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Newswise — The implementation of state laws legalizing same-sex marriage was associated with a significant reduction in the rate of suicide attempts among high school students – and an even greater reduction among gay, lesbian and bisexual adolescents, new Johns Hopkins Bloomberg School of Public Health research suggests. The researchers, publishing Feb. 20 in JAMA Pediatrics, estimate that state-level, same-sex marriage policies were associated with more than 134,000 fewer adolescent suicide attempts per year. The study compared states that passed laws allowing same-sex marriage through Jan. 2015 to states that did not enact state-level legalization. A Supreme Court decision made same-sex marriage federal law in June of 2015. The findings show the effect that social policies can have on behavior, the researchers say. “These are high school students so they aren’t getting married any time soon, for the most part,” says study leader Julia Raifman, ScD, a post-doctoral fellow in the Department of Epidemiology at the Bloomberg School. “Still, permitting same-sex marriage reduces structural stigma associated with sexual orientation. There may be something about having equal rights – even if they have no immediate plans to take advantage of them – that makes students feel less stigmatized and more hopeful for the future.” Suicide is the second most common cause of death among people ages 15 to 24 in the United States (behind unintentional injury). Suicide rates have been rising in the U.S., and data indicate that rates of suicide attempts requiring medical attention among adolescents increased 47 percent between 2009 and 2015. Gay, lesbian and bisexual high school students are at particular risk. In the new study, 29 percent of gay, lesbian and bisexual high school students reported attempting suicide in the previous year as compared to six percent of heterosexual teens. For the study, Raifman and her colleagues analyzed data from the Youth Risk Behavior Surveillance System, a survey supported by the Centers for Disease Control and Prevention. The data included 32 of the 35 states that enacted same-sex marriage policies between Jan. 1, 2004 and Jan. 1, 2015. The researchers used data from Jan. 1, 1999 to Dec. 31, 2015 to capture trends in suicide attempts five years before the first same-sex marriage policy went into effect in Massachusetts. They were also able to compare data with states that did not enact same-sex marriage laws. They conducted state-by-state analyses, comparing, for example, suicide attempt rates in a state like Massachusetts before same-sex marriage was legalized to the period right after. State same-sex marriage legalization policies were associated with a seven percent reduction in suicide attempts among high school students generally. The association was concentrated in sexual minorities, with a 14 percent reduction in suicide attempts among gay, lesbian and bisexual adolescents. The effects persisted for at least two years. The states that did not implement same-sex marriage saw no reduction in suicide attempts among high school students. It’s unclear whether the political campaigns surrounding same-sex marriage legalization were behind the reduction in suicide attempts or the laws themselves. Still, they found that the reduction in suicide attempts wasn’t realized until after a law was enacted. In a state that would go on to pass a law two years in the future – when there was likely to be much conversation in the public about it – suicide attempts remained flat before passage. Healthy People 2020, a program run by the U.S. Department of Health and Human Services (HHS), has a goal of reducing adolescent suicide rates by 10 percent by 2020. The new research suggests that the legalization of same-sex marriage has been very effective in making progress toward that goal. Despite the large reduction in suicide attempts among gay, lesbian and bisexual high school students, this population still attempts suicide at higher rates than their straight peers. “It’s not easy to be an adolescent, and for adolescents who are just realizing they are sexual minorities, it can be even harder – that’s what the data on disparities affecting gay, lesbian, and bisexual adolescents tell us,” Raifman says. She says gay, lesbian, and bisexual adolescents are also at increased risk of substance abuse, depression and HIV. Despite evidence of disparities, she says there are no population-level programs aimed at reducing suicide attempts in gay, lesbian and bisexual students. She says schools and medical providers must understand that students who are sexual minorities are at higher risk and be on high alert. While Raifman found that legalizing same-sex marriage appears to be positively associated with reducing suicide attempts, policies that take away rights or add to stigma could have the opposite effect. “We can all agree that reducing adolescent suicide attempts is a good thing, regardless of our political views,” Raifman says. “Policymakers need to be aware that policies on sexual minority rights can have a real effect on the mental health of adolescents. The policies at the top can dictate in ways both positive and negative what happens further down.” “Difference-in-Differences Analysis of the Association Between State Same-Sex Marriage Policies and Adolescent Suicide Attempts” was written by Julia Raifman, Ellen Moscoe, Bryn Austin and Margaret McConnell. The research was supported by grants from the National Institutes of Health’s National Institute on Aging (T32AI102623) and National Institute of Mental Health (R25MH083620) as well as the Maternal and Child Health Bureau, Health Resources and Services Administration at HHS (T71-MC-00009 and T76-MC-00001).
