Maternal and Child Health Receives Boost in Northern Nigeria

Minister of State for Health Dr. Muhammad Ali Pate has said that   maternal and child health in Northern Nigeria will received a boost as the Nigerian Union of Road Transport Workers (NURTW) and Partnership for Reviving Routine Immunization in Northern Nigeria and Maternal and Newborn and Child Health (PRRINN-MNCH) collaborated to provide emergency services to pregnant women in the rural areas in the Northern Nigeria.

The Minister made this known over the weekend, in Abuja in a keynote address at the signing of Memorandum of Understanding (MOU) between the PRRINN-MNCH and NURTW on how to accelerate provision of Transport Service to pregnant women on emergency.

The Minister said that the partnership between the two organizations will complement Federal Government effort in providing maternal and child healthcare service in the rural area.

He said that there are socio-economic disparities between rural and urban duelers in Nigeria adding that women in the rural areas have the highest risk of dying during child birth than those living in the urban centres.

However, the Minister said that the Federal Government has deployed Midwives and community health workers to the rural areas across the country to assist pregnant women.

Earlier, the President, National Union of Road Transport Workers Union (NURTW) Alh. Najeem Usman said that studies have shown that one of the barrier that delay women from getting to health facility in the rural area is lack of transport.

To bridge the gap, he said the NURTW and PRRINN-MNCH in collaboration with the Jigawa, Katsina, Yobe and Zamfara  state governments decided to set up an Emergency Transport Scheme (ETS) to ease the suffering of women and minimize maternal complication caused through delay in reaching health facility.

Alhaji Usman also noted that MOU was to expand the Emergency Transport Services (ETS) initiative to the entire rural communities in the country.

To achieve the overall goal of reducing the high maternal mortality ratio in Nigeria, the ETS need to be scaled up beyond the four states”, he said.

Brain Injury Doesn't Raise Dementia Risk for Most: Study But likelihood of re-injury does increase

 Having a traumatic brain injury at some time in your life doesn't raise the risk of dementia in old age, but it does increase the odds of re-injury, a new study finds.

"There is a lot of fear among people who have sustained a brain injury that they are going to have these horrible outcomes when they get older," said senior author Kristen Dams-O'Connor, assistant professor of rehabilitation medicine at the Icahn School of Medicine at Mount Sinai Medical Center in New York City.

"It's not true," she said. "But we did find a risk for re-injury."

The 16-year study of more than 4,000 older adults also found that a recent traumatic brain injury with unconsciousness raised the odds of death from any cause in subsequent years.

Those at greatest risk for re-injury were people who had their brain injury after age 55, Dams-O'Connor said. "This suggests that there are some age-related biological vulnerabilities that come into play in terms of re-injury risk," she said.

Dams-O'Connor said doctors need to look out for health issues among older patients who have had a traumatic brain injury. These patients should try to avoid another head injury by watching their balance and taking care of their overall health, she said.

To investigate the consequences of a traumatic brain injury in older adults, the researchers collected data on participants in the Adult Changes in Thought study, conducted in the Seattle area between 1994 and 2010. The participants' average age was 75.

At the start of the study, which was published recently in the Journal of Neurology, Neurosurgery & Psychiatry, none of the participants suffered from dementia. Over 16 years of follow-up, the researchers found that those who had suffered a traumatic brain injury with loss of consciousness at any time in their lives did not increase their risk for developing Alzheimer's or other forms of dementia.

The risk of another traumatic brain injury, however, more than doubled if the first injury occurred before age 25 and almost quadrupled if the injury happened after age 55. Similarly, a recent traumatic brain injury more than doubled the odds of death from any cause, the study found.

Dams-O'Connor's group plans to look at risk factors to try to understand why some people have poor long-term prognosis after a brain injury.

One expert said genetics may play a role. "My guess is that the risk for post-traumatic-brain-injury Alzheimer's disease has a genetic component with some genes increasing risk and others offering protection," said Dr. Sam Gandy, associate director of the Mount Sinai Alzheimer's Disease Research Center in New York City.

These findings should not be confused with those regarding athletes who suffer brain injuries, Gandy said.

"The dramatic examples of former [National Football League] players, hockey players and wrestlers who have an unusual illness, marked by depression, agitation and psychosis are quite different from Alzheimer's disease patients who tend to be apathetic," he said.

"Much remains to be discovered about the role of lifelong traumatic brain injury history, including severity and nature of torque and other physical factors, and late-life mental decline," Gandy said.

