Saturday, September 23, 2006

Protein Linked to Lung Development Identified

(HealthDay News) -- Research that uncovers a protein pathway critical to lung development holds the promise of new treatments for premature babies who suffer from respiratory distress syndrome.
"There is a lot of work that must be done, but at least we have a new set of molecules for which, if a receptor is found, intervention is possible," said study author Vrushank Dave, an assistant professor of pediatrics at University of Cincinnati Medical Center.
"This is the first signaling pathway that has been identified for lung maturation," Dave said. In their research, which is published in the Sept. 21 online issue of the Journal of Clinical Investigation, his team found the protein calcineurin is necessary for lung tissue development at birth.
The study was performed in fetal mice and identified a specific signaling pathway for genes that controlled how lung tissue developed. That's good news because until now, the controlling proteins for the final stages of lung development have not been identified.
"It is critical to understand that this work was done in mice, so we can't make a blanket statement saying that the (research) will translate into humans," Dave cautioned.
Still, the animal work is important because right now, there's no definitive treatment for premature babies who develop respiratory distress syndrome, Dave noted. Lungs fully develop very late in pregnancy, so premature infants are at risk for lung disease when they're born. Currently, mothers at risk for preterm delivery are given a single shot of a corticosteroid to help reduce the chances of their babies developing these conditions.
"Prenatal corticosteroids for the prevention of respiratory distress syndrome improves lung maturation; it has some confounding problems," Dave said. These infants are at a very high risk of dying, despite aggressive treatment that can include a mechanical respirator.
Almost one-fourth of premature infants develop respiratory distress syndrome because the cells that line their lungs are not fully developed, so they can't breathe properly; about 60,000 children in the United States are born each year weighing less than three pounds. Of those who survive, many suffer permanent lung damage, which can slow growth, increase the possibility of infection, and result in abnormal brain development.
The current study sheds some much needed light on the syndrome. The researchers deleted the calcineurin b1 gene in the respiratory cells of fetal mice, which stunted lung maturation and caused respiratory failure. The gene deletion decreased the synthesis of surfactant and other proteins necessary for lung development. Because they lacked the protein calcineurin, the newborn mice could not breathe properly and died soon after birth, the researchers wrote.
The mouse research may apply to premature infants because "failed lung maturation at birth results in surfactant deficiency, causing respiratory distress in the perinatal period," the authors wrote.
Future treatment will hinge on more basic science. "The idea is to find the receptor for the [calcineurin] pathway, and we don' have it at this point," Dave said.
The hope is that the description of this pathway that controls the final stages of lung development in mice might help researchers design treatments to manage respiratory distress syndrome and lung disease in premature babies.
Once the receptor is found, "we would like to find molecular targets for the receptor. If we can find that receptor, then it would be possible to see how much we can increase lung maturation," Dave said.
Finding a receptor for the pathway would activate it, but "that's not only the pathway involved. This is very complex phenomenon -- in the last few days before birth, a lot of structural and functional changes in lung are going on," he explained.
This research, Dave stressed, is in its infancy. "We don't know the therapeutic target. This (approach) would work if there's a defect in the receptor pathway, but if there's a cellular defect, that can't be cured with this research," he said.
More information
For more on acute respiratory distress syndrome, go to the American Lung Association.

MRI Detects Breast Cancer's Spread

(HealthDay News) -- Standard MRI is more accurate than another method, multidetector computed tomography (MDCT), in determining if and how far breast cancer has spread into breast ducts, Japanese researchers report.
They recommend that MRI should be used to assess patients before they have breast-conserving surgery (lumpectomy).
Researchers used MRI and MDCT on 69 patients with invasive breast cancer. In 44 of the cases, malignancy had an intraductal component.
MRI correctly identified 33 of the 44 cases, while MDCT correctly identified 27.
"MRI revealed the presence of the intraductal component with significantly higher sensitivity (75 percent) compared to MDCT (61 percent)," Dr. Akiko Shimauchi, of Tohoku University, said in a prepared statement.
"The lesions that were missed by both examinations were the ductal extension type, i.e. the tumor included a dominant mass with an outward extension of cancer cells, with a relatively small ductal component," she said.
MRI was better able to detect the smaller ductal components than MDCT, the study found.
"Patients have a lower survival rate if their surgical margins are positive for tumor cells. A positive surgical margin is usually the result of inadequate resection of the cancer's intraductal component," Shimauchi said. "Accurate preoperative diagnosis of the intraductal component allows the surgeon to achieve a cancer-free surgical margin."
The study was published in the August issue of the American Journal of Roentgenology.
More information
The U.S. National Cancer Institute has more about breast cancer surgery.

Weight Concerns Spur Women to Smoke Again After Pregnancy

(HealthDay News) -- Weight-gain worries may help drive women who quit smoking during their pregnancy to start up again after delivery, new research shows.
U.S. researchers interviewed 119 pregnant women in their third trimester who had smoked at least eight cigarettes a day but quit when they became pregnant.
Of those women, 65 percent said they were highly motivated to avoid cigarettes after delivery, and 74 percent of expressed confidence that they'd be able to do so.
"Motivated women were more likely to say they could control their weight without smoking and less likely to say they used smoking to control their weight," study author Michele Levine, of the University of Pittsburgh Medical Center, said in a prepared statement.
The study also found that women who were motivated to remain cigarette-free after delivery were also more likely to say they planned to breast-feed their babies.
The findings dealt only with what the women said they intended to do after delivery, not what they actually did, noted Boston psychologist Elyse Park, who was not involved in the study.
"Most women who are smoking want to quit during pregnancy, but the reality is that very few of them are able to do so. Even in women who are successful, very few are able to maintain quitting," Park said in a prepared statement.
More information
The American Lung Association has more about smoking and pregnancy.

Coming Clean on Personal Care Products

(HealthDay News) -- Is your deodorant boosting your breast cancer risk? And how much chemical preservative in hand and body lotions is too much?
News reports over the past few years have heightened consumer awareness of the myriad chemicals found in everyday beauty and hygiene products, but two expert dermatologists say it pays to investigate before tossing any product into the bathroom wastebasket.
The debate over deodorants and antiperspirants is one good example. Small studies have suggested that daily use of these products might raise a woman's risk for breast cancer over time, especially given the armpit's proximity to sensitive breast tissue.
But Dr. Lisa Donofrio, an assistant clinical professor of dermatology at Yale University School of Medicine, said that "there have also been a couple of studies that have been pretty good at showing that [these products] -- at least the aluminum in them -- are not really related to breast cancer." While future studies might turn up additional data, "this debate right now is probably closer to 'case closed,' " she said.
One issue that remains an ongoing source of concern for Donofrio is that of preservatives called "parabins" found in a wide range of beauty products meant to have a very long shelf life. One reason manufacturers tend to use parabins is that a small minority of consumers develop allergies to a competing class of preservatives, formaldehyde releasers.
"So, parabins are now found across the board in beauty items -- makeup, and most commonly in lotions," Donofrio said. But the problem with parabins is that they "are estrogenic, meaning they will bind to estrogen receptors [on cells], and in test tube studies, they actually stimulate breast cancer cells," she said. Higher levels of circulating estrogens has long been a prime risk factor for breast cancer.
Industry experts note that parabins are used in extremely small amounts in health and beauty products. "For that reason, they say they're just in too small amounts to cause any problems," Donofrio said. "But over a lifetime, with daily use of these creams, we don't actually know what the cumulative dose really is."
For that reason, Donofrio advises that anyone not allergic to formaldehyde releasers shy away from products containing parabins, which are usually noted on label ingredient lists as either methyl parabin or propyl parabin. For those people who are allergic to formaldehyde releasers, she suggests using products containing a third class of preservative, sodium benzoate. Compared to parabins, "it's the lesser of two evils," the Yale expert said.
Another long-debated issue -- the connection between hair dyes and certain malignancies -- may have already been solved by industry, said Dr. Steven Feldman, a professor of dermatology at Wake Forest University School of Medicine. "First of all, the link has been talked about, but the studies don't really support it," he said. In any case, he said, hair dyes used today no longer contain the suspected carcinogen that gave rise to these fears in the first place.
Of course, consumers can develop lesser ailments, such as rashes and other signs of allergy, from skin and hair products. While manufacturers can help minimize the risk, Feldman said there's not much they can do to ensure that no one ever develops a reaction to their product.
"A person can be allergic to practically anything," he said. "Fragrances, especially, are one of the more common allergens -- people can expose themselves to them even through their fabric softener in the laundry."
As with any allergy, individuals who notice a reaction should note what they were using at the time and consult their doctor, if necessary. Feldman did offer one piece of advice: "Stick to well-recognized brands," he said. "I know some people fear big business, but companies that have a lot at stake don't want to blow it, and with business, the more they have to lose, the safer I think the product will be."
On the other hand, he said, "if you go for some fly-by-night company that promises you some herbal remedy, then, if somebody sues them, they just close up shop." Buying from a nationally recognized brand may "give you some assurance about quality that you might not otherwise get," Feldman said.
Many consumers may not be aware that health and beauty products are not subject to the tough federal safety standards that guide drug development.
"Most of us expect that the products we find on store shelves have been tested for safety, but the [U.S.] government has no authority to require tests," Jane Houlihan, vice president for science at the Washington, D.C.-based nonprofit Environmental Working Group, said in a prepared statement. "An average adult is exposed to over 100 unique chemicals in personal care products every day -- these exposures add up."
Not everyone agrees that consumers need to worry about the products they apply to their bodies each day, however. In a prepared statement, scientists at the American Council on Science and Health -- which describes itself as a consumer-based advocacy group that receives some "no strings attached" funding from the cosmetics industry -- said organizations like the EWG "have invested a great deal of work in publicizing supposed health risks from myriad chemicals that have long been in everyday use with no evidence of harm to humans."
According to the New York City-based ACSH, much of the evidence for these "scares" relies on high-dose animal tests that "are not good predictors of human cancer risk."
Yale's Donofrio said that argument does have some merit. However, she said she's more concerned about the absorption of toxins through the skin and their slow build-up in the body over time.
"If you start thinking in terms of 'Well, this does this to cells in the test tube, and I'm using X amount of this over this amount of years,' then there's the potential that I could end up being those [affected] cells," she said.
More information
Find out more about the science of beauty products at the U.S. Food and Drug Administration.

