A Bangladeshi telemedicine company is set to provide healthcare services for more than five million South Asian workers in the Middle East and Malaysia in a couple of months.

Telemedicine Reference Centre Ltd (TRCL) has already signed agreements with around 25 Gulf and Malaysian companies that recruit workers from South Asia.

Telemedicine is a rapidly developing application of clinical medicine where medical information is transferred through the phone or the internet.

TRCL will launch the mobile phone-based service, said Dr Sikder M Zakir, managing director of the company.

“Under the project, we will start providing medical call-centre services to two million Bangladeshi, 1.5 million Indian and two million Nepalese and Pakistani workers,” Zakir added.

Prime Bank and two investors from the US and India are funding the project, he said.

TRCL has also signed deals with seven mobile phone companies in Malaysia, Saudi Arabia, Bahrain, UAE, Qatar and Kuwait.

The company is working to set up multilinguistic medical call centres in India, Pakistan and Nepal, from where dedicated physicians will provide healthcare advice to the expatriate workers.

All the workers under the 25 recruiting companies will be registered with TRCL to get the services free of cost. They will call a particular number and get advice in their own language.

The recruiting firms will pay the service charge to TRCL on behalf of the workers, which is no more than one US dollar a month for a person, Zakir said.

They will also be referred to hospitals if necessary.

Zakir said TRCL is now setting up branch offices in nine countries including Malaysia, UAE and Saudi Arabia to comply with those countries’ regulatory requirements.

“It’s a milestone for telemedicine service. The sector is getting institutional shape,” he added.

Established in 1999, TRCL is operating the first medical call centre or electronic referral centre manned by physicians for the largest cellphone operator in Bangladesh — Grameenphone. More than 10,000 people are using the service by dialling a hotline number (789) from their mobile phones every day.

LOS ANGELES - A new survey shows more than 75 percent of medical students believe patients would benefit if physicians were knowledgeable about complementary medicine—practices such as massage therapy and chiropractic—as well as conventional medicine. Almost three-quarters of respondents also say our medical system should include complementary and alternative medicine (CAM).

In the largest national survey of its kind, researchers from UCLA and UC San Diego measured medical students’ attitudes and beliefs about CAM.

Among the results:

* 77 percent of participants agreed to some extent that patients whose doctors know about complementary and alternative medicine in addition to conventional medicine, benefit more than those whose doctors are only familiar with Western medicine.

* 74 percent of participants agreed to some extent that a system of medicine that integrates therapies of conventional and complementary and alternative medicine would be more effective than either type of medicine provided independently.

* 84 percent of participants agreed to some extent that the field contains beliefs, ideas and therapies from which conventional medicine could benefit.

* 49 percent of participating medical students indicated that they have used complementary and alternative treatments; however, few would recommend or use these treatments in their practices until more scientific assessment has occurred

“Complementary and alternative medicine is receiving increased attention in light of the global health crisis and the significant role of traditional medicine in meeting public health needs in developing countries,” said study author Ryan Abbott, a researcher at the UCLA Center for East-West Medicine, in a press release. “Integrating CAM into mainstream health care is now a global phenomenon, with policy makers at the highest levels endorsing the importance of a historically marginalized form of health care.”

The findings were published recently in the online issue of Evidence-based Complementary and Alternative Medicine (eCAM).

The adrenal glands are the part of the body responsible for releasing three different classes of hormones. These hormones control many important functions in the body, such as:

• Maintaining metabolic processes, such as managing blood sugar levels and regulating inflammation
• Regulating the balance of salt and water
• Controlling the “fight or flight” response to stress
• Maintaining pregnancy
• Initiating and controlling sexual maturation during childhood and puberty

The adrenal glands are also an important source of sex steroids, such as estrogen and testosterone.

What are adrenal gland disorders?

