Saturday, October 31, 2009
Science Daily (October 27, 2009)
Many people perceive gambling to be a harmless recreational activity. However, it is estimated that six to eight million people in the United States personally suffer from a gambling related problem. This problem seems to grow tentacles, extending out to wreak havoc and can profoundly impact the physical, emotional, and financial health of the family (spouses, children, extended).
As stated in this month's issue of the Journal of Marital and Family Therapy, the most common treatment models for problem gambling are focused on meeting the needs of gamblers but do not address the needs of couples and families whose lives have been negatively impacted by someone else's gambling.
In the paper, the authors provide a detailed description of how problem gambling impacts families, they explain, "Our hope in writing this paper is to raise awareness about problem gambling and the importance of developing treatment programs that meet the needs of the families of problem gamblers."
As noted by the authors, many of the people who access problem gambling treatment services are family members. It is clear that the impact of gambling on families can no longer be allowed to slip "under the radar." Marriage and family therapists are well positioned to help families cope with the impact of problem gambling on their lives.
Conceptualizing and Treating Problem Gambling as a Family Issue.
Jennifer L. McComb, Bonnie K. Lee, Douglas H. Sprenkle.
Journal of Marital and Family Therapy, 2009; 35 (4): 415 DOI: 10.1111/j.1752-0606.2009.00146.x
Link to JMFT abstract
Amy Lavoie for Harvard Gazette (October 28, 2009
The rationale behind torture is that pain will make the guilty confess, but a new study by researchers at Harvard University finds that the pain of torture can make even the innocent seem guilty.
Participants in the study met a woman suspected of cheating to win money. The woman was then "tortured" by having her hand immersed in ice water while study participants listened to the session over an intercom. She never confessed to anything, but the more she suffered during the torture, the guiltier she was perceived to be.
The research, published in the Journal of Experimental Social Psychology, was conducted by Kurt Gray, graduate student in psychology, and Daniel M. Wegner, professor of psychology, both in Harvard's Faculty of Arts and Sciences.
"Our research suggests that torture may not uncover guilt so much as lead to its perception," says Gray. "It is as though people who know of the victim's pain must somehow convince themselves that it was a good idea -- and so come to believe that the person who was tortured deserved it."
Not all torture victims appear guilty, however. When participants in the study only listened to a recording of a previous torture session -- rather than taking part as witnesses of ongoing torture -- they saw the victim who expressed more pain as less guilty. Gray explains the different results as arising from different levels of complicity.
"Those who feel complicit with the torture have a need to justify the torture, and so link the victim's pain to blame," says Gray. "On the other hand, those distant from torture have no need to justify it and so can sympathize with the suffering of the victim, linking pain to innocence."
The study included 78 participants: half met the woman who was apparently tortured (actually a confederate of the experimenters who was, of course, not harmed at all), and half did not. Participants were told that the study was about moral behavior, and that the woman may have cheated by taking more money than she deserved. The experimenter suggested that a stressful situation might make a guilty person confess, so participants listened for a confession over a hidden intercom as she was subjected to the sham "torture."
The confederate did not admit to cheating but reacted to having her hand submerged in ice water with either indifference or with whimpering and pleading. Participants who had met her rated her as more guilty the more she suffered. Those who did not meet her rated her as more guilty when she felt less pain.
Gray suggests that these results offer an explanation for the debate swirling around torture.
"Seeing others in pain can perpetuate ideological differences about the justifiability of torture," says Gray. "Those who initially advocate torture see those harmed as guilty, unlike those who initially reject torture and its methods."
The findings also shed light on the Abu Ghraib scandal, where prison guards tortured Iraqi detainees. Prison guards, who are close to the suffering of detainees, see detainees as more guilty the more they suffer, unlike the more distant general public.
The case may still be open on whether torture actually makes victims more likely to tell the truth. This research suggests instead that the mere fact that someone was tortured leads observers to think that the truth was found.
The research was supported by the Canadian Social Sciences and Humanities Research Council and the Institute for Humane Studies.
Torture and judgments of guilt
Kurt Grayand Daniel M. Wegner
Journal of Experimental Social Psychology article in press doi:10.1016/j.jesp.2009.10.003
Link to Journ Exp Social Psych abstract
Friday, October 30, 2009
Try to pronounce the words "caught" and "cot." If you're a New Yorker by birth, the two words will sound as different as their spellings. But if you grew up in California, you probably pronounce them identically.
American English is slowly changing; across the nation, the two "low-back" vowel sounds in these words are merging, region by region. Now Christina Esposito of the Macalester College, Minnesota has tracked the change sweeping eastwards across the Midwest into Minnesota. She will present her findings at a meeting of the Acoustical Society of America (ASA) next week in San Antonio, TX.
Working with graduate students Hannah Kinney and Kaitlyn Arctander, she asked Minnesotans to read a list of 100 words that contain these vowels, recorded the speech, and analyzed patterns within the recordings.
"We make a visual representation of the speech, a spectrogram," says Esposito. "Every single vowel has its own unique frequencies, like a fingerprint."
Unlike past studies of other areas of the country, which rely on interviewing people over the telephone and judging differences by ear, Esposito's experiment recorded and dissected the speech quantitatively. Her results suggest that 30 percent of Minnesotans have lost the distinction between the two vowel sounds.
