Climate Change-Induced Health Crisis Looms Large

American College of Physicians warns of the potentially devastating impact of climate change on global public health.

 Climate change poses a clear and imminent threat to global health, according to the American College of Physicians (ACP). In a policy paper published April 19, 2016 in Annals of Internal Medicine, the ACP warned that unless widespread action is taken to lower greenhouse gas emissions, public and individual health will suffer dire consequences.

“We need to take action now to protect the health of our community’s most vulnerable members — including our children, our seniors, people with chronic illnesses, and the poor — because our climate is already changing and people are already being harmed,” said ACP President Wayne J. Riley, MD, MPH, MBA, MACP in a news release.

In the paper, the ACP cautioned that climate change has the potential to raise the rates of respiratory and heat-related illnesses, increase the prevalence of insect-borne and water-borne diseases, contribute to food and water shortages, and cause malnutrition. Those most vulnerable to these dangerous effects are the elderly, the poor, and the infirm.

According to Riley, doctors can help to avert this global health crisis by “advocating for effective climate change adaptation and mitigation policies, helping to advance a low-carbon health care sector, and by educating communities about potential health dangers posed by climate change.”

As protectors of public health, physicians have a responsibility to educate themselves and their patients about the effects of climate change and to work towards reducing their own and others’ energy usage. To that end, the ACP recommended that courses on climate change be included in the curricula of medical schools and continuing medical education programs.

The healthcare sector ranks close to the top for energy use, second only to the food industry. It spends about $9 billion annually on energy costs. The ACP strongly urged the healthcare industry to take a good look at its energy consumption and to cut back where possible. Potential areas of improvement are transportation, energy efficiency, use of alternative energy, green building design, waste disposal and management, food waste reduction, and water conservation.

“This paper was written not only to support advocacy for changes by the U.S. government to mitigate climate change, but to provide our international chapters and internal medicine colleagues with policies and analysis that they can use to advocate with their own governments, colleagues, and the public, and for them to advocate for changes to reduce their own health systems impact,” said Riley.

 

Article sources:

Crowley, Ryan A. “Climate Change and Health: A Position Paper of the American College of Physicians.” Ann Intern Med. Published online 19 April 2016 doi:10.7326/M15-2766

News release: American College of Physicians

Treating Depression with Light Therapy

Research reveals bright light treatment is more than just a way to beat the winter blues.

Depression is a disease that touches many lives. According to the National Institute of Mental Health, 6.4 percent of Americans suffer from some type of depression. It’s the leading cause of disability in the United States. Antidepressant medications are widely prescribed to help patients deal with the symptoms of depression. Unfortunately, they’re effective in only 55-60 percent of cases, leaving many depression sufferers searching for a viable alternative.

Light therapy has long been used to combat seasonal affective disorder (SAD), a type of depression that’s linked to the changing of the seasons. But what about depression that has nothing to do with the seasons? According to Dr. Barbara Parry, MD, a professor of psychiatry at University of California San Diego School of Medicine, exposure to bright light is an effective treatment for other types of depressive disorders too.

“Light therapy initially was used to treat seasonal affective disorder (or winter depression), but more recently has been found to be even more efficacious than antidepressants for non-seasonal depression,” says Parry.

New Evidence in Favor of Light Therapy

Recent research confirms the efficacy of treating non-seasonal depression with bright light. Scientists from the University of British Columbia (UBC) studied the effects of light therapy on the disease, both as a standalone treatment and in combination with the antidepressant fluoxetine. The study, led by UBC professor and psychiatrist Dr. Raymond Lam, MD, involved 122 patients who were exposed to a fluorescent light box for 30 minutes upon waking every day for eight weeks.

The results of the study, published in JAMA Psychiatry, showed that many patients benefited from light therapy and experienced positive effects on their mood. Light therapy helped both the patients taking fluoxetine and those who took none.

Another recent study examined the effects of light therapy on depressed cancer survivors. Patients who were exposed to a bright white light box 30 minutes each morning for four weeks experienced an improvement in their depressive symptoms. Other patients who followed the same routine with a dim red light box reported no change in symptoms.

The results of these studies should provide hope to people suffering from depression who find no relief from the current crop of treatments. “More and more people are seeking help because there is less stigma about having depression,” Lam said in a news release from UBC. “It’s important to find new treatments because our current therapies don’t work for everyone. Our findings should help to improve the lives of people with depression.”

