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38 Warao Indians have died in remote villages in Venezuela, and medical experts suspect an outbreak of rabies spread by bites from vampire bats.

Medical tests have yet to confirm the official cause, but their symptoms suggest rabies, according to two researchers from the University of California at Berkeley and other medical experts.

The two UC Berkeley researchers — the husband-and-wife team of anthropologist Charles Briggs and public health specialist Dr. Clara Mantini-Briggs — said the symptoms include fever, body pains, tingling in the feet followed by progressive paralysis, and an extreme fear of water. Victims tend to have convulsions and grow rigid before death.

Dr. Charles Rupprecht, chief of the rabies program at the Centers for Disease Control and Prevention in Atlanta, agreed with their preliminary diagnosis.

“The history and clinical signs are compatible with rabies,” Rupprecht told The Associated Press on Friday. “Prevention is straightforward: Prevent bites and vaccinate those at risk of bites.”

Venezuelan health officials are investigating the outbreak and plan to distribute mosquito nets to prevent bat bites and send a medical boat to provide treatment in remote villages on the Orinoco River delta, Indigenous Peoples Minister Nicia Maldonado said Thursday, according to the state-run Bolivarian News Agency.

Outbreaks of rabies spread by vampire bats are a problem in various tropical areas of South America, including Brazil and Peru, Rupprecht said.

He said researchers suspect that in some cases environmental degradation — including mining, logging or dam construction projects — may also be contributing to rabies outbreaks.

“Vampire bats are very adaptable,” Rupprecht said. And when their roosts are disrupted or their normal prey grow scarce, “Homo sapiens is a pretty easy meal.”

More study is needed to confirm through blood or other samples from victims that it is the rabies virus in Venezuela, researchers say.

At least 38 Warao Indians have died since June 2007, and at least 16 have died in the past two months, according to a report the Berkeley researchers and indigenous leaders provided to Venezuelan officials this week.

One village, Mukuboina, lost eight of its roughly 80 inhabitants — all of them children, Briggs said. All victims throughout the area died within two to seven days from the onset of symptoms, he said.

During a study trip Briggs and Mantini-Briggs made through 30 villages in the river delta, relatives said the victims had been bitten by bats. The couple have worked among the Warao in Delta Amacuro state for years and were invited by indigenous leaders to study the outbreak.

“It’s a monster illness,” said Tirso Gomez, a Warao traditional healer who said the indigenous group of more than 35,000 people has never experienced anything similar.

Mantini-Briggs, a Venezuelan former health official, said she was surprised to find many Warao villages now have cats — a new development. “The Waraos told us it was because there were too many bats that were biting the children,” she said.

Another tropical medicine expert, Dr. Daniel Bausch of Tulane University in New Orleans, agreed the symptoms and accounts suggest rabies transmitted by bats, and if confirmed, “probably a vaccination campaign would be in order.”

The researchers have begun taking precautions. Mantini-Briggs said she started to wonder about her own health Friday while talking with biologist Omar Linares, a bat expert at Simon Bolivar University.

She remembered there was blood on her sheet after sleeping in a hammock in a Warao village two weeks ago. Initially she had dismissed it as an unimportant insect bite or something else, but she remembered her finger hurting that morning and that she saw two small red dots there.

Confirming it must have been a bat bite, Linares suggested she get rabies shots immediately.

“I’m sure a bat bit me,” she said. “I remembered and said ‘I’m going to get vaccinated.’ “

“Free” British national health care is not able to live up to its promises.  The British have had a National Health Care System for 60 years, but according to their own reports it is not giving the population adequate care.

Self-reported receipt of care consistent with 32 quality indicators: a national population survey of adults over 50 years old in England. BMJ Online First Editorial: Measuring the quality of healthcare systems using composites BMJ Online First

The National Health Service  and private healthcare are not providing good enough basic care to a large portion of the population in England, especially older and frailer people, according to a study published on bmj.com today.

Overall, only 62% of the care recommended for older adults is actually received, conclude the authors.

The large-scale independent study of quality of care involved 8 688 people aged 50 and over and looked at 13 different health conditions including heart disease, diabetes, stroke, depression and osteoarthritis.

