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Researchers at Johns Hopkins Kimmel Cancer Center said their study of a mouth rinse that captures genetic signatures common to head and neck cancer holds promise for screening those at high risk, including heavy smokers and alcohol drinkers. Investigators asked 211 head and neck cancer patients and 527 individuals without cancers of the mouth, larynx, or pharynx to brush the inside of their mouths, then rinse and gargle with a salt solution. The researchers collected the rinsed saliva and filtered out cells thought to contain one or more of 21 bits of chemically altered genes common only to head and neck cancers. Tumor and blood samples also were collected. Cellular mishaps occur when small molecules called methyl groups clamp on to the DNA ladder structure of a gene. In the grip of too many methyl groups, these genes can incorrectly switch on or off in a process called hypermethylation. The challenge, the researchers said, is to predict which hypermethylated genes are most specific to cancer. The researchers report in the journal Clinical Cancer Research that of 21 hypermethylated genes, seven were the best predictors of cancer within cell-laden saliva. The researchers said the tests are painless, cheap, and easy-to-use, but that more studies are needed to refine the tests to identify other hypermethylated genes that play a role and automate the process.

People with restless legs syndrome or RLS are twice as likely to have a stroke or heart disease compared to people without RLS, and the risk is greatest in those with the most frequent and severe symptoms, according to research published in the journal Neurology. The study, the largest of its kind enrolling both men and women, involved 3,433 people with an average age of 68 who were enrolled in the Sleep Heart Health Study. Participants were diagnosed with RLS by detailed questionnaire and asked if they had been diagnosed with a variety of systemic diseases including cardiovascular disease and cerebrovascular disease. Of the participants, nearly seven percent of women and three percent of men had RLS. The study found people with RLS were more than twice as likely to have cardiovascular disease or cerebrovascular disease. The results remained the same after adjusting for age, sex, race, body mass index, diabetes, high blood pressure, high blood pressure medication, HDL/LDL cholesterol levels, and smoking.

 

Obese people are less likely to use their seatbelts than the rest of the population, adding to the public health risks associated with this rapidly growing problem. The connection was made by Vanderbilt University researchers, who found that as weight goes up, seatbelt use goes down. The study found that approximately 30 percent of individuals with a body mass index that qualified them as overweight, obese or extremely obese reported not using a seatbelt, compared to approximately 20 percent of the average population. Furthermore, seatbelt use declined as BMI increased, with approximately 55 percent of extremely obese individuals reporting they did not use a seatbelt. The connection between increased body mass index and decreased seatbelt use held even when controlling for other factors, such as gender, race, and seatbelt laws in the respondent’s state. The researchers said efforts should be made to raise awareness of seatbelt extenders.

 

Suppression of slow-wave sleep in healthy young adults significantly decreases their ability to regulate blood-sugar levels and increases the risk of type 2 diabetes, according to researchers at the University of Chicago Medical Center in the online edition of the  Proceedings of the National Academy of Science. Deep sleep, also called “slow-wave sleep,” is thought to be the most restorative sleep stage, but its significance for physical well-being has not been demonstrated. This study found that after only three nights of selective slow-wave sleep suppression, young healthy subjects became less sensitive to insulin. Although they needed more insulin to dispose of the same amount of glucose, their insulin secretion did not increase to compensate for the reduced sensitivity, resulting in reduced tolerance to glucose and increased risk for type 2 diabetes. The decrease in insulin sensitivity was comparable to that caused by gaining 20 to 30 pounds. Previous studies have demonstrated that reduced sleep quantity can impair glucose metabolism and appetite regulation resulting in increased risk of obesity and diabetes. This current study provides the first evidence linking poor sleep quality to increased diabetes risk. The researchers said since reduced amounts of deep sleep are typical of aging and of common obesity-related sleep disorders, such as obstructive sleep apnea these results suggest that strategies to improve sleep quality, as well as quantity, may help to prevent or delay the onset of type 2 diabetes in populations at risk.

 

Drugs that treat depression, schizophrenia and other psychotic conditions and that target a particular protein on brain cells might not be triggering the most appropriate response in those cells, according to researchers at The Ohio State University Medical Center. The researchers examined the serotonin 2A receptor, a protein on brain cells sensitive to the neurotransmitter serotonin. They examined the early chemical events that happen inside neurons when the 2A receptor is stimulated by serotonin and by a synthetic hallucinogenic agent that is thought to mimic serotonin. The findings, published online in the Proceedings of the National Academy of Sciences, show that although both compounds combine with and activate this receptor, they trigger different chemical pathways inside the neuron. The researchers said that the work could have important implications for the development of drugs that affect the serotonin 2A receptor, a key target in the treatment of several important mental disorders.
 

