Showing posts with label during. Show all posts
Showing posts with label during. Show all posts

Monday, 19 August 2013

Sympathetic neurons engage in "cross talk" with cells in the pancreas during early development

Main Category: Diabetes
Article Date: 19 Aug 2013 - 1:00 PDT Current ratings for:
Sympathetic neurons engage in "cross talk" with cells in the pancreas during early development
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The human body is a complicated system of blood vessels, nerves, organs, tissue and cells each with a specific job to do. When all are working together, it's a symphony of form and function as each instrument plays its intended roles.

Biologist Rejji Kuruvilla and her fellow researchers uncovered what happens when one instrument is not playing its part.

Kuruvilla along with graduate students Philip Borden and Jessica Houtz, both from the Biology Department at Johns Hopkins University's Krieger School of Arts and Sciences, and Dr. Steven Leach from the McKusick-Nathans Institute of Genetic Medicine at the Johns Hopkins School of Medicine, recently published a paper in the journal Cell Reports exploring whether "cross-talk" or reciprocal signaling, takes place between the neurons in the sympathetic nervous system and the tissues that the nerves connect to. In this case the targeted tissue called islets, were in the pancreas.

"We knew that sympathetic neurons need molecular signals from the tissues that they connect with, to grow and survive," said Kuruvilla. "What we did not know was whether the neurons would reciprocally signal to the target tissues to instruct them to grow and mature. It made sense to focus on the pancreas because of previous studies done in diabetic animal models where sympathetic nerves within the pancreas were found to retract early on in the disease, suggesting that dysfunction of the nerves could be an early trigger for pancreatic defects."

The researchers spent approximately three years working with lab mice to test the various scenarios in which signaling between sympathetic neurons and islet cells might take place. The experiments focused on what effects removing the sympathetic nerves would have on pancreas development in newborn mice.

Previous studies had shown that pancreatic cells release a signal of their own, a nerve growth protein, that directs the sympathetic nerves toward the pancreas and provides necessary nutrition to sustain the nerves.

In turn, Kuruvilla's team found that in mutant mice, the removal of the sympathetic neurons resulted in deformities in the architecture of the pancreatic islet cells and defects in insulin secretion and glucose metabolism.

Pancreatic islets are highly organized functional micro-organs with a defined size, shape and distinctive arrangement of endocrine cells. It's this marriage of form and function that result in cells clustered close together, that creates greater, more efficient islet cell function.

However, the mutant mice, with their sympathetic neurons removed, had islet formations that were misshapen, sported lesions and developed in a patchy, uneven manner. Because of their dysfunctional islet cell development, postnatal mice did not secrete enough insulin when confronted with high glucose, and had high blood glucose levels as a result. Increased levels of blood glucose in humans is a hallmark of diabetes.

It's known in neuroscience that the neurons in question from the sympathetic nervous system control the body's "flight or fight" response and communicate with connected tissues by releasing a chemical messenger called norepinephrine. The release of norepinephrine also plays an important role in the development and maturation of islets, said Kuruvilla.

Using sympathetic neurons and islet cells grown together in a culture dish, the researchers observed that islet cells move toward the nerves and identified norepinephrine as the nerve signal that causes the movement of the islet cells.

"Seeing how these islet cells were responding to sympathetic neurons both in a dish and the effects of removing the nerves in a whole animal on islet shape and functions were pretty remarkable," said Borden, lead author of the paper. "It was clear to us that sympathetic neurons were key to how islets were developing, something no one else had shown."

Kuruvilla said these studies, identifying sympathetic nerves as a critical player in organizing pancreatic cells during development and influencing their later function, could add to a better understanding of treating diabetes in the future. The research also lends support to the value in considering the importance of external factors such as nerves and blood vessels when transplanting islet cells for the treatment of diabetes in patients.

