed using the Child Behavioral Checklist and involved completion of a questionnaire by mothers on their children’s behavior . Also, maternal demoralization was associated with socioeconomic factors such as maternal hardship.

Studies on the relationship between exposure to air pollution during fetal development and their effects on the behavior of the child have been conducted so far, but the present study investigates the combined impact of exposure to air pollution and maternal distress on the child. “The findings support policy interventions to reduce air pollution exposure in urban areas as well as programs to screen women early in pregnancy to identify those in need of psychological or material support”, Dr Perera said.

In a recent study on the genetics of heart disease , researchers at the University of Michigan Medical School and School of Public Health, found that the level of cholesterol and other lipids in the blood is influenced by a number of changes in human DNA . Using genome wide association study ( GWAS ) techniques, researchers found more than 150 changes in human DNA that influence blood cholesterol levels. The results of the study, published in the journal Nature Genetics, reveals a new perspective on cardiovascular disease and could be the starting point for the development of new drugs for hypertension, type 2 diabetes, obesity and coronary artery disease.

These changes point genes that control cholesterol and other blood lipids and can become therapeutic targets in the future. What is interesting is that many of these genes are new as it is for the first that are associated with blood lipids. The study also points out that triglycerides significantly influence heart disease much more than previously thought . Cristen Willer , Ph.D., the lead author of one paper and year assistant professor of Internal Medicine, Human Genetics and Computational Medicine & Bioinformatics at the UM Medical School, said that these results give new clues about the biology of lipids and more places to look than before.

According to Willer, once researchers will have time to investigate these new clues, they will have a better understanding of the biology of lipids and cardiovascular disease and potential new targets for treatment. Professor Gonçalo Abecasis , Ph.D., from the UM School of Public Health and senior author of the paper,  added that however much work will be needed to study these new genes involved in heart disease and to test potential drugs.

It seems that genetic variations that influence LDL cholesterol and triglycerides increase the risk of heart disease , which raises a question regarding the role of HDL cholesterol ( good cholesterol ). Studies so far have shown that drugs that alter HDL cholesterol do not bring many benefits in terms of preventing heart disease.

Cardiovascular diseases such as hypertension, chest pain or myocardial infarction are due primarily to an unhealthy lifestyle. We know that lack of exercise, fast food, stress, obesity, smoking are the main factors that promote heart disease. Although certain drugs such as statins ( cholesterol lowering drugs ) or the antihypertensive may improve the health of a patient with heart disease, still the best way to prevent cardiovascular events consists of diet and physical activity.

There˜s about 30.000 medics from abroad practicing in Germany. That seems to suit Germany˜s need for doctors pretty well as due to overageing and the emigration to western- and northern European countries it lacks a big amount of physicians. The biggest gap seems to be found in the so called new countries, the eastern part of Germany, that generally suffers from a strong emigration of workforce.

But the spokesperson of the Physician˜s Union, Ärztegewerkschaft, at Marburg recently critizised that while the doctors from abroad are generally very welcome, their language skills are below what one might expect and hope for. He argued in favor of a profession-specific German language training for migrating doctors. Not only would the patient-doctor-interaction suffer from a lack of proper German skills but also the information exchange among colleagues might prove a bit difficult at times.

The above number has risen by 100% over the last 10 years according to the German Federal Medical Chamber, Bundesärztekammer (see link below). More than 70% of them come from European countries (EU and Non-EU). Often it is professional commercially oriented organisations arranging the formalities between the doctors and the German medical institutions. It might not be surprising if certain skills are being interpolated slightly for the sake of closing a deal. Why should this profession differ from any other field? One might also argue that even if the German language skills are not perfect at the beginning of a doctor˜s stay in Germany, they might improve quickly as soon as one is immersing into a German speaking environment. After all, doctors are used to learn big amounts of foreign words in a short time, so why should they not simply catch up German as quickly?

It is to expect that in the near future the legal requirements to practice as a doctor in Germany might be tightened regarding German language skills. Every ongoing physician would do well considering this factor should he or she play with the thought of going abroad one day for practical experience or other reasons.

I am leaving for Germany in about two months and despite what others may think about German let me reassure you that it’s not hard to understand nor learn, provided you are guided by a gifted tutor and obviously have the neuronal connections of a doctor. For all  English speaking physicians out there that are currently struggling to reach B1 or B2, I  strongly recommend giving Smarter German and Michael Schmitz a try. He will get you there in no time. I am not advertising anything here, but I never thought I could laugh, have a good time and learn German fast as hell in the same time. Remember those memorization techniques we all used in a way or another to get through medschool?  Imagine extrapolating those techniques then adding a few more to your German learning experience and you’ll get a clue what I am talking about here.

