Epinephrine autoinjectors: Who gets it and why?

Published Online: September 3, 2013

Epinephrine autoinjectors are commonly prescribed for patients at risk for anaphylaxis, including those with food allergies and insect sting allergies. However, epinephrine autoinjectors are also prescribed for other diseases. In a study by Agarwal and Wang published in The Journal of Allergy and Clinical Immunology: In Practice, the prescribing patterns for epinephrine autoinjectors within an urban adult population attending the internal medicine practice at a large tertiary care hospital were examined.

1.6% of the population was prescribed epinephrine autoinjectors. The most common indications for the epinephrine autoinjectors were food allergy (57%) and angioedema (9%). Additional diagnoses associated with the epinephrine autoinjector prescriptions included hives, insect sting allergy, asthma, allergen immunotherapy, drug allergy, idiopathic anaphylaxis and radio-contrast allergy. The authors noted that 4.5% were prescribed a suboptimal dose of epinephrine autoinjector and only about 2/3 of patients who received epinephrine auotinjector prescriptions were referred to an allergy specialist for further evaluation and management.

These results indicate that clinicians should regularly evaluate the indications and dosing for epinephrine autoinjectors and consider referral to an allergy specialist for confirmatory testing and management guidance. Additional studies to explore prescribing patterns in larger populations and guidelines for clinicians would be beneficial as well.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

15 Healthy Snacks for Fall

By KERI GANS
September 25, 2013 RSS Feed Print
Keri Gans
Keri Gans
It’s that time of year again – the kids are back at school, and you begin a hectic couple months of work and social commitments that last well into the holiday season. If your fall days are packed, create these super quick pre-dinner snacks for you and your kids. The 15 treats below are healthy, fast and inspired by the flavors of fall. Enjoy!

Roasted pumpkin seeds and chickpeas. Nothing says autumn like pumpkin! Coat a baking sheet with nonstick cooking spray, and add a layer of pumpkin seeds. Sprinkle the seeds with a dash of salt, and then roast them at 325 F for about 25 minutes, or until toasted. If you’re in a pinch, try half a serving (1/8 cup) of Eden Organic Pumpkin Seeds. Not a pumpkin lover? Roast chickpeas with cayenne and cumin instead.

Single serving cheese with fruit. Get your snack fix with an individual serving of cheese, such as string cheese, a Mini Babybel or a one-ounce piece of Cabot cheese. Pair the cheese with a piece of seasonal fall fruit, such as apples or pears.

Nuts. The nuts out of the package are fine, but how about adding an autumn twist by roasting almonds, walnuts or cashews with a trio of cinnamon, nutmeg and ground cloves? Enjoy snacking on about one ounce of nuts. I like to use a shot glass to measure out my serving, and then place them into a snack-size bag for easy transport.

Raw veggies and hummus. Slice your favorite fall veggies, and then pair them with hummus – but not just any old hummus. There are many, many flavors out there, including those that accent the season. Dip into hummus with flavors such as smoked paprika and cumin.

Granola bars. Ditch the cookies, but keep the eight ounces of non-fat milk to pair with this convenient, go-to snack. There are likely many seasonal granola bars out there that include flavors such as pumpkin, maple and cinnamon. Choose one with no more than 200 calories and eight grams of sugar and at least 3 grams of fiber.

Beef jerky. This may sound like an odd snack idea, but beef jerky has come a long way from how you may remember it. I like the gourmet dried meats from Simply Snackin, as well as the delicious flavors from Krave Jerky, including Black Cherry Barbecue and Sweet Chipotle.

Baked chips with dip. When a snack attack hits you and the kids, satisfy it with a serving of baked chips or tortilla chips dipped in guacamole or salsa. To get into the swing of fall, try Foods Should Taste Good’s Sweet Potato Tortilla Chips so it doesn’t become a ho-hum snack.

Popcorn. Ditch the large bag of microwave popcorn in favor of three cups of the air-popped variety topped with a pumpkin pie spice (a mixture of cinnamon, nutmeg, allspice, cloves and ginger). Complete this delicious snack with a small piece of cheese to keep you fuller longer.

Hot chocolate. Everyone loves warming up with a mug of hot chocolate as the weather cools. Make yours with one cup of non-fat milk, and welcome the cooler weather.

