Pruritus since childhood.

J Fam Pract. 2016 Sep;65(9):E1-4

Authors: Richardson A, Usatine RP

The itchy rash had been previously diagnosed as psoriasis. But treatment provided minimal relief. So what was causing the itch?

PMID: 27672693 [PubMed - in process]

Do autologous blood and PRP injections effectively treat tennis elbow?

J Fam Pract. 2016 Sep;65(9):635

Authors: Widstrom L, Slattengren A

Both approaches reduce pain, but the improvement with platelet-rich plasma (PRP) is not clinically meaningful. Autologous blood injections (ABIs) are more effective than corticosteroid injections for reducing pain and disability in patients with tennis elbow in both the short and long term.

PMID: 27672692 [PubMed - in process]

Which SSRIs most effectively treat depression in adolescents?

J Fam Pract. 2016 Sep;65(9):632-4

Authors: DeLucia V, Kelsberg G, Safranek S

We don't know which selective serotonin reuptake inhibitors (SSRIs) are the most effective and safe because no studies have compared these antidepressants with each other. Three SSRI antidepressant medications--fluoxetine, sertraline, and escitalopram--produce modest improvements (about 5% to 10%) in standardized depression scores without a significant increase in the risk of suicide-related outcomes (suicidal behavior or ideation) in adolescent patients with major depression of moderate severity.

PMID: 27672691 [PubMed - in process]

Pruritic, lightly-scaled patches on wrists.

J Fam Pract. 2016 Sep;65(9):627-9

Authors: Brodell AP, Helms SE

A rash first appeared on this patient's left wrist and then spread to his right. Was his chrome-colored watch to blame--or was there a different cause?

PMID: 27672690 [PubMed - in process]

PURLs: Yeast infection in pregnancy? Think twice about fluconazole.

J Fam Pract. 2016 Sep;65(9):624-6

Authors: Barzin A, Mounsey A

This study's findings regarding the risk of miscarriage may mean it's time to forego fluconazole in favor of topical azoles as first-line treatment.

PMID: 27672689 [PubMed - in process]

Depigmented patches, mild scaling on newborn · Dx?

J Fam Pract. 2016 Sep;65(9):620-2

Authors: Dasarathy J, Tandra S, Chaudhry L, Alexander C

Depigmented patches covering approximately 15% of newborn's body, surrounded by areas of thickened skin. Mild scaling and hyperpigmentation.

PMID: 27672688 [PubMed - in process]

Practice Alert: Need-to-know information for the 2016-2017 flu season.

J Fam Pract. 2016 Sep;65(9):613-27

Authors: Campos-Outcalt D

ACIP now advises against using the LAIV nasal spray. In addition, 2 new vaccines are available and 2 more may soon be approved.

PMID: 27672687 [PubMed - in process]

Bone disease in patients with kidney disease: A tricky interplay.

J Fam Pract. 2016 Sep;65(9):606-12

Authors: Nyman H, Pippitt K, Hansen A, Gunning K

Managing bone disease in patients with kidney disease involves frequent lab testing and careful evaluation of therapeutic options. This review provides guidance.

PMID: 27672686 [PubMed - in process]

A new paradigm for pain?

J Fam Pract. 2016 Sep;65(9):598-605

Authors: Davis B, Vanderah TW

A new way of thinking about pain that occurs in the absence of a pathophysiologic process or injury may alter our approach to conditions like fibromyalgia.

PMID: 27672685 [PubMed - in process]

Is an SGLT2 inhibitor right for your patient with type 2 diabetes?

J Fam Pract. 2016 Sep;65(9):587-93

Authors: Lisenby KM, Meyer A, Slater NA

Metformin isn't quite doing the job or is contraindicated? Here's a look at the patients who may benefit from these agents and the monitoring required.

PMID: 27672684 [PubMed - in process]

Maybe it is all in your head.

J Fam Pract. 2016 Sep;65(9):586

Authors: Hickner J

Recent research provides strong evidence that in some cases of intractable chronic pain, the origin of the pain signal is in the brain--rather than the body.

PMID: 27672683 [PubMed - in process]

Correction to: 2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America.

Circulation. 2016 Sep 27;134(13):e298


PMID: 27672202 [PubMed - in process]

Letter by Melgari et al Regarding Article, "Ivabradine: Role in the Chronic Heart Failure Armamentarium".

Circulation. 2016 Sep 27;134(13):e296-7

Authors: Melgari D, Ng GA, Hancox JC

PMID: 27672201 [PubMed - in process]

Letter by Koh Regarding Article, "Long-Term Effectiveness and Safety of Pravastatin in Patients With Coronary Heart Disease: 16 Years of Follow-Up of the LIPID Study".

Circulation. 2016 Sep 27;134(13):e294-5

Authors: Koh KK

PMID: 27672200 [PubMed - in process]

Long-Term Follow-Up of the Randomized (BIOMArCS-2) Glucose Trial: Intensive Glucose Regulation in Hyperglycemic Acute Coronary Syndrome.

Circulation. 2016 Sep 27;134(13):984-6

Authors: van den Berg VJ, Umans VA, Stam F, de Mulder M, Akkerhuis KM, Cornel JH, Kardys I, Boersma E

PMID: 27672199 [PubMed - in process]

Highlights from the Circulation Family of Journals.

Circulation. 2016 Sep 27;134(13):978-83


PMID: 27672198 [PubMed - in process]

Superficial Femoral Artery Is Not Left Anterior Descending Artery.

Circulation. 2016 Sep 27;134(13):901-3

Authors: Banerjee S

PMID: 27672197 [PubMed - in process]

Telestroke: Is it safe and effective?

Neurology. 2016 Sep 27;87(13):e145-8

Authors: Madhavan M, Karceski S

PMID: 27672174 [PubMed - in process]

Teaching NeuroImages: Acquired hepatocerebral degeneration: An underrecognized complication of advanced liver disease.

Neurology. 2016 Sep 27;87(13):e144

Authors: Bateman JR, Roque DA

PMID: 27672173 [PubMed - in process]

Clinical Reasoning: A 52-year-old man with diplopia and ataxia.

Neurology. 2016 Sep 27;87(13):e140-3

Authors: Bradshaw MJ, Pawate S, Bloch KC, Moots P, Reddy NM

PMID: 27672172 [PubMed - in process]

Clinical Reasoning: An 87-year-old man with chronic obstructive pulmonary disease and acute encephalopathy.

Neurology. 2016 Sep 27;87(13):e135-9

Authors: Spera K, Rubin D, Gupta T, Fantaneanu T, Henderson GV

PMID: 27672171 [PubMed - in process]

Mystery Case: Terson syndrome on CT head.

Neurology. 2016 Sep 27;87(13):e133-4

Authors: George JS, Elston JS

PMID: 27672170 [PubMed - in process]

Safety and immunologic effects of high- vs low-dose cholecalciferol in multiple sclerosis.

Neurology. 2016 Sep 27;87(13):1424

Authors: Kantor D, Sotirchos ES, Calabresi PA

PMID: 27672169 [PubMed - in process]

Pearls & Oy-sters: Tacrolimus neurotoxicity presenting as an isolated brainstem lesion.

Neurology. 2016 Sep 27;87(13):1423

Authors: Chang GY, Saadi A, Schmahmann JD

PMID: 27672168 [PubMed - in process]

A case of sudden deterioration in Parkinson disease.

Neurology. 2016 Sep 27;87(13):1422

Authors: Umemoto G, Fujioka S, Yanamoto S, Fukae J, Tsuboi Y

PMID: 27672167 [PubMed - in process]

A rare case of extensive primary meningeal osteosarcoma in childhood.

