Summer holiday time-bomb facing children with asthma

Main Category: Respiratory / Asthma
Also Included In: Pediatrics / Children's Health
Article Date: 31 Jul 2013 - 2:00 PDT Current ratings for:
Summer holiday time-bomb facing children with asthma

Parents are being warned of an 'asthma attack time-bomb' potentially facing the 1.1 million children with asthma in the UK when they go back to school after the summer holidays.

Leading charity Asthma UK has today released alarming new data showing a dramatic surge in children's hospital admissions that coincides with their return to school.

In England, more children are rushed to hospital with an asthma attack in mid-September than any other week during the year. Over 4.6 times as many children in England were hospitalised because of their asthma in the third week of September 2011, compared with just six weeks previously when hospital admissions were at their lowest.[1]

The September spike in children's asthma hospital admissions occurs year after year in the UK and in many other countries, usually two to three weeks into the autumn term. Children aged six to seven years old are the most seriously affected.[2]

Asthma UK is tackling this worrying trend by launching a campaign targeting parents. The charity believes parents can help prevent back-to-school asthma attacks by making sure children carry on taking their preventer inhalers twice daily during the summer holidays. Studies suggest that children who have been forgetting to take their medicines over the break will be at a higher risk of having a serious asthma attack when they are exposed to common classroom asthma triggers in September, such as colds, flu and stress.[3]

Dr Samantha Walker, Deputy Chief Executive of Asthma UK, explains: "Normal routines can go out of the window during the summer break, which can effectively create a time-bomb for children with asthma. Those who forget to take their preventer inhalers over the summer will be less in control of their symptoms and therefore more vulnerable to asthma attacks come term-time."

On average, two children in every classroom have asthma, making it the most common long-term condition for children in the UK. More than 25,000 children were hospitalised because of their asthma in 2011-12 [4], and eighteen children under 14 died as a result of an asthma attack in 2011.[5] Children who have allergies on top of their asthma are thought to be particularly at risk.

According to Kate Jones, her son Jack's asthma always tends to flare up in the last week of September, and the 15-year-old from the Wirral is usually hospitalised as a result. She says: "Jack's been having attacks in September for as long as I can remember. He often gets them a few weeks after returning to school following the Easter holidays too.

"I can see how parents might become a bit lax with their child's medication over the summer. It's such a busy time, whether you're going on holiday or just trying to arrange for family members to look after them while you're at work. And that's another issue; often your relatives or friends are not as aware of what medication your child should be taking and when."

Asthma UK estimates that three quarters of asthma hospital admissions could be avoided with the right care and management. The charity is urging parents whose children have asthma to order a free 'My Asthma' pack, a child-friendly resource which helps under 12s develop a fun routine to manage their asthma over the summer, and as a result, reduce their risk of an attack in September.

Find out more about the 'Teach Asthma a Lesson Next Term!' campaign. Visit www.asthma.org.uk/backtoschool to order a My Asthma pack for your child.

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

[1] Data source: Hospital Episode Statistics (HES), Health and Social Care Information Centre . Data acquired July 2013. In 2011-12, 582 children were hospitalised for their asthma in week 26 (w/c 19th September) compared with 125 children in week 20 (w/c 8th August).

[2] Sears MR, Johnston NW. Understanding the September asthma epidemic. McMaster University, Hamilton, Ontario, Canada. Journal of Allergy and Clinical Immunology, 10/2007; 120(3): 526-9

[3] Johnston NW, Johnston SL, Duncan JM, Greene JM, Kebadze T, Keith PK, Roy M, Waserman S, Sears MR. The September epidemic of asthma exacerbations in children: a search for etiology. J Allergy Clin Immunol. 2005 Jan;115(1):132-8.

[4] Hospital Episode Statistics, Department of Health; Scottish Morbidity Record, Information Services Division, NHS Scotland; Health Services Wales; Hospital Inpatients System, Department of Health, Social Services & Public Safety Northern Ireland

[5] Office for National Statistics, General Register Office for Scotland, Northern Ireland Statistics & Research Agency

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Susceptibility to deadly fungal infection increased by methamphetamine

Main Category: Infectious Diseases / Bacteria / Viruses
Also Included In: Neurology / Neuroscience;  Alcohol / Addiction / Illegal Drugs;  Respiratory / Asthma
Article Date: 31 Jul 2013 - 2:00 PDT Current ratings for:
Susceptibility to deadly fungal infection increased by methamphetamine

Methamphetamine use can make a person more susceptible to the lung infection cryptococcosis, according to a study published in mBio®, the online open-access journal of the American Society for Microbiology.