The research team led by the University of East Anglia studied whether effective healthcare interventions were received by people aged 50 and over with serious health conditions.

They used questionnaires, face to face interviews and medical-panel endorsed quality of care indicators, for both public and privately provided care, as part of the English Longitudinal Study of Aging (ELSA).

Results showed huge variations by health condition in whether or not people with particular health conditions received the appropriate intervention or care they should.

Treatment for ischemic heart disease rated well with 83% of appropriate care actually being given, but just 29% of recommended care was received by people with osteoarthritis.

Overall, there were 19 082 opportunities for care to be delivered to people, but actual care was only given in 11 911 (62%) of those opportunities.

The researchers also found that substantially more care was provided for general medical conditions (74%) than for geriatric conditions (57%), the latter comprising falls, osteoarthritis, urinary incontinence, vision problems (cataract), hearing problems, and osteoporosis.

Interestingly, medical conditions that GPs receive extra rewards for dealing with under the Quality and Outcomes Framework of their current contract were attended to better. In 75% of such cases, people did get the right treatment, but only 58% of correct treatment was received by people with conditions not covered by the contract.

Worryingly, conditions associated with disability and frailty had the largest shortfalls in terms of the care that people were not receiving but should have been.

Receipt of care was also substantially higher for screening and preventative care (80%) than for treatment and follow-up care (64%), which in turn was higher than diagnostic care (60%).

The researchers say that initiatives to improve quality for nearly all conditions are needed but the greatest scope for improvement is in chronic conditions that affect the quality of life of older people.

In particular, the quality of care for geriatric conditions was relatively poor in this study, say the researchers, and no geriatric conditions were included in the GP contract. They therefore suggest that including geriatric conditions in future payment for performance schemes for GPs would improve quality.

In an accompanying editorial, Professor Bruce Guthrie from the University of Dundee, says that the future challenge will be to get local measures of the problem of deficiencies in care and then provide local interventions to improve care.

http://www.eurekalert.org/pub_releases/2008-08/bmj-ehs081408.php

Scientists from The University of Texas School of Public Health testing a travelers’ diarrhea vaccine have found that patients getting the vaccine were significantly less likely to suffer from significant diarrhea than those who got the placebo, based on research in this week’s Lancet. The vaccine is a patch-based vaccine in Phase 2 testing (from the Iomai Corporation).

The study followed 170 healthy travelers aged 18-64 traveling to Mexico and Guatemala. Researchers found that only 3 of the 59 individuals who received the novel vaccine developed moderate or severe diarrhea. In the group that got the placebo vaccine two dozen of the 111 suffered from moderate or severe diarrhea. Only one patient in the vaccine group had severe diarrhea.

The Iomai vaccine patch could fundamentally alter the way we approach prevention of travelers’ diarrhea which previously had few effective treatments according to Herbert L. DuPont, M.D. director of the Center for Infectious Diseases at The University of Texas School of Public Health.

The Trek Study was conducted in cooperation with UT Houston, the Johns Hopkins School of Public Health and others. The volunteers were given either two doses of the vaccine patch or a placebo. Travelers wrote diaries and received checkups while traveling. The study evaluated the safety of the vaccine and the incidence of enterotoxigenic E. coli (ETEC) bacteria – which is the most common bacteria that leads to travelers’ diarrhea. Researchers noted that no vaccine-related serious side effects were observed.

Of the few vaccinated patients who became sick, the diarrhea was mild and lasted only part of a day. Patients in the placebo vaccine group suffered two days or more of illness and had more than twice as many bowel movements. An additional positive finding was that new-onset irritable bowel syndrome was three times less likely in vaccine recipients.

This year, approximately 55 million international travelers will visit countries where bacteria that cause travelers’ diarrhea are endemic, particularly Africa, Asia and Latin America, and about 20 million of those will develop travelers’ diarrhea.

Patients who suffer a case of travelers’ diarrhea are also at increased risk of later developing irritable bowel syndrome, a chronic illness characterized by pain, diarrhea or constipation. Diarrheal diseases also harm many children in developing countries, where diarrhea caused by enterotoxigenic E. coli made 210 million children sick annually (killing 380,000 of these children).

