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Study finds limited mutations involved in transmission of drug-resistant HIV

Jul 18, 2015

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Hiv Infection

Researchers at the Stanford University School of Medicine undertook the largest study of its kind about the transmission of HIV and found that only a limited number of mutations are responsible for most cases of transmission of drug-resistant HIV. The results of the study were published online on April 7 in PLOS Medicine.

For this study, data from more than 50, 000 patients in 111 countries were taken into account. The researchers found that a small group of mutations accounted for a majority of the cases of transmission-related resistance to the HIV drugs used to treat infections in resource-limited settings. Robert Shafer, MD, professor of medicine at Stanford and principal investigator for the study said that the positive thing about the results is also that the levels of transmission of drug-resistant strains have not increased globally as much as once thought. However, the worrying aspect is that there is an overall increase in drug resistance, particular in people living in the poorest parts of the world. Shafer added that it is very likely that transmitted drug resistance will increase further and hence, there is a greater need to continue monitoring to make sure that the results of long term treatment for people are successful.

Shafer opined that since we have the knowledge of the key mutation, steps could be taken to develop an inexpensive test for diagnosing it. It can assist in determining which drugs should be given to previously untreated patients.

Since the year 2003, great efforts have been made by the international community to achieve the goal of universal antiretroviral treatment for HIV. Thanks to their effort, 11.7 million people in developing and underdeveloped countries are now receiving the lifesaving treatment. But the concern is that with wider availability of these medications, drug resistance could spread and nullify those gains.

In order to take stock of the situation, Shafer and his fellow scientists reviewed HIV sequencing data on 50,870 individuals across the globe, taken from 287 studies published between 2000 and 2013. They analyzed each virus sequence for the presence of 93 mutations previously shown to be indicators of drug resistance.

They found the overall prevalence of transmitted drug resistance was on the rise. The scientists feared that this increase could undermine confidence in the ability to treat HIV in low-income regions and potentially dissuade new patients from seeking care. To make sure that such a situation doesn't arise, the study explores the possibility of creating a simple, inexpensive test for the key resistance-related mutations. Such a test could help clinicians in pinpointing the drugs likely to be most effective for individual patients. This way the flow of drug resistance could be shut off.

Another interesting finding of the study is that the drug-resistant strains did not come from a single line of resistant viruses; in fact were distinctly different from each other. It suggests that they had been acquired independently and not as a result of a single transmission chain. This pattern is different from how others microbes behave. For example, in malaria and tuberculosis resistant strains tend to move rapidly among populations. It is also not in line with an emerging pattern of drug resistance in many upper-income countries, where 20 years of HIV treatment have spawned the spread of many highly drug-resistant strains.

Shafer opined that the strains being detected in developing and under-developed countries are quite unrelated to one another. That in turn means that they have not yet have spread their tentacles in the population, suggesting that they are likely less often transmitted among people who have never received the drugs before.

References

https://medicalxpress.com/news/2015-04-limited-mutations-involved-transmission-drug-resistant.html

https://med.stanford.edu/news/all-news/2015/04/limited-mutations-involved-in-transmission-of-drug-resistant-hiv.html

Researchers solve mystery of deadly transplant infection

Jul 17, 2015

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A rare infection after a successful lung surgery resulted fatally for Harlan Dorbin and he lost his battle for life after a month post-surgery. This surgeon found this unacceptable and he made a promise to Dorbin's sister that he would get to the bottom of it.

Ankit Bharat, MD, a thoracic surgeon and surgical director of the Northwestern Medicine lung transplant program said that even though it was a perfect operation, this infection caused an abnormal buildup of ammonia that a person’s body can’t handle. Such an infection is rare but it’s almost always fatal. The irony is that no one knows what causes it, how to prevent or treat it.

In the year 2014 as many as 2100 lung transplant surgeries took place in the United States. Statistics reveals that the infection which happened to Dorbin happened to about 4% of all the lung transplant recipients. After the death of Dorbin, Bharat, who is also an assistant professor in thoracic surgery at the Northwestern University Feinberg School of Medicine spent the next several months studying and researching this infection. He used Dorbin as a case study and tested samples from hospitals all over the county, including a donor sample from Loyola Medicine.