Science Daily (October 30, 2009)
Influenza viruses evade infection-fighting antibodies by constantly changing the shape of their major surface protein. This shape-shifting, called antigenic drift, is why influenza vaccines -- which are designed to elicit antibodies matched to each year's circulating virus strains -- must be reformulated annually. Now, researchers from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, have proposed a new explanation for the evolutionary forces that drive antigenic drift. The findings in mice, using a strain of seasonal influenza virus first isolated in 1934, also suggest that antigenic drift might be slowed by increasing the number of children vaccinated against influenza.
Scott Hensley, Ph.D., Jonathan W. Yewdell, M.D., Ph.D., and Jack R. Bennink, Ph.D., led the research team, whose findings appear in the current issue of Science.
"This research elegantly combines modern genetic techniques with decades-old approaches to give us new insights into the mechanisms of antigenic drift and how influenza viruses elude the immune system," says NIAID Director Anthony S. Fauci, M.D.
"No one is sure exactly how the antigenic drift of flu viruses happens in people," says Dr. Yewdell. According to the prevailing theory, drift occurs as the virus is passed from person to person and is exposed to differing antibody attacks at each stop. With varying success, antibodies recognize one or more of the four antigenic regions in hemagglutinin, the major outer coat protein of the flu virus. Antibodies in person A, for example, may mount an attack in which antibodies focus on a single antigenic region. Mutant viruses that arise in person A can escape antibodies by replacing one critical amino acid in this antigen region. These mutant viruses survive, multiply and are passed to person B, where the process is repeated.
It is not possible to dissect the mechanism of antigenic drift in people directly, notes Dr. Yewdell. So he and his colleagues turned to a classic mouse model system developed in the mid-1950s at the University of Chicago, but used rarely since. The team infected mice with a strain of seasonal influenza virus that had circulated in Puerto Rico in 1934. Some mice were first vaccinated against this virus strain and developed antibodies against it, while others were unvaccinated.
After infecting the vaccinated and unvaccinated mice with the 1934 influenza strain, the scientists isolated virus from the lungs of both sets of mice and passed on these viruses to a new set of mice. They did this nine times. After the final passage, the researchers sequenced the gene encoding the virus hemagglutinin protein. Of course, says Dr. Yewdell, gene sequencing was not possible in the mid-1950s, when the nature of the gene was first elucidated, and until very recently, sequencing was expensive and time-consuming. "Now, with automated gene sequencers, sequencing of dozens of isolates is easily done overnight," he says.
Sequencing revealed that the unvaccinated mice -- which lacked vaccine-induced antibodies -- had no mutated influenza viruses in their lungs. In contrast, the hemagglutinin gene in virus isolated from vaccinated mice had mutated in a way that increased the ability of the virus to adhere to the receptors it uses to enter lung cells. Essentially, says Dr. Yewdell, the virus can shield its hemagglutinin antigenic sites from antibody attack by binding more tightly to its receptor.
"The virus must strike the right balance, however," Dr. Yewdell says. "Excessively sticky viruses may end up binding to cells lining the nose or throat or to blood cells and may not make it into lung cells. Also, newly formed viruses must detach from infected cells before they can spread to the next uninfected cell. Viruses that have mutated to be highly adherent to the lung cell receptors may have difficulty completing this critical step in the infection cycle."
Next, the researchers infected a new set of unvaccinated mice with the high-affinity mutant virus strain that had emerged in the first series of experiments. In the absence of antibody pressure, the virus reverted to a low-affinity form and was once again able to easily infect cells and spread.
"We propose a model for antigenic drift in which high- and low-affinity influenza virus mutants alternate," says Dr. Yewdell. In adults -- who have been exposed to many strains of influenza in their lifetime and, correspondingly, have a wide range of antibody responses -- the virus is pressured to increase its receptor affinity to escape antibody neutralization. When such high-affinity mutants are passed to people -- such as children -- who have not been exposed to many influenza strains or who have not been vaccinated against flu, receptor affinity decreases. People who have not been exposed to multiple influenza virus strains or who have never been vaccinated against influenza are said to be immunologically naïve.
"Our model predicts that decreasing the immunologically naïve population -- by increasing the number of children vaccinated against influenza, for example -- could slow the rate of antigenic drift and extend the duration of effectiveness of seasonal influenza vaccines," he says.
Hemagglutinin receptor binding avidity drives influenza A virus antigenic drift.
Scott E. Hensleyet al
Science 30 October 2009: Vol. 326. no. 5953, pp. 734 – 736 DOI: 10.1126/science.1178258
Link to Science abstract
Yahoo News covers the Reuters report (October 30, 2009)
Obama lifts ban on U.S. entry of those with HIV/AIDS
President Barack Obama, while signing an extension of the Ryan White HIV/AIDS Treatment Act, announced that the 22-year-old ban on allowing people infected with the HIV virus into the United States will be lifted on Monday.
He said the ban was imposed 22 years ago when visitors to the United States were treated as a threat.
"We lead the world when it comes to helping stem the AIDS pandemic -- yet we are one of only a dozen countries that still bar people from HIV from entering our own country," he said.
"If we want to be the global leader in combating HIV/AIDS, we need to act like it," he said.