Friday, September 22, 2006

Smokers May Be More Likely to Contract HIV

(HealthDay News) -- Smokers may be at higher risk of contracting HIV infection than nonsmokers, new research finds.
Cigarette smoking has already been linked to an increased risk of infection in general, including sexually transmitted infections.
For their analysis, researchers identified six studies that investigated the association between smoking and becoming HIV positive.

Five of the studies found smokers were at increased risk of contracting HIV. The increased risk ranged from 60 percent higher in smokers to a more than tripling of the risk.

The researchers looked at another 10 studies that assessed the association between smoking and progression to AIDS. Nine of these studies concluded that smokers were not at increased risk.

Smokers may be more vulnerable to infection due to changes in the lungs and the immune system, said the authors.

This study was published online ahead of print in Sexually Transmitted Infections.

More information
The Centers for Disease Control and Prevention have more about HIV and AIDS prevention.

New Technique Treats Pelvic Pain in Men and Women

(HealthDay News) -- A minimally invasive surgical technique that includes the addition of a foam appears to successfully treat pelvic pain in both men and women, researchers report.
The conditions are, in men, enlarged varicose veins in the scrotum, known as varicoceles, and in women, enlarged varicose veins in the pelvis, called pelvic congestion syndrome. Varicoceles may cause pain, testicular atrophy or infertility, and pelvic congestion syndrome can cause disabling chronic pelvic pain.
The results of the new study were presented March 31 at the Society of Interventional Radiology annual meeting, in Toronto.
"This is a revised method of treating varicoceles and pelvic congestion syndrome," said study author Dr. Eric Reiner, an assistant professor of vascular and interventional radiology at Yale University School of Medicine.
In both conditions, the valves in the gonadal vein don't work, Reiner said. "Instead of blood going back to the heart like it normally does, it ends up staying in the vein causing the vein to get large and causing pain."
As many as 40 percent of women have chronic pelvic pain in their life, Reiner said. As for men, some 15 percent suffer from varicoceles, and the condition is involved in 50 percent of male infertility cases, he explained.
In their study, Reiner and his Yale researchers performed the procedure on 24 patients. As of the time of the presentation, there were no recurrences of the condition.
The goal of the treatment is to seal off the vein to prevent it from becoming engorged with blood, Reiner said. To do this, a needle is passed into the vein in the groin, then a tube is placed in the vein. Next, metal coils are passed through the tube into the vein. These act as a plug to block off the vein.
The new part of the procedure is the injection of a solution called sodium tetradecyl sulfate. The solution is then turned into foam using air or carbon dioxide. "This allows the solution to go into the smaller collateral veins, closing them off, too," Reiner said.
Other techniques, including this one without foam, often result in a recurrence of the condition, Reiner said. By closing off both the large vein and the smaller collateral veins, the researchers think that a recurrence of the condition is significantly less likely. "We are hoping that this will result in a longer, more permanent solution to the problem," Reiner said.
"The best part of the procedures is that they are day procedures," Reiner said. "You go in that day and go home that night. That's a huge benefit over surgical interventions for the same conditions that frequently have overnight stays and a longer recovery time."
While this technique is not yet being used widely, Reiner believes it will become more common in the future.
More information
The U.S. National Institutes of Health can tell you more about varicoceles.

Health Tip: Varicose Veins May Not Need Treatment

(HealthDay News) -- Varicose veins, also known as spider veins, look dark blue or purple under the skin. They may also appear as twisted clumps of veins that may cause the skin above them to harden and swell.
Although many people with varicose veins don't have any other symptoms, the Cleveland Clinic says that some people may have swelling or pain in the legs, itching, soreness or aching. Some skin discoloration may also occur.
Varicose veins occur most often among women, and may be influenced by a number of factors. Being older, overweight, and having a job that requires standing all day may contribute to varicose veins. Other factors may be heredity, crossing the legs often, using birth control pills, or use of post-menopausal hormone therapies.
Treatment may not be necessary, according to the clinic, unless you are experiencing pain. Support hose may help reduce symptoms in some people, and lifestyle changes like losing weight, exercise, and getting off your feet may also help.

Lasers Zap Varicose Veins

(HealthDay News) -- Laser energy may provide a safe, non-surgical means of eliminating varicose veins, researchers report.
Duke University Medical Center vascular surgeons using the minimally invasive procedure say most patients are up and walking within hours after treatment. Traditional varicose vein surgery, in which the treated veins are "stripped" out of the leg, requires about six weeks of recovery.
In this new technique, a catheter is guided through the saphenous vein (the large leg vein) to deliver laser energy to the targeted area. The laser energy causes the affected vein to collapse, preventing blood from backing up and causing the bulges characteristic of varicose veins. After the laser treatment, blood from the sealed vein is diverted to other veins.
"The whole procedure is performed on an outpatient basis under local anesthesia," Dr. Cynthia Shortell, chief of vascular surgery at Duke, said in a prepared statement. "After the procedure, which usually takes about 15 to 30 minutes, patients are asked to begin walking, which helps stimulate blood vessels and alleviate any of the fear of walking they may have after the procedure," she added.
"In addition to being up and about much sooner, there is little to no scarring on the leg as a result of the new procedure. Any discomfort afterwards can be treated by nonsteroidal anti-inflammatory agents, and most patients are back at work within a week," Shortell said.
An estimated 100 million Americans suffer some degree of varicose veins and about 1 million have the "stripping" procedure each year.
"Up to 25 percent of women, and 15 percent of men, will develop varicose veins," Shortell said. "While there are many causes for the condition, varicose veins occur most frequently in the obese, in women after pregnancy, in the elderly and those who stand for long periods of time. There also appears to be a genetic component as well," she said.
More information
The U.S. National Women's Health Information Center has more about varicose veins.

Thursday, September 21, 2006

Nurses Struggling to Balance Work, Family

(HealthDay News) -- Many U.S. nurses are having a tough time balancing work and family life, a new study finds.
These struggles could impact on patient care, researchers warn.
"Work-family conflict has significant implications for nurses in terms of personal health, their ability to provide quality care and for the nursing profession itself," study author Joseph Grzywacz, an associate professor of family and community medicine at Wake Forest University, said in a prepared statement.
His team surveyed 1,906 registered nurses to find out how common work-family conflict is in the nursing community.
Work-family conflict occurs when work interferes with responsibilities at home or the time spent with family. It can also happen when home life gets in the way of a person's career.
The results of the survey, published in the September issue of Research in Nursing & Health, suggested that work-life conflict is common among nurses.
Half of the nurses reported that work interfered with their family life at least one day a week. Only 11 percent reported that family interfered with work this often.
The problem could exacerbate the current nursing shortage by discouraging people from entering the nursing profession or driving current nurses to leave their jobs. In previous studies, work-family conflict has been associated with lower job satisfaction, fatigue, burnout, and emotional distress or depressive symptoms.
The researchers concluded that future studies should investigate whether flexible work arrangements, such as job sharing, can reduce the frequency of work-family conflict.

More information
The American Psychological Association has more about stress in the workplace.