Another expert, Dr. Danny Liang, a neurosurgeon at North Shore-LIJ Cushing Neuroscience Institute in Manhasset, N.Y., thinks these findings are too narrow to say much about the risk of dementia as a result of traumatic brain injury.

"The study is restricted to a limited population so it's hard to extrapolate these findings to other populations," he said. "It is also possible that there were people who had traumatic brain injury who did develop dementia before age 65, so they were not included in the study," Liang said.

There also was no data on injury severity or duration of unconsciousness, he said. Brain injuries differ, and knowing the severity is important to determine the ultimate outcome, he said.

Doctor-Patient Communication Key to Sticking With Meds

Ineffective communication is a major player when patients don't properly take medication as prescribed, a new study finds.

"Communication matters. Thirty percent of people [in the study] were not necessarily taking their medications the way their doctors thought they were," study lead author Dr. Neda Ratanawongsa, an assistant professor in the department of medicine at University of California, San Francisco, said in a university news release.

"Rates for non-adherence were 4 to 6 percent lower for patients who felt their doctors listened to them, involved them in decisions and gained their trust. By supporting doctors in developing meaningful relationships with their patients, we could help patients take better care of themselves," she added.

The study authors reached their conclusions after giving questionnaires to more than 9,000 patients who took drugs to lower their blood sugar, blood pressure or cholesterol. They completed items on how they communicated with their doctors, and the researchers checked their prescription records to see if they were properly taking their medications.

Andrew Karter, a senior research scientist with the Kaiser Permanente research division who assisted with the study, pointed out what was unique about the findings. "We found that medication adherence is better if the physician has established a trusting relationship with the patient and prioritizes the quality of communication, even if that communication is not specifically focused on medication adherence," he said in the news release.

Weight-Loss Surgery Is New Diabetes Foe

Though it began as a treatment for something else entirely, gastric bypass surgery -- which involves shrinking the stomach as a way to lose weight -- has proven to be the latest and possibly most effective treatment for some people with type 2 diabetes.

Just days after the surgery, even before they start to lose weight, people with type 2 diabetes see sudden improvement in their blood sugar levels. Many are able to quickly come off their diabetes medications.

"This is not a silver bullet," said Dr. Vadim Sherman, medical director of bariatric and metabolic surgery at the Methodist Hospital in Houston. "The silver bullet is lifestyle changes, but gastric bypass is a tool that can help you get there."

The surgery has risks, it isn't an appropriate treatment for everyone with type 2 diabetes and achieving the desired result still entails lifestyle changes.

"The surgery is an effective option for obese people with type 2 diabetes, but it's a very big step," said Dr. Michael Williams, an endocrinologist affiliated with the Swedish Medical Center in Seattle. "It allows them to lose a huge amount of weight and mimics what happens when people make lifestyle changes. But, the improvement in glucose control is far more than we'd expect just from the weight loss."

Almost 26 million Americans have type 2 diabetes, according to the American Diabetes Association. Being overweight is a significant risk factor for type 2 diabetes, but not everyone who has the disease is overweight. Type 2 occurs when the body stops using the hormone insulin effectively. Insulin helps glucose enter the body's cells to provide energy.

Lifestyle changes, such as losing 5 to 10 percent of body weight and exercising regularly, are often the first treatments suggested. Many people find it difficult to make permanent lifestyle changes on their own, however. Oral medications are also available, but these often fail to control type 2 diabetes adequately. Injected insulin can also be given as a treatment.

Surgeons first noted that gastric bypass surgeries had an effect on blood sugar control more than 50 years ago, according to a review article in a recent issue ofThe Lancet. At that time, though, weight-loss surgeries were significantly riskier for the patient. But as techniques in bariatric surgery improved and the surgical complication rates came down, experts began to re-examine the effect the surgery was having on type 2 diabetes.

In 2003, a study in the Annals of Surgery reported that 83 percent of people with type 2 diabetes who underwent the weight-loss surgery known as Roux-en-Y gastric bypass saw a resolution of their diabetes after surgery. That means they no longer needed to take oral medications or insulin in most cases.

In Roux-en-Y surgery, the anatomy of the digestive system is rearranged, Sherman explained. A small portion of the stomach is attached directly to the small intestine, bypassing the rest of the stomach, duodenum and upper intestine. This not only restricts how much food the person can eat -- as do other weight-loss surgeries, such as gastric banding -- but it changes the hormones in the digestive system.

"When food or nutrients enter the mid or hind intestine, the body releases a hormone called GLP1 and other hormones that tell the brain to stop eating," Sherman said. After gastric bypass surgery, however, "you're getting this effect earlier in a meal, and it results in less cravings, too," he said. "It's unclear exactly where the mechanism for this change is right now, though some suspect the duodenum."