Neurology. 2016 Sep 27;87(13):1420-1

Authors: Zhang S, Ju Y, You C

PMID: 27672166 [PubMed - in process]

The terrorist inside my husband's brain.

Neurology. 2016 Sep 27;87(13):1308-11

Authors: Williams SS

PMID: 27672165 [PubMed - in process]

An update on gastric cancer.

Curr Probl Surg. 2016 Oct;53(10):449-90

Authors: Ahmad SA, Xia BT, Bailey CE, Abbott DE, Helmink BA, Daly MC, Thota R, Schlegal C, Winer LK, Ahmad SA, Al Humaidi AH, Parikh AA

PMID: 27671911 [PubMed - in process]

In Brief.

Curr Probl Surg. 2016 Oct;53(10):444-6

Authors: Ahmad SA, Xia BT, Bailey CE, Abbott DE, Helmink BA, Daly MC, Thota R, Schlegal C, Winer LK, Ahmad SA, Al Humaidi AH, Parikh AA

PMID: 27671910 [PubMed - in process]


Curr Probl Surg. 2016 Oct;53(10):443

Authors: Ashley SW

PMID: 27671909 [PubMed - in process]

The Reply.

Am J Med. 2016 Oct;129(10):e267

Authors: Grant PJ, Greene MT, Flanders SA

PMID: 27671859 [PubMed - in process]

Caprini Score in Hospitalized Medical Patients.

Am J Med. 2016 Oct;129(10):e265

Authors: Tafur AJ, Arcelus JI

PMID: 27671858 [PubMed - in process]

Don't Overlook the Role of Intraabdominal Pressure.

Am J Med. 2016 Oct;129(10):e261

Authors: Taleb-Bendiab T, Jacobs FM

PMID: 27671857 [PubMed - in process]

The Reply.

Am J Med. 2016 Oct;129(10):e259

Authors: Dalen JE

PMID: 27671856 [PubMed - in process]

Organic Chemistry: A Vital Part of Basic Understanding of Disease.

Am J Med. 2016 Oct;129(10):e257-8

Authors: Hashemzadeh M, Peyton LR

PMID: 27671855 [PubMed - in process]

The Reply.

Am J Med. 2016 Oct;129(10):e255

Authors: Horton WB, Subauste JS

PMID: 27671854 [PubMed - in process]

One More Fact to Know About Inpatient Glycemic Control.

Am J Med. 2016 Oct;129(10):e253

Authors: Thoelke M

PMID: 27671853 [PubMed - in process]

The Reply.

Am J Med. 2016 Oct;129(10):e251

Authors: Wakeman SE

PMID: 27671852 [PubMed - in process]

Science Alone Is Not Enough.

Am J Med. 2016 Oct;129(10):e249

Authors: Ruan X, Chiravuri S, Kaye AD

PMID: 27671851 [PubMed - in process]

Shedding Light on Shingles: The Power of Prevention.

Am J Med. 2016 Oct;129(10):1137

Authors: Herman L, Levin MJ, Rehm S

Shingles, or herpes zoster (HZ), is a common secondary infection caused by a reactivated varicella zoster virus (VZV). More than 95% of immunocompetent individuals aged at least 50 years are seropositive for VZV and are therefore at risk for developing HZ. Age-related increased incidence of HZ and its complications are thought to be related to the decline in cell-mediated immunity. Complications of HZ, which create a significant patient and economic burden, may be neurological, ophthalmological, dermatological, or visceral. HZ vaccination is essential for the prevention of HZ and its consequences. This CME activity reviews the clinical presentations and complications of HZ as well as discusses strategies for prevention (Online access:

PMID: 27671850 [PubMed - in process]

Spinal Cord Injury Model Systems: Review of Program and National Database From 1970 to 2015.

Arch Phys Med Rehabil. 2016 Oct;97(10):1797-804

Authors: Chen Y, DeVivo MJ, Richards JS, SanAgustin TB

The Spinal Cord Injury Model Systems (SCIMS) centers have provided continuous, comprehensive multidisciplinary care for persons with spinal cord injury (SCI) in the United States since their inception in 1970. In addition, the research conducted and the analysis of data collected at these centers facilitate advances in the care and the overall quality of life for people with SCI. Over the past 45 years, the SCIMS program and National Spinal Cord Injury Database (NSCID) have undergone major revisions, which must be recognized in the planning, conduct, and interpretation of SCIMS research to prevent misinterpretation of findings. Therefore, we provide herein a brief review of the SCIMS program and the associated NSCID throughout its history, emphasizing changes and accomplishments within the past 15 years, to facilitate a better understanding and interpretation of the data presented in SCIMS research publications, including the articles published in this special issue of the Archives.

PMID: 27671806 [PubMed - in process]

Current Research Outcomes From the Spinal Cord Injury Model Systems.

Arch Phys Med Rehabil. 2016 Oct;97(10):1607-9

Authors: Chen Y, Heinemann AW

PMID: 27671805 [PubMed - in process]

What Are the New Nutrition Standards for the Child and Adult Care Food Program?

J Acad Nutr Diet. 2016 Oct;116(10):1728

Authors: Marcason W

PMID: 27671763 [PubMed - in process]

Translating the Dietary Guidelines to Promote Behavior Change: Perspectives from the Food and Nutrition Science Solutions Joint Task Force.

J Acad Nutr Diet. 2016 Oct;116(10):1697-702

Authors: Ivens BJ, Smith Edge M, Food and Nutrition Science Solutions Joint Task Force

PMID: 27671762 [PubMed - in process]

Distinctions in Entry-Level Registered Dietitian Nutritionist and Nutrition and Dietetics Technicians, Registered, Practice: Further Results from the 2015 Commission on Dietetic Registration Entry-Level Dietetics Practice Audit.

J Acad Nutr Diet. 2016 Oct;116(10):1685-96

Authors: Rogers D, Griswold K, Kellogg Leibovitz P, Sauer KL, Doughten S

PMID: 27671761 [PubMed - in process]

Entry-Level Dietetics Practice Today: Results from the 2015 Commission on Dietetic Registration Entry-Level Dietetics Practice Audit.

J Acad Nutr Diet. 2016 Oct;116(10):1632-84

Authors: Griswold K, Rogers D, Sauer KL, Kellogg Leibovitz P, Finn JR

PMID: 27671760 [PubMed - in process]

Practice Paper of the Academy of Nutrition and Dietetics: Role of the Registered Dietitian Nutritionist in the Diagnosis and Management of Food Allergies.

J Acad Nutr Diet. 2016 Oct;116(10):1621-31

Authors: Collins SC

Incidence of food allergy has increased significantly over the past decade and represents an important health issue for millions of Americans. Diagnosis of immunoglobulin E-mediated food allergies is sometimes difficult because blood and skin tests have high rates of false positives, and oral food challenges are uncommon due to the expense and potential for serious reactions. Accurate diagnosis is crucial to avoid unnecessary dietary restriction, especially in children. Because registered dietitian nutritionists often work independently, receiving referrals for dietary education and guidance for a patient who is followed by one or several other practitioners, navigating the data available and making the appropriate follow-up contact optimizes treatment. The purpose of this paper is to provide guidance to the registered dietitian nutritionists and nutrition and dietetics technician, registered on appropriate and evidence-based nutrition counseling for diagnosis and management of food allergies.

PMID: 27671759 [PubMed - in process]

MyPlate at FNCE & Beyond: Join the Fun!

J Acad Nutr Diet. 2016 Oct;116(10):1538-9

Authors: Leone A, Psota TL, Holland C

PMID: 27671758 [PubMed - in process]

It Takes Vision to Prepare for Our Future.

