Multiple sclerosis 'blood blockage theory' tested

By Michelle Roberts
Health reporter, BBC News
US scientists are testing a radical new theory that multiple sclerosis (MS) is caused by blockages in the veins that drain the brain.

The answer may lie with blood flow

The University of Buffalo team were intrigued by the work of Italian researcher Dr Paolo Zamboni who claims 90% of MS is caused by narrowed veins.

He says the restricted drainage, visible on scans, injures the brain leading to MS.

He has already widened the blockages in a handful of patients.

The US team want to replicate his earlier work before treating patients.

Experts welcomed the research saying it was important to confirm the basic science before evaluating any therapy.

MS is a long-term inflammatory condition of the central nervous system which affects the transfer of messages from the nervous system to the rest of the body.

The Buffalo team, led by Dr Robert Zivadinov, plan to recruit 1,100 patients with MS and 600 other volunteers as controls who are either healthy or have neurological diseases other than MS.

Using Doppler ultrasound, they will scan the patients to see if they can find any blockages within the veins of the neck and brain.

If they can prove Dr Zamboni's theory of "chronic cerebrospinal venous insufficiency", they say it will change our understanding of MS.

Rewriting science

Margaret Paroski, who is chief medical officer at Kaleida Health, where the Buffalo researchers are based, said the work could overturn prevailing wisdom that the damage in MS is predominantly the result of abnormal immune responses.

"When I was in medical school, we thought peptic ulcer disease was due to stress. We now know that 80% of cases are due to a bacterial infection.

"Dr Zivadinov's work may lead to a whole different way of thinking about MS."

Dr Zamboni, of the University of Ferrara, believes the blockages are the cause rather than the consequence of MS and that they allow iron from the blood to leak into the brain tissue, where it causes damage.

He has performed procedures similar to angioplasty to unblock the veins and get the blood flowing normally again.

He claims this "liberation procedure" can alleviate many of the symptoms of MS and is due to publish his findings in the Journal of Vascular Surgery.

In an interview with CTV News in Canada he said: "I found the evidence of narrowing - narrowing of the veins just in MS patients.

"I'm fully convinced that this is very, very important for people."

Early days

Kevin Lipp, an MS patient from the US, has been symptom-free since being treated by Dr Zamboni.

He said: "It's only been 10 months. If nothing happens in the next two to three years, we'll know it's working."

The BBC has heard anecdotally of other surgeons in Europe testing out the same treatment.

The MS Society said more research was needed to see if this was an avenue that should be explored further.

"This is not something patients can expect as a treatment now. This is experimental work and is being tested. We need to know more about its safety and effectiveness."

Helen Yates, of the MS Resource Centre, said: "There is no doubt that this area warrants a great deal more study.

"This could represent a completely novel approach to MS research which, if proven to be relevant, could be a "sea change" in the understanding of the mechanisms involved in the condition."

Ayurstate for Prostate Care

Genetic clue to glioma brain cancer growth

BBC News

Scientists have pinpointed a mutated gene as key to the development of some types of glioma brain tumour.

Glioma is the most common form of brain tumour

The mutation leads to hugely increased levels of a chemical in the brain, which seems to feed the cancer.

The Nature study suggests that detecting higher levels of the chemical could provide doctors with a useful diagnostic tool.

It also raises hopes that blocking production of the chemical might prevent the cancer getting worse.

Prognosis

People with particular brain tumours, such as lower-grade gliomas, often carry a mutated version of a gene that controls production of an enzyme called IDH1.

The latest study, by US firm Agios Pharmaceuticals, shows that these mutations change the way the enzyme works and result in the build-up of high levels of a chemical called 2-hydroxyglutarate (2HG) in the brain.

Researchers found malignant glioma samples with IDH1 mutations had 100 times more 2HG than similar samples from patients without the mutation.

They said measuring 2HG levels could be used to help identify patients with IDH1 mutant brain tumours.

Writing in the journal, the researchers said: "This will be important for prognosis as patients with IDH1 mutations live longer than patients with gliomas characterised by other mutations.

"In addition, patients with lower-grade gliomas may benefit by the therapeutic inhibition of 2HG production.

"Inhibition of 2HG production by mutant IDH1 might slow or halt conversion of lower-grade glioma into lethal secondary glioblastoma, changing the course of the disease."

