Thursday, January 30, 2014

Psychobiotics: How gut bacteria mess with your mind

Gut bugs can change the way our brains work, offering new ways to relieve problems like stress, anxiety and depression, say two leading professors

WE HAVE all experienced the influence of gut bacteria on our emotions. Just think how you felt the last time you had a stomach bug. Now it is becoming clear that certain gut bacteria can positively influence our mood and behaviour. The way they achieve this is gradually being uncovered, raising the possibility of unlocking new ways to treat neurobehavioural disorders such as depression and obsessive-compulsive disorder (OCD).

We acquire our intestinal microbes immediately after birth, and live in an important symbiotic relationship with them. There are far more bacteria in your gut than cells in your body, and their weight roughly equals that of your brain. These bacteria have a vast array of genes, capable of producing hundreds if not thousands of chemicals, many of which influence your brain. In fact, bacteria produce some of the same molecules as those used in brain signalling, such as dopamine, serotonin and gamma-aminobutyric acid (GABA). Furthermore, the brain is predominantly made of fats, and many of these fats are also produced by the metabolic activity of bacteria.

In the absence of gut bacteria, brain structure and function are altered. Studies of mice reared in a germ-free environment, with no exposure to bacteria, show that such mice have alterations in memory, emotional state and behaviour. They show autistic patterns of behaviour, spending as much time focusing on inanimate objects as on other mice. This behavioural change is driven by alterations in the underlying brain chemistry. For example, dramatic changes in serotonin transmission are seen, together with changes in key molecules such as brain-derived neurotrophic factor, which plays a fundamental role in forming new synapses.

Cancer Painkiller Blamed for 22 Pennsylvania Deaths

Cancer painkiller mixed with heroin blamed for 22 Pennsylvania deaths

From Lorenzo Ferrigno and Kevin Conlon, CNN

updated 12:32 PM EST, Tue January 28, 2014

A deadly mix of heroin and fentanyl has led to a rise in drug overdoses in Pennsylvania.

STORY HIGHLIGHTS

"This is not accidental," Pittsburgh medical examiner says
Fentanyl is used to treat pain in cancer patients
Mixing it with heroin is "extremely dangerous" mix, prosecutor warns

(CNN) -- Dr. Karl Williams says he normally sees three or four deaths from drug overdoses in a typical week as the chief medical examiner in Pennsylvania's Allegheny County, which includes Pittsburgh.

In the past week, he saw 15 -- men and women, of various ethnicities, ranging in age from 22 to 53. All of them appear to have been heroin users who instead received a mix of heroin andfentanyl, a powerful narcotic used to treat cancer patients' pain, Williams told CNN.

"This is pretty clearly somebody manufacturing fentanyl and selling it as heroin," Williams said.

The deaths Williams has recorded are among nearly two dozen in western Pennsylvania linked to a heroin-fentanyl mix, state Attorney General Kathleen Kane said Monday. The "extremely dangerous and potentially lethal" combination has killed 22 people in six counties, Kane said in a written statement.

Heroin use soaring in U.S.

Heroin and its devastating toll

"We are working with the Allegheny County Police Department, the Pittsburgh Police, and their counterparts in the region to get this deadly mix of heroin off the streets of Western Pennsylvania, and to arrest and prosecute anyone caught selling, distributing, and producing these drugs," her statement said.

Williams said fentanyl can be 10-100 times more potent than morphine, the base molecule in heroin, and it's only distributed as a powder when someone is manufacturing it illegally. The drug is being distributed in bags marked "Income Tax," "Bud Ice" and "Theraflu, Williams said.

"This is not accidental. Somebody is deliberately trying to make a big batch of fentanyl," he said. "It is not an extraordinarily complex molecule to synthesize, and you can find instructions on the Internet. It does not take a sophisticated chemist to do this."

It's not the first time that fentanyl has turned up on the streets of Pittsburgh. In 1988, Williams said, 17 people died when a chemist distributed fentanyl as heroin.

And in 2006, in Philadelphia, 269 people were killed by fentanyl overdoses, the state Department of Drug and Alcohol Programs said. The agency raised new alarms about fentanyl in July, blaming it for 50 deaths in Pennsylvania by mid-2013.

