30 Sep

Medical News Today: Omega-3 could help prevent environmentally induced lupus

A new study suggests that docosahexaenoic acid – a type of omega-3 present in fish oil and dietary supplements – has the potential to prevent lupus, after finding the fatty acid blocked a known trigger of the disease.
[An omega-3 fish oil capsule]
Researchers suggest the omega-3 fatty acid DHA could prevent lupus triggered by exposure to crystalline silica.

In the journal PLOS One, researchers report how docosahexaenoic acid (DHA) stopped crystalline silica – a toxic mineral associated with the development of systemic lupus erythematosus (SLE) – from causing lung lesions in mice genetically predisposed to lupus.

Lupus is an autoimmune disease estimated to affect around 1.5 million people in the United States.

In lupus, the immune system mistakenly attacks and destroys healthy tissues, cells, and organs, causing pain and inflammation.

SLE is the most common form of the disease, accounting for around 70 percent of all cases. Skin is the organ most often affected by SLE, though the brain, kidneys, lungs, and other organs and tissues can also be damaged.

Crystalline silica and lupus

There are a number of environmental factors believed to trigger lupus in individuals vulnerable to the condition, one of which is exposure to crystalline silica.

Crystalline silica is a natural compound present in numerous substances, including concrete, brick, and mortar. It was classed as a carcinogen, after studies showed that exposure to small, airborne particles of the compound raised the risk of lung cancer.

Previous research has also associated occupational exposure to crystalline silica with increased risk of SLE and other autoimmune diseases, with damage to the lungs in particular.

“Cells in the lung can gobble up the silica, but it’s so toxic, it kills these cells,” explains study co-author Jack Harkema, of the Institute for Integrative Toxicology at Michigan State University.

“When they die, signals are sent out to the immune system that something is wrong. The body then produces such a strong response that it also starts to target healthy cells.”

DHA prevented 96 percent of lung lesions in silica-exposed mice

Harkema and colleagues set out to investigate whether DHA might offer some protection against the toxic effects of crystalline silica, based on knowledge that the omega-3 fatty acid has anti-inflammatory properties.

DHA is one of the three main forms of omega-3. Present in dietary supplements and fatty fish – such as salmon, tuna, and trout – DHA is considered key for brain development and function.

For their study, the researchers used female mice that were genetically predisposed to develop lupus.

The mice were randomized to one of four diets: a diet containing either 0.4 percent, 1.2 percent, or 2.4 percent DHA, or a control diet. The DHA diets were equivalent to human diets containing 2, 6, or 12 grams of DHA daily.

After 2 weeks, all groups were exposed to 1 milligram of crystalline silica once weekly for 4 weeks. They remained on the experimental diets for a further 12 weeks.

On assessing the rodents’ lungs, the researchers found that the mice which were fed the 1.2 percent, or 2.4 percent DHA diets had significantly fewer lung lesions than mice which received the control diet.

“Ninety-six percent of the lung lesions were stopped with DHA after being triggered by the silica,” notes Harkema. “I’ve never seen such a dramatic protective response in the lung before.”

The 0.4 percent diet appeared to have no effect on lung lesions, the team reports.

‘Clear indication’ that DHA can prevent silica-induced lupus

The researchers are unable to pinpoint precisely how DHA might prevent crystalline silica-induced lesions, but they speculate that the fatty acid could be altering the way lung macrophages – a type of white blood cell involved in the detection and destruction of harmful pathogens – react to the toxic substance.

“Our next step is to figure out exactly what’s happening,” says Harkema.

Still, the researchers say their current findings shed some much-needed light on ways to prevent lupus.

“What we do know is this study is a clear indication that eating DHA can prevent this one type of environmental triggering of lupus. It can suppress many of the disease’s signaling pathways, which current drugs on the market now try to target and treat.”

Study co-author James Pestka, Michigan State University

Read about a study that suggests omega-3 and omega-6 fatty acids may improve reading skills.

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30 Sep

Medical News Today: Hypertension in children, teens linked to poorer cognitive skills

Children and adolescents who have high blood pressure may be at risk of poorer cognitive skills, finds a new study published in The Journal of Pediatrics.
[A child having her blood pressure measured]
High blood pressure may hinder children’s cognitive skills, researchers find.

While high blood pressure, or hypertension, is perceived by some people to be a condition that only affects adults, studies have shown that it affects around 3-4 percent of children and adolescents aged 8-17 years.

A child’s blood pressure is calculated differently to that of adults; in general, a child is considered to have hypertension if their blood pressure is the same as or higher than 95 percent of children of the same age, sex, and height.

Similar to adults, children who are overweight or obese, have a poor diet and lack of exercise, a family history of hypertension, or who have certain medical conditions – such as heart and kidney disease – are at increased risk of high blood pressure.

According to study co-author Dr. Marc B. Lande, of the University of Rochester Medical Center in New York, and colleagues, previous research has shown that high blood pressure can interfere with adult’s cognitive functioning, but there has been little research on whether this association rings true for children.

Hypertension linked to poorer performance on cognitive tests

For their study, the research assessed the cognitive test results of 150 children aged 10-18 years. Of these, 75 had newly diagnosed hypertension, while 75 had normal blood pressure.

The team excluded subjects from the analysis if they had other conditions known to impact cognitive skills, such as learning disabilities, attention deficit hyperactivity disorder (ADHD), and sleep disorders.

“We wanted to make sure that if we found differences between children with and without hypertension, it was likely associated with the hypertension itself, not any of these other factors,” explains Dr. Lande.

Compared with children and adolescents who had normal blood pressure, those with high blood pressure performed worse on tests of visual skills, visual and verbal memory, and processing speed, the team reports.

What is more, the researchers found that high blood pressure was more common among children with sleep problems, supporting previous research suggesting poor sleep can impair cognitive functioning.

