For diabetes in obesity, weight-loss surgery beats medication

 

Friday, September 4, 2015  By Anne Harding (Reuters Health) – Weight-loss surgery beats medication for controlling type 2 diabetes in obese people, according to the longest-term trial ever to compare the two approaches. Half of the patients treated with weight-loss surgery in the study were diabetes-free at five years, said Dr. Francesco Rubino of Kings College London in the UK and colleagues in a report in The Lancet. “The five-year mark is an important mark in many diseases,” Dr. Rubino told Reuters Health by phone. “The fact that some patients at five years are basically disease-free is a remarkable finding.” In 2009, he and his colleagues randomly assigned 20 obese patients with type 2 diabetes to receive medical treatment, 20 to receive a type of weight-loss surgery called a gastric bypass, and another 20 to undergo a weight-loss operation called a biliopancreatic diversion. Eighty percent of patients who had surgery had their blood sugar under good long-term control, versus about 25 percent of patients treated with drugs only. All of the study groups had a reduction in cardiovascular risk. But the surgery-treated patients had a 50 percent lower risk of heart and blood vessel disease than those treated with drugs only, and they needed fewer drugs for treating high blood pressure or high cholesterol. The improvements in blood sugar control and heart disease risk weren’t related to how much weight patients lost. “What really is causing the remission of diabetes after surgery remains mysterious,” Dr. Rubino said. What is known, he added, is that the intestines produce a host of hormones involved in regulating metabolism. Reconstructing the gastrointestinal tract so that food bypasses the stomach and small intestine may help restore normal metabolic control, he explained. Like any surgery, weight loss operations carry risks. An international study published earlier this, for example, found that after two years, people randomized to have gastric bypass surgery had better control of their type 2 diabetes than people assigned to a medication group, but they also had a higher risk for infections and bone fractures. (See Reuters Health story of May 21, 2015.) And some patients may gain back some of the weight they lost. Still, doctors are increasingly referring to this type of surgery as “diabetes surgery,” rather than obesity surgery, said Dr. Philip Schauer, the director of the Cleveland Clinic Bariatric and Metabolic Institute and a bariatric surgeon, in a telephone interview with Reuters Health. Dr. Schauer did not participate in the new study. “There are some people, this study shows, that can go into remission for up to five years or more,” he said. “We hesitate to use the word ‘cure,’ but it’s pretty darn close to a cure, about as close to a cure as you can get.’” Dr. Schauer pointed out that about half of patients with type 2 diabetes are unable to control their blood sugar with medication and lifestyle measures. Based on the new findings, he said, bariatric surgery should be offered to these patients if they are moderately obese, for example with a body mass index (BMI) of 35. (BMI is a measure of weight in relation to height.) Currently the National Institutes of Health states that patients should have a BMI of 40, or a BMI of 35 with obesity-related illness, such as type 2 diabetes, in order to be eligible for weight loss surgery. “There are still many insurance companies today that will not pay for this surgery for any reason, whether it’s for obesity or diabetes. It means that they are denying people effective treatment,” Dr. Schauer said. “This study is going to make insurance carriers and third party payers rethink their coverage policies regarding bariatric or diabetes surgery, as we prefer to call it.” SOURCE: http://bit.ly/1JTRaqX The Lancet, online September 3, 2015.

New medical device concept could reduce time to diagnose infections

 

