In an effort to accelerate the control of malaria and help eliminate it worldwide, the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, has announced approximately $14 million in first-year funding to establish 10 new malaria research centers around the world.

The seven-year awards will establish the International Centers of Excellence for Malaria Research (ICEMRs) in regions where malaria is endemic, including parts of Africa, Asia, the Pacific Islands and Latin America. These regions include some of the focus countries of the President’s Malaria Initiative, an effort that since 2005 has worked to fight malaria in the regions most affected by the disease. Infection by malaria-causing parasites results in approximately 240 million cases around the globe annually, and causes more than 850,000 deaths each year. Teams of scientists involved in the ICEMR program will be conducting research in more than 20 countries.

“One of our primary goals with these centers is to fund cutting-edge research in malaria-endemic areas that will keep up with the rapidly changing epidemiology of the disease,” says NIAID Director Anthony S. Fauci, M.D.

Malaria has been eliminated from many parts of the globe, but 40 percent of the world’s population still live in areas where they are at risk for contracting the disease. According to Lee Hall, M.D., Ph.D., chief of the Parasitology and International Programs Branch in NIAID, sustainable and effective malaria control requires research in multiple settings on the complex interactions among the parasite, the mosquito vector, the local ecology and the human host.

“The ICEMR program seeks to address this need by creating a network of multidisciplinary research centers in malaria-endemic settings,” Dr. Hall says. “The centers aim to generate critical knowledge, tools and evidence-based strategies to support intervention and control programs by government organizations and health care institutions.”

The centers will integrate clinical and field approaches with laboratory-based immunologic, molecular and genomic methods. They will adapt their research to changes in malaria epidemiology and emerging research needs as well as opportunities within the specific regions. Their findings are expected to help inform how new interventions and control strategies are designed and evaluated in the future.

Each center will
Design and conduct multidisciplinary research on the epidemiology, transmission and pathogenesis of malaria in endemic geographic regions
Design and conduct special projects to capitalize on new opportunities and emerging public health needs
Develop and conduct training and career development programs for researchers from malaria-endemic areas

Overall, these centers are expected to bring critical infrastructure to these endemic regions and help build training and research capacity to combat malaria worldwide.

The principal investigators selected to establish the ICEMRs are as follows:
Malaria Transmission and the Impact of Control Efforts in Southern Africa
Principal Investigator: Peter Agre, M.D.
Lead Institution: Johns Hopkins University, Baltimore
Center for the Study of Complex Malaria in India
Principal Investigator: Jane Carlton, Ph. D.
Lead Institution: New York University School of Medicine, New York City
Southeast Asia Malaria Research Center
Principal Investigator: Liwang Cui, Ph.D.
Lead Institution: Pennsylvania State University, University Park
Program for Resistance, Immunology, Surveillance & Modeling of Malaria in Uganda
Principal Investigator: Matthew Dorsey, M.D.
Lead Institution: University of California, San Francisco
Latin American Center for Malaria Research and Control
Principal Investigator: Socrates Herrera-Valencia, M.D.
Lead Institution: Caucaseo Scientific Research Center, Cali, Colombia
Research to Control and Eliminate Malaria in SE Asia and SW Pacific
Principal Investigator: James Kazura, M.D.
Lead Institution: Case Western Reserve University, Cleveland
Population-based Approach to Malaria Research and Control in West Africa
Principal Investigator: Donald Krogstad, M.D.
Lead Institution: Tulane University, New Orleans
Malaria Evolution in South Asia
Principal Investigator: Pradipsinh Rathod, Ph. D.
Lead Institution: University of Washington, Seattle
Determinants of Malaria Disease in Malawi
Principal Investigator: Terrie Taylor, D.O.
Lead Institution: Michigan State University, East Lansing
Peruvian/Brazilian Amazon Center of Excellence in Malaria
Principal Investigator: Joseph Vinetz, M.D.
Lead Institution: University of California, San Diego

Source:
Nalini Padmanabhan
NIH/National Institute of Allergy and Infectious Diseases

Imagine trying to hold your breath for 30 seconds at a time, every other minute, for the next 8 hours. That’s exactly what happens during the night to some people who have sleep apnea. It’s a condition that’s costing some 12-million Americans* a good night’s sleep, and sleep apnea might do more than that. Some doctors say sleep apnea can play a role in everything from high blood pressure to heart problems. Now, there may be a link to diabetes.

