Thursday, May 16, 2013

iPad 2 May Interfere With Heart Implants, Study Suggests

The magnets in iPad 2 tablets and their covers are capable of interfering with heart implants, including pacemakers, suggests a new, small study presented Thursday at Heart Rhythm 2013, the Heart Rhythm Society's 34th Annual Scientific Sessions.

The research was performed by 14-year-old high school freshman Gianna Chien of Stockton, California and her colleagues. They found that magnetic interference could change the settings and even deactivate the technology of implantable cardioverter defibrillators (ICDs).

Chien was helped by her father, a cardiologist. She asked 26 volunteers with ICDs to hold the iPad 2 at reading distance and then, on a separate occasion, to hold the tablets against their chest.

The study showed that magnets imbedded in the iPad 2, as well as its Smart Cover, could interfere and disrupt the workings of ICDs.

Specialized magnets are rooted in the heart devices to allow doctors to adjust their settings on a set schedule. The iPad 2 and its Smart Cover magnets can undermine an ICD's ability to stabilize sudden rapid heart rates, such as fibrillation and tachycardia.

This danger can happen when a person falls asleep with the tablet sitting on their chest. Of the study participants, 30% had interference with their devices when the iPad2 was placed in that position.

However, electromagnetic interference was not seen when the iPad was at a normal reading distance from the chest. The magnetic field falls off rapidly with distance, according to Gianna Chien. Also, larger people who have more fat on their chest - not only in their abdomen - are less sensitive to the interference.

The authors suggest that other devices with imbedded magnets, such as cellphones and magnetic resonance imaging (MRI) could also impact cardiac rhythm devices. These were not examined in this study.

Chien concluded:

"Since tablets are becoming more common, I hope these findings will encourage patients who have or may be a candidate for implantable defibrillators to talk to their doctor about precautions if they use a tablet like the iPad 2."

A previous study conducted in 2006 also by the Heart Rhythm Society, revealed that magnets can pose a serious threat for patients with pacemakers and ICDs
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More Effective Treatment Of Complex Infections Likely With Cutting-Edge Bacteria Research

Bacteria are life forms, which, like all other life forms, struggle for the best living conditions for themselves. Therefore they will try to avoid getting attacked by the human immune system, and therefore they have developed various ways to protect themselves from the human immune system. When safe from the immune system, they can focus on breeding and multiplying, and if they become numerous enough, the human body will experience their presence as an infection. Some bacteria are relatively harmless, while others are fatal. The bacteria avoid being attacked by the human immune system by forming a biofilm - a surface to protect them against the immune system.

"The biofilm contributes to bacterial resistance, and that can cause severe, persistent infections around heart valve implants and in lungs and the urinary tract," explains postdoc. Mikkel Girke Jørgensen from the Department of Biochemistry and Molecular Biology at the University of Southern Denmark. Together with professor Poul Valentin-Hansen from the same institution and scientists from American Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, and Georgetown University Medical Center, Washington DC, he stands behind the new discovery.

The researchers now understand the underlying regulatory mechanisms behind the formation of biofilms. The mechanism involves small RNA molecules, which can affect bacterial gene expression and thus the decision of whether to form biofilm or not.

Bacteria can move by using their so-called flagella to swim with. When they need to form biofilms, they "turn off" the flagella, stop moving and start to form a biofilm.

"We have now established what decides whether they swim or not - and that determines whether they form biofilms or not," explains Mikkel Girke Jørgensen and continues:

"Prospects for the pharmaceutical industry are huge. This increased understanding of biofilm formation may be the first step in creating new ways to treat complicated infections in the future. "
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Androgen Deprivation Therapy For Prostate Cancer Can Cause Osteoporosis

Androgen deprivation therapy is a common and effective treatment for advanced prostate cancer. However, among other side-effects, it can cause significant bone thinning in men on long-term treatment.

A new study¹ by Vahakn Shahinian and Yong-Fang Kuo from the Universities of Michigan and Texas respectively, finds that although bone mineral density testing is carried out on some men receiving this therapy, it is not routine. They did note, however, that men were significantly more likely to be tested when they were being cared for by both a urologist and a primary care physician. Their paper² appears in the Journal of General Internal Medicine, published by Springer.