Wherever the change occurs, it happens soon after the surgery. "There's a change in blood glucose almost immediately, often before people even leave the hospital," he said.

Sherman noted that weight-loss surgery that involves banding doesn't have the same effect on diabetes. Once people lose weight, their blood sugar control may improve, he said, but it's not as dramatic as what occurs after bypass surgery.

Potential risks of gastric bypass include those that exist for most surgeries, including the possibility of excessive bleeding, blood clots and infection, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. But, these risks are often heightened in people who are obese.

Afterwards, people who've had the surgery may not absorb nutrients as well as they used to, and doctors often recommend taking certain supplements. Also, food can tend to move from the stomach to the small intestine too quickly, before it's fully digested. Called dumping syndrome, this side effect often develops after eating foods high in carbohydrates, according to Sherman. Symptoms may include abdominal pain and diarrhea.

And, despite its promise, not everyone with diabetes is an ideal candidate for gastric bypass.

It's currently recommended only for those with a body mass index (BMI) above 40 and those who have a BMI over 35 and a medical condition such as type 2 diabetes, high blood pressure or heart disease.

Type 1 diabetes, though, is not on the list. Williams noted that bariatric surgery won't help with blood sugar control in people with type 1 diabetes because type 1 is an autoimmune condition in which insulin-producing cells in the pancreas are destroyed by the immune system. In type 2, Sherman said, the problem is not in the pancreas to begin with.

Gastric bypass surgery is also best for those who haven't had type 2 diabetes for a long time, and for those who don't have to use insulin to control their blood sugar.

"Bariatric surgery is not an easy fix," Williams said. "There's a lot of prep that goes into bariatric surgery, and then it's a lifelong lifestyle adjustment. Dietary intake is restricted for life, and people have to avoid high-sugar foods. But, it's a really good option for the right person."

In an effort to find out how far the extremely contagious norovirus germs travel when a person with the sickness throws up, researchers have invented a vomiting robot.

In an effort to find out how far the extremely contagious norovirus germs travel when a person with the sickness throws up, researchers have invented a vomiting robot.

"Vomiting Larry" was created at the Health and Safety Laboratory in Britain. The reason he was developed was to help scientists understand the range of contamination norovirus has during episodes of projectile vomiting that is experienced by its sufferers.

Norovirus causes serious projectile vomiting as well as diarrhea for up to 62 hours. After exposure to the virus, the symptoms start 12 to 48 hours later. The virus can be spread by an infected person through direct contact and contaminated food or surfaces.

According to the Centers for Disease Control and Prevention, the virus sickens nearly 21 million Americans each year, causing 800 deaths and 70,000 hospitalizations.

Researchers from HSL developed Vomiting Larry to evaluate how the virus so easily spreads from person to person. Larry is made up of a cylinder body loaded with water combined with florescent liquid, a head with an open mouth, and a pump to eject water through the mouth, like a projectile vomit.

After Vomiting Larry projectile vomited, the extent of room contamination was able to be measured by the amount of particles spread across the room. The researchers found that the particles could spread over three meters and that these drops are not easily visible under white hospital lighting.

The study showed that norovirus can be separated from these small particles at concentrations effective enough to cause an infection. This implies that when someone sick with the virus throws up, the area that needs to be cleaned is much larger than previously thought.

Norovirus can quickly infect many people in a short amount of time because it passes easily from person to person. It is also resistant to several cleaning products, such as ones that are used to clean bathrooms and kitchens and hand sanitizer.

In fact, earlier research says that hand sanitizers may actually cause outbreaks instead of prevent them.

The maker of Vomiting Larry, Catherine Makison-Booth, recommends using bleach to effectively clean up the vomit.

In february of 2012, it was reported that 18.2 percent of all infection outbreaks and 65 percent of all ward closures in hospitals are due to norovirus.

