Solucion impotencia

A powerful new research facility at the heart of Kings Health Partners Academic Health Sciences Centre has been launched by Professor Dame Sally C Davies, Director General of Research and Development and Chief Scientific Adviser, Department of Health. The Biomedical Research Centre (BRC) Nucleus is funded by a £3M infrastructure grant from South London and Maudsley Charitable Funds (£1.8M) and Guys and St Thomas Charity (£1.2M) to create a unique centre housing key translational initiatives to support the development of novel therapies and treatments for mental health and related disorders.

Part of the National Institute for Health Research funded specialist BRC for Mental Health at South London and Maudsley NHS Foundation Trust (SLaM) and Kings College London, the BRC Nucleus will bring together expertise in epidemiological, biological and biostatistical research to power the collection, linkage, integration and analysis of complex data in a way not previously possible; to develop new biomarkerled approaches to treating mental health and improving service provision for patients in the local community.

The BRC Nucleus will house groundbreaking research initiatives designed to accelerate improvements in healthcare, such as

The Case Register Interactive Search (CRIS) tool a computer programme capable of anonymising data from SLaM clinical records offering researchers opportunities to ask questions which they havent been able to answer before. For example Is there a test for those with Alzheimers disease that can show if drugs would be the best treatment? Do some drugs for schizophrenia affect physical health, e.g. diabetes? Do peoples home living arrangements affect how long they spend as inpatients, receiving care in hospital wards?

OPCRIT+ a unique software programme designed to standardise diagnosis of psychiatric illnesses and collect quality data to support research for patient benefit. Together CRIS and OPCRIT+ offer the potential to exploit the previously untapped resource of patient records for patient benefit.

The BRC Community Survey of households in South East London and the BRC Care Home Study which aim to improve understanding of the needs of the population served by SLaM and other health partners and allow SLaM to improve and tailor the quality of its service provision to meet local needs and support research.

Professor Matthew Hotopf, Director of the BRC Nucleus and Chair of the BRC Analytical Methods Theme said “The BRC Nucleus is unparalleled in the comprehensive data it will offer researchers. We are delighted this exciting facility is now open for business and the BRC for Mental Health can accelerate translational medicine in pursuit of personalised mental health care.”

Professor Simon Lovestone, Director of the BRC for Mental Health adds “The BRC Nucleus has the potential to bring the power of modern, biomedical science to transform the diagnosis, assessment and ultimately treatment, of people with mental health problems.”

Source
Louise Pratt

Black gay men have less choice when it comes to sexual partners than other groups and, as a result, their sexual networks are closely knit. These tightly interconnected networks make the rapid spread of HIV more likely. In a study1) looking at social and sexual mixing between ethnic groups in men who have sex with men, H. Fisher Raymond and Willi McFarland, from the San Francisco Department of Public Health in the US, show that social barriers faced by Black gay men may have a serious impact on their health and wellbeing. Their findings are published in Springers journal AIDS and Behavior.

In the US, there is a disproportionate burden of HIV infection in Black Americans, who accounted for nearly half of all HIV/AIDS cases diagnosed in 2006 four times the national average. Raymond and McFarlands research looks at the current levels of sexual mixing between racial and ethnic groups of men who have sex with men in San Francisco, and identifies reasons that underlie these sexual mixing patterns.

A total of 1,142 gay men took part in computerassisted interviews. They were asked about their own ethnicity, the race of their sexual partners in the last six months, their perception of how easy it is to meet sexual partners of different ethnicities, where they meet sexual partners, their view of HIV infection risk and the predominant race of their network of friends.

Black gay men are the least preferred of sexual partners by other races. Black men are perceived to be riskier to have sex with, which can lead to men of other races avoiding Black men as sexual partners. They are also perceived as less welcome in the common social venues of gay men in San Francisco. As a result, Black men are three times more likely to have sexual partners that are also Black, than would be expected by chance alone.