Most of us put on something comfortable before we go to bed. Lou Flocken puts on an air flow mask. Lou has sleep apnea, and because he stops breathing several times an hour during the night, his doctor insists that he wear the mask to keep his airways open.

“They said I had 35 interruptions of my sleep per hour. So, that meant that I was never getting fully asleep as you need to, you know, you need to get into that deep sleep,” says Flocken.

Not getting that deep sleep may have landed Lou in deep trouble. Six months after he was diagnosed with sleep apnea, Lou wound up in the emergency room with heart problems.

It’s a connection that wouldn’t surprise Dr. Ulysses Magalang, a sleep expert with Ohio State University Medical Center. He says depriving your body of oxygen that often takes its toll. Those with sleep apnea may have a higher risk of stroke or heart disease. Now, doctors are looking for a possible link to diabetes.

“We do not know whether sleep apnea actually causes diabetes. What we do know is that patients with sleep apnea have an increased insulin resistance, which is a hallmark of patients with diabetes,” says Magalang.

Dr. Magalang says obesity is a common risk factor for both diabetes and sleep apnea, and fat cells seem to function similarly in both. Studies have shown that wearing airflow masks at night can prevent problems with those fat cells. The problem is, getting patients to wear them.

“At best, about 6 out of 10 people will be compliant with this machine long term. Therefore, we need new treatment options,” says Magalang.

Doctors are just now looking into any possible link between diabetes and sleep apnea. They won’t know for some time if there is one. Other than wearing a mask to treat sleep apnea, some patients undergo surgery to reshape the soft tissue in the back of their throat so they can breathe easier at night.

*Sleep Apnea, American Academy of Family Physicians, retrieved March 2008 from familydoctor

Ohio State University

A new Mayo
Clinic study found that regular physical exercise may help protect against
mild cognitive impairment, a disorder of the brain that affects nerve cells
involved in thinking abilities. This study will be presented at the
American Academy of Neurology Annual Meeting in Chicago on April 16.

Individuals with mild cognitive impairment can function reasonably well
in everyday activities, but often have difficulty remembering details of
conversations, events and upcoming appointments. Most (but not all)
patients with mild cognitive impairment develop a progressive decline in
their thinking abilities over time. Alzheimer’s disease is usually the
underlying cause.

“While the benefits of exercise are well documented for improving
overall health, this is one of the first studies to specifically look at
whether it can help protect against the development of mild cognitive
impairment,” says Yonas Endale Geda, M.D., a Mayo Clinic neuropsychiatrist
and the study’s lead investigator.

As part of the ongoing Mayo Clinic Study of Aging, Dr. Geda and a team
of Mayo Clinic researchers randomly identified 868 individuals 70 to 89
years old. Of those, 128 had mild cognitive impairment and 740 were
cognitively normal. The team conducted surveys to gather data on the
individuals’ physical exercise between the ages of 50 and 65 and one year
prior to the survey. They found that moderate physical exercise two to five
times per week during the ages of 50 to 65 was associated with a reduced
risk of mild cognitive impairment. However, the individual’s exercise
habits one year prior to the survey did not appear to be associated with a
reduced risk.

According to Dr. Geda, these findings need to be replicated in a
prospective cohort study. Additionally, the study did not address how
physical exercise could protect against mild cognitive impairment.