A final rule, to be published on Monday, will eliminate the travel ban effective just after the January 1, 2010.
An historian writing for the Society for Historians of American Foreign Relations provides a perspective:
“It compelled all non-citizens to attest that they were HIV-negative before being admitted to the United States for any reason – despite the obvious impossibility of enforcing this provision. At the same time, non-citizens living long-term in the United States were denied permanent resident categorization solely on basis of their HIV-positive status. While invoking its sovereign rights to control immigration and tourism, the U.S. government clung to policies suffused with the ignorance and bias toward HIV-positive people illustrated at the earliest stages of the AIDS pandemic.
“It disregarded the fact that for almost 25 years, it has been common medical knowledge that one cannot contract or transmit HIV casually. AIDS activists asserted that the HIV bar dissuaded immigrants unsure of their HIV status from getting tested; prompted HIV-positive immigrants not to seek to medical treatment until they had full-blown AIDS; and caused HIV-positive people seeking visas to lie on their applications and then enter the U.S. without their medications – situations posing exactly the threats to public health the 1987 ban aimed to prevent.”
Just a thought!
Let us hope we don’t make another historic blunder:
A combination of darunavir/ritonavir, etravirine, and raltegravir is “remarkably” effective in HIV-positive adolescents with extensive prior experience of antiretroviral therapy, French investigators report in the November 13th edition of AIDS. The study involved twelve adolescents, and all but one had a viral load below 400 copies/ml after a year of treatment with this combination. Impressive improvements in CD4 cell counts were observed and there were no serious side-effects.
“This [study] demonstrates that, as in adults, the majority of extensively treated adolescents can be virologically controlled with by a salvage regimen consisting of a combination of new drugs, despite a long record of suboptimal treatment and viral multiresistance”, write the investigators.
There is an urgent need for new antiretroviral drugs for HIV-positive children and adolescents who have a long history of HIV treatment and have extensive resistance to anti-HIV drugs.
Darunavir (Prezista)/ritonavir, etravirine (Intelence) and raltegravir (Istentress) are three new anti-HIV drugs that have been shown to be very effective in pre-treated adults with resistance to antiretrovirals.
Only darunavir is licensed for use in children aged 13 years and under, but a scheme in France allows “off-label” use of medicines on compassionate grounds.
Pediatricians therefore treated twelve children and adolescents with extensive resistance to antiretroviral drugs with combinations that included darunavir/ritonavir, etravirine and raltegravir.
Raltegravir was provided at a dose of 400 mg twice-daily, and nine of the patients were treated with adult doses of darunavir/ritonavir and etravirine.
Follow-up was at regular intervals over a twelve year period. Final study analysis was conducted in October 2007.
None of the individuals developed a new AIDS-defining illness and there were no deaths. Only one patient discontinued treatment with a study drug because of side-effects (darunavir/ritonavir because of gastro-intestinal problems).
There were no serious laboratory side-effects, nor were there any significant clinical side-effects, other than the already noted discontinuation of darunavir/ritonavir because of stomach problems.
“In this first pediatric observational analysis, the tolerability and efficacy of a combination of raltegravir, darunavir/ritonavir and etravirine appear remarkable”, comment the investigators.
Raltegravir, etravirine and r-darunavir combination in adolescents with multidrug-resistant virus
Thuret, Isabelle et al..
AIDS: 13 November 2009 - Volume 23 - Issue 17 - p 2364-2366 doi: 10.1097/QAD.0b013e328331a456.
Link to AIDS abstract
As the nation copes with a shortage of vaccines for H1N1 influenza, a team of Alabama researchers have raised hopes that they have found an Achilles' heel for all strains of the flu -- antioxidants.
In an article appearing in the November 2009 print issue of the FASEB Journal, they show that antioxidants -- the same substances found in plant-based foods -- might hold the key in preventing the flu virus from wreaking havoc on our lungs.
"The recent outbreak of H1N1 influenza and the rapid spread of this strain across the world highlights the need to better understand how this virus damages the lungs and to find new treatments," said Sadis Matalon, co-author of the study. "Additionally, our research shows that antioxidants may prove beneficial in the treatment of flu."
Matalon and colleagues showed that the flu virus damages our lungs through its "M2 protein," which attacks the cells that line the inner surfaces of our lungs (epithelial cells). Specifically, the M2 protein disrupts lung epithelial cells' ability to remove liquid from inside of our lungs, setting the stage for pneumonia and other lung problems. The researchers made this discovery by conducting three sets of experiments using the M2 protein and the lung protein they damage.
First, frog eggs were injected with the lung protein alone to measure its function. Second, researchers injected frog eggs with both the M2 protein and the lung protein and found that the function of the lung protein was significantly decreased. Using molecular biology techniques, scientists isolated the segment of the M2 protein responsible for the damage to the lung protein. Then they demonstrated that without this segment, the protein was unable to cause damage. Third, the full M2 protein (with the "offending" segment intact) and the lung protein were then re-injected into the frog eggs along with drugs known to remove oxidants. This too prevented the M2 protein from causing damage to the lung protein. These experiments were repeated using cells from human lungs with exactly the same results.
"Although vaccines will remain the first line of intervention against the flu for a long time to come, this study opens the door for entirely new treatments geared toward stopping the virus after you're sick," said Gerald Weissmann, M.D., Editor-in-Chief of the FASEB Journal, "and as Thanksgiving approaches, this discovery is another reason to drink red wine to your health."
