New Christian Doppler Laboratory for Complement Research opens at MedUni Vienna

Today the new Christian Doppler Laboratory for Complement Research was opened at the Center for Pathophysiology, Infectiology and Immunology at MedUni Vienna. The research institute, which is funded by the Federal Ministry of Science, Research and Economic Affairs (BMWFW) is concentrating on a special protein that is thought to play an important role in controlling excessive immune reactions.

“Christian Doppler Laboratories such as this one promote the transformation of scientific know-how into practical applications. That not only helps patients but strengthens Austria’s position as a centre for research, with all the jobs that entails,” says Reinhold Mitterlehner, Minister of Science, Research and Economic Affairs, thereby stressing the importance of the funding programme. “The CD Laboratory conducts high-level, application-oriented basic research. This involves outstanding scientists working closely with innovative companies,” says Mitterlehner. The Christian Doppler Research Association is regarded as a global model of Best Practice in promoting this type of collaborative initiative.

Endogenous proteins display anti-inflammatory properties

As part of the immune system, the complement system, which is made up of 30 plasma proteins, plays an important role in fighting pathogens by interacting closely with other components of the immune system. It helps antibodies and phagocytes to eliminate pathogens. In addition to that, the complement system helps significantly with removal of immune complexes and apoptotic (dead) material, thereby helping to maintain immune homeostasis (equilibrium).

In autoimmune diseases and immune pathologies such as rheumatoid arthritis, psoriasis or organ rejection, inflammatory processes take place in the body, triggered by its own immune system. Whereas, up until now, activation of the complement system has primarily been associated with intensification of immune reactions and inflammation, there is now evidence to suggest that complement products can prevent excessive immune responses. An important aspect of this would seem to be that the complement system disposes of dead cells and end products of immune reactions.

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Activation and regulation of the complement system results in the formation of so-called complement fragments, such as the protein C4d. Preliminary studies at the Institute of Immunology at MedUni Vienna have provided the first indications that complement fragments such as C4d inhibit immune responses, thereby having an anti-inflammatory effect.

“The long-term goal of this Christian Doppler Laboratory is to develop therapeutic approaches based on inhibitory complement proteins so as to be able to prevent inflammatory reactions appropriately,” explains Peter Steinberger of the Institute of Immunology at MedUni Vienna and director of the new CD Laboratory.

The new Christian Doppler Laboratory for complement research is embedded within the Center for Pathophysiology, Infectiology and Immunology at MedUni Vienna. The project will look in detail at the mechanisms underlying the immunomodulatory properties of the C4d molecule. In addition, receptor antagonists based on C4d are to be developed and tested as possible treatments for diseases that are associated with inappropriate immune responses.

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http://www.meduniwien.ac.at

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Sun cream labelling 'confuses buyers'

Public confused by sunscreen labelling, say experts

  • 26 June 2015
  • From the section Health
Sunbathers in their deckchairs on a beach

There is huge confusion over the labels on sun creams, and manufacturers should all use the same rating system, says the Royal Pharmaceutical Society.

A survey of 2,000 UK adults found one in five was unaware that the SPF rating does not mean protection against all sun damage – only that from UVB rays.

Protection against UVA rays is indicated by a “star” rating.

Ultraviolet A rays cause skin-ageing and wrinkles. Both UVB and UVA rays from the sun can cause skin cancer.

The protection provided by sun creams and lotions against UVB rays, which cause sunburn, is denoted by the SPF or factor on the bottle.

But there are also ultraviolet A rays (UVA) to consider too, which penetrate the skin more deeply, causing it to age – but only one in three checked the UVA star rating when buying sunscreen, the survey found.

When buying a sunscreen, you should look for the level of UVA protection (denoted by a UVA star rating) and UVB protection (denoted by the SPF).

The UVA star rating ranges from nought to five and indicates the percentage of UVA radiation absorbed by the sunscreen in comparison to UVB.

How do sunscreens and lotions protect us?

‘Complicated’

Prof Jayne Lawrence, chief scientist for the Royal Pharmaceutical Society, said: “Clearly many consumers do not realise the SPF rating applies only to the amount of protection offered against UVB rays, not UVA rays – both of which can damage the skin and cause skin cancer.

