Surgical anesthesia in young children linked to effects on IQ, brain structure

Children who received general anesthesia for surgery before age 4 had diminished language comprehension, lower IQ and decreased gray matter density in posterior regions of their brain, according to a new study. The authors of the study recommend additional studies to determine anesthesia's precise molecular effects on the brain and contribution to diminished brain function and composition.

Young children who received general anesthesia for surgery had diminished language comprehension, lower IQ and decreased gray matter density in posterior regions of their brain, according to a new study. (stock image)

Credit: © garagundi / Fotolia

Children who received general anesthesia for surgery before age 4 had diminished language comprehension, lower IQ and decreased gray matter density in posterior regions of their brain, according to a new study in the journal Pediatrics.

Researchers from Cincinnati Children's Hospital Medical Center report their findings in the journal's June 8 online edition. The authors recommend additional studies to determine anesthesia's precise molecular effects on the brain and contribution to diminished brain function and composition. Researchers say this knowledge could make it possible to develop mitigating strategies for what the authors describe as a potential dilemma for child health.

"The ultimate goal of our laboratory and clinical research is to improve safety and outcomes in young children who have no choice but to undergo surgery with anesthesia to treat their serious health concerns," said Andreas Loepke, MD, PhD, FAAP, lead study author and an anesthesiologist in the Department of Anesthesiology at Cincinnati Children's. "We also have to better understand to what extent anesthetics and other factors contribute to learning abnormalities in children before making drastic changes to our current practice, which by all measures has become very safe."

Loepke and his research colleagues have published previous studies showing widespread cell death, permanent deletion of neurons and neurocognitive impairment in laboratory rats and mice after exposure to general anesthesia. Those studies have raised concerns about similar effects in young children during a particularly sensitive neurodevelopmental period in early life, which researchers say could interfere with the refinement of neuronal networks and lead to long-term functional abnormalities.

For their current retrospective study, the authors compared the scores of 53 healthy participants of a language development study (ages 5 to 18 years with no history of surgery) with the scores of 53 children in the same age range who had undergone surgery before the age of 4.

The authors stress that average test scores for all 106 children in the study were within population norms, regardless of surgical history. Still, compared with children who had not undergone surgery, children exposed to anesthesia scored significantly lower in listening comprehension and performance IQ. Researchers also report that decreased language and IQ scores were associated with lower gray matter density in the occipital cortex and cerebellum of the brain.

Researchers, who used extensive analysis of surgical and other medical records, said the children were matched for age, gender, handedness and socioeconomic status -- all confounding factors of cognition and brain structure. The authors also factored into their calculations the types of surgeries and length of exposure to anesthetics. The anesthetics used during the surgeries included common agents such as sevoflurane, isoflurane or halothane (used alone or in combination) and nitrous oxide.

Children included in the study did not have a history of neurologic or psychological illness, head trauma or any other associated conditions. Neurocognitive assessments included the Oral and Written Language Scales and the Wechsler Intelligence Scale. Brain structural comparisons were conducted by MRI scans.

Estimated Social Cost

Extending their study a step beyond the medical data, the research team also considered the potential societal impact of their findings. Earlier research from 2008 had estimated the loss of 1 IQ point to decrease a person's lifetime earnings potential by $18,000. Factoring in the potential loss of 5 or 6 IQ points found in their current study, the researchers report that, based on the estimated 6 million children who undergo surgery in the United States each year the lifetime potential earnings loss could total $540 billion.

Emphasis on Safety

Although data in the current study highlight the need to look for improved methods of administering anesthesia, Loepke and his colleagues emphasize that current methods are very safe. Loepke advises parents who are concerned to discuss with their pediatrician and surgeon the risks of a surgical procedure -- and the potential risk of anesthetic exposure -- versus the risks of not having a surgery.

"It is important to note that no surgeries are truly elective in young children," Loepke said. "Many surgical procedures early in life treat life-threatening conditions, avert serious health complications, or improve quality of life. These cannot be easily postponed or avoided."

