Beetroot may reduce kidney failure risk after heart x-ray, research reveals

Beetroot may reduce the risk of kidney failure in patients having a heart x-ray, according to research led by Queen Mary University of London.

The new research project funded by national charity Heart Research UK will look into whether dietary inorganic nitrate found commonly in beetroot could be used in pill form to prevent one of the most common causes of kidney failure in hospital.

Coronary angiography is a type of x-ray test which is used to look at the coronary arteries in the heart and diagnose a number of heart conditions. It can also help in the planning of procedures to widen narrowed or blocked arteries in the heart.

During angiography, a special dye is injected into the blood so that the blood vessels can be seen. However the dye can cause acute kidney injury, known as contrast induced nephropathy (CIN), which is thought to be in part because it reduces levels of nitric oxide in the kidneys.

Dietary nitrate, found in abundance in vegetables such as beetroot, can increase levels of nitric oxide in the body.

Professor Amrita Ahluwalia, Co-Director and Professor of Vascular Pharmacology at Queen Mary's William Harvey Research Institute, said: "CIN is a serious consequence of coronary angiography, resulting in patients staying longer in hospitals and higher healthcare costs.

"If we find that giving dietary nitrate in capsule form could replace the lost nitric oxide in the kidneys and prevent CIN, the benefits to patients with heart disease would be substantial including reduced rates of kidney damage, less need for treatments such as dialysis and better long term survival."

Prof Ahluwalia with her colleagues Dr Dan Jones (Senior Lecturer in Clinical Trials) and Prof Anthony Mathur (Director of Intervention, Barts Heart Centre) will divide patients into two groups, one group taking nitrate capsules and the other group taking placebo capsules that do not contain nitrate.

Kidney function will then be measured and compared in both groups before the procedure, and two days and three months after to see if dietary nitrate makes a difference.

Barbara Harpham, Chief Executive of Heart Research UK, said: "Our Translational Research Project Grants aim to bridge a gap between laboratory-based scientific research and patient care, helping benefit patients as soon as possible.

"This exciting project has the potential to help reduce the risk of kidney damage and lead to better long-term survival for patients following coronary angiography."

Queen Mary's William Harvey Research Institute is just one recipient of Heart Research UK's Translational Research Project Grants. Awarded since 2009, the national charity based in Leeds has given almost £5m to fund these innovative and pioneering medical research projects across the UK.

Ref:http://www.qmul.ac.uk/media/news/2018/smd/beetroot-pill-could-help-save-patients-from-kidney-failure-after-heart-x-ray.html

Beetroot may reduce kidney failure risk after heart x-ray, research reveals

Wine polyphenols may be good for oral health

Sipping wine is good for your colon and heart, possibly because of the beverage's abundant and structurally diverse polyphenols. Now researchers report in ACS' Journal of Agricultural and Food Chemistry that wine polyphenols might also be good for your oral health.

Traditionally, some health benefits of polyphenols have been attributed to the fact that these compounds are antioxidants, meaning they likely protect the body from harm caused by free radicals. However, recent work indicates polyphenols might also promote health by actively interacting with bacteria in the gut. That makes sense because plants and fruits produce polyphenols to ward off infection by harmful bacteria and other pathogens. M. Victoria Moreno-Arribas and colleagues wanted to know whether wine and grape polyphenols would also protect teeth and gums, and how this could work on a molecular level.

The researchers checked out the effect of two red wine polyphenols, as well as commercially available grape seed and red wine extracts, on bacteria that stick to teeth and gums and cause dental plaque, cavities and periodontal disease. Working with cells that model gum tissue, they found that the two wine polyphenols in isolation -- caffeic and p-coumaric acids -- were generally better than the total wine extracts at cutting back on the bacteria's ability to stick to the cells. When combined with the Streptococcus dentisani, which is believed to be an oral probiotic, the polyphenols were even better at fending off the pathogenic bacteria. The researchers also showed that metabolites formed when digestion of the polyphenols begins in the mouth might be responsible for some of these effects.​

Ref : https://www.acs.org/content/acs/en/pressroom/newsreleases/2018/february/wine-polyphenols-could-fend-off-bacteria-that-cause-cavities-and-gum-disease.html

Wine polyphenols may be good for oral health

Daffodils may hold secrets of cancer cure

A natural extract from daffodils may help in treatment of cancer find researchers at the Faculty of Sciences at the ULB led by Denis Lafontaine. The team published their research titled, “The Amaryllidaceae Alkaloid Haemanthamine Binds the Eukaryotic Ribosome to Repress Cancer Cell Growth” in the journal Structure that appeared in their latest issue this week.