Homemade parfait. Grab an individual serving of cottage cheese (like Breakstone’s 2 percent) or a cup of low-fat plain Greek yogurt, and top it with berries. Add a sprinkle of Bear Naked Maple Pecan Granola to give it the delicious flavor of fall.

English muffin with nut butter. Savor the season by topping one of Thomas’ Pumpkin Spice English Muffins with natural almond butter or peanut butter. Try to limit the topping to one tablespoon. For a savory treat, consider spreading hummus on top of the English muffin.

Turkey slices. Construct your snack by wrapping turkey slices in lettuce and adding a little spicy mustard, or layer the turkey on 100-percent whole-grain crisps. Add a few slices of apple for an extra (seasonal) crunch.

Deviled eggs. Create a healthy version of deviled eggs by using low-fat mayonnaise or Greek yogurt. Use only two-thirds of the yolk, and replace the rest with cottage cheese. Paprika is typically the star of this dish, but make it fall-appropriate with a pinch of allspice or nutmeg.

Seasonal soup. Hot, seasonal soups make a satisfying snack. Stock up on nutritious favorites such as split pea, lentil, black bean, or chicken with vegetables, and stick to a one-cup serving.

Baked apples. Baked apples are seasonal staples that are simple to make. Put the whole apple in a microwaveable dish with a little apple juice and cinnamon. Cook them for about three minutes on high or until soft, and be sure to top the apples with a dollop of low-fat Greek yogurt to complete the snack.

Hungry for more? Write to eatandrun@usnews.com with your questions, concerns and feedback.

Keri Gans, MS, RDN, CDN, is a registered dietitian/nutritionist, media personality, spokesperson, and author of The Small Change Diet. Gans’s expert nutrition advice has been featured in Glamour, Fitness, Health, Self and Shape, and on national television and radio, including The Dr. Oz Show, Good Morning America, ABC News, Primetime, and Sirius/XM Dr. Radio.

The Artificial Pancreas Does Its Homework

By Michelle A. Cissell, Ph.D.
September 24, 2013

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JDRF-funded researchers across the globe are currently testing artificial pancreas systems. Some clinical trials are inpatient, in which participants stay overnight or for a few days in a hospital or research clinic, while others take place in an outpatient setting. In both cases, a medical team carefully monitors the daily life of each trial volunteer wearing an artificial pancreas (AP) system—examining factors such as diet, activity level, and sleep periods—to evaluate how the system performs under various conditions and extreme blood-glucose levels. But everyday life is not always as neat as it is in a clinic, especially during the childhood and teenage years.

That’s why Roman Hovorka, Ph.D., director of research in the Department of Pediatrics at the University of Cambridge Metabolic Research Laboratories in the United Kingdom, recently tested at-home use of an AP system for overnight glucose control in adolescents ages 12 to 18 who have T1D. This JDRF-funded study was one of the first to test an AP system outside the controlled environment of a research clinic. It drew on Dr. Hovorka’s unique expertise in mathematical informatics and modeling to develop control algorithms—the crucial part of the computer program that uses data from the AP system’s continuous glucose monitor (CGM) to control its insulin pump.

Working from home

For three weeks, volunteers used a specific type of insulin pump and CGM that are compatible with the closed-loop system as they would normally during the day. But at bedtime, participants wirelessly connected the two devices to a laptop running a control algorithm, and the system began modulating insulin delivery from the pump according to the CGM reading. The study tracked how well the blood-glucose level was controlled during the three weeks of nighttime AP system use compared to that during a separate three-week period when the volunteers practiced conventional pump therapy around the clock.

The at-home study recently completed, and Dr. Hovorka relates that the study team observed wide variations in insulin requirements from night to night when the system was tested at home. Some nights, a volunteer needed half the amount of insulin he or she would have taken on conventional treatment. Other nights, the opposite could be true—a participant’s CGM data might cause the system to administer twice the amount of insulin that the person would have taken normally. This observation highlights the difficulties of overnight glucose control as well as the potential benefit of a closed-loop system that helps people with T1D significantly improve their diabetes management overnight, since better control during sleep reduces the risk of hypoglycemia. Putting the nighttime hours—which account for one-third of a day—into better control should pay long-term dividends in terms of reducing the risk of diabetes complications.

