"I'm done": Florida mom gives birth to 13-pound baby

"When the baby was coming out, I was like, 'Is this baby ever going to end?'" said the doctor who delivered the baby

From: http://www.cbsnews.com/news/florida-mom-gives-birth-to-13-pound-baby/

"Butt lift" doctor ordered to stop doing surgery after woman's death

Osakatukei "Osak" Omulepu must also have a board-certified physician present for any other medical procedures

From: http://www.cbsnews.com/news/court-orders-butt-lift-doctor-to-stop-performing-surgery-after-womans-death/

Exercise versus caffeine: Which is your best ally to fight fatigue?

Chronic lack of sleep makes it hard to focus on a task. As if this didn’t make complete logical sense, multiple research studies have shown that sleep deprivation has about the same effect on our cognition and coordination as a few alcoholic beverages.

What do you do when you need to concentrate, but you’re tired?

Many of us reach for a cup of coffee, or a soda. Mountains of solid research have shown us that caffeine (in doses ranging between 30 and 300 milligrams) improves attention, alertness, reaction time, and mood, especially when we’re tired. An average cup of brewed coffee contains between 80 and 100 milligrams of caffeine; a soda, between 30 and 60.

But exercise works too. This is also well-studied. Even a short bout of any cardiovascular exercise wakes us up, speeds mental processes, and enhances memory storage and retrieval, regardless of our fitness or fatigue levels.

So, when it’s late afternoon and I’m struggling with charting or finishing one of these pieces, what should I do: exercise a bit, or go for coffee?

One recent (and very small) study compared these two wake-up methods. This well-conducted study used healthy but chronically sleep-deprived volunteers to compare three interventions: caffeine, stair-climbing, and placebo. They found that just 10 minutes of stair-climbing boosted self-reported levels of energy far more than a moderate dose of caffeine (50 mg). However, this was a very small study — only 18 out of 90 healthy, college-aged women met all the criteria and were willing to participate.

Digging deeper: Exercise offers more long-term benefits

While the findings make a whole lot of sense, I went to the existing piles of literature for more information.

Interestingly, another study looked at the effects of either exercise alone or exercise plus caffeine on cognitive tasks, and found that (perhaps predictably) exercise plus caffeine had the greater benefit.

Caffeine (in the form of coffee) has been well-studied, and regular intake is associated with lower risk of type 2 diabetes, high blood pressure, and obesity, but may increase cholesterol. It may be protective against certain types of dementia and cancer, but has been associated with bone loss and rheumatoid arthritis. Basically, there are many benefits, but there seem to be some risks as well.

But there are multiple studies suggesting that exercise has multiple long-lasting positive effects on physical fitness and function, cognition, mood, and behavior in just about all populations studied, in all ages, fitness levels, and regardless of baseline cognitive function. Some of the greatest benefits have been seen in older patients, as well as patients at risk for or diagnosed with dementia.

The take-home message? Caffeine can provide a boost in alertness and energy levels that may help you to think faster and better, for a while. But even a short burst of exercise can do the same, maybe more, and for longer. In addition, while caffeine is associated with both good and bad health outcomes, exercise is good for everything.

Sources

Neurocognitive consequences of sleep deprivation. Seminars in Neurology, 2005.

Fatigue, alcohol and performance impairment. Nature, 1997.

Quantifying the performance impairment associated with fatigue. Journal of Sleep Research, 1999.

Moderate sleep deprivation produces impairments in cognitive and motor performance equivalent to legally prescribed levels of alcohol intoxication. Occupational and Environmental Medicine, 2000.

Fatigue-related impairment in the speed, accuracy and variability of psychomotor performance: comparison with blood alcohol levels. Journal of Sleep Research, 2005.

A review of caffeine’s effects on cognitive, physical and occupational performance. Neuroscience & Biobehavioral Reviews, December 2016.

Diet, Brain, Behavior: Practical Implications, CRC Press, 2011.

The effects of low doses of caffeine on human performance and mood. Psychopharmacology, 1987.

Is caffeine a cognitive enhancer? Journal of Alzheimer’s Disease, 2010.

The effect of exercise-induced arousal on cognitive task performance: a meta-regression analysis. Brain Research, 2010.

The effect of a single bout of exercise on energy and fatigue states: a systematic review and meta-analysis. Fatigue: Biomedicine, Health & Behavior, 2013.