Loepke also stressed that researchers at Cincinnati Children's are actively looking for alternative anesthetic techniques in their ongoing laboratory studies. Drugs are being tested that show potential for lessening the harmful effects of anesthetics in laboratory rats and mice, and this research is ongoing. Additionally, the medical center is participating in an international clinical trial to test an alternative anesthetic regimen in young children undergoing urological procedures.

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Story Source:

The above story is based on materials provided by Cincinnati Children's Hospital Medical Center. Note: Materials may be edited for content and length.

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Drop in abuse and overdose after opioids were made crush-resistant

After 2010, when oxycodone - a high-dose opioid painkiller sold as OxyContin - was switched by its manufacturer to a new abuse-deterrent formulation, overdose rates fell substantially, researchers have found.

In addition to potential misuse by people receiving the original prescription, opioid painkillers may be diverted to illicit users.

The formulation change also saw a drop in the levels of dispensing, and the lower opioid overdose and prescribing levels also correlated with the withdrawal from the market of another narcotic drug in the same year, propoxyphene.

OxyContin is an extended-release formulation to deliver its higher painkilling dose in a more controlled way, but misuse of this opioid for a quicker "high" had been possible by crushing or dissolving the medication to bypass this design. The new formulation, however, is resistant to this abuse strategy.

Propoxyphene (Darvon) was withdrawn from the US market in 2010 because of data about its cardiac side-effects. First approved for sale as an analgesic in 1957, it soon became prone to misuse - and the authors cite that, by 1977, propoxyphene was the "second-leading agent in prescription drug-induced deaths."

The authors of the study in JAMA Internal Medicine describe the reduction in dispensing following these two pharmaceutical industry changes in 2010:

"The introduction of abuse-deterrent OxyContin and withdrawal of propoxyphene at the end of 2010 were associated with sudden, substantial and sustained decreases in prescription opioid dispensing.

The estimated decrease in opioid dispensing at 2 years would be enough to supply 5 mg of oxycodone each day of the fourth quarter of 2012 to 5% of the population."

Fall in level of morphine-equivalent amounts dispensed

The researchers analyzed the prescribing of opioids to commercial health plan members across the US to reach the estimated average level of morphine-equivalent dose (MED).

For all opioids combined, between 2003 and the third quarter of 2010, the dispensing rate rose from 95 mg to 163 mg MED per plan beneficiary.

Immediately following the interventions, the dispensing rate dropped by 14.8 mg MED per member, and a downward trend then continued to buck predictions, leading to the rate in the last quarter of 2012 being estimated at 139 mg MED per member, down from the 163 mg peak.

Against the predicted trend of opioid prescriptions, this represented a 19% decrease following the 2010 changes. Further, the estimated rate of overdose also dropped - by 20%.

The prescribing data, drawn from over 31 million insured members, were analyzed by Dr. Marc Larochelle, of the Harvard Medical School and Boston University School of Medicine, and coauthors. They conclude:

"Our results have significant implications for policymakers and health care professionals grappling with the epidemic of opioid abuse and overdose. Changes imposed through regulatory mandates or voluntary company actions may be a viable approach to stemming prescription abuse."

A note of caution is made with this call, however, to reduce opioid supply without harming access to the therapeutic benefit of painkilling treatments.

The authors also warn that interventions at the supply end do not cure the present demand problem, even though it "might decrease new-onset addiction in the future."

Alongside the opioid findings, the authors found that heroin overdose, conversely, increased by 23% in the study period. The authors note:

"Regardless of the mediating mechanism, a transition from prescription opioid to heroin abuse has been well documented and further efforts are needed to improve identification and treatment of these individuals."

Continue to Read more ...

Beauty in the beasties: how some of the world's creepiest critters may benefit your health

Though a well-known hymn tells us we should love "all creatures great and small," loving some of the smaller creatures on Earth - particularly the creepy-crawly kind - can prove a little challenging. So many of us have a fear of spiders, for example, that it sits in the top 10 list of phobias worldwide. But maybe this Spotlight will evoke a little warmth toward the beasts; we look at the surprising ways in which spiders and some other creepy critters may benefit human health.

Researchers have identified genes in houseflies that make them immune to the pathogens they carry - a finding that could open the door to treatments for human illnesses.

