Sunday, June 24, 2012

Cancer Viral Therapy Attacks Tumors And Does Not Harm Healthy Tissue

Intravenous viral therapy has been shown to consistently infect tumors without damaging healthy human tissue, according to a clinical trial published in the journal Nature. The authors say this is the first trial to test viral therapy on humans with cancer. They added that it is also the first trial to demonstrate tumor-selective expression of a foreign gene after intravenous administration.

The clinical study included 23 individuals whose cancer was advanced - it had spread to several organs in the body. The patients had not responded to standard treatments.

They were administered a single intravenous infusion of JX-594, a virus at five different levels of dosage. Ten days later biopsies were obtained and examined.

87% (7) of those who were given the two highest dosages had evidence in their tumor of viral replication, but not in surrounding healthy tissue. They also showed tumor-selective expression of a foreign gene - this gene was engineered into the virus to help the scientists identify it (the virus).

The patients tolerated the virus well at all dosage levels. The most common adverse events were flu like symptoms that cleared up within 24 hours.

Senior co-author, Dr. John Bell, a Senior Scientist at the Ottawa Hospital Research Institute, said:

"We are very excited because this is the first time in medical history that a viral therapy has been shown to consistently and selectively replicate in cancer tissue after intravenous infusion in humans. Intravenous delivery is crucial for cancer treatment because it allows us to target tumors throughout the body as opposed to just those that we can directly inject.

The study is also important because it shows that we can use this approach to selectively express foreign genes in tumours, opening the door to a whole new suite of targeted cancer therapies."

Dr. Bell and colleagues have been researching oncolytic viruses for over a decade. An oncolytic virus is one that attacks cancer cells. They developed KX-594 with Jennerex Inc., a biotherapeutics company founded by Dr. David Kirn, San Francisco, and Dr. Bell, Ottawa.

JX-594 originates from a vaccine virus strain that has been extensively used as a smallpox live vaccine. It can replicate naturally in cancer cells preferentially. JX-594 has also been genetically altered so that its cancer-fighting properties are more powerful.

Dr. Dell said:

"Oncolytic viruses are unique because they can attack tumors in multiple ways, they have very mild side effects compared to other treatments, and they can be easily customized for different kinds of cancer. We're still in the early stages of testing these viruses in patients, but I believe that someday, viruses and other biological therapies could truly transform our approach for treating cancer."

The trial evaluated tumor activity, even though its primary aim was to assess safety and delivery of JX-594. Three-quarters (6) of the participants on the two highest doses experienced either stabilization or shrinkage of their tumor, with this likelihood significantly dropping the lower the doses.

Dr. Dell said:

"These results are promising, especially for such an early-stage trial, with only one dose of therapy. But of course, we will need to do more trials to know if this virus can truly make a difference for patients. We are working hard to get these trials started, and at the same time, we are also working in the laboratory to advance our understanding of these viruses and figure out how best to use them. "
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What Is The Difference Between Sex And Gender?

The words sex and gender are commonly used interchangeably, but many linguists would argue that their usage is quite distinct. Sex refers to the biological and physiological characteristics, while gender refers to behaviors, roles, expectations, and activities in society.

Sex refers to male or female, while gender refers to masculine or feminine.

The differences in the sexes do not vary throughout the world, but differences in gender do.

Here are some examples of characteristics related to sex:
  • Females have a vagina, men don't
  • Males have a penis, women don't
  • Male newborns tend to weigh more than female newborns
  • Females can breastfeed their babies, males can't
  • Males have deeper voices than females
  • Females can get pregnant, males can't
  • Males have testicles and females have ovaries
Here are some examples of characteristics related to gender:
  • Women tend to do more of the housework than their spouses do
  • A higher percentage of US doctors are women, compared to Egypt
  • Nursing is often seen as a woman's job, although many men enter the profession
  • In some countries women have to cover their heads when they go outside the house
  • 120 years ago women were not allowed to vote in elections
Another way of putting it is:

Sex refers to a natural or biological feature.
Gender refers to cultural or learned significance of sex.

According to Medilexicon's medical dictionary:

Sex is "The biologic character or quality that distinguishes male and female from one another as expressed by analysis of the person's gonadal, morphologic (internal and external), chromosomal, and hormonal characteristics."

Gender is "The category to which an individual is assigned by self or others, on the basis of sex."

The word gender comes from Middle English gendre, which came from Old French, which in turn came from the Latin word genus, meaning 'kind', 'type', or 'sort'.

The word sex probably comes from Middle English, meaning 'section' or 'divide'. In Latin the word sex means the number 'six'.
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11.7% Medication Error Rate In E-Prescribing

The chances of mistakes occurring in prescriptions sent electronically are no lower than in those written out by hand, a researcher from Massachusetts General Hospital in Boston wrote in the Journal of American Medical Information Association. This will be a disappointment for health reform experts and policymakers who assured that E-prescribing would have fewer medication errors, as well as saving the government billions of dollars.

Author Karen Nanji, M.D. explained that new technology does not in itself eliminate the risk of medication errors.

In 2008, Nanji and team evaluated 3,850 electronic prescriptions from three pharmacy chain outlets in Florida, Massachusetts, and Arizona over a four-week period. They all came from outpatient computerized prescribing systems at non-hospital doctors' offices. The prescriptions were checked for medical errors by a clinical panel. They also determined whether any of the errors could potentially harm patients.

11.7% of all the prescriptions had some kind of mistake. Four percent of them had mistakes which could cause a significant or serious adverse event. The researchers added that this is no better than the error rate found in handwritten prescriptions.

The researchers do not know whether the errors were corrected by the pharmacist or whether they led to an adverse event.

A computerized prescribing system requires that comprehensive functionality and proper processes are in place, otherwise medication errors remain high, they added.

17.3% of all the errors were found in E-prescriptions for anti-infectives. E-prescriptions for nervous system medications came second, and then respiratory drugs. Nervous system, cardiovascular and anti-infective medications had the highest number of errors linked to possible adverse events. An example of an error with potential for an adverse event was dosage omission. In the majority of cases (60.7%), the errors were omissions of drug dose, duration, and frequency.

According to Surescripts, last year approximately 190,000 doctors in the USA were e-prescribing - transmitting prescriptions directly to a pharmacy computer. Physicians who electronically prescribe (e-prescribe) have been receiving hundreds of millions of dollars from the federal government in Medicare bonuses.

The vast majority of these mistakes could be eliminated if software were improved. Forcing functions could be put into the programs that would make it impossible for the doctor to complete the prescription without entering required information.

The authors warn that any additions to computer programs must not be done at the expense of speed and efficiency - put simply, they must not slow things down.

Programs had error rates that varied from 5.1% to 37.5%.

"Errors associated with outpatient computerized prescribing systems"
Karen C Nanji, Jeffrey M Rothschild, Claudia Salzberg, Carol A Keohane, Katherine Zigmont, Jim Devita, Tejal K Gandhi, Anuj K Dalal, David W Bates, Eric G Poon
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Gamers Crack AIDS Puzzle

In what might be a significant breakthrough in HIV/AIDS research, online gamers playing a game called Foldit have cracked a key protein structure problem that has had scientists scratching their heads for years. And the gamers did it in three weeks. You can read a scientific account of how researchers recruited Foldit players to work on the modeling problem and ultimately solve the crystal structure of M-PMV retroviral protease in a paper published online this week in the journal Nature Structural & Molecular Biology.

Foldit invites players to predict protein structures. The game was developed by researchers at the University of Washington, as a deliberate way to get gamers to compete by solving scientific problems. The game requires they use spatial and critical thinking skills to build 3D models of protein molecules. In this case, they were invited to build models of M-PMV, a protease enzyme that plays a key role in how a virus similar to HIV replicates in cells. Few of the players had any background in biochemistry.

By solving the mystery of the 3D structure of the protein, the gamers have helped scientists move a step forward in developing a drug that could stop viruses like HIV from spreading.

The researchers write:

"Remarkably, Foldit players were able to generate models of sufficient quality for successful molecular replacement and subsequent structure determination. The refined structure provides new insights for the design of antiretroviral drugs."

The study is a good example of how people skilled at video games can get involved in science and help solve a wide range of problems.

In Foldit, the gamers try to predict how proteins fold themselves. When the gamers are playing the game, their actions to try and solve the problem are recorded and used to create algorithms to help computers increase their spatial reasoning.

Solving problems in the game helps scientists gain a better understanding of how cells make protein, a process call biosynthesis. A particular challenge in this field is understanding how certain proteins fold into three-dimensional structures.

To win, gamers have to do well in three factors: how well you pack the protein in 3D, how efficiently you hide the hydrophobic bits of the molecule, and how you resolve the clashes. The gamers don't have to understand these factors in this way to play the game.

The game presents them with a new protein and away they go, trying to bend it around to find its ideal form. When they hit a correct move, that hits these factors, they get points. The gamers are able to chat to each other online and compare solutions. It was through sharing strategies that gamers around the world solved the M-PMV problem.

Seth Cooper, lead designer of Foldit and co-author of the paper, told the press:

"People have spatial reasoning skills, something computers are not yet good at."

