A new study from Perth’s Telethon Institute for Child Health Research shows an association between ADHD and a ‘Western-style’ diet in adolescents.

The research findings have just been published online in the international Journal of Attention Disorders.

Leader of Nutrition studies at the Institute, Associate Professor Wendy Oddy, said the study examined the dietary patterns of 1800 adolescents from the long-term Raine Study and classified diets into ‘Healthy’ or ‘Western’ patterns.

“We found a diet high in the Western pattern of foods was associated with more than double the risk of having an ADHD diagnosis compared with a diet low in the Western pattern, after adjusting for numerous other social and family influences,” Dr Oddy said.

“We looked at the dietary patterns amongst the adolescents and compared the diet information against whether or not the adolescent had received a diagnosis of ADHD by the age of 14 years. In our study, 115 adolescents had been diagnosed with ADHD, 91 boys and 24 girls.”

A “healthy” pattern is a diet high in fresh fruit and vegetables, whole grains and fish. It tends to be higher in omega-3 fatty acids, folate and fibre. A “Western” pattern is a diet with a trend towards takeaway foods, confectionary, processed, fried and refined foods. These diets tend to be higher in total fat, saturated fat, refined sugar and sodium.

“When we looked at specific foods, having an ADHD diagnosis was associated with a diet high in takeaway foods, processed meats, red meat, high fat dairy products and confectionary,” Dr Oddy said.

“We suggest that a Western dietary pattern may indicate the adolescent has a less optimal fatty acid profile, whereas a diet higher in omega-3 fatty acids is thought to hold benefits for mental health and optimal brain function.

“It also may be that the Western dietary pattern doesn’t provide enough essential micronutrients that are needed for brain function, particularly attention and concentration, or that a Western diet might contain more colours, flavours and additives that have been linked to an increase in ADHD symptoms. It may also be that impulsivity, which is a characteristic of ADHD, leads to poor dietary choices such as quick snacks when hungry.”

Dr Oddy said that whilst this study suggests that diet may be implicated in ADHD, more research is needed to determine the nature of the relationship.

“This is a cross-sectional study so we cannot be sure whether a poor diet leads to ADHD or whether ADHD leads to poor dietary choices and cravings,” Dr Oddy said.

ADHD is the most commonly diagnosed childhood mental health disorder and has a prevalence of approximately 5%. ADHD is known to be more common in boys.

Reference:

Telethon Institute for Child Health Research, Western diet link to ADHD, 29 July, 2010.

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Patients don’t have to suffer any longer after being given incorrect diagnoses

Policyholders of America (POA) released a consensus statement written by treating physicians and researchers in the field on the mechanism and treatment of illness found in people sickened by exposure to water-damaged buildings. This illness has been the subject of heated debate that has resulted in harsh allegations being lobbed at patients by experts hired by industry to cast doubt on the legitimacy of the illness. Today however, so-called “Sick Building Syndrome” is now unveiled to be very real; it’s a chronic inflammatory illness that is easily identified with available lab testing and treatable using FDA-approved medications. The research paper is the first in the field written by physicians with experience treating the illness. Thorough and rigorous, the paper references governmental agency opinions, current published literature and an extensive review of patient data that has made this subject a political and legal hot potato obstructing patient care.

Nearly six months ago, a distinguished and credentialed panel of medical doctors and researchers, all from outside of POA’s membership, were assembled and charged with developing a consensus statement on the diagnosis and treatment of a growing public health problem across America: illness acquired from water-damaged buildings. The consensus statement was then peer-reviewed by other medical doctors and researchers. The research paper is being released to help physicians and their patients understand the mechanisms, symptoms, diagnosis and treatment protocols available for sickened patients.

After reviewing hundreds of peer reviewed studies, analyzing hard data from research conducted on thousands of patients, and incorporating published results of treatment of thousands of patients, the authors embarked on this massive assignment with eyes wide open — knowing that if the resulting research did not lessen liability of the powerful stakeholders involved, industry would likely attempt to discredit the findings.

With the research now concluded, the mysterious illness now has a name: Chronic Inflammatory Response Syndrome or “CIRS”, and when the cause of the illness can be directly linked to a water-damaged building, or (“WDB”), it is called “CIRS-WDB”.