Researchers found that injected methamphetamine (METH) significantly enhanced colonization of the lungs by Cryptococcus neoformans and accelerated progression of the disease and the time to death in mouse models. C. neoformans is usually harmless to healthy individuals, but METH causes chinks in the blood-brain barrier that can permit the fungus to invade the central nervous system, where it causes a deadly brain infection.

"The highest uptake of the drug is in the lungs," says corresponding author Luis Martinez of Long Island University-Post, in Brookville, New York and of Albert Einstein College of Medicine in The Bronx. "This may render the individual susceptible to infection. We wanted to know how METH would alter C. neoformans infection."

Thirteen million people in the US have abused METH in their lifetimes, and regular METH users numbered approximately 353,000 in 2010, the most recent year for which data are available. A central nervous system stimulant that adversely impacts immunological responses, recent studies show that injected METH accumulates in various sites in the body, but the lungs seem to accumulate the highest concentrations, says Martinez, which could well impact how the lung responds to invading pathogens.

To study the impact this accumulation might have on pulmonary infection, Martinez and his colleagues injected mice with doses of METH over the course of three weeks, then exposed those mice to the C. neoformans fungus. In humans, C. neoformans initially infects the lungs but often crosses the blood-brain barrier to infect the central nervous system and cause meningitis. In their experiments, METH significantly accelerated the speed with which the infected mice died, so that nine days after infection, 100% of METH treated mice were dead, compared to 50% of the control mice.

Using fluorescent microscopy to examine lung tissue in METH-treated and control mice, the researchers found that METH enhanced the interaction of C. neoformans with epithelial cells in the lining of the lung. Seven days after exposure to the fungus, the lungs of METH-treated mice showed large numbers of fungi surrounded by vast amounts of gooey polysaccharide in a biofilm-like arrangement. METH-treated mice also displayed low numbers of inflammatory cells early during infection and breathed faster than controls, a sign of respiratory distress.

Martinez says this greater ability to cause disease in the lung may be due in part to simple electrical attraction. Their analysis shows that METH imparts a greater negative charge on the surface of the fungal cells, possibly lending them a greater attraction to the surface of the lung and an enhanced ability to form a biofilm that can protect its members from attack by the immune system. The fungus also releases more of its capsular polysaccharide in METH-treated mice, which can help the organism colonize and persist in the lung.

"When the organism senses the drug, it basically modifies the polysaccharide in the capsule. This might be an explanation for the pathogenicity of the organism in the presence of the drug, but it also tells you how the organism senses the environment and that it will modify the way that it causes disease," Martinez says.

But the fungus doesn't stop in the lungs. "The drug stimulates colonization and biofilm formation in the lungs of these animals," says Martinez. "And this will follow to dissemination to the central nervous system by the fungus."

C. neoformans in the lung moved on to the bloodstream and then into the central nervous system. The brains of METH-treated mice had higher numbers of C. neoformans cells, greater quantities of the fungus' polysaccharide, and larger lesions than control mice, indicating that METH has a detrimental effect on the blood-brain barrier, permitting the pathogen to cross more easily from the bloodstream to infect the central nervous system.

"METH-induced alterations to the molecules responsible to maintain the integrity of the blood-brain barrier provide an explanation for the susceptibility of METH abuser to brain infection by HIV and other pathogens," write the authors.

Martinez and his colleagues plan to follow up on the work by investigating how aspects of the immune system might be involved in changes the drug causes to the blood-brain barrier.

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

Patel D, Desai GM, Frases S, Cordero RJB, DeLeon-Rodriguez CM, Eugenin EA, Nosanchuk JD, Martinez LR. 2013. Methamphetamine Enhances Cryptococcus neoformans Pulmonary Infection and Dissemination to the Brain, mBio 4(4):e00400-13. doi:10.1128/mBio.00400-13.