"Games provide a framework for bringing together the strengths of computers and humans," he added.
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HIV/AIDS Rising Rapidly In China's General Population

Rates of HIV/AIDS are rising rapidly in China's general population, according to new figures released on Wednesday by the Chinese Center for Disease Control and Prevention (CDC), which reveals the largest increases in recent years to be among older people and college students, due to unsafe sexual intercourse.

According to the Chinese government's official press agency Xinhua, the CDC figures show that the number of men aged 60 and over with HIV has soared from 483 in 2005 to 3,031 in 2010. In 2005 this group accounted for only 2.2% of total HIV infections, in 2010 it accounted for 8.9%.

The number of men aged 60 and over with AIDS also soared from 237 in 2005 to 2,546 in 2010. This group accounted for 11% of all cases in 2010, double the proportion in 2005.

The CDC figures also show a massive surge in the number of HIV/AIDS diagnoses among students this year. Between January and October, a total of 1,252 cases were recorded, accounting for 21% of all student cases, reports Xinhua, who cite the CDC as saying infection has been particularly prominent among male college students aged from 20 to 24.

The Director of the CDC HIV/AIDS prevention and control center, Wu Zunyou, told the media agency that due to improvements in health and living standards in the country, older people have remained sexually active, even well after retirement, and for various reasons, such as the "death of spouses or their lack of interest, some elderly have resorted to sex services".

"Many tended to choose secluded and low-end venues and didn't use condoms, which made them highly vulnerable to HIV infections," said Wu.

Wu noted that HIV/AIDS is now scattered more widely in China than ever before, sorely challenging efforts to prevent and control the spread, and explained they were also seeing an unexpected rise in cases of infection found through hospital checks.

Chinese authorities are expecting the number of people living with HIV/AIDS in the country to reach 780,000 by the end of 2011, even though only 346,000 are registered HIV carriers or AIDS patients.

Wu said it is going to be an "extremely tough battle" for China to achieve its goal of reducing HIV/AIDS infections by 25% and deaths by 30% in 2015, from the 2010 level.

One example of how the fight against HIV/AIDS is being fought in China is the project run by international medical and humanitarian charity Médecins Sans Frontières (MSF) and the Chinese CDC in Nanning, the capital of the mountainous province of Guangxi in the far south of the country. After 7 years of providing HIV care, the MSF-CDC partnership handed over the project to local health authorities in 2010.

The project started in 2003, targeting high-risk groups such as injected drug users, sex workers and men who have sex with men. The Chinese authorities were at first sceptical, and doubted that drug users would adhere to antiretroviral (ARV) treatment.

Dr Wu Zunyou, director of the National Centre for AIDS/STD Control and Prevention, said in a statement published on MSF's website to mark the handover:

"In the early stages, we had no experience in providing treatment to drug users and AIDS patients overall."

But they found patients responded well to the treatment and were able to stick to it.

A key part of the project was targeting people living with HIV from marginalized populations. Teams went out into these communities and persuaded people to get tested and commit to treatment. Counselling, previously regarded with suspicion by the Chinese health authorities, became an essential part of the care patients received.

Another important part of the project was the training of local health workers. The project helped to establish over 40 antiretroviral treatment centres, giving over 1,700 patients free and confidential treatment and care.

Over 80% of the patients were continuing to follow treatment when the project was handed over. One of these is 28-year-old Cui (not the patient's real name), who has been receiving treatment for HIV since May 2008.

Cui told MSF:

"When I arrived in the clinic I was very sick, and people gave me a lot of encouragement. Before, I didn't know anything about treatment."

Like many of those infected, Cui didn't understand the importance of adhering to the treatment regime:

"However, the doctors and counsellors emphasized the importance of this and my health improved. It's good to talk to the counsellors. Talking with them is the only way to relieve my burdens. Every time I talk with them I cry," said Cui.
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What Are The Effects Of Radiation On Humans? What Is Radiation Poisoning?

Contrasting media reports abound regarding the dangers occurring at the Fukushima nuclear facility in Japan. The reports have triggered uncertainty, concern and even panic among members of the general public in Japan and around the world.

Workers in Japan have been bravely battling to save the facility from a disastrous meltdown, exposing their bodies to potentially dangerous and lethal doses of radiation. In this text, we attempt to explain what impact radiation may have on the human body.

Radiation takes place when the atomic nucleus of an unstable atom decays and starts releasing ionizing particles, known as ionizing radiation. When these particles come into contact with organic material, such as human tissue, they will damage them if levels are high enough, causing burns and cancer. Ionizing radiation can be fatal for humans.

REM (roentgen equivalent in man) - this is a unit we use to measure radiation dosage. We use this measurement to determine what levels of radiation are safe or dangerous for human tissue. It is the product of the absorbed dose in rads and a weighting factor (WR), which accounts for how effective the radiation is in causing biological damage.

A sudden, short dose of up to 50 rem will probably cause no problems, except for some blood changes. From 50 to 200 rem there may be illness, but fatalities are highly unlikely. A dose of between 200 and 1,000 will most likely cause serious illness - the nearer the 1,000 it is, the poorer the outlook for the human will be. Any dose over 1,000 will typically cause death.

When an atomic bomb explodes, as in Hiroshima and Nagasaki during WWII, people receive two doses of radiation: one during the explosion, and another from fallout. Fallout refers to the radioactive particles that float in the air after an explosion; they rise and then gradually descend to the ground. A dose of 100 rems will have probably cause some initial signs of radiation sickness, such as loss of white blood cells, nausea, vomiting, and headache. With a 300 rem dose you may lose hair temporarily - your nerve cells and those that line the digestive tract will be damaged. As the dose rises and more white blood cells are lost, the human's immune system becomes seriously weakened - their ability to fight off infections is considerably reduced.

Exposure to radiation makes our bodies produce fewer blood clotting agents, called blood platelets, increasing our risk of internal bleeding. Any cut on the skin will take much longer to stop bleeding.

Experts say that approximately 50% of humans exposed to 450 rems will die, and 800 rems will kill virtually anyone. Death is inevitable and will occur from between two days to a couple of weeks.

Millisieverts per hour (mSv) - this is a measure used more commonly by the International Commission on Radiological Protection. For example:
  • A gastrointestinal series X-ray investigation exposes the human to 14 mSv
  • Recommended limit for volunteers averting a major nuclear escalation - 500 mSv (according to the International commission on Radiological Protection)
  • Recommended limit for volunteers rescuing lives or preventing serious injuries - 1000 mSv (according to the International commission on Radiological Protection)
Below is a list of signs and symptoms likely to occur when a human is exposed to acute radiation (within one day), in mSv:
  • 0 to 250 mSv - no damage
  • 250 to 1,000 mSv. Some individuals may lose their appetites, experience nausea, and have some damage to the spleen, bone marrow and lymph nodes.
  • 1000 to 3000 mSv - nausea is mild to severe, no appetite, considerably higher susceptibility to infections. Injury to the following will be more severe - spleen, lymph node and bone marrow. The patient will most likely recover, but this is not guaranteed.
  • 3,000 to 6,000 mSv - nausea much more severe, loss of appetite, serious risk of infections, diarrhea, skin peels, sterility. If left untreated the person will die. There will also be hemorrhaging.
  • 6,000 to 10,000 mSv - Same symptoms as above. Central nervous system becomes severely damaged. The person is not expected to survive.
  • 10,000+ mSv - Incapacitation. Death. Those who do survive higher radiation doses have a considerably higher risk of developing some cancers, such as lung cancer, thyroid cancer, breast cancer, leukemia, and cancer of several organs.

Radiation at and around the Fukushima Daiichi nuclear power facility - March 2011

Man in radiation suit outside nuclear powerplant
Levels of radiation outside the plant have now fallen from 1,000 mSv an hour to 600-800 (18 March 2011).

Levels of Alert

Alert levels range from 0 to a maximum of 7.

In Japan on March 18th, 2011 the alert level was raised from four to five, the same as the 1979 Three Mile Island alert level.

In 1986, Chernovyl, on the other hand reached an alert level of seven.

The Japanese government initially thought the problem was just a local one, but today they announced it may have "wider consequences" They raised the severity grade because of core damage to reactors 2 and 3.

Reducing the effects on the body

Oral potassium iodide, or KI should be taken immediately following ingestion of radioactive iodine in the event of an accident or attack at a nuclear power plant, or the detonation of a nuclear bomb. KI would be useless after a dirty bomb, unless it contained radioactive iodine, and even then it would only help to prevent thyroid cancer.

Depending on the level of radiation exposure and how sick the patient becomes, doctors may use antibiotics, colony stimulating factors, blood products, and stem cell transplant.

Nuclear accidents that have occured

1952 - Chalk River, near Ottawa, Canad. Partial meltdown of the reactor's uranium fuel core. No injuries.

1957 - Windscale Pile No. 1, north of Liverpool, UK - 200 square miles became contaminated with radiation after a fire in a graphite-cooled reactor.

1957 - South Ural Mountains, Soviet Union - weapons factory exploded, releasing radioactive waste twelve miles from the town of Kyshtym. 10,000 people were evacuated. According to authorities, there were no injuries.

1976 - near Greifswald, East Germany - at the Libmin nuclear power plant; the radioactive core almost melted down. There had been a fire, safety systems failed.

1979 - Three Mile Island, near Harrisburg, Pa., USA - a reactor lost its coolant, causing overheating and partial meltdown of an uranium core. The worst accident in American history. Some radioactive gases and water were released.