The Advantages of Light Therapy

Light therapy for non-seasonal depressive disorder isn’t necessarily faster-acting than antidepressants. According to Parry, patients using light therapy for SAD tend to see results quickly, in as little as three to four days. However, for those suffering from non-seasonal depression, the effects of light exposure take longer to kick in – about five to six weeks.

That’s approximately the same amount of time it takes to experience relief with antidepressant medications (four to six weeks). However, the positive effects of antidepressants come at a cost. Users report a variety of side effects, including insomnia, lethargy, migraines, weight gain, decreased sex drive, and even suicide.

Light therapy generally results in fewer side effects, making it an excellent alternative for people who wish to avoid the unpleasant and possibly harmful effects of antidepressants. “It is a viable alternative treatment for women who are pregnant or breast-feeding who are concerned about the small, but potentially adverse, effects of antidepressant medication on their child,” says Parry.

Those who avoid medication due to cost or lack of availability are also good candidates for light therapy. The initial investment in a fluorescent light box ranges from $40 to $300. The treatment itself is as simple as plugging in the box at home and basking in its glow for 30 minutes each morning. There’s no need to disrupt the morning routine either – reading, eating, drinking coffee, checking email, shaving, and putting on makeup are all acceptable activities during a light therapy session.

Combining Treatments for Maximum Effect

 While light therapy alone is an effective treatment for depression, its impact improves when combined with other treatments, such as psychotherapy, medication, or sleep therapy. The UBC researchers found that the patients who reported the most improvement in depressive symptoms were those who also took an antidepressant. Parry is currently researching the impact of combining light therapy with shifts in sleeping schedules. According to her, “Light treatment can work faster and its effects can be enhanced by combining it with sleep therapy.”

 

Article sources:

Barbara Parry, MD, professor of psychiatry at University of California San Diego School of Medicine

Lam, Raymond W., MD. JAMA Psychiatry. 2016; 73(1): pp 56-63.

National Institute of Mental Health: “Antidepressants: A Complicated Picture”

News release, Mount Sinai Hospital/Mount Sinai School of Medicine

News release, University of British Columbia

 

 

 

Why the Brain Gets a Boost from Exercise

New research explains why exercise improves our mental health and mood.

 

Exercise is not only good for the body, but for the brain as well. Vigorous physical activity has a positive impact on brain function, mental health and mood. Now researchers from the University of California-Davis Health System have discovered one of the reasons why.

The results of their recent study show that high-intensity exercise results in increased levels of glutamate and gamma-aminobutyric acid, or GABA. These two neurotransmitters regulate the chemical messaging that occurs in the brain.

Within the brain are cells that control physical and mental wellbeing. GABA and glutamate facilitate the flow of messages between these cells. Low levels of these neurotransmitters can lead to depression and other neuropsychiatric disorders.

In a news release from UC Davis, study lead author Richard Maddock said, “Major depressive disorder is often characterized by depleted glutamate and GABA, which return to normal when mental health is restored. Our study shows that exercise activates the metabolic pathway that replenishes these neurotransmitters.”

The findings of the study, published in the Journal of Neuroscience, also provide new insights into brain metabolism. Intense physical activity causes the brain to consume large amounts of glucose and other carbohydrates. In fact, it devours more of this fuel during exercise than during other demanding activities, such as solving complex math equations or strategizing during a game of chess. The researchers now believe that the brain uses the extra energy to produce more neurotransmitters.

38 healthy volunteers participated in the study. The subjects rode on stationary bikes to reach 85% of their maximum heart rate. The research team used MRI imaging to measure GABA and glutamate levels in two areas of the brain before and after exercise. They did the same for a control group that did not exercise.

While there was no significant change in the neurotransmitter levels of the control group, the subjects who exercised showed increased levels of both glutamate and GABA. These increases occurred in two different parts of the brain: the visual cortex (where visual sensory input is processed) and the anterior cingulate cortex (which regulates heart rate, emotion and some cognitive mechanisms).

While the increased levels of glutamate and GABA appeared to diminish with time, there appear to be more enduring effects as well.

“There was a correlation between the resting levels of glutamate in the brain and how much people exercised during the preceding week,” said Maddock, who is a professor in the Department of Psychiatry and Behavioral Sciences. “It’s preliminary information, but it’s very encouraging.”

Maddock and his team hope to perform further research using brain-imaging combined with exercise to determine the impact of less intense physical activity on neurotransmitter levels. They also plan to investigate which specific types of exercise are most beneficial for those suffering from depression.

 

Article sources:

News release, University of California-Davis Health System.

Voss, M. Journal of Applied Physiology, .

