Snoring And Sleep Apnea Increase Children’s Risk Of Behavioral Problems

According to a study�conducted�by researchers at Albert Einstein College of Medicine of Yeshiva University, children who�experiment breathing disorders during sleep�also have behavioral problems. The study, conducted on a sample of 11,000 children over 6 years, was published in the journal Pediatrics. Study leader, Karen Bonuck, Ph.D, professor of family,social medicine, obstetrics & gynaecology�and women’s health at Einstein,�underlines the importance�of�the problem in children and points out that �both pediatricians and obstetricians should carefully �monitor�these children.

Sleeping Boy

Breathing difficulties usually occur in children aged between�2 and 6 years, but can also occur in children younger than 2 years. Children who snore or have sleep apnea episodes, (stop breathing during sleep),�usually�have enlarged tonsils or nasal polyps. According to the American Academy of Otolaryngology-Health�and Neck Surgery (AAO-HNS), 1 in 10 children snore regularly and 2 to 4% have episodes of apnea.�Previous studies have reported� the link between SDB (sleep-disordered breathing) �and behavioral disorders in children but�they were�somehow questionable�due to�the small�sample used and�short follow-up period. The current study clearly demonstrates that behavioral disorders, such as hyperactivity, aggressiveness, difficulties in�communicating with their peers, �are caused by SDB.

Researchers analyzed questionnaires completed by parents�regarding�symptoms and behavior of their children. It was found that behavioral problems�usually begin at the age of 7 years, and the main�symptom of these children with SDB is hyperactivity. Researchers think that SDB cause behavioral disorders because the�brain is affected: SDB not only prevents the child to rest properly,�which explains the effects on memory and attention during the day, but also disturbs the balance between various processes and biochemical mechanisms of the prefrontal cortex. All these imbalances are�reflected in the behavior of the child. This is way�the child is�not careful, not willing to listen, and cannot control his emotions and impulses.

Dr. Bonuck remarks that although snoring and sleep apnea are relatively common among children, pediatricians do not usually check if the child does indeed have SDB. In order to help the children not to develop behavioral problems, pediatricians should ask the parents if the child has any specific symptoms of SDB, that�is snoring, open mouth breathing or sleep apnea.

Underlying causes of SDB can be fixed surgically. Tonsillectomy�and nasal polypectomy�are�surgeries performed under local or general anesthesia of short duration with a minimal�recovery period. In obese children, doctors recommend weight loss to�relieve their�breathing disorders during sleep, but also prevent any long-term complications of obesity.

Popeye Proteins

In a study published in the Journal Of Clinical Investigation, scientists reported the discovery of�the role of�a family of proteins called Popeye. According�to researchers these proteins�have an important role in�determining how�exactly the heart is responding to stress. This new study can represent a first towards developing new therapies for cardiac�arrhythmias.

This new family of proteins (also known as Popdc) was discovered�ten years ago�when it was observed that they�are present in high quantities�in muscular fibers, reason for why�they were�named Popeye. Until now, the exact functions of this proteins was unknown, but this study�reveals their function and that�is to increase and to sustain the�heart rhythm when are they are�stimulated by adrenaline (hormone that is released in stressful periods).� For this study, researchers used mice that presented Popdc protein deficiency.

Physiologically, the response of heart’s dominant peacemaker to adrenaline is�to�increase�beat�rhythm�thus making the heart beat faster in order to ensure a proper amount of oxygen needed in stressful circumstances. In mice with low levels of Popdc�proteins the heart rhythm began to decline as a response to adrenaline secretion.

This response – decreased heart rhythm�when stressed�is commonly encountered�in�the elderly and could indicate a sign of sinus node disease, a condition which is properly treated by implantation of an artificial pacemaker. Scientists have concluded their results�could represent the first step in finding new treatment options for patients suffering from�sinus node disease�as well as�others arrhythmias such as atrial fibrillation or sudden cardiac death.

Heart cells And Popeye proteins

Researchers also observed that Popdc�proteins are located on the pacemaker cells of the heart, in the outer membrane.�Pacemaker cells are responsible for cardiac automatism (the propriety of�the heart to self-stimulate and to beat with a certain rate). When adrenalin is secreted, Popdc proteins increase their production of cAMP, a signalling molecule which has the capacity to modify the�electrical proprieties of the cell membrane, making the�heart beat faster. It is now�believed that this is the�actual way in which�the heart rate is influenced by�adrenaline secretion.