“Regarding the mechanism of action of physical exercise and mild
cognitive impairment, we speculate that either exercise induces chemicals
that protect brain cells, or exercise is simply a marker for an overall
healthy lifestyle, or there is some positive interaction among exercise,
healthy lifestyle and intellectually stimulating activity,” says Dr. Geda.

Dr. Geda and his team will continue to follow the study participants to
examine if the case-control study finding will also hold true in further
studies. Other members of the Mayo Clinic research team included Rosebud
Roberts, M.B.Ch.B., David Knopman, M.D., Teresa Christianson, V. Shane
Pankratz, Ph.D., Bradley Boeve, M.D., Eric Tangalos, M.D., Robert Ivnik,
Ph.D., Walter Rocca, M.D., and Ronald Petersen, M.D., Ph.D.

To obtain the latest news releases from Mayo Clinic, go to
mayoclinic/news. MayoClinic (mayoclinic)
is available as a resource for your health stories.

Mayo Clinic
mayoclinic

The globalization of health care and the growth of “transplant tourism” (traveling abroad to purchase donor organs and undergo organ transplantation) have outpaced the implementation of internationally accepted ethical standards for procurement of organs for transplantation. A new article appearing in Clinical Transplantation finds that both U.S. and foreign transplant physicians expressed serious concern about organ procurement practices in China, and that this concern influenced their patient care decisions. The study is the first to assess how the perceptions of healthcare providers on transplant tourism may influence domestic patient care decisions.

Globalization of medical and surgical technology has increased the capacity for countries worldwide to perform organ transplantation. Unfortunately, dramatic geographic variation in the availability of organs for transplantation and a parallel discrepancy in financial resources for healthcare have increasingly led desperate patients to transplant tourism. Organ procurement in China has been especially criticized for its reliance on executed prisoners as donors.

An anonymous case-based questionnaire was used to survey a sample of healthcare professionals with affiliations to hepatology and transplantation professional societies. A strong majority believed procurement practices were ethically sound in the U.S. and Europe, but only 4 percent believed that procurement practices were ethically sound in China.

The majority of doctors surveyed said that they would provide post-transplantation care for patients who underwent liver transplantation at another domestic center, in a foreign country or in China. However, respondents who suspected unethical procurement practices in China were more reluctant to do so.

The practice of transplant tourism has been decried by numerous national and international healthcare organizations. These organizations cite serious concerns about clandestine international brokers, surreptitious payment, coercion of organ donors (and/ or donor families) and substandard medical and surgical practices that may lead to lower success rates and higher risk for transmission of infectious disease.

International ethical guidelines exist to ensure that the donation of organs is voluntary, both in life and after death. Not all countries adhere to these ethical guidelines. When traveling from one country to another country for organ transplant surgery, patients risk using an organ obtained in an unsafe or unethical manner.

In 2005, the World Health Organization (WHO) reported the transplantation of 66,000 kidneys, 21,000 livers and 6,000 hearts. Approximately 10 percent of these procedures occurred via transplant tourism. Leading destination countries for transplant tourism include China, India, the Philippines and Pakistan. The number of organ transplant procedures in China is surpassed only by the U.S. According to the WHO, in 2005 China had 348 transplant centers, which performed 8,204 kidney and 3,493 liver transplantations.

Transplant tourism to China has been isolated as particularly controversial. Organ procurement from executed prisoners in China has been reported by the U.S. Department of State, non-governmental investigative reports and in medical literature. These reports indicate that over 95 percent of organ donors in China are prisoners. China’s use of prisoners, particularly those slated for execution, represents the use of a vulnerable population that is particularly susceptible to coercion. For this reason, both live and deceased donor organ procurement from prisoners violates U.S. professional guidelines and international standards ratified by the World Medical Association Statement on Human Organ Donation and Transplantation.

“Physicians caring for patients in need of organ transplantation must balance the duty to the individual patient vs. the duty to society,” says Dr. Scott Biggins of the University of California San Francisco, lead author of the study. Acting as patient advocates, most transplant professionals were not opposed to patients seeking transplantation at alternative centers to shorten waiting times. Yet, respondents who suspected unethical organ procurement practices in China would discourage patients from transplant tourism to China.