 

 

Gentler Cancer Treatment is on the Horizon

 

Researchers at the Niels Bohr Institute, University of Copenhagen have made considerable inroads in the search for a treatment that attacks cancer cells on the cellular level. This new type of treatment would target and destroy cancer cells and leave healthy cells unharmed. It would provide a gentler alternative to the more invasive cancer treatments currently used.

Chemotherapy and radiation are the most common forms of cancer treatment today. Each of these treatments is effective at killing cancerous cells, but unfortunately harms and destroys healthy cells at the same time. This results in many side effects, some of which are debilitating. In addition, the efficacy of these treatments is limited in cases where cancer has spread from the primary tumor site to other parts of the body.

In response to these issues with current cancer treatments, the researchers at the Niels Bohr Institute have been working towards finding a treatment that specifically targets malignant cells. The scientists have attempted to deceive cancer cells into absorbing a cytotoxin that ultimately destroys them, while leaving healthy cells unaffected.

Physicist Murillo Longo Martins, a post-doc in X-Ray and Neutron Science at the Niels Bohr Institute, hypothesized that there must be a way to create a microscopic vehicle that could move through the bloodstream and carry the cytotoxin directly to the cancer cells. This vehicle would then incite the cell to allow the cytotoxin in, which would ultimately lead to the destruction of the cell by the cytotoxin.

Martins used tiny magnetic beads to act as the vehicle. After the beads were injected into the bloodstream, a magnet was placed at the site of the tumor. The tiny beads, attracted by the pull of the magnet, traveled towards the tumor.

Once the vehicle was created, the researchers moved on to creating the load that the vehicle would carry. They encased the cytotoxin surrounding the magnetic beads in a ring-shaped sac, essentially creating a cytotoxic parcel.

Now that they had the vehicle and the parcel, the next step was to figure out how to get the cell to accept the parcel. Every cell has a protective membrane that guards against harmful substances and allows helpful substances to enter through receptors, or doorways. Each of these helpful substances must have a key that fits a specific doorway in the cell membrane. The researchers needed to figure out a helpful substance that would provide the key to allow the vehicle and its cytotoxic load to enter the cancer cell.

“I thought, why do breast cancer, lung cancer and ovarian cancer so often spread to the bones? Bones are composed of minerals like calcium phosphates. Do cancer cells need these substances to grow? Can these substances be used as doorways to the cell? I decided to investigate this,” explained Martins in a news release from the Niels Bohr Institute. He ultimately decided to coat the cytotoxic parcel with calcium phosphate.

The researchers conducted experiments using breast, lung and colon cancer cells, as well as healthy cells. The results were just what Martins had imagined.

“We could see that the nanoparticles with the cytotoxin were absorbed by the cancer cells. This caused the metabolism of the cancer cells to change and the cells showed signs that they were about to die. The healthy cells, meanwhile, do not show any evidences of absorbing the packages with the cytotoxin. This suggests that the method can be used to send cytotoxin around the body with reduced toxicity and could therefore be potentially safer for healthy cells,” explains Heloisa Bordallo, Associate Professor in X-Ray and Neutron Science at the Niels Bohr Institute.

Findings from the study were published in the journal Scientific Reports.

 

Article sources:

News release, Niels Bohr Institute – University of Copenhagen

New Hope in the Search for Ebola Vaccine

 

Hundreds of antibodies capable of fighting Ebola have been discovered by a team of scientists from The Scripps Research Institute (TSRI) in La Jolla, California. A sample of blood from a survivor of the 2014 Ebola outbreak revealed the largest group of antibodies yet found. This breakthrough could be instrumental in the search for an effective vaccine.

When the deadliest Ebola outbreak in history began in West Africa in March 2014, no vaccine or drug existed for the disease. Since then, 11,316 people worldwide have died from the virus. These latest findings are a huge step towards preventing such a large and fatal outbreak of the disease from ever happening again.

“Our Science paper describes the first in-depth view into the human antibody response to Ebola virus,” team leader Dr. Laura Walker said in a news release from TSRI.

“Within weeks of receiving a blood sample from a survivor of the 2014 Ebola outbreak, we were able to isolate and characterize over 300 monoclonal antibodies that reacted with the Ebola virus surface glycoprotein,” added Walker, a senior scientist at Adimab, LLC and graduate of TSRI’s doctoral program.

The researchers also discovered a weak spot in the structure of the virus. Prior studies at TSRI and other research institutes had revealed similar vulnerabilities. Antibodies have the potential to attack and annihilate the virus at these weak points. However, because it takes a while for the human immune system to produce the correct antibodies to fit each susceptible area, researchers have thus far been working with a very small number of Ebola antibodies.