Bacterial diarrhea is a serious medical problem both for children and adult travelers. The new patch vaccine technology is an advance in vaccine delivery according to Gregory Glenn, M.D. from Iomai Corporation’s chief science officer.

Iomai will initiate a Phase 3 trial of the needle-free vaccine patch vaccine in 2009. If the phase 3 trials are successful, the Iomai vaccine patch would be the first vaccine for travelers’ diarrhea available in the United States.

At the European Lung Cancer Conference in Geneva, Switzerland (25th April 2008) research was presented  that demonstrated new evidence that some common human viruses may be a part of the cause of lung cancer.

Scientists agree that tobacco smoking is by far the most important contributor to lung cancer development. It is also emerging that other factors may play a role in some cases.

Dr. Arash Rezazadeh from the University of Louisville, Kentucky, presented the results of a study on 23 lung cancer samples from patients in Kentucky.

Scientists found 6 specimens were positive for the human papilloma virus (HPV).  The human papilloma virus causes many cases of cervical cancer. One lung lesion was later shown to be a cervical cancer that had spread to the lungs.

5 out of 22 non-small-cell lung cancer samples were human papilloma virus-positive.  This finding supports the theory that human papilloma virus contributes to the development of non-small-cell lung cancer.

All patients in this study were also smokers, Dr. Rezazadeh notes. “We think HPV has a role as a co-carcinogen which increases the risk of cancer in a smoking population,” he says.

In another study, Israeli doctors presented data to suggest that measles virus could also be a factor in some lung cancers. Their study included 65 patients with non-small-cell lung cancer, of whom more than half had evidence of measles virus in tissue samples taken from their cancer.

“Measles virus is a ubiquitous human virus that may be involved in the pathogenesis of lung cancer,” says lead author Prof. Samuel Ariad from Soroka Medical Center in Beer Sheva, Israel. “Most likely, it acts in modifying the effect of other carcinogens and not as a causative factor by itself.”

A recent study of individuals with drug and treatment-resistant depression that received Deep Brain Stimulation (DBS) in the subcallosal cingulate region of the brain (SCG or Cg25) indicates that deep brain stimulation is relatively safe and results in improvement in patients about one month after treatment. The improvement in the depression continued during the one year follow up period.

The report was made in Biological Psychiatry by researchers from the University of Toronto and Emory University School of Medicine in Atlanta, Georgia.

The research started at the University of Toronto in 2002, directed by Dr. Helen S. Mayberg, MD, and other researchers including Andres Lozano, MD, PhD, neurosurgeon, and psychiatrist Sidney Kennedy, MD.

Dr. Mayberg is a professor in the Department of Psychiatry and Behavioral Sciences and the Department of Neurology at Emory University School of Medicine. Dr. Mayberg has done 20 years of research involving brain imaging that has sought to characterize brain abnormalities in major depression as well as to understand the mechanisms of various antidepressant treatments.

Deep Brain Stimulation uses high-frequency electrical pulses to target specific areas of the brain that are involved in neuropsychiatric diseases. Twenty individuals with depression received Deep Brain Stimulation for 12 months. Twelve of 20 patients had a significant improvement in depression symptoms ( using the Hamilton Depression rating scale–50 percent decrease) at six months. Seven patients were essentially well with few remaining depression symptoms (remission according to the Hamilton Depression Rating Scale). The remarkable improvement was still present at 12 months with continuing Deep Brain Stimulation. It also appears that there were no long term side effects with this treatment.

Patient had two thin wire electrodes surgically placed on each side of the brain near to subcallosal cingulate region. The wires were connected under the skin to a pulse generator that was implanted in the chest (much like a pacemaker). The scientists adjusted the intensity of the electrical stimulation based on the response of the patient. Study participants were those who had tried other conventional treatments for depression but were unable to get better. The failed treatments included medication, conventional psychotherapy and electroconvulsive therapy.

The scientists knew that the subcallosal cingulate region of the brain was a key region involved in major depression.