In the authors view, the combination of attitudes on the part of nonBlack gay men, friendships and social networks that are less likely to include Blacks, and the environments found in gay venues serve to separate Black gay men from other groups. Consequently, the sexual networks of Blacks are pushed to be more highly interconnected than other groups, with the potential for a more rapid spread of HIV and a higher sustained prevalence of infection among Black gay men.

The authors conclude “The racial disparity in HIV observed for more than a decade will not disappear until the challenges posed by a legacy of racism towards Blacks in the US are addressed.”

The study is available online free of charge on Springers information platform SpringerLink at dx.doi.org/10.1007/s1046100995746

Reference
1. Raymond HF & McFarland W (2009). Racial mixing and HIV risk among men who have sex with men. AIDS and Behavior; DOI 10.1007/s1046100995746

Source
Joan Robinson

Gonorrhea (from Late Latin gonorrhoia where gonos means “seed” and rhoe means “flow”) is a sexually transmitted bacterial infection that tends to attack the mucous membranes of the body. It is the second most common sexually transmitted disease in the U.S.; the first being Chlamydia. The bacteria reside in the warm and moist body cavities of both men and women and are highly contagious. Gonorrhea is the most common cause of female infertility and is also known as “the clap” or “the drip”. Only a fraction of women infected with the disease show any symptoms, leaving them unaware of their condition. If left untreated, gonorrhea patients can develop pelvic inflammatory disease or PID (women), or an inflammation of the epididymis, prostate gland, or urethral structure (men), all of which are far more difficult to treat. What causes gonorrhea? Gonorrhea is caused by the growth and proliferation of the bacteria Neisseria gonorrhoeae. The disease can survive in the eye, rectum, mouth, penis, throat, or vagina. This means that it can be transmitted through any variety of sexual contact.

News on Sexual Health / Sexually Transmitted Disease (STD)

For the latest news and research on Sexual Health / Sexually Transmitted Disease, and to sign up to newsletters or news alerts, please visit our Sexual Health / Sexually Transmitted Disease News Section .Once infected, a person runs a high risk of spreading the bacteria to other parts of their body. For instance, someone with gonorrhea may rub his or her eye, inadvertently spreading the infection and elongating the treatment period. The infection can also be spread from mothers to babies during childbirth. Who is at risk of getting gonorrhea? Any sexually active person can become infected with gonorrhea. Rates of infection are highest among teenagers and young adults between the ages of 15 and 29. Those who have been diagnosed with and treated for gonorrhea in the past have no resistance to the bacteria.What are the symptoms of gonorrhea? Symptoms of gonorrhea, usually appearing between two and ten days after exposure, can take up to 30 days to occur and are sometimes so mild they are mistaken for something else. Most women with gonorrhea show no symptoms. In men, the symptoms includeYellow, green, or white discharge from the penis Testicular swelling and/or pain Burning during urination Women may experienceYellow, green, or white vaginal discharge Pain or burning during urination Pain in the pelvic region Conjunctivitis (pinkeye) Irregular bleeding (between periods) Vulvitis (swelling of the vulva) Spotting after intercourseThe infection, if spread to the rectum, can cause anal itching, anal discharge, and painful bowel movements. Gonorrhea, as a result of oral sex, can also occur in the throat, characterized by burning sensations and swollen glands. Many women with gonorrhea interpret the symptoms as those of a yeast infection due to the vaginal discharge.How is gonorrhea diagnosed? If you suspect that you have gonorrhea, a professional health care worker can take a sample of discharge from the urethra (men) or cervix (women) and use it to conduct laboratory tests. Throat and anal cultures may also be taken if any symptoms suggest a spreading infection. Due to the large amount of cases in which the two occur together, the samples will be tested for both gonorrhea and Chlamydia in a laboratory. It often takes a few days for the test results to be reported. A urine test can also be done that checks for the presence of the bacteria responsible for gonorrhea. How is gonorrhea treated? Because gonorrhea is a bacterial infection, it can be treated with antibiotics. Antibiotics for the infection can be taken orally or via injection. It is important that the patient does not engage in sexual interactions until he/she has finished all of the prescribed treatment. Feeling better does not always mean that the infection is gone. Medical professionals will advise that any infected person notify everyone with whom they have had relations with in the past month about the infection. How can gonorrhea be prevented? Using a condom every time you have sex reduces your chance of contracting gonorrhea. Bacterial infections such as gonorrhea are more common among the promiscuous. If you have even the slightest inclination that you or your partner may be infected with gonorrhea, abstain from sex until consulting with a medical professional.