Findings ‘should not be a cause for concern’

The team stresses that the differences in cognitive skills between children and adolescents with and without hypertension were small, and that the cognitive test scores of both groups were within the normal range.

As such, the researchers say their results indicate that high blood pressure might lead to poorer cognitive performance in youth, rather than cognitive impairment.

However, Dr. Lande told Medical News Today that their results should not be a cause for concern for parents.

“[…] the differences between children with hypertension and those with normal blood pressure that we found were subtle and occurred in the normal range of the tests. The hypertensive children were not cognitively impaired.

Our results do, however, underscore that children with hypertension should be identified by primary care providers and managed according to published guidelines.”

Dr. Marc B. Lande

In terms of future research, Dr. Lande told MNT that the team plans to conduct neuroimaging in youth with high blood pressure, in order to assess how hypertension affects the brain.

Read about a novel sound therapy that could help treat hypertension and migraine.

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30 Sep

Medical News Today: Kidney cancer drug also attacks other cancers

From researching the chemical effects of hundreds of drugs on cell signaling pathways, a team of researchers has discovered that axitinib – a drug approved for the treatment of kidney cancer – can also attack other types of cancer via a different route.
Tablets spread on table
The discovery is an example from the growing field of drug repurposing, which investigates whether drugs already approved to treat one condition could also be safe and effective against another condition.

The study, led by researchers from the Department of Clinical Science at the University of Bergen in Norway, is published in the Proceedings of the National Academy of Sciences and there is a comment on the discovery of the “useful off-target effect” in the journal Science Signaling.

The discovery comes from a growing field of research called drug repurposing,which investigates whether drugs already approved to treat one disease or condition are effective and safe for treating other diseases.

The field is growing for a number of reasons. One is that it takes a lot of time, effort, and cost to develop a brand new drug, often more than 14 years. Drug repurposing can cut these significantly.

Many compounds approved for other uses have already been tested in humans, so detailed knowledge about their safety and how they affect the body at different doses is already available. This speeds up their journey to clinical use through clinical trials and review by drug regulators.

Another reason that drug repurposing is attracting more attention in drug development is because of increasing knowledge about how diseases arise and progress at the molecular level. This provides unprecedented opportunities for studying compounds that target molecular pathways – including those in drugs that are already approved for clinical use.

Team mapped 500 known drugs

The researchers at the University of Bergen, led by Prof. Karl-Henning Kalland, have for many years been searching for compounds that block the chemical signals that drive the growth and spread of cancer cells.

It was during a particular search – where they mapped the chemistry of 500 known drugs – that they discovered a previously unknown effect of the kidney cancer drug axitinib.

Axitinib is approved for use as a “tyrosine kinase inhibitor” that blocks the triggering of angiogenesis – the generation of new blood vessels, which tumors rely on to grow.

The new study shows that axitinib has a useful off-target effect in that it also knocks out a type of “Wnt signaling” cell communication pathway that encourages cells to mutate.

As around 90 percent of all cancer arises from mutations in cells, the researchers believe axitinib could be effective against several forms of the disease, including breast, prostate, and colorectal cancers.

Potential for combining with immunotherapy

The team also discovered a handful of other promising candidates, which they are testing further and hope to report on soon.

The off-target effects – such as blocking signaling mechanisms – do not necessarily mean these compounds will be enough to treat the particular cancer, as Prof. Kalland explains:

“Knocking out these mechanisms will not cure cancer alone, but be a contribution in the fight against cancer. Cancer has to be defeated with a combined strategy.”

In the case of axitinib, Prof. Kalland believes the effect his group has discovered could be used in combination with immunotherapy.

Immunotherapy is a type of cancer treatment designed to boost the body’s natural defenses to fight the disease.

“It is a very interesting coincidence that the specific signaling pathway that is getting attacked, both leads to a blocking of the cancer cells and stimulates the activation of immune cells, creating a great synergy effect. This synergy is to be followed up.”

Prof. Karl-Henning Kalland

Learn how four-stranded DNA could help develop targeted cancer treatments.

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30 Sep

Medical News Today: How Does Prostate Cancer Affect Sex?

Men having treatment for cancer of the prostate gland can have problems with sex. These include loss of interest in sex, and an inability to get an erection.

Various forms of prostate cancer treatment can also cause sex difficulties for men, including radiation therapy, surgery, and hormone therapy.

What is the prostate gland?

The prostate gland is a male sex organ and sits just below the bladder. The prostate’s role is to secrete a clear fluid into the urethra during ejaculation. This forms up to a third of the semen that suspends the sperm and helps with their motility among other functions.

[Prostate Gland graphic image]
The prostate gland’s role is to secrete a clear fluid into the urethra during ejaculation.

The prostate also contributes a muscle action to propel semen during ejaculation. A healthy prostate gland has a smooth, regular surface and is about the size of a walnut.

What is prostate cancer?

Cancer of the prostate gland is a disease in which cells of the prostate tissue divide without control, forming a tumor, or lump.

Prostate cancer is the most common non-skin cancer in men in the United States. There are an estimated quarter of a million new cases in the U.S. every year, according to information from the Cleveland Clinic and other sources. Tens of thousands of men die from the disease annually in the U.S.

According to the Centers for Disease Control and Prevention (CDC), most men who get prostate cancer are older than 65 years and do not die from it.

When a tumor of the prostate grows large enough, it can block the urethra, the outlet tube for urine.

Prostate cancer often produces no symptoms. When they do occur, they may include:

  • Weak or intermittent urine stream
  • Dribbling of urine
  • A feeling of having not emptied the bladder fully or having to strain
  • Blood in the urine

Cancerous cells from a prostate tumor can spread to other sites. This is rare, however, as most prostate cancers are slow-growing and do not spread.