1986 - Chernobyl, near Kiev, Ukraine, Soviet Union - a graphite core of one of four reactors caught fire and exploded. Radioactive material spread far, to other parts of the Soviet Union, Scandinavia, eastern Europe, and eventually western Europe. Although authorities claimed 31 dead, nobody is really sure what the true figure was. The worst nuclear accident on earth.

1987 - Goiânia, Brazil - a cesium-137 cancer-therapy machine was sold as scrap. 244 people became contaminated with radiation, four died.

1999 - Tokaimura, Japan - a uranium-processing nuclear fuel plant released high levels of radioactive gas into the atmosphere after an uncontrolled chain reaction. Two workers died, and one was seriously injured.

2004 - Mihama, Japan - steam (non-radioactive) leaked from a nuclear power station. Four workers died and seven other were severely burned.

2007 - Kashiwazaki, Japan - a 6.8 magnitude earthquake near Niigata caused a major fire, radiation leaks and burst pipes at a major nuclear power plant. The plant had been built right on top of an active seismic fault.

2011 - March 12, Fukushima Daiichi Nuclear Power Station, Japan - reactor number 1 exploded. One of the buildings collapsed completely. Shortly after a devastating earthquake and tsunami, the reactor's cooling system failed. Within three days two more explosions and a fire had everyone running around trying to keep the four reactors under control. The fire was contained, but some radiation leaked into the air.
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What Is Melatonin?

Melatonin is a hormone, also known as N-acetyl-5-methoxytryptamine, it is a naturally occurring compound found in humans, animals, microbes and plants. In animals and humans, melatonin levels vary during the daily cycle. It is intimately involved in regulating the sleeping and waking cycles. It is sometimes prescribed by doctors for patients with sleep problems. However, in some cases it is not suitable.

In fact, a Spanish study concluded that melatonin is better at getting people to sleep than other medications.

Melatonin is also an antioxidant.

Among mammals, melatonin is secreted into the body by the pineal gland from the amino acid tryptophan. It is also known as the "hormone of darkness" because it is secreted when it is dark. Highest levels of melatonin usually occur in humans at bedtime.

A study in the University of Granada, Spain proved that melatonin helps in controlling weight gain, even if the patient does not eat less. It was found to improve the blood lipid profile by reducing triglycerides, rasing HDL cholesterol (good cholesterol) and lowering LDL cholesterol (bad cholesterol) levels.

Japanese research found that giving melatonin to women who are trying to get pregnant with IVF (in vitro fertilization) helps improve the quality of the egg and doubles the IVF success rate. Poor egg quality is a major cause of female infertility.

According to Medilexicon's medical dictionary, Melatonin is:

"A substance formed by the mammalian pineal gland, which appears to depress gonadal function in mammals and causes contraction of amphibian melanophores; a precursor is serotonin. Melatonin is rapidly metabolized and is taken up by all tissues. It is involved in circadian rhythms."

The following side effects have been associated with melatonin supplements:
  • Confusion
  • Discomfort in the abdomen
  • Headaches
  • Nightmares
  • Sleepiness during the day
  • Sleepwalking
Melatonin may also adversely affect how some medications work, such as anticoagulants (blood-thinning drugs), birth control pills, diabetes drugs, and immunosuppressants.

Melatonin, if prescribed, is usually done so for short periods. Some experts say that treatment for longer than two months might be harmful. Not all experts agree with this.

People taking melatonin should be careful when driving or operating heavy machinery.
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What Is Vitamin K?

Vitamin K refers to two naturally occurring fat-soluble vitamins, vitamin K1 and vitamin K2. Vitamin K1 is also known as phylloquinone or phytomenadione (phytonadione), while vitamin K2 includes menaquinone and menatetrenone.

Vitamin K1 is made by plants.

Vitamin K2 is typically produced in the large intestine by bacteria. Experts say that unless the individual has intestinal damage which undermines their ability to absorb the vitamin, dietary deficiency is extremely rare. In some cases, administering a broad spectrum antibiotic long-term may reduce the vitamin-producing bacteria population (recent research has shown that the bowel might not be good at absorbing vitamin K, therefore not backing this theory).

Vitamins K3, K4 and K5 also exist - they are synthetic forms and are used to inhibit fungal growth as well as by the pet food industry.

Experts say vitamin K is crucial for proper blood coagulation (clotting) - it helps make 4 of the 13 proteins required for blood clotting. It is also involved in maintaining good bone health as we age.

Good sources of vitamin K1 include:
  • Spinach
  • Swiss chard
  • Cabbage
  • Kale
  • Cauliflower
  • Broccoli
  • Brussel sprouts
  • Avocado
  • Kiwifruit
  • Grapes
  • Parsley - two tablespoon contain 153% of RDA (recommended daily amount)
Good sources of vitamin K2 include:
  • Meat
  • Eggs
  • Dairy products
  • Natto (Japanese food made from soybeans fermented with Bacillus subtilis)

Vitamin K deficiency

Vitamin K deficiency is extremely rare in healthy adults.

Newborn infants may have a higher risk until their intestinal bacteria start production. Vitamin K deficiency among infants is potentially dangerous because it can lead to bleeding in the brain and other vital organs.

Patients with liver damage or disease, alcoholics, those with cystic fibrosis, inflammatory bowel disease, as well as those who have had surgical procedures in their abdomen have a higher risk of vitamin K deficiency.

Some people with eating disorders, such as bulimia have a higher risk of vitamin K deficiency, as well as individuals on very severe or strict diets.

Patients taking anticoagulants, salicylates, barbiturates, or cefamandole may also have a higher risk.

Signs and symptoms of vitamin K deficiency may include:
  • Heavy menstrual bleeding
  • Anemia
  • Nose bleeds
  • Bleeding gums
  • Osteoporosis is strongly linked to low vitamin K2 levels
  • Coronary heart disease is strongly linked to low vitamin K2 levels

How much vitamin K should I consume?

According to the Institute of Medicine, the recommended intake is 120 micrograms for males and 90 for females each day.
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Was It Mind Blowing? Sex, Coffee, Cola Can Cause Aneurysm, Stroke

A new study published this week from The Netherlands states that having sex, blowing your nose or even drinking coffee can temporarily raise your risk of rupturing a brain aneurysm and suffering a stroke. Little is known about activities that trigger rupture of an intracranial aneurysm. Knowledge on what triggers aneurysmal rupture increases insight into the pathophysiology and facilitates development of prevention strategies.

Dutch researchers identified eight main triggers that appear to increase the risk of intracranial aneurysm, a weakness in the wall of a brain blood vessel that often causes it to balloon. If it ruptures, it can result in a subarachnoid hemorrhage which is a stroke caused by bleeding at the base of the brain.

Monique H.M. Vlak, M.D., lead author of the study and a neurologist at the University Medical Center in Utrecht, the Netherlands explains:

"All of the triggers induce a sudden and short increase in blood pressure, which seems a possible common cause for aneurysmal rupture. Subarachnoid hemorrhage caused by the rupture of an intracranial aneurysm is a devastating event that often affects young adults. These trigger factors we found are superimposed on known risk factors, including female gender, age and hypertension."

So what do we have to look out for? According to the study published by the American Heart Association, considering the fraction of all subarachnoid hemorrhages that can be attributed to a particular trigger factor, the researchers identified the eight factors and their contribution to the risk as:
  1. Coffee consumption (10.6 percent)
  2. Vigorous physical exercise (7.9 percent)
  3. Nose blowing (5.4 percent)
  4. Sexual intercourse (4.3 percent)
  5. Straining to defecate (3.6 percent)
  6. Cola consumption (3.5 percent)
  7. Being startled (2.7 percent)
  8. Being angry (1.3 percent)
The research asked 250 patients with aneurysmal subarachnoid hemorrhage to complete a questionnaire about exposure to 30 potential trigger factors in the period shortly before their event and their usual frequency and intensity of exposure to these triggers. They then assessed relative risk using a case-crossover design that determines if a specific event was triggered by something that happened just before it.

Vlak continues:

"Reducing caffeine consumption or treating constipated patients with unruptured IAs with laxatives may lower the risk of subarachnoid hemorrhage. Whether prescribing antihypertensive drugs to patients with unruptured IAs is beneficial in terms of preventing aneurysmal rupture still needs to be further investigated."

According to the National Institute of Neurological Disorders and Stroke, more than 700,000 Americans suffer a stroke each year and about 160,000 of them die. Survivors often face serious disability as a result of the stroke.

Aneurysms may also result from congenital defects, preexisting conditions such as high blood pressure and atherosclerosis (the buildup of fatty deposits in the arteries), or head trauma. Cerebral aneurysms occur more commonly in adults than in children but they may occur at any age. They are more common in women than in men, by a ratio of 3 to 2.
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Metastatic Breast And Ovarian Cancer Vaccine - Promising Results

A trial published in Clinical Cancer Research demonstrated a positive response in both metastatic breast cancer and ovarian cancer to a recombinant poxviral vaccine.

Lead investigator James Gulley, M.D., Ph.D., director and deputy chief of the clinical trials group at the Laboratory of Tumor Immunology and Biology at the National Cancer Institute commented:

"With this vaccine, we can clearly generate immune responses that lead to clinical responses in some patients."