Finally, his research bore fruits and he was able to identify specific bacteria as a cause of this condition. He went a step ahead and also demonstrated how it can be successfully treated with antibiotics.

The exciting news here is that this condition is treatable and perhaps preventable too said Bharat. Further studies are needed to understand it better, but the good thing about the study so far is that it has already saved other patients. Bharat, who is also the lead author of the multi-center study, which was published in Science Translational Medicine on April 22, 2015 said that other centers who had patients with this infection have reached out to us and there are two patients who have recovered because of the antibiotics.

Dorbin, 47, worked in a factory where he was exposed to chemicals. He developed sarcoidosis and in seven years his lungs were gradually destroyed which lead to the need of doing a double lung transplant surgery in July 2014. Dorbin sustained on oxygen and was practically dependent on others for all his chores.

Bharat said that it was really devastating to lose a patient like Dorbin, especially after a successful transplant. But, his death did not go in vain. It is due to him these finding were possible which saved others' lives and will save the lives of many future lung transplant patients.

Dorbin got the infection almost immediately after surgery and passed away about a month later. Crystal Dorbin, his sister was one of the first people Bharat told about his research findings.

Crystal Dorbin said that he was truly very happy when she heard the news about Bharat's findings. She said her brother was a lively person and he never let his disease control him. Even though every breath was a struggle for him he was smiling and laughing all the time. He would be proud to know he helped other people like him.

Timing is of prime importance in a lung transplant. Typically surgeons have about 6 hours to transport lungs from a donor and transplant it into the recipient. But, in 80% of the cases post-surgery patients go from being oxygen dependent to having minimal or no limitations on their physical activity.

The lung transplant program at Northwestern Medicine was launched in May 2014, and since then it has completed 12 successful lung transplants.

References:

https://medicalxpress.com/news/2015-04-mystery-deadly-transplant-infection.html

https://www.medicalwebtimes.com/read/researchers_solve_mystery_of_deadly_transplant_infection/

After Learning New Words, Brain Sees Them as Pictures

Jul 16, 2015

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The human brain is perhaps the most complex thing we have ever known. The more we explore it, the more there is to explore. Scientists have been long baffled about how our brain processes thing. While a lot is now known, thanks to the research in this field, a lot still need to be explored. A study at the Georgetown University Medical Center (GUMC) reveals how our brain processes words. The results of the study were published in the Journal of Neuroscience. It says that when we look at a known word, our brain doesn't see it as a group of letters that need to be processed; instead it sees it like a picture. The study at GUMC also shows that the brain learns words quickly by tuning neurons to respond to a complete word, not parts of it.

Maximilian Riesenhuber, PhD, who leads the GUMC Laboratory for Computational Cognitive Neuroscience and who is also the study's senior author says that neurons can differentiate between real words and words that make no sense. For example, it can differentiate �turf' from �turt' (which is no word actually). There is a small area of the brain that is �holistically tuned' to recognize complete words.

There have been previous studies which had suggested that we might be recognizing words by quickly spelling them out or identifying parts of words. But, this study has a totally new take on how our brain processes words. Neurons in a small brain area remember how the whole word looks � it is something akin to a visual dictionary says Riesenhuber.

This part of the brain which is dubbed as the visual dictionary is called the visual word form area; it is situated in the left side of the visual cortex. It is just situated opposite from the fusiform face area on the right side, which remembers how faces look. Riesenhuber says while one area is selective for a whole face and allows us to quickly recognize people, the other is selective for a whole word, and helps us read quickly.

For this study 25 adult participants were asked to learn a set of 150 fake or nonsense words. With the help of functional magnetic resonance imaging (fMRI), the brain plasticity associated with learning was investigated, both before and after training.

