Scientists locate the protein that will extend your life and figure out how to make it last longer


Lengthening Telomere, a DNA protein, may be a key to extending life to much older than 100 years.

Telomeres are DNA-protein complexes that protect the end of human chromosomes from DNA damage or fusion with neighboring chromosomes.  Nutritionists have long been interested in the dynamics of telomere length in the human body, and how telomeres factor into human health, lengthening life expectancy, and even have pondered the possibility of Immortality.   Research is showing that certain nutrients play a huge part in protecting telomere length, ultimately determining how long you live.

“The best analogy that we have for telomeres is that they’re like the little tabs on the end of shoelaces,” says Dr Adam Rutherford, a geneticist and author of Creation: The Origin of Life.

Just as the tabs, or “aglets”, hold the strands of the laces together, he says, telomeres – repetitive stretches of DNA on the end of each chromosome – perform the same function.

“Chromosomes are made up of a double helix, two strands of DNA, and they need an endpoint,” says Rutherford. “Without telomeres they’d unravel, like two bits of string that have been tied together.”

Studies have shown that certain Vitamins contribute to the length of a Telomere.  Scientists at the European Journal of Nutrition (EJON) found that the B vitamin folate also plays an important part in maintenance of DNA integrity and DNA methylation, which in turn influence telomere length. Researchers have found that women who use vitamin B12 supplements have longer telomeres than those who don’t. Vitamin D3, zinc, iron, omega-3 fatty acids, and vitamins C and E also influence telomere length.

Watch the video discussion. URL:https://youtu.be/DV3XjqW_xgU

Source:www.minds.com

What You Need to Know About Human Organ Trafficking


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There’s that urban legend. You go to dinner with a good looking stranger, go back to their hotel room or yours, have a drink, and pass out. The next thing you know, you are in the bathtub, naked, covered in ice, with a poorly stitched side, and a phone nearby with a note attached. The note warns you to seek emergency medical care right away. According to medical anthropologist Nancy Scherper-Hughes, the truth is different, but is just as sinister and macabre, and tells us something about the state of global affairs today.

Nancy Scherper-Hughes has been working on the problem of human organ and tissue trafficking for a full decade. Yes, it is real, and it’s probably happening at a hospital near you. Encapsulated within is a travesty of justice, an argument over global equality, and the dark, secretive underbelly of medical science, which few of us have dared to peak at. Today, Scherper-Hughes is the director of Organ’s Watch, a nonprofit that keeps track of global organ trafficking. She is also the chair of Berkeley’s doctoral program in medical anthropology.

The truth is, organ trafficking is a reality in many parts of the world. Documented cases have shown up in Indonesia, China, India, South Africa, Brazil, and many other countries. The reason?The demand for organs is just so high. 123,000 men, women, and children are on the organ donor’s list right now. An average of 25 will die each day. As a result, there is a huge scramble to find organs, legitimate or otherwise.

11,000 organs were obtained on the black market in 2010, according to the WHO. That organization states that an organ is sold every hour, each day, every day of the year. Scheper-Hughes calls the demand for organs and tissues “insatiable.” According to her, it’s easier to trade in human body parts once they have been dehumanized through the processes of organ and tissue harvesting.

This high demand has set up a depressing yet all too familiar dynamic: organs going from poor to rich in the United States, and global South to global North. The poorest slums of the world supply kidneys, for instance, to donors in the U.S., Europe, Israel, and Canada. The UN is even looking into reports that ISIS, the wealthiest terrorist group ever, may be in the business of selling its victim’s organs. UN special envoy Nickolay Mladenov said that the matter is being investigated. Meanwhile, Scherper-Hughes says organ trafficking in wartime, particularly in dirty wars or those with undisciplined armies, is not uncommon.

Her life reads like that of a secret agent’s. The anthropologist has posed as a medical doctor in countries all over the world in order to investigate organ trafficking. She says, some of the U.S.’s topmost medical facilities have been caught with illegally trafficked organs. Scherper-Hughes has tracked organs to hospitals and medical centers in New York, Los Angeles, and Philadelphia, among other places. At one point, she found herself across the table from a group of organ transplant surgeons at a top Philadelphia hospital. The 60 year-old showed these physicians a sixty page report of interviews from a labyrinthine trail of buyers, sellers, and middle men, stretching across the world, showing just where the kidneys these doctors were implanting came from. The WHO estimates that one-fifth of all transplanted kidneys, or 70,000 of them, are trafficked each year.

Organized crime syndicates work behind the scenes. Their methods are varied. Sometimes they trick the person into giving up the organ. For instance, there are cases where the so-called patient is treated for a sickness they don’t have, and the traffickers make off with the organ. Or they force the person into giving it. But oftentimes, it is a cash payout that draws people out. There are cases where the person decides to sell their organ, say a kidney or a section of liver, but gets cheated, ending up with a much lower amount than what they were promised beforehand.

From there, the kidney, or whatever it is, goes to organ brokers, who can get $150,000 per transplant or more. $200,000 is not uncommon. Meanwhile, the donor usually only gets around $5,000. These brokers cross international lines to find “broker-friendly” hospitals in the U.S. and other developed nations. Two surgeons in the room with Scherper-Hughes in Philadelphia were implicated. The meeting ended poorly. The medical anthropologist was tossed out. The follow-up internal investigation turned up nothing. Scherper-Hughes believes many doctors are either involved, ignore where the organ came from, don’t ask questions, or are in denial. Let’s look at a few documented cases of organ trafficking.

In China in 2006, a state run hospital was exposed for trafficking the organs of prisoners of conscience. 10,000 transplantable organs are sold out of China each year, a market worth $1 billion, despite the fact that few donors are on official lists. This has become the subject of a documentary: “Human Harvest: China’s Organ Trafficking.” International investigators cite evidence that tens of thousands have been killed in China to support illegal organ trafficking by the government.

Al Jazeera, in February of this year, helped break up a three person trafficking ring in Indonesia. Here villagers in West Java, around 30 individuals, had sold their kidneys to the tune of $5,000 apiece. Other stories include a child in China who had his eyes cut out, possibly for the corneas, an African girl who was kidnapped and rescued in the UK before her organs could be harvested, and in America, the dizzying case of Kendrick Johnson. His death was deemed a freak accident in the school gym — they said the boy suffocated in a rolled up gym mat. Loved ones remained skeptical, however. After a protracted fight, his parents finally got a court order. They had the body exhumed and independently autopsied. During the autopsy, the medical examiner discovered something terrifying. The Georgia teen was found to have had all his organs removed and replaced with newspaper.

Though organ donation is regulated in the U.S., there are ways to beat the system. Corruptible funeral home directors forge death certificates and consent forms before the human remains are disposed of. In the developing world, people are kidnapped and used for their organs. Children sold into sexual slavery sometimes have their organs sold. And there are those in slums who give up their tissues, a piece of their liver, or their kidney, just to get their hands on a few hundred American dollars.

Scheper-Hughes has seen advertisements requesting organs in newspapers in Brazil, Moldova, and parts of Africa. She has also witnessed middlemen trawling the streets for donors in some countries holding wads of $100 bills. In China, one ad stated a kidney would get you $4,000 and a new iPad. Organ transplant tourism is a growing field, and here black market organs are often supplied.

The UN HUB or Global Initiative to Fight Human Trafficking, has listed the organ trade as one of their top priorities. Someday 3D printed organs using stem cells will make donation obsolete. But human organ trafficking will continue to be a serious, global problem as long as global inequality remains unchanged, desperate people of affluence and those just as desperate financially tight — tight regulations or not — believe there are huge profits to be had. The urban legend is scary, if not a bit melodramatic. The reality, however, as it often is, is in some sense even more horrifying.

Source:http://bigthink.com

Nationwide study reveals just how broken the US mental health system is.


More than 8 million Americans now suffer from psychological distress.

A nationwide study has found that more Americans than ever before now report suffering from serious mental health problems – but the country’s healthcare system is struggling to meet the demand.

The survey spanned eight years and involved more than 200,000 people living in the US aged between 18 and 64. It concluded that 3.4 percent of the population now suffer from what researchers call ‘severe psychological distress’ (SPD) – mental health issues so serious that they affect someone’s physical wellbeing.

 Extrapolated, that suggests more than 8.3 million adult Americans suffer from mental health issues, far higher than researchers had previously assumed.

And yet the study also found that access to mental health care services actually deteriorated between 2006 and 2014 for people suffering from SPD, when compared to those who didn’t report mental distress. In other words, the gap is getting bigger.

“Although our analysis does not give concrete reasons why mental health services are diminishing, it could be from shortages in professional help, increased costs of care not covered by insurance, the great recession, and other reasons worthy of further investigation,” said lead researcher Judith Weissmanfrom NYU Langone Medical Center.

To get this insight, the researchers looked at data from the 2006 to 2014 US CDC’s (Centres of Disease Control and Prevention) annual National Health Interview Survey, which has been conducted for more than 60 years in about 35,000 US households around the country.