Newswise — LOS ANGELES – Cedars-Sinai neuroscientists have uncovered processes involved in how the human brain creates and maintains short-term memories. “This study is the first clear demonstration of precisely how human brain cells work to create and recall short-term memories,” said Ueli Rutishauser, PhD, associate professor of Neurosurgery in the Cedars-Sinai Department of Neurosurgery and the study’s senior author. “Confirmation of this process and the specific brain regions involved is a critical step in developing meaningful treatments for memory disorders that affect millions of Americans.” The study’s findings, published online Feb. 20 and in the April print edition of Nature Neuroscience, involve a type of brain cell, called a persistently active neuron, that is vital for supporting short-term memory. Results indicate that this specific type of neurons remain active for several seconds when a person is required to memorize an object or image and recall it at a later time. The findings reveal critical new information on how the human brain stores and maintains short-term memories – the ability to remember ideas, thoughts, images and objects during a time frame of seconds to minutes. Short-term memory is essential for making decisions and mental calculations. “Because impaired short-term memory severely weakens someone’s ability to complete everyday tasks, it is essential to develop a better understanding of this process so new treatments for memory disorders can be developed,” said Jan Kamiński, PhD, a neuroscientist at Cedars-Sinai and lead author of the study. Researchers found persistently active neurons in the medial frontal lobe as well as the medial temporal lobe. The neurons remained active even after the patient stopped looking at an image or object. Until now, the medial temporal lobe was thought to be involved only in the formation of new long-term memories. Now, however, the new findings show that both areas of the brain are critical for maintaining short-term memory and rely upon the ongoing activity of the neurons for memorization. During the study, a team of Cedars-Sinai neurosurgeons implanted electrodes to precisely locate the source of seizures in 13 epilepsy patients. Investigators then studied the electrical activity of individual neurons while patients performed a memory test. During the test, patients viewed a sequence of three images, followed by a two-to-three-second delay. Then patients were shown another image and were asked to decide whether they had previously seen the image. “A surprising finding of this new study is that some of the persistently active neurons were only active if the patient memorized a specific image,” Kamiński said. “For example, the researchers discovered a neuron that reacted every time the patient memorized an image of Han Solo, a character in the movie Star Wars, but not any other memory.” Another key finding of the study was a correlation between the strength of the neurons’ activity and the ability to later make use of the memory. “We noticed that the larger the increase in activity, the more likely the patient was to remember the image. In contrast, if the neuron’s activity was weak, the patient forgot the image and thus lost the memory,” said Adam N. Mamelak, MD, professor of Neurosurgery, director of Functional Neurosurgery at Cedars-Sinai and a co-author of the study. Keith L. Black, MD, chair of the Department of Neurosurgery at Cedars-Sinai, said the breakthrough can be credited to the partnership between neurosurgery and neurology clinicians working with neuroscientists. “This unique collaboration allows us to discover the mechanisms of memory in the human brain,” Black said. “This is key for moving closer to finding treatments for memory disorders, epilepsy and other diseases.” Rutishauser said a next step is understanding how multiple areas of the brain work together to support short-term memory. “Now that specific neurons that support short-term memory have been discovered, we have a way to study their interaction systematically,” he said. Other Cedars-Sinai study contributors included Jeffrey Chung, MD, director of the Epilepsy Program and the Neurophysiology Laboratory; and Shannon Sullivan, research associate. Ian Ross, MD, a neurosurgeon at Huntington Memorial Hospital also contributed. This work was supported by National Science Foundation grant 1554105, National Institute of Mental Health grant R01MH110831, the McKnight Endowment Fund for Neuroscience, a NARSAD Young Investigator grant from the Brain & Behavior Research Foundation (23502), and the Pfeiffer Foundation. # # #
