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People who drink moderate amounts of alcohol and are physically active have a lower risk of death from heart disease and other causes than people who don’t drink at all, according to a study published in the European Heart Journal. The study, authored by researchers at the National Institute of Public Health at the University of Southern Denmark in Copenhagen, and the Institute of Preventive Medicine at Copenhagen University Hospitals, found that people who neither drink alcohol nor exercise have a 30-49 per cent higher risk of heart disease than those who either drink, exercise, or both. The research is the first to look at the combined influence of leisure-time physical activity and weekly alcohol intake on the risk of fatal ischemic heart disease (a form of heart disease characterized by a reduced blood supply to the heart) and deaths from all causes. The researchers said neither physical activity alone nor alcohol intake can completely reverse the increased risk associated with alcohol abstention and lack of physical activity. But both moderate to high levels of physical activity and a moderate alcohol intake are important for lowering the risk of fatal IHD and deaths from all causes.

A multi-institutional study involving Massachusetts General Hospital researchers has identified a chromosomal abnormality that appears to increase susceptibility to autism. The researchers report online in the New England Journal of Medicine that a segment of chromosome 16 is either missing or duplicated in about 1 percent of individuals with autism or related disorders, a frequency that is comparable to other genetic syndromes associated with the disorder. The researchers said while they are a long way from understanding how this chromosomal deletion or duplication increases the risk for autism, the findings represent a critical first step toward that knowledge. Population studies indicate that up to 90 percent of cases of autism and what are referred to as autism spectrum disorders have some genetic component, but only 10 percent of cases can be attributed to known genetic and chromosomal syndromes.

 

The United States places last among 19 countries when it comes to deaths that could have been prevented by access to timely and effective healthcare, according to researcher from the London School of Hygiene and Tropical Medicine and supported by The Commonwealth Fund. The study, published in the journal Health Affairs, found that while other nations dramatically improved these rates between 1997–98 and 2002–03, the U.S. improved only slightly. If the U.S. had performed as well as the top three countries out of the 19 industrialized countries in the study, there would have been 101,000 fewer deaths in the U.S. per year by the end of the study period. The top performers were France, Japan, and Australia. The researchers said that the measure of deaths amenable to healthcare is a valuable indicator of health system performance because it is sensitive to improved care, including public health initiatives. It considers a range of conditions from which it is reasonable to expect death to be averted even after the condition develops.

 

Researchers at the U.S. Department of Energy’s Brookhaven National Laboratory have found new clues to why some people overeat and gain weight while others don't. Examining how the human brain responds to “satiety” messages delivered when the stomach is in various stages of fullness, the scientists have identified brain circuits that motivate the desire to overeat. Treatments that target these circuits may prove useful in controlling chronic overeating, according to the researchers, who published their findings in the journal NeuroImage. By simulating feelings of fullness with an expandable balloon, the researchers saw the activation of different areas of the brain in normal weight and overweight people. The overweight subjects had less activation in parts of the brain that signal satiety in normal weight subjects. The overweight subjects were also less likely than normal weight subjects to report satiety when their stomachs were moderately full. During this process, the researchers used functional magnetic resonance imaging (fMRI) to scan the subjects’ brains. One notable region of the brain—the left posterior amygdala—was activated less in the high-BMI subjects, while it was activated more in their thinner counterparts. This activation was turned “on” when study subjects reported feeling full. Subjects who had the highest scores on self-reports of hunger had the least activation in the left posterior amygdala. The researchers said their work suggests targeting this part of the brain in treatment strategies.

 

While most people are aware that lifestyle choices such as eating right, getting enough exercise, and quitting smoking can help prevent cardiovascular disease, a new study suggests brushing and flossing every day could help avoid cardiovascular disease. Howard University researchers report in an article published in the Journal of Periodontology that periodontal patients whose bodies show evidence of a reaction to the bacteria associated with periodontitis may have an increased risk of developing cardiovascular disease. The findings suggest that the long-term effect of chronic periodontitis, such as extended bacterial exposure, may be what ultimately leads to cardiovascular disease.