The team managed to extract a natural anti-cancer compound from daffodils (known scientifically as Amaryllidaceae Narcissus. This compound is called haemanthamine. They then noted that haemanthamine tends to bind to ribosomes within the cells. Ribosomes are microscopic molecules within the cell that help in the synthesis of proteins. As the cancer cells multiply rapidly and spread the cancer throughout the body they depend on rapid and effective protein synthesis. If these ribosomes can be stopped, the protein synthesis comes to a halt and this stops the cancer growth in its tracks so to speak. In this new study the team found that haemanthamine can block the production of the proteins by blocking the ribosomes. They also act within the nucleolus by stopping the production of ribosomes itself. This whole process activates a chain of events called the “anti-tumour surveillance” that essentially gears up to stop the tumor growth. A protein associated with cancers called the p53 protein also is stabilized as a result and this stops the cancer growth and eliminates the cancer cells.

Daffodils have been known for their anti-cancer properties in folklore for centuries in the Greek and Roman ages. They have been used for their medicinal properties in treatment of inflammatory diseases, malaria, viral infections etc. They contain several alkaloids such as galanthamine, lycorine (LYC), haemanthamine (HAE), tazettine and haemanthamine precursor haemanthidine (HAD). This is the first study that analyzes and actually looks at the mechanism by which daffodils could help treat cancer. Haemanthamine is also found in other plants and plant products such as morphine from opium plant, quinine from cinchona tree and ephedrine from plant Ephedra sinica.

The authors conclude that in their study testing haemanthamine and its precursor haemanthidine, they find that these can stop cancer cell division. The effect may not be only due to inhibition of protein synthesis, they write but also due to the activation of the “nucleolar surveillance” and “stabilization of p53”. “HAE and HAD might prove advantageous in cancer therapy,” they write. More studies are necessary to transform these study findings into real anti cancer drugs available for treatment.

Ref : https://www.sciencedirect.com/science/article/pii/S0969212618300091?via%3Dihub

Daffodils may hold secrets of cancer cure

Omega fatty acid supplements may improve ASD symptoms in toddlers born preterm, study shows

In continuation of my update on omega fatty acids

Researchers from Nationwide Children's Hospital have shown that omega fatty acid supplements may improve autism spectrum disorder symptoms in toddlers who were born very preterm (more than 11 weeks early). The study was published recently in the Journal of Nutrition.

"The trial had two goals. First, we wanted to confirm the feasibility of a large study of toddlers born very preterm and exhibiting symptoms often seen with ASD. Second, we wanted to see what the effects of omega fatty acids would be on parent-reported ASD symptoms and related behaviors," says Sarah Keim, Ph.D., lead author on the study and principal investigator in the Center for Biobehavioral Health in The Research Institute at Nationwide Children's.

Dr. Keim and her team conducted a study where 31 toddlers who were born prematurely participated. For 3 months, half of them took a daily dietary supplement that contained a special combination of omega-3 and omega-6 fatty acids, and the other half took a placebo, although families were unaware of which they received to make the study rigorous.

The group that took the daily omega fatty acid supplement exhibited a greater reduction in ASD symptoms than those who took the placebo, according to ratings provided by the children's parents.

"We found clinically significant improvements in ASD symptoms in the treatment group, although the benefits were confined to one measure we used," explains Dr. Keim. "We need to do a larger trial to further understand the potential impacts on a larger group of children."

The researchers suggest that observed benefits of omega fatty acid supplementation could be due to the role of these nutrients in inflammation in the body. ASD is generally considered a neuroinflammatory condition, and influencing inflammation through nutritional supplementation could improve behaviors in children with ASD symptoms.

Researchers hope that by giving omega fatty acids to children early when they first show symptoms and the brain is still actively developing may help them long-term.

"Currently, no medications are available to help children born prematurely with the developmental delays and behavior problems they often experience. For very young children, the medications that physicians sometimes try tend to have many side effects. And we don't know what effect those medications have on brains that are still developing," says Dr. Keim. "If using omega fatty acid supplementation helps, it would have a really huge impact for these kids."

Dr. Keim and her team plan to expand the work in a full-scale trial in the future. They recently received a grant from the National Institutes of Health to study the effect of omega fatty acids in children ages 2-6 year who have ASD.

Ref : https://academic.oup.com/jn/article-abstract/148/2/227/4913038?redirectedFrom=fulltext

Omega fatty acid supplements may improve ASD symptoms in toddlers born preterm, study shows

Gout medication may help improve heart function in adult patients

Researchers at the University of Cincinnati (UC) College of Medicine have shown that probenecid, a drug long used to treat gout, may be able to improve heart function in adult patients who experience heart failure.

The results are published in the Journal of the American Heart Association based off a study of 20 patients at the University of Cincinnati Medical Center.

"We were testing if probenecid was safe for patients," says Jack Rubinstein, MD, associate professor in the Division of Cardiovascular Health and Disease, and corresponding author for the study. "We know that it was very likely to be safe because the medicine had been taken by people of all ages for decades. It has a very strong safety profile. We were quite happily surprised it improved the two main ways in how the heart functions. It improves how the heart contracts and how it relaxes."