Adrenal gland disorders occur when the adrenal glands don’t work properly.  Sometimes, the cause is a problem in another gland that helps to regulate the adrenal gland.  In other cases, the adrenal gland itself may have the problem.  The NICHD conducts and supports research on many adrenal gland disorders.  Some examples include:

• Cushing’s Syndrome - Cushing’s syndrome happens when a person’s body is exposed to too much of the hormone cortisol. In this syndrome, a person’s body makes more cortisol than it needs. For example, adrenal tumors can cause the body to produce too much cortisol. In some cases, children are born with a form of adrenal hyperplasia that leads to Cushing syndrome. Or, in some cases, certain medications can cause the body to make too much cortisol
• Congenital Adrenal Hyperplasia - Congenital adrenal hyperplasia is a genetic disorder of adrenal gland deficiency.  In this disorder, the body doesn’t make enough of the hormone cortisol. The bodies of people with congenital adrenal hyperplasia may also have other hormone imbalances, such as not making enough aldosterone, but making too much androgen.
• Pituitary Tumors - The pituitary gland is located in the brain and helps to regulate the activity of most other glands in the body, including the adrenal glands. In rare cases, benign (non-cancerous) tumors may grow on the pituitary gland, which may restrict the hormones it releases.

In some cases, tumors on the pituitary can lead to Cushing’s syndrome – this is called Cushing disease.  In other cases, the tumors reduce the adrenal gland’s release of hormones needed for the “fight or flight” response to stress.  If the body is unable to handle physiological stress—a condition called Addison’s disease—it can be fatal.

What are the treatments for adrenal gland disorders?

The treatment for adrenal gland disorders depends on the specific disorder or the specific cause of the disorder.  For example:

• The treatment for Cushing’s syndrome depends on the cause. If the excess cortisol is caused by medication, your health care provider can change dosages or try a different medication to correct the problem.  If the Cushing’s syndrome is caused by the body making too much cortisol, treatments may include oral medication, surgery, radiation, or a combination of these treatments.
• Congenital adrenal hyperplasia can’t be cured, but it can be treated and controlled.  People with congenital adrenal hyperplasia can take medication to help replace the hormones their bodies are not making.  Some people with congenital adrenal hyperplasia only need these medications when they are sick, but others may need to take them every day.
• Doctors can successfully treat most pituitary tumors with microsurgery, radiation therapy, surgery, drugs, or a combination of these treatments. Surgery is currently the treatment of choice for tumors that grow rapidly, especially if they threaten or affect vision.  The treatment plan for other pituitary tumors differs according to the type and size of the tumor.

LONDON - A special edition of the journal, Clinical Risk, published by the Royal Society of Medicine, looks at how the combination of an under-regulated market, “professional greed”, increased marketing and overwhelming media hype have created a “perfect storm” that threatens patients and practitioners alike. The journal’s editor argues that cosmetic surgery patients in the UK are at more risk than ever before.

Dr Harvey Marcovitch, who commissioned leading experts in the field to write for this special issue said, “Patient safety is this journal’s main aim and there can be no area of medicine where patients in the UK are more in need of protection. We need tight control of advertising of cosmetic surgery - including internet advertising. We need proper regulation of the industry and we need both surgeons and GPs to manage patient expectation.”

In one paper, entitled ‘Clinical Risk in Aesthetic Surgery’, Nigel Mercer, consultant plastic surgeon and President of the British Association of Aesthetic Plastic Surgeons (BAAPS) argues: “We have reached a stage where public expectation, driven by media hype and, dare one say, professional greed, has brought us to a ‘perfect storm’ in the cosmetic surgical market.”

He adds, “There has been a massive increase in ‘marketing’, including discount vouchers, 2-for-1 offers and holidays with surgery! In no other area of medicine is there such an unregulated mess. What is worse is that national governments would not allow it to happen in other areas of medicine. Imagine a ‘2-for-1′ advert for general surgery? That way lies madness!”

Highlights:

Clinical Risk in Aesthetic Surgery: Nigel Mercer discusses the role of the media and advertising and calls for tighter regulations in the UK, comparing this country’s lack of regulation with the Food and Drug Administration’s role in the US.

Key quotes:

- “Perhaps, like tobacco, there should be a Europe-wide ban on advertising all cosmetic ’surgical’ procedures, including on search engines…”.

- “If we have to sell anything, we should sell our advice, not procedures. If we cannot self-regulate, then, like the financial institutions, regulation will eventually be imposed…”

- “All cosmetic treatments are medical interventions, and every medical intervention has a complication and failure rate. Consequently, there are no ‘consumers’ or ‘clients’ but only ‘patients’…”

- “Perhaps the single most important factor in reducing clinical risk in cosmetic surgery is the motive for performing any procedure must never be financial gain, so I suggest we get our act together as an industry as we are in grave danger of biting the hand that feeds us.”