Says Co-Author, Ritchie Shoemaker, MD, of Pocomoke, Maryland, “This statement builds consensus by debunking false ideas about illness from water-damaged buildings and establishes the basis by which practicing physicians can assess the complex illnesses these patients experience. We don’t have to guess what might be wrong when we have the labs to prove what is abnormal. Patients don’t have to suffer any longer after being given incorrect diagnoses such as allergy, stress or depression.”

Co-authors included Laura Mark MD from Williamsburg, Virginia; Scott McMahon MD from Roswell, New Mexico; Jack Thrasher PhD of Oakland, California and Carl Grimes HHS, CIEC, President of the Indoor Air Quality Association, from Denver, Colorado.

The 161-page research paper can be found, in its entirety, at:

CIRS Peer Reviewed Paper

A layperson’s summary of the research paper follows:

• CIRS-WDB is a multisystem, multi-symptom illness acquired following exposure to the interior environment of WDB. It exists as a recognizable syndrome that is identifiable and treatable;
• CIRS-WDB is identified as immunologic in origin, with differential inflammatory responses seen according to (i) genetic susceptibility and (ii) unique aspects of host innate immune responses.
• CIRS-WDB consistently involves loss of normal control of inflammation and the resulting “inflammation gone wild.”
• Treatment of human illness that is acquired following exposure to the interior environment of WDB involves a series of steps, each correcting the physiologic problems one by one.
• CIRS-WDB can be readily identified by current methods of clinical diagnoses. This process of diagnosis is supported by (i) identification of unique subsets (“clusters”) of symptoms found in epidemiologic cohorts of affected patients; (ii) identification of unique groupings of biomarkers, such as genetic markers, neuropeptides, inflammatory markers, and autoimmune findings.
• Patients with CIRS-WDB are often given incorrect diagnoses such as depression, stress, allergy, fibromyalgia, Post Traumatic Stress
• Disorder, and somatization. Those conditions, when actually present, will not improve with therapies employed in CIRS-WDB.
• CIRS-WDB is acquired primarily from inhalation of microbial products that are contaminants found in the complex mixture of WDB.
• Re-exposure of previously affected patients will bring about immunological host responses that are enhanced in their rapidity of onset and magnitude, such that these patients are “sicker, quicker.”

Melinda Ballard, POA’s president said, “About 25% of our members have experienced health effects after exposure to toxigenic mold and other organisms in their homes and of those, the vast majority put on the treatment protocol outlined in this paper have reported back to us that their symptoms have either subsided or vanished altogether. While our experience with these members is purely anecdotal, this research paper is not; the findings are irrefutable. Most importantly, the rigorous science in the paper offers hope to so many who are in desperate need of an effective and inexpensive treatment.

POA is a nonprofit educational organization that, at no charge, helps policyholders receive adequate payment when a property insurance claim is filed. Since it was founded in 2001, more than 2.5 million people have joined, an unfortunate reflection on the manner in which claims are often handled by insurance companies. Its web address is: www.policyholdersofamerica.org. POA is a member of ACHEMMIC (the Action Committee on the Health Effects of Mold, Microbes and Indoor Contaminants), a group of scientists, researchers, physicians, indoor air quality experts, environmental engineers, industrial hygienists, structural engineers, teachers and advocates working to advance the understanding of the health effects of mold, microbes and indoor contaminants. ACHEMMIC’s website is www.achemmic.com.

Reference:

Policyholders of America, Research Shows Controversial Illness is Real and Treatable, CHARLESTON, S.C., July 27, 2010.

Related Articles:

• Sick Building Syndrome – SBS – in relation to domestic exposure
• Successful treatment of patients with mycotoxin induced disease
• A longitudinal study of environmental risk factors for symptoms associated with sick building syndrome
• Patients with indoor exposure to molds compared to patients exposed to chemicals

As of yesterday, July 26, 2010, Professor Servando Perez, President of Mercuriados Spain (people affected by chronic mercury intoxication), has began a hunger strike. Prof Perez was diagnosed two years ago as having Chronic Mercury Intoxication and Multiple Chemical Sensitivities (MCS). His case went to the highest court in Spain and a judge ruled that Prof. Perez had chronic mercury intoxicaton due to dental fillings and that the Spanish public health care system (Social Security) should treat his condition with chelation or refer him to a private clinic to do so and pay the costs. This was an incredible legal precendent.

