Testing For Urinary Proteins Might Help Diagnose Kidney Damage From Lupus

Simple urine tests for four proteins might be able to detect early kidney disease in people with lupus, researchers at UT Southwestern Medical Center have found in an animal study.

Although it might take years before such tests could be used clinically, the findings suggest they could pinpoint kidney disease better than tests currently in use, the researchers said.

“Our goal was to accurately detect something in the urine that appears only in disease,” said Dr. Chandra Mohan, professor of internal medicine and immunology at UT Southwestern and senior author of the study, available online and in today’s issue of The Journal of Immunology.

“If this testing regimen proves effective in humans, physicians might be able to predict and diagnose kidney damage noninvasively, as well as monitor whether treatments are working.”

Kidney disease is the major cause of death and disability in lupus patients, Dr. Mohan said. Early detection and treatment lead to a longer and better-quality life.

The researchers found that in mice, four proteins protease, PGDS, SAP and SOD show up in larger quantities in urine as kidney damage progresses. Each of these proteins is either present in humans or has a human equivalent. The researchers currently are studying whether the same correlation between urinary protein levels and disease occurs in humans.

Lupus is one of many autoimmune diseases that attack internal organs, tissues, joints and other parts of the body. The researchers focused on systemic lupus erythematosus affecting the kidneys, the most common and serious form of lupus.

Currently, kidney damage in humans is detected by performing a kidney biopsy, Dr. Mohan said. A kidney biopsy involves taking a tissue sample with a needle, a process that is invasive and can be stressful to patients.

In the current study, the researchers used mice that have a condition similar to human lupus. They screened urine for proteins both before and after the mice showed symptoms of kidney disease and found that 71 proteins appeared in urine after the illness became physically evident.

The researchers then focused on four proteins that were present in high levels after symptoms appeared. These proteins or their analogs had not previously been known to be present in the urine of patients or mice with lupus kidney disease.

Dr. Mohan said monitoring urinary levels of these four proteins might also reveal more about the mechanisms of lupus. Each protein is involved in a different biochemical process, so the stage of the disease at which each appears in urine might prove informative, he said.

Testing for these proteins might also have the potential to monitor kidney damage that results from diabetes, hypertension and other conditions, said Dr. Mohan.

Other UT Southwestern researchers participating in the study were Dr. Tianfu Wu, assistant professor of internal medicine; Dr. Yuyang Fu, former postdoctoral fellow in internal medicine; Dr. Deirdre Brekken, adjunct assistant professor of pharmacology; research associate Mei Yan; Dr. Xin Jin Zhou, professor of pathology and internal medicine; research associate Kamala Vanarsa; research intern Nima Deljavan; and Dr. Chul Ahn, professor of clinical sciences.

Dr. Chaim Putterman of the Albert Einstein College of Medicine also participated in this study.

The research was supported by the Lupus Research Institute and the National Institutes of Health.

Source: UT Southwestern Medical Center

Statins Reduce Risk Of Heart Attack And Stroke In Those Without Heart Disease

Among individuals without cardiovascular disease, taking statins regularly may reduce the risk of major heart and cerebrovascular events such as heart attack and stroke but not coronary heart disease or overall death, according to a meta-analysis of previously published studies, reported in the November 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Statins have been shown to reduce death and other negative outcomes associated with heart and cerebrovascular disease among those who already have these conditions, according to background information in the article. It is less clear whether these medications benefit those without cardiovascular disease. Current national treatment guidelines recommend the use of statins in these patients based on their cardiovascular risk profile and LDL-C or “bad cholesterol” level. For patients without cardiovascular disease and with normal LDL-C levels, statins are recommended only for individuals with diabetes or with two or more other cardiac risk factors that raise their 10-year risk of a heart attack or other heart event to at least 10 percent.

Paaladinesh Thavendiranathan, M.D., M.Sc., University of Toronto, Ontario, and colleagues analyzed the results of seven previously published clinical trials that assessed the benefits of statins in a total of 42,848 patients, 90 percent of whom had no history of cardiovascular disease. In each study, patients were randomly assigned to receive either statins or another form of care and were followed for at least one year, at least 100 major cardiovascular events occurred and 80 percent or more of the participants did not have cardiovascular disease.