“We aim to raise awareness of the need for adherence to international accepted ethical standards for procurement of organs and regulation of transplant tourism by international regulatory and credentialing bodies,” says Biggins.

This study is published in Clinical Transplantation.

To view the abstract for this article, please click here.

Scott Biggins, M.D., MAS, is Transplant Hepatologist at the University of California, San Francisco.

Source:
Sean Wagner

Wiley-Blackwell

Celecoxib may emerge as a potent chemopreventive agent for lung cancer, according to a recent study in Cancer Prevention Research, a journal of the American Association for Cancer Research.

Researchers tested celecoxib, a COX-2 inhibitor, among patients who were former smokers and found a significant benefit in bronchial health as measured by the Ki-67 labeling index, a marker of cellular proliferation or growth, as well as a number of other biomarkers. The findings follow a previous report published in Cancer Prevention Research that showed a similar effect on Ki-67 among former smokers and current smokers (Kim et al., Feb. 2010).

“Taken together, these findings strongly suggest that celecoxib can be used as a chemopreventive agent in these high-risk groups,” said Jenny Mao, M.D., a professor of medicine at the University of New Mexico and section chief of pulmonary and critical care medicine at the New Mexico VA Health System.

Mao cautioned, however, that both the current study, where she was the lead researcher, and the Feb. 2010 study were phase II trials, and that large phase III trials are still needed to confirm the findings.

J. Jack Lee, Ph.D., a professor of biostatistics at The University of Texas M. D. Anderson Cancer Center and the statistical editor of Cancer Prevention Research, estimates that there are currently 45 million former smokers and 45 million current smokers in the United States alone.

“The oncology community does not have a good treatment for lung cancer. Unless it is caught in the earliest stages, the five-year survival is only about 15 percent,” said Lee. “The best way is to intercept at the earliest stages and try to reverse the processes that can lead to cancer. These studies suggest celecoxib may be a tool to do that.”

For the current study, Mao and colleagues enrolled 137 patients and randomly assigned them to 400 mg celecoxib twice daily or a placebo. Patients had to be at least 45 years old, and had to have stopped smoking for at least a year.

Researchers conducted bronchoscopies at baseline and six months to measure changes in the Ki-67 labeling index. Treatment with celecoxib reduced this index by 34 percent compared to a 3.8 percent increase with the placebo group. Decreases in this index were also linked with a reduction in lung nodules, a potential precursor to cancer.

Source:
Jeremy Moore

American Association for Cancer Research

Scripps Research Institute scientists have shown for the first time that the neurotransmitter serotonin uses a specialized signaling pathway to mediate biological functions that are distinct from the signaling pathways used by hallucinogenic substances. The new findings could have a profound effect on the development of new therapies for a number of disorders, including schizophrenia and depression.

The study was published in the October 6, 2010 issue of the Journal of Neuroscience.

Serotonin has tremendous influence over several brain functions, including the control of perception, cognition, sleep, appetite, pain, and mood and mediates these effects through interactions with receptors located throughout the central and peripheral nervous systems.

“Our study shows that while both serotonin and hallucinogens act at the serotonin 2A receptor, serotonin utilizes a very specific pathway and its actions are independent of those produced by hallucinogens,” said Laura Bohn, an associate professor on the Florida campus of The Scripps Research Institute. “Future drug discovery efforts to identify lead compounds for treatment of depression may consider focusing upon those that only engage that pathway. This work may also lend insight into the mechanisms that underlie the hallucinations that occur in schizophrenia.”

This may be particularly important, Bohn said, for the treatment of depression because traditional therapies, which focus on elevating serotonin levels, can sometimes produce serious side effects such as a serotonin syndrome. This syndrome is often accompanied by hallucinations, and is especially serious when antidepressant treatments such as selective serotonin reuptake inhibitors (SSRIs) are mixed with monoamine oxidase inhibitors (MAOIs).