Needless to say, Professor Perez has not been treated yet and the Social Security has been doing everything possible to make sure that he, as with other MCS, Chronic Fatigue Syndrome/Myalgic Encephylitis and Fibromyalgia patients in Spain, do not receive proper medical services from the public health care system.

Because of this, Mercuriados Spain and many other associations, have been carrying out campaigns, popular initiatives, lobbying, legal suits, and many other strategies to change this situation, but with no positive results.

Professor Perez’s health has deteriorated and a month ago he went to emergency at the Santiago de Compostela University Hospital. They refused to attend him and he said he would not leave the hospital until the judge’s order for a chelation was carried out.

In the past month, at the hospital, Prof Perez has endured all kinds of harassment and pressures to leave. He has even been “diagnosed” as having a psychiatric illness despite the fact that his illness is organic.

We, the Spanish MCS, CFS/ME and FMS associations have mounted a campaign to support Prof Perez with emails, phone calls to the hospital, press, etc.

And now, the latest harassing strategy by the hospital is to refuse to give him food without additives. Faced with all of this, Servando Perez has started a hunger strike. Yes, he could try to get a bank loan and pay for a private chelation, but this would not help the rest of us ill people in Spain waiting to get treatment in the public health care system. The hospital says that they refuse to refer him to a private clinic (and pick up the tab) because it would set a precedent, and soon all the people with chronic heavy metal intoxication in Spain would have to be treated. And they don’t want to do that with tax money.

Servando Perez has opted for the brave and hard road to try to change the desperate situation we live with in Spain, those of us with these illnesses, and we are proud of Servando’s action.

We write you to inform you and to ask you for your support.

Please write or phone the Vice director of the Hospital Santiago de Compostela, Dr Jose-Ramón Gómez at jose.ramon.gomez.fernandez@sergas.es

or phone him at (34) 98.1950970.

We all are Servando Perez!

Thank you,

Clara Valverde

President

Liga SFC (CFS/ME League, Spain)

www.ligasfc.org

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• Article on Spanish
• Article on German
• Article on Japanese

Toxic  trio identified as the basis of celiac disease

Walter and Eliza Hall Institute scientists have identified the three protein fragments that make gluten – the main protein in wheat, rye and barley – toxic to people with celiac disease.

Their discovery opens the way for a new generation of diagnostics, treatments, prevention strategies and food tests for the millions of people worldwide with celiac disease.

When people with celiac disease eat products containing gluten their body’s immune response is switched on and the lining of the small intestine is damaged, hampering their ability to absorb nutrients. The disease is currently treated by permanently removing gluten from the patient’s diet.

Dr Bob Anderson, head of the Walter and Eliza Hall Institute’s celiac disease research laboratory, said it had been 60 years since gluten was discovered to be the environmental cause of celiac disease.

“In the years since, the holy grain in celiac disease research has been to identify the toxic peptide components of gluten; and that’s what we’ve done,” Dr Anderson said.

The research, done in collaboration with Dr Jason Tye-Din, Dr James Dromey, Dr Stuart Mannering, Dr Jessica Stewart and Dr Tim Beissbarth from the institute as well as Professor Jamie Rossjohn at Monash University and Professor Jim McCluskey at the University of Melbourne, is published in today’s issue of the international journal Science Translational Medicine.

The study was started by Professor Anderson nine years ago and has involved researchers in Australia and the UK as well as more than 200 celiac disease patients.

The patients, recruited through the Celiac Society of Victoria and the Celiac Clinic at John Radcliffe Hospital, UK, ate bread, rye muffins or boiled barley. Six days later, blood samples were taken to measure the strength of the patients’ immune responses to 2700 different gluten fragments. The responses identified 90 fragments as causing some level of immune reaction, but three gluten fragments (peptides) were revealed as being particularly toxic.

“These three components account for the majority of the immune response to gluten that is observed in people with celiac disease,” Dr Anderson said.

This knowledge has already been used by Melbourne-based biotech company, Nexpep Pty Ltd, to develop a ‘peptide-based’ immunotherapy that aims to desensitize people with celiac disease to the toxic effects of gluten. Nexpep’s Phase 1 trials of the therapy were completed in June and final results are expected in coming months.

The immunotherapy works by exposing people with celiac disease to small amounts of the three toxic peptides and is based upon the same principles as desensitization for allergies.