Influenza virus M2 protein inhibits epithelial sodium channels by increasing reactive oxygen species.
Ahmed Lazrak, Karen E. Iles, Gang Liu, Diana L. Noah, James W. Noah, and Sadis Matalon
The FASEB Journal, 2009; DOI: 10.1096/fj.09-135590
Link to FASEB journal abstract
Thursday, October 29, 2009
Science Daily (October 28, 2009)
A new study has found that chronic disruption of one of the most basic circadian (daily) rhythms -- the day/night cycle -- leads to weight gain, impulsivity, slower thinking, and other physiological and behavioral changes in mice, similar to those observed in people who experience shift work or jet lag.
The research, presented at Neuroscience 2009, the annual meeting of the Society for Neuroscience and the world's largest source of emerging news about brain science and health, is helping scientists better understand the neurobiological mechanisms behind circadian disruptions.
"Our findings have implications for humans," said lead author Ilia Karatsoreos, PhD, of Rockefeller University. "In our modern industrialized society, the disruption of our individual circadian rhythms has become commonplace, from shift work and jet lag to the constant presence of electric lighting. These disruptions are not only a nuisance, they can also lead to serious health and safety problems," he said.
Karatsoreos and his colleagues housed the animals in a day/night cycle of 20 hours (10 hours of light and 10 hours of dark), rather than the roughly 24-hour cycle to which the animals' internal brain and body clocks are normally set. After six to eight weeks, the mice exhibited numerous physiological changes not seen in a control group. These included greater weight gain, changes in body temperature rhythms, and alterations in metabolic hormones such as insulin and leptin (a key regulator of appetite). The mice with the disrupted rhythms also demonstrated behavioral changes -- specifically, increased impulsivity and decreased cognitive flexibility (the ability to adapt new strategies to new situations).
"We also found that the animals' brains displayed neural changes in the medial prefrontal cortex, an area important for regulating impulsivity and cognitive flexibility," Karatsoreos said. "Those changes may help explain some of the behavioral effects of circadian disruptions."
Research was supported by Canadian Institutes of Health Research, the National Institute of Mental Health, and Sepracor.
Smokers who crushed computer-simulated cigarettes as part of a psychosocial treatment program in a virtual reality environment had significantly reduced nicotine dependence and higher rates of tobacco abstinence than smokers participating in the same program who grasped a computer-simulated ball, according to a study described in the current issue of CyberPsychology and Behavior.
Benoit Girard, MD, Vincent Turcotte, and Bruno Girard, MBA, from the GRAP Occupational Psychology Clinic (Quebec, Canada), and Stéphane Bouchard, PhD, from the University of Quebec in Gatineau, randomly assigned 91 smokers enrolled in a 12-week anti-smoking support program to one of two treatment groups. In a computer-generated virtual reality environment, one group simulated crushing virtual cigarettes, while the other group grasped virtual balls during 4 weekly sessions.
The findings demonstrate a statistically significant reduction in nicotine addiction among the smokers in the cigarette-crushing group versus those in the ball-grasping group. Also, at week 12 of the program, the smoking abstinence rate was significantly higher for the cigarette-crushing group (15%) compared to the ball-grasping group (2%).
Other notable findings include the following: smokers who crushed virtual cigarettes tended to stay in the treatment program longer (average time to drop-out > 8 weeks) than the ball-grasping group (<>
"It is important to note that this study increased treatment retention. All too often individuals drop out of treatment prior to completion. It will be interesting now to go further and compare this to other popular treatments such as the nicotine patch," says Brenda K. Wiederhold, PhD, MBA, BCIA, Editor-in-Chief of CyberPsychology and Behavior, from the Interactive Media Institute, San Diego, CA.
Crushing Virtual Cigarettes Reduces Tobacco Addiction and Treatment Discontinuation.
Benoit Girard, Vincent Turcotte, Stéphane Bouchard, Bruno Girard.
CyberPsychology & Behavior, 2009; 12 (5): 477 DOI: 10.1089/cpb.2009.0118
Link to CPB abstract
Lungs too damaged for use in transplant operations may be salvageable through a gene-based technique, doubling or tripling the supply of organs, said the Canadian author of a report on the method.
The flawed lungs could be removed from donors’ bodies after death and repaired using the gene IL-10, which lowers inflammation, said Shaf Keshavjee, the senior scientist for a study reported in the journal Science Translational Medicine. Pigs that received organs given this treatment had improved lung function, and laboratory tests showed that IL-10 may boost the performance of human donor lungs too, according to the research.
Last year, 234 people in the U.S. died while waiting for a lung transplant, according to the Organ Procurement and Transplantation Network, a federal program. Currently, more than 1,800 people in the U.S. are waiting for a lung. If the method is proven in human trials, the process may become standard for lung transplants within five years, Keshavjee said.
“Worldwide, only 15 percent of donor lungs are used, because those are the ones that we can judge the function to be suitable for transplantation,” said Keshavjee, a senior scientist at the McEwan Centre for Regenerative Medicine, part of the Toronto-based University Health Network, in a telephone interview on Oct. 27.