BRAIN CANCER: THREE-DRUG COCKTAIL MAY IMPROVE OUTCOMES FOR PATIENTS WITH GLIOBASTOMA MULTIFORME
Researchers at Wake Forest University Baptist Medical Center suggests that a three-drug cocktail may one day improve outcomes in patients with glioblastoma multiforme, a type of brain tumor with a dismal prognosis. Two of the drug candidates have been developed, and the team is working on the third—all targeted to kill or impair cancer cells and spare a healthy brain. The researchers expect the cocktail to be tested in patients within five years. They said the treatment would be based on the first-ever documented “molecular signature” of glioblastoma multiforme tumors. The researchers had previously reported that three different proteins are found in high levels individually in these cancers. In their current study, published in the journal Clinical Cancer Research, they found all three biomarkers were significantly higher in glioblastoma multiforme tissue compared to normal brain and to brain tumors that are less aggressive. All glioblastoma multiforme tumors had at least one of the markers present and 95 percent had at least two of them.

 

A research team at Weill Cornell Medical College in New York City has identified two genes that may be crucial to the production of an immune system cytokine called interleukin-10. The researchers said the findings, reported in the journal Immunity, fill an important “missing link” in a biochemical pathway that’s long been tied to disorders ranging from lupus and Type 1 diabetes, to cancer and AIDS. IL-10 production has to be kept in a delicate balance for health, the researchers said. Too much IL-10 can leave the body more vulnerable to killers such as viruses and cancer, and to certain antibody-driven autoimmune diseases such as lupus, while too little can lead to run-away inflammatory pathology. They said a better understanding of IL-10 regulation moves us closer to understanding these illnesses and—potentially—how to better treat them.

 

An estimated 750,000 hospitalized patients experience cardiac arrest and undergo CPR annually, and less than 30 percent of those leave the hospital alive. In a paper published in the New England Journal of Medicine, researchers quantified the impact of receiving a life-saving electrical shock (defibrillation) among hospitalized patients experiencing a form of cardiac arrest known as ventricular arrhythmia. They found that the chances of survival for hospitalized patients improve dramatically if defibrillation is administered within the expert-recommended two minutes following a cardiac arrest. The researchers found 30 percent of patients with cardiac arrest due to ventricular arrhythmia received life-saving defibrillation more than two minutes after initial recognition of their cardiac arrest, a delay that exceeds guidelines-based recommendations. The delayed defibrillation was linked to a significantly lower probability of survival to hospital discharge—22 percent vs. 39 percent when defibrillation wasn’t delayed—and a 26 percent lower likelihood among survivors of being discharged without major neurological impairment. The findings also revealed certain hospital characteristics were associated with delayed defibrillation, including small hospital size (fewer than 250 beds); occurrence of cardiac arrest in hospitalized patients whose heart rhythm was not being constantly monitored in specialized units; and occurrence of cardiac arrest after-hours (i.e., nights and weekends).

 

Temple University researchers report that women who had stopped being religiously active were more than three times more likely to have suffered generalized anxiety and alcohol abuse or dependence than women who reported always having been active. The study, published in the journal Social Psychiatry and Psychiatric Epidemiology, also found that men who stopped being religiously active, conversely, were less likely to suffer major depression when compared to men who had always been religiously active. The researchers speculate that one possible explanation for the gender differences in the relationship between religious activity and mental health is that women are more integrated into the social networks of their religious communities. When they stop attending religious services, they lose access to that network and all its potential benefits. Men may not be as integrated into the religious community in the first place and so may not suffer the negative consequences of leaving.

 

CAVITIES: WINEMAKING WASTE EFFECTIVE AGAINST DISEASE-CAUSING BACTERIA  

A class of chemicals in red wine grapes may significantly reduce the ability of bacteria to cause cavities, according to a study published in the Journal of Agricultural and Food Chemistry. The findings suggest that specific polyphenols, present in large amounts in fermented seeds and skins cast away after grapes are pressed, interfere with the ability of bacteria to contribute to tooth decay. Beyond cavities, the action of the wine grape-based chemicals may also hold clues for new ways to lessen the ability of bacteria to cause life-threatening, systemic infections. The findings from researchers at University of Rochester Medical Center and the New York State Agricultural Experiment Station at Cornell University, point to an emerging trend in the design of drugs against bacteria by focusing on disrupting their ability to cause disease without killing them.