Russia's drug-resistant TB spreading more easily

NATURE | NEWS
Newly discovered mutations help tuberculosis to stay infectious while evolving resistance to multiple drugs.

ZUMA Press, Inc. / Alamy

A patient undergoing chest X-rays at an anti-tubercular clinic in St. Petersburg.

Bacterial 'superbugs' are getting ever more potent. Tuberculosis (TB) strains in Russia carry mutations that not only make them resistant to antibiotics but also help them to spread more effectively, according to an analysis of 1,000 genomes from different TB isolates — one of the largest whole-genome study of a single bacterial species so far.

TB, which is caused by the bacterium Mycobacterium tuberculosis, exploded in Russia and other former Soviet nations in the early 1990s, after the collapse of the Soviet Union and its health system. The incomplete antibiotic regimens some patients received, meanwhile, sparked rampant drug resistance. But the latest study of TB cases in Russia, published today in Nature Genetics¹, indicates that such ‘programmatic’ failures may not be the only explanation for the rise of drug-resistant TB in the region — biological factors also play a big part.

As part of a long-standing effort to study the rampant drug-resistant TB in Samara, a region of Russia about 1,000 kilometres southeast of Moscow, researchers collected TB isolates from 2,348 patients and sequenced the entire genomes of 1,000 of them. This enabled the team to identify previously unknown mutations linked to antibiotic resistance, as well as 'compensatory mutations' that improve the ability of drug-resistant TB to spread.

Nearly half of the TB isolates were multi-drug resistant, which means that they were impervious to the two common first-line antibiotics that cure most TB infections, while 16% of these isolates also harboured mutations that made them impervious to ‘second-line’ drugs. These infections are more expensive to treat, and patients who receive ineffective drugs are more likely to spread TB.

Antibiotics in Animals Tied to Risk of Human Infection

A federal analysis of 30 antibiotics used in animal feed found that the majority of them were likely to be contributing to the growing problem of bacterial infections that are resistant to treatment in people, according to documents released Monday by a health advocacy group.

... scientists from the F.D.A. studied 30 penicillin and tetracycline additives in animal feed. They found that 18 of them posed a high risk of exposing humans to antibiotic-resistant bacteria through food.

Resistant bacteria make it difficult and sometimes impossible to treat infections with ordinary antibiotics. The scientists did not have enough data to judge the other 12 drugs.

At least two million Americans fall sick every year and about 23,000 die from antibiotic-resistant infections, the Centers for Disease Control and Prevention estimates. Representatives of the food industry largely blame hospitals and treatments given to people for the rise of deadly superbugs. But many scientists believe that indiscriminate use of antibiotics in animal feed is a major contributor.

Farmers and ranchers feed small amounts of the drugs to animals over their lifetimes to keep them healthy in crowded conditions, causing bacteria to develop a resistance passed on to people through the environment and eating meat from the animals.

The F.D.A. has tried repeatedly to rein in the use of the drugs in animals. It adopted regulations in 1973 that required companies to submit studies showing that a drug’s use in animal feed did not promote resistance in people.

In 1977, the agency proposed withdrawing approvals for animal feed additives containing penicillin and most tetracyclines, but it never followed through, said Avinash Kar, a lawyer for the Natural Resources Defense Council. The group sued the agency in 2012 to try to force it to carry out the 1977 proposal.

“This is an agency that has repeatedly found, since the 1970s, that these drugs pose a risk to human health, but it has not done anything meaningful with those conclusions,” Mr. Kar said.

Obama Interview about Marijuana

ANNALS OF THE PRESIDENCY

GOING THE DISTANCE

On and off the road with Barack Obama.

BY DAVID REMNICK

When I asked Obama about another area of shifting public opinion—the legalization of marijuana—he seemed even less eager to evolve with any dispatch and get in front of the issue. “As has been well documented, I smoked pot as a kid, and I view it as a bad habit and a vice, not very different from the cigarettes that I smoked as a young person up through a big chunk of my adult life. I don’t think it is more dangerous than alcohol.”