A specific fMRI technique known as fMRI-rapid adaptation was used to investigate the changes in the word form area of the brain. It was found that the brain responded to the fake words like nonsense words before the participants learnt it. But, after training the neurons responded to the learned words like they were real words. Laurie Glezer, PhD the study’s lead author says that this study is the first of its kind to show how neurons change their tuning with learning words and it demonstrates the brain’s plasticity.

Riesenhuber opined that these findings don't just help in revealing how the brain processes words, but it also provides insights into how to help people with reading disabilities. He adds that for people who cannot learn words by spelling them out, learning the whole word as a visual object can be a good strategy. Riesenhuber also added that when their first groundbreaking study on the visual dictionary was published in Neuron in 2009, they were contacted by a number of people who had been through reading difficulties and they said that learning word as visual objects helped a great deal.

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Riesenhuber also revealed that the visual word form area in the brain does not care how the word sounds, what matters is just how the letters of the word look together. He also added since this kind of learning happens only in a small part of the brain, it is a good example of selective plasticity in the brain.

References

https://medicalxpress.com/news/2015-03-words-brain-pictures.html

https://www.iflscience.com/brain/our-brain-sees-known-words-pictures

Gene therapy clips out heart failure causing gene mutations

Jul 15, 2015

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A new study led by the researchers at the Research Center at Icahn School of Medicine at Mount Sinai has revealed about a new gene therapy that can clip out genetic material linked to heart failure and replace it with the normal gene in human cardiac cells. The study is published in Nature Communications.

Roger J. Hajjar, MD, Director of the Cardiovascular Research Center of Mount Sinai Heart at Icahn School of Medicine at Mount Sinai said that genetic mutations are the culprits behind the weakening of heart muscles that is typically seen in patients with heart failure. He added that their study is significant because it reveals that certain forms of heart failure can now be treated by a newly devised gene therapy. This therapy acts like molecular scissors and acts by cutting out the mutated gene part and inserting a normal genetic code in its place.

When the heart muscles get weakened, it is plagued by cardiomyopathies and can lead to heart enlargement and heart failure. Often such conditions are genetically inherited. There are quite a number of inherited gene mutations that are associated with cardiomyopathies, which includes mutations in the phospholamban (PLN) gene. It is a critical regulator of healthy cardiac cell function and its calcium cycling.

For this study, the researchers concentrated on R14del mutation as it has been identified in a number of families with genetic heart failure. The characteristics of this mutation are dilated heart muscle, dysfunctional heart muscle contraction, dangerous arrhythmias, and likelihood of heart failure by middle age.

Skin samples from an R14del heart failure patient were collected for the study. These skin cells were induced to become pluripotent stem cells (iPSCs) in the lab. These stem cells, which carry the genetics of the heart failure patient, were then differentiated from the skin cells into specialized heart muscle cells called cardiomyocytes (iPSC-CMs), which also carry the patient’s genetic history. When these beating cardiac cells were examined in the laboratory, it was confirmed that R14del mutation causes common abnormalities linked to heart failure like improper pumping of calcium within cell compartments, enlargement of heart muscle tissue, electrical instability causing arrhythmias, etc.

In order to rectify the gene mutation in cardiomyocytes researchers made use of two novel methods. First, they used a specifically designed transcription activator to target and eliminate the presence of R14del-associated disease in cardiac cells. The diseased gene was cut out and was replaced with a normal PLN gene resulting in normally functioning cardiomyocytes.

Secondly, they used an adeno-associated viral-vector (AAV) gene therapy approach with the harmful part of a virus removed to safely target the inside of cardiac cells. It knocked-down the abnormal PLN gene in cardiac cells and simultaneously express normal PLN gene successfully reversing disease. This method also corrected the functional abnormalities of the cardiac cells.

Dr. Hajjar said that the findings of their study have far reaching effects as it offers potentially new strategies to target and interrupt the disease causing path of the mutation associated with cardiomyopathies and heart failure. After testing this therapy is human cardiac cells, they now aim to test this approach in vivo in animal and pre-clinical studies. Hopefully, there will come a day when this gene therapy approach will be used to correct the gene abnormality in heart failure patients.