J Acad Nutr Diet. 2016 Oct;116(10):1529

Authors: Beseler L

PMID: 27671757 [PubMed - in process]

Most American Association of Oral and Maxillofacial Surgeons Members Have Not Adopted the American Society of Anesthesiologists-Recommended Nil Per Os Guidelines.

J Oral Maxillofac Surg. 2016 Oct;74(10):1926-31

Authors: Johnson RE, Eckert PP, Gilmore W, Viswanath A, Finkelman M, Rosenberg MB

PURPOSE: The purpose of this study was to determine if American Association of Oral and Maxillofacial Surgeons members have integrated the current American Society of Anesthesiologists (ASA) nil per os (NPO) guidelines into their preoperative instructions.
MATERIALS AND METHODS: We designed and implemented a cross-sectional study and enrolled a random sample of private-practice American Association of Oral and Maxillofacial Surgeons members who practice in the United States. The predictor variables were year of graduation from residency, dual degree (MD and DDS or DMD) or single degree, and region. The primary outcome variable was adoption of the ASA NPO guidelines, defined as recommending fasting times of 2 hours for clear liquids and 6 hours for solid foods. To collect data, a systematic online search was implemented. Appropriate univariate and bivariate statistics were computed, and the level of significance was set at .05; in addition, 95% confidence intervals were calculated.
RESULTS: The study sample was composed of 431 oral and maxillofacial surgeons (OMSs). Almost all of the study sample (99.1%) did not adopt the ASA guidelines. The fasting recommendations were different from 2 hours for clear liquids and 6 hours for solid foods. However, recommendations of 2 hours or greater for clear liquids were made by 99.8% of OMSs, and recommendations of 6 hours or greater for solid foods were made by 99.3%. Only 4.4% of OMSs made different recommendations for clear liquids and solid foods. No substantial association was found between whether OMSs adopted the most current ASA guidelines and the year they graduated from residency or the obtainment of dual degrees.
CONCLUSIONS: OMSs in private practice are overwhelmingly recommending longer fasting times for clear liquids and solid foods on their Web sites when compared with the current ASA guidelines before ambulatory anesthesia. The ASA guidelines are based on meta-analysis; therefore, deviations in practice, although not incorrect, may call for discussion.

PMID: 27670066 [PubMed - in process]

The Perfect Match.

J Oral Maxillofac Surg. 2016 Oct;74(10):1905-7

Authors: Miloro M

PMID: 27670065 [PubMed - in process]

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Prophylaxis With a Middle East Respiratory Syndrome Coronavirus (MERS-CoV)-Specific Human Monoclonal Antibody Protects Rabbits From MERS-CoV Infection.

J Infect Dis. 2016 May 15;213(10):1557-61

Authors: Houser KV, Gretebeck L, Ying T, Wang Y, Vogel L, Lamirande EW, Bock KW, Moore IN, Dimitrov DS, Subbarao K

With >1600 documented human infections with Middle East respiratory syndrome coronavirus (MERS-CoV) and a case fatality rate of approximately 36%, medical countermeasures are needed to prevent and limit the disease. We examined the in vivo efficacy of the human monoclonal antibody m336, which has high neutralizing activity against MERS-CoV in vitro. m336 was administered to rabbits intravenously or intranasally before infection with MERS-CoV. Prophylaxis with m336 resulted in a reduction of pulmonary viral RNA titers by 40-9000-fold, compared with an irrelevant control antibody with little to no inflammation or viral antigen detected. This protection in rabbits supports further clinical development of m336.

PMID: 26941283 [PubMed - indexed for MEDLINE]

Related Articles

Immunological Characterization and Neutralizing Ability of Monoclonal Antibodies Directed Against Botulinum Neurotoxin Type H.

J Infect Dis. 2016 May 15;213(10):1606-14

Authors: Fan Y, Barash JR, Lou J, Conrad F, Marks JD, Arnon SS

BACKGROUND: Only Clostridium botulinum strain IBCA10-7060 produces the recently described novel botulinum neurotoxin type H (BoNT/H). BoNT/H (N-terminal two-thirds most homologous to BoNT/F and C-terminal one-third most homologous to BoNT/A) requires antitoxin to toxin ratios ≥1190:1 for neutralization by existing antitoxins. Hence, more potent and safer antitoxins against BoNT/H are needed.
METHODS: We therefore evaluated our existing monoclonal antibodies (mAbs) to BoNT/A and BoNT/F for BoNT/H binding, created yeast-displayed mutants to select for higher-affinity-binding mAbs by using flow cytometry, and evaluated the mAbs' ability to neutralize BoNT/H in the standard mouse bioassay.
RESULTS: Anti-BoNT/A HCC-binding mAbs RAZ1 and CR2 bound BoNT/H with high affinity. However, only 1 of 6 BoNT/F mAbs (4E17.2A) bound BoNT/H but with an affinity >800-fold lower (equilibrium dissociation binding constant [KD] = 7.56 × 10(-8)M) than its BoNT/F affinity (KD= 9.1 × 10(-11)M), indicating that the N-terminal two-thirds of BoNT/H is immunologically unique. The affinity of 4E17.2A for BoNT/H was increased >500-fold to KD= 1.48 × 10(-10)M (mAb 4E17.2D). A combination of mAbs RAZ1, CR2, and 4E17.2D completely protected mice challenged with 280 mouse median lethal doses of BoNT/H at a mAb dose as low as 5 µg of total antibody.
CONCLUSIONS: This 3-mAb combination potently neutralized BoNT/H and represents a potential human antitoxin that could be developed for the prevention and treatment of type H botulism.

PMID: 26936913 [PubMed - indexed for MEDLINE]

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Vaccine-Induced Immunogenicity and Protection Against Pneumocystis Pneumonia in a Nonhuman Primate Model of HIV and Pneumocystis Coinfection.

J Infect Dis. 2016 May 15;213(10):1586-95

Authors: Kling HM, Norris KA

BACKGROUND: The ubiquitous opportunistic pathogen Pneumocystis jirovecii causes pneumonia in immunocompromised individuals, including human immunodeficiency virus (HIV)-infected individuals, and pulmonary colonization with P. jirovecii is believed to be a cofactor in the development of chronic obstructive pulmonary disease. There is no vaccine for P. jirovecii; however, most adults are seropositive, indicating natural immune priming to this pathogen. We have shown that humoral response to a recombinant subunit of the P. jirovecii protease kexin (KEX1) correlates with protection from P. jirovecii colonization and pneumonia.
METHODS: Here we evaluated the immunogenicity and protective capacity of the recombinant KEX1 peptide vaccine in a preclinical, nonhuman primate model of HIV-induced immunosuppression and Pneumocystis coinfection.
RESULTS: Immunization with KEX1 induced a robust humoral response remained at protective levels despite chronic simian immunodeficiency virus/HIV-induced immunosuppression. KEX1-immunized macaques were protected from Pneumocystis pneumonia, compared with mock-immunized animals (P= .047), following immunosuppression and subsequent natural, airborne exposure to Pneumocystis
CONCLUSIONS: These data support the concept that stimulation of preexisting immunological memory to Pneumocystis with a recombinant KEX1 vaccine prior to immunosuppression induces durable memory responses and protection in the context of chronic, complex immunosuppression.

PMID: 26823337 [PubMed - indexed for MEDLINE]

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Phagocytosis and Killing of Carbapenem-Resistant ST258 Klebsiella pneumoniae by Human Neutrophils.