France Sets Standards for Practice of Aesthetic Surgery: French consultant plastic surgeon, Alain Fogli describes the strictly defined guidelines for cosmetic surgery in France which include:

- Surgical procedures can only be undertaken by surgeons who are registered specialists and deemed competent. Possession of a general medical degree, and the fact that the practitioner is ‘experienced’ are not deemed to be sufficient qualifications

- A ban on all forms and methods of publicity and advertising, direct or indirect, in whatever form, including the Internet

Minimizing Risk in Aesthetic Surgery: Foad Nahai, President of the International Society of Aesthetic Plastic Surgeons (ISAPS) and former president of the American Society of Aesthetic Plastic Surgeons (ASAPS) describes how to minimise risk in each facet of ‘the safety diamond’: patient, facility, procedure and surgeon.

He tells readers:

“Regulations governing the training of all cosmetic surgeons are sorely needed. Governments are reluctant to become involved, as they see this issue as a ‘turf battle’ between various physician groups and not a public safety or patient safety issue. However, there is no question that this is a patient safety issue of paramount importance and I take our governments to task for not addressing it.”

- Since by law any physician is allowed to practise cosmetic surgery, attempts by individual physicians or plastic surgery organisations to restrict those who are not qualified is viewed as a restraint of trade.

Improving the Safety of Aesthetic Surgery: Recommendations Following a 14-Year Review of Cases to the Medical Defence Union (1990-2004): Consultant plastic surgeon and BAAPS Secretary, Rajiv Grover, reveals a 14-year audit of claims to the MDU which shows why patients sue. He provides recommendations to avoid these situations such as careful pre-operative counselling, thorough documentation and exploring with the patient what degree of correction and scarring is realistic - and not being falsely optimistic about the likely outcome.

Managing Risk to Reputation: Magnus Boyd, Partner at leading UK solicitors, Carter-Ruck suggests how doctors can protect their reputation and how the media can influence the outcome of a professional investigation or the expression of anger from a disgruntled patient.

Both Dr Harvey Marcovitch and Mr Nigel Mercer are available for comment.

Clinical Risk

The journal Clinical Risk aims to give both medical and legal professionals an enhanced understanding of key medico-legal issues relating to risk management and patient safety, through authoritative articles, reviews and news on the management of clinical risk. The AvMA Medical and Legal Journal and the Healthcare & Law Digest, both included within Clinical Risk, contain articles on current medico-legal issues and reports on a wide range of recently settled clinical negligence cases.

GENEVA -  Hormone replacement therapy might be beneficial for postmenopausal women at increased heart risk, say researchers.

“Although it is commonly understood that postmenopausal women, particularly those with early menopause, have an increased risk of developing coronary artery disease and it was thought that hormone replacement therapy (HRT) would help to remedy this, some well-known clinical investigations, such as the Heart and Estrogen/progestin Replacement Study (HERS), were unable to demonstrate an improved outcome in postmenopausal women using HRT,” said Dr. Thomas Schindler, chief of nuclear cardiology at the University Hospitals of Geneva, Geneva, Switzerland.

“The exact mechanism behind this increased risk, however, remains uncertain,” he added.

Some of the factors putting women at risk are an accumulation of body fat, insulin resistance, inflammation, dyslipidemia (disruption of lipid metabolism) and increases in arterial blood pressure.

Another important factor is the deprivation of naturally occurring estrogen.

For the study, the researchers evaluated the effect of long-term hormone replacement therapy with estrogen, mostly combined with progestin, on heart vessel function in 48 postmenopausal women who had been treated for coronary risk factors, such as hypercholesterolemia (high blood cholesterol) or arterial hypertension.

They were divided into groups according to HRT. The first group comprised 18 women who were on HRT at baseline and at follow-up positron emission tomography (PET) assessment of coronary endothelial function (the inner lining of the coronary vessels).

The second group comprised 18 women who were not on HRT; and group 3 comprised 12 women who were on HRT at baseline, but not at follow-up PET exam.

“Given that preventive medical treatment of coronary risk factors, such as statins (cholesterol-lowering agents) or angiotensin-coverting enzyme inhibitors, usually improves coronary endothelial function, it is not known whether HRT, which commonly promotes the release of endothelial-derived NO in postmenopausal women with already medically treated coronary risk factors, might still exert an additional protective effect on the function of the coronary endothelium and, thus, the development of coronary artery disease,” said Schindler.