In total, 21,409 patients in the trials took statins and 21,439 were assigned to placebo. The average follow-up period for the studies ranged from 3.2 to 5.2 years; average age of the participants ranged from 55.1 to 75.4 years; and the proportion of men included ranged from 42 percent to 100 percent. In patients on statin therapy, there were 924 major coronary events such as heart attack compared with 1,219 among those in control groups-a 29.2 percent reduction in risk. Major cerebrovascular events, including stroke, occurred in 440 patients taking statins and 517 controls, a 14.4 percent lower risk. Statin treatment was also associated with a 31.7 percent reduction in risk for non-fatal heart attacks and a 33.8 percent reduction in the number of revascularization procedures, which restore blood flow and include angioplasty and bypass surgery. There were no statistically significant differences between the statin and control groups in the rates of patients who died from cardiovascular disease or from all causes.

Assuming that individuals not taking statins have a 5.7 percent chance of having a major heart event over a 4.3-year period, statins can reduce that risk to 4 percent, the authors write. “Therefore, 60 patients would need to be treated for an average of 4.3 years to prevent one major coronary event.” Similarly, 268 patients would need to be treated to prevent one stroke or other major cerebrovascular event; 61 to prevent one non-fatal heart attack; and 93 to prevent one revascularization procedure.

Statins are expensive and other therapies also may work to reduce risk, the authors conclude. “Therefore, even though universal lipid-lowering therapy appears attractive, especially in an intermediate-risk primary prevention population, further studies are needed to clarify the cost-effectiveness of therapy in this group.”

American Medical Association (AMA)
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Internet-based stroke examination speeds treatment in rural areas

An Internet-based examination system enables stroke patients to be treated as rapidly in rural communities as they are in bigger hospitals with stroke teams, researchers have found.

A study of 194 stroke patients in eight rural Georgia hospitals seen via the REACH system by stroke team members at an academic medical center showed most patients got clot-dissolving tPA in less than two hours, says Dr. David Hess, chair of the Medical College of Georgia Department of Neurology and lead author on the study published in the September issue of Stroke.

The clot buster, tissue plasminogen activator, which received Food and Drug Administration approval in 1996 as the first and still the only approved stroke treatment, must be given within three hours of symptoms.

“While we have a three-hour window, the evidence suggests that if you treat patients with tPA in under two hours or, even better, under 90 minutes, you improve your outcome,” says Dr. Hess. “We actually look upon it as though we have a two-hour stroke window now.”

Sixty percent of the 30 patients treated with tPA between March 2003-February 2004 got the drug in under two hours; 23 percent were treated in 90 minutes or less. “I think it argues that the REACH system doesn’t just treat patients who never got treated before, but it treats them fast,” says Dr. Hess.

Eighty percent of the 700,000 strokes that occur annually in the United States are clot-based but only a small percentage of patients get tPA because of delays in patients seeking treatment and limited availability of stroke teams to assess and treat them when they do, Dr. Hess says.

Sam Wang, a research scientist who is now a second-year medical student at MCG, developed the REACH – Remote Evalution for Acute Ischemic Stroke – system that has a portable station at the remote site and can be accessed by a stroke specialist from any computer with Internet access. Staff at the remote hospital reach the on-call member of MCG’s stroke team by calling a 24-hour Emergency Communications Center.

A study published in the October 2003 rapid-access issue of Stroke showed essentially no difference in the results of patients seen via REACH and in person.

The newer study showed none of the treated patients had symptomatic brain hemorrhages, a potential side effect of tPA. It also indicates use of the system became more efficient over time, dropping onset to treatment time from 143 minutes in the first 10 patients to 111 minutes in the last 20.

Rural hospitals tend to have quieter emergency rooms than their big-city counterparts so patients typically are seen rapidly and have little or no wait for a confirmatory computerized tomography scan, Dr. Hess says. “There are some concerns that telemedicine would be too slow, there would be too many delays. This shows you can treat quickly. If this works in a very difficult environment with small hospitals, it’s a model of what can be done in the state of Georgia or any state,” says Dr. Hess.

