Obese kids who snore more sleepy in the daytime
Mon Dec 29, 2:22 pm ET
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NEW YORK (Reuters Health) – Obese children who have difficulty breathing while they sleep have excessive daytime sleepiness compared with slimmer children who are also chronic snorers, new research in the journal Pediatrics shows.
The symptoms in heavy children are "strikingly reminiscent of excessive daytime sleepiness patterns in adults with obstructive sleep apnea," Drs. David Gozal and Leila Kheirandish-Gozal of the University of Louisville in Kentucky write. The findings suggest, they add, that obstructive sleep apnea looks different in obese children than it does in normal weight kids, which may have implications both for how the condition is treated and how it ultimately affects organ function.
The researchers previously observed that among children with sleep problems, daytime tiredness seemed to be the main symptom in obese kids, while sleepiness tended to manifest itself as inattention and hyperactivity for normal-weight children.
To investigate their hypothesis that kids with the same level of snoring severity would be more likely to be sleepy during the day if they were obese, they observed 50 healthy 6- to 9-year-old, normal-weight children who were habitual snorers and 50 obese children, also snorers, who had been matched by gender, age and ethnicity.
Children were observed for a full night of sleep in the lab, and then the researchers conducted a multiple sleep latency test, which assessed the degree of sleepiness by measuring the time it took the children to fall asleep during the day. The test involved giving the children a chance to nap for 30 minutes every 2 hours, beginning at 8 a.m. Each child had five nap opportunities.
On average, the obese children took 12.9 minutes to fall asleep, compared with 17.9 minutes for the non-obese children. Twenty-one of the obese kids had sleep latency times of 12 minutes or less, while just 5 of the normal-weight children did. Daytime sleepiness was most strongly associated with how many times a child woke up every hour due to respiratory disturbances.
This suggests, the researchers say, that sleep fragmentation my be more common in obese children and that a lack of oxygen during sleep may play a significant role in triggering the biological response that ultimately leads to increased daytime sleepiness.
While obstructive sleep apnea was more common among the obese children than the slimmer children, obese children without the condition were still more likely to have excessive daytime sleepiness than their slimmer counterparts.
Both obesity and obstructive sleep apnea are disorders related to low-level, system-wide inflammation, the researchers add. So both conditions could act together to further increase the levels of inflammation- and sleepiness-promoting substances in the body, the researchers suggest.
While the mechanism behind the link requires further study, they conclude, for now, children with symptoms of excessive daytime sleepiness who have trouble staying awake should be evaluated for obstructive sleep apnea.
SOURCE: Pediatrics, January 2009.
http://news.yahoo.com/s/nm/20081229/hl_nm/us_obese_daytime;_ylt=AsXhzjte2TopmEVY3jilZPzVJRIF
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Tuesday, December 30, 2008
Researchers Create Molecular Manual
Researchers Create Molecular Manual
Mon Dec 29, 11:48 pm ET
MONDAY, Dec. 29 (HealthDay News) -- The first catalog of tissue-specific changes associated with hundreds of diseases has been compiled by an international research team, who said the information could help improve understanding and treatment of numerous conditions such as heart disease, breast cancer, autism and Parkinson's disease.
"Disease processes in humans are far from being exhaustively understood and characterized, in part because they are the result of complex interactions between many molecules that may take place only in specific tissues or organs," co-author Kasper Lage, of the Massachusetts General Hospital Pediatric Surgical Research Laboratories, said in a news release from the hospital.
"Experiments to directly study these interactions in human patients would not be possible, which limits our understanding of how diseases arise and which molecules and genes are involved," Lage said.
In the research, supercomputers were used to "model biological processes in tissues across the human organism, based on the knowledge from millions of already published articles," explained co-author Niclas Tue Hansen, of the Center for Biological Sequence Analysis, Technical University of Denmark. "In this way, we were able to create an extensive map of the interactions of molecules in many diseases -- a sort of molecular manual -- without carrying out experiments in patients."
The research was reported in Proceedings of the National Academy of Sciences.
