Pregnancy and alcohol consumption in the Ukraine
Alcohol consumption during pregnancy is broadly considered to be a pointless health risk for both mother and unborn child. According to the Centers for Disease Control, there are no established safe levels of alcohol use during pregnancy. Drinking during pregnancy has been linked to fetal alcohol spectrum disorders (FASD) – a wide range of physical and mental disabilities, plus lasting emotional and behavioral problems.
In a 2012 CDC study, just under 8 percent of pregnant women (1 in 13) reported consuming alcohol within the past 30 days (compared to 51.5 percent of non-pregnant women). For binge drinking (six drinks on one occasion), the percentages were 1.4 percent and 15 percent, respectively.
These are numbers that experts and advocates alike say should be reduced in the U.S. The problem is even more daunting elsewhere.
In a recent paper published in the journal Alcoholism: Clinical and Experimental Research, Christina Chambers, MPH, PhD, and Wladimir Wertelecki, MD, both in the UC San Diego School of Medicine’s Department of Pediatrics, report that alcohol consumption among pregnant women in the Ukraine is alarmingly high.
The study, which included nearly 12,000 pregnant women in two regions of the Ukraine, found that among regular alcohol consumers, more than half (54.8 percent) of the women surveyed drank some alcohol in the month surrounding conception and 12.9 percent reported drinking three or more drinks on at least one occasion during the early months of pregnancy.
Consumption rates declined only slightly at mid-pregnancy. Nearly half of the women in the study (46.3 percent) reported consuming some alcohol in the most recent month of pregnancy and 9.2 percent said they drank at least three servings of alcohol at a sitting.
“What this tells us is that the women in the study did not avoid alcohol entirely during their pregnancy, and substantial numbers drank at risky levels,” said Chambers.
“The findings of both these studies suggest there is a need and opportunity for prevention in both in the Ukraine and the United States. It is so important that we continue to raise awareness of FASD and educate all women of reproductive age that prenatal alcohol can be harmful to the developing baby.”
The Ukraine survey was conducted in collaboration with Omni-Net for Children, a not-for-profit international non-governmental organization in the Ukraine involved in birth defects prevention. The study was part of an ongoing research effort funded by the National Institutes of Health, the National Institute of Alcoholism and Alcohol Abuse and the Collaborative Initiative on Fetal Alcohol Spectrum Disorders, which promotes research on the mechanisms and prevention of FASD.
Vitamin D crystals, image courtesy of the NIH Office of Dietary Supplements
Vitamin D Increases Breast Cancer Patient Survival
Breast cancer patients with high levels of vitamin D in their blood are twice as likely to survive the disease as women with low levels of this nutrient, report University of California, San Diego School of Medicine researchers in the March issue of Anticancer Research.
In previous studies, Cedric F. Garland, DrPH, professor in the Department of Family and Preventive Medicine, showed that low vitamin D levels were linked to a high risk of premenopausal breast cancer. That finding, he said, prompted him to question the relationship between 25-hydroxyvitamin D — a metabolite produced by the body from the ingestion of vitamin D — and breast cancer survival rates.
Garland and colleagues performed a statistical analysis of five studies of 25-hydroxyvitamin D obtained at the time of patient diagnosis and their follow-up for an average of nine years. Combined, the studies included 4,443 breast cancer patients.
“Vitamin D metabolites increase communication between cells by switching on a protein that blocks aggressive cell division,” said Garland. “As long as vitamin D receptors are present tumor growth is prevented and kept from expanding its blood supply. Vitamin D receptors are not lost until a tumor is very advanced. This is the reason for better survival in patients whose vitamin D blood levels are high.”
Women in the high serum group had an average level of 30 nanograms per milliliter (ng/ml) of 25-hydroxyvitamin D in their blood. The low group averaged 17 ng/ml. The average level in patients with breast cancer in the United States is 17 ng/ml.
“The study has implications for including vitamin D as an adjuvant to conventional breast cancer therapy,” said co-author Heather Hofflich, DO, UC San Diego associate professor in the Department of Medicine.
