Daily consumption of caffeine in coffee, tea, or soft drinks increases blood sugar levels for people with type 2 diabetes and may undermine efforts to control their disease, according to researchers at Duke University Medical Center, Durham, North Carolina. Researchers used new technology that measured participants’ glucose levels on a constant basis throughout the day. The study, published in Diabetes Care, represents the first time researchers have been able to track the impact of caffeine consumption as patients go about their normal, everyday lives. It adds more weight to a growing body of research suggesting that eliminating caffeine from the diet might be a good way to manage blood sugar levels. The researchers studied 10 patients with established type 2 diabetes, who drank at least two cups of coffee every day, and who were trying to manage their disease through diet, exercise, and oral medications, but no extra insulin. Participants took capsules containing caffeine equal to about four cups of coffee on one day and then identical capsules that contained a placebo on another day. The researchers found that when the participants consumed caffeine, their average daily sugar levels went up 8 per cent. Caffeine also exaggerated the rise in glucose after meals: increasing by 9 percent after breakfast, 15 percent after lunch, and 26 per cent after dinner. There are no current guidelines suggesting diabetics shouldn’t drink coffee.  

 

Use of calcium-channel blockers, alpha-blockers, or angiotensin-converting enzyme (ACE) inhibitors appears to offer no advantages in improving clinical outcomes compared with use of diuretics when treating hypertension among individuals with metabolic syndrome, according to a report in the Archives of Internal Medicine. Researchers at Case Western Reserve University said this appears particularly true for black patients. Patients with hypertension (high blood pressure) and metabolic syndrome are at high risk for the complications of cardiovascular disease. Because some medications for high blood pressure (including alpha-blockers, ACE inhibitors, and calcium-channel blockers) have a favorable metabolic profile—for instance, have more favorable short-term effects on blood glucose or blood cholesterol levels—they have been advocated over other drugs (beta-blockers and diuretics) for the treatment of patients with metabolic syndrome. A total of 42,418 participants with hypertension and at least one other risk factor for cardiovascular disease were randomly assigned to take a diuretic, a calcium channel blocker, an alpha-blocker, or an ACE inhibitor. Each drug was used to start treatment and other drugs could be added if necessary to control blood pressure. The researchers said no differences were noted among the four treatment groups, regardless of race or metabolic syndrome status for the primary end point (non-fatal heart attack and fatal coronary heart disease). Among patients with the metabolic syndrome (7,327 black and 15,750 white patients), the calcium channel blocker, ACE inhibitor, and alpha-blocker had higher rates of heart failure compared with the diuretic; the ACE inhibitor and the alpha-blocker also had an increased risk of combined cardiovascular disease. The study was supported in part by Pfizer.

 

The use of a drug to activate stem cells that differentiate into bone appears to cause regeneration of bone tissue and be may be a potential treatment strategy for osteoporosis, according to a report in the Journal of Clinical Investigation. The study, led by researchers from Massachusetts General Hospital and the Harvard Stem Cell Institute,  found that treatment with a medication used to treat bone marrow cancer improved bone density in a mouse model of osteoporosis, apparently through its effect on the mesenchymal stem cells that differentiate into several types of tissues. The researchers said that though stem cell therapies are often thought of as putting new cells into the body, their study suggests that medications can turn on existing stem cells that reside in the body’s tissues, acting as regenerative medicines to enhance the body’s own repair mechanisms. The study was designed to examine whether the drug bortezamib, which can alleviate bone destruction associated with the cancer multiple myeloma, could also regenerate bone damaged by non-cancerous conditions. In their first experiments, the researchers showed that treating mice with the drug increased several factors associated with bone formation.