American Society for Microbiology

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The point at which the capacity to differentiate between living and non-living beings and environmental awareness develop

Main Category: Psychology / Psychiatry
Also Included In: Pediatrics / Children's Health
Article Date: 31 Jul 2013 - 1:00 PDT Current ratings for:
The point at which the capacity to differentiate between living and non-living beings and environmental awareness develop

José Domingo Villarroel, a researcher at the Teacher Training College in Bilbao (UPV/EHU-University of the Basque Country) has studied the capacity to differentiate between living and non-living beings and how this relates to environmental awareness.

118 girls and boys between the ages of 4 and 7 from public primary schools in Plentzia, Urduliz and Sopelana participated in the research and were interviewed by Villarroel himself. He himself says that the work was very laborious, "but enjoyable and what is more, the results were very striking."

Each interview consisted of two parts. The aim of the first was to analyse the capacity of the children to differentiate between living beings and inanimate objects. The children were shown eight photos, of which four were close-ups of living beings (a dog, a bird, a tree and a flower); the other four depicted inanimate objects: the sun, clouds, a car and a motorbike. "When each of the photos was shown to them, they were asked what they could see: a living being or an inanimate object."

The images used in the second part of the interview depicted inappropriate behaviour types and they had all been selected from children's books. These examples of bad behaviour could be classified into three groups: the ones that exert a negative effect on the wellbeing of someone else (taking away someone else's possessions or using violence against one's friends); the ones that do not fit in with social rules (picking one's nose or eating in a messy way); and the ones that harm plants (treading on a flower or carving drawings on a tree trunk using a knife).

Villarroel explains that "in the interview the children were presented with a dilemma; in other words, they were shown two examples of bad behaviour, and they had to choose which of the two was worse. They were presented with two kinds of dilemmas: in one they had to choose between breaking social rules or influencing the wellbeing of others; in the other, to break social rules or harm plants".

Moral thinking and the world of emotions

The researcher felt that the results of the work were interesting. "In the first part the responses were the expected ones. In fact, many children, especially young ones, are not capable of differentiating between living beings and non-living ones; for example, they find it very difficult to understand that a tree is a living being, yet they tend to believe that cars and motorbikes are alive," explains Villarroel. Children appear to relate the fact of being alive with movement.

In the second part, he found the results more striking, because he spotted a 'paradox'. Apparently, children believe that hurting another child or plants is more reprehensible that breaking social rules, "also in the cases in which they think that plants are not living beings." In other words, they are not absolutely sure whether the flower is a living thing; but they think it is much worse to tread on a flower than to slurp your soup or stick your fingers up your nose."

According to Villarroel, that paradox suggests that the awareness towards others is developed at an early age and that the development of moral thought is linked to the affective world, in other words, with what they receive from their parents and educators, and not so much through logic or rationality. "In fact, there are two main approaches that seek to explain the development of moral thought: some believe that it has to do with logical capacity; whereas others link it to the emotions and the affective world. The results I got reinforce the second approach," says Villarroel.

The research has been published in the scientific journal SpringerPlus, under the title "Environmental judgment in early childhood and its relationship with the understanding of the concept of living beings". And Villarroel has announced that he will be pursuing his research in the same direction: "Firstly I am very interested in finding out how children develop environmental awareness through their parents. And secondly, I would like to conduct the same research in other contexts, and also by comparing children from large and small populations, for example." He is also planning to publish another article on the same line of research in the specialised journal Journal of Biological Education.

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José Domingo Villarroel (Barakaldo, Basque Country, 1967) is a PhD holder in Biology. For several years he was a teacher of science and mathematics in Statutory Secondary Education. He currently lectures and researches at the Teacher Training College in Bilbao (UPV/EHU), in the Department of the Didactics of Mathematics and Experimental Sciences. He has had various scientific papers and books published; most of them deal with the comprehension and learning processes of basic scientific concepts.

Elhuyar Fundazioa

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Undoing a hairpin doubles gene activity

Main Category: Genetics
Article Date: 31 Jul 2013 - 1:00 PDT Current ratings for:
Undoing a hairpin doubles gene activity

Male fruit flies have one X chromosome per cell, females have two. So genes on the male X must work twice as hard to produce the same amount of protein as its female counterparts. An LMU team has found a new switch involved in making this possible.

In the fruit fly Drosophila - as in humans - the sexes have different sets of chromosomes. While females have two X chromosomes in their somatic cells, males have one X and one copy of the much smaller Y. The latter determines maleness but carries very few genes, while the X chromosome has thousands of genes. Many of these encode essential proteins that must be made in equal amounts in both sexes, and males that fail to meet this requirement are inviable.