Tanning Still in Style With U.S. Teens

(HealthDay News) -- American teens are getting slightly better at using sunscreen but have failed to adopt other sun-protection habits and continue to get too many sunburns, according to research from the American Cancer Society.
Most teens still think a tan reflects good looks and good health, the survey found. The findings were published in the September issue of Pediatrics.
Researchers compared nationally representative polls of U.S. youngsters, aged 11 to 18, conducted in 1998 and 2004.
In 2004, 69 percent of the respondents reported having been sunburned during the summer, compared with 72 percent in 1998. There was a significant decrease between 1998 and 2004 in the percentage of younger teens (aged 11 to 15) who reported sunburns and a non-significant increase among those aged 16 to 18.
Between 1998 and 2004, the percentage of teens who reported regular sunscreen use increased from 31 percent to 39 percent, but there was little change in the use of other methods of sun protection.
In 2004, 21.7 percent of teens reported seeking shade when out in the sun; 22.8 percent said they wore protective clothing; 32 percent used sunglasses; and 5 percent reported wearing wide-brimmed hats.
The study also found a significant increase in the number of days teens spent at the beach -- from 6.7 days in 1998 to 10.3 days in 2004.
"Our study showed that despite widespread sun protection campaigns, there has been only a small reduction in sunburn frequency and modest increases in sun protection practices among youth between 1998 and 2004," study leader Vilma Cokkinides, an American Cancer Society epidemiologist, said in a prepared statement.
"Nevertheless, the decrease in sunburns among younger teens may be cause for optimism regarding future trends," she said. "Skin cancer prevention programs in the U.S. need to be strengthened in order to impact these trends."
More information
The U.S. Environmental Protection Agency offers

Can Prayer Heal What Ails You?

(HealthDay News) -- Whenever a loved one suffers a health crisis, well-wishers often pass on the heartfelt promise that they'll "pray for you."
In fact, so many people believe in the power of prayer that it's now caught the attention of scientific researchers.
"Praying for your health is one of the most common complementary treatments people do on their own," said Dr. Harold G. Koenig, co-director of the Center for Spirituality, Theology and Health at Duke University Medical Center. "About 90 percent of Americans pray at some point in their lives, and when they're under stress, such as when they're sick, they're even more likely to pray."
More than one-third of people surveyed in a recent study published in the Archives of Internal Medicine said they often turned to prayer when faced with health concerns. In the poll involving more than 2,000 Americans, 75 percent of those who prayed said they prayed for wellness, while 22 percent said they prayed for specific medical conditions.
Numerous randomized trials have been done to assess the effect of intercessory prayer on heart patients' health.
In one such study, neither patients nor the health-care providers had any idea who was being prayed for. The coronary-care unit patients didn't even know there was a study being conducted. And, those praying for the patients had never even met them.
The result: While those in the prayer group had about the same length of hospital stay, their overall health was slightly better than the group that didn't receive special prayers.
"Prayer may be an effective adjunct to standard medical care," wrote the authors of this 1999 study, also published in the Archives of Internal Medicine.
However, a more recent trial from the April 2006 issue of the American Heart Journal seemed to contradict these findings, suggesting that it's even possible for some harm to come from prayer.
In this study, which included 1,800 people scheduled for heart surgery, the group who knew they were receiving prayers developed more complications from the procedure, compared to those who had not been a focus of prayer. Additionally, this study found no benefit in the group that received prayers, but didn't know it.
But Koenig said there's a simple explanation why people might fare worse if they knew they were being prayed for in a study.
"These people got the news just before they went into surgery. They were given pieces of paper that said they'd be getting prayer, which may have made them think, 'Oh my God, what's wrong with me?' " Koenig explained. "That's a totally artificial situation. Normally, you have loved ones and friends praying for you and there's nothing negative in that situation."
This new study also points out the difficulty of trying to quantify the effects of prayer, said Koenig.
"Studies cannot prove that prayer does not work. We don't know any more about the efficacy of prayer after reading these studies and they shouldn't affect anyone's belief in prayer," he said.
With scant evidence to support prayer for healing, should doctors encourage the practice?
Clearly, many patients are reluctant to bring up the subject with their physicians. In one study, only 11 percent of people surveyed have mentioned prayer to their physicians. But, physicians may be more open to the subject than patients realize, particularly in serious medical situations.
In a study of doctors' attitudes toward prayer and spiritual behavior, almost 85 percent of physicians thought they should be aware of their patients' spiritual beliefs. Most doctors said they wouldn't pray with their patients even if they were dying, unless the patient specifically asked the doctor to pray with them. In that case, 77 percent of physicians were willing to pray for their patient.
The bottom line on prayer and health: If it's something you want to do and you feel it might be helpful, there's no reason you shouldn't do it.
"I think many people are convinced that prayer helps, otherwise I don't think they would do it. Some people are 'foxhole religious' types and prayer's almost a reaction or cry to the universe for help. But, many people do it because they've experienced benefit from it in the past," Koenig explained.
"So, if you have any inclination that prayer might work, do it," he said.

More information
For more research on spirituality and health, head to the U.S. National Center for Complementary and Alternative Medicine.

Brain Helps Keep Emotions at Bay

(HealthDay News) -- A new study may reveal how people function amidst distracting emotions.

Published in the Sept. 21 issue of Neuron, the findings suggest the human brain is able to prevent emotions from interfering with mental functioning.

Researchers from Columbia University Medical Center in New York City asked volunteer participants to indicate by pressing a button whether a face image was happy or fearful, while ignoring "fear" and "happy" labels written across each face.

The labels were either "congruent" (e.g., happy face, "happy" label) or "incongruent" (e.g., happy face, "fear" label). The incongruent labels were designed to represent a conflict between emotional and cognitive stimuli.

During the tests, the researchers used functional magnetic resonance imaging to determine what parts of the brain were active.

They found that when the participants were exposed to the incongruent labels, activity of the amygdala -- the brain's center for processing emotional events -- was inhibited by the anterior cingulated cortex -- the brain's center for neural processing.

The researchers speculated that their findings may help explain why people who suffer from post-traumatic stress disorder (PTSD) or depression may be unable to control emotional intrusion into their thoughts. They pointed out that the brains of people with PTSD and depression may be less able to inhibit the amygdala during emotional processing.

More information
The National Institute of Mental Health has more about Post-traumatic stress disorder PTSD.

Wednesday, September 20, 2006

Tanks and troops patrolled Bangkok early Wednesday after the army said the military was taking control.

BANGKOK, Thailand (CNN) -- The chiefs of Thailand's army, navy and air force met with King Bhumibol Adulyadej to declare they were taking over the country, according to a televised statement early Wednesday.
The coup is being led by Thai army chief Gen. Sonthi Boonyaratkalin, who announced that the military and opposition Party of Democratic Reform were taking over while Prime Minister Thaksin Shinawatra was in New York for a U.N. meeting.
Sonthi said Wednesday he would meet in the morning with government officials and leaders of other institutions, such as universities
Thaksin canceled a scheduled Tuesday evening speech to the U.N. General Assembly, a U.N. official said.
He said, however, that his government was still in control of the nation and later announced he was firing Sonthi.
Deputy Prime Minister Surakiart Sathirathai said that the supreme commander of Thailand's armed forces -- Gen. Ruengroj Mahasaranont -- would be in charge of Bangkok. Mahasaranont has made no public statement since the coup was announced.
Tanks and troops patrolled Bangkok early Wednesday after the army said the military was taking control. (Watch tanks roll through the streets of Bangkok -- 3:53)
Police were closing stores and directing traffic off Bangkok streets, residents told CNN via e-mail, but no violence was reported.
The coup plotters declared martial law and suspended the constitution of the Southeast Asian nation. They also declared Wednesday a holiday, with schools, banks and the country's stock market closed.
"The armed forces commander and the national police commander have successfully taken over Bangkok and the surrounding area in order to maintain peace and order. There has been no struggle," the coup announcement said, according to The Associated Press. "We ask for the cooperation of the public and ask your pardon for the inconvenience."
Sonthi, who is known to be close to Thailand's revered constitutional monarch, will serve as acting prime minister, army spokesman Col. Akarat Chitroj said, according to The AP. Sonthi is a Muslim in this Buddhist-dominated nation, AP reported.
Foreign news networks, including CNN, from which Thailand residents were able to monitor the beginning of the coup, were later removed from the country's cable systems.
Only one local station was broadcasting and it was showing pictures of the country's king, according to an e-mail CNN received from Nio Paul, who identified himself as an American living in Thailand.
On a television station remaining under his government's control Tuesday, Thaksin declared a state of emergency from New York.
Troops on the streets of the Thai capital had yellow ribbons on their weapons, a sign of loyalty to the nation's king, to whom the coup plotters proclaimed their loyalty.
Former Prime Minister Chuan Leekpai told AP that Thaksin had forced the military to act.
"As politicians, we do not support any kind of coup, but during the past five years, the government of Thaksin created several conditions that forced the military to stage the coup. Thaksin has caused the crisis in the country," he told The AP.
At least four tanks and a number of armored vehicles were stationed around the royal palace in Bangkok, CNN's Dan Rivers reported.
Soldiers apparently were setting up roadblocks, and what appeared to be members of the royal guard surrounded the palace.
It was unclear if the soldiers were loyal to the government or to those attempting to seize power.
Two tanks were parked outside the government headquarters, which houses Thaksin's office.
About a dozen soldiers patrolled around the Erawan Hotel in the city's business district, AP reported.
There have been 17 coups in Thailand since World War II, and rumors of an 18th have been circulating around Bangkok in recent weeks as Thaksin battled considerable pressure to step down. This is the first coup since 1992, AP reported.
International reaction to the coup was muted largely because details of the situation were scarce. John Bolton, the U.S. ambassador to the United Nations, said Secretary of State Condoleezza Rice cut short a meeting at the United Nations to try to get more information from the U.S. Embassy in Bangkok.
"We think it's important, in the short term, that we have peace in the streets in Bangkok, and that their constitutional processes be upheld," Bolton said.
And U.N. Secretary-General Kofi Annan said "This is not a practice to be encouraged."
"Over the past decade or so, they have established a solid democracy and institutions under the leadership of the king," Annan told reporters. "I'm sure they will be able to restore that institution and go back to a democratic system as soon as possible. "
Thaksin decided Monday night to reschedule his speech to the U.N. General Assembly for Tuesday night and return to Bangkok afterward, according to U.N. officials. He originally had been scheduled to address the assembly on Wednesday.
Though he canceled the Tuesday speech, it was not clear when Thaksin would return to Thailand.
Elections in Thailand are scheduled for November after the country's constitutional court ruled that a vote in April was unconstitutional.
Thaksin had called for the April elections, three years early, after opponents accused the billionaire leader of abusing the country's system of checks and balances and bending government policy to benefit his family's business.
Some Thais gathered outside Government House in Bangkok to get pictures of themselves with the tanks and troops, AP reported.
The coup caused little stir in Bangkok's popular tourist districts, where foreigners packed beer bars and cabarets just a few miles from where the tanks were posted, AP reported.
CNN's Richard Roth, Dan Rivers and Ellen Rose contributed to this report
Copyright 2006 CNN. All rights reserved.
Associated Press contributed to this report.