“People should not have to pick their way through complicated dual ratings information to understand how sunscreen works and the amount of protection it potentially provides.”

Prof Lawrence said it was time for sunscreen manufacturers to provide one easy-to-understand rating, based on a simple description of the total amount of sun protection offered: low, medium, high and very high protection.

Only 8% of people surveyed knew that the SPF rating on the product label referred to protection from UVB rays only.

And one in four said they did not know what the SPF rating stood for at all.


Many people aren’t sure what the SPF numbers on bottles of sun lotion actually mean

Among those adults with children, 15% admitted that they never checked the factor of the sun cream they used.

Cancer Research UK recommends applying two tablespoons of sunscreen every two hours when out in the sun in the UK.

Experts also advise people to stay in the shade between the hours of 11:00 and 15:00 or to cover up when out in direct sunshine between these times.

Overexposure to ultraviolet radiation is the main preventable cause of skin cancers – both malignant melanoma and non-melanoma skin cancers, Cancer Research UK says.

The sun is the main source of natural UV radiation but sun beds also produce artificial UV radiation.

A study in the British Journal of Cancer from 2011 estimated that 86% of melanomas in the UK every year are linked to too much exposure to sunlight and sunbed use.

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Online game 'may control snacking'

Online game ‘may control snacking’

  • 26 June 2015
  • From the section Health
Tempted by a donut

A computer game may help some people control their unhealthy snacking habits, suggests a small study from the University of Exeter.

The game trained participants’ brains to cut out calories by telling them to avoid pressing on pictures of certain images, such as biscuits and chocolate.

They lost a small amount of weight and appeared to eat fewer calories for up to six months afterwards.

The 10-minute game was played four times in one week.

Forty-one adults took part in the study, published in the journal Appetite.

The majority were overweight, and all said they ate calorie-dense snacks, such as crisps, biscuits, cake and chocolate, at least three times a week.

Train the brain

The online game, developed by psychologists at the University of Exeter and Cardiff University, used “brain training” techniques to change behaviour – in this case, to resist unhealthy snack foods.

It required people to avoid pressing a key when an unhealthy food appeared on the screen.

This type of training helps people associate this unhealthy food with “stopping”, the researchers said.

The results were compared with another group of 41 adults who completed the same training, but involving non-food pictures.

The results showed that participants lost an average of 1.5lb (0.7kg) and consumed around 220 fewer calories a day during the week of training.

Food diaries in the following six months suggested that the participants maintained their improved habits.

Dr Natalia Lawrence, from the University of Exeter, who led the research, said the game had the ability to change some people’s eating behaviour, but it was still early days.

“This research is still in its infancy and the effects are modest. Larger, registered trials with longer-term measures need to be conducted.

“However, our findings suggest that this cognitive training approach is worth pursuing: it is free, easy to do and 88% of our participants said they would be happy to keep doing it.”

She said this type of training could be used as one element of a weight loss programme or for improving eating behaviour.

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Online tools can help manage pain

A customer uses a computer in an internet cafe at Changzhi, Shanxi province January 25, 2010. REUTERS/Stringer
A customer uses a computer in an internet cafe at Changzhi, Shanxi province January 25, 2010.

Reuters/Stringer


(Reuters Health) – People with chronic pain may be able to use online tools to manage their symptoms, lessening the need for frequent doctor visits, an Australian study suggests.

Researchers tested a series of web-based pain management tutorials on a group of adults who had been suffering symptoms for more than six months. Regardless of how much contact the patients had with clinicians, they all experienced significant reductions in disability, anxiety and average pain levels at the end of the eight week experiment as well as three months down the line.

“While face-to-face pain management programs are important, many adults with chronic pain can benefit from programs delivered via the internet, and many of them do not need a lot of contact with a clinician in order to benefit,” lead study author Blake Dear, a psychology researcher at Macquarie University in New South Wales, said by email.

Dear and colleagues recruited patients online, then whittled the group down to 490 adults who had seen a doctor to assess their pain within the past three months, had no psychotic illnesses or severe depression and had regular access to a computer and the internet.

Participants were divided into one of three treatment groups to receive the web-based tutorials (bit.ly/1SQb0uh) along with regular contact with clinicians during the study, optional contact with providers or no contact. A fourth control group was told they were wait-listed for the online program and carried on their usual treatment with their doctors.