The doctors were able to follow the clinical response of the patients over a 12-month period using standard depression rating scales. The researchers also used neuro-psychological testing and scanning of both regional brain blood flow and glucose metabolism using positron emission tomography (PET scan).

PET scan images of these patients revealed that metabolic activity changed near the site of stimulation and throughout the previously identified depression network in the brain.

Depression is a complex disturbance of specific circuits in the brain responsible which regulate mood and emotions, according to Dr. Mayberg.

Mayberg initiated a larger version of her Toronto study at Emory in 2007. The new Emory University study will look at a number of additional ideas including the testing of patients with bipolar II depression and further refinement of the brain targeting.

Emory University Press Release

Good news from scientists–Gummi Bears can actually be produced that are good for you, or at least for your teeth.  The sugar-alcohol xylitol that is added to this delicious snack food reduces the number of bad bacteria in your mouth.

Xylitol has been used to manufacture gummy bears to produce an unlikely result– they can help prevent dental problems.  Children were given four of the xylitol bears three times a day during school hours which resulted in a lowering of the plaque producing bacteria that lead to tooth decay.

Xylitol is a natural sugar-alcohol that is commonly used to sweeten gum and candy. Xylitol has been shown to lower the  levels of the harmful streptococci mutans (MS) bacteria which commonly lead to tooth decay.  Xylitol chewing gum is available but is usually not considered to be suitable for young children. The current study was led by Kiet A. Ly from the University of Washington.

Dr. Kiet A. Ly says, “For xylitol to be successfully used in oral health promotion programmes amongst primary-school children, an effective means of delivering xylitol must be identified. Gummy bears would seem to be more ideal than chewing gum.”

The young participants in the study were received four gummis  three times daily–these had different amounts of xylitol.  Study results indicated that after six weeks of xylitol gummy snacking, the numbers of harmful streptococci mutans (MS) bacteria in the children’s mouths was significantly lowered. Dr. Ly  stated  that study shows that it is possible to develop a clinical trial of a gummi candy based tooth decay prevention trial. A study of this concept is now being carried out in the East Cleveland primary school district .

Tooth decay is an extremely common disease worldwide. The use of  Xylitol gummi bears at school would be a well tolerated and probably very safe means of reducing the this chronic childhood disease in many parts of the world.

The name of the drug is Dimebolin Hydrochloride (Dimebon) which  is an antihistamine drug  used clinically in Russia since the 1980s.

In new research , Dimebolin has garnered interest since it has been shown to have beneficial effects on persons with Alzheimer’s disease. In 2000, animal research showed potential benefit in Alzheimer’s disease models.  New results from human testing also looks promising. A six-month phase II trial showed that at 12 months patients had significant improvement compared to placebo.  Dimebon also has shown promise in a Phase III double blind trial in Russia with mild to moderate Alzheimer’s  patients.  Dimebolin is an oral medication which is a small molecule that inhibits brain cell death in patients with Alzheimer’s disease and Huntington’s disease.It is a potential drug treatment for these and other neurologic diseases. The new studies suggest that Dimebon may also have cognition improving effects in healthy people.

Dimebon has several mechanisms of action–it blocks the action of neurotoxic beta amyloid proteins and inhibits certain calcium channels which modulate the action of the neurotransmitters AMPA and NMDA.  It  may also have a neuroprotective effect by blocking a  target in the mitochondria (which may play a role in the cell death in neurodegenerative diseases).  Additional studies will continue in both Russia and other nations into the applications of Dimebon as an Alzheimer’s disease treatment and as neuroprotective agent.

Results from the Russian study were presented  at the 60th annual meeting of the American Academy of Neurology (AAN) in Chicago this week.

Medivation, Inc. (Nasdaq: MDVN) has announced publication of the results of its first Alzheimer’s disease  clinical trial of ab investigational drug Dimebon in the July 19, 2008 issue of The Lancet. The double-blind, placebo controlled study showed that, patients with mild-to-moderate Alzheimer’s disease given Dimebon experienced statistically significant improvements compared to placebo in all the key aspects of  Alzheimer’s disease: memory and thinking, activities of daily living, behavior and overall function.