If for any reason the laptop lost the CGM signal or its connection to the pump, the system automatically returned to a preset insulin-infusion rate to restart conventional treatment. Dr. Hovorka says the system is simple and safe to use and seemed to be well accepted by the study participants. “The safety mitigation system allows us to be confident that the system is safe,” he states. “What is most challenging for the volunteers is using a new pump. Generally, they are quite relaxed, because they find it’s just a matter of pushing a button on the laptop to start closed loop.”

Since the launch of its Artificial Pancreas Project, JDRF has led the way in research on closed- loop systems, and this study is no exception. Aaron J. Kowalski, Ph.D., JDRF’s vice president of treat therapies, views Dr. Hovorka’s at-home trial of an AP system as “transformational.” Dr. Kowalski explains, “The trial is a huge advance because the studies are happening in outpatients who are unsupervised, meaning there is not a doctor or nurse in the next room—and that’s the real world. This study is blazing a trail.”

Glucose management: anything but child’s play

Dr. Hovorka is also applying his knowledge to better improve glucose control in young children with T1D. Many children, especially those too young to talk, are not able to recognize or communicate symptoms of dangerously high or low blood-glucose levels. Moreover, young children have small bodies, so they often need only minute amounts of insulin, which can be difficult to dispense accurately. These factors can make glucose control in young children extremely challenging for parents and caregivers.

Dr. Hovorka is conducting a clinical trial to test the use of standard-strength and diluted insulin in children with T1D who are two to six years old. The goal of the study is to determine whether diluted insulin can improve the safety and efficacy of closed-loop control in these young children.

In this study, children stay overnight in a research clinic on two separate occasions. On one night, the children are treated with a closed-loop system that uses insulin in the standard concentration; on the other night, the system uses an insulin formulation that has been diluted fivefold with a saline solution. Ideally, the diluted insulin should increase the accuracy of insulin delivery by the pump, reduce glucose fluctuations, and improve control in very young children compared to the standard insulin concentration.

Leading the way to better glucose control

JDRF’s goal of developing safe and effective artificial pancreas systems relies on partnerships of scientists working in many disciplines, including fields that are not traditionally associated with human disease research, like mathematics. Dr. Kowalski notes, “Dr. Hovorka is a brilliant mathematician. Working with an excellent clinical team at Cambridge, he is leading the way on control-algorithm development for the artificial pancreas.”

Dr. Hovorka himself admits to being somewhat skeptical about closed-loop systems when he first started research in the field in the mid-1990s. But over time, he says, “it became an evolving journey of realizing that we can use existing devices to much greater benefit for people with type 1 diabetes.” His persistence and creativity are now paying off in the form of innovative algorithms that forge a strong link between insulin pumps and CGMs.

With those algorithms, Dr. Hovorka and his team are tackling two of the most worrisome times for diabetes management in children—very young ages and nighttime. If his current trials successfully demonstrate improved control with a closed-loop system, then children and adolescents with T1D, along with their parents, may be able to sleep a little easier.

Autism Study Finds No Link to Celiac Disease; Gluten Reactivity Real

Date: September 25, 2013
Largest-ever study of autism and celiac disease helps clarify earlier findings; supports parent reports of gluten sensitivities

In the largest study of its kind, researchers found no link between autism and celiac disease, a severe intestinal disorder triggered by an immune reaction to gluten. However, the study also confirmed a strong association between autism and the presence of antibodies to gluten. Such antibodies indicate a significant immune reaction to the protein, which is found most commonly in wheat.

The report, by researchers at Sweden’s Karolinska Institute, appears today in the journal JAMA Psychiatry.

“In the past, we have had the believers and nonbelievers when it came to the role of gluten in autism,” comments gastroenterologist Alessio Fasano. “Hopefully this paper can clarify, once and for all, that a subset of those with autism has gluten sensitivity, a condition triggered by gluten but distinct from celiac disease.” Dr. Fasano is chief of pediatric gastroenterology at the MassGeneral Hospital for Children, home of the Lurie Center for Autism, an Autism Speaks Autism Treatment Network site.

Over the last decade, a suggested link between autism and celiac disease grew from a few case reports and the frequency of severe GI distress among children with autism. In addition, many parents of children with autism reported improvement when they switched their children to gluten-free diets.

Subsequent studies found no increased prevalence of celiac disease among those with autism. This led skeptics to discount the parent reports. At the same time, other studies found a high occurrence of gluten-related antibodies among children with autism and GI distress. (More on these studies, made possible in part by Autism Speaks resources, here and here.)