Dr Anderson said although celiac disease could be managed with a gluten-free diet, compliance with the diet is often challenging and nearly half the people on the diet still have residual damage to their small intestine. “Consequently, the immunotherapy and three other drugs are under development to help people with celiac disease.”

Reference: Walter and Eliza Hall Institute, Toxic trio identified as the basis of celiac disease, July 21, 2010

Photo: Czesia Markiewicz, Walter and Eliza Hall Institute

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The research was supported by the National Health and Medical Research Council, Coeliac UK, the Coeliac Research Fund, Nexpep Pty Ltd, BTG International and the Victorian Government.

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Related article:

• Gluten intolerance in Finland has doubled
• Gluten-free diet reduces bone problems in children with celiac disease
• New blood test for newborns to detect allergy risk

Finding removes the idea once and for all that IBS symptoms are not real and are “only psychological”

A large academic study has demonstrated structural changes in specific brain regions in female patients with irritable bowel syndrome (IBS), a condition that causes pain and discomfort in the abdomen, along with diarrhea, constipation or both.

A collaborative effort between UCLA and Canada’s McGill University, the study appears in the July issue of the journal Gastroenterology.

The findings show that IBS is associated with both decreases and increases in grey matter density in key areas of the brain involved in attention, emotion regulation, pain inhibition and the processing of visceral information.

IBS affects approximately 15 percent of the U.S. population, primarily women. Currently, the condition is considered by the medical field to be a “functional” syndrome of the digestive tract not working properly rather than an “organic” disorder with structural organ changes. Efforts to identify structural or biochemical alterations in the gut have largely been unsuccessful. Even though the pathophysiology is not completely understood, it is generally agreed that IBS represents an alteration in brain-gut interactions.

These study findings, however, show actual structural changes to the brain, which places IBS in the category of other pain disorders, such as lower back pain, temporomandibular joint disorder, migraines and hip pain — conditions in which some of the same anatomical brain changes have been observed, as well as other changes. A recent, smaller study suggested structural brain changes in IBS, but a larger definitive study hadn’t been completed until now.

“Discovering structural changes in the brain, whether they are primary or secondary to the gastrointestinal symptoms, demonstrates an ‘organic’ component to IBS and supports the concept of a brain-gut disorder,” said study author Dr. Emeran Mayer, professor of medicine, physiology and psychiatry at the David Geffen School of Medicine at UCLA. “Also, the finding removes the idea once and for all that IBS symptoms are not real and are ‘only psychological.’ The findings will give us more insight into better understanding IBS.”

Researchers employed imaging techniques to examine and analyze brain anatomical differences between 55 female IBS patients and 48 female control subjects. Patients had moderate IBS severity, with disease duration from one to 34 years (average 11 years). The average age of the participants was 31.

Investigators found both increases and decreases of brain grey matter in specific cortical brain regions.

Even after accounting for additional factors such as anxiety and depression, researchers still discovered differences between IBS patients and control subjects in areas of the brain involved in cognitive and evaluative functions, including the prefrontal and posterior parietal cortices, and in the posterior insula, which represents the primary viscerosensory cortex receiving sensory information from the gastrointestinal tract.

“The grey-matter changes in the posterior insula are particularly interesting since they may play a role in central pain amplification for IBS patients,” said study author David A. Seminowicz, Ph.D., of the Alan Edwards Centre for Research on Pain at McGill University. “This particular finding may point to a specific brain difference or abnormality that plays a role in heightening pain signals that reach the brain from the gut.”

Decreases in grey matter in IBS patients occurred in several regions involved in attentional brain processes, which decide what the body should pay attention to. The thalamus and midbrain also showed reductions, including a region — the periaqueductal grey — that plays a major role in suppressing pain.

“Reductions of grey matter in these key areas may demonstrate an inability of the brain to effectively inhibit pain responses,” Seminowicz said.

The observed decreases in brain grey matter were consistent across IBS patient sub-groups, such as those experiencing more diarrhea-like symptoms than constipation.

“We noticed that the structural brain changes varied between patients who characterized their symptoms primarily as pain, rather than non-painful discomfort,” said Mayer, director of the UCLA Center for Neurobiology of Stress. “In contrast, the length of time a patient has had IBS was not related to these structural brain changes.”