Farm grown ,tilapia (the common name for nearly a hundred different species of cichlid fishes from the tilapiine cichlid tribe) is one of the most widely eaten fish in America.  Tilapia, it turns out,  has very low levels of healthful omega-3 fatty acids and, even worse, it contains very high levels of unhealthy omega-6 fatty acids, based on  research from Wake Forest University School of Medicine.

Individuals who are eating fish as a healthy food to control inflammatory diseases such as heart disease should be aware that tilapia is not a good choice,  The harmful inflammatory potential of hamburger and pork bacon is less than the average serving of farmed raised tilapia.

The scientists  say the combination of unhealthy fats could be a potentially harmful  food source for some patients with heart disease, arthritis, asthma and others with  allergic and auto-immune diseases that are at increased risk of an  exaggerated inflammatory response.  Inflammation is now known to cause much of the damage to blood vessels, the heart, lung and joint tissues, skin, and the digestive tract in a large number of disease states. Omega 3 fatty acids in the diet are thought to be healthy additions to the diet since they help lessen the inflammation in the body.  Our modern diets contain a much greater  quantity of omega 6 fatty acids and fewer omega 3 fatty acids than those of our ancestors.

Researchers state that they found that farm-raised tilapia, as well as farmed catfish,  have several fatty acid characteristics that are generally be considered by medical science to be harmful. Tilapia has higher levels of potentially detrimental long-chain omega-6 fatty acids than 80-percent-lean hamburger, doughnuts and even pork bacon, the article says.

The health benefits of omega-3 fatty acids (long-chain n-3 polyunsaturated fatty acids), have been scientifically documented. The American Heart Association currently recommends that everyone eat at least two servings of fish per week, and that heart patients consume at least 1 gram a day of the two most critical omega-3 fatty acids, known as EPA and DHA .

In the U.S., tilapia has become a popular inexpensive seafood item on many menus—Tilapia consumption is expected to grow from 1.5 million tons in 2003 to as much as 2.5 million tons in 2010 according to the Wake Forest scientists in research published in the July 2008 edition of the Journal of the American Dietetic Association.  For people  increasing quantities of fish in their diet such as farm grown tilapia they may do more harm than good due to  high levels of omega-6 fatty acids (these are bad or unhealthy fatty acids).

In the current study, the researchers looked at a variety of tilapia from different sources, including seafood distributors that supply restaurants and supermarkets,   South American fish companies, and fish farms in several countries. The samples were flash-frozen for later analysis, which was done using gas chromatography.

The scientists found that farm grown tilapia contained very small amounts of the healthy omega-3 fatty acids - less than half a gram per 100 grams of fish, similar to flounder and swordfish. Farmed salmon and trout, by contrast, had nearly 3 and 4 grams of healthy omega-3 fatty acids, respectively.

The worse news was that the tilapia had much higher amounts of omega-6 acids generally and Arachidonic Acid  than both salmon and trout. Ratios of long-chain omega-6 to long-chain omega-3, AA to EPA respectively, in tilapia averaged about 11:1, compared to much less than 1:1 (indicating more EPA than AA) in both salmon and trout.

Arachidonic acid is an omega 6 fatty acid  pro-inflammatory lipid compound–Animal studies say unequivocally that if you feed arachidonic acid to animals they will show signs of inflammation and become sick.  Aspirin is given to many patients as a daily medication in part because it blocks the unhealthy inflammation caused by Arachidonic acid.

Tilapia is usually raised using inexpensive corn-based fish feed, that contains short chain omega-6 fatty acidds that the fish quickly convert to omega-6 acids and Arachidonic acid (these are the unhealthy fats). The ability to grow tilapia cheaply, along with their capacity to grow quickly under almost any conditions, makes the tilapia a relatively inexpensive food source.

