Friday, January 29, 2010

Smoke exposure during pregnancy may damage babies' blood pressure control.

From BBC news:

Smoke exposure during pregnancy damages a baby's blood pressure control, which may explain why such babies' risk of cot death is higher, say experts.

Maternal smoking remains one of the biggest risk factors for cot death.
A team at Sweden's Karolinksa Institute found smoke-exposed babies had abnormal surges in blood pressure, even when sleeping undisturbed in their cots.
These surges put extra demand on the heart, making it pump faster and harder, the journal Hypertension says.
The study suggests damage to the circulation may be a factor in sudden infant death syndrome (SIDS), although it set out to look at the effects of smoking on the newborn rather than cot death per se.
Dr Gary Cohen and his team studied 36 newborn babies - 17 of whom had mothers who smoked during the pregnancy.
When they examined the babies they found the ones that had been exposed to cigarette smoke showed abnormal heart rate and blood pressure responses.
And these abnormal responses got worse throughout their first year of life.

Dramatically different

At one week of age the smoke-exposed babies showed abnormally large blood pressure rises as they were lifted up from lying down.
By the age of one, the same babies appeared to have adapted to this and now showed abnormally low blood pressure responses to the same posture change.
Usually, when a person stands the heart rate increases and the blood vessels tighten, raising blood pressure slightly, to keep up the blood flow to the heart and brain.
Dr Cohen said: "Babies of smokers have evidence of persistent problems in blood pressure regulation that start at birth and get worse over time.
"This study reveals for the first time that early life exposure to tobacco can lead to long-lasting reprogramming of the infant blood pressure control mechanism."
He said this might explain why babies of women who smoke are at increased risk of cot death.
"We have known for some time that there is a cardiovascular element to sudden infant death.
"It's not just breathing, but blood pressure control and heart rate control.
"This is another piece of the jigsaw."
He plans to continue to study the babies as they grow up to see if the damage is lasting and whether it leads to problems, such as high blood pressure, in later life.
Professor George Haycock, scientific adviser for the Foundation for the Study of Infant Deaths (FSID), said: "The hypothesis presented here is highly plausible and agrees with work from other research groups.
"FSID's top piece of advice remains, cut smoking in pregnancy - fathers too, and don't let anyone smoke in the same room as your baby."
Experts say a third of cot deaths could be avoided if mothers-to-be did not smoke.
Janet Fyle, Professional Policy Advisor at the Royal College of Midwives, said: "These findings support what we know; that smoking during pregnancy can harm the developing foetus.
"The RCM would urge pregnant women who smoke to seek advice and support from their midwife about stopping smoking, for the benefit of their own long-term health.
"This would also benefit the health of their child."

Saturday, January 23, 2010

Shedding Light on Why Omega-3 Fatty Acids May Help the Heart

From Health Day:

The greater the consumption, the less shrinkage of chromosome component, research shows

By Amanda Gardner
HealthDay Reporter

TUESDAY, Jan. 19 (HealthDay News) -- Scientists think they have uncovered at least one of the reasons why omega-3 fatty acids are good for your heart.

The more omega-3 that patients with coronary heart disease consumed, the slower their telomeres shrank. Telomeres are structures at the end of a chromosome that get shorter the more times a cell divides, making them a marker of biological age.

"We're certainly not saying that this is the reason for all the benefits of omega-3 fatty acids, but it is a new pathway linking omega-3 fatty acids to biological aging in these patients," said study lead author Dr. Ramin Farzaneh-Far, an assistant professor of medicine at the University of California, San Francisco.

The findings are published in the Jan. 20 issue of the Journal of the American Medical Association.

"What they're really saying is that there is quite an impact of omega-3s on cell support and cell functioning," said Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City and a spokeswoman for the American Heart Association. "If you supplement with omega-3s or eat omega-3s, your cells stay healthier, your cells age less quickly."

Said Farzaneh-Far: "Cardiologists have known for about 20 years that increased dietary intake of omega-3 fatty acids are beneficial for patients with coronary artery disease, particularly those who have had a prior heart attack. It reduces the risk of subsequent heart attacks and death."