The majority of potential donor lungs currently can’t be used, as they are damaged or have inflammation, wrote the authors, a team of Canadian and U.S. researchers led by Keshavjee.
The researchers warmed the lungs taken from donor cadavers to normal body temperature to help the organs’ cells repair themselves. The scientists took the common-cold virus, removed its genes, and inserted the cytokine interleukin-10 gene. That enabled the virus to carry the IL-10 genes into lung cells, where they reduced inflammation.
The lungs that received the therapy had better blood flow and were more able to take in oxygen and expel carbon dioxide, the study showed.
“It’s as if gene therapy turbocharges each individual cell to manufacture many more proteins in its own IL-10 factory,” Keshavjee said.
The gene is also able to turn down the recipient’s immune system, which otherwise can reject transplanted organs.
Human trials -- in which doctors would remove a donor lung, repair it, and transplant it into a live recipient -- may begin in the next year or two, Keshavjee said.
The same concept could be applied to kidneys, livers and hearts as well, he said.
Lung Myeloid Dendritic Cells Coordinately Induce TH1 and TH17 Responses in Human Emphysema
Ming Shan et al
Science Translational Medicine 28 October 2009: Vol. 1, Issue 4, p. 4ra10 DOI: 10.1126/scitranlsmed.3000154
Link to STM abstract
Science Daily (October 27, 2009)
More than half the people who take antidepressants for depression never get relief.
Why? Because the cause of depression has been oversimplified and drugs designed to treat it aim at the wrong target, according to new research from the Northwestern University Feinberg School of Medicine. The medications are like arrows shot at the outer rings of a bull's eye instead of the center.
A study from the laboratory of long-time depression researcher Eva Redei, presented at the Neuroscience 2009 conference in Chicago, appears to topple two strongly held beliefs about depression
One is that stressful life events are a major cause of depression.
The other is that an imbalance in neurotransmitters in the brain triggers depressive symptoms.
Both findings are significant because these beliefs were the basis for developing drugs currently used to treat depression.
Redei, the David Lawrence Stein Professor of Psychiatry at Northwestern's Feinberg School, found powerful molecular evidence that quashes the long-held dogma that stress is generally a major cause of depression. Her new research reveals that there is almost no overlap between stress-related genes and depression-related genes.
"This is a huge study and statistically powerful," Redei said. "This research opens up new routes to develop new antidepressants that may be more effective. There hasn't been an antidepressant based on a novel concept in 20 years."
Her findings are based on extensive studies with a model of severely depressed rats that mirror many behavioral and physiological abnormalities found in patients with major depression. The rats, after decades of development, are believed to be the most depressed in the world.
Little Overlap Between Stress and Depression Genes
Redei used microarray technology to isolate and identify the specific genes related to depression in these animals. She examined the genes in the brain regions -- the hippocampus and amygdala -- commonly associated with depression in rats and humans.
Then she took four genetically different strains of rats and exposed them to chronic stress for two weeks. Afterwards, she identified the genes that had consistently increased or decreased in response to the stress in all four strains in the same brain regions.
Redei now had one set of depression-related genes that came out of an animal model of depression and one set of stress-related genes that came out of her chronic stress study.
Next she compared the two sets of genes to see if there were any similarities. "If the 'stress causes depression theory' was correct, there should have been a significant overlap between these two sets of genes," she said. "There weren't."
Out of a total of over 30,000 genes on the microarray, she discovered approximately 254 genes related to stress and 1275 genes related to depression, with an overlap of only five genes between the two.
"This overlap is insignificant, a very small percentage," Redei said. "This finding is clear evidence that at least in an animal model, chronic stress does not cause the same molecular changes as depression does."
Antidepressants Treat Stress Not Depression
Most animal models that are used by scientists to test antidepressants are based on the hypothesis that stress causes depression. "They stress the animals and look at their behavior," she said. "Then they manipulate the animals' behavior with drugs and say, 'OK, these are going to be good anti-depressants.' But they are not treating depression; they are treating stress."
That is one key reason why current antidepressants aren't doing a great job, Redei noted. She is now looking at the genes that differ in the depressed rat to narrow down targets for drug development.
She said another reason current antidepressants are often ineffective is that they aim to boost neurotransmitters based on the popular molecular explanation of depression, which is that it's the result of decreased levels of the neurotransmitters serotonin, norepinephrine and dopamine. But that's wrong, Redei said.
Drugs Aim at Wrong Molecular Target
In the second part of the study, Redei found strong indications that depression actually begins further up in the chain of events in the brain. The biochemical events that ultimately result in depression actually start in the development and functioning of neurons.
"The medications have been focusing on the effect, not the cause," she said. "That's why it takes so long for them to work and why they aren't effective for so many people."
Her animal model of depression did not show dramatic differences in the levels of genes controlling neurotransmitters functions. "If depression was related to neurotransmitter activity, we would have seen that," she said.
Similarities Between Human and Rodent Brains
Her findings in depressed rats, she said, are very likely applicable to humans.
"The similarities between these regions of the human and rodent brain are remarkable," Redei explained. "The hippocampus and amygdala are part of the so-called ancient lizard brain that controls survival and are the same in even primitive organisms."