Applying PET, the researchers found that HRT widely maintained coronary endothelial function, while those postmenopausal women without HRT experienced a worsening in the endothelium function.

In addition, postmenopausal women who gave up HRT during the observational period demonstrated the most severe drop in the coronary endothelial function.

Also called: RLS

Restless legs syndrome (RLS) causes a powerful urge to move your legs. Your legs become uncomfortable when you are lying down or sitting. Some people describe it as a creeping, crawling, tingling or burning sensation. Moving makes your legs feel better, but not for long.

In most cases, there is no known cause for RLS. In other cases, RLS is caused by a disease or condition, such as anemia or pregnancy. Some medicines can also cause temporary RLS. Caffeine, tobacco and alcohol may make symptoms worse.

Lifestyle changes, such as regular sleep habits, relaxation techniques and moderate exercise during the day can help. If those don’t work, medicines may reduce the symptoms of RLS.

SYDNEY - An Australian Government funded research group has developed a potential new material that can make early diagnosis of malignant melanoma, the most serious form of skin cancer possible.

Writing about their work in the ACS’ Journal of the Medicinal Chemistry, the Cooperative Research Consortium for Biomedical Imaging Develop has revealed that the novel material is currently being tested in laboratory animals.

Ivan Greguric, a group member, notes that about 130,000 new cases of malignant melanoma occur each year worldwide.

Although patients do best with early diagnosis and prompt treatment, according to the researcher, the positron emission tomography (PET) scans sometimes used for diagnosis sometimes miss small cancers, delaying diagnosis and treatment.

While searching for better ways of diagnosis, the researchers identified a new group of radioactive imaging agents, known as fluoronicotinamides.

Testing it on laboratory mice that had melanoma, the researchers observed that the novel substance revealed skin cancer cells with greater accuracy than imaging agents currently in use.

Consequently, note the researchers, this substance may become a “superior” PET imaging agent for improving the diagnosis and monitoring the effectiveness of treatment of melanoma.

They have revealed that clinical trials with this new agent are scheduled for 2010.

ST LOUIS - Many people with chronic headaches believe that weather changes trigger their woes.

Turns out they may be right, suggest new research findings.

In a study of 25 children and teenagers with migraines or chronic tension-type headaches, researchers found that symptoms tended to flare up on days when it rained or when humidity was higher than normal.

Overall, study participants were nearly three times more likely to have a headache when it was raining or humidity was higher than average, compared with drier conditions, according to findings published in the journal Headache.

People who suffer migraines or other types of debilitating headaches commonly cite weather changes as one of the triggers. But studies on the matter have come to conflicting conclusions.

For the current study, researchers gave children handheld computers to record their headache symptoms in “real time” over two weeks. They then compared that information with weather data the researchers gathered using weather-tracking software.

This is an improvement over most past studies, which have used less- precise methods, according to the researchers, led by Dr. Mark Connelly of Children’s Mercy Hospitals and Clinics in Kansas City, Missouri.

Overall, the researchers found that during periods of rain, kids in their study had a 59 percent probability of reporting headache symptoms. That compared with a 21 percent probability at rain-free times.

Similarly, the odds of headache symptoms were 58 percent when humidity was higher than average — versus 22 percent when humidity levels were average.

“Results of the present study,” Connelly’s team writes, “lend some support to the belief commonly held by children with recurrent headaches that weather changes may contribute to headache onset.”

Exactly why rain and humidity would trigger headaches in some children is not clear. Nor do the findings necessarily mean that other weather variables are unimportant.

One recent study of 7,000 patients with severe migraine or non- migraine headaches found that the risk of symptoms climbed on days when the temperature rose or barometric pressure dropped.

Low barometric pressure generally means cloudy skies and storms; in the current study, however, there was no specific link between headache symptoms and barometric pressure changes.

More research is needed to understand how weather variables may affect people’s headache symptoms, according to Connelly and his colleagues.

It also remains to be seen how such knowledge could be practically useful for patients, the researchers conclude.

SOURCE: Headache, December 21, 2009.