For the trial, funded by the National Cancer Institute, Gulley and his team involved 26 patients, all of them heavily pretreated, with 21 patients receiving at least three prior chemotherapy treatments, and designated them to receive monthly vaccinations with PANVAC vaccine that contains transgenes for MUC-1, CEA and three T cell costimulatory molecules.

In 12 breast cancer patients the team established an average time to disease progression of 2.5 months and an average overall survival rate of 13.7 months. In four patients the disease was stable. The average time to progression for the 14 ovarian cancer patients was two months and the average survival rate of 15 months.

The most common side effect after treatment was mild reactions at the injection-site.

Because of the rising interest in cancer vaccinations, Gulley recommends for further studies to be conducted in order to establish which vaccines are beneficial for particular patients.

He concludes:

"The sustained benefit seen in some patients in this study underscores the potential for therapeutic vaccines to impact clinical outcomes without toxicity. However, more studies in the appropriate patient populations are required to adequately assess efficacy."
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Early Alzheimer's Disease - Brain's Cortex Size May Predict Risk

People with no Alzheimer's disease signs whose brain cortex regions are smaller than normal probably have a higher risk of developing early symptoms of the disease, researchers from the University of Pennsylvania and Massachusetts General Hospital reported in the peer-reviewed journal Neurology this week.

Susan Resnick, PhD, who works at the National Institute of Aging, in an Accompanying Editorial in the same journal wrote:

"The ability to identify people who are not showing memory problems and other symptoms but may be at a higher risk for cognitive decline is a very important step toward developing new ways for doctors to detect Alzheimer's disease."

Bradford Dickerson, MD, and team used MRI (magnetic resonance imaging) scans to measure regions of the brain's cortex in 159 participants aged 76 years (average). None of them had any symptoms of dementia when the scans were done.

The researchers scanned regions of the cortex because other studies had demonstrated that this area of the brain becomes smaller in patients with diagnosed Alzheimer's disease.

Nineteen of the participants were found to have smaller brain cortex regions, and thus deemed to be of high risk of having early Alzheimer's. Twenty-four of them were classified as at low risk, while 116 were of average risk.

All participants were given tests that measured their memory, ability to pay attention, plan, and solve problems. These tests were performed at the beginning of the study, and then regularly over the following three years.

The authors reported that 21% of their high risk participants were found to have cognitive decline during the 36-month follow-up period, versus just 7% among those classified at average risk. None of the low-risk ones developed signs and symptoms of cognitive decline.

Dr. Dickerson said:

"Further research is needed on how using MRI scans to measure the size of different brain regions in combination with other tests may help identify people at the greatest risk of developing early Alzheimer's as early as possible."

Sixty per cent of the high risk participants had abnormally high levels of proteins (beta amyloid) linked to Alzheimer's disease in their cerebrospinal fluid, compared to just 36% among the average risk individuals, and just 19% in the low risk people.

In an Abstract in the journal, the authors concluded:

"This approach to the detection of individuals at high risk for preclinical AD - identified in single CN individuals using this quantitative ADsig MRI biomarker - may provide investigators with a population enriched for AD pathobiology and with a relatively high likelihood of imminent cognitive decline consistent with prodromal AD."
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Going Green: Digesting Tea Defends Against Alzheimer's, Cancer

Drinking, or better yet digestion and the body's ability to absorb key elements of green tea, may play a vital role in aiding the brain to fend off the development of Alzheimer's, and can protect against cancer. Digestion is a vital process which provides our bodies with the nutrients we need to survive. However, just because the food we put into our mouths is generally accepted to contain health-boosting properties, we can't assume these compounds will ever be used by the body. A new study has been published that hints this ancient Chinese remedy could play a vital role in building defenses against key life threatening conditions.

Dr. Ed Okello of Newcastle University, the executive director of the university's Medicinal Plant Research Group team and based in the School of Agriculture, Food and Rural Development explains:

"What was really exciting about this study was that we found when green tea is digested by enzymes in the gut, the resulting chemicals are actually more effective against key triggers of Alzheimer's development than the undigested form of the tea. In addition to this, we also found the digested compounds had anti-cancer properties, significantly slowing down the growth of the tumor cells which we were using in our experiments."

Green tea is tea made solely with the leaves of Camellia sinensis that have undergone minimal oxidation during processing. Green tea originates from China and has become associated with many cultures in Asia from Japan and South Korea to the Middle East. Recently, it has become more widespread in the West, where black tea is traditionally consumed. Many varieties of green tea have been created in countries where they are grown and these varieties can differ substantially due to variable growing conditions, horticulture, production processing, and harvesting time.

Over the last few decades green tea has been subjected to many scientific and medical studies to determine the extent of its long-purported health benefits, with some evidence suggesting that regular green tea drinkers have lower chances of heart disease and developing certain types of cancer. Although green tea does not raise the metabolic rate enough to produce immediate weight loss, a green tea extract containing polyphenols and caffeine has been shown to induce thermogenesis and stimulate fat oxidation, boosting the metabolic rate 4% without increasing the heart rate.

For this particular study, The Newcastle University team deemed it necessary to analyze the protective properties of the products of digestion, so they worked alongside Dr. Gordon McDougall of the Plant Products and Food Quality Group at the Scottish Crop Research Institute in Dundee, who developed technology which simulates the human digestive system.

Two compounds are known to play a significant role in the development of Alzheimer's disease (AD); hydrogen peroxide and a protein known as beta-amyloid. Long considered a key player in the development and progression of AD, beta-amyloid has gradually begun to give up many secrets of its importance. Scientists have learned an enormous amount about how beta-amyloid plaques are formed and the toxic effects that these structures as well as the earlier forms of beta-amyloid have on neurons and synapses. These findings have opened up new avenues of investigation and new possibilities for therapeutic targets.

Compounds known as polyphenols, present in green tea, possess neuroprotective properties, binding with the toxic compounds and protecting the brain cells. When ingested, the polyphenols are broken down to produce a mix of compounds. Carrying out the experiments in the lab using a tumor cell model, the Newcastle team exposed the cells to varying concentrations of the different toxins and the digested green tea compounds.

Dr. Okello continues:

"The digested chemicals protected the cells, preventing the toxins from destroying the cells. We also saw them affecting the cancer cells, significantly slowing down their growth. Green tea has been used in Traditional Chinese medicine for centuries and what we have here provides the scientific evidence why it may be effective against some of the key diseases we face today. There are obviously many factors which together have an influence on diseases such as cancer and dementia - a good diet, plenty of exercise and a healthy lifestyle are all important. But I think it's fair to say that at least one cup of green tea every day may be good for you and I would certainly recommend it."

Okello's team has already received funding from the Biotechnology and Biological Sciences Research Council (BBSRC) to discover whether the beneficial compounds are produced during digestion after healthy human volunteers consume tea polyphenols or if they already exist in the unconsumed product.

The full reports can be digested here: "In vitro protective effects of colon-available extract of Camellia sinensis (tea) against hydrogen peroxide and beta-amyloid (A(1-42)) induced cytotoxicity in differentiated PC12 cells." E J Okello, G J McDougall, S Kumar and C J Seal. Phytomedicine.
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What Is Emphysema? What Causes Emphysema?

Emphysema is a lung condition in which tiny air sacs in the lungs - alveoli - fill up with air. As the air continues to build up in these sacs, they expand, and may break or become damaged and form scar tissue. The patient becomes progressively short of breath. Emphysema is a type of COPD (chronic obstructive pulmonary disease). The main cause of emphysema is long-term regular smoking.

The alveoli turn into large, irregular pockets with holes in them. The surface area of the lungs is gradually reduced, resulting in less oxygen entering the bloodstream.

The small elastic fibers that hold open the small airways leading to the alveoli also become destroyed. When the patient breathes out they collapse, i.e. the patient has problems exhaling air.

Emphysema is not curable, the condition cannot be reversed. However, treatment may slow down its rate of progression and alleviate symptoms.

Alveolus diagram
The alveoli are the grape-like sacs

According to Medilexicon's medical dictionary, emphysema is:

1. Presence of air in the interstices of the connective tissue of a part.

2. A condition of the lung characterized by increase beyond the normal in the size of air spaces distal to the terminal bronchiole (those parts containing alveoli), with destructive changes in their walls and reduction in their number. Clinical manifestation is breathlessness on exertion, due to the combined effect (in varying degrees) of reduction of alveolar surface for gas exchange and collapse of smaller airways with trapping of alveolar gas in expiration; this causes the chest to be held in the position of inspiration ("barrel chest"), with prolonged expiration and increased residual volume. Symptoms of chronic bronchitis often, but not necessarily, coexist. Two structural varieties are panlobular (panacinar) emphysema and centrilobular (centriacinar) emphysema; paracicatricial, paraseptal, and bullous emphysema are also common.

What are the signs and symptoms of emphysema

A symptom is something the patient feels and describes, such as pain, while a sign is something everybody can detect, such as a rash.

A patient with emphysema may experience no symptoms for many years. Eventually, as the condition progresses, there is a shortness of breath (dyspnea), which starts off gradually. An individual with early stages of emphysema may avoid physical activity because it makes them pant too much. Eventually, the shortness of breath is present even when the person is resting.

What are the causes of emphysema?