Participants are asked how often over the past month they felt certain feelings, such as being so sad that nothing could cheer them up, or that everything they did was worthless.

Together, the frequency of these symptoms allows researchers to get an idea about whether someone is suffering from SPD or not.

 While SPD itself isn’t a formal diagnosis, previous research has linked a high SPD score with mental health issues such as depression and anxiety, as well as chronic diseaselower socio-economic status, and a reduced lifespan.

“Based on our data, we estimate that millions of Americans have a level of emotional functioning that leads to lower quality of life and life expectancy,” said Weissman.

“Our study may also help explain why the US suicide rate is up to 43,000 people each year.”

For perspective, that’s the highest it’s been in the US in 30 years.

In total, around 3.4 percent of the population showed signs of suffering from SPD – previous estimates had put that number at less than 3 percent.

But despite the increase in people needing support, people with SPD specifically are also finding it harder to get support than before.

Interestingly, the report suggests that the mental health care situation has gotten worse despite the introduction of the 2008 Mental Health Parity and Addiction Equity Act and the 2010 Affordable Care Act (ACA). Both included provisions that were meant to make it easier for people without insurance to access mental health support.

The team found that, in 2014, 9.5 percent of Americans who reported SPD still didn’t have health insurance that would give them access to a psychiatrist or counsellor – a slight increase from 9 percent in 2006.

About 10.5 percent of people who reported SPD in 2014 experienced delays in getting professional help due to insufficient mental health coverage, while only 9.5 percent of people said they experienced such delays in 2006.

And, in 2014, 9.9 percent of people with SPD couldn’t afford to pay for their psychiatric medications, up from 8.7 percent in 2006.

There are some limitations to this research – primarily the fact that the classification of SPD was based on self-reported symptoms, rather than being objectively determined by a healthcare professional.

The team was also specifically looking at the access people with SPD had had to health care, but didn’t investigate whether there were other patterns in demographics that would make it harder for them to get help.

While the results of this latest study paint a pretty grim picture about US health care, the team is now looking at ways the system could be improved, and suggest that getting primary care physicians more involved in mental health support could help.

“Our study supports health policies designed to incorporate mental health services and screenings into every physician’s practice through the use of electronic medical records, and by providing training for all health care professionals, as well as the right resources for patients,” said one of the researchers, Cheryl Pegus.

Source: Psychiatric Services.

Tracheal Intubation During Adult In-Hospital Cardiac Arrest and Survival.


Key Points

Question  Is tracheal intubation during adult in-hospital cardiac arrest associated with survival?

Findings  In a study of 86 628 adults with in-hospital cardiac arrest using a propensity-matched cohort, tracheal intubation within the first 15 minutes was associated with a significantly lower likelihood of survival to hospital discharge compared with not being intubated (16.3% vs 19.4%, respectively).

Meaning  These findings do not support early tracheal intubation for adult in-hospital cardiac arrest.

Abstract

Importance  Tracheal intubation is common during adult in-hospital cardiac arrest, but little is known about the association between tracheal intubation and survival in this setting.

Objective  To determine whether tracheal intubation during adult in-hospital cardiac arrest is associated with survival to hospital discharge.

Design, Setting, and Participants  Observational cohort study of adult patients who had an in-hospital cardiac arrest from January 2000 through December 2014 included in the Get With The Guidelines–Resuscitation registry, a US-based multicenter registry of in-hospital cardiac arrest. Patients who had an invasive airway in place at the time of cardiac arrest were excluded. Patients intubated at any given minute (from 0-15 minutes) were matched with patients at risk of being intubated within the same minute (ie, still receiving resuscitation) based on a time-dependent propensity score calculated from multiple patient, event, and hospital characteristics.

Exposure  Tracheal intubation during cardiac arrest.

Main Outcomes and Measures  The primary outcome was survival to hospital discharge. Secondary outcomes included return of spontaneous circulation (ROSC) and a good functional outcome. A cerebral performance category score of 1 (mild or no neurological deficit) or 2 (moderate cerebral disability) was considered a good functional outcome.

Results  The propensity-matched cohort was selected from 108 079 adult patients at 668 hospitals. The median age was 69 years (interquartile range, 58-79 years), 45 073 patients (42%) were female, and 24 256 patients (22.4%) survived to hospital discharge. Of 71 615 patients (66.3%) who were intubated within the first 15 minutes, 43 314 (60.5%) were matched to a patient not intubated in the same minute. Survival was lower among patients who were intubated compared with those not intubated: 7052 of 43 314 (16.3%) vs 8407 of 43 314 (19.4%), respectively (risk ratio [RR] = 0.84; 95% CI, 0.81-0.87; P < .001). The proportion of patients with ROSC was lower among intubated patients than those not intubated: 25 022 of 43 311 (57.8%) vs 25 685 of 43 310 (59.3%), respectively (RR = 0.97; 95% CI, 0.96-0.99; P < .001). Good functional outcome was also lower among intubated patients than those not intubated: 4439 of 41 868 (10.6%) vs 5672 of 41 733 (13.6%), respectively (RR = 0.78; 95% CI, 0.75-0.81; P < .001). Although differences existed in prespecified subgroup analyses, intubation was not associated with improved outcomes in any subgroup.

Conclusions and Relevance  Among adult patients with in-hospital cardiac arrest, initiation of tracheal intubation within any given minute during the first 15 minutes of resuscitation, compared with no intubation during that minute, was associated with decreased survival to hospital discharge. Although the study design does not eliminate the potential for confounding by indication, these findings do not support early tracheal intubation for adult in-hospital cardiac arrest.

Source:http://jamanetwork.com

Drug Overdoses Are the 9th Leading Cause of Death in the US



Story at-a-glance

  • Prescriptions for opioid painkillers rose by 300 percent between 2000 and 2009, and Americans now use 80 percent of all the opioids sold worldwide
  • Drug overdoses (63 percent of which are opioids) replaced kidney disease as the 9th leading cause of death in the U.S. as of 2015
  • Addiction affects about 26 percent of those using opioids for chronic non-cancer pain; 1 in 550 patients on opioid therapy dies from opioid-related causes within 2.5 years of their first prescription

According to the U.S. surgeon general, more Americans now use prescription opioidsthan smoke cigarettes.1 This makes sense when you consider prescriptions for opioid painkillers rose by 300 percent between 2000 and 2009,2,3 and Americans now use 80 percent of all the opioids sold worldwide.4

In Alabama, which has the highest opioid prescription rate in the U.S., 143 prescriptions are written for every 100 people.5 A result of this over-prescription trend is skyrocketing deaths from overdoses.6,7

The most common drugs involved in prescription opioid overdose deaths, specifically, include8 methadone, oxycodone (such as OxyContin®) and hydrocodone (such as Vicodin®).

As noted by Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC): “We know of no other medication routinely used for a nonfatal condition that kills patients so frequently.”9

There are safe options to treat pain, but education — both among doctors and patients — is sorely lacking. This is why I frequently write about this issue, and hope you’ll do your part in spreading the word.

Far too many people in the prime of their life are losing it to painkiller addiction, and often they simply had no idea a prescription painkiller for a temporary injury or pain would send them into the throes of drug addiction.

Drug Overdoses Now 9th Leading Cause of Death in the US

In 2014, prescription drug overdoses, a majority of which involved some type of opioid, killed more Americans than car crashes (49,714 compared to 32,675).10 This held true for 2015 as well, despite 2015 being hailed as the deadliest driving year since 2008.

In all, 38,300 Americans died in car crashes in 201511 — a sharp rise thought to be related to a combination of cheaper gas prices and hence increased travel, and using smartphones while driving.12 A rise in overdoses also suddenly placed drug overdoses in the top 10 leading causes of death in the U.S.

In 2015, 52,404 Americans died from drug overdoses; 33,091 of them involved an opioid and nearly one-third of them, 15,281, were by prescription.13,14,15 Meanwhile, kidney disease, listed as the 9th leading cause of death on the CDC’s top 10 list, killed 48,146.16

The CDC does not include drug overdoses on this list, but if you did, drug overdoses (63 percent of which are opioids), would replace kidney disease as the 9th leading cause of death as of 2015, inching its way toward the 8th slot, currently occupied by respiratory complications such as pneumonia, which took 55,227 lives in 2015.

Why Are Pregnant Women Prescribed Narcotics?

A statistic that shows just how overprescribed and misused opioid drugs are is the prescription rate for pregnant women and women of childbearing age.

Despite carrying risks of pregnancy-related problems and birth defects, shockingly, nearly one-third of American women of childbearing age are prescribed opioid painkillers17 and more than 14 percent of pregnant women were prescribed opioids during their pregnancy.18

Reasons for prescribing these extremely dangerous drugs include back and/or abdominal pain, migraine, joint pains and fibromyalgia. Clearly, if you are planning a pregnancy or are pregnant, you should go to great lengths to avoid narcotic drugs. If you wouldn’t consider taking heroin, you shouldn’t take a narcotic pain reliever.