In fact, state lines are the primary boundary for REACH because physicians have to be licensed to practice in the state where the patient is being seen, he says. National stroke care criteria could eliminate that problem, he adds.

MCG is working with the Southeast Affiliate of the American Heart Association to help develop a statewide stroke plan for Georgia. The national association wants every state to have such a plan, Dr. Hess says.

The Georgia Research Alliance helped MCG develop a business plan that could make REACH available to other states by detailing the installation, training and relationship building required for a successful program, he says.

Stroke care became more lucrative for hospitals recently when Medicare tripled their reimbursement for stroke care, but physicians are not paid to take call for such after-hour services, so staffing can be a problem, Dr. Hess says.

Georgia hospitals participating in the existing network include McDuffie Regional Medical Center, Thomson; Emanuel County Medical Center, Swainsboro; Washington County Regional Medical Center, Sandersville; Wills Memorial Hospital, Washington; Jenkins County Hospital, Millen; Jefferson Hospital, Louisville; Elbert County Hospital, Elberton; and Morgan County Hospital, Madison.

Toni Baker
Medical College of Georgia

FDA Health Alert For Merrick Beef Filet Squares Dog Treats Packaged And Distributed By Merrick Pet Care

The U. S. Food and Drug Administration is warning consumers not to use Merrick Beef Filet Squares for dogs distributed by Merrick Pet Care with a package date of “Best By 111911″ because the product may be contaminated with Salmonella.

The product was distributed nationwide through retail stores and Internet sales.

Although no illnesses associated with these products have been reported, the FDA is advising consumers in possession of these products not to handle or feed them to their pets.

In December 2009, the FDA conducted routine testing of Merrick Beef Filet Squares and detected a positive finding for Salmonella. A follow-up inspection found deficiencies in the packaging and manufacturing processes.

Salmonella can affect both humans and animals. People handling dry pet treats can become infected with Salmonella, especially if they have not thoroughly washed their hands after having contact with the treats or any surfaces exposed to these products. Consumers should dispose of these products in a safe manner by securing them in a covered trash receptacle.

Healthy people infected with Salmonella may experience some or all of the following symptoms: nausea, vomiting, diarrhea or bloody diarrhea, abdominal cramping and fever. Although rare, Salmonella can result in more serious ailments including arterial infections, endocarditis (inflammation of the lining of the heart), arthritis, muscle pain, eye irritation, and urinary tract symptoms. Consumers exhibiting these signs after having contact with this product should contact their health care provider immediately.

Pets with Salmonella infections may become lethargic and have diarrhea or bloody diarrhea, fever and vomiting. Some pets may experience only a decreased appetite, fever and abdominal pain. Infected, but otherwise healthy pets can be carriers and infect other animals or humans. If your pet has consumed any of the affected product or is experiencing any of these symptoms, contact your veterinarian immediately.

The affected Merrick Beef Filet Squares were packaged in a 10-ounce green, red and tan re-sealable plastic bag. The “best by” date is imprinted on the top portion of the bag, which is torn off when the bag is opened. The FDA recommends that consumers who are unable to determine the “best by” date discontinue use of the product.

Consumers can report complaints about FDA-regulated pet food and pet treat products by calling the consumer complaint coordinator in their area. Please see here for additional information.

U. S. Food and Drug Administration

Eye On The Environment, Climate Change Can Harm Indigenous People. Researchers Are Helping Them Adapt

The Canadian Arctic. The Amazonian jungle. The fringes of an African rainforest.

These lands are home to some of the most isolated and vulnerable people in the world – the indigenous populations of Canada, Peru and Uganda. Because of their dependence on the land for food and water, indigenous peoples’ health is particularly affected by climatic changes. Indeed, they are already seeing dramatic effects due to changing temperatures.

Inuit hunters in the Arctic have fallen through early melting sea ice as they search for seals. For the first time, there have been epidemics of malaria, a mosquito-borne disease, among the Batwa Pygmies of Uganda. In Peru, unprecedented cold conditions last year – below 10 degrees Celsius – led to an outbreak of pneumonia among the Shipibo and Shawi people, who have neither the clothing nor the housing to protect them from the cold.

