'Yoga, pranayam can do wonders to a singer's voice quality'

In terms of lineage it does not get better than this. Kaivalya Kumar Gurav is the third generation singer of the renowned Kirana gharana who is not just taking forward his legacy but has enriched it by his extensive work in this sphere. He was in the city to perform at the three-day Swarsangam sangeet mahotsav, and spoke to TOI on the sides of the event.
After a degree in engineering, he pursued his B.Com before doing his graduation and post-graduation in music. "I was a late convert only interested in disco music in my youth," he says. But that began changing when he started singing Marathi natya sangeet at various events. "At this time I realized that I had to go the whole way," he says.
Once he took up classical music in right earnest he began understanding the various difficulties and the negatives of this genre. "The reasons why audiences find classical concerts so dreary dawned upon me. I began my research in voice culture and worked on tonal qualities of a singer and methods by which he or she would not have to contort facial muscles," he says.
His work in this field has yielded results. "I have mastered the areas of how to prepare a voice for classical singing. I know how a singer can work his abdomen for base and how when breathing through the abdomen is cut the voice gets a tonal quality," he says.
Famous for his speed taans, complicated blandish, imaginative approach to his music and the aesthetics of his presentations, Kaivalya Kumar says that he has the technique for making classical music interesting and understandable. "Yoga, pranayam and meditation works wonders for a classical singer. Today I can guarantee that by practising these techniques a classical singer can be ready to take the stage in less than five years," he says.
Dismissing the belief that artists who render compact version of a raag tamper with its purity, he says, "Ustad Abdul Karim Khan, the founder of Kirana gharana could deliver a raag in less than two minutes. I have rare records dating back to 1902 to prove this. What is required is the right approach."
Saluting the maestros like Pt Bhimsen Joshi and Kumar Gandharv, Gurav said that these artists would first understand the vibrations of the venue where they were to perform and type of the audience before deciding upon what to sing. "Today singers come prepared and give a recital without understanding the requirements of the audience," he says.
Source:TNN

Begin Your Day With Eggs If You Want To Lose Weight

Beginning your day with eggs is the best way for those who want to lose weight. 
A major UK review of studies into the effects of eating eggs has found that egg contains a powerful ingredient that can help to cut the amount of calories people go on to eat at lunch and dinner.
Scientists say boiled, fried, poached or scrambled, eggs keep people fuller for longer compared with other common breakfast foods.
This appears to help people who are desperately trying to resist tempting but naughty afternoon snacks such as biscuits, cake or chocolate.
The review, published in the journal Network Health Dietitian, also revealed that the specific proteins found in eggs are far superior to other types when it comes to keeping hunger at bay.
Dietitian Dr Carrie Ruxton examined the results of six different studies over eight years.
The studies show a consistent effect on satiety and short-term energy intake. Two studies found changes in appetite-related gut hormones, which may explain why egg-eaters feel full.
A single, longer-term study revealed that people who ate an egg breakfast rather than having cereal had a significantly greater weight loss and lost inches around the waist.
"While more research is needed, particularly on long-term weight loss, the evidence suggests a promising role for eggs in weight management," the Daily Express quoted Dr Ruxton as saying.
He also noted two additional benefits of including eggs in a weight loss diet.
The first is portion control. Dr Ruxton said that since eggs come in a fixed unit of around 78 calories per egg, this helps people to recognize how much they have consumed.
Secondly, he said, the vitamin D content of eggs may help to support general health in overweight people since vitamin D levels are known to be low in this group, leading to an increased risk of diabetes and heart disease.
"There are few natural sources of vitamin D in the diet so eggs can play a role here too," he added.
An average egg contains a high level of protein at 6.5g, representing 13 per cent of an adult's daily requirement.
Source-ANI
 

Gene expression test identifies low-risk thyroid nodules

Penn Medicine editorial suggests 25,000 unnecessary surgeries can be avoided

 A new test can be used to identify low-risk thyroid nodules, reducing unnecessary surgeries for people with thyroid nodules that have indeterminate results after biopsy. The results of the multi-center trial, which includes researchers from the Perelman School of Medicine at the University of Pennsylvania, appear online in the New England Journal of Medicine.

Ultrasound-guided fine-needle aspiration biopsies (FNA) accurately identify 62-85 percent of thyroid nodules as benign. For those deemed malignant or unclassifiable, surgery is currently required. However, about 20-35 percent of nodules have inconclusive results after FNA. This novel test classifies genes from the thyroid nodule tissue obtained through FNA.

"This test, currently available at Penn Medicine, can help us determine whether these nodules with indeterminate biopsy results are likely to be benign," said Susan Mandel, MD, MPH, professor of Medicine in Endocrinology, Diabetes and Metabolism in the Perelman School of Medicine at Penn."If so, patients may be able to avoid unnecessary surgeries and lifelong thyroid hormone replacement treatment."

In an accompanying NEJM editorial, J. Larry Jameson, MD, PhD, Dean of the Perelman School of Medicine and Executive Vice President for the Health System at the University of Pennsylvania, notes that the gene expression test is able to identify nodules at low risk of malignancy, making it possible to avoid approximately 25,000 thyroid surgeries per year. "In this era of focusing on high-quality outcomes at lower cost, this new gene expression classifier test is a welcome addition to the tools available for informed decision making about the management of thyroid nodules," writes Jameson.

The gene expression classifier was tested on 265 indeterminate thyroid nodules, and was able to correctly identify 92 percent of cases as suspicious. The test demonstrated a 85 - 95 percent negative predictive value, effectively ruling out a malignancy.

The Penn research team included Dr. Mandel, Zubair Baloch, MD, PhD, and Virginia A. LiVolsi, MD, both professors of Pathology and Laboratory Medicine. The investigation was funded by a research grant provided by Veracyte, Inc., the maker of the gene expression classifier.

Source:University of Pennsylvania School of Medicine 

The business called “modern medicine

There are hundreds of anecdotes and data to show that we are often taken for an expensive and life-threatening ride by the business complex of research, doctors, hospitals, medicines and medical equipment.ery in the US has the same potential for graft and corruption as casino gambling and construction rackets" wrote Lisa Van Dusen in theCanadian Medical Journal in 1997. I wanted to review this statement in today's scenario.