Mayer added that the next steps in the research will include exploring whether genes can be identified that are related to these structural brain changes. In addition, there is a need to increase the study sample size to address male-female differences and to determine if these brain changes are a cause or consequence of having IBS.

Literature:

University of California, Study finds structural brain alterations in patients with irritable bowel syndrome, Los Angeles, July 22, 2010.

Photo: UCLA

More interesting EMM Articles:

• CFS finally recognized as medical impairment under guidelines
• The psychogenic thesis for environmental diseases no value for science, destructive for legal rights
• MCS – Multiple Chemical Sensitivity a disease caused by toxic chemical exposure
• The department of Health of the Austrian Government recognizes MCS – Multiple Chemicval Sensitivity as a physical disease
• The naked truth about MCS – Multiple Chemical Sensitivity including foreword about German Situation

P.A.N.D.O.R.A. NeuroEndocrineImmune (NEI) Center Resolution Approved by the New Jersey State Senate

Coral Gables, FL, July 17, 2010 –(PR.com)– Resolution SR-20 supporting the establishment of the NeuroEndocrineImmune (NEI) Center™, the first research center in the state of New Jersey and in the U.S., dedicated to understanding and treating chronic neuroendocrineimmune (NEI) illnesses which includes chronic fatigue syndrome, fibromyalgia, multiple chemical sensitivity, Gulf War Illness and other bacterial & viral infections chronic illnesses was passed unanimously by 38-0 votes by the New Jersey State Senate on June 10, 2010.

Senate Resolution (SR) 20, sponsored by Senator Christopher “Kip” Bateman (R), Senate Deputy Conference Leader, and Senator Loretta Weinberg (D), Chair of the Senate Health Committee, cited studies that an estimated 20 million American adults and children suffer with NEIDs. The economic impact and loss of worker productivity in the United States due to CFS/ME, alone, is estimated to be over $9 billion per year. Chronic illness represents 75% of all the health care costs in the U.S.

“It makes sense to locate the NEI center in New Jersey,” said Senator Weinberg. “As the nation’s medicine chest, New Jersey is home to research institutions and private businesses that can cooperate to find a cure for these debilitating diseases.”

Senator Bateman added, “I look forward to the passage of Senate Resolution 20, solidifying legislative support for the research center, and have high hopes that this will, in fact, be a great step forward toward finding answers for the sufferers of these debilitating diseases.”

Assembly Resolution 202 passes unanimously

Late last year, a similar resolution unanimously passed the New Jersey State Assembly 78-0. “Having a research center… is essential to promoting research into the etiology of, and therapeutic interventions for neuroendocrineimmune disorders (NEIDs),” according to Assembly Resolution (AR) 202 which was sponsored by Assemblyman Upendra Chivukula (D), Deputy Speaker; Assemblyman Herb Conaway, Jr. (D), Chairman, Health Committee; Assemblywoman Connie Wagner (D), Vice-Chairman; and Assemblywoman Mary Pat Angelini (R), member of the Health Committee

P.A.N.D.O.R.A. partners with the Lanford Foundation-Lifelyme™, Inc.

To be based in Newark, New Jersey, the NeuroEndocrineImmune (NEI) Center™ is a community patient-driven project of P.A.N.D.O.R.A, (Patient Alliance for Neuroendocrineimmune Disorders Organization for Research & Advocacy, Inc) in partnership with the Lanford Foundation-Lifelyme™, Inc.

The NEI Center™ is the first research center to incorporate scientific and clinical research, quality in patient care, and social services, all in one state-of-the art facility. The establishment of The NEI Center™ is based on the philosophy that the similarities in symptoms of neuroendocrineimmune disorders (NEIDs) are the human body’s response to similarities in the underlying pathophysiologies that cause these disorders.

The cornerstone of the NEI Center’s mission is that discoveries and advances made in any one of the NEIDs will be applicable and beneficial to other NEIDs, thereby bringing medical researchers closer to a cure. At its inception, the NEI Center™ will include research of the following disorders/illnesses:

Chronic fatigue syndrome (CFS), fibromyalgia (FM), Gulf War syndrome or illness (GWS/I), multiple chemical sensitivity (MCS), and other associated bacterial and viral illnesses.

