GastroIntestinal / Gastroenterology News

Stomach bug going around your home? You might want to reach for hand sanitizer, suggests research being presented at the 42nd Annual Meeting of the Infectious Diseases Society of America (IDSA).

Families that used alcohol-based hand sanitizer gel had a 59 percent reduction in the spread of gastrointestinal illnesses compared with families that didn’t use sanitizer, according to a Harvard Medical School study.

“This is the first randomized trial to show that hand sanitizer reduces the spread of germs in the home,” said Thomas J. Sandora, MD, MPH, an assistant in medicine in the Division of Infectious Diseases at Children’s Hospital Boston and instructor of pediatrics at Harvard Medical School. “Using hand sanitizers is an excellent method for hand hygiene and can be an alternative to soap and water, particularly when a sink isn’t convenient.”

Hand sanitizers are used without water. They are not cleaning agents, and don’t remove surface dirt. Washing with soap and water is necessary to remove visible soil, said Dr. Sandora.The Centers for Disease Control and Prevention (CDC) recommends routine use of alcohol-based sanitizers by healthcare workers, noting that, compared to soap and water, alcohol-based sanitizers are easier and quicker to use, and cause less skin irritation. The sanitizers also are very effective at reducing germs on the skin, according to CDC.

The Healthy Hands, Healthy Families study included 292 families with at least one child in day care who were tracked for five months: 155 were provided with hand sanitizer and hand hygiene educational materials, and 137 were not given sanitizer and were provided only with materials about basic nutrition. Those provided sanitizer were told to place bottles of it around the house including in the bathroom, kitchen and baby’s room and to apply it to their hands after using the toilet, before preparing food, after diaper changes and at other appropriate times. Investigators called the families every other week to record how much of the sanitizer they had used.

Investigators also recorded reports of a gastrointestinal and respiratory illness in the families. When a family member came home with a gastrointestinal bug, families that used the sanitizer had a 59 percent decrease in the illnesses spreading to others in the home. Although there was no significant decrease in the spreading of respiratory illnesses among the families that used sanitizer, researchers found families that used greater amounts of the sanitizer were less likely to pass around those types of illnesses.

“We believe hand sanitizer reduces the transmission of the cold and other respiratory illnesses in the home, too, although the evidence wasn’t as strong as it was for stopping the spread of gastrointestinal illnesses,” said Dr. Sandora. “We think that’s probably because people were more diligent about using the sanitizer after a gastrointestinal-related incident, such as using the bathroom or vomiting, than after a respiratory incident, such as nose-wiping or sneezing.

“The families seemed very willing to use the sanitizer,” he said. “It’s widely available in stores, but is not being used in most homes.”

Available in a squeeze bottle or pump, sanitizer gel is alcohol-based and is used without water. A dime-sized amount of hand sanitizer should be poured on the hands and rubbed over all surfaces until dry. Effective hand-washing with soap and water involves scrubbing the fronts and backs of the hands and between the fingers for about 10 to 15 seconds.

Hand sanitizer differs from antibacterial soap. Antibacterial soap must be used with water, and is marketed as having the ability to kill bacteria. However, research has shown that while antibacterial soap does reduce bacteria and other microbes, it is no more effective at doing so than non-antibacterial soap.

Co-authors of a paper on the topic being presented by Dr. Sandora are: Elsie M. Taveras, Mei-Chiung Shih, Elissa A. Resnick, Grace M. Lee, Dennis Ross-Degnan and Donald A. Goldmann.

IDSA is an organization of physicians, scientists and other health care professionals dedicated to promoting human health through excellence in infectious diseases research, education, prevention and patient care. Major programs of IDSA include publication of two journals, The Journal of Infectious Diseases and Clinical Infectious Diseases, an Annual Meeting, awards and fellowships, public policy and advocacy, practice guidelines and other membership services. The Society, which has 7,500 members, was founded in 1963 and is headquartered in Alexandria, Va.

Copies of 2004 IDSA news releases are available online at pcipr.

Public Communications, Inc. (PCI)
35 E. Wacher Dr., Ste 1254
Chicago, IL 60601
United States
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According to a study published on bmj,
doctors should recommend fiber, antispasmodics, and peppermint oil as
first-line treatments for irritable bowel syndrome (IBS). Recent proof
of the effectiveness of these treatments should also lead to changes in
the national guidelines that specify how to manage IBS.