Just as I was sitting down to write this piece, I happened to glance at a beautiful book Bottom Line Medicine by Richard K Stanzack. The author had been a registered nurse in the US medical system and he came out after getting disgusted. The amount of research he has done to write this authentic book fascinated me as he was not privy to those documents as a nurse. That might be his advantage as we doctors are being spoon-fed by company representatives who get us the best medical literature that one could hope to get in addition to the free conferences and lectures that they provide us with.

The case of the missing data is an excellent medical satire written on the lines of Sir Arthur Connon Doyle's Silver Blaze (Penguin classic 1981) in the British Medical journal by James Le Fanu, a family physician in London. This sums up the present scenario. "Risk factor screening for major diseases such as cardiovascular disease, alcohol abuse,diabetes mellitus raised cholesterol and breast cancer, and subsequent treatment of the detected risk factors/diseases in the The Malmö Preventive Project did not reduce total mortality in the intervention group as a whole." Malmo was the famous study which follwed the trial subjects for a very long time in Europe. "Epidemiologic data, however, consistently show a continuous, positive, linear relationship of the height of both systolic and diastolic blood pressure with the incidence of stroke and heart attack. No threshold level distinguishes those who will have a cardiovascular event from those who will not. In fact, most heart attacks and many strokes occur among persons with 'normal' blood pressures," writes Michel Alderman commenting on almost all the major studies in the field.My own analysis of the 17 major studies of hypertension treatment with drugs, some of them followed up for nearly 20 years, showed how we are taken for a ride. There are three ways one can sell research results in medical interventions: relative risk reduction, absolute risk reduction and number needed to be treated to get that benefit. In the 17 hypertension drug treatment trials thus analysed the relative risk reduction was very impressive to sell but does not mean anything for the practising doctor on the ground. But that is exactly what is being shown in mainline journal articles and company literature. In the analysis reported in the BMJ of 18 June 2002, researchers claim clinical trials are reported with misleading statistics. The table below is theirs.

To give an example, if the statistically anticipated death in five years in a group of 1,000 research subjects with hypertension is 10 (how to estimate this God only knows) and if that is reduced to five by our treatment, the study would record that as 50% reduction in death by the drugs concerned! Very impressive indeed! The truth, however, is that there has been a statistical reduction of five deaths in 1,000 apparently healthy adults in five years by our treatment, which works out to an absolute death reduction of  0.05%-almost negligible. The latter is the absolute risk reduction. Similarly, the MRC study of mild to moderate hypertension showed that to "save one possible stroke in the next five years, we have to treat 850 healthy people with anti-hypertensive drugs for a period of five years with all the risks of adverse drug reactions!" The chart below shows the causes of death in MRFIT (Multiple Risk Factor Intervention trial) data which is self-explanatory. At the end of the day the balance sheet was that intervention was not worth it from our point of view and was a curse from the patients' point of view. The final death tally was not statistically significant.MRFIT data after 16 years follow up of thousands of subjects on hypertension treatment

Roger Sherwin is the Chair of epidemiology at Tulane after having been at Cambridge, Johns Hopkins, etc, who was involved with most of the major studies of interventions has this to say at the end of it all. "In other words, we found that changing the "risk factors" does not apparently change the risks. This necessarily means that the "risk factors" are not as important as was thought. Indeed, it should be concluded that the "risk factors" were no such thing, at least as far as this trial (MRFIT) is concerned.The story is similar for diabetes, cancer, and even drug interventions of AIDS! Maggie Mahar's Money Driven Medicine is another great book from where I have lifted the following lines in italics (mine) that sums up the whole book which has facts and figures with authentic cross references. "What the manifold tales, stats, and interviews illuminate is a system almost irreversibly infected by money. The story here is one of market failure, of a peculiar sector where the drive for profit demands not efficiencies and innovations, but volume and market share. That may be fine when we're talking widgets, but when it means more heart surgeries, less time with patients, more collusion with drug companies, and higher prices for less care-well, even Adam Smith would feel a little ill. But believe me, he'd think twice before summoning the ambulance."Does all this mean that doctors should close shop and go hunting? Never ever! Doctors were needed in the past; they are vital today and will be relevant for all times to come as long as there are patients. How do the two statements that I have made above go hand in hand? A recent study in the British Medical Journal showed that even in major surgical procedures it is the placebo doctor effect that was important to the extent of nearly two-thirds of the times. This brings back to memory the famous quotation from Oliver Wendell Holmes that the "two most powerful drugs that medicine ever discovered are the two kinds words of a good doctor."  Good doctors are the need of the hour.Even a major event like total myocardial revascularization (like bypass surgery ) study "showed that those that had the surgery got relief from pain but also those that were told that they had a successful surgery but never had any surgery done had equally benefited from pain. Moreover, at the end of five years the sham operation group's blood supply had become normal on scanning," wrote Roger Laham, one of the researchers and the director of angiogenesis laboratory at Harvard. The study did show that the operation was more of a sham and what worked was the faith in the doctor that assured them that their operation was a success." Most of our interventions, including surgery in many areas, have not been shown to do good to our patients. How are the patients relieved of their troubles after the interventions? They were relieved because they believed in their doctors and had faith in them. They survived inspite of interventions but because of their doctors.This boils down to spirituality in medicine. Spirituality has nothing to do with religion. On the contrary, spirituality is simply sharing and caring. James F Peabody was a great doctor at the Mass General Hospital and wrote this note in 1927 that became the major motto of that hospital even to this day. He said that "patient care is caring for the patient." That is true spirituality. After all who heals the sick?A great surgeon like Michel De Bakey, who died recently at the ripe old age of 96, who could innovate major surgical feats during his life at Baylor would have accepted the fact that he could only stitch the wound but could never heal the same. The scientific proof of that statement of mine, if such a proof was ever needed, could be guessed from this question. Could any surgeon, including Michel De Bakey, make a great operation heal in a dead body? Healing occurs in a living body only. What then is the difference between the living body and that of the dead? The dead do not breathe! Breath (spires in Latin) is the root of the word spirituality according to our cave dwelling ancestors. The latter thought, in their wisdom, that there was one difference between their living brethren and the dead ones. The dead did not breathe. They surmised, very scientifically compared to our epidemiological science that breath entered the body at birth and left the body at death. They wrongly drew the wrong conclusion that breath was God and the word spirituality thus connects to God and religion.That is the conclusion of all our studies in modern medical science today. "Passion makes some of the best observations but, draws, many times, most wretched conclusions" wrote John von Neumann years ago. Our research has made some wonderful observations but we have drawn wrong conclusions from those studies. Let us change the science of medicine from the reductionist science of linearity that we discussed above to that of the future science of chaos and holism as was elegantly shown by Professor David Eddy, a former professor of cardiovascular surgery at Stanford converted to a mathematician, to get at the right holistic science for medicine in his ground-breaking research work which could be accessed by readers on www.archimedesmodel.com.By:Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS. He is also editor-in-chief of the Journal of the Science of Healing Outcomes, chairman of the State Health Society's Expert Committee, Govt of Bihar, Patna. He is former vice chancellor of Manipal University at Mangalore and former professor for Cardiology of the Middlesex Hospital Medical School, University of London. Prof Dr Hegde can be contacted at hegdebm@gmail.com