"This study reveals interactions between two co-developing systems, sympathetic neurons and pancreatic islet cells, that has important implications for peripheral organ development, and for regeneration of these tissues following injury or disease," said Kuruvilla.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our diabetes section for the latest news on this subject. Please use one of the following formats to cite this article in your essay, paper or report:

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'Sympathetic neurons engage in "cross talk" with cells in the pancreas during early development'

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Friday, 16 August 2013

International research team identifies top risk factors for children during influenza pandemic

Main Category: Pediatrics / Children's Health
Also Included In: Flu / Cold / SARS
Article Date: 15 Aug 2013 - 2:00 PDT Current ratings for:
International research team identifies top risk factors for children during influenza pandemic
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An international team of pediatric specialists, representing the world's five major pediatric emergency medicine research networks, has identified several crucial risk factors for alerting clinicians to children most susceptible to life-threatening infections from the H1N1 influenza (flu). It is the first study to detail which clinical factors at hospital arrival in children with influenza-like illness and H1N1 infection are associated with the progressive risk to either severe infection or death.

In a study now on online in the prestigious British Medical Journal, researchers examined pediatric cases from dozens of emergency departments in hospitals around the world during the global influenza pandemic of 2009. The results enabled the team to pinpoint several clinical risk factors for severe infections in youngsters who arrive at a hospital with influenza-like illnesses due to H1N1 infections. The information would be invaluable during a pandemic, when emergency departments and primary-care facilities experience large surges of young patients who arrive with flu-like symptoms.

The study, which assessed each patient's clinical history and physical examination, identified the following predictors of severe H1N1 infection and potentially fatal outcomes in children:

History of chronic lung diseaseHistory of cerebral palsy/developmental delaySigns of chest retractions (difficulty breathing)Signs of dehydrationRequires oxygen to keep blood levels normalHeart rate that exceeds normal range (tachycardia) relative to age

"The basic question clinicians face when they are in the middle of an influenza epidemic like H1N1 is whether their patient is at risk of severe complications," said Stuart Dalziel, lead author of the study and a pediatrician at New Zealand's Starship Children's Hospital and The University of Auckland, and vice-chair of the Paediatric Research in Emergency Departments International Collaborative (PREDICT) network. "One of the key strengths of this study is that it provides clinicians with meaningful and more precise information that can enable them to identify those children with fever and flu-like symptoms who are at greater risk of severe complications."

The findings stem from 265 pediatric cases culled from 79 emergency departments of hospitals associated with the Pediatric Emergency Research Networks (PERN) in 12 countries.

"Having a more accurate idea of what to look for in pediatric cases, especially during a pandemic, would be especially important to clinicians because it provides crucial guidance for those who would be trying to direct the appropriate levels of treatment for many patients in a short time," said Nathan Kuppermann, professor and chair of emergency medicine at the University of California, Davis, one of the study's senior authors and a principal investigator in the Pediatric Emergency Care Applied Research Network (PECARN).

Because of its unparalleled global network of hospitals and patient data, the PERN study also added weight to the efficacy and use of the anti-viral drug oseltamivir (trade name Tamiflu) to treat the children with H1N1 influenza virus infections to reduce the severity of infection. Researchers noted there was good evidence of an association between oseltamivir treatment and a reduced frequency of death in children admitted to an intensive care unit for assisted ventilation.

"This study shows the incredible power of PERN, bringing together five pediatric emergency research networks and many emergency departments from around the world, to produce this very significant study which has the power to identify the most at-risk children in a future influenza pandemic," said Terry P. Klassen, the study's senior author, CEO and scientific director at the Manitoba Institute of Child Health in Canada and a site investigator with Pediatric Emergency Research Canada (PERC).

The global research collaborative is comprised of the five major pediatric networks, which are located in Europe and the Middle East (Research in European Paediatric Emergency Medicine, or REPEM), North America (PECARN, PERC and the Pediatric Emergency Medicine Collaborative Research Committee), and in Australia and New Zealand (PREDICT). Together, the five networks have access to data from more than three million pediatric emergency department cases annually from more than 100 hospitals, which are located in four of the six World Health Organization (WHO) regions.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our pediatrics / children's health section for the latest news on this subject.