Exercise and caffeine improve sustained attention following fatigue independent of fitness status. Fatigue: Biomedicine, Health & Behavior, 2015.

Effects of habitual coffee consumption on cardiometabolic disease, cardiovascular health, and all-cause mortality. Journal of the American College of Cardiology, September 2013.

Habitual coffee consumption and risk of cognitive decline/dementia: A systematic review and meta-analysis of prospective cohort studies. Nutrition, December 2015.

Coffee and autoimmunity: More than a mere hot beverage! Autoimmunity Reviews, May 2017.

Cognitive Benefits of Exercise Intervention. La Clinica Terapeutica, Nov-Dec. 2016.

Role of exercise on the brain. Journal of Exercise Rehabilitation, October 2016.

Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis. British Journal of Sports Medicine. 2017.

The effects of exercise training on elderly persons with cognitive impairment and dementia: A meta-analysis. Archives of Physical Medicine and Rehabilitation. October 2004.

Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychological Science, 2003.

Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial. JAMA, 2008.

The post Exercise versus caffeine: Which is your best ally to fight fatigue? appeared first on Harvard Health Blog.

From: Monique Tello, MD, MPH http://www.health.harvard.edu/blog/exercise-versus-caffeine-which-is-your-best-ally-to-fight-fatigue-2017060811843

Mayo Clinic Minute: Prescription for exercise

From: Mayo Clinic https://www.youtube.com/watch?v=0Mm95rpPws4

Is Full Lymph Node Removal Needed for Melanoma?

Survival was just as long for those who had less extensive surgery, large study finds

From: http://www.webmd.com/melanoma-skin-cancer/news/20170608/is-full-lymph-node-removal-always-needed-for-melanoma?src=RSS_PUBLIC

Old and new models for studying host-microbe interactions in health and disease: C. difficile as an example

There has been an explosion of interest in studying the indigenous microbiota, which plays an important role in human health and disease. Traditionally, the study of microbes in relationship to human health involved consideration of individual microbial species that caused classical infectious diseases. With the interest in the human microbiome, an appreciation of the influence that complex communities of microbes can have on their environment has developed. When considering either individual pathogenic microbes or a symbiotic microbial community, researchers have employed a variety of model systems with which they can study the host-microbe interaction. With the use of studies of infections with the toxin-producing bacterium Clostridium difficile as a model for both a pathogen and beneficial bacterial communities as an example, this review will summarize and compare various model systems that can be used to gain insight into the host-microbe interaction.

From: Young, V. B. http://ajpgi.physiology.org/cgi/content/abstract/312/6/G623?rss=1

Intermediate filament proteins of digestive organs: physiology and pathophysiology

Intermediate filament proteins (IFs), such as cytoplasmic keratins in epithelial cells and vimentin in mesenchymal cells and the nuclear lamins, make up one of the three major cytoskeletal protein families. Whether in digestive organs or other tissues, IFs share several unique features including stress-inducible overexpression, abundance, cell-selective and differentiation state expression, and association with >80 human diseases when mutated. Whereas most IF mutations cause disease, mutations in simple epithelial keratins 8, 18, or 19 or in lamin A/C predispose to liver disease with or without other tissue manifestations. Keratins serve major functions including protection from apoptosis, providing cellular and subcellular mechanical integrity, protein targeting to subcellular compartments, and scaffolding and regulation of cell-signaling processes. Keratins are essential for Mallory-Denk body aggregate formation that occurs in association with several liver diseases, whereas an alternate type of keratin and lamin aggregation occurs upon liver involvement in porphyria. IF-associated diseases have no known directed therapy, but high-throughput drug screening to identify potential therapies is an appealing ongoing approach. Despite the extensive current knowledge base, much remains to be discovered regarding IF physiology and pathophysiology in digestive and nondigestive organs.