Researchers from the Royal Adelaide Hospital and University of Adelaide believe our oldest mammalian relative may help us to better understand ovarian cancer.

University of Adelaide geneticist, Dr Frank Grutzner says DNA mapping of the platypus has uncovered an interesting relationship between their sex chromosomes and DNA sequences found in human ovarian cancer.

“Weve identified DNA on the sex chromosomes of the platypus that is similar to the DNA that is affected in ovarian cancer and other diseases of reproduction like male infertility,” Dr Grutzner says.

“Cancers often show a large number of DNA changes and it is difficult to decide which ones are important for the development of the disease. The comparison with distantly related species like platypus helps us in identifying important DNA sequences that have been conserved by evolution over millions of years.

“We are excited by the fact that the analysis of the platypus genome gives us new directions in investigating the molecular basis of ovarian cancer.”

Working in partnership with Dr Grutzner is Assoc Prof Martin Oehler, Gynaecological Oncologist specialised in ovarian cancer treatment, from the Royal Adelaide Hospital who says its about finding new ways to tackle the disease.

“We hope this sort of research might one day lead to the development of an early detection test and more effective therapies against ovarian cancer,” Dr Oehler says.

“Ovarian cancer is the most lethal gynaecological cancer and ranks as the 6th most common cause of cancer death in Australian women.”

Both Dr Oehler and Dr Grutzner say the applications of this research are not limited to ovarian cancer, as they try to gain a better understanding of a number of diseases.

Higher selenium levels in the blood may worsen prostate cancer in some men who already have the disease, according to a study by researchers at DanaFarber Cancer Institute and the University of California, San Francisco.

A higher risk of moreaggressive prostate cancer was seen in men with a certain genetic variant found in about 75 percent of the prostate cancer patients in the study. In those subjects, having a high level of selenium in the blood was associated with a twofold greater risk of poorer outcomes than men with the lowest amounts of selenium. By contrast, the 25 percent of men with a different variant of the same gene and who had high selenium levels were at 40 percent lower risk of aggressive disease. The variants are slightly different forms of a gene that instructs cells to make manganese superoxide dismutase (SOD2), an enzyme that protects the body against harmful oxygen compounds.

The research findings suggest that “if you already have prostate cancer, it may be a bad thing to take selenium,” says Philip Kantoff, MD, director of DanaFarbers Lank Center for Genitourinary Oncology and senior author of the study that is published by the Journal of Clinical Oncology on its website now and later will be in a print journal. The lead author is June Chan, ScD, of the University of California, San Francisco.

The unexpected results are the first to raise concern about this potentially harmful consequence of taking supplemental selenium. Kantoff says, “These findings are interesting particularly in light of the recent negative results from the SELECT prevention study, which asked if selenium could protect against prostate cancer.”

The new study reveals the strong interaction between selenium and SOD2 to influence the biology of prostate cancer, a finding that these investigators had shown in a previous study. The authors say the current research demonstrated that variations in the make up of the SOD2 gene dramatically alter the effects of selenium on the risk of aggressive prostate cancer.

Selenium is a mineral found widely in rocks and dirt. Small amounts of selenium are essential for health 40 to 70 micrograms is the recommended daily intake. In recent years, supplemental selenium has been sold and promoted as a means of preventing prostate cancer, largely based on observational studies that found higher risk of prostate cancer incidence and mortality in areas of the country that are naturally low in selenium.

However, research aimed at confirming the benefits of selenium supplementation have been mixed. Recently, the SELECT study, which involved 35,000 men, was halted early when, after more than five years, it showed that the supplements didnt affect the incidence of prostate cancer.