“Moral and political victory,” said Marly Silverman, a CFS and fibromyalgia patient who founded P.A.N.D.O.R.A. in July 1, 2002, “On behalf of P.A.N.D.O.R.A., we are mindful of the historical significance of the unanimous vote by the New Jersey Senate as well as by the New Jersey Assembly in 2009. Patients across this country will be celebrating what is an amazing and pivotal moment in the history of the neuroendocrineimmune disorders community. The New Jersey Legislature has demonstrated a caring commitment to a community of patients who for the first time in the state of New Jersey can look forward to a brighter and fruitful future.”

Veny W. Musum, chairman of the NEI Center Project, who was diagnosed with chronic Lyme disease in 2004 along with his wife, Patricia, added, “The passage of SR 20 is a moral and political victory for millions of individuals stricken with neuroendocrineimmune disorders who have been living far too long without the compassionate support, research and treatment options they deserve. I am proud of my state of New Jersey!”

Advocates Extraordinaire™ & community support

“The overall community support has been outstanding for this patient-driven, physician-approved project. The unanimous votes by each New Jersey senator came about because of the involvement of individuals who participated in the Advocate Extraordinaire™ program, by making calls, writing e-mails and thanking the New Jersey Legislature for their vision and support of the Center,” said Dr. Kenneth Friedman, one of the founding board trustees of the NEI Center, as well as former member of the CFS Advisory Committee, and a member of the Executive Board of P.A.N.D.O.R.A.

“The New Jersey legislators unanimous support for the NEI Center reflects the kind of leadership needed to bring about positive change in our nation’s Health Care,” said Sandi Lanford, Co-founder of the NEI Center™ and the President-Founder of the Lanford Foundation-Lifelyme™, Inc, who was born and raised in New Jersey. The overall community support has been outstanding for this patient-driven, physician- approved project. The unanimous votes by the New Jersey Legislature came about because of the involvement of individuals who participated in the Advocate Extraordinaire™ program, by making calls, writing e-mails and thanking the New Jersey legislators for their vision and support of the Center,” said Dr. Kenneth Friedman, one of the founding board trustees of the NEI Center, as well as former member of the CFS Advisory Committee, and a member of the Executive Board of P.A.N.D.O.R.A.

Dr. Lesley Fein, member of the NEI Center Project team, stated “This center will be a beacon of hope for patients nationwide, and a place which will bring scientific innovation in New Jersey as well as in the rest of the country.”

Present at the passage of the law were Veny Musum, Chairman of the NEI Center Project and Debbie Floyd, team member of the NEI Center™ project.

NEI Center set to open by 2012

The NEI Center founders are already preparing fundraising efforts to make the Center operational by late 2011-early 2012. For more information about The NEI Center™, visit www.neicenter.com.

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About P.A.N.D.O.R.A., Inc- Patient Alliance for Neuroendocrineimmune Disorders Organization for Research & Advocacy – Based in Coral Gables, Florida, P.A.N.D.O.R.A. was founded on July 1, 2002 by Marly C. Silverman, a chronic fatigue syndrome and fibromyalgia patient. Its mission is to raise awareness of the plight of persons with chronic fatigue syndrome, fibromyalgia, chronic Lyme disease, multiple chemical sensitivities/EI, and Gulf War illness, and advocate on quality of life issues. P.A.N.D.O.R.A.is Built on Hope – Strong on Advocacy – Finding a Cure through Research. For more information, visit www.pandoranet.info.

The study confirms previous research in which study author Stephen G. Grant, Ph.D., associate professor of environmental and occupational health at Pitt’s Graduate School of Public Health, discovered evidence of abnormalities in the HPRT gene located on the X chromosome in cord blood from newborns of non-smokers exposed to environmental tobacco smoke.

In the current study, Dr. Grant confirmed smoke-induced mutation in another gene called glycophorin A, or GPA, that is representative of oncogenes – genes that transform normal cells into cancer cells and cause solid tumors. The GPA mutation was the same level and type in newborns of mothers who were active smokers and of non-smoking mothers exposed to tobacco smoke. Likewise, the mutations were discernable in newborns of women who had stopped smoking during their pregnancies, but who did not actively avoid secondhand smoke.