The scientists’ current study supports a long-standing hypothesis that hallucinations may arise from the metabolites formed from elevated serotonin levels. Since there is a difference in the way the two neurotransmitters signal, this may represent a means to preserve the effects of serotonin while preventing the adverse side effects caused by the metabolites.

Serotonin Versus Hallucinogens

The study, coauthored by Cullen Schmid, a graduate student in the lab, showed that serotonin signals through the serotonin 2A receptor by recruiting a regulatory protein called пЃўarrestin2, and that the actions of serotonin at the receptor are far different than those produced by hallucinogenic N-methyltryptamines, a class of naturally occurring substances found in several plants and in minute amounts in the human body and which includes the abused drug, DMT. The study found that the N-methyltryptamines activate the serotonin 2A receptor independently of arrestin2.

Both serotonin and the N-methyltryptamines produce what is known as a head twitch response in animal models, which indicates that the serotonin 2A receptor has been activated. Any interruption in the exclusive serotonin pathway prevents that behavioral response to serotonin, but has no effect on N-methyltryptamine-induced head twitches, indicating a distinct divergence in the signaling pathways utilized by these two neurotransmitters.

“Despite the fact that they activate the same receptor, serotonin leads to the assembly of a number of proteins associated with the receptor that the metabolites of serotonin do not produce,” Bohn said. “But whether the lack of this complex formation is why compounds like DMT lead to hallucinations is not clear.”

Bohn continues to investigate these and other questions.

In addition to Bohn, the study, “Serotonin, But Not N-Methyltryptamines, Activates the Serotonin 2A Receptor via an Arrestin2/Src/Akt Signaling Complex in Vivo,” was authored by Cullen L. Schmid of The Ohio State University Neuroscience Graduate Studies Program and Scripps Research.

The work was supported by the National Institute on Drug Abuse of the National Institutes of Health.

Source:
Mika Ono
Scripps Research Institute

According to the World Health Organization (WHO), 2,371 humans have been officially infected with the influenza A (H1N1) virus – the so-called swine flu virus – with 42 deaths in Mexico and 2 deaths in the United States. Below is a list of countries, with confirmed human case totals, and deaths.

Mexico – 1,112 confirmed cases, 42 deaths
USA – 896 confirmed cases, 2 deaths
Canada – 201
Spain – 81
United Kingdom – 32
Germany – 10
France – 5
Italy – 5
New Zealand – 5
South Korea – 3
El Salvador – 2
Netherlands – 2
Austria – 1
China/Hong Kong – 1
Colombia – 1
Costa Rica – 1
Denmark – 1
Guatemala – 1
Ireland – 1
Israel – 1
Poland – 1
Portugal – 1
Sweden – 1
Switzerland – 1

WHO says travel restrictions related to the current outbreak of swine flu are not recommended. If you are ill you should delay your trip, while returning travelers who become ill should seek medical care. These prudent measures will help limit the spread of influenza, as well as many other communicable diseases.
Can I eat pork meat and pork products?
If the pork meat and pork food products have been handled properly transmission of swine influenza to humans is not possible. Cooking pork meats to a temperature of 70C (160F) kills the virus. So the answer is YES, pork meat and pork food products are safe to eat.

See our Map Of H1N1 Outbreaks
See our Mexico Swine Flu Blog

The “blessings of greater longevity are bringing profound new social challenges” for U.S. residents, such as issues related to long-term care, Leon Kass, chair of the President’s Council on Bioethics and a fellow at the American Enterprise Institute, writes in a Washington Post opinion piece. The number of individuals with Alzheimer’s disease likely will triple by 2050, a problem compounded by a “shortage of caregivers” and a “cultural refusal to honor the need for care,” Kass writes. U.S. residents prefer “to place our hopes programs that promote healthier aging and in scientific research seeking remedies for incapacitating diseases,” rather than offer “communal support to the millions of Americans … who give demanding daily care to aged parents or spouses,” he writes. According to Kass, efforts to address “the crisis in long-term care will be difficult and costly,” and the “roles the federal and state governments should play” remain undetermined. He adds that the U.S. “should certainly examine how current government policies — such as Medicare reimbursement schemes — fail to support the most needed kinds of care” (Kass, Washington Post, 9/29).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

