A Global Outlook For The Generics Industry: From Commodity To Value Added Generics, 14-15 May 2012, London

A Global Outlook For The Generics Industry: From Commodity To Value Added Generics, 14-15 May 2012, London

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'A Global Outlook For The Generics Industry: From Commodity To Value Added Generics, 14-15 May 2012, London'

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Health Buzz: Type 2 Diabetes Harder to Treat in Teens

Health Buzz: Type 2 Diabetes Harder to Treat in Teens

Obesity-Linked Diabetes Difficult to Treat in Teens

Overweight teens who develop diabetes have a tougher time managing the condition than do adults. Not only does it progress more rapidly, but it's also harder to treat, according to a study published Sunday in the New England Journal of Medicine. Researchers analyzed 700 overweight teens under 17 who were recently diagnosed with type 2 diabetes, and found that 46 percent of those treated with the drug metformin were not able to maintain healthy blood sugar levels. They needed to begin stronger insulin injections within slightly less than a year. Among all the study participants, 1 in 5 had a serious complication such as very high blood sugar, typically leading to hospitalization. "It's frightening how severe this metabolic disease is in children," study author David M. Nathan, director of the diabetes center at Massachusetts General Hospital , told the New York Times. "It's really got a hold on them, and it's hard to turn around."

• Best Diabetes Diets
• 5 Weight-Loss Tricks That Don't Involve Dieting or (Much) Exercise

How to Conquer Food Cravings

No matter where he's traveled or what the adventure, the flight home ends exactly the same way for David Kessler. Once the plane lands in San Francisco, he starts dreaming of dumplings. In particular, he wants the ones in the airport food courtâ€"pouches of steamed shrimp joined by sweet, caloric sauce. However, Kessler knows that if he can steer past the food court and on to baggage claim, he will forget all about the dumplings and thus, trounce the craving.

In the universal battle between want and willpower, Kessler has an advantage he wants to share. The former Food and Drug Administration commissioner and author of The End of Overeating says that understanding cravings enables us to better combat them. Combat them, because most of us aren't exactly craving kale. It's probably not a surprise that the worst foods for your health are also the ones we're most likely to want.

Let's start with a quick science lesson. Remember Pavlov's dogs? They drooled in anticipation of food at the sight of people in lab coats because lab-coated people also fed them. Well, Pavlov's dogs aren't the only animals conditioned to respond to association.

The plane lands; Kessler dreams of dumplings. It's 7:30 a.m.; millions of Americans crave coffee. You smell Cinnabon; good luck with that.

Every craving begins with a cue, says Kessler, who defines craving as "cue-induced wanting." The trick is to know your cues. And to know yourself. [Read more: How to Conquer Food Cravings]

• Best Weight-Loss Diets
• Is a Gluten-Free Diet Smart for Weight Loss?

You May Be Fat and Not Even Know It

There's more to fat than meets the eye. Literally. While most of the population obsesses over that which wiggles and jiggles, research suggests it's the fat we can't see that's of greater concern. And it's not just about how much fat you have, but where you tend to store it that worries most doctors.

There are two types of fat: subcutaneous and visceral. Subcutaneous fat is located beneath the skin in places like the abdomen, thighs, hips, and buttocks. You know it, you see it, you hate it. Visceral fat, better known as belly fat, is located deep within the midsection, surrounding the liver, heart, lungs, and digestive tract. And it's invisible to the naked eye. "People are self-conscious about the fat they can see," says Heather Hausenblas, associate professor of exercise and health psychology at the University of Florida's College of Health and Human Performance, but "hidden fat, in people of any size, poses the bigger threat." Why? Visceral fat churns out inflammatory substances called cytokines that can wreak havoc on the body's organs.

Subcutaneous fatâ€"that roll of fat you can pinch between your fingersâ€"patiently sits beneath the outermost layer of skin, and while unsightly, it's not as dangerous as visceral fat. A 2004 study published in the New England Journal of Medicine showed that the removal of subcutaneous fat through liposuction â€"nearly 23 pounds of itâ€"in obese women had no effect on their blood sugar, blood pressure, or cholesterol levels after three months. Visceral fat, on the other hand, is very active metabolically. It constantly releases substances that travel to the liver and influence the production of blood fats. "[It] supplies a feeding tube to your vital internal organs, messing up the blood that is sent to those organs," says Hausenblas. That's why the subcutaneous fat on your thighs, she explains, doesn't matter as much to your health as the visceral fat in your belly. [Read more: You May Be Fat and Not Even Know It]

• 10 Things the Food Industry Doesn't Want You to Know
• Flat-Belly Dietâ€"What You Need to Know

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You May Be Fat and Not Even Know It

You May Be Fat and Not Even Know It

There's more to fat than meets the eye. Literally. While most of the population obsesses over that which wiggles and jiggles, research suggests it's the fat we can't see that's of greater concern. And it's not just about how much fat you have, but where you tend to store it that worries most doctors.