The main cause of emphysema is long-term, regular tobacco smoking. It may also be caused by marijuana smoking (much less common), exposure to air pollutions, factory fumes, coal and silica dust.

In rare cases, a patient may have inherited a deficiency of Alpha-1 antitrypsin, a protein that protects the elastic tissue in the lungs.

What are the possible complications of emphysema?

Pneumothorax, also called collapsed lung. This can be fatal in patients with severe emphysema because the lungs have become so weak.

Cor pulmonale - a part of the heart expands and becomes weak. This happens when pressure in the arteries that connect the lungs and heart increases.

Giant bullae - empty spaces, called bullae develop in the lungs. Giant bullae are very large, sometimes half the size of the lung. Not only does the lung have a much smaller surface area, the bullae can become infected. Patients with giant bullae are more likely to develop pneumothorax.

Recurring infections - chest infections, pneumonia, influenza, cold and the common cold are like to occur more often in patients with emphysema.

Pulmonary hypertension - abnormally high blood pressure in the arteries of the lungs.

Diagnosing emphysema

The doctor will carry out a physical examination and ask some questions, such as:
  • smoking status and history
  • whether he/she suffers from shortness of breath and how long for
  • what makes shortness of breath worse
  • whether there is a cough and if that cough brings up sputum
  • the patient's medical history
  • whether his/her family have a history of lung disease
The doctor may order some tests, which may include:
  • Chest X-ray - this can help the doctor determine whether the emphysema is advanced, and also exclude any other reasons for the dyspnea.
  • CT (computerized tomography) scan - this may be ordered to help the doctor decide whether lung surgery is required.
  • Blood test - blood may be taken from an artery to determine how well the lungs are transferring oxygen into the blood, and removing CO2.
  • Lung function tests - these tests tell the doctor how well the patient's lungs inhale and exhale air, as well as showing how much air the lungs can hold. The doctor will also have a better idea of how efficiently the lungs are transferring oxygen into the bloodstream. The patient will probably be asked to blow into a spirometer. Spirometry can be done at the doctor's office or a nearby hospital or clinic. The patient has to blow as hard as possible into a small tube that is attached to a machine. The machine measures the time taken to blow all the air out of the lungs. If the patients airways are blocked it will take longer.
A modern USB PC-based spirometer

What are the treatment options for emphysema?

Emphysema is incurable; there is no treatment to reverse the condition. However, symptoms can be relieved and its progression can be slowed down with proper treatment.

Stop smoking - smoking is the main cause of emphysema in the first place. Stopping smoking will considerably slow down its progress.

Bronchodilators - types of medications that relax airways that have become constricted, thus relieving shortness of breath, breathing problems, and coughing. These drugs are more effective for the treatment of chronic bronchitis or asthma, but can help emphysema patients to some degree.

Steroid aerosol sprays - these are inhaled. Corticosteroids are effective for shortness of breath. However, they must be used under the careful monitoring of a doctor because long-term usage can result in weakened bones, elevated blood pressure and cataracts. Long-term steroid use also significantly raises the risk of developing diabetes.

Antibiotics - patients with emphysema generally get more infections, such as pneumonia or acute bronchitis than other people. Such conditions require antibiotic treatment.

Rehabilitation techniques - the patient can be taught certain breathing exercises that may help reduce shortness of breath and improve his/her ability to do exercise. Patients may undergo weight changes, which need to be addressed.

Oxygen - those with severe symptoms may require supplemental oxygen, which is usually administered through the nostril via a narrow tubing.

Surgery - a surgeon may surgically remove some of the damaged tissue, which helps the remaining lung tissue work better, this may help the patient breath better.

Lung transplant - when other options have not worked and symptoms are very severe, the doctor may recommend lung transplant
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Nutrient Balance As Sensed By The Brain

There is no doubt that eating a balanced diet is essential for maintaining a healthy body weight as well as appropriate arousal and energy balance, but the details about how the nutrients we consume are detected and processed in the brain remain elusive. Now, a research study discovers intriguing new information about how dietary nutrients influence brain cells that are key regulators of energy balance in the body. The study, published by Cell Press in the journal Neuron, suggests a cellular mechanism that may allow brain cells to translate different diets into different patterns of activity.

"The nutritional composition of meals, such as the protein:carbohydrate (sugar) ratio has long been recognized to affect levels of arousal and attention," explains senior study author, Dr. Denis Burdakov, from the University of Cambridge. "However, while certain specialized neurons are known to sense individual nutrients, such as the sugar glucose, it remains unclear how typical dietary combinations of nutrients affect energy balance-regulating brain circuits."

Dr. Burdakov and colleagues studied how physiological mixtures of nutrients influenced "orexin/hypocretin" neurons, which are known to be critical regulators of wakefulness and energy balance in the body. Previous research had demonstrated that orexin/hypocretin neurons are inhibited by glucose. Surprisingly, the current study revealed that physiologically relevant mixtures of amino acids, the nutrients derived from proteins (such as egg white), stimulated and activated the orexin/hypocretin neurons. The researchers went on to show that when orexin/hypocretin neurons were simultaneously exposed to amino acids and sugars, the amino acids served to suppress the inhibitory influence of glucose.

Taken together, these results support a new and more complex nutrient-specific model for dietary regulation of orexin/hypocretin neurons. "We found that activity in the orexin/hypocretin system is regulated by macronutrient balance rather than simply by the caloric content of the diet, suggesting that the brain contains not only energy-sensing cells, but also cells that can measure dietary balance," concludes Dr Burdakov. "Our data support the idea that the orexin/hypocretin neurons are under a 'push-pull' control by sugars and proteins. Interestingly, although behavioral effects are beyond the scope of our study, this cellular model is consistent with reports that when compared with sugar-rich meals, protein-rich meals are more effective at promoting wakefulness and arousal."
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What Is Heart Rate? What Is A Healthy Heart Rate?

A person's heart rate, also known as their pulse, refers to how many times their heart beats per minute. Our heart rates vary tremendously, depending on the demands we make on our bodies - a person who is sleeping will have a much lower heart rate compared to when he/she is doing exercise.

There is a technical difference between heart rate and pulse, although they both should come up with the same number:
  • Heart rate - how many times the heart beats in a unit of time, nearly always per minute. The number of contractions of the lower chambers of the heart (the ventricles).
  • Pulse (pulse rate) - as the blood gushes through the artery from a heart beat, it creates a bulge in the artery. The rate at which the artery bulges can be measured by touching it with your fingers, as on the wrist or neck.
According to Medilexicon's medical dictionary:

Heart beat is "A complete cardiac cycle, including spread of the electrical impulse and the consequent mechanical contraction."

Pulse is "Rhythmic dilation of an artery, produced by the increased volume of blood thrown into the vessel by the contraction of the heart. A pulse may also at times occur in a vein or a vascular organ, such as the liver."

Doctors and other healthcare professionals measure patients' heart rates when monitoring their health, gauging the effectiveness of certain treatments, or making a diagnosis.

Athletes and sports people usually measure their heart beats so that they can gain maximum efficiency from their training regimes.

What is a normal resting heart rate (pulse rate)?

For a human aged 18 or more years, a normal resting heart rate can be anything between 60 and 100 beats per minute. Usually the healthier or fitter you are, the lower your rate. A competitive athlete may have a resting heart rate as low as 40 beats per minute.

Champion cyclist, Lance Armstrong has had a resting heart rate of about 32 beats per minute (bpm). Fellow cyclist Miguel Indurain once had a resting heart rate of 29 bpm.

According to the National Health Service, UK, the following are ideal normal pulse rates at rest, in bpm (beats per minute):
  • Newborn baby - 120 to 160
  • Baby aged from 1 to 12 months - 80 to 140
  • Baby/toddler aged from 1 to 2 years - 80 to 130
  • Toddler/young child aged 2 to 6 years - 75 to 120
  • Child aged 7 to 12 years - 75 to 110
  • Adult aged 18+ years - 60 to 100
  • Adult athlete - 40 to 60
(There is a considerable amount of overlap from 14 to 17 years of age, with younger and older ages, depending on which health authorities you use for data)

Checking your own heart rate:
  • The wrist (the radial artery) - place the palm of your hand facing upward. Place two fingers on the thumb side of your wrist gently, you will sense your pulse beating there. Either count them for up to one minute, or thirty seconds and then multiply by two. Counting for 15 seconds and then multiplying by four is less accurate. It is also possible to test the pulse by touching the other side of the wrist, where the ulnar artery is.
  • The neck (the carotid artery) - place the index and third fingers on the neck, next to your windpipe. When you feel your pulse, either count for the whole sixty seconds, or do it in a 30 or 15 second spell and multiply by two or four.
  • The human heart rate may also be measured at the following points:

  • The brachial artery - under the biceps or inside the elbow
  • Abdominal aorta - over the abdomen
  • Apex of the heart - by placing your hand or fingers on the chest
  • Basilar artery - at the side of the head, close to the ear
  • Dorsalis pedis - the middle of dorsum of the foot
  • Superficial temporal artery - the temple
  • The facial artery - the lateral edge of the mandible
  • The femoral artery - in the groin
  • The posterior tibial artery - behind the medial malleoulus of the feet

Pulse evaluation
Testing the pulse rate at the radial artery

An electrocardiograph, also known as an ECG or EKG is a more accurate way of checking a patient's heartbeat. ECGs are commonly used in critical care medicine, and many other fields of medicine.

