Surgical-site infections increase the risk of blood clots after colorectal surgery, study finds

According to a research conducted by investigators at the Johns Hopkins Hospital, surgical-site infections after abdominal surgery are associated with a higher risk of blood clots than other patients who did not develop postoperative infection. Even if they receive anticoagulants to prevent blood clots, some patients still develop these complications within the first month after surgery, especially those who had a surgical infection.

The study led by Johns Hopkins scientists and published in the Journal of the American College of Surgeons, shows that patients who had surgical-site infection after abdominal surgery have a 4 times greater risk of developing deep vein thrombosis or pulmonary embolism, compared with patients who did not have surgical infection. One possible explanation for this association is that inflammatory proteins involved in the infection cause activation of platelets that lead to blood clots. Blood platelets, or thrombocites, are cells, in fact  cell fragments in the blood, that play a role in hemostasis, that is they stop the bleeding. The study showed that 4% of patients had DVT, but of these 92% had previously received anticoagulants which should prevent blood clots. Study leader Susan L. Gearhart, MD, associate professor of surgery at year the Johns Hopkins University School of Medicine, said that patients with surgical-site infections must be treated with great care in order not to develop DVT.

Almost all surgical patients treated at The Johns Hopkins Hospital receive prophylaxis not only with anticoagulants but also devices to keep blood flowing in the legs during hospitalization. However, this prophylaxis ceases when patients are discharged. Dr. Gearhart pointed out that  medical staff need to be carefully trained about the importance of DVT prophylaxis, and that there have been created automated checklists to remind healthcare professionals about this issue. Deep vein thrombosis and pulmonary embolism are potentially fatal complications that can occur after surgery, especially in orthopedics. These complications can be prevented, this is why there is so much emphasis on anticoagulant prophylaxis. However, it turned out that even if patients do receive prophylaxis, they still developed DVT or pulmonary embolism, especially if they had surgical-site infection.

Investigators arrived at these conclusions after analyzing the records of 615 patients treated at The Johns Hopkins Hospital between 2009 and 2011. Of these, 25 developed DVT even though most (92%) had received prophylaxis with anticoagulants. What investigators also discovered was that 14 of the 25 have had postoperative infection, indicating that there is a link between surgical infection and risk of DVT.

New drug for bipolar disorder is now under investigation

Oxford University researchers have identified a new drug to treat bipolar disorder, a psychiatric disorder in which people experience feelings of mania alternating with depression. The new drug is similar to lithium but it has no adverse effects or the toxicity of lithium, which is a major advantage for the patient.

The new compound, which was already tested on animals, is called ebselen and will be included in clinical trials to be studied in humans. Co-principal investigator Dr Grant Churchill of the Department of Pharmacology at Oxford University, said that lithium is used for over 60 years and remains the most effective method of treatment for bipolar disorder. He said that ebselen is a drug created for other conditions but works like lithium and has no toxic effects.

Bipolar disorder is a relatively common disorder in psychiatry. It is estimated to affect about one in 100 people and can occur at any age. People with bipolar disorder have extreme feelings of mania (hypomania) and depression that affect their everyday lives. Lithium remains the most effective method of treatment for bipolar disorder because it treats both mania and depression. In addition, what is important is that lithium reduces the risk of suicide.

Although lithium is effective in treating depression and mania in bipolar disorder, it still has a number of side effects that limits its use. Also note that long-term lithium use affects the kidneys which can lead to kidney failure. Also other unwanted effects are weight gain, which can be quite unpleasant for the patient, and thirst. Another thing that should be known about lithium is that it becomes toxic at twice the therapeutic dose, so it should be used with caution. Researchers have long wanted to discover a drug to act as lithium but their efforts were not successful.

Now researchers used a U.S. National Institutes of Health Clinical Collection containing drugs created for diverse disorders but with not precise indication. They looked especially for a drug that acts like lithium and found that this drug could be ebselen. Ebselen is an antioxidant that has been designed as a treatment for stroke but that never came to be released on the market.

Experiments on animals have shown positive results and now is to be tested in people with bipolar disorder to see if it has the same effect. The other lead author, Dr Sridhar Vasudevan of the Department of Pharmacology at Oxford University, said: “‘This is one of the first handful of examples of drug repurposing, where a new use has been found for an existing drug.”

New genes of Acute Lymphocytic Leukemia

Researchers from VIB (the Flanders Institute for Biotechnology) made new discoveries about acute lymphatic leukemia (ALL), one of the most common forms of leukemia in children. Although chemotherapy induces remission in approximately 75% of children, this treatment has many side effects.