Patients in the regular contact group were required to have weekly phone or email conversations with clinicians trained in psychology, while people in the optional contact group were told this was available if they wanted to do it and the non-contact group was told clinicians were only available if they had technical difficulties or a mental health emergency.

The regular contact group had an average of 68 minutes of contact with clinicians over the eight-week treatment period, compared with 13 minutes for the optional contact group and about 5 minutes for the group with only emergency contact.

During that time, people in the treatment groups also had five web-based lessons that focused on pain management using cognitive behavior therapy techniques.

At the end of the eight weeks, patients in the treatment groups had average reductions of at least 18 percent in disability, 32 percent for anxiety, 36 percent for depression and 12 percent in typical pain levels.

These improvements were sustained or even improved after three months, and there were no significant differences between the intervention groups based on how much contact people had with clinicians.

In addition, people in the treatment groups had significantly greater reductions in disability, depression and anxiety than the patients wait-listed for the online courses.

One limitation of the study, the researchers acknowledge in the journal Pain, is that the study didn’t examine what therapies people received in the control group getting “treatment as usual,” which makes it impossible to know if people in that group would have recovered without any treatment.

Also, because all of the study participants asked to join a web-based symptom management program, it’s possible the results would be different among people not seeking out this type of care, the authors note.

It’s also possible that, given more than just the three months of follow up, more differences would emerge between the treatment groups, said Christine Rini, a behavioral health researcher at the University of North Carolina Chapel Hill.

“More broadly speaking, it may be that the most critical information that patients get from doctors working with an internet-based pain management program is communicated relatively quickly, and that additional contact does not really matter,” Rini, who wasn’t involved in the study, said by email.

SOURCE: bit.ly/1FF5S2O Pain, online May 30, 2015.


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Consumers unclear about risks or benefits of e-cigarettes

A customer tries different e-cigarette flavors at the Henley Vaporium in New York, June 23, 2015. REUTERS/Lucas Jackson
A customer tries different e-cigarette flavors at the Henley Vaporium in New York, June 23, 2015.

Reuters/Lucas Jackson


(Reuters Health) – While some smokers consider electronic cigarettes a potential aid in quitting, some people who have already quit see them as a temptation to resume a habit they fought hard to ditch, a small study suggests.

Researchers in Scotland interviewed 64 smokers and found little consensus about the potential benefits and harms of e-cigarettes, which may reflect division in the medical community on the appropriateness of promoting e-cigarettes as a safer alternative to the real thing, the authors note in the journal Tobacco Control.

“Because e-cigarettes are relatively new products we are only beginning to learn about the health risks,” senior study author Amanda Amos, a researcher at the Center for Population Health Sciences at the University of Edinburgh Medical School, said by email.

E-cigarettes are designed to mimic the real thing, with a glowing tip that emits a cloud of vapor. There’s a battery and heating element inside as well as a cartridge that holds nicotine and other liquids or flavorings.

Because part of what makes cigarettes harmful is the tobacco smoke, it’s possible that e-cigarettes might be safer because they don’t actually burn tobacco. Even so, the nicotine inside e-cigarettes is still addictive.

Amos and colleagues conducted 12 focus groups and 11 individual interviews with current smokers and people who had quit smoking within the past year.

Most participants viewed smoking as a form of addiction and believed willpower played a strong role in quitting. Almost all of them had tried e-cigarettes at least once.

They generally viewed e-cigarettes as distinct from other nicotine replacement products like patches or gum that are designed to help people quit. Because general practitioners give nicotine alternatives to smokers trying to quit, the study participants tended to think of these as medical products.

With e-cigarettes, however, people were less clear about what their intended purpose or correct use might be, though they were seen as less directly tied to smoking cessation than patches or gum.

Some people saw e-cigarettes as a more satisfying replacement to smoking, while others viewed them as less desirable or even as a threat to smoking cessation.

“This paper shows that the public’s view of e-cigarettes is far from being clear, with a great deal of ambiguity around the product and its intended use,” Dr. Ricardo Polosa, a professor of internal medicine at the University of Catania in Italy.