Sports shops sell heart-rate watches that communicate with a device you strap around your chest. The readings on your watch tell you what your heart rate is - some can even work out heart-rate averages over set periods, such as the whole of an exercise session.

Bear in mind that your heart rate can be influenced by several factors, such as:
  • Your level of physical activity at the time
  • How fit you are
  • The ambient temperature
  • The position of your body - standing, sitting, lying down, etc.
  • Your mental and/or emotional state - excitement, anger, fear, anxiety, and other factors can raise your heart beat
  • The size of your body
  • Some medications
Bradycardia - a medical term that refers to a heart beat that is too slow, such as below 60 beats per minute (for a non-athlete)

Tachycardia - a medical term that refers to a resting heart beat of more than 100 beats per minute, an excessively fast heart beat for an adult

If you think you have bradycardia or tachycardia, see your doctor, especially if you are also short of breath, feel dizzy, and/or have fainting episodes.

What is your maximum heart rate?

This is the maximum number of times your heart can beat per minute. It is a useful measure for sports people, so they can gauge their training intensities.

There are two ways you can find out what your maximum heart rate is:
  • Have it clinically tested - usually by a cardiologist or an exercise physiologist. People over 35 years of age who are overweight or have not done exercise for a long time are advised to have their maximum heart rates clinically tested by a trained health care professional. The health care professional may use a treadmill and a electrocardiograph.
  • Predicted maximum heart rate - this involves using a mathematical formula, called the age-adjusted formula.

    For adult males: 220 minus your age. For a 25 year-old man it would be 195 bpm (220 minus 25)

    For adult females: 226 minus your age. For a 25 year-old woman it would be 201 bpm (226 minus 25)

    It is important to remember that this formula gives a rough figure, a ballpark figure. Ideally, you should have your maximum heart beat measured clinically.
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Binge Drinking Damages Teenage Girls' Brains More Than Boys'

Teenage girls who binge-drink have a higher risk of long-term harm to the brain compared to boys of the same age who also binge drink, researchers from the University of California, San Diego and Stanford University reported in Alcoholism: Clinical and Experimental Research.

Their definition of binge-drinking is consuming at least four (for females) or five (for males) alcoholic drinks at one sitting.

The investigators said that activity levels in several regions of the brain among girls who binge drink were lower than what one would normally find among typical teenagers.

Co-author, Susan Tapert, from Stanford University, said:

"These differences in brain activity were linked to worse performance on other measures of attention and working memory ability."

Although changes in brain activity levels were observed among teenage boys who binge drink, they were less severe than what was observed in the girls.

The authors warned that teenage girls are particularly vulnerable to the harmful effects of alcohol abuse.

There could be many reasons why the girls' brains are more affected, including:
  • A girl's brain tends to develop a couple of years earlier than a boy's.
  • A girl has a slower metabolic rate than a boy
  • There is usually a higher body-fat ratio in a girl than a boy
  • Girls generally weigh less than boys
  • Boys and girls have hormonal differences
The authors added that what they found among teenage male and females was similar to studies on adults who abuse alcohol - women tend to be more vulnerable to its harmful effects on the brain.

Of the 95 teenagers who participated in this study, 40 said they had taken part in sessions of binge drinking.

The researchers asked them how often they had consumed an alcoholic drink during their lifetime, and also what their alcohol consumption had been during the three months before the study began.

The boys and girls were asked to carry out tasks which activated brain parts responsible for spatial working memory, while at the same time being scanned with an MRI (medical resonance imaging) device.

Impaired spacial memory can lead to several problems in daily living, including driving a vehicle, using a map, remembering how to get somewhere, taking part in certain sports, and figural reasoning.

The researchers stressed that none of their 95 participants was alcoholic or had a drink problem. Any binge-drinking session was done socially, and subsequent drinking of alcohol did not occur again for several weeks.

However, Edith Sullivan, from Stanford University School of Medicine, said that the harmful effects of drinking too much persisted for a long time after the event.

Sullivan said:

"Long after a young person - middle school to college - enjoys recovery from a hang-over, this study shows that risk to cognitive and brain functions endures."

According to the authors, nearly 30% of all teenagers in America in their last year of school reported binge drinking during the previous four weeks. Data from the CDC (Centers for Disease Control and Prevention) shows that approximately 75% of alcohol consumed in the USA (all ages) is done so during binge-drinking sessions.
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What is Claustrophobia? What Causes Claustrophobia?

Claustrophobia is an anxiety disorder; the sufferer has an irrational fear of having no escape or being closed-in. It frequently results in panic attack and can be triggered by certain stimuli or situations, such as being in a crowded elevator, a room without windows, or sitting in an airplane. Some people may even experience claustrophobia when wearing tight-necked clothing.

The word claustrophobia originates from Latin claustrum which means "a shut in place" and Greek phobos, which means "fear". Research has shown that approximately 6% of people suffer the disorder worldwide, but the majority are not receiving treatment for it.

People with claustrophobia can find the disorder hard to live with, as they will go to great lengths to avoid small spaces and situations that trigger their panic and anxiety. They will avoid certain places like the subway/underground and will prefer to take the stairs over using a lift/elevator no matter how many floors they need to ascend/descend.

According to Medilexicon's medical dictionary claustrophobia is:

"A morbid fear of being in a confined place."

What are the Symptoms of Claustrophobia?

A symptom is something the patient feels or reports, while a sign is something that other people, including the doctor detects. A headache may be an example of a symptom, while a rash may be an example of a sign.

A claustrophobic may suffer symptoms similar to anxiety that are triggered by being in a small space. The phobia of the small space is based on the fear of running out of oxygen along with the fear of restriction. When in an small confined space, someone with claustrophobia may start to show the following symptoms:
  • Sweating
  • Accelerated heart rate
  • Increased blood pressure
  • Hyperventilation, or 'over-breathing'
  • Shaking
  • Sweating
  • Panic attacks
  • Light-headedness
  • Nausea
  • Fainting
  • Fear of actual harm or illness
It is not essentially the small spaces that trigger the anxiety but the fear of what can happen to the person if confined to that area, hence the fear of running out of oxygen. Examples of small spaces that could trigger a claustrophobic's anxiety are:
  • elevators/lifts
  • basements/cellars
  • small rooms
  • airplanes
  • locked rooms
  • cars
  • trains
  • crowded areas
As claustrophobia is also defined by the phobia of being restricted, being confined to one area can also trigger the anxiety (e.g. having to wait in line at a checkout/cash register). There have also been studies to support the theory that MRI machines can cause claustrophobia, due to the prolonged length of time spent in a confined space with restricted movement.

As the above situations can cause a claustrophobic to suffer anxiety and panic attacks, a claustrophobic will try their best to avoid them. The following are examples of how a claustrophobic may behave:
  • As soon as they enter a room they may urgently check out where the exits are and position themselves near them. When all the doors are closed they may feel troubled.
  • In a crowded party, even if the venue is a large and spacious room, they will position themselves near the door.
  • Avoid driving during peak times, when traffic is likely to be congested
  • Avoid travelling as a passenger in a car during peak traffic times
  • In severe cases, some individuals with claustrophobia may panic when a door is closed
  • Avoid using elevators and use the stairs, even if this means getting tired, out of breath and sweating a lot

What Causes Claustrophobia?

Claustrophobia is generally the result of an experience in the person's past (usually in their childhood) that has led them to associate small spaces with the feeling of panic or being in imminent danger. Examples of these kinds of past experiences are:
  • falling into a deep pool and not being able to swim
  • being in a crowded area and getting separated from parents/group
  • crawling into a hole and getting lost/stuck
As the experience will have dealt some kind of trauma to the person, it will affect their ability to deal with a similar situation rationally. The mind links the small space/confined area to the feeling of being in danger and the body then reacts accordingly (or how it thinks it should). This type of cause is known as classic conditioning and can also be a behavior inherited from parents or peers. If for example, a claustrophobic has a child, the child may observe their parent's behavior and develop the same fears.

There are other theories behind the causes of claustrophobia, these are:
  • Smaller Amygdala - the amygdala is a tiny part of the brain that is used to control how the body processes fear. During a study, Fumi Hayano discovered that people who suffered panic disorders had a smaller amygdale than average. This smaller size could interfere with how the body processes panic and anxiety.
  • Prepared Phobia - there is also a theory that phobias develop on the genetic level rather than psychologically. The research behind this theory suggests that claustrophobia and some other phobias are dormant evolutionary survival mechanisms. A survival instinct buried within our genetic code that was once crucial to human survival but is no longer needed.

How is Claustrophobia Diagnosed?

Claustrophobia would be diagnosed as a result of seeing a psychologist. The patient may be seeing the psychologist because they suffer the symptoms of claustrophobia, or they could be originally seeing them about another anxiety problem or phobia.

The psychologist would ask for a description of the symptoms and what triggers them. Using their knowledge and resources, the psychologist would then determine the type and severity of the patient's phobia.

There are methods put in place to help decide if the patient is suffering claustrophobia and to what extent. These methods are:
  • Claustrophobia questionnaire - Originally developed in 1993 and modified in 2001 this has been a helpful way of identifying the symptoms of claustrophobia.
  • Claustrophobia Scale - Developed in 1979, this method is made up of 20 questions that when answered can help establish the levels of anxiety when diagnosing the claustrophobia.