An artist's rendition of the DOTS qPCR device. Credit: Dustin Harshman When a patient arrives at a hospital with a serious infection, doctors have precious few minutes to make an accurate diagnosis and prescribe treatment accordingly. Doctors' ability to act quickly and correctly not only makes a difference to the patient's outcome, it determines whether the infection spreads to other patients in the clinic, and can even contribute to the development of drug-resistant bacteria. Luckily for patients and doctors alike, a new diagnostic device created by collaborative team of UA engineers and scientists may significantly reduce the amount of time necessary to diagnose tissue infections. The device's novel approach to molecular diagnostics, called DOTS qPCR, is faster, more efficient and less expensive than alternatives currently being used in clinics. The work is described online in the journal Science Advances. "We have developed a completely different type of system than what exists out on the market," said Dustin Harshman, a former graduate student in the Biomedical Engineering Graduate Interdisciplinary Program, currently a scientist at Ventana Medical Systems. "We want to see physicians get diagnostic information more rapidly and prescribe better initial therapies." Pathogens and infectious diseases are typically detected using a technique called polymerase chain reaction, or PCR. The method involves rapidly heating and cooling DNA molecules from a biological sample in a process called thermal cycling. This results in the amplification of the target DNA into millions, and even billions of copies. Scientists and physicians can then use the copies to identify the type of pathogen causing the infection. The problem is that most PCR tests can take up to an hour or more, and a physician's decision-making window is typically less than ten minutes. "With DOTS qPCR we are able to detect amplification and identify the infection after as few as 4 thermal cycles, while other methods are working with between 18 and 30," said Jeong-Yeol Yoon, a professor in the Department of Agricultural and Biosystems Engineering and a joint appointment in the Department of Biomedical Engineering. "We can get from sample to answer in as little as 3 minutes and 30 seconds." DOTS qPCR, invented by Yoon and his research group, stands for droplet-on-thermocouple silhouette real-time PCR. The technology relies on the measurement of subtle surface tension changes at the interface of a water droplet suspended in an oil medium. The water droplet, which contains the target DNA to be amplified, is moved along a heat gradient in the oil to begin the chain reaction. As more copies of the target DNA are produced, they move towards the oil-water interface, resulting in measurable changes in surface tension. Remarkably, the size of the droplet can be measured using a smartphone camera, providing a method to observe the course of the reaction in real time. "What's interesting about the way we approached this is that we've developed a deep understanding of what's happening at a molecular level in our system," said Harshman, who initially struggled to determine how to monitor the course of the reaction. "That kind of understanding gave us the ability to figure out why it was failing, and then leverage that failure as an advantage to create a completely new method." In addition to much faster diagnosis times, the system does not require samples to be completely free of other contaminants. This can save valuable time otherwise spent preparing samples for testing. "The system still works with relatively dirty samples," said Yoon. "We can use very minimal processing and still make the detection in a short time." Yoon emphasized that DOTS qPCR is inexpensive compared to its counterparts, which employ costly and time-intensive testing methods involving fluorescence detection, lasers and dark chambers. "It's easy to use, smartphone-integrated and saves money and labor using expensive equipment," explained Yoon. "This technology has a lot of commercial potential, and we'd be happy to work with industry to bring it to market." DOTS qPCR also has major applications in biological research, where PCR is an indispensable tool used in studying everything from hereditary disease to the evolutionary tree. Ultimately, Harshman and Yoon hope the technology will transform the operations of hospital emergency rooms, where saving time to diagnosis translates into saving lives. "We're envisioning a device that will provide physicians with answers as soon as they perform a biopsy, while they're still sitting with the patient," said Harshman. "By saving diagnosis time, we can decrease complications for patients, isolate infections to prevent spreading, and avoid creating selective pressure for antibiotic-resistant bacteria, which is a huge burden on the medical system." Story Source: The above post is reprinted from materials provided by University of Arizona. The original item was written by Raymond Sanchez. Note: Materials may be edited for content and length. Journal Reference: D. K. Harshman, B. M. Rao, J. E. McLain, G. S. Watts, J.-Y. Yoon. Innovative qPCR using interfacial effects to enable low threshold cycle detection and inhibition relief. Science Advances, 2015; 1 (8): e1400061 DOI:10.1126/sciadv.1400061 University of Arizona. "New medical device concept could reduce time to diagnose infections." ScienceDaily. ScienceDaily, 4 September 2015. <www.sciencedaily.com/releases/2015/09/150904194857.htm>

A new sensor system enables researchers to know the risk of corrosion in reinforced concrete structures in real time

 