The patients were offered probenecid as part of a randomized, double-blind, crossover and placebo-controlled single-center clinical trial. Patients, who averaged 57 years of age, were enrolled during four-week periods between June 2013 and April 2015.

They were required to undergo an echocardiogram, an electrocardiogram and six-minute endurance test along with other assessments, explains Rubinstein, a UC Health cardiologist and member of the UC Heart, Lung and Vascular Institute.

The study's first author is Nathan Robbins, a senior research assistant in the UC College of Medicine, who started out volunteering with Rubinstein in the laboratory examining the echocardiograms of animals treated with probenecid before later being hired to help recruit heart failure patients.

"This is the first time probenecid has been used in heart failure patients and we showed it increases the ejection fraction in patients with heart failure," says Robbins. "It was exciting to be able to see this medicine work from the bench to the bedside."

Rubinstein also partnered with basic scientists led by Sakthivel Sadayappan, PhD, professor in the UC College of Medicine and director of the heart branch of the UC Heart, Lung and Vascular Institute. Sadayappan and his researchers examined probenecid in animal heart cells and found it improved how well the heart uses calcium, an important component in cardiac muscle contraction.

"The medicine works in ways we know about and in ways we don't know about," says Rubinstein. "For the past four or five years we have been figuring out some of the ways the medicine works. We have figured out a lot of them, but there is still a lot we don't know."

Heart failure occurs when the heart pump is not strong enough to move blood throughout the body and meet the body's needs for oxygen, explains Rubinstein. It affects 5.7 million people in the United States, according to the Centers for Disease Control and Prevention.

"The repercussions are potentially significant--if we are able to confirm this experiment in larger studies with longer-term follow up--this could present a new way of treating heart failure for which there are limited medical therapies available," says Rubinstein.

"Left ventricular assist devices, pacemakers, heart transplants and medications are available to treat heart failure patients, but outcomes for patients with heart failure are still worse than outcomes for the vast majority of cancer patients," says Rubinstein. "That's what we want to effectively change."

Other researchers in the UC College of Medicine also assisting the study are Mark Gilbert, MD, Mohit Kumar, James McNamara, PhD, Patrick Daly, MD, Sheryl Koch, PhD, Ginger Conway, Mohamed Effat, MD, and Jessica Woo.

The study performed at UC Medical Center is related to Rubinstein's work with probenecid to treat children and young adults with hypoplastic left heart syndrome. He received a $154,000 grant in June 2017 from the American Heart Association and Children's Heart Foundation to tackle this project with researchers at Cincinnati Children's. Hypoplastic left heart syndrome is a birth defect that affects normal blood flow through the heart.

Ref : http://healthnews.uc.edu/news/?/29740/

Gout medication may help improve heart function in adult patients

Gluten-free diet may help protect against neuropathic pain

A strict gluten-free diet may help protect against the nerve pain that some people with gluten sensitivity experience, according to a preliminary study released today that will be presented at the American Academy of Neurology's 70th Annual Meeting in Los Angeles, April 21 to 27, 2018.

"These findings are exciting because it might mean that a relatively simple change in diet could help alleviate painful symptoms tied to gluten neuropathy," said lead author Panagiotis Zis, MD, PhD, of the University of Sheffield in Sheffield, United Kingdom, and a member of the American Academy of Neurology. "While our study shows an association between a self-reported gluten-free diet and less pain, it does not show that one causes the other."

Gluten sensitivity has been associated with peripheral neuropathy -; a condition in which a person's peripheral nerves become damaged, often causing weakness, numbness and pain, typically in the hands and feet. When a person has nerve pain that can't otherwise be explained, and has a sensitivity to gluten, the diagnosis might be gluten neuropathy.

The study involved 60 people with an average age of 70 who had gluten neuropathy. They were asked about the intensity of their pain, their other neuropathy symptoms, their mental health and whether they followed a strict gluten-free diet. A total of 33 of the participants had pain with their neuropathy, or 55 percent.

People who were following a gluten-free diet were more likely to be free of pain than people who did not follow a strict gluten-free diet. A total of 56 percent of those without pain were on a gluten-free diet, compared to 21 percent of those with pain. After adjusting for age, sex and mental health status, researchers found that people following the strict diet were 89 percent less likely to have pain with their neuropathy than people not following the diet.

The study also found that people with painful gluten neuropathy scored significantly worse on the mental health assessment, which has a range of zero to 100 with 100 being best. Those with painful gluten neuropathy had an average score of 76, as opposed to the average score of 87 for those with painless gluten neuropathy.

"This study is promising because it shows that a gluten-free diet may help lower the risk of pain for people with gluten neuropathy," Zis said. "More research is needed to confirm these results and to determine whether the gluten-free diet led to the reduction in pain."

Ref:https://www.aan.com/PressRoom/Home/PressRelease/1627

Gluten-free diet may help protect against neuropathic pain

FDA Approves New Indication for Gilotrif (afatinib) in EGFR Mutation-Positive NSCLC

In continuation of my update on afatinib...