"Our findings have the potential to advance the knowledge of pathways, genes and proteins involved in hundreds of human disorders and perhaps contribute to better treatment strategies for some of these serious diseases," co-corresponding author Dr. Patricia Donahoe, a professor of surgery at Harvard Medical School, said in the news release.
http://news.yahoo.com/s/hsn/20081230/hl_hsn/researcherscreatemolecularmanual;_ylt=ApurgbP.acgaEVGBzhlUSn_VJRIF
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The catalog is available at the Web site of the Center for Biological Sequence Analysis.
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Mon Dec 29, 11:48 pm ET
MONDAY, Dec. 29 (HealthDay News) -- The first catalog of tissue-specific changes associated with hundreds of diseases has been compiled by an international research team, who said the information could help improve understanding and treatment of numerous conditions such as heart disease, breast cancer, autism and Parkinson's disease.
"Disease processes in humans are far from being exhaustively understood and characterized, in part because they are the result of complex interactions between many molecules that may take place only in specific tissues or organs," co-author Kasper Lage, of the Massachusetts General Hospital Pediatric Surgical Research Laboratories, said in a news release from the hospital.
"Experiments to directly study these interactions in human patients would not be possible, which limits our understanding of how diseases arise and which molecules and genes are involved," Lage said.
In the research, supercomputers were used to "model biological processes in tissues across the human organism, based on the knowledge from millions of already published articles," explained co-author Niclas Tue Hansen, of the Center for Biological Sequence Analysis, Technical University of Denmark. "In this way, we were able to create an extensive map of the interactions of molecules in many diseases -- a sort of molecular manual -- without carrying out experiments in patients."
The research was reported in Proceedings of the National Academy of Sciences.
"Our findings have the potential to advance the knowledge of pathways, genes and proteins involved in hundreds of human disorders and perhaps contribute to better treatment strategies for some of these serious diseases," co-corresponding author Dr. Patricia Donahoe, a professor of surgery at Harvard Medical School, said in the news release.
http://news.yahoo.com/s/hsn/20081230/hl_hsn/researcherscreatemolecularmanual;_ylt=ApurgbP.acgaEVGBzhlUSn_VJRIF
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British doctors could get Internet post reviews: minister
British doctors could get Internet post reviews: minister
Mon Dec 29, 11:37 pm ET
AFP/File – British patients could soon rate their doctors by posting reviews on an official health service website, …
LONDON (AFP) – British patients could soon rate their doctors by posting reviews on an official health service website, Health Minister Ben Bradshaw said in comments published Tuesday.
By being able to read feedback from other patients, people would be better able to decide which doctor they wanted to consult, the junior minister told The Guardian newspaper.
The scheme would take its cue from the way people leave comments and ratings about books and music on Internet retail sites, Bradshaw said.
Posters would be able to leave positive and negative feedback, though the site would be moderated.
However, doctors' representatives voiced concern that it would descend into a meaningless popularity contest rather than providing accurate information about medical skills.
Officials have been told to get the necessary software ready in 2009, The Guardian said.
Since April, the National Health Service's Choices website has allowed people to post comments on hospitals. Bradshaw wants to extend the scheme to family doctors, called general practitioners (GPs).
"On NHS Choices there is already some useful information about whether a practice offers extended hours and how it performs on the quality indicators," Bradshaw said.
"But the quality scores look like the results of an east European election under the Soviet regime. Nearly all get 96 percent, 97 percent or 98 percent.
"That doesn't really give people an idea of whether the practice is better or worse than others in the area.
"I want people to be able to read comments. It may be that people think the GP is fantastic and they can always get an appointment within 48 hours. Or they may have terrible experiences and think the receptionist is really rude."
He added: "I would never think of going on holiday without cross-referencing at least two guide books and using Trip Adviser (a travel review website). We need to do something similar for the modern generation in healthcare.
"I can already learn a lot from the comments of people, both positive and negative, about a type of treatment or a hospital. We need to extend the service to cover GPs."
However, Laurence Buckman, chairman of the British Medical Association's GPs committee, accused the government of not thinking the plan through properly.
"A website on which people can slander or praise irresponsibly is the wrong approach," he said.
"Patients should be able to choose a doctor, but I don't think this is the way to do it.
