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Thursday, 24 October 2013

First Windpipe Transplant Holding Up Over Time: Report

WEDNESDAY, Oct. 23 (HealthDay News) -- Five years ago, researchers performed the first successful transplant of a tissue-engineered airway on a 30-year-old Colombian woman. Today, she's still doing well, according to a new follow-up report on the surgery.

The woman who received the engineered section of windpipe has not experienced a rejection of the implanted airway, the researchers said.

The mother of two received the transplant after part of her own windpipe had collapsed due to complications from tuberculosis. An international team of researchers led by Dr. Paolo Macchiarini implanted a tissue-engineered trachea.

Along with his team, Macchiarini, who was at the Hospital Clinic of Barcelona, in Spain, at the time, created the airway using cells from a human donor trachea combined with the products of the patient's own stem cells, as well as epithelial cells taken from a healthy part of the woman's windpipe.

After receiving the transplant, the woman had no complications and was discharged from the hospital 10 days after surgery. Four months later, she still had no antidonor antibodies and did not need to take drugs to suppress her immune system to prevent her from rejecting the new airway. At that time, researchers cautioned that a longer follow-up would be needed to measure the success of the transplant.

Six months after surgery, the patient began to experience persistent coughing, according to the report. Scarring in the area of the transplant had caused a narrowing of her airway. A stent placed to hold her airway open was effective and she no longer experiences any symptoms, the researchers reported, although the stent requires regular monitoring.

Now, five years later, the woman who underwent the pioneering procedure is enjoying a normal social and working life. The follow-up findings, published Oct. 23 in the journal The Lancet, noted that regular tests of her lung function and other key indicators show that she has good lung function and has not had any complications involving her immune system.

"These results confirm what we and many patients hoped at the time of the original operation: that tissue-engineered transplants are safe and effective in the long term," Macchiarini said in a journal news release. "However, the scarring that occurred in this patient shows that long-term biomechanical stability can be improved -- something which is currently under active preclinical investigation."

"The results of a first-in-man active clinical trial will soon provide the definitive evidence that is needed before this stem-cell-based tissue-engineering technology can be translated into routine clinical practice," said Macchiarini, who currently is with the Karolinska Institute in Stockholm, Sweden.

Alan Russell, of the Disruptive Health Technology Institute at Carnegie Mellon University and the Allegheny Health Network, in Pittsburgh, wrote in an accompanying journal editorial that this is "the end of the beginning for tissue engineering; the groundwork has been laid for clinical implementation in other specialties."

-- Mary Elizabeth Dallas MedicalNews
Copyright © 2013 HealthDay. All rights reserved. SOURCE: The Lancet, news release, Oct. 22, 2013

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Flu Season Off to Slow Start...

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Oct. 23 (HealthDay News) -- The 16-day federal government shutdown earlier this month hindered the ability of U.S. health officials to monitor flu activity around the country.

Turns out, there wasn't much to monitor because there haven't been many outbreaks of the infectious disease so far this fall, officials said.

But that could change at a moment's notice, noted the health officials, who are fond of saying that the only thing predictable about the flu is its unpredictability.

So far, there have been isolated cases of flu in Alabama, South Carolina and Texas, according to the U.S. Centers for Disease Control and Prevention.

"The flu has been pretty quiet right now," said Dr. Joe Bresee, chief of the epidemiology and prevention branch in the CDC's Influenza Division. "But flu is coming, it's right around the corner and we expect an increase to come in the next few weeks."

And now's a perfect time to get vaccinated, he said, adding, "it's never too late to get vaccinated."

Getting vaccinated is the best way to prevent the flu, and there's plenty of vaccine to go around, Bresee pointed out.

"We expect to have 135 to 139 million doses available, so there should be plenty of vaccine to vaccinate anybody who wants to be vaccinated," he said.

The number of Americans getting vaccinated has risen since the H1N1 pandemic flu in 2009, according to Bresee.