Moreover, in addition to larger climate changes occurring in these areas, in each case, rapid economic and social change because of the extraction of mineral, forest and oil resources (depending on the country), is having a significant effect on both the climate and the health of the indigenous groups.

But it’s not just a story full of doom and gloom. Now, a multi-disciplinary team of scholars from Uganda, Peru and Canada is setting out to study both some of the health effects of climate change on indigenous groups, along with some of the factors that may help them adapt to some of these changes. Leading the project are Drs. James Ford and Lea Berrang-Ford of McGill’s Dept. of Geography.

The research project has some very concrete goals. One of the objectives is to pilot one intervention per community. Suggestions range from planting medicinal herb gardens in Uganda, to creating on-line web-based traditional health knowledge banks in the Arctic, and developing agricultural technical training programs in Peru. The aim of the pilot interventions is to find solutions which can help communities adapt and which can be scaled up in future.

More information about the research:
It’s based on a “bottom-up” approach of working closely with indigenous people and their organizations, rather than a “top-down” approach driven by climate and epidemiological modeling.
In all three countries, indigenous groups identified two main areas of concern during preliminary meetings: water-security, and food-security. For indigenous groups in Uganda and Peru, people were also worried about an increase in vector-borne diseases. In each of the communities people said that they were particularly concerned about the health effects of climate change on children and the elderly, groups that are especially vulnerable to disease.
In all three countries, current health systems combine traditional healing techniques with “western” allopathic medicine. Indeed, in both Peru and Uganda pilot research revealed that traditional medicine is the first response when group members encounter health problems.
A further goal is to train community-based adaptation leaders in each Indigenous community who may be able to help alleviate health problems among Indigenous people in the future.
The Indigenous Health Adaptation to Climate Change (IHACC) research project exists thanks to a $2.5-million grant, spread over five years, and funded jointly by the International Development Research Council (IDRC) and the Tri-Councils – the Canadian Institutes of Health Research (CIHR), the Natural Sciences and Engineering Research Council (NSERC), and the Social Sciences and Humanities Research Council (SSHRC).

McGill University

Strategic Research Program Needed To Determine Whether, HowPast Climate Influenced Human Evolution

Understanding how past climate may have influenced human evolution could be dramatically enhanced by an international cross-disciplinary research program to improve the sparse human fossil and incomplete climate records and examine the link between the two, says a new report from the National Research Council.

Climate and fossil records suggest that some events in human evolution — such as the evolution of new species or movements out of Africa — coincided with substantial changes in African and Eurasian climate. This raises the intriguing possibility that environmental factors affected or controlled our species’ evolution. By altering the landscape, past changes in climate may have exerted pressures that led to genetic selection and innovation in humans. But because the human fossil record and our understanding of past climate conditions are incomplete, the details of how climates influenced human evolution remain unclear.

The report recommends several research initiatives over the next 10 to 20 years:

- a major effort to locate new fossil sites using modern remote-sensing tools and traditional ground examination. In addition, many existing sites should be further analyzed to better determine when species first appeared and then disappeared, along with noting specific adaptations and behaviors. Currently, efforts to understand links between climate and evolution are limited by gaps in the human fossil record.

- a comprehensive program to drill on land and in lakes and ocean basins in the regions where humans evolved. An integrated drilling program should be part of a larger effort to collect more data to reconstruct past environments — including temperatures, precipitation, and vegetation — near human fossil sites. Describing the plants and animals that lived with our human ancestors is a key component for understanding past environments.

- a major investment in climate modeling experiments for the key time intervals and regions that are critical for understanding human evolution. The objective would be to characterize regional and local climates in the areas where humans evolved and to integrate these modeling experiments with records of the past ecology and environment.

- an enhanced public outreach effort, including teaching curricula and traveling exhibitions, that takes advantage of broad public interest in human evolution and climate change.

A public briefing to discuss the report’s findings and recommendations will be held on March 31 at the Smithsonian Institution’s National Museum of Natural History in Washington, D.C. Several members of the committee that wrote the report will present and answer audience questions. For more information, please call or e-mail the Office of News and Public Information (contacts listed above).