Funding: PECARN is supported by HRSA/MCHB/EMSC through the following cooperative agreements: U03MC00001, U03MC00003, U03MC00006, U03MC00007, U03MC00008, U03MC22684, and U03MC22685. Stuart Dalziel is supported by the Health Research Council of New Zealand. John M.D. Thompson received funding from the Logan Campbell Trust, Auckland, New Zealand, to attend an investigator meeting, with time funded by CureKids, New Zealand. Investigators’ time was funded by their host institutions and/or research networks. No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Predictors of severe H1N1 infection in children presenting within Pediatric Emergency Research Networks (PERN): retrospective case-control study

BMJ 2013; 347 doi: 10.1136/bmj.f4836

Stuart R Dalziel, John MD Thompson, Charles G Macias, Ricardo M Fernandes, David W Johnson, Yehezkel Waisman, Nicholas Cheng, Jason Acworth, James M Chamberlain, Martin H Osmond, Amy Plint, Paolo Valerio, Karen JL Black, Eleanor Fitzpatrick, Amanda S Newton, Nathan Kuppermann, Terry P Klassen

UC Davis Health System

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Tuesday, 30 July 2013

No improvement seen in HIV-associated lymphoma survival during the antiretroviral therapy era

Main Category: Lymphoma / Leukemia / Myeloma
Also Included In: HIV / AIDS
Article Date: 30 Jul 2013 - 0:00 PDT Current ratings for:
No improvement seen in HIV-associated lymphoma survival during the antiretroviral therapy era
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Stable survival rates were observed for HIV-associated lymphoma patients during the antiretroviral therapy (ART) era in the US, according to a new study published in the Journal of the National Cancer Institute.

Studies have shown that HIV infection increases the risk of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) and that incidence for many lymphoma types has not decreased in the ART era. Furthermore, lymphoma is the most frequent cancer-related cause of death among HIV-infected persons. However, trends in presentation and survival have not been investigated among HIV-associated lymphoma patients in routine care since the beginning of the ART era.

Satish Gopal, M.D., M.P.H., from the Program in Global Oncology at the Lineberger Comprehensive Cancer Center of the University of North Carolina, and colleagues compared differences in presentation and survival, across histologic subtypes and diagnosis years, among HIV-infected lymphoma patients. They also examined predictors of death in this population. Data from 476 HIV-associated lymphoma patients living in the US who were diagnosed with various types of lymphoma including HL, diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), primary central nervous system lymphoma (PCNSL), and other types of NHL, between 1996 and 2010 were analyzed using various statistical methods.

Their results demonstrate that HIV-associated lymphoma is heterogeneous and changing since the ART era began. Clinical presentations across the different lymphoma subtypes was highly variable during the study period (79 HL, 201 DLBCL, 56 BL, 54 PCNSL, and 86 with other NHL). Histologic shifts in the proportion of BL vs other NHL subtypes is increasing consistent with other reports. Data showed that more recently diagnosed patients were older and more likely to be male, of nonwhite/nonblack ethnicity (primarily Latino patients), to be men who have sex with men, and to have prior AIDS-related illness. They were also more likely to be on ART at lymphoma diagnosis with higher CD4 counts and better HIV control. The authors also report that more recent diagnosis year was not associated with decreased mortality and that 61.6% of patients with HIV-associated HL were alive 5 years after lymphoma diagnosis, compared with 50.0% for BL, 44.1% for DLBCL, 43.3% for other NHL, and 22.8% for PCNSL. Of note, lymphomas occurring on ART were associated with a doubling of mortality, which may suggest important biologic differences between tumors developing on and off ART, although these results require confirmation.

Gopal and colleagues conclude, "These results highlight an ongoing need to elucidate lymphoma biology and optimize treatments for this challenging population to reduce deaths from one of the leading causes of mortality in the modern ART era."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our lymphoma / leukemia / myeloma section for the latest news on this subject.

In an accompanying editorial, Kieron Dunleavy, M.D., and Wyndham H. Wilson, M.D., Ph.D., from the Metabolism Branch of the Center for Cancer Research at the National Cancer Institute, state the findings reflect the shifting demographics of the HIV epidemic in the US. However, the shift towards more biologically favorable and curable types of lymphoma has not resulted in improved survival over the study period. They assert, "In conclusion, because HIV-associated lymphomas are potentially as curable as those arising in HIV-negative patients, it is critical that they be approached with the same care as HIV negative cases."

Journal of the National Cancer Institute

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'No improvement seen in HIV-associated lymphoma survival during the antiretroviral therapy era'

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Monday, 29 July 2013

The frequency and duration of patient-doctor contact during dialysis care key to patients' health

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our urology / nephrology section for the latest news on this subject.