A large proportion of HIV-positive gay men in Switzerland have anorectal infection with chlamydia, investigators report in the November 15th edition of Clinical Infectious Diseases. The researchers suggest that undiagnosed anal chlamydia infections could be contributing to the continued spread of HIV amongst gay men in Switzerland.
Gay and other men who have sex with men remain the group most affected by HIV in many industrialized countries, including Switzerland. Sexually transmitted infections also disproportionately affect gay men. If left untreated these infections, including chlamydia, can significantly increase the risk of acquiring HIV. As reported on aidsmap.com UK investigators found that many chlamydia infections in gay men were in the rectum, and that HIV-positive gay men were disproportionately affected by rectal chlamydia
Investigators from the Swiss HIV cohort therefore postulated that anorectal chlaymdia infection could be contributing to the ongoing HIV epidemic amongst gay men in the country.
The only factor that the investigators were able to identify as being associated with anorectal infection with chlamydia was a greater number of sexual partners. Men who reported two or more partners in the previous two years were significantly more likely to be diagnosed with the infection than men reporting fewer partners.
“The high prevalence together with a strong association with multiple sex partners…suggest a possible role for anorectal chlamydial infection in sustaining the ongoing HIV epidemic among men who have sex men in Switzerland”, comment the investigators.
Noting that tests for the infection were easy to perform, they suggest that their findings “underscore a potential role fir expanded rectal chlamydial screening” as part of routine HIV care. They recommend that tests for the infection should be offered even if patients do not report any symptoms suggestive of the infection.
High prevalence of anorectal chlamydial infection in HIV-infected men who have sex with men in Switzerland.
Thanh Dang et al,
Clinical Infectious Diseases 49: 1532-1535, 2009. DOI: 10.1086/644740
Link to CID abstract
Wednesday, October 28, 2009
Up to a third of children and adolescents who took common antipsychotic drugs for the first time became overweight or obese in as little as 11 weeks, raising their risk for diabetes and heart disease, U.S. researchers said on Tuesday.
They said doctors who prescribe antipsychotics to children should carefully consider the benefits against the risks, and keep close watch on children taking the drugs.
"These data confirm prior findings that children and adolescents are highly vulnerable to antipsychotic medication," Dr. Christopher Varley and Dr. Jon McClellan of the Seattle Children's Hospital wrote in a commentary in the Journal of the American Medical Association.
"These results challenge the widespread use of atypical antipsychotic medications in youth," they wrote.
The study looked at four of the most common antipsychotic drugs used in children -- Johnson & Johnson's Risperdal or risperidone, Eli Lilly's Zyprexa or olanzapine, Bristol-Myers Squibb's Abilify or aripiprazole and AstraZeneca's Seroquel or quetiapine.
A team led by Dr. Christoph Correll of Zucker Hillside Hospital and the Feinstein Institute for Medical Research in New York studied 272 children and teens aged 4 to 19 with bipolar disorder, schizophrenia and disruptive or aggressive behavior spectrum disorders.
After roughly 11 weeks, those who took Zyprexa gained an average of 18.7 pounds (8.5 kg), those on Seroquel gained 13.4 pounds (6.1 kg), those on Risperdal gained 11.7 pounds (3.5 kg) and those on Abilify gained 9.7 pounds (4.4 kg).
Altogether, 10 percent to 36 percent of patients became overweight or obese within 11 weeks.
"The weight gain is dramatic, rapid and pervasive," Correll said in a telephone interview.
Even so, he said, not all of the drugs performed the same.
Children who took Zyprexa had the most dramatic weight gain and the biggest changes in metabolic factors such as blood sugar, cholesterol, and triglycerides, which can cause heart problems and diabetes.
Abilify, a drug that is usually not linked with weight gain in adults, did cause children to gain weight, but did not raise cholesterol or blood sugar levels.
Correll hopes to conduct more research to determine what caused these differences.
"We will look at genetics and look at blood samples to see what changed early on that predicted weight gain," he said.
Currently, only two atypical antipsychotics are approved for youth -- Risperdal and Abilify. But in June, a Food and Drug Administration panel of experts backed wider use of Zyprexa, Seroquel and Pfizer's Geodon for children and teens.
At the time, many panel members expressed concern about rising sales of the drugs to young people and the lack of long-term safety studies.
They were especially worried about the chance the drugs might be misused to treat other conditions such as attention deficit hyperactivity disorder.
The FDA has yet to act on the panel's endorsement.
Last November, a panel of outside experts called on the FDA and other U.S. health agencies to study the long-term effects of prescribing antipsychotic drugs to children.
Zyprexa is Lilly's top-selling drug with sales of $4.7 billion last year. Seroquel is the second-best seller for AstraZeneca with 2008 sales of $4.5 billion.
Cardiometabolic Risk of Second-Generation Antipsychotic Medications During First-Time Use in Children and Adolescents
Christoph U. Correll; Peter Manu; Vladimir Olshanskiy; Barbara Napolitano; John M. Kane; Anil K. Malhotra
Link to JAMA abstract
Editorial: Implications of Marked Weight Gain Associated With Atypical Antipsychotic Medications in Children and Adolescents
Christopher K. Varley, MD; Jon McClellan, MD
JAMA. 2009;302(16):1811-1812 .
Link to JAMA editorial extract
Richard Galpin for BBC News, Moscow (October 28, 2009)
Robin Gorna, head of the International Aids Society has told the BBC that the epidemic in Russia is now out of control. She urged Russia to do much more to prevent the spread of HIV among an estimated two million drug users.