J Infect Dis. 2016 May 15;213(10):1615-22

Authors: Kobayashi SD, Porter AR, Dorward DW, Brinkworth AJ, Chen L, Kreiswirth BN, DeLeo FR

Carbapenem-resistant Klebsiella pneumoniae strains classified as multilocus sequence type 258 (ST258) are among the most widespread multidrug-resistant hospital-acquired pathogens. Treatment of infections caused by these organisms is difficult, and mortality is high. The basis for the success of ST258, outside of antibiotic resistance, remains incompletely determined. Here we tested the hypothesis that ST258K. pneumoniae has enhanced capacity to circumvent killing by human neutrophils, the primary cellular defense against bacterial infections. There was limited binding and uptake of ST258 by human neutrophils, and correspondingly, there was limited killing of bacteria. On the other hand, transmission electron microscopy revealed that any ingested organisms were degraded readily within neutrophil phagosomes, thus indicating that survival in the neutrophil assays is due to limited phagocytosis, rather than to microbicide resistance after uptake. Our findings suggest that enhancing neutrophil phagocytosis is a potential therapeutic approach for treatment of infection caused by carbapenem-resistant ST258K. pneumoniae.

PMID: 26768252 [PubMed - indexed for MEDLINE]

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Combination Emtricitabine and Tenofovir Disoproxil Fumarate Prevents Vaginal Simian/Human Immunodeficiency Virus Infection in Macaques Harboring Chlamydia trachomatis and Trichomonas vaginalis.

J Infect Dis. 2016 May 15;213(10):1541-5

Authors: Radzio J, Henning T, Jenkins L, Ellis S, Farshy C, Phillips C, Holder A, Kuklenyik S, Dinh C, Hanson D, McNicholl J, Heneine W, Papp J, Kersh EN, García-Lerma JG

Genital inflammation associated with sexually transmitted infections increases susceptibility to human immunodeficiency virus (HIV), but it is unclear whether the increased risk can reduce the efficacy of pre-exposure prophylaxis (PrEP). We investigated whether coinfection of macaques with Chlamydia trachomatis and Trichomonas vaginalis decreases the prophylactic efficacy of oral emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF). Macaques were exposed to simian/human immunodeficiency virus (SHIV) vaginally each week for up to 16 weeks and received placebo or FTC/TDF pericoitally. All animals in the placebo group were infected with SHIV, while 4 of 6 PrEP recipients remained uninfected (P= .03). Oral FTC/TDF maintains efficacy in a macaque model of sexually transmitted coinfection, although the infection of 2 macaques signals a modest loss of PrEP activity.

PMID: 26743846 [PubMed - indexed for MEDLINE]

Related Articles

Influenza Vaccine Effectiveness Against 2009 Pandemic Influenza A(H1N1) Virus Differed by Vaccine Type During 2013-2014 in the United States.

J Infect Dis. 2016 May 15;213(10):1546-56

Authors: Gaglani M, Pruszynski J, Murthy K, Clipper L, Robertson A, Reis M, Chung JR, Piedra PA, Avadhanula V, Nowalk MP, Zimmerman RK, Jackson ML, Jackson LA, Petrie JG, Ohmit SE, Monto AS, McLean HQ, Belongia EA, Fry AM, Flannery B

BACKGROUND: The predominant strain during the 2013-2014 influenza season was 2009 pandemic influenza A(H1N1) virus (A[H1N1]pdm09). This vaccine-component has remained unchanged from 2009.
METHODS: The US Flu Vaccine Effectiveness Network enrolled subjects aged ≥6 months with medically attended acute respiratory illness (MAARI), including cough, with illness onset ≤7 days before enrollment. Influenza was confirmed by reverse-transcription polymerase chain reaction (RT-PCR). We determined the effectiveness of trivalent or quadrivalent inactivated influenza vaccine (IIV) among subjects ages ≥6 months and the effectiveness of quadrivalent live attenuated influenza vaccine (LAIV4) among children aged 2-17 years, using a test-negative design. The effect of prior receipt of any A(H1N1)pdm09-containing vaccine since 2009 on the effectiveness of current-season vaccine was assessed.
RESULTS: We enrolled 5999 subjects; 5637 (94%) were analyzed; 18% had RT-PCR-confirmed A(H1N1)pdm09-related MAARI. Overall, the effectiveness of vaccine against A(H1N1)pdm09-related MAARI was 54% (95% confidence interval [CI], 46%-61%). Among fully vaccinated children aged 2-17 years, the effectiveness of LAIV4 was 17% (95% CI, -39% to 51%) and the effectiveness of IIV was 60% (95% CI, 36%-74%). Subjects aged ≥9 years showed significant residual protection of any prior A(H1N1)pdm09-containing vaccine dose(s) received since 2009, as did children <9 years old considered fully vaccinated by prior season.
CONCLUSIONS: During 2013-2014, IIV was significantly effective against A(H1N1)pdm09. Lack of LAIV4 effectiveness in children highlights the importance of continued annual monitoring of effectiveness of influenza vaccines in the United States.

PMID: 26743842 [PubMed - indexed for MEDLINE]

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Flow-Tolerant Adhesion of a Bacterial Pathogen to Human Endothelial Cells Through Interaction With Biglycan.

J Infect Dis. 2016 May 15;213(10):1623-31

Authors: Salo J, Pietikäinen A, Söderström M, Auvinen K, Salmi M, Ebady R, Moriarty TJ, Viljanen MK, Hytönen J

BACKGROUND: Bacterial pathogens causing systemic infections disseminate from the initial infection focus to the target organs usually through the blood vasculature. To be able to colonize various organs, bacteria need to adhere to the endothelial cells of the vascular wall, and the adhesion must be strong enough to resist the shear force of the blood flow.Borrelia burgdorferi sensu lato spirochetes, the causative agents of the tick-borne disease Lyme borreliosis, disseminate hematogenously from the tick bite site to the joints, the heart, and the central nervous system of the patient.
METHODS: We used both wild-type and genetically modified B. burgdorferi s. l. bacteria, recombinant borrelia adhesins, and an array of adhesion assays carried out both under stationary and flow conditions to investigate the molecular mechanisms of borrelial adhesion to human endothelial cells.
RESULTS: Borrelia garinii, a member of the B. burgdorferi s. l. complex, adhered to biglycan expressed by human endothelial cells in a flow-tolerant manner. The adhesion was mediated by the decorin-binding protein A (DbpA) and DbpB surface molecules of B. garinii.
CONCLUSIONS: The proteoglycan biglycan is a receptor molecule for flow-resistant adhesion of the bacterial pathogen B. garinii on human endothelial cells.

PMID: 26740275 [PubMed - indexed for MEDLINE]

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Low Prolactin and High 20-α-Hydroxysteroid Dehydrogenase Levels Contribute to Lower Progesterone Levels in HIV-Infected Pregnant Women Exposed to Protease Inhibitor-Based Combination Antiretroviral Therapy.