Tuesday, September 19, 2006

Air Pollution Linked to Lung Cancer

(HealthDay News) -- A study of Texas residents suggests that tiny metallic bits of air pollution could account for some cases of lung cancer.

The researchers aren't sure exactly how dangerous the particles are, nor do they fully understand their potential relationship to tobacco smoke.

Still, "It's disturbing that there might be something in the environment causing the problem," said study author Dr. Yvonne Coyle, an associate professor of internal medicine at the University of Texas Southwestern Medical Center at Dallas. "It could be these metals, and we need to look at that further."

According to Coyle, 10 percent to 15 percent of lung cancer cases occur among nonsmokers. One possible explanation: Inhalation of air pollution, especially fine particulate matter -- bits of metal that are too small to be seen with the naked eye but can still enter the lungs.

Mining, smelting and petroleum production all produce this type of pollution, Coyle said, as can motor vehicle exhaust.

But while air pollution has been directly linked to respiratory disorders and heart disease, its role in lung cancer is still under debate.

In the new study, Coyle and her colleagues tried to determine if exposure to metallic bits of air pollution was associated with higher levels of lung cancer. To find the answer, they compared lung cancer rates in 254 Texas counties from 1995-2000 to federal reports that companies filed when they released pollution between 1988 and 2000.

The researchers found an "association" between various types of lung cancer and releases of zinc, chromium and copper. When the study results were adjusted to take into account the effects of factors such as gender and race, zinc was still linked to lung cancer.

The findings of the federally funded study appear in the September issue of the Journal of Thoracic Oncology.

The study doesn't say how much more likely it is for people to develop lung cancer if they're exposed to higher levels of the pollutants.

Also, the role of smoking is unclear because the county-by-county statistics didn't reveal whether the individual lung cancer patients smoked. However, Coyle said smoking levels were consistent across the counties studied.

More research needs to be done to confirm the results and "determine who is at the greatest risk, given this exposure," Coyle said.

Dr. Michael Thun, head of epidemiologic research for the American Cancer Society, suggested that the value of the study is limited because it didn't take into account smoking by the lung cancer patients.

"It's clear that smoking is such a powerful cause of lung cancer that it's very difficult in wealthy countries to identify any separate contributions from air pollution," Thun said. "It's extremely hard to measure, and this study doesn't solve that problem."

More information
Learn more about air pollution from the U.S.
Environmental Protection Agency.

Palate Implants Improve Sleep Apnea

(HealthDay News) -- A minimally invasive surgical technique that involves the insertion of small polyester rods into the soft palate may be an effective, long-term treatment for mild-to-moderate obstructive sleep apnea.

Dr. Regina P. Walker of the Hinsdale Medical Center in Hinsdale, Ill., and colleagues tested the Pillar procedure in 22 middle-aged patients, including 16 men and six women, with mild-to-moderate sleep apnea. Although some of the patients had previously tried a treatment called continuous positive airway pressure (CPAP), none had undergone any earlier surgery for their sleep apnea.

After 90 days, 17 of the subjects showed significant improvements in their snoring intensity, daytime sleepiness and apnea hypopnea index, a measure of breathing interruptions that occur during sleep. Most significantly, these results were sustained after 15 months, indicating that the improvements could be permanent, according to Walker.

Overall, the patients' apnea hypopnea index decreased from a mean of 19.5 to 13 events per hour after 90 days, and to 12.8 events per hour after 15 months.

Walker was expected to present the study at the 110th annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery Foundation, being held Sept. 17-20 in Toronto, Canada.

"This is an important study," said Dr. Michael Friedman, chairman of head and neck surgery at Rush-Presbyterian-St. Luke's Medical Center in Chicago. "Sleep apnea is a huge problem affecting at least 12 million Americans. If you count very mild forms of sleep apnea, the number goes up to 50 million."

In sleep apnea, breathing stops or gets very shallow during sleep. Each pause in breathing typically lasts 10 to 20 seconds or more. These pauses can occur 20 to 30 times or more an hour. The most common type of sleep apnea is obstructive sleep apnea, according to the U.S. National Institutes of Health.

Even mild forms of sleep apnea can increase a person's risk of cardiovascular disease by five times, Friedman said. The condition is also associated with an increased risk of high blood pressure, weight gain, memory problems, depression and impotence.

Until the Pillar procedure was introduced about six years ago, patients with sleep apnea only had two treatment options: CPAP, a machine that keeps the airways open during sleep; and invasive surgery to remove excess tissue in the mouth and throat.

Although both treatments are effective, they have drawbacks, Friedman said. Because many patients are unwilling or unable to use a CPAP machine, compliance is only about 40 percent. And the results of invasive surgery tend to diminish after a year as tissues loosen and symptoms return, he said.

During the in-office Pillar procedure, patients receive a local anesthetic before several polyester rods are inserted into their soft palate. Pain is usually minimal and can be managed with over-the-counter medications.

Most patients can resume full activity the same day and return to their usual diets after a day or two. They usually can't even feel the implants after a week or two. Rarely, implants work their way to the surface and must be re-implanted, Friedman said.

It's not the rods themselves that tighten loose tissue and reduce symptoms of sleep apnea, but the scar tissue that forms around them. "Scar tissue tends to become more effective over time," Friedman said. "That's why this study is important, because it shows that the results are stable or even better after 15 months, whereas the results of invasive surgery drop off after a year."
Although most of the patients in Walker's study were overweight or mildly obese, the Pillar procedure isn't recommended for patients who are morbidly obese. Friedman estimated that up to 50 percent of sleep-apnea patients are candidates for the procedure, but said it probably would be a stand-alone treatment for only about half of them.

"The nice thing about this procedure is it doesn't eliminate the possibility of other procedures," Walker said. "Quite often, we can combine many treatments. Studies are now being done on implant patients who use CPAP machines to see if it's possible to reduce CPAP pressure."

The Pillar procedure costs about $1,500, which insurance may cover in patients with diagnosed sleep apnea but not in patients who simply have snoring problems. "It's still a fairly new procedure that doesn't have a specific CPT code," Walker said. "I would say that about 25 to 30 percent of procedures in sleep-apnea patients are being paid for, although the number appears to be increasing."

Some doctors are using the Pillar procedure to treat severe sleep apnea. "But this hasn't been well-studied," Walker said. "So, it's too early to say if the implants will be of benefit to such patients."

More information
To learn more about sleep apnea, visit the National Institute of Neurological Disorders and Stroke.

Tiny Balloons Open Blocked Sinuses

(HealthDay News) -- A new procedure that uses tiny balloon catheters to prop open inflamed sinuses is easing the misery of chronic sinusitis sufferers.