Introducing – Goji Berries

Other Names: Lycium barbarum, wolfberry, gou qi zi, Fructus lycii

Goji berries grow on an evergreen shrub found in temperate and subtropical regions in China, Mongolia and in the Himalayas in Tibet. They are in the nightshade (Solonaceae) family.

Goji berries are usually found dried. They are shriveled red berries that look like red raisins.

Why do people use goji berries?

Goji berries have been used for 6,000 years by herbalists in China, Tibet and India to:

    * protect the liver

    * help eyesight

    * improve sexual function and fertility

    * strengthen the legs

    * boost immune function

    * improve circulation

    * promote longevity

Goji berries are rich in antioxidants, particularly carotenoids such as beta-carotene and zeaxanthin. One of zeaxanthin’s key roles is to protect the retina of the eye by absorbing blue light and acting as an antioxidant. In fact, increased intake of foods containing zeathanthin may decrease the risk of developing age-related macular degeneration (AMD), the leading cause of vision loss and blindness in people over the age of 65.

In recent years, goji juice has become popular as a health beverage. Companies marketing goji juice often mention the unsupported claim that a man named Li Qing Yuen consumed goji berries daily and lived to be 252 years old. Marketers also list extensive health benefits of goji juice, even though there are few published clinical trials in humans.

What research has been done on goji berries?

Goji has only been tested on humans in two published studies. A Chinese study published in the Chinese Journal of Oncology in 1994 found that 79 people with cancer responded better to treatment when goji was added to their regimen.

There have been several test tube studies that show that goji berry contains antioxidants and that goji extracts may prevent the growth of cancer cells, reduce blood glucose, and lower cholesterol levels. However, that doesn’t necessary mean that goji will have the same benefits when taken as a juice or tea.

Although goji berries like the ones used in traditional Chinese medicine aren’t very expensive, goji juice is very pricey. Considering that a 32-ounce bottle of goji juice (about an 18-day supply) can run as high as $50 USD, the evidence isn’t compelling enough at this time to justify the cost of goji juice.

Also, we don’t know the side effects of regular goji consumption, or whether it will interfere with treatments or medications.

What do goji berries taste like?

Goji berries have a mild tangy taste that is slightly sweet and sour. They have a similar shape and chewy texture as raisins.

In traditional Chinese medicine, goji berries are eaten raw, brewed into a tea, added to Chinese soups, or made into liquid extracts.

Goji juice is also available, usually in 32-ounce bottles.

Goji berries have appeared in snack foods in North America. For example, the health food store Trader Joe’s sells a goji berry trail mix.

Possible drug interactions

Goji berries may interact with anticoagulant drugs (commonly called “blood-thinners”), such as warfarin (Coumadin®). There was one case report published in the journal Annals of Pharmacotherapy of a 61-year old woman who had an increased risk of bleeding, indicated by an elevated international normalized ratio (INR). She had been drinking 3-4 cups daily of goji berry tea. Her blood work returned to normal after discontinuing the goji berry tea.

Where to find goji berries

Whole goji berries are available at Chinese herbal shops.

Goji juice can be found in some health food stores, online stores, and through network marketers.

WHO Maps World’s Deadliest Roads

GENEVA - The most dangerous place in the world to travel on roads is in the impoverished East African state of Eritrea, says the World Health Organisation (WHO) in its first report on global road safety.

To identify the most hazardous roads, WHO experts sifted through a mass of data which showed that around 1.3 million people are killed each year on the world’s highways. A further 20 to 50 million people sustain non-fatal injuries.

The global record for road deaths per capita goes to the former Italian colony of Eritrea where figures showed an estimated 48 deaths per 100,000 people.

Road travel in the Cook islands in the South Pacific is nearly as dangerous too, with a statistical 45 deaths per 100,000. The archipelago north-east of New Zealand is home to just 13,325 citizens and five of them died in road accidents in 2007. Egypt (41.6) and Libya (40.5) also both had a poor road safety record.

Driving too fast, drinking and driving along with the failure to use seatbelts and talking on mobile phones while at the wheel were given in the report as key contributing factors to the high number of fatalities and accidents on roads around the world.

“These are stunning figures that need not, should not, be so high. Over 90 percent of these deaths occur in low-income and middle-income countries, which have less than half of the world’s registered vehicles. This is another statistic that tells us something is wrong,” WHO Director General Margaret Chan said in a statement.

