Within two years, around 60 percent of the world's heart disease burden is expected to occur in India, according to researchers in India and Canada. The study, published in The Lancet, also reports that India has a higher rate of types of heart disease that lead to worse prognoses than do developed countries, and on average heart disease occurs at a younger age in Indian people. Ischemic heart disease is the leading cause of death globally. In 2001, the disease accounted for 7.1 million deaths worldwide, 80 percent of which were in low-income countries. Between 1990 and 2020, these diseases are expected to increase by 137 percent for men and 120 percent for women in developing countries, compared with 30 percent to 60 percent in developed countries.

HEART FAILURE: GENETIC VARIANT EXPLAINS WHY BETA-BLOCKERS DON’T WORK FOR ALL PATIENTS
A genetic variation, found predominantly in African-Americans, protects some people with heart failure, enabling them to live longer than expected, according to researchers at the University of Maryland School of Medicine in Baltimore and the Washington University School of Medicine in St. Louis. The researchers found that the genetic variation acts just like beta-blockers, a class of drugs used to treat chronic heart failure. The study, published in the online version of Nature Medicine, found that African-American heart failure patients with the genetic variation had a natural protection against both death and the need for a heart transplant that was the same as the protection provided by beta-blocker therapy. Those patients who were given beta-blockers did not experience additional benefits from the medications because their own “genetic beta blockade” was already protecting them. The researchers say their discovery adds to the accumulating evidence that genetic differences contribute to the way people respond to medications, and should encourage the use of genetic testing in clinical trials to identify people who can benefit from therapy tailored to their personal genetic makeup.

Many cancer survivors in Canada are overweight and inactive, which could put them at risk for health problems, including their cancer returning, researchers from University of Alberta in Edmonton report. Both physical inactivity and obesity are risk factors for developing cancer, as well as for the recurrence of cancer. Lifestyle is just as important after diagnosis, the researches note. The researchers analyzed data from a 2005 Community Health Survey of more than 114,000 adults. The study showed that only about 21 per cent of cancer survivors and about 25 per cent of Canadians in general, are physically active. It also found that about 18 per cent of cancer survivors report being obese, compared to about 15 per cent of Canadians in general. An additional 34 per cent of cancer survivors report being overweight, compared to about 37 per cent of Canadians in general.

 

Children with attention deficit hyperactivity disorder, or ADHD, should get careful cardiac evaluation and monitoring—including an electrocardiogram (ECG)—before treatment with stimulant drugs, according to a statement from the American Heart Association. The scientific statement is published online in Circulation: Journal of the American Heart Association. Warnings from the U.S. Food and Drug Administration about stimulant medications and public concern for the safety of using them have prompted the current statement. Studies have shown that stimulant medications like those used to treat ADHD can increase heart rate and blood pressure. These side effects are insignificant for most children with ADHD; however, they’re an important consideration for children who have a heart condition. In 2003, an estimated 2.5 million children took medication for ADHD. Surveys indicate that ADHD affects an estimated 4 percent to 12 percent of all school-aged children in the United States, and it appears more common in children with heart conditions. Data from the FDA showed that between 1999 and 2004, 19 children taking ADHD medications died suddenly and 26 children experienced cardiovascular events such as strokes, cardiac arrests, and heart palpitations.

 

BREAST CANCER: LOW VITAMIN D LEVELS INCREASES RISK
Researchers at the German Cancer Research Center have shown that women with a very low blood level of vitamin D have a considerably increased breast cancer risk. A connection between vitamin D level and the risk of developing breast cancer has been implicated for a long time, but its clinical relevance had not yet been proven. The researchers, in collaborations with scientists at the University Hospitals in Hamburg-Eppendorf, studied 25-hydroxyvitamin D as a marker for both endogenous vitamin D and vitamin D from food intake. Previous studies have focused on nutritional vitamin D. The researchers found in a study of 1,394 breast cancer patients and an equal number of healthy women after menopause that women with a very low blood level of 25-hydroxyvitamin D have a considerably increased breast cancer risk. The effect was found to be strongest in women who were not taking hormones for relief of menopausal symptoms. However, the authors note that, in this retrospective study, diagnosis-related factors such as chemotherapy or lack of sunlight after prolonged hospital stays might have contributed to low vitamin D levels of breast cancer patients.

MALARIA: MUTATION IN HUMAN GENE PROTECTS AGAINST FATAL RESPONSE
Researchers at the University of Toronto and McGill University report that people who have an enzyme deficiency or those who carry the gene trait for this deficiency may be protected from severe and fatal malaria. Malaria causes an estimated 500 million clinical cases worldwide with symptoms ranging from headache, high fevers, and nausea to more than 1 million deaths annually. The study, published in the New England Journal of Medicine, reports that a deficiency in an enzyme called pyruvate kinase, which is required for energy production in the body, provides protection against malaria infection. Understanding how these mutations make us more resistant to malaria can help us design innovative new strategies to prevent or treat severe malaria in places such as sub-Saharan Africa, the researchers said.

