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

Study With Newborn Babies Finds Fine Particulate Matter From Traffic May Influence Birth Weight

After the scientists had investigated the effects of the exposure of adults and children to particulate matter in the past, they are now first focussing on the risks to unborn life in this recent study. This is the continuation of the GSF’s successful cooperation with the internationally renowned French research institution, with the common objective of tracing the causes of environment-related health disorders.

For the study which has now been published online, data from the cohort study LISA were used, in which the influence of living conditions and behaviours on the development of the immune system and allergies is studied. 1016 mothers and their children born in Munich between 1998 and 1999 were studied. All women included in the study had not moved out during the pregnancy. On the basis of a measuring campaign at 40 locations in the city of Munich, the concentrations of traffic-related atmospheric pollutants during pregnancy, including fine particulate matter (those with a diameter of less than 2.5 micrometers, PM2,5), could be modelled at the home address of the pregnant women. The model took into account the distance of each home from streets, the population density near the home as well as the fluctuations in the concentration of the air pollutants over time during the pregnancies.

Using a detailed questionnaire, the study authors could disentangle the influence of air pollutants from that of other factors known to influence birth weight. In particular, maternal smoking, the height and weight of the mother before pregnancy, the educational level of the mothers as well as the duration of the pregnancy and the child’s gender could be controlled for.

The proportion of newborns with a birth weight below 3,000 grams increased with increasing concentrations of fine particulate matter (PM2,5) during pregnancy. A similar association was observed between the absorbance of fine particulate matter and birth weight. The absorbance of particulate matter is considered to be a marker of the particles originating from traffic, and in particular from diesel vehicles.

Earlier American Studies had already suggested that fine particulate matter might influence the birth weight. This recent study is the first study from Germany and Western Europe and also the first one to suggest so clearly that traffic-related air pollutants have an influence.

The biological mechanisms which could explain the influence of air pollutants on the growth of the unborn child are not known as yet. Fine particulate matter consists of hundreds of chemical substances. It is conceivable that a minor fraction of the fine particulate matter reaches the blood through the lungs and influences the placenta or other organs which are responsible for regulating the growth of the foetus. Studies from the US and Poland have for example shown that polycyclic aromatic hydrocarbons (PAH), which are produced during incomplete combustion processes, can reach the foetus and influence its growth.


With 13,000 employees the French Institute for Health and Medical Research INSERM is one of the biggest publicly funded research institutions in France. INSERM is exclusively committed to research into human health in the fields of biology, medicine and public health. Its mission is to promote the exchange between fundamental research and clinical research as well as questions of therapy and diagnosis and public health issues. Homepage:

The GSF – National Research Center for Environment and Health investigates the foundations of medical care of the future as well as ecosystems with an essential significance to health. It mainly focuses on chronic degenerative diseases, such as pulmonary diseases, allergies, cancer and cardiovascular diseases, which are substantially influenced by personal risk factors, lifestyle and environmental conditions.

More Information: Slama R, Morgenstern V, Cyrys J, Zutavern A, Herbarth O, Wichmann HE, Heinrich J and the Lisa study group. 2007 (in press). Traffic-related Atmospheric Pollutants Levels During Pregnancy and Offspring’s Term Birth Weight: an Approach Relying on a Land-Use Regression Model. Environ Health Perspect (doi:101289/ehp10047). On-line access:

Contact: Heinz Joerg Haury

GSF – National Research Center for Environment and Health

UVA Amherst Dialysis Staff Recognized With National Patient Safety Award

Laura Simms has spent 12 hours a week receiving hemodialysis treatment since last fall, when her kidneys failed as a result of high blood pressure. The 50-year-old Monroe resident says the staff at University of Virginia Health System’s Amherst Dialysis clinic have become like family to her.

“They pamper you,” she said. “They are continuously checking on you, making sure you’re okay and asking if they can get you anything. I’m very pleased, and I love the staff there.”