This recent discovery of such a large number of antibodies will change that. 77 percent of the antibodies isolated could potentially have the ability to attack the virus at one of its vulnerable sites and neutralize the virus. In addition, several antibodies provided protection against Ebola in mouse models.

“These types of antibodies could be developed into different types of antibody cocktails or therapeutics, in addition to advancing vaccine design,” said Dr. Andrew Ward, a study co-author and Associate Professor at TSRI.

If researchers do create an effective Ebola treatment that becomes widely used, the virus could mutate and become resistant to the treatment. With the findings from this study, researchers now have the tools to potentially devise secondary treatments to combat this kind of resistance.

The research team has chosen to reveal the antibodies’ genetic sequences to the scientific community to encourage further investigation and study. There is also hope that the techniques used to reveal the Ebola antibodies will be effective in discovering treatments for other viruses, such as Zika.

Findings from the study were published in the February 18, 2016 edition of Science.

 

Article sources:

News release, The Scripps Research Institute.

CDC: “2014 Ebola Outbreak in West Africa”.

10 Facts About the Zika Virus You Need to Know Now

The Zika virus is frightening. It seems like every day there are more cases of it in the United States. The best thing you can do is learn as much as you can about it. The following facts will help you understand what it is, what it can do, and how to protect yourself.

#1: Mosquitos Are Most Likely to Spread It

Mosquitos are what carries the Zika virus the most. So far, there has been one case of the Zika virus being transmitted through sexual intercourse. As more people become infected with the virus, the chances of catching it from someone will be higher.

#2: Symptoms Are Mild

The good news is that most people who are infected with the Zika virus never experience any symptoms, and if they do, they are mild. The most common symptoms of the virus are fever, rash, muscle pain, joint pain, headache, and conjunctivitis. These symptoms last for about a week and then go away on its own.

#3: Fetuses Are More at Risk

The Zika virus harms fetuses the most. As they are developing in the womb, the Zika virus can cause a condition call microcephaly. It causes the baby to have a small head and brain.

You probably know of the story of Jose Wesley, who was born with microcephaly. He appears to have no head, and continues to live despite the predictions doctors had about his longevity. Babies who are born with this physical disability often have heart problems, blindness and are hearing impaired as well.

#4: Zika Has Been Around for a Long Time

Zika was first discovered in 1947 in Africa. The problem is that when it was discovered, researchers thought it couldn’t harm people. Around the 1950s to 1980s, many people started to see the virus more in people. It’s not until now that they’ve finally pinpointed how it’s affected fetuses.

#5: The Zika Virus Is Spreading

It started in Africa and then went to South America. It spread much like it has to the United States. People from South America travelled to Africa, were bitten, and then were bitten by mosquitos in South America. The last known location of the mosquitos carrying the Zika Virus is Puerto Rico. This may mean the mosquitoes are travelling north, and may be in the United States soon.

#6: Mosquitos Pass It Between Each Other

More mosquitoes contract the virus by biting each other. Mosquitos do this often, and it could be the reason for the huge outbreak that’s occurred.

#7: People Are Bringing It Back from Other Countries

There are 30 countries that have been identified with the Zika virus outbreak. Americans are urged not to visit these countries, especially if they are pregnant. By limiting the exposure, it can keep the virus from coming to the United States and infect Americans.

#8: Inspect Repellant Can Help

For anyone travelling to one of the 30 countries, it’s important to use insect repellant. It can help fend off the mosquitos that carry the virus.

#9: Mosquitos Control Can Decrease the Chances of Zika Virus in the U.S.

As the spring approaches, it’s important for cities to consider adequate moisture control. By limiting the number of mosquitos in the area, there’s less of a chance the virus will be spread.

#10: Mosquitos in the U.S. Can Get It from Infected Individuals

As more people become infected with the Zika virus, mosquitos will bite them and transmit it to others. This will make the Zika

This is the reason the United States is requiring all people who have visited one of the 30 countries to be tested for the virus before entering. The only way to gain control over the spread of this virus is to keep it contained in certain areas. This way only the people who are living in them will be at risk.

A Vaccination Is in the Making

Researchers are busy working on a vaccine for the Zika virus. This vaccine will prevent the virus from its horrifying effects on fetuses. The vaccination will need to be safe for pregnant women and the fetus, so many studies will need to be conducted. It may be a while before a vaccine is available. Until then, stay away from the identified countries, and use insect repellent.