Chan said the report’s findings would serve as a basis for discussion at the First Global Ministerial Conference on Road Safety, which is due to take place in Moscow in November 2009.

“This will be a milestone event in international road safety that will serve as a call to action to reduce the impact of road traffic crashes over the next decade,” said Chan.

The safest road conditions were found amid the islands and atolls which make up the Micronesian nation of the Marshall Islands. Here 59,000 residents have a mere 2,487 vehicles between them. Only one fatal road accident was recorded in 2007.

France and Germany suffered 7.5 and six fatalities per 100,000 respectively compared to Britain (5.4) and the US where more than 251 million vehicles are registered. The quota here was 13.9 fatalities per 100,000 people. A similar level could be found in Sri Lanka, Turkey and Azerbaijan.

How Salmonella can be Used To Kill Tumors

BRAUNSCHWEIG -  German scientists have shown how the bacteria migrate into tumors. Sara Bartels and Siegfried Weiss, of the Helmholtz Centre for Infection Research (HZI) in Braunschweig, say that a messenger substance from the immune system makes blood vessels in the cancerous tissue permeable, and thereby enables the bacteria to conquer and destroy the tumour.

The researchers add that, simultaneously, blood streams from the vessels into the cancerous tissue, a so-called necrosis develops, and the tumor dies.

“This influx of blood was the starting point for our investigations. There is an immunological messenger present during bacterial elicited inflammation that causes this kind of reaction. We searched for it - and found it,” says Siegfried Weiss, Head of the Molecular Immunology group at the HZI.

The researchers have revealed that this messenger is named after its role in the immune system: tumor necrosis factor, TNF-alpha for short.

They say that immune cells produce TNF-alpha when recognizing salmonella, thus alarming other immune cells.

According to them, a small amount of TNF-alpha is subsequently enough to dissolve the walls of the blood vessels in the tumor and allow the blood to stream into the cancerous tissue.

They hope to be able to modify salmonella so that they can migrate specifically into tumors and cause them to die.

Since salmonella can live even in tissues that are badly supplied with blood, the researchers believe that they can be used in tumor therapy.

This is interesting because chemotherapeutics cannot be transported to an area where there is no blood flow, and even radiation therapy requires oxygen for its reactions in the tissue.

“We have obtained an important indication of how bacteria migrate into tumors. We can now try to manipulate these bacteria to use them in cancer therapy without causing deadly infections,” says Sara Bartels.

“We need to find the right amount of bacteria aggressiveness, allowing the tumor to be colonized and destroyed without harming the patient,” she adds.

If the scientists succeed in accomplishing this feat, they may be able to take the next step forward: using salmonella to release therapeutic substances within the tumor and thus participate in its destruction.

“Our experiments are currently limited to absolutely basic research and experiments with laboratory mice. It may take years before this method is usable for human patients,” says Siegfried Weiss

The study has been published in the scientific journal PLoS ONE.

Steroid Hormone Deficiency May be Behind Cardiovascular Disease

BOSTON - The deficiency of steroid hormones called androgens, such as testosterone, may be behind cardiovascular disease, according to a study.

Published in the Journal of Andrology, a report on the study underscores the fact that a number of studies have linked androgen deficiency to an increased mortality in men.

Testosterone (T) is an anabolic hormone with a wide range of beneficial effects on men’s health.

However, according to Boston University School of Medicine (BUSM) researchers, the therapeutic role of T in men’s health remains a hotly debated issue for a number of reasons, including the purported risk of prostate cancer.

Working in collaboration with researchers from Lahey Clinic Northshore, Peabody, Massachusetts, they evaluated several relevant articles pertinent to androgen deficiency and vascular disease, and determined that a relationship did exist between androgen deficiency and CVD.

“In view of the emerging evidence suggesting that androgen deficiency is a risk factor for CVD, androgen replacement therapy could potentially reduce CVD risk in hypogonadal men. It should be emphasized, however, that androgen replacement therapy should be done with very thorough and careful monitoring for prostate diseases,” said lead author Dr. Abdulmaged M. Traish, a professor of biochemistry and urology as well as the director of Laboratories for Sexual Medicine, Institute for Sexual Medicine at BUSM.

To further elucidate the role of androgen deficiency in vascular disease, the researchers recommend large, long-term, double-blind, randomised, placebo-controlled clinical trials be carried out.