Previous studies had found that the risk of developing prostate cancer was modified by a strong interaction between SOD2 and selenium. The new research was designed to look at the effect of this interaction on men already diagnosed with prostate cancer.

Scientists examined banked blood samples, DNA, and medical records of 489 male DanaFarber patients diagnosed between 1994 and 2001 with localized or locally advanced prostate cancer. Their mean age was 62, and their mean PSA (prostatespecific antigen) measurement was 6.0 ng/mL. About half the men were assessed as having a good disease risk, onethird had an intermediate risk, and the remaining onesixth were at poor risk. The researchers measured the level of selenium in the blood and, using the stored DNA, they determined the SOD2 genotype the specific form of the SOD2 gene carried by each patient.

Simply having a high level of selenium was associated with a slightly elevated risk of aggressive prostate cancer. But the risk was much more strongly affected by the interaction of selenium levels and whether the patient had a certain variant of the SOD2 gene. Men with the highest selenium levels and the “AA” form of the SOD2 gene were 40 percent less likely to have been diagnosed with aggressive prostate cancer than the men with same gene form but low levels of selenium.

But for men carrying the “V” form of the gene, selenium had the opposite effect. In these men, those with the highest levels of selenium in their blood were about twice as likely to have an aggressive type of prostate cancer as their counterparts with low selenium levels.

The study couldnt determine whether any of the men had been taking selenium supplements or not. But the researchers noted that men in the large SELECT prevention trial had a much higher average selenium level than those in the current study.

“Among the 25 percent of men with the AA genotype, having greater selenium levels may protect against aggressive disease,” the authors concluded. “However, for the 75 percent of men who carry a V allele, higher selenium levels might increase the likelihood of having worse characteristics.”

Therefore, they add, it is important to know which type of SOD2 gene a man has when considering the risks and potential benefits of taking selenium supplements. Additionally, the authors say the effects of the interaction between the SOD2 genotype and selenium may help explain apparently conflicting results of previous studies.

The results may seem counterintuitive to the public, who have been told for years that antioxidants can help people live longer, healthier lives with a lowered risk of cancer. However, Kantoff says, “There is some precedent to this research has suggested that antioxidants could be protective if you dont have cancer, but once you do, then antioxidants may be a bad thing.”

In addition to Kantoff and Chan, other authors of the paper include William Oh, MD, Wanling Xie, PhD, Meredith Regan, ScD, and Miyako Abe, PhD, of DanaFarber; Meir J. Stampfer DrPH, MD, of Brigham and Womens Hospital and the Harvard School of Public Health, and Irena King, PhD, of the Fred Hutchinson Cancer Research Center, Seattle.

The work was supported by grants from the National Cancer Institute and several foundations and charitable organizations.

DanaFarber Cancer Institute is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the DanaFarber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute.

FIRMAGON® (degarelix) a new fastacting hormone treatment for advanced prostate cancer is being offically launched in the UK yesterday at the British Association of Urological Surgeons Annual Meeting in Glasgow.

Prostate cancer is the most common cancer in men, and over 35,000 cases a year (1) are diagnosed in the UK , with 10,239 men dying in 2007.(2)

Prostate cancer is fuelled by the male hormone testosterone. The most widely used hormone treatments slow cancer cell growth by lowering production of testosterone in the testicles.

FIRMAGON® is given as a simple injection beneath the skin and acts in a unique way by forming a self gelling depot. It rapidly blocks hormone receptors in the pituitary gland, taking almost immediate effect. This is unlike existing hormone treatments which take up to four weeks to reduce testosterone to the required levels.(3)

Trials have shown that the new drug can reduce levels of the male hormone, testosterone, below 0.5ng/ml within three days in more than 96 per cent of patients (4). This makes FIRMAGON ® as effective as surgery to remove the testicles,

Mr John Anderson , consultant urological surgeon at the Royal Hallamshire Hospital says This is an important new step for the treatment of advanced hormonedependent prostate cancer, with FIRMAGON ® offering a new option and hope for many patients.Our goal is to achieve fast and sustained reduction in tesosterone levels and FIRMAGON® offers a rapid impact which is comparable to the immediacy achieved by surgery.

