Blame Common Colds on Your Chromosome 'Caps?'

By Amy Norton
HealthDay Reporter

TUESDAY, Feb. 19 (HealthDay News) -- Some people seem to catch a cold every few weeks while others appear immune. Now a preliminary study suggests that the protective "caps" on your chromosomes could partly explain the mystery.

The study, reported in the Feb. 20 issue of the Journal of the American Medical Association, found that healthy young adults were more prone to catching a cold when their immune system cells had relatively short telomeres.

Telomeres are lengths of DNA that sit at the ends of your chromosomes. Think of them like the plastic caps at the ends of a shoelace: Telomeres help keep your chromosomes -- which carry your genes -- from fraying and sticking together.

As people age, their telomeres gradually get shorter, and research has linked shorter telomere length to older adults' risks of developing and dying from infections, cancer and heart disease.

"But there's been very little known about telomere length in young people, certainly in relation to health," said Sheldon Cohen, a professor of psychology at Carnegie Mellon University in Pittsburgh who led the new study.

Because colds and other respiratory infections are the most common health woe in younger people, Cohen's team decided to see whether telomere length mattered in their risk of developing a cold.

The researchers recruited 152 healthy 18- to 55-year-olds, and measured telomere length in the volunteers' T cells -- immune system cells that fight off infection. They then exposed the men and women to a cold virus via nasal drops, and quarantined them in a hotel to be monitored.

Over the next five days, 22 percent of the volunteers developed cold symptoms, and the odds were higher among those with shorter telomeres in a particular subtype of T cell. Of the one-third with the shortest telomeres, 26 percent became sick, versus 13 percent among the one-third with the longest telomeres.

"This is something new and provocative," said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University School of Medicine in Nashville, Tenn., who was not involved in the research.

"All of us know some people who get one cold after another, and others who seem like they're able to be around people with colds but remain robust," said Schaffner, who is also a spokesman for the Infectious Diseases Society of America.

These findings, Schaffner said, raise the possibility that there is some role for the telomeres in our T cells.

"We're not all created equal in terms of our telomeres," he said. "Just like some of us are short, and some are tall."

What does that mean for you during cold and flu season? Nothing right now, according to both Schaffner and Cohen.

For one, nobody knows if they have skimpy telomeres. And even if they did, it's not clear whether there's anything they could do about it.

"There is a lot of research interest right now in whether it's possible to alter telomere length, either through some kind of behavioral change or a medication," Cohen said. "But we're pretty far from that point."

What's more, the current findings do not prove that shorter telomeres, per se, mean more cold misery. The researchers did account for other factors, such people's age, weight and race. But Cohen said there could be other explanations. It's possible, for example, that some genetic factor makes people have shorter T-cell telomeres and renders them more vulnerable to colds.

On the other hand, shorter telomeres may impair T cells' ability to battle cold viruses, Cohen said.

Still, no one knows yet whether these findings could one day have practical use.

"This is really the first evidence that this biomarker of aging may be important for 25-year-olds as well as 65-year-olds, and for acute health conditions as well as chronic," Cohen said.

Of course, you do not need to wait for any telomere-lengthening therapy to curb your risk of catching a cold. "Wash your hands," Schaffner advised. "And try to avoid people who are sneezing and coughing."

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Sheldon Cohen, Ph.D., professor, psychology, Carnegie Mellon University, Pittsburgh; William Schaffner, M.D., chair, preventive medicine, Vanderbilt University School of Medicine, Nashville, Tenn.; Feb. 20, 2013, Journal of the American Medical Association

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Fraudulent Data May Have Led to Use of Risky Treatment in ICUs

By Amanda Gardner
HealthDay Reporter

TUESDAY, Feb. 19 (HealthDay News) -- Studies loaded with fraudulent data may have encouraged the use of a treatment for patients in intensive care units that now appears to do more harm than good, new research shows.

At issue is hydroxyethyl starch, an intravenous solution sometimes used to replace lost blood volume in critically ill patients. According to a new review article in the Feb. 20 issue of the Journal of the American Medical Association, the starchy solution may instead boost their risk of death or kidney failure.