Researchers of the Universitat Politècnica de València have developed a new sensor system able to quickly and non-destructively detect the risk of corrosion in the concrete structure of buildings and do so when the first symptoms appear. The information provided by this system, which has been patented by the UPV, is of particular significance for building safety. It enables any necessary intervention to be made sufficiently in advance, reducing, at the same time, repair and maintaining costs. The system also includes a pulse voltammetry unit, which provides information on the intensity of the corrosion for every point in the network of sensors of the structure analysed, and specific software for analysing the electrical response from each sensor. Today, the most common way to determine the corrosion speed of the rebars in a reinforced concrete structure is based on destructive techniques, for which it is necessary to expose the rebars at a certain distance in order to electrochemically measure the intensity of the corrosion. It is then necessary to repair the area with mortars. Its benefits include a reduction in the time and cost of the diagnosis of the structure. In addition, it is able to register in real time the state of maintenance and the speed of corrosion of the rebars at several points of the structure, even in non-accessible areas. Application The system could be installed both in new constructions and restoration projects. In the first case, it must be incorporated when the concrete is poured in those areas of the structure most exposed to corrosion caused by humidity, carbon dioxide or chlorides, among others. In restoration projects, it permits a non-destructive control and monitoring of the effectiveness of the restoration. Miguel Alcañiz, Román Bataller, José Manuel Gandía, José Enrique Ramón and Juan Soto, researchers at the Centre for Molecular Recognition and Technological Development (IDM, in Spanish), together with Manuel Valcuende, from the Grupo de Recuperación del Patrimonio Cultural of the Universitat Politècnica de València have taken part in the development of this project. Story Source: The above post is reprinted from materials provided by Asociación RUVID.Note: Materials may be edited for content and length. Asociación RUVID. "A new sensor system enables researchers to know the risk of corrosion in reinforced concrete structures in real time." ScienceDaily. ScienceDaily, 4 September 2015. <www.sciencedaily.com/releases/2015/09/150904121626.htm>

FAA beta testing B4UFLY smartphone app to keep drone pilots informed

 

The FAA is beta testing a smartphone app to inform drone pilots of any restrictions or requirements in effect at a location (Credit: Noel McKeegan/Gizmag.com) Image Gallery (5 images) Small Unmanned Aerial Vehicles (UAVs), or drones, have quickly gained popularity with the public. And as is so often the case with rapidly advancing technologies, it can be hard for the public to know legally what they can and can't do with the technology – or in the case of drones, where they can and can't fly. To help dispel confusion surrounding drone flights, the US FAA is beta testing its B4UFLY smartphone app, which tells users about any restrictions on unmanned aircraft they might want to fly in a particular area. B4UFLY was released on August 28 to about 1,000 beta users from the public, government, and industry for a 60-day trial. With drones recently caught interfering with rescue services at fires and security alerts prompted by a rash of UAV sightings by pilots at airports, the FAA says the aim of the app is to encourage voluntary compliance with aviation regulations by packaging real-time, publicly available information in a user-friendly format. Based on standing laws and regulations as well as Temporary Flight Restrictions (TFR), the app provides red, orange, and, yellow status warnings regarding specific locations, the parameters of the warning, a Planner Mode for future flights and locations, and links to FAA information resources. "The FAA is responsible for ensuring the safety of the flying public and people and property on the ground," says the authority. "We believe a key way to help people fly unmanned aircraft safely is to provide situational awareness to let them know where it’s not a good idea to fly because there might be a conflict in the airspace they’re flying in. That’s exactly what B4UFLY is designed to do." The app is currently for iOS only and not yet available in the App Store, but the FAA says that a later app for general release will include both iOS and Android versions. Source: FAA

Diabetes symptoms: When diabetes symptoms are a concern

 