The report was sponsored by the National Science Foundation. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies. They are independent, nonprofit institutions that provide science, technology, and health policy advice under an 1863 congressional charter. Committee members, who serve pro bono as volunteers, are chosen by the Academies for each study based on their expertise and experience and must satisfy the Academies’ conflict-of-interest standards. The resulting consensus reports undergo external peer review before completion. For more information, visit here.

National Research Council

Combining Stem-Cell And Gene-Therapy Techniques To Tackle A Deadly Blood Disease

The National Institutes of Health has awarded a three-year, $3.9 million grant to Children’s Hospital Boston researchers and their colleagues to develop a therapy to treat Fanconi anemia, a fatal genetic blood disease.

The researchers will investigate new ways to create induced pluripotent stem (iPS) cells from a patient’s skin or other tissue and transform them into genetically repaired hematopoietic stem cells that can make normal blood cells.

Fanconi anemia is characterized by progressive bone marrow failure, multiple congenital anomalies and a predisposition to cancer. Somehow, a defect in DNA repair causes progressive blood stem cell loss, usually resulting in death by age 20. Although the rare syndrome could potentially be treated with gene therapy, since it usually results from a single genetic mutation, the same DNA repair defect has thwarted gene therapy efforts to date. The team will push to understand the barriers to genetic correction of Fanconi anemia in mice, hoping their findings will translate to patients.

The research project is a collaboration among three members of Dana-Farber/Children’s Hospital Cancer Center: David Williams, MD, chief of Hematology/Oncology and director of Translational Research, George Daley, MD, Ph.D., director of Stem Cell Transplantation, and Alan D’Andrea, MD, chief of research in Radiation Oncology.

Two of the co-principal investigators will be discussing their efforts in Boston this weekend at the Congress of the International Society of Paediatric Oncology, the world’s largest pediatric oncology meeting.

– On Friday, Oct. 22, 10:30-noon (Ballroom A), Williams will give a talk titled “Somatic Cell Reprogramming to Facilitate Genetic Correction in Fanconi Anemia” in a session on gene therapy and pediatric oncology. Williams, who completed an early study in children with Fanconi anemia to try to genetically correct endogenous blood stem cells, will discuss how clinical trials have defined a new research focus. “At the end of three years, one hope would be, in the mouse system, to generate corrected iPS cells and be able to differentiate them into corrected blood stem cells,” Williams says.

– On Sunday, Oct. 24, 3-3:30 p.m. (Auditorium), Daley will give a keynote talk titled “Modeling Bone Marrow Failure Syndromes with Induced Pluripotent Stem Cells.” Daley plans to address some of the limitations of reprogramming Fanconi anemia cells. “The grant is aimed at defining precisely what mechanism is lacking in Fanconi cells that is required for efficient reprogramming,” Daley says. “We believe the DNA repair defects of Fanconi cells are a problem because the reprogramming technique may stress the DNA repair response and make them relatively resistant to reprogramming. With improved methods, we should achieve reprogramming of Fanconi cells too.”

The grant combines the efforts of three leading experts in the field. Their three projects are connected by common goals: To better understand the reprogramming technology and DNA repair pathways involved in Fanconi anemia cells first in mice, and then to leverage those insights for rapid development of new therapeutic approaches for translation to patients.

Williams’ group will concentrate on reprogramming patient-specific cells, using state-of-the-art methods to genetically correct these cells, and transforming them into functional hematopoietic stem cells for transplant. Daley’s lab will probe how defects in DNA double-strand break repair affects reprogramming of iPS cells. D’Andrea’s team will concentrate on the details of how the hematopoietic stem cell defect generates bone marrow failure and test new potentially therapeutic small molecules.

The Fanconi anemia grant marked Children’s Hospital final research award from the 2009 American Recovery and Reinvestment Act, the biggest boost in federal research funding in U.S. history. The stimulus funding infused hospital labs and clinics with about $55 million in direct support of more than 100 projects.

Dana-Farber/Children’s Hospital Cancer Center is a top referral center for children with Fanconi anemia and is hosting the international oncology meeting at the John B. Hynes Veterans Memorial Convention Center.