Is it less dangerous? I asked.

Obama leaned back and let a moment go by. That’s one of his moves. When he is interviewed, particularly for print, he has the habit of slowing himself down, and the result is a spool of cautious lucidity. He speaks in paragraphs and with moments of revision. Sometimes he will stop in the middle of a sentence and say, “Scratch that,” or, “I think the grammar was all screwed up in that sentence, so let me start again.”

Less dangerous, he said, “in terms of its impact on the individual consumer. It’s not something I encourage, and I’ve told my daughters I think it’s a bad idea, a waste of time, not very healthy.” What clearly does trouble him is the radically disproportionate arrests and incarcerations for marijuana among minorities. “Middle-class kids don’t get locked up for smoking pot, and poor kids do,” he said. “And African-American kids and Latino kids are more likely to be poor and less likely to have the resources and the support to avoid unduly harsh penalties.” But, he said, “we should not be locking up kids or individual users for long stretches of jail time when some of the folks who are writing those laws have probably done the same thing.” Accordingly, he said of the legalization of marijuana in Colorado and Washington that “it’s important for it to go forward because it’s important for society not to have a situation in which a large portion of people have at one time or another broken the law and only a select few get punished.”

As is his habit, he nimbly argued the other side. “Having said all that, those who argue that legalizing marijuana is a panacea and it solves all these social problems I think are probably overstating the case. There is a lot of hair on that policy. And the experiment that’s going to be taking place in Colorado and Washington is going to be, I think, a challenge.” He noted the slippery-slope arguments that might arise. “I also think that, when it comes to harder drugs, the harm done to the user is profound and the social costs are profound. And you do start getting into some difficult line-drawing issues. If marijuana is fully legalized and at some point folks say, Well, we can come up with a negotiated dose of cocaine that we can show is not any more harmful than vodka, are we open to that? If somebody says, We’ve got a finely calibrated dose of meth, it isn’t going to kill you or rot your teeth, are we O.K. with that?”

Drug helps to clear traumatic memories

NATURE | NEWS

Medication removes markers from brain’s DNA to increase effectiveness of existing treatment.

Traumatic experiences leave a signature in the brain that is hard to erase. Painflul memories of war or child abuse are recorded in DNA as chemical marks in the genome, which makes conditions such as post-traumatic stress disorder (PTSD) difficult to treat with behavioural approaches.

Now, researchers report¹ that in mice, clearing these epigenetic markers with a drug can dramatically improve the effectiveness of a common behavioural treatment for PTSD, allowing the brain to dissociate a specific memory from the emotion associated with it.

In people with PTSD or other anxiety disorders, the pain associated with a specific memory fails to subside over time, as it usually would. “Every day they’re reliving it,” says Li-Huei Tsai, a neuroscientist at the Massachusetts Institute of Technology in Cambridge, and a co-author of the study. Exposure to the memory through photos or virtual reality simulations of the traumatic event in a safe environment — part of a technique known as extinction therapy — can help to dull the pain, but people with severe PTSD tend to relapse.

To simulate the disorder, Tsai and her colleagues delivered electrical shocks to the feet of mice while playing a loud sound. When the mice had learned to associate the sound with the painful stimulus, they would freeze whenever they heard it, even if they did not receive another shock. A day after the fear-conditioning, the researchers repeatedly played the sound in a safe environment, and made the mice forget the fearful association. But when the extinction therapy was started a month after the fear-conditioning, it did not work — in part because the bad memory had become epigenetically engrained.

Combined treatment

In rodents, Tsai says, it seems to take about a week for a memory to be permanently written into the epigenome. But her work suggests that a class of drugs called histone deacetylase inhibitors (HDACis), which clear epigenetic marks from DNA, can lengthen that window.

When researchers gave the mice an HDACi before they began the extinction therapy, the drug seemed to 'prime' the epigenome, creating a brief period in which memories could be reconsolidated, or modified. The HDACi alone had no effect on the mice’s memories, but just one dose combined with extinction therapy made the mice stop freezing when they heard the traumatic sound.