Years before diagnosis, quality of life declines for Parkinson's disease patients

Research published in the Journal of Parkinson's Disease

 Growing evidence suggests that Parkinson's disease (PD) often starts with non-motor symptoms that precede diagnosis by several years. In the first study to examine patterns in the quality of life of Parkinson' disease patients prior to diagnosis, researchers have documented declines in physical and mental health, pain, and emotional health beginning several years before the onset of the disease and continuing thereafter. Their results are reported in the latest issue of Journal of Parkinson's Disease.

"We observed a decline in physical function in PD patients relative to their healthy counterparts beginning three years prior to diagnosis in men and seven and a half years prior to diagnosis in women," says lead investigator Natalia Palacios, PhD, Department of Nutrition, Harvard School of Public Health. "The decline continues at a rate that is five to seven times faster than the average yearly decline caused by normal aging in individuals without the disease."

The study included 51,350 male health professionals enrolled in the Health Professionals Follow Up Study (HPFS) and 121,701 female registered nurses enrolled in the Nurses' Health Study (NHS). In both ongoing studies, participants fill out biannual questionnaires about a variety of lifestyle characteristics and document the occurrence of major chronic disease. In the NHS study, questionnaires measured health-related quality of life in eight areas: physical functioning, role limitations due to physical problems, role limitations due to emotional problems, vitality, bodily pain, social functioning, mental health, and general health perceptions. In the HPFS, only physical functioning was assessed.

Researchers identified 454 men and 414 women with PD in the two cohorts. At 7.5 years prior to diagnosis, physical function among PD cases, in both men and women, was comparable to that in the overall cohort. A decline began approximately 3 years prior to diagnosis in men and approximately 7.5 years prior to diagnosis in women. Physical function continued to decline thereafter at a rate of 1.43 and 2.35 points per year in men and women, respectively. In comparison, the average yearly decline in individuals without PD was 0.23 in men and 0.42 in women. Other measures of quality of life, available only in women, declined in a similar pattern.

Dr. Palacios notes that a strength of the study is the availability of prospective data on both PD patients and a healthy comparison group, and the ability to chart the deterioration in functioning and quality of life over the whole study follow-up, which included many years prior to diagnosis.

"This result provides support to the notion that the pathological process leading to PD may start several years before PD diagnosis," says Dr. Palacios. "Our hope is that, with future research, biological markers of the disease process may be recognizable in this preclinical phase."

Source:Eurekalert

Scientists develop mouse model that could lead to new therapies for liver cancer

Researchers have created the first mouse model demonstrating the role of a cancer promoting gene, Astrocyte elevated gene-1 (AEG-1), in hepatocellular carcinoma, or liver cancer. The mouse model represents a critical step in understanding the molecular mechanisms of liver cancer progression and could lead to novel therapies for the disease.

Insights from the mouse model were recently published in the journal Hepatology by a team of researchers led by Devanand Sarkar, M.B.B.S., Ph.D., Harrison Scholar at Virginia Commonwealth University (VCU) Massey Cancer Center, Blick Scholar and assistant professor in the Department of Human and Molecular Genetics and member of the VCU Institute of Molecular Medicine (VIMM) at VCU School of Medicine. AEG-1 was originally cloned in the lab of the study's co-author, Paul B. Fisher, M.Ph., Ph.D., Thelma Newmeyer Corman Endowed Chair in Oncology Research and program co-leader of Cancer Molecular Genetics at Massey, professor and chair of the Department of Human and Molecular Genetics and director of VIMM.

"My colleagues and I have been researching the role of AEG-1 in cancer development for several years and have shown it is linked to a diverse array of cancers, including liver cancer," says Sarkar. "This mouse model represents a breakthrough in our ability to test and translate our laboratory findings."

The mouse model gave the researchers a deeper understanding of the role of AEG-1 in liver cancer. Sarkar and his team confirmed AEG-1 overexpression significantly accelerated the progression of liver cancer. It also caused steatosis, or fatty liver, a mechanism that promotes inflammation and cancer progression. In addition, the mouse model substantiated laboratory findings that suggested that AEG-1 plays a role in protecting liver cancer cells from chemotherapeutic drugs and alters tumor angiogenesis, or the way that new blood vessels are formed within the tumor.

The researchers plan to use the model to further explore the molecular mechanisms by which AEG-1 promotes liver cancer, including the role of AEG-1 in fat metabolism and obesity-related diseases.

"This model moves us forward in the research process by allowing us to test a variety of compounds that could inhibit AEG-1 and prevent the development and progression of liver cancer," says Sarkar. "Ultimately, we hope our efforts will lead to new therapies and save lives."