Disclosures: The DOPPS is administered by Arbor Research Collaborative for Health and is supported by scientific research grants from Amgen (since 1996), Kyowa Hakko Kirin (since 1999, in Japan), Sanofi Renal (since 2009), AbbVie (since 2009), Baxter (since 2011), Vifor Fresenius Renal Pharma (since 2011), and Fresenius Medical Care (since 2012) without restrictions on publications. Dr. Robinson has received speaker's fees from Kyowa Hakko Kirin. Dr. Pisoni has received speaker's fees from Amgen, Kyowa Hakko Kirin, and Vifor; has served as a consultant for Pursuit Vascular; and has served on an advisory panel for Merck. Dr. Akizawa has received speaker's fees and research grant for Kyowa Hakko Kirin. The corresponding author and all other authors have no potential conflicts of interest to declare.

Article: "Associations of Frequency and Duration of Patient-Doctor Contact in Hemodialysis Facilities with Mortality," appeared online on July 25, 2013, doi: 10.1681/2012080831.

Study co-authors include Angelo Karaboyas, MS Bruce Robinson, MD, FACP, Yun Li, PhD, Shunichi Fukuhara, MD, DMS, Brian Bieber, MS Hugh Rayner MD, FRCP, Vittorio Andreucci, MD, Ronald Pisoni, PhD, Friedrich Port, MD, Hal Morgenstern, PhD, Tadao Akizawa, MD, PhD, and Rajiv Saran, MBBS, MD, MRCP, MS.

American Society of Nephrology

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Friday, 26 July 2013

Preventing nerve injury during thyroid surgery by routine exposure of recurrent laryngeal nerve

Main Category: Ear, Nose and Throat
Also Included In: Endocrinology;  Neurology / Neuroscience
Article Date: 25 Jul 2013 - 1:00 PDT Current ratings for:
Preventing nerve injury during thyroid surgery by routine exposure of recurrent laryngeal nerve
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Recurrent laryngeal nerve injury is the most common serious complication of thyroid surgery. Therefore, preventing recurrent laryngeal nerve injury is an important goal in thyroid surgery.

A retrospective clinical controlled study from Xinhua Hospital, Shanghai Jiao Tong University School of Medicine demonstrates that dissecting the recurrent laryngeal nerve during thyroid surgery is clinically significant for preventing nerve injury.

To determine the value of dissecting the recurrent laryngeal nerve during thyroid surgery with respect to preventing recurrent laryngeal nerve injury, this study retrospectively analyzed clinical data from 5 344 patients undergoing thyroidectomy. Among these cases, 548 underwent dissection of the recurrent laryngeal nerve, while 4 796 did not. There were 12 cases of recurrent laryngeal nerve injury following recurrent laryngeal nerve dissection (injury rate of 2.2%) and 512 cases of recurrent laryngeal nerve injury in those not undergoing nerve dissection (injury rate of 10.7%). This difference remained statistically significant between the two groups in terms of type of thyroid disease, type of surgery, and number of surgeries.

Among the 548 cases undergoing recurrent laryngeal nerve dissection, 128 developed anatomical variations of the recurrent laryngeal nerve (incidence rate of 23.4%), but no recurrent laryngeal nerve injury was found. In addition, the incidence of recurrent laryngeal nerve injury was significantly lower in patients with the inferior parathyroid gland and middle thyroid veins used as landmarks for locating the recurrent laryngeal nerve compared with those with the entry of the recurrent laryngeal nerve into the larynx as a landmark.

Among the 548 cases, seven of the 442 cases (1.6%) with the inferior parathyroid gland as a landmark for locating recurrent laryngeal nerves showed recurrent laryngeal nerve injury; two of the 79 cases (2.5%) with the middle thyroid vein as a landmark were injured; and three of the 27 cases (11.1%) with the recurrent laryngeal nerve into the larynx as the landmark showed recurrent laryngeal nerve injury.

These findings were published in Neural Regeneration Research (Vol. 8, No. 17, 2013).

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our ear, nose and throat section for the latest news on this subject.