Androgen deprivation therapy cuts off the production of testosterone by the male testes. This prolongs the life of men with advanced prostate cancer, often by years. However, the therapy can cause osteoporosis which carries an increased risk of fracture. There are treatments available which can help reduce the extent of osteoporosis suffered. Despite recommendations for bone mineral density testing being incorporated into practice guidelines in 2002, it still does not seem to be carried out frequently enough.

In order to ascertain current levels of testing, the researchers looked at the medical records of over 80,000 men with prostate cancer in a Medicare claims database between 1996 and 2008. Although they noted that the levels of bone mineral density testing had increased over those years, only just over 11 percent of men received a test for osteoporosis in the last year studied.

According to the authors, "The absolute rates of bone mineral density testing remain low, but are higher in men who have a primary care physician involved in their care." Levels of testing were lowest in men being cared for by just a urologist alone.

The authors emphasize that bone care is not within the usual remit of most urologists and, as such, may be outside their comfort zone for diagnosis and management. Urologists are not alone in this, though, as breast and colorectal cancer patients also tend to fare better with the involvement of a primary care physician in addition to their oncologist.

It would therefore appear important to derive a system whereby primary care physicians remain involved in the care of men with prostate cancer. In addition, urologists need to be made more aware of the risk to bones and men starting androgen deprivation therapy need to know to ask about the test.
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Erectile Dysfunction Tied To Long Term Painkiller Use

A new study suggests that long term use of opioid prescription painkillers for back pain is tied to a higher risk of erectile dysfunction (ED). The findings are published in the 15 May online issue of the journal Spine.

Lead author Richard A. Deyo, an investigator with the Kaiser Permanente Center for Health Research says in a statement:

"Men who take opioid pain medications for an extended period of time have the highest risk of ED."

With his colleagues, Deyo, who is also Professor of Evidence-based Family Medicine at Oregon Health & Science University, found the link by analyzing electronic health records of over 11,000 men enrolled in a health plan.

They believe theirs is the first study to find such a link using electronic health records.

The reason they did the study was because men with chronic pain sometimes experience erectile dysfunction because of depression, smoking, age, or opioid-related hypogonadism (low testosterone due to painkiller use).

But little is known, they note, about how common ED is in men with back pain, and which risk factors may be important.

So they searched the electronic records to find out if men taking prescription painkillers were also the ones most likely to be prescribed testosterone replacement or medications for ED.

They found 11,327 men in Oregon and Washington enrolled in the Kaiser Permanente health plan who went to see their doctor complaining of back pain in 2004.

For each patient they identified, they looked at his pharmacy records covering six months before and six months after the back pain visit to find out if they had received opioids and testosterone replacement or ED medications.

The analysis showed that over 19% of men who took high-dose opioids (classed as more than 120 mg of morphine-equivalent) for at least four months were also prescribed testosterone replacement or medications for ED. This compared with only 7% who received ED prescriptions but did not take opioids.

Of the men who took low-dose opioids for at least four months, 12% also received prescribed testosterone replacement or medications for ED.

In looking at other factors, Deyo and colleagues found being over 60, having depression or other illnesses, or taking sleeping pills (sedative hypnotics like benzodiazepines), were all independently linked to ED. Age was the biggest factor, with men aged 60 to 69 being 14 times more likely to be receiving prescriptions for ED medications than men aged 18 to 29.

However, when they took out the effects of these factors in the figures, they found patients taking high-dose opioids were still 50% more likely to be given prescriptions for ED than men those who did not take the painkillers.

Deyo says just because they have found this link, it does not necessarily mean that prescription painkillers actually cause ED, but it is "something patients and clinicians should be aware of when deciding if opioids should be used to treat back pain."

Deyo has spent over 30 decades studying treatments for back pain. He says that while there is "no question" that for some patients taking opioids is the right treatment for back pain, "there is also increasing evidence that long-term use can lead to addiction, fatal overdoses, sleep apnea, falls in the elderly, reduced hormone production, and now erectile dysfunction".

The US Centers for Disease Control and Prevention (CDC) say prescription opioid use in the United States has grown enormously. Between 1999 and 2010, sales quadrupled.

A survey published in 2008 in the journal Pain, suggested that 4.3 million adult Americans regularly use opioids. The ones most commonly prescribed are hydrocodone, oxycodone, and morphine.