Source:Virginia Commonwealth University 

Personalized Medicine for Parkinson's Disease

infoZine - Researchers have taken a step toward personalized medicine for Parkinson's disease, by investigating signs of the disease in patient-derived cells and testing how the cells respond to drug treatments. The study was funded by the National Institutes of Health.
The researchers collected skin cells from patients with genetically inherited forms of Parkinson's and reprogrammed those cells into neurons. They found that neurons derived from individuals with distinct types of Parkinson's showed common signs of distress and vulnerability -- in particular, abnormalities in the cellular energy factories known as mitochondria. At the same time, the cells' responses to different treatments depended on the type of Parkinson's each patient had.
The results were published in Science Translational Medicine.
"These findings suggest new opportunities for clinical trials of Parkinson's disease, in which cell reprogramming technology could be used to identify the patients most likely to respond to a particular intervention," said Margaret Sutherland, Ph.D., a program director at NIH's National Institute of Neurological Disorders and Stroke (NINDS).
A consortium of researchers conducted the study with primary funding from NINDS. The consortium is led by Ole Isacson, M.D., Ph.D., a professor of neurology at McLean Hospital and Harvard Medical School in Boston. 
The NINDS consortium's first goal was to transform the patients' skin cells into induced pluripotent stem (iPS) cells, which are adult cells that have been reprogrammed to behave like embryonic stem cells. The consortium researchers then used a combination of growth conditions and growth-stimulating molecules to coax these iPS cells into becoming neurons, including the type that die in Parkinson's disease.
Parkinson's disease affects a number of brain regions, including a motor control area of the brain called the substantia nigra. There, it destroys neurons that produce the chemical dopamine. Loss of these neurons leads to involuntary shaking, slowed movements, muscle stiffness and other symptoms. Medications can help manage the symptoms, but there is no treatment to slow or stop the disease.
Most cases of Parkinson's are sporadic, meaning that the cause is unknown. However, genetics plays a strong role. There are 17 regions of the genome with common variations that affect the risk of developing Parkinson's disease. Researchers have also identified nine genes that, when mutated, can cause the disease.
Dr. Isacson and his collaborators derived iPS cells from five people with genetic forms of Parkinson's disease. By focusing on genetic cases, rather than sporadic cases, they hoped they would have a better chance of seeing patterns in the disease process and in treatment responses. Three of the individuals had mutations in a gene called LRRK2, and two others were siblings who had mutations in the gene PINK1. The researchers also derived iPS cells from two of the siblings' family members who did not have Parkinson's or any known mutations linked to it.
Because prior studies have suggested that Parkinson's disease involves a breakdown of mitochondrial function, the researchers looked for signs of impaired mitochondria in patient-derived neurons. Mitochondria turn oxygen and glucose into cellular energy. The researchers found that oxygen consumption rates were lower in patient cells with LRRK2 mutations, and higher in cells with the PINK1 mutation. In PINK1 mutant cells, the researchers also found increased vulnerability to oxidative stress, a damaging process that in theory can be counteracted with antioxidants.
Next, the researchers tested if neurons derived from patients and healthy volunteers were vulnerable to a variety of toxins, including some that target mitochondria. Compared to neurons from healthy individuals, patient-derived neurons were more likely to become damaged or die after exposure to mitochondrial toxins. Patient-derived neurons also suffered more damage from the toxins than did patient-derived skin cells.
Next, the researchers attempted to rescue the toxin-exposed cells with various drug treatments that have shown promise in animal models of Parkinson's, including the antioxidant coenzyme Q10 and the immunosuppressant rapamycin. All patient-derived neurons -- whether they carried LRRK2 or PINK1 mutations -- had beneficial responses to coenzyme Q10. However, the patient-derived neurons differed in their response to rapamycin; the drug helped prevent damage to neurons with LRRK2 mutations, but it did not protect the neurons with PINK1 mutations. 
These results hint that iPS cell technology could be used to help define subgroups of patients for clinical trials. To date, interventional trials for Parkinson's disease have not focused on specific groups of patients or forms of the disease, because there have been few clues to point investigators toward individualized treatments. Although the current study focused on genetic forms of Parkinson's, iPS cell technology could be used to define disease mechanisms and the most promising treatments for sporadic Parkinson's as well.
The NINDS Parkinson's Disease iPS Cell Research Consortium is one of three such consortia funded by NINDS. One of the consortia is focused on developing iPS cells for the study of Huntington's disease, and another focuses on amyotrophic lateral sclerosis (ALS) and frontotemporal dementia. 
The Huntington's disease consortium recently reported successful derivation of iPS cells and iPS-generated neurons from patients. Cells from patients with both early and later onset disease showed severe defects in physiology, metabolism, and cell viability, compared to cells from healthy volunteers. These results were reported in the June 28th issue of Cell Stem Cell. The consortium is led by led by Leslie Thompson, PhD, a professor of psychiatry and human behavior at the University of California, Irvine. 
Skin cell and iPS cell lines developed by the consortia are available to both academic and industry researchers through the NINDS human cell line repository at the Coriell Institute. To date the NINDS repository has distributed more than 200 cell lines worldwide.
Source:Infozine.com

Avocado, Olive Oil Triple Chances of IVF Success

Foods typically eaten as part of the Mediterranean diet help triple the chances of success for women trying to have a baby through IVF.
A study found monounsaturated fat - found in olive oil, sunflower oil, nuts and seeds - was better than any other kind of dietary fat for would-be mothers.
Those who ate the highest amounts were 3.4 times more likely to have a child after IVF as opposed to those who ate the lowest amounts.
In contrast, women who ate mostly saturated fat, found in butter and red meat, produced fewer good eggs that could be used in fertility treatment.
US researchers behind the study believe that monounsaturated fats - which are already known to protect the heart - could improve fertility by lowering inflammation in the body.
"The best kinds of food to eat are avocados, which have a lot of monounsaturated fat and low levels of other sorts of fat, and olive oil," the Daily Mail quoted study leader Professor Jorge Chavarro as saying.
Prof. Chavarro said that the study was small, but the findings required further investigation.
"While these results are interesting, this is the first time to our knowledge that dietary fats have been linked to treatment outcome in IVF," he said.
He said that higher levels of monounsaturated fat were linked to higher live birth rates, which 'ultimately people are looking for'.
The study took place among 147 women having IVF at the Massachusetts General Hospital Fertility Center.
Their intake of different dietary fats was recorded and the result of fertility treatment compared between the highest and lowest third of intake in each category.
Women eating the highest levels of all types of fat had fewer good eggs available for use in treatment.
Prof Chavarro said that the link was driven by saturated fat intake, as high levels of polyunsaturated fat consumption lead to production of poorer quality embryos.
Higher intakes of monounsaturated fat were linked to a 3.4 times higher live birth rate than those with the lowest intake.
For those eating least, monounsaturated fat made up nine percent of calories in their diet while it comprised a quarter for those eating the most.
"Different types of fat are known to have different effects on biological processes which may influence the outcome of assisted reproduction - such as underlying levels of inflammation or insulin sensitivity," Prof Chavarro said.
"However, it is not clear at this moment which biological mechanisms underlie the associations we found," he added.
He insisted that fish remained a source of 'good' omega 3 fatty acids, although the research was unable to pin down its contribution.
The study was presented at the European Society of Human Reproduction and Embryology in Istanbul.
Source-ANI 

Prevention is better than cure for killer cardiovascular disease

 European experts in cardiovascular medicine will today gather at a two day symposium to address the national agenda on cardiovascular disease prevention, held at Imperial College London and sponsored by leading independent academic and professional publisher SAGE.