“Although challenges might lie ahead regarding how data from such clinical trials are to be properly interpreted and whether long-term safety can be established with T supplementation, these findings warrant definite investigation into the beneficial role that androgens might have in preventing cardiovascular risk in androgen-deficient men,” added Traish.

PLEASE NOTE OTHER POSTS ON “HORMONES” AND “BIO IDENTICAL HORMONES”

NEW YORK -  Imaging techniques can help identify the types of vulnerable plaque that are most likely to cause adverse cardiac events before they occur, say researchers.

This finding comes from a clinical trial called Providing Regional Observations to Study Predictors of Events in the Coronary Tree (PROSPECT), which is the first prospective natural history study of atherosclerosis using multi-modality imaging to characterize the coronary tree.

A presentation on the study was made at the 21st annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation (CRF).

“As a result of the PROSPECT trial, we are closer to being able to predict-and therefore prevent - sudden, unexpected adverse cardiac events,” said principal investigator Dr. Gregg W. Stone, immediate past chairman of CRF, professor of medicine at Columbia University Hospital and Director of Cardiovascular Research and Education at the Center for Interventional Vascular Therapy at NewYork-Presbyterian Hospital/Columbia University Medical Center.

During the multi-centre trial, 700 patients with acute coronary syndromes (ACS) were studied using three-vessel multimodality intra-coronary imaging-angiography, intravascular ultrasound (IVUS), and virtual histology.

The purpose was to quantify the clinical event rate due to atherosclerotic progression, and to identify those lesions that place patients at risk for unexpected adverse cardiovascular events-sudden death, cardiac arrest, heart attacks and unstable or progressive angina.

The study revealed that most untreated plaques that cause unexpected heart attacks are not mild lesions, as previously thought, but actually have a large plaque burden and a small lumen area. These are characteristics that were invisible to the coronary angiogram but easily identifiable by IVUS.

Only about half of new cardiac events due to non-culprit lesions exemplified the classic notion of vulnerable plaque (rapid lesion progression of non flow limiting lesions), while half were attributable to unrecognized and untreated severe disease with minimal change over time.

Perhaps most importantly, for the first time it was demonstrated that characterization of the underlying plaque composition (with virtual histology) was able to significantly improve the ability to predict future adverse events beyond other more standard imaging techniques.

“These results mean that using a combination of imaging modalities, including IVUS to identify lesions with a large plaque burden and/or small lumen area, and virtual histology to identify a large necrotic core without a visible cap (a thin cap fibroatheroma) identifies the lesions that are at especially high risk of causing future adverse cardiovascular events,” Dr. Stone said.

SOUTHAMPTON -  Reading minds would soon be possible, thanks to British scientists who have developed a system that creates “brain to brain communication.”

The system, developed by a team at the University of Southampton, makes it possible to send messages formed by one person’s brain signals through an internet connection to another person’s brain many miles away.

Christopher James said the experiments were “the first baby steps” towards technologies that would allow people instantly to send thoughts, words, and images directly into the minds of others, reports The Times.

“This could be useful for those people who are locked into their bodies, who can’t speak, can’t even blink,” James said.

In their study, researchers used “brain-computer interfacing”, a technique that allows computers to analyze brain signals, that enabled them to send messages through an internet connection.

According to James, during transmission two people were connected to electrodes that measure activity in specific parts of the brain.

The first person generated a series of zeros and ones, where they imagined moving their left arm for zero and right arm for one.

After the first person’s computer recognizes the binary thoughts, it sends them to the internet and then to the other person’s PC.

A lamp is then flashed at two different frequencies for one and zero.

“It’s not telepathy,” James said.

He added: “There’s no conscious thought forming in one person’s head and another conscious thought appearing in another person’s mind.

“The next experiments are to get that second person to be aware of the information that is being sent to them. For that, I need to get my thinking cap on, so to speak.”

OXFORD - Learning to juggle helps one develop a sharper and better coordinated brain, say a new study.

“We tend to think of the brain as being static, or even beginning to degenerate, once we reach adulthood,” says Heidi Johansen-Berg clinical neurologist, University of Oxford, who led the study.

“In fact we find the structure of the brain is ripe for change. We’ve shown that it is possible for the brain to condition its own wiring system to operate more efficiently,” adds Johansen-Berg.

Researchers at the Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB) set out to see if changes in brain’s white matter could be seen in healthy adults on learning a new task or skill.