Open wide, as in “ooooooh!”
Scientists have discovered the DNA of millions of microbes trapped in the calcified plaque of four medieval skeletons, which may give clues to what our ancestors ate and the diseases they fought, according to news reports.
Plaque is a biofilm, usually pale yellow that naturally accumulates on teeth. It’s created by multitudinous oral bacteria attempting to attach themselves to the smooth surfaces of your teeth. When you don’t brush well or regularly visit your dentist, it builds up. It’s the stuff scraped away by dental hygienists using whirring grinders and tiny, terrifying stainless steel tools.
In the days of yore, dental hygiene was far less rigorous, of course. Plaque built up on folk’s teeth, layer upon hardening layer, until it completely covered them and was often thicker than the tooth itself.
So brush often and well – and don’t forget to thoroughly rinse off your toothbrush when you’re done. The image above is a single toothbrush bristle covered with microscopic mouth detritus.
In First Moments of Infection, a Division and a Decision
UC San Diego scientists explain how and when T cells become effector or memory lymphocytes
Using technologies and computational modeling that trace the destiny of single cells, researchers at the University of California, San Diego School of Medicine describe for the first time the earliest stages of fate determination among white blood cells called T lymphocytes, providing new insights that may help drug developers create more effective, longer-lasting vaccines against microbial pathogens or cancer.
The findings are published in the March 2, 2014 online issue of Nature Immunology.
Naïve T lymphocytes patrol the front lines of the human body’s defense against infection, circulating in blood and tissues, searching for invasive microbes and other foreign antigens. They’re called “naïve” because they have not yet encountered an invader. When they do, these T cells activate and divide, giving rise to two types of daughter cells: “effector lymphocytes” responsible for immediate host defense and “memory lymphocytes” that provide long-term protection from similar infections.
“Researchers have been trying for a very long time to understand when and how T lymphocytes give rise to effector and memory cells during an infection,” said John T. Chang, MD, assistant professor in the Department of Medicine and the study’s co-principal investigator, along with Gene W. Yeo, PhD, assistant professor in the Department of Cellular and Molecular Medicine and Institute for Genomic Medicine.
Photo: T lymphocyte, courtesy of the National Institute of Allergy and Infectious Diseases.
Treating Uterine Fibroids
Uterine fibroids are noncancerous growths of smooth muscle tissue in the uterus and extremely common. One in four women will experience them, typically in their child-bearing years. They aren’t life-threatening, but they can be enormously debilitating, causing heavy menstrual bleeding, pelvic pain, bladder problems and more.
There are treatments – drugs that release or block specific hormones and various types of surgery. The only current, 100 percent effective remedy for fibroids is a hysterectomy, which involves removing the uterus and results in sterilization. Of the estimated 600,000 hysterectomies performed annually in the United States, about 250,000 are due to fibroids.
In recent years, researchers have explored other approaches, including radiofrequency ablation in which MRI-directed sound waves are targeted at the fibroids, heating them and destroying fibroid cells. In time, the body reabsorbs the dead cells and the fibroids shrink.
We asked Shira Varon, MD, assistant clinical professor in the Department of Reproductive Medicine at the UC San Diego School of Medicine, to talk about new uterine fibroid treatments. Varon and colleagues are currently enrolling participants in a clinical trial of a new outpatient fibroid treatment.
Question: What causes fibroids? How does a woman know she has them?
Answer: Fibroids are the most common pelvic tumor in women and arise secondary to both genetic and hormonal factors. Women should suspect fibroids if they have symptoms of heavy or abnormal periods or pelvic pain or pressure.
Q: What are the shortcomings of currently available treatments?
A: Currently available surgical therapies, especially for women who still desire fertility, are limited to myomectomy (surgical removal of fibroids), which is usually performed via an open surgical procedure. Less commonly, if the patient is a candidate based on the location and size of her fibroids and skill of the surgeon, a myomectomy can be performed with a minimally invasive surgical procedure.
Q: Does radiofrequency ablation hurt?