 

Researchers at the University of Florida have coaxed liver and pancreatic cells within diabetic mice into churning out insulin by injecting the animals with a naturally occurring protein called Pdx1, opening up a new research avenue that someday could lead to safer treatments for type 1 diabetes. Pdx1 activates the genes controlling the development of the pancreas cells that make and release insulin to maintain safe levels of glucose in the body. The researchers’ approach is described online in the journal Diabetes. Earlier research has shown that inserting the Pdx1 gene into liver or pancreas cells can induce insulin production, but most gene therapy methods use viruses to introduce a piece of genetically engineered DNA into cells. The disadvantage of such approaches is that you can never be certain the viruses are entirely harmless, the researchers said. The idea with protein therapy is that eventually a person’s own cells could be reprogrammed to naturally produce the hormone, restoring the body’s ability to properly regulate blood sugar levels without having to use a potentially hazardous virus to slip corrective genes into the body or having to transplant pancreatic cells from someone else. That could eliminate the adverse effects sometimes associated with gene therapy and eliminate the need for lifelong suppression of the immune system so transplanted cells are not rejected, they said. Transgeneron Therapeutics, founded by one of the University of Florida researchers, is trying to develop a Pdx1 treatment for diabetes.

 

The same vitamin D deficiency that can result in weak bones now has been associated with an increased risk of cardiovascular disease, Framingham Heart Study researchers report in Circulation: Journal of the American Heart Association. The higher risk associated with vitamin D deficiency was particularly evident among individuals with high blood pressure. In a study of 1,739 offspring from Framingham Heart Study participants (average age 59, all Caucasian), researchers found that those with blood levels of vitamin D below15 monograms per milliliter (ng/ml) had twice the risk of a cardiovascular event such as a heart attack, heart failure, or stroke in the next five years compared to those with higher levels of vitamin D. When researchers adjusted for traditional cardiovascular risk factors such as high cholesterol, diabetes, and high blood pressure, the risk remained significant with a 62 percent higher risk of a cardiovascular event in participants with low levels of vitamin D compared to those with higher levels. Low levels of vitamin D are highly prevalent in the United States, especially in areas without much sunshine. As much as 30 percent of the population in many areas has moderate to severe vitamin D deficiency.

 

More than 98 percent of men who are circumcised can enjoy the same levels of sexual satisfaction and performance as men who are not, according to a study of nearly 4,500 males published in journal BJU International. The randomized trial, carried out by researchers from Johns Hopkins University and in Uganda, was undertaken because previous studies showed that the procedure—which is now recommended as an efficient way to reduce HIV transmission—showed conflicting results. Studies focusing on men circumcised in adulthood have been highly selective because there were medical indications for surgery, the researchers said. Also, circumcised infants can’t provide before-and-after comparisons and in most studies sample sizes were small and follow-up was short, they added. This study, carried out as part of an HIV prevention initiative, enabled researchers to compare two groups of men with the same demographic profiles and levels of sexual satisfaction and performance at the start of the study. The researchers said the study shows that being circumcised did not have an adverse effect on the men who underwent the procedure when we compared them with the men who had not yet received surgery.

 

The first clinical studies of an experimental drug have revealed that obese people who take it for 12 weeks lose weight, even at very low doses, according to researchers at Merck Research Laboratories, which developed the drug. Short-term studies also suggest that the drug, called taranabant—the second drug designed to fight obesity by blocking cannabinoid receptors in the brain—causes people to consume fewer calories and burn more, researchers report in the journal Cell Metabolism. Cannabinoid receptors are responsible for the psychological effects of marijuana, and natural “endocannabinoids” are important regulators of energy balance. The study notes, however, that the drug also comes with an increased risk of adverse side effects at higher doses, including mild to moderate gastrointestinal and psychiatric effects.