One session at the conference, chaired by Professors Joep Perk and David Wood will focus on the new 2012 Joint European Societies' Guidelines on cardiovascular disease prevention in clinical practice, which will appear in August issue (volume 19, issue 4) of the European Society of Cardiology'sEuropean Journal of Preventive Cardiology, published by SAGE.

Our chances of succumbing to cardiovascular disease (CVD) are strongly connected to our lifestyles. Smoking, an unhealthy diet, physical inactivity, and stress can all take their toll. According to The World Health Organization (WHO), over three-quarters of all CVD mortality could be prevented with adequate lifestyle changes.

CVD prevention is a society-wide effort, and needs a co-ordinated set of actions at both public and individual level. Health experts use cardiovascular epidemiology and evidence based medicine to uncover the most effective paths to prevention.

In the new joint European Guidelines, healthcare providers will find answers to key questions including:

• What is CVD prevention?
• Why is it needed?
• Who should benefit from it?
• How can CVD prevention be applied?
• When is the right moment to act?
• Where should prevention programmes be provided and implemented?

According to the experts behind the review, atherosclerotic CVD (furring of the arteries) remains the leading cause of premature death worldwide. CVD affects both men and women; of all deaths that occur before age 75 in Europe, 42% are due to CVD in women and 38% in men.

Prevention works. Over 50% of the reductions seen in coronary heart disease mortality relate to changes in risk factors, and 40% to improved treatments. This is a lifelong endeavour – we should begin efforts to prevent CVD from birth – if not before.

In terms of prevention, the experts say it's not just those most at risk that should be targeted. Education programmes aimed at the entire population are still needed. Even though there are some gaps in our understanding, there is ample evidence to justify intensive public health and individual preventive efforts.

We still need to better understand why both populations and individuals change their behaviour – exactly how changes in behaviour translate into changes in disease patterns is not always understood. More research, including research that goes right back to foetal development, is needed to better prevent CVD. We still don't know whether preventative measures can help us to completely avoid CVD, or whether these efforts merely delay its onset. We also need more data on CVD morbidity and mortality throughout the world.

This version of the joint guidelines updates the previous one issued in 2007. There is a greater focus on new scientific knowledge, and grading systems are deployed, which allow more evidence-based recommendations to be adapted to clinical practice's requirements.

The Fifth Joint Task Force (JTF) of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice, made up of representatives of nine societies plus invited experts, developed the new guidelines. The European Association for Cardiovascular Prevention & Rehabilitation (EACPR) also contributed. Experts from the nine organizations performed a comprehensive review and a critical evaluation of diagnostic and therapeutic procedures, including assessment of the risk benefit ratio. The level of evidence and the strength of recommendation of particular treatment options were weighed and graded according to ESC recommendations.

"The authors of the guidelines hope that this document will advocate a real partnership among politicians, physicians, allied health personnel, scientific associations, heart foundations, voluntary organizations, and consumers' associations. Using the complete spectrum of evidence in medicine from experimental trials to observations in populations, the aim is to foster both health promotion at the population level and primary and cardiovascular prevention at the clinical level" the JTF concluded.

Source:SAGE Publications 

Scientists discover an epigenetic cause of osteoarthritis

New research in the FASEB Journal suggests that DNA methylation is responsible for switching on and off a gene that produces the MMP13 enzyme that is known to be important in the destruction of cartilage

 In what could be a breakthrough in the practical application of epigenetic science, U.K. scientists used human tissue samples to discover that those with osteoarthritis have a signature epigenetic change (DNA methylation) responsible for switching on and off a gene that produces a destructive enzyme called MMP13. This enzyme is known to play a role in the destruction of joint cartilage, making MMP13 and the epigenetic changes that lead to its increased levels, prime targets for osteoarthritis drug development. In addition to offering a new epigenetic path toward a cure for osteoarthritis, this research also helps show how epigenetic changes play a role in diseases outside of cancer. This finding was recently published online in the FASEB Journal.

"As the population gets older, osteoarthritis presents increasing social and economic problems," said David A. Young, Ph.D., a researcher involved in the work from the Musculoskeletal Research Group at the Institute of Cellular Medicine at Newcastle University in Newcastle upon Tyne in the United Kingdom. "Our work provides a better understanding of the events that cause cartilage damage during osteoarthritis and provides hope that tailored drug development to prevent the progress of disease will improve the quality of life and mobility of many arthritis sufferers."

To make the discovery, Young and colleagues compared the extent to which DNA methylation was different in cartilage from patients suffering from osteoarthritis and healthy people of similar age. They found that at one small position, the gene for MMP13 had less DNA methylation in diseased patients. Then they confirmed that reduced methylation of this gene increases levels of the destructive enzyme MMP13.

"We've already seen how epigenetics has advanced our approach to cancer. Now we're seeing it with other diseases and even exercise." said Gerald Weissmann, M.D., Editor-in-Chief of the FASEB Journal. "This study not only lays the groundwork for a new understanding of osteoarthritis, but also shows that the old 'either/or' nature v. nurture argument is outdated: epigenetics teaches us that nature (the daily wear and tear of joints) regulates nurture (the genes in our cartilage) to cause arthritis."

Source:Federation of American Societies for Experimental Biology 

 

Algae extract increases good cholesterol levels, Wayne State research finds

Detroit - A Wayne State University researcher has found that an extract from algae could become a key to regulating cardiovascular disease.

In a study funded by Health Enhancement Products of Bloomfield Hills, Mich., Smiti Gupta, Ph.D., assistant professor in the department of nutrition and food science in the College of Liberal Arts and Sciences, has found that dietary intake of ProAlgaZyme increased the level of high-density lipoprotein (HDL) in an animal model.

While medications for the control of high plasma cholesterol levels such as statins and numerous dietary supplements primarily function by lowering levels of low-density lipoproteins (LDL), or "bad cholesterol," Gupta's research explores the effects of raising levels of HDL, or "good cholesterol," which work in part by carrying cholesterol out of the arterial wall.