Diabetes symptoms are often subtle. Here's what to look for — and when to consult your doctor. By Mayo Clinic Staff Early symptoms of diabetes, especially type 2 diabetes, can be subtle or seemingly harmless — if you have symptoms at all. Over time, however, you may develop diabetes complications, even if you haven't had diabetes symptoms. In the United States alone, nearly 7 million people have undiagnosed diabetes, according to the American Diabetes Association. But you don't need to become a statistic. Understanding possible diabetes symptoms can lead to early diagnosis and treatment — and a lifetime of better health. If you're experiencing any of the following diabetes signs and symptoms, see your doctor. Excessive thirst and increased urination Excessive thirst and increased urination are classic diabetes symptoms. When you have diabetes, excess sugar (glucose) builds up in your blood. Your kidneys are forced to work overtime to filter and absorb the excess sugar. If your kidneys can't keep up, the excess sugar is excreted into your urine along with fluids drawn from your tissues. This triggers more frequent urination, which may leave you dehydrated. As you drink more fluids to quench your thirst, you'll urinate even more Fatigue You may feel fatigued. Many factors can contribute to this. They include dehydration from increased urination and your body's inability to function properly, since it's less able to use sugar for energy needs. Weight loss Weight fluctuations also fall under the umbrella of possible diabetes signs and symptoms. When you lose sugar through frequent urination, you also lose calories. At the same time, diabetes may keep the sugar from your food from reaching your cells — leading to constant hunger. The combined effect is potentially rapid weight loss, especially if you have type 1 diabetes. Blurred vision Diabetes symptoms sometimes involve your vision. High levels of blood sugar pull fluid from your tissues, including the lenses of your eyes. This affects your ability to focus. Left untreated, diabetes can cause new blood vessels to form in your retina — the back part of your eye — and damage established vessels. For most people, these early changes do not cause vision problems. However, if these changes progress undetected, they can lead to vision loss and blindness. Next http://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-symptoms/art-20044248

Unexplained weight loss

 

Definition By Mayo Clinic Staff Unexplained weight loss, or losing weight without trying — particularly if it's significant or persistent — may be a sign of an underlying medical disorder. The point at which unexplained weight loss becomes a medical concern is not exact. But many doctors agree that a medical evaluation is called for if you lose more than 5 percent of your weight in six months to a year, especially if you're an older adult. For example, a 5 percent weight loss in someone who is 160 pounds (72 kilograms) is 8 pounds (3.6 kilograms). In someone who is 200 pounds (90 kilograms), it's 10 pounds (4.5 kilograms). Your weight is affected by your calorie intake, activity level, overall health, age, nutrient absorption, and economic and social factors. Causes

Samsung Gear S2: Hands-on

 

How does the Gear S2 measure up in the flesh? (Credit: Chris Wood/Gizmag) Samsung's newly announced Gear S2 smartwatch is instantly appealing. It offers a compelling combination of touch and physical controls, a sharp colorful interface and two distinct flavors of hardware. Read on for Gizmag's full hands-on impressions. Like many smartwatches these days, there are two variants of the Gear S2. There's only one size on offer here, but two very distinct models – the sporty Gear S2 and the more traditional looking S2 classic. Not only do the straps differ between the two versions, but the way they attach to the body also varies (it disappears into the body on the standard model),. The design of the bezel is also simpler on the standard model, with a smooth aesthetic as opposed to the ridged look on the classic. The design of both versions is clean and appealing. It's easily the best-looking smartwatch that Samsung has ever made (and it's made quite a few). Both the rubber and leather bands feel comfortable, and the proportions of the watch as a whole are about right – it's not too bulky, but also feels reasonably substantial on the wrist. We prefer the look of the classic version, as it's a little more refined, high-end and closer to the look of a traditional watch. The circular screen packs a 360 x 360 resolution, and because that's only over 1.2-inches, you're getting a pretty sharp 302 pixels per inch. Graphics looked crisp and clear on the AMOLED panel, and colors were vivid and bright. Navigation of the Tizen OS software is handled through a combination of touch input, two physical buttons on the right hand side of the case and a rotating bezel. You turn the bezel to scroll through menus, tap the screen to make selections, and use the buttons both to go back and to access the app menu. After five or ten minutes of use, the combination of controls is intuitive and enjoyable, and makes smartwatches with touchscreen-only input feel a little more basic than they did before. The software has multiple layers, including a main app carousel and dedicated app menu. There are also complex, multi-screen apps for fitness, calendar, email, and much more. The UI is far more complicated than an Android Wear-based wearable, but nothing felt too cramped during testing, with clean and simple menus and graphics. The Gear S2 is a very promising smartwatch. The physical product looks great, the software has a unified, appealing aesthetic, and the rotating bezel input adds to the experience. Luckily, you won't need the latest and greatest Samsung smartphone to pair it with, as it will work with any Android handset running version 4.4 of the OS and up, with at least 1.5 GB RAM (that includes just about every high-end phone from the last two or three years, along with plenty of mid-ranged handsets). Android Wear watches recently got iPhone support, though, so Samsung's Tizen is still behind them in terms of compatibility. Samsung's new wearable is set to land in October; no official pricing info just yet. For more on the new smartwatches at IFA, you can hit up Gizmag's hands-ons with the Huawei Watch, new Moto 360 and Asus ZenWatch 2. Product page: Samsung http://www.gizmag.com/samsung-gear-s2-review-hands-on/39252