'Exciting new information'

Professor Lew Cantley, a cancer expert at the Beth Israel Deaconess Medical Center, who founded Agios, said it had previously been thought that IDH1 played no role in cancer.

The Agios team used techniques from an emerging area of research called cancer metabolism, which focuses on studying changes in metabolic activity in cancer cells.

He said: "What was previously considered an inactive enzyme is in reality an active oncogene and a potential therapeutic target."

Dr Laura Bell, of the charity Cancer Research UK, said: "This study has brought exciting new information to light which could eventually help doctors understand more about how certain brain tumours are likely to progress - and how best to treat them.

"But there is still some way to go before this new information could be used to help treat people wiememapping.xml">

ClariMind Memory & Concentration Supplement

Alcohol 'protects men's hearts'

BBC News

Drinking alcohol every day cuts the risk of heart disease in men by more than a third, a major study suggests.

The type of drink did not appear to change the results

The Spanish research involving more than 15,500 men and 26,000 women found large quantities of alcohol could be even more beneficial for men.

Female drinkers did not benefit to the same extent, the study in Heart found.

Experts are critical, warning heavy drinking can increase the risk of other diseases, with alcohol responsible for 1.8 million deaths globally per year.

The study was conducted in Spain, a country with relatively high rates of alcohol consumption and low rates of coronary heart disease.

The research involved men and women aged between 29 and 69, who were asked to document their lifetime drinking habits and followed for 10 years.

Crucially the research team claim to have eliminated the "sick abstainers" risk by differentiating between those who had never drunk and those whom ill-health had forced to quit. This has been used in the past to explain fewer heart-related deaths among drinkers on the basis that those who are unhealthy to start with are less likely to drink.

Good cholesterol

The researchers, led by the Basque Public Health Department, placed the participants into six categories - from never having drunk to drinking more than 90g of alcohol each day. This would be the equivalent of consuming about eight bottles of wine a week, or 28 pints of lager.

For those drinking little - less than a shot of vodka a day for instance - the risk was reduced by 35%. And for those who drank anything from three shots to more than 11 shots each day, the risk worked out an average of 50% less.

The same benefits were not seen in women, who suffer fewer heart problems than men to start with. Researchers speculated this difference could be down to the fact that women process alcohol differently, and that female hormones protect against the disease in younger age groups.

The type of alcohol drunk did not seem to make a difference, but protection was greater for those drinking moderate to high amounts of varied drinks.

The exact mechanisms are as yet unclear, but it is known that alcohol helps to raise high-density lipoproteins, sometimes known as good cholesterol, which helps stop so-called bad cholesterol from building up in the arteries.

'Binge-drinking'

UK experts said the findings should be treated with caution because they do not take into account ill-health from a range of other diseases caused by excess drinking.

"Whilst moderate alcohol intake can lower the risk of having a heart attack, coronary heart disease is just one type of heart disease. Cardiomyopathy, a disease of the heart muscle, is associated with high alcohol intake and can lead to a poor quality of life and premature death," said the British Heart Foundation's senior cardiac nurse, Cathy Ross.

"The heart is just one of many organs in the body. While alcohol could offer limited protection to one organ, abuse of it can damage the heart and other organs such as the liver, pancreas and brain."

The Stroke Association meanwhile noted that overall, evidence indicated that people who regularly consumed a large amount of alcohol had a three-fold increased risk of stroke.

"Six units within six hours is considered 'binge-drinking' and anyone indulging in regular 'binge-drinking' increases their risk of stroke greatly," said research officer Joanne Murphy.

Public health specialists warned no-one should be encouraged to drink more as a result of this study.

"The relationship between alcohol and heart disease remains controversial," said Professor Martin McKee of the London School of Hygiene and Tropical Medicine.

"While there is good evidence that moderate consumption is protective in people who are at substantial risk of heart disease - which excludes most people under the age of 40 - we also know that most people underestimate how much they drink. This paper adds to the existing literature but should not be considered as definitive. "

In the UK, the recommendation is no more than two to three units of alcohol a day for women - the equivalent of one standard glass of wine - and three to four units for men.

The British Liver Trust said: "There have been several studies suggesting that small amounts of alcohol can reduce the risk of coronary heart disease in men over the age of 40.

"But these are often misinterpreted by people looking for a health reason to consume alcohol.