 

Tonsillectomies to treat chronic and recurrent tonsillitis substantially improve a patient’s quality of life in both children and adults, according to two new studies published in a supplement to the journal Otolaryngology-Head and Neck Surgery. In one study involving 72 adults, patients showed improvement in all six subscales of the Tonsil and Adenoid Health Status Instrument, a scale used to measure the quality of life of patients pre- and post-procedure. Among the scale-related findings, 98 percent reported fewer infections in the six months following surgery, with 76.9 percent expressing strong satisfaction with the surgery results. Patients also reported substantially fewer cases of persistent bad breath, sore throats, and trips to the doctor because of sore throats. In the study involving children, 92 patients also showed significant improvements when measured with the same Tonsil and Adenoid Health Status Instrument scale, including airway and breathing, infection, health care utilization, cost of care, eating and swallowing, and behavior. Additionally, the study found significant decreases in number of sore throats, antibiotic courses, days missed from daycare/school, doctor visits, and persistent bad breath.

 

A study by researchers at Cambridge University found that doctors treating life-threatening emergencies such as allergy attacks may give the wrong dosage of adrenaline (epinephrine) because of confusing labeling. Adrenaline is stored in salt water in glass ampoules which are broken open when the drug is needed. The amount of adrenaline contained in the ampoule is usually expressed as both a dose (1 mg of the drug per 1 ml of salt water) and a ratio (1 part drug for every 1000 parts of salt water) on the label. The ratio requires doing arithmetic to figure out how much drug to give. In a simulation, where doctors were randomly assigned ampoules with labels that had either the dose or the ratio listed, the researchers found that 12 out of 14 doctors with ampoules with labels that expressed the adrenaline as a ratio overdosed their patients. They also took 1.5 minutes longer to give the adrenaline. The researchers concluded that having to do extra calculations to figure out how much adrenaline to give a person in an emergency might lead to the errors and delays which are common in administering the drug.

 

In the first study examining American physicians’ use of placebos in clinical practice in the 21st Century, 45 percent of Chicago internists report they have used a placebo at some time during their clinical practice researchers from the University of Chicago report in the January issue of Journal of General Internal Medicine. Of the respondents who reported using placebos in clinical practice, 34 percent introduced the placebos to the patient as “a substance that may help and will not hurt.” Nineteen percent said, “it is medication,” and nine percent said, “it is medicine with no specific effect.” Only four percent of the physicians explicitly said, “it is a placebo.” In addition, 33 percent of the physicians reported they gave other information to patients, including, “this may help you but I am not sure how it works.” Only 12 percent of respondents said that placebo use should be categorically prohibited. The researchers said their study indicates a need for greater recognition of the use of placebos and unproven therapies and discussion about their implications.

 

INTELLECTUALLY DISABLED: ANTIPSYCHOTIC DRUGS SHOULD NOT BE ROUTINELY USED TO TREAT AGRESSION

Antipsychotic drugs do not reduce aggression in people with intellectual disability, and their prescribing in routine practice should be reviewed and alternatives examined, according to an article The Lancet. Aggressive challenging behavior is frequently reported in adults with intellectual disability, and it is commonly treated with antipsychotic drugs. Around 200,000 people with intellectual disability in the UK, who show challenging aggressive behavior, are given antipsychotic drugs. Despite the widespread use of these drugs evidence of their efficacy for treating challenging behavior is scarce and there is potential for long-term side-effects with both typical and atypical antipsychotics. Researchers at Imperial College, London, UK measured the effects of antipsychotic drugs and placebo on the aggressive behavior of 86 non-psychotic patients from 10 inpatient and community settings in England and Wales and Australia. The patients, most with moderate or severe intellectual disability, were randomly assigned to receive haloperidol (a typical, first-generation antipsychotic drug), risperidone (an atypical, second-generation antipsychotic), or placebo. The researchers found that aggression had decreased substantially with all three treatments by four weeks, but patients receiving placebo had the greatest change. The authors noted no important differences between the treatments in terms of adverse side-effects, aberrant behavior, quality of life, and effects on careers. Importantly, in subsequent weeks, patients given placebo showed no evidence of worse response than did patients assigned to either haloperidol or risperidone.