Mary Astell - a 17th century English philosopher - once said: "None of God's creatures absolutely consider'd are in their own nature contemptible; the meanest fly, the poorest insect has its use and vertue." And it seems this may be true in relation to the medical world.

Take the common housefly. They feed on decaying organic matter - such as garbage and feces - and as a result, carry over 100 potentially life-threatening pathogens that can be transmitted to humans. Based on this information, it is no wonder many of us take the opportunity to swat the little pests when they come into close range.

But you may be surprised to learn that the common housefly could actually help scientists learn more about human illnesses. In a study published in the journal Genome Biology in October 2014, Dr. Jeff Scott and colleagues from Cornell University in Ithaca, NY, revealed how they sequenced the genome of the housefly using DNA from six female flies.

Comparing the DNA of the housefly with that of the fruit fly - which shares almost 60% of human genes - the team identified genes that make houseflies immune to the pathogens they carry, potentially bringing us closer to new treatments for human illnesses.

"The housefly genome provides a rich resource for enabling work on innovative methods of insect control, for understanding the mechanisms of insecticide resistance, genetic adaptation to high pathogen loads, host parasitoid interactions, and for exploring the basic biology of this important pest," the authors explained.

And this discovery is only the tip of the iceberg; there are many more equally as unpleasant critters that may offer benefits for human health.

Spiders: relieving pain and repairing nerve damage

Many of you are likely to be cringing at the sight of the word "spider." Millions of us hate the eight-legged monstrosities, running away at the speed of light when one randomly appears from under the sofa. But whatever your thoughts about these arachnids, there is no doubt they are amazing creatures.

There are believed to be at least 40,000 species of spiders worldwide, residing on every continent except Antarctica.

Though all spiders have the ability to bite, only around a dozen can cause harm to humans with their toxic venom. Black Widows, Brown Recluse spiders and Hobo spiders are some of the venomous spiders found in the US. A bite from one of these can cause symptoms such as fever, itching or rash, nausea and vomiting, high blood pressure and breathing difficulties. Only very rarely can a spider bite lead to death.

Researchers have identified compounds in spider venom that could help treat chronic pain.

But while spider venom can cause human harm, it may also aid human health. Earlier this month, Medical News Todayreported on a study conducted by researchers from The University of Queensland in Australia, who claimed to have identified compounds in spider venom that could help treat chronic pain in humans.

From screening the venoms of 205 species of spider, they discovered that 40% of venoms contained at least one compound that has the ability to block a pathway involved in chronic pain in humans, called Nav1.7. One particular compound that showed promise - called Hd1a - was identified in a species of spider calledHaplopelma doriae - a member of the tarantula family.

Study leader Prof. Glenn King believes the findings may lead to more effective treatments for the millions of people worldwide who suffer from chronic pain. "Untapping this natural source of new medicines brings a distinct hope of accelerating the development of a new class of painkillers that can help people who suffer from chronic pain that cannot be treated with current treatment options," he adds.

And it is not only spiders' venom that could aid progress in human medicine. Spider silk - the protein fiber that the creatures use to make their webs - may be useful for treating nerve damage in humans, according to a 2011 study by researchers from Hannover Medical School in Germany.

Spider silk is an extremely durable fiber, with one study claiming it is five times stronger than steel. The Hannover researchers believe its high durability makes spider silk a promising candidate for reconstructive nerve surgery, with the technique already proving successful in animal models.

Bees: helping to fight antibiotic resistance and treat HIV

Compared with spiders, we tend to have a higher tolerance for bees. Though they seem incapable of finding their way back out of an open window they just flew through - making us do a lot of curtain-flapping and arm-waving - they are responsible for producing one of the nation's most-loved foods: honey.

But according to scientists, these insects are capable of so much more. In 2013, MNT reported on a study published in Antiviral Therapy, in which researchers revealed how a toxin found in bee venom - melittin - has the potential to destroy human immunodeficiency virus (HIV).