 

A vaccine against the most common and deadliest strain of avian flu, H5N1, has been engineered and tested by researchers at the University of Pittsburgh’s Center for Vaccine Research and Rockville, Maryland-based Novavax. According to a study published by the journal PLoS ONE, the vaccine produced a strong immune response in mice and protected them from death following infection with the H5N1 virus. The vaccine is being tested in humans in an early-phase clinical trial. Recent outbreaks of avian flu around the world have prompted health officials to warn of its continued threat to global health and potential to trigger a flu pandemic. Unlike other avian flu vaccines, which are partially developed from live viruses, the vaccine uses a virus-like particle that is recognized by the immune system as a real virus but lacks genetic information to reproduce, making it a potentially safer alternative for a human vaccine. Given the evolving nature of H5N1, the vaccine was engineered to encode genes for three influenza viral proteins to offer enhanced protection against possible new strains of the virus. The researchers said that mice immunized twice with the vaccine developed protective antibodies against H5N1 and were protected from disease and death when directly exposed to the virus. The study was funded by Novavax.

 

OBESITY: WEIGHT TRAINING MELTS FAT AND IMPROVES METABOLISM IN MICE
Researchers at the Boston University School of Medicine found that obese mice genetically engineered to bulk up their muscles as though they had been lifting weights lost fat and showed other signs of metabolic improvement throughout their body. In a study published in the journal Cell Metabolism, the researchers found those benefits were seen even though the mice continued eating a diet high in both fat and sugar and didn’t increase their physical activity at all. The mice were engineered to produce type II, or fast, muscle fibers found in abundance in body builders are well suited to dealing with abrupt and heavy loads. Rather than becoming strong and fat “sumo mice” as some of the researchers had expected, the modified mice gained type II muscle and strength while they lost fat. The mice also showed a resolution of fatty liver and improvements in a variety of other metabolic parameters. The researchers said the findings indicate type II muscle has a previously unappreciated role in regulating the body’s metabolism, and suggests strength training may be of particular benefit to overweight individuals.

 

PACEMAKERS: IPODS DON’T INTERFERE WITH CARDIAC DEVICES
A report in the open access journal BioMedical Engineering OnLine refutes claims that portable music players, such as Apple's iPod, interfere with cardiac pacemakers. Researchers with the U.S. Food and Drug Administration in Rockville, Maryland measured the magnetic fields produced by four different iPod models: a fourth-generation iPod, an iPod with video, an iPod nano and an iPod shuffle. They also measured the voltages delivered inside the pacemaker by the magnetic fields from the iPods. All measurements indicated there would be no effects on users with cardiac pacemakers.

Over the past year, a spate of media reports speculated on iPod interference with cardiac pacemakers. These reports, however, were based on a single incident where a patient with a cardiac pacemaker suffered dizziness while using an iPod.

People with blue eyes have a single, common ancestor, according to researchers at the University of Copenhagen who have tracked down a genetic mutation that took place 6,000 to 10,000 years ago and is the cause of the eye color of all blue-eyed humans alive on the planet today. The researchers said originally all humans had brown eyes, but a genetic mutation affecting the OCA2 gene in our chromosomes resulted in the creation of a “switch,” which turned off the ability to produce brown eyes. The OCA2 gene codes for the so-called P protein, which is involved in the production of melanin, the pigment that gives color to our hair, eyes, and skin. The “switch,” which is located in the gene adjacent to OCA2, does not, however, turn off the gene entirely, but rather limits its action to reducing the production of melanin in the iris—effectively diluting brown eyes to blue.

 

A study in the Journal of Food Science explores the additional health benefits of fruits and reveals they also protect against neurodegenerative diseases, including Alzheimer’s Disease. Researchers at Cornell University investigated the effects of apple, banana, and orange extracts on neuron cells and found that the phenolic phytochemicals of the fruits prevented neurotoxicity on the cells. Among the three fruits, apples contained the highest content of protective antioxidants, followed by bananas then oranges. The authors said additional consumption of fresh fruits may be beneficial to improve effects in neurodegenerative diseases such as Alzheimer’s.

 

Children with autism have normal-size heads at birth, but develop accelerated head growth between six and nine months of age, a period that precedes the onset of many behaviors that enable physicians to diagnose the developmental disorder, according to research from the University of Washington’s Autism Center. The study also indicates that this aberrant growth is present in children who have the early onset form of autism as well as those later diagnosed with the regression type of the disorder. The researchers said this abnormal or accelerated rate of head circumference growth is a biological marker for autism. It occurs before the onset of behavioral symptoms at 12 months of age, such as a child’s failure to respond to their name, a preoccupation with certain objects, not pointing to things, a lack of interest in other people, and the absence of babbling.