From: Omary, M. B. http://ajpgi.physiology.org/cgi/content/abstract/312/6/G628?rss=1

Transient receptor potential ion channel function in sensory transduction and cellular signaling cascades underlying visceral hypersensitivity

Visceral hypersensitivity is an important mechanism underlying increased abdominal pain perception in functional gastrointestinal disorders including functional dyspepsia, irritable bowel syndrome, and inflammatory bowel disease in remission. Although the exact pathophysiological mechanisms are poorly understood, recent studies described upregulation and altered functions of nociceptors and their signaling pathways in aberrant visceral nociception, in particular the transient receptor potential (TRP) channel family. A variety of TRP channels are present in the gastrointestinal tract (TRPV1, TRPV3, TRPV4, TRPA1, TRPM2, TRPM5, and TRPM8), and modulation of their function by increased activation or sensitization (decreased activation threshold) or altered expression in visceral afferents have been reported in visceral hypersensitivity. TRP channels directly detect or transduce osmotic, mechanical, thermal, and chemosensory stimuli. In addition, pro-inflammatory mediators released in tissue damage or inflammation can activate receptors of the G protein-coupled receptor superfamily leading to TRP channel sensitization and activation, which amplify pain and neurogenic inflammation. In this review, we highlight the present knowledge on the functional roles of neuronal TRP channels in visceral hypersensitivity and discuss the signaling pathways that underlie TRP channel modulation. We propose that a better understanding of TRP channels and their modulators may facilitate the development of more selective and effective therapies to treat visceral hypersensitivity.

From: Balemans, D., Boeckxstaens, G. E., Talavera, K., Wouters, M. M. http://ajpgi.physiology.org/cgi/content/abstract/312/6/G635?rss=1

Gastrin induces parathyroid hormone-like hormone expression in gastric parietal cells

Parietal cells play a fundamental role in stomach maintenance, not only by creating a pathogen-free environment through the production of gastric acid, but also by secreting growth factors important for homeostasis of the gastric epithelium. The gastrointestinal hormone gastrin is known to be a central regulator of both parietal cell function and gastric epithelial cell proliferation and differentiation. Our previous gene expression profiling studies of mouse stomach identified parathyroid hormone-like hormone (PTHLH) as a potential gastrin-regulated gastric growth factor. Although PTHLH is commonly overexpressed in gastric tumors, its normal expression, function, and regulation in the stomach are poorly understood. In this study we used pharmacologic and genetic mouse models as well as human gastric cancer cell lines to determine the cellular localization and regulation of this growth factor by the hormone gastrin. Analysis of Pthlh^LacZ/+ knock-in reporter mice localized Pthlh expression to parietal cells in the gastric corpus. Regulation by gastrin was demonstrated by increased Pthlh mRNA abundance after acute gastrin treatment in wild-type mice and reduced expression in gastrin-deficient mice. PTHLH transcripts were also observed in normal human stomach as well as in human gastric cancer cell lines. Gastrin treatment of AGS-E gastric cancer cells induced a rapid and robust increase in numerous PTHLH mRNA isoforms. This induction was largely due to increased transcriptional initiation, although analysis of mRNA half-life showed that gastrin treatment also extended the half-life of PTHLH mRNA, suggesting that gastrin regulates expression by both transcriptional and posttranscriptional mechanisms.

NEW & NOTEWORTHY We show that the growth factor parathyroid hormone-like hormone (PTHLH) is expressed in acid-secreting parietal cells of the mouse stomach. We define the specific PTHLH mRNA isoforms expressed in human stomach and in human gastric cancer cell lines and show that gastrin induces PTHLH expression via transcription activation and mRNA stabilization. Our findings suggest that PTHLH is a gastrin-regulated growth factor that might contribute to gastric epithelial cell homeostasis.

From: Al Menhali, A., Keeley, T. M., Demitrack, E. S., Samuelson, L. C. http://ajpgi.physiology.org/cgi/content/abstract/312/6/G649?rss=1

A novel murine model of esophageal nonerosive reflux disease: from inflammation to impairment in mucosal integrity

Nonerosive reflux disease (NERD) is a highly prevalent phenotype of the gastroesophageal reflux disease. In this study, we developed a novel murine model of NERD in mice with microscopic inflammation and impairment in the epithelial esophageal barrier. Female Swiss mice were subjected to the following surgical procedure: the transitional region between the forestomach and the glandular portion of the stomach was ligated, and a nontoxic ring was placed around the duodenum near the pylorus. The control group underwent sham surgery. The animals were euthanized at 1, 3, 7, and 14 days after surgery. Survival and body weight were monitored daily. Esophageal wet weight, macroscopic lesion, histopathological alterations, myeloperoxidase (MPO) activity, cytokine levels, transepithelial electrical resistance (TEER), and mucosal permeability were evaluated. The survival rate was 78% at 14 days, with mild loss in body weight. Surgery did not induce erosive esophagitis but instead induced microscopic inflammation and increased esophageal wet weight, IL-6, keratinocyte-derived cytokine (KC) levels, and MPO activity with maximal peak between 3 and 7 days and resolution at 14 days postsurgery. Epithelial esophageal barrier was evaluated in operated mice at 7 and 14 days postsurgery; a decrease in TEER and increase in the esophageal epithelial permeability were observed compared with the sham-operated group. In addition, the inhibition of acid secretion with omeprazole significantly prevented the esophageal inflammation and impairment of barrier function at 7 days postsurgery. Thus we established a novel experimental model of NERD in mice, which can contribute to understanding the pathophysiological events associated with NERD.