"For example, if I don't give antibiotics for a viral infection because I don't think it is appropriate, the word will get out that I am a tough git. But making them happy is not what I am there for. I am there to make them healthy."
http://news.yahoo.com/s/afp/20081230/hl_afp/britainhealthinternetpolitics
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Mon Dec 29, 11:37 pm ET
AFP/File – British patients could soon rate their doctors by posting reviews on an official health service website, …
LONDON (AFP) – British patients could soon rate their doctors by posting reviews on an official health service website, Health Minister Ben Bradshaw said in comments published Tuesday.
By being able to read feedback from other patients, people would be better able to decide which doctor they wanted to consult, the junior minister told The Guardian newspaper.
The scheme would take its cue from the way people leave comments and ratings about books and music on Internet retail sites, Bradshaw said.
Posters would be able to leave positive and negative feedback, though the site would be moderated.
However, doctors' representatives voiced concern that it would descend into a meaningless popularity contest rather than providing accurate information about medical skills.
Officials have been told to get the necessary software ready in 2009, The Guardian said.
Since April, the National Health Service's Choices website has allowed people to post comments on hospitals. Bradshaw wants to extend the scheme to family doctors, called general practitioners (GPs).
"On NHS Choices there is already some useful information about whether a practice offers extended hours and how it performs on the quality indicators," Bradshaw said.
"But the quality scores look like the results of an east European election under the Soviet regime. Nearly all get 96 percent, 97 percent or 98 percent.
"That doesn't really give people an idea of whether the practice is better or worse than others in the area.
"I want people to be able to read comments. It may be that people think the GP is fantastic and they can always get an appointment within 48 hours. Or they may have terrible experiences and think the receptionist is really rude."
He added: "I would never think of going on holiday without cross-referencing at least two guide books and using Trip Adviser (a travel review website). We need to do something similar for the modern generation in healthcare.
"I can already learn a lot from the comments of people, both positive and negative, about a type of treatment or a hospital. We need to extend the service to cover GPs."
However, Laurence Buckman, chairman of the British Medical Association's GPs committee, accused the government of not thinking the plan through properly.
"A website on which people can slander or praise irresponsibly is the wrong approach," he said.
"Patients should be able to choose a doctor, but I don't think this is the way to do it.
"For example, if I don't give antibiotics for a viral infection because I don't think it is appropriate, the word will get out that I am a tough git. But making them happy is not what I am there for. I am there to make them healthy."
http://news.yahoo.com/s/afp/20081230/hl_afp/britainhealthinternetpolitics
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Liver transplants from elderly donors are safe
Liver transplants from elderly donors are safe
Mon Dec 29, 5:16 pm ET
NEW YORK (Reuters Health) – Advanced donor age, per se, does not adversely affect the transplant recipient or the survival of the organ after liver transplantation, according to a report in the Journal of the American College of Surgeons.
Previous reports have indicated that the age of the donor -- older than 60 years - contributes to decreased organ and patient survival, as well as a poorer quality of life for the recipient, the authors explain. They hypothesized, however, "that proper selection of donors older than age 60 and even over age 70" can produce outcomes comparable to those obtained with younger donors.
Dr. William C. Chapman and colleagues from Washington University School of Medicine, St. Louis, Missouri, analyzed their experience with 741 adult-to-adult whole organ transplants -- 91 donors were 60 years or older and 650 were younger than 60 years.
There was no significant difference in the number of second transplants performed or signs that another transplant was going to be needed between patients who received organs from younger and older donors, the authors report.
Overall survival rates did not significantly differ between the two groups of patients, the researchers note. Five-year survival, for example, was 67.6 percent in the patients who received organs from older donors compared with 75.5 percent in those who received organs from younger donors.
Similarly, organ survival was not significantly different between recipients of organs from younger and older donors, even when the donors were separated into three age groups - younger than 60 years, 60 to 69 years and 70 years or older.
Time between organ removable and transplant was significantly shorter for organs from older donors than for organs from younger donors, the report indicates.
"Our analysis was not able to identify any significant disadvantage in graft or patient survival based on donor age," the authors noted.