Litsa Kranias, study co-author, PhD, of the University of Cincinnati, first discovered the PLN gene R14del mutation in a Greek family said that it was a major breakthrough in molecular medicine. She also added that it would pave way for future studies in personalized therapy for heart failure patients aiming to specifically correct their defective genes.

Folkert W. Asselbergs, MD, PhD, FESC, Department of Cardiology, Division Heart & Lungs University Medical Center in Utrecht said that it is of special significance to Netherlands because about 10 percent of their patients with dilated or arrhythmogenic cardiomyopathy carry this particular founder mutation.

Battling with heart disease? Have a look at the missing link a disease-free life here.

References:

https://medicalxpress.com/news/2015-04-gene-therapy-heart-failure-mutations.html

https://www.sciencedaily.com/releases/2015/04/150429113209.htm

Neurons constantly rewrite their DNA

Jul 14, 2015

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Scientists at the Johns Hopkins University School of Medicine have made a startling discovery about neurons. The details of the study have been published online in the journal Nature Neuroscience recently. It reveals that neurons are inherently risk takers and that they use minor DNA surgeries to toggle their activity levels all day. These activities have a tremendous significance in learning, memory and brain disorders, so the scientists are hopeful that this finding will give them insights on a number of vital questions.

Hongjun Song, Ph.D., a professor of neurology and neuroscience in the Johns Hopkins University School of Medicine’s Institute for Cell Engineering said that it was long believed in the scientific community that once a cell reaches its full maturation, a DNA is totally stable � this includes all the molecular tags that are attached to it to control its genes and maintain the cell identity. However, with the finding of this research it has been revealed that some cells do alter their DNA to perform their everyday tasks, all the time.

The process of DNA alteration is known as demethylation. Methyl groups are actually regulatory tags that are tied to cytosines � the C's in DNA's 4 letter alphabets. In order to remove them a multistep process need to be followed which requires excising a tagged cytosine from the long string of paired letters that form the chromosome. It should be ideally replaced with an untagged cytosine. Since, the process needs a cut to be made in the DNA, it can increase the chances of mutation in the DNA and that is the reason why it is sparing used by most cells. However, the recent studies have revealed something not known before � it says that the mammals' brain exhibit a highly dynamic DNA modification activity. The research team of Song was curious to find out why such a risky process was going on in such a critical part of the brain.

Neurons communicate with other neurons through connections called synapses. At each synapse the initiating neuron releases chemical messengers that are intercepted by the receptor protein on the receiving neuron. Neurons are capable of toggling the volume of the communication by adjusting the activity levels of their genes. Songs team experimented by adding various drugs to neurons taken from the mouse brains and found that their synaptic activity went up and down accordingly. When the synaptic activity was up, so was the activity of the Tet3 gene, which kicks off DNA demethylation. When it was down, Tet3 was down too.

The then conducted the experiment other way round and manipulated the levels of T3 in the cells. To their surprise they found that when Tet3 levels were up, synaptic activity was down; when Tet3 levels were down, synaptic activity was up. Now the question arises whether the Tet3 levels depend on synaptic activity, or vice versa?

Through another series of experiments they found that one of the changes occurring in neurons in response to low levels of Tet3 was an increase in the protein GluR1 at their synapses. GluR1 is a receptor for chemical messengers, and its abundance at synapses is one of the ways neurons can toggle their synaptic activity.

They found that when the synaptic activity increases, Tet3 activity and base excision of tagged cytosines increases. This leads to the decrease in levels of GluR1 at synapses, which in turn decreases their overall strength and brings the synapses back to their previous activity level. It can also work the other way round. So, the crux is Tet3 levels respond to synaptic activity levels, and synaptic activity levels respond to Tet3 levels.

Song said that if we shut off neural activity, the neurons will try to get back to their usual level and vice versa. However, they cannot do it without Tet3. The ability to regulate synapse activity is the most fundamental property of neurons: Since this synaptic flexibility need mildly risky DNA surgery to work, it is possible that some brain disorders occur when neurons lose their ability to “heal” properly after base excision. Further studies can confirm this hypothesis.