The males make up for the difference in X chromosome copy number by ensuring that each gene on their X chromosome is expressed at twice the rate of its equivalent on a female X, a phenomenon known as dosage compensation. The so-called Dosage Compensation Complex (DCC) is responsible for distinguishing the X chromosome from the others in males and doubling the level of activity of most of the genes it contains. The DCC is a complicated molecular machine which, in addition to so-called MSL proteins, contains two long RNA molecules (referred to as roX RNAs). "Correct incorporation of roX RNAs is known to be essential for DCC function, but how this is accomplished has been unclear," says LMU biologist Professor Peter Becker, who studies how the operation of the DCC is regulated.

Switching to the binding mode

Members of his team have now discovered that a change in the structural conformation of the roX RNAs is a prerequisite for the functional activation of DCC. These RNAs all contain a characteristic hairpin structure, which is conserved in various fly species. "We have long supposed that such a widely conserved structure must be of functional significance, but we were unable to demonstrate a specific binding interaction between the hairpin and the MSL protein components of the DCC", Becker explains.

The reason for this is revealed in the new study. It turns out that the hairpin structure actually prevents protein binding. The hairpin must first be unwound by a specific enzyme before the MSL proteins can bind to the RNAs and a functional DCC is formed. The closed hairpin conformation is equivalent to a switch fixed in the OFF position. Unwinding of the hairpin flips the switch to ON, thus permitting assembly of the active DCC. "We believe that this switch is only activated under conditions that are found at certain sites on the X chromosome. This would ensure that dosage compensation is restricted to genes on the X", says Becker.

The researchers now assume that long RNAs play a much more active role in other regulatory complexes than has been suspected hitherto. Up to now, these RNAs have been seen as passive scaffolds for the binding of proteins. "We think though that they modulate the activity of the proteins they associate with. And we have now shown this for the DCC", Becker says. He will continue to work in this field. "Now it's getting really exciting," he says.

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ATP-Dependent roX RNA Remodeling by the Helicase maleless Enables Specific Association of MSL Proteins, Sylvain Maenner, Marisa Müller, Jonathan Fröhlich, Diana Langer, Peter B. Becker, doi: 10.1016/j.molcel.2013.06.011, Molecular Cell 2013

The study was supported by grants from the DFG to the Collaborative Research Center Transregio 5, and by an EU-funded ERC Advanced Grant for the project “Assembly and maintenance of a co-regulated chromosomal compartment” (ACCOMPLI).

Ludwig-Maximilians-Universität München

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Unintended consequences of prison reform

Main Category: Public Health
Article Date: 31 Jul 2013 - 0:00 PDT Current ratings for:
Unintended consequences of prison reform

The burden of improved conditions in state prisons may be borne by welfare recipients, according to new research from Rice University and Louisiana State University.

The study, "Intended and Unintended Consequences of Prison Reform" published online this month in the Journal of Law, Economics & Organization, examined the impact of federal court orders condemning prison crowding and the outcomes among states following these orders. The researchers found that court-mandated efforts by the federal government to improve living conditions in state prisons resulted in decreased welfare funding.

"When courts are effective in increasing spending on prisoners, the legislature has to increase taxes or cut spending in other programs, given states' balanced budget requirements," said Richard Boylan, professor of economics at Rice. "As a result, most of these increases in spending come at the expense of welfare spending and/or other social programs."

Four years before the courts stepped in, states that ultimately were court ordered to improve living conditions spent approximately 72 percent per inmate of what was spent by states that were not ordered to do so. Across the board, the litigation resulted in increased correctional expenditures to 87 percent per prisoner during the year in which the court order was issued and reaching 102 percent two years after the court order. These correctional facilities also saw lower inmate mortality rates (20 percent decrease), fewer prisoners per capita (12 percent decrease) and all-around better prison living conditions.

However, the results of the study show that these court orders resulted in a 22 percent decrease in the amount of money available for state welfare programs.

Boylan noted that their research showed that after states are released from the court orders, they did not increase their welfare cash expenditures; thus, the original change in welfare spending was permanent. He hopes that the research will underscore the unintended consequences of increased prison spending - namely, cuts to welfare programs.

"These results are a classic example of the unintended consequences of well-intentioned policymaking in the face of limited resources, where helping one vulnerable population ends up harming another," Boylan said.