The most common, slow tumors are known as acinar adenocarcinomas, and account for 9 in every 10 cases of prostate cancer, say Cancer Research UK.

Prostate cancer almost always occurs later in life. According to the Cleveland Clinic, up to 80 percent of men older than 80 years show signs of the disease after death. Many men have prostate cancer but die without a diagnosis.

Prostate cancer cannot be passed from one person to another, including via sex. It is not a contagious disease. It is not a sexually transmitted disease.

Does prostate cancer cause sex problems?

Prostate cancer itself does not usually cause problems with sex for most men with the disease.

Most symptoms of prostate cancer relate to urine output. This is because the prostate gland begins to obstruct the urethra, the tube that carries urine out of the body. As well as changes to urine flow, there can be blood in the urine.

Many men with prostate cancer do not get any symptoms in the early stages of the disease. The first time many people know that they have prostate cancer is after other symptoms have been caused by the cancer spreading – to the bone, for example.

It is uncommon, but some men with prostate cancer do have erection difficulties related to the disease itself.

How does treatment for prostate cancer affect sex?

Prostate cancer itself does not usually cause problems with sex. However, it can be usual for men to feel depressed when going through cancer diagnosis and treatment.

[Senior and psychologist]
Psychological problems surrounding cancer diagnosis and treatment can lead to sexual problems.

Worries about prostate cancer may mean less interest in sex or relationship stress. These problems should improve, and there can be support for psychological problems surrounding cancer.

There are many treatment options for prostate cancer, including just monitoring. Many men choose to monitor for any development that may need later active treatment. This approach for very slow-growing prostate cancer can be called “watchful waiting” or “active surveillance.” It does not cause sex problems.

Active treatment of prostate cancer can lead to problems with sex. These therapies include:

  • Surgery
  • Radiation therapy
  • Hormone therapy

Nerve supplies that help to control men’s erections run close to the prostate gland. This raises the challenge of protecting the nerves from damage during treatment of the nearby prostate gland.

Surgery to completely remove the prostate gland is a risk for erectile dysfunction because of the potential nerve damage. This surgery is known as total prostatectomy or radical prostatectomy.

Radical prostatectomy is not appropriate for all men with prostate cancer. It is typically reserved for men who have more aggressive prostate cancer that is likely to grow or spread, and younger men.

The prostate gland can be surgically removed in a number of ways:

  • Open surgery – the surgeon creates an opening in the belly or the area between the testicles and the anus
  • Keyhole surgery – the prostate is removed via a small wound, and the surgeon is guided by a camera

Both options are similarly effective. Keyhole surgery may mean less bleeding and less time in the hospital than open surgery.

Keyhole surgery to remove the prostate gland can also be done with the help of a robot. Also known as da Vinci surgery, this is a more recent development in keyhole surgery for prostate cancer.

Nerve-sparing prostatectomy aims to preserve the nerves that control erections. This type of prostate cancer treatment reduces the risk of erectile dysfunction, but the risk of not fully treating the cancer also needs to be considered. There is a risk that some tumor may be left in place.

Nerve-sparing surgery is not possible in all cases. It depends on where and how severe the prostate cancer is.

[man awaiting prostate cancer surgery]
Surgery is a risky treatment option for prostate cancer as it can lead to erectile dysfunction.

Biopsies are taken as part of any prostatectomy, and this enables the tissue to be examined in a lab. Biopsies may help to work out if cancer is only on one side of the prostate. If it is, the nerves on the other side may be spared.

Surgery is the riskiest treatment in terms of erectile dysfunction. Other options are also risky, including cryotherapy, in which probes are used to freeze prostate cancer cells.

Some decrease in erectile function can follow radiation therapy of the prostate. Erectile dysfunction may be less of a risk with the more focused radiation therapy called brachytherapy. This treatment involves implanting radioactive seeds into the prostate.

Hormonal therapy also carries the risk of erection problems, can cause loss of libido, and affect fertility. Treatments can also involve removing the testicles and antiandrogen drugs.

Fertility problems caused by prostate cancer treatment

Doctors may offer men the chance to store sperm before prostate treatment. Sperm banking is an option because different cancer treatments run the risk of making men infertile.

Not being able to father children may result from radiation therapy, surgery, or drug treatment.

If infertility does result from treatment and the man wishes to start a family, stored sperm can be used in artificial insemination or in vitro fertilization.

Managing sex life with prostate cancer

If erectile dysfunction does occur after prostate cancer treatment, a number of options are available to help with returning to normal sex function.

A loss of interest in sex may occur due to fatigue and other problems linked to prostate cancer and treatment. This can improve or disappear over time.

The number of men affected persistently by erectile dysfunction after prostate cancer surgery varies widely. Factors affecting likelihood include age and health before the operation.

[man and woman in bed]
Vacuum pumps, implants, and oral drugs are some of the treatments available to help men affected by erectile dysfunction.

A number of treatments are available to help achieve erections, including:

  • Drugs taken by mouth, such as avanafil (Spedra), sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra)
  • Cream applied to the penis – alprostadil (Vitaros) – and other locally active drugs such as injections and pellets
  • Vacuum pumps specially designed to draw blood into the penis before sex
  • Implants – options that are usually reserved for men who have had no success with drugs or treatments first
  • Psychological support

A number of men talk on camera about their experiences of sexual dysfunction and prostate cancer at healthtalk.org.

Does sex raise the risk of prostate cancer?

A study published in European Urology sought to answer whether frequent ejaculating protects against prostate cancer.

The study was a follow-up of one that had found that more regular ejaculation seemed to cut prostate cancer risk. The new research involved almost 32,000 men and found that ejaculating more often lowered the chances of prostate cancer.