FIRMAGON® can also improve quality of life for patients by avoiding the initial surges in testosterone associated with the most common treatment currently used.Testosterone surges in some patients with advanced disease can cause tumours to grow rapidly resulting in increased pain, obstruction of the urethra and in severe cases paralysis due to spinal cord compression.(5, 6) Doctors currently prescribe antiandrogen therapy alongside hormone treatments to combat this, but this approach, means additional complication and is associated with the possibility of more side effects.

FIRMAGON ® doesnt cause these initial hormone surges (7) and so doctors dont have to prescribe antiandrogen therapy to conteract this, avoiding associated side effects and offering an effective monotherapy.

In clinical trials FIRMAGON® is generally welltolerated. The most common side effects in clinical trials were due to the expected physiological effects of testosterone suppression,(such as hot flushes and weight increase) or injection site pain or reddening .(8)

A new free DVD Progress for a Healthy Lifestyle A Guide for Men on Hormone Therapy for Prostate Cancer aimed at patients has been produced by Ferring Pharmaceuticals who hold the marketing authorisation for FIRMAGON®, in partnership with the British Urooncology Group and ProstateUK, to promote a holistic approach to living with prostate cancer. The DVD features information about hormone treatment but also gives advice on healthy lifestyle inlcuidng excercise and how to eat a prostatehealthy diet with recipes from celebrity chef Brian Turner. It also includes practical advice from top medical experts on how to cope with some of the issues of living with hormone therapy such as sex problems and hot flushes. It also features an interview with BBC radio DJ “Whispering” Bob Harris, who has received treatment for prostate cancer.

For more information about Firmagon®, prostate cancer, diet and exercise, please go to the Prostate UK website prostateuk.org/

References

(1) Incidence on prostate cancer in UK

(2) Statistics on deaths from prostate cancer in 2007

(3) 2007 Update of ASCO Practice Guideline for the Initial Hormonal Management of AndrogenSensitive Metastatic, Recurrent, or Progressive Prostate Cancer Guideline Summary

(4) BocconGibod L, Klotz L, Schroder FH et al. Degarelix compared to leuprolide depot 7.5mg in a 12 month randomised open lable parrallel group phase III study in prostate cancer patients.Abstract 537 presented at the 23rd EAU Congress, Milan, Italy 2008.

(5) Labrie F, Dupont A, Belanger A, et al Flutamide eliminates the risk of disease flare in prostatic cancer patients treated with a luteinizing hormonereleasing hormone agonist. J Urol 138804806, 1987.

(6) elRayes BF, Hussain MH Hormonal therapy for prostate cancer Past, present and future. Expert Rev Anticancer Ther 23747, 2002.

(7) Anderson J et al. Management of advanced prostate cancer, can we improve on androgen deprivation therapy/ BJU International 2008; 101 (12)14971501.

Depression in older adults too often goes unrecognized and untreated, resulting in untold misery, worsening of medical illness, and early death. A new study has identified one important remedy Adding a trained depression care manager to primary care practices can increase the number of patients receiving treatment, lead to a higher remission rate of depression, and reduce suicidal thoughts.

The twoyear outcomes of the multicenter Prevention of Suicide in Primary Care Elderly Collaborative Trial (PROSPECT) study are published online in the American Journal of Psychiatry.

Lead author of the study is Dr. George S. Alexopoulos, director of the Institute of Geriatric Psychiatry at NewYorkPresbyterian Hospital/Westchester Division and professor of psychiatry at Weill Cornell Medical College.

“Almost one in 10 older adults in the United States has some form of depression, and onefifth among them contemplates suicide. Twothirds of these patients are treated by primary care physicians. Sadly, their depression is often inadequately treated due to the primary care physicians time constraints and the patients reluctance to discuss their symptoms and adhere to treatment,” says Dr. Alexopoulos. “The critical finding of the PROSPECT study is that adding a trained care manager to primary care practices increases the number of depressed older patients who receive treatment and improves their outcomes, not only in the short term, but over two years.