"It's edging up in most groups, which is really gratifying, especially in some of the high-risk groups like pregnant women and kids. We are seeing good gains over the last four or five years," he noted.

"But we have a long way to go," he added. "Still only half of Americans get vaccinated. Vaccine is still the single best thing folks can do to prevent flu."

It's too early to tell, however, whether this year's vaccine will be a good match for the flu strains that are circulating.

"As with most things with flu, we always hedge a little bit. We do know the vaccine is a good match for the strains that have circulated around the world and the U.S. over the summertime and that's a good sign. But we won't know really until we get into the season, but we think it will be pretty good," Bresee said.

Flu season typically starts in the fall and peaks in January and February.

Even if this season's vaccine isn't a perfect match, it can still be beneficial. Antibodies triggered in response to a vaccination with one flu virus can sometimes protect against different but related viruses, according to the CDC.

There are three kinds of flu viruses that are most common today: influenza A (H1N1) viruses, influenza A (H3N2) viruses, and influenza B viruses. According to the CDC, the 2013-2014 vaccine consists of the following three viruses:

an A/California/7/2009 (H1N1) pdm09-like virus; an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011; a B/Massachusetts/2/2012-like virus.

Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, said that, in addition to getting vaccinated, hand-washing and staying away from people with the flu are other ways of avoiding the disease.

For Horovitz, however, the take-home message is: "vaccinate, vaccinate, vaccinate."

Bresee said getting a flu shot not only prevents flu, which is bad enough, it can also head off complications from underlying chronic diseases.

For example, a study published Oct. 22 in the Journal of the American Medical Association found that people with heart disease who get a flu shot significantly reduce their risk of heart attack or stroke.

"In flu season a lot of the deaths or hospitalizations attributable to flu were probably triggered by a worsening of an underlying disease like a chronic lung disease or heart disease or diabetes," Bresee explained. "The idea is that if you prevent the flu, you also prevent the complications of those underlying diseases."

Horovitz said the flu vaccine doesn't prevent heart attacks or strokes. "But influenza is a severe viral illness that strains the body, so it wouldn't be surprising that preventing the flu can help ward off a further strain on the body," he said.

For the CDC, the recent government shutdown was a mixed bag, Bresee said. It didn't affect the flu vaccine program because the machinery to get the vaccine out and into clinics and pharmacies was already under way, he stated.

"Where the shutdown did affect us a bit was in our ability to do surveillance early in the season, which is a critical time to know what's happening with flu," Bresee said. "We kept up with surveillance to some extent, but we weren't able to look at all the data. We're catching up now and we're about up to date."

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Joe Bresee, M.D., chief, Epidemiology and Prevention Branch, Influenza Division, U.S. Centers for Disease Control and Prevention; Len Horovitz, M.D., pulmonary specialist, Lenox Hill Hospital, New York City

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Being Web-Savvy Tied to Better Health in Seniors: Study

TUESDAY, Oct. 22 (HealthDay News) -- Older men and women who use the Internet frequently are more likely to have a lifestyle that includes many cancer-preventive behaviors, according to a new study.

Compared to their peers who don't use the Internet, online aficionados were screened for colorectal cancer more often and were more likely to be physically active, eat a healthy diet and smoke less. Researchers also found that the more time older adults spent on the Internet, the more likely they were to engage in these healthy behaviors.

The study appeared Oct. 22 in the journal Cancer Epidemiology, Biomarkers & Prevention.

The findings held even after researchers accounted for people's socioeconomic status, physical abilities and mental function, study author Christian von Wagner, a senior lecturer in behavioral research in early diagnosis of cancer at the University College London, said in a journal news release.

"The interesting aspect here is a dose-response relationship between Internet use and cancer-preventive behaviors," von Wagner said. "Intermittent users were more likely to have cancer-preventive behaviors than [nonusers], and consistent users were more likely to have cancer-preventive behaviors than intermittent users."