Other donor risk factors, such as time from organ removal to transplant and variables associated with the recipient are all "important to ensure optimal outcomes" of transplants from older donors, they add.
Overall, the investigators conclude that "older donors represent an important and safe expansion of the donor pool."
SOURCE: Journal of the American College of Surgeons, December 2008.
http://news.yahoo.com/s/nm/20081229/hl_nm/us_liver_transplants;_ylt=Aums.sKJbj.Cu3IZuYxwCYzVJRIF
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Mon Dec 29, 5:16 pm ET
NEW YORK (Reuters Health) – Advanced donor age, per se, does not adversely affect the transplant recipient or the survival of the organ after liver transplantation, according to a report in the Journal of the American College of Surgeons.
Previous reports have indicated that the age of the donor -- older than 60 years - contributes to decreased organ and patient survival, as well as a poorer quality of life for the recipient, the authors explain. They hypothesized, however, "that proper selection of donors older than age 60 and even over age 70" can produce outcomes comparable to those obtained with younger donors.
Dr. William C. Chapman and colleagues from Washington University School of Medicine, St. Louis, Missouri, analyzed their experience with 741 adult-to-adult whole organ transplants -- 91 donors were 60 years or older and 650 were younger than 60 years.
There was no significant difference in the number of second transplants performed or signs that another transplant was going to be needed between patients who received organs from younger and older donors, the authors report.
Overall survival rates did not significantly differ between the two groups of patients, the researchers note. Five-year survival, for example, was 67.6 percent in the patients who received organs from older donors compared with 75.5 percent in those who received organs from younger donors.
Similarly, organ survival was not significantly different between recipients of organs from younger and older donors, even when the donors were separated into three age groups - younger than 60 years, 60 to 69 years and 70 years or older.
Time between organ removable and transplant was significantly shorter for organs from older donors than for organs from younger donors, the report indicates.
"Our analysis was not able to identify any significant disadvantage in graft or patient survival based on donor age," the authors noted.
Other donor risk factors, such as time from organ removal to transplant and variables associated with the recipient are all "important to ensure optimal outcomes" of transplants from older donors, they add.
Overall, the investigators conclude that "older donors represent an important and safe expansion of the donor pool."
SOURCE: Journal of the American College of Surgeons, December 2008.
http://news.yahoo.com/s/nm/20081229/hl_nm/us_liver_transplants;_ylt=Aums.sKJbj.Cu3IZuYxwCYzVJRIF
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Degarelix Approved for Advanced Prostate Cancer
Degarelix Approved for Advanced Prostate Cancer
MONDAY, Dec. 29 (HealthDay News) -- The injected drug degarelix has been approved by the U.S. Food and Drug Administration to treat advanced prostate cancer.
It belongs to a class of drugs called gonadotropin releasing hormone (GnRH) receptor inhibitors, which suppress the male hormone testosterone. Certain hormonal treatments for prostate cancer initiate a spurt in production of testosterone, which is believed to play a vital role in the growth of prostate cancer. Degarelix doesn't cause this, the agency said in a news release.
Prostate cancer is the second-leading cause of death among men in the United States, according to the American Cancer Society. For 2008, 186,320 men will be diagnosed with the disease and 28,660 will die from it, the ACS estimates.
In clinical testing, degarelix was compared to leuprolide, a drug used in hormonal treatment of prostate cancer. Degarelix suppressed testosterone production to levels seen in men who had had surgical removal of the testes, the agency said.
Frequently reported side effects of the drug included injection site reactions, hot flashes, weight gain, fatigue and an increase in certain liver enzymes.
Degarelix is produced for New Jersey-based Ferring Pharmaceuticals by the German drug maker Rentschler Biotechnologie.
http://news.yahoo.com/s/hsn/20081230/hl_hsn/degarelixapprovedforadvancedprostatecancer;_ylt=AnCJ7NeLRnm6p28V_rUr.lLVJRIF
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To learn more about this drug, visit the FDA.
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MONDAY, Dec. 29 (HealthDay News) -- The injected drug degarelix has been approved by the U.S. Food and Drug Administration to treat advanced prostate cancer.