“The new study is important in that it finally puts two and two together,” Dr. Fasano says. Antibody tests may be one way to identify individuals – including those with autism – who may benefit from gluten-free diets, he adds. Dr. Fasano also calls for funding of clinical trials that can determine whether such diets can help relieve not only GI issues but also behavioral symptoms in individuals with autism who have gluten sensitivity.

For more information, also see “Autism and GI Disorders” and this transcript of Dr. Fasano’s Autism Speaks webchat on autism-associated GI issues.

A To-Do List for Parkinson’s Researchers

Actor Michael J. Fox is in good enough health to return to prime time TV, but neurodegeneration researchers still have more work to do

By Todd Sher

SLOW AND STEADY PROGRESS ON PARKINSON’S: Researchers are learning more about the role of the protein alpha synuclein (the Parkinson’s corollary to amyloid beta in Alzheimer’s), which misfolds and clumps in the cells of people with the disease.
Image: Lab Science Career/Flickr

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Parkinson’s disease is coming to prime time. Tomorrow night Michael J. Fox returns to television as the star of his own sitcom nearly 15 years after retiring from Spin City to focus on finding a cure for his disease.

Michael has been careful to emphasize that the show isn’t really about Parkinson’s. Based loosely on his real life, The Michael J. Fox Show mines laughs from the everyday trials and tribulations of family man Mike Henry as he resumes his TV news job following a Parkinson’s diagnosis. Yet simply by featuring a main character living with the disease, the show puts Parkinson’s into the national conversation. This is a good moment to consider how much work remains to be done in the realm of neurodegeneration research.

The question we’ve heard most often at The Michael J. Fox Foundation is: After more than 20 years with Parkinson’s, how is Michael doing well enough to go back to work? There’s no simple answer. He acknowledges the good fortune he has in a loving, supportive family and financial independence, which have provided advantages in dealing with his disease. He says, “Everybody gets their own version of Parkinson’s. Different meds work for different people, and you’re always trying to find the perfect combination. I think I found what works for me right now. And I’m so lucky.”

But the reality is that for the estimated five million Parkinson’s patients worldwide, the status quo is still not good enough. They are living with Parkinson’s movement difficulties and nonmotor symptoms such as mood and sleep disorders as well as cognitive impairment. Medication and therapies alleviate some symptoms, but create their own problems and fail to address all the effects of Parkinson’s. We have some disease-modifying treatments in clinical trials, but nothing on the market yet. The grim truth is that those diagnosed with Parkinson’s will get worse. And for every patient, a community is affected, as the impact of the disease ripples to loved ones and caregivers. This is a global problem, but one that we can solve.

Researchers are learning more about the role of the protein alpha synuclein (the Parkinson’s corollary to amyloid beta in Alzheimer’s), which misfolds and clumps in the cells of people with the disease. Just last month the Fox Foundation–sponsored Parkinson’s Progression Markers Initiative study reported preliminary data in JAMA Neurology on protein levels in spinal fluid, a critical milestone in pursuit of biomarkers that could lead to swifter diagnosis and drug development. On the long journey toward drugs that could prevent or slow disease progression, these are some of the most promising avenues we’ve seen. And investments in one area of neurological disease are likely to pay dividends across the spectrum as research illuminates pathological overlaps between, for example, Parkinson’s and Alzheimer’s diseases.

With budgets tight there is a tendency to adopt an incremental and safe approach to project development—taking small steps forward to secure more funding. Although small steps are important, we also need to follow promising early results into uncharted territory. Drug repurposing, for example, could allow us to take existing drugs that have already been proved safe for treatment of other conditions, such as diabetes and hypertension, and apply them to Parkinson’s. Researchers are also characterizing genetic mutations associated with Parkinson’s, such as in the LRRK2 gene, to identify risk and protective factors.

And here’s another idea: Instead of holing up in our laboratories until we have enough vetted and analyzed research to enter the lengthy process of publishing a manuscript, we researchers should set aside our egos and share our data and our tools. Open-access data, nontraditional partnerships and crowdsourcing are some ways we can move the needle forward.

Finally, let’s revisit the partnership between investigators and patients. Technology-enabled solutions give researchers near-instantaneous access to a pool of informed and interested volunteers. We need to use tools like Fox Trial Finder and ResearchMatch to identify and connect with those potential participants. More so, we need to view them as collaborators—to keep them in mind when we design studies and follow up to let them know our findings. Satisfied volunteers make repeat participants.