Recently, the Renal Physicians Association recognized the dedication of the Amherst Dialysis staff with its second annual End Stage Renal Disease Patient Safety Improvement Award. Amherst Dialysis was nominated by Mid-Atlantic Renal Coalition Executive Director Nancy Armistead, MPA, and board member Frank Maddux, MD. The award is given annually to nephrology professionals who submit their best practices to the Keeping Kidney Patients Safe website. UVA’s submission addressed hand hygiene, patient falls and adherence to protocols.

W. Kline Bolton, MD, professor of internal medicine in the Division of Nephrology at the UVA School of Medicine and medical director of UVA Renal Services, accepted the award on behalf of the Amherst Dialysis staff at the RPA’s annual meeting earlier this month.

Hemodialysis removes harmful waste products and excess fluid from the blood, replicating some of the functions healthy kidneys normally perform.

Kim Smith, RN, CHN, CNN, Amherst’s RN administrative coordinator, wrote in the Keeping Kidney Patients Safe submission that the dialysis facility used the educational modules offered by the Mid-Atlantic Renal Coalition’s 5-Diamond Safety Program to educate its 35-person staff on various patient safety topics, including emergency preparedness, medication reconciliation, hand hygiene and fall prevention. Staff then formed eight groups, and each month, one group was responsible for presenting a patient safety topic to fellow employees and patients.

The presentations prompted staff to implement many new safety practices and educational tools for the facility’s 96 patients. Those included auditing to identify safety concerns and to ensure that handwashing protocol was followed, adding more hand sanitizer stations throughout the facility, and taking surveillance cultures to identify earlier potential cases of MRSA and other infections. The clinic’s Continuous Quality Improvement Committee also developed a brochure to educate patients on infection prevention and a patient newsletter and now offers nutrition education.

As a result, patient satisfaction scores have increased. In a December 2009 survey, 94 percent of the clinic’s patients said that they were satisfied with the effectiveness of patient education and the availability of medication information. Ninety-nine percent were satisfied with the “degree to which staff explain.” In June 2008, the scores for those same items were 78 percent, 79 percent and 78 percent, respectively.

“The staff really got behind the education and safety measures, and as a result, all of our numbers have really improved,” said Richard Giles, MD, medical director of Amherst Dialysis and an assistant clinical professor in the University of Virginia School of Medicine’s Department of Internal Medicine. “Ninety-six percent of our patients were vaccinated for seasonal flu this year, which is really outstanding. More patients are exercising. Patient falls have decreased. Infection rates have decreased significantly. Seeing these positive outcomes has encouraged the staff to learn even more and share their knowledge.”

The clinic’s 5-Diamond status from the Mid-Atlantic Renal Coalition has also been extended through March 2012. More information about the 5-Diamond program is available here.

Mark Okusa, MD, chief of the Division of Nephrology at the UVA School of Medicine, and Larry Fitzgerald, UVA Medical Center associate vice president for business development and finance, visited the clinic March 22 to congratulate the staff. “They are really excited to see their hard work recognized by a national organization,” Okusa said. “Their tremendous dedication is obvious both in their interactions with their patients and in their careful attention to safety and infection prevention. What’s significant about this award is that these efforts really do have a direct benefit to the patients.”

Several other UVA services are recognized as having best practices on the Keeping Kidney Patients Safe website. UVA Renal Services is recognized for hand hygiene, and the Altavista Dialysis center is recognized for fall prevention.

UVA Renal Services operates eight hemodialysis facilities throughout central Virginia. Patients with kidney failure must undergo some form of regular dialysis treatment or receive a kidney transplant. Hemodialysis patients typically require the treatment for nine to 12 hours a week.

University of Virginia Health System

Blood Biomarker Underscores Role Of Inflammation In Vascular Disease

UC Davis researchers have discovered that a blood component linked with inflammation can predict coronary artery disease in African-Americans.

Known as lipoprotein-associated phospholipase A2 (Lp-PLA2), the blood factor is also associated with but does not accurately predict heart-disease risk in Caucasians. The findings are published in the current issue of the Journal of Clinical Endocrinology and Metabolism.