It belongs to a class of drugs called gonadotropin releasing hormone (GnRH) receptor inhibitors, which suppress the male hormone testosterone. Certain hormonal treatments for prostate cancer initiate a spurt in production of testosterone, which is believed to play a vital role in the growth of prostate cancer. Degarelix doesn't cause this, the agency said in a news release.
Prostate cancer is the second-leading cause of death among men in the United States, according to the American Cancer Society. For 2008, 186,320 men will be diagnosed with the disease and 28,660 will die from it, the ACS estimates.
In clinical testing, degarelix was compared to leuprolide, a drug used in hormonal treatment of prostate cancer. Degarelix suppressed testosterone production to levels seen in men who had had surgical removal of the testes, the agency said.
Frequently reported side effects of the drug included injection site reactions, hot flashes, weight gain, fatigue and an increase in certain liver enzymes.
Degarelix is produced for New Jersey-based Ferring Pharmaceuticals by the German drug maker Rentschler Biotechnologie.
http://news.yahoo.com/s/hsn/20081230/hl_hsn/degarelixapprovedforadvancedprostatecancer;_ylt=AnCJ7NeLRnm6p28V_rUr.lLVJRIF
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Hard to hear at holiday parties? Blame your brain
Graphic shows the part of the ear where hearing loss occurs and how the auditory nerves travel to the brain; 2 c x 5 3/4 in; 96.3 mm x 146.05 mm
Hard to hear at holiday parties? Blame your brain
By MALCOLM RITTER, AP Science Writer Malcolm Ritter, Ap Science Writer – Mon Dec 29, 6:07 pm ET
NEW YORK – It's almost New Year's Eve, a time for plunging into boisterous crowds bathed in loud music. And for some of us, that means turning to an old friend and hearing things like this: "Did you know (BOOM-da-da-BOOM) went over (Bob! You look wonder-) so she said (clink-clink) and then I (Here, have another one) what would you do?" Huh? Too noisy to hear! But wait — how come these younger people understood what she said? What's wrong with your ears? Actually, part of the problem may be your brain.
In fact, it may lie in your brain's dimmer switch for controlling the input from your ears. That bit of brain circuitry appears to falter with age, and scientists are getting some clues about why.
If you have trouble understanding conversation in a noisy room, you're experiencing what's sometimes called the cocktail party problem.
That can be one of the first signs of an age-related hearing loss — a more general problem that can creep in during middle age, and affects one-third of adults ages 65 to 75.
Scientists are still trying to piece together why our hearing goes downhill with age, with the goal of trying to slow it or even reverse it.
When it comes to the cocktail party problem, the dimmer switch is a piece of that story, though it's not clear just how big a factor.
"I think it's a significant player," said Robert Frisina of the University of Rochester in New York, who is studying it.
Scientists have long known that the brain not only receives signals from the ears, but can also talk back to them. And when there's too much noise, this dimmer-switch brain circuitry tells the ears to reduce their flow of signals to the brain.
This helps the sensitive auditory system handle loud sounds that otherwise would overwhelm it and become distorted, as when a radio is turned up too loud for the speaker to handle. In addition, since background noise at a party tends to be lower-pitched than speech sounds, the dimmer switch probably can block out that distracting noise more than it does the speech, Frisina said.
By MALCOLM RITTER, AP Science Writer Malcolm Ritter, Ap Science Writer – Mon Dec 29, 6:07 pm ET
NEW YORK – It's almost New Year's Eve, a time for plunging into boisterous crowds bathed in loud music. And for some of us, that means turning to an old friend and hearing things like this: "Did you know (BOOM-da-da-BOOM) went over (Bob! You look wonder-) so she said (clink-clink) and then I (Here, have another one) what would you do?" Huh? Too noisy to hear! But wait — how come these younger people understood what she said? What's wrong with your ears? Actually, part of the problem may be your brain.
In fact, it may lie in your brain's dimmer switch for controlling the input from your ears. That bit of brain circuitry appears to falter with age, and scientists are getting some clues about why.
If you have trouble understanding conversation in a noisy room, you're experiencing what's sometimes called the cocktail party problem.