“Really, it’s not complicated at all,” Polosa, who wasn’t involved in the study, said by email. “E-cigs are a much safer alternative to smoking and are intended for smokers who are unable to quit using other methods.”

While the study is too small to draw many conclusions about public perception of e-cigarettes, it highlights widespread confusion among consumers that has been observed in many countries, said Dr. Konstantinos Farsalinos, a researcher at Onassis Cardiac Surgery Center in Athens.

“Unfortunately, the end result is that smokers are discouraged from using e-cigarettes as an alternative to smoking,” Farsalinos, who wasn’t involved in the study, said by email. “For those smokers who cannot switch with, or do not want to use the pharmaceutical medications, e-cigarettes can really be life-saving.”

SOURCE: bit.ly/1eMb7bO Tobacco Control, online June 8, 2015.


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Preclinical AD May Manifest Early

Action Points

  • Cognitive impairment may exist as early as 18 years before clinical diagnosis of Alzheimer’s disease.
  • These findings are not yet clinically relevant because screening tests are not sensitive enough.

Cognitive changes may arise much earlier in the preclinical phase of Alzheimer’s disease than previously thought, researchers reported.

Studies have shown that those changes may start showing up some 10 to 12 years before diagnosis, but a new report by Kumar Rajan, PhD, of Rush University in Chicago, and colleagues found that shifts in cognition were detectable up to 18 years before the disease manifests clinically.

Their prospective study of people from four Chicago neighborhoods who were free of dementia at baseline found that those who scored lower on a battery of cognitive tests had an increased risk of developing Alzheimer’s. That association was strongest when tests were given in the year before diagnosis, but it was still strong and significant 13 to 18 years out, they reported online in Neurology.

“The changes in thinking and memory that precede obvious symptoms of Alzheimer’s disease begin decades before,” Rush said in a statement.

However, he cautioned that the findings aren’t yet clinically relevant. It’s not yet possible to detect the changes in at-risk patients because tests aren’t sensitive enough and results are often within the normal range.

Steven DeKosky, MD, of the University of Florida in Gainesville (previously at the University of Pittsburgh), who wasn’t involved in the study, agreed that standard screening tests wouldn’t help pick up suspicious changes, although those changes coupled with biomarkers might.

“Several other studies suggest that in large groups of people followed for a long period of time, the group that subsequently is shown to have Alzheimer’s disease has changes that are different from the rest,” DeKosky said. “But these are all within the normal range. We will need something besides the standardized screening tests to be able to detect [relevant changes].”

The findings could have important implications for research and clinicians’ understanding of how early the disease begins and how much longer the underlying processes may be at work.

“Efforts to successfully prevent the disease may well require a better understanding of these processes near middle age,” Rajan said.

For their study, Rajan and colleagues relied on prospective data from the Chicago Health and Aging Project on 2,125 participants ages 65 and up. Patients underwent four cognitive tests — two on episodic memory, one on executive function, and one on general orientation and global cognition — at various time points in the study.

During the 18-year follow-up, 442 participants (21%) developed Alzheimer’s disease, with an average age of diagnosis at 83.6. Dementia incidence was higher among African Americans than European Americans (23% versus 17%).

Overall, the researchers found that those who scored lower on the cognitive battery had an increased risk of developing Alzheimer’s, and that the relationship was strongest when the tests were given in the year before diagnosis (OR 9.84, 95% CI 7.41-13.06, P<0.001).

However, it remained strong and significant when the tests were given 13 to 18 years before Alzheimer’s diagnosis, they reported (OR 3.39, 95% CI 1.72-6.67, P<0.001).

“Strong associations with executive function and global cognition were observed at the farthest time from diagnosis that appeared stronger than episodic memory, perhaps suggesting that loss in executive function might precede loss in episodic memory,” they wrote.

However, they noted that some of the executive function tests also make demands on episodic memory. Thus, “multidimensional tests in clinical trials might be better suited to detect small changes in cognition leading to clinical development of Alzheimer’s dementia.”

The ties between early cognitive changes and Alzheimer’s risk were stronger among European Americans than African Americans, the researchers said. It’s not clear why, but it’s possible that the temporal course of cognitive changes in Alzheimer’s is different between those groups, they said.