But the reasons for that benefit have not been well defined, said John Bowman, an associate professor of pharmacy practice at Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy. "We don't know the exact cellular mechanisms," he said.

Omega-3 fatty acids are plentiful in fatty fish like salmon, mackerel, herring, lake trout, sardines and albacore tuna, according to the American Heart Association.

For the new study, the researchers followed about 600 patients in the San Francisco Bay Area with coronary artery disease. Blood levels of omega-3 fatty acids and telomere length were measured at the beginning of the study and again about five years later.

"That allowed us to measure the change in telomere length over five years and see if that bore any association with levels of omega-3 fatty acids at the beginning of the study," Farzaneh-Far said.

And, indeed, there was a relationship.

"We found that as blood levels of omega-3 went up, the rate at which telomeres shortened decreased," Farzaneh-Far said. "To the extent that that is a marker of biological aging, the rate of biological aging went down."

The findings don't change current recommendations regarding omega-3 fatty acids or what people should be doing.

"The American Heart Association recommends that those with coronary heart disease get about a gram a day of omega-3 fatty acids," said Farzaneh-Far. "Our study certainly doesn't suggest any change in that."

Dr. Melissa Tracy, medical director of cardiac rehabilitation at the University of Miami Miller School of Medicine, said the new study gives "some additional support to the use of omega-3 fatty acids." But, she noted, it's unclear how far these findings could be extrapolated to other groups of people, such as those who don't have coronary artery disease.

"There are other extraneous circumstances which can impact telomere length," she said.

And, Tracy added, "we should try to do as much with our own bodies that we can. I am an advocate of proper diet, exercise, for optimizing your lifestyle, meaning reducing stress and getting enough sleep."

More information

The American Heart Association has more on omega-3 fatty acids.

SOURCES: Ramin Farzaneh-Far, M.D., assistant professor of medicine, University of California, San Francisco; Melissa Tracy, M.D., assistant professor of clinical medicine, and medical director, cardiac rehabilitation, University of Miami Miller School of Medicine; John Bowman, M.S., associate professor of pharmacy practice, Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy; Suzanne Steinbaum, M.D., preventive cardiologist, Lenox Hill Hospital, New York City and spokeswoman, American Heart Association; Jan. 20, 2010, Journal of the American Medical Association

Last Updated: Jan. 19, 2010

Copyright © 2010 ScoutNews, LLC. All rights reserved.

Friday, January 15, 2010

Artificial pancreas under development for Type 1 Diabetes

From Health Day, News for Healthier Living

Juvenile Diabetes Research Foundation partners with Johnson & Johnson for medical first

By Serena Gordon
HealthDay Reporter

WEDNESDAY, Jan. 13 (HealthDay News) -- The first version of an artificial pancreas -- a potentially revolutionary way to manage insulin delivery in people with type 1 diabetes -- may be available in as little as four years.

The Juvenile Diabetes Research Foundation (JDRF) announced Wednesday that it's partnering with Johnson & Johnson's insulin pump division, Animas Corp., to begin development of the first artificial pancreas system. The goal is to have a prototype ready for regulatory review in about four years.

This device would combine existing pump therapy and continuous glucose monitoring (CGM) technology with sophisticated computer algorithms to help prevent dangerous, potentially life-threatening low blood sugar levels, as well as to help prevent complication-inducing high blood sugar levels.

"The artificial pancreas is one of the largest projects we've ever invested in," Alan Lewis, president and CEO of JDRF, said of the nonprofit's $8 million investment.

"We're optimistic that it will transform the way people with diabetes manage their blood sugar and reduce the risk of complications while we wait for a cure," Lewis said during a press conference announcing the partnership.

The artificial pancreas would primarily benefit people with type 1 diabetes, an autoimmune disorder that destroys the body's ability to manufacture insulin. People with type 1 diabetes must replace that lost insulin through injections, either with shots or by using an insulin pump. However, it's difficult to know exactly how much insulin you need, and people with diabetes must constantly check their blood sugar to make sure it's not too high or too low. Numerous factors, such as exercise, illness and even stress, can affect blood sugar levels.

"Even the most sophisticated people with diabetes only spend 30 percent of the time in their blood sugar range, and it's often much less than that," said Aaron Kowalski, research director of the Artificial Pancreas Project at JDRF.