Going back on topic, there˜s one downside to this understandable flow of highly specialized workforce: While German doctors tend to migrate into equally wealthy countries, those migrating to Germany mostly come from countries with a worse economical standing. That means that those countries are about to lack physicians themselves as they can not afford to offer a similar education nor equal payment to the often young doctors. As most of us, they are looking for a perspective in life, security and stability which is not yet given in their home countries. Often physicians earn a very small fraction of what they could earn in Germany. The working conditions, as hard as the job generally might be, are also likely to be much better in the western parts of Europe.

So how could one resent them for trying their luck abroad?

You just need to follow these two steps:

1. Check the Federal Physician˜s Chamber of Germany website, for the formalities required to work as a physician in Germany.

2. Learn German in Berlin with a very effective private teacher.

Good Luck and see you there!

People who lead a healthy lifestyle and exercise regularly have not only a lower risk of cardiovascular disease but also a lower risk of cancer. A new study published in Cancer Epidemiology, Biomarkers, and Prevention and conducted by the American Cancer Society researchers confirms the hypothesis that sustained physical activity is important in cancer prevention. The study showed that moderate recreational activity resulted in decreased risk of breast cancer in postmenopausal women by 14%, while high physical activity decreased the risk of breast cancer by 25%.

There have been many studies conducted so far that have shown that women who have regular physical activity have a risk of about 25% lower for developing breast cancer compared to women who are inactive. However, it is unclear whether moderate physical activity such as walking has any benefit or if only intense exercise help prevent breast cancer. Also, it is unclear whether there is any association between tumor type (hormone receptor status) and individual factors such as BMI, weight status and hormonal therapies. Although there were many studies regarding the association between the risk of cancer and long periods of inactivity, though the link between sitting time and risk of cancer in postmenopausal women is unclear.

Therefore, the American Cancer Society researchers led by Alpa Patel, Ph.D. developed a study in which they compared the relationship between physical activity and breast cancer risk in postmenopausal women. Of the initial 73 615 postmenopausal women included in the trial, 4760 were diagnosed with breast cancer over the 17 years of study.

It was shown that a woman of 10 did not do any recreational physical activity at the beginning of the study. Among women who were active, the average time dedicated to physical activity was 3.5 hours per week. Physically active women’s favorite activities were walking, cycling, aerobics, dancing, so activities that involved moderate physical effort. Almost half of the women said they preferred walking as recreational physical activity. It was also discovered that physically active women were more likely to lose or maintain weight, more likely to drink alcohol and less likely to smoke. The study also showed that physically active women were more likely to use hormone therapy or to perform a mammogram in the past year.

According to the study, the most active women had a 25% lower risk of developing breast cancer than the least active women. It is important to note that this association did not differ by BMI, weight status, use of hormones or hormone receptor status. “Our results clearly support an association between physical activity and postmenopausal breast cancer, with more vigorous activity having a stronger effect,” Dr. Patel explained.

A new study published in the journal Nature Chemical Biology brings new insights on the tubercle bacillus (Mycobacterium tuberculosis), which may lead to the development of new treatments against tuberculosis. This  research was made by a French – British Team including scientists from CNRS, Inserm , the Institut Curie and Université Toulouse III – Paul Sabatier.

Tuberculosis is an infectious disease affecting the lungs and it can become life threatening if not treated properly. Statistics show that this disease kills 1.5 million people each year. Although there is a vaccine against tuberculosis (BCG), this vaccine has a variable efficacy and the immunity provided is limited. It must also be mentioned that there are antibiotics against tuberculosis but lately there are increasingly more cases of tuberculosis resistant to treatment. This is why doctors want to investigate new strategies for treatment and prevention.

Now researchers have found that aspartate, an amino acid, acts as the main source of nitrogen and it is essential to this bacillus. Moreover, researchers found the mechanism by which M. tuberculosis extracts this amino acid from its host. They now hope that these findings will help them in future studies in order to develop new vaccines and new antibiotics to treat or prevent this infectious disease.

The study led by researchers at the Institute of Structural Biology et Pharmacologie (CNRS / Universit̩ Toulouse III РPaul Sabatier ) was aimed to investigate the exact mechanism by which M. tuberculosis supplies itself with nitrogen. Researchers studied a protein called AnsP1 which works as transmembrane proteins for amino acids. It seems that this protein, when introduced into bacteria, is responsible for capturing aspartate.