How is Claustrophobia Treated?

After diagnosis has been made, the psychologist would try one or a few of the following methods to help the claustrophobic deal with their fear:
  • CBT (Cognitive Behavioral Therapy) - This is a well recognized treatment method for many other types of anxiety disorder. The goal of CBT is to retrain the claustrophobic's brain to no longer feel threatened by the places they fear. An approach taken may be slowly exposing the patient to small spaces and helping them deal with their fear and anxiety (in vivo exposure). This is the most common way claustrophobia is treated.
  • Drug Therapy - This type of therapy can help manage the anxiety symptoms, however it does not deal with the problem itself. This along with the undesired side effects makes this method far from first choice for treating claustrophobia.
  • Relaxation Exercises - Taking deep breaths, meditating and doing muscle relaxing exercises are effective at dealing with negative thoughts and anxiety.
  • Alternative/Natural medicine - There are some natural products and homeopathic medicines that some patients say help them manage panic and anxiety.
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Promising Progress With Vaccine For Ebola

Ebola is a rare but frightening disease with no cure. There are also worries of it being used in a terrorist attack. Now, researcher Charles Arntzen, from the Biodesign Institute® at Arizona State University, along with colleagues from ASU, the University of Arizona College of Medicine-Phoenix, and the United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, have made interesting progress in the search for a vaccine against the disease.

Their work, which is published in the Proceedings of the National Academy of Science, has a cutting edge approach, utilizing tobacco plants as living pharmaceutical production facilities.

The plants essentially manufacture the Ebola vaccine from a DNA blueprint in conjunction with a specially developed bacteria that is infused into the plant leaves. This approach is radically different from traditional vaccines, like that used against the flu virus, which are generally grown using animal cells, egg or yeast for a culture. Perhaps tobacco, the number one public health enemy, has a healthy use after all.

One of Arntzen's main problems that made him have to push the envelope in vaccine generation, is that outbreaks of Ebloa are infrequent, whereas other viruses like HIV that researches are working intensively for a vaccine against, have commonly occurring patterns of infection.

With Ebola being so rare and unpredictable, which is just as well, because it is such a lethal disease, making any kind of clinical trials is rather difficult. Researchers have recently been testing HIV vaccines in clusters of populations in Thailand, which has a high prevalence of the disease. However something like this is impossible with Ebola, and its rare nature makes it is more likely that the vaccine would not be used widely in an entire population, but more as a counter-measure against someone with an infection (known as passive immunization), or in a localized area to prevent an epidemic taking hold.

Testing and how to use the vaccine is not the only problem though. While it might seem that the best idea would be to create a depository of the vaccine to be used in the event of an outbreak or terrorist event, Arntzen states that despite alternatives, there are no human Ebola vaccines available. There are some promising possibilities and there have been some good results, with animals showing acceptable levels protection against the virus, but practical considerations make things difficult.

Charles Arntzen said:

"All of these existing vaccine candidates are genetically modified live viruses ... If you've got something that you're going to have to keep at liquid nitrogen temperatures for years at a time, in hopes that there will never be an outbreak, it makes it impractical. "

The problems of testing and production are further compounded, due to the dangerous nature of the disease. Experiments had to be carried out by highly skilled researchers at a state-of-the-art bio-containment facility run by the US Army Medical Research Institute in Maryland.

Their aim was to trial the vaccine on live mice. Arntzen's vaccine was at least the equivalent of other experimental vaccines (from animal sources), achieving an 80% survival rate in mice injected with lethal shots of Ebola. Additionally, his technique of cultivation using tobacco plants means not only large cost savings in production, in part due to the ease of purifying the vaccine from vegetable rather than animal matter, but also because his product can potentially be freeze-dried and stored at room temperature.

Ease-of-storage is one of the most essential requirements of the vaccine, as it would only be used in specific situations, which might not occur for years in the future.

Arntzen's vaccine also uses a different adjuvant, an additive that increases the vaccine's potency. The FDA normally approves Alum (aluminum hydroxide), but during the tests at Maryland, mice survival rates did not show any increase. Instead, a Toll-like receptor (TLR) agonist called PIC was administered with the Ebola Immune Complex (EIC). EIC is essentially an aggregate created by fusing a key surface protein (known as GP1) from the Ebola virus with a monoclonal antibody customized to bind to GP1.

The use of Toll-like receptors is an advance in vaccine techniques from standard products. Toll-like receptors are part of the body's innate immune system, involved in processes of inflammation, where defensive cells like macrophages and dendritic cells are attracted to the site of infection.

Arntzen explains that because the TLR agonist PIC acts to mimic a site of inflammation, it amplifies the immune response, without causing tissue damage.

Arntzen said:

"In immunology, that means you've got something that is much easier for our immune system to recognize ... Because it has many copies of an identical molecule, it's called a repeating array."

Ebola belongs to a class of viruses called filoviridae, due to their threadlike nature. The EIC platform may well provide a vehicle to creating vaccines against other viruses in this class, and the straightforward purification protocol might also be useful in the case of other pathogens, including hepatitis C or dengue fever, where the extraction of glycoproteins has thus far been difficult.

All in all, it would appear that Arntzen's Ebola research has pushed vaccine creation into a new era, that might even appease some of the detractors against vaccines, which in recent years have been accused of causing Autism and other problems in children.

Complaints of the use of animal sources for DNA and preservatives could be allayed by plant derived, freeze-dried vaccines, with a long shelf life.
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What Is Vitamin E? What Does Vitamin E Do?

Vitamin E refers to a group of fat soluble compounds with strong antioxidant properties. An antioxidant is a substance that reduces oxidative damage, damage caused by oxygen which can harm human tissue, cells and organs.

Vitamin E exists in eight different isomers (forms), four tocopherols and four tocotrienols:
  • Alpha-tocopherol - found in the largest quantities in human blood and tissues. This is the only form actively maintained in the human body. This form of vitamin E has the greatest nutritional significance. Most dosing and daily allowance recommendations for this vitamin are given in ATE (Alpha-Tocopherol Equivalents). This is the second most abundant form of vitamin E in the US diet. Alpha tocopherol can be found most abundantly in sunflower oil, safflower oil, and wheat germ oil. As a food additive, it has E number E308. Its molecular formula is C29H50O2.
  • Beta-tocopherol - a natural tocopherol with less antioxidant activity than alpha-tocopherol. Its molecular formula is C28H48O2.
  • Gamma tocopherol - the major form of vitamin C in the US diet. It can be found in corn oil, soybean oil, margarine and dressings. Gamma tocopherol may be important to human health, according to recent studies, as it is well absorbed in human tissue. As a food additive, it has E number E308. Its molecular formula is C28H48O2.
  • Delta-tocopherol - It is found in lower concentrations than alpha-tocopherol. As a food additive, it has E number E309. Its molecular formula is C27H46O2.
  • Alpha-tocotrienol - the most abundant form of vitamin E in palm oil. Its molecular formula is C29H44O2.
  • Beta-tocotrienol - Its molecular formula is C28H42O2.
  • Gamma-tocotrienol - a rare form of vitamin E.
  • Delta-tocotrienol - Its molecular formula is C27H40O2.
Experts believe vitamin E has benefits for:
  • Some skin conditions.
  • Parkinson's disease.
  • Helping males with infertility problems.
  • Preventing heart disease. 
  • Preventing Alzheimer's disease in advanced age. 
  • May help lower the risk of (COPD) chronic obstructive pulmonary disease by about 10 percent in both smokers and non-smokers.
  • Some patients with diabetes may enjoy protective benefits.
  • A pre-cursor of vitamin E may protect against a type of breast cancer.
  • Arthritis
  • Premenstrual symptoms.
  • Aging.
  • Prostate cancer prevention, and preventing recurrence of prostate cancer. Some studies have demonstrated benefits, while others have not.
  • Enhancing the immune system of seniors.
  • May extend the life-span of restricted groups of men.
  • It is effective in treating non-alcoholic steatohepatitis, an obesity-associated chronic liver disease. 

How much vitamin E should I have?

According to the Institute of Medicine's Food and Nutrition Board, USA, the following are recommended as daily intakes of vitamin E:
  • Infants up to 6 months - 4 mg per day
  • Infants from 7 to 12 months - 5 mg per day
  • Children aged 1 to 3 years - 6 mg per day
  • Children aged 4 to 8 years - 7 mg per day
  • Children aged 9 to 13 years - 11 mg per day
  • People aged 14 years or more - 15 mg per day
One International Unit (IU) of Vitamin E can either be 0.67 mg of RRR-alpha-tocopherol, or 0.45 mg of all rac-alpha-tocopherol.

The following foods are rich in vitamin E:
  • Almonds
  • Asparagus
  • Avocados
  • Blue crab
  • Brazil Nuts
  • Broccoli
  • Cod liver oil
  • Corn oil
  • Cottonseed oil
  • Egg Yolks
  • Green leafy vegetables, like lettuce, spinach, turnip, beet, collard, and dandelion greens
  • Hazelnuts
  • Mangoes
  • Margarine
  • Marzipan
  • Mayonnaise
  • Muesli
  • Olives
  • Papayas
  • Peanut oil
  • Pine nuts
  • Popcorn
  • Pumpkin
  • Rapeseed oil
  • Rockfish
  • Safflower oils
  • Samosas
  • Soya bean oil
  • Sunflower oil
  • Sweet Potato
  • Tomato products
  • Walnuts
  • Wheat germ oil

Vitamin E deficiency

Vitamin E deficiency is rare in developed countries. Premature babies of low birth weight may lack vitamin E and require supplementation to prevent complications.