The researchers made changes to make sure that the results could not be explained by other factors. They add, though, that further work should be done because of the possibility that other factors aside from ejaculation could account for the results remained.

The researchers do not know how ejaculation might be working to protect against prostate cancer.

A number of possible biological mechanisms have been put forward. One theory known as prostate stagnation suggests that ejaculating less often allows potentially cancer-causing secretions to build up.

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30 Sep

Medical News Today: HPV: How physicians recommend vaccine influences parents' choices

Human papillomavirus is currently the most commonly sexually transmitted infection, affecting around 79 million Americans and causing about 38,793 cancers each year. While there is a vaccine to protect against cancers caused by the virus, a new study finds that parents’ willingness to vaccinate their child depends on the language used by their physician upon vaccine recommendation.
[HPV vaccine with syringe]
Some parents who initially said they did not intend to vaccinate their children against HPV said that at least one of the messages would motivate them to agree to vaccination.

Human papillomavirus (HPV) can cause cervical cancer, vaginal cancer, and vulvar cancer in women and penile cancer in men. HPV can also cause anal cancer, oropharyngeal cancers, and genital warts in both sexes.

The virus is suggested to be responsible for more than 90 percent of anal and cervical cancers, around 70 percent of vaginal and vulvar cancers, and more than 60 percent of penile cancers. Studies have also shown that about 70 percent of cancers of the oropharynx may be linked to HPV.

All children who are 11-12 years old are recommended to receive the three-dose series of the HPV vaccine to protect against HPV. However, data have shown that only 42 percent of girls and 28 percent of boys between 13-17 years had completed the HPV vaccine series.

Previous research by Teri L. Malo, Ph.D. – a postdoctoral research associate at the Lineberger Comprehensive Cancer Center and the Department of Health Behavior, of the Gillings School of Global Public Health at the University of North Carolina (UNC) at Chapel Hill – has indicated that physician’s recommendations for the HPV vaccine is a key predictor of vaccine uptake.

They found that many physicians recommend HPV vaccine inconsistently, behind schedule, or without urgency, which could contribute to under-immunization among adolescents and uncertainty in parents. The team also found that the strength of HPV vaccine recommendations from physicians does not align with national guidelines.

In this research – published in the journal Cancer Epidemiology, Biomarkers & Prevention – Malo and colleagues aimed to evaluate whether the language used by physicians would influence parents’ decisions about whether to vaccinate their child against HPV.

Alongside their observations, the team also assessed physicians’ willingness to use particular language when communicating with parents about HPV and recommending the vaccine.

Parents most likely to support messages affirming vaccine effectiveness

Malo, with senior author Noel Brewer, Ph.D., professor of health behavior at UNC Gillings School of Global Public Health and member of UNC Lineberger Comprehensive Cancer Center, and team conducted national surveys of 777 primary care physicians and 1,504 parents of adolescents ages 11-17.

Researchers communicated six brief messages developed by the study team and nine longer messages developed by the Centers for Disease Control and Prevention (CDC) to parents and asked them whether any of these specific messages would persuade them to allow their child the HPV vaccine.

Additionally, the team read physicians the six brief messages only and asked them if they would consider using them to persuade parents to use the HPV vaccine for their children.

Study results indicated that parents were most likely to be influenced by messages that emphasized vaccine effectiveness. A total of 70 percent of parents supported messages of the effectiveness of the vaccine, 67 percent supported messages explaining cancers prevented by the vaccines, and 65 percent supported messages detailing vaccine safety.

At least half of the participating parents supported three of the brief messages and eight of the longer messages, with no significant differences in support across demographic groups.

Deemed as the most persuasive brief message of the study – with endorsement from 65 percent of parents and 69 percent of physicians – was the phrase: “I strongly believe in the importance of this cancer-preventing vaccine for [child’s name].”

Physicians preferred to use messages that emphasized the vaccine’s role in preventing cancer, accounting for 64 percent support.

Parent-provider communication may increase HPV vaccination rates

Some parents that said at the beginning of the survey that they did not intend to vaccinate their child against HPV changed their minds from at least one of the messages included in the study.

Among parents who initially said no to vaccination and who were motivated to vaccinate by the messages, the most influential messages were both those that stressed the parents’ role in preventing their child from getting HPV-related cancers and messages that highlighted the parents’ role in whether their child becomes infected with HPV.

Most parents who avoid the HPV vaccine do so out of lack of information, according to Malo. They believe either the vaccine is unsafe or not needed, and say that they do not receive a strong enough recommendation from their child’s physician to feel that it is necessary.

“Each of these concerns can be addressed by talking with a provider, and so it’s important to understand what drives parents’ hesitation so that we can help improve provider communication to decrease hesitancy about HPV vaccine. This finding really highlights the important role that parent-provider communication can play in increasing HPV vaccination.”

Teri L. Malo, Ph.D.

Limitations of the study include that it is based on self-reporting and does not account for clinical context, which could include nonverbal cues or message modifications.

Further research by the team may identify whether parents’ support of the brief or longer messages resulted in higher rates of vaccination across the survey participants.

Read about how HPV rates have fallen considerably in young women since the HPV vaccine was introduced.

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30 Sep

Medical News Today: Marasmus: Causes, Symptoms, and Treatment

Malnutrition is a condition in which a lack of nutrients in the body causes health problems. This is most often the result of a very poor diet that doesn’t contain all the vitamins and nutrients needed for the body to function properly. Marasmus is one form of malnutrition.

When a person doesn’t get the right nutrients, their bodies have difficulty going through normal motions like growing or fighting disease. These difficulties can then lead to more serious health problems.

What is marasmus?

Marasmus is a severe form of protein-energy malnutrition caused by a shortage of protein and calories in the body. Without these vital nutrients, the body becomes dangerously low in energy and important functions begin to stop.