Acute lymphocytic leukemia refers to uncontrolled proliferation of lymphoblasts in the blood. These immature white blood cells invade not only the bone marrow but also other organs such as the spleen, liver, etc.. Most often this form of leukemia occurs in children between 2 and 5 years, but there is a high rate of cure with current treatments. Now researchers at VIB, KU Leuven and UZ Leuven in collaboration with international research team, have made new discoveries about genetic mutations that underlie T-ALL, a form of ALL. They found that an important role in this disease is represented by ribosome, a cellular organelle responsible for protein production, and that there are differences in pediatric T-ALL and adult T-ALL. These findings can be the starting point for new treatments.

Acute Lymphocytic Leukemia

Jan Cools from VIB / KU Leuven stressed that there are genetic differences between this form of leukemia in adults versus children and this is the explanation for that adults do not respond to treatment. If children have a cure rate of 75%,  in adults, instead, the cure rate is 50%. For treatment to be successful, it must first be discovered what causes leukemia.

It seems that T-ALL is triggered by genetic errors that occur simultaneously. The researchers found 15 genes whose mutations result in T-ALL, and 7 of them are newly discovered as they have not been so far associated with leukemia. The findings were made after researchers analyzed using next-generation sequencing more than 20,000 genes from 67 T-ALL patients.

What was also discovered was that there are many differences between T-ALL in adults T-ALL in children. It seems that adults have more mutations than children. It was also found that, in  adults, there are mutations in other genes than those found in children. This is why adults do not respond to treatment as children respond.

The researchers also discovered for the first time that defects in ribosome can lead to activation of leukemia. It seems that the two newly discovered genes, RPL5 and RPL10, form part of ribosomes. Kim De Keersmaecker from VIB / KU Leuven said that all cells need functional ribosomes to survive  and that these mutations are the weak point in leukemia. Also they could be the target for future therapies.

Therapeutic approach for Alzheimer patients

New discoveries have been made by researchers from the Charité – Universitätsmedizin Berlin and the University of Zurich on AD. According to the study published in the current issue of Nature Medicine, the new discovery could be a new therapeutic target for Alzheimer’s disease not only to prevent but also to treat the disease already installed. Studies on laboratory animals  have shown that by blocking a transmitter of the immune system, pathological manifestations of the disease can be improved.

The incidence of Alzheimer’s disease in Germany and Switzerland is increasing, 1.5 million people are now affected by this disease and the incidence  is expected to double over the next 20 years. Alzheimer’s is one of the most common forms of dementia that affects the old population. The risk of this disease increases with age and it is believed that after 65 years, the risk doubles every five years. There are two forms of the disease: the early onset Alzheimer, which is transmitted in the family, and the late-onset, which occurs sporadically and is also the most common form.

Alzheimer patients

There are several hypotheses on the causes of Alzheimer’s disease. Cholinergic hypothesis is based on the idea that this illness is due to a decrease in a brain neurotransmitter: acetylcholine. Another hypothesis is that the accumulation of beta-amyloid deposits causes installation of Alzheimer. Finally, there is the assumption that the accumulation of tau protein in neuronal bodies leads to neurological damage.

Now researchers at the Department of Neuropathology at from Charité and from the Institute for Experimental Immunology at the University of Zurich,  have conducted studies on laboratory animals that have shown that beta-amyloid deposits can be reduced by blocking some cytokines, proteins that are part of the immune system. By affecting the immune molecule p40, a component of IL12 and IL 23, beta-amyloid deposits could be reduced by about 65%.

This discovery could provide the basis for a new therapeutic targets to treat Alzheimer’s in humans. Studies conducted so far by Professor Heppner’s and Professor Becher’s team, on laboratory animals have had positive results. It was found that mice that received antibodies that block p40 molecules had improvements in behavioral testing. What is interesting is that in the cerebrospinal fluid of patients with Alzheimer’s there have been found elevated levels of p40, which reinforces the idea that it could become a new therapeutic target.

Professor Heppner and Professor Becher believe that more studies are needed to clarify the involvement of the immune system in Alzheimer’s disease onset. They believe that IL 12 and IL 23 are not the cause of  this disease and the role of the p40 molecule need to be investigated. Drugs that block p40 molecule have been launched to the market for the treatment of psoriasis, and now researchers are eager to see this new treatment in patients with Alzheimer’s.

Researchers Identify Highly Antibiotic Resistant Bacteria at US Wastewater Treatment Plants

A team of researchers from the University of Maryland School of Public Health, in the United States, has found that the MRSA (methicillin-resistant Staphylococcus aureus) inhabits multiple WWTPs (Wastewater Treatment Plants) across the US territory. This specific type of Staphylococcus aureus is known to be the cause of many fatal bacterial infections. Before the year 2000, most of these fatal infections occured in hospitalized patients, however, after the year 2000 a rise in prevalence in healthy communities has been reported.