A report on the procedure was to be presented at the American Academy of Otolaryngology Head and Neck Surgery Foundation annual meeting Sunday, in Toronto.

"This new technology presents what seems to be faster healing, less postoperative care, minimal pain and bleeding, and improved quality of life for many patients who suffer with chronic sinusitis," said study investigator Dr. Howard L. Levine, director of the Cleveland Nasal Sinus and Sleep Center.

Chronic sinusitis, which can be due to infection, inflammation or anatomical obstructions, affects some 37 million Americans. Many people with the disorder are helped with antibiotics, but more severe cases call for surgery. In conventional endoscopic sinusotomy, an otolaryngologist uses an endoscope to examine the sinuses, and inserts micro-shavers and delicate instruments to remove diseased bone and soft tissue.

"This enlarges the sinus and returns it to function," Levine explained.
From this concept, balloon catheterization was born. The investigators describe it as another technology that will augment the ability to preserve sinus function.

Dr. David Sherris, chairman of otolaryngology at the University at Buffalo in New York, agreed. "The study shows the balloon catheter is effective in opening some sinuses, and this may prove to be less invasive for certain aspects of sinus surgery," he explained.

Even though it is performed in the operating room under general anesthesia, the new procedure is shorter, with a quicker recovery, the researchers say. Using fluoroscopic imaging, a small flexible wire is guided into the sinus. Over this guide wire, a 3-millimeter, 5-millimeter or 7-millimeter balloon is passed into the sinus cavity. Once positioned, the balloon is dilated, the catheter is removed, and the dilated opening is inspected, Levine said.

The procedure takes from 30 minutes to two hours, depending on degree of pathology and the complexity of the patient's sinus anatomy. Depending on the disease, this procedure can be combined with traditional endoscopic sinus surgery.

The multi-center landmark study analyzed six-month data from 115 patients (41 male, 74 female). Mean patient age was 47.8 years, and ranged from 21 to 76 years. Twenty-one patients (18.3 percent) had previous endoscopic sinus surgery. At 24 weeks, endoscopies showed that 82.1 percent (252 of 307 sinuses) were open. Patients showed consistent symptomatic improvement over baseline, the researchers reported.

No serious adverse events occurred, and there were no complications. Narrowing of dilated openings occurred infrequently, and revision surgery was rarely necessary, the researchers reported.
"Realistically, we know sinusitis is caused by many things -- respiratory infections, allergies. And even with the best of surgical procedures, there are always ups and downs, with the possibility for recurrence," Levine said. "The hope is that (balloon sinusotomy) will lessen disease severity and frequency and, hopefully, cure it."

Patients who are not candidates are those with nasal polyps, previous sinus surgery with severe scarring, or those with previous surgery who have new abnormal bone growth, said Levine.
In the end, people who live with the misery of chronic sinusitis now have a minimally invasive option that can preserve structure and function and allow return to normal activity faster, Levine said. He also speculated that the procedure could lower health-care costs because patients would be back to work and school sooner. "It could reduce costs in the long run, with less postoperative care compared to conventional sinusotomy," he said.

Although he is not currently trained in the procedure, Sherris said he "would be interested in trying it in minor revision sinus surgery and some sinus surgery in children."
"Longer term studies and head-to-head comparisons with standard endoscopic sinus surgery techniques will be necessary to establish the place of balloon sinuplasty in the toolbox of endoscopic sinus surgeons," Sherris said.

Because it is minimally invasive, the procedure could be "ideal for children," Levine said, noting a prospective study is under way to evaluate its feasibility in pediatric cases. The U.S. Food and Drug Administration approved the procedure for adults last year, he noted.

More information
The National Institute of Allergy and Infectious Diseases has more on sinusitis.

2004 Staph Outbreak Endangered Patients, Caregivers

(HealthDay News) -- An investigation reveals that a bacterial outbreak at a Johns Hopkins outpatient clinic posed a greater potential risk to staff and patients than previously thought.
In 2004, two health care workers at an outpatient clinic for people with HIV at the Johns Hopkins Hospital became infected with a more aggressive form of methicillin-resistant Staphylococcus aureus (MRSA).
The workers had community-acquired MRSA, which can be more dangerous to patients because it is often misdiagnosed as hospital-acquired MRSA. Community-acquired MRSA can be treated by some antibiotics, while hospital-acquired MRSA tends to be resistant to common antibiotics.
In response to this outbreak, infection control experts at Johns Hopkins conducted and investigation, the results of which are published Sept. 18 in the online edition of Infection Control and Hospital Epidemiology.
The Hopkins team swabbed 36 surfaces in the clinic and tested all other clinic staff for the presence of the infection.
While no other workers were found to be infected with community-acquired MRSA, seven surfaces tested positive for contamination, including patient exam table surfaces, pulse oximeters, countertops, computer keyboards and patient chairs.
After two weeks of intense efforts to prevent the spread of infection, another round of testing showed no positive cultures of community-acquired MRSA, so the outbreak was deemed to be over.
"Community-acquired MRSA is an increasing problem in inpatient and outpatient settings, as exposure can occur in the workplace," senior hospital epidemiologist Dr. Trish Perl, associate professor of medicine and pathology at the Johns Hopkins University School of Medicine, said in a prepared statement.
"Our experience shows that health care workers need to be aware of the risk, alert infection control staff immediately after an infection is suspected, and understand that tighter infection control procedures can guard against subsequent exposure," she said.
Symptoms of community-acquired MRSA include abscesses on the skin that must be drained to prevent foul-smelling skin infections, muscle swelling, or pneumonia and septic shock.
More information
The U.S. Centers for Disease Control and Prevention have more about community-acquired MRSA.

Sunday, September 17, 2006

Ovary Removal Raises Young Women's Death Risk

(HealthDay News) -- Younger women who have had their ovaries removed should consider estrogen therapy if they are under the age of 45, a new study suggests.

Mayo Clinic researchers found that those who said no to hormone therapy faced a higher death risk than those who said yes.

Many women with high-risk family histories have their ovaries removed, a procedure known as an oophorectomy, to help them avoid cancer or other diseases. However, experts said this new data should give them pause when deciding whether to use hormone replacement therapy afterwards.

According to one specialist, the study suggests that estrogen may have different risks and benefits, depending on a woman's age: protecting health at a younger age, seemingly neutral at menopause, but harmful at an older age.

"The study tells us that estrogen for women under 45 is very important to maintain health. Estrogen is a complex hormone in its interactions in the body, and has importance far beyond the reproductive tract," said Dr. Bobbie Gostout, a Mayo Clinic gynecologic surgeon who was not involved in the research.

The findings are published in the Oct. 1 issue of Lancet Oncology.

In their study, the researchers developed a statistical model of death due to ovarian cancer, breast cancer, coronary heart disease, hip fracture and stroke. Risks for all of these illnesses have been tied to estrogen levels.

"We aimed to investigate survival patterns in a population-based sample of women who had received an oophorectomy, and compare these with women who had not received an oophorectomy," the researchers wrote.

Women who had oophorectomies for reasons other than cancer before menopause were compared with age-matched women in the same population who did not have oophorectomies.

There were nearly 1,300 women with unilateral oophorectomy (one ovary removed), nearly 1,100 with bilateral oophorectomy (both ovaries removed), and close to 2,400 controls in the study.

The team found that certain younger women who have prophylactic bilateral oophorectomy -- surgical removal of both ovaries -- were at an increased risk of death from all causes.

Overall, mortality was not increased in women who had both ovaries removed, but that changed when the researchers broke down the findings by age.

For example, mortality was significantly higher in women who had both ovaries removed before the age of 45 years than women with intact ovaries. Furthermore, this increased mortality was seen mainly in women who had not received estrogen supplementation to the age of 45 years.

Although having both ovaries removed before age 45 years is associated with increased death risk, it is uncertain whether it helps cause death, or is merely a marker of some other underlying risk, the authors wrote.

No increased mortality was recorded in women who had just one ovary removed, regardless of their age, the study found.

In the United States, prophylactic oophorectomy prevents about 1,000 cases of ovarian cancer each year. Over the last three decades doctors have been gradually increasing their recommendations that women have ovaries removed at time of hysterectomy to avoid the risk of cancer, "but that wonderful prevention has been at the cost of removing ovaries in 300,000 women per year," Gostout said.

"This 25-year study showed a decreased incidence in ovarian cancer, however that was countered by adverse health impact in other areas," said Gostout. The increased death risk did not show up for at least a decade, and was 1.7 times greater than normal, the study found.

The work is exciting because it fills in part of the information deficit for women in this age bracket, she added.

Before this study, people were applying lessons from Women's Health Initiative -- a study that focused on women 60 years and older -- to much younger women, recommending that estrogen not be used any longer than five years.