[hands holding rice]
Around 20 million children under the age of 5 have severe forms of malnutrition.

Both adults and children can be affected by marasmus, but young children in developing countries are affected most often.

It is estimated that 20 million children under the age of five have severe forms of malnutrition like marasmus at some point in their lives, according to UNICEF. About 500,000 to 2 million children die as a result of it.

Marasmus is not always a direct result of a lack of nutrients. It can also be caused by the wrong nutrients, or an inability to absorb or process nutrients properly because of infection.

One study suggests that there are four main causes that lead to marasmus:

  1. Improper feeding
  2. Infection, such as syphilis or tuberculosis
  3. Congenital weakness of disease, such as congenital heart disease
  4. Very poor sanitary and hygienic conditions that spread disease

Marasmus is also referred to as wasting. It is most often identified by the affected person’s physical appearance, which becomes skeletally thin. The loss of body fat and muscle tissue leads to a withered appearance, often described as looking like “skin and bones.”

Other symptoms of marasmus include:

  • Thin face
  • Ribs and shoulders clearly visible through the skin
  • Very loose skin that sometimes hangs in folds in the upper arms, thighs, and buttocks
  • Persistent dizziness
  • Sunken eyes
  • Diarrhea
  • Active, alert, or irritable behavior
  • Frequent dehydration
  • Frequent infections that don’t show external signs like fever or lesions

Other forms of severe malnutrition

Marasmus is not the only form of severe malnutrition.

Kwashiorkor

Kwashiorkor is another very severe form of protein-energy malnutrition. Very serious cases of marasmus can lead to kwashiorkor. The main difference between the two is that kwashiorkor causes the affected person’s body to hold large amounts of fluid in places like the lower legs, feet, arms, hands, and face.

Unlike marasmus, someone affected by kwashiorkor may look like they are of a healthy body weight, or even plump. They may not lose weight, but this is because the fluid buildup is making up for the loss in body fat and muscle tissue.

[dermatosis hands]
Dermatosis is one of the symptoms of kwashiorkor.

Other symptoms of kwashiorkor include:

  • Loss of appetite
  • Lack of energy
  • Irritability
  • Changes in hair color to yellow or orange
  • Dermatosis – a condition in which patches of skin turn abnormally light or dark, the skin sheds, skin ulcers develop, and lesions begin to leak or bleed

It’s critical that kwashiorkor is diagnosed and treated immediately. It is even more life-threatening than marasmus and can lead to death quickly.

Marasmic-kwashiorkor

Marasmic-kwashiorkor is the third form of protein-energy malnutrition. Those affected by this condition experience a combination of marasmus and kwashiorkor. As such, they will show symptoms of both conditions as well.

For example, someone with marasmic-kwashiorkor may:

  • Be extremely thin and show signs of wasting
  • Have excessive fluid buildup in other parts of their body
  • Be severely dehydrated

Like with kwashiorkor, it is extremely important that someone showing marasmic-kwashiorkor receives immediate medical treatment. It is more difficult to recover as time goes on, and they face a high risk of death as the condition worsens.

Treatment of marasmus

Marasmus is life-threatening medical emergency, so it’s very important to treat it at the onset of symptoms. Other forms of malnutrition may look different but are just as dangerous if left untreated.

Although severe malnutrition is uncommon among children in developed countries, it’s important to look out for symptoms that may signal malnourishment. Rapid weight loss, infections, and sudden changes in behavior or appetite could be signs of a bigger problem.

It’s a good idea to visit a doctor right away if someone notices any of these symptoms. The longer marasmus goes untreated, the less chance there is of a full recovery.

Research suggests that successfully treating marasmus depends on four factors:

  1. The patient’s age – the younger the patient, the greater chance of death
  2. How much body weight the patient has lost
  3. The nutritional treatment given
  4. The ability of the patient to resist infection

In order to treat marasmus, a treatment plan must be set up by medical professionals if possible.

[Carb rich Foods]
A rich, carbohydrate-filled diet is a good form of treatment, but full recovery can still take months.

There is great difficulty in treating marasmus because the patient needs significantly more calories than a normally nourished person their age. Because their body has lost its fat supply and most of the tissue has been starved, their body no longer has the ability to digest or tolerate a normal amount of food on their own, let alone enough to bring them back to health.

As a result, feeding is usually done in small amounts and through tubes to the veins and stomach. These tubes allow for food and fluid to be delivered quickly and directly to the body.

A diet treatment rich in nutrients, carbohydrates, and calories is very important. It can still take months for a full recovery, even with the right treatment plan.

The complications linked with marasmus such as infections and dehydration must also be treated and prevented to help the patient regain their health.

Prevention of marasmus

The best way to prevent marasmus is to have a well-balanced diet. Foods rich in protein like skimmed milk, fish, eggs, and nuts are important for energy and growth. Vegetables and fruits are important for providing other nutrients and minerals and for preventing malnutrition in general.

Ensuring that complications like dehydration and diarrhea don’t reoccur for those who have been malnourished before or affected by marasmus are very important.

Good sanitation and hygiene also play a big role in spreading disease for people in developing countries. Poor sanitation and hygiene can lead to infections that may take a toll on someone who is already close to malnutrition.

Cooking foods at high heat to destroy bacteria can help, as can freezing food and reheating it before eating. Boiling water before drinking, cooking, or bathing in areas where clean water is difficult to access is important to prevent spreading waterborne diseases.

New mothers can also help prevent malnourishment in their newborns by breastfeeding as much as possible.

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30 Sep

Medical News Today: Epigenetic clock can calculate biological age, predict lifespan

Some individuals who fill their lives with fitness and healthy habits die younger than peers who live a much less healthy life. New research into the epigenetics of aging sheds some fresh light on the perplexing phenomenon of premature aging.
[Old man's face]
Premature aging has perplexed medical professionals for years.