Affecting between 5% and 20% of the population, IBS is a condition that
causes abdominal pain and irregular bowel
movements. Currently, it is difficult to treat IBS because we
do not know exactly what causes it. Usual therapies consist of fiber
supplements, probiotics,
antidepressants, hypnotherapy, and laxatives. This treatment
uncertainty, however, has resulted in the promotion of complementary
and alternative treatments by international and national bodies. An
example of this is the recently-published National Institute of Health
and Clinical
Excellence (NICE) guidelines on the management of IBS.

Therapies to treat IBS such as fiber, antispasmodics and
peppermint oil have been studied, but their effectiveness has not been
proven due to conflicting conclusions
and errors in analysis. To further clarify the effects of these
treatments, Dr. Alex Ford (McMaster University, Ontario, Canada) and
colleagues conducted a review and meta-analysis of randomized trials.
The trials – totaling over 2500 adult IBS patients – compared
fiber, antispasmodics
and peppermint oil to placebo or no treatment.

The researchers found that all three therapies were effective IBS
treatments compared to placebo or no treatment. In order to prevent IBS
symptoms in one patient, 11 people needed to be treated with fiber, 5
with antispasmodics, or 2.5 with peppermint oil. In addition, there
were no serious adverse effects associated with the treatments.

In the twelve papers (591 patients in total) that analyzed fiber,
insoluble fiber such as bran was not found to be
beneficial while isphaghula husk (soluble fiber) was found to
significantly reduce
symptoms. There were 22 studies with 1,778 patients that focused on
various
antispasmodics. The researchers found that hyoscine most successfully
prevented IBS symptoms. Hyoscine – extracted from the cork wood tree -
is also recommended by the authors to be the first-line antispasmodic
therapy in primary care.

According to four trials involving 392 patients, peppermint oil appears
to be the most effective treatment among the three.

Although these
treatments are effective, safe, and available over the counter, they
have been overlooked after newer and
more expensive drugs were introduced. Since all three treatments have
been shown
to be potentially effective therapies for IBS, “Current national
guidelines for the management of the condition should be updated to
include these data,” conclude the authors.

An accompanying commentary Professor Roger Jones (King’s
College London) argues that the results of this study should, “reawaken
interest in the pharmacotherapy of irritable bowel syndrome and
stimulate further research.” He adds, however, that, “None
of these data, of course, invalidate the importance of making a
‘holistic’
diagnosis in irritable bowel syndrome – that takes into account
physical,
psychological, and social factors – and of planning an integrated
approach to treatment,
which deals with all of these factors.”

Effect of fibre, antispasmodics, and peppermint oil in the
treatment of
irritable bowel syndrome: systematic review and meta-analysis
Alexander C Ford, Nicholas J Talley, Brennan M R Spiegel, Amy E
Foxx-Orenstein, Lawrence Schiller, Eamonn M M Quigley, Paul Moayyedi
BMJ (2008). 337:a2313
doi:10.1136/bmj.a2313
Click
Here to View Journal Website

: Peter M Crosta

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Proton pump inhibitors and histamine2 receptor antagonists – types of acid suppressive medications commonly taken to treat the overproduction of gastric acid, such as acid reflux (GERD/GORD), dyspepsia, and peptic ulcer disease may raise the risk of pneumonia, researchers from Seoul National University Hospital, South Korea, report in CMAJ (Canadian Medical Association Journal).

Acid suppressive medications are the second highest selling drugs in the world, reaching over $26 billion in 2005. The authors explained that medical literature has been looking more carefully at the impact popular drugs might have on public health.

Dr. Chun-Sick Eom, Dr. Sang Min Park and team carried out a systematic review of all studies related to acid suppressive drugs and pneumonia since August 2009 – they used three sources, MEDLIN E (PubMed), Embase and the Cochrane Library. They found that 1 in every 200 individuals taking an acid suppressive medication developed pneumonia.