Literature about Omega 3 fatty acid health benefits

Here

and Here

Literature about Omega 6 fatty acid harmful effects

Here

and Here

The Netherlands, with its very permissive marijuana laws, is known as the cannabis capital of the planet. Surprisingly, a survey published this month in PLoS Medicine, a journal of the Public Library of Science, indicates that the Dutch don’t actually experiment with marijuana as much as most people would expect. Despite much tougher drug laws in the U.S., Americans were twice as likely to have tried marijuana than the Dutch, according to the new survey. Americans were more likely to have tried marijuana or cocaine than people in the 16 other countries, including France, Spain, South Africa, Mexico and Colombia, that the survey covered.

Researchers learned that 42% of people surveyed in the U.S. had tried marijuana at least once, and 16% had tried cocaine. Only 20% of people surveyed in the Netherlands, reported having tried marijuana; in Asian countries, such as Japan and China, marijuana use was almost “non-existent,”. New Zealand was the only other country to have the same percentage of pot smokers as the U.S., but no other nation came close to the proportion of Americans who reported trying cocaine.

Why the high percentage of drug takers? Dr. Jim Anthony, chairman of the department of epidemiology at Michigan State University states that U.S. drug consumption has to do with the country’s economic affluence — rich Americans can afford to use their money for recreational drugs. Another possible factor may be an increasing awareness that marijuana may be less toxic than many other drugs, such as tobacco or alcohol. The greater popularity of cocaine may simply be due to the proximity of South America cocaine supplies, the world’s only coca plant suppliers. It’s also a matter of culture: the U.S. is home to the large baby boomer population that grew up when experimenting with drugs was a common.

Experts say the findings of the new survey don’t fairly reflect the success or failure of any particular drug policy. The survey asked only whether people had ever tried drugs in their lifetime — it did not investigate habitual use. For drug policy assessment, you should look at regular use, states Tom Riley, a spokesman for the U.S. Office of National Drug Control Policy. “Somebody having tried pot in 1968 in college doesn’t really have much to do with what the current drug use picture in the United States is.”

Strict laws don’t appear to affect whether kids will experiment with drugs. One of the questions raised by research of this type is whether Americans will want to continue supporting the incarceration of young people who use small amounts of marijuana, Anthony says. A valid question if 42% of the population has used marijuana during their lives.

The ongoing study, surveyed more than 85,000 people in 17 countries. It is part of a larger project through the World Health Organization’s World Mental Health Survey Initiative. Anthony says further research about the frequency of worldwide drug use, and new data from additional countries will be released in the future.

In spite of any evidence of danger from drinking Red Bull Energy drink, it has been banned in France until this week. The fear is based on the ingredient taurine which appears to be innocuous and is present in the human body even in those who don’t drink energy drinks.

Energy drink Red Bull is back in its original recipe in France’s store shelves for the first time on Tuesday, implementing European union regulations that state that it should be put on sale given the absence of any proof that it is harmful.

The drink had been banned in France for twelve years due to French health authorities’ concerns about unknown consequences of the ingredient taurine, a chemical forbidden in several countries.

Until now a different version of the drink, containing caffeine but not taurine, was available in France.

The French government finally had to legalize the beverage because the European Union rules state that a product made or sold in other EU countries cannot be banned if it has no proven risks.

The French health authorities still remained worried about Red Bull’s safety because of the high levels of taurine and caffeine, suspected of causing  neurophysiological problems.

One prominent feature of the new cans that went on sale on Tuesday was a logo promoting the beverages unique selling point: “taurine formula.”

According to animal studies, taurine produces a mild anxiolytic effect and may act as an anti-anxiety agent in the central nervous system

In recent years, taurine has become a popular ingredient in energy drinks. Taurine is often used in combination with other performance enhancing substances, such as creatine and anabolic steroids.  Due to recent findings in mice that taurine can alleviate muscle fatigue in strenuous workouts and raises exercise capacity, it may have some mild benefits.

Taurine is present in some contact lens solutions.

Taurine has also been shown in diabetic animals to decrease weight and lower blood sugar.  According to research, it has no effect on insulin secretion or insulin sensitivity in humans.  There is evidence that taurine could exert a beneficial effect in preventing diabetes-associated vascular disease and kidney injury in diabetic nephropathy.

In humans suffering from essential hypertension, taurine supplements caused a measurable decrease in blood pressure.