J Infect Dis. 2016 May 15;213(10):1532-40

Authors: Papp E, Balogun K, Banko N, Mohammadi H, Loutfy M, Yudin MH, Shah R, MacGillivray J, Murphy KE, Walmsley SL, Silverman M, Serghides L

BACKGROUND: It has been reported that pregnant women receiving protease inhibitor (PI)-based combination antiretroviral therapy (cART) have lower levels of progesterone, which put them at risk of adverse birth outcomes, such as low birth weight. We sought to understand the mechanisms involved in this decline in progesterone level.
METHODS: We assessed plasma levels of progesterone, prolactin, and lipids and placental expression of genes involved in progesterone metabolism in 42 human immunodeficiency virus (HIV)-infected and 31 HIV-uninfected pregnant women. In vitro studies and a mouse pregnancy model were used to delineate the effect of HIV from that of PI-based cART on progesterone metabolism.
RESULTS: HIV-infected pregnant women receiving PI-based cART showed a reduction in plasma progesterone levels (P= .026) and an elevation in placental expression of the progesterone inactivating enzyme 20-α-hydroxysteroid dehydrogenase (20α-HSD; median, 2.5 arbitrary units [AU]; interquartile range [IQR], 1.00-4.10 AU), compared with controls (median, 0.89 AU; IQR, 0.66-1.26 AU;P= .002). Prolactin, a key regulator of 20α-HSD, was lower (P= .012) in HIV-infected pregnant women. We observed similar data in pregnant mice exposed to PI-based cART. In vitro inhibition of 20α-HSD activity in trophoblast cells reversed PI-based cART-induced decreases in progesterone levels.
CONCLUSIONS: Our data suggest that the decrease in progesterone levels observed in HIV-infected pregnant women exposed to PI-based cART is caused, at least in part, by an increase in placental expression of 20α-HSD, which may be due to lower prolactin levels observed in these women.

PMID: 26740274 [PubMed - indexed for MEDLINE]

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Limited Effector Memory B-Cell Response to Envelope Glycoprotein B During Primary Human Cytomegalovirus Infection.

J Infect Dis. 2016 May 15;213(10):1642-50

Authors: Dauby N, Sartori D, Kummert C, Lecomte S, Haelterman E, Delforge ML, Donner C, Mach M, Marchant A

BACKGROUND: Following primary human cytomegalovirus (HCMV) infection, the production of antibodies against envelope glycoprotein B (gB) is delayed, compared with production of antibodies against tegument proteins, and this likely reduces the control of HCMV dissemination.
METHODS: The frequency and the phenotype of gB-specific and tegument protein-specific B cells were studied in a cohort of pregnant women with primary HCMV infection. Healthy adults who had chronic HCMV infection or were recently immunized with tetanus toxoid (TT) were included as controls.
RESULTS: Primary HCMV infection was associated with high and similar frequencies of gB-specific and tegument protein-specific B cells following primary HCMV infection. During primary infection, tegument protein-specific B cells expressed an activated (CD21(low)) memory B-cell (MBC) phenotype. Activated MBCs were also induced by TT booster immunization, indicating that the expansion of this subset is part of the physiological B-cell response to protein antigens. In contrast, gB-specific B cells had a predominant classical (CD21(+)) MBC phenotype during both primary and chronic infections.
CONCLUSIONS: The delayed production of gB-specific immunoglobulin G (IgG) during primary HCMV infection is associated with a limited induction of MBCs with effector potential. This novel mechanism by which HCMV may interfere with the production of neutralizing antibodies could represent a target for therapeutic immunization.

PMID: 26715677 [PubMed - indexed for MEDLINE]

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Role of the Gut Microbiota of Children in Diarrhea Due to the Protozoan Parasite Entamoeba histolytica.

J Infect Dis. 2016 May 15;213(10):1579-85

Authors: Gilchrist CA, Petri SE, Schneider BN, Reichman DJ, Jiang N, Begum S, Watanabe K, Jansen CS, Elliott KP, Burgess SL, Ma JZ, Alam M, Kabir M, Haque R, Petri WA

BACKGROUND: An estimated 1 million children die each year before their fifth birthday from diarrhea. Previous population-based surveys of pediatric diarrheal diseases have identified the protozoan parasite Entamoeba histolytica, the etiological agent of amebiasis, as one of the causes of moderate-to-severe diarrhea in sub-Saharan Africa and South Asia.
METHODS: We prospectively studied the natural history of E. histolytica colonization and diarrhea among infants in an urban slum of Dhaka, Bangladesh.
RESULTS: Approximately 80% of children were infected with E. histolytica by the age of 2 years. Fecal anti-galactose/N-acetylgalactosamine lectin immunoglobulin A was associated with protection from reinfection, while a high parasite burden and expansion of the Prevotella copri level was associated with diarrhea.
CONCLUSIONS: E. histolytica infection was prevalent in this population, with most infections asymptomatic and diarrhea associated with both the amount of parasite and the composition of the microbiota.

PMID: 26712950 [PubMed - indexed for MEDLINE]

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The Interleukin-1 Balance During Encephalitis Is Associated With Clinical Severity, Blood-Brain Barrier Permeability, Neuroimaging Changes, and Disease Outcome.

J Infect Dis. 2016 May 15;213(10):1651-60

Authors: Michael BD, Griffiths MJ, Granerod J, Brown D, Keir G, Wnęk G, Cox DJ, Vidyasagar R, Borrow R, Parkes LM, Solomon T

BACKGROUND: Encephalitis is parenchymal brain inflammation, commonly due to herpes simplex virus (HSV). Key host inflammatory mediators and their relationship to blood-brain barrier (BBB) permeability, neuroimaging changes, and disease outcome are poorly understood.
METHODS: We measured levels of 38 mediators in serum (n = 78) and cerebrospinal fluid (n = 37) specimens from patients with encephalitis, including 17 with disease due to HSV infection. Outcome measures were Glasgow coma and outcome scores; CSF to serum albumin ratio, reflecting BBB permeability; and, in patients with HSV infection, magnetic resonance imaging-based temporal lobe volume.
RESULTS: Serum interleukin 1 receptor antagonist (IL-1RA) levels were elevated in patients with a good outcome (P= .004). Among patients infected with HSV, the ratio of CSF IL-1β to IL-1RA was associated with a worse outcome (P= .009); a ratio of ≥0.55 pg/mL had high specificity and sensitivity for a poor outcome (100% and 83%;P= .015). Temporal lobe volume had a negative correlation with serum IL-1RA level (P= .012) and a positive correlation with serum IL-1α level (P= .0003) and CSF IL-1β level (P= .007). A normal coma score was associated with an elevated interleukin 10 (IL-10) level in serum specimens from HSV-infected patients (P= .007) and CSF specimens from all patients (P= .016); the IL-10 level correlated inversely with BBB permeability (P= .005).
CONCLUSIONS: A proinflammatory cytokine response is associated with greater clinical severity, BBB permeability, and neuroimaging damage during encephalitis. IL-1 antagonists should be investigated as adjunctive treatment in encephalitis.

PMID: 26712949 [PubMed - indexed for MEDLINE]

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Epidemiological Markers for Interactions Among Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus in Upper Respiratory Tract Carriage.

J Infect Dis. 2016 May 15;213(10):1596-605

Authors: Lewnard JA, Givon-Lavi N, Huppert A, Pettigrew MM, Regev-Yochay G, Dagan R, Weinberger DM

BACKGROUND: Cocolonization by Streptococcus pneumoniae and Haemophilus influenzae among children has been noted in numerous studies, as has an inverse relationship involving colonization with these species and Staphylococcus aureus. Interactions among these pathogens could mediate unanticipated outcomes of clinical interventions, including changes in H. influenzae and S. aureus disease incidence following pneumococcal vaccine introduction. However, it remains unclear whether cocolonization patterns represent true interspecies interactions or whether they result from confounding factors.
METHODS: We investigated polymicrobial carriage using longitudinal data from 369 Bedouin children and 400 Jewish children in Israel who were enrolled in a 7-valent pneumococcal conjugate vaccine (PCV7) trial. Children were swabbed 10 times between 2 and 30 months of age.
RESULTS: The pathogens followed distinct age and seasonal distributions, but polymicrobial carriage associations persisted after controlling for these and other confounding factors. Receipt of PCV7 resulted in pneumococcal serotype replacement but did not influence total carriage of S. pneumoniae, H. influenzae, or S. aureus.
CONCLUSIONS: The fact that S. pneumoniae, H. influenzae, and S. aureus polymicrobial carriage patterns do not result from confounding by age and season supports the idea of active interspecies interactions. However, pneumococcal serotype replacement may prevent changes in H. influenzae and S. aureus carriage among PCV7 recipients.