Researchers from the CDC also reported recently that in 30% of deaths from overdosing on opioid painkillers, patients had also taken benzodiazepines.

Written by Catharine Paddock PhD
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Malaria-Carrying Mosquitoes More Strongly Attracted To Smell Of Humans

A new study shows for the first time that infection with the malaria parasite causes mosquitoes to change smell-stimulated behavior so they are more strongly attracted to the smell of humans than uninfected mosquitoes.

The burden of malaria around the world is huge: the parasite infects over 200 million people a year and kills an estimated 770,000, note the researchers.

The infection, which causes fever and headache, and in severe cases can result in coma or death, spreads through human populations because malaria-inducing Plasmodium parasites living in the guts of female Anopheles mosquitoes pass into people's bloodstreams through mosquito bites.

There are different strains of malaria-inducing Plasmodium parasites, and different strains of host Anopheles mosquitoes. One of the deadliest parasites is Plasmodium falciparum, which is predominantly carried by Anopheles gambiae mosquitoes.

Writing in a 15 May online issue of PLOS ONE, researchers from the London School of Hygiene & Tropical Medicine in the UK describe how they showed significantly more A. gambiae mosquitoes infected with P. falciparum "landed and probed" on a fabric matrix emanating human skin odor than uninfected mosquitoes.

Previous studies have already shown that the malaria parasite changes host behavior to help it spread. For example, malaria-infected mosquitoes tend to consume larger, more frequent blood meals than uninfected mosquitoes.

However, this is the first study to show that the parasite changes odor-related behavior in its mosquito host.

(An intriguing example of altering host behavior featured recently in a study published in the journal mBio that describes how the luminous bacterium Vibrio fischeri regulates the daily rhythm of its host, the Hawaiian bobtail squid, by interacting with its clock genes.)

The researchers say their results offer a useful starting point for improving malaria control and eradication. It could help us find out more about how A. gambiae mosquitoes infect humans.

And, by understanding the olfactory changes that underly the altered smell-seeking behavior of the mosquitoes, it may be possible to find compounds to make traps for monitoring or capturing parasite-carrying A. gambiae mosquitoes, they conclude.

In another study published recently in the journal Science, researchers in the US show how they used a bacterium to stop the malaria parasite developing in the mosquito and created a stable population where immunity to the parasite was passed onto new generations.
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Novel Coronavirus Might Spread Between Humans, Says World Health Organization

The Novel Coronavirus (nCoV) is emerging as a major challenge for countries across the world and experts from the various governments that have been affected are desperately looking for some form of guidance. A new report by the World Health Organization (WHO) reveals that the virus may be able to spread by human-to-human contact.

In fact, WHO has just been invited by the The Ministry of Health of the Kingdom of Saudi Arabia to try and help them fully assess nCoV and come up with recommendations and ways to try and tackle it.

Novel Coronavirus infection is a relatively new disease in humans; there are still many questions that remain unanswered, says WHO. It is going to take some time before we fully understand nCoV.

What we know about nCoV so far

Coronaviruses affect the upper respiratory tract of birds and mammals, although they may also affect the gastrointestinal tract. They are quite common and are responsible for about one third of all common colds.

The Novel Coronavirus is a new coronavirus strain that began infecting people in the Middle East last year.

It was first identified around the beginning of 2012 when a man in Saudi Arabia became sick with symptoms that appeared to be very similar to SARS - he died in June 2012.

Three months later, a patient from Qatar became ill after a trip to Saudi Arabia. He was transported to the UK for further treatment. Lab tests were conducted which confirmed that the patients were both infected with nCoV.

Since then, nCoV infection has killed 18 people in the Middle East.

NCoV and it's similarity to SARS

Another well known virus that was similarly caused by a Coronavirus was the famous SARS CoV infection which first emerged in the Guangdong Province in southern China in November 2002.

Even though SARS and nCoV belong to the same family, the effects they have on human cells differ substantially. nCoV disrupts more human genes more aggressively and frequently than the SARS coronavirus did.

NCoV is also proving to have a higher fatality rate than SARS, its 50% death rate is a lot higher than the 9.5% rate during the 2002/2003 SARS pandemic that was responsible for the deaths of 774 out of 8,098 confirmed cases of human infection in 37 countries.