Boehringer Ingelheim  announced that the U.S. Food and Drug Administration (FDA) has approved a supplemental New Drug Application (sNDA) for Gilotrif (afatinib) for the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have non-resistant epidermal growth factor receptor (EGFR) mutations as detected by an FDA-approved test. The new label includes data on three additional EGFR mutations: L861Q, G719X and S768I. The FDA granted Priority Review status to Gilotrif in evaluating this application.

Gilotrif, an oral, once-daily tablet, was previously approved in the U.S. for the first-line treatment of patients with NSCLC whose tumors have EGFR exon 19 deletions or exon 21 L858R mutations. In addition, Gilotrif is approved in the U.S. for patients with squamous cell carcinoma of the lung whose disease has progressed after treatment with platinum-based chemotherapy.

“With this expanded indication for Gilotrif, NSCLC patients whose tumors have certain EGFR mutations now have an approved therapy that specifically targets these mutations,” said Sabine Luik, M.D., senior vice president of Medicine & Regulatory Affairs, Boehringer Ingelheim Pharmaceuticals, Inc. “This approval is a result of our company’s commitment to delivering meaningful treatment advances in areas with high unmet medical need and reflects the tireless efforts of physicians, researchers and patients who participated in our studies.”

The sNDA approval is based on a pooled analysis of three studies from the LUX-Lung clinical trial program (Phase II LUX-Lung 2 study and Phase III studies LUX-Lung 3 and LUX-Lung 6) that examined Gilotrif in NSCLC patients whose tumors have EGFR mutations, including L861Q, G719X or S768I. This analysis showed that Gilotrif was active in these EGFR mutations based on objective response rate, duration of response, disease control, progression-free survival and overall survival.

“Compared with other EGFR mutations, L861Q, G719X or S768I substitution mutations are associated with a poorer prognosis and limited treatment options,” said Edward Kim, M.D., Levine Cancer Institute, Carolinas HealthCare System. “The approval of Gilotrif as a targeted therapy for these additional non-resistant EGFR mutations significantly alters the treatment strategy for this population.”

To determine if a patient is eligible for Gilotrif, physicians must conduct a test for genetic mutations – also known as biomarker testing – to determine the type of EGFR mutation present.

“This approval is more welcome news for our lung cancer community,” said Laurie Fenton Ambrose, president and CEO of Lung Cancer Alliance. “These types of advances are helping expand access to treatment options for patients who might benefit from targeted therapies to fight their specific type of lung cancer.”

Ref : https://www.drugs.com/mtm/afatinib.html

FDA Approves New Indication for Gilotrif (afatinib) in EGFR Mutation-Positive NSCLC

Diabetes drug use during pregnancy may increase risk of obesity or overweight in children

In continuation of my update on metformin

When women take the common diabetes medication metformin during pregnancy, it may put their children at increased risk of having obesity or overweight.

A growing number of pregnant women are taking metformin to treat gestational diabetes or a condition called polycystic ovary syndrome (PCOS). PCOS is a common cause of infertility and can put women at risk of developing diabetes and other metabolic health problems. PCOS affects an estimated 7 percent to 10 percent of women of childbearing age, according to the Hormone Health Network.

When pregnant women with PCOS or gestational diabetes take metformin, the medication crosses the placenta and is passed to the fetus.

"Our findings indicate the offspring of women who took metformin for PCOS during pregnancy are more likely to meet the criteria for obesity or overweight than children whose mothers were given a placebo during pregnancy," said the study's first author, Liv Guro Engen Hanem, M.D., of the Norwegian University of Science and Technology in Trondheim, Norway. "The results were surprising, since limited past research in this area had suggested metformin would have a protective effect on the children's metabolic health."

The researchers invited parents of 292 children who participated in two previous randomized clinical trials to be part of this study. In the previous trials, pregnant women with PCOS were assigned to take either metformin or a placebo during pregnancy. The researchers wound up reviewing body mass index (BMI) and other measurements for 161 children born following the two earlier studies.

At four years of age, the children whose mothers were randomized to metformin during pregnancy tended to weigh more than the children whose mothers took the placebo. Although metformin did not appear to affect birth weight, the trend became apparent when children reached six months of age. At the age of four years, the children in the metformin group had higher BMI scores and were more likely to meet the criteria for obesity or overweight than children in the placebo group.

"Few studies have examined the long-term health of children born to women with PCOS who took metformin," Hanem said. "Our findings indicate more research is needed to determine its effects on children who were exposed in the womb."

Ref : https://www.endocrine.org/news-room/2018/diabetes-drug-use-during-pregnancy-linked-to-childs-weight

Diabetes drug use during pregnancy may increase risk of obesity or overweight in children

Failed osteoarthritis drug may help lessen opioid dependence

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A new study from Indiana University suggests that a drug proven safe for use in people may prevent opioid tolerance and physical dependence when used in combination with opioid-based pain medications.