According to the lead researcher of the study, assistant professor Amy Sapkota, the prevalence of these community-acquired MRSA infections is continuously rising. Despite this fact, researchers have not yet been able to identify the exact sources of MRSA infection. “This was the first study to investigate U.S. wastewater as a potential environmental reservoir of MRSA”, said Amy Sapkota.

The current study has been published in the November issue of the journal Environmental Health Perspectives and is the first study to confirm the presence of MRSA in the wastewater treatment plants from the United States. A precedent study led by Swedish scientists  showed that MRSA was present in the wastewater treatment plants from Sweden.

MRSA

Researchers from the University of Nebraska Medical Center, in collaboration with the research team from the University of Maryland School of Public Health, collected water samples from four wastewater treatment plants (two from the Mid West and two from the Mid Atlantic area). The criteria through which these four wastewater plants were selected included the fact that discharged water is reused in irrigation. The aim of the study was to detect whether or not MRSA are still present in the discharged water.

Along with the antibiotic resistant bacteria (MRSA), researchers found out that MSSA (methicillin-susceptible Staphylococcus aureus) was also present in the discharged water coming from all four wastewater treatment plants. The results show that 45% of the samples contained MRSA whilst 55% was MSSA. Before passing through the treatment plant, 83% of the water samples were shown to contain MRSA. However, after water was processed and treated, only samples from one wastewater treatment plant contained bacteria. These samples were taken from one of the plants that doesn’t regularly use chlorination in the treating process.

From the isolated bacterial cultures, researchers found that 93% of the MRSA strains and 29% of the MSSA strains were resistant to more than two classes of antibiotics. According to the team of researchers, although water treatment plants are effective against reducing the number of bacteria through the treatment process, the same treatment plants might be responsible for increasing the number of extremely resistant bacteria. These are particularly the treatment plants that don’t use chlorination in the water treatment process.

“Our findings raise potential public health concerns for wastewater treatment plant workers and individuals exposed to reclaimed wastewater”, said doctoral student Rachel Rosenberg Goldstein, whilst concluding: “Because of increasing use of reclaimed wastewater, further research is needed to evaluate the risk of exposure to antibiotic-resistant bacteria in treated wastewater”.

Study Abstract

New therapeutic targets on B-acute lymphoblastic leukemia identified

New discoveries have been made on adult B-lymphoblast acute leukemias. The research, made by U.S. scientists, was published in Cancer Discovery, a journal of the American Association for Cancer Research.

The researchers wanted to find out what genetic alterations are associated with poor prognosis in patients with B-lymphoblast acute leukemias. Therefore, a team led by Ari Melnick, MD, associate professor of medicine and director of the Raymond and Beverly Sackler Center for Biomedical and Physical Sciences at Weill Cornell Medical College and a hematologist-oncologist at New York-Presbyterian Hospital / Weill Cornell Medical Center, studied 215 specimens obtained from patients with B-lymphoblast acute leukemias.

B-acute lymphoblastic leukemia

The specimens were taken from patients enrolled in a large Eastern Cooperative Oncology Group phase III clinical trial. Melnick said the intention to make an integrative epigenomics study came from the desire to discover why this type of adult patients with leukemia have a poor prognosis. He said he hoped to discover, along with underlying causes of this fact, and new therapeutic targets for the treatment of leukemia.

In most cases, genetic alterations are associated with epigenetic changes in the DNA. Epigenetic changes occur when DNA is not packed as it should. It should be noted that genetic alterations, along with the epigenetic changes, stimulate carcinogenesis process. The study conducted by Melnick  revealed that many of the features of B-lymphoblast acute leukemias are due to epigenetic changes. Furthermore, these epigenetic changes could be the basis for the discovery of key processes in the development of leukemia. Melnick said that one of the findings was that the surface molecule CD25 is an indicator of aggressive forms of leukemia. In addition, the researchers also found that mutant forms of MLL proteins leads to expression of a oncoprotein, BCL6, is involved in the proliferation and survival of leukemia cells.

Based on this discovery, the researchers then created Bcl6 inhibitors and showed that they can destroy leukemia cells in patients enrolled in the study. Now researchers want to use CD25 as a marker to identify severe forms of leukemia and create appropriate therapies for such situations.