There are two types of fat: subcutaneous and visceral. Subcutaneous fat is located beneath the skin in places like the abdomen, thighs, hips, and buttocks. You know it, you see it, you hate it. Visceral fat, better known as belly fat, is located deep within the midsection, surrounding the liver, heart, lungs, and digestive tract. And it's invisible to the naked eye. "People are self-conscious about the fat they can see," says Heather Hausenblas, associate professor of exercise and health psychology at the University of Florida's College of Health and Human Performance, but "hidden fat, in people of any size, poses the bigger threat." Why? Visceral fat churns out inflammatory substances called cytokines that can wreak havoc on the body's organs.

[See: Is Your House Making You Fat?]

Subcutaneous fatâ€"that roll of fat you can pinch between your fingersâ€"patiently sits beneath the outermost layer of skin, and while unsightly, it's not as dangerous as visceral fat. A 2004 study published in the New England Journal of Medicine showed that the removal of subcutaneous fat through liposuction â€"nearly 23 pounds of itâ€"in obese women had no effect on their blood sugar, blood pressure, or cholesterol levels after three months. Visceral fat, on the other hand, is very active metabolically. It constantly releases substances that travel to the liver and influence the production of blood fats. "[It] supplies a feeding tube to your vital internal organs, messing up the blood that is sent to those organs," says Hausenblas. That's why the subcutaneous fat on your thighs, she explains, doesn't matter as much to your health as the visceral fat in your belly.

[See: Flat-Belly Dietâ€"What You Need to Know]

Visceral fat makes the body more vulnerable to type 2 diabetes, heart disease, non-alcoholic fatty liver disease, high blood pressure, Alzheimer's disease, and even certain types of cancer. A recent laboratory study, for example, suggests that visceral fat may promote the spread and growth of ovarian cancer. Says Ernst Lengyl, a professor of obstetrics and gynecology at the University of Chicago who led the research: "Cancer cells can feed from visceral fat and," he adds, "there isn't necessarily a connection to obesity because lean women also get ovarian cancer." Other cancers such as breast, gastric, and colon, research shows, may also be fueled by visceral fat.

So who accumulates visceral fat? "Everyone," says John Morton, associate professor of surgery and director of bariatric surgery at the Stanford University School of Medicine. Men have more visceral fat than women, although after menopause, women tend to gain more visceral fat than subcutaneous fat. Genetics can also play a role. "Some ethnic minorities like Hispanics and Native Americans are more prone to collecting visceral fat," says Morton. If we all have it, how do you know if you should be concerned? To find out, doctors say you need nothing more than a mirror and a tape measure.

The most precise way to gauge visceral fat is through an MRI or CT scan, but these procedures can be costly and inaccessible. MRIs and CT scans have shown that waist circumference is an indicator of abdominal fat. So simply take a good look at the shape of your body. Those with an apple shape have a large percentage of their total body fat concentrated above their waist. They're more likely to have more abdominal fat, and therefore more visceral fat, than those with a pear shape, or larger lower body, where body fat settles primarily below the waist. Also measure your waist. Studies show that women with a waist circumference of 35 inches or more and men with a measure of 40 inches or higher have dangerous levels of visceral fat.

Children Typically Excluded From Clinical Drug Trials

Children Typically Excluded From Clinical Drug Trials

MONDAY, April 30 (HealthDay News) -- Children are more likely than adults to suffer from a number of diseases, but few clinical trials are conducted to test new drugs in children with these conditions, researchers have found.

In a new study, researchers looked at all clinical trials registered worldwide from 2006 to 2011 for drugs to treat these common conditions: asthma, migraine headaches, schizophrenia, depression, diarrheal illness, lower respiratory infection, malaria, bipolar disorder and HIV/AIDS.

[Read: 'Publication Bias' Casts Doubt on Antidepressants for Autism.]

While children account for 60 percent of the patients with these conditions, only 12 percent of the clinical drug trials involved children, the investigators found. The gap was widest for conditions that are widespread in low- and middle-income countries.