Yet, in 2015, 27 million Americans either used illegal drugs and/or misused prescription drugs, and addiction to opioids and heroin now costs the U.S. more than $193 billion each year.

Please, take care to avoid becoming part of this devastating trend. Studies show addiction affects about 26 percent of those using opioids for chronic non-cancer pain. Worse, 1 in 550 patients on opioid therapy dies from opioid-related causes within 2.5 years of their first prescription.19

According to the latest data from the National Center for Health Statistics, life expectancy for both men and women dropped between 2014 and 2015, for the first time in two decades, and overdose deaths appear to be a significant contributor.20,21,22

Drug Industry Is Responsible for Mass Addiction

Many believe the drug companies that create and sell these drugs need to be held accountable for America’s rapidly escalating drug problem, especially since several have been caught lying about the benefits and risks of their drugs.

As noted by the Organic Consumers Association,23 the drug industry has “fostered the opioid addiction epidemic” by:

Introducing long-acting opioid painkillers like OxyContin, which prior to reformulation in 2010 could be snorted or shot. Many addicts claimed the high from OxyContin was better than heroin.

From a chemical standpoint, OxyContin is nearly identical to heroin, and has been identified as a major gateway drug to heroin.

Changing pain prescription guidelines to make opioids the first choice for lower back pain and other pain conditions that previously did not qualify for these types of drugs.

Promoting long-term use of opioids, even though there’s no evidence that using these drugs long-term is safe and effective.

Downplaying and misinforming doctors and patients about the addictive nature of opioid drugs. OxyContin, for example, became a blockbuster drug mainly through misleading claims that Purdue Pharma knew were false from the start.

The basic promise was that it provided pain relief for a full 12 hours, twice as long as generic drugs, giving patients “smooth and sustained pain control all day and all night.”

However, for many the effects don’t last anywhere near 12 hours, and once the drug wears off, painful withdrawal symptoms set in, including body aches, nausea and anxiety. These symptoms, in addition to the return of the original pain, quickly begin to feed the cycle of addiction.24

Drug Enforcement Administration Struggles to Hold Drug Makers Accountable for Black Market Sales

Evidence has repeatedly shown opioid makers have acted with callous disregard for human life, yet they keep getting off the hook with little more than a slap on the wrist. The Washington Post recently published an article detailing the Drug Enforcement Administration’s (DEA’s) failure to bring an opioid maker to justice.25

In 2011, the DEA began investigating Mallinckrodt Pharmaceuticals, one of the largest manufacturers of oxycodone in the U.S. This was the first time the DEA targeted a drug manufacturer for violating laws designed to prevent black market sales of legal narcotics.

To date, it’s also the largest prescription drug case the DEA has ever pursued. Federal prosecutors accused Mallinckrodt Pharmaceuticals of ignoring “its responsibility to report suspicious orders as 500 million of its pills ended up in Florida between 2008 and 2012.”

In all, 66 percent of all oxycodone sold in Florida between those years was shipped to suspected “pill mills” selling prescription drugs to addicts.

In 2010 alone, one distributor, Cincinnati-based KeySource Medical, shipped 41 million oxycodone tablets made by Mallinckrodt to Florida. That’s enough pills to give every man, woman and child in the state 2.5 pills each. Cardinal Health, one of the largest drug distributors in the U.S., was also sending extremely large amounts of Mallinckrodt-made oxycodone pills to Florida.

One Delray Beach doctor named Barry Schultz received 92,400 oxycodone pills from Sunrise Wholesale in just 11 months. He once prescribed 1,000 pills to a single patient, all in one day — a clearly suspect prescription by any reasonable standard.

At the time these enormous shipments were made, the street value of one “oxy” pill was $30. Schultz was sentenced to 25 years in prison in 2016 after being charged with drug trafficking and one case of manslaughter, following the overdose death of one of his patients. As noted in the featured article:26

“‘Mallinckrodt knew through law enforcement reports that Barry Schultz was diverting controlled substances, and that the diverted oxycodone was supplied by Mallinckrodt through Sunrise,’ prosecutors later wrote in an internal document sent to the company. ‘When Mallinckrodt continued to distribute oxycodone to Sunrise for such purposes, and continued to pay incentives in the form of chargebacks for the product sales to Barry Schultz, Mallinckrodt was diverting oxycodone.'”

A pharmacy in Sanford, Florida, also stood in receipt of suspicious amounts of pills. Over the course of four years, it received 5.8 million oxycodone pills — nearly 20 times more than the state average for pharmacies.

By law, drug manufacturers must notify the DEA when suspicious orders such as these occur. Mallinckrodt stood accused of 44,000 federal violations, totaling $2.3 billion in fines. In all, federal prosecutors claimed 222,107 Florida orders were “excessive” and should have been reported to the DEA as suspicious.

Oxycodone Maker Gets Off Scot-Free — Again

Yet, despite a massive five-state investigation spanning several years, the U.S. government has taken no legal action against Mallinckrodt, and likely never will. “Instead, the company has reached a tentative settlement with federal prosecutors,” The Washington Post writes, adding:

“Under the proposal, which remains confidential, Mallinckrodt would agree to pay a $35 million fine and admit no wrongdoing … The case shows how difficult it is for the government to hold a drug manufacturer responsible for the damage done by its product. DEA investigators appalled by rising overdose deaths said they worked for years to build the biggest case of their careers only to watch it falter on uncertain legal territory and in the face of stiff resistance from the company.

‘They just weren’t taking this seriously, and people were dying,’ said a former law enforcement official who spoke on the condition of anonymity because the case is pending … ‘It wasn’t their kids, their wives, their husbands, their brothers. It was some hillbilly in Central Florida, so who cares?'”

A $35 million fine is a drop in the bucket for a company that boasts $3.4 billion in annual revenue, with a net profit of $489 million,27,28 and will do absolutely nothing to deter it or other drug companies from continuing business as usual. As noted by The Washington Post:

“Drug manufacturers have paid much larger fines for other misdeeds. Glaxo­SmithKline was fined $3 billion, and Pfizer was fined $2.3 billion for illegally promoting off-label drug use and paying kickbacks to doctors. Purdue Pharma paid a $600 million fine, and three of its executives pleaded guilty to charges that they misled regulators, doctors and patients about the risks of the painkiller that is widely blamed for setting off the nation’s opioid crisis: OxyContin.

All of those cases were initiated by the Food and Drug Administration [FDA]. The largest fine the DEA has levied against a drug distributor was the $150 million that McKesson, the nation’s largest drug wholesaler, recently agreed to pay following allegations that it failed to report suspicious orders of painkillers. For a company the size of Mallinckrodt, a $35 million fine is ‘chump change,’ one government official said.”

Drug Industry Ensures Leniency by Hiring DEA and DOJ Agents

Last year, seven U.S. senators demanded to find out why there has been such a sharp decline in enforcement actions by the DEA against wholesalers suspected of distributing prescription narcotics to the black market.29

According to The Washington Post, DEA lawyers began delaying and blocking enforcement efforts by DEA agents against opioid distributors in 2013, suddenly insisting on increasingly higher standards of proof before moving cases forward. This included proof of intent — a factor that is very difficult to prove and typically only required in criminal cases.

In 2011, the DEA took 131 actions against distributors. By 2014, that number had dropped to 40. In that same time frame, the number of “immediate suspension orders” dropped from 65 to nine. (The suspension order allows the agency to freeze shipments of narcotics, effective immediately.) The question is why. I’ve written about the dangers of the revolving door policy that allows regulators to be hired by industry and vice versa on numerous occasions.

In this case, former DEA and Department of Justice (DOJ) officials hired by the drug industry fought for lenience and a “soft approach” to the burgeoning drug addiction problem.30 They succeeded, thereby allowing the problem to grow more or less unrestrained, despite official promises to the contrary. Many DEA officials did in fact suspect Clifford Lee Reeves II, the lawyer in charge of approving their cases, of secretly working for the drug industry.

New FDA Chief Unlikely to Take Hard Line Against Opioids

Unfortunately, President Trump’s nominee for head of the FDA, Dr. Scott Gottlieb, is also in the opioid industry’s pocket, having received nearly $45,000 in speaker’s fees from opioid manufacturers and distributors.31 During his confirmation hearing, Gottlieb stated he believes the U.S. opioid crisis is a “public health emergency on the order of Ebola and Zika” that requires dramatic action, and promised that developing a strategy to curb the opioid epidemic would be his “highest and most immediate priority.”32

The question is whether or not he’ll actually follow through. Gottlieb’s drug industry ties are so significant, he’s agreed to recuse himself for one year from decisions involving more than 20 different drug companies with whom he has decades’ long financial connections.