Researchers in the Linda and Jack Gill Center for Biomolecular Science at IU Bloomington have discovered that a compound previously tested to treat osteoarthritis pain appears to block neuropathic pain and decrease signs of opioid dependence. The work is reported in the journal Molecular Pharmacology.

Human trials of the drug to treat osteoarthritis pain conducted by Indianapolis-based drug manufacturer Eli Lilly and Co. found that the drug lacked efficacy. However, the drug's use in treating other kinds of pain and lessening opioid dependence had not been tested before.

"The potential to quickly begin using this compound in combination with opioid-based medication to treat pain and reduce addiction makes this discovery very significant," said lead investigator Andrea G. Hohmann, a Linda and Jack Gill Chair of Neuroscience and professor in the IU Bloomington College of Arts and Sciences' Department of Psychological and Brain Sciences. "We already know this drug is safe for use in people, so moving into human trials will not require as many regulatory hurdles."

The need for non-addictive alternatives to opioid-based pain medication is urgent due to the rapid rise in overdose deaths over the past decade. According to the Centers for Disease Control and Prevention, over 64,000 Americans died from drug overdoses in 2016, including from illicit drugs and prescription opioids. To tackle this issue, IU last year launched the Responding to the Addictions Crisis Grand Challenge initiative to invest $50 million to prevent and reduce addictions in Indiana.

To test the potential of the experimental drug to treat pain and reduce addiction symptoms, IU scientists administered the compound and the opioid morphine to male mice with neuropathic pain. While morphine initially reduced the pain, mice quickly developed tolerance to morphine's effectiveness, similar to people who require higher doses of opioid over time to achieve relief.

Ref : http://molpharm.aspetjournals.org/content/93/2/49

Failed osteoarthritis drug may help lessen opioid dependence

Aspirin appears to reduce risk of death, hospitalization for people with heart failure and diabetes

In continuation of my update on aspirin and its uses..

For people living with both Type 2 diabetes and heart failure, taking an aspirin each day appears to lower the risk of dying or being hospitalized for heart failure, according to research being presented at the American College of Cardiology's 67th Annual Scientific Session. But the data also reveal aspirin use may increase the risk of nonfatal heart attack or stroke, a somewhat contradictory finding that surprised researchers.

The study is the first to assess aspirin as a preventive measure for patients who have both diabetes and heart failure. Aspirin, a blood thinner, is strongly recommended for patients who have previously had a heart attack or stroke, but guidelines are unclear regarding its use as a preventive measure for patients who have cardiovascular risk factors but no history of heart attack or stroke. Previous studies in people who have not had those types of health events have shown conflicting evidence of aspirin's potential benefits in the general population. In patients with heart failure, some studies suggest a daily aspirin may even be harmful.

About 27 million people in the U.S. have Type 2 diabetes and about 6.5 million U.S. adults have heart failure, a condition in which the heart becomes too weak to pump enough blood to meet the body's needs. Each condition is associated with an elevated risk of cardiac events, including heart attack and stroke. This study sheds new light on the potential risks and benefits of aspirin for people with both conditions.

"We were surprised to see a paradoxical increase in nonfatal heart attacks and nonfatal stroke, parallel to the decrease in mortality," said Charbel Abi Khalil, MD, PhD, assistant professor of medicine at Weill Cornell Medicine-Qatar and the study's lead author. "This finding might be due to the fact that those patients lived longer; given their mean age of 70 years, perhaps these patients were predisposed to more cardiac events."

Using data from a United Kingdom database known as The Health Improvement Network (THIN), researchers extracted health records of more than 12,000 patients ages 55 and older who had Type 2 diabetes and heart failure but no prior history of heart attack, stroke, peripheral artery disease or atrial fibrillation. Roughly half had been prescribed daily aspirin and half had not.

Researchers analyzed health outcomes over an average of five years of follow-up. All-cause mortality and hospitalization for heart failure were tracked as a composite primary outcome. All-cause mortality, hospitalization for heart failure, major bleeding events and nonfatal heart attack or stroke were tracked separately as secondary outcomes. Those taking a daily aspirin were found to show a 10 percent decrease in the primary outcome, no difference in major bleeding events, and a 50 percent increase in nonfatal heart attack or stroke.

Aspirin interferes with blood's ability to clot, by reducing the activity of platelets, which aggregate during clot formation. Heart failure and diabetes cause changes in the blood that make clot formation more likely, which is why these conditions are associated with a higher risk of heart attacks and strokes.

"Both heart failure and diabetes are associated with increased blood clotting activity," Abi Khalil said. "Because it decreases platelet aggregation, aspirin is thought to lower the likelihood of forming harmful blood clots like those responsible for heart attacks and strokes."

Abi Khalil said patients should speak with their doctors to assess the benefits and risks of taking aspirin.