Scientists pointed out this study shows only the mechanism by which the heart adapts to stress, but the exact mechanism according to which adrenaline acts on cardiac cells is not fully understood. Maybe in the future they will be able to elucidate this mechanism and to discover new treatment options for cardiac�arrhythmias induced by stress.

Revolutionary Radiotherapy Technique Promises To Minimize Healthy Tissue Irradiation

A new radiotherapeutic approach that is able to specifically�target cancer affected tissues was designed by scientists at�the University of Granada and the university hospital Virgen de las Nieves in Granada. A batch of eighty patients�suffering from�epidermoid malignant tumors of the oropharynx and oral cavity were the subjects this new, less invasive,�approach was tested on.

This new approach to postoperative oncological treatment seems to have a significantly diminished degree of toxicity,�even though�its effectiveness is tantamount to the one of the traditional protocol.

All 80 patients were included in the study conducted by the University of Granada in a period of time stretching from 2005 to 2008. The anatomopathological type of proliferative process they presented with was a form of epidermoid cancer of the ENT sphere ( mouth and pharynx). Each and every one of these subjects had previously underwent surgery which implied the removal of one or several lymph nodes. A classification of these lymph nodes was applied so as to divide them into different risk groups. Using this method, physicians were able to spare the areas unlikely prone to recurrence and to direct their weapons against those probably including residual malignant cells. The groundbreaking idea managed to allow the application of a continuous therapy, with a�significantly lowered risk of side effects and equal efficiency.

Radiotherapy

It is a well-known fact that overwhelming majority of malignant tumors of the pharynx and mouth metastasize through the lymph nodes and are very prone to recurrence. This is the main reason why they need additional radiotherapy, sometimes in association with chemotherapy. These therapeutic options have a high degree of toxicity, severely damaging the mucous membranes of the mouth and thus forcing patients to halt the treatment. Stopping the treatment at a certain point means lowering its success rate.

The main goal of the above mentioned lymph node classification and the team work involving surgeons, pathologists and many others, is to design an individualized risk map for each patient. This achievement allows physicians to specifically apply treatment to every subject according to their risk of recurrence and to minimize the irradiated volume of tissue in comparison to the traditional treatment.

The new, revolutionary treatment was applied� over a period of three years, during which oncologists managed to obtain a diminished area of irradiation in approximately 44% of subjects, sparing a volume of roughly 118 cc in each patient.It has to be mentioned that there was no increase in recurrence rate and also that almost all ( 95 % ) patients underwent a complete radiotherapeutic cycle, during which signs of toxicity were significantly minimized.

The leader of the study was Miguel Martínez Carrillo�from the university hospital Virgen de las Nieves and supervised by�University of Granada professors Rosario del Moral Ávila and José Mariano Ruiz de Almodóvar Rivera.

Sudden Cardiac Death And Circadian Rhythms Link On A Molecular Basis

In a study�due to�be published in the March issue of the journal Nature, scientists report the discovery of a molecular basis of the link�between circadian rhythms and sudden cardiac death.

Sudden cardiac death is a natural , rapid and unexpected death�that occurs within one hour after the onset of cardiac�acute symptoms. Sudden cardiac death is the leading cause of death in the United States of America,�accounting for�700-800 deaths�each day. The most common cause of�SCD is ventricular arrhythmia, an abnormal heart rhythm. Ventricular arrhythmias occur mainly in the morning, probably because the peak of stress hormones�occurs in this part of the day. However, this fact�could not be clearly explained until now.

Sudden cardiac death is the direct consequence of cardiac arrest, which can be reversed if medical staff acts�promptly before the final shutdown of�the brain function (cerebral death) and other functions (biological death). SCD�may occur in�apparently healthy persons, or may occur in�patients suffering from cardiomyopathy. The only practical method of preventing SCD is�to control�the coronary risk factors: hypertension, ventricular hypertrophy, high cholesterol and�obesity among others.