A: RF ablation, or RFA, is a minimally invasive laparoscopic procedure that has a similar recovery and pain profile to a laparoscopic tubal ligation.
Q: What’s known about the long-term effects of RF? Once a woman has had fibroids, is she likely to get them again?
A: We are currently studying long-tern effects of RFA. The data that we have has followed patients for two years after having the procedure. It appears to be very safe without harm to the surrounding uterus. Whether or not a woman gets fibroids again depends upon her age at the time of the procedure, genetic factors and hormonal factors.
The awe of similars
Samuel Hahnemann’s “law of similars" is one of the foundations of homeopathy and the notion that “like cures like.” That is, a substance that produces certain symptoms in a healthy person should be able to relieve those same symptoms in an unwell person.
For example, a person drinking a cup of strong coffee for the first time is likely to experience some or all of the effects of caffeine: racing thoughts, palpitations, increased urine production, shaky hands, excitability and restlessness (which is admittedly why many coffee drinkers consume the stuff in the first place).
According to Hahnemann’s law of similars, coffee should do just the opposite in a sick person already experiencing these symptoms. For example, a homeopath (someone who practices homeopathy) would treat a hyperactive child or an insomniac with a preparation of “coffee cruda,” or unroasted coffee beans. According to homeopathic hypothesis, the caffeine in the cruda would calm the kid and help the insomniac sleep.
Such notions are widely disputed, to say the least. There is very little empirical evidence, broadly accepted, that homeopathic remedies are effective treatments for any specific condition. Indeed, some homeopathic notions, such as medicinal concoctions in which the “active ingredient” has been diluted to the point of no longer actually existing in the concoction, fly in the face of scientific logic and reason.
But this blog post isn’t about celebrating the law of similars but rather the awe of the same. Many, many objects and phenomena in nature appear remarkably alike in appearance, but are, in fact, completely different or unrelated in function or purpose.
Take the two images above: The one on the left is a scanning electron micrograph of different human circulatory system cells: dimpled red blood cells, bumpy white blood cells, called lymphocytes, and disk-shaped platelets. The image on the right is a scanning electron micrograph of diverse pollen grains magnified many times.
The “Red Queen Effect” Writ Small
In what amounts to an evolutionary arms race at the molecular level, researchers at the University of California, San Diego School of Medicine describe how pathogens target or take advantage of key molecules on the surfaces of cells to evade detection or boost infection.
The findings are published in the March issue of The FASEB Journal.
All living cells are coated with chains of sugar molecules called glycans, with every organism sporting its own cloak of unique and characteristic glycan patterns, said first author Vered Padler-Karavani, PhD, a researcher at Tel Aviv University who originally worked with Ajit Varki, MD, co-director of UC San Diego’s Glycobiology Research and Training Center, and others on the study, including Takashi Angata, now at Academia Sinica in Taiwan.
In mammals, cell suface glycan chains are tipped with acidic sugars called sialic acids, which indicate to circulating immune system cells via receptors known as Siglecs that the cell is part of the host and not to be attacked as an invader.
However, certain pathogenic bacteria have evolved sialic acid containing glycans that mimic mammalian cells, using them to hide from and evade immune cells. Meanwhile, other pathogens, such as flu viruses, use sialic acids as binding targets to attack and infect host cells. In response to these dual pressures, mammalian sialic acids and Siglec receptors must be continuously tweaked to foil invasive microbes. But the faster evolving microbes adapt to the tweaks and the process repeats, over and over again.
The phenomenon is indicative of the so-called “Red Queen effect,” noted the researchers, a classic evolutionary concept inspired by Lewis Carroll’s novel Through the Looking-Glass. “Now, here, you see, it takes all the running you can do, to keep in the same place,” the queen says to Alice.
“Like Alice, who runs fast but finds herself still in the same spot, we find that certain sugar-receptors on our immune cells evolve rapidly in response to even more rapidly evolving pathogens, leading to a never-ending evolutionary arms race,” said Padler-Karavani.
The findings may have future implications for efforts to find new treatments and approaches to pathogens that try to take advantage of glycans, said Varki.