As noted by Dr. Andrew Kolodny, co-director of Opioid Policy Research at Brandeis University:33 “Our country is in desperate need of an FDA commissioner who will take on the opioid lobby, not one who has a track record of working for it.” Senator Edward Markey (D-Mass) also criticized Trump’s choice for the FDA saying,34 “Gottlieb’s record indicates that he would not take the epidemic and the FDA’s authority to rein in prescription painkillers and other drugs seriously.”

Prescription Painkillers Are Gateway Drugs to Heroin and Other Deadly Highs

Oxycontin and other opioid pain killers have been identified as the primary gateway drugs to heroin.35 Chemically, these drugs are very similar and provide a similar kind of high. According to a 2013 U.S. Substance Abuse and Mental Health Services Administration report, nearly 80 percent of people who use heroin have previously used prescription painkillers.36 Opioids work by attaching to opioid receptors in your brain, thereby blocking pain signals.

This also has the effect of creating a sensation of pleasure or euphoria — and addiction. Over time they can also result in increased pain perception, setting into motion a cycle where you need increasingly larger doses, making a lethal overdose more likely.

Oxycontin’s high rate of addiction is the result of a short half-life (the amount of time the drug stays in your system before you are left wanting more). Opioids are also very potent immune suppressors. As such they can wreck your health in serious ways, leaving you far worse off than where you started.

Many users are also turning to much stronger types of opioids, such as fentanyl, which is seeing the fastest rate of growth in use. Deadly overdoses involving fentanyl rose by 50 percent between 2013 and 2014, and another 72 percent between 2014 and 2015. Fentanyl is a synthetic opioid that can be anywhere from 500 to 1,000 percent more potent than morphine.

Besides a more potent high, price is another factor driving its popularity. Since it can be created in a lab, it’s far cheaper than heroin, which in turn is cheaper than prescription opioids.

A recent NPR story37 reveals the tremendous impact fentanyl is having on many people’s lives. Allyson, a 37-year old client at the AAC Needle Exchange and Overdose Prevention Program in Cambridge, Massachusetts, says she’s lost 30 friends to these deadly painkillers. “Basically, my entire generation is gone in one year,” she said.

Are You or Someone You Love Addicted to Painkillers?

Some of the marketing material for opioids claims the drug will not cause addiction “except in very rare cases,” describing the adverse effects patients experience when quitting the drug as a “benign state” and not a sign of addiction. This simply isn’t true. Panic is one psychological side effect commonly experienced when quitting these drugs, and this can easily fuel a psychological as well as physical dependence on the drug.

It’s important to recognize the signs of addiction, and to seek help. If you’ve been on an opioid for more than two months, or if you find yourself taking higher dosages, or taking the drug more often, you’re likely already addicted and are advised to seek help from someone other than your prescribing doctor. Resources where you can find help include:

With all the health risks associated with opioid painkillers, I strongly urge you to exhaust other options before resorting to these drugs. For a long list of alternative pain treatments, please see my previous articles, “Treating Pain Without Drugs,” and “New Treatment Guidelines for Back Pain Stress Non-Drug Interventions.”

Source:.mercola.com

Light at Night Damages Health and Potentially Future Generations


There is a significant cost to your health from light pollution resulting from living in a 24/7 society. A growing number of street lights and lit signs obscure the night sky, and your bedroom is likely dimly lit from street lamps, digital equipment or alarm clocks.

light exposure at night

Story at-a-glance

  • Light pollution triggers significant health changes in humans, animals and plants and may be a hidden cost of a 24/7 lifestyle
  • Recent research identified health problems in the offspring of laboratory animals exposed to even dim light at night, showing it affects the animals’ immune and endocrine systems
  • Both dim light at night and electromagnetic fields from electronic devices trigger mitochondrial damage, potentially affecting epigenetic expression in future generations

It’s not possible to “feel” the changes in your brain and body from outdoor street light that seeps in around your bedroom curtains or the dim glow from your alarm clock.

Yet, even a dim light at night affects your natural sleep cycle and produces biological changes which, in turn, may affect your risk for health conditions such as obesitydiabetescancer and depression.

I have been a long-time advocate of sleeping in complete darkness. Even a small amount of light is enough to make a difference in your health. And now, recent research demonstrates your exposure to light pollution may affect the health of your children.

Light Exposure at Night May Alter Immunity of Future Generations

In a study at Ohio State University, researchers concluded exposure to light at night may produce immune and endocrine disruptions.1 To isolate the effect light has on sleep quality and not on interruption of sleep, they used naturally nocturnal hamsters that normally sleep during daylight hours.

The hamsters were separated into two groups; for nine weeks one group was exposed to dim light all night while the other was exposed to standard light days and dark nights. Following this the hamsters were allowed to mate and then all were returned to standard lighting conditions.

Initially, the researchers noted an increase in body mass of both male and female hamsters exposed to dim light at night.2 The next generation was also raised under standard lighting conditions. The researchers ran a series of tests on the hamster pups once they achieved adulthood.3

They found parental history of light exposure prior to conception left the following generation of hamsters with an impaired immune response and decreased endocrine activity.

These health conditions were passed down through either parent’s genetic material, meaning it didn’t matter whether it was the mother or father that was exposed to dim light at night; the effect could be traced to either parent.

The impaired adaptive immune function noted in the hamster offspring illustrates a transgenerational effect of light at night.

While the exposure did not change the DNA sequence of the hamsters, it did affect the epigenetic expression of that DNA. Epigenetics describes changes to genetic expression not occurring from an actual sequence change in DNA, but rather how the genes are expressed.

For instance, exposure to environmental factors such as nicotine or alcohol may trigger sections of DNA to be switched on or off.

These changes in genetic expression can be passed to offspring while still maintaining the exact genetic sequencing. In this study, light exposure at night changed the epigenetics of the hamster offspring, negatively affecting their immune system.

Light Pollution Also Affects Your General Health

Senior author Randy Nelson, Ph.D., professor and chair of neuroscience at Ohio State’s Wexner Medical Center commented on the significance of the results:4

“Now, we’re seeing for the first time in these hamsters that it’s possible this damage isn’t just being done to the affected individuals, but to their offspring as well. These weren’t problems that developed in utero. They came from the sperm and the egg.

It’s much more common to see epigenetic effects from the mothers, but we saw changes passed on from the fathers as well.

I think people are beginning to accept that light pollution is serious pollution and it has health consequences that are pretty pronounced — an increase in cancers, depression, cardiovascular disease, diabetes and anxiety disorders.

We should be concerned about the increasing exposures to light at night from our tablets and phones and TVs.”

Exposure to light at night, even when awake doing shift work or dim light exposurewhen sleeping, may be associated with an increased risk of certain cancers, cardiovascular disease, gastrointestinal ailments and mood disorders, regardless of the type of illumination.5

In both the recent study and others,6 animals exposed to light during night hours had greater weight gain. In some mice, up to 50 percent more weight was gained over eight weeks, despite identical activity levels and available food.

Other studies show that rates of cancers dependent on hormones, such as breast cancer or prostate cancer, increase with exposure to light at night.7

The suppression of melatonin, a sleep regulating hormone, by blue light emitted from electronic media and other lighting, is linked with reduced sleep quality and interrupted sleep.8 Poor sleep quality increases your risk of depression and may impact your reproductive health as well.9

Mitochondrial Damage Is at the Center of Poor Health

Mitochondrial function plays an important role in many of the diseases and changes associated with aging, and melatonin plays a unique part in stabilizing the function of molecular mechanisms and biogenesis of your mitochondria.10 Melatonin acts as an antioxidant and regulator of mitochondrial functions.11

It is selectively used by mitochondrial membranes, a function not exhibited by other antioxidants. The hormone effectively prevents oxidative stress-induced mitochondrial dysfunction.

As exposure to light, and specifically blue light, severely impacts your melatonin production, it also has a substantial effect on your overall health.

Your mitochondria are tiny powerhouses inside the cells of your body. They are the primary source of energy for your cells, and thus your body. Since mitochondrial function is at the heart of everything that happens in your body, optimizing it is extremely important for good health and disease prevention.

For example, one of the universal characteristics of cancer is serious mitochondrial dysfunction with radically decreased numbers of functional mitochondria.

A disruption of your circadian rhythm, and therefore your secretion of melatonin and subsequent effect on mitochondria, has been associated with aberrant cell proliferation and cancer.12

Mitochondrial dysfunction also plays a central role in insulin resistance, the hallmark symptom of diabetes.13,14 Glucose and lipid metabolism are principally dependent on mitochondria to generate energy. Insulin resistance from mitochondrial dysfunction may contribute to subsequent increases in heart disease.

Cell death and survival are critical to neurodegeneration, and mitochondrial function is an important determinant of both.15

The relationship between melatonin and mitochondrial function has led to the emergence of melatonin as a potential therapeutic tool for treatment of neurodegenerative disorders, such as Parkinson’s and Alzheimer’s disease.16

How Much Light Is Too Much?