Image of a Stethoscope On a ECG with Venticular Tachycardia

The results of this study�lay the foundation for new methods of prevention and treatment of this fatal event. According to a study�conducted�by researchers at Case Western Reserve University School of Medicine,�the genetic factor Kruppel-like�Factor 15 (KLF15) correlates body’s circadian rhythm with the heart’s electrical activity. Both lack and excess of KLF15�increases the risk of arrhythmias.�It has been�noted that patients with heart failure�present a lack of�KLF15. Also it has been discovered that patients with Brugada�syndrome, a genetic cardiac arrhythmia, present�an excess of KLF15.

The discovery KLF15�does not only explain the molecular basis of ventricular arrythmya�and sudden cardiac death, but can also�be the basis for developing�new strategies�in oreder�to prevent SCD. For example, by increasing KLF15�in patients with heart failure, especially in the morning, when the risk of SCD is increased,�the number of sudden cardiac events could be�reduced.

Dr.�Darwin Jeyaraj, MD, MRCP, assistant professor of medicine at Case Western Reserve University School of Medicine, points out that this�is only the mere beggining�of a series of research intended to cast light on the link between circadian rhythms and sudden cardiac death.

Mukesh�K. Jain, MD, Faha, professor of medicine, noted the importance of this remarkable� finding: “This is the first time a definitive link between circadian rhythms and sudden cardiac death�has been established”. He also added that further studies are needed�so as to�evaluate the link between heart disease and circadian rhythm disruption.

New Hope For Regenerating Damaged Nerves

According to a study published in the journal PLoS One,�a new way to regenerate damaged nerves has been discovered. Dr.Jason Huang, associate professor of Neurosurgery and chief of Neurosurgery at Highland Hospital, and his colleagues, discovered that the dorsal root ganglion neurons�(DRG�cells)�help new nerves to form, without triggering an immune response from the body.

This represents a remarkable finding because more than 350, 000 patients every year in the United States�suffer from severe�lesions that affects their peripheral nerves. In order for a nerve to�heal itself, the two portions, that are in good condition, must find each other and reconnect. This is a natural process that occurs only�when the injury is small. However, when the wound is to severe, the nerve is not capable of repairing itself.

Dr. Huang, associate professor of Neurosurgery and chief of Neurosurgery at Highland Hospital, an affiliate of the University of Rochester Medical Center, pointed out that this kind of injuries are very serious and, although there are many options of treatment, none of them is ideal.��Along with his team,�Dr. Huang�intends to grow living nerves in the laboratory and then�to transplant them. This way patients would recover their nerve functions�more rapidly.

Damage Nerve Cells

The technique used by Dr. Huang to reconnect a damaged nerve is represented by transplantation. He harvested a�patient’s healthy nerve tissue and then�transplanted back�into the injured area. There is no immune response from the body since the tissue comes from the same�patient.

However, this technique cannot be performed in all patients. Those who are victims of car accidents, thus having multiple injuries, cannot be treated this way.� Other methods include nerve transplantation from�cadavers or animals, with the disadvantages of�immunosuppressant therapy.

One modern technology in regenerating damaged nerves�is represented by NeuraGen�Nerve Guide, a technique�used by Dr. Huang and other neurosurgeons. This procedure involves�inserting a collagen tube through which parts of damage nerve cells can find each other and reconnect easier. NeuraGen Nerve Guide�seems to be the�best way to�regenerate damaged nerves over short distances.

In the PLoS�study, Dr. Huang and his team examined different methods to regenerate damaged nerves in rats. The researchers took nerve cells from different species of rats and�transplanted them into the wound area.�NeuraGen technology was used alone or in combination with DRG cells or with Schwann cells. The results�revealed�that tubes that contains DRG cells, unlike Schwann cells, did not trigger any immune response.

New Treatment Scheme Shows Promise For Prostate And Pancreatic Cancer

Photodynamic therapy, a combination between certain drugs and laser light, can destroy cancer cells, but nowadays�it can be�only�used to treat skin cancer.�Internal tumors�can not be�treated with this type of therapy because�there is no proper technique that can specify the exact amount of laser light that must be administrated in order to destroy them. Researchers from Lund University, Sweden are developing a software which can resolve this problem.

“I think we are about to see a real breakthrough, both for us and for other research groups around the world who conduct research on cancer treatment using laser light”, says Johannes Swartling, Doctor of Atomic Physics at Lund University.