Baby's Health Is Tied to Mother's Value for Family

The value that an expectant mother places on family -- regardless of the reality of her own family situation -- predicts the birthweight of her baby and whether the child will develop asthma symptoms three years later, according to new research from USC. The findings suggest that one's culture is a resource that can provide tangible physical health benefits. "We know that social support has profound health implications; yet, in this case, this is more a story of beliefs than of actual family support," said Cleopatra Abdou, assistant professor at the USC Davis School of Gerontology. Abdou studied 4,633 socioeconomically disadvantaged white, black and Hispanic women, gauging their "familism," or, more specifically, their beliefs about familial roles and responsibilities, using a questionnaire. Familism was determined by responses to statements such as, "Single moms can do just as well as married parents," or "It is better for children if their parents are married." Abdou then tracked the health of their children and found that, for every one-point increase in familism, there was a 71-gram increase in birthweight independent of a whole host of other factors -- including the gender of the infant or whether the mother was married. (For context, average birthweight in the U.S. is around 7.5 pounds, or roughly 3,400 grams. Low birthweight, typically defined as under 5.5 pounds or 2,500 grams, has been linked to health problems later in life.) Higher familism also predicted lower rates of asthma in the children up to three years later. Though one might expect to see healthier children from mothers who reported strong family support, familism is a cultural measure that exists outside of an individual's actual circumstances. "Cultural beliefs and ideals can be distinct from one's present reality. Familism is about beliefs and ideals within families. That's why familism is referred to as a cultural resource. The cultural resource of familism appears to favorably impact both reproductive health in mothers as well as critical markers of physical health in offspring. That is, the transmission of health from one generation to another," Abdou said. Abdou's findings were published online on Nov. 9 in the journal Social Science & Medicine, in an article coauthored by Tyan Parker Dominguez of USC and Hector F. Myers of UCLA. The results may shed light on the so-called "Hispanic Paradox" or "epidemiologic paradox," first documented in 1986 by Markides and Coreil, which found that immigrant populations in the United States tend to be relatively healthy compared to their peers, despite being poorer. In general, poorer populations tend to be less healthy than wealthier ones. The epidemiologic paradox diminishes over time, with immigrant populations becoming less and less healthy as they start assimilating into American culture. Abdou theorizes that U.S.-born populations, in addition to immigrant populations, can benefit in terms of mental and physical health from strong cultural resources, a theory that is supported by this study. Her work continues to probe the connections between health and culture in diverse populations in the United States and the Middle East.

Cognitive Deficits from Concussions Still Present After Two Months

The ability to focus and switch tasks readily amid distractions was compromised for up to two months following brain concussions suffered by high school athletes, according to a study at the University of Oregon. Research team members, in an interview, said the discovery suggests that some athletes may need longer recovery periods than current practices dictate to lower the risk of subsequent concussions. Conventional wisdom, said lead author David Howell, a graduate student in the UO Department of Human Physiology, has typical recovery at seven to 10 days. "The differences we detected may be a matter of milliseconds between a concussed person and a control subject, but as far as brain time goes that difference for a linebacker returning to competition too soon could mean the difference between another injury or successfully preparing to safely tackle an oncoming running back," Howell said. The findings are based on cognitive exercises used five times over the two months with a pair of sensitive computer-based measuring tools -- the attentional network test and the task-switching test. The study focused on the effects of concussions to the frontal region of the brain, which is responsible for working, or short-term, memory and executive function, said Li-Shan Chou, professor of human physiology and director of the UO Motion Analysis Laboratory. The study was published online ahead of print by Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine. "If a person goes back to the playing field without a full recovery, that person is put into great danger of being re-injured," Chou said. "In any given season, if you suffer a concussion, the chances of your suffering a second one is three to six times higher and suffering a third is eight times higher. There are accumulations in this kind of injury. It doesn't go away easily." A big unknown, the researchers said, is just how serious such injuries are for adolescents, whose brains are still developing. It could be the brain can recover more easily, or such injuries could continue to produce deficits that last a lifetime. "We just don't know," Chou said, adding that most previous studies have involved college-aged athletes and older adults. Each year, there are 300,000 to 500,000 mild traumatic brain injury incidents, or concussions, with 100,000 tied to football, Chou said. He also cited a 2011 report from the Centers for Disease Control and Prevention that called such injuries a silent epidemic, with sports-related concussions in youths rising by 60 percent in the last decade. Another source of concussions, he added, is improvised explosive devices used in warfare. Through an arrangement with Eugene-area schools, 20 high school athletes who had suffered a concussion -- primarily football players but also others from soccer, volleyball and wrestling -- were assessed within 72 hours of injury and then again one week, two weeks, a month and two months later. Each of the subjects, whose diagnosis was made by a certified athletic trainer and/or physician, was matched with a healthy control subject of the same sex, body size, age and sport. "After two months following the concussions, these individuals were still significantly impaired in their executive function, compared to age-matched, activity-matched and gender-matched control populations," said co-author Louis Osternig, professor emeritus of human physiology and a fellow of the American College of Sports Medicine. Osternig, also a certified athletic trainer, noted that self-reports by the subjects about how they were feeling sometimes were at odds with test results, which continued to show subtle deficits in cognitive functioning. The researchers also noted anecdotal reports from concussed athletes and their parents of declines in academic performance during the two-month period. Additional data linking the deficits found in cognitive testing to the subjects' gait -- their task-shifting abilities while walking -- currently are being analyzed in the ongoing project, which is funded by the Department of Defense Telemedicine & Advanced Technology Research Center (W81XWH-11-1-0717), National Athletic Trainers Association, Veterans Administration and a translational research award from a joint UO-PeaceHealth Oregon Region collaboration program. "By using tools from cognitive psychology, neuroscience and human physiology, this interdisciplinary team of scientists is improving our understanding of how brain trauma affects reaction time, and they are helping to create better outcomes for athletes, soldiers and others who are affected by concussions," said Kimberly Andrews Espy, vice president for research and innovation and dean of the graduate school. "UO researchers are working to improve the health and well-being of people in our local communities and throughout the world." "The brain is the controller of our body movement," Chou said. "If you have a brain injury, are there any differences that we can pick up in the way a subject moves the body? In this lab, we are using motion analysis as a way to detect any deficiencies or abnormalities of body movement." Chou said that his lab's goal, for now, is to disseminate the findings to the public and to talk to parents, athletic trainers and, perhaps, coaches directly to say: "These are the facts. We may not be able to draw any line on what clinically should or shouldn't be done. However, these are our observations based on our scientific testing."