The researchers examined income per capita, state unemployment, race, percentage of state population residing in urban areas and age distribution between 1951 and 2006 in 12 states (Alabama, Arkansas, Florida, Louisiana, Mississippi, New Mexico, New Hampshire, Oklahoma, Rhode Island, South Carolina, Tennessee and Texas) that have been subject to court orders calling for increased prison funding.

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The research was funded by Rice University and Louisiana State University. Naci Mocan, the Ourso Distinguished Chair of Economics at Louisiana State University, co-authored the study.

Rice University

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UNMC study to test 'breakthrough' drug in mantle cell lymphoma patients - FDA expected to approve drug in 6 months

Main Category: Lymphoma / Leukemia / Myeloma
Also Included In: Clinical Trials / Drug Trials
Article Date: 31 Jul 2013 - 1:00 PDT Current ratings for:
UNMC study to test 'breakthrough' drug in mantle cell lymphoma patients - FDA expected to approve drug in 6 months

The University of Nebraska Medical Center is involved in testing a drug the Food and Drug Administration has fast-tracked towards approval because of its dramatic results in patients with mantle cell lymphoma and other cancers.

"This experimental drug, Ibruitinib, is so promising that the FDA gave it fast track designation which rarely happens," said Julie M. Vose, M.D., chief of the division of hematology and oncology and Neumann M. and Mildred E. Harris Professor at UNMC. "Patients who've been on the treatment have had remarkable results with limited side effects. We are able to offer this to patients through an expanded access program which occurs about six months before the FDA approves it."

The new study is targeted for patients age 18 and older with mantle cell lymphoma who've relapsed - meaning other treatments have failed. The study, which aims to enroll as many patients as possible, is being conducted in about 50 locations across the United States and in Puerto Rico. Those eligible for the study will be provided the drug at no cost.

The FDA designated Ibruitinib as a breakthrough therapy. The designation is intended to expedite the development and review of drugs for serious or life-threatening conditions that demonstrate the drug may have substantial improvement over available therapy. The study will remain open until the medication is FDA approved, which should be by the end of the year, Dr. Vose said.

Dr. Vose, who is principal investigator of the UNMC study, said Ibruitinib works differently than other drugs for this type of cancer. The drug, developed by Pharmacyclics, Inc and Johnson & Johnson's Janssen Pharmaceutical division, basically poisons one of the pathways that helps the cancer grow.

"It kills the lymphoma," she said. "It has fairly limited side effects. It's a pill rather than an intravenous delivery, and it also has potential to be used with other treatments due to the limited side effects."

Steven "Robert" Whisnant of Morganton, N.C., and his wife, Quteen, came from North Carolina for the trial after his physicians told him there was nothing else they could do. Whisnant has had a dramatic response to the medication as have many other patients, Dr. Vose said.

"I'm thankful that there's somebody out there trying to find different things to help people because if I hadn't have gotten the medication, I'd have died," Whisnant said. "So far it seems to be working. All the tumors in my neck are gone and the ones in my stomach have shrunken. It gives us hope and I'm thankful for that."

Mantle cell lymphoma is a rare, B-cell non-Hodgkin lymphoma that most often affects men over the age of 60. The disease may be fast or slow growing. It comprises about five percent of all non-Hodgkin lymphomas.

Dr. Vose said results thus far have seen a 75 percent response rate in patients with mantle cell lymphoma whose disease has failed all other treatments.

"We have been involved in several of the first clinical trials with this particular medication," Dr. Vose said. "We don't think it's a cure but it's been found to be able to keep patients in remission longer to control their symptoms and allow them to have a good quality of life. These patients have very limited other options. This is a breakthrough and works very quickly."

Clinical trials began on Ibruitinib a few years ago. It also is being tested at other sites for other types of lymphoma, leukemia and multiple myeloma.

Other co-investigators in the study are UNMC physicians Jim Armitage, M.D., Phil Bierman, M.D., and Greg Bociek, M.D.

For more information about the study "An Open Label Treatment Use Protocol for Ibrutinib in Subjects With Relapsed or Refractory Mantle Cell Lymphoma", contact Maribeth at 402 559-9053 or mahohens@unmc.edu. For a complete list of other study locations go to clinicaltrials.gov and search "NCT01833039."

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