The investigators, from the Washington University School of Medicine, explained that melittin is able to make holes in the protective, double-layered membrane that surrounds the HIV virus. Delivering high levels of the toxin to the virus via nanoparticles could be an effective way to kill it.

Study author Dr. Joshua L. Hood believes these findings could lead to the creation of a vaginal gel to halt HIV transmission. "Our hope is that in places where HIV is running rampant, people could use this gel as a preventive measure to stop the initial infection," he explained.

A more recent study published in September 2014 claims bees may also be useful for creating a new class of antibiotics. Researchers from the Lund University in Sweden discovered lactic acid bacteria in fresh honey found in the stomachs of bees that has antimicrobial properties.

The team found that the bacteria is effective against a number of drug-resistant pathogens responsible for potentially life-threatening infections, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus(VRE).

At a time when existing antibiotics are increasingly failing to work against such infections, the researchers say their findings suggest a viable alternative.

Scorpions: helping to treat heart problems

Like spiders, scorpions are creepy but fascinating. There are around 90 species of scorpions living in the US, most likely to be found in rocky and sandy areas.

While a scorpion's venom can cause heart problems, researchers have found it could also treat them.

All scorpions are venomous, though only 25-30 species possess a venom that is toxic enough to cause severe illness in humans.

A person who is unlucky enough to be stung by one of these more deadly species may experience difficulty breathing, muscle spasms, high blood pressure, a rise or reduction in heart rate and irregular heartbeat. But while their venom can cause heart problems, you may be surprised to learn that it could also treat them.

A 2011 study by researchers from the University of Wisconsin-Madison School of Medicine and Public Health found that compounds in the venom of the African Emperor scorpion, or Pandinus imperator, may be effective for the treatment of heart failure.

The researchers found that the compounds, called calcins, activate the release of calcium in human heart cells, allowing better heart muscle contraction - something that is limited in patients with heart failure.

Another study published in 2010 identified a compound in the venom of the Central American bark scorpion - a species commonly kept as a pet - that could stop heart bypasses from failing.

The study researchers - from the University of Leeds in the UK - explain that the compound, called margatoxin, could prevent neointimal hyperplasia following heart bypass surgery - a common complication that causes blood vessel blockage. Margatoxin works by blocking a potassium ion channel called Kv1.3, which is involved in neointimal hyperplasia.

"These results look promising, but we won't know if this approach will benefit patients undergoing bypass surgery until more research is undertaken in patients to establish its long-term efficacy and safety," commented Prof. Peter Weissberg, medical director at the British Heart Foundation, adding:

"This is a good example of a substance that is dangerous in its natural form - a scorpion sting, having potential medicinal benefits if used appropriately."

Frogs: aiding the fight against cancer

Of all the creatures featured in this Spotlight, frogs are probably one of the least feared, but they are certainly one of the most interesting. They have the ability to jump more than 20 times their body length, and some species - such as the Budgett's frog - have camouflage capabilities.

There are more than 6,000 species of frogs worldwide, of which 90 reside in the US. While many species of frog are venomous, very few cause harm to humans. In fact, some species of frog could aid humans in the fight against cancer.

In 2011 a study by researchers from Queen's University Belfast in Northern Ireland that revealed thediscovery of two proteins in the skin of the Waxy Monkey Frog and the Giant Firebellied Toad that can disrupt angiogenesis, or new blood vessel growth.

The researchers explain that cancer tumors develop their own blood supply, fueling themselves with oxygen and nutrients to help them grow. A protein that can switch off blood vessel growth means tumors would be unable to fuel themselves, meaning they would stop growing. "Stopping the blood vessels from growing will make the tumor less likely to spread and may eventually kill it. This has the potential to transform cancer from a terminal illness into a chronic condition," says study author Prof. Chris Shaw.

On the other hand, Prof. Shaw says such a protein could be used to activate blood vessel growth, which could treat a number of conditions in which rapid blood vessel repair is required, such as blood vessel damage following stroke.

Reptiles: helping to manage and treat diabetes

Some of you may not have heard of the Gila monster. Found in southwestern US and northwestern Mexico, it is the only venomous lizard in the US, and one of only a few venomous lizards worldwide. Rest easy, though; a bite from this beast is not fatal to healthy adults. But its saliva could be a lifesaver.