Clinical drug trials in children are important because youngsters often respond differently to medications than adults, the study authors pointed out in an American Academy of Pediatrics news release.

"We found that there is a large discrepancy between global disease burden in children and the amount of clinical trial research devoted to this population," Dr. Florence Bourgeois, an assistant professor at Harvard Medical School, said in the news release.

Lack of funding may be a major reason why there are so few clinical drug trials involving children, she noted.

"We found that 58.6 percent of pediatric drug trials were conducted without any industry funding, relying solely on nonprofit organizations. In contrast, the majority of adult drug trials (64.7 percent) received industry funding," Bourgeois said.

[Read: Many Clinical Trials Moving Overseas.]

She said additional programs and incentives are needed to increase the number of drugs tested in children.

"It is critical that drugs are studied that are most likely to benefit children, particularly children in developing countries who appear to be most neglected in the current research portfolio," Bourgeois said.

The study was slated for Saturday presentation at the Pediatric Academic Societies annual meeting, in Boston. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. Food and Drug Administration has more about children and clinical trials.

Copyright © 2012 HealthDay. All rights reserved.

1/3 With Arthritis Report Anxiety or Depression

1/3 With Arthritis Report Anxiety or Depression

1/3 With Arthritis Report Anxiety or Depression

April 30, 2012 -- One-third of people 45 and older with arthritis report that they are depressed or anxious, a new study shows. �

And anxiety may even be more common than depression among these people.

"The emotional consequences of arthritis are high," says researcher Louise Murphy, PhD. She is an epidemiologist in the division of population health at the CDC in Atlanta.

Many doctors are trained to routinely look for symptoms of depression in people with chronic pain conditions like arthritis, but focusing on symptoms of anxiety may also be needed. In the new study, rates of anxiety were almost twice as high as those of depression.

"If we only focus on identifying depression, we are missing out on a substantial amount of people," she says. The findings are publishedin Arthritis Care and Research.

Anxiety More Common Than Depression

Murphy and colleagues looked at rates of reported depression and anxiety among 1,793 people with all types of arthritis. Fully 31% of the participants had anxiety and 18% were depressed. What's more, 84% of people who were depressed also had anxiety, while 50% of those with anxiety were also depressed.

Only half said they'd sought treatment for depression or anxiety in the past year.

Lifestyle changes such as getting regular exercise can often help improve pain as well as anxiety and depression. "The recommendation is to engage in 150 minutes of physical activity a week, but this can be short bursts such 10-minute walks, 15 times a week," says Murphy.

Counseling and/or medication may also have a role, she says.

Better Arthritis Treatment Leads to Less Anxiety, Depression

"Many patients with arthritis have depression or anxiety related to pain, loss of function or participation, and uncertainty," says David Pisetsky, MD, in an email. He is the chief of rheumatology at Duke University Medical Center in Durham, N.C.

"Symptoms can be improved by decreasing pain, increasing physical activity, and controlling disease," he says.

It makes sense that people with arthritis would feel anxious, says Martin Jan Bergman, MD. He is a clinical associate professor of medicine at Drexel University College of Medicine in Philadelphia and chief of rheumatology at Taylor Hospital in Ridley Park, Pa.

"If a person is concerned that they are not going to be able to take care of their family or go to work, they are going to be anxious about that," he says.

Making sure the arthritis is treated as aggressively as possible will help reduce pain, limit disability, and likely have spillover benefits for anxiety and depression. "People who feel good about their treatment have much less anxiety," he says.

�

Clues To Reversing Cognitive Deficits In Humans Offered By Mouse Study

Clues To Reversing Cognitive Deficits In Humans Offered By Mouse Study

Main Category: Epilepsy
Also Included In: Neurology / Neuroscience
Article Date: 30 Apr 2012 - 1:00 PDT

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The ability to navigate using spatial cues was impaired in mice whose brains were minus a channel that delivers potassium - a finding that may have implications for humans with damage to the hippocampus, a brain structure critical to memory and learning, according to a Baylor University researcher.

Mice missing the channel also showed diminished learning ability in an experiment dealing with fear conditioning, said Joaquin Lugo, Ph.D., the lead author in the study and an assistant professor of psychology and neuroscience in Baylor's College of Arts Sciences.

"By targeting chemical pathways that alter those potassium channels, we may eventually be able to apply the findings to humans and reverse some of the cognitive deficits in people with epilepsy and other neurological disorders," Lugo said.