Hubble Peers into the Heart of a Galactic Maelstrom

 

This NASA/ESA Hubble Space Telescope image shows Messier 96, a spiral galaxy just over 35 million light-years away in the constellation of Leo (The Lion). It is of about the same mass and size as the Milky Way. It was first discovered by astronomer Pierre Méchain in 1781, and added to Charles Messier’s famous catalogue of astronomical objects just four days later.
The galaxy resembles a giant maelstrom of glowing gas, rippled with dark dust that swirls inwards towards the nucleus. Messier 96 is a very asymmetric galaxy; its dust and gas are unevenly spread throughout its weak spiral arms, and its core is not exactly at the galactic center. Its arms are also asymmetrical, thought to have been influenced by the gravitational pull of other galaxies within the same group as Messier 96.
This group, named the M96 Group, also includes the bright galaxies Messier 105 and Messier 95, as well as a number of smaller and fainter galaxies. It is the nearest group containing both bright spirals and a bright elliptical galaxy (Messier 105).

Image credit: ESA/Hubble & NASA and the LEGUS Team, Acknowledgement: R. Gendler
Text credit: European Space Agency

Last Updated: Sep. 4, 2015

Editor: Ashley Morrow

Childhood Obesity

 

A large quantity of children in the WORLD has obesity and certain groups of children are more affected than others. While there is no single or simple solution, National Childhood Obesity Awareness Month (USA), provides an opportunity for learning about ways to prevent and address this serious health concern. Childhood obesity is a major public health problem. Children who have obesity are more likely to have obesity as adults. This can lead to lifelong physical and mental health problems, including diabetes and increased risk of certain cancers. Children who have obesity face more bullying and stigma. Childhood obesity is influenced by many factors. For some children and families factors include too much time spent in sedentary activities such as television viewing; a lack of bedtime routine leading to too little sleep; a lack of community places to get adequate physical activity; easy access to inexpensive, high calorie snacks and beverages; and/or a lack of access to affordable, healthier foods. There are many ways children can get regular physical activity. Being physically active improves children's overall health. There are ways parents can help prevent obesity and support healthy growth in children. To help ensure that children have a healthy weight, energy balance is important. To achieve this balance, parents can make sure children get adequate sleep, follow recommendations on daily screen time, take part in regular physical activity, and eat the right amount of calories. Parents can substitute higher nutrient, lower calorie foods such as fruit and vegetables in place of foods with higher-calorie ingredients, such as added sugars and solid fats. Parents can serve children fruit and vegetables at meals and as snacks. Parents can ensure access to water as a no-calorie alternative to sugar-sweetened beverages. Parents can help children get the recommended amount of physical activityeach day by encouraging them to participate in activities that are age-appropriate and enjoyable. There are a variety of age appropriate aerobic, muscle and bone-strengthening activities that kids can do. Addressing obesity can start in the home, but also requires the support of communities. We can all take part in the effort to encourage more children to be physically active and eat a healthy diet. The federal government (USA) is currently helping low-income families get affordable, nutritious foods through programs, such as the Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Child and Adult Care Feeding Program (CACFP). State and local stakeholders including health departments, businesses, and community groups can help make it easier for families with children to find low-cost physical activity opportunities and buy healthy, affordable foods in their neighborhoods and community settings. Schools can help students' be healthy by putting into action policies and practices that support healthy eating, regular physical activity, and by providing opportunities for students to learn about and practice these behaviors. With more than 60% of children (in the USA) younger than age 6 participating in some form of child care on a weekly basis, parents can engage with child care providers to support healthy habits at home and in child care settings. Working together, states, communities, schools, child care providers, and parents can help make healthier food, beverages, and physical activity the easy choice for children and adolescents to help prevent childhood obesity.     http://www.cdc.gov/features/childhoodobesity/