References:

https://medicalxpress.com/news/2015-04-neurons-constantly-rewrite-dna.html

https://www.hopkinsmedicine.org/news/media/releases/neurons_constantly_rewrite_their_dna

World failing in fight against antibiotic resistance

Jul 13, 2015

2244

The world of science made great strides in medicine and won the battle against many deadly diseases with the invention of antibiotics. But, seems like all we have earned all these years is going to get wasted because of the rise in antibiotic resistance. Countries around the globe are doing too little on their part to fight the misuse of antibiotics, which is a major factor in fueling drug resistance. If the same continues long treatable diseases will become deadly and untreatable said the World Health Organisation.

The UN healthy agency did its first ever analysis on how the world is responding to the problem of antimicrobial resistance and they have revealed that there are �major gaps' in all six regions of the world.

Keiji Fukuda, WHO’s assistant director general for health security, said in a statement that this is the single greatest challenge in infectious diseases today. Almost all the types of microbes including virus, parasites, etc., are becoming resistant to medicines. He expressed his particular concern over bacteria which are becoming progressively less treatable by the available antibiotics. He added that this is happening in all parts of the world and that all countries must do their bit to tackle this humongous global threat.

About a year ago, the World Health Organization has published a compelling study on the phenomenon which cautioned that if significant action was not taken in due time, the world would be headed for “a post-antibiotic era”. Such an era would be devastating for mankind because in that era common infections and minor injuries that have been treatable for decades may once again kill said Charles Penn, WHO coordinator on antimicrobial resistance.

He warned that we would lose the benefits of the advancement in medical science. It would not be possible to treat a range of serious conditions such as blood stream infections, pneumonia, tuberculosis, malaria and HIV with known treatments and medicines. The benefits of advanced medical treatment, such as cancer chemotherapy and major surgery will also become much riskier and may well be lost.

A survey of 133 countries asking government to assess their response to resistance to antimicrobial medicines was conducted by the UN agency. 60 WHO members including the United States and China did not take part in the survey. The UN report of the survey which breaks down the data on a regional basis and does not provide country-specific information reveals that the situation is dangerous and the global response is conspicuously lacking. Only about a quarter of countries that responded to the survey had comprehensive national plans in place to fight resistance to antibiotics. Also, only eight of the 47 WHO member states in Africa had responded to the survey.

One of the major concerns brought to light by this survey is the sales of such drugs without prescription which remains widespread around the world. Counterfeit and low-quality drugs have also been reported in many regions. Many countries also lack standard treatment guidelines, raising the possibility of overuse of the drugs. Both overuse and misuses of antimicrobial medicines speed the emergence of resistant microorganisms. The lack of knowledge among people is especially worrying since public awareness about the dangers of misusing antibiotics remains low in all regions. Many people even in the developed European countries continue to believe antibiotics can be used to fight viral infections, which is not the case.

It was also noted that monitoring of the use of such drugs was also “infrequent” in most regions, except for European countries where a lot of progress has been made in this area. A draft of the Global Action Plan has been created by WHO for addressing antimicrobial resistance. It is likely that all member states will be asked to approve it at its annual meeting in Geneva in coming month.

References:

https://medicalxpress.com/news/2015-04-world-antibiotic-resistance.html

https://www.commondreams.org/news/2015/04/29/nations-failing-combat-global-threat-antibiotic-resistant-superbugs-who

Healthy elders may hold key to fighting cancer

Jul 12, 2015

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Cancer

There is interesting new evidence from the Scripps Research Institute which suggest that the immune system of healthy seniors would hold the clues for beating the most aggressive form of breast cancer. It says that some seniors have likely fought off cancer successfully without even knowing it � in the process that have developed antibodies that could hold promising avenues for new cancer therapies.

For their research, scientists at Scripps have started mining the DNA from the blood samples from healthy adults aged 80+ years � the so called �wellderly' to unveil the secret to their long lives. In this process, they have found antibodies which bond with a type of cancer for which there is no targeted therapy.

This research is funded by two grants from the California Breast Cancer Research Program, managed by the UC Office of the President and supported in part by taxpayer donations on the state tax return.