"Almost certainly, what is happening is that some of the starch molecules leak out of blood vessels into the kidney itself so the kidney doesn't work as efficiently," said Dr. David Taylor, chairman of pulmonary and critical care medicine at Ochsner Health System in New Orleans. He was not involved in the new review.

Luckily for American patients, hydroxyethyl starch is not commonly used in the United States, Taylor said. But the new analysis serves as a cautionary tale on how fraudulent data can end up endangering patients' lives.

As Taylor explained it, critically ill patients often develop leaky vessels, and so quickly require intravenous fluids to keep their blood pressure stable and to improve organ function.

One such fluid is simple saline or salt water, known as crystalloid solution. This is the cheapest fluid available, but it tends to leak out of blood vessels, which means it can also leak into the lungs, under the skin and into various organs.

As a result, researchers have spent considerable time and effort trying to find less leaky alternatives to saline. The protein albumin, derived from human blood, is commonly used after cardiac surgery, when the risk of fluid collecting in the lungs is high, Taylor explained. Although albumin is less leaky than saline, it is more expensive.

Hydroxyethyl starch is similar to albumin, but it contains starch molecules, which are less likely to leak out of the blood vessels than saline.

Still, many researchers had reservations about using a starch-based solution from the beginning, Taylor said.

"If you have salt water and it leaks out, you just get some salt into the tissue and it goes away with a little bit of time," he explained. On the other hand, "if you have starch in the tissue it's not so easy to get starch out of there, and many people were worried about the possibility of complications."

It turns out there was even more reason to be suspicious of any alleged benefits of hydroxyethyl starch. In 2011, investigators discovered that the lion's share of research on the treatment that was conducted by German anesthesiologist Dr. Joachim Boldt was fraudulent and had to be retracted.

So the author of the current paper wondered: Would the purported benefits of hydroxyethyl starch hold up once Boldt's data was excluded?

Led by Dr. Ryan Zarychanski, of the University of Manitoba in Winnipeg, Canada, the team pooled data from 38 previous studies on the issue, including those by Boldt.

That analysis concluded that patients who received hydroxyethyl starch did not fare any better than other types of fluid.

But when the Boldt studies were excluded from the mix, hydroxyethyl starch was actually associated with an increased risk of death, kidney failure and need for dialysis among patients, the new research found.

It's impossible to gauge how many patients were damaged by Boldt's falsified research, but this new study highlights "how the inclusion or exclusion of the Boldt papers associated with research misconduct can shift the balance toward harm," said Dr. Massimo Antonelli, author of an editorial accompanying the new study.

"It showed also how the worldwide administration of starches for volume replacement therapy have caused the increase of acute renal failure and affected mortality," said Antonelli, a professor of intensive care and anesthesiology at the Catholic University-A.Gemelli University Hospital in Rome.

He added that a task force of the Surviving Sepsis Campaign, an organization devoted to reducing death from sepsis, recently issued guidelines warning against using starches for fluid replacement.

"These findings will reinforce [those] recommendations," he said.

Taylor stressed, however, that it would still be helpful to find alternatives to both albumin and saline.

A person in the intensive care unit (ICU) can have 1-2 liters more of fluid going into their body than out, said Taylor. Each liter weighs 1 kilogram, or 2.2 pounds.

"It's possible to gain anywhere from 8-10 pounds in fluid [in the ICU] so it would be a great to have an alternative to 10 pounds of weight," he said. However, a starch solution "is not a good alternative because it increases the risk of dying or needing dialysis," Taylor said.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: David Taylor, M.D., chairman, pulmonary and critical care medicine, Ochsner Health System, New Orleans; Massimo Antonelli, M.D., professor, intensive care and anesthesiology, Catholic University-A. Gemelli University Hospital, Rome; Feb. 20, 2013, Journal of the American Medical Association

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1 in 8 Americans Diagnosed With Type 2 Diabetes: Poll

By Amanda Gardner
HealthDay Reporter

WEDNESDAY, Feb. 20 (HealthDay News) -- A staggering one in eight Americans has been diagnosed with type 2 diabetes, a new Harris Interactive/HealthDay poll suggests.

And more than one third of those polled have been diagnosed with diabetes or have a parent, sibling, spouse or child with the condition.