The research was done in Baylor College of Medicine Intellectual and Developmental Disabilities Research Center Mouse Neurobehavior Core in Houston during Lugo's time as a researcher there.

The channel, called Kv4.2, delivers potassium, which aids neuron function in the brain's hippocampus. The hippocampus forms memory for long-term storage in the brain. Potassium also helps to regulate excitability.

Individuals who have epilepsy sometimes exhibit altered or missing Kv.4.2 channels or similar types of channels.

In the experiment investigating navigation, "knockout" mice - those without the channel - were tested in a water maze four feet in diameter and 12 inches deep, with eight trials daily - each lasting about a minute - over four days, he said. Their performance was compared with that of normal mice.

Both groups responded to visual cues - colored symbols - in learning their way around the maze, but the knockout mice did not respond as well as the normal mice in terms of spatial cues - hidden platforms in the water.

"When the mice don't have this channel, it hurts their ability to learn," Lugo said.

In a separate experiment examining fear conditioning, both knockout mice and normal mice were placed in a cage, and researchers sounded a tone before giving the mice a mild electric shock. In repeated trials, both groups began to freeze upon hearing the tone as they anticipated a shock. But the normal mice also reacted to the context - being placed in the cage - while the mice who did not have the Kv4.2 channel reacted only to the tone.

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Major Breakthrough In Macular Degeneration Research

Major Breakthrough In Macular Degeneration Research

Main Category: Eye Health / Blindness
Article Date: 30 Apr 2012 - 1:00 PDT

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University of Kentucky researchers, led by Dr. Jayakrishna Ambati, have made a major breakthrough in the "dry" form of age-related macular degeneration known as geographic atrophy (GA). GA is an untreatable condition that causes blindness in millions of individuals due to death of retinal pigmented epithelial cells. The paper, "DICER1 loss and Alu RNA Induce Age-Related Macular Degeneration via the NLRP3 Inflammasome and MyD88," was published in the premier journal Cell.

Ambati, professor of physiology, and professor and vice chair of ophthalmology and visual sciences at UK, is a leader in the field of macular degeneration research. Previous research from the Ambati laboratory published in the journal Nature showed that in human eyes with geographic atrophy there is a deficiency of the enzyme DICER1, leading to accumulation of toxic Alu RNA molecules in the retinal pigmented epithelium. The Cell paper shows that when these RNAs build up in the eye they trigger activation of an immune complex known as the NLRP3 inflammasome. In turn, this leads to the production of a molecule known as IL-18, which causes death of retinal pigmented epithelial cells and vision loss by activating a critical protein known as MyD88.

Importantly, Ambati and colleagues found evidence that activity of the inflammasome, IL-18, and MyD88 were all increased in human eyes with GA. They then showed that blocking any of these components could prevent retinal degeneration in multiple disease models. The researchers are excited that blocking these pathways could herald a new potential therapy for GA, for which there is no approved treatment.

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Ambati is working with iVeena Pharmaceuticals, Inc. of Salt Lake City to commercialize therapies for geographic atrophy.
Authors on the paper include Ambati as well as Valeria Tarallo, Yoshio Hirano, Bradley D. Gelfand, Sami Dridi, Nagaraj Kerur, Younghee Kim, Won Gil Cho, Hiroki Kaneko, Benjamin J. Fowler, Sasha Bogdonaovich, Romulo J.C. Albuquerque, Judi Z. Baffi and Mark E. Kleinman, all of the UK Department of Opthalmology and Visual Science. Additional authors include: William W. Hauswirth and Vince A. Chiodo of the University of Florida; Jennifer F. Kugel, James A. Goodrich and Steven L. Ponicsan of the University of Colorado; Gautaum Chaudhuri of Meharry Medical College; Michael P. Murphy of the MRC Mitochondrial biology Unit; Joshua L. Dunaief of the University of Pennsylvania; Balamurali K. Ambati of the University of Utah and the Veterans Affairs Salt Lake City Healthcare System; Yuichiro Ogura of the Nagoya City University Graduate School of Medical Sciences, Japan; Jae Wook Yoo and Dong-ki Lee of Sungkyunkwan University, Korea; Patrick Provost of Université Laval, Quebec; David R. Hinton of the University of Southern California; and Gabriel Nunez of the University of Michigan Medical School.
Ambati is also the Dr. E. Vernon and Eloise C. Smith Endowed Chair in Macular Degeneration Research.
This research was supported by the National Eye Institute, the Doris Duke Charitable Foundation, the Burroughs Wellcome Fund, and Research to Prevent Blindness.
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