I guess I’m asking a lot. But these should be our default practices: Funding inventive and innovative projects and collaborating with our peers and nontraditional partners as well as patients.

Michael J. Fox is optimistic, and I’m so glad to see him back on the screen. His attitude is infectious, and we hope it will inspire researchers to find a way to return every Parkinson’s patient to a career they love—or better yet, never leave it in the first place.

Todd Sherer is CEO of The Michael J. Fox Foundation for Parkinson’s Research.

Updated prevalence of food allergy in the United States

Published Online: September 3, 2013

Food allergy is a common condition, and estimates of its prevalence vary worldwide and even within the United States. The National Health and Nutrition Examination Survey (NHANES) is a periodic survey designed to collect health information on a nationally representative sample of Americans. Between 2007 and 2010, NHANES gathered information about allergies to specific foods, such as peanut, tree nuts, fish, shellfish, wheat, egg, and milk by questionnaire. In a recent article published in The Journal of Allergy and Clinical Immunology (JACI), McGowan et al examined the prevalence of food allergies in NHANES, demographic and clinical characteristics of those affected by this condition, and the percentage of those who reported milk, fish, and shellfish allergy who actually avoided the food in their diet.

A total of 20,686 individuals were surveyed between 2007 and 2010. The overall prevalence of self-reported food allergy was 8.96% (CI 8.32 – 9.60%), corresponding to 6.53% in children (95% CI 5.69 – 7.37%) and 9.72% in adults (95% CI 8.94 – 10.5%). “Other,” milk, peanut, and shellfish were the most common food allergies in both children and adults. Among adults, those of female gender and higher household education level had a higher prevalence of self-reported food allergy, and Non-Hispanic black race/ethnicity was associated with food allergy in all ages. A large proportion (25-35%) of individuals who reported an allergy to milk, shellfish, and fish had recently consumed the food.

This report is unique in that it contains information about specific food allergies from a population that is truly representative of the United States and reports on adults with food allergies, who have not been well studied. This article also highlights the need for more sophisticated methods, such as a validated food allergy questionnaire, to use for large-scale epidemiologic studies of food allergy.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

5 Ways to Shut Down Emotional Eating

une 13, 2013 | By Cynthia Sass, MPH, RD

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After a bad day, do you seek solace in ice cream, cheesecake, or whipped cream straight from the can? You may keep eating fatty foods when you’re feeling down because you’re less likely to taste the fat in food, according to new research from the University of Wurzburg in Germany.

In the study, scientists asked a group of volunteers to sample a variety of creamy drinks that contained different amounts of fat. Before tasting the treats, the study subjects were shown three different videos. The first depicted a happy scene, the second sad, and the third neutral. The humdrum video had no influence on the volunteers’ taste buds, but after watching the two emotional clips, the participants were less able to tell the drinks apart. The lesson: emotions impact our sensory perceptions of food. And eating anything–when what you really need has nothing to do with food–is a pattern that if broken, can dramatically transform your health, and your waistline. If you’re open to trying, here are five strategies to put into action.

Let it out
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A friend once told me that her therapist advised her to go to a garage sale or thrift store, buy some cheap dishes, take them into her back yard, and smash them to bits. When I asked if she did it, she said she had, just with one dish, and it was one of the most liberating moments of her life. Whether you’re walking around with anger, sadness, or anxiety bottled up inside, allowing it to fester ups the chances that you’ll use food to detach, or stuff it back down. For this reason, I often advise my clients to find healthy ways to release their feelings, like watching a tearjerker to have a good cry, or furiously scrubbing the tub to let out aggression. I’m not a huge fan of Freud, but I do love his quote, “Unexpressed emotions will never die. They are buried alive and will come forth in uglier ways.” Truth.

Don’t multi-soothe
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If you find yourself drifting into the kitchen during a TV commercial to snatch that pint of Cherry Garcia you’ve been trying not to think about, stay put. Sit in a chair and eat the ice cream without distractions. It will probably feel incredibly awkward, but that’s the point. Inside your comfort cocoon, it’s easy to lose track of how fast and how much you’re eating, or that you’re even eating at all. Uncoupling these behaviors and just eating is like turning the lights on, which can lead to eating far less, or realizing that eating really isn’t the best way to cope. Powerful.