The researchers revealed that:

Proton pump inhibitor use raised pneumonia risk overall by 27% compared with non-use
Histamine2 receptor blocker use raised pneumonia risk overall by 22% compared with non-use

The authors wrote:
“Several previous studies have shown that treatment with acid-suppressive drugs might be associated with an increased risk of respiratory tract infections and community-acquired pneumonia in adults and children. However, the association between use of acid-suppressive drugs and risk of pneumonia has been inconsistent. Given the widespread use of proton pump inhibitors and histamine2-receptor antagonists, clarifying the potential impact of acid-suppressive therapy on the risk of pneumonia is of great importance to public health.”
A considerable number of hospitalized patients, estimated to be between 40% and 70%, are given acid-suppressive drugs. The researchers suggest that they could contribute significantly towards the hospital-acquired pneumonia totals. Their impact on community-acquired pneumonia rates might be even larger.

Doctors should be cautious about prescribing acid suppressive drugs, the authors wrote, especially if the patient has an elevated risk of developing pneumonia.

Acid suppressive drugs might be prescribed for the following diseases and conditions:

Dyspepsia
Gastroesophageal reflux disease (GORD/GERD)
Laryngopharyngeal reflux
Peptic ulcer disease (PUD)
Barrett’s esophagus
To prevent stress gastritis
Gastrinomas and other conditions that cause hypersecretion of acid
Zollinger-Ellison syndrome.

“Use of acid-suppressive drugs and risk of pneumonia: systematic review and meta-analysis”
Chun-Sick Eom, Christie Y. Jeon, Ju-Won Lim, Eun-Geol Cho, Sang Min Park and Kang-Sook Lee
CMAJ 10.1503/cmaj.092129

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In teenagers, laparoscopic gastric banding surgery for treatment of extreme obesity can significantly improve and even reverse the metabolic syndrome, a new study found. The results were presented at The Endocrine Society’s 91st Annual Meeting in Washington, D.C.

An increasing number of obese adolescents have the metabolic syndrome, said a study co-author, Ilene Fennoy, MD, MPH, a pediatric endocrinologist at New York City’s Columbia University Medical Center.

The metabolic syndrome is a cluster of metabolic risk factors that increase the chance of later developing diabetes and cardiovascular disease. Weight loss can reduce the risk factors that are part of the syndrome: abdominal obesity as shown by a large waist circumference (waistline), low HDL (“good”) cholesterol, high triglycerides (fats in the blood), high blood pressure and high blood sugar.

“Few treatments, however, have succeeded in achieving major weight loss or greatly improving adolescents’ medical complications of obesity – until now,” Fennoy said.

In the new study, 24 morbidly obese teens between the ages of 14 and 17 years underwent laparoscopic gastric banding, also called the “Lap-Band” procedure. This minimally invasive weight loss surgery uses a band that can repeatedly be adjusted to make the stomach smaller.

Six months after the operation, patients had a statistically significant decrease in their body mass index (BMI, a measure of body fat) as well as their waist circumference and blood levels of C-reactive protein, a measure of inflammation that is linked to increased risk of cardiovascular disease. These improvements continued to 1 year in the 12 patients whose follow-up was that long.

Other features of the metabolic syndrome improved rapidly in the first 6 months and continued to a year, but with “less dramatic” changes, the authors reported in their abstract.

Five patients with 12-month follow-up met the criteria for a diagnosis of the metabolic syndrome before surgery. Only two still had this diagnosis a year later, a decrease in prevalence from 41.7 to 16.7 percent.

“Laparoscopic gastric banding surgery may be a useful intervention for morbidly obese teenagers to decrease the risk of early development of cardiovascular disease and other illnesses related to obesity,” Fennoy said.

Currently approved for use only in adults, the Lap-Band procedure is being studied in teenagers under age 18. Long-term studies are needed to confirm that this procedure effectively improves the metabolic syndrome in adolescents, Fennoy said.

Eun-Ju Lee, a fourth year medical student at Columbia University Medical Center, and a Doris Duke Fellow in the Division of Pediatric Endocrinology presented the study results.

Source:
Aaron Lohr

The Endocrine Society Continue reading →

The American Gastroenterological Association (AGA) Foundation for Digestive Health and Nutrition (FDHN) announced that Anisa Shaker, MD, is the recipient of the AGA-General Mills Bell Institute of Health and Nutrition Research Scholar Award in Gut Physiology and Health. This award provides $225,000 over three years for a young investigator working toward an independent career studying the relationship of gut microflora to physiology and immune function.