It’s common knowledge that smoking raises risks of lung cancer. And yet researchers haven’t known whether continued smoking by lung cancer patients would increase the risk of the cancer’s spread.

Researchers at West Virginia University studying the relationship between death rates from lung cancer and how much a person smoked have found that smoking intensity in fact predicts how the disease will progress.

Patients who smoked two packs a day had a 58 percent higher risk of their lung cancers returning or spreading compared with nonsmoking patients.

Smoking intensity is one of only two factors found to predict lung-cancer mortality, according to the study published in the May issue of the journal Lung Cancer. The other factor is the stage of the cancer when diagnosed. Almost 350 patients with non-small cell lung cancer were studied.

Males older than age 60 were found to be the heaviest smokers at the time of diagnosis. Patients who smoked more than 61 packs a year had the greatest risk of their cancers recurring, and their survival times were shortest. They were 41 percent more likely to die from lung cancer than patients who smoked less.

“This study is important because lung cancer causes more deaths than any other type of cancer,” said lead investigator Nancy L. Guo, Ph.D., a researcher with the Mary Babb Randolph Cancer Center.

“Because five-year survival rates of patients with non-small cell lung cancer are only about 15 percent, it’s useful to know which patients are most likely to have their tumors come back,” she said. “Our study showed that those who smoked more than 61 packs a year are more likely to develop tumor recurrence and should be considered for more aggressive therapy.”

Chemotherapy drugs could be offered to prevent recurrence and spread of tumors, the authors said. And the heaviest smokers might also be targeted for measures to help them quit smoking.

Patients older than age 60 smoked, on average, 164 packs a year. Males smoked 189 packs a year compared with females’ average of 112.

Patients with stage 3 tumors smoked an average of 198 packs a year.

The study is titled “Impact and interactions between smoking and traditional prognostic factors in lung cancer progression.”

In addition to the Mary Babb Randolph Cancer Center, the study also involved researchers from the WVU Department of Community Medicine.

Source: West Virginia University Health Sciences Center

According to preliminary research results from the Department of Veterans Affairs, approximately 15 percent of recently returned female veterans utilizing the VA health care system report experiencing sexual trauma during military service.

The cross-sectional study, presented at the American Public Health Association’s 136th Annual Meeting & Exposition in San Diego, examined health care screening data of over 100,000 veterans of Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) who utilized medical care at any Veterans Health Administration facility during a six-year period.

Along with the more than one in seven women, 0.7 percent of males also reported having experienced military sexual trauma (MST). Both males and females reporting MST were more likely to be diagnosed with a mental health condition than patients who did not report MST.

“These data highlight the importance of the VA’s universal screening policy,” said Joanne Pavao, MPH, a Department of Veterans Affairs researcher on the study, “as well as early intervention among veterans who have experienced sexual trauma, to prevent long-term consequences.” VHA policy requires that all male and female veterans are screened for experiences of military sexual trauma and that free treatment for MST-related conditions is provided at all VA health care facilities.

Session 4365.0 – Burden of mental illness associated with military sexual trauma among veterans deployed to Iraq and Afghanistan

Date: Tuesday, October 28, 2008 – 4:45 PM

Researchers: Rachel Kimerling, PhD; Amy E. Street, PhD; Joanne Pavao, MPH; Kristian Gima, BA; Mark W. Smith, PhD; Ruth Cronkite, PhD and Susan M. Frayne, MD, MPH

Source
Mr. David Fouse
Communications Director

American Public Health Association