The research is limited in that it was based on a retrospective analysis of health records, rather than a randomized controlled trial. Further studies would help to confirm the findings, further elucidate the risks and benefits of aspirin use in this patient population, and potentially inform specific guidelines for treatment of patients with diabetes and heart failure.

The study was funded by the biomedical research program at Weill Cornell Medicine-Qatar, a program supported by Qatar Foundation.

Abi Khalil will present the study, "Primary Prevention with Aspirin Reduces Mortality in Type 2 Diabetes and Heart Failure: Results from the THIN Primary Care Database," on Sunday, March 11 at 9:45 a.m. ET in Poster Hall A/B.

The ACC's Annual Scientific Session, which will take place March 10-12 in Orlando, brings together cardiologists and cardiovascular specialists from around the world to share the newest discoveries in treatment and prevention. Follow @ACCinTouch, @ACCMediaCenter and #ACC18 for the latest news from the meeting.

Aspirin appears to reduce risk of death, hospitalization for people with heart failure and diabetes

Low-cost drug could prevent postpartum hemorrhage after normal delivery

In continuation of Tranexamic acid (TXA)

Postpartum hemorrhage (major blood loss after labor and birth) is the leading cause of maternal mortality worldwide, accounting for approximately one-quarter of all maternal deaths. In a study to be presented at the Society for Maternal-Fetal Medicine's (SMFM) annual meeting, The Pregnancy Meeting™, researchers will unveil findings that demonstrate that tranexamic acid prevents blood loss after vaginal births and postpartum hemorrhage (PPH) among women who have an operative vaginal delivery (use of a vacuum or forceps) or an episiotomy. In the United States, about 3.1% of births occur via operative vaginal delivery and 11-12% of births include an episiotomy. These rates, however, vary between low, middle and high-income countries.

Tranexamic acid (TXA) has long been used to reduce bleeding in elective surgeries, trauma patients, and menstrual blood loss. More recently, TXA has been recommended for the treatment of PPH and studied for use following cesarean birth. However, until now, there were no methodically sound studies that demonstrated TXA could prevent PPH in vaginal births. The research presented today is part of the "TRAnexamic Acid for Preventing Postpartum Hemorrhage after Vaginal Delivery," more commonly referred to as the TRAAP Trial.

In multicenter, randomized control study in France, researchers gave nearly 4,000 women in labor either one gram of TXA or a placebo. In the group that received the TXA, there was a reduction in the incidence of postpartum blood loss. In sub-group analysis, the researchers found that TXA reduced PPH in women with instrumental vaginal delivery and episiotomy. Further, there was no increase in severe adverse events in the TXA group, including thrombotic events, as compared to the placebo group in the three months after delivery.

"TXA should be considered for women who deliver via operative vaginal delivery and episiotomy in conjunction with prophylactic oxytocin," said Loïc Sentilles, MD, PhD, lead author of the study and chair of the Department of Obstetrics and Gynecology at Bordeaux University Hospital. "At the dosage studied, the only side effect observed was an increase in nausea and vomiting."

There are certain risk factors that increase the likelihood of a woman experiencing PPH, including obesity, prolonged or augmented labor, previous cesarean birth, and others. However, more women with PPH have no identifiable risk factors. Therefore, it is therefore essential to prevent PPH and ultimately save women's lives

Low-cost drug could prevent postpartum hemorrhage after vaginal delivery

Soy milk found to be most nutritious among various types of plant-based milk

In continuation of my update on soy millk,

How healthy is your almond milk really? It may taste good and may not cause you any of the unpleasant reactions caused by cow's milk. But though plant-based milk beverages of this kind have been on the market for a couple of decades and are advertised as being healthy and wholesome for those who are lactose-intolerant, little research has been done to compare the benefits and drawbacks of the various kinds of plant-based milk. 

A new study from McGill University looks at the four most-commonly consumed types of milk beverages from plant sources around the world - almond milk, soy milk, rice milk and coconut milk - and compares their nutritional values with those of cow's milk. After cow's milk, which is still the most nutritious, soy milk comes out a clear winner.

The researchers compared the unsweetened versions of the various plant-based milks in all cases and the figures below are based on a 240 ml serving.

Soy milk - the most balanced nutritional profile

• Soy milk is widely consumed for its health benefits linked to the anti-carcinogenic properties of phytonutrients present in the milk known as isoflavones.

• Has been a substitute for cow's milk for 4 decades.

• Concerns, however, are the 'beany flavor' and the presence of anti-nutrients (substances that reduce nutrient intake and digestion).

• Lactose free and can act as an alternative for patients with allergy issues caused by soybeans and almonds.

• Concerns, apart from the high carbohydrate count, is that consumption of rice milk without proper care can result in malnutrition, especially in infants.

• Widely consumed in Asia and South America

• Consumption can help reduce levels of harmful low-density lipoproteins (bad cholesterol) that are associated with cardiovascular diseases.