Understanding nCoV

WHO reports that "we know nCoV has infected people since 2012, but we don't know where this virus lives. We know that when people get infected, many of them develop severe pneumonia. What we don't know is how often people might develop mild disease."

Older men with existing medical conditions appear to be particularly vulnerable to nCoV infection. WHO warned that this trend may change over time.

One of the main concerns WHO, other health organizations and government bodies have about the virus is how it is being transmitted. A WHO official recently stated that the nCoV is likely able to spread from human-tohuman.

WHO wrote in an online communique:

"Of most concern, however, is the fact that the different clusters seen in multiple countries increasingly support the hypothesis that when there is close contact this novel coronavirus can transmit from person-to-person.

This pattern of person-to- person transmission has remained limited to some small clusters and so far, there is no evidence that this virus has the capacity to sustain generalized transmission in communities."

WHO praises the Saudi Arabian government for its diligent surveillance system and control measures; this could be why so many cases have been identified in the country.
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Antibiotics May Cure 40% Of Chronic Back Pain Cases

For nearly half of all chronic back pain sufferers, s simple course of antibiotics may cure about 40% of patients with chronic back pain, researchers from the University of Southern Denmark and the University of Birmingham, England, reported in the European Spine Journal. Neurologists are describing this breakthrough as "the stuff of Nobel Prizes".

The scientists demonstrated an association between long-term back pain and infection with Propionibacterium acnes, a bacterium commonly found on human skin that is involved in causing acne.

According to trial evidence, administering antibiotics to clear infection may bring an end to the constant lower back pain and all the misery that comes with it - offering a simpler, better and much cheaper option than surgery.

If the results of the trial can be confirmed in larger studies, millions of people around the world who suffer from long-term back pain could experience a complete change in quality of life.

The Mayo Clinic estimates that approximately 80% of all Americans will have low back pain at least once in their lives, and a significant proportion of these people develop chronic back pain. Back pain is the most common reason for absence from work in the USA.

According to the National Health Service, UK, approximately four million people in the United Kingdom suffer from chronic back pain.

Two studies have been published in the European Spine Journal. In the first study, Hanne B. Albert PT., MPH., Ph.D., from The Back Research Centre, University of Southern Denmark, and team demonstrated how bacteria invade the injury sites of slipped discs and cause painful inflammation, as well as harming surrounding vertebrae.

Experts had previously believed that if bacterial infections played a role in back pain, it was probably only a minor one. However, this trial showed that nearly half of all the patients with slipped discs tested positive for bacterial infection, and mostly by the acne-causing bacterium Propionibacterium acnes.

Dr. Albert and colleagues believe the bacterium is probably the cause of up to 40% of all cases of long-term back pain.

In the second study, the same researchers tried out an antibiotic combination treatment based on their discovery. They recruited 162 volunteers, all of them chronic back pain sufferers. They defined "chronic" as somebody whose back pain has lasted for more than six months. All of the participants had had a slipped disk and had signs of bone swelling.

The patients were divided into two groups:
  • The antibiotic group - they were administered Amoxicillin (amoxicillan) and clavulanate for 100 days

  • The placebo group - they received an inactive placebo (dummy drug)
The antibiotic treatment proved effective in 80% of cases. The authors wrote that patients experienced significant reductions in disability and pain.

Dr. Albert wrote:

"Antibiotics should be considered as a treatment option for this special subgroup of patients with chronic low back pain (CLBD).

More confirmatory work in other populations and studies on improved protocols as well as the background science should be encouraged."

The Daily Telegraph quoted Dr. Peter Hamlyn, an expert neurosurgeon from University College London hospital, who said:

"Make no mistake this is a turning point, a point where we will have to re-write the textbooks. It is the stuff of Nobel prizes."

Nursing Times quoted Professor Laura Piddock, from the University of Birmingham, England, who cautioned that antibiotics should only be considered for chronic lower back pain if a bacterial cause has been identified. Inappropriate use of antibiotics can contribute to the proliferation of resistant bacteria.

Professor Piddock said "For this reason, physicians are encouraged to liaise with their consultant microbiologist colleagues for the most appropriate tests to carry out."
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