Your body requires exposure to bright daylight, especially in the early morning, to produce healthy amounts of melatonin each night. While melatonin helps regulate sleep and protects your mitochondria, that isn’t all it does.

It is also a free radical scavenger that helps support your immune system and thymus gland, and helps you feel good in the morning. It also may protect your brain against aging. Your body secretes all the melatonin it needs based on natural circadian rhythms that are largely reliant on light.

Getting sunlight in the morning is one way to help reset your circadian clock daily. Ten to 15 minutes of morning sunlight sends a strong message that it’s time to rise and shine. In this way, your body is less likely to be confused by weaker light signals later in the day.

My rule of thumb is, if there is enough light in your bedroom at night to see your hand in front of your face, then there is too much light. Your body requires light during the day to produce healthy amounts of melatonin, but at night light inhibits production. So, it’s difficult to get too much light during the day and easy to get too much at night.

The problem of light pollution has become so pervasive that the American Medical Association (AMA) has issued statements warning against light at night. In 2012, during their annual meeting, the AMA voted on a policy recognizing that exposure to light at night can disrupt sleep and LED street lamps could create dangerous driving conditions.17

In 2016, the AMA again voted on guiding principles for the selection of public lighting options.18 The policy statement specifically addressed the new “white light” LED street lamps being erected around the U.S. to save energy, and the vote was unanimous.19

The concern is prompted by the color spectrum used in the LED street lights. The AMA recommends a color temperature no greater than 3000 Kelvin (k). The color temperature of the LED lighting currently being installed ranges between 4000 k and 5000 k, containing high levels of short-wavelength blue light in the spectrum.

Color of Your Light Matters

As detailed in my interview with Dr. Alexander Wunsch, a world class expert on photobiology, lighting is an important health consideration. Natural sunlight simply cannot be beat, but unless you spend a majority of your time outside, you’ll need to give some serious consideration to the kind of artificial lighting you use at home and at work.

Not all artificial light is created equally. The LED lights installed in major cities are harsh, triggering complaints from local residents. Blue lighting from LED lights reduces contrast at night and therefore reduces visibility. While this limits everyone’s ability to see potential danger, it is especially difficult for people over 50 to see well in this lighting.20 According to the AMA statement:21

“Unshielded LED lighting causes significant discomfort from glare. Discomfort and disability glare can decrease visual acuity, decreasing safety and creating a road hazard. Various testing measures have been devised to determine and quantify the level of glare and vision impairment by poorly designed LED lighting.”

Electric lighting is not inherently dangerous to humans or animals. However, it is important to balance safety at night against long term health. Light pollution has an effect on plants and animals, including preventing some trees from recognizing seasonal variations, and affecting the breeding cycles and foraging of wildlife.22 According to the AMA statement in 2016:23

“Despite the energy efficiency benefits, some LED lights are harmful when used as street lighting. The new AMA guidance encourages proper attention to optimal design and engineering features when converting to LED lighting that minimize detrimental health and environmental effects.”

Additionally, the AMA estimates that LED street lights have a five times greater impact on natural sleep rhythms than conventional street lamps they are replacing.24 Recent surveys have found these brighter residential blue wavelength street lights are associated with excessive sleepiness during the day, impaired daytime functioning, obesity and dissatisfaction with sleep quality.

These effects may be improved when cities begin using LED lighting options operating at 3000 k or less, often called warm white lights. These lights help balance the need for safety, reduced financial cost and smaller carbon footprint against your long-term health and the health of plants and animals exposed to external lighting.

Use REVERSE Sunglasses After the Sun Sets

In addition to eliminating all light exposure when you go to bed, it is also really important to filter light after sunset. The only light source our ancient ancestors had at night was from fire, which has virtually no blue or green light. Exposure to these light frequencies after the sun sets virtually assures that you will lower your melatonin and melanopsin levels. It also increases your risk of blindness from macular degeneration.

So, head on over to Amazon25 and pick up a pair of reverse sunglasses to protect your vision after dark. The glasses are only $9 and they are far superior to traditional blue-blockers as they also filter out the yellow and green that can impair retinal health. They are my absolute new favorite now, and I only use the amber blue-blockers during the day when I need to lecture in a dark hall illuminated by artificial light.

Also Beware of Electromagnetic Frequency Emitted From Electronic Light Sources

While wearing a sleep mask may help reduce the amount of light seeping through your eyelids, it is also important to address the electromagnetic field (EMF) emitted from electronic devices that is at least as dangerous as the light. Although blue light at night reduces your melatonin secretion, and therefore antioxidant protection for your mitochondrial function, EMF from electronic devices also damages mitochondria by producing oxidative damage.

Thus, your computer, cell phone and other electronic devices may be doing double duty health damage. One major concern of exposure to EMF has been the development of cancer.26 Scientists have long believed that cancer is initiated by damage to a cell’s genetic structure, but the initial damage can actually be traced to mitochondrial damage.

DNA damage triggered by EMF also leads to changes in cell function and cell death. EMF sources in your home, such as WiFi routers, cell phones and microwave ovens, may increase your risk of cancer.27,28,29 In 2011 the World Health Organization (WHO) classified cell phone radiation as a 2B carcinogen, or possibly carcinogenic to humans.30

It is REALLY important that you turn off your Wi-Fi every night before you go to bed to minimize your exposure. In future articles I will discuss how you can use a Faraday cage to really improve protection from these sources.

EMF also has a detrimental effect on the health of your brain, altering function and potentially fueling dementia. Even though measured EMF from cell phones is considered low, studies have demonstrated it can alter your brain function and activity.31 EMF from cell phones and Wi-Fi is also linked to changes in brain neurons that affect memory and the ability to learn.32

Interestingly, EMF from cell phones may also reduce the number of antioxidants available in your saliva, one of the first lines of defense your body has against microbial infections.33 Talking on a cell phone for up to one hour may reduce your salivary antioxidant levels by 25 percent. The proximity of your parotid salivary glands to where your cell phone is held during a conversation increases exposure to EMF.

EMF Found Where You May Not Expect It and How to Guard Your Health

Protecting yourself from EMF radiation begins by knowing what devices are emitting EMF and then developing alternatives to reduce exposure. This is not an exclusive list, but while you may have expected to see some of the devices on the list, others may come as a surprise.

Cellphones Cordless phones Bluetooth headsets
Refrigerators Radios Televisions
Wi-Fi modems and routers TV remote controls Microwave ovens
Alarm clocks Lamps Outlets
Powerlines and cell phone towers Smart meters (transmitting your utility usage wirelessly to your utility company) Computers including laptops, e-readers and tablets

The importance of the health of your mitochondria cannot be overstressed.

One of the strategies I’ve recently started having great success with is a modified Faraday cage over my bed. You may easily incorporate shielding material at home using different types of EMF conductive fabric for different applications, such as bedding, curtains or canopies.

Remember, as you spend at least seven or eight hours each day in your bedroom, it is an important place to start reducing EMF exposure. If building your own bed canopy with proper conductive material is not something you want to attempt, you can purchase a bed canopy kit fitting twin to king size beds.

Source:mercola.com

Diabetes Taking a Higher Toll on Life Than Suspected


In a time when information travels at the speed of the internet, there continues to be a staggering amount of misinformation shared about type 2 diabetes. The distortion of the truth contributes to the growing epidemic across the world, with estimates that 422 million have been diagnosed with diabetes.1

diabetes deaths

Story at-a-glance

  • There continues to be a staggering amount of misinformation about diabetes that may contribute to the growing epidemic across the world; estimates are 422 million currently have diabetes
  • It is the No. 1 cause of death in Mexico, causes more deaths in the U.S. than originally believed and is the most expensive disease in terms of total cost in the U.S.
  • Children exposed to high blood sugar while in the womb have a high risk of developing diabetes as adults and are at greater risk for medical complications immediately after birth

Just as overwhelming are the numbers of people who suffer from prediabetes, a condition where your blood sugar is higher than normal, but not high enough to be diagnosed with diabetes.

An estimated 38 percent of Americans have prediabetes2 and according to the Centers for Disease Control and Prevention (CDC), 90 percent of them don’t know they have it.

Unfortunately, even your own physician may share outdated information with you that won’t help to stabilize or reverse the condition. Despite the growing prevalence of high blood sugar (hyperglycemia), the fact is that type 2 diabetes is completely preventable with a few simple, inexpensive lifestyle adjustments.

Impaired insulin and leptin sensitivity are two of the underlying triggers for hyperglycemia and the diagnosis of diabetes.

The rapidly rising number of people affected demonstrates the cause is not due to genetics, but is rather prompted by changes to national nutrition guidelines initiated by the now-refuted Seven Countries Study.

Published in the 1950s by economist Ancel Keys, Ph.D., the study sparked a rather large increase in the quantity of carbohydrates recommended and a severe reduction in healthy fats.3 This triggers cellular resistance to the hormones insulin, ghrelin and leptin, and is the real foundation of high blood sugar.