Children’s Hospital Boston is home to the world’s largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults since 1869. More than 1,100 scientists, including nine members of the National Academy of Sciences, 12 members of the Institute of Medicine and 13 members of the Howard Hughes Medical Institute comprise Children’s research community. Founded as a 20-bed hospital for children, Children’s Hospital Boston today is a 392-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. Children’s also is the primary pediatric teaching affiliate of Harvard Medical School.

Dana-Farber Cancer Institute is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute. It provides adult cancer care with Brigham and Women’s Hospital as Dana-Farber/Brigham and Women’s Cancer Center and it provides pediatric care with Children’s Hospital Boston as Dana-Farber/Children’s Hospital Cancer Center. Dana-Farber is the top ranked cancer center in New England, according to U.S. News & World Report, and one of the largest recipients among independent hospitals of National Cancer Institute and National Institutes of Health grant funding.

Source: Children’s Hospital Boston

Quitting Smoking Before Pregnancy Could Save Babies’ Lives

If more women quit smoking before they became pregnant, it would save infant lives, concludes a new study from the Centers for Disease Control and Prevention (CDC).

Despite a decline over the past decade in the number of women who smoke during pregnancy, smoking is still a major cause of newborn deaths, early births and babies born with low birth weight.

“We know about half of women quit when they find out that they are pregnant, but a lot of women are still smoking during pregnancy,” said Patricia Dietz, DrPh, lead study investigator.

The study appears online and in the July issue of the American Journal of Preventive Medicine.

Dietz and co-investigators examined data from the US Linked Birth/Infant Death Data Set, which included all 3.3 million births of single babies that occurred in the United States (with the exception of California) during 2002. About 11.5 percent of babies, or 386,000, had mothers who smoked during pregnancy.

Researchers determined that prenatal smoking caused 5 percent to 8 percent of premature births and 13 percent to 19 percent of cases of low birth weight in babies carried to full term. Of infants who died, 5 percent to 7 percent of preterm-related deaths and 23 percent to 34 percent of deaths caused by sudden infant death syndrome (SIDS) might have been preventable if the mother had not smoked before pregnancy.

In addition, the researchers wrote that if all women quit smoking during pregnancy, it could cut health care costs by about $232 million every year – and improve overall health for both mothers and children.

“The percentage of SIDS deaths that might be avoided with smoking cessation is a significant number,” said Diane Ashton, M.D., deputy medical director of the March of Dimes. “For women who smoke and are considering pregnancy, we strongly recommend that they get preconception counseling for smoking cessation.”

Given these sobering statistics, why do some women continue to smoke during pregnancy?

“Studies have shown that these women may be dealing with a lot of stress, such as economic hardship, or they might be dealing with depression or other mental health issues,” Dietz said. “Most of them are living with other smokers that make it difficult to quit. They may be living in communities where it’s acceptable to smoke – where everyone is smoking. So it’s really complex.”

“This is an addiction,” Ashton said. “If pregnancy could cure addiction then none of these issues would be a problem. During pregnancy, women tend to be a little more highly motivated to address their addictions, but a lot of it depends on the level of readiness of the individual.”

“Infant morbidity and mortality attributable to prenatal smoking in the US.”
Dietz PM, et al.
Am J Prev Med 39(1), 2010.

Health Behavior News Service

Papua New Guinea Officials Discuss Strategies To Integrate HIV/AIDS Services Into Agricultural System

Officials from Papua New Guinea’s National Agricultural Research Institute recently met with a representative from the global health firm Options to discuss ways to integrate HIV/AIDS services into agricultural research programs, Papua New Guinea’s Post-Courier reports.

According to Rachel Grellier, a social development consultant at Options, if the spread of HIV is not contained in Papua New Guinea, the country’s agricultural system will face food and labor constraints because the system is dependent on labor. Grellier said the meeting aimed to discuss the situation with stakeholders and to develop ways to address the impact HIV/AIDS is expected to have on the agricultural system.

Grellier said that it is important to determine which agricultural systems are already experiencing the effects of HIV/AIDS and which aspects of each system are most vulnerable, adding that it will help stakeholders develop recommendations to address the situation. According to Grellier, strategies that aim to counter the effects and to address likely responses should be developed (Laraki, Papua New Guinea Post-Courier, 3/20).