“This is important because depression can either become chronic or relapse after an initial improvement,” adds Dr. Alexopoulos. “Most diseases have worse outcomes when an old person becomes depressed. Depression almost doubles the risk for death. It follows that treating depression effectively can reduce sickness, disability and death.”

The study, conduced by NewYork Presbyterian/Weill Cornell, the University of Pittsburgh, and the University of Pennsylvania, followed 599 patients aged 60 years and older with depression at 20 primary care practices of varying sizes in New York and Pennsylvania. Participants were randomized to receive either the PROSPECT intervention or usual care. Those in the PROSPECT group were assigned a care manager a trained social worker, nurse or psychologist who helped the physician offer treatment according to accepted practice guidelines, monitored treatment response and provided followup over two years. Practice guidelines included the antidepressant citalopram (Celexa), with the option of other drugs or psychotherapy.

After two years, nearly 90 percent of patients in the PROSPECT care management group had received treatment for depression, compared with 62 percent of those receiving usual care by their physicians. The decline in suicidal ideation (thinking about and/or planning suicide) was 2.2 times greater in the PROSPECT group.

Remission of depression happened faster in the PROSPECT intervention group and remission rates continued to increase between months 18 and 24, while no appreciable increase occurred in the usual care group during the same period.

The PROSPECT intervention worked especially well for a subgroup of patients with major depression, the more severe form of the disease, with a greater number achieving remission, or the near absence of symptoms. Patients with minor depression had favorable outcomes regardless of their study group.

Various forms of care management are being used successfully for cardiovascular patients needing anticoagulation medication and for diabetes patients needing insulin monitoring, says Dr. Alexopoulos. “The PROSPECT study has demonstrated that care management is highly successful for older adults with major depression.”

“At this time, our nation is focused on disease prevention as a way to improve the health of Americans and to reduce health care cost. Reducing depression over long periods of time can be one of the ways to achieve this objective,” continues Dr. Alexopoulos. “Care management, like that of the PROSPECT study, is relatively inexpensive. Finding ways to reimburse it can make it broadly available and have a major impact on the overall heath care.”

Dr. Alexopoulos serves as a paid member of the speakers bureau and a paid member of the Scientific Advisory Board for Forest Laboratories Inc., the maker of the antidepressant drug citalopram (Celexa). Forest offered free citalopram and a small stipend to support the study.

Coauthors include Drs. Martha L. Bruce and Patrick J. Raue of NewYorkPresbyterian/Westchester and Weill Cornell Medical College; Dr. Charles F. Reynolds III of the University of Pittsburg; Drs. Ira R. Katz, David W. Oslin and Thomas Ten Have of the University of Pennsylvania; and Dr. Benoit H. Mulsant of the University of Toronto.

NewYorkPresbyterian Hospital/Westchester Division

NewYorkPresbyterian Hospital/Westchester Division, opened in 1894, is one of the worlds most advanced centers for psychiatric care. The Westchester Division serves children, adolescents, adults and the elderly with comprehensive outpatient, day treatment, partial hospitalization and inpatient services. In addition to clinical treatment, the Westchester Division is also a center for interdisciplinary medical research and education through its academic affiliate, Weill Cornell Medical College. NewYorkPresbyterian Hospital also comprises NewYorkPresbyterian Hospital/Weill Cornell Medical Center, NewYorkPresbyterian Hospital/Columbia University Medical Center, NewYorkPresbyterian Morgan Stanley Childrens Hospital and NewYorkPresbyterian Hospital/The Allen Pavilion. NewYorkPresbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report.

It is possible to determine which patients run a high risk of developing Alzheimers disease and the dementia associated with it, even in patients with minimal memory impairment. This has been shown by recent research at the Sahlgrenska Academy, University of Gothenburg, Sweden.

The results have been published in the most recent issue of the prestigious medical journal Lancet Neurology.