"Type 2 diabetes has become one of the most common and fastest growing diseases. Fully one in eight adults -- approximately 29 million people -- now report that they have been diagnosed with this dangerous condition," said Harris Poll Chairman Humphrey Taylor.

Added Dr. Ronald Tamler, clinical director of the Mount Sinai Diabetes Center in New York City: "Diabetes is very insidious. You don't know you're in trouble until the complications hit or until it's so out of control you have uncontrolled urination and thirst" -- two of the common symptoms of diabetes.

While type 2 diabetes is occurring in epic proportions, the new poll also found that awareness of the disease is still surprisingly low, with only 21 percent of those surveyed considering themselves well-versed on the disease. That means the remaining 79 percent may not know they're at risk or may already have the disease, which is known as the "silent" killer.

But people already diagnosed with diabetes tend to be much more aware of the health risks, with slightly more than two-thirds considering themselves either "extremely" or "very" knowledgeable about the disease, the poll found.

Still, 35 percent of respondents with diabetes said their diabetes was only "somewhat" controlled and 5 percent said it was "not at all" well controlled.

"Because diabetes is a chronic condition, the treatment of which is critically dependent on patient behavior and self-care, this may be the most alarming finding," Taylor said.

On a more encouraging note, many people polled do understand that a number of factors can contribute to type 2 diabetes, including being overweight (79 percent of respondents realize this is a risk factor), diet (74 percent) and physical inactivity (62 percent).

These numbers were greater among people who had been diagnosed with diabetes.

Interestingly, 60 percent of respondents know that genetics can be a component of type 2 diabetes.

"We have a public perception that type 2 diabetes is entirely a disease of lifestyle and that is not true," said Dr. Robert Ratner, chief scientific and medical officer of the American Diabetes Association. "There is no question that lifestyle contributes to it, but the problem is one of biology . . . Environment really does play a role but the biology sets them up."

Indeed, certain ethnic groups, including many Native American tribes, bear a disproportionate diabetes burden, Ratner added.

Most adults, whether they actually have diabetes or not, seem fairly knowledgeable about the long-term consequences of the disease, which can include amputation of limbs, blindness, kidney disease and heart disease, the poll found.

There was an exception. Only 39 percent of adults overall and 56 percent of those with type 2 diabetes knew that the disease can cause strokes.

"People need to be aware that this is another disease caused by diabetes that can be prevented," said Nancy Copperman, director of Public Health Initiatives at North Shore-LIJ Health System in Great Neck, N.Y. "The idea of having a stroke might motivate them to change their lifestyle."

The disease seems to be taking a toll on those polled, with 20 percent acknowledging it has been a "significant" burden and 43 percent saying it has been "somewhat" of a burden for themselves and their families. The burden comes in the form of dietary restrictions, medication costs, eye problems, cardiovascular problems and foot problems.

In addition, 9 percent of people with type 2 diabetes said the condition has rendered them unable to work.

Still, with awareness of genetic factors as well as lifestyle contributors, "you can live a very full and happy life and thrive with diabetes," said Mount Sinai's Tamler.

In people with type 2 diabetes, either the body doesn't produce enough of the hormone insulin or cells can't use the insulin properly. Insulin is necessary for the body to use glucose -- blood sugar -- for energy. When glucose builds up in the blood instead of going into cells, it can lead to diabetes complications, according to the American Diabetes Association.

The prevalence of type 2 diabetes found in this new poll is higher than that reported by the U.S. Centers for Disease Control and Prevention, although the CDC data is more rigorous, Ratner said.

The poll was conducted online within the United States by Harris Interactive from Feb. 4 through 6, among 2,090 adults aged 18 and older. The survey was not based on a probability sample, so no estimate of theoretical sampling error can be calculated.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Humphrey Taylor, chairman, The Harris Poll; Ronald Tamler, M.D., Ph.D., clinical director, Mount Sinai Diabetes Center, New York City; Nancy Copperman, R.D., director, Public Health Initiatives, North Shore-LIJ Health System, Great Neck, N.Y.; Robert Ratner, M.D., chief scientific and medical officer, American Diabetes Association

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1 in 8 Americans Diagnosed With Type 2 Diabetes: Poll

By Amanda Gardner
HealthDay Reporter

WEDNESDAY, Feb. 20 (HealthDay News) -- A staggering one in eight Americans has been diagnosed with type 2 diabetes, a new Harris Interactive/HealthDay poll suggests.