• Nutritional values are reduced if stored for over 2 months.

• Almonds have a high content of monounsaturated fatty acids (MUFA) that are considered helpful in weight loss and weight management. MUFA also helps in reduction of low-density lipoprotein (bad cholesterol).

• A wholesome, complete food, providing all major nutrients like fat, carbohydrates and proteins.

• Can help humans by providing a wide range of host-defence proteins because various beneficial anti-microbial effects are found in both human and bovine milks. (E.g., a study shows that in the case of infants, consumption of cow's milk has considerably reduced risk of fever and respiratory infections.)

• But the presence of various pathogens like Salmonella spp and Escherichia coli O157:H7 in milk have been associated with disease outbreaks around the world.

• One of the most common allergies among infants and children affecting 2.2-3.5% of children (a greater percentage than those who are affected by peanuts and tree nut allergies). As many as 35 % of these infants outgrow being allergic to milk by the age of 5-6, and this may increase to 80% by age 16.

• Lactose intolerance, due to the absence or deficiency of the enzyme lactase in the digestive tract, affects somewhere between 15-75 % of all adults depending on race, food habits and gut health.

• Some studies have suggested that 80 % of people of African origin and 100 % of those of Asian and Indigenous American origin are lactose intolerant.

Rice milk - sweet taste and relatively little nutrition

Coconut milk - no protein and few calories, but most of them from fat

Almond milk - need for complementary sources of food to provide essential nutrients

Cow's milk benefits & drawbacks

Cow's milk allergy & lactose intolerance

The researchers add that more work will need to be done to understand the effects of various conventional and novel processing methods on the nutritional profile, flavour and texture of these alternative milks.

Ref : https://www.mcgill.ca/newsroom/fr/node/32895

Soy milk found to be most nutritious among various types of plant-based milk

One hundred percent fruit juice does not alter blood sugar levels

The results are consistent with prior studies which have shown that consumption of 100% fruit juice is not linked to increasing risk of developing type 2 diabetes. It also supports a growing body of evidence that fruit juice has no significant impact on glycemic control.

The study involved comprehensive data analysis that quantitatively evaluated the correlation between consumption of 100% juice and blood glucose control.

The systematic review involved a meta-analysis of 18 randomized controlled trials (RCT) and assessed the effect that 100% juice from fruits like apple, citrus, berry, pomegranate, and grape, has on fasting blood insulin and blood glucose levels. This was used as a biomarker for diabetes risk.

According to The American Diabetes Association, more than 90% of the 29 million cases in adults and children in the United States fall in the category of type 2 diabetes—a metabolic disorder where the body is incapable of responding to insulin.

Following a healthy lifestyle is the first line of defense for preventing and treating type 2 diabetes. A healthy diet, regular physical exercise, and maintaining a healthy weight are also encouraged.

The US Dietary Guidelines state that  a healthy eating pattern should  include vegetables, fruits, low-fat or fat-free dairy, grains, and a variety of protein foods. A 4-oz. glass of 100% fruit juice could replace one serving (1/2 cup) of fruit, and can supplement whole fruit to help people add more nutrition to their diets.

Ref : https://www.eurekalert.org/pub_releases/2018-01/kc-n-nrf011718.php

One hundred percent fruit juice does not alter blood sugar levels

Researchers test new anti-malaria medication

In continuation of my update on Fosmidomycin

Fosmidomycin  Piperaquine

An international research team has conducted successful phase II clinical tests of a new anti-malaria medication. The treatment led to a cure in 83 cases. The new combination of drugs was developed by Professor Peter Kremsner of the Tübingen Institute of Tropical Medicine and the company DMG Deutschen Malaria GmbH. The study was recently published in Clinical Infectious Diseases and is freely accessible.

In the study, the researchers tested the efficacy, tolerability and safety of a combination of the drugs Fosmidomycin and Piperaquine. The twofold medication was administered for three days to patients aged one to thirty who were infected with malaria via the Plasmodium falciparum pathogen. In the 83 evaluable cases, there was a 100% cure rate. Patients tolerated the treatment well, and it led to a swift reduction of clinical symptoms. Safety issues were limited to changes in electrocardiogram readings, as had been described for Piperaquine.

The study was conducted at the Centre de Recherches Médicales de Lambaréné (CERMEL) in the African country of Gabon; CERMEL has close ties with the University of Tübingen. Financial support came from the nonprofit organization Medicines for Malaria Venture (MMV).

"This study represents a milestone in the clinical research into Fosmidomycin," says Tübingen Professor of Tropical Medicine Peter Kremsner. The substance was originally extracted from Streptomyces lavendulae and today can be produced synthetically. It blocks a metabolic pathway for the production of Isoprenoid in the malaria pathogen. This makes the malaria pathogen unable to metabolize or reproduce. Because Isoprenoids are formed via a different synthesis path in the human body, humans have no target structures for Fosmidomycin. For this reason humans tolerate the drug well and suffer barely any side effects. In addition, this unique mechanism excludes the possibility of cross-resistance to the drugs used in earlier malaria treatments.