Article: " Routine exposure of recurrent laryngeal nerve in thyroid surgery can prevent nerve injury " by Chenling Shen, Mingliang Xiang, Hao Wu, Yan Ma, Li Chen, Lan Cheng (Department of Otolaryngology & Head and Neck Surgery, Ear Institute, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China)

Shen CL, Xiang ML, Wu H, Ma Y, Chen L, Cheng L. Routine exposure of recurrent laryngeal nerve in thyroid surgery can prevent nerve injury. Neural Regen Res. 2013;8(17):1568-1575.

Full text: http://www.sjzsyj.org:8080/Jweb_sjzs/CN/article/downloadArticleFile.do?attachType=PDF&id=625

Neural Regeneration Research

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'Preventing nerve injury during thyroid surgery by routine exposure of recurrent laryngeal nerve'

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Smoking during pregnancy linked to child conduct disorder

Editor's Choice
Academic Journal
Main Category: Pregnancy / Obstetrics
Also Included In: Smoking / Quit Smoking
Article Date: 25 Jul 2013 - 0:00 PDT Current ratings for:
Smoking during pregnancy linked to child conduct disorder
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Mothers who smoke during pregnancy are more likely to have children with conduct disorder (CD), according to a study published in the journal JAMA Psychiatry.

The study, carried out by researchers at the University of Leicester in the UK, analyzed the relationship between smoking during pregnancy and the risk of the child developing CD.

CD is a behavioral problem where a child can become highly aggressive, antisocial and defiant.

There are two types of the disorder:

Early onset CD occurs when a child shows symptoms of the disorder before the age of 10, and is often associated to ADHD (attention deficit hyperactivity disorder) Adolescent-onset is the most common type of this disorder, when the child shows CD symptoms after the age of 10. This often occurs alongside ADHD.

Researchers compared three studies for this latest research. The Christchurch Health and Development Study (CHDS), which includes biological and adopted children; the Early Growth and Development Study (EGDS), an adoption-at-birth study; and the Cardiff IVF (In Vitro Fertilization) Study (C-IVF), an adoption-at-conception study within genetically related families and genetically unrelated families.

The researchers looked at the levels of smoking during pregnancy, which were measured by the average number of cigarettes pregnant mothers smoked each day. This varied across all three studies.

Results revealed that children had a higher risk of developing CD if their mothers smoked during pregnancy, compared with mothers who did not smoke. This was the finding in both the children who were reared by genetically related mothers and those reared by genetically unrelated mothers.

Additionally, mothers who smoked more than 10 cigarettes a day had an even higher risk of their child developing CD.

Darya Gaysina of the University of Leicester says:

"Our findings suggest an association between pregnancy smoking and child conduct problems that is unlikely to be fully explained by postnatal environmental factors (for example, parenting practices) even when the postnatal passive genotype-environment correlation has been removed.

The causal explanation for the association between smoking in pregnancy and offspring conduct problems is not known but may include genetic factors and other prenatal environmental hazards, including smoking itself."

The study authors conclude that further research is needed, looking particularly at psychopathologic conditions to fully understand the association between smoking during pregnancy and conduct disorder.

The authors add that this could have important implications for future intervention and prevention programs aimed at remediating child conduct problems.

Previous studies have suggested that smoking during pregnancy can lead to ADHD. Research from Cincinnati Children's Hospital Medical Center revealed that a child is 2.5 times more likely to develop ADHD if their mother smoked during pregnancy.

Written by Honor Whiteman


Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today Visit our pregnancy / obstetrics section for the latest news on this subject.

Maternal Smoking During Pregnancy and Offspring Conduct Problems: Evidence From 3 Independent Genetically Sensitive Research Designs, JAMA Psychiatry, July 24, 2013.

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posted by Gloria on 25 Jul 2013 at 6:12 am

If the "facts" stated in this article were true we'd have the majority of "baby boomers" with conduct disorders. Our mothers smoked during pregnancy, no one told them they shouldn't. I, alone, have 17 first cousins and none of us have conduct disorders. As an RN I've seen the effects of smoking on my patients including smoking through the stoma on a tracheotomy patient. I abhor smoking but this article makes no sense to me.

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'Smoking during pregnancy linked to child conduct disorder'

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