In 2007, a study by researchers from the University of North Carolina at Chapel Hill School of Medicine revealed how exenatide - a synthetic form of a compound found in the saliva of the Gila monster, called exendin-4 - may help people with diabetes control their condition and lose weight.

A synthetic form of a compound found in the saliva of the Gila monster - called exendin-4 - may help people with diabetes control their condition and lose weight.

The compound works by causing the pancreas to produce more insulin when blood sugar is too high. In the study, 46% of patients who were given exenatide in combination with diabetes drug metformin had good control of their blood sugar, compared with only 13% of control participants.

"The Gila monster only eats three or four times a year, and a compound produced in its salivary glands called exendin-4 may help them digest these meals very slowly over time. That is an advantageous quality when translated into controlling diabetes," commented Dr. Michael Trautmann of pharmaceutical company Eli Lilly - who helped develop the drug.

The Gila monster is not the only reptile that could help treat diabetes. A 2012 study published in Nature Communications found toxins in snake venom that could be beneficial for the condition, and they could even help treat high blood pressure and cancer.

The team analyzed gene sequences from the Burmese python and garter snake to reach their findings. They found that - although the venoms of these snakes can be harmful to humans - the toxins in them can be changed into harmless molecules that could make effective drugs.

"The venom gland of snakes appears to be a melting pot for evolving new functions for molecules, some of which are retained in venom for killing prey, while others go on to serve new functions in other tissues in the body," said lead author Dr. Nicholas Casewell, from the Liverpool School of Tropical Medicine in the UK.

It seems that what Mary Astell said is not far from the truth; even "the meanest fly" or "the poorest insect" has its uses.

Continue to Read more ...

Beauty in the beasties: how some of the world's creepiest critters may benefit your health

Though a well-known hymn tells us we should love "all creatures great and small," loving some of the smaller creatures on Earth - particularly the creepy-crawly kind - can prove a little challenging. So many of us have a fear of spiders, for example, that it sits in the top 10 list of phobias worldwide. But maybe this Spotlight will evoke a little warmth toward the beasts; we look at the surprising ways in which spiders and some other creepy critters may benefit human health.

Mary Astell - a 17th century English philosopher - once said: "None of God's creatures absolutely consider'd are in their own nature contemptible; the meanest fly, the poorest insect has its use and vertue." And it seems this may be true in relation to the medical world.

Take the common housefly. They feed on decaying organic matter - such as garbage and feces - and as a result, carry over 100 potentially life-threatening pathogens that can be transmitted to humans. Based on this information, it is no wonder many of us take the opportunity to swat the little pests when they come into close range.

But you may be surprised to learn that the common housefly could actually help scientists learn more about human illnesses. In a study published in the journal Genome Biology in October 2014, Dr. Jeff Scott and colleagues from Cornell University in Ithaca, NY, revealed how they sequenced the genome of the housefly using DNA from six female flies.

Comparing the DNA of the housefly with that of the fruit fly - which shares almost 60% of human genes - the team identified genes that make houseflies immune to the pathogens they carry, potentially bringing us closer to new treatments for human illnesses.

"The housefly genome provides a rich resource for enabling work on innovative methods of insect control, for understanding the mechanisms of insecticide resistance, genetic adaptation to high pathogen loads, host parasitoid interactions, and for exploring the basic biology of this important pest," the authors explained.

And this discovery is only the tip of the iceberg; there are many more equally as unpleasant critters that may offer benefits for human health.

Spiders: relieving pain and repairing nerve damage

Many of you are likely to be cringing at the sight of the word "spider." Millions of us hate the eight-legged monstrosities, running away at the speed of light when one randomly appears from under the sofa. But whatever your thoughts about these arachnids, there is no doubt they are amazing creatures.

There are believed to be at least 40,000 species of spiders worldwide, residing on every continent except Antarctica.

Though all spiders have the ability to bite, only around a dozen can cause harm to humans with their toxic venom. Black Widows, Brown Recluse spiders and Hobo spiders are some of the venomous spiders found in the US. A bite from one of these can cause symptoms such as fever, itching or rash, nausea and vomiting, high blood pressure and breathing difficulties. Only very rarely can a spider bite lead to death.