And more than one third of those polled have been diagnosed with diabetes or have a parent, sibling, spouse or child with the condition.

"Type 2 diabetes has become one of the most common and fastest growing diseases. Fully one in eight adults -- approximately 29 million people -- now report that they have been diagnosed with this dangerous condition," said Harris Poll Chairman Humphrey Taylor.

Added Dr. Ronald Tamler, clinical director of the Mount Sinai Diabetes Center in New York City: "Diabetes is very insidious. You don't know you're in trouble until the complications hit or until it's so out of control you have uncontrolled urination and thirst" -- two of the common symptoms of diabetes.

While type 2 diabetes is occurring in epic proportions, the new poll also found that awareness of the disease is still surprisingly low, with only 21 percent of those surveyed considering themselves well-versed on the disease. That means the remaining 79 percent may not know they're at risk or may already have the disease, which is known as the "silent" killer.

But people already diagnosed with diabetes tend to be much more aware of the health risks, with slightly more than two-thirds considering themselves either "extremely" or "very" knowledgeable about the disease, the poll found.

Still, 35 percent of respondents with diabetes said their diabetes was only "somewhat" controlled and 5 percent said it was "not at all" well controlled.

"Because diabetes is a chronic condition, the treatment of which is critically dependent on patient behavior and self-care, this may be the most alarming finding," Taylor said.

On a more encouraging note, many people polled do understand that a number of factors can contribute to type 2 diabetes, including being overweight (79 percent of respondents realize this is a risk factor), diet (74 percent) and physical inactivity (62 percent).

These numbers were greater among people who had been diagnosed with diabetes.

Interestingly, 60 percent of respondents know that genetics can be a component of type 2 diabetes.

"We have a public perception that type 2 diabetes is entirely a disease of lifestyle and that is not true," said Dr. Robert Ratner, chief scientific and medical officer of the American Diabetes Association. "There is no question that lifestyle contributes to it, but the problem is one of biology . . . Environment really does play a role but the biology sets them up."

Indeed, certain ethnic groups, including many Native American tribes, bear a disproportionate diabetes burden, Ratner added.

Most adults, whether they actually have diabetes or not, seem fairly knowledgeable about the long-term consequences of the disease, which can include amputation of limbs, blindness, kidney disease and heart disease, the poll found.

There was an exception. Only 39 percent of adults overall and 56 percent of those with type 2 diabetes knew that the disease can cause strokes.

"People need to be aware that this is another disease caused by diabetes that can be prevented," said Nancy Copperman, director of Public Health Initiatives at North Shore-LIJ Health System in Great Neck, N.Y. "The idea of having a stroke might motivate them to change their lifestyle."

The disease seems to be taking a toll on those polled, with 20 percent acknowledging it has been a "significant" burden and 43 percent saying it has been "somewhat" of a burden for themselves and their families. The burden comes in the form of dietary restrictions, medication costs, eye problems, cardiovascular problems and foot problems.

In addition, 9 percent of people with type 2 diabetes said the condition has rendered them unable to work.

Still, with awareness of genetic factors as well as lifestyle contributors, "you can live a very full and happy life and thrive with diabetes," said Mount Sinai's Tamler.

In people with type 2 diabetes, either the body doesn't produce enough of the hormone insulin or cells can't use the insulin properly. Insulin is necessary for the body to use glucose -- blood sugar -- for energy. When glucose builds up in the blood instead of going into cells, it can lead to diabetes complications, according to the American Diabetes Association.

The prevalence of type 2 diabetes found in this new poll is higher than that reported by the U.S. Centers for Disease Control and Prevention, although the CDC data is more rigorous, Ratner said.

The poll was conducted online within the United States by Harris Interactive from Feb. 4 through 6, among 2,090 adults aged 18 and older. The survey was not based on a probability sample, so no estimate of theoretical sampling error can be calculated.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Humphrey Taylor, chairman, The Harris Poll; Ronald Tamler, M.D., Ph.D., clinical director, Mount Sinai Diabetes Center, New York City; Nancy Copperman, R.D., director, Public Health Initiatives, North Shore-LIJ Health System, Great Neck, N.Y.; Robert Ratner, M.D., chief scientific and medical officer, American Diabetes Association

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Drug, Alcohol Abuse More Likely Among High School Dropouts

TUESDAY, Feb. 19 (HealthDay News) -- The link between poor academic performance and substance abuse just got stronger, with a new U.S. government report showing ties between the two.