NEW & NOTEWORTHY In this study, we standardized an experimental model of nonerosive reflux disease (NERD) in mice. This model involves an acute inflammatory response followed by impaired esophageal mucosal integrity, even in the absence of inflammation. Thus this model can serve for evaluation of pathophysiological aspects of NERD and open new perspectives for therapeutic strategies for patients with this disorder.

From: Silva, R. O., Oliveira, F. F. B., Bingana, R. D., Arruda, M. O., Woodland, P., Lee, C., Souza, M. A. N., Soares, P. M. G., Santos, A. A., Sifrim, D., Souza, M. H. L. P. http://ajpgi.physiology.org/cgi/content/abstract/312/6/G658?rss=1

A longitudinal study of whole body, tissue, and cellular physiology in a mouse model of fibrosing NASH with high fidelity to the human condition

The sequence of events that lead to inflammation and fibrosing nonalcoholic steatohepatitis (NASH) is incompletely understood. Hence, we investigated the chronology of whole body, tissue, and cellular events that occur during the evolution of diet-induced NASH. Male C57Bl/6 mice were assigned to a fast-food (FF; high calorie, high cholesterol, high fructose) or standard-chow (SC) diet over a period of 36 wk. Liver histology, body composition, mitochondrial respiration, metabolic rate, gene expression, and hepatic lipid content were analyzed. Insulin resistance [homeostasis model assessment-insulin resistance (HOMA-IR)] increased 10-fold after 4 wk. Fibrosing NASH was fully established by 16 wk. Total hepatic lipids increased by 4 wk and remained two- to threefold increased throughout. Hepatic triglycerides declined from sixfold increase at 8 wk to threefold increase by 36 wk. In contrast, hepatic cholesterol levels steadily increased from baseline at 8 wk to twofold by 36 wk. The hepatic immune cell population altered over time with macrophages persisting beyond 16 wk. Mitochondrial oxygen flux rates of FF mice diet were uniformly lower with all the tested substrates (13–276 pmol·s^–1·ml^–1 per unit citrate synthase) than SC mice (17–394 pmol·s^–1·ml^–1 per unit citrate synthase) and was accompanied by decreased mitochondrial:nuclear gene copy number ratios after 4 wk. Metabolic rate was lower in FF mice. Mitochondrial glutathione was significantly decreased at 24 wk in FF mice. Expression of dismutases and catalase was also decreased in FF mice. The evolution of NASH in the FF diet-induced model is multiphasic, particularly in terms of hepatic lipid composition. Insulin resistance precedes hepatic inflammation and fibrosis. Mitochondrial dysfunction and depletion occur after the histological features of NASH are apparent. Collectively, these observations provide a unique overview of the sequence of changes that coevolve with the histological evolution of NASH.

NEW & NOTEWORTHY This study demonstrates in a first of kind longitudinal analysis, the evolution of nonalcoholic steatohepatitis (NASH) on a fast-food diet-induced model. Key findings include 1) hepatic lipid composition changes in a multiphasic fashion as NASH evolves; 2) insulin resistance precedes hepatic inflammation and fibrosis, answering a longstanding chicken-and-egg question regarding the relationship of insulin resistance to liver histology in NASH; and 3) mitochondrial dysfunction and depletion occur after the histological features of NASH are apparent.

From: Krishnan, A., Abdullah, T. S., Mounajjed, T., Hartono, S., McConico, A., White, T., LeBrasseur, N., Lanza, I., Nair, S., Gores, G., Charlton, M. http://ajpgi.physiology.org/cgi/content/abstract/312/6/G666?rss=1

Letter to the editor: Treating nonalcoholic fatty liver disease with statins. Are all statins equal?