"This study shows that could be an error -- that women under the age of 50 face a different risk/benefit scenario than older women," Gostout said.

But whether all women who've had bilateral oophorectomy should receive estrogen therapy isn't yet proven, another expert said.

The researchers looked at associations in this study, "but don't prove cause and effect," noted Dr. Andrew Berchuck, director of gynecologic oncology at Duke University, and president-elect of the Society of Gynecologic Oncologists. Estrogen replacement after menopause is a "patient-by-patient decision, and physicians and patients must look at individual risk factors and symptoms," he said.

There's a long-running debate about what age to remove ovaries, "but there's very little science because these studies require long-term follow-up, and that's hard to do," Berchuck said. "This study adds some ammunition to the argument that says 'leave the ovaries in closer to the natural age of menopause' -- about 50 years -- but it's by no means conclusive," he said.

Gostout agreed these decisions are tough, and best left to an individual woman and her doctor.

"If a woman is considering hysterectomy, she will probably be invited to make a decision about her ovaries. That decision should be highly individualized," Gostout cautioned. "No woman should be told that because she's having a hysterectomy her ovaries must removed as well."

Rather, the decision is based on age and family risk for breast and ovarian cancer, she said.
If a woman needs her ovaries removed because of disease or elects to have them removed, estrogen replacement is recommended until the average age of menopause, age 50, Gostout said.

"Don't be scared away from estrogen-replacement therapy in the premenopausal age because there are some concerns in the postmenopausal age," Berchuck added.

In the meantime, women who have had their ovaries removed in the past should not be "alarmed or frightened," Gostout said, since "the increased risk [of illness] for any single woman is very tiny." She said it might also be reasonable for these women to ask their physicians about "estrogen-replacement therapy if they're not already taking it and they're less than 50 years of age."

More information
Find out more about hormone-replacement therapy at the U.S. National Heart, Lung, and Blood Institute.

Saturday, September 16, 2006

Spleen Cells May Prove Effective Target for Lupus Treatment

(HealthDay News) -- Research done on mice specially bred to develop lupus has uncovered an area of the spleen that may give rise to the disease.
The area is called the marginal zone of the spleen and it appears that this is where B cells from the immune system go awry and turn into cells that attack the body's own tissues and organs, researchers say.
"This current work gives rise to new possibilities for targeted therapies that are perhaps much milder and more effective than current therapies," said the study's lead author, Thomas Enzler, a visiting scholar, internist and immunologist at the University of California, San Diego. However, he was quick to add that it would be a long time before any such potential therapy could be available for humans.
Results of the study were published Thursday in the online edition of the journal Immunity.
Lupus is an autoimmune disease in which the immune system mistakenly attacks the body's tissues and organs. The disease can affect the joints, kidneys, lungs, brain, blood or skin. As many as 1.5 million Americans have lupus, and the disease is far more common in women than in men, according to the Lupus Foundation of America (LFA).
Previously, researchers had developed a mouse version of lupus. These mice are bred to overproduce an immune system hormone (cytokine) known as B-cell activating factor (BAFF). In humans with lupus, the BAFF cytokine is often present in much higher-than-normal levels. B cells produce antibodies. Normally, antibodies are produced to protect against viruses and bacteria. In the case of someone with lupus, however, the B cells produce autoreactive antibodies. This means the antibodies attack normal, rather than diseased, tissue.
When the mice overproduce BAFF, they develop lupus, though the mouse version isn't exactly the same as the human version.
The UCSD researchers transplanted some of the cells from the spleens of the marginal zone of the lupus mice into mice that didn't have their own B cells. Lupus-like antibodies began to develop in these mice immediately.
The researchers also removed the spleens of some of the lupus mice when they were in the early stages of developing the disease, or the scientists interrupted the production of the B cells. When they did this, lupus was diminished or prevented.
"It seems to be that the marginal zone is really important for developing autoimmune disease in transgenic mice," Enzler explained.
Dr. Joan Merrill, medical director of the Lupus Foundation of America and head of the clinical pharmacology research program at Oklahoma Medical Research Foundation, said, "This is an exciting scientific paper."
But, Merrill said, people with lupus shouldn't rush to their doctors to remove their spleens. "If a lupus patient has a splenectomy, the disease doesn't go away," she said, explaining that sometimes lupus patients have to have their spleens removed due to complications of the disease, and it doesn't cure lupus.
She also pointed out that this study was done in mice and the human immune system doesn't work in exactly the same way as the mouse immune system does.
Still, Merrill added that with this study and other research, "We're beginning to unravel some of the mysteries surrounding lupus, and I'm cautiously optimistic about the future. We're trying to find better targets and develop better and safer medicines."

More information
To learn more about lupus, visit the Lupus Foundation of America.

Prostate Biopsy Doesn't Have to Be Painful

(HealthDay News) -- Pain during prostate biopsy can be reduced by injecting an anesthetic at certain points, according to a new study out of the Mayo Clinic.
Prostate biopsies are commonly performed on men who have had abnormal digital rectal exams or elevated prostate-specific antigen (PSA) tests, both of which look for prostate cancer.

A new study to be presented Thursday at the annual meeting of the North Central Section of the American Urological Association, in San Diego, found that about 16 percent of patients experience a moderate or higher level of pain during their biopsy.
For this study, researchers recruited 243 men scheduled to undergo a prostate biopsy and assigned them to receive an anesthetic to reduce pain at one of three locations.

The men who received the anesthetic injection at the prostate apex -- the part of the prostate closest to the urethra -- and surrounding rectal tissues had the best pain relief.
"Prostate biopsy evokes significant anxiety for some men due to anticipated pain associated with the procedure," Richard Ashley, Mayo Clinic urology resident and lead study investigator, said in a prepared statement.
"Patients should request that anesthetic be used at the time of a biopsy, and pain control should be the standard of care in a urologist's office," he said.

More information
The National Cancer Institute has more about prostate cancer.

Commentary on Nutritional Treatment

from Willam Walsh, Ph.D., Senior Scientist, Pfeiffer Treatment Center http://www.hriptc.org/
(The following information is taken from Dr. William Walsh's discussion on Safe Harbor's "Integrative Psychiatry" email list for professionals.

To preserve Dr. Walsh's wealth of information, we have posted his comments here, with the notation of added commentary [with the date] as discussion goes on.)

SAMe
SAMe is very promising for undermethylated persons and a bad idea for those who suffer from a genetic tendency for overmethylation. I don't particularly like the "allopathic" method you referred to which is simply trial & error. SAMe can do great harm if given to the wrong person.

I hate going to funerals. (17 Dec, 2002)The mechanisms of action of SAMe and TMG are quite different. Most of our methyl groups come from dietary methionine. The methionine is converted to SAMe in a reaction with magnesium, ATP, methionine-adenosyl-transferase, and water. SAMe is a relatively unstable carrier of methyl groups and is the primary source of methyl for most reactions in the body.

Once the methyl group has been donated, the residual molecule is s-adenosyl-homocysteine which converts to homocysteine. TMG (betaine) is a biochemical which can donate a methyl group to homocysteine, thus converting it back to methionine.

The TMG route is secondary to the 5-methyl-tetrahydrofolate/B-12 reaction which the primary route for restoring methionine. Methionine and SAMe supplements directly introduce new methyl groups into the body.

TMG can provide a methyl group only to the extent that there is insufficient folate/B-12 to do the job. In some persons, the methylation effect of TMG is very minimal. In addition, persons who are undermethylated have a SAM cycle which is "spinning very slowly", much like a superhighway with little traffic.

The answer for them is NOT to more efficiently convert the small amount of homocysteine to methionine (using TMG), but rather to directly introduce more methionine or SAMe into the body. A small percentage of persons with sufficient dietary methionine cannot efficiently produce SAMe --- These persons need supplemental SAMe, and not methionine or TMG and are the exception to the rule. In most other cases, methionine supplements alone are sufficient.

TMG is a great way to treat individuals with dangerously high homocysteine levels. TMG can be very useful in augmenting methionine therapy along with B-6/P-5-P , serine, etc. The challenge is to supply enough methyl groups to help the patient, without creating dangerously high levels of homocysteine. Use of TMG is an "insurance policy" against this happening. (Jan 22, 2003)

A quick way to test for need for methylation therapy is to carry out a cautious trial of SAMe.