Researchers have identified compounds in spider venom that could help treat chronic pain.

But while spider venom can cause human harm, it may also aid human health. Earlier this month, Medical News Today reported on a study conducted by researchers from The University of Queensland in Australia, who claimed to have identified compounds in spider venom that could help treat chronic pain in humans.

From screening the venoms of 205 species of spider, they discovered that 40% of venoms contained at least one compound that has the ability to block a pathway involved in chronic pain in humans, called Nav1.7. One particular compound that showed promise - called Hd1a - was identified in a species of spider calledHaplopelma doriae - a member of the tarantula family.

Study leader Prof. Glenn King believes the findings may lead to more effective treatments for the millions of people worldwide who suffer from chronic pain. "Untapping this natural source of new medicines brings a distinct hope of accelerating the development of a new class of painkillers that can help people who suffer from chronic pain that cannot be treated with current treatment options," he adds.

And it is not only spiders' venom that could aid progress in human medicine. Spider silk - the protein fiber that the creatures use to make their webs - may be useful for treating nerve damage in humans, according to a 2011 study by researchers from Hannover Medical School in Germany.

Spider silk is an extremely durable fiber, with one study claiming it is five times stronger than steel. The Hannover researchers believe its high durability makes spider silk a promising candidate for reconstructive nerve surgery, with the technique already proving successful in animal models.

Bees: helping to fight antibiotic resistance and treat HIV

Compared with spiders, we tend to have a higher tolerance for bees. Though they seem incapable of finding their way back out of an open window they just flew through - making us do a lot of curtain-flapping and arm-waving - they are responsible for producing one of the nation's most-loved foods: honey.

But according to scientists, these insects are capable of so much more. In 2013, MNT reported on a study published in Antiviral Therapy, in which researchers revealed how a toxin found in bee venom - melittin - has the potential to destroy human immunodeficiency virus (HIV).

The investigators, from the Washington University School of Medicine, explained that melittin is able to make holes in the protective, double-layered membrane that surrounds the HIV virus. Delivering high levels of the toxin to the virus via nanoparticles could be an effective way to kill it.

Study author Dr. Joshua L. Hood believes these findings could lead to the creation of a vaginal gel to halt HIV transmission. "Our hope is that in places where HIV is running rampant, people could use this gel as a preventive measure to stop the initial infection," he explained.

A more recent study published in September 2014 claims bees may also be useful for creating a new class of antibiotics. Researchers from the Lund University in Sweden discovered lactic acid bacteria in fresh honey found in the stomachs of bees that has antimicrobial properties.

The team found that the bacteria is effective against a number of drug-resistant pathogens responsible for potentially life-threatening infections, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE).

At a time when existing antibiotics are increasingly failing to work against such infections, the researchers say their findings suggest a viable alternative.

Scorpions: helping to treat heart problems

Like spiders, scorpions are creepy but fascinating. There are around 90 species of scorpions living in the US, most likely to be found in rocky and sandy areas.

While a scorpion's venom can cause heart problems, researchers have found it could also treat them.

All scorpions are venomous, though only 25-30 species possess a venom that is toxic enough to cause severe illness in humans.

A person who is unlucky enough to be stung by one of these more deadly species may experience difficulty breathing, muscle spasms, high blood pressure, a rise or reduction in heart rate and irregular heartbeat. But while their venom can cause heart problems, you may be surprised to learn that it could also treat them.

A 2011 study by researchers from the University of Wisconsin-Madison School of Medicine and Public Health found that compounds in the venom of the African Emperor scorpion, or Pandinus imperator, may be effective for the treatment of heart failure.

The researchers found that the compounds, called calcins, activate the release of calcium in human heart cells, allowing better heart muscle contraction - something that is limited in patients with heart failure.

Another study published in 2010 identified a compound in the venom of the Central American bark scorpion - a species commonly kept as a pet - that could stop heart bypasses from failing.