Distance yourself
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Over the years I’ve had numerous clients tell me that they can’t keep certain foods around, because if they’re there, they’ll eat them, especially when they’re emotional. But unless you live alone, it can be impossible to completely banish all “high risk” foods. One thing that may help, however, is making them harder to get to. Research shows (and my own experience confirms) that the fewer steps you have to go through to get to a food, the more likely you are to eat it, and vice versa. So, stashing candy or cookies on a higher shelf, wrapped in another bag or inside of a sealed container, really does diminish the chances of eating it. It also provides the opportunity to consider other options. One client told me that this trick resulted in a major breakthrough. She said, “I thought to myself well, I can either go in the closet, get the step stool, and pull down that old Halloween candy, or call my friend, and in that moment, picking up the phone just seemed easier.” For her, this felt like a huge triumph, especially the next morning, when she woke up without a food hangover–or regret.

Prevent the spiral
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One of the biggest challenges many of my clients face is not letting a small indulgence snowball into a big binge. Countless clients have told me, “After I went off track, I figured what the heck, I might as well keep eating.” This all or nothing tendency is especially common among people with a history of dieting, and ending it can be incredibly transformative, both emotionally and physically. If you’re perfectionistic, it can feel like there’s little difference between one “bad” meal and one “bad” day, but that’s not the truth. An analogy I use often is debt. If you were on a strict budget to get out of debt, and you spontaneously spent an extra $100, it wouldn’t make sense to then go on a spending spree and charge hundreds more to your credit card, right? If you did, you’d just dig a deeper hole that would take longer to get out of, and that’s exactly what happens with food. This very pattern is why many women remain roughly the same size for years, despite constantly being on diets. If that sounds familiar, know that you can break the cycle. Many of my clients discover that after a short detour, it is possible to get right back on the road, rather than getting lost.

Structure your time
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For most of my clients, the risk of eating emotionally is greater on the weekends, when they have hours of unstructured time. If you’re in the same boat, plan a project or activity you enjoy, and build in a deadline. For example, if you’re making something (jewelry, crafts, etc.), plan to give it to a friend or family member on a specific date. And once you’ve finished a project, start another. This lifestyle change can result in finally ending what some of my clients refer to as “two day food orgies” and add to your quality of life in numerous ways.

What’s your take on this topic? Do you struggle with emotional eating? Please tweet your thoughts to @CynthiaSass and @goodhealth

Cynthia Sass is a registered dietitian with master’s degrees in both nutrition science and public health. Frequently seen on national TV, she’s Health’s contributing nutrition editor, and privately counsels clients in New York, Los Angeles, and long distance. Cynthia is currently the sports nutrition consultant to the New York Rangers NHL team and the Tampa Bay Rays MLB team, and is board certified as a specialist in sports dietetics. Her latest New York Times best seller is S.A.S.S! Yourself Slim: Conquer Cravings, Drop Pounds and Lose Inches. Connect with Cynthia on Facebook, Twitter and Pinterest.

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Viral Inflammation During Pregnancy Disrupts Brain-Cell Connections

Date: September 23, 2013
Study with mice helps explain why maternal infection during pregnancy increases the risk that offspring will develop autism

Studies have long shown that maternal infection during pregnancy increases the risk that a child will develop autism. A newly published study may help explain why – and provide early guidance for the development of potential treatments.

The new study, by autism researchers at the University of California-Davis Center for Neuroscience, appears in the Journal of Neuroscience.

The researchers documented abnormal brain-cell development in the pups of pregnant mice that had been injected with viral RNA to mimic a flu (influenza) infection. The brain cells of these pups had much higher levels of a class of immune molecules called major histocompatibility complex 1 (MHC1).

The high MHC1 levels, in turn, interfered with the brain cells’ ability to form connections with other brain cells. This is in line with earlier research suggesting that autism stems from the altered development of brain connections.

In their experiments, the researchers then blocked the development of the excess MHC1 molecules in the pups’ developing brains. This restored the normal growth of brain-cell connections.

“We know that activation of a mother’s immune system during pregnancy is a risk factor for autism, but how we get from risk factor to brain changes that contribute to autism has not been clear,” comments Daniel Smith, Autism Speaks senior director for discovery neuroscience.