This particular�software�comes with�some unique features: it uses optical fibers that are not only emitting light, but�are also able to gather information about the size, level of invasion of the tumor, information that�is sent back to the computer�to which the laser instrument is connected. This means that the software is continually calculating the optimal dose of laser light that can be adjusted if necessary. The goal of the treatment is to remove the entire cancer mass without damaging the�surrounding tissue. The software can be also associated with therapies that are using other types of light like LED or infra-red light.

The photodynamic therapy was tested in Sweden on patients with prostate cancer� demonstrating that it can work�on�internal tumors.�In the spring of this year in Canada and in the USA a clinical study on patients with recurrent prostate cancer will begin. The same photodynamic therapy is used in the UK� on patients with pancreatic cancer.

Light Laser Therapy

The scientists�pointed out that laser light therapy appears to have minimum side effects,�unlike conventional therapy for prostate cancer that presents a risk for impotence and urinary incontinence and�higher cancer recurrence risk.

The main goal was to adjust the dosage of laser light that can ensure an effective and positive result for cancer patients for whom conventional cancer treatment schemes present major limitations.

Photodynamic Therapy Mechanism Of Action

Before starting the procedure, the�patient receives a drug which has effect only in the presence of light, called light-activated drug. This drug will spread�throughout the body and will reach the area where the tumor is located. After this procedure, the patient will be�anesthetized and the surgeon will insert in the area where the tumor is located, some needles that contains optical fibers. When this optical fibers come into contact with the light-activated-drug, a reaction with�the surrounding oxygen takes place, which is�indispensable for the intense metabolism of cancer cells, depriving them of oxygen and�therefore killing them.

Molecule That Offers Hope For Future Allergy Treatments Discovered

A new molecule that could help treat allergic people has recently been discovered. Researchers at the University of Nottingham have found that DC-SIGN, a receptor found on the surface of antigen presenting cells, may improve�body’s allergic response to house dust mite.
This seems a promising discovery not only because it may be the keystone of�a new�allergy therapy, but also because it helps understand how the body reacts to environmental allergens.

Allergy

An�allergy is an exaggerated reaction caused by the immune system in response to contact with certain foreign substances, called allergens. Usually, these substances are harmless, but to some people they can give rise to an allergic reaction. In response to allergens, the body produces� specific antibodies, called IgE, which triggers an inflammatory response. IgE�is an antibody that all of us have in small amounts. Allergic persons, however, produces IgE in large quantities. Symptoms, such as wheezing, runny nose, itching eyes, are common among people who are prone to allergies.

What researchers from The University of Nottingham discovered was that DC-SIGN binds to the major allergen from the dust house mite, called Der p 1. The connection between the receptor,DC-SIGN ,and allergen triggers a mechanism that could desensitize immune responses to allergens.

DC-SIGN is a molecule which functions as a receptor on the surface of the immune cells and recognizes allergens from house dust mite. House dust mite are microscopic organisms which�excreted proteins�and, if inhaled, these proteins� may attack the respiratory passages causing asthma.

Dr.Amir Ghaem-Maghami, Professor Farouk Shakib in the University’s School of Molecular Medical Sciences, underlined that there has been an increase in the prevalence of allergies over the past few decades, especially in the industrialised countries. He also pointed that although the medical care improved significantly lately, the mortality and morbidity of allergic asthma remain high. The discovery of DC-SIGN is even more important as up to 80 per cent of people suffering from�asthma are allergic to house dust mite.

This finding, published this week in the Journal of Biological Chemistry, could provide useful information in developing more effective and efficient treatment option that could help�asthma patients from around the world.

New Clinical Trial Investigates The Possiblity To Extend The Viability Of Heart Transplant

A new technology called the Organ Care System is undergoing clinical trials in the United States. The technology aims to increase the time a human heart remains viable between transplants by using a device that combines software, fluid dynamics and preservative solutions to avoid ischemia.

“Because the device completely prevents ischemia during transport, the organ maintains normal energy stores, so that organs transplanted using the device will be in better condition at the time of transplant,” said Dr. Bruce Rosengard, surgical director of cardiac transplantation at Massachusetts General Hospital in Boston.