"If you want to look after your health, stay within the limits of no more than 3-4 units a day for men or 2-3 for women and aim to give yourself at least two days off alcohol a week."

Professor Alan Maryon-Davis, president of the UK Faculty of Public Health, agreed that the message from this study was not clear: "At the end of the day, you're juggling different risks and benefits, maybe helping your heart or maybe damaging your brain and liver.

"The simple message is moderation.

"Stick to the guidelines, and you won't go far wrong."

Cardiofy Heart Care Supplement

Rising Obesity Will Cost U.S. Health Care $344 Billion a Year

Study Finds More Than Half of the Population in Several States Could Be Obese by 2018

By NANCI HELLMICH
Abc News

If Americans continue to pack on pounds, obesity will cost the USA about $344 billion in medical-related expenses by 2018, eating up about 21% of health-care spending, says the first analysis to estimate the future medical costs of excess weight.

These calculations are based on the projection that in 10 years 43% of Americans adults may be obese, which is roughly 30 or more pounds over a healthy weight, if obesity continues to rise at the current rate. Extra weight increases the risk of diabetes, heart disease and many types of cancer.

This report comes as the country struggles to find ways to curb medical costs and Congress debates health care legislation.

"Obesity is going to be a leading driver in rising health-care costs," says Kenneth Thorpe, chairman of the department of health policy and management at Emory University in Atlanta. Thorpe did this special analysis on obesity for America's Health Rankings, the 20th annual assessment of the nation's health on a state-by-state basis.

"There is a tsunami of chronic preventable disease about to be unleashed into our medical-care system which is increasingly unaffordable," says Reed Tuckson of United Health Foundation, sponsor of the report with the American Public Health Association and Partnership for Prevention.

Using weight data, Census statistics and medical expenditure information, Thorpe found:

•An obese person will have an average of $8,315 in medical bills a year in 2018 compared with $5,855 for an adult at a healthy weight. That's a difference of $2,460.

•If the percentage of obese adults doesn't change but stays at the current rate of 34%, then excess weight will cost the nation about $198 billion by 2018.

•If the obesity rate continues to rise until 2018, then Colorado may be the only state with less than 30% of residents who are obese.

•More than 50% of the population in several states could be obese by 2018: Oklahoma, Mississippi, Maryland, Kentucky, Ohio and South Dakota.

The report adds to the growing body of evidence of obesity's impact on medical costs. A study released in July showed that obese Americans cost the country about $147 billion in weight-related medical bills in 2008, double what it was a decade ago. It now accounts for about 9.1% of medical spending.

Food Poisoning May Hurt for Life

Doctors Say Foodborne Illness Might Cause Long-Term Problems Such as Seizures

By KRISTINA FIORE
MedPage Today Staff Writer
Abc News

Episodes of food poisoning may have serious long-term consequences -- including kidney failure or mental retardation -- particularly among children, researchers say.

A new report that reviews previous data has found that five common foodborne pathogens may increase the risk of serious complications, according to lead author Tanya Roberts, of the Center for Foodborne Illness in Grove City, Pa.

"Our report addresses the fact that most foodborne pathogens can cause severe disease in some small probability of cases," Roberts said during a press briefing. "These serious or long-term complications include kidney failure, paralysis, seizures, hearing and visual impairment, and mental retardation."

The five major pathogens are Campylobacter, E. coli, Listeria monocytogenes, Salmonella, and Toxoplasma gondii. But more than 200 pathogens can contaminate food and cause disease, Roberts said.

While the severity of the acute infection varies greatly, depending on the pathogen and the patient's own vulnerability, the most common symptoms are diarrhea and vomiting. But even after a patient recovers from these symptoms, they may have to deal with longer-term effects.

Researchers aren't sure exactly how prevalent the long-term effects are. That's why Roberts and other researchers have called for a strong national surveillance network to keep track of cases of foodborne illness and monitor them for long-term effects.

"There's a great deal of uncertainty about the magnitude of these problems and the scope of the issue," said Craig Hedberg, of the University of Minnesota School of Public Health, who was not involved in the study.

"That uncertainty springs from the fact that we don't have good surveillance for the diseases, much less long-term follow-up of cases to really estimate the rate of occurrence for these serious conditions."

Roberts said the next step would be to set up a systemized reporting system "to follow acute foodborne illnesses an