 

Frequent snoring appears to be associated with the development of chronic bronchitis, according to a report in the Archives of Internal Medicine. Chronic bronchitis involves inflammation of the lower airways accompanied by a persistent cough and the production of mucus or phlegm. Snoring appears more common among individuals with bronchitis. Researchers at the Korea University Ansan Hospital in Ansan, South Korea studied 4,270 individuals and found that, after adjusting for age, smoking, and other bronchitis risk factors, individuals who snored five to six times per week or less were 25 percent more likely to develop bronchitis and those who snored six to seven times per week 68 percent more likely. The association was strongest in individuals who had never smoked, who worked at home, or who were overweight.

 

Stroke victims may benefit from human mesenchymal stem cell (hMSC) or bone marrow stromal cell (BMSCs) transplantation, according to two studies published in the journal Cell Transplantation. In both studies, the migration of chemically “tagged” transplanted stem cells were tracked to determine the degree to which the transplanted cells reached damaged areas of the brain and became therapeutically active. Researchers at Pochon CHA University College of Medicine in South Korea found hMSC cells transplanted into animal stroke models with cerebral artery occlusion showed indications of migration as early as one or two weeks following transplantation. At ten weeks, the majority of the cells were detected in the core of the infarcted area, the researchers said. The study concluded that there is a strong tendency for transplanted hMSCs to migrate toward the infarcted area regardless of injection site but that the degree of migration was likely based on differences in each animal’s ischemic condition.

 

The annual number of Americans older than 65 newly diagnosed with diabetes increased 23 percent between 1994-1995 and 2003-2004, according to a report in the Archives of Internal Medicine. Researchers at Duke University Medical Center, Durham, North Carolina analyzed Medicare program data for patients first diagnosed with diabetes during 1994 (33,164 patients), 1999 (31,722 patients) and 2003 (40,058 patients). This data was compared with that of two control groups consisting of individuals without the disease who were of similar race and ethnicity to those with diabetes. Death and complications of diabetes such as cardiovascular, cerebrovascular (damage to blood cells in the brain), ophthalmic (eye), renal (kidney), and lower extremity events were recorded. After diagnosis, the death rate in patients having diabetes decreased by 8.3 percent when compared with those who were not diagnosed with the disease. Most patients with diabetes experienced at least one complication within the next six years; for example, almost half had congestive heart failure.

 

BRAIN TUMORS: DRUG HELPS PATIENTS LIVE LONGER
People who receive high doses of the chemotherapy drug methotrexate to treat a certain type of brain tumor appear to live longer than people receiving other treatments, according to research published in the journal Neurology. Researchers from Massachusetts General Hospital Cancer Center in Boston found high-dose methotrexate alone or in combination with other chemotherapy drugs is the most effective treatment available for primary central nervous system lymphoma, or PCNSL. The study found 52 percent of the participants achieved complete remission and 40 percent of these patients have not relapsed after an average of seven years. The average survival rate of all participants who received methotrexate was 4.5 years. In contrast, the average survival rate for patients who receive radiation therapy for this type of brain tumor is one year.

 

HERPES: RESEARCHERS FIND GENETIC LINK
There’s a high probability that people who are prone to herpes simplex virus outbreaks can inherit that susceptibility through their genes, researchers at the University of Utah reported. In The Journal of Infectious Diseases, the researchers identify a region on the long arm of human chromosome 21 with high odds—at least 1,000-to-1—of being linked to cold sore susceptibility. The researchers said they pinpointed six specific genes in that chromosomal region as candidates for making people prone to outbreaks of cold sores. Cold sores occur when the herpes virus reactivates from its quiescent state within the nerve, infecting the lip, nose, or face. Discovery of the probable link could lead to the development of new drugs that reduce the frequency of herpes outbreaks, the researchers said. The probable genetic link is not the only component believed to trigger reactivation of HSV and cold sores. Environmental factors, such as fever, wind, and sunburn, also are believed to play a part. Viral factors, like strain and burden of latent infection, also probably influence the frequency of HSV outbreaks.