The findings suggest more research is needed to develop a better clinical understanding of the earliest manifestations of the disease process, as the prodromal phase may span many decades, Rajan said.

Sam Gandy, MD, PhD, of Mount Sinai Hospital in New York City, who wasn’t involved in the study, said based on these results and others, physicians “will almost certainly begin looking harder at the cognition of ‘asymptomatic’ subjects with positive amyloid scans.”

“Long story short, I think that our vigilance is heightened and, given that the only encouraging trial data are from prevention trials, this will turn out to be a good thing for patients in the end,” Gandy told MedPage Today. “I would take reports like this seriously, constantly re-evaluating the state of the art for screening exams and adjusting practice accordingly.”

The study was supported by the National Institute on Aging and the International Alzheimer’s Association.

Rajan disclosed no relevant relationships with industry. Some co-authors disclosed relevant relationships with Pain Therapeutics and Zinfandel Pharmaceuticals.

last updated 06.26.2015

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Memory, Thinking Tests May Hint at Alzheimer's Risk

Memory, Thinking Tests May Hint at Alzheimer’s Risk

News Picture: Memory, Thinking Tests May Hint at Alzheimer's Risk

Latest Alzheimers News

WEDNESDAY, June 24, 2015 (HealthDay News) — Mistakes made on memory and thinking tests may be early warning signs of Alzheimer’s disease, researchers report.

Low scores on such tests could serve as a “red flag” for the progressive brain disease up to 18 years before it can be diagnosed, the study authors added.

“The changes in thinking and memory that precede obvious symptoms of Alzheimer’s disease begin decades before,” study author Kumar Rajan, of Rush University Medical Center in Chicago, said in a news release from the American Academy of Neurology.

“While we cannot currently detect such changes in individuals at risk, we were able to observe them among a group of individuals who eventually developed dementia due to Alzheimer’s,” Rajan said.

The study involved more than 2,000 black and white people from Chicago. The participants were an average age of 73. None were diagnosed with Alzheimer’s at the start of the study, and each completed tests of memory and thinking skills every three years over nearly two decades.

During the study period, 23 percent of the black people and 17 percent of the white people developed Alzheimer’s. Those who had the lowest test scores were at greater risk for the disease.

After the first year, those with lower test scores were about 10 times more likely to develop Alzheimer’s than those with the best scores. These odds increased as the scores dropped below average, the study published online June 24 in the journal Neurology found.

“A general current concept is that in development of Alzheimer’s disease, certain physical and biologic changes precede memory and thinking impairment,” Rajan said. “If this is so, then these underlying processes may have a very long duration. Efforts to successfully prevent the disease may well require a better understanding of these processes near middle age.”

— Mary Elizabeth Dallas

MedicalNews
Copyright © 2015 HealthDay. All rights reserved.

SOURCE: American Academy of Neurology, news release, June 24, 2015

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Affordable Care Act initiative supports care coordination in rural areas

Affordable Care Act initiative supports care coordination in rural areas

June 25

– By Patrick Conway, M.D., Deputy Administrator for Innovation and Quality and Chief Medical Officer, Centers for Medicare & Medicaid Services

While we have accomplished a lot to make sure Americans have access to good, quality health care, continuing to reform our health care system by increasing quality and lowering costs will need everybody to be a part of the effort.  Part of that will mean continuing important work with health care providers to reform health care delivery, efforts that have already shown promising results, including through Accountable Care Organizations (ACOs).  ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to provide coordinated, high-quality care to their Medicare patients to help them deliver better care at lower cost.  Learn much more about ACOs in our fact sheet out today.

The Centers for Medicare & Medicaid Services (CMS) today announced two modifications to the design of the ACO Investment Model, which will help rural areas and small group practices gain more access to the benefits that ACOs have shown across the country.  These two changes will newly allow ACOs starting in the Medicare Shared Savings Program in 2015 to apply in the upcoming application round, and it will remove the 10,000 or fewer assigned beneficiary eligibility criteria for rural ACOs that started in the Medicare Shared Savings Program in 2015 (or will start in 2016).

These two changes reflect the Innovation Center’s commitment to listening to suggestions and ensuring that demonstrations are widespread, including rural providers and smaller physician groups.