 

A study from Danish researchers has found that childless men have a lower risk of developing prostate cancer than fathers, and that, paradoxically, the more children a father has, the lower the risk of the disease. The study, which appears in the journal Cancer, found that men without children were 16 percent less likely than those with children to be diagnosed with prostate cancer. The authors also note that additional studies are required to identify the underlying biologic, environmental, social and/or behavioral factors that explain the observed differences in prostate cancer risk between fathers and childless men and between men fathering few and those fathering many children.

 

MIT researchers have uncovered a critical difference between flu viruses that infect birds and humans, a discovery that could help scientists monitor the evolution of avian flu strains and aid in the development of vaccines against a deadly flu pandemic. The researchers found that a virus’ ability to infect humans depends on whether it can bind to one specific shape of receptor on the surface of human respiratory cells. The researchers, in an article published Nature Biotechnology, said that this could help not only monitor the bird flu virus, but it can aid in the development of potentially improved therapeutic interventions for both avian and seasonal flu.

 

Despite a 1990 consensus recommendation from the National Institutes of Health that lumpectomy plus radiation was the treatment of choice for early stage breast cancer, the United States continues to have the highest rate of mastectomy surgery among industrialized countries. A recent survey shows that only 74 percent of women diagnosed with early stage breast cancer (ductal carcinoma in situ or DCIS) chose breast-conserving surgery—even though 82 percent of their physicians had recommended the procedure. The researchers found that women’s individual understandings of breast cancer and the risks associated with detection, treatment, and reconstructive surgery are heavily influenced by the ideas of vigilant detection, aggressive treatment, and conformity in maintaining appearances. The researchers said that the burden of personal responsibility is so ingrained that women often feel that they are to blame for not detecting the disease earlier or for having failed to pursue the most aggressive treatment.

 

With medical tourism rising across the European Union, consumers, insurers, and governments are increasingly interested in the relative cost of common procedures in different countries. In a collection of papers published as a supplement to the journal Health Economics, a group of EU policy analysts and economists address the issue of treatment cost variations using a “case vignette” approach that standardizes patients in nine European countries needing care for hip replacements, stroke, acute myocardial infarction, birth delivery, appendectomy, cataract, and dental filling. The comparison of cost components by vignette found that prices varied greatly. The researchers said the large differences in costs and reimbursement provides opportunities for cross border trade.

 

A disease most Americans have never heard of could soon become more prevalent if dengue, a flu-like illness that can turn deadly, continues to expand into temperate climates and increase in severity, according to a commentary by Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, and David Morens, Fauci’s senior scientific advisor. Their commentary appears in the JAMA. Previously confined to tropical and subtropical climates, the mosquito-borne illness is becoming a much more serious problem along the U.S.-Mexico border and in the commonwealth of Puerto Rico. Dengue occurs sporadically and has had a relatively small impact on the United States. However, the disease tends to occur in explosive epidemics. Moreover, the NIAID scientists note, efforts to control the populations of mosquitoes that transmit dengue have fallen short of their goal. Recognizing the threat to public health posed by dengue, NIAID allocated $33.2 million in fiscal year 2007 for nearly 60 dengue research projects, including basic research on dengue, projects to develop vaccines, diagnostics and therapeutics for the disease; and clinical trials of vaccines.

 

Adolescent girls who frequently eat meals with their families appear less likely to use diet pills, laxatives, or other extreme measures to control their weight five years later, according to researchers at the University of Minnesota School of Public Health. The researchers studied 2,516 adolescents at 31 Minnesota schools over the course of five years. Among teen girls, those who ate five or more meals with their families each week in 1999 were significantly less likely to report using extreme measures—including binge eating and self-induced vomiting—to control their weight in 2004, regardless of their sociodemographic characteristics, body mass index, or family connectedness. Among adolescent boys, regular family meals did not predict lower levels of disordered eating behaviors five years later. The researchers said given their findings and those of other studies and the prevalence of disordered eating among teen girls, it is important to find ways to help families eat meals together.