“Researchers are working hard to try to understand how the environment of the digestive system relates to and affects other bodily functions, including a person’s immunity,” said Nicholas F. LaRusso, MD, AGAF, chair of the AGA Foundation. “The AGA Foundation is grateful for the support shown by the General Mills Bell Institute of Health and Nutrition in funding research that will help gastroenterologists continue to better understand and manage digestive health.”

“This award will allow me to continue to cultivate and expand growing research interests that align with my clinical interest in inflammatory disorders and malignancies of the luminal GI tract. This generous funding will also provide me with protected time necessary for continued focused research, afford me the opportunity to continue to generate meaningful data and ultimately, to be a competitive candidate for independent federal grant support,” said Dr. Shaker.

An assistant professor of medicine at Washington University School of Medicine, Dr. Shaker will focus her research on investigating epimorphin (Epim -/-) mice microbiota in colitis and colitis-associated cancer to understand gut microbial ecology during homeostasis and disease, delineate factors that modulate the intestinal microbiota, and uncover potential therapies to establish a luminal environment protective against colitis and colitis-associated cancer. (Mice that lack the protein Epim -/- are protected from the development of colitis and colitis-associated colon cancer.

Said Susan Crockett, PhD, RD, senior technology officer, General Mills Bell Institute of Health and Nutrition, “As part of General Mills’ mission of nourishing lives, the Bell Institute is committed to championing health innovation. We value the collaborative partnership with AGA and are committed to providing research funding to further elucidate the relationship between gut microbiota and health.”

Source:
Jennifer Chisholm
American Gastroenterological Association Continue reading →

Godstone Farm in Surrey has closed to visitors while the Health Protection Agency leads the investigation into an outbreak of E Coli 0157 among people who have visited there.

The Agency’s Surrey and Sussex Health Protection Unit (HPU) is working with local environmental health officers, the Veterinary Laboratory Agency and Godstone Farm in response to 36 cases of gastrointestinal illness which have occurred following visits to the animal farm in Surrey.

Of the 36 cases, 12 children are currently in hospital with complications arising from the infection which causes diarrhoea and can lead to kidney failure, especially in young children.

Measures to reduce the risk of the infection spreading were put in place by the farm last week but as more cases have been reported, the farm has agreed to close to enable detailed investigations into the source of the infection. During the peak of the school holidays, the farm which allows people to see and pet a variety of farm animals, receives up to 2,000 visitors a day.

Dr Angela Iversen, Director of the Health Protection Unit, said: “This is a large outbreak of this infection. The farm owners are co-operating fully and we are working closely with them and with colleagues across health and local authorities to investigate the source. Our advice is that the farm should remain closed to visitors while this work goes on.”

It is believed the outbreak began around August 8th. Anyone who visited the farm since that date, or any member of their household, even if they did not personally visit the farm, who becomes unwell with the following symptoms should seek medical advice or contact NHS Direct on 0845 4647:

- diarrhoea (which can be bloodstained)
- vomiting
- fever
- abdominal pain and cramps
- feeling weak or lethargic
- passing less urine than usual
- pallor
- fits

Dr. Iversen added: “We are urging parents to follow strict hand washing with their families when visiting these farms. Although many parents may carry alcohol gels with them, this should be an adjunct to hand washing with soap and water and not a substitute.

“Eli 0157 is an infection that people can pick up when handling or stroking animals, unless hands are thoroughly washed afterwards to minimise the risk. It can also be spread easily from person to person so good hygiene is vital, especially in young children whose hand washing after using the toilet and before eating should be supervised. ”

Notes

- E coli 0157 bacteria usually cause diarrhoea which settles within seven days without treatment. The diarrhoea may contain blood. Occasionally, serious kidney and blood complications can occur. Good hygiene is very important in preventing person-to person spread and small children should be supervised with hand washing after using the toilet and before eating.

- Escherichia coli (commonly referred to as E. coli) is a species of bacteria commonly found in the intestines of humans and animals. There are many different types of E. coli, and while some live in the intestine quite harmlessly, others may cause a variety of diseases. The bacterium is found in faeces and can survive in the environment.

- To avoid getting strains capable of causing intestinal disease people should avoid eating undercooked meat, in particular inadequately cooked minced beef and avoid drinking unpasteurised milk. Individuals working with uncooked meats or on farms should pay close attention to good hygiene practices, as should visitors to farms.

- It is important to always wash your hands with soap after going to the toilet and before and after handling food.

- Hand washing in young children should be supervised, especially after handling animals or their surroundings, for instance on a visit to a farm.