In addition, researchers showed that the mutant form of a genetically inactivated bacillus cannot survive in an environment that contains aspartate as the only source of nitrogen. The next step was to see if indeed aspartate is the major source of nitrogen for M.tuberculosis. To check this, researchers used a technique that involved the use of heavy isotope of nitrogen and found that indeed the bacillus takes nitrogen from aspartate. These findings prove the hypothesis, namely that AnsP1 is responsible for capturing nitrogen from its host.

Moreover, the experiments on mice showed that the bacillus strains were  attenuated when AnsP1 was inactivated. Now researchers hope that AnsP1 will become the new therapeutic target for the discovery of new antibiotics and new more effective vaccines for tuberculosis.

Researchers at the University of Florida and University of California, San Francisco, have made some interesting discoveries in the research on a new vaccine against HIV. The study, published in Journal of Virology, reveals that  blood from human subjects infected with HIV causes an immunological reaction against a feline AIDS virus protein.

Janet Yamamoto, a professor of retroviral immunology at the UF College of Veterinary Medicine and the study ‘s corresponding author, said that one of the major reasons why it has not been possible until now the development of an effective vaccine against HIV is because we do not know which parts of HIV we must combine in order to produce the most effective vaccine.

The vaccine that researchers are working at the moment consists of T cells that activate an immune response in T cells from HIV-positive individuals against the feline AIDS virus. Researchers are manipulating in fact peptides that are small pieces of protein that can stimulate T cells of the body to recognize viral peptides in infected cells and destroy them. But as stated Yamamoto, HIV is composed of several peptides and not all peptides can be used as vaccine components. In previous experiments, researchers used whole HIV proteins as vaccine components but none was effective enough so that it becomes a commercial vaccine.

According to Yamamoto, in humans, some peptides induce immune responses, that is either they stimulate HIV infection or they have no effect at all, while others may have anti -HIV activities that are lost when the virus changes or acquires a mutation to avoid the immune system. Therefore, researchers are investigating those viral peptides in the feline AIDS virus  that do not change or mutate. Yamamoto said they surprisingly managed to find some of the feline AIDS virus peptides that are effective in producing T cells that fight HIV.

Researchers isolated T cells from HIV-positive individuals and incubated these cells with different peptides essential for the survival of both human and feline HIV viruses. Then researchers compared the immune responses found with feline immunodeficiency virus ( FIV ) with those found when they used HIV-1 peptides. Yamamoto pointed out that they indeed found a peptide region on FIV that stimulates T cells to kill HIV. She also added that this region found in feline viral peptide is present in several AIDS -like viruses across multiple animal species and that it must be an essential region for the survival of the virus since it cannot mutate.

Asthma is an increasingly common diagnosis in America; according to statistics there are over 26 million people suffering from asthma, but the latest analysis shows these patients may be misdiagnosed or have other medical conditions they are not aware of.  Tod Olin , MD, MSCS , a pediatric pulmonologist at National Jewish Health, explained that it is very common and logical for general practitioners to diagnose and treat any respiratory problem as asthma particularly in children. He also mentioned that there are also other problems besides asthma that we should think especially when treatment fails .

According to Dr. Olin, asthma is used as an ‘umbrella’ term to describe wide a range of respiratory diseases. He said that there are many conditions that mimic asthma and that we need to make sure that we have the correct diagnosis before starting treatment. Among medical conditions that mimic asthma and which must be taken into account when one begins a treatment, there is acid reflux, allergies and heart problems.

Many of the patients with asthma, after trying several therapies that fail, are sent to National Jewish Health, one of the most popular respiratory hospital in the nation. But a recent analysis revealed some interesting findings. It was shown that one in four patients sent to National Jewish Health in the period 2005-2008 did not have asthma at all, and that about 70 % of them had other conditions besides asthma, conditions that were not properly treated. After being  re-evaluated by specialists at National Jewish Health, patients were diagnosed more accurately with respiratory diseases and were prescribed appropriate therapy. In this way specialists were able to decrease by half the number of hospitalizations and the symptoms experienced by children during sport.

Dr Olin pointed out that this discovery is really eye-opening. “We spend a lot of time and resources treating people for asthma in this country, and for some, it’s just the wrong diagnosis,” he pointed out. According to the Centers for Disease Control and Prevention, United States spend more than $ 50 billion dollars each year for asthma patients. Dr. Olin said that if patients could be diagnosed and treated properly, this would make a big difference both in terms of costs and quality of life of patients.  Dr Olin advises patients who take drugs for asthma and still have symptoms more than twice a week or have been hospitalized for respiratory problems, to be re- evaluated by a specialist.