BREAST CANCER: ACCUPUNCTURE RELIEVES HOT FLUSHES IN PATIENTS TAKING TAMOXIFEN
Acupuncture provides effective relief from hot flushes in women who are being treated with the anti-estrogen tamoxifen following surgery for breast cancer, according to researchers at Vestfold Central Hospital in Tonsberg, Norway. In a press conference at the 6th European Breast Cancer Conference in Berlin, the researchers said that breast cancer patients who received traditional Chinese acupuncture had a 50 percent reduction in hot flushes, both during the day and the night. Three months after the last treatment a further reduction was seen. There were no significant changes seen during the day in a second group of patients given sham acupuncture. At night there was a slight reduction during the treatment period but, once treatment had ceased, the number of hot flushes increased again. Tamoxifen can cause many of the symptoms that occur during menopause, including hot flushes. For healthy women, hormone replacement therapy has traditionally been used to alleviate symptoms, but it is associated with an increased risk of relapse in women with estrogen sensitive breast cancers.

 

CHEMOTHERAPY: SINGLE AGENT SHOWN TO BE SUFFICIENT TO CAUSE “CHEMOBRAIN”
Researchers from the University of Rochester Stem Cell and Regenerative Medicine Institute and the Harvard Medical School report in the open access Journal of Biology that treatment with a single chemotherapeutic agent, 5-fluorouracil, by itself is sufficient to cause a syndrome of delayed degeneration in the central nervous system. The widely used chemotherapeutic agent 5-FU is employed, alone or in combination with other agents, in the treatment of cancers of the colon, rectum, breast, stomach, pancreas, ovaries, and bladder. Cancer treatment with chemotherapeutic agents is often associated with delayed adverse neurological consequences—an occurrence often referred to as “chemobrain,” which may compromise the quality of life of a proportion of cancer survivors.

 

CHAGAS: FIRST METHOD TO TEST DRUGS FOR MAJOR TROPICAL DISEASE DEVELOPED
Researchers at the University of Georgia said they have identified for the first time a sensitive method for testing and assessing the efficacy of treatments for Chagas’ disease. The study, published in the online edition of the journal Nature Medicine, could lead to new treatments for long-term sufferers of a disease that can be fatal. Chagas’ disease is a tropical parasitic sickness that currently affects more than 16 million people, with a staggering 100 million at risk, largely in the tropical areas of South and Central America. And yet the main drug used to treat the disease is highly toxic and causes serious side effects. The researchers said that the immunological markers they developed through working with mice provide a means to monitor drug treatment efficacy in humans, something that has been the biggest impediment to developing new drugs.

 

Massachusetts General Hospital investigators, in collaboration with the Harvard University Health Services, have found that 90 days of vigorous athletic training produces significant changes in cardiac structure and function and that the type of change varies with the type of exercise performed. The study, published in the Journal of Applied Physiology, involved both endurance and strength athletes. At the end of the 90-day study period, both groups had significant overall increases in the size of their hearts. For endurance athletes, the left and right ventricles—the chambers that send blood into the aorta and to the lungs, respectively—expanded. In contrast, the heart muscle of the strength athletes tended to thicken, a phenomenon that appeared to be confined to the left ventricle. The most significant functional differences related to the relaxation of the heart muscle between beats—which increased in the endurance athletes but decreased in strength athletes, while still remaining within normal ranges.

 

DIET: WHAT MOTHER EATS CAN INFLUENCE INFANT’S SEX
Researchers from the Universities of Exeter and Oxford have provided the first evidence that a child’s sex is associated with the mother’s diet. In a study published in the journal Proceedings of the Royal Society B: Biological Sciences, the researchers report finding a clear link between higher energy intake around the time of conception and the birth of sons. The findings may help explain the falling birth-rate of boys in industrialized countries, including the United Kingdom and the United States, because women are consuming less calories there the researchers said. The study focused on 740 first-time pregnant mothers in the U.K. who did not know the sex of their fetus. They were asked to provide records of their eating habits before and during the early stages of pregnancy. Of the women in the group with the highest energy intake at conception, 56 percent had sons. That compared with 45 percent for women in a group that consumed the lowest number of calories. As well as consuming more calories, women who had sons were more likely to have eaten a higher quantity and wider range of nutrients, including potassium, calcium, and vitamins C, E, and B12. There was also a strong correlation between women eating breakfast cereals and producing sons.