Got Food Allergies? You Can Now Test Your Meal On the Spot Using a Cell Phone

Are you allergic to peanuts and worried there might be some in that cookie? Now you can find out using a rather unlikely source: your cell phone. A team of researchers from the UCLA Henry Samueli School of Engineering and Applied Science has developed a lightweight device called the iTube, which attaches to a common cell phone to detect allergens in food samples. The iTube attachment uses the cell phone's built-in camera, along with an accompanying smart-phone application that runs a test with the same high level of sensitivity a laboratory would. Food allergies are an emerging public concern, affecting as many as 8 percent of young children and 2 percent of adults. Allergic reactions can be severe and even life-threatening. And while consumer-protection laws regulate the labeling of ingredients in pre-packaged foods, cross-contaminations can still occur during processing, manufacturing and transportation. Although several products that detect allergens in foods are currently available, they are complex and require bulky equipment, making them ill-suited for use in public settings, according to the UCLA researchers. The iTube was developed to address these issues, said Aydogan Ozcan, leader of the research team and a UCLA associate professor of electrical engineering and bioengineering. Weighing less than two ounces, the attachment analyzes a test tube-based allergen-concentration test known as a colorimetric assay. To test for allergens, food samples are initially ground up and mixed in a test tube with hot water and an extraction solvent; this mixture is allowed to set for several minutes. Then, following a step-by-step procedure, the prepared sample is mixed with a series of other reactive testing liquids. The entire preparation takes roughly 20 minutes. When the sample is ready, it is measured optically for allergen concentration through the iTube platform, using the cell phone's camera and a smart application running on the phone. The kit digitally converts raw images from the cell-phone camera into concentration measurements detected in the food samples. And beyond just a "yes" or "no" answer as to whether allergens are present, the test can also quantify how much of an allergen is in a sample, in parts per million. The iTube platform can test for a variety of allergens, including peanuts, almonds, eggs, gluten and hazelnuts, Ozcan said. The UCLA team successfully tested the iTube using commercially available cookies, analyzing the samples to determine if they had any harmful amount of peanuts, a potential allergen. Their research was recently published online in the peer-reviewed journal Lab on a Chip and will be featured in a forthcoming print issue of the journal. Other authors of the research included graduate student and lead author Ahmet F. Coskun and undergraduate students Justin Wong, Delaram Khodadadi, Richie Nagi and Andrew Tey, all of whom are members of the Ozcan BioPhotonics Laboratory at UCLA. Ozcan is also a member of the California NanoSystems Institute at UCLA. "We envision that this cell phone-based allergen testing platform could be very valuable, especially for parents, as well as for schools, restaurants and other public settings," Ozcan said. "Once successfully deployed in these settings, the big amount of data -- as a function of both location and time -- that this platform will continuously generate would indeed be priceless for consumers, food manufacturers, policymakers and researchers, among others." Allergen-testing results of various food products, tagged with a time and location stamp, can be uploaded directly from cell phones to iTube servers to create a personalized testing archive, which could provide additional resources for allergic individuals around the world. A statistical allergy database, coupled with geographic information, could be useful for future food-related policies -- for example in restaurants, food production and for consumer protection, the researchers said.