Ms Gorna was speaking ahead of a major international conference on Aids which is taking place in Moscow.
It is believed there are now at least a million people infected with HIV in Russia.
The vast majority are people under the age of 30. Most were infected because they share needles for injecting heroin.
According to some estimates, there are almost two million intravenous drug users in the country - the result of the large quantities of heroin flowing from Afghanistan into Russia.
International experts have raised concerns over Russian laws which they say hamper efforts to slow down the HIV infection rate.
It is illegal to give drug addicts substances such as methadone as an alternative to injecting heroin.
As the conference opened on Wednesday, Russia's chief medical official acknowledged the scale of the epidemic, but insisted there would be no change of policy on methadone.
Gennady Onishchenko said that HIV infections in Eastern Europe and Central Asia were "a highly important problem for all of us, not only for medical but also for social reasons".
"The danger is that the epidemic will cross over from a concentrated one to a general one," he said.
But he added that methadone would remain illegal.
"Russia speaks out categorically against this component in prevention programs," he said.
The Russian government also does not fund any needle exchange programs.
There is particular concern because until now international donors have financed the major prevention programs in Russia.
But they are having to stop their funding because Russia is now considered to be a middle-income country and does not want to receive financial aid from abroad.
National Geographic (October 28, 2009)
The Story Behind Our Photo of Grieving Chimps
The November issue of National Geographic magazine features a moving photograph of chimpanzees watching as one of their own is wheeled to her burial. Since it was published, the picture and story have gone viral, turning up on websites and TV shows and in newspapers around the world. For readers who’d like to know more, there is an interview with the photographer, Monica Szczupider.
Nearly 80% of girls say that having the HPV vaccine makes them think twice about the risks of having sex, according to a University of Manchester study published in the British Journal of Cancer.
The survey – the first to focus on girls’ views of the vaccine rather than their parents’ – showed that, despite speculation that the vaccine could make girls more likely to start having sex younger, it highlighted the risks of sex for the overwhelming majority.
The study also revealed that the support of parents is crucial to the success of the vaccination program – of the girls whose parents refused the vaccine, 42 per cent actually wanted it. And 10 per cent of those who were vaccinated didn’t want it.
Dr Loretta Brabin, study author based at the University’s School of Cancer and Imaging Sciences, said: “This is the first insight into how a girl decides whether the vaccine is important to her and who influences her decision.
“Talking to their parents was massively influential on the girls, and mums and dads will play an important role in maintaining the success of the program so far.
“The thing that put girls off the most was fear of needles and how much it would hurt.
“Some girls had also heard rumors about side-effects, which had filtered down from the media and their parents and had been exaggerated along the way.
“Interestingly, media suggestions that the vaccine could make girls more likely to start having sex at a younger age hadn’t affected them. In fact, the vaccine actually made them more aware of the risks of sex.”
The researchers questioned over 500 twelve and thirteen year olds who had been offered the vaccine in a study in Manchester before the vaccine was available nationally.
Although 79 per cent of girls said the vaccine reminded them of the risks of sex, 14 per cent said they might take more sexual risks because of it.
Nearly four in five girls said they discussed the decision to have the vaccine with their parents. Ninety-three per cent of girls said having the vaccine shows that you are serious about your health and 54 per cent felt the jab was very important to them.
In the UK, girls aged 12 to 13 are offered the HPV vaccine as a part of the government’s vaccination program that started last year. The vaccine has the potential to prevent at least 7 out of 10 cervical cancers.
Dr Lesley Walker, director of cancer information at Cancer Research UK, said: “Despite the scare-stories, this research suggests that the HPV vaccine could make the majority of girls more cautious about sex.”
The study was funded by GlaxoSmithKline which makes the Cervarix vaccine
A survey of adolescent experiences of human papillomavirus vaccination in the Manchester study.
L Brabin, S A Roberts, R Stretch, D Baxter, P Elton, H Kitchener and R McCann
British Journal of Cancer 101: 1502-1504; advance online publication, October 6, 2009; doi:10.1038/sj.bjc.6605362
Link to BJC abstract
The BJC site also posts
Web Focus on Human Papillomavirus (HPV)
Link to Web Focus on HPV
Mayo Clinic researchers have found that a sometimes deadly stomach bug, Clostridium difficile, is on the rise in outpatient settings. Clostridium difficile is a serious bacteria that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. These findings were presented October 26 at the 2009 American College of Gastroenterology (ACG) Annual Meeting in San Diego.
Clostridium difficile, often called C. difficile or "C. diff," is a bacterium that is resistant to some antibiotics and is most often contracted by the elderly in hospitals and nursing homes.
"Recent reports have shown increasing incidence and severity of C. difficile infection -- especially in the older population," says Darrell Pardi, M.D., Mayo Clinic gastroenterologist and senior author on the study. "Our study examines why the cases are on the rise and who is getting the infection."
In the study, patients with community-acquired infection were also less likely than the hospital-acquired group to have been exposed to antibiotics before their infection. Thus, many of the community-acquired infections lacked the traditional risk factors for infection, namely recent hospitalization and exposure to antibiotics.