Diabetes Now the No. 1 Cause of Death in Mexico

Today, diabetes is the leading cause of death in Mexico, followed closely by ischemic heart disease, a common consequence triggered by hyperglycemia.4 Diabetes accounted for 14.7 percent of all deaths in the country.

According to early 2000 estimates, the total number of diabetics in Latin American countries will exceed the combined number in the U.S., Canada and Europe by 2025.5 The financial cost from disability and treatment in Latin America reached over $65 million in the early 2000s.6

Rising rates of obesity in the last 40 years in Mexico has fueled the growing diabetes epidemic.7 The percentage of Mexico’s population that is overweight and obese has grown from less than 40 percent in 1975 to over 64 percent in 2014, just under the U.S. rate of 67 percent, but far past the global rate of 38 percent.

Increasing weight gain is also related to soda consumption. In 2012, Mexico was the world’s leading per capita consumer, drinking approximately 176 liters (46.5 gallons) per person, per year.8 By 2016, after a 2014 sugar tax was imposed, per capita consumption fell slightly to 163 liters (36 gallons) per person, per year.9

Drinking Coke has become such a cultural decision that, according to Dr. Salvador Villalpando, childhood obesity specialist at the Federico Gomez Children’s Hospital in Mexico City:

“About 10 percent of kids are being fed soda from zero to [6] months of age. By the time they reach [2] it’s about 80 percent. It’s cultural.

Mexican mums like having chubby kids in their homes as it shows they’re feeding them properly. And they are so used to feeding them sodas, they don’t stop even when there is clean water.”

Costly Supplies Limit Care

People with diabetes in Mexico struggle not just with the disease and dietary choices, but also accessing medical care and supplies. Medication and supplies may cost as much as monthly housing in Mexico.10

Dr. Carlos Aguilar Salinas, vice head of the endocrine department at Mexico’s National Institute of Medical Sciences and Nutrition, said:11

“In the middle of the 1970s and especially after the ’80s, the prevalence of diabetes exploded. Diabetes is now one of the biggest problems in the health system in Mexico. It’s the first cause of death. It’s the first cause of disability. It’s the first cause of early retirement. It’s the main cost for the health system.”

In 2015 there were over 11 million people diagnosed with diabetes,12 in a country with a total population of 127 million. The sheer number of people requiring care and follow up is straining the public health care system and reducing access to medical care.

The system pays for severe complications of the disease, but the daily management of the condition is left largely to the patients. Unfortunately, this has left people open to influence by swindlers promising a cure in a bottle or shot, costing thousands of pesos on products that are useless and may be toxic.13

Diabetes Kills More Americans Than Previously Believed

The number of people with diabetes in the U.S. is also growing, and recent research demonstrates more people may be dying from the condition than was originally believed.

According to The Obesity Society, type 2 diabetes accounts for nearly 90 percent of all diagnosis of diabetes,14 and obesity is a major risk factor for type 2 diabetes. The CDC ranks diabetes as the seventh leading cause of death in the U.S.15

However, analysis of death certificate information and follow up indicates a greater number of deaths should be attributed to diabetes. For the study, researchers analyzed data for participants who had previously participated in the National Health and Nutrition Survey and the National Health Interview Survey.

Participants who subsequently died during the study were evaluated based on self-reporting for diabetes. The researchers then searched the death certificates for cause of death.

Based on the survey data, over 11 percent had died from complications of diabetes, but less than 4 percent had diabetes complications mentioned on their death certificates.16 The researchers found:17

“The proportion of deaths in which diabetes was assigned as the underlying cause of death (3.3 to 3.7 percent) severely understated the contribution of diabetes to mortality in the United States.

Diabetes may represent a more prominent factor in American mortality than is commonly appreciated, reinforcing the need for robust population-level interventions aimed at diabetes prevention and care.”

Cost of Treating Diabetes Is Higher Than Other Diseases

The financial cost of treating diabetes extends to traditional medical care, indirect costs, disability and cost of treating complications. According to the Institute for Health Metrics and Evaluation, in 2013 diabetes health care costs were over $101 billion and topped the list of the costliest health care expenses.18

Researchers traced costs related to 155 disease for 18 years.19 They found only 20 of those diseases were responsible for over half of all medical costs in the U.S. In terms of total dollars spent, diabetes was the most expensive.

However, in their list of top 10 costly health care diagnoses, four others were health conditions commonly associated with a diagnosis of diabetes.

Ischemic heart disease ranked second on the list, costing over $88 billion. Other health problems associated with diabetes include vision and hearing problems, hypertension and depression.20 Indirect disability costs may also be related to nerve dysfunction, kidney disease, vision loss and Alzheimer’s disease.21

Until now, the link between hyperglycemia and the increased incidence of Alzheimer’s disease, a progressive form of dementia, has not been clear. In a recent study, researchers discovered hyperglycemia damages immune function, impairing response in early Alzheimer’s disease.22

The study, published in Scientific Reports, found hyperglycemia modified macrophage migration inhibitory factor (MIF or MMIF) in the brain of individuals with Alzheimer’s disease.

This may suggest sugar damage to MIF reduces some of the enzyme’s functions and blocks others completely. This may be related to the process that allows Alzheimer’s to develop.

Studies are gradually unearthing the complex changes in the brain that occur with the development of Alzheimer’s that may start as much as 10 years prior to clinical symptoms. During this pre-symptomatic period, toxic changes are setting the stage for development of disease.

Hyperglycemia in Pregnancy Increases Risk of Diabetes in Children

Doctors have long known that high blood sugar during pregnancy has a harmful effect on the growing baby. A recent small Danish study now suggests that when an infant is exposed to high blood sugar levels in utero it may trigger the production of altered fat cells, making the children more likely to develop metabolic disease in adulthood.23

Researchers tested the adult children of 206 women who had diabetes during their pregnancy. The children had larger fat cells and secreted more leptin, a hormone made by fat cells that influences your feelings of hunger. Some of the women had diabetes prior to the pregnancy, while others developed gestational diabetes during pregnancy. They compared the results against a control group of children whose mothers didn’t have diabetes.24

The results from this study offer some clues about how hyperglycemia during pregnancy may increase the risk of diabetes later in life. Lead author Ninna Hansen of the University of Copenhagen talked about the results, saying:25

“Fetal hyperglycemia affects fat stem cells and these defects can be detected several years later. If (high blood sugar) or diabetes is present during pregnancy, our study supports the importance of aiming at normal blood glucose levels to reduce the negative impact on the cells of the unborn baby. Women who are lean and fit before pregnancy have a reduced risk of developing gestational diabetes during pregnancy.”

Hyperglycemia during pregnancy also increases the risk to children for other disabilities, including cognitive disability,26 birth defects27 and autism.28 Infants born to mothers who experienced hyperglycemia during pregnancy may also have an increased risk of experiencing health difficulties immediately following birth including respiratory distress, hypoglycemia, polycythemia and iron abnormalities.29

Daily Screen Time May Predict Risk of Diabetes

Past research has demonstrated an associated risk between spending more than three hours in front of a screen each day with type 2 diabetes in adults. However, a link between screen time and the risk of type 2 diabetes in children has been unclear.30 To probe this link, researchers surveyed nearly 4,500 children between ages 9 and 10 years.

Several factors associated with the development of diabetes in children were measured, including total body fat, insulin resistance, blood pressure and physical activity.31

Of those surveyed, 41 percent spent one hour or less in front of a screen daily, while 28 percent spent between one and two hours, and 18 percent spent three or more hours each day.32 The researchers found a strong correlation between three or more hours of screen time and high levels of leptin, fasting glucose and insulin resistance. They commented on the results, saying:33

“Our findings suggest that reducing screen time may be beneficial in reducing type 2 diabetes risk factors, in both boys and girls and in different ethnic groups from an early age. This is particularly relevant, given rising levels of type 2 diabetes, the early emergence of type 2 diabetes risk, and recent trends suggesting that screen time related activities are increasing in childhood and may pattern screen-related behaviors in later life.”

Mitochondrial Dysfunction Is at the Heart of Diabetes and Most Other Disease

Watch the video discussion:

In this short TED talk, Dr. Sarah Hallberg discusses the success she has treating people with diabetes, reducing their blood sugar using dietary choices. At the core of the pathology behind diabetes is mitochondrial dysfunction and eating a high-carbohydrate diet that bathes your mitochondria in glucose, which in turn suppresses mitochondrial metabolism.34

Your mitochondria are tiny energy producers inside most of your cells. They are the primary source of energy required to keep your body functioning optimally.

As mitochondrial function is at the heart of your health, optimizing it is extremely important to health and disease prevention. Mitochondrial dysfunction may lead to cardiovascular disease, depression, type 2 diabetes, stroke and neurological dysfunction. In essence, at the core of many diseases are dysfunctional mitochondria, and the diseases are simply different labels for a foundational pathology at the cellular level.