Newswise — PHILADELPHIA— Cervical cancer is the leading cause of cancer deaths for women low- and middle-income countries, including Botswana, where 75 percent of cervical cancer patients suffer from advanced forms of the disease. These patients can face wait times as long as five months after diagnosis before receiving lifesaving treatment. A new, multidisciplinary model of cervical cancer care developed by a University of Pennsylvania team based in Botswana cut the delay between diagnosis and treatment by more than 50 percent, according to research published this month in the Journal of Global Oncology. Limited access to preventive screenings combined with the HIV epidemic are driving the high rate of cervical cancer in Botswana, which has the second highest HIV prevalence in the world. The risk of developing cervical cancer in women infected with HIV is three- to six–fold higher than those who are HIV-negative. In Botswana, more than two-thirds of all cervical cancer cases occur among women who are also living with HIV. However, radiation therapy is not available at in public clinics in Botswana, requiring patients to seek care at private hospitals, which can be a cumbersome process with wait times as long as five months. “With so many women suffering from advanced cervical cancer in Botswana, long delays between treatment and diagnosis can mean the difference between life and death,” said Surbhi Grover, MD, MPH, director of Global Radiation Oncology in the Perelman School of Medicine at the University of Pennsylvania and head of Oncology at Princess Marina Hospital in Botswana. “We saw an urgent need to develop a care program that gives cervical cancer patients the treatment they need as quickly as possible.” Grover and her fellow researchers at Princess Marina Hospital developed a multidisciplinary team (MDT) approach to streamline care and communication between providers and get patients to treatment facilities faster. Weekly care team meetings were established across providers, including radiation oncologists, clinical oncologists, gynecologists, nurse coordinators, and palliative care specialists to discuss patient cases and develop treatment plans. The teams also worked to together to submit paperwork and other documentation, further reducing delays in treatment and simplifying the overall process. “While this type of model might seem common in the United States or other developed countries, it’s actually a quite complicated process that lacks a global standard of guidelines,” Grover said. “We saw many different models across the world, but no published outcomes on how to successfully implement an MDT approach for cervical cancer care.” Over a six-month period, the team saw 135 patients, 60 percent of whom were diagnosed with cervical cancer and 42 percent had locally advanced cancer the required chemo-radiation. However, thanks to the MDT model, 62 percent of those patients required only one clinic visit to coordinate care, reducing the time between diagnosis and treatment initiation by more than 50 percent, with the median delay from biopsy to treatment initiation cut to 39 days from an average of 108 days before the new care model. “With this model, we’ve shown that the MDT approach works in a resource-limited setting and actually helps address several challenges providers face,” Grover said. “Many of our patients must travel long distances or face other barriers that prevent them from returning to the clinic for multiple visits. Offering patients a comprehensive treatment plan during one clinic visit is a game-changer.” Similar MDT models are being developed for head and neck cancer, breast cancer, and palliative care in Botswana. A follow-up clinic is also being piloted where patients with gynecological cancer receive continued follow-up care after chemotherapy and radiation are complete. All patients seen in the Penn MDT clinic will be linked to this new clinic and will receive regular communication about follow-up care. “What this approach really shows is the importance of integrated care and treatment models,” Grover said. “We hope our MDT model will be applied on a broad scale across many different illnesses and clinics in resource-limited settings worldwide.” ###
Newswise — Australia could save AUD $3.4 billion (USD $2.3 billion) in healthcare costs over the remaining lifetimes of all Australians alive in 2010 by instituting a combination of taxes on unhealthy foods and subsidies on fruits and vegetables, according to a new study published in PLOS Medicine by Linda Cobiac, from the University of Melbourne, Australia and colleagues. An increasing number of Western countries have implemented or proposed taxes on unhealthy foods and drinks in an attempt to curb rates of dietary-related diseases, however the cost-effectiveness of combining various taxes and subsidies is not well-understood. In the new study, researchers modeled the effect of taxes on saturated fat, salt, sugar, and sugar-sweetened beverages and a subsidy on fruits and vegetables on the Australian population of 22 million alive in 2010. They simulated how different combinations of these taxes and subsidies—designed so there would be less than a one percent change in total food expenditure for the average household—impacted