Quick Detection of Periodontitis Pathogens

— Twelve million Germans suffer from periodontitis, an inflammation that can lead to the loss of teeth if left untreated. A new diagnostic platform enables the pathogens to be detected quickly, enabling dentists to act swiftly to initiate the right treatment.
Bleeding gums during tooth brushing or when biting into an apple could be an indication of periodontitis, an inflammatory disease of the tissues that surround and support the teeth. Bacterial plaque attacks the bone, meaning teeth can loosen over time and in the worst case even fall out, as they are left without a solid foundation to hold them in place. Furthermore, periodontitis also acts as a focal point from which disease can spread throughout the entire body: If the bacteria, which can be very aggressive, enter the bloodstream, they can cause further damage elsewhere. Physicians suspect there is a connection between periodontitis pathogens and the sort of cardiovascular damage that can cause heart attacks or strokes. In order to stop the source of inflammation, dentists remove dental calculus and deposits from the surface of teeth, but this is often not enough; particularly aggressive bacteria can only be eliminated with antibiotics.
Of the estimated 700 species of bacteria found in the mouth cavity, there are only eleven that are known to cause periodontal disease in particular; of these, some are deemed to be severely pathogenic. If these biomarkers are present in the gingival sulcus -- the small gap around the base of the tooth -- then the patient is at high risk of a severe form of periodontitis. But the only way to find out is by conducting a bacteria test. The problem is that current methods for identifying pathogens are time-consuming and must be carried out in an external contract laboratory. Conventional bacterial analysis using microbial culture carries the risk of bacteria being killed as soon as they come into contact with oxygen.
Bacterial analysis in less than 30 minutes
A new mobile diagnostic platform is designed to speed up identification of the eleven most relevant periodontitis pathogens considerably. Scientists at the Fraunhofer Institute for Cell Therapy and Immunology IZI in Leipzig have collaborated with two companies, BECIT GmbH and ERT-Optik, to develop a lab-on-a-chip module called ParoChip. In future this will allow dentists and medical labs to prepare samples quickly and then analyze the bacteria. All the steps in the process -- the duplication of DNA sequences and their detection -- take place directly on the platform, which consists of a disk-shaped microfluidic card that is around six centimeters in diameter. "Until now, analysis took around four to six hours. With ParoChip it takes less than 30 minutes. This means it's possible to analyze a large number of samples in a short amount of time," says Dr. Dirk Kuhlmeier, a scientist at the IZI.
The analysis is conducted in a contactless and fully automated manner. Samples are taken using sterile, toothpick-shaped paper points, after which the bacteria are removed from the point and their isolated DNA injected into reaction chambers containing dried reagents. There are eleven such chambers on each card, each featuring the reagent for one of the eleven periodontal pathogens. The total number of bacteria is determined in an additional chamber, via polymerase chain reaction (PCR). This method allows millions of copies of even tiny numbers of pathogen DNA sequences to be made. In order to generate the extremely quick changes in temperature that are required for PCR, the disk-shaped plastic chip is attached to a metal heating block with three temperature zones and mechanically turned so it passes over these zones. This causes a fluorescent signal to be generated that is measured by a connected optical measuring device featuring a fluorescence probe, a photo detector and a laser diode. The key benefit is that the signal makes it possible not only to quantify each type of bacterium and thus determine the severity of the inflammation, but also to establish the total number of all the bacteria combined. This enables doctors to fine-tune an antibiotic treatment accordingly.
"As the connected optical measuring system allows us to quantify bacteria, ParoChip is also suited to the identification of other bacterial causes of infection, such as food-borne pathogens or those that lead to sepsis ," says Kuhlmeier, who goes on to emphasize further advantages of the compact diagnostic platform: "Using ParoChip does away with many of the manual steps that are a necessary part of current bacteria tests. The synthetic disks can be produced cheaply and disposed of after use in the same way as disposable gloves." Already available as a prototype, ParoChip is initially intended for use in clinical laboratories; however it could also be used by dentists to carry out inhouse analysis of patient samples in their own practice