There were no differences between community- and hospital-acquired infections in terms of what patients were treated with (primarily metronidazole), response rates, or recurrence rates after treatment.
"We are seeing more cases of C. difficile in the community, but they tend to be less severe and in a younger population," says Dr. Pardi. "The growing incidence of C. difficile infection in both inpatient and outpatient settings could be linked to the increasing usage of antibiotics and to the possibility that C. difficile may be getting resistant to some of our newer antibiotics."
"Doctors have gotten better at spotting C. difficile in hospitals and nursing homes; however, now doctors and patients need to be more aware that you can get this infection as an outpatient and that a case of diarrhea or abdominal cramps at home could become serious," says Dr. Pardi.
Supporting Los Alamos National Laboratory's role in the international Center for HIV/AIDS Vaccine Immunology (CHAVI) consortium, researchers are using the Roadrunner supercomputer to analyze vast quantities of genetic sequences from HIV infected people in the hope of zeroing in on possible vaccine target areas.
Physicist Tanmoy Bhattacharya and HIV researcher Bette Korber have used samples taken by CHAVI across the globe -- from both chronic and acute HIV patients -- and created an evolutionary genetic family tree, known as a phylogenetic tree, to look for similarities in the acute versus chronic sequences that may identify areas where vaccines would be most effective.
In this study the evolutionary history of more than 10,000 sequences from more than 400 HIV-infected individuals was compared.
The idea, according to Korber, is to identify common features of the transmitted virus, and attempt to create a vaccine that enables recognition the original transmitted virus before the body's immune response causes the virus to react and mutate.
"DNA Sequencing technology, however, is currently being revolutionized, and we are at the cusp of being able to obtain more than 100,000 viral sequences from a single person," said Korber. "For this new kind data to be useful, computational advances will have to keep pace with the experimental, and the current study begins to move us into this new era."
"The petascale supercomputer gives us the capacity to look for similarities across whole populations of acute patients," said Bhattacharya. "At this scale we can begin to figure out the relationships between chronic and acute infections using statistics to determine the interconnecting branches -- and it is these interconnections where a specially-designed vaccine might be most effective.
What is Roadrunner?
On Memorial Day, May 26, 2008, the "Roadrunner" supercomputer exceeded a sustained speed of 1 petaflop/s, or 1 million billion calculations per second. "Petaflop/s" is computer jargon -- peta signifying the number 1 followed by 15 zeros (sometimes called a quadrillion) and flop/s meaning "floating point operation per second." Shortly after that it was named the world's fastest supercomputer by the TOP500 organization at the June 2008 International Supercomputing Conference in Dresden Germany.
The Roadrunner supercomputer, developed by IBM in partnership with the Laboratory and the National Nuclear Security Administration, will be used to perform advanced physics and predictive simulations in a classified mode to assure the safety, security, and reliability of the U.S. nuclear deterrent. The system will be used by scientists at the NNSA's Los Alamos, Sandia, and Lawrence Livermore national laboratories.
The secret to its record-breaking performance is a unique hybrid design. Each compute node in this cluster consists of two AMD Opteron™ dual-core processors plus four PowerXCell 8i™ processors used as computational accelerators. The accelerators used in Roadrunner are a special IBM-developed variant of the Cell processor used in the Sony PlayStation 3®. The node-attached Cell accelerators are what make Roadrunner different than typical clusters.
Roadrunner is still currently the world's fastest with a speed of 1.105 petaflop/s per second, according to the TOP500 announcement at the November 2008 Supercomputing Conference in Austin Texas, and it again retained the #1 position at the June ISC09 conference.
An experimental drug cocktail that includes three prescriptions now widely available offers the best hope in developing a single agent to treat drug-resistant H1N1 swine flu, says a virology researcher in the University of Alabama Birmingham (UAB) Division of Pediatric Infectious Diseases.
In laboratory testing, the triple combination of oseltamivir (Tamiflu), amantadine (Symmetrel) and ribavirin showed a significant capacity to stop flu-virus growth, says Mark Prichard, Ph.D, who serves on the board of directors of the International Society for Antiviral Research. The combo drug works better in the test tube than currently recommended single or double antiviral therapies used to treat both seasonal and swine flu strains, he says.
Prichard presented his data in September at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy held in San Francisco. The triple-combo testing is led by Adamas Pharmaceuticals, Inc. based in Emeryville, California and Prichard maintains a consulting agreement with Adamas Pharmaceuticals
"These findings suggest strongly that the triple combo is highly synergistic against virus replication, meaning it strikes multiple targets within H1N1 flu and other strains," Prichard says. "Only human testing will determine for sure, but this combo has the potential to be the antiviral therapy of choice for serious flu infection and to address Tamiflu resistance."
The synergy was seen in swine flu and seasonal flu strains, as well as H3N2 seasonal flu and the highly pathogenic H5N1 avian influenza strain, Prichard says.
Because flu infection typically lasts for shorter periods of time than many other chronic infections, the three-pronged antiviral approach means the circulating strains of flu virus may not have time to develop resistance to the combo, Prichard says. "That's why this research is so timely, and why antiviral safety and testing data is crucial.
The testing is partnership between UAB, Adamas, the United States Naval Health Research Center in San Diego, Utah State University in Logan, and the Amsterdam Medical Center in the Netherlands.