Source:mercola.com

Lung ultrasound to manage fluid volume in dialysis.


Volume overload is an important, but often hidden risk factor for all-cause and cardiovascular death in end stage renal disease (ESRD) patients. Monitoring lung water could be used as a biomarker for detecting and monitoring lung congestion in populations at risk for pulmonary edema, as substantial lung water accumulation may occur before clinical symptoms of heart failure and in other conditions appear, explains the author of the present Italian study. Until recently, measuring lung water meant using costly radioactive compounds, X-rays or placing catheter into the pulmonary artery. But as the present study shows, ultrasound (US) could also allow valid, reproducible estimates of lung water.

Why ultrasound? Water accumulates in the lung interstitium, thickening the interlobular septa and thereby generating visible bundles in the ultrasound. These bundles are a US equivalent of B lines (BL-US) detected in chest radiographs – which means that simply counting BL-US could offer an estimate of lung water. Studies have also shown that the number of BL-US is associated with parameters such as LV filling pressure, larger LV end-diastolic and end-systolic diameters, LV mass index, left atrial volume index, tricuspid regurgitation velocity and estimated pulmonary artery systolic pressure in heart failure (HF) patients. And: Ultrasound could also be particularly valuable in intensive care patients, where it could be used to discriminate moderate and severe lung congestion.

Ultrasound (US) is a well-validated technique that allows reliable estimates of lung water in the care of hemodialysis patients at high cardiovascular risk, summarizes the author.

 

Abstract

Volume overload is a hidden, pervasive complication in dialysis patients with dyspnea and pulmonary edema being its main clinical manifestations. Measuring lung water has clinical potential because it allows timely treatment of lung congestion at a preclinical stage. Chest ultrasound (US) is a novel, well-validated technique that allows reliable estimates of lung water in clinical practice. The application of this technique in dialysis patients has shown that an unsuspectedly high proportion of these patients have moderate to severe lung congestion which is usually asymptomatic. Furthermore, lung congestion in these patients is only loosely associated with fluid excess as measured by bioimpedance (BIA). Lung congestion is associated with a high death risk in dialysis patients and therefore represents a potential treatment target. The “Lung water by Ultra-Sound guided Treatment to prevent death and cardiovascular complications in high risk ESRD patients with cardiomyopathy” (LUST) study will provide important information about the clinical value of this technique in the care of hemodialysis patients at high cardiovascular risk.

Volume overload is considered a main, hidden risk factor for all-cause and cardiovascular death in end stage renal disease (ESRD) patients [1]. Observational studies support the hypothesis that chronic volume expansion is per se (i.e., above and beyond blood pressure and other risk factors) a strong, direct predictor of the risk of death in hemodialysis patients [2, 3]. A major reason hindering optimization of fluid volume status in dialysis patients is the almost universal presence of LVH and its associated LV diastolic and systolic dysfunction [4] which makes these patients hypotension-prone and unable to mount a successful counter-regulatory hemodynamic response to the volume removal at the UF rate applied in standard dialysis schedules.

Estimates of fluid volume in dialysis patients are being increasingly applied to guide the prescription of ultrafiltration and dietary sodium intake in dialysis patients. These estimates include the measurement of total and extracellular fluid volume by bio-impedance (BIA) [5], inferior vena cava diameter, plasma volume changes across dialysis by the Crit-Line system and circulating levels of cardiac natriuretic peptides. All these biomarkers still have a low evidentiary basis supporting their systematic use in ESRD. Though small trials based on surrogates seem to support the use of BIA [6, 7] we still lack trials based on clinical endpoints documenting the usefulness of this technique. Inferior vena cava diameter does not provide useful information for probing dry weight [8]. As with BIA, there are no clinical trials using valid clinical endpoints which test the value of this measurement in clinical practice. In a clinical trial testing the application of Crit-Line to guide UF, the Crit-Line Intradialytic Monitoring Benefit (CLIMB) study, adverse events in the active arm of the trial were significantly higher than in the control arm [9]. Finally, cardiac natriuretic peptides, ANP, BNP and Pro-BNP, largely reflect left ventricular (LV) myocardial mass and LV end-diastolic pressure rather than circulating volume [10, 11].

It should be noted that, however, reliable and accurate a technique might be, the derived estimates of global fluid volumes may be insufficient to guide clinical decisions about fluid volume optimization in ESRD patients. Fluid accumulation in critical organs like the lung is of particular importance. Until recently, no easily applicable method for measuring fluid accumulation in this organ was available. Overall, notwithstanding the large majority of nephrologists who have no doubt about the paramount importance of body fluid volume optimization in the care of dialysis patients, most dialysis centers have no established clinical policy for evaluating and monitoring fluid volume status [12].

Fluid Excess, Hemodynamic, and Pulmonary Congestion

Together with the heart, the lung is the organ where fluid excess poses the major health hazards. Accumulation of fluid in a dialysis patient’s lungs entails a high risk for pulmonary edema [13, 14]. Superficially, pulmonary edema might be equated with volume overload. However, fluid overload apart, lung water content also depends on two additional, quite relevant factors: left ventricular (LV) function and lung permeability. In both LV systolic and diastolic dysfunction, LV end-diastolic pressure and hence left atrial pressure are high; retrograde transmission of this pressure to pulmonary veins and lung capillaries results into high pulmonary capillary wedge pressure — “hemodynamic congestion”. Hemodynamic congestion sets the stage for extravasation of fluid into the lung interstitium and into the alveoli, resulting into “pulmonary congestion”.

Even though pulmonary congestion is, in most cases, attributable to high pulmonary capillary pressure concomitant with fluid overload, this alteration may also occur without fluid overload pointing to fluid redistribution triggered by systemic arterial and/or venous vasoconstriction. In this regard, it cannot be overemphasized that fluid removal in patients with decompensated heart failure has just a loose relationship with the improvement of dyspnea [15]. In the same vein, application of continuous intrathoracic impedance monitoring in these patients showed that pulmonary congestion may antedate by 2 weeks frank pulmonary edema in these patients. Of note, a high degree of tolerance to fluid accumulation in the lung without superimposed dyspnea is well-documented in patients with nephrotic syndrome where an estimated average lung water excess as high as 1.7 l can remain asymptomatic [16]. Yet, in the vast majority of cases, particularly in patients with LV disorders, congestion eventually triggers clinical lung congestion, i.e., dyspnea, a symptom most often leading to hospitalization.

The relevance of the second factor that may facilitate lung congestion in patients with kidney diseases, lung permeability, is obvious in acute kidney injury a condition where, independently of fluid overload, systemic inflammation may dramatically increase alveolo-capillary permeability and trigger life-threatening congestion [17]. Furthermore, pulmonary capillaries are recognized as a vulnerable segment of the cardiopulmonary circulation in patients with heart disease [18] which has obvious implications in dialysis patients, a population where cardiomyopathy is almost universal [4].

Measuring Lung Congestion

Because substantial lung water accumulation may occur before clinical symptoms in heart failure and in other conditions, monitoring lung water has prima facie credibility as a biomarker for detecting and monitoring lung congestion in populations at risk for pulmonary edema. However, until recently measuring lung water entailed either the use of costly radioactive compounds [19], exposure to X-rays [20] or the placement of a catheter into the pulmonary artery to apply the thermo-dilution technique [21]. The discovery that ultrasound (US) may allow valid, reproducible estimates of lung water as well as corollary information on other pulmonary alterations has been a breakthrough in pulmonary medicine [22].

The rationale for adopting ultrasound to measure lung water is that water accumulation in the lung interstitium thickens the interlobular septa. This thickening produces a reverberation of the US beam and generates visible bundles at narrow basis going from the probe to the edge of the echotomography screen. These bundles are a true US equivalent of B lines [BL-US] detected in chest roentgenograms and their simple count provides an estimate of lung water [23] (Fig. 1). The number of BL-US is associated with LV filling pressure [23] as well as with larger LV end-diastolic and end-systolic diameters, LV mass index, left atrial volume index, tricuspid regurgitation velocity and estimated pulmonary artery systolic pressure in heart failure (HF) patients with dyspnea as well as in those without overt cardiac decompensation [24]. Beyond heart failure, the technique is of particular value in intensive care patients where it is a powerful instrument to discriminate moderate and severe lung congestion (areas under the ROC curves of 0.94 and 0.96 respectively) [25].

Figure 1.

Ultrasound B lines in interstitial lung edema are generated because the US beam reverberates against the thickened (edematous) interlobular septa.