High school seniors who dropped out of school before graduating were more likely to drink, smoke cigarettes and use marijuana and other illegal drugs, according to a new report from the U.S. Substance Abuse and Mental Health Services Administration.

The researchers said their findings should prompt communities to develop strategies to keep teens in school and prevent problems with substance abuse.

"The fact that nearly one in seven students drops out of high school has enormous public health implications for our nation," SAMHSA Administrator Pamela Hyde said in an agency news release. "Dropouts are at increased risk of substance abuse, which is particularly troubling given that they are also at greater risk of poverty, not having health insurance, and other health problems. We have to do everything we can to keep youth in school so they can go on to lead healthy, productive lives, free from substance abuse."

The study revealed high school seniors (typically between 16 and 18 years of age) who dropped out of school were more than twice as likely to be smokers, or have smoked in the past month, than students who stayed in school. The study also found that more than 31 percent of seniors who didn't receive their diploma used drugs, compared with about 18 percent of students who had finished high school.

The researchers also noted that about 27 percent of high school dropouts smoked marijuana, while close to one in every 10 abused prescription drugs. Meanwhile, only about 15 percent of those who completed high school used marijuana and just 5 percent abused prescription drugs.

Dropouts were also more likely to drink -- the study showed that nearly 42 percent of seniors who didn't finish high school drank and about a third engaged in binge drinking.

In contrast, about 35 percent of those students who stayed in school drank and only about one-quarter said they binged on alcohol.

-- Mary Elizabeth Dallas
Copyright © 2013 HealthDay. All rights reserved. SOURCE: U.S. Substance Abuse and Mental Health Administration, news release, Feb. 14, 2013

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Fluorescent Tracer 'Lights Up' Brain Tumor for Surgery

By Barbara Bronson Gray
HealthDay Reporter

TUESDAY, Feb. 19 (HealthDay News) -- Neurosurgeons report that they harnessed the power of fluorescent light to illuminate a brain tumor so the entire growth could be removed.

A report describes a case in which a patient with glioblastoma swallowed a pill, called 5-ALA, and was taken to surgery about four hours later. The medication attached itself to tumor cells, causing them to glow brightly. Once the skull was opened, the doctors focused a blue light on the tumor, which gave the cancerous cells a pink glow, so the surgeons could differentiate malignant tissue from healthy tissue.

"This is a very, very good thing," said study author Mitchel Berger, chairman of neurosurgery at the University of California, San Francisco. "In this case, we just happened to notice we could see evidence of the tumor spreading along the way of the ventricles [a communicating network of brain cavities], which showed we could see tumor dissemination."

The authors noted that the best way to extend survival is to remove as much of the brain tumor as possible. The research is published in the Feb. 19 issue of the Journal of Neurosurgery.

It's not always easy to see precisely where a tumor has spread in the brain. Some types of tumors can be particularly difficult to identify and remove, even with the benefit of MRI and surgical microscopes.

The use of fluorescence appears to be more effective than MRI technology, at least in this case, because the glow allows surgeons to see microscopic remnants of the tumor and areas of the cancer that might be mistaken for edema, or swelling, Berger explained. "This is an inexpensive way to identify high-grade tumors," he said.

Glioblastomas are a fast-growing type of tumor that usually occurs in adults and affects the brain more often than the spinal cord, according to the U.S. National Cancer Institute.

Why do tumor cells respond differently to the fluorescent drug than the body's other cells do? Their metabolism involves porphyrin, which has a tremendous ability to absorb light, Berger explained. Porphyrin is an organic compound, like the pigment in red blood cells. The pill used in the case report is derived from porphyrin.

The report focused on the case of a 56-year-old man who had undergone resection of a glioblastoma located in the right occipital lobe of his brain in 2005. Several years later, when symptoms reappeared, an MRI scan showed three distinct, new sites of tumor in the patient's right temporal lobe.