the death and morbidity rates of Australians as well as healthcare spending over the remainder of their lives. The greatest impact, the researchers concluded, came from a sugar tax, which could avert 270,000 disability-adjusted life years (DALYs, or years of healthy lifespan across the population lost due to disease). “That is a gain of 1.2 years of healthy life for every 100 Australians alive in 2010,” the authors say. “Few other public health interventions could deliver such health gains on average across the whole population.” A salt tax was estimated to save 130,000 DALYS over the remainder of the lives of Australians alive in 2010, a saturated fat tax 97,000 DALYs, and a sugar-sweetened beverage tax 12,000 DALYs. Combined with taxes, the fruit and vegetable subsidies made for additional averted DALYs and reduced health sector spending, but on their own were not estimated to lead to a clear health benefit. Overall, when combined to maximize benefits, the taxes and subsidies could save an estimated 470,000 DALYs and reduce spending by AUD $3.4 billion (USD $2.3 billion). “Simulation studies, such as ours, have uncertainty. For example, we are reliant on other research estimating the responsiveness of the public to changes in food prices. There are also implementation issues for the food industry.” “Nevertheless, this study adds to the growing evidence of large health benefits and cost-effectiveness of using taxes and regulatory measures to influence the consumption of healthy foods,” the authors say. “We believe that with such large potential health benefits for the Australian population and large benefits in reducing health sector spending…the formulation of a tax and subsidy package should be given more prominent and serious consideration in public health nutrition strategy.” “Several countries have imposed taxes on sugary drinks, with the UK the latest to consider such a policy. Our research suggests that even bigger health gains and cost savings may be possible with food taxes and subsidies on a wider range of foods.” Research Article Funding: LJC was supported by a National Health and Medical Research Council Fellowship (Grant number 1036771; www.nhmrc.gov.au). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.   Competing Interests:LJC is a member of the Editorial Board of PLOS Medicine. Citation:Cobiac LJ, Tam K, Veerman L, Blakely T (2017) Taxes and Subsidies for Improving Diet and Population Health in Australia: A Cost-Effectiveness Modelling Study. PLoS Med 14(2): e1002232. doi:10.1371/journal.pmed.1002232   Author Affiliations:Centre for Health Policy, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia School of Public Health, The University of Queensland, Herston, Queensland, Australia, Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme, Department of Public Health, University of Otago, Wellington, Wellington, New Zealand     SEE ORIGINAL STUDY
Newswise — WINSTON-SALEM, N.C. – In medieval Europe, when astrology and blood-letting were frequently employed in the diagnosis and treatment of disease, one therapy for rabies was to place some pieces of hair from the rabid dog onto the victim’s bite wound. It didn’t work. But it did give rise to the notion that “the hair of the dog that bit you” – a drink – can cure a hangover. This concept is rather ancient, too, having first appeared in print in 1546. It doesn’t work, either. “There’s no scientific evidence that having an alcoholic drink will cure a hangover,” said Laura Veach, Ph.D., director of screening and counseling intervention services and training in the Department of Surgery at Wake Forest Baptist Medical Center. “It will, at best, postpone one.” A hangover develops when an elevated concentration of alcohol in the blood caused by drinking falls sharply after drinking stops. The symptoms – usually some combination of headache, thirst, fatigue, dizziness, nausea and general grumpiness – reach their peak when the blood-alcohol level hits zero. “Taking a drink the morning after may temporarily make you feel better because you’re putting alcohol back into the system,” said Veach, who holds a doctoral degree in counseling. “But it doesn’t cure the hangover; it just sort of tricks you by masking the symptoms. They’re going to show up eventually.” So is there no cure? “Rest, hydration and aspirin can help some, but they won’t make the hangover go away,” Veach said. “The only real cure is time.” What if you want to help somebody who’s tipsy, buzzed, smashed or otherwise inebriated get sobered up? You give them black coffee, right? “No, all that does is give you a wide-awake drunk,” Veach said. The liver, she explained, detoxifies alcohol in the system and does so at only one rate, which is about one drink per hour. “There’s nothing we know of that can speed up that process,” Veach said. “Not drinking coffee, taking a shower, standing on your head, getting slapped, walking around outside in the cold. Nothing.”