Acute lymphoblastic leukemia refers to malignant proliferation of leukocytes and represents about 75% of leukemias in children. A clear cause of leukemia is not identified, but there were put into question many factors. Among the causes of this disease include exposure to benzene, ionizing radiation, pesticides and others. If the child can treat acute lymphoblastic leukemia in most cases, the same cannot be said for adults. Symptoms of this disease are fever, pallor, swollen lymph nodes, fatigue, bleeding, bruising, etc.

Stem cell therapy – The future Treatment for spinal cord injury

European researchers have made significant progress in the attempt to treat spinal cord injuries using stem cell therapy. Although there have been several attempt to cure spinal cord injury patients, the results were not so encouraging. Now, however, the project “From stem cell technology to functional restoration after spinal cord injury ‘(Rescue) has promising results so far. Researchers analyzed the ability of human stem cells to treat spinal cord injuries. To find out if stem cell therapy is successful, researchers investigated both neural stem cells and non-neural stem cells and have conducted experiments on laboratory animals. Research were not easy because stem cells can induce tumors development due to the ability of these cells to proliferate continuously. Thus, the researchers first wanted to check if the experiment is safe. But they found that grafting adult neural stem cells from human biopsies lead to uncontrolled proliferation. Therefore it must be found a new way to use the stem cells in order to treat spinal cord injuries.

Stem Cell Therapy

Stem cells are young cells that can divide and differentiate in various cell lines. There are embryonic stem cells, that are extracted from the blastocyst, an embryo formation stage, and adult stem cells that are found in different parts of the body. Depending on the potency, stem cells are classified in totipotent cells, pluripotent, multipotent and unipotente. Lately there has been a great stir in the medical world for stem cell therapy because it is believed it can cure various diseases that, currently, are considered incurable. Stem cell therapy has applications in several medical areas. The best known example is the use of stem cell therapy in bone marrow transplants in diseases like lymphoma or restoring blindness. Also, stem cells are used in the treatment of neurodegenerative diseases such as Alzheimer’s, Parkinson’s or heart disease.

Studies on the use of neural stem cells have been made and there are continuing research. It is a hope not only for patients with spinal cord injuries but also patients suffering from stroke or other neural diseases.

Rescue researchers were able to differentiate human neural precursor-derived astrocytes that have a role in axonal growth on collagen scaffolds. Researchers have focused on cell differentiation. They tried to guide stem cells to a specific cell line using viral vectors. With these viral vectors researchers transferred transcription factors that lead to the formation of a certain cell lines. Furthermore, researchers were able to develop a new viral vector that can be used in clinical practice. Although other studies and research must be made, Rescue scientists have made significant progress in the treatment of spinal cord injuries.

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Study Shows Little Difference Between Organic And Conventional Food

New study shows that organic food is not as healthy as it is thought. Organic food was supposed to be significantly superior in terms of  nutritional value , taste and low bacterial contamination. No substantial evidence that could link nutritional benefits to consumption of organic products was found.

Researchers from Stanford University School of Medicine made a review of 17 human studies and 223 food studies. They compared safety, nutritional value and health benefits of both conventional and organic foods.

Dr. Crystal Smith-Spangler and Dr. Dena Bravata, team liders, discovered no significant evidence to prove that organic foods have  more important beneficial effects on the human body than common foods.

Previous studies on organic food showed that organic rice has high levels of arsenic. Organic strawberries were also found with a lower level of potassium and phosphorous than conventionally grown strawberries. However, researchers found that there are higher levels of omega-3 acid, vitamin c, phenol and other antioxidants in organic products, but a deficiency in these compounds is extremely rare.

Furthermore, because of the use of different fertilizers, the scientists have found high levels of nitrogen in organic foods which “is very unlikely to provide any health benefits” as Dr. Smith-Spangler stated.

Organic foods are made using farming methods that don’t include addition of pesticides or any other chemicals. They are not processed using chemical food additives, irradiation or industrial solvents. In addition, organic meat and dairy products must come from free-range animals which are fed organic vegetables and fruits.

Organic Vegetables

Many countries demand producers a certain certification to grow and sell organic foods within their territory. In this context, organic food is supposed to be the food produced according to each country’s organic standards, which are usually set by the national governments or international organizations.

Reasearchers were looking for long-term studies concerning the health outcomes of  people who consumed organic foods versus common foods, but the maximum time of a study consisted of only 24 months. They declared that they still have no significant evidence whether organic foods bring more long-term health benefits than common foods.

The study provoked controversial responses from different health organizations like a UK charity called the The Soil Association. This association, which believes in healthy, humane and sustainable food, farming and land use.