 

Employees who lose their jobs because of their health suffer more significant depression and detrimental health outcomes than people who lose their jobs for non-health reasons, according to a study from researchers at the University of Michigan. The study, published in the Journal of Health and Social Behavior, also suggests that people who are reemployed quickly have better health outcomes than those who remain unemployed. Increasingly, part-time, temporary, or short-term service industry jobs are replacing the standard, full-time jobs disappearing from manufacturing and other industries, and the new jobs often lack health insurance coverage or unemployment insurance eligibility. The researchers said their findings underscore the social and economic importance of structuring health insurance, unemployment benefits, and re-employment programs to meet the needs of an evolving workforce, as nonstandard employment contracts become more common.

 

Patients in small towns and isolated rural areas have lower organ transplant rates and are less likely to be wait-listed than patients in urban areas, according a study from researchers at Dartmouth Medical School published in JAMA. Organ transplantation offers the best and often only hope for long-term survival for patients with end-stage heart, liver, and kidney disease. However, despite federal regulation and national efforts to ensure equal access to the limited pool of donated organs, previous research has demonstrated the presence of significant barriers to access to transplantation services for racial minorities, women, and patients with low socioeconomic status or poor insurance. The researchers said rural residents represent another group that may have impaired access to transplant services. Nearly 14 percent of the U.S. population lives outside major urban areas. The researchers found patients living in small towns and isolated rural regions were eight percent to 15 percent less likely to be wait-listed and 10 percent to 20 percent less likely to undergo heart, liver, and kidney transplantation than patients in urban environments.

 

Backed by a government intent on promoting innovation and fuelled by the “brain gain” of talented scientists and entrepreneurs returning from abroad, China’s health biotech industry only needs a more favorable investment climate to emerge as a global force in the production of therapies and medicines—both new and low-cost generics—according to a study published in Nature Biotechnology. Though China has proven itself a medical innovator capable of stunning breakthroughs, the study from researchers at McLaughlin-Rotman Centre for Global Health found Chinese firms face an uphill battle in attracting high-risk venture capital needed to sustain innovative, research-driven projects. They said the intense interest of potential international investors is typically muted by an uncertain financial system, rigid restrictions on the export of capital that limit the options for exiting investments and continuing doubts about the Chinese government’s approach to quality control and intellectual property rights. The study in part was funded by Burrill & Company, a part owner of The Journal of Life Sciences.

With the start of the New Year, many workers and retirees are facing higher co-payments as employers seek to deal with the rising cost of health insurance, but a study from researchers at the University of Michigan and Harvard University finds co-pays should be reduced for at least some patients. By cutting a few dollars off the co-pay, the study suggests that employers could increase the chances that employees with chronic illnesses will take certain preventive medicines. And that could pay off in the long run, in the form of fewer hospitalizations or emergency room visits for employees with diabetes, high blood pressure, asthma, and other conditions. Specifically, the study published in the journal Health Affairs, showed that a major private employer significantly increased the use of important preventive medicines among its employees by automatically making some medications free and slashing co-pays for other drugs by 50 percent. Meanwhile, another employer that kept its co-pays the same didn’t experience the same increase in use of preventive medicines. The study authors said that all research to this point has shown that individuals will not buy important medical services even if there’s a small financial barrier: $5 or even $2. But the study showed that when you remove those barriers, people started using these high-value services significantly more.

 

The most thorough study to date of the impact of the Medicare Prescription Drug Benefit (Part D) found that this benefit led to a 13.1 percent decrease in out-of-pocket expenses for patients and a 5.9 percent increase in prescription use. Researchers from the University of Chicago Medical Center, Harvard University, and Virginia Commonwealth University used data from more than 117,000 patients to assess the impact of the new prescription benefit plan. They compare out-of-pocket costs and the number of pills purchased by those who were eligible for Part D with comparable patients who were not. They also compared Part D enrollees to patients who were eligible for, but did not enroll in, Part D. The researchers said the study, published online at the web site of the Annals of Internal Medicine, found that the benefit had a modest but significant effect on both savings and drug use.