The broader wellderly study is ongoing at Scripps Research and is led by Professor Eric Topol.

Brunie Felding, an investigator at Scripps said that he was always of the opinion that the human immune system is really our best defense against cancer. But, when he saw the so called �wellderly' he wondered if these people have antibodies which hold the key to their long healthy life. And that is definitely something scientists should look into.

Battles fought and won:

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When the white blood cells from the blood samples of cancer-free wellderly were analysed, some interesting things were noted. Felding says that those finding amount to past victories against cancer.

When subjected to an “immune library” generated from the wellderly blood samples, a particular protein in aggressive “triple negative” breast cancer cells was recognized by an antibody from the wellderly and sparked particular interest. This cancer cell protein is a part of a signaling pathway. Felding is hopeful that this could be a driving pathway in this form of cancer � it is an indicator to show a way to therapeutic targets.

Exploring the antibody memory

The idea that healthy older women could have successfully fought cancer without even knowing was a novel one. This is how the human immune system works � when a pathogen enters a human body, the body creates antibodies to combat and neutralize it. These antibodies stay in the immune memory even after the pathogen is gone; it is useful in case the pathogen comes back. A similar principle applies in cancer development.

Felding is of the opinion that if there were aberrant cells at some point in a person’s body, but a noticeable cancer never developed, it is likely that the immune system handled those stray cells. However, the antibody memory would be there for years to come.

For this study, researchers were specifically looking for how the body deals with one of the most dreaded form of breast cancer � known as triple negative breast cancer. Since, there are no targeted therapies for triple negative tumors, finding an effective therapy for it is one of the main goals for this research.

The cancer cells that were exposed to the wellderly immune library belong to a very aggressive triple negative breast cancer of a woman named Elizabeth who was one of Felding’s friends, who succumbed to this disease. When the genome of Elizabeth’s cancer was looked at, Felding and her group saw that the protein Apolipoprotein E, or ApoE, was more than one-hundred-fold enriched during the progression of Elizabeth’s breast cancer. The interesting noted by the researchers was that this protein was recognized by some of the wellderly antibodies.

There are two likely conclusions one could derive from it – the antibodies that recognize ApoE could have come disease-blocking properties and could hold useful in designing a targeted therapy. Or it may be that ApoE is a flashing signpost pointing researchers down a pathway to be analyzed as a possible disease driver. The concept is very promising says Felding.

Click here to get more information on cancer and how this person managed to beat it.

References

https://medicalxpress.com/news/2015-04-healthy-elders-key-cancer.html

https://www.universityofcalifornia.edu/news/healthy-elders-may-hold-key-fighting-cancer

Mother’s Diet Influences Weight-Control Neurocircuits in Offspring

Jul 11, 2015

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Mothers have a big role to play in their child's life. While nurturing them to become responsible adults is one of the big tasks she has to carry out, there is something else that is equally important. A women must take due care about her diet during pregnancy and lactation. According to Penn State College of Medicine researchers, a mother's diet at this stage may prime offspring for weight gain and obesity later in life. The researchers looked at rats whose mothers consumed a high-fat diet and found that the offspring's’ feeding controls and feelings of fullness did not function normally.

The findings of this study were published in the Journal of Physiology. It suggests that there are significant effects of maternal and perinatal diet on some of the regions that control feeding and satiety in the brain. How the maternal diet has an impact on these functions is still not understood.

Some previous researches on obesity have revealed that obesity compromises the neurocircuits that control how the stomach and intestine work to regulate how much one eat. The time around pregnancy and lactation is important in the development of these neurocircuits. It has been observed in both human and laboratory studies that the offspring of mothers who are obese or consume a high-fat diet during pregnancy are much more likely to be overweight and have weight-related problems such as metabolic syndrome, diabetes and heart disease later in life.