"Whether you have a young child with diabetes or you're an adult with diabetes, it's very difficult. Type 1 is a 24-7, 365-days-a-year job. It's a real struggle and folks just want some relief. While our goal at JDRF is to find a cure and walk away, this is important while we wait and it's one of the biggest advances in diabetes management," Kowalski said.

The holy grail of diabetes management, short of a permanent cure, is a system that could take over all of the jobs that people with type 1 diabetes currently do themselves -- calculating the impact of food and exercise on insulin levels, as well as adjust for the glucose naturally produced in the body. Experts refer to this as a "closed-loop" system.

This initial artificial pancreas system, however, won't be able manage all of those tasks. People with diabetes will still need to input the amount of carbohydrates they're eating so the insulin pump knows how much insulin is needed, and manual blood sugar checks will still be necessary to confirm the CGM readings.

"Trying to mechanically reproduce the human pancreas is going to be very difficult," said Dr. Henry Anhalt, a pediatric endocrinologist and medical director at Animas. That's why the initial system is going to attempt to prevent serious highs and lows in blood sugar levels. "It's a step towards the perfection we're seeking and will significantly improve the quality of life," he said.

Both Anhalt and Kowalski said the initial system will help give parents and people with diabetes some peace of mind.

"For a parent to be able to get some sleep, knowing a child's blood sugar won't go too high or low, is truly revolutionary," said Anhalt.

Although the exact configuration of the new device hasn't been settled, it will combine an Animas insulin pump with a DexCom CGM system that will wirelessly transmit information to the pump. The pump will be programmed with sophisticated mathematical algorithms that will instruct it to stop insulin delivery if the CGM senses that the blood sugar levels are dropping, or to increase insulin delivery if the CGM senses that blood sugar levels are rising unexpectedly.

Of the announcement, Dr. Neslihan Gungor, a pediatric endocrinologist at Scott and White Memorial Hospital in Temple, Texas, who is not involved in the project, said, "There is much progress going on, and hopefully we will have that closed loop system someday. And, this gives me hope for the future."

"Every day in our clinic, we ask parents to check so many blood sugars a day and they always have to keep so many factors in mind. How much is my child going to eat? Is he or she going to exercise? What is the current blood sugar? If someone could develop an algorithm that could keep all these things in mind, that would be great, and it would make daily life easier," Gungor said.

More information

To learn more about the artificial pancreas, visit the Juvenile Diabetes Research Foundation.

SOURCES: Neslihan Gungor, M.D., pediatric endocrinologist, Scott and White Memorial Hospital, Temple, Texas; Jan. 13, 2010, press conference, New York City, with Alan Lewis, Ph.D., president and CEO, Juvenile Diabetes Research Foundation (JDRF); Aaron Kowalski, Ph.D., assistant vice president for glucose control research, and research director, artificial pancreas project, JDRF; Henry Anhalt, D.O., medical director, Animas Corp.

Last Updated: Jan. 14, 2010

Copyright © 2010 ScoutNews, LLC. All rights reserved.

Friday, January 8, 2010

The one-off, one-hour treatment that can cure blindness

From the UK's Daily Mail
By Oona Mashta
Last updated at 10:04 PM on 19th December 2009

Early symptoms of wet AMD can be as terrifying as they are debilitating - faces are blurred, blind spots appear in the centre of vision and straight lines seem to waver. If left untreated, patients can lose their sight within three months.
Wet AMD (age-related macular degeneration) is an aggressive, rapidly developing condition in which abnormal blood vessels form in the macula, the part of the eye responsible for vision, resulting in scarring.
It is also the leading cause of blindness in those over 60. Wet AMD is usually seen in this age group and genetics are thought to play a major role, although smoking and exposure to sunlight are also risk factors.
However, a new NHS treatment is offering hope to the 250,000 UK sufferers. The revolutionary surgical procedure uses beams of radiation to destroy the abnormal blood vessels at the back of the eye that are the cause of sight loss.
Currently, patients suffering from AMD are treated with regular injections of a drug into the eyeball.
These are required up to every month, usually for the rest of their life.
With the new procedure, called epimacular brachytherapy, surgeons thread a probe into the eye until it reaches the abnormal area in the retina. They then give a precisely timed dose of radiation in a beam just 5.4mm wide.
Research into epimacular brachytherapy shows the radiation is safe. Unlike previous forms of radiation therapy for wet AMD, the peak dose is targeted directly to the abnormal vessels, minimising damage to healthy surrounding tissue.
The one-hour operation is carried out as a day-case ophthalmology surgical procedure under local anaesthetic.
Tim Jackson, consultant eye surgeon at King's College Hospital in London, says: 'This is a relatively straightforward procedure. And unlike the injections, which need repeating on a regular basis, the beauty of this technique is that it is a one-off treatment.
'By killing the abnormal blood vessels that cause the problem, you can produce a permanent benefit rather than just suppressing the disease.'
The most common side effect is that it can speed up the development of cataracts in patients who have not undergone cataract