“The earlier we can catch Alzheimers disease, the more we can do for the patient. The disease is one that progresses slowly, and the pharmaceuticals that are currently available are only able to alleviate the symptoms”, says Kaj Blennow, professor at the Sahlgrenska Academy, and a world leading researcher in the field.

Several biomarkers have been identified in recent years. Biomarkers are proteins that can be detected in the cerebrospinal fluid and used to diagnose Alzheimers disease. It is now clear that the typical pattern of biomarkers known as the “CSF AD profile” can be seen in the cerebrospinal fluid of patients even with very mild memory deficiencies, before these can be detected by other tests.

“The patients who had the typical changes in biomarker profile of the cerebrospinal fluid had a risk of deterioration that was 27 times higher than the control group. We could also see that all patients with mild cognitive impairment who deteriorated and developed Alzheimers disease had these changes in the biomarker profile of their cerebrospinal fluid”, says Kaj Blennow.

The scientists were also able to show a relationship between the profile of biomarkers and other typical signs of the disease, such as the presence of the gene APOE e4 and atrophy of the hippocampus, which is the part of the brain cortex that controls memory.

“Our discovery that an analysis of biomarkers in the cerebrospinal fluid can reveal Alzheimers disease at a very early stage will have major significance if the new type of pharmaceutical that can directly slow the progression of the disease proves to have a clinical effect. It is important in this case to start treatment before the changes in the brain have become too severe”, says Kaj Blennow.

The research is part of a European research project known as DESCRIPA. Samples from 168 patients from seven countries are included in the study.

A major study of three to 19 yearolds has provided vital data on the weight problems faced by the growing number of children and young people with type 1 diabetes, which is more prevalent in younger age groups than type 2 diabetes. The findings of the SEARCH for Diabetes in Youth Study Group, published online by Pediatric Diabetes, show that children and youths with type 1 diabetes are more likely to be overweight than those without diabetes.

Researchers from six clinical centres across the USA took part in the study, which compared data from 3,953 diabetics, aged between three and 19, taking part in the SEARCH study, with data for 7,666 nondiabetic children and youths from a national US study.

“The links between type 2 diabetes and excess weight are well documented, but are less clear in type 1 diabetes which affects less than 10 per cent of people with diabetes but is more common in children and young people” explains lead researcher Dr Lenna Liu from the Center for Child Health, Behavior and Development at Seattle Childrens Hospital USA.

“When people have diabetes their blood glucose can become too high” she continues. “In type 1 diabetes, this happens because an autoimmune process has destroyed the insulinproducing beta cells in the pancreas, allowing glucose levels to rise. Type 2 diabetes occurs when not enough insulin is being produced or the insulin is not working properly. Traditionally a disease in overweight adults, type 2 diabetes is increasingly being seen in younger patients as childhood obesity levels increase.”

The populationbased study looked at a racially and ethnically diverse group of children and young people with diabetes and compared them with the nondiabetic control group.

Most of the children and youths who took part in the study had type 1 diabetes (89 %) and tended to be younger 49% of the type 1 group were aged three to 11, compared to 7% of the type 2 group.

The type 1 diabetes subjects were equally split between male and female and threequarters (75%) were nonHispanic White, 12% were Hispanic, 9% were African American, 4% were Asian/Pacific Islanders and 1% were American Indian. Key finding included

NonHispanic White males aged from three to 11 with type 1 diabetes were more likely to be overweight/obese than females (34% versus 27%) while females were more likely to be overweight/obese when they were 1219 years of age (37% versus 29%).

African American females were significantly more likely to be overweight/obese inboth age groups than males (54/55% versus 36/36%) but there were no significant differences between Hispanic males and females.

More than a fifth of the children and youths with type 1 diabetes (22%) were overweight, compared with 10% of those with type 2 diabetes and 16% of those without diabetes.

When this was broken down by race/ethnicity, 28% of Hispanic children and youths with type 1 diabetes were overweight, as were 24% of Asian/Pacific Islanders, 23% of African Americans, 21% of nonHispanic Whites and 15% of American Indians.

The figures for children and youths with type 2 diabetes showed that 15% of Asian/Pacific Islanders were overweight, as were 14% of nonHispanic Whites and 11% of Hispanics.