From: Athyros, V. G., Katsiki, N., Mikhailidis, D. P. http://ajpgi.physiology.org/cgi/content/full/312/6/G681?rss=1

BDA AGM Video

From: BritishDietetic https://www.youtube.com/watch?v=9Sot44wbxpA

New e-book helps dentists comply with Sec. 1557 final rule

Dentists with practices that receive certain federal financial assistance might understandably remain confused about Section 1557 of the Affordable Care Act.

From: By David Burger http://www.ada.org/en/publications/ada-news/2017-archive/june/new-e-book-helps-dentists-comply-with-sec-1557-final-rule

"Growing" concern about non-cow's milk for kids

Soy, almond and rice milks are increasingly popular, but are they nutritious enough for growing children?

From: http://www.cbsnews.com/news/drinking-non-cows-milk-soy-almond-may-affect-childrens-height-study/

Rats invade elementary school, spread rash

Health officials say rash was caused by mites that live on rats, which were found underneath portable classrooms at Villa Park Elementary School

From: http://www.cbsnews.com/news/rash-spreads-among-students-teachers-after-rats-invade-calif-elementary-school/

#MayoClinicNeuroChat about AVM and Stroke

From: Mayo Clinic https://www.youtube.com/watch?v=ssHq3d2ut58

Heart disease advances haven't reached America's poor

Results are "shocking," says American Heart Association expert

From: http://www.cbsnews.com/news/heart-disease-cardiovascular-advances-havent-reached-americas-poor/

Medical marijuana dispensary bakes pot into pizza

The Ermont dispensary in Quincy, Massachusetts, is getting creative with its recipes for marijuana edibles, and patients appreciate the options. Juli McDonald of CBS Boston station WBZ reports.

From: http://www.cbsnews.com/videos/medical-marijuana-dispensary-bakes-pot-into-pizza/

Pot pizza now offered at medical marijuana dispensary

“A lot of our patients really wanted to basically figure out a different way to medicate" – but it doesn't come with toppings

From: http://www.cbsnews.com/news/pot-pizza-offered-at-boston-area-medical-marijuana-dispensary/

Toddlers Who Drink Milk Alternatives May Be Shorter

Difference is small, about a half inch at age 3, study finds

From: http://www.webmd.com/children/news/20170607/toddlers-who-drink-cows-milk-alternatives-may-be-shorter?src=RSS_PUBLIC

Special Brain Scans May Predict Autism

In small study, technique identified 82 percent of infants later diagnosed with the disorder

From: http://www.webmd.com/brain/autism/news/20170607/special-brain-scans-may-predict-autism-in-high-risk-babies?src=RSS_PUBLIC

"Social jet lag" may take a toll on your health

A new study looks at what happens when weekday early risers become late-night party animals on the weekends

From: http://www.cbsnews.com/news/staying-up-late-and-sleeping-in-on-weekends-may-harm-heart/

Recall: Star Snacks Co. Cashews

Star Snacks Co. recalls Southern Grove Cashew Halves and Pieces with Sea Salt, in 8-ounce canisters, sold in 29 states.

From: http://www.webmd.com/diet/news/20170607/recall-star-snacks-co-cashews?src=RSS_PUBLIC

Trump says he's keeping Francis Collins as NIH director

Collins has served as NIH director since 2009

From: http://www.cbsnews.com/news/trump-says-hes-keeping-francis-collins-as-nih-director/

Antidepressants During Pregnancy Safe for Baby

It finds newborns aren't more likely to be irritable, hard to feed or sleepless

From: http://www.webmd.com/baby/news/20170607/antidepressants-during-pregnancy-safe-for-baby-study?src=RSS_PUBLIC

Mayo Clinic Minute: 6 tips to healthy eating on a budget

From: Mayo Clinic https://www.youtube.com/watch?v=WViSvPFUVd8

Pregnancy after breast cancer study may ease worries

Younger women with breast cancer don't need to give up hope of having a baby, new research shows

From: http://www.cbsnews.com/news/pregnancy-after-breast-cancer-study-may-ease-worries/

Even moderate drinking could harm the brain

New research looks at the effects of different levels of alcohol intake on brain health

From: http://www.cbsnews.com/news/even-moderate-drinking-could-harm-the-brain/