The technique, now available on the NHS, is being trialled on 363 patients at 15 hospitals around the country. Researchers are appealing for more participants. The radiation therapy costs about £6,000 privately. So far, the results have been encouraging. Preliminary studies show that 91 per cent of patients maintain vision.
One success story is that of Margaret Findlay, 84, from South London. Margaret had always been staunchly independent, so when two years ago she rapidly started to lose her sight, it was all the more difficult to come to terms with.
Within weeks, she had to give up driving and ask family and friends for help with chores, especially shopping.
'My eyesight deteriorated so quickly it was devastating. I had to ask for lots of help,' she says. 'I also had to give up my other passion of reading, which was a great pity because all my life I've loved books - I'll read anything in print.'
When she saw her GP in February 2007, he referred her to Mr Jackson, who diagnosed wet AMD. He offered her epimacular brachytherapy.
'I jumped at the chance,' says Margaret. 'My attitude is that if you get the opportunity of a potential remedy, you take it. I went straight ahead and signed the consent forms.'
After the procedure, in May 2007, Margaret could see perfectly straight away, and within weeks she was back behind the wheel. She says: 'I suffered no pain. It was such a relief to get my independence back.'
• Patients who want to participate in the trial should visit

Saturday, January 2, 2010

The amazing new operation that means anyone can see in HD

From the UK's Daily Mail:

By Alice Grebot
Last updated at 2:49 AM on 06th December 2009

The first artificial lens implant to treat cataracts was carried out in London just over 60 years ago. Pioneered by ophthalmic surgeon Sir Harold Ridley, it was a concept that would go on to save the sight of millions.
Now, a groundbreaking new type of lens has been developed that can be adjusted to give a patient perfect vision after it has been inserted into the eye.
Made from a unique material, the lens has the ability to change shape when a certain strength of laser light is shone on to it, meaning it can be tailored to an individual patient's needs - whether they have cataracts or are long or short-sighted, or have astigmatism, for example. This is a condition that causes blurred vision due to the front of the eye not being a regular shape.
Surgery using the innovative light-adjustable lens (LAL), developed by a US company and a Nobel prize-winning scientist, has been carried out on the first patients in the UK in the past few weeks by consultant ophthalmic surgeon Mr Bobby Qureshi.
'You can virtually promise people who have cataract surgery that they will have perfect vision, whereas before that hasn't been possible,' says Mr Qureshi. 'What's more exciting is that some people may even achieve "super vision", which is better than 20/20 (normal vision).
'Every eye has microscopic imperfections that can limit vision. With this lens, we can correct these and potentially give people high-definition vision.'
He says: 'This is an incredible operation. It is probably the biggest breakthrough in cataract surgery for decades. I feel so fortunate to be pioneering it in the UK. This has raised the bar of cataract surgery to a whole new level.'
A cataract is the clouding of the lens, the part of the eye that helps focus light on to the retina to form an image. As the lens ages, it starts to turn yellow and cloudy. Light is unable to pass through to the retina and vision becomes blurred. Left untreated, cataracts can lead to blindness.
About a third of people in the UK over 65 have cataracts in one or both eyes. Typically, treatment is a replacement lens implant but perfect vision could not be guaranteed - until now.
Mr Qureshi, who specialises in cataract surgery and lens implants, explains: 'Cataract surgery is one of the most common surgeries performed worldwide. We do around 300,000 in Britain each year on the NHS alone.
'Traditionally, it involves the insertion of monofocal lenses - these improve distance vision but have only a single focus, so patients will still need glasses for reading and the majority have some residual long sight, short sight or astigmatism, which means glasses are required
'Ten years ago, multifocal implants came along, offering patients better vision for both near and distance. But many are still left with residual astigmatism and require laser eye surgery, or still need to use glasses.
'Part of the reason for this is that due to their design multifocal lenses can cause lights to glare at night. They also don't correct intermediate vision very well. The difference with the LAL is that for the first time we can put a lens into the eye and change the strength of it from outside the eye via a computer.'
Mr Qureshi says the LAL will also help anyone with presbyopia (age-related long-sightedness) - something that begins around the age of 40 and affects everyone at some point. The procedure can remove the need for glasses altogether.
'Potentially, anyone over 40 who wears glasses could have total freedom from them with this operation and possibly sharper vision than could ever have been achieved before,' says Mr Qureshi.
The key with the LAL is the unique materials called 'macromers' embedded in the make-up of the lens. When UV light of a specific wavelength is shone into the eye, they group together, producing a swelling that changes the lens curvature. In other words, the lens can be reshaped precisely for each patient's needs.
So far, 1,000 patients have been operated on worldwide and the first cases in the UK were done three weeks ago by Mr Qureshi, who works at the private London Eye Hospital.
He performs the procedure - which is carried out under local anaesthetic and takes ten to 15 minutes - by making a 2mm incision in the eye. Through this, the cloudy lens is fragmented using high-frequency ultrasound and is removed through a fine tube.
The LAL is rolled up and inserted through the same incision. It unfolds once inside the eye.
Mr Qureshi says: 'In just a couple of hours, patients should notice an improvement in their vision - often even better than it was before their eye problems.

How the made-to-measure lens works

1. The 15-minute procedure is carried out under local anaesthetic. A 2mm incision is made in the eye. Through this, the cloudy lens is fragmented using high-frequency ultrasound. This is then removed through a fine tube.

2. The light-adjustable lens (LAL) is rolled up and inserted through the same incision. It unfolds once inside the eye.
'But certainly by the time I see patients a few days later, their vision is already at 90 per cent.'
The next step is the adjustment, which is done ten days to a fortnight after the lens implant. Once Mr Qureshi has evaluated the patient's vision, he or she will be seated with their chin resting on a support, much like during a normal eye test.
A sophisticated computer then shines beams of UV light into the eye and on to the lens for about 90 seconds, changing its shape. A few days later, the patient returns for any finetuning, after which, using further beams of light, the LAL is 'locked in' to position.
Mr Qureshi says the procedure does not carry significantly more risks than traditional cataract surgery. But because the light can make a patient's eyes susceptible to UV light until the LAL is locked in, they must wear protective glasses.
They must also use anti-inflammatory and antibiotic eye drops for four to six weeks.
The hope is that the operation will eventually be available on the NHS. In the meantime, it costs about £3,000 privately.
Part-time nurse Gill Balfour, 61, from Epsom, Surrey, was one of the first in the UK to have the LAL. For the past ten years she has been wearing glasses or contact lenses to correct presbyopia.
'Mr Qureshi explained all about the LAL and I did my own research. I was really excited about having it done,' she says.
Gill opted for blended vision rather than a multifocal lens and had a predominantly distance lens implanted in her left eye about three weeks ago. It has now been locked in. Next week, she will have a predominantly near lens inserted into her right eye.
Gill says the vision in her left eye improved dramatically as soon as the lens was inserted.
'I had to wear a protective patch overnight. But as soon as I removed it the following day, I could tell immediately that the vision in that eye was better. Everything was brighter. I suddenly saw the world in a different light.
'Through the new lens, I realised that white looked really white, whereas through my right eye it was slightly yellow.
'Through my left eye, I can now read the smallest line of letters on an eye chart, which is two lines better than normal vision. Before, without glasses or contacts, it would have been a complete blur.
'The amazing thing is that these lenses will last for the rest of my life.'