Newswise — WASHINGTON — In the first successful randomized trial of its kind, researchers have provided preliminary evidence that telephone-based smoking cessation counseling given to smokers shortly after undergoing lung cancer screening can be effective at helping people stop smoking. “We found that at this teachable moment — a time when smokers are thinking about their health and may be ready to make a change — offering help makes a difference, and may help save lives,” says the study’s lead researcher, Kathryn L. Taylor, PhD, a behavioral scientist and a professor of oncology at Georgetown Lombardi Comprehensive Cancer Center. The study published February 14 in the journal Lung Cancer, was led by researchers at Georgetown Lombardi and conducted with 92 participants at three centers — MedStar Georgetown University Hospital in Washington, DC, Hackensack University Medical Center in New Jersey, and Lahey Hospital and Medical Center in Massachusetts. “Millions of current smokers are now eligible for lung cancer screening, so this setting represents an important opportunity to exert a large public health impact on cessation among smokers who are at very high risk for multiple tobacco-related disorders,” she says. “This is a great way to engage smokers who have not sought out cessation help.” These study findings were so promising that investigators have been funded through NIH to conduct a much larger study of telephone-based cessation counseling. It will enroll 1,300 patients at five medical centers nationwide. Lung cancer screening recommendations issued in 2013 by the U.S. Preventive Services Task Force suggest that people who have smoked long enough to have accumulated a minimum of 30 pack-years (i.e., one pack per day for 30 years, or two packs per day for 15 years, etc.) should have an annual low-dose CT lung cancer screening test. The idea is to intervene early enough that disease spotted on the screening can be effectively treated. In the U.S., lung cancer is the leading cancer killer in both men and women — almost 160,000 Americans were expected to die from lung cancer in 2016, according to the American Lung Association. Taylor points out that the NIH has said that effective smoking cessation programs should be a part of screening programs, and has funded several groups of researchers to develop effective strategies. In this preliminary study, 92 people about to undergo lung cancer screening agreed to receive either telephone counseling or standard of care (a list of free and low-cost cessation resources). Once participants received their screening results, they were randomized to one of the two groups, each with 46 participants. Each group had an equal number of participants with abnormal screening findings, indicating possible precancerous lesions or chronic obstructive pulmonary disease (COPD). Each group also contained an equal number of participants with minor abnormalities on their screen, as well as those with normal results. None of the participants were diagnosed with lung cancer. Participants in the telephone-counseling group were given their first session after finding out their screening results. Over the next three months, six 10-15 minute sessions were conducted. At the end of the study, a nicotine saliva test was given to participants who said they had quit in order to confirm their abstinence. Researchers found that eight (17 percent) people in the telephone counseling group had verifiably quit, compared to two (4 percent) in the other group. “If this preliminary study is replicated, telephone counseling has the potential to improve cessation in a setting that reaches a large number of hard-to-reach, long-term smokers who are at very high risk for multiple tobacco-related diseases,” Taylor says. Charlotte Hagerman, who along with Taylor, offered the telephone counseling to participants, describes the counseling as “a motivational intervention. Everyone acknowledged that smoking is very harmful to their health, but some people thought it was too late to change their fate. Counseling helped them understand that it is not too late.” Population-based studies have shown that older smokers who quit can have an increased life expectancy, Taylor says. Hagerman says there were also a number of participants who “were ready to quit, and were very excited to receive the help we were offering. I found this very gratifying, and felt that what we were doing was important and mattered to people,” says Hagerman, who was trained as a tobacco treatment specialist for the study. “More than 50 percent of participants said in their first interview that they were not ready to quit, yet some of these people did quit. This finding indicates that it is important to offer the cessation intervention to everyone who undergoes lung cancer screening, and not only those who are already considering quitting. This is exactly what we hope for – to be able to reach the people who are not already planning to quit on their own,” says Taylor. In addition to Taylor and Hagerman, co-authors from Georgetown University Medical Center include George Luta, PhD; Paula G. Bellini, MA; and Cassandra Stanton, PhD. David