 

HEART TRANSPLANTS: STUDY CONTRADICTS GOVERNMENT’S LOWERED STANDARD
Heart surgeons at Johns Hopkins University School of Medicine have evidence to support further tightening rather than easing of standards used to designate hospitals that are best at performing heart transplants. In a study to be presented at the 44th annual meeting of the Society of Thoracic Surgeons in Fort Lauderdale, Florida, the Hopkins team recommends that the benchmark for designation as a high-volume hospital rise from ten heart transplants per year to 14. High-volume centers consistently show higher survival and fewer complication rates. However, the standard, which is officially set by the U.S. Centers for Medicare and Medicaid Services and which qualifies medical centers for federal reimbursement, was recently lowered from 12 per year to ten. The researchers reviewed the patient records of 14,401 men and women who received a heart transplant in the United States between 1999 and 2006. They found that death rates one month and one year after transplant were higher at hospitals that performed fewer than 14 heart transplants per year, which was the case for a majority of the 143 U.S. medical centers licensed to perform them. The overall average death rate one year after surgery was 12.6 percent. However, patients had a 16 percent greater chance of dying in a hospital that performed fewer than five heart transplants per year and had the best chances of surviving, with a 30-day mortality rate of less than 1 percent, at a hospital that performed more than 40 procedures per year. Patients at hospitals with volumes of less than 10 had an 80 percent greater chance of dying within a month. The researcher said that death rates flattened for the majority of patients in hospitals with heart transplant volumes at 14 or more per year.  

 

CARBON MONOXIDE: GAS FOUND TO CAUSE LONG-LASTING DAMAGE TO HEART
Lack of oxygen isn’t the only way that carbon monoxide damages the heart, according to researchers at Rhode Island Hospital. In a study published in the journal Academic Emergency Medicine, carbon monoxide also causes direct damage to the heart muscle, separate from the effects of oxygen deprivation, which reduces the heart’s pumping capacity and permanently impairs cardiac function. When inhaled, carbon monoxide—the leading cause of accidental poisoning deaths across the country—displaces oxygen in the blood and deprives organs such as the heart, brain, and other vital organs of life-sustaining oxygen. Based on previous studies, researchers have speculated that there may be other mechanisms besides oxygen deprivation that lead to carbon monoxide-related heart damage, although these have not been clearly defined. The researchers examined an animal model in which blood and other systemic factors were eliminated in order to determine the direct effects of carbon monoxide on cardiac function in the recovery phase. The pressure generated in the left ventricle of the heart was used as an indicator of heart function. The researchers found animals exposed to carbon monoxide did not recover cardiac function—including blood pressure—to the extent that a control group exposed to nitrogen did after treatment with 100 percent oxygen. These findings suggest that carbon monoxide has an independent toxic effect on the heart separate from oxygen deprivation.

 

HOSPITAL QUALITY: TOP INSTITUTIONS HAVE 27 PERCENT LOWER MORTALITY RATE
Patients treated at top-rated hospitals nationwide are nearly one-third less likely to die, on average, than those admitted to all other hospitals, according to a study released today by HealthGrades, an independent healthcare ratings organization. Patients who undergo surgery at these high-performing hospitals also have an average 5 percent lower risk of complications during their stay, researchers found. The annual HealthGrades Hospital Quality and Clinical Excellence study, now in its sixth year, identifies hospitals in the top 5 percent nationally in terms of mortality and complication rates for 27 procedures and diagnoses, from bypass surgery to total knee replacement. HealthGrades said disparities in the hospitals care patients receive, based simply on where they choose to seek treatment, highlight a troubling phenomenon in the U.S. healthcare system: a persistent and preventable gap between high-quality hospitals and the rest of the field. The 2008 study found that 171,424 lives may have been saved and 9,671 major complications avoided during the three years studied had the quality of care at all hospitals matched the level of those in the top five percent.