For this new study, researchers experimented on rats. They fed one group of rats a high-fat diet during pregnancy and lactation. After weaning, their offspring were fed the same diet. Once the rats reached adolescence, the researchers measured their neural activity involved in energy balance and appetite regulation. The lead investigator Kirsteen Browning, associate professor of neural and behavioral sciences said that they looked at the circuits that relay information from the stomach and the small intestine to the brain and back to the stomach telling it how to work. It was found that parts of these reflexes were not functioning properly even before they saw obesity.

When a person is obese, the normal reflex mechanisms, which help limit the amount of food we eat, can malfunction and become less sensitive. Browning added that rats that were on the high-fat diet looked exactly the same as the control group rats in terms of weight, but their feeding reflexes were already showing signs of not functioning properly.

Browning remarked that it is high time we started taking the problem of obesity seriously. It doesn't just have to do with food; brain is also playing a bigger role here. He also cautioned that obesity is a very complex disease that has many genetic and environmental factors playing important roles. So, it is not compulsory that women who ate a high fat diet during their pregnancy are going to have obese children and vice versa. It is just another risk factor.

An understanding of the biological mechanisms underpinning obesity could help stem the tide of obesity. The oversimplified rule of eat less and workout more to lose weight cannot work for everyone because there are other factors in play as well. It is important that we recognize the critical window during development that can have very long-term outcomes. One of such factors is attention to mothers’ health, wellbeing and diet.

Browning said that more research is needed to determine the precise perinatal timeframe within which feeding neurocircuits are vulnerable to unhealthy alteration. Also, whether these changes can be reversed once set into motion. Another important thing that needs to be tested is whether the fat content or the caloric load of the rats’ diet induced the changes. Hopefully, all these questions are going to be answered by Browning after further research.

Check this guide out for a safe and efficient way to exercise and have a proper diet during pregnancy.

References

https://medicalxpress.com/news/2015-03-mother-diet-weight-control-neurocircuits-offspring.html

https://news.psu.edu/story/350597/2015/03/30/research/mothers-diet-influences-weight-control-neurocircuits-offspring

Better Diabetes Blood Sugar Management Leads To Fewer Eye Surgeries

Jul 8, 2015

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Type I Diabete

A new study reveals that intensive management of type 1 diabetes can significantly reduce the risk of having a diabetes-related eye surgery by nearly a whopping 50 percent. The blood sugar targets set for this study participants were quite stringent. But, even for people who couldn't meet the target, it was observed that even a 10 percent improvement in hemoglobin A1C�a three-month estimate of average blood sugar levels led to around 35 percent reduction in the risk of diabetes-related eye surgery, as per the study.

Results of the research are published in the April 30 issue of the New England Journal of Medicine.

Dr. David Nathan, study’s senior author, director of the Massachusetts General Hospital Diabetes Center and Clinical Research Center in Boston said through this study they aim to show how a modest period of tight blood sugar control can lower the need for eye surgery.

Type 1 diabetes is an autoimmune disease that destroys the body's ability to produce insulin. Typically, the A1C goal for people with this disease is under 7 perfect. So, if one can bring it down to 7 from 7.7 or from 8.5 to 7.7 � it would lead to a 35% reduction in diabetes related eye procedures. A lower A1C is definitely better, as long as it is achieved as safely as possible.

It is not good to lower blood sugar too much too fast. Also, elevated blood sugar levels for a long time can lead to long term health consequences which include eye issues.

Diabetes destroys eyes in several ways Nathan explains. Even though our eyes balls are tiny when compared to the whole body, the eyes have enormous blood flow through very fine, small caliber vessels. Abnormalities like breakage of these vessels causing blood leakage can develop in these vessels due to persistently high sugar levels. Such problems in the eye vessels can lead to a condition called macular edema and diabetic retinopathy. Another problem diabetics face is they tend to develop cataract about a decade earlier in life.

For this research two studies were included and encompassed about 1400 people with type 1 diabetes. The first study dates back to 1980s and had two groups of people�one that received intensive diabetes management, while the other group received standard care. It lasted about 10 years. The second study followed most of the people from the initial study over the long term, though the intensive management stopped.