In surgery, when the surgeons viewed the fluorescent tumor cells, they could tell rather than being a new tumor, the cancer had spread from its original location on the right side of the brain through a pathway along the wall of the right ventricle. The researchers found that the use of 5-ALA during surgery enabled them to see the actual pathway of the tumor as it had spread.

The use of 5-ALA changed the patient's prognosis. "Multi-centric disease worsens the prognosis," Berger explained.

While the technique has been used in Europe for several years, the U.S. Food and Drug Administration has not approved the use of 5-ALA in the United States. Any surgeons using 5-ALA do so with limited permission from the FDA, Berger noted. The medication, 5-ALA, is manufactured by DUSA Pharmaceuticals.

Dr. Michael Schulder, vice chairman of the department of neurosurgery at North Shore University Hospital in Manhasset, N.Y., explained that "while the FDA considers 5-ALA a drug, which would require a lengthy process for approval, neurosurgeons see it as a surgical aid, which would take far less time to get the OK."

While Schulder said he thinks 5-ALA probably will add about six months to the anticipated survival of patients with high-grade gliomas, he said that attempts to improve the ability to remove these tumors will only go so far. "In the end, however helpful the use of 5-ALA or similar compounds may be in the surgical removal of brain cancers, it won't be the answer. The treatments will have to be biological to truly have an impact on survival, and ultimately, on a cure."

Schulder said he thinks it would be possible for fluorescence to be used in other types of surgeries, if surgeons could become comfortable using a surgical microscope with the benefit of a special light (something neurosurgeons are accustomed to using). He noted that he also thinks the technique might apply to some spinal surgeries, where visualizing the spinal cord is critical.

Schulder said he thinks the use of fluorescence in cancer surgery is promising. "It's a very important concept: if you can see a tumor better, you can remove it without affecting healthy tissue."

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Mitchel Berger, M.D., professor and chairman, neurosurgery, department of neurological surgery, University of California, San Francisco; Michael Schulder, M.D., vice chairman, department of neurosurgery, North Shore University Hospital, Manhasset, N.Y.; Feb. 19, 2013, Journal of Neurosurgery

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Human Teeth Healthier in the Stone Age Than Today: Study

TUESDAY, Feb. 19 (HealthDay News) -- Something to think about next time you're in the dentist's chair: Ancient humans had healthier teeth than people do today, researchers say.

This decline in oral health over the past 7,500 years is the result of changes in oral bacteria due to human evolution and industrialization, the study authors said. These changes have led to chronic oral and other health problems, according to the report published Feb. 18 in Nature Genetics.

"The composition of oral bacteria changed markedly with the introduction of farming, and again around 150 years ago," explained study leader Alan Cooper, a professor and director of the University of Adelaide's Australian Centre for Ancient DNA, in a center news release. "With the introduction of processed sugar and flour in the Industrial Revolution, we can see a dramatically decreased diversity in our oral bacteria, allowing domination by caries [cavities]-causing strains. The modern mouth basically exists in a permanent disease state."

The international team of researchers examined DNA that had been preserved in tartar -- calcified dental plaque -- found on 34 prehistoric northern European human skeletons. They used these samples to analyze how oral bacteria changed from the Stone Age to the last hunter-gatherers, medieval times and later with the introduction of food manufacturing in the Industrial Revolution.

The evolution of human behavior and diet have had a negative impact on oral health, the investigators said.

"This is the first record of how our evolution over the last 7,500 years has impacted the bacteria we carry with us, and the important health consequences," Cooper said. "Oral bacteria in modern man are markedly less diverse than historic populations and this is thought to contribute to chronic oral and other disease in post-industrial lifestyles," he pointed out.

Study lead author Christina Adler, now at the University of Sydney, added that "dental plaque represents the only easily accessible source of preserved human bacteria." And, she said in the news release, "Genetic analysis of plaque can create a powerful new record of dietary impacts, health changes and oral pathogen genomic evolution, deep into the past."

The researchers said their research is being expanded to include other periods in time, other areas of the world and other species, such as Neanderthals.

-- Mary Elizabeth Dallas
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Australian Centre for Ancient DNA, news release, Feb. 18, 2013

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