B. Abrams, PhD, and Ray Niaura, PhD, are Georgetown faculty and also affiliated with the Schroeder Institute for Tobacco Research and Policy Studies. Jenna A. Kramer, NP and Eric D. Anderson, MD are from MedStar Georgetown University Hospital in Washington, DC; Shawn Regis, PhD, Andrea McKee, MD, and Brady McKee, MD, are from Lahey Hospital and Medical Center, Burlington, MA; and Harry Harper, MD and Michael Ramsaier, BS are from Hackensack University Medical Center, Hackensack, NJ. The authors report having no personal financial interests related to the study. The study was supported by the Prevent Cancer Foundation and Georgetown Lombardi’s NCI Cancer Center Support Grant P30 CA051008. About Georgetown Lombardi Comprehensive Cancer CenterGeorgetown Lombardi Comprehensive Cancer Center is designated by the National Cancer Institute as a comprehensive cancer center — the only cancer center of its kind in the Washington, DC area. A part of Georgetown University Medical Center and MedStar Georgetown University Hospital, Georgetown Lombardi seeks to improve the diagnosis, treatment, and prevention of cancer through innovative basic and clinical research, patient care, community education and outreach, and the training of cancer specialists of the future. Connect with Georgetown Lombardi on Facebook (Facebook.com/GeorgetownLombardi) and Twitter (@LombardiCancer). About Georgetown University Medical CenterGeorgetown University Medical Center (GUMC) is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health). GUMC’s mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing & Health Studies, both nationally ranked; Georgetown Lombardi Comprehensive Cancer Center, designated as a comprehensive cancer center by the National Cancer Institute; and the Biomedical Graduate Research Organization, which accounts for the majority of externally funded research at GUMC including a Clinical and Translational Science Award from the National Institutes of Health. Connect with GUMC on Facebook (Facebook.com/GUMCUpdate), Twitter (@gumedcenter) and Instagram (@gumedcenter).
Newswise — Only one new drug has become available over the past 50 years for the estimated 1.5 million Americans and five million-plus people worldwide suffering from lupus, but new research has identified a previously unknown mechanism involved in the immune response that could provide an alternative therapy target. Lupus (also known as systemic lupus erythematosus) is a chronic autoimmune disease in which the immune system is unable to distinguish the difference between foreign invaders, such as viruses and bacteria, from its own healthy body tissue, so it attacks itself, damaging skin, joints, and kidneys – among other organs – in the process. The disease is also marked by elevated levels of type I interferon, a substance normally secreted by immune cells in response to viral infections. The origin of the interferon signature in lupus has remained a mystery for years. While working to solve this enigma, researchers, including Iwona Buskiewicz, Ph.D., and Andreas Koenig, Ph.D., assistant professors of pathology and laboratory medicine at the University of Vermont’s Larner College of Medicine, uncovered an unexpected finding: a protein that normally signals an immune system pathway during viral infections was spontaneously activated in lupus patients, even in the absence of viral infection. Their results were published recently in the journal Science Signaling. “Typically, this protein – mitochondrial antiviral signaling or MAVS – is responsible for recognizing viral infections,” explains Buskewicz, who adds that her team’s publication is “the first paper showing that the interferon pathway can be activated by something other than viral infection or nucleic acids.” The culprit of this phenomenon? Oxidative stress in cells, which is sufficient to induce the clustering of MAVS at the mitochondria – the energy-producing organelles within each cell – and drive interferon production in the absence of viruses. Why it is located at the mitochondria is still a missing piece of the puzzle, Buskewicz admits. She and her colleagues’ findings suggest that in lupus patients, environmental stress may contribute to their production of type I interferon, which normally helps regulate immune system activity. In their study, introduction of an anti-oxidant reversed the clustering of MAVS and prevented the subsequent production of interferon. Buskiewicz and her colleagues believe that MAVS could be targeted therapeutically with antioxidants directed to the mitochondria.The next step for the research team members, who in addition to the Larner College of Medicine at the University of Vermont, hail from the Wellcome Trust, University of Glasgow, SUNY Upstate Medical Center, and Weill Cornell Medical College, is to collaborate with rheumatologists to further explore a potential therapy, by examining the degree of MAVS clustering and interferon levels before and after antioxidant therapy.“We need to develop a drug that can revive the mitochondria,” she says. “A more focused antioxidant therapy targeting the particular organelle may have more efficacy.”