PMID: 26704617 [PubMed - indexed for MEDLINE]

Related Articles

Inhibition of MicroRNA 195 Prevents Apoptosis and Multiple-Organ Injury in Mouse Models of Sepsis.

J Infect Dis. 2016 May 15;213(10):1661-70

Authors: Zheng D, Yu Y, Li M, Wang G, Chen R, Fan GC, Martin C, Xiong S, Peng T

BACKGROUND: MicroRNAs (miRs) are a class of short RNA molecules, which negatively regulate gene expression. The levels of circulating miR-15 family members are elevated in septic patients and may be associated with septic death. This study investigated whether inhibition of miR-195, a member of the miR-15 family, provided beneficial effects in sepsis.
METHODS AND RESULTS: Sepsis was induced by injection of feces into the peritoneum in mice. miR-195 was upregulated in the lung and liver of septic mice. Silencing of miR-195 increased the protein levels of BCL-2, Sirt1, and Pim-1; prevented apoptosis; reduced liver and lung injury; and improved the survival in septic mice. Silencing of miR-195 provided similar protection in lipopolysaccharide-induced endotoxemic mice. In endothelial cells, upregulation of miR-195 induced apoptosis, and inhibition of miR-195 prevented lipopolysaccharide-induced apoptosis. miR-195 repressed expression of its protein targets, BCL-2, Sirt1, and Pim-1. Furthermore, overexpression of Pim-1 prevented apoptosis induced by lipopolysaccharide and miR-195 mimic. Inhibition of Pim-1 attenuated the protective effects of miR-195 silencing in septic mice.
CONCLUSIONS: Silencing of miR-195 reduced multiple-organ injury and improved the survival in sepsis, and the protective effects of miR-195 inhibition were associated with upregulation of Bcl-2, Sirt1, and Pim-1. Thus, inhibition of miR-195 may represent a new therapeutic approach for sepsis.

PMID: 26704614 [PubMed - indexed for MEDLINE]

Related Articles

Interferons Induce STAT1-Dependent Expression of Tissue Plasminogen Activator, a Pathogenicity Factor in Puumala Hantavirus Disease.

J Infect Dis. 2016 May 15;213(10):1632-41

Authors: Strandin T, Hepojoki J, Laine O, Mäkelä S, Klingström J, Lundkvist Å, Julkunen I, Mustonen J, Vaheri A

Hantaviruses are zoonotic viruses that show various degrees of vasculopathy in humans. In this study, we analyzed the regulation of 2 fibrinolytic parameters, tissue plasminogen activator (tPA) and its physiological inhibitor, plasminogen activator inhibitor 1 (PAI-1), in Puumala hantavirus (PUUV)-infected patients and in human microvascular endothelial cells. We detected strong upregulation of tPA in the acute phase of illness and in PUUV-infected macaques and found the tPA level to positively correlate with disease severity. The median levels of PAI-1 during the acute stage did not differ from those during the recovery phase. In concordance, hantaviruses induced tPA but not PAI-1 in microvascular endothelial cells, and the induction was demonstrated to be dependent on type I interferon. Importantly, type I and II interferons directly upregulated tPA through signal transducer and activator of transcription 1 (STAT1), which regulated tPA gene expression via a STAT1-responsive enhancer element. These results suggest that tPA may be a general factor in the immunological response to viruses.

PMID: 26704613 [PubMed - indexed for MEDLINE]

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Safety and Immunogenicity of a Tetravalent Dengue Vaccine Candidate in Healthy Children and Adults in Dengue-Endemic Regions: A Randomized, Placebo-Controlled Phase 2 Study.

J Infect Dis. 2016 May 15;213(10):1562-72

Authors: Sirivichayakul C, Barranco-Santana EA, Esquilin-Rivera I, Oh HM, Raanan M, Sariol CA, Shek LP, Simasathien S, Smith MK, Velez ID, Wallace D, Gordon GS, Stinchcomb DT

BACKGROUND: A safe, effective tetravalent dengue vaccine is a global health priority. The safety and immunogenicity of a live attenuated, recombinant tetravalent dengue vaccine candidate (TDV) were evaluated in healthy volunteers from dengue-endemic countries.
METHODS: This multicenter, double-blind, phase 2 study was conducted in Puerto Rico, Colombia, Singapore, and Thailand. During stage I, 148 volunteers aged 1.5-45 years were sequentially enrolled into 4 age-descending groups and randomized at a ratio of 2:1 to receive TDV or placebo. In stage II (group 5), 212 children aged 1.5-11 years were randomized at a ratio of 3:1 to receive TDV or placebo. Participants received a subcutaneous injection of TDV or placebo on days 0 and 90 and were followed for analysis of safety, seropositivity, and neutralizing antibodies to DENV-1-4.
RESULTS: Injection site pain, itching, and erythema (mostly mild) were the only solicited adverse events more frequently reported with TDV than with placebo in all age groups. After 2 TDV doses, seropositivity was >95% in all 5 groups for DENV-1-3 and 72.7%-100% for DENV-4; geometric mean titers ranged from 582 to 1187 for DENV-1, from 582 to 1187 for DENV-2, from 196 to 630 for DENV-3, and from 41 to 210 for DENV-4 among the 5 groups.
CONCLUSIONS: TDV was well tolerated and immunogenic in volunteers aged 1.5-45 years, irrespective of prevaccination dengue exposure.

PMID: 26704612 [PubMed - indexed for MEDLINE]

Related Articles

Transient Increase in Herpes Simplex Virus Type 2 (HSV-2)-Associated Genital Ulcers Following Initiation of Antiretroviral Therapy in HIV/HSV-2-Coinfected Individuals.

J Infect Dis. 2016 May 15;213(10):1573-8

Authors: Fife KH, Mugwanya K, Thomas KK, Baeten JM, Celum C, Bukusi E, de Bruyn G, Mujugira A, Vwalika B, Wald A, Lingappa JR, Partners in Prevention HSV/HIV Transmission Study Team

BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) in human immunodeficiency virus (HIV)-infected persons beginning antiretroviral therapy (ART) has been incompletely characterized for herpes simplex virus type 2 (HSV-2).
METHODS: We evaluated genital ulcer disease (GUD) and HSV-2-associated GUD at quarterly visits or when spontaneously reported at monthly visits in 3381 HIV/HSV-2-coinfected individuals in a placebo-controlled trial of suppressive acyclovir therapy to prevent HIV transmission, 349 of whom initiated ART during the study. Incidence was calculated for months before and after ART initiation, and incidence rate ratios (IRRs) were calculated.
RESULTS: GUD incidence increased from 15.0 episodes per 100 person-years before ART to 26.9 episodes per 100 person-years in the first full quarter after ART initiation (IRR, 1.83;P= .03), and the incidence of HSV-2-associated GUD increased from 8.1 to 19.0 episodes per 100 person-years (IRR, 2.20;P= .02). Subsequently, the incidence of GUD was similar to that before ART, although the numbers were small. Persons receiving suppressive acyclovir had fewer GUD episodes, but the IRR after beginning ART was similar in the acyclovir and placebo groups.
CONCLUSIONS: Initiation of ART in HIV/HSV-2-coinfected persons is associated with a transient increase in GUD and HSV-2 GUD. Acyclovir reduces the incidence of GUD but does not prevent an increase in GUD incidence during the first quarter following initiation of ART.