Healthy Swimming Year-Round

 

Stay healthy and avoid recreational water illnesses (RWIs) when you swim or use the hot tub/spa by following a few simple steps. Even though it is frequently associated with summer, swimming is a physical activity many people enjoy all year long. Indoor pools, hot tubs, and even outdoor pools in warm climates are popular year round. Swimming is a fun activity for people of all ages and offers many health benefits; however, recreational water (water from pools and hot tubs) can also spread germs that cause recreational water illnesses (RWIs). The germs that cause RWIs are spread by swallowing, breathing in the mists or aerosols of, or having contact with contaminated water in swimming pools, hot tubs, water parks, water play areas, interactive fountains, lakes, rivers, or oceans. RWIs can also be caused by chemicals in the water or chemicals that vaporize from the water and cause indoor air quality problems. Stay Healthy in the Pool The best way to prevent RWIs is to take an active role in stopping the spread of germs by following the steps of healthy swimming. To help protect yourself and your family and friends from germs, here are a few easy and effective steps all swimmers can take each time we swim: Keep the pee, poop, sweat, and dirt out of the water! Stay out of the water if you have diarrhea. Shower before you get in the water. Don’t pee or poop in the water. Don’t swallow the water. Every hour—everyone out! Take kids on bathroom breaks. Check diapers, and change them in a bathroom or diaper-changing area–not poolside–to keep germs away from the pool. Reapply sunscreen. Drink plenty of fluids. Check the free chlorine level and pH before getting into the water. Pools: Proper free chlorine level (1–3 mg/L or parts per million [ppm]) and pH (7.2–7.8) maximize germ-killing power. Hot tubs/spas: Proper disinfectant level (chlorine [2–4 parts per million or ppm] or bromine [4–6 ppm] and pH [7.2–7.8]) maximize germ-killing power. Most superstores, hardware stores, and pool-supply stores sell pool test strips. Think Healthy. Swim Healthy. Be Healthy! **Remember that swim diapers and swim pants are not a replacement for frequent diaper changing and regular trips to the bathroom. Swim diapers and swim pants are not designed to keep diarrhea (the most serious water contaminant) from leaking into the pool. Parents should never allow their children to enter the water when they are ill with diarrhea, even if they are wearing swim diapers or swim pants. For more information, check out the Triple A's of Healthy Swimming: Awareness, Action, and Advocacy. Stay Healthy in the Hot Tub The germs that cause RWIs can also be spread in hot tubs. To stay healthy while soaking in the hot tub, follow these HOT steps! Heed… rules for safe and healthy use. Exclude children less than 5 years of age from using hot tubs. If pregnant, consult a healthcare provider before using hot tubs, particularly in the first 3 months of pregnancy. Observe... the hot tub and its surroundings. Hot tub temperature should not exceed 104°F (40°C). Check hot tub water; CDC recommends maintaining free chlorine at 2–4 parts per million [ppm] or bromine at 4–6 ppm, and pH at 7.2–7.8. Pool and hot tub test strips are available at local home improvement stores, discount retailers, and pool–supply stores. If you want to practice using them at home, check out our Pool & Spa (Hot Tub) Test Strips Home Test Instructions. Talk…to hot tub owners/staff and other hot tub users. Are chlorine or bromine levels and pH checked at least 2 times per day? Are they checked during times when the hot tub is most heavily used? Talk to hot tub staff and users about RWIs and share these tips with them. Helpful Resources To help spread the message about RWI prevention, CDC's Healthy Swimming Program has developed a variety of health promotion materials, including: Healthy swimming brochures, available for free in English and Spanish Fact sheets on frequently-asked RWI questions in English and Spanish Videos that remind swimmers to play it safe and stay out of the water when ill with diarrhea Podcasts on preventing illness and injury while swimming Posters on preventing RWIs and chemical injuries A mobile app for healthy swimming information on the go For more in-depth information on healthy swimming, go to the Healthy Swimming website. Remember, healthy swimming is no accident. Think Healthy. Swim Healthy. Be Healthy.   http://www.cdc.gov/features/healthy-swimming-year-round/index.html