Monday, January 20, 2014

New Thinking On Women And Alcohol

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Story Options for Women problem drinkers beyond going Cold Turkey

The ‘No More Tears’ Shampoo, Now With No Formaldehyde

By KATIE THOMASJAN. 17, 2014

Johnson & Johnson's decision to reformulate its baby products is the first step in an effort to remove an array of increasingly unpopular chemicals from its personal care products. Laura Pedrick for The New York Times

SKILLMAN, N.J. — The only hint that something is different inside millions of bottles of Johnson’s Baby Shampoo arriving on store shelves are two words: “Improved Formula.”

The shampoo has the same amber hue, the same sudsy lather and — perhaps most important — the same familiar smell that, for generations of Americans, still conjures memories of childhood bath time.

What’s different about the shampoo, and 100 other baby products sold by Johnson & Johnson, isn’t so much about what’s been added; it’s what’s missing. The products no longer contain two potentially harmful chemicals, formaldehyde and 1,4-dioxane, that have come under increasing scrutiny by consumers and environmental groups.

Revising a Formula for Baby Shampoo

Responding to pressure from consumers’ groups, Johnson & Johnson revised the ingredients in its baby shampoo to remove a formaldehyde-releasing preservative called quaternium-15.

Even before their removal, customers would not have found formaldehyde or 1,4-dioxane listed on bottles because they aren’t technically ingredients.

Formaldehyde, which has been identified by government scientists as a carcinogen, is released over time by preservatives, like quaternium-15. And 1,4-dioxane, which has been linked to cancer in animal studies, is created during a process used to make other ingredients mild — important for a company that has sold billions of bottles of baby shampoo on its “No More Tears” claim.

Johnson & Johnson has removed the preservatives that release formaldehyde, and said it has reduced the levels of 1,4-dioxane to very limited trace amounts, from one to four parts per million.

Johnson & Johnson executives are quick to note that formaldehyde occurs naturally in many products — a person’s exposure to formaldehyde in an apple, they claim, is greater than it is in 15 bottles of baby shampoo. And 1,4-dioxane is found in their products at levels low enough to be safe.

But as the scientists set to work, they discovered that replacing the problem ingredients often led to a chain reaction of unintended consequences. One new preservative led to a snow-globe effect, with particles settling at the bottom of the bottle. But the fix for that turned the shampoo from a golden honey color to a dull brown. Another change turned the consistency to water.

After Slow Execution, Renewed Death Penalty Debate and Threat of Lawsuit

GUANGZHOU, Jan. 18 (Xinhua) -- Three new cases of human H7N9 were reported Saturday in south China's Guangdong Province, bringing the total number of cases in the province to 21, provincial health authorities said.

One of the patients is a 5-year-old girl surnamed Pan, who is from provincial capital city of Guangzhou and in stable condition. She is receiving treatment in hospital, according to a statement from the provincial health and family planning commission.

Another patient is 83-year-old woman surnamed Yang, who is being treated at a local hospital and is in critical condition, it said.

A 62-year-old man surnamed Zhou from Shenzhen is confirmed contracting the H7N9 bird flu virus. He is in stable condition, the statement said.

So far, Guangdong has confirmed 21 human H7N9 cases since August. Two of them have died.

Thursday, January 16, 2014

In Annual Speech, Vermont Governor Shifts Focus to Drug Abuse

Gov. Peter Shumlin, a Democrat, used his State of the State Message on Wednesday in Montpelier to encourage public debate on the growing problem of drug abuse and addiction in his state.

MONTPELIER, Vt. — In a sign of how drastic the epidemic of drug addiction here has become, Gov. Peter Shumlin on Wednesday devoted his entire State of the State Message to what he said was “a full-blown heroin crisis” gripping Vermont.

“In every corner of our state, heroin and opiate drug addiction threatens us,” he said. He said he wanted to reframe the public debate to encourage officials to respond to addiction as a chronic disease, with treatment and support, rather than with only punishment and incarceration.

“The time has come for us to stop quietly averting our eyes from the growing heroin addiction in our front yards,” Governor Shumlin said, “while we fear and fight treatment facilities in our backyards.”