Lung Congestion in ESRD

Lung US has specifically been validated in ESRD patients where it holds high intra and interobserver reproducibility as well as high technical reproducibility, i.e. it provides reproducible results with different echo-tomography machines [26]. Measuring the degree of lung congestion in dialysis patients has clinical potential for various reasons. Lung congestion is common both in hemodialysis [26-28] and in peritoneal dialysis [29] patients where it is usually asymptomatic. There is a dose–response relationship in dialysis patients between the number of US B lines and both the risk of mortality and cardiovascular complications which is largely independent of other risk factors ([27, 28]). In addition, the number of US-B lines is strongly associated with various echocardiography parameters including left atrial volume, pulmonary artery pressure, Ee’ ratio (an index of diastolic function) and, particularly, with the ejection fraction; these associations hold true both predialysis and postdialysis implying that the relationships are largely independent of volume overload [26].

Lung auscultation to detect crackles at the lung bases is a cornerstone for the diagnosis and the monitoring of congestion in patients with heart failure and in those with chronic kidney failure [30]. However, as with several other time honored clinical signs [31], the reliability of auscultation for the diagnosis of lung congestion has not, until very recently, been specifically assessed in the dialysis population. Investigators of the “Lung water by Ultra-Sound guided Treatment to prevent death and cardiovascular complications in high risk ESRD patients with cardiomyopathy” (LUST) [32], a randomized trial testing whether the use of lung US in high risk hemodialysis patients may improve clinical outcomes and echocardiographic indicators of cardiomyopathy in these patients, adopted lung sonography as a reference test to examine the diagnostic reliability of crackles as a sign of pulmonary congestion [33] in over 1000 paired measurements of lung water by US with simultaneous standardized auscultation of the thorax. These analyses showed that crackles were quite insensitive in detecting interstitial lung edema found by lung US [26].

Lung congestion in heart failure is a gradual phenomenon and pulmonary edema may supervene after one or more weeks of insidious accumulation of fluid in the lung [34]. This is of particular relevance in dialysis patients, a population where lung water (as measured US-B lines) only weakly correlated with total body water (by BIA) and interdialysis weight gain10. Furthermore, dialysis patients have increased alveolo-capillary permeability [35] and the average estimated interstitial lung water in ESRD patients is about 1.2 l, an unsuspectedly high degree of pulmonary congestion [23].

The application of lung US has relevant clinical potential. However, its usefulness in patients needs to be tested in a randomized trial comparing a treatment policy guided by this technique with that using the standard approach. Currently, the usefulness of targeting asymptomatic lung congestion remains unproven. The CLIMB study is a cautionary tale about accepting on purely physiologic grounds the use of medical devices and the lack of proper trials testing their impact on clinical endpoints.

Lung US is a well-validated, simple and low-cost technique which can be easily applied by nephrologists at the bedside by using virtually all, old and new, US machines [36] including affordable hand-held US devices. The LUST study is currently testing whether the use of lung US by nephrologists may improve clinical outcomes in high risk dialysis patients. It will provide important information about the clinical value of this technique in the care of hemodialysis patients at high cardiovascular risk.

Source:http://onlinelibrary.wiley.com

‘Indian firm’s Zika virus vaccine 100% efficient in animal trials’.


Infected mosquitoes can be carriers of the Zika virus.

Study shows that it works against both Asian and African strains of virus

The Hyderabad-based Bharat Biotech’s ‘killed Zika virus vaccine’ using an African strain has shown 100% efficacy against mortality and disease in animal studies, a study has shown. A ‘killed virus vaccine’ or ‘inactivated vaccine’ contains virus that has been grown in culture and then killed using physical or chemical processes.

The results of the study has been published in the Nature group journal Scientific Reports. Two doses (5 and 10 microgram) of the vaccine given through intramuscular route on days 0 and 21 to mice were found to protect the animals against Zika virus seven days after the second vaccination.

The vaccine was found to confer 100% protection against infection caused by an Asian Zika virus strain as well as by the African Zika virus strain.

All the animals that were not vaccinated died eight days after infection by the African strain and 12 days after infection by the Asian strain.

While all the animals that received the vaccine exhibited “undetectable” viral load, the amount of virus present in animals that did not receive the vaccine peaked four days after being infected with either the African or Asian Zika virus strain.

“The vaccine was developed using the African strain of the virus. It is important to prove that the vaccine developed with the African strain also protects against Zika infection caused by the contemporary Asian strains of Zika virus.

Importing the contemporary Asian strains into the country was difficult, and hence the vaccine challenge studies with Asian strain had to be outsourced to a contact research organisation in the U.S.,” says K. Sumathy from Bharat Biotech and the first author of the paper. A particular kind of mouse — AG129 — which is highly immunocompromised and hence highly susceptible to virus infection was used for the study.

Immune response

The level of immune response induced by the vaccine was also studied using another kind of mouse model — Balb/c mice. Unlike the AG129 mice, this mouse model is immunocompetent and elicits full spectrum of immune response.

Animals that received the vaccine developed Zika-neutralising antibodies on day 14 after the first dose and a week after the second dose.

When the animals were infected with Zika virus post-vaccination, the virus in the vaccinated animals was “undetectable”, while 72-96 hours after infection it peaked in animals that did not receive the vaccine.

“In both the mice models, the vaccine-induced protective immunity against virus challenge was observed,” says Dr. Sumathy. “Vaccine was made only with the African virus strain, but the vaccinated mice was challenged [infected] with both the African and the Asian strains. Our vaccine offered equivalent protection against challenge with both the African and the Asian strains of Zika virus.”

Though 5 and 10 microgram of vaccine were tested, the amount of antibodies elicited by the higher dose was “not significantly” higher than that elicited by 5 microgram of the vaccine, says Dr. Sumathy. Vaccination protected the animals against Zika virus and disease up to 14 and 20 days after being challenged with the virus.

The company also carried out passive immunisation studies to show that the Zika vaccine-induced antibodies confer protection against the virus in mice that were exposed to the virus.

Rabbits were vaccinated with the vaccine and the vaccine-induced antibodies were given to mice. While no virus was detected in mice 24-144 hours after passive immunisation, the viral load peaked 72-96 hours in mice that did not receive vaccine-induced antibodies.

Source:thehindu.com

Hemophilia – Gene Therapy .


uniQure has built an exciting portfolio of clinical and pre-clinical programs focused on hemophilia.

uniQure has built an exciting portfolio of clinical and pre-clinical programs focused on hemophilia. This overall effort is well supported by uniQure’s proprietary position with our AAV5 viral vector, which has shown particular affinity for reaching the liver. AAV5 has the benefit of a low prevalence of pre-existing anti-AAV5 antibodies in patients screened to date in uniQure’s clinical trials and as indicated in medical literature. uniQure also has gained extensive experience in the development and regulatory approval of the first gene therapy approved in the Western world: Glybera.

Hemophilia B

uniQure is developing a gene therapy for hemophilia B, a severe orphan blood clotting disorder. The program’s gene therapy product candidate consists of an AAV5 vector carrying a therapeutic human Factor IX, or FIX, gene cassette that uniQure has exclusively licensed from St. Jude Children’s Research Hospital in Memphis, Tennessee. uniQure is currently conducting a Phase I/II study of AMT-060 in patients with severe hemophilia B and advanced joint disease.

In December 2016, the Company presented updated clinical data from our Phase I/II trial (view press release).  In January 2017, AMT-060 received Breakthrough Therapy designation from the U.S. Food and Drug Administration in January 2017 based on results from this ongoing, dose-ranging study (view press release).

The data from our Phase I/II study demonstrate AMT-060 is delivering sustained and significantly improved clinical benefits to patients suffering from severe hemophilia B by enabling them to discontinue bi-weekly infusions of FIX replacement therapy and to essentially eliminate the risk of spontaneous bleeding. We are observing a therapeutic benefit from AMT-060 that is clearly superior to their  previous prophylactic FIX  replacement therapy regimen, even in patients with advanced joint disease who still experienced many bleeds despite prophylaxis with FIX.

At both doses evaluated, AMT-060 appears to be safe and well-tolerated with no loss of FIX activity, no activation of T-cell response and no development of inhibitors for any of the 10 patients in the study.

The data from this ongoing study demonstrate clinically significant and sustained increases in FIX activity, substantial reductions in FIX replacement usage and a near cessation of spontaneous bleeding episodes.

AMT-060 has demonstrated a very low screening failure rate, with all patients screened in the study testing negative for pre-existing anti-AAV5 NABs, which suggests that a large proportion of the hemophilia patient population may be eligible for treatment with AMT-060.   The proprietary elements of AMT-060, including our fully-humanized FIX gene cassette and AAV5 vector, are the only gene therapy components clinically demonstrated in hemophilia B to be safe, effective, and durable for up to six and a half years.  These factors, along with our commercial-scale manufacturing capabilities, differentiate AMT-060 from other hemophilia gene therapies in development, and we look forward to advancing our program into a late-stage clinical study.

 

Hemophilia A

As another indication important to uniQure’s efforts in liver/metabolism, the Company is in pre-clinical evaluation for a gene therapy to treat hemophilia A.  We expect to provide an update on this program sometime in the first half of 2017.

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