Within a week or two you should have your answer. If she clearly is improving on the SAMs (which is frightfully expensive)..... you can get usually the same benefits (albeit more slowly) using methionine plus calcium, magnesium, and B-6. This should be side-effect free unless (a) the methylation is begun too abruptly or (b) the patient has a rare genetic enzyme disorder which disrupts the SAM cycle. We've found that direct methylation is usually more successful than tinkering with the SAM cycle. The primary way humans receive most of their methyl groups is from dietary methionine. It's often hard to improve on Mother Nature. (Jan 20, 2003)

SAMe is likely to cause great worsening of symptoms, including mania, if given to an OVER-methylated person. The incidence of overmethylation in our patient database of 1,500 bipolar cases is about 18%. Bipolar disorder is not a single condition, but a collection of very different biochemical disorders under the same umbrella diagnosis. SAMe works great for truly undermethylated patients, but all hell breaks out if given to someone who is overloaded (genetically) with methyl groups. The right way to do this is to (a) first determine the person's innate methylation tendency & then (b) act accordingly. (Jan 31, 2003)

Schizophrenia
Severe wheat gluten intolerance can cause classic symptoms of schizophrenia, and amounts to about 4% of all schizophrenia diagnoses in the U.S. These persons usually become quite normal when placed on a gluten-free diet.I've done medical histories for more than 2,000 persons diagnosed with schizophrenia and have always been struck by the high frequency of schizophrenia in other relatives. Interestingly, the schizophrenia would often skip a generation.

NIMH data suggests that the overall incidence of schizophrenia in the USA is between 1% and 4%, depending on the definitions. However, the incidence of schizophrenia for children who have a schizophrenic parent is about 16%. This number doesn't change much for children of schizophrenics adopted at birth. I don't think there is "a schizophrenia gene", partly because this is a garbage term which encompasses several completely different conditions.

There are a number of biochemical ingredients which predispose to each phenotype of SZ..... these may be either genetic or acquired. However, I'm absolutely certain there is a genetic component in most cases.

Carl Pfeiffer was the first to develop meaningful chemical classifications of schizophrenia (and separate treatments for each phenotype). Carl Pfeiffer of Princeton, N.J. saw more than 20,000 schizophrenics in his lifetime. He found that 90% of all SZ patients could be classified into 3 large groups, with completely different etiologies & treatment approaches. These he termed "histapenia", "histadelia", and "pyroluria". The remaining 10% fit into several splinter groups.

One of the splinter groups was gluten intolerance, which represents 4% (1 case in 25). This is a rare form of schizophrenia, but if you've got it, it's everything!Multiple food & chemical sensitivities are also associated with histapenia (low histamine, overmethylation), the largest of all SZ groups, amounting to about 48% of all cases.

For this group, SZ symptoms often worsen if exposed to the offending substances, & nice improvements often occur if they are identified & avoided. However, the food sensitivities usually disappear after about 1 year of aggressive Folate/B-12/B-3 treatment, which is the primary route to a normal life for these patients.

We've known for more than 20 years that the metallothionein protein system does not perform well in most ADHD patients. About 68% of them exhibit very poor control of Cu & Zn, based on lab data from more than 6,000 patients diagnosed with ADD/ADHD. Autism is different in that about 90% of patients exhibit Cu/Zn imbalances that are generally much more severe than in ADHD.For several months, we have extended our metallothionein-promotion protocol to ADHD, behavior, depression, and schizophrenic patients who exhibit Cu/Zn imbalance.

The informal results so far are very encouraging. However, we've not yet done a formal outcome study for these populations, and thus have no statistics yet.We are considering applying MT-Promotion to Alzheimers & Parkinsons patients in the near future. Both disorders involve serious oxidative stress and abnormal trace metal levels. In addition, recent research has revealed a striking metallothionein deficiency in the brains of Alzheimers patients. (Feb 25, 2003)I've evaluated more than 3,500 patients with a diagnosis of bipolar or schizophrenia. The predominance of auditory hallucinations, serious self abuse, aggressiveness, inability to continue school, and social isolation...... all point in the direction of classic "paranoid schizophrenia", although many of these patients are labeled "bipolar disorder with psychotic features". Most severely mentally ill persons with a history of exceptional artistic or musical talent test as overmethylated. The biochemical recipe for these patients usually consists of (1) overmethylation, (2) low folate levels, and (3) elevated blood copper levels. All three of these chemical imbalances impact dopamine and norepinephrine in the brain, and together can cause rather extraordinary abnormalities in these important neurotransmitters. In my opinion, the key to successful treatment is biochemical treatment to overcome these chemical imbalances...... fortunately this can be accomplished using aggressive therapy with nutrients to normalize the chemical factors.Most mental breakdowns are triggered by severe stress, but the underlying cause is genetic and involves brain chemistry. Many persons self-medicate with alcohol, marijuana, or other illegal drugs in a desperate attempt to feel better. Many patients and their families erroneously believe that the EtOH or drug experiences were the underlying cause of the condition. They are wrong! This adult-onset condition will strike eventually in most cases, even if substance abuse never occurs.Traditional medicine can provide medication support which can usually eliminate (temporarily) most/all psychosis symptoms. However, these patients are usually plagued by drug side effects and are a mere shadow of their original selves. Common side effects are (a) fatigue, (b) inability to focus/concentrate for more than a few minutes, (c) change in personality, (d) massive weight gain, etc. The most popular drugs for these patients are Zyprexa, Seroquil, Risperdal, Geodon, and Clozaril..... the so-called atypical antipsychotics. Since most patients hate these medications, poor compliance is a major problem.I've seen many young schizophrenics and bipolar patients achieve complete recoveries through biochemical (nutrient) therapy. This rarely occurs with traditional medication therapy. (May 12, 2003)Some of schizophrenics who spontaneously get better are those who experience a toxic psychosis. I have a friend who had a toxic psychosis after an accidental overdose of a medication during childbirth. For 6 hours she was a full blown paranoid schizophrenic..... No symptoms in the following 20 years. Also, schizophrenia comes in mild, moderate, and severe versions. Many persons with a very mild genetic tendency for SZ can experience an environmental insult which pushes them into a temporary mental illness. Most will become quite ok with or without therapy.The real problem is the millions of SZ persons who have moderate to severe SZ which does not go away easily. (May 27, 2003)

Taurine
Yes, I've read a few articles and a book that talked about Taurine's slow metabolism and tendency to build up over time. Because of this, I've believed that high doses of Taurine (1,000 to 2,000 mg/day) are ok in the beginning..... but that the dosages need to be reduced within 2 weeks to about 400 to 500 mg/day..... to achieve the same effect.I believe that Taurine is especially effective for (1) combating seizure tendency and (2) reducing liver stress in processing fats. There have been several reports of intolerances and side effects from use of Taurine, and I feel that indiscriminant high doses are unwise.About 12 months ago, there was a fad among several alternative practitioners in which high doses of Taurine were given to every autistic patient. One of the reasons given was "to assist the liver cope with stresses associated with toxic metal overload". This seems to be a poor reason, since Taurine's action in the liver appears to be limited to fat metabolism, and most autistics are slender malabsorbers with low lipid levels. (June 24, 2003)

Womb Trauma
There is an exquisite and fragile biological/biochemical process during gestation in which short, dense immature brain cells are pruned, grow into fully-developed brain cells, and then (remarkably) experience growth inhibition to complete the process. The molecular biology of this process is becoming very well defined, and it is clear that many environmental events can hinder or disrupt early brain development. The primary culprits are oxidative stress, teratological chemicals, and infections. The least appreciated of these harmful factors is oxidative stress which can deplete key proteins and enzymes required for normal brain development.Environmental harm to a developing fetus can result from (a) biochemical inadequacies of the mother, and (b) external environmental insults. We're all familiar with birth defects that can result from Thalidomide, Thorazine, Prolixin, Haldol, and other psychiatric medications. Also the dangers of mercury, lead, and other toxics are well established, and we know that a mother's improper diet (e.g. inadequate folic acid) can be harmful. Although lower on the radar screen, fetal oxidative stresses can be equally devastating.What I'm leading up to.... is the scientific fact that serious emotional or physical stresses experienced by the mother can impair early brain development, especially if the mother is not biochemically intact. For example high emotional stresses or physical trauma to the mother will weaken the activity of metallothionein (MT) and glutathione (GSH) proteins, andincrease oxidative stress in the brain. MT-1 and MT-2 are directly involved in growth of immature brain cells. MT-3 is a key protein required for pruning and growth inhibition. These proteins also have the job of defending against oxidative stress in the brain and are consumed in the process. Maternal emotional stresses and psychic traumae deplete the embryonic brain of MT proteins and can compromise brain development.Womb trauma is real and the concept of "a cry so deep" is not psycho-babble guesswork. Rather, it is solidly supported by scientific fields such as embryology and molecular biology. (Aug 1, 2003)If fetal or early infant traumae have resulted in a brain that hasn't completely matured..... therapies to promote MT and GSH appear very promising..... especially in tandem withbehavioral therapies which stimulate the development of new brain cells.If the net result of the traumae is biochemical or neurotransmitter differences, then biochemical therapy aimed at normalizing brain chemistry would be indicated.If the traumae resulted in diminished ability to tolerate environmental toxins (for example an incompetent blood-brain barrier), then avoidance of such toxins would be an important aspect of treatment.If the traumae resulted in an innate inability to cope with emotional stresses, then counseling or other psychological services could be very beneficial.If the traumae resulted in a brain that is structurally different, this may represent "brain damage" that may be refractory to all treatments. (Aug 1, 2003)