About 1M STIs Diagnosed Annually in Papua New Guinea, WHO Says
In related news, the World Health Organization has estimated that about one million curable sexually transmitted infections are transmitted annually in the country, Manish Jain, Save the Children Fund’s program director in Papua New Guinea, said Tuesday, PACNews/Marianas Variety reports.

Jain said the country’s STI prevalence is among the highest in the world. According to a report recently released by the National AIDS Council, people living with STIs are 40% more vulnerable to HIV than people without an STI. He added that HIV is spread quickly and easily in areas with high prevalence of other STIs.

A Papua New Guinea Institute of Medical Research study conducted among people at high risk of HIV in the country’s Eastern Highlands province found a 21%, 19%, 24% and 51% incidence of gonorrhea, chlamydia, syphilis and trichomoniasis, respectively. In addition, 74% of people had at least one STI and 43% had more than one; however, less than 1% of the people were receiving treatment, Jain added.

Jain on Tuesday signed a memorandum of understanding with the Eastern Highlands provincial government to implement a program aimed at improving STI clinics and bolstering STI prevention and treatment programs (PACNews/Marianas Variety, 3/19).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Race Is Strong Predictor For Restless Legs Syndrome

New research shows that Caucasian women may suffer from restless legs syndrome (RLS), a sleep disorder characterized by the strong urge to move the legs, up to four times more than African-American women. The study, presented at CHEST 2009, the 75th annual international scientific assembly of the American College of Chest Physicians (ACCP), found that, overall, non-African-American (NAA) patients experienced RLS four times more often than African-Americans (AA). Furthermore, 2 out of 5 Caucasian women were found to have RLS, nearly four times the incidence of RLS in African-American women and the highest incidence among all groups.

“There are significant ethnic differences in the prevalence of restless legs syndrome, but the exact causes of higher prevalence among Caucasians are unknown,” said Ammar Alkhazna, MD, University of Missouri, Kansas City, MO. “This likely reflects a combination of factors, including a genetic predisposition to RLS, diet — including iron intake — medications, and possibly culture.”

To determine the incidence of RLS among AA and NAA patients, Dr. Alkhazna and his colleagues analyzed standardized interview responses from 190 patients seen at a primary clinic. Of the patients, 103 were AA (42 percent were men) and 87 were NAA, of which 40 percent were men and the majority were Caucasians. Among AA, the diagnosis of RLS was definite in 12 percent of patients, while among NAA, the diagnosis of RLS was definite in 36 percent. In the AA group, the prevalence of RLS was 12 percent for both genders. In the NAA group, the prevalence of RLS among men was 29 percent and 40 percent among women.

“Some risk factors for restless legs syndrome appear to be more common among women,” said Dr. Alkhazna. “Women are more likely to be iron deficient than men and have rheumatoid arthritis, which are known risk factors for RLS.”

Researchers also found that the overall prevalence of definite RLS was 23 percent, which is significantly more than many previous studies have reported at 3 to 10 percent. Dr. Alkhazna explains that this increased prevalence of RLS could be attributed to the specific study population.

“We believe our study results reflect at least our clinic’s patient population. Because our patient population is multiracial and quite diverse, we expect our results would be similar in other large, urban centers with similar pools of patients,” said Dr. Alkhazna. “However, as many diseases and medications can lead to the development of restless legs syndrome, there will likely be a difference between populations attending medical clinics as opposed to those who are well and healthy.”

“Restless legs syndrome is a common sleep disorder that may not be easily recognized by patients and clinicians,” said Kalpalatha Guntupalli, MD, FCCP, President of the American College of Chest Physicians. “Educating clinicians and patients about the signs and symptoms of RLS may raise awareness about this overlooked condition and lead to earlier diagnosis and treatment.”

CHEST 2009 is the 75th annual international scientific assembly of the American College of Chest Physicians, held October 31-November 5 in San Diego, CA. The ACCP represents 17,400 members who provide patient care in the areas of pulmonary, critical care, and sleep medicine in the United States and throughout the world. The ACCP’s mission is to promote the prevention and treatment of diseases of the chest through leadership, education, research, and communication.

Source: American College of Chest Physicians