Epigenetics, a relatively new sphere of research, is proving to be a fascinating and far-reaching topic.

In short, epigenetics charts changes in chromosomes that take place without modifying the DNA sequence itself.

By altering the ways in which DNA is packaged and replicated, changes can be made to the whole organism without a single base pair of DNA being moved out of place.

Researchers from the University of California-Los Angeles (UCLA) set out to examine how epigenetics might influence human aging.

The team wanted to investigate whether epigenetics could offer insight into the question of premature aging, specifically. As Dr. Douglas Kiel, professor at Harvard Medical School and senior scientist at the Institute of Aging Research at Hebrew SeniorLife, says:

“In geriatric medicine, we are always struck by the difference between our patients’ chronological age and how old they appear physiologically.”

To open up this question, the UCLA scientists led a team of 65 researchers in seven countries. They used data from 13 separate studies, including the Women’s Health Initiative and Framingham Heart Study. In all, 13,000 people’s DNA was analyzed from blood samples.

By recording age-related changes to human DNA and calculating an individual’s biological age, the team found that they could accurately estimate someone’s lifespan.

The paper, published this week in the journal Aging, explains how a higher biological age – regardless of chronological age – predicts an earlier death.

“Our research reveals valuable clues into what causes human aging, marking a first step toward developing targeted methods to slow the process.”

Steve Horvath, project lead, professor of human genetics and biostatistics

Charting methylation

Using a series of molecular methods, the scientists measured each individual’s rates of aging. One of the techniques used was an epigenetic clock, designed by Prof. Horvath in 2013.

Prof. Horvath’s epigenetic clock works by tracking methylation. Methylation is a process where methyl groups are added to DNA; this generally leads to a reduction in gene transcription, altering a person’s phenotype without altering their genotype.

Methylation is natural and steadily occurs over time; the team found that by comparing an individual’s chronological age with their blood’s biological age, they could predict life expectancy.

“We were stunned to see that the epigenetic clock was able to predict the lifespans of Caucasians, Hispanics, and African-Americans.

This rang true even after adjusting for traditional risk factors like age, gender, smoking, body mass index, disease history, and blood cell counts.”

First author Brian Chen, the National Institute on Aging

The team found that around 5 percent of the population age at a faster rate and have a decreased life expectancy. Prof. Horvath says: “Accelerated aging increases these adults’ risk of death by 50 percent at any age.”

As an example, if we compared two 60-year-old men who have stressful jobs and smoke; the first man has a top aging rate, the other is average. The likelihood of the first man dying in the next 10 years is 75 percent, whereas the latter of the two has just a 60 percent chance of dying in the next 10 years.

The future of aging research

These findings might help explain why certain people who live otherwise healthy lives seem to die young. However, this is not free rein to take up smoking and heavy drinking. As Prof. Horvath mentions, traditional risk factors like high blood pressure and diabetes “still predict mortality more strongly than one’s epigenetic aging rate.”

The large and thorough nature of this study gives it a great deal of weight. The next step is to see whether these findings can be utilized in real-world situations. As Dr. Kiel explains: “If we can prove that DNA methylation accelerates aging, we can devise strategies to slow the rate and maximize a person’s years of good health.”

The importance of epigenetic changes and how they impact premature aging are yet to be fully explained. It may be that they influence other factors already present in an individual. For instance, perhaps they enhance the effects of certain diseases or remove our ability to fight them off.

Because epigenetics is receiving a great deal of attention currently, answers to these questions are likely to gradually trickle in. Medical News Today asked Chen about other research he is currently involved in.

“Our current focus is on understanding what biological mechanisms control the ‘ticking’ of the epigenetic clock and investigating the implications of having a discrepancy between one’s epigenetic age and their chronological age,” he replied.

Asked what type of study he would like to carry out given unlimited time and funds, Chen told MNT:

“We and a number of other groups are now trying to develop a similar clock in animal models. This will allow the greater scientific community to understand the role of the epigenetic clock in relation to other markers of aging. Animal models will allow us to examine differences in the clock across tissues and across the lifespan in the same individuals.”

Read more about the inner workings of epigenetics.

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30 Sep

Could Prescribed NSAID Painkillers Raise Heart Failure Risk?

News Picture: Could Prescribed NSAID Painkillers Raise Heart Failure Risk?By Dennis Thompson
HealthDay Reporter

Latest Heart News

WEDNESDAY, Sept. 28, 2016 (HealthDay News) — Use of prescription-strength ibuprofen, naproxen and other commonly used pain relievers may be tied to a higher risk of heart failure, researchers report.

Medicines like these fall into a category of painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs). These medications may raise a person’s relative risk of heart failure by nearly 20 percent, according to the analysis of medical records for nearly 10 million patients.

That risk increases with the amount of NSAIDs a person is taking, said study author Andrea Arfe, a Ph.D. student at University of Milano-Bicocca, in Italy.

A person’s risk of hospitalization for heart failure doubles for some NSAIDs used at very high doses, including diclofenac (Cataflam or Voltaren), etoricoxib (Arcoxia), indomethacin (Indocin), and piroxicam (Feldene), Arfe said.

Also, “our findings — which focused only on prescription NSAIDs — might apply to over-the-counter NSAIDs as well,” Arfe said. “Although over-the-counter NSAIDs are typically used at lower doses and for shorter durations, they are sometimes available at the same doses as prescription NSAIDs and they may be inappropriately overused.”

Still, the nature of the study can only point to an association between NSAID use and heart failure risk — it can’t prove cause-and-effect. And one expert believes that most patients who need an NSAID for their pain can safely continue using the drugs.

The findings were reported Sept. 28 in the BMJ.