Zinc
There have been several recent published articles which indicate that zinc and zinc metallothionein proteins (1) tend to prevent brain strokes, (2) tend to assist brain recovery after strokes, and (3) that deficiency of Zn or Zn-MT is associated with increased stroke likelihood. An occasional test for plasma Zn could help identify the proper dosage. Most adults can safely start with 25 to 50 mg/day of Zn. Without indication of B-6 deficiency, it might be a good idea to limit pyridoxine hydrochloride (usual form of B-6) to about 200 mg/day. B-6 is very helpful in enhancing the utilization of Zn.After use of these nutrients with thousands of persons, I'm not aware of a single case of harm. However, it is a good idea to introduce zinc gradually & to take Zn during the PM only. (June 3, 2003
Every 5 years or so, the zinc experts of the world convene for a symposium in which they share new advances in Zn technogy & research..... It's usually headed up by the eminent Prof. Prasad.One of the topics is laboratory testing to indicate an individual's Zn status. They consider about 10 different methods including packed cells, taste tests, etc...... The last two symposia resulted in the consensus that none of the testing options is wonderful, but that the best of the commercially available tests is plasma zinc. Taste tests didn't make the top three methods.However the Zn experts also stated that the most definitive determination of zinc depletion is the presence of symptoms of Zn depletion which disappear after Zn supplementation.My organization has evaluated the Zn status of 18,000 patients and we've tried all of these methods. Our standard protocol involves plasma Zn, being careful to use acid-etched, trace-metal-free tubes.We find that virtually all treatment-naive ASD persons are very Zn depleted and overloaded in "free" (unbound by ceruloplasmin) copper. Our patient population for ASD is 2,800. Our database of 5,600 ADHD patients indicates that about 75% are depleted in Zn. The remaining 25% have problems associated with pyrrole disorders, methylation disorders, EFA disorders, toxic overloads, etc. (July 22, 2003)

The high level of zinc depletion in ASD appears to stem from a genetic weakness in the metallothionein protein system.Cu/Zn ratios in hair are very helpful in ADHD and behavior disorders..... but far less useful in ASD, depression, and schizophrenia. Tracking plasma Zn, serum Cu and serum ceruloplasmin levels can be very helpful in guiding dosages aimed at normalizing Zn.

Management of Zn & Cu levels is a challenging problem in ASD. Sometimes rather extraordinary Zn dosages are required to normalize blood Zn levels.Virtually all ASD persons are Zn depleted., but not all exhibit an elevated Cu/Zn ratio. A minority of ASD patients exhibit normal or low Cu levels in serum, but have vastly inadequate levles of ceruloplasmin. Thus, the level of "unbound" Cu can be very high, even though all standard measures of Cu appear to be low. Some of these patients seem to have a mild version of Wilson's Disesase. (July 24, 2003)

Friday, September 15, 2006

Bacopa: A Better Memory Booster?

Bacopa: A Better Memory Booster?

Q: What you can tell me about bacopa? I first read about it as a treatment for memory problems. Do you know anything about its effectiveness in treating memory problems or what the recommended dosage should be?

A: Bacopa (Bacopa monnieri) is an herb native to India that has been used traditionally in Ayurvedic medicine to enhance memory, learning and concentration and also to treat anxiety, heart problems, digestive disorders, asthma, and bronchitis. Most of the research on bacopa has been in animals, but a few small studies on humans have also been done.

The single study I've been able to find on bacopa's effect on memory was a small, double-blind, placebo-controlled 12-week trial conducted in Australia with 46 volunteers between the ages of 18 and 60, divided into two groups.

The volunteers in one group were given 300 milligrams of bacopa daily, and the others received a placebo. Prior to the study, the researchers tested all the volunteers to assess their verbal learning abilities, memory and speed of information processing. The tests were repeated five and 12 weeks after the study began. The researchers noted a significant improvement among the volunteers in the bacopa group compared to those in the placebo group.

A review article of some 38 scientific studies of bacopa was published in the March, 2004, issue of the journal Alternative Medicine Review, and noted two small studies that demonstrated an improvement in cognitive function in children as a result of taking bacopa.

A single small-scale human study also found a decrease in anxiety symptoms among patients treated with bacopa.

Bacopa is now being widely promoted as a treatment for memory problems, but I would recommend more proven protective strategies. Keep your mind active by reading newspapers and books, doing crossword puzzles, playing musical instruments, participating in ongoing education, and learning a new language. As far as supplements to enhance memory are concerned, the ones listed below have been studied more thoroughly than bacopa:

Ginkgo biloba. This well-studied botanical remedy increases blood flow to the head, has a reputation as a memory-enhancing agent and may slow the progression of dementia in early onset Alzheimer's disease. You probably won't notice any effects for six to eight weeks. (Look for products standardized to 24 percent ginkgo flavone glycosides and 6 percent terpene lactones; the dose is 60 to 120 milligrams twice a day with food.) Ginkgo has low toxicity, although it may cause mild stomach irritation.

Acetyl-L-carnitine (also called ALC or ALCAR) is an amino acid derivative. Human clinical studies of this compound are currently underway, and the early evidence from animal trials is encouraging. Many people take ALC as a cognitive enhancer. The dose is 500-1,000 milligrams twice a day on an empty stomach. It is nontoxic, but this is an expensive regimen.

Phosphatidyl serine, or PS. A naturally occurring lipid that is a component of cell membranes, PS is considered a brain-cell nutrient. Human studies have reported positive effects on memory and concentration; PS may improve cognitive function in normal adults and may help reverse age-related cognitive decline. The supplement form, derived from soybeans, is readily available, but fairly expensive. The starting dose is 100 milligrams two or three times a day; if this produces positive benefits after a month or more, it may be possible to go on a lower maintenance dose. It is nontoxic.

Andrew Weil, M.D.
Author of:
Eight Weeks to Optimum Health
Spontaneous Healing
The Natural Mind
The Marriage of the Sun and Moon
Health and Healing
Natural Health, Natural Medicine
From Chocolate to Morphine (with Winifred Rosen)

Thursday, September 14, 2006

Low Folate Levels Could Cut Colon Cancer Risk

(HealthDay News) -- Conventional wisdom has indicated that high levels of folate cut risks for colorectal cancer, but a new study suggests low levels may do the trick, too.

Folate is a B vitamin found in fruits such as bananas and oranges, leafy green vegetables, asparagus, broccoli, liver, and many types of beans and peas.

Outside experts called the findings intriguing but preliminary, stressing that caution needs to be exercised when interpreting the conclusions.

"In a lot of ways, it's counterintuitive, but it may have validity," said Dr. Howard Manten, an associate professor of medicine and pediatrics at the University of Miami Miller School of Medicine. "We need confirmatory studies."

"It's an interesting study, but with relatively small numbers of patients," added Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La.

This advice does not necessarily pertain to pregnant women, he added, since there is good evidence that extra folate in the diet greatly cuts the risk for having children with neural tube defects such as spina bifida.

Indeed, folic acid has long been known for its effect on reducing certain birth defects when taken in sufficient quantities by pregnant women. That was the rationale behind the U.S. Food and Drug Administration's 1998 order for folic-acid fortification of enriched grain products such as cereals and breads. Canada made fortification mandatory that same year.

According to the study, which appears in the April 25 online issue of Gut, there are also initiatives now in Europe to fortify food with folate.

Previous research had found that folate might protect against colorectal cancer. But many of those studies had looked at dietary intake rather than how much folate was circulating in the body, the authors stated.

In the current study, the biggest-ever prospective look at circulating levels of folate and colorectal cancer risk, researchers at Umea University, Sweden, looked at 226 people with colon cancer and 437 controls from the Northern Sweden Health and Disease Cohort.

Participants completed questionnaires on lifestyle, including diet, and also submitted blood samples for analysis.

People with either the lowest or highest levels of circulating folate were the least likely to develop bowel cancer, the researchers found. Those in the middle were almost twice as likely to develop the disease.

People with a common mutation in the MTHFR gene, which lowers a person's circulating folate levels, also had a lower risk of developing the cancer.

There was no apparent link between homocysteine, an amino acid which may play a role in atherosclerosis, and folate. B vitamins, including folate, tend to keep homocysteine levels down.
If nothing else, the findings should make people think twice before they supplement their diet with large amounts of any one nutrient.

"The study shows us that before we start adding extra things into our diet, we may want to really study them carefully, as we may be doing more harm than good," Brooks said.

More information
To learn more about folic acid, visit the American Dietetic Association.

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