Newswise — Arlington, Va.- People suffering from back pain should consider first trying chiropractic services and other non-drug therapies in light of a new research review that found common over-the-counter and prescription pain medications have limited effectiveness for back pain and raise the risk of side-effects, according to the American Chiropractic Association (ACA). The review, published this month in Annals of the Rheumatic Diseases, examined 35 randomized, placebo-controlled trials, encompassing 6,000 patients, to determine the effectiveness and safety of non-steroidal anti-inflammatory drugs (NSAIDs) for spinal pain. The authors of the report found that NSAIDs provided “clinically unimportant effects” when compared with patients who received only a placebo. Meanwhile, those who used NSAIDs had a 2.5 times greater risk of experiencing gastrointestinal disorders. “At present, there are no simple analgesics that provide clinically important effects for spinal pain over placebo,” the authors noted. The news about NSAIDs follows reports last year that prescription opioids also have limited effectiveness for back pain—one of the most common causes of disability worldwide. “The American Chiropractic Association urges people to try non-drug approaches to back pain relief first, before resorting to over the counter or prescription medications,” said ACA President David Herd, DC. “In addition to spinal manipulation, chiropractors can offer a range of non-drug therapies for back pain and recommend exercises and important lifestyle changes to help prevent future back pain and injury.” According to a 2016 Gallup survey, more than 35 million people visit a chiropractor annually. About the American Chiropractic AssociationThe American Chiropractic Association (ACA) is the largest professional association in the United States representing doctors of chiropractic. ACA promotes the highest standards of ethics and patient care, contributing to the health and well-being of millions of chiropractic patients. Visit us at www.acatoday.org to find an ACA chiropractor near you.
Newswise — Developing medications for children can be challenging—taste and texture are important, but safety is also a major concern, according to pharmaceutical sciences professor Om Perumal at South Dakota State University. As co-founder and chief scientific officer of Tranzderm Solutions, he is adapting his corn protein-based drug delivery method to oral pediatric formulations.“Our core technology is the same, but we’ve refined it and are finding new ways to utilize it,” said Perumal. His patented drug delivery system uses zein, a protein found in dried distillers grain, a co-product of ethanol production, to encapsulate the medication. The nanoparticles are approximately 500 times smaller than the diameter of a human hair. To apply to oral pediatric formulations, Perumal explained, “We’ve modified the nanoparticles by coating them with milk proteins.” explained Perumal. “Our idea is to use products kids like.”Providing federal incentiveBefore 1998, about 70 percent of the drugs used for children had not undergone clinical testing for the newborn to 17-year-old population, according to the National Institutes of Health Medline Plus. “Drugs behave differently in children than adults,” Perumal explained. However, the pharmaceutical industry did not have much incentive to do the testing because the pediatric medications make up only 10 percent of the pharmaceutical market. To encourage the development of drugs customized for children, the federal government in 2002 passed the Best Pharmaceutical for Children’s Act. It grants incentives to drug companies conducting Food and Drug Administration-requested pediatric studies.Adapting to pediatric market“We are developing formulas customized for children that are safe and can be flexible based on the age of the patient,” Perumal explained. Their initial work targets infants and toddlers, who need either an oral suspension or a chewable form.“Dissolving a drug that is not water soluble can result in a thick, uninviting suspension,” he explained. In addition,” using an excipient, such as high amounts of alcohol, to dissolve the drug is out of the question for young children.” The zein nanoparticles, which are not water soluble, protect the drug and the milk protein coating makes them more water dispersible. “We have the best of both worlds,” Perumal noted. In addition, the milk powder masks the drug’s taste. “We can put the nanoparticles into a liquid, a chewable tablet or a capsule,” he said. “We could even use them as food sprinkles.” Identifying potential medicationsThe patent-pending drug delivery method can be optimized using different milk proteins, such as casein, lactoferrin and lactoglobulin. To mimic how the delivery system works, Perumal is testing the formulations using simulated gastric and intestinal fluid. “We don’t want it to release in the food matrix,” he explained. The medication should be absorbed, typically within 24 hours, in the intestinal tract. Milk has thus far worked best, but experiments are underway to test the formulation in yogurt and other food matrices.His first target medications are antiretrovirals, which children who are HIV-positive must take for a lifetime. Using a rat model, Perumal and his team found that his formulation has two to four times higher absorption than what’s currently on the market.Another target medication is a drug under investigation to treat neuroblastoma, a cancer which affects infants and children up to 10 years old. Though neuroblastoma accounts for 6 percent of cancer in children, Perumal said no pediatric drug formulation is available for the investigational compound. In addition, what works for children will be useful for patients who have swallowing difficulties, such as the elderly. However, Perumal cautioned, the delivery platform is in the early stages of development. Pharmaceuticals take anywhere from 15 to 20 years to reach the market.