Source
Health Protection Agency Continue reading →

Could the bacteria that we carry in our bodies decide who we marry? According to a new study from Tel Aviv University, the answer lies in the gut of a small fruit fly.

Prof. Eugene Rosenberg, Prof. Daniel Segel and doctoral student Gil Sharon of Tel Aviv University’s Department of Molecular Microbiology and Biotechnology recently demonstrated that the symbiotic bacteria inside a fruit fly greatly influence its choice of mates.

The research was done in cooperation with Prof. John Ringo of the University of Maine, and was recently published in the Proceedings of the National Academy of Sciences (PNAS).

Love, marriage and fruit flies

Based on a theory developed by Prof. Rosenberg and Dr. Ilana Zilber-Rosenberg, the scientists propose that the basic unit of natural selection is not the individual living organism, plant or animal, but rather a larger biological milieu called a holobiont. This milieu can include plant or animal life as well as their symbiotic partners. In the case of animals, these partners tend to be microorganisms like intestinal bacteria.

“Up to now, it was assumed that the host organism undergoes evolution on its own, while its symbiotic bacteria undergo their own evolution,” Prof. Rosenberg says. “The mechanism that we discovered enables evolution to occur more rapidly in response to environmental changes. Since a generation is shorter for bacteria than for multicellular organisms, they genetically adjust more quickly to changes in the holobiont,” says Prof. Rosenberg.

Conducting their experiments on the rapidly-reproducing fruit fly, the scientists were able to test this new theory. The first experiment repeated a study carried out two decades ago by a Yale University researcher, in which a fly population was divided in half and fed different diets – malt sugar versus starch. A year later, when the flies were re-integrated as one group, those who had been fed starch preferred starch-fed mates, while the sugar-fed flies preferred mates of a similar nutritional background. The repeat experiment carried out by the Tel Aviv University researchers shows that this dietary influence takes effect within just a generation or two rather than over an entire year.

In their second experiment, the Tel Aviv University team repeated the first, but with the addition of an antibiotic, which killed the bacteria and eliminated the specific mate preference. The mating process became random, with no dietary influence.

In subsequent experiments, the researchers successfully isolated the bacterial species responsible for reproductive isolation in flies with diet-related mating preferences, and found the bacteria Lactobacillus plantarum to be present in greater numbers in starch-fed fruit flies than in sugar-fed flies. When L. plantarum was reintroduced into the antibiotic-treated flies, the preferential mating behavior resumed – proving that this bacterial species is at least partly responsible for the mating preference.

Rewriting Darwin?

Finally, in cooperation with Prof. Avraham Hefetz of Tel Aviv University’s Department of Zoology, the team analyzed the sexual pheromones produced by the fruit flies. There turned out to be differences in pheromone levels between the two groups of flies – differences that again disappeared after administering antibiotics.

“The finding indicates that pheromone alterations are a mechanism by which we can identify mating preferences. We therefore hypothesize that it is the bacteria that are driving this change,” Prof. Rosenberg says. He adds that these discoveries have implications for our entire understanding of natural selection – something which may even lead to the development of a new theory of evolution.

Source:
George Hunka

American Friends of Tel Aviv University Continue reading →

W. L. Gore & Associates (Gore) today announced at the 35th annual VEITHsymposium™ in New York that it has received regulatory clearance from Health Canada’s Therapeutic Products Directorate to market the GORE EXCLUDER AAA Endoprosthesis and GORE TAG Thoracic Endoprosthesis in Canada. Planning is underway for Canadian physician training on the devices, and the subsequent commercial product release timeline will be announced in the near future. The GORE EXCLUDER AAA Endoprosthesis and the GORE TAG Thoracic Endoprosthesis devices are the leading options for less invasive treatment of abdominal aortic aneurysm (AAA) and thoracic aortic aneurysm (TAA) in North America. The GORE EXCLUDER AAA Endoprosthesis and the GORE TAG Thoracic Endoprosthesis were previously granted regulatory approval in the US, Europe, Japan and South Korea.