“We’re still a long way from knowing whether these results will lead to safe, new treatments,” Dr. Smith adds. “But studies like this – which point to specific biochemical pathways and abnormalities in connections between neurons – take us one step closer.”

The study’s lead investigators – Bradford Elmer and Myka Estes – are pursuing their research with the support of Autism Speaks’ Weatherstone Predoctoral Fellowships. The study’s senior author, Kimberley McAllister, is the recipient of an earlier Autism Speaks research grant that helped lay the foundation for the current study.

Tags: Science, autism, Autism Speaks, Bradford Elmer, Dan Smith, Kimberley McAllister, maternal immune activation and autism, maternal infection during pregnancy, MIND Institute, Myka Estes, prenatal infection and autism, UC-Davis

Use of acid-suppressive drugs during pregnancy and the development of toddler asthma

Published Online: September 3, 2013

Gastro-Acid-suppressive drugs are considered effective and safe to use during pregnancy to treat gastro-oesophageal reflux disease (GERD). Recent studies reported a causal relation between prenatal exposure to acid suppressive drugs and the development of childhood asthma but unmeasured confounding could not be ruled out.

In a Letter to the Editor in The Journal of Allergy & Clinical Immunology (JACI), Mulder et al. investigated the association between prenatal exposure to acid suppressive drugs and toddler asthma with a confounding minimizing case-crossover design.

This study was performed with data from the Groningen prescription database IADB and compared 1,253 children with asthma with 1,253 of their own siblings without asthma. Children were identified as having asthma with the aid of dispensed prescriptions for asthma medication. All children could be followed in the database for at least 5.5 years from birth. Maternal exposure was defined as receiving at least one prescription for either proton pump inhibitors, histamine-2-antagonists or other drugs for GERD during pregnancy.

The authors found that the use of acid suppressive drugs during pregnancy was associated with the development of asthma in children. The validity of previous reported results are supported by this study because findings showed the minimal influence of confounding in these associations. However, more study for example of the mechanism or development of other atopic conditions in relation to acid suppressive drugs, is now warranted, and the benefit risk-balance of such drugs should be reconsidered during pregnancy.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

Walnut-Rich Diet Helps Overweight Adults Against Diabetes and Heart Problems

A new finding has found added benefits of walnut for overweight adults. Medical researchers say walnuts help in protecting against diabetes as well as heart diseases in overweight adults.
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Since ancient times Walnuts are recognized as the most delicious and healthiest of all nuts. They contain antioxidants, which counter the effects of cell damage as well as aging. Earlier studies have focused on the effects of walnut and walnut oil on disease prevalence as well as mortality. This new study establishes that by adding walnuts in the diet, overweight adults can improve their endothelial function.
The latest finding was provided by medical experts from Yale -Griffin Prevention Research Center in Connecticut.
“We know that improving diets tends to be hard, but adding a single food is easy,” Dr. David Katz, lead author, said in a news statement.
The team conducted a study that involved 46 adults of ages 30-75 who had a large Body Mass Index (more than 25) and whose waist circumference exceeded 40 inches (men) and 35 inches (women). Apart from this, the participants were required to be non smokers and had to carry one or more added risk factor for metabolic syndrome – combination of medical disorders that elevate the risk of diabetes as well as cardiovascular disease.
Later the researchers randomly assigned the group of participants to a two week diet that either included walnut enriched ad libitum diet or an ad libitum diet minus walnut. The participants who belonged to the walnut diet had to consume upto 56 gms of unroasted, shelled English walnuts everyday as a snack or with meal.
According to the researchers, adding walnuts in the diet offers dual benefits; it is nutrient rich and also helpsin removing food that contain less nutritious food.
On completing the test, the researchers noticed that there was a vast improvement in the endothelial function of overweight adults with visceral adiposity when they took walnuts daily. Apart from this, daily walnut intake did not lead to unwanted weight gain.
The researchers stated, “The primary outcome measure was the change in flow-mediated vasodilatation (FMD) of the brachial artery. Secondary measures included serum lipid panel, fasting glucose and insulin, Homeostasis Model Assessment-Insulin Resistance values, blood pressure, and anthropometric measures…”
The study “Effects of Walnuts on Endothelial Function in Overweight Adults with Visceral Obesity: A Randomized, Controlled, Crossover Trial,” is documented in the journal of American College of Nutriti