“This study suggests that inflammation may be a more important mechanism in heart disease for African-Americans than it is for Caucasians and increases our growing understanding of how heart-disease processes vary in different ethnic groups,” said Lars Berglund, senior study author and associate dean for research at the UC Davis School of Medicine. “The more we appreciate such differences, the better we can individualize treatment and prevention approaches.”

Lp-PLA2 was recently identified as a marker for the inflammatory processes involved in atherosclerosis. It is considered key to the progression and rupture of fatty plaques that can block coronary arteries and lead to heart attacks. It predominately binds to low-density lipoprotein – or LDL – which is a general marker of increased heart-disease risk. Berglund noted, though, that more well-known factors like LDL and high cholesterol cannot provide the whole picture of heart disease.

“There are other important elements of heart disease – like inflammation – that need to be better explained,” he said.

For the current study, Berglund and his team measured Lp-PLA2 levels in the blood of 336 Caucasians and 224 African-Americans who were about to undergo diagnostic coronary arteriography – a test used to determine coronary artery disease in high-risk patients – at two hospitals in New York. Coronary arteriography findings were compared with the amount and activity levels of Lp-PLA2 from each research subject.

During the procedure, contrast dye and X-rays are used to detect narrowed or blocked arteries, indicating the potential for heart attacks.

“Arteriography is highly effective but considered too risky and expensive for general screening,” said Berglund. “That is why researchers are always on the lookout for other reliable predictors of heart-attack risk that can be identified with a simple blood test.”

The outcomes showed that Lp-PLA2 activity was higher among Caucasians and African-Americans with coronary artery disease. In addition, only in African-Americans was the Lp-PLA2 index found to independently predict coronary artery disease.

Although the test for Lp-PLA2 is widely available, Berglund said it is too soon to recommend widespread testing to affect treatment decisions. The study population was not representative of the general population as all participants already had symptoms of heart disease. Berglund’s team plans further studies of Lp-PLA2 and other inflammatory components of the blood in a wider range of patients to get a clearer picture of their roles in predicting heart disease for different ethnic and racial groups. The outcomes of his current study, however, give him hope that African-Americans at high risk for heart disease will one day be treated for inflammation more aggressively and earlier in the disease process.

“This study has helped open the field,” said Berglund. “More information will allow us to better tailor therapy to specific patient needs.”

In addition to Berglund, other study authors included Erdembileg Anuurad and Byambaa Enhkmaa of UC Davis, Thomas Pearson of the University of Rochester and Zeynep Ozturk of the University of Istanbul.

The study was funded by grants from the National Heart, Lung and Blood Institute, the UC Davis Clinical and Translational Science Center and the American Heart Association.

Karen Finney
University of California – Davis – Health System

Beyond The Abstract Detection Of Prostate Specific Antigen Coupled To Immunoglobulin M In Prostate Cancer Patients

UroToday – Xeptagen findings published in the latest issue of Cancer Detection and Prevention may open a new gateway for the management of prostate cancer patients. The study provides the first evidence that circulating prostate specific antigens (PSA) may be detected complexed to IgM at significantly elevated levels in a much higher number of patients with prostate cancer compared to free PSA levels, therefore achieving the needed discrimination between benign prostatic hypertrophy and prostate cancer. Assessment of PSA-IgM levels in the free PSA grey zone (4 ng/mL – 10 ng/mL), where the outcome of biopsies is most equivocal and unpredictable, leads to a clear identification of cancer patients. Due to the limited overlapping of serum levels of PSA-IgM and PSA, the combined use of both biomarkers improves even further the accuracy of prostate cancer detection. The study provides further support of the occurrence of biomarkers-IgM complexes in cancer and strengthens previous studies on liver and colorectal cancer, where assessment of squamous cell carcinoma antigen (SCCA) (Beneduce et al. Cancer 2005), О±-fetoprotein (AFP) (Beneduce et a.l. Int. J. Biol. Markers 2004) and carcinoembryogenic antigen (CEA) (Castaldi et al. Int. J. Biomarkers 2005) complexed to IgM provided much better diagnostic indexes than the determination of the corresponding free biomarkers for cancer detection.

