Gastric bypass surgery just as effective in teenagers as in adults, study suggests

ScienceDaily (Oct. 22, 2012) — Teenagers with severe obesity can benefit from gastric bypass surgery just as much as adults. A study by Sahlgrenska Academy, University of Gothenburg, Sweden and Karolinska Institutet, Sweden found that 81 teenagers lost an average of 96.8 pounds following surgery, significantly improving their health and quality of life.

The study, published by the International Journal of Obesity, involved eighty-one 13-18 year-olds who had gastric bypass surgery, which had previously been performed on people younger than 18 in exceptional cases only.

The new study found that gastric bypass surgery is just as effective in teenagers as in adults. At two-year follow-up, the teenagers had averaged weight loss from 292.6 to 195.8 pounds, their self-rated quality of life had increased and a number of risk factors for cardiovascular disease -- primarily insulin levels -- had greatly improved.

"The teenagers who participated in the study represent a highly vulnerable group, with a history of psychosocial problems related to obesity, including bullying and underlying mental disease," says Torsten Olbers, a researcher at Sahlgrenska Academy, Senior Surgeon at Sahlgrenska University Hospital and the leader of the study.

"With that in mind, the results are surprisingly good. We will certainly want to carefully examine potential adverse effects of gastric bypass surgery in teenagers. But no other treatment is currently available for this group. Moreover, we know from earlier studies that teenagers with severe obesity are at risk of developing other diseases and poorer quality of life as adults. For that reason, we hope that the method can eventually be offered to more teenagers" Torsten Olbers concludes.

"Given that these teenagers have tried all other weight control options and are extremely difficult to treat, pediatricians are very receptive to a new treatment method," says Professor Claude Marcus at Karolinska Institutet, who was the pediatrician in charge.

The researchers stress that gastric bypass surgery does not automatically have an effect on psychological problems: some of the teenagers continued to experience them despite having lost weight. Furthermore, surgical complications such as volvulus and gallstones required follow-up surgery in some cases.

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The above story is reprinted from materials provided by University of Gothenburg, via AlphaGalileo.

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Journal Reference:

T Olbers, E Gronowitz, M Werling, S Mårlid, C-E Flodmark, M Peltonen, G Göthberg, J Karlsson, K Ekbom, L V Sjöström, J Dahlgren, H Lönroth, P Friberg, C Marcus. Two-year outcome of laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity: results from a Swedish Nationwide Study (AMOS). International Journal of Obesity, 2012; DOI: 10.1038/ijo.2012.160

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Ultraviolet light effective in hospital infection control, study suggests

ScienceDaily (Oct. 18, 2012) — Research being presented at IDWeek 2012™ shows that a specific spectrum of ultraviolet light killed certain drug-resistant bacteria on the door handles, bedside tables and other surfaces of hospital rooms, suggesting a possible future weapon in the battle to reduce hospital-associated infections.

Researchers at Duke University Medical Center and the University of North Carolina Hospital System used short-wave ultraviolet radiation (UV-C) to nearly eliminate Acinetobacter, Clostridium difficile or vancomycin-resistant enterococci (VRE) in more than 50 patient rooms at the two medical facilities.

"We're learning more and more about how much the hospital environment contributes to the spread of these organisms," said lead researcher Deverick J. Anderson, MD, an assistant professor of medicine at Duke and co-director of the Duke Infection Control Outreach Network. Given previous findings by the University of North Carolina team that UV-C is effective at decreasing methicillin-resistant Staphylococcus aureus (MRSA) in hospital rooms, he believes that the new study lays critical groundwork.

"We have a solid foundation to show that this approach succeeds in both experimental and real-world conditions," Anderson said. "Now it's time to see if we can demonstrate that it indeed decreases the rate of infections among patients."

His group's work is among the significant research being discussed at the inaugural IDWeek meeting, taking place through October 21 in San Diego. With the theme Advancing Science, Improving Care, IDWeek features the latest science and bench-to-bedside approaches in prevention, diagnosis, treatment, and epidemiology of infectious diseases, including HIV, across the lifespan. More than 1,500 abstracts from scientists in this country and internationally will be highlighted over the conference's five days.

"Healthcare-associated infections are linked with significant morbidity and mortality," said Liise-anne Pirofski, MD, an IDWeek chair for the Infectious Diseases Society of America. "Although there are multiple sources for these infections, the hospital environment itself can play an important role. The findings of this study suggest that UV light could hold promise for eliminating bacteria from hospital rooms and reducing the risk of infection with these difficult bacterial pathogens in the healthcare environment. That would be a result to benefit us all."

UV-C, which is harmful to microorganisms, has been used for decades in food, air and water purification and to sterilize equipment in laboratory settings. This study demonstrates that its medical application may offer new strategies for reducing the estimated 1.7 million hospital-associated infections that occur annually in the United States. The cost of treating these infections, often involving increasingly antibiotic-resistant bacteria, ranges from an estimated $4.5 billion to as much as $11 billion.

In their study, the Duke and University of North Carolina researchers questioned whether UV-C could be utilized to eliminate three of the most problematic germs and improve the cleanliness of patient rooms. Given the tough economics of healthcare today, hospitals' environmental services are under pressure to turn rooms over quickly, and many surfaces can get missed by even the most diligent crews.