Results of her study, titled "ProAlgaZyme and its Sub-fractions Increase Plasma HDL-Cholesterol via Up Regulation of ApoA1, ABCA1 and SRB1 and Inhibition of CETP in Hypercholesterolemic Hamsters," were published recently in the Journal of Nutrition and Dietary Supplements.

"The cholesterol mechanism is crucial to heart disease," Gupta said. "Very few agents increase good cholesterol, but we found that this algae extract does. The ratio of total to HDL cholesterol improved significantly. This result, if replicated in humans, would be consistent with a decreased risk of heart disease."

ProAlgaZyme, a clear liquid, was administered as part of the drinking fluid over four weeks. In addition to increasing HDL levels, the group found that it also changed the expression of genes involved in the reverse cholesterol transport mechanism. And while they don't know exactly how it will function in humans, Gupta said other research suggests a similar outcome.

"Its biological effect over time and toxic effects, if any, need to be further investigated in a long-term study in an animal model before testing its effects in humans," she said. "But this is a step in the right direction, since increased HDL is considered an important therapeutic target for improvement of the lipid profile and thus reduction of the risk for cardiovascular disease."

Source:

Wayne State University - Office of the Vice President for Research 

UC Davis study finds that above-normal weight alone does not increase the short-term risk of death

Severe obesity does increase mortality, but only with diabetes or hypertension

 An evaluation of national data by UC Davis researchers has found that extra weight is not necessarily linked with a higher risk of death.

When compared to those with normal weight, people who were overweight or obese had no increased risk of death during a follow-up period of six years. People who were severely obese did have a higher risk, but only if they also had diabetes or hypertension.

The findings, which appear in the July-August issue of The Journal of American Board of Family Medicine, call into question previous studies -- using data collected when obesity was less common -- linking higher short-term mortality with any amount of extra weight.

"There is currently a widespread belief that any degree of overweight or obesity increases the risk of death, however our findings suggest this may not be the case," said Anthony Jerant, professor of family and community medicine and lead author of the study. "In the six-year timeframe of our evaluation, we found that only severe obesity was associated with an increased risk of death, due to co-occurring diabetes and hypertension."

Based on the study, Jerant recommends that doctors' conversations with patients who are overweight or obese, but not severely obese, focus on the known negative effects of these conditions on mental and physical functioning, rather than on an increased short-term risk of death.

By contrast, Jerant added that it is important for doctors to talk with severely obese patients who also have diabetes or hypertension about their increased short-term mortality risk and treatment, including weight loss.

"Our results do not mean that being overweight or obese is not a threat to individual or public health," said Jerant. "These conditions can have a significant impact on quality of life, and for this reason alone weight loss may be advisable."

In conducting the study, Jerant used nationwide data from 2000 to 2005 of nearly 51,000 adults aged 18 to 90 years who participated in the Medical Expenditure Panel Surveys on health-care utilization and costs. The surveys include information on health conditions such as diabetes and hypertension.

Body mass index (BMI), or weight adjusted for height, was calculated for each respondent. The study categorized people as underweight (BMI < 20), normal weight (BMI 20 to < 25), overweight (BMI 25 to < 30), obese (BMI 30 to 35) or severely obese (BMI > 35).

Mortality was assessed using the National Death Index. Of the 50,994 people included in the UC Davis analysis, just over 3 percent (1,683) died during the six years of follow-up.

The investigators found that severely obese people were 1.26 times more likely to die during follow-up than people in the normal weight group. However, if people with diabetes or hypertension were eliminated from the data, those who were overweight, obese or even severely obese had similar or even lower death rates than people of normal weight. Consistent with a number of prior studies, underweight people were nearly twice as likely to die than people with normal weight, regardless of whether diabetes or hypertension was present.

The prevalence of overweight and obesity has increased dramatically in recent decades. An estimated one-third of all U.S. adults over age 20 are obese and another one-third are overweight. In addition to diabetes and hypertension, health problems associated with these conditions include heart disease, osteoarthritis and sleep apnea.

The relationship between weight and mortality is a controversial topic in public health. Although studies based on data collected 30 years ago showed that mortality risk rose as weight increased, analyses of more recently collected data, including the current one, call this assumption into question.

"Our findings indicate that the risk of having an above-normal BMI may be lower than in the past," said Jerant. "While this study cannot explain the reasons, it is possible that as overweight and obesity have become more common, physicians have become more aware of associated health issues like high blood pressure, cholesterol and blood sugar, and are more aggressive about early detection and treatment of these conditions."

Jerant said that the six-year period of his investigation limits the ability to make assumptions about the link between unhealthy weight and the risk of death over a longer timeframe.

"We hope our findings will trigger studies that re-examine the relationship of being overweight or obese with long-term mortality," said Jerant. 

Source:University of California - Davis Health System 

Seniors need more than medicine

A new study has found that although there has been an explosion in the scientific underpinning of modern medicine, gaps still remain in our knowledge when it comes to clinicians looking after patients' well being, especially for older people.
La Trobe University Adjunct Associate Professor Benny Katz, Australian Centre for Evidence Based Aged Care (ACEBAC), looked into the current trend of evidence-based medicine and it being adopted as a means of achieving optimal medical care to reduce variations in clinical practice.
‘Randomised controlled trials are considered the highest level of scientific evidence. However, older individuals are either excluded or underrepresented in these studies, and those who are included are often atypical of patients seen in clinical practice.
‘There are many clinical scenarios that do not lend themselves to being answered by randomised controlled trials.
‘The aim of this study was to examine the approach to clinical decision making in frail older persons when there is little or no scientific evidence to guide management,’ says Dr Katz.
The ageing population will result in larger numbers of patients with complex age-related conditions seeking treatment for pain.
Dr Katz, who is also a Geriatrician at St Vincent's Hospital and Director of the Victorian Geriatric Medicine Training Program—used a case study to highlight many important issues surrounding the management of pain in older adults.
‘There is a need in clinical practice to find a balance with evidence-based medicine and the preferences of the patient for optimal health outcomes,’ says Dr Katz.
The study also highlights the importance of Comprehensive Geriatric Assessment (CGA)—a multidimensional process designed to detect factors that may have a significant impact on the well being of an older adult.
‘When treating older people, clinicians not only need to take into consideration the severity of pain, but also the impact of pain and its treatment on cognition, mood and functional status.
‘Combining the practices of pain medicine and CGA may result in a better outcome,’ says Dr Katz.
‘A focus on the medical aspects and adjustment of treatment based solely on age will often not be adequate as it fails to take into consideration the heterogeneity of older adults.
‘Some will have aged ‘well’ and need little modification to the approach used for younger patients, while others who are frail or have multiple comorbidities will require a modified approach,’ says Dr Katz.
The study—The Science and Art of Pain Management in Older Persons: Case Study and Discussion—is available on request.
Source:Science Alert