According to the American Academy of Orthopaedic Surgeons (AAOS), NSAIDs decrease inflammation and pain by blocking an enzyme called cyclooxygenase. This enzyme comes in two forms, COX-1 and COX-2. COX-1 protects the stomach lining from digestive acids, while COX-2 is produced by injured or inflamed joints.

Traditional NSAIDs — like aspirin or ibuprofen — block the action of both COX-1 and COX-2, which is why some people suffer from stomach upset after taking them, the AAOS said. Newer NSAIDs like celecoxib (Celebrex) target only COX-2, and are referred to as COX-2 inhibitors.

Doctors have been concerned for some time that NSAIDs might play a role in heart failure, because they cause people to retain sodium, explained Dr. Christopher O’Connor, editor-in-chief of the cardiology journal JACC: Heart Failure.

“These drugs have been around for a long time, and they have important pain relief and anti-inflammatory properties, but they also have cardiovascular side effects,” said O’Connor, who serves as chief executive officer of the Inova Heart and Vascular Institute in Falls Church, Va. “They have been shown to hold onto sodium, and there’s some reduction in kidney function.”

To look more closely at this link between NSAIDs and heart failure, Arfe and colleagues pored through millions of European health records from 1999 through 2010. The patients came from Germany, Italy, the Netherlands and the United Kingdom.

The analysis included a total of 27 individual NSAIDs, including 23 traditional NSAIDs and four selective COX 2 inhibitors. The researchers identified more than 92,000 hospital admissions for heart failure, and matched those patients against 8.2 million patients without such histories.

The researchers concluded that people who’d been prescribed an NSAID within the preceding two weeks had a 19 percent increased risk of hospital admission for heart failure.

“We also found evidence that the risk of heart failure varied according to the type of the used NSAID,” Arfe added.

After accounting for other health factors — including history of kidney failure and risk factors for heart disease — the researchers determined that seven traditional NSAIDs and two COX-2 inhibitors particularly increased risk of heart failure.

The traditional NSAIDs that increase risk of heart failure are diclofenac, ibuprofen (Motrin), indomethacin, ketorolac (Toradol), naproxen (Aleve or Midol), nimesulide, and piroxicam. The two COX-2 inhibitors are etoricoxib and rofecoxib (neither is approved for use in the United States).

On the other hand, the COX-2 inhibitor celecoxib (Celebrex) did not increase risk of heart failure at commonly used doses, which provides patients a safe alternative, Arfe said.

What to do?

O’Connor believes that anyone regularly taking an NSAID for pain or inflammation should talk with their doctor about their personal heart risk, rather than dropping the medication without consultation.

He stressed that these study results report a relative increase in risk — which means there would be little added danger from NSAIDs in people with good heart health who need the medication for their pain.

“This isn’t an absolute, that you take the drug and you’re going to end up in the hospital with heart failure,” O’Connor said. “It’s increasing the risk. If you’re low risk for heart failure to begin with, if your risk of heart failure is 1 percent and you go to 1.2 percent, that’s probably acceptable for you and me. But if you go from 20 percent to 30 percent, that’s a pretty big bump in risk.”

People taking over-the-counter NSAIDs would do well to limit their use, O’Connor added. “Try to take it in as short-term a fashion as you can,” he said.

Arfe said these findings “may have large public health consequences and they point to the need for further research to assess the safety of over-the-counter NSAIDs under the conditions they are typically used.”

“Patients should adopt a prudent attitude and avoid over-using over-the-counter NSAIDs without seeking medical advice,” he concluded.

MedicalNews
Copyright © 2016 HealthDay. All rights reserved.

SOURCES: Andrea Arfe, Ph.D. student, University of Milano-Bicocca, Milan, Italy; Christopher O’Connor, MD, editor-in-chief, JACC: Heart Failure and CEO, Inova Heart and Vascular Institute, Falls Church, Va; Sept. 28, 2016, BMJ

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30 Sep

Hurdles Ahead for Zika Vaccine: Experts

News Picture: Hurdles Ahead for Zika Vaccine: ExpertsBy Dennis Thompson
HealthDay Reporter

Latest Infectious Disease News

WEDNESDAY, Sept. 28, 2016 (HealthDay News) — Work is progressing on developing a vaccine that can thwart the Zika virus, but it will take years to get one to market, experts warn.

Two rival vaccines for Zika have the best chance of becoming available for field testing by early next year, said Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases (NIAID).

But testing the vaccines could become complicated if Zika does not reappear in the South American countries where it achieved epidemic proportions this year, Fauci wrote in a commentary published Sept. 29 in the New England Journal of Medicine.

Testing could also be hampered if vaccine manufacturers aren’t able to quickly make the millions of doses needed for field trials, added Dr. Stephen Thomas, an infectious diseases doctor at SUNY Upstate Medical University in Syracuse, N.Y. He also wrote a commentary in the same journal.

“The challenge is not just showing that it is safe and has the clinical benefit you want, but making enough doses and deploying it,” said Thomas. He recently moved to SUNY after serving as the Zika program lead for the Walter Reed Army Institute of Research in Silver Spring, Md. “There are a lot of very complex issues at play here,” he said.

The earliest scientists will know whether a Zika vaccine works is early- to mid-2018, Fauci said. All told, it could take three to five years to have an effective vaccine to use in areas of active Zika transmission, Thomas added.

Zika is the first mosquito-borne virus known to cause terrible birth defects, most of them brain-related. The most common defect is microcephaly, in which a child is born with an abnormally small brain and skull. Thousands of babies have been born with Zika-linked microcephaly, most of them in Brazil, since an outbreak began in South America in April 2015.

Zika infections began occurring in south Florida this summer, with 43 cases as of Sept. 21, according to the U.S. Centers for Disease Control and Prevention. There have been no reports yet of microcephaly in the state.