Newswise — BIRMINGHAM, Ala. – February is American Heart Month, and it is an important time to be informed on the most beneficial foods and nutrients to maintain a heart-healthy diet. According to the American Heart Association, heart disease is the leading global cause of death; 2,200 Americans die each day from heart disease. Wholesome nutrition is a major factor in combating plaque build-up in coronary arteries, which results in the most common type of heart disease, coronary artery disease. The AHA encourages limiting “sugary drinks, sweets, fatty or processed meats, solid fats, and salty or highly processed foods” to maintain a heart-healthy diet. The Centers for Disease Control and Prevention suggests that a poor diet — among diabetes, obesity, physical inactivity and excessive alcohol use — is one of the most influential lifestyle choices that put people at a higher risk for heart disease. Americans are advised by organizations such as the CDC and the AHA to consume more fruits and vegetables and less sodium and sugar. Carleton Rivers, RDN, assistant professor in the Department of Nutrition Sciences in the University of Alabama at Birmingham School of Health Professions and program director of the UAB Dietetic Internship, is an expert on dieting and nutrition. She says eating fresh fruits and vegetables cooked using a low-fat method are great for heart health. “Choose vegetables that have a rich color like dark leafy greens, sweet potatoes, squash, carrots and zucchini,” Rivers said. “Just be sure not to substitute fresh fruits with 100 percent fruit juice or dried fruit.” Fruit juice and dried fruit are high in sugar and may be consumed in a greater amount than a whole piece of fruit. Fruit juices also lack the fiber needed to control blood sugar. Rivers says fiber and protein are important. “Fiber is important for gastrointestinal motility, blood sugar control and lower low-density lipoprotein (LDL) cholesterol,” Rivers said. “Fiber is great for appetite control because it can fill you up and keep you feeling fuller for longer.” She says protein is needed to build and maintain muscles and can be found in a variety of sources such as lean meats cooked using a low-fat method, such as baking. The AHA and CDC advise cooking meals at home to have a healthy, balanced diet, and Rivers agrees it may be easier to eat healthy when one cooks or prepares meals at home. “Many restaurants add butter and salt to improve the taste of dishes,” Rivers said. “This of course increases the calorie amount for a meal. Before going to a restaurant, look up the nutrition facts for the menu items you think you would want to eat, then make a decision based on which menu items are lower in calories, saturated fat, sodium and sugar.” As much as the AHA and the CDC encourage a heart-healthy diet, Rivers says a “cheat day” is OK every now and then to allow yourself to have a little bit of what you are craving to help prevent derailing from a diet all together. Your favorite piece of chocolate or guacamole and tortilla chips are what Rivers recommends as two heart-healthy treats to have on those “cheat days.” “The occasional bite of dark chocolate or a nice glass of pinot noir is a perfect reward for your efforts to sustain your heart health.” To find heart-healthy recipes and recommendations, visit the UAB Heart and Vascular Services recipe website.