Study Finds Quiet Time, 'Brain at Rest' Important for Learning

While quiet moments for reflection are becoming a rarity in today's busy world, a new study has suggested that the long-lost art of introspection - even daydreaming - may be an increasingly valuable part of life.
Psychological scientist Mary Helen Immordino-Yang and colleagues surveyed the existing scientific literature from neuroscience and psychological science, exploring what it means when our brains are 'at rest.'
In recent years, researchers have explored the idea of rest by looking at the so-called 'default mode' network of the brain, a network that is noticeably active when we are resting and focused inward.
Findings from these studies suggested that individual differences in brain activity during rest are correlated with components of socioemotional functioning, such as self-awareness and moral judgment, as well as different aspects of learning and memory.
Immordino-Yang and her colleagues believe that research on the brain at rest can yield important insights into the importance of reflection and quiet time for learning.
"We focus on the outside world in education and don't look much at inwardly focused reflective skills and attentions, but inward focus impacts the way we build memories, make meaning and transfer that learning into new contexts," said Immordino-Yang, a professor of education, psychology and neuroscience at the University of Southern California.
While outward attention is essential for carrying out tasks and learning from classroom lessons, for example, the reflection and consolidation that may accompany mind wandering is equally important, fostering healthy development and learning in the longer term.
"Balance is needed between outward and inward attention, since time spent mind wandering, reflecting and imagining may also improve the quality of outward attention that kids can sustain," said Immordino-Yang.
She and her colleagues argue that mindful introspection can become an effective part of the classroom curriculum, providing students with the skills they need to engage in constructive internal processing and productive reflection. Research indicates that when children are given the time and skills necessary for reflecting, they often become more motivated, less anxious, perform better on tests, and plan more effectively for the future.
And mindful reflection is not just important in an academic context - it's also essential to our ability to make meaning of the world around us. Inward attention is an important contributor to the development of moral thinking and reasoning and is linked with overall socioemotional well-being.
Immordino-Yang and her colleagues worry that the high attention demands of fast-paced urban and digital environments may be systematically undermining opportunities for young people to look inward and reflect, and that this could have negative effects on their psychological development. This is especially true in an age when social media seems to be a constant presence in teens' day-to-day lives.
According to the researchers, perhaps the most important conclusion to be drawn from research on the brain at rest is the fact that all rest is not idleness.
While some might be inclined to view rest as a wasted opportunity for productivity, the researchers suggested that constructive internal reflection is critical for learning from past experiences and appreciating their value for future choices, allowing us to understand and manage ourselves in the social world.
The findings were published in the July issue of Perspectives on Psychological Science, a journal of the Association for Psychological Science.
Source-ANI

 

Neuroprotective dietary supplements for chronic spinal cord injury

Researchers from the Department of Neurosurgery at the David Geffen School of Medicine and the Department of Integrative Biology and Physiology at UCLA have found that a diet enriched with docosahexaenoic acid (DHA), an omega-3 fatty acid, and curcumin, a component of the Indian spice turmeric, can protect the injured spinal cord and minimize the clinical and biochemical effects of spinal cord myelopathy in rats. This finding is fleshed out in the article "Dietary therapy to promote neuroprotection in chronic spinal cord injury. Laboratory investigation," by Langston Holly, M.D., and colleagues, published today online in the Journal of Neurosurgery: Spine. DHA reduces inflammation and provides structural material to plasma membranes. Curcumin produces strong anti-inflammatory and antioxidant effects. Both agents are safe to use and have been documented to have positive effects on the injured brain. Thus the researchers hypothesized that the combined effects of DHA and curcumin could protect the spinal cord from the cascade of cellular and related biological injuries that result from chronic cord injury.

Cervical spondylotic myelopathy is the most common disorder of the spine found in middle-aged patients. Neurological deficits associated with this disorder are related to a primary mechanical spinal injury that is followed by a secondary biological injury. Wear and tear on the spine, due to age or congenital narrowing of the spinal canal, leads to mechanical compression of the spinal cord. This cord compression in turn leads to biological cell injury or death and consequent neurological dysfunction. The primary mechanical injury can usually be corrected by surgery or other management strategies; to date, the secondary biological injury has been more difficult to treat.

The authors set out to develop a noninvasive way to promote neuroprotection from the biological injury that follows spinal cord compression in cervical spondylotic myelopathy. In the laboratory, the authors studied three groups of rats. To simulate cervical spondylotic myelopathy, the researchers placed an expandable polyvinyl alcohol sponge between two laminae of the spine in the animals. This produced delayed myelopathy. After the procedure, the first group of rats was fed a "Western diet" (a form of rat chow high in saturated fats and sugar), whereas the second group was fed a diet enriched with DHA and curcumin. A third group was given a standard rat diet and the animal's spines were left intact.

The animals' walking ability was examined before the procedure and repeatedly for several weeks following it. The researchers compared each group's walking behavior before and after the procedure and noted any differences between groups. Animals fed the Western diet demonstrated significant gait dysfunction as early as three weeks postoperatively, which continued throughout the six-week test period. Animals fed a diet enriched with DHA and curcumin displayed no significant difference in walking ability compared with preoperatively and demonstrated significantly better gait function six weeks after the procedure than animals fed the Western diet. Accompanying this paper, the authors provide two videos showing differences in gait function between these two groups.