Calorie-Burning Brown Fat Is a Potential Obesity Treatment, Researchers Say

A new study suggests that many adults have large amounts of brown fat, the "good" fat that burns calories to keep us warm, and that it may be possible to make even more of this tissue. The study's lead author, Aaron Cypess, MD, PhD, is presenting the results at The Endocrine Society's 93rd Annual Meeting in Boston. "We are now even more optimistic that brown fat could be used for treating obesity and diabetes," said Cypess, an assistant professor at Harvard Medical School and the Joslin Diabetes Center in Boston. Cypess heads the research team that two years ago published a study showing that brown fat is present in adults, not just in infants and small mammals, as scientists had thought. Although most adult fat is calorie-storing white fat, most adults have some brown fat in an area extending from the front of the neck to the chest, he reported at The Endocrine Society's meeting in 2009. Now they have learned that brown fat cells lie in deeper fat, not superficial fat, and that the number of regions of brown fat varies by person, Cypess reported. They discovered this by measuring the expression of a protein found exclusively in brown fat, called uncoupling protein-1. However, even in those regions where many brown fat cells are present, they are mixed with white fat cells. "It's a marbling at the cellular level," Cypess said. "We wondered: Wouldn't it be nice if you could grow more brown fat? The answer is yes." In their new study, the researchers succeeded in growing mature human brown fat cells from preadipocytes, or pre-fat cells, that they obtained from a fresh sample of brown fat taken from the neck of a patient having routine surgery. The process took about two weeks in a laboratory dish but likely occurs more quickly in the body, Cypess said. "Some of these preadipocytes may have the choice to become either white or brown fat," he said. In another experiment, Cypess and his colleagues measured how many calories brown fat burns. To do so, they measured the fat cells' oxygen consumption rate in both cultures and surgical tissue samples from volunteers. "We demonstrated that brown fat burns up a substantial number of calories," Cypess said. "We have an organ in our body whose job it is to generate heat and burn calories." Although Cypess said stimulating the growth of additional brown fat may be a promising treatment of obesity, it cannot replace traditional approaches such as diet and exercise. He said, "As powerful as brown fat could be at burning calories, we can easily out-eat the benefit." The National Institutes of Health and the Eli Lilly Foundation funded this study.

Shifting the Balance Between Good Fat and Bad Fat

— In many cases, obesity is caused by more than just overeating and a lack of exercise. Something in the body goes haywire, causing it to store more fat and burn less energy. But what is it? Sanford-Burnham researchers have a new theory -- a protein called p62. According to a study the team published December 21 in the Journal of Clinical Investigation, when p62 is missing in fat tissue, the body's metabolic balance shifts -- inhibiting "good" brown fat, while favoring "bad" white fat. These findings indicate that p62 might make a promising target for new therapies aimed at curbing obesity. "Without p62 you're making lots of fat but not burning energy, and the body thinks it needs to store energy," said Jorge Moscat, Ph.D., Sanford-Burnham professor. "It's a double whammy." Moscat led the study with collaborators at Helmholtz Zentrum München in Germany and the University of Cincinnati. p62 and obesity Moscat's team had previously produced mice that completely lack the p62 protein everywhere in their bodies. As a result, the animals were obese. They also had metabolic syndrome. In other words, as compared to mice with p62, mice lacking p62 weighed more, expended less energy, had diabetes and had a hyper-inflammatory response that's characteristic of obesity. While those results showed that the lack of p62 leads to obesity, "we didn't know which tissue was responsible for these effects, because p62 was missing in all of them," Moscat said. Some researchers believe that muscle tissue, where energy is expended, controls obesity. Others suspect the liver is a key player, or that the brain's appetite control center is most responsible for obesity. But then there's fat itself -- both white fat and brown fat. White fat is the type we think of as unwanted body fat. Brown fat, on the other hand, is beneficial because it burns calories. Many researchers now believe that brown fat somehow malfunctions in obesity, but the details are unclear. p62 shifts the balance between white fat and brown fat In their latest study, Moscat and colleagues set out to pinpoint the specific tissue responsible for obesity when p62 is missing. They made several different mouse models, each missing p62 in just one specific organ system, such as the central nervous system, the liver, or muscle. In every case, the mice were normal. They weren't obese like the mice lacking p62 everywhere. Then they made a mouse model lacking p62 only in their fat tissue. These mice were obese, just like the mice missing p62 in all tissues. Upon further study, the researchers found that p62 blocks the action of an enzyme called ERK while activating another enzyme called p38. When p62 is missing, the enzyme p38 is less active in brown fat, while ERK is more active in white fat. As a result, Moscat said, p62 is "a master regulator" in normal fat metabolism. According to Moscat, the discovery of p62's role in brown fat tissue is encouraging, because fat tissue is much more accessible than other parts of the body -- the brain, for example -- for potential drug therapies. "This makes it easier to think about new strategies to control obesity," he said. New methods for preventing or treating obesity, a major epidemic in the United States, are urgently needed. Drug therapies designed to minimize the intake of food have had limited success and also produce considerable side effects.