The human digestive tract needs fat to absorb vitamin E. Those with fat-malabsorption disorder have a higher risk of becoming vitamin E deficient. Deficiency can sometimes lead to peripheral neuropathy, impairment of the immune response, retinopathy, skeletal myopathy, or ataxia.

Vitamin E supplements may sometimes interact with certain medications. Ask your doctor or a qualified pharmacist if you are not sure.
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Foster Kids Get More Psychiatric Drugs

A Government Accountability Report released this Thursday showed America's foster children being prescribed powerful psychotropic drugs, at doses beyond what the Food and Drug Administration has approved. At a congressional hearing the same day, Thursday saw lawmakers discussing both the problems and possible solutions.

Obviously, those in foster care are more likely to have had elements of abuse or traumatic experiences during their upbringing, thus they are more likely to end up on medication, especially once they are labeled as problem children, hopping from one home to the next.

By way of example, three-quarters of the children who enter Maryhurst's program, a nonprofit agency for neglected or abused children in Kentucky, are on psychotropic drugs, but by the time they leave, well over half are on reduced or no medication at all.

Maryhurst president and CEO Judy Lambeth continued :

"Our children come to us on many medications, but over time we want to reduce the medication as much as possible and hopefully, to where they wouldn't need any at all. That's a fine balance, but we want them to be able to participate in the treatment and if they're overmedicated, they can't do that."

Medicaid, administered by individual states and overseen by the Department of Health and Human Services (HHS), provides prescription drug coverage to foster children, so medication is clearly the easy way out a lot of the time.

A part of it also has to do with simplifying and streamlining care to hundreds or thousands of children at a time, who have ended up without official parents or guardians and thus in foster care.

More shocking than simply a slight overuse of psychotropic drugs

However, the results are more shocking than simply a slight overuse of psychotropic drugs on foster kids, even if just for expediency.

Government Accountability Office (GAO) experts say there is more evidence of misuse, overuse and potential health risks than simply a statistic showing foster kids are on medication more than those with regular homes.

They examined five states Florida, Maryland, Massachusetts, Michigan, Oregon, and Texas; cases include :
  • The concomitant use of five or more psychotropic drugs for which there is no established benefit
  • Children prescribed doses higher than the maximum levels cited in guidelines developed by Texas based on FDA-approved labels.
  • Children under 1 year old were prescribed psychotropic drugs.
The GAO state that there are no established usages for mental health conditions in infants; providing them these drugs could result in serious adverse effects. Using higher than recommended doses exposes children to the risks of side effects and serious health problems.

Putting aside the creation of wanton costs for Medicaid, there is no medical precedent for using five or more psychotropic drugs on the same patient.

Selected states' monitoring programs for psychotropic drugs provided to foster children, seem to fall short of the guidelines published by the American Academy of Child and Adolescent Psychiatry (AACAP). The guidelines, which states are not required to follow, cover four categories :
  • (1) Consent: Each state has some practices consistent with AACAP consent guidelines, such as identifying caregivers empowered to give consent.
  • (2) Oversight: Each state has procedures consistent with some but not all oversight guidelines, which include monitoring rates of prescriptions.
  • (3) Consultation: Five states have implemented some but not all guidelines, which include providing consultations by child psychiatrists by request.
  • (4) Information: Four states have created websites about psychotropic drugs for clinicians, foster parents, and other caregivers.
GAO recommended that The Department of Health and Human Service (HHS) begin endorsing guidance for states on best practices for overseeing psychotropic prescriptions for foster children. HHS agreed with the recommendation. Agency comments will be incorporated and addressed in a written report that will be issued in December 2011.
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Gay Married Men Enjoy Better Health Than Single Gay Men

Men in same-sex marriages enjoy better health, have fewer doctor visits and lower health care costs compared to other gay or bisexual men, researchers from the Mailman School of Public Health wrote in the American Journal of Public Health. They added that when states offer legal protections for same-sex marriages, as is the case in Massachusetts, gay men generally have lower overall levels of stress. The article is titled "Effect of Same-Sex Marriage Laws on Health Care Use and Expenditures in Sexual Minority Men: A Quasi-Natural Experiment."

Lead author, Mark L. Hatzenbuehler, PhD, said:

"Our results suggest that removing barriers to marriage improves the health of
gay and bisexual men."
During a twelve-month period after the legalization of same-sex marriage in Massachusetts in 2003, the following changes were noted among gay and bisexual males:
  • 13% fewer medical care visits
  • A significant drop in the number of mental healthcare visits
  • 14% lower health care costs
  • HIV-related visits remained about the same among males who were HIV positive
Hatzenbuehler and team gathered data on 1,211 patients from a community-based health clinic in Massachusetts that specialized in sexual minorities. After the state approved the same-sex marriage law, they examined the clinic's billing records and found that the following conditions, all stress-related, became considerably less frequent - high blood pressure (hypertension), depression and adjustment disorders.

Dr. Hatzenbuehler said:

"These findings suggest that marriage equality may produce broad public health benefits by reducing the occurrence of stress-related health conditions in gay and bisexual men."

The authors explained that prior studies had indicated that not allowing same sex marriages resulted in more stress for gay and bisexual people. They added that this new study is the first to determine what impact same-sex marriage policies might have on healthcare usage and expenditure among gay and bisexual males.

As there were not enough lesbians visiting the clinic, they could not include this group of people in their study.

Dr. Hatzenbuehler said:

"This research makes important contributions to a growing body of evidence on the social, economic, and health benefits of marriage equality."
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Mosquitoes With West Nile Virus Appearing In Various Parts Of The USA

The Connecticut Department of Public Health's State Mosquito Management Program has announced that mosquitoes in Bridgeport tested positive for WNV (West Nile Virus) on June 21st - the first cases identified by CAES (Connecticut Agricultural Experiment Station) in 2011.

Theodore G. Andreadis, Ph.D., Chief Medical Entomologist, CAES, said:

"The detection of infected mosquitoes in June suggests early amplification of virus activity. With warming temperatures, the isolation of West Nile virus in mosquitoes can be expected to increase and expand to other areas of the state throughout the summer."

Connecticut Department of Public Health Commissioner Dr. Jewel Mullen, said:

"The finding by the CAES provides an early warning that the virus is circulating again this year in Connecticut. We encourage residents and visitors of Connecticut to take steps to prevent mosquito bites while spending time outdoors this holiday weekend and throughout the summer and early fall."

Connecticut authorities inform that last year WNV-positive mosquitoes were trapped in 24 municipalities, the first being trapped on June 14th, 2010. Eleven people in the state were reported with WNV infections last year.

CAES has 91 mosquito-trapping stations in 72 municipalities. Traps are set on Monday and Thursday nights. Specimens are collected every ten days from each site on a rotating basis. Scientists say they pool (collect) the mosquitoes for testing according to date, collection site, and species.

The mosquitoes are tested for viruses that are of public health concern. Results are posted on the CAES website.

Tennessee - the state's Public Health Laboratory confirmed WNV in mosquitoes in Memphis, Nashville and Knoxville. State officials urge citizens to use repellants and take other precautions to prevent mosquito and other insect bites.

Abelardo C. Moncayo, PhD, director of the Vector-Borne Diseases program for the Tennessee Department of Health, said:

"These positive tests tell us that individuals bitten by mosquitoes in Tennessee could be at risk for contracting West Nile Virus. We can help control mosquito populations and lessen the risk of infection by emptying containers with standing water, keeping doors and windows screened, and wearing mosquito repellent when outside."

Authorities inform that Tennessee is the 10th state so far in 2011 to show positive tests for WNV in mosquitoes, horses or birds. Last year, Tennessee had four reported human cases of WNV infection. The record was in 2002, with 56 cases.

South Dakota - Dr. Lon Kightlinger, State Epidemiologist for the South Dakota Department of Health, said:

"We do expect more mosquitoes this summer with so many areas affected by flooding. West Nile has already been detected in mosquitoes in neighboring states (Iowa and North Dakota) and the peak transmission period for the virus is approaching so now is the time to get in the habit of using insect repellent."

Officials in South Dakota inform that peak WNV transmission occurs from mid-July through mid-September. There have been over 1,700 human cases reported in the state since 2002, including 26 deaths.

Ohio - two mosquito pools in the City of Columbus tested positive for WNV.

Ohio Department of Health Director Ted Wymyslo, M.D.,said:

"Mosquitoes that transmit West Nile have arrived. To protect yourself and your loved ones from mosquito bites be sure to use mosquito repellent and remove standing water from your property."

No human cases have been reported in the state so far. Ohio has had reported cases of human WNV infection every year since 2002. In 2002 there were 441 cases, 108 in 2003, 12 in 2004, 61 in 2005, 48 in 2006, 23 in 2007, 15 in 2008, 2 in 2009, and 5 last year.
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