The study involved nearly 6,000 men and women aged 50 and older who completed surveys every two years between 2002 and 2011, on their demographics, mental abilities, physical activity and diet. They also were asked about their Internet and email usage and colorectal and breast cancer screenings.

The researchers found that 41 percent of those surveyed said they did not use the Internet, 38 percent reported using the Internet sporadically and 20 percent were online regularly.

Although Internet use didn't affect women's decisions to be screened for breast cancer, those who regularly used the Internet were twice as likely to be screened for colorectal cancer, the study revealed.

Both male and female regular Internet users were 50 percent more likely to exercise and 24 percent more likely to eat five servings of fruits and vegetables each day, according to the study. People who used the Internet consistently also were 44 percent less likely to smoke.

The study also revealed that demographics play a role in how much people use the Internet. Use was more prevalent among those who were younger, white and had more money and education. Men also were online more than women. Meanwhile, Internet use was much less prevalent among the disabled and those who were older, less wealthy and nonwhite.

"It is important that policymakers recognize the role Internet use plays in influencing inequalities in cancer outcomes, and help increase access to the Internet among this demographic," von Wagner said.

Although the study showed an association between Internet usage and cancer-preventive behaviors, it did not prove a cause-and-effect relationship.

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Health Tip: Avoid Weight Gain at College

(HealthDay News) -- It's common for college students to pack on a few pounds while they're away at school.

The Academy of Nutrition and Dietetics offers these suggestions to help prevent weight gain while you're at college:

Never skip meals. Be especially sure to start the day with a healthy breakfast to kick start your metabolism.Make healthy food choices, and pay attention to portion sizes.Choose high-fiber foods (such as fruits and veggies, beans and whole grains) to help you feel more full for longer periods.Include a lean protein in each meal. Good choices include lean turkey, chicken, pork, fish or beef; beans, nut butters and reduced-fat cheese.Eat healthier fats from nuts, seeds, avocados and canola or olive oils. Avoid desserts and fried foods.Drink water, fat-free or low-fat milk, unsweetened coffee or tea. Avoid sugary drinks, and limit alcohol to one drink per day.

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Learning Challenging Skills Tied to Better Memory in Seniors

TUESDAY, Oct. 22 (HealthDay News) -- Learning mentally challenging new skills such as digital photography may help keep older adults' minds sharp, a new study suggests.

But less-challenging activities -- such as doing word puzzles or listening to classical music -- aren't likely to provide any mental benefits, according to the report scheduled for publication in an upcoming issue of the journal Psychological Science.

"It seems it is not enough just to get out and do something -- it is important to get out and do something that is unfamiliar and mentally challenging, and that provides broad stimulation mentally and socially," lead researcher Denise Park, a psychological scientist at the University of Texas at Dallas, said in a news release from the Association for Psychological Science.

"When you are inside your comfort zone you may be outside of the enhancement zone," Park explained.

The study included 221 adults, aged 60 to 90, who were randomly assigned to take part in a particular type of activity for 15 hours a week for three months. Some of the participants were assigned to learn a new skill -- digital photography, quilting, or both -- that required a high degree of mental effort.

Other participants did more familiar activities at home, such as listening to classical music and completing word puzzles, or took part in a group that did social activities such as field trips and entertainment.

After three months, only the participants who learned a new skill showed improvements in memory.

"The findings suggest that engagement alone is not enough," Park said. "The three learning groups were pushed very hard to keep learning more and mastering more tasks and skills. Only the groups that were confronted with continuous and prolonged mental challenge improved."

The results provide new insights into how everyday activities can help keep people's minds sharp as they age, according to Park.

"We need, as a society, to learn how to maintain a healthy mind, just like we know how to maintain vascular health with diet and exercise. We know so little right now," she said.

The researchers plan to assess the participants at one year and five years down the road to see if the beneficial effects of learning a new skill continue over the long term.

"This is speculation, but what if challenging mental activity slows the rate at which the brain ages? Every year that you save could be an added year of high-quality life and independence," Park said.

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