For the first study, it was aimed to get the A1C to 6.05. However, the average A1C ended up at 7 percent. In the 23 years that followed, 63 people out of 711 who were under intensive management underwent diabetes-related eye surgery while 98 of the 730 people in the standard therapy group had diabetes-related eye surgery. Also, people in the intensive therapy group, had a 48% lower risk of cataract surgery. �It was also noted that the costs of diabetes-related eye surgeries were 32 percent less for the group that received intensive management.

Helen Nickerson, director of translational development for JDRF said that interventions to control glucose levels can improve outcomes, preserve life and prevent disabilities.

Type 1 diabetes is prevalent worldwide with close to 38 million people suffering from it. The study authors opined that intensive therapy can benefit them and reduce morbidity and health care costs. This study didn't include people suffering from type 2 diabetes whose estimated number is 10-20 times higher than type 1 diabetes. But, as per the evidences from previous research it is seen that people with type 1 diabetes are slightly more likely to have eye disease.

References:

https://medicalxpress.com/news/2015-04-diabetes-blood-sugar-eye-surgeries.html

https://health.usnews.com/health-news/articles/2015/04/29/better-diabetes-blood-sugar-management-leads-to-fewer-eye-surgeries

Keeping food visible throughout the house is linked to obesity

Jul 7, 2015

2574

Abdominal Obesity

Cases of obesity are increasing at an alarming rate and there are a lot of researches going on to find out the factors that have a direct relation with it. A team of researchers at the Ohio State University have identified two unrelated by strong predictors of obesity. First is low self-esteem about one's weight and the other is keeping food visible available outside the kitchen in the house.

This study at the Ohio State University revolved around finding out if the architectural features of the house and food availability have any link with obesity; they also measured a number of psychological factors. The study revealed that architectural features had nothing to do with relationship to obesity status, however, several food-related findings did. It is published in the International Journal of Obesity.

Both obese and non-obese people participated in the study. It was seen that obese people kept more food visible throughout the house and typically ate more of unhealthy food like fried foods, sweets, etc., as compared to their non-obese counterparts. It was also seen that both groups spend about the same amount of money on food, ate similar amounts of total calories. However, non-obese participants spent less on fast food than obese individuals.

Charles Emery, professor of psychology at Ohio State and lead author of the study said that the amount of food in the homes was similar, but obese individuals spread the food throughout the house. They created an environment where food was easily visible and it became harder to avoid food. Such a finding has not been documented before.

It was also reported in the study that obese individuals have lower self-esteem about their bodies and they also exhibit signs of depression. In the earlier studies effects of home environment and psychological factors have not been examined together before. It is important to focus of self-esteem in adult weight-loss programs. Only when adults feel good about themselves will they be motivated to implement behavioral changes.

Through this study the predictors of obesity are identified but it doesn't mean that they are the causes of the weight issues. Emery opined that they have tried to create a detailed picture of the home environment obese people live in. However, no one can say with surety whether obesity led to the environment or vice versa.

For this study 100 participants between the age of 20 and 78 were recruited by the research team. Half of them were not obese and the rest of them were obese with an average BMI of 36.80. A 2 house home visit was conducted by the researchers � they interviewed them about food consumption, assessed the layout and food storage in the homes and got self-report psychological questionnaires done by the participants. 2 weeks later they followed them up to evaluate their food purchases and physical activity.

Emery pointed out that in the study, obese participants reported they were less able to avoid eating – whether they were hungry or not. This reflects a greater preoccupation with food. If food is something you’re thinking about a lot, it potentially becomes a source of stress. One can’t just stop eating, but can definitely change the way you eat and change the way you think about eating.

Emery noted that while multiple metabolic and genetic factors contribute to obesity, but the home is a logical place to consider in efforts to improve health. He said that home environment is crucial since that’s where most people spend a majority of their time. Home is the place to start to help people establish healthier habits and behaviors.

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References:

https://medicalxpress.com/news/2015-04-food-visible-house-linked-obesity.html

https://www.universityherald.com/articles/18462/20150428/keeping-food-visible-throughout-the-house-may-be-linked-to-obesity.htm

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