The study researchers - from the University of Leeds in the UK - explain that the compound, called margatoxin, could prevent neointimal hyperplasia following heart bypass surgery - a common complication that causes blood vessel blockage. Margatoxin works by blocking a potassium ion channel called Kv1.3, which is involved in neointimal hyperplasia.

"These results look promising, but we won't know if this approach will benefit patients undergoing bypass surgery until more research is undertaken in patients to establish its long-term efficacy and safety," commented Prof. Peter Weissberg, medical director at the British Heart Foundation, adding:

"This is a good example of a substance that is dangerous in its natural form - a scorpion sting, having potential medicinal benefits if used appropriately."

Frogs: aiding the fight against cancer

Of all the creatures featured in this Spotlight, frogs are probably one of the least feared, but they are certainly one of the most interesting. They have the ability to jump more than 20 times their body length, and some species - such as the Budgett's frog - have camouflage capabilities.

There are more than 6,000 species of frogs worldwide, of which 90 reside in the US. While many species of frog are venomous, very few cause harm to humans. In fact, some species of frog could aid humans in the fight against cancer.

In 2011, MNT reported on a study by researchers from Queen's University Belfast in Northern Ireland that revealed thediscovery of two proteins in the skin of the Waxy Monkey Frog and the Giant Firebellied Toad that can disrupt angiogenesis, or new blood vessel growth.

The researchers explain that cancer tumors develop their own blood supply, fueling themselves with oxygen and nutrients to help them grow. A protein that can switch off blood vessel growth means tumors would be unable to fuel themselves, meaning they would stop growing. "Stopping the blood vessels from growing will make the tumor less likely to spread and may eventually kill it. This has the potential to transform cancer from a terminal illness into a chronic condition," says study author Prof. Chris Shaw.

On the other hand, Prof. Shaw says such a protein could be used to activate blood vessel growth, which could treat a number of conditions in which rapid blood vessel repair is required, such as blood vessel damage following stroke.

Reptiles: helping to manage and treat diabetes

Some of you may not have heard of the Gila monster. Found in southwestern US and northwestern Mexico, it is the only venomous lizard in the US, and one of only a few venomous lizards worldwide. Rest easy, though; a bite from this beast is not fatal to healthy adults. But its saliva could be a lifesaver.

In 2007, a study by researchers from the University of North Carolina at Chapel Hill School of Medicine revealed how exenatide - a synthetic form of a compound found in the saliva of the Gila monster, called exendin -4 - may help people with diabetes control their condition and lose weight.

A synthetic form of a compound found in the saliva of the Gila monster - called exendin-4 - may help people with diabetes control their condition and lose weight.

The compound works by causing the pancreas to produce more insulin when blood sugar is too high. In the study, 46% of patients who were given exenatide in combination with diabetes drug metformin had good control of their blood sugar, compared with only 13% of control participants.

"The Gila monster only eats three or four times a year, and a compound produced in its salivary glands called exendin-4 may help them digest these meals very slowly over time. That is an advantageous quality when translated into controlling diabetes," commented Dr. Michael Trautmann of pharmaceutical company Eli Lilly - who helped develop the drug.

The Gila monster is not the only reptile that could help treat diabetes. A 2012 study published in Nature Communications found toxins in snake venom that could be beneficial for the condition, and they could even help treat high blood pressure and cancer.

The team analyzed gene sequences from the Burmese python and garter snake to reach their findings. They found that - although the venoms of these snakes can be harmful to humans - the toxins in them can be changed into harmless molecules that could make effective drugs.

"The venom gland of snakes appears to be a melting pot for evolving new functions for molecules, some of which are retained in venom for killing prey, while others go on to serve new functions in other tissues in the body," said lead author Dr. Nicholas Casewell, from the Liverpool School of Tropical Medicine in the UK.

It seems that what Mary Astell said is not far from the truth; even "the meanest fly" or "the poorest insect" has its uses.

Written by Honor Whiteman

Continue to Read more ...