Current transplantation methods are based on the addition of a saline solution and the use of ice in order to keep the heart viable. Doing so only allows a transplantation window of three, maybe four hours, before the heart is no longer useful to a new patient.

The new system will offer patients that need a heart transplant the possibility to receive a compatible heart from someone situated at a greater distance, thus increasing the chances to find a compatible heart. European surgeons were able to transplant a viable heart after as many as eight hours after the heart has been introduced into the new device.

The purpose of the clinical trial undergoing in the United States is to determine the 30-day survivability rates of patients that receive the heart after using the new device. European studies show that the 30-day survivability rate was almost 97 percent, based on a study on 138 transplanted patients. The current trial includes 9 country-wide hospitals whilst being led by the Heart Transplant Program from UCLA. The trial is expected to be complete by the end of 2012, after 50 percent of the 128 patients will have received a heart that has been kept viable with the help of the new device.

Organ Care System

To the present day, surgeons refuse to transplant almost 70 percent of the available donated hearts because they fear it is not the best heart their patients can receive. If the FDA approves the use of the Organ Care System, the number of rejected hearts could drop significantly due to the fact that the heart is kept in a more natural environment.

But the use of the new system offers more than just increased viability:� “Its use in Europe is proving to be highly sensitive in identifying hearts with underlying pathology, such as cocaine scarring, that makes them unsuitable,” said Tamer Khayal,�TransMedics' vice president of clinical development, the company that developed the system.

Also, this new technology could perhaps allow the resuscitation of a heart that suffered slight damage from brain death. This possibility might become reality, as transplant surgeon Ayyaz Ali managed to resuscitate animal hearts that have stopped beating. Another option would be the treatment of severely damaged hearts through the aid of gene therapy, cellular therapy and even drug therapy.

In the future, the new Organ Care System could also be used to increase the viability of other organs, already being used to aid the transplantation of human lungs, whilst prototypes for liver and kidney systems are already in development.

New And Effective Treatment For Patients With Huntington Disease

Researchers from University of Alberta discovered a new therapy which can restore motor skills that are affected by Huntington disease. This promising therapy may delay or even stop the progression of� this debilitating disease.

“We didn’t expect to see such dramatic changes after administering this therapy. We expected to see improvement, but not complete restoration of motor skills. When we saw this, we were jumping with excitement in the lab. This is very promising and should give hope to those with Huntington disease. I think it’s a treatment that deserves to go to clinical trials because it could have huge potential.”, said Simonetta Sipione, the leader of this study.

Huntington diseases is a genetic condition in which is synthesized an abnormal protein that can trigger brain cell death, causing impairment of motor and cognitive functions and eventually�death. Patients diagnosed with this disease present lower levels of GM1, a brain molecule. The scientists were able to normalize the level of this molecule in lab models with Huntington disease and after this procedure�they also�observed that the motor skills of lab models normalized within days. This study was published in the journal Proceedings of the National Academy of Sciences.

GM1�molecule which was used by the scientists in this research was produced both naturally and synthetically. The molecule which was also used in clinical trials for Parkinson’s disease treatment and for the treatment of others neurodegenerative conditions, represents a hope for patients with Huntington disease. The clinical trial for the treatment of this debilitating disease will probably begin�within a year or two.

Huntingtond Disease

In this research lab models with Huntington disease received� GM1 molecule based therapy�for a period of four weeks. In the first two weeks after finishing the treatment, the lab models presented normal or improved motor skills. The bad news is that�after this period the motor skills declined and after another�four weeks,�the motor skills returned to the same level of impairment as before treatment. The scientists hope that in near�future they will be able to develop a treatment with this molecule which can be administrated at certain intervals of time.

Researchers were also curious if restored levels of GM1�molecule can improve cognitive function which is affected by Huntington disease. They observed that therapy with GM1 improves neurons activity and decrease the toxicity of the mutant protein which is�a result of this genetic disease.

“Because of the way it works, we think it will work on cognitive symptoms of the disease too,” says Sipione.

The scientists highlight that it is very important for the medical world to understand that some of the treatments are working in lab models and� may no effect on human models. For this reason they hope that the clinical trials for this new therapy for Huntington disease will begin as soon as possible. Researchers are very optimistic that in the near�future, a�working treatment for this debilitating disease will be established in practice,�and this�particular study results�are definitely a huge step forward.