Approximately one in eight children and youths with type 1 diabetes (13%) were obese, less than the 79% of subjects with type 2 diabetes and the 17% without diabetes.

When this was broken down by race/ethnicity, 20% of African American children and youths with type 1 diabetes were obese, as were 17% of Hispanics, 17% of Asian/Pacific Islanders and 11% of nonHispanic Whites.

The figures for children and youths with type 2 diabetes showed that 91% of African Americans were obese, as were 88% of American Indians and 75% of Hispanics.

“Knowing the prevalence of overweight and obesity in children and young people with type 1 and type 2 diabetes is very important as it helps us to identify those individuals by age, gender or race/ethnicity who face the greatest risk of the clinical complications associated with excess weight” say Dr Liu. “We feel that further studies are critical to help us to better understand how weight causes complications in the growing number of children and young people with diabetes and influences the diagnosis and treatment they receive.” The study was funded by the US Centers for Disease Control and Prevention and the National Institutes of Health.

Notes

Prevalence of overweight and obesity in youth with diabetes in USA the SEARCH for Diabetes in Youth Study. Liu et al. Pediatric Diabetes. Published online.

Pediatric Diabetes is a bimonthly journal devoted to disseminating new knowledge relating to the epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes inchildhood and adolescence. www3.interscience.wiley.com/journal/118545642/home

Source

Most healthy 25 year olds dont stay up at night worrying whether they are going to develop diabetes in middle age. The disease is not on their radar, and middle age is a lifetime away.

As it turns out, many should be concerned. Researchers at Northwestern University Feinberg School of Medicine have found that young adults (18 to 30 years old) with low aerobic fitness levels as measured by a treadmill test are two to three times more likely to develop diabetes in 20 years than those who are fit.

The study also shows that young women and young African Americans are less aerobically fit than men and white adults in the same age group, placing a larger number of these population subgroups at risk for diabetes.

“These young adults are setting the stage for chronic disease in middle age by not being physically active and fit,” said Mercedes Carnethon, lead author and assistant professor of preventive medicine at Northwesterns Feinberg School. “People who have low fitness in their late teens and 20s tend to stay the same later in life or even get worse. Not many climb out of that category.”

The study will be published in the July issue of Diabetes Care.

In the study, the most important predictor of who will develop diabetes is the participants Body Mass Index (BMI), a measure of the bodys fat content.

“The overwhelming importance of a high BMI to the development of diabetes was somewhat unexpected and leads us to think that activity levels need to be adequate not only to raise aerobic fitness, but also to maintain a healthy body weight,” Carnethon said. “If two people have a similar level of fitness, the person with the higher BMI is more likely to develop diabetes.”

Carnethon stressed that unfit young adults can avoid a future with diabetes by exercising and losing weight. “Improving your fitness through physical activity is one way you can modify your body fat,” she said. “Research shows that combining regular physical activity with a carefully balanced diet can help most people maintain a healthy body weight and lower the likelihood of developing diabetes.”

This is the longest observational study to focus on the relationship between aerobic fitness and the development of diabetes. Most previous research has focused on the selfreported health behavior of physical activity, but people dont always accurately report their activity level. Fitness, easily measured by a standard treadmill test, provides a more accurate measure than a selfreport.

In addition, this study is the first to look at the development of diabetes over a 20 year period. Because diabetes develops over a long period of time, the number of people affected in the population rises with age. Previous studies that followed adults for a shorter period of time may have stopped short before diabetes was diagnosed.

Data from the study came from the Coronary Artery Risk Development in Young Adults (CARDIA) study, which began in January 1984 and ended in December 2001. The fitness study included 3,989 participants at baseline and 2,231 at the 20year testing. The black and white men and women were 18 to 30 at the time of enrollment. Fasting blood sugar levels (the blood marker used to define diabetes) were measured at the beginning of the study and multiple times over 20 years.

The study was funded by the National Heart, Lung and Blood Institute.

Source
Marla Paul