The new combination meets WHO guidelines for combination therapies. The two drugs mechanisms against differing target structures means that they attack the parasite in the bloodstream independently of one another. This meets WHO requirements for a fast and effective treatment of the acute phase of infection, and for protection against relapse due to reappearance of the infection. The researchers say the effective mechanism helps to delay the formation of a possible resistance. Further studies are in planning to optimize dose.

Ref : https://www.uni-tuebingen.de/en/newsfullview-landingpage/article/vielversprechender-malaria-wirkstoff-erprobt.html

Researchers test new anti-malaria medication

FDA grants approval for first drug to treat inherited breast cancer

In continuation of my update on olaparib

The U.S. Food and Drug Administration  expanded the approved use of Lynparza (olaparib tablets) to include the treatment of patients with certain types of breast cancer that have spread (metastasized) and whose tumors have a specific inherited (germline) genetic mutation, making it the first drug in its class (PARP inhibitor) approved to treat breast cancer, and it is the first time any drug has been approved to treat certain patients with metastatic breast cancer who have a "BRCA" gene mutation. Patients are selected for treatment with Lynparza based on an FDA-approved genetic test, called the BRACAnalysis CDx.

"This class of drugs has been used to treat advanced, BRCA-mutated ovarian cancer and has now shown efficacy in treating certain types of BRCA-mutated breast cancer," said Richard Pazdur, M.D., director of the FDA's Oncology Center of Excellence and acting director of the Office of Hematology and Oncology Products in the FDA's Center for Drug Evaluation and Research. "This approval demonstrates the current paradigm of developing drugs that target the underlying genetic causes of a cancer, often across cancer types."

Breast cancer is the most common form of cancer in the United States. The National Cancer Institute at the National Institutes of Health estimates approximately 252,710 women will be diagnosed with breast cancer this year, and 40,610 will die of the disease. Approximately 20-25 percent of patients with hereditary breast cancers and 5-10 percent of patients with any type of breast cancer have a BRCA mutation. BRCA genes are involved with repairing damaged DNA and normally work to prevent tumor development. However, mutations of these genes may lead to certain cancers, including breast cancers.

Lynparza is a PARP (poly ADP-ribose polymerase) inhibitor that blocks an enzyme involved in repairing damaged DNA. By blocking this enzyme, DNA inside the cancerous cells with damaged BRCA genes may be less likely to be repaired, leading to cell death and possibly a slow-down or stoppage of tumor growth. Lynparza was first approved by the FDA in 2014 to treat certain patients with ovarian cancer and is now indicated for the treatment of patients with germline breast cancer susceptibility gene (BRCA) mutated, human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer, who have been previously treated with chemotherapy. Patients with hormone receptor (HR)-positive breast cancer should have been treated with a prior hormonal (endocrine) therapy or be considered inappropriate for endocrine treatment.

FDA also expanded the approval of the BRACAnalysis CDx, an approved companion diagnostic to Lynparza, to include the detection of BRCA mutations in blood samples from patients with breast cancer.

The safety and efficacy of Lynparza for the treatment of breast cancer was based on a randomized clinical trial of 302 patients with HER2-negative metastatic breast cancer with a germline BRCA mutation. The trial measured the length of time the tumors did not have significant growth after treatment (progression-free survival). The median progression-free survival for patients taking Lynparza was 7 months compared to 4.2 months for patients taking chemotherapy only.

Common side effects of Lynparza include low levels of red blood cells (anemia), low levels of certain white blood cells (neutropenia, leukopenia), nausea, fatigue, vomiting, common cold (nasopharyngitis), respiratory tract infection, influenza, diarrhea, joint pain (arthralgia/myalgia), unusual taste sensation (dysgeusia), headache, indigestion (dyspepsia), decreased appetite, constipation and inflammation and sores in the mouth (stomatitis).

Severe side effects of Lynparza include development of certain blood or bone marrow cancers (myelodysplastic syndrome/acute myeloid leukemia) and inflammation in the lungs (pneumonitis). Lynparza can cause harm to a developing fetus; women should be advised of the potential risk to the fetus and to use effective contraception. Women taking Lynparza should not breastfeed as it could cause harm to a newborn baby.

This application was granted Priority Review, under which the FDA's goal is to take action on an application within 6 months where the agency determines that the drug, if approved, would significantly improve the safety or effectiveness of treating, diagnosing or preventing a serious condition.

Lynparza is also approved for the treatment of patients with BRCA-mutated, advanced ovarian cancer who have received three or more treatments of chemotherapy, and for the maintenance treatment of patients with recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer whose tumors have completely or partially responded to chemotherapy.

Ref : https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm592347.htm

FDA grants approval for first drug to treat inherited breast cancer