Last year, he said, nearly twice as many people here died from heroin overdoses as the year before. Since 2000, Vermont has seen an increase of more than 770 percent in treatment for opiate addictions, up to 4,300 people in 2012.

Mexico: 3 Way Battle: Drug Gangs - Vigilantes - Army

Vigilantes vs Knights Templar

MEXICO CITY — The scenes are incongruous. Inside the heavily guarded colonial state government building in Michoacán on Monday, a solemn lineup of officials vowed that the federal government would restore authority to a region that has descended into lawlessness.

But a couple of hundred miles away, in Michoacán’s agricultural lowlands, pickup trucks filled with armed men calling themselves self-defense forces have been careening down country roads for the past week, advancing on towns encircling the region’s main city, Apatzingán. They have promised to seize the city, the stronghold of the Knights Templar, the state’s powerful drug gang.

Security analysts have said, however, that these self-defense forces themselves are murky and may even include members of other gangs.
“Tierra Caliente has become a no man’s land full of personal vendettas, serial kidnappings, forced disappearances, and murders that come and go unnoticed, every day,”.

Mr. Bagley said the vigilante groups had emerged to fill the “vacuum or void in which citizen security is so precarious” that any armed group can step in.

Army vs Vigilantes

MEXICO CITY — Mexican soldiers met fierce resistance on Tuesday as they began disarming vigilante groups that have been fighting drug gangs in the agricultural lowlands of the western state of Michoacán.

In a fluid conflict that is emerging as the first major security test of President Enrique Peña Nieto’s 13-month presidency, the government sent police and army convoys across the western state to restore order in the region, known as the Tierra Caliente, or the hot country.

But as tanks and trucks entered small towns where the vigilantes had taken control in the past few days, soldiers who tried to confiscate weapons found themselves surrounded by shouting townspeople rallying behind the self-defense forces.

Spokesmen for the groups said Tuesday that they would not give up their weapons until the government arrested the top leaders of the Knights Templar, the drug ring that controls parts of the state and that has branched out into extortion and kidnapping.

Self-defense groups said four civilians were killed in the village of Antúnez when soldiers were confronted by a large crowd.

Townspeople vs Army

ANTÚNEZ, Mexico — Word spread quickly: The army was coming to disarm the vigilante fighters whom residents viewed as conquering heroes after they swept in and drove out a drug gang that had stolen property, extorted money and threatened to kill them. They even had to leave flowers and other offerings at a shrine to the gang’s messianic leader.

Farmers locked arms with vigilantes to block the dusty two-lane road leading here. The soldiers demanded to be let in; people begged them to leave. Tempers flared, and rocks were thrown. The soldiers fired into the air, and then, residents said, into a crowd. At least two people were killed on Tuesday, officials and residents said.

“He was just a farmer, and now he died for a cause,” one resident, Luis Sánchez, said of Mario Torres, 48, a lime picker who was not part of the vigilante group but was among the two buried on Wednesday as mourners cried out against the government and the soldiers.

As the Rev. Antonio Mendoza, the Roman Catholic priest who presided over the funeral of the two victims here on Wednesday, put it, “the solution is legality and rule-of-law reforms.”

“Until we have them,” he added, “people will take justice into their own hands.”

According to residents, the Knights Templar moved in a couple of years ago, erecting a shrine to its mysterious leader, Nazario Moreno González. The government says that he was killed three years ago and that his followers, who revere him with something approaching religious adoration, have forced people to leave offerings to him. Yet there have been many reports across Michoacán that Mr. Moreno González is still alive. (The Knights Templar are an offshoot of his old gang, La Familia Michoacana.)

Residents told of a long ordeal of terror and helplessness. A landowner was killed when he refused to surrender property. Trucks, money and other valuables ended up with gang leaders and their allies. And death threats became commonplace. The town police, residents said, were bought off or forced to work for the gang.

One of the first things the vigilantes did was destroy the image of Mr. Moreno González in the shrine’s doghouse-size chapel. Residents later replaced it with a statue of the Virgin of Guadalupe, the patron saint of Mexico.
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