PROSTATE CANCER: PROTEIN HELPS PREDICT SURVIVAL
An Oregon Health & Science University Cancer Institute researcher has identified a protein that is a strong indicator of survival for men with advanced prostate cancer. The C-reactive protein, also known as CRP, is a special type of protein produced by the liver that is elevated in the presence of inflammation. The researcher said this could mean that a simple blood test that is already available could help in clinical decision making and patient counseling. The research, published online in the journal Cancer, also suggests that inflammation may play an important role in driving prostate cancer progression and resistance to therapy.

 

Higher wealth is linked with a lower risk of stroke in Americans between the ages of 50 and 64, but does not predict strokes in those over age 65, researchers reported in Stroke: Journal of the American Heart Association. Researchers at the Erasmus Medical Center in Rotterdam, The Netherlands reported that lower wealth, education, and income are associated with increased stroke up to age 65, and wealth is the strongest predictor of stroke among those factors. After age 65, the association of education, income, and wealth with stroke are very weak, and wealth did not clearly predict stroke, the researchers said. The researchers analyzed data from 19,445 participants in the ongoing University of Michigan Health and Retirement Study, which surveys Americans age 50 and older every two years. Researchers divided all participants’ wealth levels into six categories. Researchers found that the 10 percent with the lowest wealth had three times the stroke risk at age 50 to 64, compared with those in the 75th-89th percentile. However, at age 65 and older, stroke risk was not significantly different between the two wealth groups for men or women.

 

A breath monitoring device developed by scientists at the University of Florida and Gainesville, Florida-based Xhale could help prevent the emergence of drug-resistant strains of HIV by monitoring medication adherence in high-risk individuals. HIV patients who fail to adhere to their dosing regimens increase the likelihood that their virus will mutate into a drug-resistant strain. The only effective system to ensure compliance, the scientists said, is directly observed therapy, or DOT, where a healthcare worker observes patients taking his or her medication regularly. That process, though, is inconvenient for patients, as well as for clinic personnel who have to track them down when they fail to show up. The machine developed by the scientists provides a virtual DOT from home. The machine sits in a patient’s home and uses breath monitoring to record patient compliance. When medication needs to be taken, it beeps. If the patient fails to hit a button after about five minutes, the beeps grow louder and louder until the patient comes. If the patient doesn’t come after a certain amount of time, the machine can call the clinical trial coordinator and indicates that subject or patient didn’t take the medication as prescribed. The device records the results of each breath test, allowing patients to bring a memory card or USB key to the clinic once a month and receive a printout of their results.

 

DOCTORS: U.S. SEES DECLINE IN NUMBER OF GENERAL SURGEONS
The number of general surgeons per 100,000 Americans has declined by more than 25 percent during the past 25 years, according to a report in the Archives of Surgery. There is some question as to whether there will be an adequate number of general surgeons to care for an increasingly elderly population, with its attendant increased demand for surgical care. Researchers at the University of Washington, Seattle, analyzed the number of general surgeons per 100,000 population using the American Medical Association’s Physician Masterfiles from 1981, 1991, 2001, and 2005. The number of active general surgeons fell to 16,662 in 2005 from 17,394 in 1981. During that same period, the ratio of general surgeons to the population declined to 5.69 surgeons per 100,000 people from 7.68 surgeons per 100,000 people. That represented more than a 25 percent decline in the ratio of surgeons per 100,000 people.

 

HOSPITAL INFECTIONS: CRIME SCENE TECHNIQUES FIND BLOOD ALL OVER HEMODIALYSIS UNIT
In a nod to the television drama CSI, researchers at the Netherlands’ Deventer Hospital used crime scene forensic techniques to highlight the risk of infection in hospitals. The researchers employed Luminol, a chemical used by crime scene investigators, to detect traces of blood in their hemodialysis unit. Luminol reacts with microscopic amounts of blood to produce bright blue luminescence, which allows investigators to track invisible blood splashes in the environment. The study, published in the Journal of Hospital Infection, found traces of blood on many surfaces including cupboard handles, telephones, computer keyboards, side tables, and the floor, even though some of these surfaces had been cleaned. They expect that these results can be reproduced in other hospitals that plan to use Luminol in the future as described in their paper.

ORAL HEALTH: PRESENCE OF CERTAIN ANTIBODIES SIGNALS HEALTHIER TEETH AND GUMS
Antibodies present in people with good oral health could become the first tool for dental professionals to assess a patient's probable response to periodontal disease treatments, according to researchers at the University of Michigan School of Dentistry. The antibody is to a protein called HtpG, the bug that makes it is Porphyromonas gingivalis, an important pathogen in periodontal disease. The antibody also has potential as a vaccine candidate, according to the researchers, who published their findings online in the Public Library of Science. They discovered that the HtpG antibodies were present in much lower amounts in people with periodontal disease, and in much higher concentrations in those with healthier teeth and gums. Typically, antibodies are elevated in people with disease, because they help fight the disease.