PMID: 26704611 [PubMed - indexed for MEDLINE]

Related Articles

Potential Clinical and Economic Value of Long-Acting Preexposure Prophylaxis for South African Women at High-Risk for HIV Infection.

J Infect Dis. 2016 May 15;213(10):1523-31

Authors: Walensky RP, Jacobsen MM, Bekker LG, Parker RA, Wood R, Resch SC, Horstman NK, Freedberg KA, Paltiel AD

BACKGROUND: For young South African women at risk for human immunodeficiency virus (HIV) infection, preexposure prophylaxis (PrEP) is one of the few effective prevention options available. Long-acting injectable PrEP, which is in development, may be associated with greater adherence, compared with that for existing standard oral PrEP formulations, but its likely clinical benefits and additional costs are unknown.
METHODS: Using a computer simulation, we compared the following 3 PrEP strategies: no PrEP, standard PrEP (effectiveness, 62%; cost per patient, $150/year), and long-acting PrEP (effectiveness, 75%; cost per patient, $220/year) in South African women at high risk for HIV infection (incidence of HIV infection, 5%/year). We examined the sensitivity of the strategies to changes in key input parameters among several outcome measures, including deaths averted and program cost over a 5-year period; lifetime HIV infection risk, survival rate, and program cost and cost-effectiveness; and budget impact.
RESULTS: Compared with no PrEP, standard PrEP and long-acting PrEP cost $580 and $870 more per woman, respectively, and averted 15 and 16 deaths per 1000 women at high risk for infection, respectively, over 5 years. Measured on a lifetime basis, both standard PrEP and long-acting PrEP were cost saving, compared with no PrEP. Compared with standard PrEP, long-acting PrEP was very cost-effective ($150/life-year saved) except under the most pessimistic assumptions. Over 5 years, long-acting PrEP cost $1.6 billion when provided to 50% of eligible women.
CONCLUSIONS: Currently available standard PrEP is a cost-saving intervention whose delivery should be expanded and optimized. Long-acting PrEP will likely be a very cost-effective improvement over standard PrEP but may require novel financing mechanisms that bring short-term fiscal planning efforts into closer alignment with longer-term societal objectives.

PMID: 26681778 [PubMed - indexed for MEDLINE]