Better Work Environment May Cut Hospital Readmission Rates

THURSDAY, Jan. 3 (HealthDay News) -- Hospitals with a good work environment for nurses have fewer patient readmissions than those with poor working conditions, according to a new study. Researchers analyzed data from more than 200,000 nurses and 412 hospitals in California, New Jersey and Pennsylvania. The investigators found that readmission rates to hospital within 30 days after discharge were 7 percent lower for Medicare patients over age 65 with heart failure, 6 percent lower for heart attack patients and 10 percent lower for patients with pneumonia who were treated in hospitals with good work environments. The study by researchers at the University of Pennsylvania School of Nursing appears in the January issue of the journal Medical Care. "Our results suggest that improving nurses' work environment and reducing nurses' workload are organization-wide reforms that could result in fewer readmissions for Medicare beneficiaries with common medical conditions," lead author Matthew McHugh, a health policy expert, said in a nursing school news release. "This is consistent with the evidence showing significant associations between the nurse work environment, staffing, and other patient outcomes," he added. The researchers noted that preventable hospital readmissions cost Medicare more than $15 billion a year, and Medicare is now penalizing hospitals with high rates of patient readmissions. One way to improve nurses' working conditions is to reduce their workload by hiring more nurses, McHugh said. The increased costs of doing so may be offset through things such as increased productivity, fewer patient readmissions, and reduced expenses related to nurse turnover and retraining. While the study found an association between nurses' working conditions and patient readmissions, it did not prove a cause-and-effect relationship. -- Robert Preidt

You can walk or run away from cataracts

http://www.healthnewsobserver.com/articles/detail/you-can-walk-or-run-away-from-cataracts Improved cardiovascular health has been shown to decrease the risk of developing cataracts. This week, in the journal Medicine & Science in Sports & Exercise, researchers compared vigorous (running) and moderate (walking) exercise to the risk of developing cataracts in a group of 32,610 runners and 14,917 walkers enrolled in the National Runners’ and Walker’s Health studies over a 6 year time period. The authors estimated the baseline energy expenditure as metabolic equivalents (METs) for runners and walkers. Typical METs range from 1 at rest, to 3.6 if walking 3.4 miles per hour, to 7 if jogging, to 23 for a world class runner running at a 4:17 mile pace or 14 miles per hour. During the follow up, 733 runners and 1,074 walkers developed cataracts. Compared to those who expended < 1.8 MET hours/day, the risk of cataracts was 16.4% lower for those who expended 1.8 to 3.6 MET hours per day, 19% lower at 3.6 to 5.4 MET hours per day, 26% lower at 5.4 to 7.2 MET hours per day, 34% lower at 7.2 to 9 MET hours/day, and 42% lower at > 9 MET hours per day.

Cataracts are a clouding of the lens within the eye that decreases vision. This is primarily a disease of aging with half of all Americans having a cataract by age 65. Other risk factors include diabetes, smoking, alcohol use, elevated lipids, obesity, and prolonged exposure to sunlight. Now, it appears that lack of exercise may be a risk factor.

While it is difficult to pull out exactly how much running or walking took place each week by participants in this study, it is clear that both running and walking regularly decrease the risk of developing cataracts. The authors concluded that it didn't matter if you ran or walk. The reduction in the risk of developing cataracts was the same. So, you truly can walk or run away from your cataracts.

Researchers find new molecule to target in pancreatic cancer treatment

Researchers find new molecule to target in pancreatic cancer treatment

Medical Clowns - Dream Doctors Project

Joint BMJ/ Telegraph investigation exposes flaws in regulation of medical devices

http://thedailymedical.com/2009/01/19/physical-findings-of-aortic-regurgitaion.aspx

There are many signs of aortic regurgitation or insufficiency that can be present during physical examination and direct us to the diagnosis. A patient with aortic valve insufficiency will present a diastolic decresendo murmur, best heard at the left sternal border. If the regurgitation is severe enough to cause obstruction of the mitral valve area during diastole then the Austin Flint murmur may be present. This is a diastolic murmur heard over the mitral valve area due to obstruction of the mitral valve orifice. The Corrigan’s pulse or water hammer pulse is the result of the acute decreased in pressure during the late systole and early diastole, can be palpated at the radial and femoral area. De Musset’s (head bobbing) and Duroziez’s  (pistol-shot sound over femoral area) signs are the result of the markedly increased in pressure during early systole follow by a decreased in pressure during late systole and late diastole.

Academic Life in Emergency Medicine: P-video: How to remember the GCS scoring

 Academic Life in Emergency Medicine: P-video: How to remember the GCS scoring: In this inaugural P-video, Dr. Jeremy Faust gives us a quick way to remember how keep the maximum subscores of the Glasgow Coma Scale str...