The GORE EXCLUDER AAA Endoprosthesis is an implantable device indicated for the endovascular treatment of AAA, a condition caused by the degenerative weakening and dilation of the abdominal aorta. If left untreated, it can rupture and result in fatality. The GORE TAG Thoracic Endoprosthesis is an implantable device used to treat TAA, or an aneurysm of the descending thoracic aorta, the body’s main circulatory vessel. TAA is a life-threatening condition generally believed to be significantly under-diagnosed, and patients with TAA are at risk of death due to internal bleeding resulting from a ruptured aorta.

Until recently, treatment for AAA and TAA required invasive, large incision surgery and a lengthened hospital stay to repair the diseased or damaged artery. With the GORE EXCLUDER AAA Endoprosthesis and the GORE TAG Thoracic Endoprosthesis, aneurysms can be prevented from rupturing through a minimally invasive procedure, thereby reducing the hospital stay, morbidity and mortality associated with surgery.

“Gore is pleased to expand its international efforts to improve patient care for both AAA and TAA, with less invasive treatment alternatives for the Canadian patient population,” said John Sininger, Leader of the Gore Medical Products Division. “The GORE EXCLUDER Device and the GORE TAG Device have already proven to be valuable alternatives to invasive open surgery elsewhere, and Gore welcomes the opportunity to advance less invasive endovascular therapies for aortic diseases in Canada.”

The GORE EXCLUDER AAA Endoprosthesis is an endovascular graft and stent combination that seals off the aneurysm and creates a new path for the blood to flow. The GORE EXCLUDER AAA Endoprosthesis is inserted through a small incision in the patient’s leg using a catheter-based delivery technique. Once the graft is correctly positioned in the diseased aorta, the device self-expands using radial force and metal anchors to permanently secure it to the walls of the aorta.

The GORE TAG Thoracic Endoprosthesis is a thoracic endoprosthesis that internally relines the thoracic aorta and isolates the diseased segment from blood circulation. The GORE TAG Thoracic Endoprosthesis is comprised of an ePTFE graft with an outer self-expanding nitinol support structure to combine both device flexibility and material durability. The device is inserted by a catheter delivery technique through a small incision in the patient’s groin.

About Veithsymposium™

Now in its fourth decade, VEITHsymposium™ provides vascular surgeons, interventional radiologists, interventional cardiologists and other vascular specialists with a unique and exciting format to learn the most current information about what is new and important in the treatment of vascular disease. The 5-day event features over 400 rapid-fire presentations from world-renowned vascular specialists with emphasis on the latest advances, changing concepts in diagnosis and management, pressing controversies and new techniques. Press registration details can be found at VEITHpress or contact Pauline T. Mayer at 631.979.3780 or e-mail ptmptmhcm. VEITHsymposium™ is sponsored by Cleveland Clinic (Cleveland, OH).

About W.L. Gore & Associates

The Gore Medical Products Division has provided creative therapeutic solutions to complex medical problems for three decades. During that time, more than 25 million innovative Gore Medical Devices have been implanted, saving and improving the quality of lives worldwide. The extensive Gore Medical family of products includes vascular grafts, endovascular and interventional devices, surgical materials for hernia repair, soft tissue reconstruction, staple line reinforcement, and sutures for use in vascular, cardiac and general surgery. Gore was recently named one of the best companies to work for by Fortune magazine for the 11th consecutive year. For more information, visit goremedical.

GORE, EXCLUDER®, TAG®, and designs are trademarks of W. L. Gore & Associates.

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Scientists who last year identified a new genetic risk factor for coeliac disease, have, following continued research, discovered an additional seven gene regions implicated in causing the condition. The team, lead by David van Heel, Professor of Gastrointestinal Genetics at Barts and The London School of Medicine and Dentistry, have further demonstrated that of the nine coeliac gene regions now know, four of these are also predisposing factors for type 1 diabetes. Their research sheds light not only on the nature of coeliac disease, but on the common origins of both diseases. It is published online today (2 March 2008) in Nature Genetics.

Professor van Heel and his team, including collaborators from Ireland, the Netherlands, and the Wellcome Trust Sanger Institute, first performed a genome wide association study in coeliac disease. Genetic markers across the genome were compared in coeliac disease subjects versus healthy controls. They then assessed around 1,000 of the strongest markers in a further ~ 5,000 samples. Their results identified seven new risk regions, six of which harbour important genes critical in the control of immune responses, highlighting their significance in the development of the disease.