That can be one of the first signs of an age-related hearing loss — a more general problem that can creep in during middle age, and affects one-third of adults ages 65 to 75.
Scientists are still trying to piece together why our hearing goes downhill with age, with the goal of trying to slow it or even reverse it.
When it comes to the cocktail party problem, the dimmer switch is a piece of that story, though it's not clear just how big a factor.
"I think it's a significant player," said Robert Frisina of the University of Rochester in New York, who is studying it.
Scientists have long known that the brain not only receives signals from the ears, but can also talk back to them. And when there's too much noise, this dimmer-switch brain circuitry tells the ears to reduce their flow of signals to the brain.
This helps the sensitive auditory system handle loud sounds that otherwise would overwhelm it and become distorted, as when a radio is turned up too loud for the speaker to handle. In addition, since background noise at a party tends to be lower-pitched than speech sounds, the dimmer switch probably can block out that distracting noise more than it does the speech, Frisina said.
On the Net:
Information on aging and hearing: http://www.nidcd.nih.gov/health/hearing/presbycusis.asp
How hearing works: http://www.bcm.edu/oto/research/cochlea/Hearing/
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Information on aging and hearing: http://www.nidcd.nih.gov/health/hearing/presbycusis.asp
How hearing works: http://www.bcm.edu/oto/research/cochlea/Hearing/
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Researchers unlock secrets of 1918 flu pandemic
Policemen in Seattle wearing masks made by the Red Cross, during the influenza epidemic in a National Archives photo dated December 1918.(National Archives/Handout/Reuters)Researchers unlock secrets of 1918 flu pandemic
Mon Dec 29, 5:44 pm ET
Mon Dec 29, 5:44 pm ET
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WASHINGTON (Reuters) – Researchers have found out what made the 1918 flu pandemic so deadly -- a group of three genes that lets the virus invade the lungs and cause pneumonia.
They mixed samples of the 1918 influenza strain with modern seasonal flu viruses to find the three genes and said their study might help in the development of new flu drugs.
The discovery, published in Tuesday's issue of the Proceedings of the National Academy of Sciences, could also point to mutations that might turn ordinary flu into a dangerous pandemic strain.
Yoshihiro Kawaoka of the University of Wisconsin and colleagues at the Universities of Kobe and Tokyo in Japan used ferrets, which develop flu in ways very similar to humans.
Usually flu causes an upper respiratory infection affecting the nose and throat, as well as so-called systemic illness causing fever, muscle aches and weakness.
But some people become seriously ill and develop pneumonia. Sometimes bacteria cause the pneumonia and sometimes flu does it directly.
During pandemics, such as in 1918, a new and more dangerous flu strain emerges.
"The 1918 influenza pandemic was the most devastating outbreak of infectious disease in human history, accounting for about 50 million deaths worldwide," Kawaoka's team wrote.
It killed 2.5 percent of victims, compared to fewer than 1 percent during most annual flu epidemics. Autopsies showed many of the victims, often otherwise healthy young adults, died of severe pneumonia.
"We wanted to know why the 1918 flu caused severe pneumonia," Kawaoka said in a statement.
They painstakingly substituted single genes from the 1918 virus into modern flu viruses and, one after another, they acted like garden-variety flu, infecting only the upper respiratory tract.
But a complex of three genes helped to make the virus live and reproduce deep in the lungs.
The three genes -- called PA, PB1, and PB2 -- along with a 1918 version of the nucleoprotein or NP gene, made modern seasonal flu kill ferrets in much the same way as the original 1918 flu, Kawaoka's team found.
Most flu experts agree that a pandemic of influenza will almost certainly strike again. No one knows when or what strain it will be but one big suspect now is the H5N1 avian influenza virus.
H5N1 is circulating among poultry in Asia, Europe and parts of Africa. It rarely affects humans but has killed 247 of the 391 people infected since 2003.
A few mutations would make it into a pandemic strain that could kill millions globally within a few months.
Four licensed drugs can fight flu but the viruses regularly mutate into resistant forms -- just as bacteria evolve into forms that evade antibiotics.
(Reporting by Maggie Fox, editing by Will Dunham and John O'Callaghan)
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