“We have demonstrated that there are changes in the white matter of the brain - the bundles of nerve fibres that connect different parts of the brain - as a result of learning an entirely new skill,” explains Johansen-Berg.

A group of young healthy adults, none of whom could juggle, was divided into two groups each of 24 people. One of the groups was given weekly training sessions in juggling for six weeks and asked to practice 30 minutes every day. Both groups were scanned using diffusion MRI before and after the six-week period.

“We challenged half of the volunteers to learn to do something entirely new. After six weeks of juggling training, we saw changes in the white matter of this group compared to the others who had received no training,” said study co-author Jan Scholz of FMRIB.

After the training, there was a great variation in the ability of the volunteers to juggle. All could juggle three balls for at least two cascades, but some could juggle five balls and perform other tricks, says an Oxford university release.

All showed changes in white matter, however, suggesting this was down to the time spent training and practicing rather than the level of skill attained.

These findings were published in Nature Neuroscience.

JEFFERSON - Migraine sufferers may be more vulnerable to an alcohol-induced headache after a night of drinking, according to researchers.

Until now, studying the mechanism behind migraine and other forms of recurrent headaches has not been possible in an animal model, says Michael Oshinsky, assistant Neurology professor at Jefferson Medical College (JMC).

Oshinsky developed a rat model in which headaches are induced by repeatedly stimulating, over weeks to months, the brain’s dura mater with an inflammatory mixture. Dura mater is the outermost, toughest, and most fibrous of the three membranes covering the brain and spinal cord.

Oshinsky and Christina Maxwell, doctoral student in the neuroscience programme, used their model to study the effects of alcohol on rats who suffer recurrent migraines, compared to rats free of headaches.

Such headaches are associated with hypersensitivity to light, sound and touch on the head and face. Researchers, using four groups of rats, measured their sensitivity to touch around the eye. They monitored the change in pain threshold of the face resulting from the repeated dural stimulation.

“Our results suggest that dehydration or impurities in alcohol are not responsible for hangover headache,” Oshinsky said.

“Since these rats were sufficiently hydrated and the alcohol they received contained no impurities, the alcohol itself or a metabolite must be causing the hangover-like headache. These data confirm the clinical observation that people with migraine are more susceptible to alcohol-induced headaches.”

Oshinsky and his lab are now also studying the mechanism for the induction of headache, and also the metabolites of alcohol that cause hangover, said a JMC release.

The study was presented at Neuroscience 2009, the Annual Meeting of the Society for Neuroscience, in Chicago.

DETROIT  - Scientists now have physical proof of how species evolve and the fittest survive, after a 21-year study in which they documented the evolution of single-celled E. coli bacteria over 40,000 generations.

Richard Lenski, Hannah professor of microbial ecology at Michigan State University (MSU), said: “It’s extra nice now to be able to show precisely how selection has changed the genomes of these bacteria, step by step over tens of thousands of generations.”

Lenski’s team periodically froze bacteria for later study, and technology has since developed to allow complete genetic sequencing. By the 20,000-generation midpoint, researchers discovered 45 mutations among surviving cells in the bottled bacteria.

Those mutations, according to Darwin’s theory, should have conferred some advantage, and that’s exactly what the researchers found.

The results “beautifully emphasise the succession of mutational events that allowed these organisms to climb toward higher and higher efficiency in their environment”, noted Dominique Schneider, molecular geneticist at the Universit Joseph Fourier in Grenoble, France.

Lenski’s long-running experiment itself is uniquely suited to answer some critical questions — such as whether rates of change in a bacteria’s genome move in tandem with its fitness to survive.

A mutation involved in DNA metabolism arose around generation 26,000, causing the mutation rate everywhere else in the genome to increase dramatically.

The number of mutations jumped to 653 by generation 40,000, but researchers surmise that most of the late-evolving mutations were not helpful to the bacteria, said an MSU release.

Gene mutations involved in human DNA replication are involved in some cancers. Many of the patterns observed in the experiment also occur in certain microbial infections, “and cancer progression is a fundamentally similar evolutionary process”, observed collaborator Jeffrey Barrick.

“So what we learn here can help us better understand the course of these diseases.”

The paper involved collaboration with scientists from South Korea as well as France and MSU.

The findings were published in Nature.