Coeliac disease is common in the West, afflicting around 1 per cent of the population. It is an immune-mediated disease, triggered by intolerance to gluten (a protein found in wheat, barley and rye containing foods), that prevents normal digestion and absorption of nutrients. If undetected it can lead to a number of often severe problems among them anaemia, poor bone health, fatigue and weight loss. Currently only a restricted diet can diminish symptoms.

Professor van Heel said: “So far our findings explain nearly half of the heritability of coeliac disease – now studies with many more samples from individuals with coeliac disease are needed to identify the precise causal genetic variants from each region, and understand how these influence biological processes.”

The research was funded by Coeliac UK and The Wellcome Trust.

The paper, ‘Newly identified genetic risk variant for celiac disease related to the immune response’ is published online, on 2 March 2008, in Nature Genetics.

Barts and The London School of Medicine and Dentistry offers international levels of excellence in research and teaching while serving a population of unrivalled diversity amongst which cases of diabetes, hypertension, heart disease, TB, oral disease and cancers are prevalent, within east London and the wider Thames Gateway. Through partnership with our linked trusts, notably Barts and The London NHS Trust, and our associated University Hospital trusts – Homerton, Newham, Whipps Cross and Queen’s – the School’s research and teaching is informed by an exceptionally wide ranging and stimulating clinical environment.

At the heart of the School’s mission lies world class research, the result of a focused programme of recruitment of leading research groups from the UK and abroad and a ??100 million investment in state-of-the-art facilities. Research is focused on translational research, cancer, cardiology, clinical pharmacology, inflammation, infectious diseases, stem cells, dermatology, gastroenterology, haematology, diabetes, neuroscience, surgery and dentistry.

The School is nationally and internationally recognised for research in these areas, reflected in the ??40 million it attracts annually in research income. Its fundamental mission, with its partner NHS Trusts, and other partner organisations such as CRUK, is to ensure that that the best possible clinical service is underpinned by the very latest developments in scientific and clinical teaching, training and research.

Websites
coeliac/
wellcome.ac/

icms.qmul.ac/

icms.qmul.ac/Profiles/Gastro/van%20Heel%20David.htm

nature/ng/index.html

Source: Sally Webster

Queen Mary, University of London Continue reading →

Patients with the condition commonly known as heartburn may benefit from lifestyle interventions rather than just medication, suggest researchers in this month’s British Journal of General Practice (BJGP).

Gastro-oesophageal reflux disease (GORD) affects between 20% and 40% of the population in the western world and 32 million prescriptions for proton pump inhibitors (PPIs) were issued in 2008 in the UK at a cost of ??220 million a year.

Researchers from Bucks New University in Middlesex and Kings College London are suggesting that an educational programme for GORD sufferers, perhaps offered by nurses in primary care, might make a difference in reducing the amount of medication used.

The study gave 42 people being prescribed medication for GORD symptoms a 1.5 hour educational session each week over four weeks, then interviewed them on their symptoms and their affect on their lives after three months. Participants were encouraged to record their symptoms, look at their diet, learn about managing stress, set goals for themselves and identify their three biggest problems relating to GORD.

The authors write: “Following the intervention, patients felt more in control, believed that their treatment could help them, experienced fewer symptoms, were less concerned about their illness and had a greater understanding of and were less affected by their reflux than before the intervention.

“The intervention improved patients’ perception of their illness at three months, and improved their illness experience in many areas including testing patients’ sense of control, perception and understanding of their condition, and also symptom severity.

“There was no improvement in symptoms that prevent patients from eating or drinking what they like, which may reflect the fact that, despite reporting symptoms, patients did not let these interfere with what they wanted to consume anyway.”

Br J Gen Pract 2010; 60: 891-896).

Also in this month’s BJGP

Stanton and colleagues provide a valuable overview of the evidence guiding clinical decision making in patients with respiratory tract symptoms and infections, and offer a series of practical suggestions aimed at improving their management

In their study from Oslo, Hoye and co-workers discovered that deferred prescribing was not always endorsed by GPs, and emphasise the need for careful negotiation and the provision of information to patients when issuing wait-and-see prescriptions.

A non-drug approach to the management of hypertension is also explored in a systematic review from Ireland suggesting that patients have an important role to play in the effective management of this condition

The BJGP’s golden anniversary is marked in the Back Pages by a series of short pieces by all but one of its editors, tracing the development of one of the world’s oldest and most influential primary care publications.

Source: Royal College of General Practitioners

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