The application for the second round of the ACO Investment Model was made available for viewing on  June 2nd. On July 1st, 2015, the application will open for ACOs that started in the Shared Savings Program in 2014 and 2015 – or are scheduled to start in 2016.

The ACO Investment Model is expected to provide a total of $114 million in upfront investments to up to 75 ACOs across the country. Making payments of shared savings in both upfront and ongoing amounts will help these ACOs invest in care coordination, health information technology, and population health platforms to help shift our health care system from one that provides reactive care to one that provides proactive, preventive care.

Through the CMS Innovation Center, this initiative will provide upfront and ongoing investments in infrastructure and redesigned care process to help eligible ACOs continue to provide higher quality care. This will help increase the number of beneficiaries that can benefit from lower costs and improved health care through Medicare ACOs. CMS will recover these payments through an offset of an ACO’s earned shared savings.

ACOs are one part of the overall effort provided by the Affordable Care Act to help lower costs and improve care and quality. For example, the Affordable Care Act has helped reduce hospital readmissions in Medicare by nearly eight percent between 2012 and 2013 – translating into 150,000 fewer readmissions – and quality improvements have resulted in saving 50,000 lives and $12 billion in health spending from 2010 to 2013.

For more information on the ACO Investment Model, please visit: http://innovation.cms.gov/initiatives/ACO-Investment-Model/.

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Take control, take the test for HIV

Did you know that about 1 in 7 of the more than 1 million Americans infected with Human Immunodeficiency Virus (HIV) don’t know they’re carrying the virus?

And, about 1 in 4 people in the U.S. who test positive for HIV are tested too late to get the full advantage of treatment. The good news is that testing is an important first step in getting HIV-infected people the medical care and support they need to improve their health and help them maintain safer behaviors – and Medicare can help.

Medicare covers HIV screening for people with Medicare of any age who ask for the test, pregnant women, and people at increased risk for the infection (such as gay and bisexual men, injection drug users, or people with multiple sexual partners).

HIV is the virus that can lead to Acquired Immunodeficiency Syndrome, or AIDS. There have been many advances in treatment, but early testing and diagnosis play key roles in reducing the spread of the disease, extending life expectancy, and cutting costs of care.

Take control and take the test. Visit Health & Human Services’ Aids.gov website to learn more about National HIV Testing Day, June 27 and watch our video.

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Malaria parasite protein essential for parasite invasion into red blood cells

A new study led by researchers at Harvard T.H. Chan School of Public Health finds that a malaria parasite protein called calcineurin is essential for parasite invasion into red blood cells. Human calcineurin is already a proven target for drugs treating other illnesses including adult rheumatoid arthritis and lupus, and the new findings suggest that parasite calcineurin should be a focus for the development of new antimalarial drugs.

“Our study has great biological and medical significance, particularly in light of the huge disease burden of malaria,” said senior author Manoj Duraisingh, John LaPorte Given Professor of Immunology and Infectious Diseases. “As drug resistance is a major problem for malaria control and eradication, it is critical that that we continue to develop new antimalarials that act against previously unexploited targets in the parasite to keep priming the drug pipeline.”

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The study appears online June 25, 2015 in Cell Host & Microbe.

The research team at Harvard Chan School used cutting edge genetic and cell biological methods to provide definitive evidence of the essentiality and function of calcineurin in parasite invasion. They found that the protein allows the malaria parasite to recognize and attach to the red blood cell surface. Parasites with inhibited calcineurin failed to invade and were not infective. Studies from a group at the University of Glasgow, which are published in the same issue of the journal, show the importance of calcineurin through different stages of the malaria life-cycle, implicating the protein as a potential target for blocking malaria transmission.

In addition to opening the door to potential new malaria treatments, these studies suggest that calcineurin could be targeted to treat other parasitic diseases. Researchers at Boston College working in collaboration with the Harvard Chan group showed that calcineurin is also important for cellular attachment by a related parasite that causes toxoplasmosis.

“Our study shows that the ability of malaria parasites to engage red blood cells is driven by an ancient mechanism for cellular attachment,” said lead author Aditya Paul, a postdoctoral researcher at the Harvard Chan School. “In addition to a possible drug target, calcineurin underlies a very basic aspect of parasite biology.”

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Harvard School of Public Health

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