NIAID has developed an experimental DNA-based vaccine that recently entered human safety trials. At the same time, Walter Reed is collaborating with pharmaceutical manufacturer Sanofi Pasteur to develop a vaccine based on inactivated Zika virus, Fauci said.

Both vaccines should be ready for field testing by January, when summer in South America rolls around, Fauci added.

Public health experts believe that Zika will flare up again with the coming of the summer mosquito season, which will provide an opportunity to test the vaccines and gather valuable data on effectiveness, he said.

“We don’t think the outbreak is going to disappear in a year, the way Ebola did,” Fauci said. “Zika likely will hang around in South America and the Caribbean and Puerto Rico for more than one season. We hope it doesn’t, but if it does we will be ready to start a phase 2 trial.”

Regardless, public health officials also are considering alternative plans for testing the vaccines, should Zika outbreaks fail to appear, Fauci said.

Candidate vaccines will be tested using the “animal rule,” he explained.

“If you vaccinate a non-human primate and you create an immune response that protects the animal, then you go to humans and do a lot of studies of safety,” Fauci said.

“You can include thousands of people, even though there’s no infection in society, and you measure what their immune response is. If the immune response is comparable to what the animal got when the animal was protected, then you can make an assumption that immune response would also protect a human,” he said.

Human challenge trials are another way to test a Zika vaccine. Half of a group of healthy volunteers would receive the Zika vaccine, and half would not. All then would be exposed to Zika virus, Fauci said.

“If you protect those who are vaccinated but don’t protect those who are not vaccinated, you can assume the vaccine works,” Fauci said. “That is much quicker than doing a field trial, which may take a year or more. With this, you could find out the answer in a month or so.”

However, there are safety considerations in human challenge trials, Fauci said.

Zika is a very mild virus, causing no symptoms in four out of five people. It mainly poses a danger to the unborn, as an infection in a pregnant woman can lead to devastating birth.

But the virus has also been linked to rare cases of Guillain-Barre syndrome, in which people experience muscle weakness and paralysis, Fauci noted.

“You have to make sure you give it a good ethical review before you challenge a human,” Fauci said. “You have to make sure you have all of your ducks in order, in terms of informed consent.”

Those plans assume that a candidate vaccine is available in quantities for testing, which is not a firm assumption, Thomas said in his commentary.

Production would have to scale up from 1,500 doses made in a research lab for initial testing to millions of doses churned out by a state-of the art manufacturing facility, he said.

“Now everything is different,” Thomas said. “It’s like cooking for the family versus cooking for the cruise ship.

“It is going to require a bunch of different groups to come together and make this thing work, but there are a lot of reasons to be optimistic that it can be done,” he said.

MedicalNews
Copyright © 2016 HealthDay. All rights reserved.

SOURCES: Anthony Fauci, M.D., director, U.S. National Institute of Allergy and Infectious Diseases; Stephen Thomas, M.D., infectious diseases physician, SUNY Upstate Medical University, Syracuse, N.Y.; Sept. 29, 2016, New England Journal of Medicine

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30 Sep

Zika May Be Passed on Through Tears, Sweat: Report

News Picture: Zika May Be Passed on Through Tears, Sweat: ReportBy Dennis Thompson
HealthDay Reporter

Latest Infectious Disease News

WEDNESDAY, Sept. 28, 2016 (HealthDay News) — The Zika virus might be able to pass from person to person through bodily fluids like tears or sweat, doctors reported Wednesday.

A 38-year-old man in Salt Lake City appears to have contracted Zika while caring for an elderly man who died from complications related to Zika infection, according to a report in the New England Journal of Medicine.

The younger man came into direct contact with the older man’s tears and sweat while taking care of him, and that appears to be the way he contracted Zika, doctors at the University of Utah School of Medicine wrote in the journal.

Up to now, Zika virus mainly has been transmitted through mosquito bites, although in rarer instances it has been passed on through sexual contact.

The 73-year-old man had recently returned from a three-week trip to the southwest coast of Mexico, where he had been bitten by mosquitoes. Soon after returning to Utah, he reported Zika-like symptoms, including abdominal pain, sore throat, fever, red eyes and diarrhea. He eventually was hospitalized due to dangerously low blood pressure, labored breathing and an abnormally fast heart rate.

The man’s condition declined while in the hospital, and he suffered respiratory and kidney failure. He died on day four of hospitalization, after care was withdrawn, the doctors wrote.

Five days after the older man died, the younger man reported having developed red eyes, fever, muscle pain and a facial rash. His urine and blood tested positive for Zika.

There has been no active mosquito transmission of Zika in Salt Lake City, the doctors reported, but the younger man had placed his hands on the older man while helping care for him.

The younger man had helped reposition the older man in his sick bed, and had wiped the man’s eyes without using gloves, the doctors said.

The older man’s death from Zika is rare. Up to now, only nine deaths directly caused by Zika infection have been confirmed in adults, the doctors noted in their letter.

“Whether contact with highly infectious bodily fluids from patients with severe [Zika] infection poses an increased risk of transmission is an important question that requires further research,” the University of Utah doctors concluded.

Zika is the first mosquito-borne virus known to cause severe birth defects, most of them brain-related. The most common defect is microcephaly, in which a child is born with an abnormally small brain and skull. Thousands of babies have been born with Zika-linked microcephaly, most of them in Brazil, since an outbreak began in South America in April 2015.

Zika infections have been occurring in south Florida, with an estimated 40 to 50 cases in the Miami area, according to the federal Centers for Disease Control and Prevention. There have been no reports of locally transmitted cases of microcephaly in the state or anywhere else in the United States.

MedicalNews
Copyright © 2016 HealthDay. All rights reserved.

SOURCE: Sept. 28, 2016, New England Journal of Medicine

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Source: MediciNet