The study focused on general-medical and intensive-care units of the two medical centers and identified patients with infections from the targeted bacteria. Clostridium difficile, or C. diff as it is commonly known, can trigger serious intestinal conditions. Acinetobacter can cause pneumonia and serious blood, wound and urinary tract infections. VRE most frequently infects the urinary tract, bloodstream, wounds or catheter sites. Each bacterium can survive for prolonged periods on surfaces.

After the patients were discharged, the researchers obtained multiple cultures from each of five specific locations in the hospital rooms and bathrooms -- "high-touch" areas that included bed rails, remote controls and toilets. A special machine with eight UV bulbs mounted on a central column was then positioned strategically in each room and turned on for as long as 45 minutes to eradicate both vegetative bacteria and bacterial spores. Fifteen more cultures were taken from the same locations in every room, and the pre- and post-treatment bacteria counts were compared.

The numbers of bacterial CFUs, or colony-forming units, fell precipitously. Fifty-two CFUs of Acinetobacter were seen before irradiation, but only 1 CFU afterward -- down 98.1 percent. As for VRE, the proportion decrease was nearly the same -- 719 CFUs before and 15 after, a 97.9 percent drop.

The culturing initially was not sensitive enough to isolate C. diff, but improved techniques allowed the researchers to do further testing and the results in the UV-C treated rooms were just as dramatic.

"We would never propose that UV light be the only form of room cleaning, but in an era of increasing antibiotic resistance, it could become an important addition to hospitals' arsenal," Anderson said.

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The above story is reprinted from materials provided by Society for Healthcare Epidemiology of America, via EurekAlert!, a service of AAAS.

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Biomarker Discovery May Lead to Effective Blood Test for Ectopic Pregnancy

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Vegetable-derived compound effective in treating triple-negative breast cancer, research suggests

ScienceDaily (Oct. 17, 2012) — A new compound created from a rich source in vegetables including broccoli and brussel sprouts has been developed to combat triple-negative breast cancer (TNBC). This research is being presented at the 2012 American Association of Pharmaceutical Scientists (AAPS) Annual Meeting and Exposition, the world's largest pharmaceutical sciences meeting, in Chicago, Ill., on Oct. 14 -- 18, during Breast Cancer Awareness Month.

TNBC accounts for approximately 15-20 percent of all breast cancer cases in the U.S. It is one of the most aggressive forms of breast cancer; it grows faster, spreads to other parts of the body earlier, is harder to detect on a mammogram and recurs more often.

Mandip Sachdeva, Ph.D. and Chandraiah Godugu, P.h.D. from Florida A&M University, in collaboration with Stephen Safe, Ph.D., from Texas A&M University, have evaluated the activity of novel C-substituted diindolylmethane (C-DIM) derivatives and demonstrated that they have superior anticancer activities. Sachdeva's study reveals that these synthetic compounds derived from diindolylmethane (DIM), commonly found in various types of cruciferous vegetables, can be used to treat several types of cancer, including triple-negative breast cancer. C-DIMs are also being investigated for their cancer prevention activity.

"Targeted treatment options for TNBC are limited; current treatments, such as infusions, result in poor patient compliance and increased toxicity," said Sachdeva. "We are confident that the compounds we are currently working with are an effective treatment for triple-negative breast cancer. These compounds are safer for the patient than current treatments available."

In contrast to existing anticancer drugs, the diindolylmethane compounds are orally active, so they could be available to patients in pill form and safe to take daily. When taken in combination with existing anticancer drugs, the diindolylmethane compounds can effectively decrease the number of treatments a patient receives.

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New malaria drug requires just one dose and appears twice as effective as existing regimen

ScienceDaily (Oct. 17, 2012) — Scientists are reporting development of a new malaria drug that, in laboratory tests, has been twice as effective as the best current medicine against this global scourge and may fight off the disease with one dose, instead of the multiple doses that people often fail to take.

A report on the drug appears in ACS' Journal of Medicinal Chemistry.

Gary Posner and colleagues explain that malaria continues to kill almost 1 million people annually. The best existing treatment is so-called artemisinin combination therapy (ACT). It requires patients to take pills every day for several days, and many patients fail to complete the regimen. As a result, these patients don't get better, and it opens the door for malaria parasites to develop resistance to ACT. To stop that from happening, the researchers developed a new type of ACT that could stop malaria in a single dose.

They describe a series of new compounds they developed that, given once, are more effective than traditional artemisinin-derived substances. One of the new compounds, when combined with mefloquine, killed off all of the parasites in some mice with just a single oral dose and allowed those mice to live almost twice as long as those treated with conventional ACT.

The authors acknowledge funding from the National Institutes of Health, the Johns Hopkins Malaria Research Institute and the Bloomberg Family Foundation.

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The above story is reprinted from materials provided by American Chemical Society.

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Journal Reference:

Alexander M. Jacobine, Jennifer R. Mazzone, Rachel D. Slack, Abhai K. Tripathi, David J. Sullivan, Gary H. Posner. Malaria-Infected Mice Live Until at Least Day 30 after a New Artemisinin-Derived Thioacetal Thiocarbonate Combined with Mefloquine Are Administered Together in a Single, Low, Oral Dose. Journal of Medicinal Chemistry, 2012; 55 (17): 7892 DOI: 10.1021/jm3009986

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