The reproductive success of men in non-industrialized societies is closely tied to their social status, finds a new meta-analysis.
Engineers have developed a 3-D printable ink that produces a synthetic bone implant that rapidly induces bone regeneration and growth. This hyperelastic "bone" material, whose shape can be easily customized, one day could be especially useful for the treatment of bone defects in children.
Over two thirds (68 per cent) of the public would like more rest, according to the world's largest ever survey on the topic. The study also revealed that nearly a third (32 per cent) of respondents said they need more rest than the average person, while 10 per cent think they need less.
Can having a few drinks help people with clinical depression feel better? Yes. At least in terms of biochemistry, say scientists.
Researchers have received a five-year, $4 million federal grant to study how mobile technology can assist African American and Hispanic patients in adhering to their diabetes treatment plans.
It's over a hundred years since the first case of Alzheimer's disease was diagnosed. Since then we've learned a great deal about the protein 'tangles' and 'plaques' that cause the disease. How close are we to having effective treatments -- and could we even prevent dementia from occurring in the first place?
Genetic differences have been found that help to explain why some babies are born bigger or smaller than others. It also reveals how genetic differences provide an important link between an individual's early growth and their chances of developing conditions such as type 2 diabetes or heart disease in later life.
In a new study, researchers investigated what parts of the brain may be involved in deciding if something is worth the effort. The team found a relevant pattern of activity in three areas of the brain, the supplementary motor area (SMA), dorsal anterior cingulate cortex (dACC) and putamen.
Women who experience hot flashes and night sweats earlier in life are more likely to die from cardiovascular disease (CVD) when compared to women with later onset menopausal symptoms, according to research. Up to 80 percent of women experience menopausal symptoms, particularly hot flashes and night sweats, at some point during the menopause transition.
A new analysis of marijuana legislation offers a framework for states that are considering legalizing the drug and want to protect public health, rather than corporate profits.
Researchers have found that even moderate alcohol consumption may change the structure of the heart in ways that increase the risk of atrial fibrillation.
Preschool teachers and staff show signs of implicit bias in administering discipline, but the race of the teacher plays a big role in the outcome, according to new research. The results help explain why black students tend to be suspended at much higher rates than white students, the authors say.
Many diseases that lead to blindness, such as glaucoma and macular degeneration, are caused by the death of certain cells in the human retina that lack the ability to regenerate. But in species such as zebrafish these cells, known as Muller glial cells (MGs), do serve as retinal stem cells that are capable of generating new cells. In a new study, a research team investigated whether the regenerative power of cells in zebrafish could be recreated in mammals, specifically mice.
A common pathway involved in photoreceptor death has been identified in retinitis pigmentosa, advanced dry age-related macular degeneration and other retinal diseases, with early evidence of a possible halt to vision loss related to treatment of the pathway.
In an important discovery in the battle against the United States’ growing drug epidemic, an economist has found the Carolinas could be a hotspot for the trafficking and production of the drug Ecstasy.
Hot flashes – the bane of existence for many women during menopause – can be reduced in frequency by almost half for about 50 percent of women over eight weeks of acupuncture treatment, according to scientists.
Why do some people lead a perfectly healthy lifestyle yet still die young? A new international study suggests that the answer lies in our DNA.
One in six women in the U.S. takes antidepressants to improve her well-being, but what is she to do when the medication that is meant to help disrupts another area of her life?
Breastfeeding is not only good for children, but also for their mothers, providing more health benefits and preventing more maternal diseases than previously known, new research shows.
Researchers have succeeded to place a layer of graphene on top of a stable fatty lipid monolayer, for the first time. Surrounded by a protective shell of lipids graphene could enter the body and function as a versatile sensor. The results are the first step towards such a shell, say authors of a new report.
Offspring with a father who smoked prior to conception had more than three times higher chance of early-onset asthma than children whose father had never smoked. Both a father's early smoking debut and a father's longer smoking duration before conception increased non-allergic early-onset asthma in offspring. This suggests that not only the mother's environment plays a key role in child health, but also the father's lifestyle, shows a new study including 24,000 children.
Eating bread made with ancient grains could help lower cholesterol and blood glucose, a recent randomized trial suggests. Compared with modern grain varieties which are often heavily refined, ancient grains offer antioxidant and anti-inflammatory profiles. They also contain beneficial vitamins (B and E), minerals (eg, magnesium, iron, potassium), which protect against chronic diseases.
The brain's biological clock stimulates thirst in the hours before sleep, according to a study. Scientists have known that rodents show a surge in water intake during the last two hours before sleep. The study now reveals that this behavior is not motivated by any physiological reason, such as dehydration. So if they don't need to drink water, why do they?
Depression in pregnancy increases the risk of behavioral and emotional problems in children, says a new review.
The Region of the Americas is the first in the world to have eliminated measles, a viral disease that can cause severe health problems, including pneumonia, blindness, brain swelling and even death. This achievement culminates a 22-year effort involving mass vaccination against measles, mumps and rubella throughout the Americas.
For those people living with diabetes, every day requires around-the-clock monitoring and management, explain experts. This daily monitoring can be a particular challenge for young people who also have to be attentive to when and what they eat and drink, as well as their activities at home, in school or while hanging out with friends. Even a minor ailment like a cold may require changes in the medical regimen because of the effect inflammation has on the blood sugar.
Time is of the essence when getting people stricken with acute ischemic strokes to treatment. Current professional guidelines recommend that stent retrievers be used to remove blood clots from stroke patients within six hours for people to benefit. But new research finds that the procedure has benefits for people up to 7.3 hours following the onset of a stroke.
A fungus that compromises the immune system of mosquitoes, making them more susceptible to infection with the parasite that causes malaria, has been discovered by scientists. Because environmental microorganisms can vary greatly from region to region, the researchers say the findings may help explain variations in the prevalence of malaria in different geographic areas.
Could rehabilitation programs for heart disease patients be used to help people recovering from bowel cancer get back on their feet? That’s the question cancer care experts have been exploring.
Brown adipose tissue – the main organ generating heat in the body -- is also an endocrine organ that secretes signaling factors that activate the fat and carbohydrates metabolism, report scientists.
People with cystic fibrosis (CF) need help to ensure they are getting correct nutrition and the right amount of enzymes. They also need constant reminders. Researchers are now developing a digital support device to promote autonomy, but are finding that this is no easy task.
First generation cephalosporins—antibiotics introduced as a treatment against bacterial infections in 1963—now show promise for tuberculosis (TB) therapy, according to new research. Tuberculosis, caused by Mycobacterium tuberculosis, is the most deadly infectious disease in the world. Standard TB therapy takes at least six months and patients infected with multi-drug resistant (MDR) or extensively drug resistant (XDR) strains undergo treatments that are even longer (up to 24 months). Treatment is often associated with severe side effects. Studies indicate that the cost of developing a new drug has soared to $2.6 billion.
Tau PET is a new and promising imaging method for Alzheimer’s disease. A case study in Sweden now confirms that tau PET images correspond to a higher degree to actual changes in the brain. According to the researchers behind the study, this increases opportunities for developing effective drugs.
A new cancer treatment that uses red lights to target and kill cancer cells alternatively without surgery has been presented by researchers.
Highly caffeinated energy drinks (EDs) have been of concern to the public-health community for almost a decade. Many young people consume EDs with alcohol to decrease alcohol’s sedative effects and stay awake longer, enabling them to drink more alcohol. Adding to the growing body of research linking ED consumption with risk-taking and alcohol-related problems, this study examined its relationship with drunk driving. Importantly, the researchers differentiated between the different ways in which EDs are consumed: exclusively with alcohol, exclusively without alcohol, or both with and without alcohol depending on the occasion.
In regions where cancer survival is poorer, people on average have lower awareness of cancer symptoms, according to new research.
A deep-freezing technique known as cryoablation is a viable alternative to traditional surgery in many early-stage breast cancers, researchers have found in a new clinical study.
Currently, excess body weight contributes to as many as 1 in 5 cancer-related deaths. Obesity is associated with increased risk of at least eight types of cancer. Now obesity has been identified as a health risk that is “quickly overtaking tobacco as the leading preventable cause of cancer.”
Sociologists look back to 2007 to understand how the No Child Left Behind Act acquired an alternative meaning: "NCLB means children left behind."
Scientists have found antibiotic-resistant bacteria in prairie soils that had little or no exposure to human or animal activity.
A new WHO air quality model confirms that 92% of the world's population lives in places where air quality levels exceed WHO limits. Some 3 million deaths a year are linked to exposure to outdoor air pollution. Indoor air pollution can be just as deadly. In 2012, an estimated 6.5 million deaths (11.6% of all global deaths) were associated with indoor and outdoor air pollution together.
Dental surface restorations composed of dental amalgam, a mixture of mercury, silver, tin and other metals, significantly contribute to prolonged mercury levels in the body, according to new research.
Toxins from mold found growing on nuts or corn can weaken the airways’ self-clearing mechanisms and immunity, opening the door for respiratory diseases and exacerbating existing ones, suggests a new study.
A new study from the active volcano K?lauea, which is on the big island of Hawaii, reports that people -- especially children -- with asthma are at greater risk of having serious asthma attacks if they live in a community with high levels of the volcanic gas sulfur dioxide than if they live upwind of the volcano.
Biomedical engineers, artificial blood vessels bioengineered in the lab and implanted in young lambs are capable of growth within the recipient, a groundbreaking new study demonstrates. If confirmed in humans, these new vessel grafts would prevent the need for repeated surgeries in some children with congenital heart defects.
Patients in inpatient rehabilitation after a stroke, brain injury, or spinal cord injury have significant rates of interruptions of their rehab program—often including being transferred back to the hospital for treatment of complications, reports a new study.
Researchers have found that interval exercise training (resistance-based and cardiovascular) improves endothelial function in older adults. Resistance interval training in particular could help reduce the risk of heart disease in adults with type 2 diabetes.
The association between provider case volume and outcomes has long been suggested in cancer care. A research team has completed a review of outcomes for patients with locally advanced squamous cell head and neck cancers treated with intensity-modulated radiation therapy (IMRT) and found a distinct association between higher-volume treatment centers and improved overall survival.
The underlying cause of male infertility is unknown for 30 percent of cases. In a pair of new studies, researchers have determined that the reproductive homeobox (RHOX) family of transcription factors -- regulatory proteins that activate some genes and inactivate others -- drive the development of stem cells in the testes in mice. The investigators also linked RHOX gene mutations to male infertility in humans.
The “balanced scorecard” has emerged in recent decades as a popular workplace tool for appraising and rewarding employee performance. A study finds evaluators using a balanced scorecard tended to award high ratings and bonuses to employees who performed well financially, rather than to those who scored well in corporate social responsibility.
Non-alcoholic fatty liver disease (NAFLD), the most common liver disease worldwide, is increasing in prevalence and is currently estimated to affect approximately one-quarter of the general population. A new study reveals the clinical and economic burden of NAFLD in the United States and Europe. The findings will help clinicians and policy makers develop strategies to deal with this serious chronic disease.
Researchers have expanded the role of the newly discovered CRISPR protein C2c2 that targets RNA instead of DNA. C2c2 has been described as an RNA-guided RNA-cutting enzyme; however, a full understanding of how this protein acts to cleave RNA was lacking before this study.
Sufferers of migraines, cluster headaches, tension headaches or other headache disorders are at greater risk of developing a thyroid condition called hypothyroidism, according to a new study.
New research offers unprecedented insights into the causes of childhood diarrhea, the second-leading cause of death of children worldwide, and suggests that the role of pathogens has been vastly underestimated.
A protein tracer shows a distinctive pattern of brain protein deposition specific to chronic traumatic encephalopathy, a disease typically confirmed after death. A link between brain injury and long-term health has been gaining attention in recent years.
Scientists have examined if bias with single-blind peer review might be greatest in the setting of author or institutional prestige. The authors found that reviewers were more likely to recommend acceptance when the prestigious authors' names and institutions were visible (single-blind review) than when they were redacted (double-blind review), and also gave higher ratings for the methods and other categories. There was no difference in the number of errors detected.
Scientists evaluated the association between lowering low-density lipoprotein cholesterol (LDL-C) and relative cardiovascular risk reduction across different statin and nonstatin therapies.
In an analysis that included nearly 1,300 patients with large-vessel ischemic stroke, earlier treatment with endovascular thrombectomy (intra-arterial use of a micro-catheter or other device to remove a blood clot) plus medical therapy (use of a clot dissolving agent) compared with medical therapy alone was associated with less disability at 3 months, according to a study.
Talking about suicide is associated with such strong stigma that young people whose parents have taken their own life must turn to strangers, for example people they meet on the internet, to ventilate their grief, a new doctoral thesis concludes.
Researchers can now explain how the properties of the skin change depending on the environment. The new findings explain, among other things, why people don’t dehydrate in dry air. The research results can also be used in the cosmetic and pharmaceutical industry to make substances penetrate the skin more effectively.

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