Paracetamol overdose and liver failure

University of Adelaide researchers have identified a key step for the future prevention of liver failure resulting from taking too much of the everyday painkiller paracetamol (also known as acetaminophen).
Published in the Proceedings of the National Academy of Sciences (PNAS), the study pinpoints a target for new treatments to prevent the potentially lethal consequences of paracetamol overdose.
"Paracetamol is the most frequently used over-the-counter pain medication," says Dr Grigori Rychkov, Senior Research Fellow in the University's School of Medical Sciences.
"Overdose of paracetamol is the most common cause of acute liver failure and the leading cause of liver damage requiring transplantation in developed countries. The precise mechanisms of liver toxicity due to paracetamol overdose, however, have remained unclear."
It has been known for a long time that paracetamol overdose is associated with toxic levels of calcium in liver cells but nobody has known how the calcium gets into the cells.
The University of Adelaide researchers have identified a channel transporting calcium across the cell membrane that is triggered by paracetamol overdose, known as Transient Receptor Potential Melanostatine2 (TRPM2). Once the channel is activated, the cells become overloaded with calcium, leading to cell death. If this continues and enough cells die, it can lead to liver failure.
The research, conducted by PhD student Ehsan Kheradpezhouh, showed in laboratory studies that when the TRPM2 channel was missing or blocked, liver cells were protected from paracetamol damage.
"We now have a potential drug target for treating paracetamol overdose and possibly some other liver-damaging poisonings," says Dr Rychkov.
Currently paracetamol overdose can be effectively treated - but only if caught within 18 hours.
"If we can block the TRPM2 channel we might be able to prevent the toxicity or extend this timeframe. If we can stop the calcium uptake and cell death, we'll be giving the liver a better chance for recovery and, hopefully, preventing complete liver failure," says Dr Rychkov.

Continue to Read more ...

Menstrual cramps relieved by erectile dysfunction drug

For many women, monthly menstrual cramps can stop them in their tracks, causing nausea, vomiting, diarrhea and dizziness. But according to researchers from Penn State College of Medicines, a common drug used to treat erectile dysfunction in men could provide some relief.
In a recent study published in the journal Human Reproduction, the researchers, led by Dr. Richard Legro, studied the effects of sildenafil citrate - commercially known as Viagra - on women with primary dysmenorrhea (PD).
According to the team, PD is the most common reason for pelvic pain in women. Although it is painful and disruptive, it is not due to other diseases.
Anti-inflammatory drugs - including ibuprofen - are the most widely used treatment for pain relief of menstrual cramps, but the researchers say it does not work for all women, and is associated with ulcers and kidney damage when used repeatedly.
Erectile dysfunction drugs have previously shown an improvement in pelvic pain when taken orally, the researchers note, but this can often result in headaches, which they say makes it largely unsuitable for chronic use.
As a result, the researchers from this latest study assessed the results of using sildenafil citrate vaginally, which they say had not yet been tried to alleviate PD.

Larger studies needed to confirm results

Little blue pill: women who took a drug that is used to treat erectile dysfunction in men experienced relief from their menstrual pain.

To conduct their research, the investigators randomized 25 women between the ages of 18 and 35 to use either sildenafil or a placebo drug.
Working with researchers at Nova Gradiska General Hospital in Croatia, the team from Penn State collected data on how the participants rated their pain during a 4-hour period.
After 2 hours, the researchers observed that uterine artery pulsatility index was "significantly lower" in the group taking sildenafil citrate, compared with those in the placebo group.
More importantly, the patients in the sildenafil group experienced alleviated menstrual pain, and there were no reported side effects.
Although the researchers thought the drug would soothe pain by increasing blood flow, they observed that both sildenafil and the placebo increased uterine blood flow, so they say they do not yet understand why the drug alleviates pain.
Dr. Legro, who is also professor of obstetrics and gynecology and public health sciences at Penn State, says:



"If future studies confirm these findings, sildenafil may become a treatment option for patients with PD. Since PD is a condition that most women suffer from and seek treatment for at some points in their lives, the quest for new medication is justified."

The study was funded by the National Institutes of Health, but the authors note that they did not meet their sample size due to loss of funding.
As a result, they say larger, multi-center studies must be completed in order to confirm the findings of their study.

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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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