Luca Beneduce, Ph.D, as part of Beyond the Abstract on UroToday. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc… of their research by referencing the published abstract.

Link to Full Abstract

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Pandemic Influenza H1N1 In Mexico

Gerardo Chowell and coworkers report the incidence of pandemic influenza H1N1 morbidity and mortality in 32 Mexican states in 2009 and quantify the association between local influenza transmission rates, school cycles, and demographic factors. By using the epidemiological surveillance system of the Mexican Institute for Social Security, which covers about 40% of the Mexican population (107 million individuals), they compiled age- and state-specific rates of incident influenza-like illness and pandemic H1N1 influenza cases by day of symptom onset to analyze the geographic patterns of the dissemination of the flu pandemic across Mexico in 2009.

Using these data as inputs to a mathematical model they show that the age distribution of pandemic influenza morbidity was greater in younger age groups while the risk of severe disease was highest in older age groups. But most importantly, these findings support the effectiveness of early mitigation efforts including mandatory school closures and cancellation of large public gatherings, reinforcing the importance of school cycles in the transmission of pandemic influenza.

Funding: This work was funded by the Fogarty International Center, National Institutes of Health (fic.nih/). LS acknowledges support from the RAPIDD program of the Science and Technology Directorate, Department of Homeland Security, and the Fogarty International Center. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: LS received consulting fees from SDI, a health data warehouse business in Pennsylvania, and received research support from Pfizer for a pneumococcal vaccine study, but this is not relevant to the topic of this paper. MAM has been named on a US government patent for an experimental influenza vaccine as required by Federal requirements.

“Characterizing the Epidemiology of the 2009 Influenza A/H1N1 Pandemic in Mexico”
Chowell G, EchevarrГ­a-Zuno S, Viboud C, Simonsen L, Tamerius J, et al. (2011)
PLoS Med 8(5): e1000436. doi:10.1371/journal.pmed.1000436

American Diabetes Association Urges Congress To Examine Ravages Of Childhood Obesity And Type 2 Diabetes

The American Diabetes Association (ADA) today, applauded Chairman Chris Dodd (D-CT), Ranking Member Lamar Alexander (R-TN), and members of the U.S. Senate Subcommittee on Children and Families for holding a hearing on, “Childhood Obesity: The Declining Health of America’s Next Generation.” Appearing before the Committee was Francine Kaufman, M.D., a prominent pediatric endocrinologist, past president of the ADA, and a distinguished professor of Pediatrics and Communication at the University of Southern California.

Dr. Kaufman shared compelling information based on her first-hand observations and research as a clinician, about the dangerous rate of childhood obesity cases among children and young adults, and the strong correlation between type 2 diabetes and childhood obesity. According to Kaufman, “Children who are overweight, obese and unfit are at increased risk of developing high blood pressure, abnormal lipid levels, inflammation in their blood vessels and higher than normal blood sugar levels. These disorders are precursors of diabetes and adult-onset cardiovascular disease.”

Kaufman went on to illustrate that one in three children born in the year 2000 will develop diabetes at some point in his or her life, and that this statistic is nearly one in two for children in minority communities. “Today, there is no doubt that obesity in youth, along with its associated medical conditions, is the major health
challenge of this century,” said Kaufman. “Despite the efforts of government and public health officials, the
number of overweight and obese youth continues to increase. More needs to be done to combat the ever growing epidemics of obesity and diabetes.”

Today, 23.6 million children and adults in the United States — or nearly 8 percent of the population — have diabetes. Diabetes is among the leading causes of death by disease in the United States. Since 1987, the death rate due to diabetes has increased by 45 percent, while the death rates due to heart disease, stroke, and cancer have declined.

The American Diabetes Association is the nation’s premier voluntary health organization supporting diabetes research, information and advocacy. The Association’s mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. Founded in 1940, the Association provides services to hundreds of communities across the country. For more information please call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or visit www.diabetes. Information from both these sources is available in English and Spanish.