“These findings back up our previous conclusion that passive, or secondary, smoke causes permanent genetic damage in newborns that is very similar to the damage caused by active smoking,” said Dr. Grant. “By using a different assay, we were able to pick up a completely distinct yet equally important type of genetic mutation that is likely to persist throughout a child’s lifetime. Pregnant women should not only stop smoking, but be aware of their exposure to tobacco smoke from other family members, work and social situations.”

Literature: University of Pittsburgh Schools of the Health Sciences, Exposure to secondhand smoke in the womb has lifelong impact, June 30, 2010

Related Environmental Medicine Matters Articles:

• Secondhand Smoke Exposure and Depressive Symptoms
• Second Hand Smioking results in Liver Disease, UCLA Study finds
• Male Reproductive Organs are at Risk from Environmental Hazards
• Majority of US hospitals will have smoke-free campuses by end of year
• 2009 edition of the Tobacco Atlas catalogues catastrophic toll of tobacco worldwide

The FDA and the NIH have independently confirmed the XMRV findings as published in Science, October last. This confirmation was issued by Dr. Harvey Alter of the NIH during a closed workshop on blood transfusion held on May 26-27 in Zagreb. Two journalists from the Dutch magazine for health professionals, ORTHO, who have been working on XMRV stories for several months, were able to obtain a copy of the Alter lecture.

In the October 8, 2009 issue of Science Express, the Lombardi-Mikovits group at the Whittemore Peterson Institute (WPI), the Cleveland Clinic and the National Cancer Institute (NCI) reported that 67% of 101 chronic fatigue syndrome (CFS) patients tested positive for infection with xenotropic murine retrovirus (XMRV). Only 3.7% of 218 healthy subjects tested were positive for this gammaretrovirus. Since that time, a number of research groups have proved unable to independently confirm these findings.

On Friday last, the AABB released an Association Bulletin recommending that its member blood collectors actively discourage potential donors who have been diagnosed with CFS from donating blood or blood components. This interim measure was proposed by the AABB Interorganizational Task Force on XMRV. This Task Force includes representatives from several government agencies, including the Center for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the National Institutes of Health (NIH).

The fact that the measure was introduced suggests the presence of information not yet published. The ORTHO journalists were able to obtain a pdf document of the lecture given by Harvey Alter at the IPFA/PEI 17th Workshop on ‘Surveillance and screening of Blood Borne Pathogens’ in Zagreb. The International Plasma Fractionation Association (IPFA) represents the not-for-profit organizations around the world involved in plasma fractionation. The IPFA is based in Amsterdam, the Netherlands.

The highly-experienced Dr. Harvey Alter is Clinical Studies Chief at the Infectious Diseases and Immunogenetics Section of the Department of Transfusion Medicine at the NIH Clinical Center in Bethesda. “The data in the Lombardi, et al Science manuscript are extremely strong and likely true, despite the controversy”, was one comment on the XMRV findings reported by Alter in Zagreb. “Although blood transmission to humans has not been proved, it is probable. The association with CFS is very strong, but causality not proved. XMRV and related MLVs are in the donor supply with an early prevalence estimate of 3%-7%. We (FDA & NIH) have independently confirmed the Lombardi group findings.”

ORTHO contacted Dr. Harvey Alter today for a reaction. He did not want to comment, but confirmed that a paper is soon to be published.

Literature:

ORTHO, Dutch magazine for health professionals, FDA and NIH confirm ‘XMRV findings’, Gendringen, NL (MMD Newswire) June 22, 2010.

No Longer Focusing on Tender Points

The American College of Rheumatology (ACR) is proposing a new set of diagnostic criteria for fibromyalgia that includes common symptoms such as fatigue, sleep disturbances, and cognitive problems, as well as pain. The new criteria are published in the May issue of the ACR journal Arthritis Care & Research.

“These new criteria recognize that fibromyalgia is more than just body pain,” said Robert S. Katz, one of the authors of the new criteria and a rheumatologist at Rush University Medical Center. “This is a big deal for patients who suffer symptoms but have had no diagnosis. A definite diagnosis can lead to more focused and successful treatment and reducing the stress of the unknown.”

Routine lab tests can not detect fibromyalgia, a condition that is characterized by unexplained pain from head to toe and exhaustion. Instead, the diagnosis has been made by a tender point test, a physical exam that focuses on 18 points throughout the body. When light pressure is applied to these points, clustered around the neck, shoulder, chest, hip, knee, and elbow regions, patients with fibromyalgia feel tenderness or pain.