The Soil Association appreciated some aspects of the study, while criticizing others. The declared that this study treats crop trials as if they were clinical trials of medicine and exaggerates with the differences between the studies they reviewed. Moreover they emphasized the fact that the study focuses more on the negative effects rather than the positive ones, when it should be vice versa.

New Study Links Physical Activity to Lower Cancer Rates

A new study reveals that an active lifestyle that includes brisk walking, gardening, housework and other activities is linked to a reduced chance of breast cancer. This is the largest study that researches the effects of physical activity on breast cancer and is a part of the ongoing research led by EPIC (the European Prospective Investigation of Cancer).

Scientists studied over eight thousand cases of breast cancer and discovered that the group of women who were physically active, have a 13% lower chance of developing breast cancer. The same study also revealed that even a moderate daily activity reduces the chance of cancer development by almost 8%.

Precedent studies have estimated that physical activity is also related to a reduced risk of other cancers, not only breast cancer. Estimations show that almost 3% of breast cancers, 4% of womb cancers and 5% of colon cancers are in direct link to the fact that people spend less than 150 minutes per week for physical activity.

One of the authors of the study, professor Tim Key, who is an epidemiologist at the University of Oxford, UK, said that this study accentuates the importance of physical activity in everyday life. He added that recent studies have shown how important physical activity is in reducing the risk of bowel cancer, concluding that future studies are necessary in order to investigate the mechanisms that stand behind this connection.

Brisk Walking

 Doctors and governmental authorities recommend at least 150 minutes of moderate physical activity every week. Unfortunately, only 39% of men and less than 30% of women manage this weekly.

The director of information from Cancer Research UK, Sara Hiom, said that “While maintaining a healthy body weight and cutting back on alcohol remain two of the best ways of reducing our risk of breast cancer, being active can clearly play a role too “ but doesn’t have to cost you money or too much time”.

She also said that there’s no need for an excessive or intense workout. Normal and moderate exercise and physical activities such as gardening, walking the dog, brisk walking or daily housework should suffice. She also added that small changes in our everyday routine can make a big difference. These changes could include taking the stairs instead of the elevator or walking to school instead of using public transportation.

“Keeping active could help prevent more than 3,000 cases of cancer in the UK every year. And it can have a positive effect on your health”, she concluded.

Personalized Antiplatelet Treatment Improves PCI Outcome According To Study

Researchers have demonstrated for the first time the connection between alcohol and cancer in humans. At 244th National Meeting & Exposition of the American Chemical Society, researchers have provided the scientific explanation of the relationship between alcohol and cancer risk. Silvia Balbo, Ph.D., who led the study, explained that researchers now have the first evidence showing how acetaldehyde resulting from alcohol leads to altered cellular DNA in humans.

Alcohol And Dna

The fact that alcohol is considered a risk factor for cancer is not new. It is a well-known fact that alcohol is a risk factor for cancers of the esophagus, pharynx, larynx, oral cavity, liver, breast or rectum. Alcohol contributes to some extent to the development of various types of cancer and the risk depends on the characteristics of each patient, and on the amount and type of alcohol. For example, it is well-known fact that alcohol is a major risk factor for squamous cell cancer of the esophagus,along  with tobacco use. Alcohol is degraded in the body into acetaldehyde, a compound that is similar to formaldehyde. It is known that formaldehyde is a human carcinogen. Formaldehyde is a chemical that is found in many household products, fuel burning devices in building materials etc.

Previous studies have shown that occupational exposure to formaldehyde is associated with blood and oropharyngeal cancers. Acetaldehyde, a breakdown compound of alcohol, was also associated with cancer. Laboratory studies have shown that acetaldehyde induces cellular DNA abnormalities with the occurrence of chromosomal aberrations. After several studies on cell cultures and laboratory animals, researchers determined that acetaldehyde is an animal carcinogen.

The human body naturally has many defense mechanisms against cancer. For example, there are some enzymes that repair different faults that can occur during the formation genes. These enzymes may be deficient in some people, and so cancer occurs. Sometimes carcinogens are so strong that the body is no longer able to defend itself. Regarding alcohol, there is an enzyme called alcohol dehydrogenase, which converts acetaldehyde into a less harmful compound called acetate. Nevertheless, it was observed that 30% of Asians (people of Asian descent) can not properly convert acetaldehyde into acetate. In other words, the risk of cancer is much higher.

Silvia Balbo, who is also a research associate in the laboratory of Stephen Hecht, Ph.D., a noted authority on cancer prevention at the University of Minnesota, said that acetaldehyde interfere with DNA in the process of making up genes. In this way acetaldehyde irreversibly alter genetic material in cells so that increases the risk of cancer.