The authors also examined the effects of diet after spinal injury on the molecular level. They measured levels of 4-hydroxynonenal (4-HNE), brain-derived neurotrophic factor (BDNF), and syntaxin-3 in the region of the rat spine that was compressed as well as in a region lower in the spine—the lumbar enlargement—where nerves controlling the lower limbs are attached to the spinal cord. The lumbar enlargement was included because cord injury can extend downward from the original site. Significantly higher levels of 4-HNE, an indication of severe cellular membrane damage, were found in both spinal sites in rats fed the Western diet. There was no significant difference between the levels of 4-HNE found in rats fed a diet enriched with DHA and curcumin and control rats with intact spines. Levels of BDNF and syntaxin-3 were significantly lower in both spinal sites in rats fed the Western diet. There were no significant differences in the levels of BDNF and syntaxin-3 between rats fed the diet enriched with DHA and curcumin and control rats. BDNF is a key factor involved in neural repair and promotes the transmission of information across synapses. Syntaxin-3 plays an important role in the release of neurotransmitters into the synapses.

This study shows that diet can play an important role in the response of the rat body to spinal injury. Rats fed a diet enriched with DHA and curcumin displayed significantly better walking ability than animals fed a "Western diet" high in saturated fats and sugar. In addition, there were significant differences in the levels of 4-HNE, BDNF, and syntaxin-3 between rats fed the Western diet and rats fed the DHA and curcumin–enriched diet. On the other hand, there were no significant differences in any of the parameters examined between rats fed the enriched diet and control rats with intact spines.

On the basis of their findings, the authors conclude: "DHA and curcumin can counteract the effects of chronic spinal cord compression through several molecular mechanisms, resulting in the preservation of neurological function."

Source:Journal of Neurosurgery Publishing Group 

Study links carcinogens to cancer stem cells -- but spinach can help

Researchers at Oregon State University for the first time have traced the actions of a known carcinogen in cooked meat to its complex biological effects on microRNA and cancer stem cells.

The findings are part of a growing awareness of the role of epigenetics in cancer, or the ways in which gene expression and cell behavior can be changed even though DNA sequence information is unaltered.

The scientists also found that consumption of spinach can partially offset the damaging effects of the carcinogen. In tests with laboratory animals, it cut the incidence of colon tumors almost in half, from 58 percent to 32 percent.

The research at OSU's Linus Pauling Institute was recently reported in the journal Molecular Nutrition and Food Research, in work supported by the National Institutes of Health.

"Cancer development is a complex, multi-step process, with damaged cells arising through various means," said Mansi Parasramka, a postdoctoral scholar with LPI. "This study showed that alterations of microRNAs affect cancer stem cell markers in colon cancer formation.

"MicroRNAs are very small factors that do very big things in cells," she said.

Traditionally, cancer was thought to be caused by changes in DNA sequence, or mutations, that allowed for uncontrolled cell growth. That's still true. However, there's also increasing interest in the role played by epigenetics, in which such factors as diet, environmental toxins, and lifestyle affect the expression of genes – not just in cancer, but also cardiovascular disease, diabetes, and neurological disorders.

Included in this epigenetic equation is the formation of microRNAs – once thought to be "junk DNA" - which researchers were at a loss to understand. It's now known that they influence which areas of DNA get expressed or silenced.

There are hundreds of microRNAs, and the OSU scientists monitored 679 in their experiments. When they don't work right, bad things can happen, including abnormal gene expression leading to cancer.

"Recent research is showing that microRNAs are one of the key epigenetic mechanisms regulating cellular functions in normal and diseased tissues," said Rod Dashwood, the Helen P. Rumbel Professor for Cancer Prevention and director of LPI's Cancer Chemoprotection Program.

"But unlike mutations which are permanent genetic changes in DNA," he said, "the good news about epigenetics and microRNA alterations is that we may be able to restore normal cell function, via diet and healthy life style choices, or even drug treatments."

Epigenetics essentially makes every person biologically unique, Dashwood said, a product of both their genetics and their environment. That includes even identical twins.

The findings of the new study should lead to advances in understanding microRNAs, their effects on cancer stem cells, and the regulatory processes disrupted in disease development, the OSU scientists said. This might lead one day to tailored or "patient specific" therapies for cancer, Dashwood said.

Source:Oregon State University 

UCLA bioengineers discover single cancer cell can produce up to 5 daughter cells

Findings could aid researchers in understanding progression of disease

It's well known in conventional biology that during the process of mammalian cell division, or mitosis, a mother cell divides equally into two daughter cells. But when it comes to cancer, say UCLA researchers, mother cells may be far more prolific.

Bioengineers at the UCLA Henry Samueli School of Engineering and Applied Science developed a platform to mechanically confine cells, simulating the in vivo three-dimensional environments in which they divide, and found that, upon confinement, cancer cells often split into three or more daughter cells.

"We hope that this platform will allow us to better understand how the 3-D mechanical environment may play a role in the progression of a benign tumor into a malignant tumor that kills," said Dino Di Carlo, an associate professor of bioengineering at UCLA and principal investigator on the research.

The biological process of mitosis is tightly regulated by specific biochemical checkpoints to ensure that each daughter cell receives an equal set of sub-cellular materials, such as chromosomes or organelles, to create new cells properly.

However, when these checkpoints are miscued, the mistakes can have detrimental consequences. One key component is chromosomal count: When a new cell acquires extra chromosomes or loses chromosomes — known as aneuploidy — the regulation of important biological processes can be disrupted, a key characteristic of many invasive cancers. A cell that divides into more than two daughter cells undergoes a complex choreography of chromosomal motion that can result in aneuploidy.

By investigating the contributing factors that lead to mismanagement during the process of chromosome segregation, scientists may better understand the progression of cancer, said the researchers, whose findings were recently published online in the peer-reviewed journal PLoS ONE.

For the study, the UCLA team created a microfluidic platform to mechanically confine cancer cells to study the effects of 3-D microenvironments on mitosis events. The platform allowed for high-resolution, single-cell microscopic observations as the cells grew and divided. This platform, the researchers said, enabled them to better mimic the in vivo conditions of a tumor's space-constrained growth in 3-D environments — in contrast to traditionally used culture flasks.

Surprisingly, the team observed that such confinement resulted in the abnormal division of a single cancer cell into three or four daughter cells at a much higher rate than typical. And a few times, they observed a single cell splitting into five daughter cells during a single division event, likely leading to aneuploid daughter cells.

"Even though cancer can arise from a set of precise mutations, the majority of malignant tumors possess aneuploid cells, and the reason for this is still an open question," said Di Carlo, who is also a member of the California NanoSystems Institute at UCLA. "Our new microfluidic platform offers a more reliable way for researchers to study how the unique tumor environment may contribute to aneuploidy."

Source:

University of California - Los Angeles