To meet the previous diagnostic criteria, which were established in 1990, patients must have widespread pain in all four quadrants of their body for a minimum duration of three months and experience moderate pain and tenderness at a minimum of 11 of the 18 specified tender points.

“There are numerous shortcomings with the previous criteria, which didn’t take into account the importance of common symptoms including significant fatigue, a lack of mental clarity and forgetfulness, sleep problems and an impaired ability to function doing normal activities,” said Katz.

According to Katz, fibromyalgia pain may fluctuate, which can affect the number of tender points, and the tender point test did not adequately measure symptom severity or the effectiveness of new treatments.

“The tender point test also has a gender bias because men may report widespread pain, but they generally aren’t as tender as women. Fibromyalgia may be under-diagnosed in both men and women because of the reliance on 11 tender points, and also due to failing to account for the other central features of the illness,” said Katz.

Additionally, due to the confusion regarding the tender point test, the authors note that most primary care doctors don’t bother to check tender points or they aren’t checking them correctly. Consequently, fibromyalgia diagnosis in practice has often been a symptom-based diagnosis. The new criteria will standardize a symptom-based diagnosis so that all doctors are using the same process.

The tender point test is being replaced with a widespread pain index and a symptom severity scale. The widespread pain index score is determined by counting the number of areas on the body where the patient has felt pain in the last week. The checklist includes 19 specified areas.

The symptom severity score is determined by rating on a scale of zero to three, three being the most pervasive, the severity of three common symptoms: fatigue, waking unrefreshed and cognitive symptoms. An additional three points can be added to account for the extent of additional symptoms such as numbness, dizziness, nausea, irritable bowel syndrome or depression. The final score is between 0 and 12.

To meet the criteria for a diagnosis of fibromyalgia a patient would have seven or more pain areas and a symptom severity score of five or more; or three to six pain areas and a symptom severity score of nine or more.

Some criteria will remain unchanged. The symptoms must have been present for at least three months, and the patient does not have a disorder that would otherwise explain the pain.

To develop and test the new criteria, researchers performed a multicenter study of 829 previously diagnosed fibromyalgia patients and a control group of rheumatic patients with non-inflammatory disorders using physician physical and interview examinations. The data were processed by the National Data Bank for Rheumatic Diseases.

The authors note the study has a number of limitations. They recommend a follow-up test in the primary care setting that includes patients with other rheumatic conditions to determine the rate of misclassification that may occur.

The study was funded by Lilly Research Laboratories. Lilly Research Laboratories did not participate in the design of the study, see the results of the study, or review the manuscript or submitted abstracts.

Literature:

Rush University, New Criteria Proposed for Diagnosing Fibromyalgia Suggests No Longer Focusing on Tender Points, May 24, 2010

A simple blood test can now predict whether newborn babies are at high risk of developing allergies as they grow older, thanks to research involving the University of Adelaide.

Professor Tony Ferrante, an immunologist from SA Pathology and the Children’s Research Centre at the University of Adelaide, says the new marker may be the most significant breakthrough in allergy testing for some decades.

“A protein in the immune cells of newborns appears to hold the answer as to whether a baby will either be protected, or susceptible to the development of allergies later on,” Professor Ferrante says.

Amounts of the cell signalling protein, called protein kinase C zeta, are much lower in children at risk of allergies.

Professor Ferrante says the blood test is far more effective than previous indicators, such as a family’s clinical history, or measuring the allergy-inducing antibody IgE.

In collaboration with Professor Susan Prescott from the University of Western Australia and Princess Margaret Hospital for Children, Professor Ferrante’s research team has refined the new marker for allergy risk, originally discovered in 2007, but now modified to a simple and manageable blood test at birth.

The researchers are also looking at whether fish oil supplements given to both pregnant women and those who have just given birth can reduce the risks of the children developing allergies.

“There is evidence that the levels of this important protein increase with fish oil supplementation to protect against allergy development,” Professor Ferrante says.

Australia has one of the highest allergy rates in the world, with 40% of children now suffering from allergic diseases, including food allergies, eczema, asthma and hay fever. These conditions frequently persist into adulthood, placing a heavy burden on the healthcare system.

Literature: The University of Adelaide, New blood test for newborns to detect allergy risk, 21 May 2010